Scope of Practice

While the Center’s identity and defined scope of practice are the product of an evolving process (rooted in our mission, and influenced by changing campus needs and national trends), the primary focus of our practice includes work with such issues as: depression, anxiety disorders, relationship problems, academic stress, grief, trauma, family issues, many personality disorders, assertiveness and anger management problems, crisis related problems, alcohol and drug problems, eating disorders, self-esteem issues, stage of life and existential issues, homesickness, and adjustment to university life.

We may also work with clients on such issues as self-injurious behavior, suicidal and/or homicidal ideation, Bipolar Disorder, and Borderline Personality Disorder.

The Center’s ability to provide treatment is contingent upon students’ capacity to function at a minimally self-sufficient level and/or have adequate support systems in place which will allow them to function at a minimally self-sufficient level. When this is not the case, referral to other off campus services may be made.

In many of these cases, it is beyond the Center’s scope of practice to provide ongoing counseling and psychotherapy for students who are diagnosed with severe, long-term psychiatric conditions, and individuals who appear to present a recurring high risk to themselves or the Plymouth State University community. These individuals need more intensive/extensive services than we can offer, such as ongoing psychiatric or other medical involvement, frequent use of 24-hour emergency services, case management, day treatment programs, or specific treatment techniques such as Dialectical Behavioral Therapy (DBT); students would be referred to such outside treatment resources, as necessary.

Examples include those with severely impaired personality disorders; those with high risk behaviors, such as significant suicidality or homicidality; other, somewhat less severe levels of intent to harm others or self; clients without relative stability for the following diagnoses Bipolar and Related Disorders, Schizophrenia Spectrum and Other Psychotic Disorders, Dissociative Disorders, Feeding and Eating Disorders, and Substance Use Disorders.

There are certain referrals for evaluation, disposition, and/or treatment that may be better responded to by off-campus clinical resources. These often are situations of conflict of interest, the need for specialized expertise, or the need for more comprehensive care, among other reasons. Specialized requests for services must be individually assessed in regard to our capacity to evaluate and/or treat, and clinical judgment must be applied. Specialized requests may include (but are not necessarily limited to) referrals from the following:

Requests for an evaluation for safety/risk concerns toward self or others.

Cases involving ethical challenges or dilemmas, e.g. dual relationship concerns.

Referrals for evaluation involving ethical challenges.

Requests from students to prescribe or issue letters of support for emotional support animals (ESA). While we understand how animals can be helpful for people, we are not able to provide documentation to establish the need for ESA’s. Students can discuss the need for an ESA with their primary care physician or other treatment providers, in collaboration with the Campus Accessibility Services (CAS) office.

We do not provide students with written excuses for missed classes, assignments, exams, internships/practicums, or other work. However, Counseling Center clinicians may, upon client request, write a note or general letter summarizing a student’s attendance in treatment and the types of concerns that the student has reported experiencing. Students who require specific accommodations due to mental health concerns or general medical issues must be registered with Campus Accessibility Services (CAS) office. If a student has an established history with a counselor at the Counseling Center, that counselor may be able to provide CAS with the documentation necessary to justify the student’s request for accommodations due to a mental health issue.