1. Counseling Services Director of Counseling Services
Sue Reimondo
Counseling Services Director of Counseling Services
Individual Therapy Sessions

2. Eliminate wait list, avoid burnout while sustaining quality treatment.
Mission
In support of Berea College’s mission, Counseling Services promotes the psychological, interpersonal, academic, and vocational development of students while providing mental health consultation to students and the campus community.
Vision
Eliminate wait list, avoid burnout while sustaining quality treatment.

3. SIPOC Suppliers Inputs Policies Outputs Customers
-Students (Self-referral)
-Faculty/Staff
-Previous Therapist
-Parent(s)
-White House Clinics
-Friends
-Campus Life
-Public Safety
-Disability Services
-Campus Christian Center
-Student of Concern team
Clients s
Referral or Follow-Up from Student of Concern
Requests for Information
Requests for Trainings
Requests for presentations
Info from previous therapists
-HIPPA
-FERPA
-Professional Ethics
(i.e. age of students you can see w/o consent, When you must break confidentiality, Residential Life, Labor Requirement, Full Time Student Requirement, Swim Requirement, Emotional Support Animal Policy)
-Consent for Treatment
-Release of Information
-65 Programs(Last Year)
-Individual Therapy Sessions
-Couple Sessions
-Group Sessions
-Faculty/ Labor Consultation
-Trainings
-Overview of Services
-Preventative Measures
-Crisis Intervention
-“On Call” Services
-Committee Work
-Grant Admin
-Psychological Assessment
-Medication Management
-Reports
-Session Documentation
-Students
-Faculty
-Staff
-CELTS
-Couples
-Groups
-Parents/ Guardians
-White House Clinics (Information)
-Bridge Program
-Virgil Burnside
-ARCT

4. Hi-Level Process Map 2016-2017 academic year
Volume = 428 distinct students, 2280 sessions per yr.
Lead Time = Max. wait list days before scheduling.
Rework = Continual cycle of expediting, rescheduling.
Constraint = Under current treatment plan students may remain in therapy longer than our current model can sustain. Therapists scheduled at max capacity requiring costly rework to handle “known unknown” emergencies.
Hi-Level Process Map
academic year
Students request services
Student self-assesses triage form
Student waitlisted if not emergency
Appointment scheduled
Students fill out intake forms
Therapy begins
Volume: 428 Students/2280 Sessions
Peak Wait Time: 102 Days
Hours Available: 86 hours per week
Session Time: minutes
Average # of Sessions: 5
Psychiatric Hours Available: 11
On Call: 1 week at a time

5. SWOT Analysis Internal External Strengths Weaknesses Threats
Opportunities
SWOT Analysis
Internal
External
Fully Licensed Therapists
Caring Staff
Experience/Berea Experience
Relationship With Campus
Location and Space
Creative
Varied Areas of Expertise
Generalists
Supremacy of Academics
Student Demographics
Lack of Family Support
Lack of Part Time Option
Lack of Support from Faculty
Increased Funding
Create Group Culture
Educating Faculty/Staff
Support from Marketing & Communications
Online Scheduling Assessment
Center Hours
Targeted Programs
Termination Conversations
Transition to different leadership style
Technology (Reaching different outreach mediums)
Reactive
Lack of time for program development
Misalignment of Understanding Responsibility
High Demand-Low Supply (27% of campus seen)
1 administrative assistant

6. At current staffing levels and program offerings therapists
Problem Statement
At current staffing levels and program offerings therapists
cannot meet demand.
Students in need of non-emergency care frequently wait-listed
for services (max wait list 102 days). Therapists
scheduled to max capacity which triggers costly expediting/rescheduling
when faced with “emergency” situations.
Inability to meet with students early in a crisis cycle may lead to
intentional or unintentional escalation of crisis.

