Society of Counseling Psyc hology Section on College and University Counseling Centers

SCUCC Newsletter Volume 9, Issue 1

From the SCUCC Chair

Inside this issue: From the SCUCC Chair

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From the SCUCC Newsletter

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Editor Collaborative Care in a University Student Health Center

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Leadership

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Roster College counseling today: Contemporary students and how counseling centers meet their needs

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Ask Us Anything

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Barbara Meehan, Ph.D. George Mason University [email protected]

Membership Information

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students. I want to thank Lauren Woolley for her tremendous leadership of our section last year. I have some big shoes to fill but I am enthusiastic about the opportunity to continue to work with Lauren and other members of the SCUCC Executive Committee this year.

Over the past month, I gave quite a bit of thought to poHello to SCUCC returning and tential focus areas for this newsletter submission. Initially, new members! I hope everyI planned to write about a one’s year is going well and you are taking occasional time current “hot topic” in higher outs to honor the work you do education that intersects with and celebrate your impact on the work of counseling centers.

However, as days passed and I went through my daily early morning ritual of reviewing the Chronicle of Higher Ed, Inside Higher Ed, list-serve discussions, Google alerts leading me to random articles and blog posts related to college students and college student mental health (by the way, I am reconsidering the latter as some of the content is indeed quite random!), I was reminded that there is no one preeminent “hot topic”. Rather, the topics abound and all are acutely relevant to our discipline. For example: sexual

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From the SCUCC Newsletter Editor Welcome to this issue of the SCUCC Newsletter! I am so happy to have been given the opportunity to serve SCUCC as the incoming Newsletter Editor. I know that I have big shoes to fill, as both Kristin and Tiffany did a wonderful job with previous editions. I’m just hoping that I can continue their good work…

Feature SCUCC @ APA

Fall/Winter 2014

Larry Carter II, Ph.D. University of California, Riverside [email protected]

After spending a few years working in primary health care, I’m very happy to have returned to the university counseling center world. I

truly believe that the work we do has the ability to significantly impact student success. This importance is reflected in the content of this Newsletter. Please refer to Barbara’s column outlining new SCUCC initiatives, Lauren’s article on collaborative care, and Jon’s piece on how counseling centers are meeting student needs. I hope you enjoy the issue, and I also hope you will consider submitting something for a future issue. Happy Reading!

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Continued from the SCUCC Chair: violence, Title IX, alcohol and other drugs, campus safety, balancing access with ongoing services in counseling centers, staff retention and development, serving special populations (international students, student veterans, student-athletes, diverse students, adult degree seekers, undocumented students, etc.), telehealth, training of emerging professionals… These are topics that arose just in the past week. The list goes on and on. The breadth of these topics led me to reflect on how (and no need to sit down as this is not a new revelation) the role of counseling centers and counseling center professionals has undergone a tremendous expansion as all of the above intersect directly with our work. We are experts in mental health and college student mental health. However, more and more of late, we are charged with being experts on all things related to college students. As a discipline, we have become adept at adapting to meet this new charge. But to remain nimble and successful in doing so requires all counseling center personnel (and trainees aspiring to be college counseling center personnel) to be knowledgeable about all of the many concerns/issues/ developments impacting students we serve and other academic and student affairs units with whom we consult and partner. As we all know, understanding of contextual factors and embedded systems are critical to effecting meaningful change. But to sustain our flexible and adaptable approach to meeting the needs of our dynamic environments, we need to ensure we keep pace with, and yes, even get ahead of, trends and hot topics. There are

many professional associations that provide a place for those in like-roles to collaborate and challenge one another to dig deep into these issues and explore divergent strategies for addressing them. However, SCUCC is one of the few organizations that encompasses such a diverse membership: from graduate students beginning to explore potential settings of interest, to practicum/intern/ postdoctoral trainees, to early career psychologists, to counseling center leadership, to senior student affairs administrators. Such a membership pool provides a fertile ground for a rich exchange of new (and, of course, tried and true) ideas. And perhaps more importantly, our section provides an opportunity for ongoing development of emerging professionals and emerging leaders within our discipline. Couched within APA, SCUCC is also poised to engage in ongoing collaboration with areas of specialization within mental health to ensure we remain cutting edge, relevant, and effective. But to achieve these goals, we need a strong and robust membership base. I applaud previous leaders of our Section: Lauren Woolley, Jan CollinsEaglin, Kristin Harris-MacDonald, Larry Marks, Tiffany O’Shaughnessy, Jon Brunner, Chris Daoud, James Lyda, Larry Carter, Christine Zhou, Jonathan Dator, and so many others before them for their efforts in sustaining and revitalizing interest in our Section. Because of their success, we have a group of strong and dedicated members ready to strengthen our existing infrastructure and develop additional opportunities for meaningful contribu-

