Accessibility Resources Center

University of New Haven

300 Boston Post Road
West Haven, CT 06516

Date: December 1, 2019

To: Erica Hutchinson
Accessibility Services Coordinator
From: Jennifer Korn, Ph.D.
Subject: Recommendation Report for clinical services at ARC

Attached is the report for my study about student access to clinical counseling services at the
University of New Haven. I completed the tasks requested: determine the current availability of
counseling services at the ARC, determine if the level of student demand for counseling services
is accommodated by the counseling services currently offered, examine national college statistics
about counseling availability at schools, and compare and contrast the potential solutions that
will make counseling services more available.

I conducted primary and secondary research to perform these tasks. I studied research articles
and statistics, consulted with the receptionist at ARC, distributed a questionnaire to students who
utilize counseling services at the ARC, explored the costs of hiring counselors, and then analyzed
my results and made a recommendation.

My key findings are that students who are receiving counseling services at the ARC do not feel
that meeting biweekly is effective and would prefer to meet with their therapists at least once per
week. Based on the secondary research I conducted, I also determined that the current frequency
of therapy is insufficient. Although it would be best for the ARC to hire more therapists and
extend the clinic hours, the ARC cannot afford to make both of these changes because of the
recent budget cuts throughout the university. Because expanding the clinic hours would require
changing the hours of therapists currently working at the ARC, it is unlikely that this change
alone would make therapists available more often; however, later hours would appeal to students
who are only available in the evening. Hiring more therapists is more expensive than expanding
the clinic hours, but it will increase the availability of therapists.

I recommend one of two courses of action: hiring two additional therapists and expanding the
clinic hours by three hours or hiring two additional therapists for 25-minute appointments during
the clinic’s normal hours.
I appreciate you allowing me to conduct this research, and I look forward to working with you if
you do decide to pursue my recommended course of action. If you have any questions about my
report, you can contact me at ​jkorn2@unh.newhaven.edu​ or at 845-642-2644.
 Providing Sufficient Counseling Services
for Students Who Need Weekly Counseling
at the Accessibility Resources Center
A Recommendation Report

Prepared for: Erica Hutchinson

Accessibility Services Coordinator
Accessibility Resources Center

Prepared by: Jennifer Korn, Ph.D.

Licensed Clinical Psychologist

December 1, 2019

Accessibility Resources Center

University of New Haven
300 Boston Post Rd.
West Haven, CT 06516
 Abstract 

“Providing Sufficient Counseling Services

for Students Who Need Weekly Counseling
at the Accessibility Resources Center
A Recommendation Report”

Prepared by: Jennifer Korn, Ph.D.

Licensed Clinical Psychologist

On October 25th, Erica Hutchinson, Accessibility Services Coordinator of the Accessibility

Resources Center (ARC), approved a proposal by Jennifer Korn, a clinical psychologist, to
perform a research study on providing ample counseling services to students who need weekly
counseling and to report her findings. Jennifer first conducted secondary research to gain an
understanding of how counseling services are serving students nationally and to determine the
recommended frequency of therapy for mental health improvement. Then, she distributed
questionnaires to students who currently receive counseling at the ARC to determine their
counseling needs, evaluated the costs and feasibility of hiring additional therapists, examined
ways to maximize services, and evaluated two solutions. Students who currently receive
counseling believe that weekly counseling would help them more than their current bi-weekly
sessions. Some participants would prefer to meet with their counselors during evening hours. As
there are currently four counselors staffed at the ARC, the most effective solution would be to
hire four additional counselors so that appointments for current students can be made weekly;
however, this option is too expensive for ARC’s budget. While the solutions may need to be
tweaked for maximized effectiveness, a combined course of action is likely the most feasible. I
recommend that if the ARC cannot extend the clinic hours by three hours in addition to hiring
two new therapists, the ARC hires two additional therapists to hold 25-minute sessions during
the clinic’s current hours.

