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.     

A Framework for College Counseling Responses to Large Scale Traumatic Incidents

Abstract

Although most psychotherapists have limited experience dealing with large scale catastrophic incidents, college and university counseling centers today need to be prepared for crisis events such as terrorist attacks, war, and local catastrophes. This article presents a conceptual model for designing counseling center responses to large scale traumatic incidents. Familiar college mental health constructs are applied to the relatively unfamiliar territory of responding to traumatic incidents. First, DSM-IV-TR diagnostic criteria are used to define three levels of student need based on different types of stressful or traumatic events and expected reactions. Next, a corresponding three-part response plan is discussed, including preventive, intermediate, and advanced counseling and psychotherapy interventions. Finally, the college counseling roles of crisis intervention and student development consultation are discussed in relation to the aftermath of large scale traumas. The influence of staff attitudes and values, and other limitations of the model, also are described.     

Collecting Multidimensional Client Data Using Repeated Measures: Experiences of Clients and Counselors Using the CCAPS‐34

Many college counseling centers do not collect client data at each session because of perceived burdens. This study explored 55 clients’ and 16 doctoral counselor trainees’ experiences collecting and using data on client distress at each session over the course of counseling at a large public university's counseling center. Results indicated that the majority of both clients and counselors found the process convenient and clinically useful. Findings, clinical implications, and future directions are discussed.     

Readability of Informed Consent Documents at University Counseling Centers

The extent to which clients understand the nature and anticipated course of therapy is referred to as informed consent. Counseling psychologists often provide informed consent documents to enhance the education of services and for liability purposes. Professionals in numerous health care settings have evaluated the readability of their informed consent documents, but no such peer-reviewed research exists for university counseling centers. This study evaluated the informed consent documents for psychotherapy from university counseling centers using three readability formulas (Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and Simple Measure of Gobbledygook [SMOG] Grading). The findings support the authors’ exploratory hypotheses that informed consent documents in university counseling centers are rated as challenging to read for college students. Recommendations and implications for practice are discussed.     

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.     

Psychotherapy with College Student Survivors of War and Political Trauma

The purpose of this article is to bring to the fore a topic that has received little mention in the college student literature: conducting psychotherapy with survivors of war and political trauma who seek treatment at college and university counseling centers. Following a discussion of political trauma in relation to typical developmental challenges of the college years, several case examples illustrate clinical issues for these students. In addition, personal and professional issues faced by the counselors who work with this population will be addressed. Psychotherapy with these clients has demonstrated the potential of resiliency in the aftermath of political trauma.     

Sociocultural Factors and Referral Outcome: An Exploratory Investigation

ABSTRACT

One response to increased service needs at university counseling centers has been community provider referrals. However, certain demographic groups may be more successful in these referrals than others. We hypothesized that students who identify as White, female, sexual minority, and older, would be more likely to be successfully referred. Self-reported demographic information was collected from clients at a Mid-Atlantic counseling center. A logistic regression analysis was conducted to test differences in referral status. Age alone emerged as significant, with older students being more likely than younger students to have a successful referral outcome. Implications of these findings are discussed.     

Providing Psychological Counseling in Community Colleges: Even Greater Challenges and Fewer Resources

Community college counseling is often not well understood in the “university-centric” higher education community. In fact, work at community college counseling centers typically involves an exaggerated version of the challenges found at university counseling centers. At a community college, there are usually vastly fewer resources from the college (number of staff, facilities, and overall financial support), and the student clients often face many more struggles (economic, academic, and psychological). Recently, various professional counseling organizations have begun including community college counselors, and expanded collaboration between those who work at community colleges and at universities benefits all.     

Effectiveness of Brief DBT-informed Group Therapy on Psychological Resilience: A Preliminary Naturalistic Study

This naturalistic study was designed to examine the effectiveness of a 4-week skill-based group therapy that focuses on building resilience. The group, informed by Dialectical Behavior Therapy (DBT; Linehan, 1993, 2015), targets general clients at college counseling centers and emphasizes mindfulness as a coping strategy to stress, cognitive rigidity, emotion dysregulation, and interpersonal difficulties. Results indicated that group members showed clinically significant improvement in psychological resilience and general mental health at the conclusion of group therapy. Implications are discussed.     

Cross-cultural or intercultural counseling or psychotherapy

Summary We have reviewed the problems in counseling or psychotherapy posed by cultural differences. Few if any solutions to these problems have been proposed. It has been the general conclusion that theories and methods of psychotherapy developed in Western culture are not applicable in other cultures.This view is rejected on the basis that there are universals of human nature, a basic one being the common motive of self-actualization. The goal of counseling or psychotherapy is to facilitate the development of self-actualization in clients. Cultures can be evaluated in terms of their contribution to the self-actualization of their members. The major conditions for the development of self-actualizing persons are known, and must be present in counseling or psychotherapy as practiced with any client, regardless of his culture. These conditions are not time-bound nor culture-bound. The problems of practicing counseling or psychotherapy in other cultures are viewed as problems of implementing these conditions. Certain characteristics of clients which present obstacles to the implementation of the conditions are associated with certain cultures. Until cultural changes lead to changes in these characteristics, counseling or psychotherapy will be difficult and in some cases impossible with certain clients from certain cultures. Structuring and client education and training may change client expectations and make therapy possible. In any case, however, to accede to client expectations, abandoning methods which have been demonstrated to be related to self-actualization as an outcome of counseling or psychotherapy, is to abandon self-actualization as the goal, and to accept goals which are often inconsistent with self-actualization.     

