Missouri State University, Springfield Division of Student Affairs Departmental External Review Counseling and Testing Center (CTC) June 1-2, 2015 External Reviewers: Mary-Jeanne (MJ) Raleigh, Ph.D., LPCS, Director of Counseling and Psychological Services, University of North Carolina, Pembroke Paul Polychronis, Ph.D., ABPP, Director of Counseling Center, University of Central Missouri Dr. Paul Polychronis and I were invited to review Counseling and Testing Center (CTC) at Missouri State University, Springfield. A CAS-based self-study was conducted by the department staff, results from this review was shared with a committee of MSU community members. After the committee reviewed all documentation, and the initial findings of the CTC staff, recommendations were made with a focus on aiding the external review team. The list of MSU members involved with the internal review is included in the pre-external review report along with the list of recommendations from the group. No formal written report was generated by the committee. We reviewed the self-study, the extensive associated documentation provided, the completed rating criterion of the staff and all documentation in the pre-external review report. We spent a full day on campus, talking with multiple stakeholders related to CTC (interview schedule attached). The following report offers a review in four parts: an executive summary, including areas of excellence and areas for improvement; assessment of significant items, recommended follow-up actions, and concluding comments. Executive Summary: Overall we agree with the observations of the staff and the internal review committee, which indicated that CTC is a well-functioning service, in compliance with many of the areas of the CAS standards for Counseling Services. Evidence of strong ethical practice, excellent collaborative work with both internal and external colleagues, strong organization and leadership structure along with a positive programming presence was easy to find and clearly demonstrated. Areas of challenge include mission, program evaluation, human resources, facilities and technology with few clearly articulated learning outcomes. The stakeholders with whom we met, both those on the CTC staff and those external to it, were open, forthcoming, and committed to the success of the center. MSU colleagues clearly hold the CTC staff in high esteem and speak of them with great respect and understanding of the gravity of the work CTC does on campus. Areas of Excellence: The staff is comprised of excellent clinicians who exemplify ethical practice. It is clear that this staff has great respect for each other and care for the students of MSU. Dr. Greiner demonstrates
MSU-CTC External Review Report 2 concern for the staff and deep regard for his colleagues in the division of Student Affairs. CTC also operates effectively as a training center, expanding the services available and contributing to the preparation of master s-level clinicians. The campus reputation of the clinical and crisis response services available through CTC is excellent. SoBears is an exemplary program that many staff commented on with enthusiasm and it is a great demonstration of the commitment of this team to serving the campus community. Areas for Improvement: The current department mission statement is preliminary and outlines the functions of the office rather than the philosophy or learning and development outcomes of the department. Technology limitations can be accounted for by lack of financial support and reticent on the part of staff to embrace existing technology. We would highly recommend that CTC execute Titanium software as soon as possible, several issues that were pointed out by staff would easily be resolved by using a scheduling software system. Administrative support is insufficient for the size of the staff and scope of services. The current CTC facilities are inadequate for the services provided, for potential expansion, and for accessibility and privacy concerns. Finally, assessment of the program as a whole is needed but even more critical for CTC is a community wide satisfaction survey that elicits response from clients, non-clients, faculty and staff specifically focused on the department s reputation on campus and perception of the quality of care students receive with the CTC team. Assessment of Significant Items: Part Number Part Discrepancies Strengths Needed Improvements 1 Mission The mission statement is not reviewed on a regular basis or displayed in meaningful places for the MSU community. 2 Program Learning outcomes need to be developed, clearly articulated and documented. Little evidence was found to The current mission meets the CAS standards; CTC is in compliance with this area of the standards. CTC is a solid, comprehensive counseling center, addressing all of the services required by the standards. All members of The current mission statement is minimal and does not do justice to the scope and nature of CTC. A broad based statement of mission, reflective of the institution's values with clear learning outcomes would provide continuity and purpose and would communicate the unique characteristics of the unit more effectively to stakeholders. Develop and articulate intended learning and development outcomes and summarize the evidence of these accomplishments. In
MSU-CTC External Review Report 3 address services for distance and/or online students. Outreach programming is done, but there is room for improvement in scope, creativity and the assessment of programing efforts. Although all mental health professionals can perform a range of behavioral assessments, violence and threat assessment is a newer area of expertise that CTC is eager to learn. the staff are available for consultation with faculty, staff, parents, and students regarding student mental health concerns. CTC provides individual, educational outreach, consultation, training, supervision, assessment, crisis and emergency intervention, and intake. Their trainees expressed very positive feelings about their experiences with the clinic. Campus partners offered many accolades for the counseling center staff. collaboration with other student affairs units, determine a coherent institutional approach to meeting the needs of distance students. Continue to develop group therapy opportunities and to develop skill in appropriate and successful referrals by staff. CTC staff will need to explore violence and threat assessment training. A clear reason for biannual staff retreats needs to be developed since an interest in these types of events was expressed by staff but purpose and function were vague. 3 Organization and Leadership CTC struggles to develop a clear articulated vision and mission to steer long and short term goals. CTC staff model ethical behavior and demonstrate strong institutional citizenship. Dr. Doug Greiner, the director, is appropriately qualified. His duties include administration, staff recruitment, supervision, direct service, outreach, consultation, assessment, and university committees. Doug is engaged in budgeting, planning, preparing reports, responding to requests for administrative information, and coordinating staff efforts in clinical and outreach endeavors. The incoming director will need to develop vision and mission for the department. A clear leadership development process for the CTC staff and trainees can be implemented. 4 Human Resources Support staffing is minimal for the size and complexity of the center. Despite consistent and concerted efforts, the professional staff is not reflective of diversity. The number of clinical staff is inadequate for the needs of this university The quality, dedication, and professionalism of the CTC staff are admirable. They have earned the respect of faculty, administrators, and other professionals throughout the university. They are all a wellqualified team. The investment of the staff in Efforts should be made to provide additional office support; current level of support staffing is inadequate given the number of clinicians and range of services. Inclusion of front office staff in office functioning and policy development is critical.
