STUDENT PSYCHOLOGICAL SERVICES

Health Services Advisory Committee

May 8, 2013

Bert Epstein

But, first a therapy cartoon…

Student Psychological Services--- Outline

Presentations to Campus Community Specialized Services:

Spanish-Language TherapyPsychiatric Services

TherapyDrop-In & Individual Therapy

Wait List & Outcome Consultations to Campus Community Training Component:

Weekly 2-hour seminar, over 30 topics

Presentations by SPS Staff Workshops

8 Seminars (purposeful reduction from 19 last year)

240 Students (projected; up from 87 last year)○ Range = 4 – 80

Outreach to Classrooms:16 Classes (down from 21 last year)518 Students (down from 734 last year)

○ Range = 22 - 50

Specialized Services (8/20 -

4/30)

Spanish-Speaking Therapy (10 hrs/wk) & Psychiatric Service (4 hrs/wk)

SPA Cs SPA Sess PSY Cs PSY Sess0

50

100

150

200

250

2011-122012-13

Drop-In Appointments (8/15-4/15)

33% increase last year over previous; 11% increase this year

0

2008-09 2009-10 2010-11 2011-12 2012-130

50

100

150

200

250

300

Accessibility% Students requesting drop-in seen same day:

2011-12 2012-13 (Spring Semester)

75% 90%* **

* Shifted to having all students be seen in DI.

** About 5% not seen same day because their schedule does not permit. Other 5% not seen because too many people came in same day, and so we triage such that people with least urgent need (through careful screening) asked to return next day.

Accessibility

Average Wait time to be Seen:

2011-12: 5 Days

2012-13 (Spring Semester): 0 Days

Wait List … The Good News: Average number students on Wait List:

2011-12: 50 2012-13: 22

Average number days from first contact to first ongoing therapy appointment (not including drop-in appointment):2011-12: 62 2012-13: 29

Students Who Did Not Respond to Call After Being Put on Wait List: 2011-12: 54% 2012-13: 24%

Wait List Disposition

After Initial Drop-In Session, when clients were put on wait list, they then were:

Seen: 58% Referred: 9% No Response: 24% [last year was 54%] Declined: 8% To be seen in summer: 2%

Outcome: Client Evaluations “My academic performance was

compromised a little in the beginning, but has improved since then.”

“It is amazing how accomplished I feel for doing this!”

“It helped me concentrate much better in school.”

Outcome: Client Evaluations “I was able to work on my problems and not let

them interfere with my school work (which it had been). For example: I was able to focus on school and not have my concentration break easily.”

“As I felt better about myself, I had more energy to devote to my school work. If I hadn’t had someone to talk to, I may have dropped out of school. I was surprised how quickly I was able to recover with the help of my therapist.”

Outcome: Client Evaluations “I am coming back to school after 20+

years. I had a huge fear of failure. I believe therapy gave me the faith I needed to succeed. I am happy to say that I am averaging a 4.0!”

“I was going to give up on class, but after talking with Shoshana I was better able to rationalize things and stay in class.”

Outcome: Client Evaluations “I was at a C or D, and now I am at an

A.”

“I am less stressed and more able to focus on what I need and feel more capable to work done for classes.”

Outcome: GAF Scale GAF= Global Assessment of Functioning GAF score assigned by therapist at end of therapy

80-90: Absent/Minimal Symptoms 70-80: Transient, expectable reactions 60-70: Mild Symptoms (functioning well) 50-60: Moderate Symptoms (moderate function) 40-50: Serious Symptoms (serious impairment) 30-40: Impairment in reality or in several areas 20-30: Reality problems or can’t function in almost any area

0-20: Suicidal or can’t take care of self

Outcome: % Improvement in GAF*

Minor Moderate Significant Substantial

+ 1-5 pts + 6-10 pts + 11-15 pts + 16-20 pts

* Global Assessment of Functioning (GAF) change score reported by

therapist at end of treatment

0%

.0

5

10

15

20

25

30

35

40

45

50

2011-122012-13

Outcome: CCAPS (Counseling Center Assessment of Psychological Symptoms)

This is first year of use at SPS 62 symptom questionnaire completed by

student at intake, followed by similar 34 question version at 3rd and final session60 students (of 300) measured, as they

received multiple CCAPS Asks students to rate each symptom

statement on a 0-4 scale, with 0 meaning it was “not at all like me” and 4 meaning it was “extremely like me”

Outcome: CCAPS (Counseling Center Assessment of Psychological Symptoms)

Items on the Hostility Scale- Overall, intended to show not danger but frustration, irritability, tension

I have difficulty controlling my temper I sometimes feel like breaking or

smashing things I get angry easily I feel irritable I am afraid I may lose control and act

violently I frequently get into arguments I have thoughts of hurting others

Outcome: CCAPS – Change Score – first to last administration - % improvement of “reliable change” NOTE: Subscale scores deflated due to beta version

Depression Anxiety Social Anx. Academic Eating Hostility Alcohol Distress0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

Areas of Strength

Client satisfaction Diversity of services (individual,

Spanish-speaking, psychiatry, outreach) Access – very good capability to see

students immediately Large number of students reached

through classroom presentations Robust training program and very

satisfied trainees

Areas of improvement this year Improved communication with

community clinics and increased referrals -> more capacity here

Expanded “pro bono” program where therapists in the community see SRJC students for free

Improved access – almost all students seen immediately

Much shorter wait list

Areas for focus next year

Transition to new supervisors Streamline client and therapist

paperwork Further refinement of intake/triage/wait

list Technology: Expand website & Bring on

Electronic Medical Records Further implement new, extensive

Outcome Measurement system

Questions & Comments