Brief Therapy Model
Mental Health Services (MHS) strives to provide short-term treatment in order to help students: 1) achieve their academic and personal goals, 2) cope with challenges, and 3) encourage personal growth. Our services are available to students whose concerns fall within our scope of practice. In order to meet the mental health needs of as many students as possible, students may be eligible to receive up to 9 individual or couples appointments per academic year. Group therapy is an exception. Clients may attend as many group sessions as desired.
We do our best to exercise clinical judgment in deciding when to facilitate a referral to other services on campus or in the local community. A difficult balance exists between providing sufficient services and meeting the demand for those services. Given our inherent resource limits, the wish for MHS to provide unlimited individual services must be balanced with what is reasonable to provide. We recognize that students do not all have the same level of financial resources. We strive to navigate the realities of what it means to provide good clinical care while also considering issues of safety, equity, and social justice.
Students whose needs cannot be accommodated within our treatment model will be referred to community resources. Referrals might occur immediately following the initial consultation. Referrals might also occur after some treatment and a further assessment has taken place. If you are unsure of whether counseling services provided at MHS are the best fit for your needs, the counseling staff welcomes the opportunity to meet with you to discuss your individual situation.
Our brief individual counseling model is designed to help students manage immediate problems and provide short-term therapy. These services are ideal for issues that have arisen recently or that are expected to resolve relatively quickly. We also offer brief couples counseling for students wishing to address communication, trust, or intimacy issues. Decisions regarding treatment recommendations are made by counseling staff in consultation with the MHS leadership team.
In addition to short-term individual and couples therapy, MHS offers a strong group counseling program with many helpful options. Counseling staff may often recommend group treatment as the preferred mode of treatment. While individual counseling is brief, students may participate in one or various groups throughout their time at Wash U. We run multiple groups each year. Some groups are specifically themed and some are aimed at more general concerns. Themed groups may include those for grief and loss, stress management, unhealthy eating or body image, or dissertation support. The typical group involves about 6-8 students, meets weekly for 60-90 minutes, and is facilitated by one or two therapists. Please see our group page for more information.
What We Don’t Offer
We can help many students with their concerns, but we are not a full-service mental health clinic. For those students whose presenting issues suggest a need for more open-ended counseling services, MHS staff can help to facilitate a referral for counseling close to campus.
Some common examples of issues that may be more appropriate to an outside referral include:
- Individuals with chronic mental health conditions that require longer-term, ongoing care
- Clinical presentations, such as some personality disorders, that indicate short-term therapy may be ineffective and/or detrimental
- A need or desire to be seen more frequently than MHS can accommodate. Most of our clients are seen 1-3 times per month
- High utilization of MHS crisis intervention services indicates that standard session frequency is inadequate
- Chronic suicidality and/or recent history of multiple suicide attempts
- Severe or chronic self-injury
- A history of multiple psychiatric hospitalizations
- Issues that require more specialized care than can be provided at MHS, including:
- Significant or chronic disordered eating symptoms posing a medical danger
- Significant or chronic substance use/abuse which compromises therapy
- Active symptoms of psychosis at risk for progressive deterioration
- Student concerns which require a specific type of therapy not practiced by the staff
- Student issues that tend to worsen in short-term counseling
In addition to the reasons indicated above, some other reasons why we may need to deny services or refer individuals to community resources include:
- Lack of motivation or engagement in treatment, as evidenced by:
- Inability to identify a treatment goal appropriate for brief therapy
- Inconsistent attendance
- Poor compliance with treatment recommendations
- Ongoing treatment relationship with another mental health provider
- Inappropriate, harassing, menacing, threatening, or violent behaviors
- Mandated or required treatment, including:
- Counseling ordered through legal proceedings, such as substance abuse treatment, alcohol education, anger management, parenting education, or domestic violence treatment
- Counseling required by employers, government agencies, academic departments, or university judicial sanctions
- Individual counseling initiated only to earn credit for a class
- Comprehensive psychological evaluation of any type, including but not limited to:
- Neuropsychological evaluations
- Forensic assessments
- Custody evaluations
- Assessment and documentation for service or support animals
- Fitness-for-duty evaluations
- Instances where a staff member determines that treatment would be detrimental to the client or to the proper functioning of the facility
When a community referral is the most appropriate treatment option, students typically will be provided with several options. The referral process may or may not include a meeting with the Mental Health Care Manager. To the best of the clinician’s ability, these options should address circumstances regarding insurance, finances, and transportation.
Occasionally, MHS clinicians may provide services that extend beyond our scope of practice. These circumstances may include:
- Appropriate management of a crisis when a student’s eligibility for services has ended
- Coverage through upcoming graduation within the current semester
- Completion of treatment for clients making good progress, but needing limited extension of services
- Supporting high-functioning clients with chronic conditions on well-defined short-term therapy goals
- Treatment of some individuals with eating disorders when clinically indicated
Individuals who believe their circumstances represent an exception to the MHS scope of practice may submit a petition for an exception to the policy. A committee led by the MHS Associate Director will review all petitions and must approve any exceptions granted.
Note: A separate psychiatry scope of services statement applies to students seeking medication management for mental health issues.
- MHS provides clinical services to all full-time Washington University Danforth Campus day students who have paid the Student Health and Wellness fee. Spouses or partners of full-time students are not eligible for individual counseling or psychiatric services. Spouses or partners are eligible for couples counseling if their spouse/partner has paid the Student Health and Wellness fee.
- Students who take an approved medical leave and have paid the Student Health and Wellness fee for the current semester may continue to be seen in MHS for that semester. Exceptions may be made for international students when services cannot be accessed in the local community in their native language, but are available at SHS.
- Upon graduation, students are eligible to be seen until December 31st for the Fall semester and May 31st for the Spring semester.
- During summer break, currently enrolled students are eligible to receive services regardless of credit hours, as well as continuing students who are enrolled full-time for the upcoming fall semester.
- Consistent with its mission to provide only clinical services to students, MHS does not undertake forensic evaluations (e.g., court-ordered custody evaluations; evaluations for eligibility for disability or emotional support animals, etc.) or make forensic recommendations or provide expert testimony.
Medical management of ADHD is available to qualifying students.
In order to maintain the availability of quality psychiatric services for students with immediate mental health needs/crises, Habif does not provide testing services for the diagnosis of ADD/ADHD. See more information on the treatment of ADHD at Habif. For referral information to testing services in the St. Louis community, please call 314-935-6695.
Note: Due to the impact of COVID and uncertainties related to governmental policies, restrictions, and legislation, we will not be accepting any new or transferred patients that require the prescription of stimulant medications. Stimulant medications include but are not limited to Adderall, Adderall XR, Ritalin, Concerta and Focalin. If you are already receiving stimulant medications, we encourage you to try to continue to work with your current provider. If you are hoping to consider starting a stimulant, we will try to assist you in finding a provider outside of Habif that accepts your insurance.
There may be situations in which Habif clinicians deem it appropriate to support accommodations for students under their care, however it is important to note that Habif clinicians provide documentation supporting accommodations only within the context of a treatment relationship.