Adapting Dialectical Behavior Therapy for College Counseling Centers

College counseling centers report increased student presentation with severe psychological issues (Gallagher, 2012 ). Although dialectical behavior therapy (DBT) has demonstrated efficacy with multiple clinical populations, standard model DBT is not feasible for many traditional college counseling centers. This article describes the iterative development and evolution of a comprehensive DBT program adapted to fit the scope of a traditional college counseling center. Guidelines for implementing lessons learned over the 3 years of the program are provided.     

Effectiveness of Short Term Dialectical Behavior Therapy Skills Training in College Students with Cluster B Personality Disorders

This pilot project investigates the efficacy of an 11-week dialectical behavior therapy skills training class in increasing adaptive skill use and emotion regulation in college students with cluster B personality disorders or traits. Subjects are students (N?=?19, mean age = 21.31, 1 male, 18 female) at a southeastern university counseling center. Students meeting criteria but not interested in attending the group were recruited to serve as control subjects who received treatment as usual. As compared to treatment as usual, dialectical behavior therapy participants had significant improvement in increasing skills use and decreasing maladaptive coping skills; there was a trend for improvement in difficulty regulating emotions.     

Dialectical Behavior Therapy in College Counseling Centers: Current Trends and Barriers to Implementation

The purpose of this study was to examine trends and barriers in implementation of dialectical behavior therapy (DBT) programs in college counseling centers (CCCs). Participants were 107 CCC employees who participated in an electronic survey. One third of respondents endorsed use or planned use of DBT at their centers. The most prevalent primary mode of DBT offered was group skills training. Highly endorsed barriers to implementation included productivity demands and lack of individual therapists, time for team consultation, and willingness to offer phone coaching. Suggested implementation strategies include developing community partnerships, use of virtual teams, supporting programs with campus data, and adapting DBT strategically.     

辩证行为疗法治疗边缘人格障碍案例分析

辩证行为疗法（dialectical behavior therapy,DBT）是在传统认知行为疗法基础上发展而来的一种新型认知行为心理治疗方法,由美国华盛顿州立大学教授玛莎·莱恩汉（Mar-sha M Linehan）博士于20世纪90年代初创立,它以辩证法的基本原则为理论基础,强调病患与治疗师之间,理性与感性之间,接受与改变之间的辩证训练和策略的应用。该疗法的治疗策略主要包括辩证法策略、合理化认同策略和啦啦队鼓励策略等,辩证法的策略贯穿于整个治疗过程。文章以一边缘人格障碍患者为例,具体说明辩证行为治疗策略的应用。     

An Integrative Approach: Relational Cultural Theory and Cognitive Behavior Therapy in College Counseling

This article presents an integrative framework for using cognitive behavior therapy through the lens of relational cultural theory. The authors provide an overview of cognitive behavior therapy and relational cultural theory, followed by suggestions on how to facilitate cognitive behavior therapy using the principles of relational cultural theory in college counseling. A case illustration is used to demonstrate the integration of cognitive behavior therapy and relational cultural theory.     

Trainees Versus Staff: Exploring Counseling Outcomes in a College Counseling Center

Investigators compared counseling outcomes among nonpaid graduate-level trainees and professional staff at a college counseling center. Counseling outcomes for 331 college student participants were measured using the Outcome Questionnaire 45.2 (OQ45.2), employing a pretest–posttest design. The two groups of service providers did not differ significantly (p = .179; α > .05). A unique aspect of this study was the statistical control for the clients’ readiness to change. The implications for practice in college counseling centers suggest the use of graduate-level trainees as effective counseling providers and a method to cope with high demand for services.     

Estimating the Efficiency of Therapy Groups in a College Counseling Center

College counseling centers are facing rapidly increasing demands for services and are tasked to find efficient ways of providing adequate services while managing limited space. The use of therapy groups has been proposed as a method of managing demand. This brief report examines the clinical time savings of a traditional group therapy program in a college counseling center. The savings were mixed from semester to semester, ranging from 5 individual therapy spots lost to 10 individual therapy spots gained depending on the estimation. Considerations are offered for the use of therapy groups to manage clinical demand based on this report.     

Therapy Dogs on Campus: Recommendations for Counseling Center Outreach

This article describes the design and implementation of a dog therapy outreach program through the counseling center at West Chester University in Pennsylvania. Two main goals were identified for this program: (a) provide stress relief and comfort to students across campus, and (b) increase potential access to counseling services and improve perceptions of the department by providing students with the opportunity to interact with department members outside of the office. Collected student responses appear to support the stated goals. Recommendations for other counseling centers are provided in developing this type of outreach programming.     

College Counseling Today: Contemporary Students and How Counseling Centers Meet Their Needs

There is evidence that today’s college and university students are struggling with emotional and behavioral health problems at higher rates than in past generations. This article explores the various ways, utilizing a range of models, that college and university counseling centers have mobilized to respond to these challenges. We examine literature about the characteristics and concerns of the current student generation along with what counseling centers are doing to respond to the challenge of student needs. We describe a survey (N = 408) of members of the Association for University and College Counseling Center Directors (AUCCCD) and American College Counseling Association (ACCA) that elicited the kinds of services, functions, structures, and organizational relationships found in today’s counseling centers. In addition to confirming the core mission of providing counseling and psychotherapy, the survey revealed widespread counseling center collaboration and consultation activities beyond the counseling room. The survey also indicated a variety of administrative and structural arrangements in the way counseling centers are placed on their individual campuses. Finally, we suggest a framework for planning, executing, and evaluating counseling center and campus initiatives.     