Keywords: counseling services, ARC, clinic, hours, therapists, weekly therapy, availability
 Table of Contents 

Executive Summary​………………………………………………………………………………….1

Introduction​…………………………………………………………………………………………..2

Research Methods​…………………………………………………………………………………....4
Task 1: Determine the current availability of counseling at the ARC​………………………...4
​ ......4
Task 2: Determine if the current availability of services at the ARC is adequete.……...…
Task 3: Examine statistical data regarding counseling
availability​…………………………..4
Task 4: Compare the cost efficiency of potential solutions and student preference​…………..5
Task 5: Review my findings and make this recommendation
report​…………………………..5

Results​………………………………………………………………………………………………...6
Task 1: Determine the current availability of counseling at the ARC​………………………...6
Task 2: Determine if the current availability of services at the ARC is adequete…………..​….6
Task 3: Examine statistical data regarding counseling
availability​…………………………..7
Task 4: Compare the cost efficiency of potential solutions and student preference​…………..7

Conclusions​……………………………………………………………………………………….....10
Current availability of counseling at the ARC​…………………………………………...…..10
Student demand of counseling​……………………………………………………………….10
Counseling availability statistics​…………………………………………………………….10
Cost efficiency of solutions​…………………………………………………………………..10

Recommendation​………………………………………………………………………………...….11
​ …………………………………………...11
Option 1: Split half of the counselors’ sessions…
Option 2: Expand clinic hours ​……………………………………………………………....11

References​…………………………………………………………………………………………...12

Appendix: Student Questionnaire​………………………………………………………………....13

 1
Executive Summary 
To determine the best course of action for providing effective counseling services to students in
need of frequent counseling, Erica Hutchinson, Accessibility Services Coordinator, asked me to
determine the current availability of counseling at the ARC, determine if the students’ counseling
needs are met by the ARC, analyze statistical data about counseling availability and the cost of
hiring more counselors, compare the solutions that will allow for more frequent counseling
sessions, and present my findings and recommendations.

*first two sentences cut* Currently, the ARC only offers counseling at a bi-weekly basis with no
additional therapeutic support. Erica Hutchinson requested that I determine the most effective
and cost-efficient way to make counseling at the ARC more accessible to students who are
seeking more frequent support.

To complete this report, I performed the tasks explained in my abstract and letter of transmittal: I
reviewed research articles and statistics, obtained information from the receptionist at ARC and
Erica Hutchinson, distributed a questionnaire to students who currently receive counseling
services at the ARC, examined the costs of hiring counselors, and then analyzed my results and
wrote this recommendation report.

My most significant finding is that even with counseling only being available biweekly, the
counseling center only accommodates about 4.5% of the student body. The majority of students
who completed the survey expressed a desire for more frequent counseling sessions. Because of
the results from my primary research and statistical data about mental health issues growing
worldwide, I agree that the counseling center must expand its services to assist students with
their mental health needs. I concluded that any effective solution would include the hiring of at
least two additional therapists. The best solution would be to hire at least four additional
therapists; however, that is too expensive for the clinic’s budget. I also cannot be sure whether all
students who currently utilize the counseling center will begin to see their counselors more often
once they are able to; however, it is important that these services are available to anyone who
needs them.

I recommend one of two solutions: hiring two new therapists and splitting half of each
counselor’s sessions or hiring two new therapists and expanding the clinic hours to accommodate
students with later availability. I propose that hiring two new therapists and splitting up half of
each counselor’s sessions is the better course of action for students’ needs because even with
half-length sessions every other week, students are still able to be seen by their counselors every
week.
 2
Introduction:  
To determine the most effective way to improve accessibility to mental health services on
campus, Erica Hutchinson, the Accessibility Services Coordinator of the Accessibility Resources
Center (ARC), asked me to determine the current availability of counseling, explore the level of
student demand for counseling services, examine statistical data regarding counseling
availability and cost on college campuses, balance the costs of potential solutions, and present
my findings and recommendations.

