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Ohio State Newark and
Central Ohio Technical College
The Office of Student Life:
Counseling Services
Procedures Manual
Created June 2022
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Table of Contents:
Clinical Services & Mission Statement…………………………………………………………………...……….Page 6
Websites…………………………………………………………………………………………………………………………..Page 6
Program Assessment & Development
Scope of Services………………………………………………………………………………………………………….…. Page 8
Clinical Eligibility……………………………………………………………………………………………………….………Page 9
Summer Semester Eligibility Guidelines……………………………………………….……………….…………Page 10
Guidelines for the Treatment of Minors………………………….………………………………….….…...….Page 11
Client’s Rights & Service Provision Process
Client’s Rights & Responsibilities…………………………………………………………………………………. Page 13
Missed Appointment Policy…………………………………………………………………………………………… Page 13
Client Reassignment Process…………………………………………………………………………………………. Page 14
Intake Policy……………………………………………………………………………………………………………………Page 14
Drop-In Sessions……………………………………………………………………………………………………………. Page 14
Crisis Procedures…………………………………………………………………………………………………………….Page 15
Hospitalization Procedures…………………………………………………………….………………………..Pages 15-16
Urgent Services Available to Students………………………………………………………………….….……..Page 16
Duty to Protect……………………………………………………………………………………………………………….Page 17
On-Going Service Procedures for
Individuals………………………………………………………………………………………………………………..Pages 17-18
Levels of Care & Disposition……………………………………………………………………………………..Pages 18-19
Telehealth Services……………………………………………………………………………………….………….Pages 19-20
Telehealth Procedures…………………………………………………………………………………………………….Page 21
Telehealth Crisis Protocols………………………………………………………………………………………………Page 22
Referrals & Linkage…………………………………………………………………………………………………..Pages 23-24
MindWise Screening Tool………………………………………………………………………………………………..Page 24
Group Counseling Procedures…………………………………………………………………………………. Pages 24-25
Confidentiality Procedures & Privacy Practices
Confidentiality & Privacy Practices………………………………………….……………………………………. Page 27
Accessibility & Access to Client Records………………….……………………………………………………. Page 28
Information Requests……………………………………………………………………………………………………. Page 28
Consultation…………………………………………………………………………………………………………… Pages 28-29
Procedures for Subpoenas…………………………………………………………………………………….……... Page 29
Procedures for Communication………………………………………………………………………………. Pages 29-30
Releasing Individually Identifiable Health Information…………………………………………………… Page 29
Communication & Environment………………………………………………………………………………. Pages 29-30
Electronic Communication……………………………………………………………………………………………… Page 30
Faxing………………………………………………………………………………………………………………………Pages 30- 31
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Breaches………………………………………………………………………………………………………………………… Page 31
Documentation Procedures
Clinical Files & Clinical Documentation…………………………………………………………………………….Page 33
Documentation Time Parameters……………………………………………………………………….…………. Page 33
Record(s) of Previous Treatment……………………………………………………………………………………. Page 33
Termination Guidelines……………………………………………………………………………………………………Page 33
Quality Assurance
Quality Assurance……………………………………………………………………………………………………………Page 35
Counseling Services Surveys……………………………………………………………………………………. Pages 35-37
Safety & Crisis Intervention Procedures
University Crisis…….………………………………………………………………………………………………………. Page 39
After Hours Procedures…………….………………………………………………………………….……….……… Page 39
On Site Emergency Procedures……………………………………………………………………………………. Page 39
Scheduling Guidelines
Scheduling Overview for Therapists………………………………………………………………………...……. Page 41
Scheduling Process for Clients………………………………………………………………………………………. Page 41
Scheduling Initial Appointment…………………………………………………………………………………Pages 41-42
Returning Client Guidelines for Therapists……………………………………………………………………. Page 42
Client Reassignment Guidelines for Therapists…………………………………………………………….… Page 43
Counseling Services Outlook Forms
Appointment Request Form………….………………………………………………………………………………. Page 45
Staff/Faculty Referral Form……………………………………………………………………………………………. Page 45
Counseling Services Q&A Form…………………………….………………………………………………………….Page 45
Presentation Request Form………………………………………………………………………………………Pages 45-46
Appendix A – Staff/Client Use Forms
Student Records Request Form…………………………………………………………………………………Pages 48-50
Clinician Chart Review Form……………………………………………………………………………………. Pages 51-53
Informed Consent for Services………………….………………………………………………………………Pages 54-56
Informed Consent for Telehealth Services……………….……………………………………………… Pages 57-58
