These enhancements are the fruit of a focused action plan by Baylor University, affirmed and funded by the Board of Regents, to ensure that the educational, physical, emotional and spiritual needs of students, and especially survivors of interpersonal violence, are given priority attention.
The Baylor Counseling Center has long offered students a wide array of services to support student well-being, but the University's action plan presented an opportunity to dramatically enhance Baylor's caring community and take mental health services to the next level.
Like other university counseling centers across the country, Baylor's Counseling Center has consistently grown to address an ever-present modern reality: student demand for university counseling services has been increasing unabated for nearly two decades. In addition, professionals have seen a rise in the complexity and severity of issues.
The statistics show the growth. According to the American College Health Association's (ACHA) 2015 National College Health Assessment, nearly 58 percent of college students reported feeling overwhelming anxiety in the prior year, and 54.5 percent reported experiencing above average to tremendous stress. The range of issues students face go far beyond what many might consider typical collegiate stressors, such as classes, jobs or relationships. Many students faced complex issues related to trauma from interpersonal violence or sexual assault, eating disorders, addiction and more.
Mental health experts and college administrators and staff have studied the trends and have found many reasons for the uptick in mental health needs, but have not pinpointed a specific cause.
There are also uniquenesses to this generation. Students have high expectations. Whether they set those expectations for themselves or whether those come from elsewhere, they expect levels of success, grades and opportunity that are sometimes more difficult to achieve than expected.
In 1999, the Baylor Counseling Center treated approximately 350 students. By 2005, this number nearly doubled, to 610. That jump was only the beginning. In the 2015-16 school year, the Counseling Center served 1,300 students. In the last six years, Baylor's undergraduate population has increased by 2,000 students, a figure that accounts for only some of the uptick.
As the volume of students seeking counseling increased, universities enacted strategies to see as many students as possible. The most common strategy was to limit the number of sessions a student could visit the counseling center. Baylor capped students at 12 sessions per academic year, a limit similar to or higher than many peer institutions. Students could return each academic year for an additional 12 sessions — roughly the length of a semester. Even with these adjustments, waiting lists were the norm for universities; backlogs of up to two weeks were common. Additionally, students seeking specialized treatment often were referred to outside agencies better equipped to treat more complex issues.
Baylor's Counseling Center continued to add resources through the years; however, the demand made it difficult to see students quickly after an initial consultation. Students often come to the clinic during the Counseling Center's walk-in hours and visit with a staff counselor. From that initial visit, Counseling Center staff would consider the best next step for treatment. Students would get further treatment, although that next appointment often wasn't available immediately.
Baylor has taken steps to respond in recent years, adding additional staff, including specialists, and starting group therapy sessions to expand access to more students. These changes began to alleviate the backlog, but for a university committed to supporting student well-being, taking steps to move into the top tier of university counseling centers nationally was prioritized.
In February 2016, the Baylor Board approved and funded an administrative action plan to prevent acts of sexual violence on campus and to improve treatment and services for all those impacted by interpersonal violence. The Counseling Center was provided with additional funding for a two-fold purpose: to alleviate the immediate backlog of students waiting to see a counselor and to take steps to be the "gold standard" in university counseling centers moving forward.
Within two weeks of the announcement, Baylor had hired 11 part-time staff members, many of whom had their own private practices in the area, to allow the students to be seen promptly. Those 11 counselors worked with the Counseling Center through the end of the semester and enabled the clinic to meet the immediate demands of both initial and follow-up visits.
The Counseling Center now employs 21 full-time staff members. In the world of college counseling, the ratio of full-time staff to students serves as a benchmark. As Baylor's enrollment has increased, new hires were needed just to maintain their ratio, which had been about 1:1,660 (one full-time staff member for every 1,660 students). New staff hires have reduced that ratio to 1:750, a level commensurate with many of the top universities in the nation. Beyond the all-important ability to see more students and eliminate waiting lists and session limits, increased staffing has created a ripple effect throughout the Counseling Center. Among these effects, the Counseling Center no longer has session limits or fees for service.
In recent years, trends have shifted counseling centers away from hiring generalist practitioners to staff with specific areas of expertise. Several new positions include experts in working with victims of sexual assault and interpersonal violence, an addictive behavior specialist, an eating disorder specialist and a dialectical behavioral therapist, who specializes in working with students who engage in self-harmful behaviors or harbor suicidal thoughts.
In addition to providing specialized care for students on the Baylor campus, these specialists raise the knowledge level of the entire staff.
The Counseling Center has expanded training and development of current employees with funds allotted by the Board. For example, Dr. Edna Foa, a clinical psychology professor at the University of Pennsylvania and one of the nation's foremost experts on the treatment of post-traumatic stress disorder (PTSD), came to campus to speak to Counseling Center staff. The Counseling Center also welcomed Waco-area mental health professionals who work with victims of interpersonal violence to participate. The administrative action plan makes it possible for the Counseling Center to bring top-of-the-line training opportunities to Waco.
For the Baylor Counseling Center, serving the well-being of students takes staff beyond the walls of the Counseling Center itself. By reaching students where they are, Counseling Center staff can make students aware of the services provided, educate students on mental health and help them grow comfortable with the idea of seeking care. If a student is aware of the Counseling Center and comfortable with visiting counselors early, he or she can sometimes keep a smaller problem from becoming a bigger one. In the last two years, the Counseling Center has averaged approximately 125 different outreach presentations across campus, in chapel, with student organizations, in trainings with residence hall staff and community leaders, and other on-campus events.
The Baylor Counseling Center's main office is housed in the McLane Student Life Center (SLC), but in Spring 2017 the center gained additional office space on campus to provide care for trauma patients. In addition to offices for new staff members, the most notable feature of their second campus home is a trauma recovery area where individuals who have training meet with students privately and interact with them in key moments. Other new rooms in the offices provide group therapy to students and house other resources that serve multiple students. The second location more than doubles the Counseling Center's space—from 4,250 square feet in the SLC to 11,880 square feet overall.
Everyone currently on staff in the Counseling Center is trained and equipped to provide care to students dealing with a traumatic event, such as sexual assault. But with the addition of further skilled staff and the expansion in facilities, the Counseling Center is taking their trauma care to the next level.
Dr. Cheryl Wooten, who joined the Counseling Center in 2011, leads a team of three clinicians in a specialized Trauma Recovery Team. This team gains additional insight through training and conferences to make sure the Center is constantly aware of the latest developments in this area.
The Trauma Recovery Team works closely with the Title IX Office and the Baylor Police Department to facilitate holistic care for victims. Additionally, the team has developed protocols and guidelines for the Counseling Center to share their knowledge with colleagues and to ensure each staff member is constantly equipped to provide the best possible care.
Staff, specialization, outreach, expanded facilities and enhanced trauma recovery care: these are some of the visible ways the Counseling Center is taking a leap forward. To help measure the improvement, a team of seasoned professionals from universities like Cornell, Pepperdine, Houston and Washington University in St. Louis — leading universities in clinical care —visited the Counseling Center in Fall 2016 and provided an appraisal of Baylor's progress and noted additional improvements that could be made. No university counseling center can cover everything; some severe mental health concerns will always require a level of care not found on college campuses. But the Baylor Counseling Center's new resources will serve students with a level of prompt service and enhanced expertise that places the University in the top tier of collegiate counseling centers.