Scope of Practice

Because of limited resources, coupled with our desire to serve as many students as possible, Counseling Services has adopted a brief treatment model.  We are committed to maintaining our ability to provide students with high quality, appropriate counseling services.  At the same time, we are also committed to providing services within the limits of our expertise, which is required by professional ethics.

As generalist therapists, we are similar to primary care physicians; that is, we are able to address a wide variety of concerns within our office, but there are some concerns that may require treatment services we are unable to offer.

Some examples of clinical concerns that will likely be addressed through a community referral include but are not limited to:

  • Individuals with chronic mental health conditions that require longer-term or ongoing care
  • A need or desire to be seen more frequently than bi-weekly, or on a long-term basis
  • Excessive utilization of NUCS crisis intervention services
  • Chronic suicidality and/or recent history of multiple suicide attempts
  • Severe and chronic self-injury
  • A history of multiple psychiatric hospitalizations
  • Evidence or risk of progressive deterioration in mental or emotional functioning that requires intensive intervention
  • Concerns that require more specialized care, including:
    • Significant or chronic disordered eating symptoms posing  a medical danger
    • Significant or chronic substance use/abuse, need for drug testing
    • Specialty care (ie. EMDR, psychoanalysis, DBT Program)

Sometimes a referral is the best option

In addition to the clinical reasons indicated above, some other reasons why we may need to recommend a referral to community resources include but are not limited to:

  • Lack of motivation or engagement in treatment, as evidenced by:
    • Unwillingness to provide information sufficient for clinical assessment
    • Inability to identify a treatment goal appropriate for brief therapy
    • Inconsistent attendance
    • Poor compliance with treatment recommendations
    • Failure to follow through with recommended treatment in the context of multiple crisis intervention sessions
    • Ongoing treatment relationship with another mental health provider
    • Inappropriate, harassing, menacing, threatening, or violent behaviors
    • Mandated or required treatment, including but not limited to:
      • 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 classes
      • Comprehensive psychological evaluation of any type, including but not limited to:
        • Neuropsychological evaluations
        • ADHD testing
        • Forensic assessments
        • Custody evaluations
        • Assessment and documentation for service or support animals
        • State/Federal benefit programs, including vocational rehabilitation and social security/disability
        • Fitness-for-duty evaluations
        • Pre-surgical mental health evaluations
        • Other situations that are determined to be outside the scope of services provided by NUCS, or in which case a clinical staff member determines that treatment would be detrimental to the client or to the proper functioning of the department.

        Referral Process

        During the intake appointment or during any subsequent stage of treatment, a NUCS clinician may determine that a client’s needs appear to fall outside our scope of practice.  In such instances, the clinician is encouraged to consult with colleagues regarding case disposition. 

        When a community referral is the most appropriate treatment option for a client, NUCS staff can assist client with identifying appropriate community treatment options.

        NUCS clinicians are not case managers, and are not responsible for ensuring that clients follow up on referrals provided.