Center for Collegiate Mental Health (CCMHPENN STATE '6 rm CE Togeth Acknowledgements D E PA R T M E N T O F P S Y C H O L O G Y: The 2014 Annual Report was made possible by: ➤ Collaborative efforts of over 280 university and college counseling centers ➤ Association of University and College Counseling Center Directors (AUCCCD) ➤ Titanium Software, Inc. ➤ van Ameringen Foundation ➤ Student Affairs Administrators in Higher Education (NASPA) ➤ American College Counseling Association (ACCA) ➤ American College Personnel Association (ACPA) ➤ Commission for Counseling and Psychological Services (CCAPS) ➤ The American Foundation for Suicide Prevention (AFSP) ➤ Penn State University’s Student Affairs Professor of Clinical Psychology Louis G. Castonguay, Ph.D. CCMH Research Team at Penn State University E X E C U T I V E D I R E C TO R : Doctoral Students in Clinical Psychology Rebecca Janis, B.S. Soo Jeong Youn, M.S. Andrew McAleavey, M.S. Henry Xiao, B.A. CCMH Advisory Board Members (2014) Rob Davies, Ph.D.—Assistant Director, University of Utah Counseling Center Dennis Heitzmann, Ph.D.—(ex-officio)—Director, Counseling and Psychological Services, Penn State University Nathaniel Hopkins, Ph.D.—Staff Psychologist, Coordinator for Information and Systems, University of Kentucky Counseling Center Shelly Lear, Ph.D.—Director of Counseling and Student Wellness, Hobart and William Smith Colleges Brian Mistler, Ph.D.—Associate Dean of Students and Ben Locke, Ph.D.—Associate Director, Clinical Services, Director of Health Services, Ringling College of Art and Design PROJECT MANAGER: Ariella Soffer, Ph.D.—Intake Coordinator, Counseling and Wellness Services, Hunter College Counseling and Psychological Services Ashley Stauffer, M.S. COUNSELING AND P S Y C H O LO G I C A L S E R V I C E S : Kristin Hogan, Psy.D.—Post Doctoral Fellow Aki Kawamoto, Ph.D.—Staff Psychologist & Assessment Robert Tringone, Ph.D.— Staff Psychologist, St. John’s University Curtis Wisely, Psy.D.—Director of Counseling Services, School of Professional Counseling, Lindsey Wilson College Coordinator N E W M E M B E R S I N 2 01 4 : Brett Scofield, Ph.D.—Assistant Director, Research and Cynthia Cook, Ph.D.—Executive Director of Counseling, Technology Shannan Smith-Janik, Ph.D.—Staff Psychologist & Practicum Coordinator Leann Terry Diederich, Ph.D.—Staff Psychologist & Health, and Career Services, University of Houston– Clear Lake Michelle Cooper, Ph.D.—Clinical Director Counseling and Psychological Services, Western Carolina University Group Therapy Coordinator Carolyn Heitzmann, Ph.D.—University of Delaware, D E PA R T M E N T O F E D U C AT I O N A L P S Y C H O LO G Y, C O U N S E L I N G , A N D S P E C I A L E D U C AT I O N : David Reetz, Ph.D. (AUCCCD liaison)—Director, Professors of Counseling Psychology Kathleen Bieschke, Ph.D. Jeffrey A. Hayes, Ph.D. Center for Counseling and Student Development Aurora University Counseling Services Ryan Weatherford, Ph.D.—Professor and Staff Psychologist, Counseling and Psychological Services, West Chester University Recommended Citation Center for Collegiate Mental Health. (2015, January). 2014 Annual Report (Publication No. STA 15-30). Table of Contents 1 CCMH: Bringing Science and Practice Together— Introduction and Orientation 2 Standardized Data Set (SDS) 7 Mental Health History Items 20 Mental Health Trends 21 Appointment Categories 21 Critical Incident Form (CIF) 22 Clinician Index of Client Concerns (CLICC) 26 Counseling Effectiveness 27 Client Dropout 27 Counselor Survey Update 29 Average Number of Attended Individual Sessions 29 Counseling Center Resource Utilization by Clients 30 Comparisons by Gender, Race, and Previous Mental Health Utilization 32 Provider Data 34 Center Information 35 Participating Institutions 35 CCMH Member Institutions 38 References CCMH: Bringing Science and Practice Together INTRODUCTION AND ORIENTATION The mental health of today’s college students continues to be a top-level concern for institutions of higher education, whether it is viewed from the perspective of staffing mental health services on campus, responding to after-hours crises in residence halls, providing accessible treatment with limited budgets, managing behavioral threats, or maintaining student safety during personal crises. With the backing of more than 280 counseling centers, multiple national organizations, and the addition a full-time project manager in 2014, CCMH is striving to infuse the national dialogue about college student mental health with high quality data that is capable of informing policy. This year’s report summarizes data contributed to CCMH during the 2013-2014 academic year, closing on June 30, 2014. De-identified data were contributed by 140 college and university counseling centers, describing 101,027 unique college students seeking mental health treatment, 2,900 clinicians, and over 770,000 appointments The following are key concepts to keep in mind while reviewing this report: 1) Counseling center members, that contributed data for research, first received local IRB approval. 2) The actual number of clients may vary by question because not all questions are asked at each center. 3) CCMH members using Titanium Schedule are able to contribute all clinical data described in this report. CCMH members using the CCAPS Web service (via Medicat, Point and Click, and Pyramed) are currently only able to contribute CCAPS data. 4) Because data is gathered as part of routine clinical practice at participating counseling centers, CCMH clinical data is thought to closely represent the population of students who are seeking services at participating institutions that contribute data. ➤ Standardized Data Set (SDS)—The SDS was not changed during 2013-2014. One new data form was added: Clinician Index of Client Concerns (CLICC)— Designed by the CCMH Advisory Board, the CLICC was added to Titanium for pilot testing in 2013 with the goal of refining for the 2015-2016 year. The data resulting from the CLICC will help to answer two common and important questions about students seeking mental health treatment at the local and national levels: (1) “What are the most common concerns of students seeking mental health services?” and (2) “What are the primary concerns of students seeking services?” The form is comprised of 43 checkbox items, and the clinician is asked the following: • “Please indicate your assessment of the client’s primary concerns (check those that apply)” and • “Choose the top concern of those already selected” ➤ The Counseling Center Assessment of Psychological Symptoms (CCAPS)–The CCAPS was last re-designed in the summer of 2012. Please email ccmh@psu.edu for more information about the CCAPS, the CCAPS Technical Manual, the CCAPS Clinician’s Guide, or the CCAPS Training Webinar. ➤ Recent Publications—CCMH is excited to share with you the following publications that have occurred in the past academic year: • Castonguay, L.G. & Muran, J.C. (2015). Fostering collaboration between researchers and clinicians through building practice-oriented research: An introduction. Psychotherapy Research, 23(1),1-5, doi: 10.1080/10503307.2014.966348 • Effrig, J.C., Maloch, J.K., McAleavey, A.A., Locke, B.D., & Bieschke, K.J. (2014). Change in depressive symptoms among treatment seeking college students who are sexual minorities. Journal of College Counseling, 17, 271-285. doi: 10.1002/j.2161-1882.2014.00063.x • McAleavey, A.A., Lockard, A.J. Castonguay, L.G, Hayes, J.A., & Locke, B.D. (2015). Building a practice research network: Obstacles faced and lessons learned at the Center for Collegiate Mental Health. Psychotherapy Research, 25(1), 134-151, doi: 10.1080/10503307.2014.883652 • Johnson, M.C., Graceffo, J.M., Hayes, J.A., & Locke, B.D. (2014). Examining treatmentseeking college students with and without military experience and trauma histories. Journal of College Counseling, 14, 260- 270. doi: 10.1002/j.21611882.2014.00062.x • Lockard, A.J., Hayes, J.A., Neff, K. & Locke, B.D. (2014). Self-compassion among college counseling center clients: An examination of clinical norms and group differences. Journal of College Counseling, 17, 249- 259. doi: 10.1002/j.2161-1882.2014.00061.x 1 • Nordberg, S.S., Hayes, J.A., McAleavey, A.A., Castonguay, L.G., & Locke, B.D. (2013). Treatment utilization on college campuses: Who seeks help for what? Journal of College Counseling, 16, 258-274, doi: 10.1002/j.21611882.2013.00041.x • Castonguay, L.G., (2013). Psychotherapy outcome: A problem worth re-revisiting 50 years later. Psychotherapy, 50(1), 52-67, doi: 10.1037/ a0030898 • Lockard, A.J., Hayes, J.A., & Graceffo, J. (2013). Effective counseling for ethnic minority clients: Examining changes utilizing a practice-research network. Journal of College Counseling, 16, 243256, doi: 10.1002/j.2161-1882.2013.00040.x • Maloch, J.K., Bieschke, K.J., McAleavey, A.A., Castonguay, L.G., & Locke, B.D. (2013). Eating concerns in college women across sexual orientation identities. Journal of College Counseling, 16(3), 275-288, doi: 10.1002/j.21611882.2013.00042.x • Nordberg, S.S., Castonguay, L.G., Fisher, A.J., Boswell, J.F., & Kraus, D. (2014). Validating the rapid responder construct within a practice research network. Journal of Clinical Psychology, 70(9), 886-903, doi: 10.1002/jclp.22077 Center Stories #1 At our center we collect and use CCMH data for a variety of uses. Each year the data is used in our annual report. This year I added the CLICC data to share the primary concerns at intake. Since we also require our staff to fill out a CLICC form at closing, I was able to provide this data in the report as well. In addition we use the CCAPS at every session to help track client progress. — Joe Hamilton, M.A., L.P.C., Assistant Director, University Counseling Services, Truman State University Standardized Data Set (SDS) The Standardized Data Set (SDS) was developed with input from more than 140 counseling centers and represents a uniform set of questions typically asked of students seeking services. Because not all centers ask all questions, the total number of responses varies by question. What is your gender identity?