General Demographic Intake Form………………………………………………………………………… Pages 59-62
DSM-V Cross-Cutting Measures Questionnaire………………….…………………………………………… Page 63
Safety Plan……………………………………………………………………………………………………………… Pages 64-65
Missed Appointment Guidelines……………………………………………………………………………………. Page 66
Release of Information………………………….………………………………………………………………………. Page 67
Templates
Referral Letter for Office of Disability Services…………………………………………………………………Page 69
Verification Letter………………………………………………………………….………………………………………. Page 70
Outreach Email to Students from Appointment Request Form ……………………………………….Page 71
Student Intern Procedures
Purpose & Guidelines…………………………………………………………………………………………………….Pages 73
Duties & Tasks…………………………………………………………………………………………………………. Pages 73-74
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Titanium
Users Manuel & Instructions……………………………………………………………………………………………Page 76
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CLINICAL SERVICES &
MISSION
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Counseling Services is an outpatient agency within The Office of Student Life through both Ohio
State Newark and Central Ohio Technical College (COTC) institutions.
Mission Statement
The mission of Counseling Services is to promote the emotional, interpersonal, and
psychological well-being of students to prevent, assess, and treat the mental health issues for
Ohio State Newark and COTC students. We are committed to pursuing diversity and inclusion
and to serve as an advocate for social justice in the college community.
Client Services
Counseling Services provides short-term outpatient counseling to currently enrolled students
attending either Ohio State Newark or COTC (campuses in Newark, Coshocton, Knox and
Pataskala). We also provide services to enrolled students who are under age 18, with their
parent/guardian’s consent. We are unable to offer treatment to College Credit Plus students
and they should refer to their sponsoring high school for assistance. We can offer a wide array
of mental health services to students wanting help with personal issues or concerns. While our
focus is heavily on individual therapy, we may include group therapy, drop-in sessions,
workshops, education/consultation, on-campus referrals, and off-campus referrals within the
community. Common concerns addressed in therapy might include stress or anxiety,
depression, academic concerns, relationship concerns and identity development. In the event
of a crisis, Counseling Services may be called upon for consultation, often in conjunction with
other campus partners, such as the Office of Public Safety and Dean of Students/Director of
Student Life. At times, some students may require more intensive services or a higher level of
care to meet their mental health needs; therefore, Counseling Services provides appropriate
referral information to students.
Websites
Ohio State Newark - https://newark.osu.edu/students/student-life/counseling-services/
COTC - https://www.cotc.edu/counseling-services
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PROGRAM ASSESSMENT &
DEVELOPMENT
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Program Assessment and Development
Counseling Services may offer workshops, presentations, education, and consultation to
faculty/staff. These services are coordinated by the Lead Mental Health Therapist who reports
to the Dean of Students/Director of Student Life.
The primary goal of Counseling Services is to initiate and maintain programs depending on
students’ needs. Counseling Services strives to establish programs that meet the
comprehensive well-being of students while promoting their academic progress.
Activities may include but are not limited to:
1. Evaluating the effectiveness of Counseling Services by coordinating, monitoring,
and continually improving the student experience.
2. Evaluating Scope of Services includes:
• Individual therapy/counseling
• Group therapy/counseling
• Assessment and Diagnosis within clinical staff’s scope of expertise
• Drop-in sessions
• Consultation/education for faculty, staff, and parent/guardian/family
• Workshops
• Community referral and linkage
• On-Campus referrals
3. Increase the awareness of mental health resources available on-campus to
students and continue to make appropriate referrals to community providers as
well as make students aware of resources.
4. Analyze the effectiveness of services through assessment and track ongoing
trends both locally and nationally based upon the concerns presented by
students who have utilized Counseling Services.
