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Presenting Concerns in Counseling Centers: The View from Clinicians on the Ground.

This blog is a summary of a CCMH study on presenting concerns in counseling centers published in 2017.

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Assessing Sleep Difficulty in University Counseling Centers: What Happens when Clients and Clinicians Disagree?

This blog is a summary of a sleep research article recently accepted for publication that used CCMH data.

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The Alignment Model: Using the Clinical Load Index (CLI) to Guide Counseling Center Staffing

 Alignment (n) - the proper positioning or state of adjustment of parts (as of a mechanical or electronic device) in relation to each other.

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Sexual Minority Clients in College Counseling Centers

The Center for Collegiate Mental Health, a practice research network of over 650 university and college counseling centers, has produced many publications looking at mental health distress and treatment outcomes for different populations and demographic groups seeking services at counseling centers. One of the populations that has been frequently studied is LGBTQ+ students. In this blog, we summarize our findings related to this population with hopes that it will be helpful to clinicians working with college students.

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Differences in Presenting Concerns by Demographic and Identity Group

People are often curious about how the mental health concerns of students seeking treatment at college counseling centers differ by demographic and identity characteristics. In this blog, the Center for Collegiate Mental Health (CCMH) examines that question using data from the self-reported client demographics items in the Standardized Data Set (SDS) and the Clinician Index of Client Concerns (CLICC), a checklist of possible presenting problems that is completed by the clinician after evaluating a student who is seeking mental health services. When completing the CLICC, the clinician can check all relevant concerns from a list of more than 50 problem areas. There is often an assumption that certain demographic identity groups disproportionately experience higher rates of all mental health concerns across the board. In reality, the picture is much more nuanced. This blog examines the differences in rate of clinician assessed presenting concerns across the following demographic characteristics:

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An Insider’s Guide to CCMH

Professionally Growing up in CCMH: An Insider’s Perspective

CCMH now comprises over 625 counseling centers, and continues to grow and adapt every year to new challenges and demands by using clinically relevant research. The data gathered are immense in scope and impact, and we are also constantly trying to create practical and actionable meaning to change the field of counseling. A natural question might be: who is the “we” in CCMH, and how do “we” actually “complete” projects with the data collected?

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Examining the Effectiveness of Campus Counseling for College Students with Disabilities

The following is a summary of an article recently accepted for publication using CCMH data.

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Part 5 of 5: Counseling Center Experiences After the Onset of COVID-19

The impact of COVID-19 has led to widespread concerns about its unique effects on college students’ mental health. To examine this topic more broadly, CCMH is completing a five-part blog series using a wide range of longitudinal clinical data from students seeking mental health services at college counseling centers nationally.

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Part 4 of 5: Impact of COVID-19 on Students Served at College Counseling Centers

The impact of COVID-19 has led to widespread concerns about its unique effects on college students’ mental health. To examine this topic more broadly, CCMH is completing a five-part blog series using longitudinal clinical data from students seeking mental health services at college counseling centers nationally.

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Part 3 of 5: Mental Health Impact of COVID-19 on Various Demographic Groups

The impact of COVID-19 has led to widespread concerns about its unique effects on college students’ mental health. To examine this topic more broadly, CCMH is completing a five-part blog series using a wide range of longitudinal clinical data from students seeking mental health services at college counseling centers nationally.

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Part 2 of 5: Mental Health Changes after the Onset of COVID-19

The impact of COVID-19 has led to widespread concerns about its unique effects on college student’s mental health. To examine this topic more broadly, CCMH is completing a five-part blog series using a wide range of longitudinal clinical data from students seeking mental health services at college counseling centers nationally.

