Policies and Procedures Manual Therapist Training Manual 55 Fair Drive, Costa Mesa, CA 92626 • vanguard.edu COUNSELING CENTER PREFACE The following summarizes guidelines for operation of the Vanguard Counseling Center. The contents are reviewed and additions and/or revisions are made periodically as needed. This document was initially written to conform to the Accreditation Standards for University and College Counseling Centers outlined by the International Association of Counseling Services. The Vanguard University Counseling Center is not currently accredited by IACS. Revised January 5, 2015 By Doug Hutchinson Licensed Marriage & Family Therapist VUCC Director Michele Robison Licensed Psychologist VUCC Associate Director Page | 1 Contents Vanguard University Mission and Identity Statement .............................................................................. 4 Vanguard University Counseling Center Mission Statement ................................................................... 4 Availability of Services............................................................................................................................. 5 Counseling Services .................................................................................................................................. 5 Consultation .............................................................................................................................................. 5 Crisis Intervention..................................................................................................................................... 6 Outreach Services ..................................................................................................................................... 6 Referral Resources .................................................................................................................................... 7 Evaluation of Services: Counseling Services Year End Report ............................................................... 7 ETHICAL STANDARD AND GUIDELINES ............................................................................................ 8 Statement Regarding Professional Ethics ................................................................................................. 8 Confidentiality .......................................................................................................................................... 8 Release of Information .............................................................................................................................. 9 Conflict of Interest .................................................................................................................................... 9 Therapy Never Includes Sex ..................................................................................................................... 9 SPECIFIC CLINICAL PROCEDURAL GUIDELINES............................................................................ 10 Client Records......................................................................................................................................... 10 Intake ...................................................................................................................................................... 11 Contacting Clients................................................................................................................................... 11 Waiting List ............................................................................................................................................ 11 Mandated Counseling ............................................................................................................................. 12 Psychological Assessment ...................................................................................................................... 12 Referring a Client to a Psychiatrist ......................................................................................................... 12 Recording Client Sessions ...................................................................................................................... 12 Hospitalization Procedures ..................................................................................................................... 13 After-Hours Crisis Response .................................................................................................................. 13 Treatment of Minors ............................................................................................................................... 14 Abuse Reporting ..................................................................................................................................... 14 Potential Violent Clients ......................................................................................................................... 15 OTHER ADMINISTRATIVE AND OFFICE PROCEDURAL GUIDELINES ....................................... 15 Fees ......................................................................................................................................................... 15 Page | 2 Budget Management ............................................................................................................................... 16 Physical Facilities ................................................................................................................................... 16 Technology ............................................................................................................................................. 16 Electronic Mail Communication ............................................................................................................. 16 Scheduling............................................................................................................................................... 17 PERSONNEL GUILDELINES .................................................................................................................. 17 General Characteristics ........................................................................................................................... 17 Director ................................................................................................................................................... 17 Associate Director................................................................................................................................... 19 MFT Trainees.......................................................................................................................................... 21 Secretary III for Student Services ........................................................................................................... 21 SUPERVISION GUIDELINES .................................................................................................................. 22 General Guidelines.................................................................................................................................. 22 Supervision of Marriage and Family Therapist Trainees/Interns ........................................................... 23 Supervision Documentation .................................................................................................................... 24 APPENDIX I – References ......................................................................................................................... 24 APPENDIX II – Identifying and Responding to Dangerous Students........................................................ 25 Tips for Faculty & Staff .......................................................................................................................... 25 Warning Signs of Suicide ....................................................................................................................... 25 How Should You Respond...................................................................................................................... 26 Do’s and Don’ts in Responding to Suicidality........................................................................................ 26 In an Emergency ..................................................................................................................................... 27 Tips for Helping a Stressed Student ........................................................................................................ 