Responding to the Covid-19 pandemic at a university counseling center: administrative actions, client retention, and psychotherapy outcome

ABSTRACT

In this article, we examine how Counseling and Psychological Services (CAPS) at a large private university in the western United States addressed the abrupt suspension of in-person mental health services and switch to telebehavioral health due to the Covid-19 pandemic. We used descriptive data, binary logistic regression, and hierarchical linear modeling to investigate changes in number of sessions and clients, use of online mental health platforms, and changes in clients’ psychological functioning. Overall, we found that CAPS had a decrease in scheduled appointments (including intake) and no change in attendance rates. We estimate that premature termination impacted about 32–34% of individual therapy clients and 29–37% of group clients. The number of new users for our online therapeutic platforms did not appear to be affected. Clients in 2020 were not significantly more distressed than clients in the previous 3 years and we found no significant differences in outcome between 2020 and previous years, indicating that levels of distress and treatment trajectories remained similar across years. Future research should focus on longer-term client outcomes as well as increasing accessibility to therapy in pandemic conditions.

KEYWORDS:

• Covid-19
• telebehavioral health
• university counseling center
• client attrition
• psychotherapy outcome

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

David M. Erekson

Dr. David M. Erekson is an associate clinical professor at Brigham Young University's Counseling and Psychological Services (CAPS). He earned a master's degree in the psychology of education from Teachers College, Columbia University and a Ph.D. from Brigham Young University. His research focuses on psychotherapy research, practice-based evidence, and the use of actuarial methods in both psychotherapy and psychological assessment.

Russell J. Bailey

Dr. xRuss J. Bailey is an associate clinical professor in Counseling and Psychological Services at Brigham Young University. His degree is in Clinical Psychology from BYU and his current emphases include clinical treatment of anxiety, psychotherapy research, and improving mental health care. He believes in human capacity to improve well-being through scientific inquiry, awakened and present emotions, and engagement in chosen life directions.

Kara Cattani

Dr. Kara Cattani is a Clinical Professor and the Clinical Director of Counseling and Psychological Services at Brigham Young University.  She earned her PhD in Clinical Psychology from Florida State University and divides her time between administrative work, clinical practice, training of graduate students, consulting, and clinical research.

Sheilagh T. Fox

Sheilagh T. Fox is a doctoral candidate in clinical psychology at Brigham Young University. She is currently completing her predoctoral internship at the University of Utah Counseling Center. Her interests include psychotherapy process and outcome, common factors across therapeutic modalities, and the intellectual history of psychology.

Melissa K. Goates-Jones

Dr. Melissa K. Goates Jones is an assistant professor in the Psychology Department at Brigham Young University. She earned her PhD in Counseling Psychology from the University of Maryland and currently teaches and trains clinical psychology doctoral students. Her research interests include psychotherapy process and outcome, women’s issues, and the study of cultural diversity.