Scope of Services
• Individual therapy/counseling
• Group therapy/counseling
• Assessment and Diagnosis within clinical staff’s scope of expertise
• Drop-in sessions
• Consultation/education for faculty, staff, and parent/guardian/family
• Community referral and linkage
• On-Campus referrals
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Clinical Eligibility
Students who display symptoms that require specialized treatment not offered by Counseling
Services or require more intensive services may be provided with referral information to better
meet their needs. Counseling Services does not offer medication management/psychiatry
services or ongoing case management services. While it is up to the therapist's discretion
whether a student is deemed appropriate for Counseling Services, the therapists will assist
students with locating appropriate resources. Examples of symptoms that are beyond the scope
of Counseling Services may include but are not limited to:
• Functional impairment that may require a higher level of care
• Chronic and severe Post-Traumatic Stress Disorder (PTSD)
• Frequent dissociative episodes
• Eating disorders
• Severe AOD use and/or dual diagnosis (In need of detox or rehabilitation)
• Recent suicide attempt(s) that may or may not have resulted in psychiatric
hospitalization(s)
• Multiple suicide attempts in the past year
• Treatment non-compliance
• History of repeated impulsive, serious risk-taking, or dangerous behaviors within the
past year
• Psychosis
• Active self-harming with chronic history of persistent self-harm
• Severe issues related to gambling, pornography, and sexualized behaviors
• Certain personality disorders
• Other severely displayed symptoms at the therapist’s discretion
Individuals Eligible for Counseling Services
Currently enrolled Ohio State Newark and COTC students are the population served by
Counseling Services. Students must be appropriate to be treated at an outpatient level of care.
Students are eligible for 10 sessions per academic year. An academic year would include a fall
semester, spring semester, and summer semester cycle over back-to-back semesters. A
student must be enrolled in at least one class during the same semester that that they wish to
be seen for counseling. The number of sessions beyond 10 will be continually evaluated by the
therapist. Students are not required to have health insurance or Student Health Insurance (SHI)
as Counseling Services treatment is offered at no cost. Graduated students from Ohio State
Newark and COTC are no longer eligible for treatment through Counseling Services but can still
receive services until the end of the month that they graduate from their enrolled program.
Failure for a student to be enrolled can serve as a dismissal from Counseling Services. College
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Credit Plus students are ineligible for Counseling Services and should refer to their sponsoring
high school for assistance.
Summer Semester Eligibility Guidelines
Summer semester/term can create ambiguity whether a student is eligible for Counseling
Services. Guidelines for eligibility are as follows:
• A student must be enrolled for any summer term/semester classes.
• A student is eligible for counseling over the summer semester if they are enrolled in at
least one class even if there is a staggered start date, meaning their class does not start
at the beginning of the summer semester but at another time during the semester.
• Student is enrolled for any summer term/semester classes, and student is enrolled for
upcoming fall semester.
• Student is an incoming first year student, and they are enrolled for the upcoming fall
semester. Student can only be seen starting in the same month of the beginning of fall
semester (ex: typically, in August).
Enrollment verification may be necessary to ensure that student is enrolled and eligible
for treatment through Counseling Services.
It should be noted that a student’s “intention to enroll” is not the same as being officially
enrolled in classes.
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Guidelines for the Treatment of Minors
In general, Counseling Services treats enrolled students 18 years of age and older. While minors
younger than 18 years of age may be enrolled at Ohio State Newark or COTC as students,
Counseling Services may not provide the most developmentally appropriate services. If a
student is under the age of 17 and has immediate/local support from a parent or guardian, all
efforts will be made to link the student and family to an appropriate service. Local community
mental health providers often require the parent/guardian be present for most visits and to
support the minor in between sessions.
Lawriter – ORC – 5122.04 Outpatient services for minors without knowledge or consent of parent or
guardian. Counseling Services will obtain parental consent/permission whenever possible.
Under Ohio Law, a student can receive psychotherapy for 30 days or 6 sessions whichever comes
first until parental consent or consent from the minor’s guardian must be given to continue
services.
The following procedures are recommended should a student under age 18 and need ongoing
mental health services:
• The therapist will consult with the Lead Mental Health Therapist or Director of Student
Life.
• The student should be informed about the Ohio counseling law (ORC-5122.04)
governing services before beginning treatment.