28 VUCC Crisis Response Protocol………………………………………………………………………………………………………… 29 Page | 3 MISSION Vanguard University Mission and Identity Statement The purpose of Vanguard University is to pursue knowledge, cultivate character, deepen faith, and equip each student for a life of leadership and service. To fulfill that purpose, Vanguard gathers a community of learners resolved to blend the pursuit of academic excellence with growth as authentic Christians. The educational experience at Vanguard, therefore, promotes the integration of faith, learning, and living. The university believes that scholarship in the arts, sciences, and professional studies illuminated by Christian truth fosters the intellectual development, moral maturity, and spiritual vitality of students. The university motto – Truth, Virtue, and Service – expresses our conviction that learning involves the whole person: head, heart, and hands. A hallmark of a Vanguard education is the emphasis on the relational and collaborative nature of learning. The university cultivates a campus ethos that embraces a personal learning experience. Caring and supportive relationships among students, faculty, and staff provide opportunities for persons to share their faith journeys, to explore their hopes, and to nourish their souls. The community provides a safe place for free inquiry into the nature of truth, the acquisition of knowledge, the resolution of intellectual challenges, and the exploration of Christian faith for everyday living and for the enrichment of the life of the mind. Under the auspices of the Assemblies of God in Southern California, the university embraces its Pentecostal heritage of Spirit-empowered life and thought. Faculty, staff, and students display considerable diversity in denominational affiliation, cultural expression, and academic pursuits. Together, they affirm the authority of Scripture, the Lordship of Jesus Christ, and belief that human nature, though marred by sin, nevertheless enjoys the potential redemption through God’s salvation in Jesus Christ. From this Evangelical and Pentecostal perspective, and in service to the church and society, the Vanguard community commits itself to global Christian witness and to social transformation. Vanguard University Counseling Center Mission Statement The Vanguard University Counseling Center exists to empower individuals to live a more productive, responsible and holistic Christian lifestyle through Christian care, compassion, professional competence and shared knowledge. Page | 4 SERVICES Availability of Services The Counseling Center is open for regular services most of the year. Office hours are from 8:00 am to 5:00 pm, Monday through Friday. Operation hours for counseling services may be available as early as 8:00 am to as late as 8:00 pm, Monday through Friday. Saturday appointments may also be available. The Counseling Center observes holiday and vacation days as designated by the university. The Counseling Center is mandated to provide psychological services to the student population of Vanguard University. Any undergraduate, graduate, or SPS student enrolled full or part-time at Vanguard University is considered eligible for counseling services at the Counseling Center. Any member of the Vanguard University community may request and receive access to services related to referrals, consultation, outreach and prevention, or crisis intervention. Counseling Services Any student seeking counseling services through the Counseling Center will first be asked to complete a Counseling Request Form. After filling out the form, the student will be scheduled for an intake appointment. Once the student has received an intake appointment, the students’ needs will be evaluated by the Director or the Associate Director before being assigned to a therapist or referred out. Referrals are based upon “scope of practice” limits and the resources of the Counseling Center. Ongoing counseling services available through the Counseling Center include individual counseling, marital or premarital couples counseling, and group counseling. Individual sessions are typically 45 to 50 minutes in length. Couples sessions are typically 45 to 60 minutes in length. At least one member of the couple must hold current student status at Vanguard University to obtain couples counseling through the Counseling Center. Consultation In addition to ongoing counseling services, the Counseling Center provides the opportunity for consultation to members of the Vanguard University community. The primary motivating factor for consultation services is the welfare and progress of the Vanguard University student population and/or any identified client. Thus, the Counseling Center endeavors in its role as consultant to be an advocate for students on campus, attempting to identify pertinent issues and potential concerns within the community as a whole that may impede student development. Consultation may be initiated by Vanguard University staff or by outside entities. As appropriate, consulting parties may include students (e.g., Student Government Association); appropriate campus personnel (e.g., faculty, Student Life staff); other persons associated with Page | 5 students (e.g., parents, spouses); or other community agencies (e.g., psychiatrists, other mental health professionals). Consultation services fall within the appropriate ethical and legal boundaries regarding client confidentiality and release of information. Crisis Intervention The Counseling Center is available during normal hours of operation to assist in the management of crises occurring on campus. This applies to any Vanguard University community member, including but not limited to students, faculty, or staff. In individual cases, the Counseling Center provides initial assessment, followed by the least intrusive course of treatment possible to manage the crisis. (For example, when a student seen at the Counseling Center manifests suicidal ideation, treatment would begin with assessment for imminent danger, and then may include safety planning, increased frequency of sessions, identifying outside resources or referrals, calling parents, bringing in Residence Life personnel if the student is residential, or ultimately, voluntary or involuntary hospitalization should all other levels of management fail.) However, because each case requires an individualized response, the Counseling Center does not maintain a blanket crisis “policy,” save that any individual member of the Vanguard University community who comes to the Counseling Center requiring crisis intervention will be evaluated and offered appropriate assistance within the scope of practice of the Counseling Center. If a new client comes in for a single walk-in session, a client file will be created in Titanium and a note will be created for the walk in session. In cases involving existing clients, the walk-in session will be documented in the existing file as a progress note. If a crisis occurs after normal hours of operations, the Director is available for consultation over the phone. If however it is an emergency, dial 911. Outreach Services The staff of the Counseling Center recognizes that many Vanguard University students will not be inclined to utilize traditional counseling services. In order to attempt to address the needs of these students in alternative ways, the Counseling Center offers preventive and reactive outreach services. These services are designed to facilitate the mission of the university and the Counseling Center within the Vanguard University community and are developed with regard to current student/campus trends and pertinent developmental issues. Outreach services are delivered in a variety of ways. The Counseling Center attempts to be available to faculty, staff, and student groups seeking outreach programming (e.g., training, workshops, and guest lecturers). In addition, the Counseling Center looks for opportunities to sponsor original programming for the Vanguard University community (e.g., retreats Page | 6 conferences, chapel speakers). Finally, web-based wellness and self-care information can be found on the Counseling Center website http://www.vanguard.edu/services/counselingcenter/self-help-resources/ Referral Resources To assist in meeting the continuing and longer-term wellness needs of the Vanguard University community; the Counseling Center attempts to maintain an adequate referral list of community mental health agencies. This list includes local marriage and family therapists, psychologists, psychiatrists, hospitals and extended care facilities, hotlines, and other specialized agencies. Referral