A Comparison of Telehealth and In-Person Therapy at College Counseling Centers

The COVID-19 pandemic had a substantial long-term impact on how mental health services were delivered across the country.  College counseling centers, similar to most other mental health facilities, were forced to abruptly transition to remote services in March of 2020.  To better understand this unprecedented systemic migration to remote care, CCMH began collecting data on the service modalities (in-person, video, audio, and text) offered at centers during the early phases of the pandemic.  At the time, there were ongoing questions regarding the staying power of telehealth services once students resumed a more typical academic instruction environment, which eventually occurred in 2021-2022. Now, approximately four years after the onset of the COVID-19 pandemic, CCMH completed an initial investigation evaluating in-person, video, and hybrid (combined) services, answering the following questions:

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College Counseling Centers are Increasingly Treating a Greater Percentage of Students who Represent Diverse Identities: 11-Year Trends

The demography of higher education institutions in the United States has notably changed over the last two decades.  For example, the proportion of college students who identify as racially/ethnically diverse has shifted nationally, rising from 45.3% of the general student population in 2010 to 52.1% in 2022 (National Center for Education Statistics, NCES, 2010; 2022).  Notably, in the same time period, the percentage of college students who identify as Hispanic/Latino/a/x increased from 11.8% to 18.9%, and the representation of Asian American/Asian students rose from 5.5% to 6.6%.  Additionally, there has been movement in the percentage of students from other traditionally marginalized groups, such as the LGBQQ+ (Lesbian, Gay, Bisexual, Queer, Questioning, plus others) and TGNB+ communities (e.g., Transgender, Non-binary, plus others).  The proportion of students identifying as TGNB+ in the general student body increased from 1% in 2014 to 4% in 2023 (Healthy Minds Study, HMS, 2014; 2023).  Likewise, the American College Health Association (ACHA) noted changes in the proportion of college students who identify as LGBQQ+, rising from 6.6% in 2008 to 19.6% in 2019.

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Student Experiences of Discrimination and Mental Health

After the murder of George Floyd on May 25, 2020, and the national reckoning that ensued, CCMH immediately began to explore ways students could share recent experiences of discrimination when they seek services at college counseling centers. This initiative was deemed critical by the collective collegiate mental health community given the CCMH measures at the time did not adequately capture experiences of discrimination from the student’s perspective, and there was cautious optimism this awareness raising effort would help clinicians more effectively comprehend the contextual environments of students and enhance the support services they provide. Moreover, research emphasizing that discrimination is connected to increased mental health distress, social isolation, and suicidality (Oh et al., 2018; Paradies et al., 2015) further highlighted the need for this endeavor.

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2023 Annual Report

The CCMH 2023 Annual Report describes 185,114 unique college students seeking mental health treatment, 4,817 clinicians and more than 1.2 million appointments from the 2022-23 academic year. This is the 15th year the report has been produced.

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Symptoms and Presenting Concerns of Clients in Greek Life: How Do They Compare With Other Students?

College fraternities and sororities (referred to collectively as Greek life) are a long-standing component of higher education in the United States. Greek life can frequently intersect with treatment and outreach at university counseling centers (UCCs), as certain concerns such as alcohol abuse and sexual assault are reported at higher rates among students in Greek life than students in the general student body (e.g., Zimmerman, 2022). However, less is known about how Greek-affiliated students seeking college counseling services compare with non-affiliated students.  For example, while non-clinical Greek-affiliated students report lower depression and anxiety symptoms than non-affiliated students in the general student body (Grace et al., 2022), it is unclear whether this is true among treatment-seeking students as well. A better understanding of Greek-affiliated clients’ symptoms and presenting concerns when they begin counseling could help colleges/universities and UCCs identify intervention, outreach, and general support needs for these students. As such, this blog explored four questions about Greek-affiliated students seeking counseling at UCCs:

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Comparing Graduate and Undergraduate Students Presenting for Counseling

College counseling centers serve the needs of diverse student populations, including students at both the undergraduate and graduate levels. The demands faced by students at these various stages of their academic careers vary, which may result in differences in symptoms and presenting concerns between graduate and undergraduate students. It is also possible that graduate and undergraduate students systematically differ on other demographic identity variables that could lend insight to their presenting concerns. An understanding of potential differences between these groups could help inform the support services provided by academic institutions and college counseling centers. As such, this blog examined the following questions:

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International Students Are More Socially Isolated than Domestic Students, and the Gap Is Growing After COVID-19

International students in the United States consistently report higher rates of social isolation than their domestic peers (Prieto-Welch, 2016; Smith & Khawaja, 2011). Some research suggests that this disparity has grown during the COVID-19 pandemic due to the transition to online learning, fewer opportunities for in-person social activities, and increased discrimination faced by international students (Al-Oraibi et al., 2022; Koo & Jiang, 2022; Maleku et al., 2022). As colleges and universities transition to more sustained post-pandemic operations, understanding recent changes in social isolation among international students could help institutions provide them with appropriate support. Additionally, examining changes in social isolation among international students at college counseling centers could inform recommendations for students who are struggling the most and clarify impacts of social isolation on mental health symptoms. In this blog, we explore three questions about social isolation among international students attending colleges and universities within the United States:

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Why Counseling Center Staff Are Leaving and Why We Should Take Notice

The Association for University and College Counseling Center Directors (AUCCCD) and the Center for Collegiate Mental Health (CCMH) share and collaborate on data regarding counseling center trends. This blog, the first featuring our partnership, focuses on counseling center staff turnover. As part of the annual renewal process, CCMH requested turnover data from its member centers in Summer 2022 while AUCCCD requested turnover and recruitment data from its membership during the Fall of 2022. The data reflects information from the 2021-2022 academic year.

