National Research Consortium of Counseling Centers in Higher Education

Project 8: Psychologist Decision-making About Private Practice Clients (2024-present)

The number of US adults who received mental health services in the past year increased from 27.2 million to 41.4 million from 2002 to 2020 (National Survey on Drug Use and Health, 2002-2020). The severity of concerns has also worsened. Despite these increasing needs, the net availability of mental health professionals is shrinking. This situation has contributed to a nationwide mental health crisis, especially among those with significant barriers to help-seeking, including the over 30 million Americans who are uninsured (Cha & Cohen, 2022) and less likely to receive treatment due to high out of pocket costs (Rowan et al., 2013; Walker et al., 2015). Individuals with the most severe symptoms are the least likely to be insured and encounter financial barriers that cause them to forego treatment at higher rates than the general population (Garfield et al., 2011; Walker et al., 2015).

In light of increased demand for services, extreme barriers to help-seeking, and disproportionate impacts on individuals with severe symptoms and fewest resources, it is imperative that we understand how mental health providers decide whether to accept new clients into their practices. This qualitative study seeks to better understand these issues through focus group discussions with practicing psychologists in the Austin metro area. Focus groups will explore psychologists’ practice structures, considerations when accepting or declining new clients, and overall perceptions of the mental healthcare system and its ability to meet growing community mental health needs.

Project 7: Understanding Student Distress and Academic Success (2016 - present)

Institutions of higher education have placed a greater emphasis on promoting well-being among students given the acceleration in demand for student mental health care. Past research examined student success in terms of non-malleable factors such as demographics, standardized tests and high school grades, with less attention to modifiable factors.

Understanding Student Distress and Academic Success is a prospective, 6-year longitudinal investigation of the ways in which malleable psychosocial well-being factors in a variety of domains (perfectionism, coping self-efficacy, social integration/belonging, grit, resilience, and meaning in life) are associated with persistence, retention, and trajectories of academic performance in addition to distress and suicidality in a sample of over 7,000 postsecondary students from 15 U.S. institutions of higher education.

Project 6: Survey of Distress, Suicidality, and Student Coping (2011)

In an effort to further understand the continuum of suicidal thinking, as established by Research Consortium Project 5: The Nature of Suicidal Crises in College Students (2006), the Research Consortium designed a 79-item survey. The objectives of this survey were a) to confirm findings related to the continuum of suicidal thinking in college students, b) to understand student stressors, attitudes, and coping behaviors related to a recent stressful period, and c) to gain insight into students’ utilization of resources and help-seeking behaviors. Data were obtained on over 26,000 students at 74 U.S. colleges and universities.

View project 6 survey codebook

Project 5: The Nature of Suicidal Crises in College Students (2006)

Given the increased incidence of college student suicide and limitations in solely applying an individual, clinically focused paradigm of suicide prevention to college campuses, this study sought to better understand the continuum of suicidality in college students. A comprehensive survey on suicidality was created and administered across 70 participating U.S. colleges and universities and data was collected from 26,451 undergraduate and graduate students. Lifetime prevalence of suicidality, past year suicidal ideation and prevalence of suicide preparation, methods and attempts were reported, alongside characteristics of serious suicidal ideation, contributing factors, associated mood states, help seeking, and protective factors. The proposed paradigm focused on suicidality as a population level problem rather than an individual issue, calling for the entire campus community to share the responsibility of reducing student suicidality. Specifically, it points to the need to expand the intervention efforts to include prevention at the campus environment and personal level, early level interventions alongside treatment for individuals already in crisis, and implementing relapse prevention efforts.

View project 5 survey codebook

Project 4: Mental Health Concerns of Non-Clinical Sample (2002)

In order to continue establishing a database which included both clinical and non-clinical samples, our fourth project concentrated on recruiting students who had not sought counseling at the time they were surveyed. They were asked to fill out the same Counseling Concerns Survey booklet that was used in Project 3. Such sampling helped to determine differences in mental health concerns experienced by students who seek counseling versus those who do not avail themselves of such services. This fourth sampling allowed us to compare students' mental health concerns over a 12-year time span (i.e., across the previous three samples). Data were obtained on 1,500 students at 15 colleges and universities.

Project 3: Psychotherapy Process and Outcome Study (1997-98)

Building on the success of these first two projects, The Research Consortium implemented a psychotherapy process/outcome study to investigate the impact of counseling services on the mental health concerns of college students. Students were recruited for the study during the 1997-98 school year when they came to the counseling centers for their initial appointment. The student agreed to participate by filling out a consent form and was then instructed to complete the Counseling Concerns Survey and the Stages of Change Measure before the first session. Before each subsequent individual therapy session, the client filled out the Outcome Questionnaire-45 (OQ-45). An optional, though highly recommended, measure that each center was encouraged to include is the Working Alliance Inventory completed by both the client and the therapist before the start of the fourth session of therapy. Six weeks after the date of termination, the student was mailed the OQ-45 and the Service Satisfaction Scale-30 as follow-up measures. Information about therapist theoretical orientation was obtained using the Coan Theoretical Orientation Survey. Data were obtained on 4,500 clients and 241 therapists across 42 centers.

View project 3 survey codebook

Project 2: Mental Health Concerns of Non-Clinical Sample (1994-95)

In 1994-95, The Research Consortium conducted its second study which focused on the mental health concerns of students who had not sought counseling (i.e., a non-clinical sample) so that we could compare them to the clinical sample from Project 1. The same Counseling Concerns Survey was used in this second study so that direct comparisons could be made. Each center recruited a sample of students who had not sought counseling at the time of contact, resulting in some 2,500 participants from 28 campuses.

Project 1: Nature and Severity of College Students’ Counseling Concerns (1991)

In 1991, the Research Consortium implemented its first study, a survey of students seeking counseling services. The primary aim was to establish baseline data about the severity of students' concerns with the goal of tracking variations in the types and severity of presenting problems over time. The four-page Counseling Concerns Survey, developed for this study, was comprised of sections on demographics and mental health history, presenting problems (a 42 item list comprised of common student concerns), and the Brief Symptom Inventory. Students seeking services at 32 participating counseling centers were surveyed over the course of 12 months, resulting in data from approximately 3,000 clients.