resources are made available to any Vanguard University student, staff member, or faculty member and are included on the website. In formulating referrals, the Counseling Center attempts to identify clinically competent community counselors and agencies that are sensitive to the unique needs and demands of members of a Christian educational community. The Counseling Center referral list is subject to ongoing revision, and is updated continually in order to evaluate the quality of service providers included as well as to maintain good working relationships with these agencies. However, the Counseling Center does not assume responsibility for actual services rendered by outside agencies. Evaluation of Services: Counseling Services Year End Report The Counseling Center is committed to self-evaluation in order to maintain the quality and effectiveness of its services. It is the responsibility of the Counseling Center Director to compile an annual statistical report for the purposes of quality assurance, documentation of services rendered, and dissemination of information regarding service utilization, needs assessment, trend analysis, and comparison with national and normative data. The Counseling Services Year End Report should contain the following sections: Demographics Statistics: This section should include, but is not limited to, total number of clients, gender, academic status, ethnicity, referral resource, and major area of study. The majority of this information will be accessed via client and therapist completion of intake paperwork. Termination Statistics: This section should include but is not limited to total number of clients, total number of sessions, overall progress at termination, termination status, issues addressed. This information will be accessed via counselor completion of the Termination Report. Satisfaction Survey Results: This section should include item analysis and a summary of qualitative comments provided via client completion of the Counseling Experience Questionnaire. Page | 7 ETHICAL STANDARD AND GUIDELINES Statement Regarding Professional Ethics Professional counseling staff employed by the Vanguard University Counseling Center are expected to know and comply with the relevant ethical principles and legal guidelines governing clinical practice in the State of California. Professional counseling staff includes those with a degree and/or licensure and those volunteering as a MFT Trainee in the field of Marriage and Family Therapy practice in compliance with the Code of Ethics of the American Association for Marriage and Family Therapy and the Standards published by the California Association for Marriage and Family Therapy. Each licensed Counseling Center counselor will maintain all requirements of their respective state licensing board. Confidentiality In accordance with professional ethics and California state law, any information shared in the context of professional counseling is considered confidential. All Counseling Center staff (i.e., the Director, Associate Director, all counseling staff, administrative staff, and any clinical supervisor employed by the Vanguard University) is obligated to take reasonable steps to protect the confidentiality of the Counseling Center clients. Counseling staff must notify potential clients of the following exceptions to confidentiality: The client gives written authorization for the sharing of information. The counselor believes that a client is a danger to harm himself/herself, or is gravely disabled. The counselor believes that a client is a danger to harm another person or the property of another person. The counselor is informed of or suspects the abuse or potential abuse of a child. The counselor is informed of or suspects the abuse or potential abuse of an elderly person or other dependent adult. The counselor is an MFT intern, trainee or practicum student and is discussing client information with a clinical supervisor employed by the Counseling Center. The MFT intern, trainee or practicum student will provide the client with the supervisor’s name in writing at the time of intake or initial consultation, per California state law. The client’s record is subpoenaed in accordance with an appropriate, legally defined situation. Page | 8 Release of Information The Counseling Center attempts to comply with the Guidelines for Release of Privileged Records and/or Information Concerning Clients developed by the Organization of Counseling Center Directors in Higher Education. The individual client is designated the “Holder of the Privilege.” Protection of the rights and interests of the clients is the primary concern of Counseling Center staff with regard to the release of confidential information. Reasonable attempts should be made to secure a client’s written informed consent before any exchange of information occurs. The client is entitled to a copy of any signed Release of Information Form. The Director of the Vanguard University Counseling Center is the designated “Keeper of Records” for all Counseling Center clients. Unusual requests for client information or requests from a secondary party should be referred to the Director. Individual counseling staff may handle routine exchange of information initiated or approved of in writing by the client as appropriate. While all Counseling Center staff members bear individual responsibility for upholding the legal and ethical guidelines for disseminating client information, ultimate responsibility for the appropriate release of information falls to the Director. All requests for release of confidential client information are evaluated on a case-by-case basis by counseling staff and/or the Director. In the event that a Counseling Center therapist would like to contact a client’s previous therapist or psychiatrist, the therapist must obtain a Release of Information Form from the client. The therapist then may send a copy of the Release of Information Form to the appropriate person. If a Counseling Center therapist would like to review VU counseling center records of their client from a previous therapist, they must obtain authorization which can be found on the Counseling Philosophy General Consent Form. Conflict of Interest When possible, the counseling staff will make every effort to avoid situations that may present a conflict of interest in the treatment and/or referral of clients. The Counseling Center attempts to comply with the practices outlined in the OCCDHE Guidelines on Conflict of Interest. Therapy Never Includes Sex The Counseling Center counseling staff is aware of the California law as it applies to therapy and sex. According to California laws: Page | 9 Any act of sexual contact, sexual abuse, sexual exploitation, sexual misconduct or sexual relations by a therapist with a patient is unprofessional, illegal, as well as unethical as set forth in Business and Professions Code sections 726, 729,2960(o), 4982(d) and 4992.3(k). “Sexual contact” means the touching of an intimate part of another person, including sexual intercourse. Sexual exploitation can include sexual intercourse, sodomy, oral copulation, or any other sexual contact between a therapist and a patient or a former patient under certain circumstances. Sexual misconduct includes a much broader range of activity, which may include fondling, kissing, spanking, nudity, verbal suggestions, innuendoes or advances. This kind of sexual behavior by a therapist with a patient is unethical, unprofessional, and illegal. If a client at the VUCC reports to their therapist that any of the above violations occurred with a previous therapist, the VUCC therapist will give the client a copy of “Professional Therapy Never Includes Sex” booklet and assist them in understanding their rights. SPECIFIC CLINICAL PROCEDURAL GUIDELINES Client Records Any clinical contact between a Counseling Center counselor and a client, by phone or in person, will be documented appropriately. In addition, any clinical consultation or supervision directly pertaining to the client must also be documented in the client’s file. In cases following normal intake procedure, each client file will typically include the following documents: Counseling Request Form, Counseling Philosophy and Informed Consent Form, Client Information Questionnaire, CCAPS 34 Inventory, Intake Interview, and Therapy Progress Notes. Any additional documentation regarding treatment should also be included in the client file as appropriate. This may include, but is not limited to, the following: assessment and treatment plan, Release of Information Form, Consent to Video/Audio Recording, Consent to