Tacoma is a Western Washington community of about 193,000 that’s on the water. The Puget (PYOU-jet) Sound flows from the capitol city of Olympia, 25 minutes to our south, to the very northern tip of Washington State, from which you can see British Columbia, Canada. Hop a ferry and you’re there in two hours. Closer to home is the fun of Seattle, roughly 40 minutes to our north. Cosmopolitan, progressive and simply beautiful, Seattle is an easy jaunt from a home base in Tacoma.
Tacoma itself is a port town with working roots. A number of turn-of-the-century, exposed brick buildings downtown have been transformed from old factories, train stations and mills into museums, independent movie houses, microbreweries, and the award-winning campus of the University of Washington Tacoma. Due to the speed of this development, there’s been some media attention given Tacoma’s renaissance. Tacomans have witnessed the addition of everything from a convention center to a fondue joint, from light rail to wine bars, and bridge building to doggie daycare. What an intern would probably experience for the length of a training year is simply a nice place to live that feels like it’s in motion.
The city’s population is diverse, with strong Korean American, African American and Latino communities to the south and east of campus. Point Defiance Park is a particular source of pride for it old growth forest, zoo & aquarium, craggy beaches and scenic five-mile loop through the park.
The University of Puget Sound campus is in Tacoma’s North End neighborhood, a warm residential community that is easy to navigate and, happily, relatively easy to afford. Life in the North End and nearby neighborhoods of 6th Ave, Proctor District, Downtown and Stadium District is eclectic. Minor league baseball, gourmet groceries 24/7, live jazz and folk music, great Thai restaurants, independent films and the Almond Roca Factory are all in our midst.
The University of Puget Sound is an independent, liberal arts institution. The undergraduate enrollment of roughly 2,600 students is primarily residential. Though established in 1888 by what’s now the United Methodist Church, Puget Sound today is governed by an independent Board of Trustees.
Puget Sound students come from most of the 50 states with approximately 75% of the student body from outside Washington State. The university’s ethnic minority student enrollment is about 27%. Students who identify as Asian-American or Pacific Islander comprise the largest ethnic minority group on campus, with a strong Hawaiian community. About 85% of our students are receiving some form of financial aid.
Traditionally aged undergraduates make up the majority of our student population. Select graduate programs complement our liberal arts identity. Approximately 150 grad students are enrolled in Occupational Therapy, Physical Therapy, Educational Administration, Counselor Education or teaching programs. Graduate students are eligible for counseling services and provide the opportunity to work with clients who are older adults.
The availability of diverse campus groups encourages students to interact based upon some common interest in ethnicity, faith or sexual orientation. Vibrant student organizations have included APASU (Asian/Pacific Islander), BSU (Black Student Union), CHiSPA (Hispanic awareness and culture), Hui o’Hawai’i, Jewish Student Union, Inter-Varsity Christian Fellowship, Pagan Student Alliance, and B-GLAD, which is Puget Sound’s lesbian, gay, bisexual, transgender, and straight ally alliance. Of course there are a great many student organizations beyond these, and Psychology Interns with a special interest in college student leadership skills may wish to consider affiliating with one of these groups as one of their “discretionary” (non-clinical) training activities.
The Division of Student Affairs (DSA) mission is, in part, to "...foster the lifelong development of personal values, integrity, and self-reliance; respect for differences; questioning, critical thinking, and ethical discourse; effective leadership skills; and community responsibility, engagement, service, and interdependence for the common good."
As a collective, DSA supports the university’s academic mission by providing services and creating educational opportunities designed to enhance student ability to develop their full potential.
Vital to being able to reach that potential in this emotionally and academically challenging environment is a student’s physical and mental health, of course. Survey data from our clients affirm that they find treatment not only reduces their symptoms but enables them to cope better on their own in other areas of their lives.
Part of our role is to provide students the experience of managing their own health care needs for the first time. This education may include their learning to make and keep appointments, to follow a behavioral or medical recommendation, to refill their prescriptions on time, to provide the fullest information they feel comfortable with and to come for help before a crisis erupts. Trainees contribute directly to the DSA mission, of course, bringing their talent, background and tremendous clinical service to Puget Sound students.
