For the past 20 years, a significant part of my job has been to direct a university-based mental health center. Our center is affiliated with the Department of Psychology at the University of Kentucky. The center’s mission is to provide effective and affordable mental health services to the community and to provide a site to train doctoral students in the department’s clinical psychology Ph.D. program.
These centers, also known as ‘training clinics,’ are found on many university campuses. They are typically affiliated with graduate programs in clinical or counseling psychology, marriage and family therapy, or related fields of study. Although not widely publicized, they can be a terrific resource for obtaining low-cost, state-of-the art mental health care.
The clinics are structured so that graduate students provide all of the services, under close supervision by licensed mental health professionals who are faculty in the affiliated department at the university. Additional supervision may sometimes be provided by appropriately credentialed mental health clinicians in the community.
Typically, individual counseling or psychotherapy with adults, children or adolescents is the most commonly provided service at these training clinics. In addition, couples or family therapy is sometimes offered. To ensure quality supervision of the student therapists, therapy sessions are videotaped so they can be reviewed and discussed on a regular basis by the licensed supervisor.
Group-based therapies are also often provided. For example, our center provides an adult coping skills group based on dialectical behavior therapy, or DBT, an effective treatment for borderline personality disorder. This one-year, weekly group program provides training in DBT skills related to areas such as improving relationships, managing times of crisis or distress, and learning how to better handle difficult emotions.
Examples of other types of groups include teaching children how to manage frustration and anger or have better social skills, teaching parents how to be more effective in dealing with their children’s challenging behaviors, and teaching mindfulness-based skills to adults.
Assessment and medications
Depending on the particular clinic, assessment services may also be offered. Psychological evaluations for learning disabilities, attention deficit-hyperactivity disorder (ADHD), and clarification of other mental health diagnoses may be conducted.
Some clinics may also provide medication services. At our center, for example, we have an advanced psychiatric resident, a physician (MD) who is in training to become a psychiatrist. This doctor can see clients of the center to assess the need for medication and to prescribe and monitor recommended medications.
Research and outreach
In addition to the training and community service missions, the training clinics also provide a site for student and faculty research to better understand mental illnesses and to refine treatment interventions for various conditions. Clients have the option to voluntarily participate in ongoing research studies.
Another important focus of many of the clinics is community outreach. Graduate students may provide free community education programs, often targeted at underserved populations in the community. Topics can include parenting skills, stress management, having healthier relationships, or conflict resolution. These services may be provided in sites such as homeless shelters, residential substance abuse facilities, schools, or correctional settings.
Pros and cons of training clinics
It’s important to understand some of the potential benefits and limitations of seeking mental health services through a university mental health training clinic. Some of the advantages include:
1) Affordable services
Because these clinics are staffed by students in training, they typically have very affordable fees, often more than half off the customary fees of licensed providers. In additions, most clinics offer a “sliding scale,” which allows for fees to be reduced even further if the client has a limited income or other financial difficulties. Insurance may not be accepted, but clinic fees are typically less than the co-payment amount that would be charged through the person’s insurance.
2) Use of scientifically proven techniques
Student therapists are being trained in the most up-to-date, research-based types of mental health treatment. As a result, clients can expect to receive effective treatment specifically tailored to their presenting needs and concerns.
3) Experienced supervisors
Student therapists receive intensive supervision from highly trained supervisors who are devoted to providing both excellent training to students and outstanding care to clients.
Despite these significant benefits, there are also a few potential limitations associated with training clinics:
1) Supply and demand
Because of the significant advantages noted above related to effective services and low cost, there can be a great demand for services through training clinics. There can often be a lengthy wait before services can be provided.
2) Variability in therapist experience
Since students are providing the services in the training clinics, it’s important to understand that there is a fairly wide range of experience among the therapists. Some will be in the beginning stages of their graduate training, while others will be more advanced, having completed several years of training.
3) Service limitations
Most of the university-based training clinics will be in larger metropolitan areas, so accessibility can be difficult for clients in rural areas. Also, clinics are limited in the types and numbers of clients they can serve. Since the student therapists will typically have a small caseload, the clinics can’t serve a large number of clients. Also, individuals with more severe issues such as psychosis, imminent harm to self or others, and current legal issues may not be accepted for services. Finally, emergency or on-call services are not usually provided.
Finding a training clinic
How can you locate a university-based mental health training clinic? One useful resource is the website of the Association of Psychology Training Clinics (APTC). This is a primarily US-based group of professional directors of university-affiliated psychology training clinics. Their “list of member clinics” provides contact information for about 150 training clinics throughout the US and a few international sites. Another route is to search the websites of local universities and see if they have a mental health training clinic with services available to the community. Training clinics can be a wonderful resource and they are certainly worth checking out.
Here’s a question: Have you had any experience with a university-based mental health training clinic? Please leave a comment. Also, please subscribe to my blog and feel free to follow me on Twitter, “like” my Facebook page, or connect on LinkedIn. Thanks!