Psychological Testing, Safety/No Suicide Contract, Suicide Potential Form, and assessment report and data. As outlined in California State Law (H & S Code Section 123145, AB 2257), all client files will be kept for seven (7) years. After seven years, only a one-page summary of the client’s records will be kept and the remainder will be destroyed in an appropriate manner (i.e., preserving client privacy). Page | 10 In accordance with California state law, all client files pertaining to the current academic year will be stored on Titanium, which is a secured system. In addition, all files from previous years will be stored on Titanium. Access to actual client files is limited to currently employed Counseling Center staff. Intake After a client fills out a Counseling Request Form, the client will be contacted to set up an intake session. During the intake session, the client is expected to complete the CCAPS 34 Inventory, sign the General Consent to Therapy portion of the Counseling Philosophy and informed Consent Form, indicating the client’s consent to treatment at the Counseling Center. Additionally, the therapist will complete an Adult Psychosocial History Interview and provide the client the Beck Depression Inventory or the Beck Anxiety Inventory as necessary. The goal of the intake session is to initiate counseling and help determine the client’s needs. After the initial session clients will either be assigned to a therapist based on the client’s needs and the therapist’s qualification or placed on a waiting list. If the client is placed on the waiting list, the client will be contacted on a weekly basis in order to maintain contact with the client and continue to assess the needs of the client. Contacting Clients When a therapist is assigned a client, it is expected that the therapist will attempt to contact the client by phone the same day. If the client has indicated on the Counseling Request Form that it is appropriate to leave a message, then the therapist may leave a message. In the event that the client does not return the call, the therapist is expected to attempt to contact the client by phone three times over the period of a week. If the client never returns a phone call, then it is appropriate for the therapist to send the client an Unable to Reach New Client Letter. In the event that after seeing a client for any period of time the therapist is no longer able to reach the client (i.e., the client stops coming to sessions, the client stops returning phone calls), the therapist is expected to attempt to contact the client three times over the period of a week. If the client is still unreachable, it is appropriate for the therapist to send a Returning Client/No Show Letter to the client. Waiting List In the event that Counseling Center MFT interns, trainees and Practicum students caseloads become “full” or all the therapy rooms and office space becomes booked, it may become necessary to institute a “waiting list” until such time as demand for services can be accommodated. A client may also choose to be placed on a waiting list if he or she has Page | 11 preferences for a particular counselor or counselor demographic should these not be available at the time the student seeks Counseling Center services. If a client is placed on the waiting list, they are sent an e-mail letting them know of the wait list and an approximation of how long it might be to get an appointment. They are also told to call or come in if their situation changes and they need immediate assistance. Self-care resources are also provided. If the client reports being in a state of crisis, the client will be evaluated by the Director or Associate Director before being placed on the wait list and is given some resources and referred out if necessary. Mandated Counseling Often students are mandated to come to counseling by Residence Life, the Student Care Committee or the Provost’s office. In the event that a student is mandated to come to counseling, it is the responsibility of the mandating party to have the student sign a Limited Release of Information if they want any information. The person mandating the counseling is also responsible for making sure the client attends counseling; it is not the responsibility of the staff of the Counseling Center. Psychological Assessment In conducting psychological assessment, Counseling Center counselors comply with the relevant standards of ethical practice with regard to psychological testing outlined by the American Psychological Association and the American Association of Marriage and Family Therapists. Any assessment related to the employment or prospective employment of an individual by the university will comply with the Standards for Educational and Psychological Testing in the Ethical Principles of Psychologists and Code of Conduct. Referring a Client to a Psychiatrist Reasons may occur in which the Counseling Center client needs to be evaluated by a psychiatrist for medical reasons. The therapist may give clients recommended referrals which can be found in their training manual, and on the VUCC website. Recording Client Sessions Audio and/or videotaping of Counseling Center clients is to be used for supervision and educational purposes only. Any audio or video recording of a client session should be destroyed or recorded over after it has been reviewed and discussed in supervision. Page | 12 Hospitalization Procedures In the event that a student in the care of the Counseling Center should require hospitalization due to a mental health issue during the course of normal business hours, Counseling Center professional staff will assist in facilitating the hospitalization process. In all cases of voluntary hospitalization, a responsible party (e.g., parents, relative, roommate) will be contacted to provide transportation to the hospital. The student may not transport him/herself to the hospital. The staff of the Vanguard University Counseling Center will not transport a student to the hospital. In the case of an involuntary hospitalization, Campus Safety will be contacted to provide officers on scene to maintain safety. In addition, The PET Team will be contacted to conduct an on-site assessment and transport of the individual to the hospital. Their number is 866-830-6011. The treating therapist will inform their supervisor as soon as possible. Counseling Center staff will then inform the Coordinator of Disability Services that a student was hospitalized. After-Hours Crisis Response Attempted suicide or self-harm 1. Resident Assistant (RA) or Resident Director (RD) calls Campus Safety immediately. 2. Campus Safety calls 911 and directs help to the emergency. 3. In the event that 911 is called first, RA or RD calls Campus Safety immediately after so that they can provide presence and direct help to the emergency. 4. Campus safety notifies any additional campus officials as deemed appropriate. 5. Vanguard University Counseling Center Director is contacted for consultation and a written report is sent to the Director. If the student is a current client of the Counseling Center, the report is placed in the client file. If the student is not a current client, a file will be started at the VUCC. Evidence of emotional distress and/or threat of harm to oneself 1. RA calls his or her own RD or the RD on duty. 2. RD evaluates situation and determines whether to inform Director of Residence Life (or designee). 3. Director of Residence Life and RD determine whether Campus Safety assistance is needed. 4. RD notifies Campus Safety of concern. Campus Safety provides presence and/or support as necessary. 5. If requested by RD, Director of Residence Life, or Campus Safety Office, Campus Safety coordinator may contact the Counseling Center for consultation. If it is after hours, the director of the counseling center may be contacted. 