* n Percentage Woman 54,960 62.4 Man 32,358 36.7 Transgender 254 0.3 Self-Identify 480 0.5 This question is from the Standardized Data Set Question #88 What was your sex at birth? Overall (%) n=8,112 Male (%) n=2,997 Female (%) n=5,078 Transgender (%) n=19 Self-Identity (%) n=5,078 Female 66.1 0.2 99.7 47.4 70.5 Male 33.8 99.8 0.3 52.6 27.9 0.0 0.0 0.0 0.0 1.6 Transgender (%) n=238 Self-Identity (%) n=471 22.7 9.8 9.3 Intersex This question is from the Standardized Data Set Question #90 Do you consider yourself to be: Overall (%) n=81,445 Heterosexual Male (%) n=29,874 Female (%) n=50,862 86.1 87.0 86.6 Lesbian 1.7 0.0 2.5 7.6 Gay 2.8 7.2 0.1 5.9 6.8 Bisexual 4.7 2.5 5.9 18.1 10.6 Questioning 2.1 1.7 2.3 6.3 7.0 Self-Identify 2.6 1.5 2.6 39.5 56.5 This question is from the Standardized Data Set Question #91 2 Since puberty, with whom have you had sexual experience(s)? Overall (%) n=7,239 Male (%) n=2,545 Female (%) n=4,631 Transgender (%) n=17 Self-Identity (%) n=46 47.2 4.8 71.0 5.9 17.4 Mostly with men 8.6 2.8 11.8 0.0 15.2 About the same number of men and women 1.6 1.0 1.8 23.5 15.2 Only with men Mostly with women 2.6 4.2 1.5 29.4 13.0 Only with women 26.7 73.4 1.3 17.6 15.2 I have not had sexual experiences 13.2 13.9 12.7 23.5 23.9 This question is from the Standardized Data Set Question #93 People are different in their sexual attraction to other people. Which best describes your current feelings? Are you: Overall (%) n=8,346 Only attracted to women Male (%) n=3,026 Female (%) n=5,254 Transgender (%) n=17 Self-Identity (%) n=49 31.4 82.1 2.4 17.6 10.2 Mostly attracted to women 4.4 7.7 2.1 58.8 20.4 Equally attracted to women and men 3.2 1.3 3.9 11.8 36.7 Mostly attracted to men 11.4 3.1 16.2 5.9 16.3 Only attracted to men 48.1 4.6 73.7 5.9 6.1 1.5 1.2 1.7 0.0 10.2 Female (%) n=51,981 Transgender (%) n=243 Self-Identity (%) n=463 Not sure This question is from the Standardized Data Set Question #94 What is your race/ethnicity? Overall (%) n=83,436 Male (%) n=30,749 African-American/ Black 9.6 8.0 10.6 5.8 3.7 American Indian or Alaskan Native 0.4 0.3 0.4 1.2 1.1 Asian American/Asian 6.6 6.9 6.5 4.1 5.4 Hispanic/Latino/a 7.6 7.1 7.9 8.6 5.0 Native Hawaiian or Pacific Islander 0.2 0.2 0.2 0.4 0.0 Multiracial White Self-Identify 4.6 4.2 4.8 4.5 7.8 69.3 71.2 68.2 74.1 68.3 1.7 2.1 1.5 1.2 8.9 This question is from the Standardized Data Set Question #95 3 What is your country of origin? Country n Country n Country n Country n Country n Afghanistan 87 Ecuador 88 Jordan 27 Peru 131 Turkey Albania 33 Egypt 41 Kenya 40 Philippines 166 Uganda 17 Argentina 55 El Salvador 48 78 Ukraine 47 Australia 48 Eritrea 11 32 Ethiopia 56 United Arab Emirates 16 Bahamas Korea, Democratic People's Republic of Bangladesh 92 Finland 13 Belarus 13 France 67 Belgium 15 Germany Bolivia 31 Ghana Bosnia and Herzegovina Brazil 30 200 Bulgaria 39 Cameroon 24 Canada 286 Chile 48 China 935 Colombia 278 Congo, The Democratic Republic of the 11 Costa Rica 25 Cuba 95 Czech Republic 12 Denmark 11 Dominican Republic 103 Poland 51 Puerto Rico Romania Korea, Republic of 401 Russian Federation 241 44 150 United Kingdom United States 215 72305 Kuwait 31 Rwanda 80 Lebanon 28 Saudi Arabia Greece 35 Liberia 17 Senegal 16 United States Minor Outlying Islands Guatemala 47 Lithuania 11 Serbia 18 Uruguay 48 Sierra Leone 15 Uzbekistan 15 Singapore 21 Venezuela 167 Somalia 11 Vietnam 154 South Africa 37 28 14 171 Guinea Guyana Haiti 12 Malaysia 30 Mexico 135 Honduras 41 Hong Kong 52 India 746 Indonesia Iran, Islamic Republic of 42 208 425 12 90 173 Moldova, Republic of 11 Morocco 22 Spain 40 Virgin Islands, U.S. Netherlands 31 Sri Lanka 34 Zimbabwe New Zealand 24 Sudan 24 Sweden 35 Nigeria 127 Norway 29 Switzerland 17 12 Syrian Arab Republic 20 Iraq 31 Oman Ireland 37 Pakistan Israel 43 Taiwan 94 Italy 89 Palestinian Territory, Occupied 36 Thailand 54 Panama 37 Trinidad and Tobago 51 Paraguay 14 Jamaica 141 Japan 87 136 224 12 Countries with less than 10 individuals: Aland Islands Burundi Kyrgyzstan Niger Algeria Cambodia Northern Mariana Islands American Samoa Cape Verde Lao People’s Democratic Republic Andorra Cayman Islands Latvia Qatar Angola Christmas Island Anguilla Comoros Antigua and Barbuda Congo Armenia Cote D’ivoire Aruba Croatia Austria Cyprus Azerbaijan Dominica Bahrain Estonia Barbados Fiji Belize Gambia Benin Georgia Bermuda Grenada Bhutan Guam Botswana Hungary Brunei Darussalam Iceland Burkina Faso Kazakhstan This question is from the Standardized Data Set Question #31 4 Lesotho Libyan Arab Jamahiriya Luxembourg Macao Macedonia, The Former Yugoslav Republic of Malawi Mali Marshall Islands Mauritania Mauritius Mongolia Montenegro Mozambique Myanmar Nauru Netherlands Antilles Portugal Saint Kitts and Nevis Saint Lucia Slovakia Slovenia Suriname Swaziland Tajikistan Tanzania, United Republic of Togo Tunisia Turkmenistan Turks and Caicos Islands Vanuatu Virgin Islands, British Yemen Zambia Are you an international student? Overall (%) n=83,083 Male (%) n=30,140 Female (%) n=52,255 Transgender (%) n=238 Self-Identity (%) n=450 Yes 4.7 5.7 4.1 2.1 3.8 No 95.3 94.3 95.9 97.9 96.2 Transgender (%) n=206 Self-Identity (%) n=410 This question is from the Standardized Data Set Question #32 Are you the first generation in your family to attend college? Overall (%) n=72,420 Male (%) n=26,192 Female (%) n=45,612 Yes 23.5 21.5 24.7 21.4 23.7 No 76.5 78.5 75.3 78.6 76.3 Transgender (%) n=244 Self-Identity (%) n=463 18.8 This question is from the Standardized Data Set Question #56 Current academic status Overall (%) n=82,268 Male (%) n=31,151 Female (%) n=53,410 Freshmen/first-year 19.6 18.9 20.0 20.9 Sophomore 20.3 20.0 20.5 16.8 19.4 Junior 22.7 23.3 22.4 20.9 22.0 Senior 22.1 22.5 21.8 25.4 21.2 Graduate/professional degree student 13.6 13.2 13.9 12.3 16.0 Non-student 0.2 0.3 0.2 0.8 0.2 High school student taking college classes 0.0 0.0 0.0 0.0 0.0 Non-degree student 0.3 0.3 0.3 0.4 0.0 Faculty or staff 0.1 0.1 0.1 0.0 0.0 Other 1.0 1.2 0.9 2.5 2.4 Female (%) n=16,912 Transgender (%) n=73 Self-Identity (%) n=149 This question is from the Standardized Data Set Question #37 Graduate or professional degree program Overall (%) n=27,436 Male (%) n=10,302 Post-Baccalaureate 12.7 12.2 13.1 9.6 4.0 Masters 13.6 11.8 14.6 11.0 18.1 Doctoral degree 7.2 8.1 6.6 6.8 8.1 Law 2.1 2.4 1.9 4.1 0.7 Medical 1.9 1.8 2.0 0.0 0.7 Pharmacy 0.6 0.5 0.6 1.4 0.0 Dental 0.2 0.2 0.2 0.0 0.0 Veterinary Medicine 0.6 0.2 0.9 2.7 0.0 55.2 57.0 54.1 61.6 65.1 6.0 6.0 6.1 2.7 3.4 Not Applicable Other This question is from the Standardized Data Set Question #39 5 What year are you in your graduate/professional program? Overall (%) n=13,633 Male (%) n=5,235 Female (%) n=8,298 Transgender (%) n=33 Self-Identity (%) n=67 1 34.4 33.3 35.1 30.3 37.3 2 25.3 22.7 27.0 21.2 22.4 3 15.7 16.3 15.3 21.2 14.9 4 17.0 18.4 16.1 21.2 13.4 5+ 7.6 9.3 6.4 n<10 11.9 Transgender (%) n=217 Self-Identity (%) n=433 This question is from the Standardized Data Set Question #41 Did you transfer from another campus/institution to this school? Overall (%) n=79,415 Male (%) n=29,106 Female (%) n=49,659 Yes 21.3 22.5 20.5 26.7 24.9 No 78.7 77.5 79.5 73.3 75.1 Transgender (%) n=199 Self-Identity (%) n=399 This question is from the Standardized Data Set Question #46 What kind of housing do you currently have? Overall (%) n=71,433 On-campus residence hall/apartment Male (%) n=26,047 Female (%) n=44,788 37.2 35.3 38.3 43.2 34.8 On/off campus fraternity/sorority house 2.2 2.7 2.0 0.0 0.0 On/off campus co-operative housing 1.0 1.1 1.0 0.0 n<10 58.3 59.5 57.6 55.8 60.9 1.3 1.5 1.1 n<10 n<10 Off-campus apartment/house Other This question is from the Standardized Data Set Question #42 With whom do you live? (check all that apply) Overall (%) Male (%) Female (%) Transgender (%) Self-Identity (%) Alone 10.3 (n=9,033) 10.7 (n=3,459) 10.0 (n=5,477) 14.6 (n=37) 12.5 (n=60) Spouse, partner, or significant other 7.8 (n=6,889) 6.8 (n=2,220) 8.4 (n=4,606) 10.6 (n=27) 11.7 (n=56) Roommate(s) 49.7 (n=43,777) 49.2 (n=15,924) 50.1 (n=27,526) 45.7 (n=116) 45.7 (n=116) Children 2.2 (n=1,933) 1.5 (n=489) 2.6 (n=1,433) 0.8 (n<10) 1.9 (n<10) Parent(s) or guardian(s) 7.7 (n=6,752) 7.6 (n=2,445) 7.7 (n=4,231) 6.7 (n=17) 12.3 (n=59) Family other 3.4 (n=2,955) 3.2 (n=1,033) 3.4 (n=1,889) 3.5 (n<10) 5.0 (n=24) 1.1 (n=968) 1.0 (n=329) 1.1 (n=614) 2.4 (n<10) 4.0 (n=19) Other This question is from the Standardized Data Set Question #44 6 Relationship status Single Serious dating or committed relationship Overall (%) n=84,460 Male (%) n=30,954 61.6 67.5 Female (%) n=52,802 58.2 Transgender (%) n=243 Self-Identity (%) n=461 59.3 57.9 35.8 34.7 32.5 26.9 35.8 Civil union, domestic partnership, or equivalent 0.4 0.3 0.4 0.8 2.0 Married 4.3 4.2 4.3 2.9 4.6 Divorced 0.6 0.5 0.7 0.4 0.4 Separated 0.6 0.6 0.6 0.8 0.4 Widowed 0.1 0.0 0.1 0.0 0.0 Female (%) n=50,167 Transgender (%) n=232 Self-Identity (%) n=450 This question is from the Standardized Data Set Question #33 Mental Health History Items Attended counseling for mental health concerns Overall (%) n=79,841 Male (%) n=28,983 Never 52.0 56.8 49.5 29.3 27.6 Prior to college 18.7 16.7 19.9 22.4 20.9 After starting college 16.4 15.9 16.6 19.8 23.3 Both 12.9 10.7 14.0 28.4 28.2 Transgender (%) n=235 Self-Identity (%) n=445 This question is from the Standardized Data Set Question #1 Taken a prescribed medication for mental health concerns Overall (%) n=78,713 Never Male (%) n=28,508 Female (%) n=49,525 67.4 69.4 66.4 54.5 49.2 8.8 8.5 8.9 11.5 13.0 After starting college 12.9 12.5 13.1 13.2 18.2 Both 10.9 9.5 11.6 20.9 19.6 Prior to college This question is from the Standardized Data Set Question #2 Center Stories #2 At our counseling center we have mainly used the data for our annual report. We have also used CCMH data to share what the numbers look like for our small staff and how those numbers have been steadily increasing. The numbers were helpful a few years ago to change a part-time position into a full-time position. We have also been using the data to better show our consultation efforts. I think this will show how much extra advocacy and consult work we do. — Dan Dengel, Ph.D., Assistant Director, Student Counseling Center, La Salle University 7 NOTE: The following paired questions ask the student to identify “How many times” and “The last time” for each experience/event. Frequencies for “The last time” questions are based on students who reported having the experience one time or more. Been hospitalized for mental health concerns (how many times) Overall (%) n=82,467 Male (%) n=29,873 Female (%) n=51,892 Transgender (%) n=237 Self-Identity (%) n=465 Never 89.8 89.8 89.9 82.3 80.6 1 time 6.5 6.2 6.6 12.2 13.3 2-3 times 2.9 3.0 2.8 5.1 5.4 4-5 times 0.4 0.5 0.4 0.0 0.4 More than 5 times 0.4 0.5 0.4 0.4 0.2 This question is from the Standardized Data Set Question #64 Been hospitalized for mental health concerns (the last time) Overall (%) n=7,928 Male (%) n=2,851 Female (%) n=4,953 Transgender (%) n=38 Self-Identity (%) n=86 Never 1.4 1.5 1.4 2.6 0.0 Within the last two weeks 8.4 9.4 8.0 5.3 2.3 Within the last month 4.4 4.8 4.1 2.6 3.5 Within the last year 21.4 22.6 20.6 26.3 26.7 Within the last 1-5 years 39.4 37.3 40.6 28.9 44.2 More than 5 years ago 25.0 24.5 25.3 34.2 23.3 This question is from the Standardized Data Set Question #65 Purposely injured yourself without suicidal intent (e.g., cutting, hitting, burning, etc.) (how many times) Overall (%) n=82,347 Male (%) n=29,796 Female (%) n=51,851 Transgender (%) n=237 Self-Identity (%) n=463 39.3 Never 76.2 84.3 72.0 52.7 1 time 5.6 4.6 6.1 3.4 5.8 2-3 times 6.5 5.0 7.3 13.9 12.5 4-5 times 2.3 1.5 2.8 4.2 3.7 More than 5 times 9.4 4.6 11.8 25.7 38.7 This question is from the Standardized Data Set Question #72 Purposely injured yourself without suicidal intent (e.g., cutting, hitting, burning, etc.) (the last time) Never Within the last two weeks Within the last month Overall (%) n=16,212 Male (%) n=3,838 Female (%) n=12,021 Transgender (%) n=101 Self-Identity (%) n=252 1.2 1.7 1.0 0.0 0.8 14.2 15.1 13.8 9.9 19.0 8.4 8.5 8.4 11.9 7.5 Within the last year 20.6 20.9 20.4 25.7 22.2 Within the last 1-5 years 32.5 31.8 32.8 32.7 29.8 More than 5 years ago 23.2 22.1 23.6 19.8 20.6 This question is from the Standardized Data Set Question #73 8 Seriously considered attempting suicide (how many times) Overall (%) n=82,383 Male (%) n=29,877 Female (%) n=51,802 Transgender (%) n=238 Self-Identity (%) n=466 Never 69.0 71.4 68.2 31.9 35.2 1 time 11.5 10.9 11.8 18.9 15.0 2-3 times 11.0 9.7 11.6 21.0 19.5 4-5 times 2.2 1.9 2.4 7.1 6.0 More than 5 times 6.2 6.1 6.1 21.0 24.2 This question is from the Standardized Data Set Question #74 Seriously considered attempting suicide (the last time) Never Within the last two weeks Within the last month Overall (%) n=20,371 Male (%) n=6,776 Female (%) n=13,195 Transgender (%) n=134 Self-Identity (%) n=266 1.4 1.5 1.4 0.0 0.8 16.5 18.8 15.2 16.4 16.9 9.4 9.4 9.4 9.0 7.5 Within the last year 20.8 20.8 20.7 16.4 26.3 Within the last 1-5 years 34.0 33.0 34.6 36.6 32.0 More than 5 years ago 17.9 16.5 18.7 21.6 16.5 Transgender (%) n=236 Self-Identity (%) n=464 This