tions, collaboration, networking, and leadership development. And to that end, we have some exciting new initiatives on the horizon, including focused efforts to grow our section membership via a newly formed Membership Committee, development of a stronger social media presence, and formation of a committee to begin development of a tiered mentorship program where members at each stage of training and career development can be paired with a more advanced member of the profession to receive tailored mentoring and guidance relative to their career interests. This is just a snapshot of the initiatives underway to continue to build our Section and I am excited about what lies ahead. SCUCC has the capacity to represent our discipline’s successes in managing competing demands while still honoring and maintaining the core values and principles that serve as the foundational basis for our work. So please, email me with ideas, questions, interest in becoming more involved, or your favorite “hot topic” of the day! Barbara

Volume 9, Issue 1

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Recipients of the 2014 SCUCC Awards: Jon Brunner Ph.D. Florida Gulf Coast University Counseling Center Outstanding Contribution to Counseling Center Work Award

Jodi Caldwell, Ph.D. Georgia Southern University Counseling and Career Development Center Counseling Center Outstanding Contribution to Counseling Center Work Award

Alli Anderson, Ph.D Georgia Southern University Counseling and Career Development Center Counseling Center Outstanding Early Career Psychologist Award

Have Something to Say? We’d love to hear your voice in our next newsletter. All submissions with information relevant to the needs of University and College Counseling Centers are encouraged. The deadline for submissions for the Spring/ Summer 2015 Newsletter is

April 15, 2015. Articles should be approximately 500-700 words in length. For more information contact: Larry Carter II, Ph.D. SCUCC Newsletter Editor [email protected]

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Collaborative Care in a University Student Health Center Lauren Woolley, Ph.D. University of San Diego Counseling Center Coordinator of Collaborative Care Senior Staff Psychologist [email protected] Approximately two years ago the University of San Diego (USD) Wellness Department implemented a unique, innovative and integrated model of care. USD is a private, Catholic university with a student population of approximately 5,500 undergraduate and 2,650 graduate/law students. Our Wellness Department includes the Counseling Center (CC), Student Health Center (SHC), Disability and Learning Difference Resource Center (DLDRC), and Center for Health and Wellness Promotion (CHWP). We share an electronic medical record system, protocols and utilize an inter-disciplinary approach to providing comprehensive wellness services to students. While we share the dream of a Wellness Office, with the exception of the CC and DLDRC, we are spread out across campus. We have over 40 Health, Mental Health, Addiction, Public Health and Leadership professionals, and support staff. Over the past decade, the number of students reporting emotional and psychological

difficulties has rapidly increased. Counseling Centers across the nation report significant increases in the utilization rates and severity of presenting conditions. Hence, universities must reassess their provision of mental health services. The 2012 American College Health Association (ACHA) data indicated that 18% of USD students (21% national) reported being diagnosed and/or treated by a professional for a mental health condition within the last 12 months. Nine percent of USD students identified depression as a factor affecting academic performance and 8% reported a clinical diagnosis of depression. Four percent of USD students indicated they seriously considered suicide. Forty-two percent reported binge drinking past two weeks and 15% three or more binge episodes in the past two weeks. During 2012-2013, 14.6% of students presented at the CC or CHWP for a mental health concern and 4% of these students were reporting recent/ current suicidal ideation. Hence, this data indicates a

significant gap between the number of students reporting mental health concerns and those presenting for treatment. Especially alarming is the number of students (~285) reporting recent/ current suicidal ideation not seeking services. Czyz et al. (2013) suggested the following barriers keep suicidal students from seeking treatment: 

Perception that professional help is not needed due to problems being minor and transient (66%)

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Lack of time (27%)

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Preference for selfmanagement of problems (18%)

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Preference for seeking help from family or friends (16%)

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Pragmatic barriers to accessing services (16%)

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Concern about stigma or discomfort discussing problems with professionals (12%) Given our SHC has significantly more unique patient

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SCUCC Leadership Roster Barbara Meehan — Chair

Lauren Woolley — Past Chair

Jon Brunner — Treasurer

James Lyda — Communications Chair

Dawn Danz — Research Committee

Larry Marks — Webmaster

Jon Weber — Student Liaison

Larry Carter II — Newsletter Editor

Jon Reeves — Student Liaison

Upcoming Conferences American College Personnel Convention 03/05/15—03/08/15, Tampa, FL www.myacpa.org American Group Psychotherapy Association 02/23/15—02/28/15, San Francisco, CA www.agpa.org

American Counseling Association 03/12/15-03/15/15, Orlando, FL www.counseling.org/convention American Psychological Association Convention 08/06/15—08/09/15, Toronto, ON, CA www.apa.org/convention

