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 Therapy Psychiatric Services  Therapy Drop-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 =

Specialized Services (8/20 - 4/30)  Spanish-Speaking Therapy (10 hrs/wk) & Psychiatric Service (4 hrs/wk)

Drop-In Appointments (8/15-4/15) 33% increase last year over previous; 11% increase this year

Accessibility % Students requesting drop-in seen same day: (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: : 5 Days (Spring Semester): 0 Days

Wait List … The Good News:  Average number students on Wait List: : : 22  Average number days from first contact to first ongoing therapy appointment (not including drop-in appointment): : : 29  Students Who Did Not Respond to Call After Being Put on Wait List:  : 54% : 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 pts pts pts pts  * Global Assessment of Functioning (GAF) change score reported by therapist at end of treatment

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 3 rd and final session 60 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

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