Counseling & Psychological Services Assessment

Mission Statement

At USU CAPS we embrace a holistic approach to student development by helping remove psychological, emotional and behavioral barriers to learning and success. We work to enhance the university experience for students and promote a healthy environment on campus, preparing students to be effective contributors in the world.

Services Provided

CAPS is dedicated to supporting students socially and emotionally as they learn life skills that will help them succeed academically and make meaningful contributions in their community. To achieve this goal CAPS provides a variety of services to help meet the individual needs of students.

Individual, group, and couple’s therapy; clinical consultation, intake and crisis management; assessment

CAPS staff attend to a wide range of student concerns, including adjustment issues related to stress, attending college, and individuation from family; relationship problems; issues of diversity or sexual orientation; a variety of clinical problems, including mood and anxiety disorders, eating disorders, both acute and chronic post-traumatic stress syndromes, suicidality, and characterological and psychotic symptoms. In addition to individual therapy, many students benefit from participating our successful group therapy program. CAPS also provides full-battery psychoeducation assessments for students who suspect learning disabilities, attention deficit or cognitive impairment secondary to head injury, seizures or emotional difficulties.

Outreach/consultation

Throughout the year CAPS provides workshops and presentations to exposed students to a variety of information and skills to help them increase their self-awareness, coping skills, and quality of life and relationships. Frequently requested topics include: stress/anxiety management, developing grit and resilience, emotion regulation, healthy communication, and helping students in distress. Programs are designed to meet the specific needs of each requesting organization. Our REACH Peers also facilitate events on various mental health related issues (i.e., Depression Screening Day, Healthy Relationships Week, Stress Bust, etc.). CAPS works closely with a number of entities across campus, providing consultation, assisting in referrals, and collaborating to promote a healthy campus environment (CAPS Staff Liaisons with USU Colleges and Departments). CAPS staff also meet individually with faculty, staff and students to provide referral information, self-help resources, and consultation regarding topics in psychology, concerns about students, and issues affecting the work environment.

Training

CAPS has four doctoral interns each year that work full-time. Each year interns are selected from the 30 to 60 students, from APA approved doctoral programs accost the nation, who apply for our APA approved doctoral internship. These students have completed all their doctoral course requirements before going on a required one-year internship. CAPS also has two graduate assistants and four practicum students from the USU APA approved combined psychology doctoral program. For over 30 years CAPS has helped the students in that program meet their training requirements. Under supervision, Interns, GAs and practicum students provide clinical services, assessment, outreach and consultation. Additionally, each year CAPS selects 10 to 14 USU undergraduate student volunteers to be CAPS REACH peers. These students attend a weekly seminar/class and receive individual supervision. REACH peers organize outreach workshops (i.e. anxiety screening days, body image fair, and stress bust, etc.) and provide individual education sessions to our clients.

Goals and Learning Outcomes:

CAPS Goals and Assessment Goals for 2017-2018

1. Provide effective clinical, outreach, and training services
   1. Continue to support therapist development and involvement in professional organizations and professional development activities.
2. Provide effective clinical services
   1. Show the increase in clinical services to students that is expected due to the recent funding of three more clinical positions.
   2. Continue discussing therapy outcomes (changes on CCAPS) and CSS results during summer change meetings.
   3. Assess for differences in client satisfaction between undergraduate and graduate students.
      Note: before school started this year, we changed the CSS to indicate if the student is an undergraduate or graduate student. We will be looking at the CSS survey results this summer to see if there are differences between these two groups.
   4. Work with Center for Collegiate Mental Health (CCMH) to learn how to run CCAPS change reports in Titanium for individual therapists and trainees and have supervisors discuss the results with supervisees at the end of each year.
3. Provide effective training to Interns, GAs, Practicum Students, and REACH peers.
   1. Continue assessing and discussing the effectiveness of trainees, supervisors, and training programs.
4. Provide effective outreach programs
   1. Develop the CAPS website to include an online system for requesting outreach presentations.
   2. During summer change meetings discuses and update outreach procedures and evaluation forms.

