Scope of Practice
Scope of Practice for Counseling Services
The role of the Santa Fe College Counseling and Wellness Center is to provide brief mental health counseling and related services to help students identify barriers, improve coping, and achieve personal goals. Our services are available to eligible students whose concerns fall within our scope of practice. Those whose needs cannot be accommodated within our treatment model will be referred to community resources for care. Such referrals might occur immediately following an intake, or they might occur after some treatment and a further assessment of need has taken place.
The Santa Fe College Counseling and Wellness Center provides short-term individual counseling for students whose symptoms are mild to moderate. This may include connecting students with additional campus or local resources, if requested by the student, or if deemed necessary by the staff. Consistent with our brief, solution-focused model, the Counseling and Wellness Center is unable to provide the full continuum of care to treat individuals struggling with more significant or prolonged issues.
Counseling services include:
- Screening/early outreach, triage, assessment, and referral services
- Short-term individual, couples (where all parties are actively enrolled students), and group counseling
- Crisis intervention and urgent risk assessment
- Consultation to providers, staff/faculty, and family members
Common issues addressed in counseling include:
- Personal Issues: stress and anxiety, depression, anger, loneliness, guilt, low self-esteem, grief and loss, and certain levels of substance misuse
- Relationship Issues: romantic relationship difficulties, sexual concerns, roommate problems, family issues.
- Developmental Issues: identity development, adjustment to college, life transitions, sexual orientation/gender issues
- Academic Concerns: test and performance anxiety, perfectionism, underachievement, low motivation
- Other Issues: effects of trauma, sexual assault, abuse, or discrimination; concerns from childhood or adolescence, spiritual concerns, body image, food preoccupation, healthy lifestyle choices, etc.
Issues to be referred to community providers
Concerns or symptoms that may warrant referral to off-campus treatment providers (either from the start of treatment or following a period of short-term counseling at the Counseling and Wellness Center) may include:
- A need or desire for sessions more than once per week (most students are seen 1-4
times per month)
- Excessive use of the walk-in crisis intervention services indicates that standard session frequency is inadequate.
- History of multiple traumatic experiences
- Chronic mental health conditions that require longer-term, ongoing care
- Unmanaged, chronic issues requiring psychiatric stabilization
- Clinical presentations, such as some personality disorders, that indicate short-term therapy may be ineffective and/or detrimental
- Dissociative episodes
- Prolonged depersonalization/derealization
- Chronic suicidal ideation and/or recent history of multiple suicide attempts
- Severe and chronic self-injury
- A history of multiple psychiatric hospitalizations.
- Issues that require more specialized care than can be provided at the Santa Fe College
Counseling and Wellness Center, including:
- Significant or chronic disordered eating symptoms posing medical danger
- Significant or chronic substance misuse which compromises therapy
- Active symptoms of psychosis at risk for progressive deterioration
Other reasons why we may be unable to provide services and may refer individuals to community resources include but are not limited to:
- Lack of motivation or engagement in treatment, as evidenced by:
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- Unwillingness to provide information sufficient for clinical assessment
- Inability to identify a treatment goal appropriate for brief therapy
- Inconsistent attendance of scheduled appointments at the Santa Fe College Counseling and Wellness Center. This may include coming late, missing appointments, cancelling with less than 24 hours’ notice
- Poor compliance with treatment recommendations
- Failure to follow through with recommended treatment in the context of multiple crisis intervention sessions
- Ongoing treatment relationship with another mental health provider
- Inappropriate, harassing, menacing, threatening, or violent behaviors
- Mandated or required treatment, including but not limited to:
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- Counseling ordered through legal proceedings, such as substance use disorder treatment, alcohol education, anger management, parenting education, or domestic violence treatment
- Counseling required by employers, government agencies, academic departments, or classes
- Individual counseling initiated only to earn credit for a class
- Comprehensive psychological evaluation of any type, including but not limited to:
- Neuropsychological evaluations
- Forensic assessments
- Custody evaluations
- Assessment and documentation for service or support animals
- State/Federal benefit programs, including vocational rehabilitation and social security/disability
- Fitness-for-duty evaluations
- Pre-surgical mental health evaluations
- Other situations that are determined to be outside the scope of services provided by the Santa Fe College Counseling and Wellness Center, or in which case a clinical staff member determines that treatment would be detrimental to the client or to the proper functioning of the facility.
Referral Process
During the intake appointment or during any subsequent stage of treatment, a counselor may determine that a student’s needs appear to fall outside our scope of practice. In such instances, the clinician is encouraged to consult with colleagues, the Coordinator, or the Director regarding case disposition. If the clinician is a trainee, the supervising counselor must be consulted.
When a community referral is the most appropriate treatment option for a client, they should be provided with referral options. These options should, to the best of the clinician’s ability, address client circumstances regarding insurance, finances, and transportation.
Santa Fe College Counseling and Wellness Center counselors are not case managers, and are not responsible for ensuring that clients follow up on referrals provided. Such contacts are encouraged, however, in cases with a moderate or higher level of risk or instability.
Students under 18 years of age
For students under the age of 18 years, we must have parental consent to treat. Parents are typically asked to sign a consent to treat, however, students under 18 may be seen for a one-time crisis contact prior to obtaining consent. While a student under age 18 can expect that we maintain their confidentiality, they need to be informed that their parent, guardian or custodian holds the legal right to request information concerning the student’s treatment.
References
https://www.weber.edu/CounselingCenter/scope.html
https://www.union.edu/counseling-center/policies/scope-practice