question is from the Standardized Data Set Question #75 Made a suicide attempt (how many times) Overall (%) n=82,249 Male (%) n=29,798 Female (%) n=51,751 Never 91.1 93.0 90.2 75.0 72.8 1 time 6.0 4.8 6.5 13.1 15.5 2-3 times 2.3 1.8 2.6 8.9 9.5 4-5 times 0.3 0.2 0.3 0.8 0.6 More than 5 times 0.3 0.3 0.3 2.1 1.5 This question is from the Standardized Data Set Question #76 Made a suicide attempt (the last time) Overall (%) n=6,318 Male (%) n=1,777 Female (%) n=4,370 Transgender (%) n=55 Self-Identity (%) n=166 Never 1.4 1.7 1.3 0.0 0.0 Within the last two weeks 5.5 6.8 5.1 5.5 0.9 Within the last month 2.9 3.4 2.8 1.8 1.7 Within the last year 14.5 15.3 14.2 14.5 12.1 Within the last 1-5 years 42.8 40.9 43.4 40.0 49.1 More than 5 years ago 33.0 31.9 33.3 38.2 36.2 This question is from the Standardized Data Set Question #77 9 Considered causing serious physical injury to another (how many times) Overall (%) n=82,223 Male (%) n=29,780 Female (%) n=51,748 Transgender (%) n=237 Self-Identity (%) n=458 Never 89.1 86.1 91.0 81.0 74.0 1 time 3.4 3.9 3.0 4.6 6.1 2-3 times 3.9 5.1 3.2 7.2 7.9 4-5 times 0.8 1.0 0.7 1.3 2.2 More than 5 times 2.8 3.9 2.1 5.9 9.8 This question is from the Standardized Data Set Question #78 Considered causing serious physical injury to another (the last time) Never Within the last two weeks Overall (%) n=6,885 Male (%) n=3,167 Female (%) n=3,575 Transgender (%) n=38 Self-Identity (%) n=105 2.6 2.7 2.5 0.0 2.9 20.4 20.1 20.8 10.5 17.1 Within the last month 11.1 11.6 10.8 2.6 9.5 Within the last year 22.8 23.1 22.7 13.2 21.9 Within the last 1-5 years 29.3 28.6 29.6 42.1 35.2 More than 5 years ago 13.8 14.0 13.5 31.6 13.3 This question is from the Standardized Data Set Question #79 Intentionally caused serious physical injury to another (how many times) Overall (%) n=81,913 Male (%) n=29,685 Female (%) n=51,537 Transgender (%) n=233 Self-Identity (%) n=458 Never 96.7 95.2 97.6 92.7 93.4 1 time 1.6 2.3 1.3 3.9 2.2 2-3 times 1.1 1.5 0.8 2.6 2.2 4-5 times 0.2 0.3 0.1 0.4 0.9 More than 5 times 0.4 0.7 0.2 0.4 1.3 This question is from the Standardized Data Set Question #80 Intentionally caused serious physical injury to another (the last time) Overall (%) n=2,047 Male (%) n=1,075 Female (%) n=929 Transgender (%) n=13 Self-Identity (%) n=30 Never 3.2 2.1 4.5 0.0 3.3 Within the last two weeks 5.7 4.4 7.5 0.0 0.0 Within the last month 5.7 4.8 6.9 0.0 0.0 Within the last year 15.1 13.5 17.0 0.0 20.0 Within the last 1-5 years 36.7 37.5 35.8 46.2 30.0 More than 5 years ago 33.6 37.7 28.2 53.8 46.7 This question is from the Standardized Data Set Question #81 10 Someone had sexual contact with you without your consent (e.g., you were afraid to stop what was happening, passed out, drugged, drunk, incapacitated, asleep, threatened or physically forced) (how many times) Overall (%) n=81,408 Male (%) n=29,542 Female (%) n=51,171 Transgender (%) n=231 Self-Identity (%) n=464 Never 81.1 93.6 74.2 76.6 57.5 1 time 10.7 4.0 14.4 12.6 16.4 2-3 times 5.2 1.5 7.2 5.6 14.0 4-5 times 0.8 0.2 1.1 2.2 3.0 More than 5 times 2.3 0.7 3.1 3.0 9.1 This question is from the Standardized Data Set Question #82 Someone had sexual contact with you without your consent (e.g., you were afraid to stop what was happening, passed out, drugged, drunk, incapacitated, asleep, threatened or physically forced) (the last time) Overall (%) n=11,911 Male (%) n=1,462 Female (%) n=10,224 Transgender (%) n=50 Self-Identity (%) n=175 Never 1.0 2.0 0.9 0.0 0.6 Within the last two weeks 3.8 3.3 3.9 0.0 1.7 Within the last month 3.4 2.7 3.5 4.0 4.6 Within the last year 18.6 15.5 19.1 14.0 16.6 Within the last 1-5 years 38.1 29.8 39.3 30.0 41.7 More than 5 years ago 35.1 46.6 33.4 52.0 34.9 This question is from the Standardized Data Set Question #83 Experienced harassing, controlling, and/or abusive behavior from another person (e.g., friend, family member, partner, or authority figure) (how many times) Overall (%) n=81,979 Male (%) n=29,685 Female (%) n=51,598 Transgender (%) n=233 Self-Identity (%) n=463 46.4 41.5 Never 67.2 75.8 62.6 1 time 7.0 4.5 8.4 5.2 5.8 2-3 times 7.2 5.3 8.2 11.2 10.6 4-5 times 2.0 1.3 2.4 5.6 3.2 16.7 13.1 18.4 31.8 38.9 More than 5 times This question is from the Standardized Data Set Question #84 Experienced harassing, controlling, and/or abusive behavior from another person (e.g., friend, family member, partner, or authority figure) (the last time) Never Within the last two weeks Within the last month Overall (%) n=19,932 Male (%) n=5,263 Female (%) n=14,331 Transgender (%) n=104 Self-Identity (%) n=234 1.1 1.6 1.0 1.9 0.4 11.3 11.9 11.2 5.8 12.4 7.9 7.6 8.0 9.6 6.0 Within the last year 20.0 19.1 20.3 25.0 24.8 Within the last 1-5 years 36.6 30.9 38.7 38.5 38.9 More than 5 years ago 23.0 29.0 20.9 19.2 17.5 This question is from the Standardized Data Set Question #85 11 Experienced a traumatic event that caused you to feel intense fear, helplessness, or horror (how many times) Overall (%) n=80,131 Male (%) n=29,094 Female (%) n=50,358 Transgender (%) n=227 Self-Identity (%) n=452 Never 62.0 67.6 59.0 53.3 46.2 1 time 16.7 14.0 18.3 15.4 13.7 2-3 times 12.6 11.0 13.4 17.2 21.0 4-5 times 2.2 1.8 2.4 4.0 2.2 More than 5 times 6.4 5.5 6.9 10.1 16.8 This question is from the Standardized Data Set Question #86 Experienced a traumatic event that caused you to feel intense fear, helplessness, or horror (the last time) Overall (%) n=22,192 Never Within the last two weeks Within the last month Male (%) n=6,862 Female (%) n=15,035 Transgender (%) n=87 Self-Identity (%) n=208 1.2 1.4 1.1 1.1 0.0 12.1 13.6 11.6 5.7 7.2 7.2 8.0 6.9 3.4 4.8 Within the last year 22.2 22.4 22.1 20.7 22.1 Within the last 1-5 years 34.9 32.6 35.8 39.1 39.9 More than 5 years ago 22.5 22.1 22.6 29.9 26.0 This question is from the Standardized Data Set Question #87 Center Stories #3 The University of Kentucky has, in contrast to the national trend, been increasing its enrollment. The result has been a number of conversations at various levels of the administration about capacity for student services. We have presented information to several audiences including the Board of Trustees, the Provost, and administrative leaders in Academic Affairs that illustrate how that growth has impacted and continues to impact what we do. We have, somewhat successfully, made an argument for increased staffing, as well as space for those staff and related budget. We have presented a lot of data, primarily usage and staffing information, but also CCMH-related data such as: • Change in CCAPS critical items to demonstrate effectiveness • CCAPS change curves to talk about the benefit of extending treatment time to argue that we need to maintain our center as a treatment service and not become assessment and referral or crisis response. • CLICC data to talk about anxiety as replacing depression as the most prevalent presenting problem, and how we are developing more anxietyfocused workshops as well as implementing Therapist Assisted Online tools for anxiety. — Nathaniel Hopkins, Ph.D., HSPP, Staff Psychologist, Coordinator for Information and Systems, University of Kentucky Counseling Center 12 Please select the traumatic event(s) you have experienced: Overall (%) n=18,966 Male (%) n=5,609 Female (%) n=13,126 Transgender (%) n=80 Self-Identity (%) n=151 Childhood physical abuse 18.9 (n=3,581) 19.4 (n=1,087) 18.0 (n=2,369) 23.8 (n=19) 29.8 (n=45) Childhood sexual abuse 16.7 (n=3,170) 10.1 (n=569) 19.0 (n=2,493) 23.8 (n=19) 23.8 (n=36) Childhood emotional abuse 45.9 (n=8,704) 42.4 (n=2,377) 46.0 (n=6,036) 62.5 (n=50) 59.6 (n=90) Physical attack (e.g., mugged, beaten up, shot, stabbed, threatened with a weapon) 15.8 (n=3,004) 24.2 (n=1,356) 11.7 (n=1,536) 23.8 (n=19) 21.9 (n=33) Sexual violence (rape or attempted rape, sexually assaulted, stalked, abused by intimate partner, etc.) 27.2 (n=5,151) 6.7 (n=378) 35.0 (n=4,5996) 36.3 (n=29) 46.4 (n=70) Military combat or war zone experience 1.4 (n=256) 3.2 (n=178) 0.5 (n=69) 2.5 (n<10) 0.7 (n<10) Kidnapped or taken hostage 1.2 (n=222) 1.0 (n=54) 1.2 (n=160) 1.3 (n<10) 2.6 (n<10) 12.3 (n=2,335) 15.2 (n=850) 10.8 (n=1,415) 13.8 (n=11) 12.6 (n=19) Terrorist attack 0.9 (n=174) 1.6 (n=87) 0.6 (n=84) 0.0 (n=0) 0.7 (n<10) Near drowning 9.9 (n=1,882) 13.9 (n=782) 7.9 (n=1,034) 13.8 (n=11) 12.6 (n=19) Diagnosed with life threatening illness 4.3 (n=812) 4.9 (n=276) 3.9 (n=508) 6.3 (n<10) 5.3 (n<10) Natural disaster (e.g., flood, quake, hurricane, etc.) 5.2 (n=981) 6.3 (n=354) 4.6 (n=600) 5.0 (n<10) 4.6 (n<10) Imprisonment or torture 1.2 (n=230) 2.5 (n=140) 0.6 (n=77) 2.5 (n<10) 3.3 (n<10) Animal attack 4.0 (n=761) 5.3 (n=297) 3.3 (n=436) 3.8 (n<10) 8.6 (n=13) 24.8 (n=4,706) 26.0 (n=1,460) 23.8 (n=3,122) 25.0 (n=20) 19.2 (n=29) Serious accident, fire, or explosion (e.g., an industrial, farm, car, plane, or boating accident) Other (please specify) This question is from the Standardized Data Set Question #99 ** The total N includes treatment seeking students who reported having experienced at least 1 trauma experience on the SDS Question #99. 13 Felt the need to reduce your alcohol or drug use (how many times) Overall (%) n=79,654 Male (%) n=28,884 Female (%) n=50,100 Transgender (%) n=228 Self-Identity (%) n=442 Never 73.3 67.0 77.0 74.6 67.6 1 time 10.1 10.9 9.6 11.4 12.0 2-3 times 9.8 12.0 8.6 7.9 10.6 4-5 times 1.7 2.2 1.4 2.2 2.9 More than 5 times 5.1 7.9 3.4 3.9 6.8 This question is from the Standardized Data Set Question #66 Felt the need to reduce your alcohol or drug use (the last time) Overall (%) n=16,405 Male (%) n=7,353 Female (%) n=8,881 Transgender (%) n=48 Self-Identity (%) n=123 2.4 2.2 2.6 0.0 2.4 29.2 33.1 26.0 16.7 30.9 Within the last month 17.1 18.0 16.4 18.8 9.8 Within the last year 29.1 27.4 30.4 25.0 30.9 Within the last 1-5 years 18.6 16.1 20.6 27.1 25.2 3.6 3.2 4.0 12.5 0.8 Never Within the last two weeks More than 5 years ago This question is from the Standardized Data Set Question #67 Others have expressed concern about your alcohol or drug use (how many times) Overall (%) n=79,553 Male (%) n=28,838 Female (%) n=50,039 Transgender (%) n=230 Self-Identity (%) n=446 Never 82.7 77.7 85.6 86.1 79.4 1 time 7.2 8.3 6.5 3.0 8.7 2-3 times 6.2 7.9 5.1 6.5 7.0 4-5 times 1.1 1.4 0.9 2.6 0.7 More than 5 times 2.9 4.7 1.9 1.7 4.3 This question is from the Standardized Data Set Question #68 Others have expressed concern about your alcohol or drug use (the last time) Overall (%) n=10,423 Male (%) n=4,826 Female (%) n=5,492 Transgender (%) n=27 Self-Identity (%) n=78 2.7 2.8 2.6 0.0 2.6 22.6 25.2 20.6 0.0 17.9 Within the last month 14.8 14.7 14.8 25.9 11.5 Within the last year 32.0 31.4 32.6 29.6 26.9 Within the last 1-5 years 22.8 21.4 23.7 40.7 39.7 5.1 4.6 5.7 3.7 1.3 Never Within the last two weeks More than 5 years ago This question is from the Standardized Data Set Question #69 14 Received treatment for alcohol or drug use (how many times) Overall (%) n=81,323 Male (%) n=29,831 Female (%) n=51,250 Transgender (%) n=235 Self-Identity (%) n=457 Never 95.8 93.4 97.2 95.7 96.9 1 time 3.1 4.8 2.1 3.8 2.4 2-3 times 0.8 1.3 0.5 0.0 0.7 4-5 times 0.1 0.2 0.1 0.0 0.0 More than 5 times 0.2 0.4 0.1 0.4 0.0 This question is from the Standardized Data Set Question #70 Received treatment for alcohol or drug use (the last time) Overall (%) n=2,639 Male (%) n=1,501 Female (%) n=1,120 Transgender (%) n<10 Self-Identity (%) n=11 Never 3.1 3.3 2.9 0.0 0.0 Within the last two weeks 9.5 8.7 10.6 14.3 0.0 Within the last month 5.9 6.0 5.8 28.6 0.0 Within the last year 24.2 24.2 24.4 14.3 18.2 Within the last 1-5 years 40.8 42.5 38.2 42.9 63.6 More than 5 years ago 16.4 15.3 18.0 0.0 18.2 This question is from the