According to the CDC, about half of all Americans are diagnosed with a mental health related
illness in their lifetime. College Stats reported that “suicide is the third leading cause of death
among college students” (College Stats). With younger people being at an elevated risk for
mental health issues that lead to major depression and suicide, it is important that they have
access to routine counseling. Currently, students who seek counseling services at the ARC must
wait at least two weeks for an appointment. Not everyone at the university who struggles with
mental illness seeks help from the counseling center; however, there is still a long wait time for
those who do. This situation is not sufficient because infrequent counseling hinders the
stabilization and overall treatment of students who need help.

As a licensed psychologist, I was asked to determine the best way to make counseling services
more available to all students. I was specifically asked to perform 5 tasks:
● Determine the current availability of counseling at the Accessibility Resources Center.
● Determine if the current availability of services at the Accessibility Resources Center is
adequate.
● Examine statistical data regarding counseling availability and cost of counseling at
college campuses.
● Compare the potential solutions that will make counseling services more available.
● Present my findings and make a recommendation.

I found that as counseling services are only available no sooner than bi-weekly, the level of
student need for counseling services is not met, especially for students who are struggling with
mental health issues and are trying to get healthier. Therapists at the University of New Haven
work without taking insurance or charging clients with a fee, which means they don’t make as
much money as therapists who practice independently. This explains why therapists are difficult
to recruit.

I found two possible solutions to help make counseling more available. First, hiring more
therapists and expanding clinic hours would allow for more availability. The other solution is to
hire more therapists and split up half of the counselors’ appointments. The best way to resolve
 3
the issue is to double to current counseling staff; however, the Accessibility Resource Center’s
budget does not make this feasible.

I recommend that the Accessibility Resource Center hires at least two more therapists and offers
shortened appointment times. While expanding the clinic hours is also helpful in terms of
expanding accessibility, it is unlikely to decrease the amount of clients each therapist has. The
additional therapists and shortened appointment times make it possible for students to be seen
more often than once every two weeks.

In the following sections, I provide details about my research methods, the results I gathered, the
conclusions I determined from the results, and my recommendation.
 4
Research Methods 
I began my research by searching articles about mental health issues, therapists, college student
trends, and costs. Primary research I conducted includes information obtained from Erica
Hutchinson, as well as an interview with a psychology professor on campus.

I broke this project into 5 tasks, as listed in the introduction. The sections below explain how I
performed each task.

Task 1: Determine the current availability of counseling at the ARC

Upon being asked to complete this project by Erica Hutchinson, I asked about her how long a
student would have to wait to be seen. I called the ARC to speak with a receptionist about
booking an appointment to confirm the information Erica Hutchinson gave me.

Task 2: Determine if the current availability of services at the ARC is adequate

The American Psychological Association administered a survey to counseling clinics on college
campuses (“College Students’ Mental Health”). I conducted a thorough review of the APA’s
survey results on mental health issues in college students to determine the necd of providing
counseling services.

I examined a research study conducted by the National Center for Biotechnology Information to
determine the relationship between session frequency and mental health improvement (Erekson
et al, 2015). I also distributed a questionnaire to students who receive counseling services at the
ARC to find out if they believe seeing a therapist biweekly is enough and if they think they need
to be seen more often. The survey was sent out as a Google Form on November 1st to the 320
students registered with the ARC counseling clinic; the questionnaire received 150 responses.

I also asked Erica Hutchinson for information about students who receive education services.
Although not all students who have identified needs seek counseling specifically, many students
in this population do seek therapy in addition to those who do not receive educational services
from the ARC. Receiving this information helped me determine if the ARC is accommodating
these students with adequate counseling services.