Asian American Psychological Association 08/05/15, Toronto, ON, CA www.aapaonline.org

Association of Black Psychologists Annual International Convention 07/22/15—07/25/15, Las Vegas, NV www.abpsi.org

Association for University & College Counseling Center Directors 10/18/15—10/21/15, Salt Lake City, UT www.aucccd.org

Association for Women in Psychology Conference 03/05/15-03/08/15, San Francisco, CA www.awpsych.org

NASPA 03/21/15-03/25/15, New Orleans, LA http://www.naspa.org/conf

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Collaborative Care in a University Student Health Center, continued contacts than the CC or CHWP (4,348 in 2012-2013 compared to 996 at the CC and165 at CHWP), we determined that it was an ideal location to identify students with mental health needs. Additionally, the US Preventative Services Task Force recommends screening for depression and anxiety in a primary care setting. We created an eight question survey which included the PHQ-4, AUDIT-C and a question regarding self-harm and suicide. This survey was given to every student coming to the SHC for a routine appointment. Our medical providers found it challenging to effectively address the results of the survey along with the students’ physical concerns within the span of a 20 minute appointment. Moreover, they observed that students referred to the CC were not following through and continuing to return to the SHC for services. Therefore, we needed a new plan. We reviewed best practices for collaborative care and determined having a mental health provider readily available onsite to medical providers and patients resulted in more students getting connected with mental health treatment. Hence, members of our CC took shifts serving as mental health (MH) consultants in the SHC. We initially questioned whether students would be irritated by a mental health professional asking them about their depression when they came to the SHC to address a sprained ankle. Remarkably, the response from

students was overwhelmingly positive. To assess the effectiveness of our screenings, we conducted a review of 150 randomly selected charts. Of these charts, we excluded eight from our review, because they were missing the drop in section alerting the medical providers to the completed SHC-8. Our findings revealed the following: 

The PHQ-4 is a valuable screening instrument.

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Screening identifies a significant number of cases (44% of positive screens) not already connected with CC or CHWP clinical services.

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Providing MH resources to those screenings interpreted as “negative” or “situational” by the medical provider has benefit (7% sought counseling services soon after their SHC appointment).

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Students may initially decline MH services, but seek services soon after (38%).

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Getting an immediate (e.g., MH Consultant met with student in exam room versus calling student/sending a secure message following their medical appointment) MH connection was more likely to result in the student engaging in counseling.  30% of those agreeing to have a MH provider reach out to them soon after the visit, followed through with counseling  62% of those receiving immediate MH connections, continued with counseling

For universities considering a similar collaborative care model, we encourage the mental health and medical providers to have weekly case consultation meetings. These meetings have strengthened and stream-lined the care we provide to students. Additionally, this meeting provides a powerful forum for medical and mental health providers to learn from each other (e.g., the importance of screening for B -12 deficiency in depressed students endorsing vegan/ vegetarian diets). Not surprisingly, the screening process increased the numbers of students receiving mental health services in our wellness department. We provided this data to our Vice President of Student Affairs and were able to secure funds for a Wellness Case Manager to coordinate connecting students with complicated mental health and medical needs to providers in the community. While implementing our collaborative care model was initially challenging, the benefits continue to outweigh the obstacles we encountered. References Czyz, E. K., Horwitz, A. G., Eisenberg, D., Kramer, A., & King, C. A., (2103). Self-reported barriers to professional help seeking among college students at elevated risk for suicide. Journal of American College Health, 61(7), 398-406. doi: 10.1080/0744 8481.2013.820731

Volume 9, Issue 1

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College Counseling Today: Contemporary Students and How Counseling Centers Meet Their Needs Jon Brunner Ph.D. Executive Director, Counseling and Health Services Licensed Psychologist Florida Gulf Coast University

An important component of the mission of SCUCC is to encourage and support research related to university and college counseling centers. Investigating the services, structure and functions of counseling centers and the issues facing today’s college students is paramount to our field. In the October edition of the Journal of College Student Psychotherapy a monograph, written by Jon Brunner, David Wallace, Linda Reymann, Jes Sellars, and Adam McCabe, was published addressing the myriad issues facing today’s campus counseling centers and the students they serve. This monograph included a review of the health and wellness of today’s students (including the research on college student mental health as well as report on the extensive survey data), counseling center models and aspirational standards, counseling center services impact on academic performance, and a review of the critical role of consultation and collaboration found with today’s centers. In addition results were presented from a survey of 408 counseling center directors regarding the services and functions of their centers, organizational structure, location, intake procedures, records, supervision, professional identity of staff, additional departmental areas directors supervise and whether the

center was merged or linked. Demographic information specific to centers was collected and results were presented by size of institution and type (public or private). Finally, a framework for planning, executing and evaluating counseling center functions and campus initiatives was suggested. Clear support for the various clinical functions of today’ counseling centers were found. This includes counseling and therapy, emergency and crisis services, assessment, case management and psychiatric services. In addition to directly managing the mental health needs of students, today’s center are involved in extensive consultation and collaboration, prevention through outreach and education along with direct education and training for graduate students. A particularly noted consultation function was the finding that 95% of centers are involved in studentof-concern committees and 84% were involved in threat assessment teams on their campuses. In terms of structure and process it was found that 54% of the centers provide psychiatric services with over half of the centers using electronic records. At least 63% of the directors report to a student affairs officer with 39% of directors reporting they have another service area (most often health services) reporting to them.