Standardized Data Set Question #71 Think back over the last two weeks. How many times have you had: five or more drinks* in a row (for males) OR four or more drinks* in a row (for females)? (*A drink is a bottle of beer, a glass of wine, a wine cooler, a shot glass of liquor, or a mixed drink.) Overall (%) n=66,762 Male (%) n=23,768 Female (%) n=42,412 Transgender (%) n=192 Self-Identity (%) n=390 None 58.9 53.6 61.6 74.0 70.3 Once 17.2 17.3 17.2 14.6 12.6 Twice 11.3 12.8 10.6 5.7 8.2 3 to 5 times 9.5 11.7 8.4 5.2 4.9 6 to 9 times 2.0 2.9 1.6 0.0 1.5 10 or more times 1.1 1.7 0.7 0.5 2.6 This question is from the Standardized Data Set Question #19 Think back over the last two weeks. How many times have you smoked marijuana? Overall (%) n=79,362 Male (%) n=28,865 Female (%) n=49,819 Transgender (%) n=232 Self-Identity (%) n=446 None 80.0 74.0 83.4 82.8 75.8 Once 5.2 5.8 4.9 3.0 5.6 Twice 3.5 4.2 3.1 3.0 3.6 3 to 5 times 4.4 5.8 3.6 3.0 4.9 6 to 9 times 2.2 3.1 1.7 2.6 2.7 10 or more times 4.7 7.1 3.3 5.6 7.4 This question is from the Standardized Data Set Question #96 15 Please indicate how much you agree with the statement: “I get the emotional help and support I need from my family.” Overall (%) n=54,514 Male (%) n=19,516 Female (%) n=34,543 Transgender (%) n=149 Self-Identity (%) n=306 Strongly disagree 10.5 9.9 10.8 22.8 20.9 Somewhat disagree 13.7 12.9 14.0 25.5 24.2 Neutral 15.6 17.1 14.7 16.1 18.6 Somewhat agree 30.6 30.1 31.0 24.2 26.1 Strongly agree 29.5 30.0 29.5 11.4 10.1 This question is from the Standardized Data Set Question #22 Please indicate how much you agree with the statement: “I get the emotional help and support I need from my social network (e.g., friends, acquaintances).” Overall (%) n=55,922 Strongly disagree Somewhat disagree Male (%) n=20,176 Female (%) n=35,285 Transgender (%) n=145 Self-Identity (%) n=316 8.8 9.9 8.2 8.3 7.3 13.1 14.2 12.4 9.7 13.9 Neutral 19.5 21.9 18.1 17.9 15.5 Somewhat agree 36.7 34.2 38.1 31.7 40.2 Strongly agree 21.9 19.7 23.1 32.4 23.1 This question is from the Standardized Data Set Question #23 Center Stories #4 West Carolina University Counseling and Psychological Services has utilized CCMH data to advocate and educate campus stakeholders and the greater community about the efficacy of counseling as well as current trends. WCU distributes publicity flyers that incorporate CCMH data to all incoming students and families as well as other members of the campus community. Additionally, the Assistant Vice Chancellor of Student Affairs utilizes CAPS/CCMH data in her presentation to parents during orientation and routinely requests updated trend data from our Director. CAPS/CCMH data was also requested for inclusion in the Student Affairs divisional annual report submitted to our Board of Trustees. — Michelle K. Cooper, Ph.D., HSP-P, LCAS-A, Clinical Director / Licensed Psychologist, Counseling and Psychological Services, Western Carolina University 16 Are you registered, with the office for disability services on this campus, as having a documented and diagnosed disability? Overall (%) n=83,469 Male (%) n=30,461 Female (%) n=52,287 Transgender (%) n=250 Self-Identity (%) n=471 Yes 7.5 8.2 7.0 8.8 10.6 No 92.5 91.8 93.0 91.2 89.4 This question is from the Standardized Data Set Question #60 If you selected “Yes” for the previous question, please indicate which category of disability you are registered for (check all that apply): Overall (%) Male (%) Female (%) Transgender (%) Self-Identity (%) 45.5 (n=2,830) 53.3 (n=1,332) 40.2% (n=1,467) 50.0 (n=11) 40.0 (n=20) 2.6 (n=160) 2.2 (n=55) 2.9 (n=104) 4.5 (n<10) 0.0 (n=0) 26.5 (n=1,651) 26.5 (n=662) 26.6 (n=971) 18.2 (n<10) 28.0 (n=14) Mobility Impairments 3.0 (n=185) 2.8 (n=69) 3.2 (n=115) 0.0 (n=0) 2.0 (n<10) Neurological Disorders 6.0 (n=374) 5.3 (n=132) 6.5 (n=239) 0.0 (n=0) 6.0 (n<10) Physical/Health Related Disorders 10.7 (n=665) 7.2 (n=181) 13.0 (n=475) 0.0 (n=0) 18.0 (n<10) Psychological Disorder/Condition 20.8 (n=1,291) 17.0 (n=425) 23.1 (n=844) 27.3 (n<10) 32.0 (n=16) Visual Impairments 2.5 (n=157) 2.6 (n=64) 2.5 (n=90) 4.5 (n<10) 4.0 (n<10) Other 12.8 (n=794) 13.2 (n=329) 12.3 (n=450) 27.3 (n<10) 18.0 (n<10) Attention Deficit/ Hyperactivity Disorders Deaf or Hard of Hearing Learning Disorders This question is from the Standardized Data Set Question #61 Please indicate your level of involvement in organized extra-curricular activities (e.g., sports, clubs, student government, etc.) Overall (%) n=46,699 Male (%) n=16,709 Female (%) n=29,528 Transgender (%) n=127 Self-Identity (%) n=235 None 30.9 32.6 30.0 29.9 27.7 Occasional participation 21.4 22.7 20.6 19.7 22.1 One regularly attended activity 19.1 19.0 19.1 25.2 23.4 Two regularly attended activities 15.4 13.6 16.4 16.5 18.7 Three or more regularly attended activities 13.2 12.1 13.9 8.7 8.1 This question is from the Standardized Data Set Question #48 17 Do you participate on an athletic team that competes with other colleges or universities? Overall (%) n=76,622 Male (%) n=6,431 Female (%) n=45,577 Transgender (%) n=206 Self-Identity (%) n=408 Yes 6.9 8.4 6.1 4.4 4.4 No 93.1 91.6 93.9 95.6 95.6 Female (%) n=45,119 Transgender (%) n=198 Self-Identity (%) n=402 This question is from the Standardized Data Set Question #50 Religious or spiritual preference Overall (%) n=71,978 Agnostic Male (%) n=26,259 12.6 14.9 11.2 18.2 21.9 Atheist 8.7 12.3 6.3 23.7 23.1 Buddhist 1.0 1.1 1.0 3.5 2.2 Catholic 17.4 15.8 18.5 6.1 3.0 Christian 32.4 27.8 35.4 12.1 7.2 Hindu 0.9 0.9 0.9 0.0 0.5 Jewish 2.6 2.9 2.5 2.0 0.7 Muslim 1.4 1.6 1.2 0.5 0.0 18.9 18.4 19.1 24.7 19.7 4.1 4.2 3.9 9.1 21.6 No preference Self-Identify This question is from the Standardized Data Set Question #97 To what extent does your religious or spiritual preference play an important role in your life? Overall (%) n=57,259 Male (%) n=20,822 Female (%) n=35,958 Transgender (%) n=165 Self-Identity (%) n=314 12.4 Very important 15.1 12.8 16.5 9.7 Important 24.1 22.6 25.0 19.4 21.3 Neutral 35.3 35.4 35.2 37.6 36.9 Unimportant 13.9 15.1 13.2 13.3 11.5 Very unimportant 11.6 14.1 10.1 20.0 17.8 Transgender (%) n=181 Self-Identity (%) n=359 This question is from the Standardized Data Set Question #36 How would you describe your financial situation right now? Overall (%) n=62,721 Male (%) n=22,524 Female (%) n=9,657 Always stressful 15.6 13.2 16.8 20.4 22.0 Often stressful 22.3 20.4 23.3 24.9 24.5 Sometimes stressful 35.1 35.5 34.8 35.9 32.9 Rarely stressful 19.8 22.2 18.5 15.5 14.5 Never stressful 7.3 8.8 6.6 3.3 6.1 This question is from the Standardized Data Set Question #57 18 How would you describe your financial situation growing up? Overall (%) n=43,150 Male (%) n=15,314 Female (%) n=27,465 Transgender (%) n=119 Self-Identity (%) n=252 Always stressful 10.4 8.4 11.5 16.0 14.7 Often stressful 14.9 13.4 15.8 14.3 16.7 Sometimes stressful 24.1 23.4 24.4 30.3 24.6 Rarely stressful 28.9 30.9 27.9 21.0 29.0 Never stressful 21.7 23.9 20.5 18.5 15.1 Transgender (%) n=126 Self-Identity (%) n=244 This question is from the Standardized Data Set Question #58 Are you a member of ROTC? Overall (%) n=43,711 Male (%) n=15,760 Female (%) n=27,581 Yes 0.8 1.2 0.5 0.8 0.0 No 99.2 98.8 99.5 99.2 100.0 This question is from the Standardized Data Set Question #51 Have you ever served in any branch of the US military (active duty, veteran, National Guard or reserves)? Overall (%) n=84,520 Male (%) n=30,892 Female (%) n=52,909 Transgender (%) n=250 Self-Identity (%) n=469 Yes 1.7 3.2 0.9 3.6 1.1 No 98.3 96.8 99.1 96.4 98.9 This question is from the Standardized Data Set Question #98 Did your military experience include any traumatic or highly stressful experiences which continue to bother you? Overall (%) n=1,269 Male (%) n=865 Female (%) n=390 Transgender (%) n<10 Self-Identity (%) n<10 Yes 30.4 33.2 24.9 11.1 20.0 No 69.6 66.8 75.1 88.9 80.0 This question is from the Standardized Data Set Question #53 Center Stories #5 I’m occasionally asked how students who use our Counseling Center compare to those at other universities. To answer that question, I draw upon data supplied by the Center for Collegiate Mental Health, which compiles information from Roosevelt and hundreds of university counseling centers across the United States. This information allows us to draw broad conclusions about collegiate mental health and provides a good overview of the issues some of our students deal with every day. — Sue Stock, Ph.D., Licensed Clinical Psychologist and Director, Roosevelt University Counseling Center 19 Mental Health Trends As of this report, CCMH has generated five datasets over six years (Fall 2008, 2010-2011, 2011-2012, 2012-2013, 20132014) making it possible to begin examining trends among college students seeking mental health services. To examine trends across key mental health indicators, the following items were simplified to “Yes” or “No”, providing a proxy for the life-time prevalence on each item. These items may have changed slightly over time; please refer to prior versions of the SDS for specifics. Data Sets Year # of Institutions Total # of Clients Fall 2008 66 32,329 2010-2011 97 82,611 2011-2012 120 97,012 2012-2013 132 95,109 2013-2014 140 101,027 Attended counseling for mental health concerns Taken a medication for mental health concerns Been hospitalized for mental health concerns Purposely injured yourself without suicidal intent (e.g., cutting, hitting, burning, hair pulling, etc.) 60 35 12 25 50 30 51.0% 45.2% 47.6% 48.7% 48.1% 32.9% 32.6% 25 7.0% 10 12 25 20 25.0% 23.8% 25.5% 8.0% 5 11.2% 10 8 8.0% 7.8% 10.8% 7.9% 5.0% 4 3.3% 3.3% 3 2013–2014 2012–2013 2011–2012 1 2010–2011 0 0 2 2.4% 2.2% Fall 2008 2013–2014 2012–2013 2011–2012 2 2010–2011 4 Fall 2008 2012–2013 2012–2013 2011–2012 2 2010–2011 0 4 Fall 2008 2013–2014 2012–2013 2011–2012 2010–2011 Fall 2008 5 7.9% 6 Intentionally caused serious injury to another person 6 15 10 8.0% 8.9% 2013–2014 35 8.8% 2012–2013 Considered seriously hurting another person 8 2013–2014 0 0 Made a suicide attempt 30.3% 30.9% 5 2011–2012 10 2010–2011 15 Seriously considered attempting suicide 30 23.8% 22.5% 23.2% 21.0% 21.8% Fall 2008 7.8% 2012–2013 2 2010–2011 0 4 20 9.0% Fall 2008 2013–2014 2012–2013 2011–2012 2010–2011 0 5 10.3% 10.2% 6 15 10 10 8 Fall 2008 2013–2014 2012–2013 2011–2012 2010–2011 Fall 2008 10 31.0% 31.8% 20 30 20 34.0% 2011–2012 40 0 Had unwanted sexual contact(s) or experience(s) Experienced harassing, controlling, and/or abusive behavior from another person (e.g., friend, family member, partner, authority figure, etc.) Experienced a traumatic event that caused you to feel intense fear, helplessness, or horror Felt the need to reduce your alcohol or drug use 25 40 40 30 20 22.0% 21.0% 21.0% 35 19.1% 18.9% 15 35.9% 36.7% 35.5% 30 33.3% 32.8% 30 25 20 20 2013–2014 2012–2013 0 2011–2012 5 2010–2011 10 Fall 2008 2013–2014 0 2012–2013 5 26.2% 26.7% 25.9% 27.2% 26.7% 15 2011–2012 10 25 20 2010–2011 15 36.9% 37.7% 38.0% 31.1% Fall 2008 2013–2014 0 2012–2013 5 2011–2012 10 2010–2011 15 38.3% 35 25 Fall 2008 2013–2014 2012–2013 2011–2012 0 2010–2011 5 Fall 2008 10 20 ** Note: The Fall 2008 data set was the first “pilot” effort by CCMH. As such, data were only pooled between September 2008 and December 2008 from a much smaller number of institutions. Please see the 2009 Annual Report for details. Others have expressed concern about your alcohol or drug use Received treatment for alcohol or drug use 20 6 15 16.6% 16.9% 16.7% 17.7% 17.3% 5 5.0% 4.8% 4.6% 4 2013–2014 2012–2013 2011–2012 1 2010–2011 2 Fall 2008 0 2013–2014 2012–2013 2011–2012 2010–2011 Fall 2008 5 4.4% 4.2% 3 10 Critical Incident Form (CIF) 0 Appointment Categories Each