CHWS makes its contribution to the Division’s goals by offering primary health care, individual, couples and group psychotherapy, outreach programs, consulting, crisis intervention, wellness education and leadership development opportunities.
"Counseling, Health and Wellness Services (CHWS) helps University of Puget Sound students achieve their intellectual, social, and emotional potential by offering professional psychological and primary health care. These services are integrated, individualized, and aspire to the highest standards. CHWS facilitates student development by emphasizing prevention strategies in addition to the treatment of existing conditions and the provision of acute care. Consequently, students develop skills that foster lifelong health: The knowledge and confidence to be one's own health care advocate and the ability to function effectively as an individual and as part of a community."
Our staff is multi-disciplinary. Health Staff (Physician Assistants, Registered Nurse, Consulting Physician, Consulting Psychiatrist, and Registered Dietitian) and Psychology Staff (three Licensed Psychologists, one of which is a Substance Abuse Prevention Specialist, two Doctoral Interns, and two Practicum Counselors) work in tandem. Rounding-out our team is a Bookkeeper, a Medical Assistant and a Receptionist, and a crew of 14 student employees. This merging of mental and physical health offerings enables interns to collaborate on treatment planning and outreach with medical practitioners, for a more holistic perspective of college health.
CHWS staff are regarded particularly strong allies to the LGTBQ students on campus; members of the Psychology Staff have developed and advised student groups related to gender, sexuality, and assault prevention on campus. CHWS frequently receives requests for a sexual education program fondly referred to as"Banana Over Sex". This is a fun multidisciplinary outreach opportunity for interns that is typically co-presented by members of the counseling staff and medical staff.
The Psychology Staff as a group sees about 20% of the student body each year. A Psychology Intern could see anywhere from 80 – 100 different therapy clients during the training year, depending upon how they manage the number of sessions they offer each client and how many brief or crisis contacts they happen upon as they cover the clinic’s walk-in hours. This will naturally vary by the theoretical orientation and developmental needs of each intern, as well as by the severity of the clinical presentations they have on their caseload. CHWS has no session limit, and we encourage interns (and ourselves) to make the length of treatment match the therapeutic need. We are “well-utilized” (very busy) during most of the academic year, so we do remain attuned to when we might reasonably terminate therapy with each client, but we do not have an arbitrary upper limit. Psychology Interns will find that they do have a few clients they treat through most of the year, but also need to be adept at quickly establishing rapport and assessing needs at intake, as they will have just a few contacts with some clients, too.
About 60% of Puget Sound students are female and 40% male, as is common in liberal arts settings. Students of color present at CHWS in proportion to their numbers on campus, which is considered very positive, since nationally students of color typically utilize psychological services in numbers smaller than their presence on campus.
Clients are most often being treated for both an Axis I diagnosis and a DSM V-code. In our opinion this is an exceptional opportunity for trainees to deepen clinical effectiveness, as clients are neither too compromised to engage in “talk therapy” nor too high-functioning to change as a result of it. GAF (Axis V) scores for most of our clients fall between 35 -75. Because both clinical and developmental issues are most often at play with our clients, an intern’s ability to perceive relational and developmental issues is quite important.
The most frequent issues students present with are depressive disorders (major depression, dysthymia), anxiety disorders (generalized anxiety, PTSD, social phobia, panic disorder, OCD), attention deficit/hyperactivity disorder, eating disorders, substance use, adjustment disorders, bipolar disorders (cyclothymia, bipolar affective disorder) and V-codes such as bereavement, sexual trauma recovery, cultural/religious/sexual identity problems or parent-child relational problems. We work with students on characterological issues that may be holding them back (both treatment for personality disorders and work on clusters of features that do not reach the diagnostic threshold) but it’s relatively rare for the primary diagnosis here to be on Axis II.
As is true for most university counseling centers, presentations range in severity from “access to a new insight or behavior” to a suicide attempt or psychotic episode. Client needs range in chronicity from response to a recent loss to coping with long-standing mental health concerns. It makes sense then that the number of sessions ranges from a single consultation to extended treatment with some case management.
Only currently enrolled Puget Sound students are eligible for services. In some cases we assess that a student’s treatment needs could be best served in the community, and we refer them on. We do not provide clinical services to faculty or staff, but we frequently work with these constituents, providing consultation and crisis response to assist them in their interactions with distressed students.