University of Florida tries the online counseling program Therapist Assisted Online (TAO)

20 Jan

When parents are packing their children off to college, some are sending children to school who have some severe mental health and emotional issues. Trip Gabriel has an article in the New York Times which outlines the issues some students face while they are at college. In Mental Health Needs Growing At Colleges Gabriel reports:

Stony Brook is typical of American colleges and universities these days, where national surveys show that nearly half of the students who visit counseling centers are coping with serious mental illness, more than double the rate a decade ago. More students take psychiatric medication, and there are more emergencies requiring immediate action.
“It’s so different from how people might stereotype the concept of college counseling, or back in the ’70s students coming in with existential crises: who am I?” said Dr. Hwang, whose staff of 29 includes psychiatrists, clinical psychologists and social workers. “Now they’re bringing in life stories involving extensive trauma, a history of serious mental illness, eating disorders, self-injury, alcohol and other drug use.”
Experts say the trend is partly linked to effective psychotropic drugs (Wellbutrin for depression, Adderall for attention disorder, Abilify for bipolar disorder) that have allowed students to attend college who otherwise might not have functioned in a campus setting.
There is also greater awareness of traumas scarcely recognized a generation ago and a willingness to seek help for those problems, including bulimia, self-cutting and childhood sexual abuse.
The need to help this troubled population has forced campus mental health centers — whose staffs, on average, have not grown in proportion to student enrollment in 15 years — to take extraordinary measures to make do. Some have hospital-style triage units to rank the acuity of students who cross their thresholds. Others have waiting lists for treatment — sometimes weeks long — and limit the number of therapy sessions.
Some centers have time only to “treat students for a crisis, bandaging them up and sending them out,” said Denise Hayes, the president of the Association for University and College Counseling Center Directors and the director of counseling at the Claremont Colleges in California.
“It’s very stressful for the counselors,” she said. “It doesn’t feel like why you got into college counseling.”
A recent survey by the American College Counseling Association found that a majority of students seek help for normal post-adolescent trouble like romantic heartbreak and identity crises. But 44 percent in counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.
The most common disorders today: depression, anxiety, suicidal thoughts, alcohol abuse, attention disorders, self-injury and eating disorders.
If a student has had prior problems, the student and family should have a plan for dealing with issues like depression or eating disorders while the student is at college. Often that might include therapy sessions with a counselor near the college. Often, students and families do not want to seek help because many feel there is a stigma to mental illness.
Megan O’Neill reported in the Chronicle of Higher Education article, Campus Psychological Counseling Goes Online for Students at U. of Florida which discussed the online counseling program Therapist Assisted Online (TAO):
Therapist Assisted Online, or TAO, began at Florida this past fall. Designed specifically for students battling anxiety—a primary mental-health issue on college campuses—it is the first research-supported program of its kind in the United States, Ms. Benton believes.
In the pilot program, 26 students treated under TAO showed more improvement, calculated using a system called Behavioral Health Measure­-20, than 26 participants in the in-person group-therapy sessions at the counseling center. The students treated under TAO also made more progress than about 700 students receiving individual in-person therapy.
“The results blew me away, not to mention the fact that it stunned all of my counselors, who I think are still trying to come to terms with what happened,” Ms. Benton says.
The director is the first to point out the limitations of the pilot. Both the student patients and the counselors self-selected, indicating a certain level of motivation and comfort with new technology. The pool of participants was small. Other research studies show that online patients experience results equal to those of in-person patients.
Still, the model could spell major change for mental-health services in higher education, where the number of students in need of treatment and the severity of diagnoses has climbed steadily during the past decade, according to professionals in the field…
TAO consists of seven interactive treatment modules meant to be completed during a seven-week period. It includes assessments of current symptoms and level of function, as well as cognitive–behavorial and mindfulness exercises. Student patients participate in 10- to 15-¬minute video consultations with their counselors once a week, and receive daily encouraging text messages.
The online-treatment program falls between self-help and traditional therapy, Ms. Benton says. The relationship between the counselor and the patient remains paramount. The weekly video consultations and the content of the modules work in concert.
Counselors monitor progress, and layers of risk management are in place. Participating students must provide emergency contact information and authorize the counseling center to use it, if necessary.
Jurisdictional Issues
Much of the technical work is being done within the E-Learning, Technology, and Creative Services division of the university’s College of Education. Glenn E. Good, dean of the college and a licensed psychologist, estimates that the university has spent about $200,000 to develop TAO.
Officials are exploring the licensing potential of the program, he says, although the priority is to produce an effective, replicable treatment rather than a profitable business.
TAO and other types of online psychotherapy are inappropriate for seriously ill patients, counselors at the University of Florida and others say. Moreover, the regulation of mental-health professionals in the United States is done at the state level, creating geographic limitations even though the treatment is done online.
“There are interjurisdictional problems,” says John C. Norcross, a researcher and professor of psychology at the University of Scranton. “If you launch a website in Pennsylvania and the therapist you are talking to is in Florida and the patient is Louisiana, it is a regulatory and malpractice nightmare.”
Where the licensing and regulation of mental-health professionals is done at the national level, such as in Australia and Britain, online psychotherapy has been in use for years, Mr. Norcross says.
Nevertheless, TAO promises clear advantages for mental-health professionals in higher education and their patients, experts say. They cite time and cost savings, the flexible and discreet nature of delivery, and the potential scalability….

