Counseling Services

General Policies & Procedures

Confidentiality and Recordings

Each individual is entitled to privacy in his/her work with a counselor.  All contacts with a counselor are confidential to the Counseling and Health Services professional staff.  Written permission is required for Counseling Services to release information to others.  A court order may require an exception to the lawful protection of individual legal rights to privileged communication with a counselor or psychiatrist.

If it becomes clear in the counseling session that there is a real danger to oneself or to others, we are required to take action.  Also, reports of abuse of children or others unable to care for themselves will also require some action to be taken.  Confidentiality laws do not apply in these cases.

A record is kept of an individual's work with us.  It contains information individuals have provided to us in writing as well as counseling notes of individual sessions.  As of Fall 2010, records are kept in secure electronic form for a period seven (7) years after the student's last visit. Previous to Fall 2010, paper records were destroyed after a period of seven (7) years after an individual's last visit. Counseling Services files never become a part of the permanent SIUE educational record.

Additional records of sessions are sometimes taken such as the counselor's personal notes and audio tapes.  These are destroyed in a timely manner and do not become part of an individual's counseling record. SIUE Counseling Services is a training site for master's and doctoral level therapists in training. These trainees are required to video record their sessions for quality control and training purposes ONLY. These recordings are destroyed in a timely manner and never become a part of the individuals counseling record.

If you have questions about confidentiality and your privacy, please talk with a counselor.

Attendance Policies

Screening appointments:

• Students are required to complete necessary forms (Health History Form, Notice of Privacy Practices, Treatment Agreement, and Clinical Questionnaire) at cougarcare.siue.edu under the "forms" tab before being seen for screening.
• IMPORTANT: If you do not complete your forms before the day of your scheduled appointment we cannot guarantee that you will be seen that day.
• Appointment openings due to cancellations will be offered to students scheduled for screenings in the future who have completed required forms.

Late arrivals:

• The student will be seen if they are less than 15 minutes late to check in at the front desk.
  
• The student will be required to reschedule their appointment if they are 15 minutes or more late to check in at the front desk.

First  “no-show”:

• The counselor will attempt to contact the student through secure messaging (cougarcare.siue.edu) to make another appointment for a time and date that works for counselor and student.
• Contact will include a reminder of the no-show policy.
• If the counselor does not hear from the student within two weeks of the initial no-show, then the counselor will inactivate the file.
• If the student does not contact their counselor or Counseling Services within 30 days, then their file will remain inactivated and the student may have to complete the initial screening process if they seek services at a later date.

Second “no show” in 30 day period:

• The next available appointment will be at least 30 days from the second no-show.
• The counselor will attempt to contact the student through secure message.
• If the student does not respond or reschedule within 2 weeks, their file will be inactivated.
• If there is no contact from the student within the 30 days after the no show, then their file will remain inactivated and they may have to complete the initial screening process if they seek services at a later date.

Cancellations:

• A student is "late" in canceling appointments if they do not notify Counseling Services within 24 hours of their canceled appointment. This is because Counseling Services needs time to be able to make the appointment time available to other students.
• If a student establishes a pattern of late cancellations, then they may be required to wait a longer period of time before being seen, or become ineligible for services.

Psychiatric Care Policy

After a counselor has established an ongoing therapeutic relationship with a student and has thoroughly assessed his or her situation, the counselor will decide whether medication may be an appropriate treatment option.  Counseling Services has a part-time psychiatrist on staff to address the medication needs of current clients.  The psychiatrist provides services only to eligible clients referred by a counselor at Counseling Services.  Students who want medication are not eligible to see the psychiatrist at Counseling Services unless they are ongoing clients at Counseling Services.  If a client discontinues counseling, he or she will no longer be eligible for psychiatric care at Counseling Services. If you would like more information about psychotropic medications, please see our Medications and Therapy resource page.

Counseling and Disability Support Services’ Assessment Protocol for Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

It is important for students to understand that the assessment and diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) is a serious matter. Therefore, SIUE is dedicated to a diligent and professional protocol of assessment when ADD/ADHD is suspected. There are several reasons for this, including:

• ADD/ADHD is often misdiagnosed by the layperson or other professional not properly trained in the psychometrics necessary to make proper assessment. 
• The symptoms usually associated with ADD/ADHD are very similar to symptoms associated with a number of other disorders, such as anxiety disorders or depression.
• Even if properly assessed and diagnosed in childhood, a college student’s brain has developed and changed considerably since childhood, warranting further assessment before confirming the diagnosis.
• The academic demands of SIUE are significantly more difficult than most high school standards. Consequently, students may need to make adjustments in their learning style and strategies in addition to treatment.
• If the student’s condition is misdiagnosed and they are started on medications, then they may suffer severe impairment in academic performance and a negative impact on their personal behavior.
• Some of the medications used to treat ADD/ADHD are habit-forming or addictive. SIUE is particularly mindful of the use of medications by students and the potential of prescription medication abuse.