Task 3: Examine statistical data regarding counseling availability

Erica Hutchinson initially informed me that hiring counselors can be difficult because of the
university’s limited budget. Especially with recent budget cuts that came as a result of the new
buildings on campus, the ARC would need to find therapists who can settle for a salary that the
clinic can afford. To further research the role pre-determined salaries have in recruiting
counselors, I reviewed an article by the National Public Radio about how insurance companies
play a role in therapist accessibility (Dembosky).

5
The National Association of School Psychologists published a research article about
psychologist to student ratios (Griffith). While the article focuses on therapist shortages in public
schools, it does apply to the University of New Haven because of the school’s limited funding.

Task 4: Compare the cost efficiency of potential solutions and student preference
When estimating the cost of therapists, I used the average salary provided by the Bureau of
Labor Statistics.

As both solutions offered in my recommendation are similar in cost, I needed to compare them
based on cost efficiency. To do this, I compared how each solution would affect the availability
of services. I also used my student survey results to weigh the demand for night availability
versus the demand for more frequent sessions.

*Task 5 removed*
 6
Results 
In this section, I present the results of my research. I provide detailed results of each task carried
out for this project.

Task 1: Determine the current availability of counseling at the ARC

My first finding was that therapists are usually booked two weeks in advance. A receptionist at
the clinic informed me that the earliest I can see someone is two weeks from the day I called. She
said biweekly appointments are standard at the clinic, especially in the middle of the semester.

Task 2: Determine if the current availability of services at the ARC is adequate

According to the survey administered by the APA, mental health issues on campuses are rising.
The survey obtained responses from 400 counseling center directors and the results include the
following, “Directors report that 21 percent of counseling center students present with severe
mental health concerns, while another 40 percent present with mild mental health concerns.”
(“College Students’ Mental Health,” 2013).​ ​Data from​ ​College Statistics about the rise of mental
health issues on campuses supports these findings. Not only do more people need to seek
treatment, but to get treated effectively, one must seek treatment on a regular basis.

The research study conducted by the National Center for Biotechnology Information found that
weekly counseling sessions yield a faster recovery than fortnightly groups (Erekson et al, 2015).
As mental health issues in college students are becoming more concerning, the availability of
weekly counseling sessions is necessary in providing effective treatment.

When researching demographic data specific to the University of New Haven, I discovered that
an estimated 10% of students require special education services. If all 700 students requiring
services are split between four counselors, the current ratio would be 1 counselor per 175
students. Although not all students with identified needs specifically require counseling, many
students who do not receive education services are in need of counseling. If each counselor
currently working at the university worked five full days a week, they each could accommodate a
maximum of 80 students who visit them biweekly. With only four counselors currently staffed,
only about 320 students are receiving services. Less than 5% of the student body is receiving
services at the ARC, yet the clinic is still overbooked.

I sent my questionnaire to all 320 students currently registered with the ARC. Out of the 150
students who participated, 114 of them said they prefer to see a counselor weekly. In a separate
question, 38 participants said they would benefit from having access to evening hours at the
clinic. The majority of the participants answered that their symptoms of mental health issues
affect their everyday lives, which suggests a significant need for frequent therapy sessions. This
 7
research helped me determine that the counseling services provided by the ARC do not meet the
needs of students who need therapy on a weekly basis.

Task 3: Examine statistical data regarding counseling availability

According to the article by National Public Radio, insurance companies do play a part in keeping
patients away from therapy (Dembosky 2016). Therapists do not want to work with insurance
companies because they cannot afford the wages provided through insurance. Similarly,
therapists who work at the ARC do not set their own rates because the ARC does not take
insurance or a fee from clients. Seasoned therapists are more likely to want to set their own fee
so that they can sustain a living off their work. With this in mind, finding therapists to work at
the university is challenging.

The National Association of School Psychologists found that “under the recommended ratios, a
school psychologist would serve between 65 and 91 students receiving ​special education
services​.” (Griffith, 2018). The article addresses that there is a national shortage in psychological
services and the actual psychologist to student ratio is more than two times the recommended
ratio in high schools. The research I conducted indicates that the current issue at the ARC is
prevalent around the country.

