Examining the Effectiveness of Campus Counseling for College Students with Disabilities

The following is a summary of an article recently accepted for publication using CCMH data.

Background

While the number of college students with disabilities continues to increase (Hurst & Hudson, 2005; U.S. Department of Education, 2019), research shows that students with disabilities in general graduate at a lower rate than their nondisabled peers (Wessel et al., 2009), remain underrepresented in the workplace (U.S. Bureau of Labor Statistics, 2020), and are at an increased risk of experiencing mental health issues on campus, including increased rates of anxiety, academic distress, suicidality, and self-injury (Coduti et al., 2016). Individual counseling, such as that offered through university counseling centers (UCC) has the potential to help mitigate academic and psychological distress among college students and play an important role in promoting positive outcomes among this growing group of students. Still, very little is known about the use of campus-based individual counseling services, or the relative effectiveness of these services, for students with disabilities.

To address this gap in research, O’Shea et al. (2021) examined the effectiveness of campus-based counseling for students with disabilities, using data gathered by the Center for Collegiate Mental Health (CCMH) for the 2016-2019 academic years. The 34-item version of the Counseling Center Assessment of Psychological Symptoms (CCAPS) was used to assess treatment outcomes by measuring changes in the Distress Index (DI) and academic subscales. The Standardized Data Set (SDS) was used to identify clients who registered with disability services at their respective institutions, including the category of disability they are experiencing. For the purpose of comparisons, participants were assigned to one of three groups: help-seeking students with only psychiatric disabilities (n = 643), students with disabilities other than only psychiatric disabilities (n = 3,833), and students without a disability (n = 54,576). To assess changes over the course of treatment, clients’ final (i.e., within 14 days of their last attended appointment) CCAPS administrations were recorded.

Results indicate that students with both psychiatric and other disabilities present to UCCs with higher levels of academic distress in comparison to their nondisabled peers, and students with psychiatric disabilities present with higher levels of psychological distress than students with non-psychiatric disabilities. While students across the three groups (no disability, psychiatric disability, non-psychiatric disability) saw a reduction in psychological and academic distress over the course of treatment, students with psychiatric and non-psychiatric disabilities experienced less improvement in psychological and academic distress than their nondisabled peers. These results suggest that students with psychiatric and non-psychiatric disabilities change less or at a slower rate in counseling in comparison to their peers without disabilities.

Implications for Practice

The results of this study are consistent with the 2017 CCMH Annual Report, which demonstrated that the length of treatment required to achieve the same level of symptom reduction varies widely across students and that different presenting concerns are associated with different lengths of treatment.

In addition, this study offers helpful information for counseling practitioners who work with students with disabilities about their approaches to improve the academic and psychological distress of this growing population of students. When working with students with disabilities, it is important for therapists to thoroughly assess the resource history (e.g., IEP versus resources currently being used), assess for any resource gaps that now exist that are different from high school (Individual Education Plans – IEPs vs. accommodations in higher Education), and any current impact on functioning, identity, and the impact on student self-efficacy, in order to be attentive to the comprehensiveness of the disposition. Clinicians at university counseling centers should be aware of the issues and barriers that students with disabilities may face and focus on identifying appropriate therapeutic targets and approaches to treatment that build on students’ strengths while addressing issues and obstacles to treatment effectiveness. Furthermore, counselors at university counseling centers should work with students to cultivate resources and supportive networks on campus, encouraging the establishment of collaborative networks with other campus-based health services and disability-related services. Leveraging these resources and networks is likely to benefit students with disabilities, as they provide opportunities for shared experiences and social support, which have been found to negatively predict academic distress (Fleming et al., 2018).

University counseling centers may consider providing additional trainings on the following: (a) the contextual barriers faced by students with psychiatric and non-psychiatric disabilities; (b) legislation related to disability rights in higher education; (c) issues related to stigmatization, access, and inclusion in college settings; and (d) the implications of the increased risk factors demonstrated by students with disabilities, as they have been found to be at a higher risk for self-injurious and suicidal behavior (Coduti et al., 2016).

Moreover, the provision of services to students with disabilities should not be the sole responsibility of offices of counseling centers and disability support services. As the number of college students with disabilities and psychiatric disabilities is at an all-time high, and given the unique challenges related to mental health, academic and psychological distress, and academic persistence and success, students with disabilities should be able to receive informed assistance from multiple sources on campus. Finally, colleges and universities are encouraged to evaluate the alignment between their expressed desire to support students with disabilities and how they have resourced the counseling center using the Clinical Load Index (CLI). Counseling centers with a high CLI will be very limited in their ability to provide treatment to students in general and especially to students requiring longer treatment, such as students with one or more disabilities.

O'Shea, A. M., Kilcullen, R., Hayes, J., & Scofield, B. (In Press) Examining the effectiveness of campus-based counseling for improving academic and psychological distress among college students with disabilities. Rehabilitation Psychology.

Amber O' Shea, Ph.D.
Assistant Professor
Rehabilitation and Human Services
Department of Educational Psychology, Counseling, and Special Education
Pennsylvania State University