Responding to the Covid-19 pandemic at a university counseling center: administrative actions, client retention, and psychotherapy outcome

In this article, we examine how Counseling and Psychological Services (CAPS) at a large private university in the western United States addressed the abrupt suspension of in-person mental health services and switch to telebehavioral health due to the Covid-19 pandemic. We used descriptive data, binary logistic regression, and hierarchical linear modeling to investigate changes in number of sessions and clients, use of online mental health platforms, and changes in clients' psychological functioning. Overall, we found that CAPS had a decrease in scheduled appointments (including intake) and no change in attendance rates. We estimate that premature termination impacted about 32-34% of individual therapy clients and 29-37% of group clients. The number of new users for our online therapeutic platforms did not appear to be affected. Clients in 2020 were not significantly more distressed than clients in the previous 3 years and we found no significant differences in outcome between 2020 and previous years, indicating that levels of distress and treatment trajectories remained similar across years. Future research should focus on longer-term client outcomes as well as increasing accessibility to therapy in pandemic conditions.