Clinical Assessment at College Counseling Centers: The Consultant-on-Duty Model.

The consultant-on-duty (COD) clinical consultation model maximizes efficient use of services, is distinct from other university counseling center (UCC) services, and precedes therapy. This model enables clinicians to ensure optimal fit between client need and type of UCC services provided, including brief therapy. The 4 objectives of the COD model include quick access to initial consultation, management of treatment expectations, collaborative treatment decisions, and planning for client assistance. Keywords: brief therapy, clinical consultation, clinical service model ********** Clinical service delivery in university counseling centers (UCCs) has been a topic of discussion in the literature for several decades. While the debate is still ongoing about a possible increase in the severity of psychopathology among students seeking help at UCCs (Sharkin & Coulter, 2005), data are mounting that suggest increased use of clinical services on campuses across the United States. Mental health needs in college students are an ongoing concern for universities. A high number of college students tend to report, among others, depression, anxiety, higher than average use of psychotropic medication (Soet & Sevig, 2006), increased perfectionism, stress, and sleep concerns (Erdur-Baker, Aberson, Barrow, & Draper, 2006). Many of these distressed students rely on psychological services provided by UCCs. UCCs provide crucial mental health services on campus that extend to improved retention and academic performance for students (Bishop, 2010; Sharkin, 2004); however, resource and budget constraints, coupled with high student mental health needs, have placed high demands on UCC staff and clinical services. Because staff resources at counseling centers are often limited and may not have kept pace with increased student needs, effective and efficient service provision becomes a key issue for the agencies. This article addresses the need for time-sensitive service delivery models, provides an overview of existing delivery models, and presents a detailed example of how a particular UCC is managing the demand with a clinical consultation system. Outpatient Clinical Service and Consultation Models Efficient service delivery becomes a pertinent issue when there is a gap between demand and service availability, as is the case in some of today's UCCs. UCCs, not unlike other mental health service agencies, have to define the types of services they provide and screen clients for a match between needs and service options. Rudd (2004) noted that UCCs may increasingly take on the functions of community mental health centers and be faced with similar questions about funding, administration, and scope of services. Clinical Consultation and Assessment Models Consultation and intake models have been discussed in the literature under terms such as assessment in brief therapy (Budman & Gurman, 1988), psychodynamic assessment and consultation (Carlson, 2004), clinical intake systems (Murphy & Martin, 2004), and mental health triage systems (Rockland-Miller & Eells, 2006). These clinical service delivery models vary by purpose, accessibility of services, clinical time investment, and specificity of services provided. Murphy and Martin (2004) surveyed 117 UCCs about their clinical service delivery models and categorized them as follows: (1) A centralized wait list system, where counselors do the intake and then place the client on a centralized wait list; (2) A centralized client assignment system, where an individual (e.g., clinical coordinator) or a small group of people (e.g., clinical coordinator plus two other staff members) assign clients after intake; (3) A decentralized system, where individual counselors are responsible for picking up any clients they do intakes with; and (4) A clinical team system, where intakes are staffed by small groups of staff members. …