Editorial Introduction: Guns on Campus

ABSTRACT

Most college counseling centers do not utilize telehealth despite evidence of positive outcomes. The aim of this study was to examine the telehealth experience of students in a college counseling center. Participants were health professional students who utilized at least one telehealth visit between November 2015 and April 2017 (N = 67). Methods: In June 2017, the authors administered a telehealth survey that assessed access, experience, effectiveness, and impact on therapeutic alliance. Of 67 students, 36 (53.7%) responded. The majority reported telehealth was convenient (34, 94.4%), time-saving (34, 94.4%), and helped them to feel better (30, 83.3%). Over half used telehealth because of distance (20, 55.5%). Eighty-one percent reported telehealth as being as good, nearly as good, or no different than meeting in person. Conclusion: Telehealth is a viable option for college counseling centers and is experienced as convenient, time-saving, and effective with little negative impact on therapeutic alliance.     

Chapter 7: Fostering Development

Summary

This chapter reports a case of college student psychotherapy involving short 1doses” of counseling over the course of a student's four-year college career. During treatment, the student addressed and increasingly came to terms with issues involving relationships with his family, friends, and love interests. By his own report, he gained considerably from this experience.     

Investigation of Clinically Significant Change by Severity Level in College Counseling Center Clients

The authors investigated the number of sessions necessary for college counseling center clients of different levels of severity of distress at intake to achieve clinically significant change (CS) in therapy. The Outcome Questionnaire‐45 (M. J. Lambert, N. B. Hansen, et al., 1996) was used to categorize 914 clients by severity of distress. Analyses of outcome indicated that clients with less and more severe distress needed 14 and 20 sessions, respectively, for 50% in each group to achieve CS. Implications are discussed.     

Anxiety,Depression and the 4.0

ABSTRACT

Nontraditional women are a growing presence on college campuses. This study identifies a cohort group of nontraditional women who were high achievers academically, yet sought counseling for depression, anxiety, and interpersonal problems. While these clients initially sought only symptom relief, the counselors saw underlying problems they felt needed to be addressed. A short-term counseling model was utilized that offered symptom relief and laid the foundation for longer-term counseling upon referral. Results of the ex post facto study indicate significant gains for the women in self-esteem and satisfaction with family life, as well as symptom relief for depression and anxiety. Data show this model offers symptom relief while beginning to address associated underlying issues.     

A Short-Term Dynamic Psychotherapy Approach for College Students

Abstract

This article explores the need for university counseling centers (UCCs) to implement brief therapies and describes one such treatment, intensive short-term dynamic psychotherapy (ISTDP), as a particularly viable therapeutic approach in this setting. Because ISTDP is not appropriate for all students seeking therapy, a careful assessment of the client is conducted prior to deciding which treatment approach is best suited for the client. The different restructuring techniques that comprise ISTDP are discussed. The article ends with a brief vignette from a therapy session with a student involving ISTDP techniques.     

Expanding Counseling Services Through a Collaborative Practicum-Based Resource

Abstract

This article notes the growing challenges for college counseling centers. One solution to these challenges is described as a collaborative initiative designed to actively help university students presenting a range of personal problems with a practicum-based service.     

Save Me from Myself: College Students' Fears of Losing Control and Acting Violently

Violent behavior on college campuses has been a long-standing problem that has received increased attention due to recent shootings. At present, the factors that predict college students' violent behavior are not well understood. To increase knowledge in this area, two studies were conducted that examined the prevalence and predictors of college students' fears of committing violent behavior. Data from a single university indicated that less than 2% of the general student body possessed strong fears of acting violently and more than 80% of students had no such fears. Among clients at the university counseling center, 7% expressed strong fears of acting violently whereas 71% of clients had no such fears. Similar prevalence rates were found in a sample of 27,616 clients from 66 university counseling centers. Predictors of fears of acting violently included low academic motivation, suicidal ideation, irritable feelings, fears of having a panic attack in public, having harmed another person previously, having nightmares or flashbacks, and getting into frequent arguments.     

University Counseling Center Clients' Expressed Preferences for Counselors

ABSTRACT

This archival study explored patterns of client preferences from a randomized sample of 881 clients at a Midwestern university counseling center. Information from client intake forms was collected for a four year time frame. Results showed that 61% of the clients did not express preferences for particular types of counselors when asked on intake forms. Thirty-nine percent of the clients did express a preference for a particular type of counselor. Chi-square analyses found that clients with preferences tended to have prior therapy experience and tended to prefer counselor gender over other traits. Women and people of color tended to be the most likely to express counselor preferences. It is suggested that future research clarify the meaning behind preferences, the lack of preferences, and clients' expectations for counseling.     

A case for routine involvement of threat assessment and management teams with college students at risk for suicide

ABSTRACT

Institutions of higher education and their counseling centers are under intense pressure to prevent student suicide. This article proposes that routinely using threat assessment and management teams in working with suicidal students would add value to existing suicide prevention efforts. The unique features of threat assessment and management provide several advantages over traditional clinical intervention. First and foremost, the majority of students who die of suicide do not seek services from campus counseling centers. These students may, nonetheless, come to the attention of campus constituents in a number of ways and may readily be referred to a threat assessment and management team. For students who are clients of the counseling center, a campus should still activate a threat assessment and management process. In this way, threat assessment and management may be useful for students who refuse to seek help as well as in providing assistance when students are engaged in treatment. Nonetheless, higher education in general and counseling centers in particular have not engaged in a standard practice of involving threat assessment and management teams with students who present at risk for suicide. Limitations to clinical approaches for suicide prevention are reviewed in contrast with the complementary advantages of threat assessment and management as applied to suicidal students. Regularly including threat assessment and management in working with suicidal students in higher education may provide synergy in improving the likelihood of desirable outcomes in preventing suicides.