7. Charter
Mission – In support of Berea College’s mission, Counseling Services promotes the psychological, interpersonal, academic, and vocational development of students while providing mental health consultation to students and the campus community.
Burning platform – Waitlisted students may intentionally or unintentionally escalate crisis. Therapists scheduled to max capacity required to expedite/reschedule to meet emergency situations.
Process Description – From request for services to delivery of services
Problem Statement – At current levels of staffing and program offering, we can’t meet demand.
Sponsor – Virgil Burnside
Process Owner – Sue Reimondo
Team Lead – Sue Reimondo/Joshua Johnson
Facilitator – Aaron Beale
Team – Sue Reimondo, Tricia Isenstein, Debra Ratliff, Julie LeBrun, Joshua Johnson, Angela Taylor, Brandon Noble

8. Current State Value Stream Analysis

9. Current State Students scheduled based on limited availability
Students placed on wait list once available scheduled sessions are booked. (102 day max. wait list time
recorded)
Therapists scheduled at max. capacity with expediting/rescheduling needed to handle emergencies
or crisis.
Capacity Totals:
100% variability/unpredictability in induction schedule.
214 individual students seen per term.
(428 students for entire fiscal calendar year)
1,140 individual sessions per term.
(2,280 sessions conducted for entire fiscal calendar year)

10. Future State Overview

11. Future State induction example (full-time therapist)

12. Future State Value Stream Analysis

13. Future State On Demand Induction Schedule:
Therapists available to provide same day service up to induction maximum. After that level reached students seen during next days induction with max. wait of 24 hours.
Monday: Debra can induct 2-3 new students weekly (30 per term)
Tuesday: Sue can induct 2-3 new students weekly (30 per term)
Wednesday: Julie can induct 5 new students weekly (60 per term)
Thursday: Josh can induct 6 new students weekly (72 per term)
Friday: Tricia can induct 6 new students weekly (72 per term)
Group Therapy:
Students directed to group therapy upon completion of 4 session 6 week cycle. “Skills based” groups offered daily to facilitate access and support students transition from individual care.
Capacity Totals:
New student inductions per week
Individual students served per term (Up to 528 students per Fall/Spring terms)
1,564 Individual sessions available per term (Includes backfill of returning clients)

14. Future State Process Script
(explanation to students)
“Our Counseling Services data and outside research shows that individual sessions reach their max.
therapeutic value in 3-4 sessions. We believe that you can graduate to group care, or no regularly
scheduled care, in this time. Our therapy sessions are specifically designed to bring needed relief
in 4 sessions. We believe that most students can thrive after that with the help of ongoing group
therapy if necessary. However, we will always be here for you. If, after trying our groups, you feel
the need for more individual sessions, come in and see me on my new patient day and we will start
another cycle.”

15. Future State Induction Tracking Board

16. Future State Color Coded Cycle Calendar

17. Future State Color Coded Schedule Guide

18. Results Sessions conducted 8/21-11/10 2017 (12 weeks) = 932
Serving 296 individual students
Sessions conducted 8/22-11/ (12 weeks) = 758
Serving 252 individual students
Crisis appointments 8/21-11/ (12 weeks) = 22
Crisis appointments 8/22-11/ (12 weeks) = 57
We believe our “same day” service model for 2017 has contributed significantly to
the dramatic reduction in “Crisis” appointments.
So far in 2017 NO WAIT LIST FOR SERVICES
2016 UP TO 102 DAY WAIT LIST TO HAVE APPOINTMENT SCHEDULED
Savings calculation:
If increase in sessions continues at the same rate observed in 12 week sample for 11 months (Counselors work an 11 month contract) the Counseling Center will be able to provide an additional 696 sessions.
WITH NO WAIT LIST FOR SERVICES!
To convert this additional capacity to a dollar figure we used the bottom of the insurance reimbursement scale ($55) and multiplied that figure by the additional capacity. (696 x $55 = $38,280 worth of increased capacity)

19. Future State Group Therapy Flyer

20. Call or email anytime, but send what you have so far
Progress Check
Call or anytime, but send what you have so far