MSU-CTC External Review Report 4 community. students and the center is apparent. They offer high quality clinical services, as well as outreach programming, consultation, training, and community involvement. The training component of CTC is well managed and supervised. Continued efforts should be made to add diversity to the staff, as positions become available. Expansion of staff would permit a broader range of services and activities, which are currently constrained by current clinician workloads. Some concern was expressed for the limitation of services for students in need. Limitation on the number of appointments a student can schedule is directly related to the minimal number of clinical staff. The training clinic is a critical element of CTC in need of expansion and focus. Trainees spoke highly of the experiences with CTC but are in need of more focused educational modules, group as well as individual supervision specific to the needs of trainees along with training components for supervisors (if possible supervisory certification in MO should be pursued for all interested staff). 5 Ethics None. The center adheres to appropriate ethical guidelines. The staff are aware of appropriate legal and ethical standards such as disposition and access to records. Records are managed in accordance with relevant ethical and legal standards. The CTC policies and procedures manual should be updated and reviewed annually, included in this document should be front office procedure, Titanium Software parameters and relevant ethical and statutory requirements. 6 Law, Policy, and Governance None. The center adheres to Missouri law related to confidentiality in counseling relationships and provides appropriate None.
MSU-CTC External Review Report 5 confidentiality/informed consent/release of information forms and documentation. Staff are aware of legal and policy responsibilities, crisis response issues and protocols, and risk management considerations. 7 Diversity, Equity, and Access Current facilities are not fully accessible for students with disabilities. Windows in the office expose students directly to the hallway limiting the comfort and privacy of the waiting room. Confidentiality in the therapy relationship is not a concern. No clear plan exists for distance learners. CTC is clearly committed to creating a welcoming and inclusive environment for all students. Staff evidence strong multicultural counseling competence. Revise the CTC mission to more clearly reflect the commitment to diversity. Continue to make efforts to diversify the staff. Consider ways to increase privacy in the front office space. 8 Institutional and External Relations None Based on interviews with stakeholders, there is strong awareness and respect for clinical and crisis response services. CTC has established relationships with mental health resources in the Springfield area that support the work of the department and the good work of the community at large. MSU colleagues feel connected to CTC and spoke about the ease of referral and consultation with the staff. There is room for improvement in the working relationship with other Division partners, specifically as related understanding appropriate limits for crisis response. Clearly articulated expectations and training with Housing and Police departments in regard to when and when not to contact the on-call CTC staff would be helpful. Clinical staff providers carry high caseloads and cannot realistically be expected to also respond to after hour crisis calls, this will result in staff burnout, a decrease in therapeutic efficacy and poor morale. 9 Financial Resources Current funding is inadequate for CTC to support internships in the training clinic, staff This team does a good job of using the limited resources effectively to serve students, they have CTC should explore possible grant funding sources, collaborative funding with other Division departments
MSU-CTC External Review Report 6 development to support leadership and supervisory training and limits the potential to expand needed services. 10 Technology Technology is not current used effectively. Titanium software would assist with issues of communication between the front office staff and clinical providers, streamline scheduling, allow a more comprehensive intake process with threat assessment instruments for each intake and decrease liability around clinical treatment decisions while allowing medication and supervisory information to be immediately accessible. managed to do quite a bit of programming and outreach with limited financial support. CTC staff is eager to learn Titanium software and are hoping to be trained in the software immediately. and seek possible training collaboration with career and disability services. The current level of financial support does not permit needed expansion of staff or services. The potential impact of this extremely strong counseling center is constrained by funding limitations. The incoming director will need to implement an administrative directive with clear deadlines for when and how Titanium will be implemented. 11 Facilities and Equipment This is the area with the most significant discrepancies from the standards. The director and staff have used the space available in appropriate ways to identify appropriate clinician offices, and ensure student privacy to the extent possible. The current environment does not allow space for any additional staff or trainees, which limits potential expansion of services. The current facility also does not provide adequate group therapy rooms. Client privacy is limited, particularly when crises require clients to be escorted from the office area (and through the outer office and administrative building). Accessibility to those with physical disabilities is limited.
