Financial Stress, Treatment Outcomes, and Academic Success at College Counseling Centers
College dropout is highly prevalent among first-time, full-time college students. Approximately 39% of students do not complete their degree program within 8 years, and 23.3% of first-year students dropout in the first 12 months (Hanson, 2024). Understanding which students are at risk of dropout and how campus services can promote student success may improve student retention.
One of the services that supports student success is university counseling centers. Counseling centers are essential for promoting the well-being of college students and helping support students as they adjust to the academic and personal demands of school. While counseling centers are helpful in improving student outcomes, there is still a significant portion of students who voluntarily leave school while in therapy. In the CCMH 2022 Annual Report, current financial stress was a significant predictor of withdrawing from school. In the same report, greater distress at the end of treatment and smaller improvements in symptoms during counseling were associated with a greater risk of dropout. However, less is understood about how the severity of financial stress is related to risk of academic withdrawal in addition to symptom improvement. We aim to revisit and expand upon what was originally examined in the 2022 Annual Report by addressing the following questions about university counseling center clients:
- Do students with higher financial stress begin treatment with different levels of symptoms and experience a divergent amount of improvement than those with lower financial stress?
- Are students with greater financial stress more likely to voluntarily withdraw from school during treatment?
- What percentage of students who voluntarily withdraw from school during treatment are financially stressed compared to those who do not voluntarily withdraw?
- Do students who voluntarily withdraw from school during treatment demonstrate the same amount of symptom reduction as other students in counseling who do not withdraw?
A total of 19,403 undergraduate students treated at 55 counseling centers between 2021 and 2024 were included in this study. To address our research questions, clients’ perceived financial stress was assessed through self-report using the Standardized Data Set (SDS), and voluntary academic withdrawal was reported by clinicians on the Case Closure Form. Distress was assessed using the Counseling Center Assessment of Psychological Symptoms-34 (CCAPS-34).
Do students with higher financial stress begin treatment with different levels of symptoms or have a divergent amount of improvement than those with lower financial stress?
To answer this question, we first grouped students into “low financial stress” (i.e., reporting no or rare financial stress at their first counseling appointment), “some financial stress” (reporting that finances were sometimes stressful), and “high financial stress” groups (reporting often or always being stressed about finances). Students with higher levels of financial stress initiated treatment with greater distress.
The figure below displays changes in psychological symptoms for clients with low, some, and high financial stress. All three groups experienced reductions in distress. Regardless of clients’ financial stress, there was a similar amount of improvement in symptoms. However, those with high financial stress ended services with a higher level of distress, demonstrating an outcome gap.
Are students with greater financial stress more likely to voluntarily withdraw from school during treatment?
The figure below depicts the percentage of clients who terminated treatment because they were voluntarily withdrawing from college. A total of 395 (2%) students voluntarily withdrew from school during treatment. As seen in the figure, individuals who reported high financial stress were more likely to voluntary withdrawal from school during treatment. Specifically, 2.4% of students with high levels of financial stress withdrew, while 2.0% with some financial stress and 1.7% of those with low financial stress left school.
College dropout is highly prevalent among first-time, full-time college students. Approximately 39% of students do not complete their degree program within 8 years, and 23.3% of first-year students dropout in the first 12 months (Hanson, 2024). Understanding which students are at risk of dropout and how campus services can promote student success may improve student retention.
What percentage of students who voluntarily withdraw from school during treatment are financially stressed compared to those who do not voluntarily withdraw?
We examined the proportion of financial stress experienced by clients who voluntarily withdrew from school. The findings are similar to the figure above, showing that those experiencing some or high financial stress are disproportionately represented in the group of clients who voluntarily withdrew from college. Compared to students who did not voluntarily withdraw, those who did were more likely to be experiencing greater financial stress.
Do students who voluntarily withdraw from school during treatment demonstrate the same amount of symptom reduction as other students in counseling who do not withdraw?
The figure below displays average distress at the start and end of treatment for the clients who voluntarily withdrew from school during counseling compared to clients who did not. Both groups experienced a decrease in average distress between the start and end of treatment. However, those who persisted in school, compared to those who withdrew, demonstrated greater reductions in distress during treatment and lower levels of distress at the end of treatment.
Summary, Implications, and Future Directions
In this research blog, we investigated relationships among financial stress, psychological distress, and voluntary academic withdrawal among university counseling center clients. The following conclusions were reached:
- Students with higher financial stress reported more severe psychological distress at both the beginning and end of treatment than those with lower financial distress. This highlights the mental health disparities among students with financial difficulties.
- Students demonstrated similar levels of symptom improvement during treatment regardless of their current financial stress, although outcome gaps and disparities exist in the levels of distress experienced at the end of services. This suggests that counseling centers provide effective support to students experiencing the full array of financial difficulties.
- Clients experiencing high financial stress were more likely to voluntarily withdraw from school compared to those with low financial stress. Additionally, among those who withdrew from school, 38% were experiencing high financial stress. In contrast, 32% of clients who did not voluntarily withdraw during treatment reported high financial stress.
- Those who persisted in school during counseling experienced a greater reduction in distress between the start and end of treatment compared to those who withdrew.
This study highlights the salience of financial stress as a risk factor for dropping out of school. To promote better outcomes and student success, we make the following recommendations:
- Not every student experiencing financial stress is seeking care at counseling centers. Thus, college campuses may need to evaluate the relationship between financial stress and student success within the general student body. Moreover, colleges and universities may consider ways to systematically identify students with financial difficulties and needs, such as student body screenings.
- For students receiving care at college counseling centers, clinicians should consider specifically asking about financial difficulties at the first counseling session. This could facilitate referrals to appropriate resources outside of treatment when needed (financial aid offices, housing assistance, need-based services, etc.). Fostering collaborative relationships between the counseling center and relevant campus offices may facilitate these referrals.
- Adjunctive support services that address these financial needs coupled with counseling care that improves overall distress symptoms will better position students to persist and succeed in school.
References
Center for Collegiate Mental Health (2022). 2022 annual report.
https://ccmh.psu.edu/assets/docs/2022%20Annual%20Report.pdf
Hanson, M. (2024, August 16). College dropout rates. Education Data Initiative.
https://educationdata.org/college-dropout-rates