Year in Review: CCMH Research Publications in 2024

This study examined predictors of academic distress among students who were past or current U.S. service members (n = 3,318) and a random sample of non-service members (n = 3,318) in college counseling. 

Pre-treatment predictors of academic distress were tested separately for service members, non-service members, and both samples combined. 

Results suggested that past treatment history, social support, service member status, and race/ethnicity are related to academic distress among students in college counseling (e.g., White service members reporting higher distress than non-service member clients of other racial/ethnic backgrounds). 

Additionally, having a history of trauma was uniquely related to higher academic distress among service member clients. 

This study compared Native American and White students’ general psychological distress and academic distress at the beginning of counseling and their change in symptoms during treatment.  

The authors used a sample of students with high initial general psychological distress (9.689) and academic distress (9,643).  

On average, Native American and White students began counseling with similar levels of general psychological distress. However, Native American students reported higher academic distress at the beginning of treatment.  

Native American students experienced faster and larger decreases in general psychological distress than White students during counseling. Native American and White students had a similar amount of improvement in academic distress during counseling, but Native Americans still ended services with higher academic distress.  

This study examined levels of general psychological distress and the relationships among perfectionistic thoughts, self-compassion, and distress in a non-clinical, national U.S. sample of 472 Doctor of Veterinary Medicine (DVM) students. 

LGBQQ+ DVM students reported lower self-compassion, higher general psychological distress, and higher rates of suicidal ideation than heterosexual DVM students. 

As a group, DVM students reported similar levels of distress as students being treated at college counseling centers. 

Perfectionistic thoughts were associated with lower self-compassion, which in turn was related to higher general psychological distress. This indicates that low self-compassion may be a mechanism by which perfectionistic thoughts lead to higher distress among DVM students. 

This study compared symptom levels and mental health history between transgender and genderqueer students (TGQ; n = 1,583) and a random sample of cisgender students (n = 1,583) in college counseling. 

TGQ students reported higher symptoms in several areas than cisgender students at the beginning of counseling, such as depression, generalized anxiety, social anxiety, eating concerns, and frustration/anger, though cisgender women had higher alcohol use symptoms. 

TGQ students were more likely to have a history of suicidal ideation and non-suicidal self-injury in the past year than cisgender students, and transgender students used approximately 1.5 more individual therapy sessions than cisgender students.  

This study examined changes in psychological symptoms and intersectional identities among sexual and gender minority (SGM) students in college counseling between 2012-2015 (n = 231,867) and 2020-2021 (n = 89,510). 

The percentage of counseling center clients who identified as SGM rose significantly from 2012-2015 to 2020-2021. Sexual minority clients were also more likely to identify with a marginalized race/ethnicity in 2020-2021 than in 2012-2015. 

SGM clients in later years reported more severe mental health symptoms at the beginning of counseling than in earlier years (e.g., academic distress, anxiety, depression). 

There were differences in levels of certain symptoms between specific groups of SGM clients. For example, non-binary students reported especially high symptoms in comparison with those of other gender identities. 

This study examined the relationship between social support and improvement in general psychological distress during counseling among international (n = 2,390) and domestic U.S. students (n = 37,695). 

International students reported lower social support than domestic students at the beginning of counseling. 

International students reported higher distress at the beginning and end of counseling than domestic students. 

International students who reported low social support at the beginning of counseling had more severe symptoms at the end of counseling than international students with higher social support and domestic students. 

This study examined the relationship between first-generation students’ (FGSs) and continuing-generation students’ (CGSs) sense of mattering to others and their levels of psychological symptoms at the beginning of counseling in the United Kingdom (N = 242). 

FGSs and CGSs reported similar levels of mattering and symptoms at the beginning of counseling. 

For both FGSs and CGSs, a stronger sense of mattering to others (and a lower sense of not mattering) was correlated with lower levels of symptoms at the beginning of counseling. 

