Clinical Glossary
The Stepped Care Model
The model of stepped care was introduced to Counseling Services as a means of responding to increases in clinical demand (i.e., number of appointments) and overall severity of presenting concerns (i.e., intensity and duration). The basic idea is that clients begin their interaction with our department through a behavioral health consult, during which a collaborative decision is made about which of the available modalities of treatment are most appropriate.
Initial Assessment
From there, the Assessment and Triage Counselor makes a determination on which of our existing services are most appropriate for the given concern. We factor in transportation, insurance, ability to pay, treatment history, goals and motivation level into these decisions. These sessions typically last 45 minutes. The stepped decisions are as follows:
- Assignment to Life Skills
- Assignment to Group Therapy
- Assignment to Individual Therapy
- Referral
Life Skills
Let’s say you neither need nor desire therapy, but could use provider support in gaining knowledge that would help you better respond to life stressors (e.g., anxiety, sleep, loneliness). Life Skills is designed for you. Through a course of 2-5 intensive, weekly sessions, you will learn the skills needed to better tolerate distress.
Group Therapy
Many concerns that present to counseling are interpersonal/interactional/relational in nature. For example, resolving emotional pain after a break-up; transitioning through stages of grief, making friends/meeting new people, developing social skills, dating, and resolving conflict. Different groups are offered for a variety of presenting concerns. While some create opportunities for students with marginalized group identities to establish community, others focus on navigating the terrain of complex issues like post-traumatic stress.
There is significant value in having these therapeutic conversations in individual therapy. For above-named types of concern, however, there is often exponentially greater value in experiencing growth and support in the context of a group. Counseling Groups offer a safe space for learning, accountability, practice, normalization, validation, as well as the development of trust and hope differently than is experienced in individual therapy. Counseling Services defines all of its groups as “treatment” as opposed to “support” groups.
Individual Therapy
Reserved for more chronic, moderately severe presenting concerns, individual therapy is the top tier of intervention offered in our department. There are a number of scenarios where individual therapy is particularly appropriate, useful, and therefore responsible.
Referral
Given our use of a short-term model of care, there are some presenting concerns that best respond to long-term care, intensive outpatient treatment, residential treatment, or partial/full hospitalization. As such, we aim to do our best to pair you with an appropriate form of intervention. A referral does not mean that we cannot or do not want to work with you or your presenting concerns. It is an action to represents our commitment to your health and well-being and a recognition of when your needs exist outside our scope of practice. Examples of presenting concerns fit for referral include the following:
- Psychoses
- Bipolar disorders
- Long-term, severe depression
- Severe, complex trauma history
- Active substance abuse or dependence
- Lengthy history of presenting problem
- Moderate to severe personality disorders
- Active, severe or untreated eating disorders
- Clients with chronic suicidal threats and/or attempts
- Clients with multiple psychotropic medication needs
Making Steps
One of the primary value propositions of the Stepped Care Model is its ability to step clients up to a higher level of treatment, down to a lower level of treatment, or out either due to a need for referral to a provider in the community or because therapeutic goals have been met. In an effort to ensure consistent and timely quality of care, regardless of your initial disposition, your progress in therapy will be monitored by the Behavioral Health Case Manager with a goal of determining if you are responding well or need adjustments.
Consultation Appointments
These appointments serve a task-oriented function of enabling space for students to voice concerns or be paired with resources. The following are examples of reasons you may request or be scheduled for a consultation:
- Post-Hospitalizations
- Referrals
- Case Management for linking with community resources
- Letters for Medical Withdrawal,
- Group Screenings in advance of beginning group counseling
- Receiving guidance on supporting a peer/friend
Psychological Assessments
Psychological evaluation is the process whereby a qualified provider gathers more information to better develop a clinical diagnosis. The need for them may present as a standard part of treatment. They may also be directly requested by students for such purposes as ADAAA accommodations (e.g., Trauma and Stressor-Related Disorders, Anxiety and Mood Disorders, AD/HD).