A proper diagnosis that takes all of the above into account requires a qualified mental health professional conducting a clinical interview and usually a number of objective assessments. Additionally, it may be necessary to rule out the possibility that the student has an undiagnosed learning disability that would warrant a different kind of treatment and accommodations. Tests that may be included in the assessment include:

• Clinical interview conducted by a trained mental health professional
  • Brown Attention Deficit Disorders Scale
  • Conner’s Adult ADHD Rating Scale (CAARS)
• Personality Assessment Inventory (PAI)
• Beck Depression Inventory (BDI)
• Beck Anxiety Inventory (BAI)
• Connor’s Continuous Performance Test II (CPT-II)
• Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)
• Wechsler Individual Achievement Test-Third Edition (WIAT – III)
• Wechsler Memory Scales-Fourth Edition (WMS-IV)
• Other tests as needed

The effective treatment of ADD/ADHD usually includes a “multimodal” approach that includes counseling, education, academic accommodations and medication treatment. In some instances all four interventions are not necessary. The treatment plan is to be determined by the interdisciplinary team working with the student. Also available to the student are referrals to providers, diagnosticians, and tutors that may be of help. If a student takes medication, it is necessary that the person be routinely evaluated and followed by a mental health professional.

At SIUE, the assessment, diagnosis, and treatment of ADD/ADHD is managed by two departments: Counseling Services (CS) and Disability Support Services (DSS). An SIUE student can begin the process of determining what is causing their attention issue with either department with the expectation that he or she will be working with the other department fairly quickly. For students to successfully complete the assessment and diagnostic process, they must understand their role:

• Each student seeking services will need to meet with professionals in both CS and DSS.
• The student must sign release of information forms for the departments to be able to openly communicate throughout the assessment process.
• The student will be assigned a therapist within CS and will be asked to work directly with them on a regular basis for interview, assessment, feedback, treatment planning, and/or possible referral.
• The student must exercise patience. In order for an appropriate diagnostic picture to be attained, the professionals in CS and DSS will need time to gather information, analyze results, and possibly gather more information.
• Because this process is time consuming and requires significant resources on the part of SIUE and the student, the student must read and sign this agreement in the presence of a CS or DSS representative.

Guidelines for a Housing/Counseling Considerations Cancellation Request

If you are submitting a Cancellation of Single Student Housing Contract request and indicating Counseling Considerations as your reason, please note the following guidelines.  These guidelines will be used when reviewing the cancellation request.

• The process of verifying and reviewing a Counseling Considerations Cancellation Request can take two weeks or more before a decision is made and the student is informed of the decision.
• The student is strongly encouraged to sign a Release form with his/her Medical/Mental Health Professional.  This will allow University Housing to verify the submitted information.
• If the student is currently seeing a Medical/Mental Health Professional (private or University), the student will need to provide documentation from the Medical/Mental Health Professional, on the professional’s stationary (prescription pad notes will not be accepted).

• If the student is not currently seeing a Medical/Mental Health Professional, the student will need to do the following:
  

  • Make an appointment with a Medical/Mental Health Professional.  You may choose SIUE Counseling Services (618-650-2842).
  • Be seen or under treatment for a minimum of FOUR visits (more visits may be necessary if clinically required) with the Medical/Mental Health Professional.
  • Provide documentation from Medical/Mental Health Professional, on professional’s stationary (prescription pad notes will not be accepted).

• Documentation from the Medical/Mental Health Professional must include:
  

  • Length of time the student has been seen/under treatment by Medical/Mental Health Professional.
  • Treating Medical/Mental Health Professional’s contact information.
  • Psychological disorder and therapeutic rationale for release from University Housing contract.

•  At SIUE Counseling Services, the student’s issue must be clinically significant and be directly related to the Housing situation.  Merely having a psychological disorder does not indicate that the Medical/Mental Health Professional will recommend that a Housing contract be canceled.  Therefore, a recommendation will not be made merely to assist a student in canceling their Housing contract.  Each request will be reviewed by the entire clinical team before a recommendation can be made.  Ultimately, the final decision will be made by University Housing.
• Once a decision has been made, all disputes of the cancellation decision will handled by University Housing at 618-650-3931 and not SIUE Counseling Services.

Release of Information Policy: 

Before a student is seen by a mental health professional in Counseling Services, they must sign a release that includes the following information:

• All communication between a client and a counselor, psychologist, or psychiatrist is confidential and will not, except under the circumstances explained below, be disclosed to anyone outside of Counseling Services unless written authorization to release information is given. A Release of Information Form will need to be signed to have a Counseling Services professional staff communicate information to anyone. A record is kept of a client’s work with us. It contains information a client has provided to Counseling Services in writing as well as counseling notes from client sessions. As of Fall 2010, records are kept in perpetuity, meaning they are kept indefinitely in secure electronic form. Previous to Fall 2010, records were destroyed after a period of 7 years from an individual's last visit. Counseling Services files never become a part of the permanent SIUE educational record.
  