center contributing data to CCMH is asked to assign each of their local appointment types to a CCMH Appointment Category. These “umbrella” categories make it possible to accurately describe the types of treatment being provided across counseling centers without effecting how a counseling center codes their appointments locally. Appointment Category # of attended appointments % of attended appointments # of centers reporting 1. Brief screening or walk-in 31,365 6.0% 116 2. Initial clinical evaluation 74,753 14.4% 127 289,560 55.7% 133 4. Specialized individual treatment 9,971 1.9% 72 5. Specialized treatment without a therapist 1,073 0.2% 13 3. Individual psychotherapy/ counseling 6. Psychiatric evaluation 7,522 1.4% 78 7. Psychiatric follow-up 17,983 3.5% 71 8. Case management 12,010 2.3% 70 9. Psychological testing or assessment 2,973 0.6% 63 10. Other individual 9,889 1.9% 81 11. Other individual (client not present) 7,599 1.5% 44 12. Couples therapy 5,440 1.0% 83 41,503 8.0% 103 14. Group – workshop 2,689 0.5% 27 15. Group – clinic 2,698 0.5% 23 16. Group – other 2,152 0.4% 30 0 0.0% 271 0.1% 13. Group – psychotherapy 17. Group – other (client not present) 18. Medical Added in the summer of 2012, the Critical Incident Form (CIF) enables clinicians to record the occurrence of “critical incidents” during, or just prior to, treatment. Piloting of this form began in 2012, and has continued during the 2013-2014 academic year. In 2014, CCMH received a grant from The American Foundation for Suicide Prevention for the work being done with the Critical Incident Form. This grant was awarded to CCMH for the purpose of identifying risk factors of counseling center clients who may be at risk for attempting suicide while in treatment and describing treatment characteristics that are associated with effective suicide prevention. To date, 45 schools have participated in piloting this form. The CIF will be reviewed by the CCMH Advisory Board in 2015. Critical Incident Form (CIF) Item Frequency* Suicidal ideation that required intervention or plan 953 Suicide attempt (prior to treatment) 217 Suicide attempt (during treatment) 46 Homicidal ideation that required intervention or plan 22 Psychotic symptoms Psychiatric hospitalization for threat to self Psychiatric hospitalization for threat to others Psychiatric hospitalization for other mental health concern Medical hospitalization: drugs or alcohol 68 223 5 59 104 Medical hospitalization: other 48 Withdrawal from school for psychological reasons 97 Withdrawal from school: other 38 Death of client: suicide 1 Death of client: drugs or alcohol 3 0 Death of client: other 0 1 Other 371 None 10,522 *Depending on center policy, clinicians were asked to complete the CIF after every clinical contact, or at pre-designated time points (e.g.: intake/1st clinical contact and end of treatment), or only when there was a critical incident to report. 21 Center Stories #6 While our center has used CCMH data from its inception, I’d like to share a broader story within the University of Wisconsin System: In Fall 2012, counseling centers within the University of Wisconsin System (all thirteen 4-year schools, and four of the thirteen 2-year schools that have on-campus services) adopted the SDS as the foundation of their intake paperwork, allowing centers to compare their client data to both national (CCMH) and state benchmarks. In 2013, the schools also adopted the CCAPS as the instrument of choice to track symptom change over time. A systemwide committee, the Counseling Impact Assessment Committee, oversees this project, which employs a faculty researcher and graduate assistants to coordinate data sharing, analysis and reporting to each campus annually. The project is self-funded by participating campuses, many of whom are CCMH members. Participating campuses have reported the following applications of the data so far: • Annual reporting that includes year-by-year trends and comparison to benchmarks • Presenting to administrators, faculty, students and other constituents about client issues and outcomes • Providing data to AVP dashboard • Program planning and evaluation • Comparing center data to population assessment data • Writing grant proposals • Securing new resources (professional staff and space upgrades) —most centers have added staff in the past few years, when our state system has undergone severe budget cuts —on our campus, showing that our clients have higher rates of several risk factors (e.g., suicidal ideation, self-injury, past treatment and hospitalizations) helped justify the addition of a case manager • Choosing focus for staff training/professional development, based on trends in student data • Faculty research in college student mental health In 2014-15 we have shifted from sharing data anonymously to sharing it confidentially, which will allow us to make some pre-post comparisons to client survey responses at the end of each semester which is also part of the project data collection. — John Achter, Ph.D., Director and Licensed Psychologist, University of Wisconsin-Stout Counseling Center Clinician Index of Client Concerns (CLICC) Designed by the CCMH Advisory Board, the CLICC was piloted during the 2013-2014 data year with the goal of refining for 2015-2016. The CLICC is intended to serve multiple purposes including: (a) quickly describing student’s presenting concerns (locally/nationally), (b) examining the match between student’s self-report and provider’s evaluations, and (c) supporting a variety research efforts. The CLICC is typically completed following the first meeting with a new client. It is comprised of 43 check-box items and the clinician is asked to do the following: • “Please indicate your assessment of the client’s primary concerns (check those that apply)” and • “Choose the top concern of those already selected” 22 CLICC – “Check all that apply” For the following chart, clinicians are asked to “check all that apply” for each client such that one client may have many concurrent concerns. As a result, this chart illustrates how often each concern presents across all clients, regardless of how many concerns a student had or what their top concern was (N=25,475). Concern 55.1% Anxiety Depression 45.26% 43.18% Stress 30.32% Family 28.96% Academic performance Relationship problem (specific) 28.26% Interpersonal functioning 21.57% Self-esteem/confidence 19.56% 14.67% Sleep 13.7% Social isolation Adjustment to new environment 12.92% Mood instability 12.52% 11.84% Eating/body image 11.48% Alcohol 10.9% Grief/loss Career 9.74% Trauma 9.46% Attention difficulties 8.99% 8.09% Identity development Anger management 7.85% Suicidality 7.51% 6.99% Perfectionism 6.52% Drugs Sexual abuse/assault (victim) 6.36% Health/medical 6.15% Financial 5.97% Self-injurious thoughts or behaviors 5.73% Harassment/emotional abuse (victim) 4.45% Other 4.31% Obsessions or compulsions 4.21% Legal/judicial/conduct 3.34% Physical abuse/assault (victim) 3.31% Sexual orientation 2.47% Racial, ethnic, or cultural concerns 2.32% Sexual concern 1.88% Violent thoughts or behaviors towards others 1.42% Religion/spirituality 1.36% Discrimination 0.68% Gender identity 0.63% Pregnancy related 0.60% Addiction (not drugs or alcohol) 0.56% Psychotic thoughts or behaviors 0.56% None 0.44% Stalking (victim) 0.28% 0 2,500 5,000 7,500 10,000 12,500 15,000 Frequency 23 CLICC – “Top-most concern” For this question, clinicians are asked to choose one primary concern (i.e., the top-most concern) per client. As a result, this chart illustrates how often each presenting concern is the top-most concern for students (N=25,475). Concern Anxiety 19.6% Depression 15.6% Relationship problem (specific) 9.2% 5.9% Stress 4.7% Academic performance Family 4.3% Interpersonal functioning 3.5% Grief/loss 3.3% Mood instability 3.0% 2.8% Adjustment to new environment 2.8% Alcohol 2.2% Self-esteem/confidence Other 2.1% Eating/body image 2.0% Trauma 1.8% Sexual abuse/assault (victim) 1.6% Career 1.5% Attention difficulties 1.5% Suicidality 1.4% Anger management 1.3% Identity development 1.2% Drugs 1.1% Legal/judicial/conduct 1.0% Social isolation 0.7% Obsessions or compulsions 0.7% Health/medical 0.7% Self-injurious thoughts or behaviors 0.5% Sleep 0.5% Perfectionism 0.4% Harassment/emotional abuse (victim) 0.4% Physical abuse/assault (victim) 0.4% Sexual orientation 0.3% Sexual concern 0.3% Financial 0.3% Psychotic thoughts or behaviors 0.2% Gender identity 0.2% Pregnancy related 0.2% Addiction (not drugs or alcohol) 0.1% None 0.1% Racial, ethnic, or cultural concerns 0.1% Violent thoughts or behaviors towards others 0.1% Religion/spirituality 0.1% Stalking (victim) 0.0% 0.0% Discrimination 0 1,250 2,500 Frequency 24 3,750 5,000 CLICC “Top-most concern” by CCAPS Subscale scores The table below integrates the two concepts of student’s self-reported distress (CCAPS-34 mean subscale scores) with counselor-reported evaluations of student’s primary presenting concern (“top-most” CLICC data, N=25,475). This analysis provides a unique perspective on the interaction of these concepts, which will help to examine questions such as: Do student presenting concerns, as measured by the CCAPS, match therapist perceptions of the most prominent presenting concern? AND What kinds of distress are associated with which types of presenting concerns? For each presenting concern, we have highlighted the peak CCAPS-34 subscale score in bold. Hostility Alcohol Use 1.11 0.75 0.93 0.64 0.92 0.86 0.57 2.63 0.79 0.72 0.49 Academic Distress 1.15 0.73 Social Anxiety 0.60 Generalized Anxiety 0.81 Depression 0.95 Frequency Eating Concerns CCAPS-34 Subscales 1 Anxiety 4,990 1.55 2.42 2.04 1.95 5 Depression 3,984 2.45 2.14 2.29 2.52 8 Relationship problem (specific) 2,349 1.42 1.60 1.60 1.61 4 Stress 1,507 1.44 1.76 1.67 1.98 26 Academic performance 1,191 1.37 1.54 1.63 11 Family CLICC item # and description 9 12 6 1,086 1.33 1.53 1.61 1.60 0.88 0.84 0.59 Interpersonal functioning 894 1.58 1.60 2.15 1.60 0.87 0.95 0.60 Grief/loss 843 1.57 1.74 1.57 1.96 0.75 0.84 0.61 Mood instability 755 2.17 2.33 2.16 2.25 1.15 1.51 0.90 20 Adjustment to new environment 715 1.59 1.68 1.96 1.75 0.87 0.70 0.44 29 Alcohol 704 0.80 1.10 1.18 1.32 0.65 0.71 2.08 19 Self-esteem/confidence 555 1.64 1.55 2.28 1.75 1.18 0.77 0.63 44 Other 531 1.11 1.53 1.52 1.61 0.74 0.69 0.49 14 Eating/body image 512 1.50 1.58 1.96 1.50 2.94 0.57 0.69 36 Trauma 451 1.69 2.26 1.79 1.95 0.99 0.96 0.75 38 Sexual abuse/assault (victim) 420 1.61 1.94 1.70 1.76 0.96 0.80 1.02 27 Career 393 0.83 1.12 1.42 1.53 0.73 0.55 0.43 28 Attention difficulties 380 0.97 1.46 1.51 2.53 0.76 0.73 0.52 33 Suicidality 361 2.99 2.38 2.49 2.59 1.15 1.37 0.85 Anger management 327 1.37 1.61 1.67 1.47 0.83 2.36 0.89 0.61 7 18 Identity development 312 1.51 1.58 1.86 1.77 0.85 0.72 30 Drugs 271 1.14 1.31 1.36 1.64 0.60 0.81 1.23 42 Legal/judicial/conduct 262 0.77 0.91 1.05 1.14 0.48 0.63 0.96 10 Social isolation 190 2.02 1.59 2.78 1.70 0.89 0.70 0.34 Obsessions or compulsions 189 1.46 2.08 1.83 1.61 0.90 0.87 0.47 13 Health/medical 170 1.48 1.81 1.64 1.98 0.92 0.67 0.49 32 Self-injurious thoughts or behaviors 134 2.54 2.15 2.45 2.12 1.05 1.23 0.73 15 Sleep 120 1.29 2.14 1.65 2.11 0.76 0.69 0.66 Perfectionism 111 1.26 1.66 1.65 1.78 0.99 0.72 0.31 39 Harassment/emotional abuse (victim) 98 1.64 1.85 1.71 1.74 0.82 0.86 0.52 37 Physical abuse/assault (victim) 91 1.71 1.88 1.85 1.98 0.89 1.09 0.78 22 Sexual orientation 84 1.67 1.65 2.15 1.63 0.81 0.77 0.63 16 Sexual concern 80 1.01 1.16 1.47 1.49 0.51 0.79 0.90 41 Financial 65 1.57 1.68 1.36 1.99 0.98 0.70 0.48 35 Psychotic thoughts or behaviors 54 