Fifty-three percent of the directors indicated that their center was merged or linked to other services in some fashion. It is the authors’ hope that this extensive review of critical issues and the survey findings, regarding center services and function, will provide a rich backdrop for discussion regarding today’s campus counseling services. Going forward in this discussion counseling center directors and staff need to be knowledgeable experts regarding student mental health as well as the necessary services and functions and center process and structure to address these issues on campuses. References Brunner, J. L., Wallace, D. L., Reymann L. S., Sellers, J. J. & McCabe, A. G. (2014), College counseling today: Contemporary students and how counseling centers meet their needs. Journal of College Student Psychotherapy, 28(4), 257 -324. doi:10.1080/87568225. 2014.948770

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Ask Us Anything... Where counseling center professionals answer questions posed by graduate students who are interested in counseling center work. Do you have any recommendations with regard to my curriculum vita, if I’m interested in obtaining a UCC internship? Bert Epstein, Psy.D. “Include substantial information about clinical placements. Towards the end add a couple of lines of personal hobbies.” Larry Carter II, Ph.D. “My advice would be to conceptualize your CV as a representation of who you are and what you might bring to the internship experience. Give some thoughts to your strengths and your values, and integrate and highlight those in the text of your CV. Sometimes a subtle change in wording can change the way in which the information is perceived in a meaningful way.”

What would you recommend for interns/post-docs in terms of networking activities? Jon Brunner, Ph.D. “Well, the first and best way to network is to join our section. Congratulations on your first really smart move :)! More seriously, I think an effective way to get involved and network is through participating in college student mental and behavioral health study and research. Look for any opportunities that are presented in your program, independent study, etc.” Bert Epstein, Psy.D. “Go to as many professional conferences as possible, and join organizations such as DIV17, ACPA, local and state psychological associations.”

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Did your internship/post-doc site lead directly to work in a UCC setting? If not, when did you start searching for UCC job opportunities? Bert Epstein, Psy.D. “Yes/Yes. My internship was at a prestigious APA-accredited UCC, and I believe that helped. My post-doc was at an HMO, and I know that helped because my first director told me later she knew I would be familiar with brief therapy.” Jessi Manning, Ph.D., HSPP “It’s no surprise that I ended up in a university counseling center, as most of my training experiences, including master’s internship, graduate assistantship, internship, and postdoc, were in counseling centers. When I was searching for a permanent position, I didn’t even consider other types of positions. My experiences at numerous counseling centers helped make me more competitive for UCC jobs, but what ended up being just as important was considering what type of UCC was a good fit for me. UCC’s can vary widely in their size, funding, reputation on campus, services offered, etc., and I wanted to make sure wherever I ended up would be a good fit. What I learned through my experiences was that psychological testing is a must have for me, and I have somewhat of a preference for larger centers. This helped focus my job search, and I’m now in my fourth year as a permanent staff member at a large counseling center, where I primarily conduct psychological testing and provide supervision. My encouragement to trainees is not just to focus on getting experience in UCC’s, but to experience different types of UCC’s if possible—each one has their own feel, and finding a good fit in both directions is important.”

Contributor Information Jon Brunner, Ph.D.

Larry Carter II, Ph.D.

Executive Director of Counseling and Health Services

Staff Psychologist

Florida Gulf Coast University Fort Myers, FL

The Counseling Center University of California, Riverside Riverside, CA

Bert H. Epstein, Psy.D.,

Jessi Manning, Ph.D., HSPP

Assistant Director, Student Health Services,

Psychological Testing Coordinator

Mental Health Programs

Counseling and Psychological Services

Santa Rosa Junior College

Purdue University

Santa Rosa, CA

West Lafayette, IN

DID YOU HEAR THE NEWS?

“A Strategic Primer on College Student Mental Health” Authored by Louise Douce and Richard Keeling Now Available online at: http://www.apa.org/pubs/newsletters/access/2014/10-14/college-mental-health.pdf

Membership Application Section on College and University Counseling Centers A Section of the Society of Counseling Psychology—Division 17American Psychological Association

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