Wait Time for Counseling Affecting Perceived Stigma and Attitude toward the University
Abstract A sample of 99 undergraduates in counseling was divided into two groups based on wait time from triage to intake, "less wait time" (up to two weeks) versus "more wait time" (at least two weeks). The less wait time group showed higher willingness to recommend the university, higher institutional commitment, and lower perceived stigma for receiving psychological help, versus the more wait time group. These three outcomes are often part of a university's overall mission, and may enhance the perceived value of a counseling center to a university. These differences were partially supported compared to a not-in-counseling control group. The study results should be regarded as encouraging and in need of more rigorous follow-up. (114 words) Key words: wait time, institutional commitment, willingness to recommend university, counseling stigma Wait Time for Counseling Affecting Attitude toward the University and Perceived Stigma It has been noted (Hanfmann, 1978; May, 2008) that ideally college students coming for psychotherapy should be seen immediately, with no wait for services. Pinkerton, Talley and Cooper (2009) noted that it is best to have a therapist appointment within 24 hours of a students' request for help. In a national survey of 228 College Counseling Directors, Gallagher (2011) found that 46% of Directors reported that once counselor schedules are filled wait lists begin to develop, and 88% of these Directors report that such wait lists lead to concerns that some students may not be getting help when they need it. Using a wait list system at their university counseling center, Levy, Thompson-Leonardelli, Smith and Coleman (2005) found that regardless of race, students who waited longer than three weeks were less likely to return to their first scheduled counseling session versus students who waited three weeks or less. Rockland-Miller and Eells (2006) wrote about using a clinical triage system in the college counseling center setting. They pointed to how an increasing number of centers have adopted a triage screening approach to simultaneously address the issues of increased pathology and increased volume of students seeking services. In this approach there aren't waiting lists per se; instead, students are immediately seen (e.g., during "walk in" hours) or screened over the phone, albeit briefly, and designated as urgent or non-urgent. Urgent cases receive immediate assignment or outside referral. Non-urgent cases often wait for assignment to a counselor who will complete the intake and provide treatment. Almost 35% (79/228) of counseling centers reported using a triage system to manage caseloads, according to Gallagher's (2011) survey. One unfortunate byproduct of this system is that students who are assessed to be non-urgent at triage face a longer wait, particularly as counselors quickly absorb urgent cases, as well as other scheduled intakes, into their generally already full caseloads. The observation of this phenomenon at the counseling center studied here raised a question, i.e., "what happens to those students assessed as non-urgent at triage as they wait to see a counselor." DiMino and Blau (2012) found a significant positive relationship for non-urgent undergraduates between length of wait time after triage and no-show rate for scheduled intake (after triage). The current study explored other outcomes for non-urgent students who wait for services; namely how wait-time impacts specific attitudes towards the university and psychological help. Counseling Center Research and the Academic Mission of the University Studies (e.g., Sharkin, 2004) have called for additional research looking at other indicators of counseling effectiveness beyond retention. Cooper and Archer (2002) advocated that counseling centers engage in more research activities, and Stone and Archer (1990, p. 587) include the idea of "thinking scientifically in a specific context. …