1.63 2.22 2.11 1.93 1.00 1.38 0.62 23 Gender identity 51 1.38 1.79 2.02 1.57 0.88 0.89 0.30 2 3 Continued on next page 25 Academic Academic Distress Distress Eating Eating Concerns Concerns Hostility Hostility Alcohol Use Use Alcohol Pregnancy related 43 1.65 1.63 1.40 1.96 0.85 0.79 0.34 Addiction (not drugs or alcohol) 36 1.34 1.50 1.75 1.72 1.03 0.96 0.77 43 None 31 0.33 0.75 1.03 0.60 0.52 0.35 0.58 21 Racial, ethnic, or cultural concerns 25 1.53 1.74 1.83 2.00 1.00 1.16 0.53 34 Violent thoughts or behaviors towards others 16 1.91 2.23 1.93 2.23 0.91 2.72 1.13 24 Religion/spirituality 15 1.92 1.72 2.19 1.95 0.91 0.67 0.30 40 Stalking (victim) 12 1.02 1.57 1.57 1.57 0.67 0.71 0.32 25 Discrimination 4 1.31 1.56 1.80 1.33 1.33 0.50 0.67 Frequency Frequency Generalized Generalized Anxiety Anxiety 17 31 CLICC item # and description Depression Depression Social Social Anxiety Anxiety CCAPS-34 Subscales ** NOTE: CCAPS subscale scores range from 0-4 Notable findings: • On the whole, CCAPS subscale scores (student reported data) demonstrate agreement with CLICC results (counselor reported data) suggesting that student-reported distress (type and severity) tends to align with the counselor’s evaluation of their primary presenting concern. This has a variety of implications for future research. • When Anxiety is identified as the primary concern by the clinician, the Generalized Anxiety CCAPS-34 subscale is also the highest in severity. • When Depression is identified as the primary presenting concern by the clinician, the Depression and Academic Distress subscales have nearly equivalent peak elevations. In addition, Generalized Anxiety and Social Anxiety subscales are also elevated. • When Academic performance is identified as the primary presenting problem, the Academic Distress subscale stands out with a peak elevation in comparison to other CCAPS-34 subscales. • When Suicidality is checked as the primary concern on the CLICC, all of the CCAPS-34 subscales, except for the Alcohol Use and Eating Concerns are above the Elevated cut point, suggesting that suicidality (as the primary concern) results in wide-spread distress. • The Eating Concerns and Alcohol Use CCAPS-34 subscales are significantly elevated only when the presenting concerns are identified as being in similar areas, such as Eating/body image and Alcohol, respectively. Counseling Effectiveness A recurring question asked of counseling centers regards the effectiveness of services provided. The answers to this question can guide professional development, treatment planning, and provide data to support self-advocacy by counseling centers. McAleavey, Youn, et al. (2013) explored this question within data gathered from college counseling centers that contribute data to CCMH. In psychotherapy research, the “gold standard” for comparison of therapy effectiveness has been considered the randomized controlled trial (RCT). The magnitude of client improvement observed in counseling centers can be compared in a similar manner. For individuals entering counseling centers with high levels of initial distress (above the CCAPS elevated cut points), the amount of positive change observed was equivalent to that documented in RCT’s for Depression, Generalized 26 Anxiety, Social Anxiety, Eating Concerns, and Hostility subscales. While these students are not consistently returning to normal symptomatic levels (compared to a normative nonclinical sample) by the end of their treatment, the study shows that counseling is likely effective at reducing specific symptoms for several psychological disorders. A possible interpretation is that students at counseling centers are not receiving enough sessions to completely reduce symptoms. The results of this study provide evidence that counseling centers are indeed effective in reducing symptoms and that there is room to improve, arguably through the addition of treatment resources. Client Dropout Dropout from psychotherapy has been a problem for the last 50 years. Swift and Greenberg’s (2012) recent metaanalysis shows that dropout rates remain high, finding an average rate nearly 20% across all treatment settings. Of particular note, their study finds that the “university-based clinic” had the highest rate of dropout across all settings, at 30.4%. While their definition of university-based clinic includes both training clinics and counseling centers, it would appear that dropout is an important issue for the college student demographic. Students are seeking increasing amounts of services for increasingly diverse symptoms, often from centers with inadequate resources to treat all of those in need. As such, dropout presents a challenging problem for counseling centers: clients who drop out may reduce the effectiveness of their own treatment (due to increased rates of relapse associated with incomplete treatment), students waiting for services must wait longer, and the counseling center’s overall clinical flow is less efficient. Xiao et al. (2013) have examined dropout within CCMH using an aggregate dataset from 2010-2012, and found that the rates are high. Roughly 40% of clients that have attended at least one individual psychotherapy appointment are failing to attend their last scheduled appointment. Ultimately, Xiao et al. (2013) hope to examine the the feasibility of a predictive tool that will assess client risk of dropout using intake variables. While development of an assessment tool with good sensitivity and specificity is underway, there are several individual variables that have been found to be predictive of client dropout: Clients that endorsed financial distress were up to 1.26 times more likely to dropout of treatment than those who indicated no financial distress. Similarly, individuals that were prescribed psychiatric medication were 1.17 times more likely to dropout than those who never received psychiatric medication. Predictors of those who are less likely to dropout of treatment include graduate students (.683 times that of freshman), and individuals that have attended counseling after starting college (.869 times that of those who have never attended counseling). While consideration of individual variables may be difficult to decipher (especially for providers with packed schedules), the statistical examination of multiple predictive variables may lead to the development of a dropout assessment tool that could have important utility for counseling centers and their staff. This linking of research and practice highlights the benefits of large-scale Practice Research Networks (PRN’s) such as CCMH. Counselor Survey Update As a Practice Research Network, a major CCMH mission has been to conduct clinically syntonic research. With this in mind, in the summer of 2013, CCMH sent a survey to member centers asking participation by all staff at each site. The goal of the survey was to determine the major areas of research interest among counseling center staff: “We want to know what you want to know.” The questions in the survey assessed the types of research that would be the most clinically valuable, important and actionable, so that the projects would generate the most enthusiasm for research among practitioners, as well as be viable and applicable in a large-scale PRN (McAleavey, Castonguay, et al., 2013). CCMH received over 600 responses including 96 directors. Most of the responders were full-time clinical staff (58%), but there were also trainees, administrative staff and part-time staff completing the survey, which allowed for diverse needs and interests to be reflected in the answers. Responders were asked to rate the importance of different types of research projects, all answers targeting the question “what would be most useful?” 27 We also asked responders if they had any suggestions regarding additional research projects that they thought would help CCMH meet the needs of practitioners and clients. We received a total of 388 suggestions for research projects. Using the Generic Model of Psychotherapy (Orlinsky and Ronnestad, 2004), which offers a holistic summary of different types of psychotherapy issues based on the research literature, we have coded three quarters of the responses. Preliminary results are included below: The results of the survey showed that almost all areas of research were of interest, with special focus on the process of counseling, high-risk clients, (negative) outcome predictions, effectiveness of counseling, as well as therapist characteristics that impact treatment outcome. Additionally, 70% of responders stated that they would be either “very likely” or “almost definitely” willing to participate in a project that was deemed to be clinically valuable, despite their schedules. 120 Client characteristics 93 Treatment outcome 80 Therapeutic contract characteristics 52 Treatment delivery system (counseling center characteristics) 44 Non-psychotherapy factors that impact treatment outcomes 25 Therapist characteristics Therapeutic operations (client presentation, therapist understanding, interventions, client responsiveness) 24 23 Society-related 18 Long-term outcomes Impact of therapist's professional network 14 Professional development 14 Therapeutic bond 12 Client self-relatedness 12 Post-session outcomes (individual session impact/quality) 6 Therapist self-relatedness (e.g., countertransference) 4 Therapist psychological functioning 4 Impact of client's social network 2 Daily events in client’s social network 2 Society (cultural belief and value patterns, social institutions) 2 Client in-session experience (e.g., insight) 1 0 10 20 30 Percentage of Responses 28 40 50 60 The largest suggestion categories were client characteristics, treatment outcomes, and therapeutic contracts. The modal suggestion type was “what treatment works with this kind of client?” Other common categories included treatment delivery systems (e.g., impact of policies or practices), effects of different treatment types, and supervision. In conclusion, there is considerable interest in research among mental health providers within the CCMH membership, as evidenced by the high response rate, strong ratings of clinical value across all research domains, and numerous research suggestions. In addition, respondents indicated that they were very likely to participate in research if a project is both clinically valuable and relevant. These results help to underscore the potential contributions practice research networks in forging linkages between practice and research. Average Number of Attended Individual Sessions A common question among counseling centers is, “What is the average number of counseling sessions attended by clients?” To examine this question we reviewed the appointment data for initial clinical evaluations and any individual counseling sessions as follows: A. Total number of attended appointments (initial and individual counseling): 372,745 B. Total number of clients who attended appointments in A: 78,395 C. Average number of attended counseling sessions per client (A divided by B): 4.75 This preliminary analysis, of actual appointment attendance data across 140 institutions and approximately 370,000 appointments, indicates that clients attend slightly less than 5 sessions of individual counseling on average (including an intake, but excluding other types of appointments). Counseling Center Resource Utilization by Clients College counseling center resources are limited and in high demand. Often centers do not have the resources to treat all of the students in need of services, and many centers have a waitlist before students can be seen for treatment. One way to help