From Intention to Action
Transcript of From Intention to Action
From Intention to Action
Campus Exchange: Leveraging Mental Health Innovation
Centre for Innovation in Campus Mental Health
June 9,2015
Dr. John Meissner & Larry McCloskey
Overview
1. FITA’s origins in LOTF findings
2. Opportunities and difficulties in the development
of mental health services
3. Mental health, achievement /retention research
4. FITA students, interns, intake & recruitment
5. Sharing FITA (UToronto: St. George & Humber)
6. Discussion
From Intention to Action was developed with the support of
the Ontario Ministry of Training, Colleges and
Universities .
Goals of FITA
Help the most vulnerable post-secondary
students
Improve psychological well-being, grades &
retention
Train new generation of counsellors and
psychotherapists
Intervene at the earliest possible stage by
reaching out to secondary schools to recruit
students identified as at risk (transition support)
Provide cost-effective services (50%+ services
offered by graduate student interns).
What is FITA?
Began as student support / retention program developed for students
struggling academically and has evolved to focus on mental health.
FITA is based on 4 primary : Program Components
• Provides assessment, feedback, and collaborative goal
setting.(M.B.T.I., Strong II, LASSI, BASC2, Nelson-Denny Reading, WJ- writing
samples)
• 12 consecutive, weekly meetings with coordinators.
• Counselling with a goal of developing a strong therapeutic alliance
and supportive relationship.
• Emphasis on personal and emotional issues where applicable.
• Learning strategies and, when needed, tutorial support
4th Floor MacOdrum Library
FITA Team
Origins of the FITA Model
Learning Opportunities Task Force in Ontario
& 7 year longitudinal follow-up
The Nancy Factor (therapeutic alliance)
Assessment
Student commitment
Transformative impact on graduation rates of
students with disabilities
Challenges & Opportunities
• Our values in serving students
• Challenges of increasing mental health
services in the face of increasing demand
• Present financial realities – PSE’s, provinces,
nation
• Until there is public funding support for
counselling and therapy we make a case for
incremental development of services & a
vision for the future
Mental Health Funding
• Students spend most of their time on campus &
expect service to be provided where they live.
• In most PSEs there is no legal agreement
designating a contract to PSEs to provide mental
health services (i.e., core funding).
• The onus of developing a PSE mental health system
has fallen on PSE service providers whose
employers normally set a central priority on their
academic mandate.
Finance and Retention
All schools have to address the problems
of attracting and retaining students. For
every student that stops, drops, or
transfers, the institution loses significant
income. Retaining even a small number
of students can provide a major return on
equity that far exceeds student service
costs.
Mental Health and Retention
Healthy Minds research:
Mental Health and Academic Success in College. Eisenburg, Golberstein, and Hunt (2009) http://www.bepress.com/bejeap/vol9/iss1/
Depression & anxiety (and both together) have a significant negative impact on GPA
Depression is a significant predictor of drop-out
Of the 9 DSM questions regarding depression, anhedonia (“little interest or pleasure in doing things”) has the strongest impact on grades and retention (i.e., “just going through the motions”)
Mental Health and Grades
Hysenbegasi, A., Hass, S., and Rowland, J. Ment
Health Policy Econ 8, 145-151 (2005)
In depressed students, GPA = loss of 0.49 or half a letter
grade
This means that a C student will be placed on AW and
have to face the prospect of Suspension
Aspiring B+ to A- students face the prospect of a GPA not
sufficient to confidently meet requirements for graduate or
professional programs following graduation
Treatment (primarily medication) was associated with a
protective effect with a gain of 0.44
Depression Anxiety & Academics
- Anhedonia undermines brains reward system
- ( just going through the motions).
- Withdrawal / avoidance affects attendance
- Stress> cortisol < memory (< tests score).
- hippocampus< 10% with depression
- sleep loss < adaptability & learning
- poor sustained effort < academic self-
determination (correlates r = .60 with PSE grades)
- - poor concentration < effective planning & T.M.
- Memory impairment is significant in meta-analyses
(n = 95 studies) with major depressive episodes.
Mental Health and Grades
DeBerardet al. (2004) "Predictors Of Academic Achievement And Retention Among college
Freshmen: A Longitudinal Study." College Student Journal 38.1 (2004): 66-80. Academic
Search Premier. Web. 20 Apr. 2012.
SF-36 Mental Health Composite Scale indicated that overall
level of mental health was a significant independent
predictor of achievement
SF-36 Mental Health Composite, while not showing a
statistically significant Pearson correlation with cumulative
GPA, did evidence a beta value that was statistically
significant, indicating the presence of suppressor
relationship among the predictor variables
Arria et al.: Healthy Minds Network
Eisenburg’s Model: Healthy Minds
7-Yr Graduation Rates of AW
Students (non-FITA)
FITA Students 2011-12 (N=115)
FITA and Grades
n μ1 ± St. Dev.a μ2 ± St. Dev.b Mean Diff.c P
AW 76 4.23 ± 1.52 4.90 ± 1.51 .67 <.0005
OW 52 6.90 ± 2.61 6.78 ± 2.41 -.13 .417 (n.s.)
RT 38 6.16 ± 2.29 6.49 ± 2.03 .32 .024
Overall 186 5.62 ± 2.54 5.96 ± 2.24 .34 <.0005
a. Mean of pre-program Overall GPA and standard deviation.
b. Mean of post-program Overall GPA and standard deviation.
c. Difference between pre- and post-program mean Overall GPAs.
n.s.