Trends in Social Anxiety Symptoms and Isolation in Students Seeking College Counseling Services

The Center for Collegiate Mental Health (CCMH) 2022 Annual Report highlighted that Social Anxiety is the area of distress that demonstrated the largest 12-year increase among students seeking services at college counseling centers nationally. Social anxiety has been found to be prominent among college students and linked to mental health problems later in life (Purdon et al., 2001; Schry et al., 2012). Clients with higher social anxiety symptoms utilize more UCC services (Kilcullen et al., 2021; Janis, 2017) and experience stigmatization (Anderson et al., 2015). Thus, it is important to better understand current trends in social anxiety for students seeking college counseling services to provide clinicians and institutions with nuanced information that may inform care and programs. In the current blog, we further explored the trends in social anxiety, including information from clinicians’ assessments, as well as co-occurring problems that are associated with social anxiety. Specifically, the following questions were answered:

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The Relationship Between Experiences of Discrimination and Presenting Distress

In recent years, there has been increased attention on discrimination and its negative effects on well-being, including both physical and mental health. Students on university and college campuses are not immune from experiencing discrimination. According to data from the National College Health Assessment (NCHA), 7.9% of students experienced discrimination, and this rate is even higher in students who identify with minority identities.

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2022 Annual Report

2022 Annual Report

The CCMH 2022 Annual Report describes 190,907 unique college students seeking mental health treatment, 4,688 clinicians and more than 1.2 million appointments from the 2021-22 academic year. This is the 14th year the report has been produced.

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CCMH Membership Benefits

The Center for Collegiate Mental Health (CCMH) is the largest practice-research- network of its kind in the world, focusing on the research of college student mental health. More details about CCMH history and our mission is described here in a prior blog. This particular blog zooms in to focus on the benefits of CCMH membership, as membership with CCMH gives a counseling center access to various tools and resources. Whether you are a current member, or someone interested in membership, this blog is designed to review each of the membership tools/benefits available and expand a bit to share how members use them in their centers.

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Exploring College Counseling Center Trends in Clients with Marginalized Gender Identities: Another View from Above

This blog post is dedicated in loving memory of Nora Maginnis (1963 to 2022). Nora, who served as a Psychiatric Nurse Practitioner at Penn State Counseling and Psychological Services, was a beloved colleague and trailblazer in providing affirming care for individuals who identify as transgender and non-binary. Nora, your tremendous work and impact will always be remembered.

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Membership Growth Over Time

CCMH Membership Growth

CCMH operates and exists thanks to our membership of over 750 colleges and universities! Since 2013, membership has grown substantially, which has allowed us to offer new tools and conduct more research that, in turn, supports college counseling centers and the clients served. All of our members contribute to research by providing center level characteristics and Clinical Load Index (CLI) information. This vital data contribution from members supported the development of the Clinical Load Index (CLI) and three years of subsequent national CLI distributions.

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Predictors of Suicidal Behavioral in College Students Seeking Treatment

This blog is a summary of a CCMH peer-reviewed study that examined predictors of suicide behavior amongst student clients who received services at counseling centers nationally.

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Varsity Student Athletes Utilization of College Counseling Centers

This blog is a summary of a CCMH peer-reviewed study that examined the utilization rates, presenting concerns, and treatment outcomes of varsity athletes who seek services at college counseling centers.

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Counseling & Students with Paid Employment

This blog highlights findings from an exploratory study currently in preparation that seeks to characterize student clients who report paid employment compared to those who don’t.

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Exploring Collegiate Trends in Diverse Sexual Orientation: The View from Above

CCMH is celebrating Pride Month by taking a closer look at the population of Lesbian, Gay, Bisexual, Queer, Questioning, and other (LGBQQ+) student clients with diverse sexual identities who received care at university and college counseling centers (UCCs).

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Effectiveness of College Counseling Centers

This blog is a summary of a CCMH study on the effectiveness of treatment in college counseling centers published in 2019.

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Psychotherapy Outcome for College Students with ASD and other Disabilities in a National Sample: Replication, Refinement, and Extension

The April 2022 CCMH blog post has been guest authored by Jonathan C. Cox and E. Shannon Neeley-Tass at Brigham Young University, Provo, UT.  Dr. Cox and Dr. Tass have graciously written April's post to share their findings for Autism Acceptance Month.  CCMH is incredibly grateful to Dr. Cox and Dr. Neeley-Tass for conducting this important research, using the CCMH dataset, and for share their findings with the CCMH community.

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