• All intake paperwork will need to be completed by the parent/guardian in addition to
the student prior to starting treatment with a Counseling Services therapist, such as the
following:
o Informed Consent
o Release of Information (ROI)
o Informed Consent for Remote Services
o General Demographic Information
o DSM-V Cross-Cutting Measure Questionnaire (completed by student)
o Safety Plan (completed by the student and their parent/guardian)
• The therapist will contact the parent/guardian to facilitate the signing of the ROIs and
inform the parent/guardian of any services provided including urgent or emergency
services.
• The Lead Mental Health Therapist or Director of Student Life will support the therapist
in the development of the most appropriate treatment plan possible.
• The assigned therapist will need to develop a treatment plan with the student that
includes regular contact with the parent/guardian.
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CLIENT’S RIGHTS &
SERVICE PROVISION PROCESS
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Client’s Rights & Responsibilities
Clients receive information about treatment provided by Counseling Services, confidentiality,
limits of confidentiality, and responsibilities when they elect to participate in services. These
rights and responsibilities for the client are covered in the following forms:
• Informed Consent
• Informed Consent for Remote Services
Therapists are advised to ensure that clients understand their rights and responsibilities during
their first appointment and answer questions related to them over the duration of treatment.
Client’s rights (as documented in the Informed Consent form):
• You have a right to receive competent and professional treatment. You have the right to
be treated with respect and you have the right to a therapeutic relationship without
physical, sexual, verbal, or other abuse or exploitation. You have the right to request a
different therapist. You have the right to file a complaint. You have the right to evaluate
our services. You have the right to review your clinical file as permissible under FERPA
and State of Ohio laws and regulations. If you have concerns about your rights and/or
your therapist, communicate with your therapist directly and/or you may contact the
Lead Mental Health Therapist, Charley DePriest via phone at the Office of Student Life
phone number at (740) 364-9578.
Client’s responsibilities (as documented in the Informed Consent form):
• You are responsible to be an active and collaborative participant in your counseling
sessions, including any therapeutic homework and/or exercises as assigned by your
therapist. You are responsible to communicate your needs and concerns to your
therapist.
Missed Appointment Policy
Counseling Services makes every effort to ensure that students are scheduled in a timely
manner. If a student needs to cancel and/or reschedule an appointment, we ask that students
notify Counseling Services at least 24 hours before the scheduled appointment. Counseling
Services can be notified by calling the Office of Student Life at 740-364-9578 or by emailing the
therapist directly. If a student is more than 15 minutes late for their appointment, the student
may be asked to reschedule. Three missed appointments or three appointments being late
outside of the 15-minute grace period may result in termination of services. If a student “no
shows” an appointment two times in a row, the student will be asked to consult with their
therapist before being allowed to reschedule an appointment to discuss whether Counseling
Services is a good fit at this time or if referrals need to be offered. The Lead Mental Health
Therapist will be notified by the therapist regarding students who are in violation of the missed
appointment policy so consultation can ensue on a case-by-case basis.
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Client Reassignment Process
Whenever a client makes a request with a therapist different than the therapist last seen, the
following process should be utilized:
• The therapist should ascertain the reason that the request is being made by the student
to assess whether there is a clinical need to reassign the student.
• If there is not a clinical need to re-assign the student to another therapist, it should be
explained to the student that it would be best to maintain services with the current
therapist so that continuity of care can remain consistent.
• If there is a clinical need expressed by the student that would interfere with the
therapeutic process, the student can be given a choice between seeing another
therapist on campus or receiving a referral off campus. It should be explained to the
student that another therapist on campus might not be able to see them immediately as
their schedule is dependent on volume of students at the time of the request.
• The Lead Mental Health Therapist should be notified with any requests by students to
be reassigned to a different therapist for purposes of consultation and active monitoring
of the student in what they might need.
Intake Policy
• If a student is requesting a specific therapist for an intake, the student might be granted
the request if that therapist is available but must also be aware that there could be a
wait period based on volume, whereas another therapist could have greater availability
to see a student sooner. The student will be made aware of these potential
discrepancies in therapist schedules so that they can make an informed choice for
themselves. Typically, students are assigned a therapist based upon a “first come first
serve” basis.
