Prior to the pandemic, college counseling centers that offered telehealth sessions were the exception rather than the norm.
“For most college counseling centers this is a fairly novel and new approach to providing therapeutic services,” says Dr. Andrew Lee, president of the American College Counseling Association (opens in new tab) and director of Counseling and Psychological Services at Monmouth University (opens in new tab) in New Jersey. “I do know of some centers that have provided telehealth services in the past, but it was definitely a minority.”
That changed in March when counseling centers everywhere were forced online. But unlike how the mass migration of classes to a virtual setting has garnered mixed results, counseling centers have largely enjoyed a smooth transition to the digital world.
Moving counseling forward
“It is very convenient to be able to see your counselor from your phone as opposed to having to drive or even having to walk across campus,” Lee says. “That convenience factor is one of the benefits of being able to provide telehealth services.”
Dr. Barry A. Schreier, chair of the Association for University and College Counseling Center Directors (opens in new tab) and director of University Counseling Service at the University of Iowa (opens in new tab), says there is evidence that tele mental health is as beneficial to students as traditional visits.
“There’s consistent research out there that says broadly tele mental health is as effective as in-person counseling,” Schreier says. More research is underway to see how it’s rolling out with college students who are not doing it because they chose to but because they had to.
Online counseling can also have its complications. Often, counseling centers are not licensed to provide care across state lines, which can cause problems with so many students attending school online from their homes. For example, at the University of Iowa, more than 20% of students live in Illinois and can’t be treated by staff at the counseling center.
As a result of these limitations, many higher ed institutions have been adding additional resources for their students often in the form of support groups or skills-building groups that are not technically clinical services but are still services the counseling center can deliver, says Schreier.
Institutions are also working with telehealth companies that generally can cross state lines and have the added benefit of being accessible to students outside the 9 to 5 schedule most counseling centers operate on.
At Moravian College (opens in new tab) of Bethlehem, Pennsylvania, counselors had long struggled to find available psychiatric practitioners for students who needed that additional care. Just prior to the pandemic they decided to partner with Mantra Health (opens in new tab), which provides telehealth appointments with qualified practitioners.
“It worked out really well,” says Dr. Allison Blechschmidt, Counseling Center director at Moravian College. “Mantra provides a platform that works well for higher education.”
Few counselors think telehealth is a perfect substitute for in-person visits, but believe it will continue to be a major part of counseling.
“I've said many times I think students and people in general crave that human connection and contact, which makes counseling what it is,” Lee says. “It does seem apparent, though, that the field of college counseling has been irreversibly changed by this pandemic. We know now that what was once considered fringe or adjunctive of treatment can be effective and there is a greater comfort on the part of students and counselors with the use of technology to deliver these types of therapeutic services.”
Best practices for supporting student mental health remotely
Watch for sudden changes in behavior. If you have a student who used to be outgoing and interactive, someone who maybe was getting their work done and they did it well, and all of a sudden, they're not getting it done, that’s a student who may need help, Blechschmidt says.
Break into smaller groups online. Of course, spotting change in an online setting can be difficult, which is why breaking a class into smaller groups or making time for one-on-one communications can be helpful. One strategy Schreier recommends is holding post-class time for 15 minutes or so at the end of a video session to create these communication opportunities.
Follow-up and open up. “We have professors at Iowa who say, ‘I’ve gotten counseling and here’s how it helped me,’” Schreier says. He notes when a faculty member is willing to share that it can help destigmatize therapy for the student.
Prioritize human connection. “It's really important again to maintain that human connection, whether it's through the computer through Zoom or whether it's face-to-face,” Lee says. “We're all people who are going through an incredibly difficult experience together, and acknowledging the truthfulness of that and the impact that this has had on all of us might be a way to reduce some of the stigma and the shame of seeking counseling services. Ultimately, it's just being a person that is caring for another person.”