The University of Florida describes TAO:

What is TAO?
Tao is a seven-week, interactive, web-based program that provides assistance to help overcome anxiety.
TAO is based on well research and highly effective strategies for helping anxiety.
Each of the seven weeks, participants will watch videos, complete exercises, and meeting with a counselor via video conferencing for a 10-15 minute consultation.
Weekly exercises taking approximately 30-40 minutes to complete.

What are the experiences of UF students using TAO?
TAO Pilot OutcomesDuring the Fall 2013 Semester, we compared outcomes for individual face-to-face psychotherapy, group psychotherapy and Therapist Assisted Online for students with anxiety across seven sessions.
All participants completed the Behavioral Health Measure-20 (BHM-20) prior to each session.
On the BHM-20 higher scores indicate fewer symptoms and better functioning. The graph on the right shows change across time on the anxiety subscale of the BHM-20. On the BHM-20 a score of 2.6 indicates normal non-problematic functioning.

Who is eligible?
Currently enrolled students who want help with anxiety and worry.
Students who have access to computer with webcam.
Students who are not experiencing severe depression.
Students without a current substance abuse problem.
If taking medication, must have been on the same dose for at least one month prior to starting the treatment.
18 years old or older.
Currently living within 50 miles of Gainesville.
How do I sign up?
Call the Counseling and Wellness Center and ask to schedule a TAO triage appointment.
If you are already seeing a counselor, then tell your counselor you are interested.

We look forward to helping with your anxiety in TAO!

Parents must recognize the signs of distress and get help for their child. If you are a student in distress, get help because there are many different therapies to get you back on track.

Resources for Parents & Students

◦National Resources

◦National Suicide Prevention Lifeline: 1-800-273-TALK (8255) hour hotline

◦Mental Health America screenings for depression and other mental health conditions Click on the Take a Screening link under Finding Help
◦mpowersheets is a youth awareness campaign that helps fight stigma

◦The Virginia Tech Tragedy: Tips and Resources

◦Active Minds to Peer student support and advocacy group on college campuses

◦NAMI on Campus

Student-run organizations that provide support, education, and advocacy

◦Disability and Civil Rights Resources rights under ADA and how to file a discrimination complaint

◦Education and Community Integration of importance of community integration for those with mental health conditions

◦Community Integration Tools College Experience: Tips for Reducing
Stress and Getting the Accommodations You Need

◦Center for Psychiatric Rehabilitation on reasonable accommodations

◦Job Accommodation Network on accommodations in educational settings

◦Association on Higher Education and Disability

◦Office of Civil Rights, Department of Education form and procedures

Trauma Resources

◦Understanding Mental Illness After the Virginia Tech Tragedy for dealing with trauma as well as educational resources

◦Higher Education Resources on Violence

◦Preventing Violence and Promoting Safety in Higher Education Settings

Evaluation Resources

◦Guide by Department of Education guide to evaluating drug and alcohol prevention projects

◦Resources through the Higher Education Center

Mental Health Screening Tools

◦Screening For Mental Health non-profit with college screening programs

◦Teenscreen University’s mental health screening program

Where information leads to Hope. © Dr.

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