6. Campus Safety notifies any additional campus officials as deemed appropriate. Page | 13 Treatment of Minors As a general rule, the Counseling Center does not participate in the treat of minors. However, in the event that a minor does seek services at the Counseling Center (e.g., a 17 year old student), the minor is informed parental consent will be necessary for treatment to occur. There are some exceptions (i.e., harm to self, drugs, sex, and alcohol). The therapist will need to obtain a signed copy of the Minor Consent for Therapy Form from the minor’s parents. Exceptions to this rule are made only in strict compliance with those exceptions outlined in California state law, as follows: “A minor who is 12 years of age or older may consent to mental health treatment or counseling on an outpatient basis… if both of the following requirements are satisfied: (1) The minor, in the opinion of the attending professional, is mature enough to participate intelligently in the outpatient services; AND, (2) The minor (A) would present a danger of serious physical or mental harm to self or to others without the mental health treatment or counseling… OR, (B) is the alleged victim of incest or child abuse.” California law also recognizes that an “emancipated” minor may consent to treatment. If a parent who has consented to the treatment of a minor client at the Counseling Center requests information or records regarding that treatment, release of such information or record is at the discretion of the counselor, in consultation with the minor client and the Counseling Center Director. California law gives health care providers the right to refuse access to records anytime it is determined that access to these records would have a detrimental effect on the provider’s professional relationship with the minor client or the minor’s physical well-being. (Cal. Health and Safety Code §123115(a)(2)). Parents may not receive information or notification regarding the treatment of an emancipated minor without the minor client’s consent. Any exception with regard to the treatment of a minor must be approved by the Counseling Center Director or Associate Director prior to commencing treatment. Abuse Reporting The Child Abuse and Neglect Reporting Act, Article 2.5 of Chapter 2 of Title 1 of Part 4 of the California Penal Code Sections 11164 to 11174.3 requires any “health practitioner” (e.g., Psychiatrist, psychologist, Marriage and Family Therapist) licensed or intern/trainee, who has knowledge of or observes a child in his or her professional capacity or within the scope of his or her employment who he or she knows or reasonably suspects has been the victim of child abuse, to report the known or suspected instance of child abuse to a child protective agency immediately, or as soon as practically possible by telephone, and to prepare and send written report thereof within 36 hours of receiving such information. Page | 14 Potential Violent Clients The Counseling Center attempts to follow OCCDHE Guidelines for Dealing with Potentially Violent Clients. In the case when a counselor believes that a client is a danger to harm another person or the property of another person, typically Campus Safety, the appropriate police department, and the person in danger would be notified by the Counseling Center. Any clinician who suspects potential violence toward an identifiable third party should consult with the Director or other staff as available to formulate a plan for handling this situation. Any clinician who determines that they themselves may be in danger of harm should immediately leave the office and consult with the Director and/or the Department of Campus Safety. Subpoena The following procedure applies to any subpoena for any former or current Counseling Center client records or information: 1. Any subpoena for client records served in person to the Counseling Center will be directed to the Director. Should a process server arrive at the Counseling Center, staff is instructed not to accept service. If the subpoena is received by mail, the Counseling Center Director will follow the stops outlined below. 2. The Director or the client’s Counseling Center counselor (if still working at the Counseling Center) will attempt to contact the client to inform him or her of the subpoena, and to discuss the implications of the release of client records and information. If the Counseling Center is not successful in contacting the client, skip to #5. 3. If after discussion the client consents to the release of his or her records, the Director or counselor will obtain written authorization from the client to release these records. 4. If the client does not consent to the release of his or her records, the Director or counselor will inform client of alternative courses of action (e.g., “quashing” the subpoena), and recommend that the client discuss these with his or her own attorney. 5. General Counsel will determine further action in response to the subpoena. No action beyond this point should be undertaken without consulting General Counsel and the Counseling Center Director. OTHER ADMINISTRATIVE AND OFFICE PROCEDURAL GUIDELINES Fees All services performed by the Counseling Center are free of charge. Page | 15 Budget Management It is the responsibility of the Counseling Center Director to manage all departmental budgetary concerns. This includes but may not be limited to: being trained on and familiar with university Business Office policies and procedures, submitting annual requests and adjustments for overall Counseling Center budget, advocating for Counseling Center employees’ compensation, purchase requests using the university’s Datatel system; submitting staff reimbursement requests, maintaining budget records in agreement with monthly Business Office statement and attending of periodic budget meetings. Physical Facilities The Counseling Center is located on the 2nd floor of the Scott Academic Center. The Counseling Center aspires to provide a physical space and office décor that is perceived by students as comfortable and appropriate for counseling. In addition to individual counselor offices, the Counseling Center dedicates specific spaces within the physical building to practicum student training, group counseling, and file storage. Technology Client notes or other counseling-related materials are not saved on Counseling Center computers. All client files are stored on Titanium, which is a confidential and password-protected system. Any client demographic data saved via computer for the purposes of census, tracking, or outcomes measurement is password-protected, and stored on the secretary’s individual computer hard drive (i.e., c:\ drive) as opposed to a system or network drive (i.e., s:\ drive. The Counseling Center will not send confidential information via fax unless informed consent to do so is obtained from the client, and the Counseling Center is confident that the faxed material being sent is secure from unauthorized access. Client audio or video recordings are destroyed after purpose of recording is fulfilled (e.g., reviewed for supervision). Electronic Mail Communication Due to the inability to insure the confidentiality of e-mail communications, the Counseling Center discourages clients from using e-mail to communicate with Counseling Center staff and their therapist. Counseling Center staff as well as trainees, practicum students and MFT Interns will not conduct personal counseling via e-mail, text messaging or over the Internet. It is the expectation that counselors will not usually respond to personal counseling related material conveyed via e-mail or text messagin. In cases where exceptions are made to this practice (e.g., confirmation of an appointment time in response to client’s e-mail or text message query) Counseling Center counselors will take measures to safeguard the client’s confidentiality by attempting to delete or exclude any Page | 16 information that might explicitly identify another university office (e.g., Residence Life). Personal counseling-related content should never be communicated by VUCC staff or therapists via e-mail or text messaging. Student inquiries regarding services offered by the Counseling Center or other logistical questions may be addressed via e-mail. Scheduling The scheduling of clients for initial or intake appointments and ongoing scheduling of recurring clients in the responsibility of the individual therapist assigned to that client. PERSONNEL GUILDELINES General Characteristics Counseling Center seeks to recruit, retain, and develop the best people. This is further defined as hiring experienced Christian staff that reflects diverse background and hiring staff with advanced preparation and an excellent record of service, who will integrate their Christian faith in their professional roles(s) and interactions. In its hiring practices, the Counseling Center complies with guidelines set forth by the university Office of Human Resources. The Counseling Center does not discriminate on the basis of age, race, ethnicity, national origin, gender, socioeconomic status, disability, or status as a veteran, in any of its policies, practices, or procedures. The employee understands and agrees that his or her employment is “at will,” for no definite period, and may, regardless of the date of payment of wages and salary, be terminated at any time, with or without reason, and with or