Academic Functioning
Questionnaire: 2014-15
* p < .005 ** p < .05 *** n.s.
Mental Health of FITA Students
In 2013/2014 and 2014/2015 FITA students saw
improvements in SF-36 over time, indicating a
positive treatment effect (p<.002)
Last years students Students who had 10+
sessions improved to within a single percentile
point of the average range.
Students with the lowest SF-36 scores showed the
greatest improvements
Mental Health 2013-2014
Plot of SF36 Mental Health composite scores across
administration times between the amount of total
sessions.
Plot of SF36 Mental Health composite scores
across administration times between genders.
FITA and Mental Health
Composite Scores 2014-2015
Therapeutic Alliance in the 2013-14
FITA Program
1. Task Alliance
moderates increases in grades:
b = .14, t(60) = 2.32, p
< .02
2. Increases in grades moderate increases in mental health:
b = 1.06, t(60) = 2.09,
p < .04
Program Continuity: Trust, Respect,
awareness, program, & engagement
Self-reports: Comparison to previous years
2011-2012 2012-2013 2013-2014 2014-2015
Interactions with Coordinators:
“I was treated with respect by the FIT: Action
members.”
4.72 4.72 4.92 4.90
Quality of Information Received:
“I trusted the information I received.” 4.61 4.60 4.66 4.59
Academic Self-Awareness:
“I am more aware of my strengths and
weaknesses.”
4.2 4.12 4.41 4.44
Program Involvement
“I have attended meetings with my counselor.” 4.11 4.72 4.68 4.75
Appropriateness of Academic Courses
“I am taking appropriate courses for my major.” 3.79 3.62 4.41 4.51
Recruitment
Recruitment
Twice weekly email newsletters sent to all Carleton students
Cross-campus posters and flat-screens
Departmental administrators (emails and visits)
Ads in the student paper
High schools
Email letter from VP Student Services and Registrar to AW students
Campus offices: SASC, HCS, PMC, ISSO, 1st Year Experience,
Registrar’s Office, Residence
Monthly display table in high traffic area
Classroom presentations
Social media
Parent newsletter
Graduate student newsletter
FITA Students Present With…
Depression
Anxiety
Perfectionism
Stressful living situations (roommates, Res, commute)
Shame and low self-esteem
Bereavement
Break-ups
Complicated family of origin (continuing conflict)
Medical conditions
Extreme pressure to succeed (e.g. international students)
Undiagnosed or ‘dormant’ LD/ADHD
Financial issues
Lack of motivation (program, career)
Social stressors and isolation
Intake
Referrals: flow-through model throughout the academic year
• Self
• Campus staff/faculty (HCS, PMC, SASC)
• High school guidance counsellors/teachers
• Friends and family
Requirements:
• Distress
• Commitment
Process:
1. 1-hour interview including MBTI if no, student receives formal referral letter
2. Application (demonstrates commitment)
3. Coordinator matching and sessions begin
4. Assessment and feedback
Intake is a Continual Process
Referral – call/email chat with Team Leader
Referral letter
Interview
• MBTI
• Application
Coordinator matching
Sessions 2-12
1st session
Feedback
Online Testing
• Continue, or
• Cut back, or
• Exit
Testing Session
If No If Yes
Counselling Interns
Master’s in Counselling
Approx. 7 per term
Over half of our students matched with interns
2nd Year students | Have completed courses in counselling theories, ethics, tests
& measurements, ASIST, and begun ‘microcounselling’
3 days/week, 2 semesters | Approx. 12 hours client contact/wk
| 1 hour individual clinical supervision each
| 1 hour group/wk
Benefits of Using Interns
Cost-efficient
Balance b/w expertise and student relatability
New energy each year | Keeps us fresh and up-to-date in practices, regulations, and
current climate of counsellors and students
Diverse areas of expertise
| Training future counsellors/psychotherapists (CCPA and CRPO requirements)
Universities selecting interns from their own grad programs may increase quality (and enrolment) in these counselling programs | Quality internship
| Job marketability (our interns’employment)
Staffing options
Conclusions
We can change the environment for distressed
students allowing for greater educational access.
These changes are cost effective and can be
provided by graduate students.
These changes take place as a result of developing a
therapeutic relationship over time with one individual
Regardless of whether a diagnosed disorder is
present, we can improve the functioning of distressed
students, resulting in greater psychological well-being
and academic success
Sharing this Program
We would like to share this program in the
hopes of having a provincial model to
address mental health needs.
The FITA model makes the best use of
research on assessment, therapeutic
alliance, and support that taps into a
network of offices and programs to support
students.
The following manual is our attempt to
capture our program in a very practical
manner than can be useful on other
campuses
FITA Manual
Might FITA be a program for your college or
university?
As part of our agreement with the Ontario Ministry of Training
Colleges and Universities we will collaborate with other
colleges and universities to share this program on a not-for-
profit basis. From Intention To Action (FITA) :
Is scalable (has worked with 30, 100, and 250 students)
Consistently results in significant improvements in grades,
psychological wellbeing and study skills, and is well-liked
Is transferable – same results with different supervisors,
coordinators, and students in different departments
www.carleton.ca/fita
Engagement: a different paradigm