The NIU College of Education’s Community Counseling Training Center has shifted to offering telehealth during the statewide stay-at-home order.
Clinic Director Kimberly Hart, a clinical assistant professor in the Department of Counseling and Higher Education, says the March 30 shift to using Microsoft Teams provided continuity of care for clients experiencing ongoing mental health concerns.
Supervised telehealth counseling also gives graduate students who are counselors in training the opportunity to continue developing their skills while the physical clinic in Graham Hall is closed.
“Mental health is always important,” Hart says. “In times of transition and uncertainty, that’s when our mental health needs, crises and instability can arise, and being able to continue to provide mental health services for our clients is significant.”
Think of recent earthquakes in Puerto Rico, she says.
“It wasn’t just a single earthquake, and then everything was fine,” she says. “The ground kept trembling for a couple days, and there was uncertainty of when it was going to stop. When will we be able to rebuild? When will it be safe to go and actually sleep in my bed again?”
Such widespread anxiety and grief elevated the importance of maintaining Community Counseling Training Center operations, which are provided free of charge to around 500 NIU students, faculty, staff and members of the DeKalb community each year.
Because most of the clinicians are practicum-level, pre-master’s degree students, Hart and other administrators took “a strong look” at their policies and procedures to determine whether telehealth was a viable, ethical and legal option.
Using Microsoft Teams – the same communication-and-collaboration platform suddenly familiar to office workers across the country – offers accessibility and compliance with HIPAA laws and preserves the richness of face-to-face interaction.
“With telehealth services, having that video, as well as audio, you get more information and more direct connection with clients than when you have audio only,” Hart says.
Teams even helps to maintain the best practices of training observation through its function for licensed NIU professors of Counseling and doctoral-level supervisors-in-training who who live-supervise every appointment through a “listen-only” mode, she adds: The “chat” feature in Teams allows supervisors to send private messages to the student-clinicians in the moment, offering advice without distracting clients.
“Ask them more about that feeling or that experience. Did you hear the tone in their voice change? I can provide that feedback in real-time without having to knock on the door or doing anything that may throw off or disrupt the direct client communicating in giving that input,” Hart says. “That’s been a really awesome addition.”
Preparation for the new process had to be relatively quick, given the center’s commitment to supporting existing client requests received just prior to the need to suspend in-person services.
Many careful and expedient decision had to be made to prepare graduate level-counselors, including a two-hour course in how to use Teams as well as training specific to effective and ethical delivery of telehealth. The clinic’s pre-existing use of TitaniumSchedule software for electronic records retrieval and management was another important factor that made transitioning to remote telehealth services possible so quickly.
Nine of the 30 students enrolled this semester were unable to participate because they either lack the technology or confidential spaces in their homes to ensure safe and secure services.
However, Hart says, those still engaged in the supervised practice are gaining an edge in the job market for internships and post-degree employment.
“Even when you think about crisis service lines that have been in existence for decades, that’s a form of telehealth services,” she says. “Some of this training goes into that.”
And while Hart is hearing from new clients seeking to start treatment during the coronavirus (COVID-19) pandemic, some others have chosen to postpone their appointments until the clinic reopens for in-person services.
“They recognize, as we do, the temporariness of this, and they’re like, ‘Well, I’m stable enough. I’m good. I know I can call for a wellness check-in, but I’ll wait for services until we’re face-to-face,” she says.
Some other clients are “working professionals in their own transition” who have yet to schedule telehealth appointments, she adds, perhaps because “they haven’t seen the emails or the calls from us while they’re trying to find their own new routine.”
Most clients remaining in treatment are grateful for the telehealth, Hart says, and are continuing to work on concerns or goals that were “going on before the changes, the physical distancing requirements and some of the uncertainties.”
“We’ve seen the greater majority of clients who are starting back really want to continue to focus on their primary mental health concerns that were existing prior to the pandemic, as well as just having that continued connection when there are so many areas of some of their lives where they had to disconnect or to distance in some ways,” she says.
“Offering remote-delivered telehealth services through the Community Counseling Training Center was a challenging and critical decision to make,” she adds. “I hope the service and training benefits through this clinic response will have ongoing benefits for CCTC clients, counselors and supervisors-in-training even after the stay-at-home order is lifted.”