without advance notice, and that this “at will” employment status cannot be modified except by written agreement signed by an authorized representative, specifically referencing that its purpose is to modify this paragraph. The Counseling Center seeks to hire three types of employees: full-time employees, i.e., Director; part-time employees, i.e., Associate Director, and Secretary III for Student Services. Director DESCRIPTION: The Director of Counseling Services provides dynamic and collaborative leadership, the overall vision, and the underlying framework for the development and delivery of mental health services at Vanguard University. The Director of Counseling Services is a core member of the Student Life Department. The Director of Counseling Services reports to the Vice President of Student Affairs. DIRECTOR OF COUNSELING SERVICES RESPONSIBILITIES: Page | 17 Management responsibilities: Makes independent decisions relative to the operations of the department by convening staff meetings, conducting annual evaluations of the department’s programs and services, and reporting annually on the work of the department (usage, programs, trends, etc.). Develops and allocates the department’s annual budget, the analysis of short- and longterm fiscal plans, and the development and implementation of appropriate technology to support the mission of the Counseling Center. Develops programs, policies, procedures, and reporting requirements related to the department. Develops departmental performance expectations and is accountable for the department’s compliance with University accounting, auditing, and personnel principles, policies and procedures. Develops responsive, efficient, and effective client services and establishes effective monitoring systems to help insure the highest quality care. Develops implements and evaluates utilization plans for space, equipment, and other physical resources. Reviews and evaluates staffing needs; recruiting and hiring staff; and establishing personnel policies and procedures according to University regulations and organizational guidelines. Oversees Associate Director to ensure the development and maintenance of training guidelines, policies, and procedures, publicity and marketing of training program, the recruitment of trainees, and the coordinating of weekly supervision meetings are all done in accordance with all relevant legal and ethical standards and guidelines. Oversees all legal and ethical clinical practices within the VUCC and remains updated on current legal and ethical standards within the profession through membership in relevant professional organizations and attendance of appropriate professional conferences and/or workshops. Functions as the official Keeper of Records for the VUCC. Counseling Responsibilities: Offers efficient, highly competent, and personalized counseling and psychological services to Vanguard University undergraduate and graduate students including intake assessment, individual, group, and couples counseling. Provides consultation and guidance to Student Affairs units, academic departments, and other University entities regarding individual student cases, community issues, and emergency situations. Coordinates crisis management response on-site during normal business hours, and is on call for after hours and weekend consultation via cell phone. Outreach Responsibilities: Page | 18 Serves as the lead in the implementation of mid-to large-scale Counseling Services events, such as National Depression Screening Day. Evaluates the utilization, effectiveness, and impact of programs and services and takes appropriate subsequent actions. Provides representation for the VUCC through participation in administrative meetings and other university functions, programs, and/or events. Engages actively with Student Affairs leadership to assess student trends, campus climate issues, and the needs of different student communities to develop innovative and responsive programs and services. MINIMUM QUALIFICATIONS: Master’s degree in Counseling or Clinical Psychology. California license or license-eligible to practice in candidate’s field of specialization. Demonstrated ability and appropriate licensure to supervise and train clinical trainees and interns. Demonstrated ability to conduct intake clinical interviews, including psycho-diagnostic assessment, case conceptualization, and treatment plan formulation for students from diverse ethnic, cultural, and socio-economic backgrounds, ranging in age from 17 to 25 with a broad spectrum of psychological problems, ranging from adjustment issues to major psychiatric disorders. Demonstrated ability to provide individual, couples and group counseling, and crisis intervention for psychological emergencies. Demonstrated knowledge of college student development and resident life issues. Demonstrated autonomy, effectiveness, and sensitivity in clinical work. Excellent interpersonal and communication skills. Excellent ability to work as a member of a collaborative, multidisciplinary team. Maintenance of lifestyle consonant with Vanguard University principles and values. Associate Director DESCRIPTION: The Associate Director is responsible for quality assurance of clinical services provided by all subordinate staff, including licensed therapists, registered interns, MFT Trainees, and practicum students of the Vanguard University Counseling Center, in addition to offering efficient, highly competent, and personalized counseling and psychological services to Vanguard University undergraduate and graduate students. The Associate Director reports to the Director of Counseling Services. RESPONSIBILITIES: The Associate Directors duties include the following: Assures quality of clinical services provided by supervisees meets established standards, guidelines and regulations, where applicable. This includes chart audits, observation of sessions, review of documentation and other supervisory activities to assure quality of care standards. Assures that supervisees operate within their scope of expertise and practice. Provides clinical supervision, training and direction for supervisees. Page | 19 Communicates deficiencies, concerns and achievements of supervisees to the Director of Counseling Services. Develops training programs, workshops, program development, or other activities as appropriate. Maintains integrity of services that is consistent with mission statement. Communicates and advises the Director of Counseling Services on agency activities when appropriate. Promotes agency within the community to referring agencies, community partners and governmental departments as appropriate. Models good clinical skills, professionalism, and demeanor. Communicates with the Director of Counseling Services on personnel issues involving supervisees. Provides psychological services to student clients including intake assessment; individual, group, and couples counseling; consultation services; education, training, and outreach. Offers crisis management response onsite during normal business hours and is on call for after hours and weekend consultation via cell phone. Provides consultation and guidance to Student Affairs units, academic departments, and other University entities regarding individual student cases, community issues, and emergency situations. Remains updated on current legal and ethical standards within the profession through membership in relevant professional organizations and attendance of appropriate professional conferences and/or workshops. Chairs the Student Wellness Advisory Team (SWAT) MINIMUM QUALIFICATIONS: Master’s degree in Social Work or Counseling or Clinical Psychology from an accredited program. California license in candidate’s field of specialization. Have met the requirements to supervise MFT Trainees & MFT Interns in the State of California. Demonstrated ability to provide effective and dynamic supervision to MFT Trainees. Demonstrated ability to conduct intake clinical interviews, including psycho-diagnostic assessment, case conceptualization, and treatment plan formulation, for students from diverse ethnic, cultural and socio-economic backgrounds, ranging in age from 17 to 25 with a broad spectrum of psychological problems, ranging from adjustment issues to major psychiatric disorders. Demonstrated ability to provide individual, couples and group counseling, and crisis intervention for psychological emergencies. Demonstrated autonomy, effectiveness and sensitivity in clinical work. Demonstrated expertise in addressing one or more of the following student subpopulations: veterans, underserved multicultural or