MSU-CTC External Review Report 7 12 Assessment and Evaluation Clear and consistent assessment procedures need to be designed based on department mission and implemented for clinical services, educational programing and training clinic. This is an area of challenge for CTC but the team is well aware of the need and importance of evaluation to improve not only services but treatment of students. Develop comprehensive assessment protocols focused on learning outcomes, clinical standards and therapeutic efficiency. I would recommend standardizing case review meetings to include assessment of treatment plans, termination evaluations, outcome and quality of documentation. Priority Recommended Follow-up Actions (in addition to those noted in the chart above and at more length below): 1. Update the mission statement to be less generic and more reflective of the distinctive characteristics of CTC; consider an accompanying statement of core values to articulate more clearly the beliefs and philosophy of the counseling center. 2. Design and execute an assessment protocol. Develop assessment procedures for clinical effectiveness, staff performance, client satisfaction, therapeutic quality and notation standards. 3. Revise Policy and Procedure manual to more accurately reflect clinical standards, front office operations and ethical standards including Titanium usage. Concluding Comments: Based on the documentation provided, the report of the internal review committee, and the interviews conducted during the external review visit, CTC is an excellent university counseling center. The CTC director and staff were very engaged in the process, not at all guarded or defensive, and eager for feedback from the external reviewers. Overall, the review process and all those involved in it were very transparent and authentic. The self-study was comprehensive and reflected a solid review process. Overall, CTC is in compliance with the CAS standards for Counseling Services and in the area of ethical and outreach programming exceeds the standards. The staff is highly aware of the diversity within the university community and committed to meeting their needs. CTC operates with a high level of demand for services and manages to meet the demand without the use of wait lists. One element of the center that permits this is its important role in providing training for graduate students in related area. The four primary areas in need of improvement are the following:
MSU-CTC External Review Report 8 Although there is ample evidence that CTC staff are strongly committed to diversity, inclusion, and social justice, as well as student learning this is not effectively conveyed in the mission statement, reports, promotional and marketing materials, webpage, and publicity efforts. There is little information specifically describing advocacy for sexual assault survivors, multicultural and inclusion programming, learning and CTC s educational initiatives. These elements need to be reflected in the mission statement, vision, goals and policy and procedure manual of the department. A comprehensive policy and procedure manual is needed and can include but not be limited to: administrative expectations, ethical standards, front desk operations, intern/training manual, assessment instruments, intake process and case distribution process. All parties acknowledge that the current facilities are not adequate for the needs of the service; they are particularly problematic in terms of accessibility for students with disabilities, as well as privacy for clients, given the current location. Space constraints also limit consideration of new positions or expansion of the training program. Assessment of services and program elements is a critical aspect of clinical mental health services on campus. The information obtained allows for growth of services, support for financial and personnel requests, measures efficacy of treatment, evaluate staff and can be used to focus individual therapy process. There is minimal program assessment conducted or utilized for organizational decision making. CTC, under the guidance of Dr. Greiner, has demonstrated excellence in college counseling with a dedicated and impressive staff including the front office staff. This team clearly cares deeply about the students of MSU. With limited financial backing, minimal staff, and inadequate facilities this staff has been able to offer excellent services to the students of MSU.
MSU-CTC External Review Report 9 Missouri State University Counseling Center CAS EXTERNAL REVIEW ITINERARY June 1-2, 2015 TEAM MEMBERS MJ Raleigh (Lead Reviewer) Paul Polychronis mary-jeanne.raleigh@uncp.edu Office: 910.521.6202 Cell: 603.568.5250 ppolychr@ucmo.edu Office: 660.543.4060 Cell: 660.909.5909 Sunday, May 31 SCHEDULE MJ Raleigh arrives Springfield (from Chicago) on American Airlines 3614 @ 12:00pm (noon) Doug will pick-up MJ @ airport Paul Polychronis arrives by car (time TBD) 5:30pm Dinner with Director Dinner at 6:00pm at Café Cusco Vegetarian and Vegan options http://www.cafecusco.com/ External Review Team given final Itinerary and other materials Monday, June 1 8:30-9:45am Tour of Center & Meet with Senior Clinical Staff 311 CARR 9:45-10:00am Break 10:00-10:45am Dr. Dee Siscoe, VP of Student Affairs 200 CARR 10:45-11:00am Break 11:00-11:45am Student Affairs Council 308 PSU 11:45-12:00pm Break 12:00-1:00pm Lunch with Director (Meal catered by Chartwells) 311 PSU 1:00-2:30pm BIT Team (includes Dean of Students, Residence Life, Health Center, etc.) 309 PSU 2:30-3:00pm Break 3:00-4:00pm Open Forum (Students, Faculty, & Staff) 308 PSU 4:00-4:30pm External Review Team (MJ & Paul) Meeting 311 PSU 5:30pm Dinner with Director Dinner at 6:00pm at Gilardis http://gilardisonwalnut.com/ Vegetarian and Vegan options Tuesday, June 2 8:30-9:00am Returning Center Graduate Assistants (2) 311 CARR 9:00-9:30am Front Office Staff, Testing Coordinator 311 CARR 9:30-9:45am Break 9:45-10:00am Exit meeting with Director 311 CARR 10:00-10:30pm External Review Team (MJ & Paul) Meeting 305 CARR
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