Foundational Documents

Professional Standards

CAPS has been accredited by the International Association of Counseling Services (IACS) since 1994. CAPS also has excellent training programs, including an American Psychological Association (APA) accredited internship. In addition to adhering to IACS Standards for University and College Counseling Services and APA Commission on Accreditation standards, CAPS staff, as required by Utah law, adheres to Utah Division of Occupational and Professional Licensing for Psychology Statutes and Rules; APA Ethics Codes and Guidelines; and the Association of State and Provincial Psychology Boards (ASPPB) Code of Conduct. Additionally, CAPS takes the Council for the Advancement of Standards in Higher Education (CAS) Standards for Counseling Services in to consideration when making decisions related to service provision.

Additionally, to stay current in the field psychology and consistent with the standards of care for University Counseling Centers, CAPS staff participate in continuing educational activities throughout the year and CAPS/CAPS staff are members of and participate in the following professional organizations:

• American College Counseling Association (ACCA),
• Association of University and College Counseling Center Directors (AUCCCD),
• Association of University and College Counseling Center Outreach (AUCCCO),
• Association for the Coordination of Counseling Center Clinical Services (ACCCCS),
• Center for Collegiate Mental Health (CCMH),
• Association of Psychology Postdoctoral and Internship Centers (APPIC),
• Association of Counseling Center Training Agencies (ACCTA),
• American Psychological Association (APA),
• Utah Psychological Association (UPA),
• Association for Applied Psychophysiology and Biofeedback (AAPB),
• Association for Applied Sports Psychology (AASP),
• and American Group Psychotherapy Association (AGPA).

Program Evaluation

CAPS staff believes in self-reflection and continual improvement. For continued accreditation of CAPS services and training program, CAPS completes annual reports, required self-study reports, and site visits for IACS and APA. CAPS also completes USU Division of Students affairs requested annual reports and self-studies. Additionally, every summer CAPS has several “Change Meetings”. During these meetings client surveys, training program evaluations, and other information gathered throughout the year are discussed, program policies and procedures are review, and changes are decided on and implemented. CAPS also gathers information and feedback from clients in a variety of ways throughout the year.

Titanium

Titanium is an electronic medical record software (EMS) system developed for college counseling centers. It is currently being used in over 1100 facilities worldwide. Titanium is the only EMR fully compatible with the Center for Collegiate Mental Health (CCMH) system of information gathering. CCMH uses information gathered from over 400 university and college counseling centers for research and to publish annual reports on college student mental health. Because of CAPS involvement with CCMH we are able to compare USU students seeking services to students seeking services across the nation on a variety of factors, such as severity of USU students seeking services compared average college students seeking services.

Counseling Center Assessment of Psychological Symptoms (CCAPS)

The CCAPS is a multi-dimensional assessment instrument included in Titanium. CAPS give the CCAPS to students before each session, which allows the therapist to see severity and changes in symptoms related to depression, generalized anxiety, social anxiety, academic distress, eating concerns, hostility, and substance use. Because of CCMH and CCAPS, USU CAPS can compare its clients’ symptoms and client outcomes and has been able to show (using the CCAPS Pre-Post Change Data Table) that for the last three years USU CAPS clients have changed (decrease symptoms severity on the CCAPS) in many areas at a higher rate than the national average.

Changes in CCAPS for USU CAPS Compared to National Averages 2014 to 2017

Client Satisfaction Surveys (CSS)

CAPS clients participating in individual therapy usually complete a CSS right before their sixth individual therapy session. If a client terminates before the sixth session, they complete the survey at their last session or they are emailed a link to the survey.

Summary of CAPS 2016-2017 Client Satisfaction Survey Results

Group Satisfaction Surveys

Students in group therapy are asked to complete a group satisfaction survey right before their last group each semester. During Fall 2016 and Spring 2017, 64% of students in process groups (Understanding Self-and Other and Women’s Groups) reported becoming more capable to creating meaningful relationships as a result of their group work. 100% of students in skills based groups reported group helped them improve their crisis management skills.

The Partners for Change Outcome Management System (PCOMS)

Several of CAPS therapist also use the PCOMS an evidence-based method used to improve the quality and outcome of therapy. It is a brief instrument used within each individual therapy session that collects client feedback regarding the therapeutic alliance and outcome of care. PCOMS involves administering two simple clinical tools, the Outcome Rating Scale (ORS) at the beginning of each session and the Session Rating Scale (SRS) at the end of each session. Feedback from the PCOMS enables a therapist to make rapid and effective adjustments to treatment, therefore enhancing the therapist’s ability to tailor and improve service delivery.