A Case Study: An ACT Stress Management Group in a University Counseling Center

The aim of this study was to examine the effectiveness of an acceptance and commitment therapy (ACT) stress management group in a college counseling center setting. This study explored (a) the effectiveness of ACT in increasing participants’ ability to tolerate distress, which directly affects their ability to function in a stressful college setting; (b) the effectiveness of ACT in decreasing participants’ level of experiential avoidance, which directly affects their willingness to engage in their day-to-day tasks, responsibilities, and social interactions; and (c) the impact of ACT treatment on anxiety symptoms traditionally targeted in cognitive-behavioral therapy interventions. The results of this initial investigation show promising support for the prediction that an ACT Stress Management Group would significantly reduce participants’ level of experiential avoidance and increase their ability to tolerate distress.     

Applying Dialectical Behavior Therapy to Self‐Harm in College‐Age Men: A Case Study

Researchers suggest an increase in self‐harm among men. Specifically, college‐age men appear to be at risk for self‐harming behaviors, and counselors often overlook these behaviors in treatment. In this article, the authors describe the issue of self‐harm and illustrate the use of dialectical behavior therapy (DBT; Linehan, 2014 ) with male college students. The authors use a case study to illustrate the use of a modified form of DBT with a male college student who self‐harmed. Limitations of this approach and implications for college counselors are also addressed.     

Writing Effectively as Counseling Center Directors and Administrators: Lessons Learned From a 2-Minute Speech

Administrative writing is a crucial skill needed for the counseling center professional to be able to transmit knowledge and values for the rest of the campus community. This article highlights both conceptual and technical aspects of effective writing.     

Practicing in the 21st Century College Counseling Center

Although college and university counseling centers often struggle with misperceptions of their work and their role in the campus community, limited research has addressed this issue. In this article, common campus misperceptions are explored. Among the issues that often increase the misperception of counselors and counseling services include misunderstandings by campus departments about the role of counseling for students, the perception that counseling is often a solution to any emotional or behavioral issue, and the difficulty of avoiding dual relationships with students on many campuses. Implications for campus counseling centers, including strategies for combating misperceptions, are discussed.     

Psychotherapy Services Provided by a College Counseling Center

Abstract

This study compared the delivery of psychological services at a university counseling center after an interval of almost 40 years in a partial replication of an earlier study at the same center. The results indicate that the changes that have occurred in service delivery reflect more the transitions in the culture of the university than trends in mental health treatment.     

The Use of Family Therapy Within a University Counseling Center

As a counterpoint to the oftentimes adversarial way that parents are viewed when they appear to be overinvolved in the lives of their college-aged students, this article advocates for the use of a family therapy perspective in university counseling centers. Benefits of this perspective include a broadening of the lens through which individual concerns are seen and a more nuanced social justice analysis in which issues of gender, race, and class are highlighted. A review of family therapy literature is intertwined with discussion regarding the relevance of this perspective when working with college students. Vignettes illustrate various applications of college-based family psychotherapy.     

Counseling a Student Presenting Borderline Personality Disorder in the Small College Context: Case Study and Implications

This case study examines the dynamics and challenges associated with counseling a client experiencing borderline personality disorder in the small college institutional context. The work of counseling centers at small private institutions has been relatively unexplored in the extant college counseling literature. To help fill this gap, the current case study explores a counselor's work with a student at a private, Catholic women's college.     

Brief Therapy at a University Counseling Center: Working Alliance,Readiness to Change,and Symptom Severity

The authors investigated whether students receiving short–term individual counseling at a university counseling center showed progress as evidenced by perceived client and counselor outcomes and the roles that client readiness to change and working alliance played in this setting. The results indicated that the counselor reports, not the client reports, reflected statistically significant change in client symptoms. Changes in symptom severity were not associated with working alliance and readiness to change.     

The Dose-Response Relationship at a College Counseling Center

Abstract

Most college counseling centers have adopted session limits for their psychotherapy clients though little evidence exists to support such cutoff points. In the past eight years, a few studies have been published using survival analysis statistics for investigating the speed of recovery in psychotherapy. The outcome of clients at a university counseling center was studied to assess change across time, on a session-by-session basis. The analysis of these data showed that 14 sessions of psychotherapy were required for 51% of clients to meet criteria for clinically significant change. Results were interpreted as suggesting that limiting psychotherapy at college counseling centers may result in improvements that are not clinically meaningful for the majority of clients receiving services.     

Distress Tolerance Skills for College Students: A Pilot Investigation of a Brief DBT Group Skills Training Program

This report outlines the evaluation of a brief dialectical behavior therapy (DBT) group skills training program for students presenting with serious psychological concerns (referral reasons included suicidality, self-injury, and substance use). Students were enrolled in distress tolerance groups ranging from 7–10 weeks. The majority of the students in the sample were receiving psychiatric medication, individual therapy, or both. All students (N = 22) demonstrated significantly improved scores on measures of emotion regulation and functional and dysfunctional coping. These results are the first to show that targeted skills training with DBT mindfulness and distress tolerance skills can produce beneficial outcomes in college students in the context of a short-term intervention.