UNC community clinic hits therapy caseload capacity, continues offering assessments

The UNC Psychology and Neuroscience Community Clinic has reached capacity for its therapy caseload for this semester and has limited openings for assessment services.

Based out of the UNC Department of Psychology and Neuroscience, the clinic operates through two locations — an on-campus one, Evergreen House, and the off-campus Finley Community Research Center and Clinic.

The clinic is a community-based training facility for the doctoral program in clinical psychology. The Evergreen House primarily serves adults and students, while the Finley Clinic is where the clinic conducts its assessment services and serves children, couples and families.

With services provided on a sliding scale by clinical psychology graduate students, the clinic is able to offer a more affordable therapy option. However, its capacity is limited by the clinical psychology doctoral program's funding and cohort size.

Graduate student training program

The clinic trains clinical psychology graduate students in evidence-based practices focused on assessment and therapy. Services may also be provided by licensed psychologists, postdoctoral fellows and social work graduate students.

Students complete one year of coursework and research before providing individual therapy services under supervision.

On average, the UNC clinical psychology doctoral program admits between eight and 10 graduate students each academic year, Jennifer S. Kirby, director of clinic operations and training, said. Typically, applicant pools are over 500 people.

In the clinic, between 25 to 30 students usually provide assessment and therapy services in a given year.

“Our primary objective is providing high-quality care to the campus and community,” Kirby said. "And at the same time, we're training our graduate students.”

Kirby said the clinic takes the majority of their caseload at the beginning of the fall semester.

The graduate training program discourages students from taking new cases past February, Jen Kogos Youngstrom, director of clinical services and director of assessment, said. She said this allows clients to receive a full course of treatment before the end of the semester.

During their first year, graduate students primarily do coursework and research, Director of Clinical Psychology Anna Bardone-Cone said. By their second year, students start moving through the clinics’ training practice and providing individual therapy to clients.

“So our training involves coursework, there's clinical work and there's research," Bardone-Cone said. "I'd say those are the main kind of buckets.”

She said that graduate students stay in the program for five years before advancing to an internship that is typically yearlong and clinically focused.

The students receive intense supervision, Kirby said, and their sessions with clients are typically reviewed and recorded. The class is led by two main supervisors, Youngstrom and professor Jonathan Abramowitz, director of the anxiety clinic.

“It’s a really neat intersection of both applied practice and clinical research that is operated through the clinic,” Kirby said.

Access to clinic resources

The clinics operate on a sliding scale, meaning the fee for therapy is based on the income of the client. Fees range from $10 to $80.

Kirby said the clinics offer their services at a lower cost to incentivize people to seek treatment from their graduate student providers. It also allows the clinics to accommodate clients without insurance or mental health coverage.

“Our average rate for therapy cost is around $25 a session, taking into account the sliding scale,” Kirby said.

Community Clinic Teaching Fellow Emily Walsh said the clinic prices are more accessible compared to other community mental health services or private practices that only accept insurance or charge $180 sessions out of pocket.

Walsh said most therapy within the undergraduate community typically revolves around stress, anxiety and depression.

Compared to UNC's Counseling and Psychological Services, which is free, the clinics offer more long-term care.

However, the clinics have a much smaller capacity than CAPS because each graduate student has a limited caseload, Youngstrom said.

She said the class size of the graduate students depends on how many faculty and teaching assistant lines are available and how much funding the University is providing to their program.

Of the 25 to 30 graduate students that usually provide services, each student usually has around three cases at a time for therapy and one to two cases per semester for assessments.

From July 1, 2020 to June 30, 2021, the therapy and assessment clinics served 178 unique clients — 88 in therapy clinics and 93 in the assessment clinic, according to Youngstrom.

This clinic is funded from fees for mental health services provided through the clinic to members of the community as well as to UNC students, UNC Media Relations said in an email.

The University does not provide funding to operate the clinic, Media Relations said. The Department of Psychology and Neuroscience commits $350,000 of the funds it receives each year for graduate student support to the clinical program, according to Media Relations.

Walsh said the clinics would be able to accommodate more people if UNC received more state funding for mental health services. At a national level, mental health is an issue of values where funding is not being prioritized like physical health, she said.

Walsh said that she always sends referrals for individuals she cannot accommodate on the clinic's case load. The clinic's referral list includes resources for psychotherapy, medication prescribers and crisis response, as well as resources for Spanish-speaking individuals, people who identify as LGBTQ+ and Black, Indigenous and other people of color.

To access the clinics, Walsh told the Daily Tar Heel that a formal referral from a provider is not required and students can email the clinic at clinic@unc.edu or submit an initial inquiry form. Services are not guaranteed.

“It’s frustrating as an organization that wants to provide services,” Bardone-Cone said.

The Community Clinics will have more openings for clients in August or September 2022.

university@dailytarheel.com

CORRECTION: An earlier version of the article incorrectly stated whether Community Clinics will have more openings in August or September of 2022. There will be more openings. In addition, a previous version of the article's photo caption incorrectly stated Anna Bardone-Cone's title. She is the Director of Clinical Training of the UNC-CH clinical psychology program. The Daily Tar Heel apologizes for this error.