Task 4: Compare the cost efficiency of potential solutions and student preference
According to the Bureau of Labor Statistics, the average salary of a counselor working in an
office for educational support services is $74,250 (“Bureau of Labor Statistics,” 2018). If two
additional full-time therapists are hired, this would cost around $148,500 a year.

Based on the survey I administered to students currently receiving counseling services, the
majority of them would prefer more frequent counseling over nighttime availability. See figure
1:1 for a visual representation of this data.
 8

Figure 1.1 Student Survey Response to Clinic Change Options

The figure above shows that 61% of participants prefer more frequent therapy, 29% prefer later
clinic hours, and 10% are satisfied with their experience at the counseling clinic.

To compare each solution in terms of cost, session frequency, student preference, and
effectiveness, I created a decision matrix. Although both of my recommendations include the
third option, I placed it in my decision matrix to determine the effectiveness of that solution
alone. See figure 1.2 for each solution’s ratings and scores for the weighted criteria.

Figure 1.2 Decision Matrix

 9
I weighed the frequency of sessions and mental health improvement the most important because
those are the main goals of this research and they are also intertwined: increasing the frequency
of counseling sessions will influence mental health improvement. Although the recent budget
cuts do limit the ARC, two of the three options are of equal cost. Although hiring two new
therapists is implemented in both solutions, I added this as a third option so that there is also an
analysis of that change. This solution scored lowest in cost because it is the most expensive
option and only hiring two new therapists would not allow for significant mental health
improvement on its own because it will still be difficult for students to get therapy once a week.
The preference of students was measured by the survey I administered. The inclusion of
students’ preference in my decision matrix is important because it shows feedback from the
recipients of the ARC’s counseling services.
 10
Conclusions 
Here, I will present the conclusions I reached after completing the tasks described above.

Current availability of counseling at the ARC

Based on information provided by Erica Hutchinson and the receptionist at the counseling clinic,
I conclude that the earliest students can book an appointment at the center is two weeks in
advance. The current demand for counseling is too high for the center to offer weekly
counseling.

Student demand of counseling

Based on the information obtained from the student questionnaire, I conclude that students who
currently utilize counseling services are not satisfied with the frequency of their appointments.
Because there is a connection between frequent counseling sessions and mental health recovery,
services offered at the ARC are not sufficient in improving students’ mental health. The majority
of student responses to question 5 of the survey indicate that students are struggling with their
mental health.

Based on information obtained from Erica Hutchinson, I conclude that the counseling center is
not large enough to accommodate the 10% of students who require special educational services,
although not all students who receive special education services pursue counseling.

Counseling availability statistics

On the basis of my research, I conclude that there are several factors that affect the availability of
therapists, including insurance, salary, and counselor-to-student ratios. Because insurance
companies and pre-determined salaries make it difficult for therapists to make a living wage,
many therapists do not prefer to work where they cannot set their own rates. As the demand for
counseling services is on the rise, counselors’ case loads are no longer ideal. I conclude that there
is a nationwide shortage of counselors.

Cost efficiency of solutions

I conclude that splitting up sessions to increase the frequency of appointments is more cost
efficient than expanding clinic hours. Based on the student questionnaire responses, receiving
weekly counseling is more of a priority for students than evening availability and splitting
appointments will save the clinic from having to hire additional therapists, as more students
would have access to counseling.
 11
Recommendation 
I recommend that in addition to hiring two new therapists, the ARC counseling clinic pursues
one of two options:

Option 1: Split half of the counselors’ sessions

Hiring two additional therapists alone would help spread out each counselor’s caseload;
however, it is unlikely that all students will be able to access counseling on a weekly basis. To
maximize the cost of hiring two therapists, I recommend splitting up half of each counselor’s
appointments so that they can hold mini-sessions between full appointments. The mini session
times would alternate every week so that students can access them when they normally would
have their full sessions. This would not only allow for more availability, but it will also be more
cost-efficient.