understand and inform allocation of resources within centers is to look at utilization rates and how counseling center services are being used. Information about how resources are being allocated could also potentially be used to identify students who may be more likely to use a large amount of counseling center resources and who might benefit from long-term care, such as referrals to external providers. With this in mind, we looked at the 2013-2014 data to determine how resources are distributed among students seeking services. The following points describe client utilization of all appointment types/services across all centers in 2013-2014: • One (1) is the most common number of appointments per client/per year. • Clients averaged 6.79 appointments with a range of 1-128 appointments. • 20% of clients accounted for over 50% of all appointments. • 10% of clients accounted for 36% of all appointments, averaging 20.78 appointments. • 5% of clients accounted for 22% of all appointments, averaging 36.06 appointments. • 1% of clients accounted for 6.6% of all appointments, averaging 38.59 appointments. • 10 clients utilized a total of 878 appointments. These findings demonstrate that a relatively small percentage of clients utilize a large proportion of counseling center resources when compared to the average client. Future research could examine characteristics of these clients in order to assist clinicians in the treatment planning process. On the other hand, mental health providers are well aware that clients with complex mental health histories, comorbid diagnoses, complicated medication regimens, difficult financial/insurance situations, and complicated family dynamics may simply require extensive resources. This type of information could help counseling centers, and institutions, begin to examine resource allocation (and needs) on a more nuanced level. 29 Comparisons by Gender, Race, and Previous Mental Health Utilization Comparisons by Race Using the 2013-2014 CCMH data, the tables below show the mean subscale scores of the seven CCAPS-34 subscales, the Distress Index, and CCAPS items for suicidal/homicidal ideation by gender, race, and previous mental health utilization (counseling, medication, and hospitalization). Significance tests were conducted using t-tests, and effect sizes are presented to show the magnitude of the mean differences. Effect sizes allow us to understand the statistical analysis results in a practical way by discussing the strength of the mean differences across groups to determine if the differences across these groups are clinically meaningful. Following Cohen’s (1988) suggestion, effect sizes of 0.20 are considered small, 0.50 are medium, and 0.80 and higher are large. For example, the effect size of the difference in the depression mean scores between men and women is 0.10, which is considered to be small and therefore not very meaningful. Homicidal items: Comparisons by Race Table 2. CCAPS-34 Subscales, Distress Index, and Suicidal and Homicidal Items: Comparisons by Gender Students of Color Sig. Effect Size1 Depression 1.60 1.72 *** 0.11 Generalized Anxiety 1.89 1.79 *** 0.10 Social Anxiety 1.87 1.85 * 0.02 Academic Distress 1.91 2.05 *** 0.13 Eating Concerns 0.94 0.97 * 0.02 Hostility 0.85 1.03 *** 0.22 Alcohol Use 0.75 0.59 *** 0.18 1.70 1.76 *** 0.06 CCAPS-34 Subscale Distress Index Suicidal and Homicidal items Comparisons by Gender Table 1. CCAPS-34 Subscales, Distress Index, and Suicidal and White I have thoughts of ending my life 0.67 0.79 *** 0.11 I have thoughts of hurting others 0.20 0.31 *** 0.16 Effect size = Mean difference divided by the pooled standard deviation. The absolute values are presented. 1 Scale: “0”= not at all like me to “4”= extremely like me. *p< .05, ***p< .001 Men Women Sig. Effect Size1 Depression 1.57 1.68 *** 0.10 Table 3. CCAPS-34 Subscales, Distress Index, and Suicidal Generalized Anxiety 1.69 1.96 *** 0.26 and Homicidal items: Comparisons by mental health services Social Anxiety 1.80 1.90 *** 0.10 Academic Distress 1.95 1.96 ns 0.01 Eating Concerns 0.66 1.12 *** 0.42 CCAPS-34 Subscale Comparisons by Prior Counseling Hostility 0.94 0.87 *** 0.08 Alcohol Use 0.79 0.65 *** 0.15 1.64 1.76 *** 0.15 Distress Index utilization Have you ever attended counseling for mental health concerns? I have thoughts of hurting others 0.72 0.33 0.69 0.17 *** *** No Sig. Effect Size1 Depression 1.83 1.47 *** 0.34 Generalized Anxiety 2.10 1.66 *** 0.43 Social Anxiety 2.03 1.72 *** 0.30 Academic Distress 2.08 1.85 *** 0.21 Eating Concerns 1.10 0.82 *** 0.24 Hostility 0.98 0.83 *** 0.18 Alcohol Use 0.76 0.67 *** 0.10 1.91 1.55 *** 0.42 CCAPS-34 Subscale Suicidal and Homicidal items I have thoughts of ending my life Yes 0.03 0.24 Effect size = Mean difference divided by the pooled standard deviation. The absolute values are presented. 1 Scale: “0”= not at all like me to “4”= extremely like me. Distress Index ***p< .001 Suicidal and Homicidal items *** Due to differences in sample size, comparisons are recorded for only those who identified as “man” or “woman” on SDS Question #88 I have thoughts of ending my life 0.87 0.55 *** 0.28 I have thoughts of hurting others 0.26 0.20 *** 0.08 Effect size = Mean difference divided by the pooled standard deviation. The absolute values are presented. 1 Scale: “0”= not at all like me to “4”= extremely like me. ***p< .001 30 Comparisons by Prior Psychiatric Medication Use Comparisons by Prior Psychiatric Hospitalizations Table 4. CCAPS-34 Subscales, Distress Index, and Suicidal and Table 5. CCAPS-34 Subscales, Distress Index, and Suicidal and Homicidal items: Comparisons by psychiatric medication use Homicidal items: Comparisons by hospitalizations for mental Have you ever taken a prescribed medication for mental health concerns? health concerns Yes No Sig. Effect Size1 1.85 1.54 *** 0.29 Have you been hospitalized for mental health concerns? CCAPS-34 Subscale Depression Yes No Sig. Effect Size1 Depression 1.88 1.62 *** 0.25 2.14 1.84 *** 0.29 CCAPS-34 Subscale Generalized Anxiety 2.19 1.72 *** 0.47 Generalized Anxiety Social Anxiety 2.07 1.78 *** 0.28 Social Anxiety 2.01 1.86 *** 0.15 Academic Distress 2.13 1.87 *** 0.23 Academic Distress 2.09 1.94 *** 0.13 Eating Concerns 1.12 0.88 *** 0.21 Eating Concerns 1.11 0.94 *** 0.15 Hostility 0.98 0.86 *** 0.14 Hostility 1.08 0.88 *** 0.23 Alcohol Use 0.78 0.68 *** 0.11 Alcohol Use 0.85 0.68 *** 0.19 1.95 1.61 *** 0.41 1.95 1.70 *** 0.30 Distress Index Distress Index Suicidal and Homicidal items Suicidal and Homicidal items I have thoughts of ending my life 0.91 0.61 *** 0.26 I have thoughts of ending my life 1.10 0.66 *** 0.38 I have thoughts of hurting others 0.25 0.22 *** 0.04 I have thoughts of hurting others 0.29 0.22 *** 0.10 Effect size = Mean difference divided by the pooled standard deviation. The absolute values are presented. 1 Effect size = Mean difference divided by the pooled standard deviation. The absolute values are presented. 1 Scale: “0”= not at all like me to “4”= extremely like me. Scale: “0”= not at all like me to “4”= extremely like me. ***p< .001 ***p< .001 31 Provider Data The Standardized Data Set includes some basic demographic information about providers at participating counseling centers. The 2013-2014 dataset represents over 2,900 unique providers. Answer totals vary by question since some counseling centers do not gather this data, or a counselor chose not to answer one or more questions. Gender Highest Degree (descending sort) n Percentage (%) Male 286 31.8 Doctor of Philosophy 377 42.1 Female 609 67.7 Master of Arts 126 14.1 Transgender 2 0.2 Doctor of Psychology 120 13.4 Prefer not to answer 2 0.2 Master of Science 73 8.2 Master of Social Work 71 7.9 Doctor of Medicine 31 3.5 Bachelor of Arts 27 3.0 Master of Education 27 3.0 Doctor of Education 13 1.5 Other Age n Average Age Modal Age Age (years) 825 42.06 40 33 Race/Ethnicity n Percentage (%) 77 8.6 2 0.2 67 7.5 Caucasian/White 651 72.9 Hispanic/Latino/a 53 5.9 African-American/Black American Indian or Alaskan Native Asian American/Asian Native Hawaiian or Pacific Islander Multi-racial Prefer not to answer Other 1 0.1 21 2.4 6 15 0.7 1.7 n 11 1.2 Bachelor of Science 7 0.8 Nursing (e.g. RN, RNP, PNP) 5 0.6 Education Specialist 4 0.4 Doctor of Osteopathy 3 0.3 Highest Degree-Discipline (descending sort) n Percentage Counseling Psychology 329 37.1 Clinical Psychology 296 33.4 Social Work 75 8.5 Other 67 7.6 Counselor Education 52 5.9 Psychiatry 35 3.9 Marriage and Family Therapist 10 1.1 Nursing 9 1.0 Community Psychology 5 0.6 Educational Psychology 4 0.5 Higher Education 4 0.5 Health Education 1 0.0 Are you licensed under your current degree? Yes n=626 71.3% No n=252 28.7% 32 Percentage (%) Position Type: (descending sort) n Professional Staff Member Percentage (%) 676 75.4 Pre-Doctoral Intern 83 9.3 Post-doctoral Level (non-psychiatric) 38 4.2 Master’s Level Trainee 33 3.7 Doctoral Level Trainee (not an intern) 31 3.5 Other 31 3.5 5 0.6 Psychiatric Resident How much is your current therapeutic practice guided by each of the following theoretical frameworks? Analytic/ Psychodynamic (%) n=814 Not at all (0) Behavioral (%) n=816 Cognitive (%) n=824 Humanistic (%) n=815 Systems Theory (%) n=803 6.1 2.3 1.1 2.5 4.1 A little (1) 14.4 11.3 2.3 3.8 16.8 Some (2) 20.5 23.3 11.4 11.9 23.5 Moderate (3) 24.2 29.9 30.5 24.0 32.1 Greatly (4) 24.2 24.5 36.3 35.2 17.6 Very greatly (5) 10.6 8.7 18.4 22.6 5.9 2.8 2.9 3.5 3.5 2.6 Mean Figure 1. How much is your current therapeutic practice guided by each of the following theoretical framework? 5.0= Very Greatly 4.0= Greatly 3.54 3.0= Moderate 2.78 2.60 Systems Theory Humanistic Cognitive 0.0= Not at all 2.89 Behavioral 1.0= A little Analytic/Psychodynamic 2.0= Some 3.53 33 Center Information The information below describes the 140 colleges and universities that contributed data to the 2013-2014 CCMH data set. Does your counseling center currently have an APA accredited What psychiatric services are provided by your center? pre-doctoral training program? n n Percentage (%) Percentage (%) None 40 29.2 Yes 42 30.4 Part time, in house 63 46.0 No 96 69.6 Full time, in house 16 11.7 Part time, off campus consultant Other 6 4.4 12 8.8 Is your counseling center currently accredited by IACS (International Association of Counseling Services)? n Percentage (%) Yes 68 49.3 No 70 50.7 Does your center have an annual individual psychotherapy limit? n Percentage (%) Yes 51 37.2 No 86 62.8 Which services are integrated with your counseling center? (check all that apply) Career Services Disability Services n Percentage (%) 13 9.3 If you answered “yes” to session limit, please enter your individual psychotherapy session limit* n Percentage (%) 2 3.7 8 5.7 40 28.6 Employee Assistance Program 3 2.1 8 2 3.9 Learning Services 4 2.9 10 10 19.6 Health Services 18 12.9 12 20 39.2 Testing Services 24 17.1 14 2 3.9 Other 13 9.3 13.7 Drug & Alcohol Treatment Program 7 15 7 16 4 7.8 20 2 3.9 24 1 2.0 *No school that provided information entered less than 7 sessions Check each service for which you charge a standard fee (don’t check services that are initially free–e.g., first 8 sessions)? n Intake 2 1.4 Individual Counseling 6 4.3 Group Counseling 5 3.6 23 16.7 23 16.7 Psychiatric Evaluation (initial meeting) Psychiatric Follow-up (ongoing client) Formal Assessment: Psychological 11 8.0 Formal Assessment: Career 12 8.7 8 5.8 17 12.3 Formal Assessment: Disability Other 34 Percentage (%) Participating Institutions Data for the 2013-2014 CCMH data set has been contributed by 140 colleges and universities that hold membership with CCMH. Demographics for these institutions