Evaluation of Trainees, Supervisors, and Training Programs

Evaluations of the competency and skills of trainees are completed on doctoral interns by their supervisors throughout the year. Baseline evaluations are completed on interns in October; mid-year evaluations are completed in January; and final evaluations are completed in July. Evaluations are completed on GAs and Practicum students at mid-semester and at the end of each semester. Evaluations on REACH peers are completed at the end of each semester. Trainees evaluate supervisors and training programs twice a year. All trainee sessions with clients are videotaped for review in weekly supervision meetings and trainees and supervisors share feedback with each other throughout the year. Additionally, the CAPS training committee meets monthly to discussed issues related to trainees and training programs.

Evaluations of Outreach Presentations and Workshops

Depending on the type and format of the presentation, Outreach/Workshop Evaluation forms are given out at the end of some presentations and workshops. Presenters then review the evaluations and make changes based on the feedback. Over the last several years, CAPS has been striving to improve assessment of clinical services, but has not been consistently assessing outreach services. Prior to Fall 2017, the CAPS REACH Peer Coordinator was also responsible for outreach coordination and was often too busy with REACH Peers to devote much time to outreach coordination and assessment of outreach services. With the recent addition of two new staff positions (starting Fall 2017), CAPS was able to designate one of the new staff members “Outreach Coordinator”. This staff member has recently joined the Association of University and College Counseling Center Outreach (AUCCCO). CAPS plans on reviewing outreach procedures and assessment of outreach during summer 2018 change meetings.

Assessment Plan/Matrix 2017-2018

Outcomes Data

Information based on Titanium records (with Diversity Groups and Assessment reports information added)
*Priority Consult Sessions started at CAPS Fall 2014
Table does not include all CAPS activities (e.g., group supervision, practicum class, meetings, trainings, etc.)

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*Scores on the CCAPS are divided into three ranges of distress, Low-Distress (white), Moderate Distress (yellow), and Elevated Distress (red), using Low and High cut-scores (Low-Cut and High-Cut). Clients that score over the Low-Cut include Moderate Distress plus Elevated Distress scores. Those that score over the High-Cut include Elevated Distress scores only.

National Average = The national average Pre-Post change in CCAPS scores for the indicated subscale and cut-score over several years.

CAPS Average = The average difference in Pre-Post change in CCAPS scores for USU CAPS clients during the specified academic year.

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CAPS clients participating in individual therapy usually complete a CSS right before their sixth individual therapy session. If a client terminates before the sixth session, they complete the survey at their last session or they are emailed a link to the survey. (N = 155)

This is an abbreviated summary and does not include all CSS questions

Continuous Improvement

1. When therapists attend professional development workshops and conferences, we often report back concerning workshop/conference “highlights” it may be helpful for the rest of our staff to know. We also share information in staff meetings and case consultation sessions.
2. Over the past several years students have noted on CSS that the waitlist for therapy at CAPS is too long and CAPS does not have enough therapists. Last year we were able to secure two new therapist positions for Logan Campus and one for Statewide Campuses; getting us closer to the IACS recommendations of one full time staff therapist for every 1000 to 1500 students.
3. Over the last year we have improved in our ability to use Titanium to track outreach more consistently as a staff.
4. Our internship program has been APA accredited since 1999. We have continued to improve our training programs to meet changing APA accreditation requirements and recommendations.
5. We discuss feedback receive and suggested changes throughout the year at staff meetings and open meetings. During summer Change Meetings we discuss and agree on changes to CAPS forms, paper work, and policies and procedures and then implement agreed upon changes.

Supporting Documents

Reports

• Changes in CCAPS for USU CAPS Compared to National Averages 2014 to 2017
• USU CAPS CCAPS National Comparison report 2016-2017
• USU CAPS CCAPS National Comparison report 2015-2016
• USU CAPS CCAPS National Comparison report 2014-2015
• Summary of CAPS 2016-2017 Client Satisfaction Survey Results
• CAPS 2016 Division of Student Affairs Self Study
• Summary Chart of Services Provided 2011 to 2017