Health Services Advisory Committee
May 8, 2013
Bert Epstein
But, first a therapy cartoon…
Student Psychological Services--- Outline
Presentations to Campus Community
 Specialized Services:

 Spanish-Language Therapy
 Psychiatric Services

Therapy
 Drop-In & Individual Therapy
Wait List & Outcome
 Consultations to Campus Community
 Training Component:

 Weekly 2-hour seminar, over 30 topics
Presentations by SPS Staff

Workshops
 8 Seminars (purposeful reduction from 19 last
year)
 240 Students (projected; up from 87 last year)
○ Range = 4 – 80

Outreach to Classrooms:
 16 Classes (down from 21 last year)
 518 Students (down from 734 last year)
○ Range = 22 - 50
Specialized Services (8/20 - 4/30)

Spanish-Speaking Therapy (10 hrs/wk)
& Psychiatric Service (4 hrs/wk)
250
200
150
2011-12
2012-13
100
50
0
SPA Cs
SPA Sess
PSY Cs
PSY Sess
Drop-In Appointments (8/15-4/15)
33% increase last year over previous; 11% increase this year
300
250
200
150
100
50
0
2008-09
2009-10
2010-11
2011-12
2012-13
500
0
Accessibility
% Students requesting drop-in seen same
day:
2011-12
75%
2012-13 (Spring Semester)
90%* **
* Shifted to having all students be seen in DI.
** About 5% not seen same day because their schedule
does not permit. Other 5% not seen because too many
people came in same day, and so we triage such that
people with least urgent need (through careful screening)
asked to return next day.
Accessibility

Average Wait time to be Seen:
 2011-12: 5 Days
 2012-13 (Spring Semester): 0 Days
Wait List … The Good News:

Average number students on Wait List:
 2011-12: 50

Average number days from first contact
to first ongoing therapy appointment (not
including drop-in appointment):
 2011-12: 62

2012-13: 22
2012-13: 29
Students Who Did Not Respond to Call
After Being Put on Wait List:

2011-12: 54%
2012-13: 24%
Wait List Disposition

After Initial Drop-In Session, when
clients were put on wait list, they then
were:
Seen: 58%
 Referred: 9%
 No Response: 24% [last year was 54%]
 Declined: 8%
 To be seen in summer: 2%

Outcome: Client Evaluations

“My academic performance was
compromised a little in the beginning,
but has improved since then.”

“It is amazing how accomplished I feel
for doing this!”

“It helped me concentrate much better in
school.”
Outcome: Client Evaluations

“I was able to work on my problems and
not let them interfere with my school work
(which it had been). For example: I was
able to focus on school and not have my
concentration break easily.”

“As I felt better about myself, I had more
energy to devote to my school work. If I
hadn’t had someone to talk to, I may have
dropped out of school. I was surprised how
quickly I was able to recover with the help
of my therapist.”
Outcome: Client Evaluations

“I am coming back to school after 20+
years. I had a huge fear of failure. I
believe therapy gave me the faith I
needed to succeed. I am happy to say
that I am averaging a 4.0!”

“I was going to give up on class, but
after talking with Shoshana I was better
able to rationalize things and stay in
class.”
Outcome: Client Evaluations

“I was at a C or D, and now I am at an
A.”

“I am less stressed and more able to
focus on what I need and feel more
capable to work done for classes.”
Outcome: GAF Scale

GAF= Global Assessment of Functioning

GAF score assigned by therapist at end of therapy

80-90: Absent/Minimal Symptoms
70-80: Transient, expectable reactions
60-70: Mild Symptoms (functioning well)
50-60: Moderate Symptoms (moderate function)
40-50: Serious Symptoms (serious impairment)
30-40: Impairment in reality or in several areas
20-30: Reality problems or can’t function in almost any area
0-20: Suicidal or can’t take care of self







Outcome: % Improvement in GAF*
50
45
40
35
30
2011-12
25
2012-13
20
15
10
5
0
Minor.
+ 1-5 pts
Moderate
+ 6-10 pts
Significant
+ 11-15 pts
Substantial
+ 16-20 pts
50%
0%

* Global Assessment of Functioning (GAF) change score reported by
therapist at end of treatment
Outcome: CCAPS (Counseling Center
Assessment of Psychological Symptoms)
This is first year of use at SPS
 62 symptom questionnaire completed by
student at intake, followed by similar 34
question version at 3rd and final session

 60 students (of 300) measured, as they
received multiple CCAPS

Asks students to rate each symptom
statement on a 0-4 scale, with 0
meaning it was “not at all like me” and 4
meaning it was “extremely like me”
Outcome: CCAPS (Counseling Center
Assessment of Psychological Symptoms)
Items on the Hostility Scale
- Overall, intended to show not danger but frustration,
irritability, tension
I have difficulty controlling my temper
 I sometimes feel like breaking or
smashing things
 I get angry easily
 I feel irritable
 I am afraid I may lose control and act
violently
 I frequently get into arguments
 I have thoughts of hurting others

Outcome: CCAPS – Change Score – first to last
administration - % improvement of “reliable change”
NOTE:
Subscale scores deflated due to beta version
100.00
90.00
80.00
70.00
60.00
50.00
40.00
30.00
20.00
10.00
0.00
Depression
Anxiety
Social Anx.
Academic
Eating
Hostility
Alcohol
Distress
Areas of Strength
Client satisfaction
 Diversity of services (individual,
Spanish-speaking, psychiatry, outreach)
 Access – very good capability to see
students immediately
 Large number of students reached
through classroom presentations
 Robust training program and very
satisfied trainees

Areas of improvement this year
Improved communication with
community clinics and increased
referrals -> more capacity here
 Expanded “pro bono” program where
therapists in the community see SRJC
students for free
 Improved access – almost all students
seen immediately
 Much shorter wait list

Areas for focus next year
Transition to new supervisors
 Streamline client and therapist
paperwork
 Further refinement of intake/triage/wait
list
 Technology: Expand website & Bring on
Electronic Medical Records
 Further implement new, extensive
Outcome Measurement system

Questions & Comments