international groups, or athletes is preferred. Ability to work cooperatively with a variety of people Maintenance of lifestyle consonant with Vanguard University principles and values. Page | 20 MFT Trainees DESCRIPTION: MFT Trainees report to the Counseling Center Director or Associate Director. The primary focus of this position is to provide wellness-related services to the students of Vanguard University. RESPONSIBILITIES: Provides time-limited individual, couples, and/or group counseling to the Vanguard University student population under the supervision of a licensed MFT or licensed Psychologist. Conducts intakes and other forms of psychological assessment. Provides crisis intervention and management (which may include nights and weekends). Attends and participates in Counseling Center operations and events, including Counseling Center sponsored activities, peer clinical consultation, supervision, or other similar functions. Performs other appropriate duties assigned by the Counseling Center Director or Associate Director. MINIMUM QUALIFICATIONS: Current Master’s level student in an accredited or approved program. Registered as an MFT Trainee with the State of California. Demonstrated ability to provide individual, couples and group counseling, and crisis intervention for psychological emergencies. Demonstrated effectiveness and sensitivity in clinical work. Excellent interpersonal and communication skills. Excellent ability to work as a member of a team. Knowledge and acceptance of principles and philosophies of Vanguard University. It is expected that the MFT Trainee will: Contact their Supervisor immediately with any emergencies that may arise with a client (i.e., suicide attempt, abuse, hospitalization, 5150, etc.). Complete and submit paperwork and reports to the business office on a weekly basis, or as directed by the Supervisor. Personally provide malpractice insurance for at least $1,000,000 liability/$3,000,000 aggregate. Proof of insurance needs to be provided, maintained, and updated annually by the trainee. Secretary III for Student Services DESCRIPTION: The Secretary III for Student Services assists the office staff of the Counseling Center, Disability & Learning Services and the Office of Student Success, Retention & Family Relations in coordinating day-to-day office operations. This position reports to the Director of Counseling Page | 21 Services but is responsible for assisting other members of the three offices as required. This is a full-time hourly position, 12-months out of the year. RESPONSIBILITIES: Answers and directs phone calls. Assists all walk-in customers, provides information on an as needed basis, and directs them to appropriate staff if necessary. Manages clerical aspects of three offices. Receives and delivers mail. Coordinates department scheduling for various offices. Maintains weekly reports of students served for three offices. Plans and attends departmental functions and meetings. Maintains in-house library. Supervises student workers. Assists in maintaining the workflow of the offices. Orders and maintains adequate office supply inventory. Writes memos and letters on behalf of the staff. Maintains statistics of programs’ growth. Assists various staff in problem solving in their responsible areas. Maintains filing system. Maintains excellent rapport with students, parents, staff, faculty and vendors. Provides spiritual care for students and staff member within the departments. Performs related duties as assigned. MINIMUM QUALIFICATIONS: High School diploma required. Bachelor degree preferred. Three years of consecutive successful work experience equivalent to Secretary III Proficient working knowledge of Microsoft Word, Excel, and Outlook programs. Knowledge and acceptance of principles and philosophies of Vanguard University. Maintenance of lifestyle consonant with Vanguard University principles and values. SUPERVISION GUIDELINES General Guidelines Professional counselors volunteering at the Counseling Center are expected to know and comply with the relevant ethical principles and legal guidelines governing clinical supervision in the State of California. When engaging in supervision, Counseling Center counselors follow the Ethical Standards outlined by the California Association of Marriage and Family Therapists. Each licensed Counseling Center supervisor will complete the minimum number of supervision continuing education units per license renewal cycle required by their respective state licensing board. Page | 22 All Counseling Center supervisors aspire to the Requirement for Supervisors outlined by the Board of Behavioral Sciences. Counselors must be registered with the Board of Behavioral Science (BBS), have received an Intern Registration Number, or be a trainee in good standing in an accredited master’s (or higher) program. Counselors must submit an original “Responsibility Statement for Supervision of a Marriage, Family and Child Counselor Intern or Trainee” statement prior to the commencement of any counseling or supervision. Supervisors will have met all BBS requirements for supervising in the area of marriage, family and child counseling per Title 16, California Code of Regulations Section 1833.1. Intern/trainee Supervisor will discuss and oversee all clients assigned to the intern/trainee, providing assistance and/or instruction with regards to assessment and treatment plans, which may include, at the supervisor’s discretion, assigned reading material, video, audio, discussion, or presentations on various psychotherapeutic topics or techniques. The intern/trainee agrees to the following supervision schedule: One (1) hour per week for individual supervision, and /or two (2) hours per week for group supervision as defined and required in Title 16, California Code of Regulations Section 1833(b), in each week where any qualifying experiences is gained by the intern/trainee. In order to receive supervision credit, the intern/trainee must attend at least one scheduled supervision session per week. The intern/trainee is responsible for all correspondence with the BBS to meet their requirements, and it is the intern/trainees responsibility to make sure that all forms are signed and submitted to the BBS. Limits of Confidentiality in Supervision The intern/trainee understands that all information presented in supervision, including that of a therapeutic nature, will be used for evaluation of their clinical skills, evaluation of the supervisee’s competency to be an effective therapist, and in supervisory team program planning. Supervision of Marriage and Family Therapist Trainees/Interns MFT Trainees/Interns volunteering at the Counseling Center are supervised primarily by the Counseling Center Director and/or Associate Director. Supervision in these cases follows the stipulations outlined by the Board of Behavioral Sciences for Supervised Professional Experience with regard to number of hours (one per ten for interns and one per five for trainees), availability of supervisor, written supervision agreement, and verification of experience for California licensure. It is the responsibility of the intern/trainee to maintain a log of hours for SPE validation purposes. Page | 23 Supervision Documentation All unlicensed Counseling Center counselors will provide each client with a supervisor’s name in writing at the time of intake or initial consultation, per California state law. This information can be found on the Counseling Philosophy and Informed Consent Form. Each time a client is discussed in supervision and recommendations are made, it is the responsibility of the trainee/intern to make note of the recommendations in the clients file as part of the SOAP notes. APPENDIX I – References Ethical Principles of Psychologists and Code of Conduct http://www.apa.org/ethics/code/index.aspx International Association of Counseling Services, Inc. The Accreditation Association for University and College Counseling Services http://www.iacsinc.org/ Board of Behavioral Sciences Requirements for MFT Supervisors http://bbs.ca.gov/ CAMFT Ethical Standards – Part 1 http://camft.org/camftbenefits/whatiscamft_ethnic1.html AAMFT Code of Ethics http://www.aamft.org/resources/lrm_plan/ethics/ethicscode2001.asp Professional Therapy Never Includes Sex Copyright © 2004, California Department of Consumer Affairs OCCDHE Guidelines Conflict of Interest Copyright © 2000, Organization of Counseling Center Directors in Higher Education OCCDHE Guidelines for Dealing with Potentially Suicidal Clients Copyright © 2000, Organization of Counseling Center Directors in Higher Education OCCDHE Guidelines for Dealing