A full session every week is more favorable, but ARC cannot afford to hire enough therapists for
that option to be feasible. If a considerable number of students do not opt for weekly therapy, full
sessions can become an option for students when those slots are available.

Option 2: Expand clinic hours

If ARC does not want to pursue mini-sessions, I recommend that in addition to hiring two new
therapists, the clinic expands its hours so that it will be open from 9:00 am - 8:00 pm. With clinic
hours expanded, therapist shifts would have to be changed. For example, instead of all therapists
working from 9:00 am - 5:00 pm, some may work 12:00 pm - 8:00 pm.

When compared to the first option, this would not be as effective in increasing the frequency of
sessions; however, it does create more flexibility in scheduling and accommodates students who
are not available during normal business hours.
 12
References 
College Students' Mental Health is a Growing Concern, Survey Finds . (2013, June). Retrieved
from ​https://www.apa.org/monitor/2013/06/college-students​.

Data and Publications - Mental Health . (2018, January 26). Retrieved from
https://www.cdc.gov/mentalhealth/data_publications/index.htm​.

Dembosky, A. (2016, July 14). Frustrated You Can't Find A Therapist? They're Frustrated, Too.
Retrieved from
https://www.npr.org/sections/health-shots/2016/07/14/481762357/frustrated-you-can-t-fi
nd-a-therapist-they-re-frustrated-too​.

Erekson, D. M., Lambert, M. J., & Eggett, D. L. (2015, October 5). The relationship between
session frequency and psychotherapy outcome in a naturalistic setting. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/26436645​.

Griffith, M. (2018, October 17). What is the Cost of Providing Students with Adequate
Psychological Support. Retrieved from
https://www.nasponline.org/research-and-policy/policy-matters-blog/what-is-the-cost-of-
providing-students-with-adequate-psychological-support​.

Mental Health Guide for College Students. (n.d.). Retrieved from

https://collegestats.org/resources/mental-health-guide/​.

Occupational Employment Statistics - 19-3031 Clinical, Counseling, and School Psychologists.

(2019, March 29). Retrieved from ​https://www.bls.gov/oes/current/oes193031.htm​.
 13
Appendix: Student Questionnaire  
This is the questionnaire I distributed to the 320 students currently receiving counseling services.
I received 150 responses. The percentages in boldface below show the percentage of respondents
who selected each response.

Counseling Services Satisfaction Survey

1. How often would you prefer to see a counselor at the school clinic?
76% Weekly
16% Biweekly
2% Monthly
6% As needed

2. Do you believe that your mental health would improve if you receive counseling more
often?
73% Yes
27% No

3. When would you prefer to have your therapy sessions?

54% Standard office hours 9-5
8% Early morning
38% Late evening

4. If the ARC hired more counselors, which option would you prefer?
61% I would prefer to see my therapist more often, even if the sessions need to be
shorter.
29% I would prefer to see my therapist in the evening, even if it’s not every week.
10% I do not mind continuing to see my counselor at the rate I currently do.

5. “I often have feelings of hopelessness.”

Strongly Disagree ​ 2% ​ ​ 27% ​ ​ 22% ​ ​ 36% ​ ​ 13%​ ​ Strongly Agree

“I have difficulty coping with stress.”

Strongly Disagree ​ 8% ​ ​ 21% ​ ​ 7% ​ ​ 42% ​ ​ 22%​ ​ Strongly Agree

“I have lost interest in activities I used to enjoy.”

Strongly Disagree ​ 18% ​ ​ 10% ​ ​ 36% ​ ​ 25% ​ ​ 11%​ ​ Strongly Agree

“I often isolate myself.”

 14
Strongly Disagree ​ 2% ​ ​ 17% ​ ​ 28% ​ ​ 30% ​ ​ 23%​ ​ Strongly Agree