• Most limits to confidentiality are to ensure safety. If there is evidence of imminent danger of harm to the client or other(s), we must take action. If a client describes abuse of a child or elder, the information will be reported to the appropriate agency. It is possible a court order may require release of privileged communication.
  

• Counseling information cannot be released to the following without the client’s consent:
  

  • parents or guardians, spouse, siblings, or significant other
  • another doctor, lawyer, or health organization
  • insurance company, disability payment source, or state agency

Procedure:

• A client may review his counseling record in the confines of the Counseling Services office with a counselor and only by appointment.
• A client wishing to grant release of information to another party must complete the Release of Information form.  
• The standard charge for copies is $1.00 per page.  This includes records released to an individual, a legal firm, or an insurance company.  There is no charge if records are released directly to another physician or health care facility, or another entity of SIUE.
• A summary of a client’s counseling record may be prepared by a client’s Counseling Services therapist for $20.00. A summary is a written document created by a therapist based on the contents of the chart describing the counseling episode.
• Records may be faxed or mailed. A cover sheet or letter must be affixed to accompany all documents.
• The legal counsel of SIUE may wish to review cases involving probable legal action before the information is released.  In a legal case, the whole chart is copied at the written request of the legal counsel.  Counseling Services will not release any medical information obtained from another clinic, hospital, or private physician if marked “not for secondary disclosure”. 
• Counseling Services will not release records pertaining to alcohol/drug use, mental health, HIV/AIDS, abortion, and sexual assault unless the written consent is signed. 
• In cases of immediate transfer by ambulance or police of a client to any emergency facility or hospital, appropriate information can be sent with the client, including photocopies of clinical notes and identification information.  This material should be provided for continuity of care.  Also in these cases, all attempts will be made to contact the emergency contact person(s) supplied by the client on his/her Client Intake Questionnaire form or at the client’s verbal request to contact such persons as so designated.
• Pages of the chart with the stamp “re-disclosure is prohibited” may accompany records released by the records technician.  The recipient of the information is then prohibited from using the information for other than the stated purpose and will prevent disclosure to a third party. 
• Fees may be waived by permission of the Director of Counseling Services.

Student Complaint / Grievance Policy

Student complaints are handled largely through the existing chain of command. Given the existing laws regarding confidentiality and psychological/health services, a therapist/health service provider is restricted in terms of what he or she can disclose. If a student has a complaint about an employee or consultant of  Counseling Services or Health Service, he or she is directed to speak with that employee’s director, or if necessary, the immediate supervisor of the employee. The complaint should initially be lodged informally by speaking with someone in the department. However, the complaint can be lodged more formally in writing first to the Director within five (5) working days of the incident. The written complaint or grievance should include a description of the incident, date, time, and persons involved in the complaint.

After receiving the grievance, the director shall then respond within five (5) working days of the date that the grievance was signed and filed. If the student is not satisfied with the outcome of that discussion or response, he or she is directed to the next higher level of administration. In each case, careful consideration is given to the emotional stress the student may already be in as well as any complications arising from a possible mental or physical illness. If a complaint comes from a non-student, it is handled administratively first by the director, then by the Associate Vice-Chancellor of Student Affairs, and finally, if necessary, the Vice-Chancellor for Student Affairs. The Director reserves the right to consult with the General Counsel of the University around issues or complaints that may have legal implications. Documentation of a student complaint would become part of the confidential record.

If the student is not satisfied with his or her current therapist or health care provider, he or she can request another therapist within the department at no charge or accept a referral to another provider outside the university. Any costs incurred by the student seeking these services outside of the university are not covered by the university.

Any complaints, if found to have merit, will be used in the supervision of the employee involved to improve the person’s skills and function. If the complaint is significant, the student may take legal action as prescribed by current statutes. Each week the clinical staff meets in a case conference to discuss problematic cases to ensure quality of service to the student.

Alcohol and Drug Policy

Policy Regarding Services for Faculty and Staff

Counseling Services is able to to offer consultation to faculty and staff pertaining to problem resolution and goal-setting in the interest of the education of SIUE students. However, Counseling Services, in accordance to code 1.17 of the American Psychological Association's code of ethics, is not able to offer it's services for personal use amongst SIUE faculty and staff because of the conflicting relations that can quickly arise.  However, in the event that a faculty or staff member requests personal counseling services, a referral to Magellan Health Services or another mental health professional will be provided.