Challenges to addressing student mental health in embedded counselling services: a survey of UK higher and further education institutions

With reports continually demonstrating increased demand and severity of student mental health needs, it is important to gain a fuller understanding of the impact on embedded student counselling services. The aims of this research were to identify (a) service similarities, (b) factors which impact on services, (c) characteristics of service users, and (d) the use of therapeutic technology (e.g. online self-help). An online survey was completed by 113 heads of UK student counselling services across Higher Education (HE), Further Education (FE), and Sixth Form Colleges (SFCs), to capture service data from the academic year 2013/14. Students predominantly received high-intensity support (e.g. counselling) and referrals increased over 3 years. Challenges to embedded counselling services and their implications for development are discussed.     

Development of an Internet Intervention to Promote Wellbeing in College Students

Objective

While tertiary students commonly experience distress that substantially impacts functioning and performance, few seek help. Innovative strategies are needed to promote wellbeing and address this distress. The current article describes the development, acceptability testing, and use of an Internet intervention to promote student wellbeing and resilience—thedesk.

Method

Acceptability and useability of the program were evaluated by user analytics and focus groups.

Results

In the first 3.5 years, 118,000 individuals accessed the website and had 163,000 sessions averaging 5.3 min and 6.9 accessed pages. Users’ wellbeing scores were positively skewed, suggesting that the engaged content has broad relevance. While the percentage of people leaving the site after viewing the homepage was considered acceptable at 50%, there is significant room to improve engagement. Responses from consumer focus groups suggested high acceptability, perceived usability, and likely utility. Concerns included data security and, for international students, the need for greater direction on program use.

Conclusions

While further research is needed to evaluate the effects of thedesk on wellbeing and distress, the current results suggest that it provides highly accessible support that is well accepted by most tertiary students and has the potential for use as a stand‐alone intervention or, adjunctively, to increase the impact of other student support.     

The Role of Social Support,Being Present,and Self‐kindness in University Student Psychological Distress

Objective

Self‐kindness, which is thought to be part of self‐compassion, has the potential to contribute to mental health, as well as serve as a focus for interventions. However, little attention has been given to the potential role of self‐kindness specifically, especially in the context of mindful presence and available social support, in buffering distress.

Method

Structural equation modelling was used to test a theoretically based model of how these factors relate to each other and psychological distress. Participants were 592 Australian university students.

Results

Results confirmed our hypotheses, showing that: (a) receiving social support is important to the capacity for self‐kindness both directly and indirectly through the ability to “be present,” and (b) the relationship between social support and psychological distress is partially mediated by the practices of self‐kindness and being present. The model of social support, being present, and self‐kindness accounted for half the variance in psychological distress. With the addition of stressors, a regression model explained a total of 62% of the variance.

Conclusions

These findings have implications for understanding the construct of self‐kindness and its role in the development of interventions to improve student success.     

L’évaluation psychologique en situation transculturelle : une révision de la littérature

Human migration provokes transcultural clinical encounters that may challenge the way clinicians see themselves and how they proceed in their usual practices. In the field of psychology, psychological assessment is an important tool to better understand the patients’ needs and to design psychological interventions. Considering that most diagnostic tests and manuals have been developed in the Western context, the application of these tools with other populations remains controversial. The present literature review aims to describe the state of current knowledge on psychological transcultural assessment. Specifically, we will address: (1) the use of psychological tests in transcultural contexts, (2) the development of the Cultural Formulation Interview (CFI, DSM-5) and (3) the clinical interview: language, therapeutic relationship and participation of interpreters. In the first section, we discuss the international norms for scales and tests translation and adaptation, as well as the cultural issues that may bias the test’ application and interpretation. In the second section, we describe the creation of the CFI, and its use in recent studies. The CFI is composed by four clusters: (1) cultural definition of a problem, (2) cultural perceptions of cause, context, and support, (3) cultural factors affecting self-coping and past help seeking, and (4) cultural factors affecting current help seeking. The revised studies indicated that the CFI has a positive impact on the cultural sensibilization of mental health professionals, also improving the relationship between the patients and professionals. The cultural formulation may also prevent misdiagnosis. Beyond the use of tests and structured interviews, the clinician also faces other challenges during a transcultural assessment. We discuss in the third section the transferential and countertransferential relationship in a transcultural situation. Several elements may influence this relationship, at an individual, institutional and societal level. The evaluation of these elements may allow the clinician to better understand results of the psychological assessment. We also describe the current guidelines for the use of interpreters during health consultations in France. In conclusion, several advances have been made in the field of transcultural psychological assessment, among other things the development of guides for good translation and cultural adaptation of tools, as well as the integration of cultural issues into the DSM. However, research and changes in clinical practice are still needed, as the evaluation of cultural biases in cognitive tests and the expansion of cultural competences training among clinicians.     

Family-Involved Mental Health Care Among OEF/OIF Veterans With and Without PTSD Using VHA Administrative Records

Prior research indicates that veterans are interested in including family members in health care and that family-inclusive mental health treatment can improve treatment outcomes. Consequently, the Veterans Health Administration’s (VHA) directive requires providers to offer family-inclusive mental health services to veterans. However, the extent to which veterans engage in family-inclusive mental health services at the VHA remains unclear. Using data from a longitudinal registry of male and female veterans with and without posttraumatic stress disorder, we examined the extent to which veterans included family members in their mental health care and predictors of engagement in family-involved therapy visits using VHA administrative records over a 5-year time span. Of the 1,329 veterans who received mental health care during the study, 8.4% received a family therapy visit—the number of visits per veteran ranged from 1 to 34. Results from logistic regressions indicate that relative to White veterans, Black veterans were 61.0% less likely to receive a family-involved therapy visit. Married veterans or veterans living with a partner, and veterans with poor romantic relationship functioning, were more likely to receive a family-involved therapy visit. These findings indicate that only a small percentage of veterans received a family therapy visit across 5 years. Efforts to understand barriers to family-involved therapy visits and strategies to increase engagement in family-involved visits may improve clinical outcomes and promote patient-centered care.     

Training and Supervising Lay Providers in Kenya: Strategies and Mixed-Methods Outcomes☆☆☆

ObjectiveTraining lay providers to deliver mental health interventions is both effective and cost-effective. However, more research is needed to document training and supervision procedures and to collect lay providers’ feedback.MethodsThis study documents training and supervision from a randomized controlled trial of the Shamiri intervention, a four-session, school-based intervention that significantly reduced symptoms of anxiety and depression in Kenyan adolescents. We delivered a 10-hour training to 13 lay providers, M (SD)_age = 21.00 (1.95), %_female = 61.54. We also hosted 30-minute supervision meetings twice weekly. Training and supervision were delivered primarily by undergraduates. Independent raters coded session recordings for fidelity and quality of services, and we collected quantitative and qualitative feedback from lay providers.ResultsReliability and mean ratings for all six of our fidelity and quality measures (delivering required content, adhering to specified details, thoroughness, skillfulness, clarity, and purity) were very good to excellent. Lay provider quantitative ratings of training were also overwhelmingly positive, with an overall satisfaction rating of 6.46/7.00. We identified central qualitative themes in lay provider comments: Generally, comments about training style, content, and personal interactions were overwhelmingly positive, and many lay providers reported personal growth. Comments about timing and location of training were mixed.ConclusionsThis study provides preliminary evidence that a very brief training delivered primarily by undergraduates can teach high school-graduate lay providers to deliver effective mental health interventions. Additionally, we discuss lessons learned and implications for future research, including the importance of considering local context when planning and of continuously collecting and addressing lay provider feedback.