Having a sense of mattering appeared to be more protective for FGSs than CGSs: while mattering was associated with lower symptoms for both groups, the relationship between mattering and lower symptoms was stronger for FGSs. 

This study explored how students with different combinations of identities and clinical characteristics (N = 2,579) experienced the working alliance in the first four sessions of college counseling. 

Most students reported a strong working alliance during counseling. However, a minority (approximately 6%) reported a weak working alliance across all four of their initial sessions. 

Women of color with severe general psychological distress and a history of prior counseling were overrepresented in the group of clients with a weak working alliance. 

LGBTQQ+ students were also less likely to report a strong working alliance in the first four counseling sessions. 

This article describes the development and research support for the Clinical Load Index (CLI). The CLI was designed to provide a more accurate and consistently comparable supply-demand metric that describes the landscape of staffing levels.  

CLI scores can be conceptually thought of as the “average annual caseload” for a “standardized counselor” within a counseling center, or the average number of clients a typical full-time counselor would see in a year at that center. 

The CLI calculation includes the number of students who use a counseling center each year, the total number of clinical hours available at the counseling center during a typical week, and the typical number of clinical hours counseling center clinicians engage in per week (24). 

Using data from 2017 to 2022, the authors found that CLI varies widely across institutions but is fairly stable from year to year. Centers with higher CLIs (i.e., more clinical demand per counselor) tend to provide fewer sessions and facilitate less symptom change than centers with lower CLIs. 

CCMH gives member centers an individualized CLI report each year, which centers can use to evaluate the level of services they may be able to provide given current staff levels, as well as advocate for the staffing needed to meet their clinical demands. 

This study examined the suitability of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62) for use with students of five different racial/ethnic backgrounds: Asian American, Black/African American, Hispanic/Latinx, Native American, and White. 

Based on a national U.S. sample (N = 307,685), the overall structure of the CCAPS was consistent across the racial/ethnic groups (i.e., the CCAPS-62 subscales were generally equally suitable for use with all groups). 

Students of different racial/ethnic backgrounds responded differently to some of the CCAPS-62 items. For example, Asian American students’ responses on the Eating Concerns subscale may under-estimate their actual level of these symptoms in comparison with other racial/ethnic groups. 

The authors provide recommendations for interpreting the CCAPS-62 with diverse clients, such as discussing clients’ responses with them to help interpret their scores. 

This study examined preferences for individual versus group and telehealth versus in-person therapy among former college counseling clients (n = 455) and students from a general student body sample (n = 322). 

On average, students from both samples strongly preferred individual therapy over group therapy. 

Students also reported preferences for in-person therapy over teletherapy. This preference was particularly strong when comparing in-person individual therapy with group teletherapy (i.e., strong reluctance to engage in group teletherapy compared to in-person individual therapy). 

Older individuals and women reported stronger preferences for individual versus group therapy, while social anxiety symptoms were associated with preferences for using online self-help materials.  

This study examined whether number and frequency of individual therapy sessions was related to symptom reduction and academic dropout among 16,197 students in college counseling. 

Within short-term individual counseling, students who received a higher number of sessions and more frequent sessions showed more improvement in symptoms during treatment. 

In turn, students who had more improvement in symptoms were less likely to drop out of their college or university during treatment. This relationship remained even after controlling for significant correlates of dropout, such as gender, history of psychiatric hospitalization, and academic distress at the beginning of counseling. 

This study examined the effectiveness of telehealth counseling during the COVID-19 pandemic among 448 students who received college counseling in the United Kingdom. 

This book reviews current knowledge about trends in various aspects of college student mental health (e.g., depression, suicide, anxiety, substance use), college student development, and interventions to increase college students’ wellbeing. 

Data on these topics were drawn from multiple national sources, including CCMH, the Healthy Minds Study, and the National College Health Assessment. 

Recent contextual factors that influence college students’ mental health and development are also discussed, including the COVID-19 pandemic, discrimination, and social media. 

This text can serve as a guide to professionals with interest in college student mental health or as a resource for students in classes on related topics.