are listed below. Campus Characteristic n Percentage (%) Type of Institution Public 88 62.9 Private 45 32.6 5 3.6 Northeast (CT, ME, MA, NH, NJ, NY, PA, RI, VT) 35 26.5 Midwest (IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI) 34 25.8 South (AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV) 48 36.4 West (AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY) 15 11.4 4 2.9 1,501-2,500 13 9.4 2,501-5,000 12 8.6 Campus Characteristic Athletic Division Combined Location of Campus Enrollment Under 1,500 n Percentage (%) 5,001-7,500 12 8.6 7,501-10,000 15 10.8 None 9 6.6 10,001-15,000 21 15.1 Division I 78 57.4 15,001-20,000 16 11.5 Division II 22 16.2 20,001-25,000 16 11.5 Division III 27 19.9 25,001-30,000 6 4.3 30,001-35,000 11 7.9 0-4 136 97.8 35,001-40,000 5 3.6 1-5 0 0.0 40,001-50,000 6 4.3 0-100 1 0.7 50,001 and over 2 1.4 Other 2 1.4 Grade Scale CCMH Member Institutions 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. American University Anderson University Appalachian State University Arkansas State University Auburn University Augustana College Barry University Boston College Bowling Green State University Brigham Young University Bucknell University Buffalo State College Cabrini College California Lutheran University California State Polytechnic University, Pomona 16. California State University, Chico 17. California State University, Fullerton 18. California State University, Long Beach 19. California State University, Monterey Bay 20. California State University, Sacramento 21. California State University, San Bernardino 22. California State University, San Marcos 23. Case Western Reserve University 24. Central College 25. Claremont University Consortium 26. Clayton State University 27. Cleveland State University 28. Coastal Carolina University 29. Colby College 30. Colgate University 31. College of Charleston 32. College of Saint Benedict Saint John’s University 33. College of Southern Nevada 34. College of Staten Island 35. College of William & Mary 36. Collin County Community College 37. Colorado State University 38. Columbia College Missouri 39. Columbia College Chicago 40. Columbus State University 41. Connecticut College 42. Cornell University 43. Culver-Stockton College 44. Dartmouth College 45. DePaul University 46. Dickinson College 47. Dominican University 48. Duke University 35 *This map lists all 283 CCMH member institutions 49. East Carolina University 50. East Carolina University— Student Health Services 51. Eastern Kentucky University 52. Eastern Michigan University 53. Eastern Washington University 54. Edgewood College 55. Elizabeth City State University 56. Elon University 57. Emerson College 58. Emory University 59. Fairfield University 60. Ferris State University 61. Florida Gulf Coast University 62. Florida International University 63. Fort Lewis College 64. Franklin & Marshall College 65. George Mason University 66. Georgia College and State University 67. Georgia Gwinnett College 68. Georgia Institute of Technology 69. Georgia State University 70. Gonzaga University 71. Grand Valley State University 72. Hamilton College 73. Heartland Community College 74. Hobart and William Smith Colleges 75. Houghton College 76. Howard University 77. Hunter College 78. Husson University 36 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. Idaho State University Illinois Institute of Technology Illinois State University Illinois Wesleyan University Indiana University Iowa State University Jewish Theology Seminary John Jay College of Criminal Justice Johns Hopkins University Johnson & Wales University Kennesaw State University La Salle University Lafayette College Lamar University Lawrence University Lee University Lehigh University Lehman College Lewis Clark State College Lindsey Wilson College Louisiana State University Loyola Marymount University Loyola University– Chicago Marquette University Marywood University Metropolitan State University of Denver Miami University, Ohio Michigan State University Middle Tennessee State University Mississippi State University 109. Montana State University -– Bozeman 110. Montclair State University 111. New College of Florida 112. North Carolina State University 113. North Dakota State University 114. Northeastern Illinois University 115. Northern Arizona University 116. Northern Illinois University 117. Northwestern University 118. Notre Dame College 119. Ohio State University 120. Ohio University 121. Old Dominion University 122. Oregon State University 123. Pace University 124. Pace University, Westchester Campuses 125. Pennsylvania State University 126. Pepperdine University 127. Polytechnic University 128. Purdue University 129. Quincy University 130. Ramapo College of New Jersey 131. Regis University 132. Rhode Island College 133. Rice University 134. Ringling College of Art and Design 135. Robert Morris University 136. Rochester Institute of Technology 137. Roger Williams University 138. Roosevelt University 139. Rutgers University – Camden Campus 140. Sacred Heart University 141. Saddleback College 142. Saint Joseph’s University 143. Saint Louis University 144. Saint Mary’s College of California 145. Salem State University 146. Salisbury University 147. Sam Houston State University 148. San Jose State University 149. Santa Clara University 150. Santa Rosa Junior College 151. Seton Hall University 152. Simpson College 153. Slippery Rock University 154. South Dakota State University 155. Southern Illinois University Carbondale 156. Southern Oregon University 157. Southern Polytechnic State University 158. Spalding University 159. Springfield College 160. St. Cloud State University 161. St. Edward’s University 162. St. John’s University 163. St. Mary’s College of Maryland 164. St. Norbert College 165. Stetson University 166. Stevenson University 167. Suffolk University 168. SUNY Brockport 169. SUNY Cortland 170. SUNY Fredonia 171. SUNY Geneseo 172. SUNY Oswego 173. Susquehanna University 174. Syracuse University 175. Tarleton State University 176. Temple University 177. Texas A&M University 178. Texas A&M University – Corpus Christi 179. Texas State University 180. Texas Tech University 181. The California Maritime Academy 182. The Richard Stockton College of New Jersey 183. The University of Akron 184. The University of Maine 185. The University of Memphis 186. The University of Southern Mississippi 187. The University of Texas at Arlington 188. The University of Texas at Austin 189. The University of the South 190. Towson University 191. Truman State University 192. Tulane University 193. Union College 194. University at Buffalo 195. University of Alabama 196. University of Arkansas 197. 198. 199. 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211. 212. 213. 214. 215. 216. 217. 218. 219. 220. 221. 222. 223. 224. 225. 226. 227. 228. 229. 230. 231. 232. 233. 234. 235. 236. 237. 238. 239. 240. 241. 242. 243. 244. 245. 246. 247. 248. University of British Columbia University of California, Berkeley University of California, Davis University of California, Irvine University of California, Los Angeles University of California, Merced University of California, Riverside University of California, San Diego University of California, San Francisco University of California, Santa Barbara University of California, Santa Cruz University of Central Florida University of Central Missouri University of Central Oklahoma University of Colorado at Boulder University of Connecticut University of Dayton University of Delaware University of Florida University of Hawaii at Hilo University of Houston University of Houston – Clear Lake University of Illinois at Chicago University of Illinois at Urbana Champaign University of Iowa University of Kansas Medical Center University of Kentucky University of Maryland, Eastern Shore University of Massachusetts, Dartmouth University of Massachusetts, Lowell University of Miami University of Michigan University of Missouri University of Missouri, Kansas City University of Montana University of Nevada, Reno University of North Carolina at Chapel Hill University of North Carolina at Charlotte University of North Carolina at Greensboro University of North Carolina at Pembroke University of North Florida University of North Texas University of Northern Iowa University of Notre Dame University of Oregon University of Pennsylvania University of San Francisco University of Sheffield (UK) University of South Carolina University of South Florida – Tampa Campus University of South Florida St. Petersburg University of Tennessee Knoxville 249. University of Texas at Dallas 250. University of Texas at San Antonio 251. University of the Sciences, Philadelphia 252. University of Utah 253. University of Washington – Seattle 254. University of Washington – Tacoma 255. University of Waterloo 256. University of Wisconsin – River Falls 257. University of Wisconsin – Madison 258. University of Wisconsin -Whitewater 259. University of Wisconsin – Parkside 260. University of Wisconsin – Platteville 261. University of Wisconsin – Stout 262. University of Wyoming 263. Valparaiso University 264. Virginia Commonwealth University 265. Virginia Military Institute 266. Virginia Polytechnic Institute and State University 267. Wake Forest University 268. Washington State University 269. Wayne State University 270. Weber State University 271. West Chester University 272. West Texas A&M University 273. West Virginia University 274. Western Carolina University 275. Western Connecticut State University 276. Western Illinois University 277. Western Kentucky University 278. Western Michigan University 279. Western Washington University 280. Winthrop University 281. Wright State University 282. Xavier University 283. Yeshiva University 37 References Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. McAleavey, A. A., Castonguay, L. G., Youn, S., Xiao, H., & Locke, B. (2014, June). What counselors want to know: A survey of practicing psychotherapists’ interest in research through a Practice Research Network. Paper presented as part of a panel at the 2014 Society for Psychotherapy Research (SPR), 45th International meeting, Copenhagen, Denmark. McAleavey, A. A., Youn, S., Xiao, H., & Castonguay, L. G. (2013, October). Evaluating routine practice and evaluating the methods of evaluation: How effective are routine practices for different symptom types, and what can different methods tell us? Paper presented as part of a panel at the conference of the North American Society for Psychotherapy Research (NASPR), Memphis, TN. 38 Orlinsky, D. E., Ronnestad, M. H., & Willutzki, U. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change. Bergin and Garfield’s handbook of psychotherapy and behavior change, 5, 307-389. Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547. Xiao, H., McAleavey, A. A., Youn, S., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2013, October). Predictor of premature termination: Modeling data to reduce drop outs. Paper presented as part of panel at the 2013 North American Society for Psychotherapy Research (NASPR), Memphis, TN. This publication is available in alternative media on request. Penn State is an equal opportunity, affirmative action employer, and is committed to providing employment opportunities to minorities, women, veterans, individuals with disabilities, and other protected groups. Nondiscrimination: http://guru.psu.edu/policies/AD85.html U.Ed. STA 15-30 MPC131813 39 Contact Information Center for Collegiate Mental Health Penn State University 501 Student Health Center University Park, PA 16802 Phone: 814-865-1419 Email: ccmh@psu.edu Web: ccmh.psu.edu 40