When wait times for appointments at the University of Florida’s counseling center reached four or five weeks, Sherry Benton knew she had to try something different.
“When you’re depressed, four to five weeks is the difference between making it through the semester and tanking academically,” said Ms. Benton, who was director of the counseling center at the time, four years ago.
The university, like many of its peers, had been expanding its center for years, and had recently hired four new therapists, bringing its total to 37; but it still wasn’t keeping up with student demand.
So Ms. Benton set about creating an online therapy program that would reduce the amount of time counselors spent with some students to as little as 10 to 15 minutes per week, allowing them to see three or four times as many students — via videoconference — as they typically saw in an hour. She named the program Therapist Assisted Online, or TAO, a Chinese word meaning “the path” or “the “way.”
When the University of Florida conducted a pilot of the program, in 2013, it found that students treated using TAO showed more improvement than participants in individual and group-therapy sessions. A year later, Ms. Benton left the university to commercialize the program.
Today 52 institutions in the United States and Canada use TAO, making it one of the most popular online treatment programs among colleges. WellTrack, a self-help program that does not involve videoconferencing, is used at 35 colleges.
Expanding Capacity
As the demand for counseling continues to outpace supply at many colleges, a growing number of institutions are turning to online therapy as a way to expand capacity without adding staff. On some campuses, online programs are being used to treat students with less-severe symptoms; on others, they’re being used to support students between sessions, or while they’re waiting for treatment.
In programs like TAO and WellTrack, students progress through a series of educational modules that combine videos and educational material with quizzes, mood assessments, and other interactive features. Some programs allow counselors to monitor students’ progress or interact with them online. The most intensive, like Therapist Assisted Online, include weekly videoconferences with therapists.
When you’re depressed, four to five weeks is the difference between making it through the semester and tanking academically.
Colleges that use teletherapy say some students prefer it over face-to-face counseling because it’s available anywhere, anytime. It lets them seek help when they need it, and does away with scheduling conflicts. Teletherapy can also expand access to counseling, serving those who study online, live far from campus, or are uncomfortable visiting the counseling center.
“Most of our students are extremely busy, and TAO lets them pace themselves,” said Maggie Gartner, executive director of student counseling services at Texas A&M University, which purchased the program for $15,000 this summer. “Our students are also very technologically savvy, and really are able to relate this way.”
Online programs aren’t cheap — costs can range from $5,000 to $20,000 a year, depending on the size of the institution — but they’re still a bargain compared with the cost of hiring a new counselor.
Research into the effectiveness of online therapy with college-age populations is still in its infancy, but studies suggest that it can help ease symptoms of depression and anxiety and, in some cases, may be more effective than traditional therapy.
Still, not everyone is sold on online therapy as an alternative, or supplement, to face-to-face meetings. Only 9 percent of campus-counseling-center directors reported using telepsychology in a 2015 survey by the Association for University and College Counseling Center Directors, though that share has increased significantly since 2012, when just 0.3 percent of directors said they used it. In this year’s survey, some respondents reported a lack of student interest in online treatment.
“Campuses are really getting creative with the use of online therapy,” said Sara Abelson, vice president for student health and wellness at Active Minds, a campus-based group that supports students with mental illness. “But I think campuses are also really looking for evidence of its effectiveness.”
Testing One Program
At the University of Minnesota-Twin Cities, which is trying out an online program called SilverCloud that was created at Trinity College Dublin, counseling staff members have extended the trial period because not as many students signed up as they’d hoped. To try to recruit more students, the university has added online interventions to the list of services on its mental-health website.
Patricia Frazier, associate chair of the psychology department, who is leading the research project evaluating the SilverCloud program, says the university initially saw the product as a way to bridge the gap for students who were put on the wait list, “to give them some skills and help in the meantime.” However, in retrospect, focusing on students who were seeking face-to-face counseling may not be the best approach, she said. “They already want in-person help.”
Still, the early evidence from students who have used the online program has been encouraging. “We are finding significant decreases in symptoms,” she said.
Kelly Field is a senior reporter covering federal higher-education policy. Contact her at kelly.field@chronicle.com. Or follow her on Twitter @kfieldCHE.