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Part 1 of 5: COVID-19’s Impact on College Student Mental Health

The impact of COVID-19 has led to widespread concerns about its unique effects on college students' mental health. Surveys of college students conducted after March 2020 have repeatedly suggested that psychological distress among college students has increased. CCMH data, representing nearly 50,000 treatment-seeking students at 140+ institutions, suggests that the impact of COVID-19 on college students' mental health is considerably more nuanced than generally reported. To examine the impact of COVID-19 on mental health more thoroughly, using a broader range of longitudinal clinical data, CCMH will offer a five-part blog series to describe the impact of COVID-19 on college student mental health from multiple perspectives. While surveys offer an important perspective and provide an immediate snapshot of data, CCMH data is gathered methodically over time and then examined retrospectively. While this method requires patience for data to accumulate, it also provides a more robust population-level perspective (among students seeking services).

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2020 Annual Report

The 2020 Annual Report expands on the 2019 Annual Report that introduced the concept of the Clinical Load Index (CLI). The 2020 Annual Report provides an updated CLI distribution representing more colleges and universities and describes differences in counseling center practices at the low and high ends of the CLI distribution. 

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Exploring the Relationship Between Client Risk Factors and Telehealth Services in College Counseling Centers

In March 2020, college counseling centers, along with many other healthcare facilities across the United States, encountered the unprecedented challenge of rapidly transitioning to tele-services in response to COVID-19. To accomplish this feat, counseling centers promptly transformed their in-person care to tele-services in a matter of days/weeks. While most college counseling centers continue to provide telehealth during the 2020-2021 academic year, many questions have emerged regarding the sustained utilization of tele-services within college counseling centers in the future. Some of the most common questions include: (a) will tele-services, at least in some capacity, become a permanent part of counseling center services?; (b) will some colleges/universities delegate a portion of traditional in-person counseling services to external telehealth vendors?; and (c) given tele-services are the most prominent current mode of treatment, what proportion of students seeking counseling center services possess risk factors that make them a poor fit for tele-services?

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Returning therapy clients: Determining prevalence rates and identifying predictive variables

Staff who work in college counseling centers are aware that many clients discontinue services only to return to treatment at a later time. Thus, a longstanding question within the field of collegiate mental health is how often do clients return for subsequent courses of services and are there signs or predictors that might signal if a client is more likely to return to services. To examine this further at CCMH, Kilcullen et al. (2020) evaluated the rates at which clients return for additional courses of therapy in university counseling center (UCC) settings and a range of associated variables.

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Rates of Discrimination and Racial/Ethnic/Cultural Concerns Among College Students Seeking Counseling Services

Recent national events have renewed our collective focus on racial injustice and the experiences of discrimination and racial, cultural and ethnic concerns. In an effort to contribute to this dialogue, CCMH took a closer look at the frequency in which students initiate counseling with discrimination and/or racial, cultural or ethnic concerns as primary presenting problems. To accomplish this, CCMH examined responses from the Clinician Index of Client concerns (CLICC), which is a checklist of possible presenting problems that is completed by the clinician after evaluating a student who is seeking mental health care. “Discrimination” and “Racial, ethnic, or cultural concerns” are two presenting problems that therapists can choose from a comprehensive checklist of more than 40 problem areas. Clinicians can “check all that apply” within the list of concerns. “Anxiety” and “Depression” have historically been assessed as the most common primary presenting problems experienced by college student seeking services (2019 Annual Report, p.15). Examining a large national sample of 82,685 clients from 98 college counseling centers during the 2018-2019 academic year, CCMH found that clinicians identified Discrimination as a presenting problem for 0.7% of clients and Racial, ethnic, or cultural concerns was selected for 2.7% of clients. Zooming in, it was discovered that the frequency of these presenting concerns varied considerably between majority and minority identity groups. CCMH has outlined the findings below (Please note, these data reflect the rates in which clinicians identify Discrimination and Racial, ethnic, or cultural concerns as primary presenting problems for students entering treatment and do not measure the percentage of clients who report a history of these problems):

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COVID-19 Impact on College Student Mental Health

COVID-19 has resulted in widespread concern about college-student’s mental health – both during the spring of 2020 and forecasting into the future. Recent surveys of college students have suggested that that college students’ psychological distress increased significantly following the COVID-19 response and shutdowns in March 2020. Because CCMH continuously pools national data from students seeking mental health services at college counseling centers, we were curious to see if our data support this hypothesis.

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