Direct Service Activities
State, local, and campus public health guidelines surrounding the COVID-19 pandemic are continually evolving and CAPS is equipped to provide telehealth services to students. Interns work full-time for the Evanston CAPS office, which serves approximately 8,000 undergraduate students and 8,000 graduate students. Each intern carries a caseload of approximately 15-20 individual clients with case management and systems coordination, client advocacy, and clinical documentation as warranted by clinical needs and standards of care.
Each intern is involved in a process-oriented psychotherapy group with a senior staff co-therapist for 1.5 hours per week, starting with intensive process observation in the first academic quarters, and followed by co-facilitation in subsequent quarters if appropriate. The intern may be involved in the pre-group screening interviews and shares the responsibility with the senior co-therapist for the clinical documentation. Interns may also co-lead (with a senior staff therapist) a structured or semi-structured psychoeducational group. Interns receive 30 minutes of weekly individual supervision when co-facilitating a group.
Each intern serves as a clinician for clients' access appointments (which include brief assessment and disposition planning), same-day crisis appointments to assist students in urgent distress, and consultation with third parties (e.g., peers, parents, faculty, staff, and community providers) regarding the mental-health concerns of students.
Interns rotate in the same manner as senior staff and Postdoctoral Fellows to provide after-hours on-call consultation to a third-party crisis service.CAPS uses a third-party agency to manage all direct crisis calls from NU students, with the expectation that the majority of the calls are managed by them, with after-hours and weekend on-call staff sought out for consultation only in extreme situations. On average, each intern covers about three evenings and one weekend per academic quarter.
Initial Assessment, Consultation, and Crisis Intervention Services
Each intern will provide weekly daytime access coverage for scheduled and drop-in appointments. During these shifts, interns provide telehealth or in-person brief clinical assessment, risk assessment and crisis intervention, and consultation for third parties who express concern for students’ mental health.
When students access CAPS services through scheduled or drop-in appointments, the provider gathers information about the student’s concerns, clinical presentation, background and demographics, and risk level, and determines the type of services that will most suit the student’s needs. From the access appointment, next-step services may include additional assessment, group therapy, short-term individual therapy, crisis appointment, referral to an off-campus provider, follow-up case management, or outreach and educational programming.
Interns rotate with staff to provide after-hours on-call crisis coverage. On average, interns are responsible for covering one week of after-hours on-call per academic quarter. CAPS uses the third-party external agency (ProtoCall) that screens calls from students during evenings and weekends, and they manage most of the students’ urgent needs. The CAPS on-call counselor is contacted only when the ProtoCall counselor needs consultation, assistance with emergencies that require hospital care, or systems coordination. CAPS sets the threshold of consultation from the CAPS After-hours counselor at ProtoCall to limit the after-hours workload for CAPS staff and interns to only extreme and necessary circumstances.
Extended Intake Assessment
Students can occasionally benefit from additional assessments beyond what is typically allotted at the point of access. Each intern is responsible for one hour per week of intake assessment. Interns integrate available data with clinical information gathered from the interview to develop a diagnostic formulation and treatment plan for the client and collaborate with the client to initiate appropriate services at CAPS, on campus, or in the community. The intern is responsible for the follow-up case management, advocacy, and consultation for each client seen at intake.
Outreach and Education
In the spirit of community-based prevention and strengths-based positive psychology, outreach and education workshops are structured or semi-structured interventions in group formats that help Northwestern University students learn healthy and effective coping to foster mental health.
Outreach programs may vary in topic and format and might include presentations on developmental or mental health issues for students (e.g. relationship and communication skills, body image and eating disorders, depression, test anxiety, sleep health, mindfulness), paraprofessional skill training sessions, debriefing sessions for critical events, or presentations about CAPS services.
Incorporating both psychoeducation and experiential formats, the interventions are based on evidence-based, biopsychosocial approaches. Some workshops are under the rubric of CAPS’ Stress Management Clinic, and they employ various evidence-based approaches to stress and anxiety reduction, including meditation and mindfulness, cognitive-behavioral, biofeedback, and relaxation techniques. Some presentations are components of small-and large-scale outreach events at various times of the year, including Body Acceptance Week, Discovering USA, and others.
CAPS has chosen the Question-Persuade-Refer (QPR) Suicide Prevention Gatekeeper Training Program, a nationally recognized, empirically-based, community-focused suicide prevention program, to educate the Northwestern community about suicide and the resources available for those needing professional help. Each intern will become a Certified QPR Gatekeeper Instructor, a certification that will belong to the intern for three years. Interns complete QPR self-study materials and, consistent with the CAPS apprenticeship model, first observe senior CAPS clinicians providing QPR training to the Northwestern community, then subsequently assume responsibility for conducting the training with another facilitator.
The minimum requirements for interns' participation in outreach & education are the following: each intern (a)completes three academic quarters of a drop-in informal consultation program on campus (Let’s Talk); (b)co-facilitates two suicide prevention training (QPR); (c)participates in activities related to one large-scale outreach event which may require a number of activities, including attending planning meetings, tabling events, helping with preparation work, collaborating with student orgs, campus partners, marketing, and providing feedback for improvements; and (d)completes one month of social media outreach in collaboration with Northwestern marketing in winter or spring quarter.
When the COVID-19 pandemic is still a threat to the health and safety of students and staff, our outreach and education work takes the virtual form to minimize risk. We provide relevant TeleReach and virtual gathering spaces to assist students in their coping with the pandemic, sociocultural and political oppression and inequities, and other national and local current events.