with Potentially Violent Clients Copyright © 2000, Organization of Counseling Center Directors in Higher Education OCCDHE Guidelines Evaluating and Reporting Possible Child Abuse Cases Copyright © 2000, Organization of Counseling Center Directors in Higher Education OCCDHE Guidelines Release of Privileged Records and/or Information Concerning Clients Copyright © 2000, Organization of Counseling Center Directors in Higher Education Page | 24 APPENDIX II – Identifying and Responding to Dangerous Students Tips for Faculty & Staff Suicide is the second leading cause of death in college age students. It is especially important that faculty and staff are aware of what can be done to prevent such a tragedy. This brochure will help you become aware of signs of a distressed student, things that you might do to help the student, signs of suicidal ideation, and when and how to make effective referrals for additional help. Warning Signs of Suicide Depressive: changes in behavior, inability to concentrate, socially withdrawn, easily agitated, crying, abusing substances. Verbal signs: direct or indirect; verbally or in written materials (e.g., assignments, papers, etc.). Behavioral: giving away possessions, writing a suicide note, acquiring means to commit suicide, organizing business and personal matters. Look for a cluster of signs. A suicidal person who gives warning signs will most often present more than one sign. Tips for Recognizing Troubled Students At one time or another, everyone feels depressed or upset. However, there are two levels of student distress which, when present over a period of time or when accompanied by a stressful or traumatic event, suggest that the problems are more than the “normal” ones. Ambiguous Signs of Danger Although not disruptive to others in your class, these behaviors may indicate that something is wrong and help may be needed: Serious grade problems Unaccountable change from good to poor performance Change from frequent attendance to excessive absence Change in pattern of interaction Marked change in mood, motor activity, or speech Marked change in physical appearance Repeated request for special consideration New or regularly occurring behavior which pushes the limits and may interfere with class management Unusual or exaggerated emotional response Page | 25 Clear Signs of Imminent Danger These behaviors usually show that the student is in crisis and needs emergency care: Highly disruptive behavior (hostility, aggression, etc.) Inability to communicate clearly (garbled, slurred speech, disjointed thoughts) Loss of contact with reality (seeing/hearing things that are not there, beliefs or actions at odds with reality) Overt suicidal thoughts and gestures Homicidal threats How Should You Respond Ambiguous Signs of Danger Consult with a mental health professional at Vanguard University Counseling Center Talk to the student in private Express your concern in non-judgmental terms Listen to the student and repeat the main point of what the student is saying Respect the student’s value system Ask if the student is considering suicide Make appropriate referrals Make sure the student understands what action is necessary Clear Signs of Imminent Danger Call 911 Notify Campus Safety Notify Counseling Center Do’s and Don’ts in Responding to Suicidality Do: Do stay calm Do acknowledge the students feelings Do take the student seriously Do encourage discussion Do stay with the student until the police arrive Do Not: Do not minimize the student’s distress Do not over commit Do not ignore the student Do not leave the student alone Page | 26 When to Make a Referral Even though a student asks you for help with a problem and you are willing to help, there are circumstances when you should suggest other resources: The help necessary is not your expertise You are not comfortable in handling the situation You know the student personally (friend, neighbor, friend of a friend) and think you may not be objective enough to help The student is reluctant to discuss the situation with you You feel overwhelmed or pressured for time How to Make a Referral To the student: Be frank with the student about the limits of your time, ability, expertise, and/or objectivity Let the student know that you think she/he should get assistance from another source Assure them that many students seek help over the course of their college career Assist the student in choosing the best resource Try to help the student know what to expect if she/he follows through on the referral Consider these questions before making the referral: What are the appropriate and available resources for the student? With whom would the student feel most comfortable? Who will make the initial contact, you or the student? In an Emergency Try to stay calm. Find someone to stay with the student while calls are made. For students expressing a direct threat to themselves or others, or who act in a disruptive, a bizarre, or a highly irrational way, call: For Transportation and/or protection: Costa Mesa Police (24 hours) – 911 For emergency consultation, evaluation, treatment, and referral: Vanguard University Counseling Center (714) 556-3610 ext 5256 (between 8am and 5pm) Page | 27 Tips for Helping a Stressed Student Common Warning Signs Academic Problems Excessive procrastination Uncharacteristically poor academic preparation or performance Repeated requests for extensions or special considerations Disruptive classroom behavior Excessive career or course choice indecision A pattern of absence or tardiness Avoiding or dominating discussions Verbal or written references to suicide or homicide Frequently falling asleep in class Interpersonal Problems Behavioral Problems Asking advisor/instructor for help with personal problems Dependency on an advisor/instructor Hanging around the office Avoidance of an advisor/instructor Disruptive behavior Inability to get along with others Withdrawal from friends Complaints from other students Change in personal hygiene Dramatic weight gain or loss Irritability Alcohol/drug use Impaired speech Disjointed thoughts Tearfulness Intense emotion Inappropriate responses Difficulty concentrating Engaging in self-injury Sudden mood or behavior changes Suggestions for Intervening Talk to the student privately to help minimize embarrassment and defensiveness. Listen carefully to the student. Respond to both the content and emotion in the conversation. Frankly and honestly discuss your observations and perceptions of the situation with the student. Ask if the student is having any thoughts of harming self or others. Acknowledge inappropriate or strange behavior without being judgmental. Try to respect the student’s value system even if you don’t agree with it. Offer the student help and affirm that help is available. Clarify the limits on your ability to help. Instead, offer to connect the student with experts trained to assist struggling students. Avoid making promises of complete confidentiality. It’s difficult to get others involved in helping if you can’t share what’s going on. Instead, you might promise to only share the information that others “need to know” to do their jobs. As staff and faculty, it is important to know that most people who have suicidal ideations don’t want to die. They just want the pain to go away. If a student appears to be an imminent risk of causing harm to self or others, call Campus Safety at (714) 966-6799 and/or 911 immediately. How to Make a Referral Emergency Referrals If a student appears to be an imminent risk of causing harm to self or others, call Campus Safety at (714) 966-6799 and/or 911 immediately. If the student does not appear to be an imminent risk and the emergency occurs between M-F, 8am-5pm, call the Vanguard University Counseling Center at (714) 619-6480. Ask to speak to a counselor. Please be prepared to provide a description of the situation and someone will work with you to determine appropriate actions to take to most effectively help the student. If the emergency occurs outside of the VU Counseling Center’s business hours, call Campus Safety at (714) 966-6799 and/or 911. You may also contact the Counseling Center Director, Doug Hutchinson at 714. 296.9802. Non-Emergency Referrals Encourage the student to contact the VU Counseling Center directly at (714) 619-6480 to schedule an appointment Offer to walk with the student to the counseling center if you believe extra support and encouragement are needed. To refer a student to the Students of Concern team email students.concern@vanguard.edu or http://www.vanguard.edu/studentlife/studentreferral-contact-form/ to submit referral Page | 28