Drop-In Sessions
• Unscheduled drop-in appointments are offered to students throughout the fall and
spring semesters. Students are not required to fill-out any paperwork ahead of time to
attend drop-in sessions. Typically, there is one therapist assigned to the drop-in hour for
that day and time to answer questions and ascertain what a student might need. Drop-
in sessions are approximately 20 minutes in length depending upon the student’s needs
and are designed to be an expedient means for a student to meet with a counselor to
receive immediate support as well as determine next steps. Students can choose to
meet with that therapist or choose another drop-in time on another day and hour if that
would suit their needs better, understanding that availability for a specific therapist
could be limited. Students are seen by a therapist during this time based upon a “first
come first serve basis” which is subject to availability depending upon volume.
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Crisis Procedures
• All students who participate in counseling must complete a safety plan prior to the
intake. This safety plan should be reviewed by the therapist and client prior to the
beginning of counseling.
• Students who have engaged in treatment with Counseling Services and express active
thoughts of suicide, thoughts of harming others, or active psychosis will be assessed for
safety to determine if they are at imminent risk. The crisis assessment form can be
found in Titanium.
• If the student is not determined to be at immediate risk to harm themselves or others,
their safety plan can be reviewed and modified, as necessary. Appropriate follow-up
can then be scheduled for the client as well as other referrals made if pertinent to the
client’s needs.
• If a student is not familiar with Counseling Services and arrives as a drop-in appointment
due to an expressed crisis, their information will be obtained via our initial intake
paperwork/consent forms. The student will then be assessed for safety and a safety
plan developed with them during their time in session if they are not determined to be
an imminent harm to themselves or others. Their safety plan would include 24/7
emergency services information. Appropriate follow-up would be discussed to best
meet their needs.
Hospitalization Procedures
• If a student presents as an imminent risk to harm themselves or others, expressing
active suicidal ideation with plans, means, and intent, homicidal ideation with plans,
means, and intent, or with severe psychosis where the student cannot keep themselves
safe, hospitalization becomes necessary to provide the student with a secure
environment.
• The student will be assessed for safety by a therapist using the crisis assessment form in
Titanium, and if it is determined that a safety plan would not be enough to ensure that
the student could keep themselves or others safe, the student will be asked to go to the
hospital for further assessment and stabilization.
• Campus Public Safety will be contacted via phone (740-366-9237) or via Skype to
provide the student with an escort to Licking Memorial Hospital to ensure the student
will get there safely whether the hospitalization is voluntary or involuntary.
• The student will be asked if they would like their instructors and/or advisor notified that
they needed immediate medical attention via email. The student will sign a release of
information if they are able so that the email can be sent.
• If the student is a minor, the student will sign a release of information if able, so that
their parent or legal guardian can be contacted to provide an update on their condition.
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• If a student is being seen for counseling virtually and is off campus and the therapist
believes the student needs to be hospitalized for stabilization, the student will be asked
if there is an individual present that they trust from their safety plan that could provide
transportation to the nearest hospital. The student will remain on screen during the
virtual session as they reach out to their supportive contact(s). They will continue to
stay in session with the clinician until their contact arrives and can be confirmed by the
therapist with brief instructions to go directly to the hospital due to a mental health
emergency.
• In situations, where a student does not have a supportive person or is non-voluntary but
shared imminent plans for harm to themselves or others, Campus Public Safety will be
contacted (740-366-9237) to link the student with transportation and escort to the
hospital through the local police department in the student’s area. The therapist will
continue the virtual session if possible until law enforcement arrives. If the connection
is lost during the session, the therapist will request confirmation by Campus Public
Safety that contact was made with the student and the student was transported to the
hospital for further evaluation.
• The Lead Mental Health Therapist will be notified of any student hospitalizations due to
a mental health crisis.
Urgent Services Available to Students
While Counseling Services does not offer 24/7 crisis management services and operate as a fully
staffed crisis center, therapists can assist students to get urgent help to ensure their safety.
If a student is in immediate danger of harming themselves or others, please call 911 or go to
the nearest Emergency Room. If the student lives in Knox, Licking, Marion, Morgan,
Muskingum, Perry, Pickaway, or Washington county, they can call 2-1-1 or text their zip code
to 898211 for crisis services.
To speak to someone outside of normal office hours, Ohio State Newark students can reach the
Ohio State University After-Hours Line at (614) 292-5766.
Other important crisis hotlines/textlines include the following:
• Ohio State Newark/COTC campus security – Call (740) 366-9237
• National Suicide Hotline – Call (800) 273-8255
• Crisis Textline – Text “START” to 741741
• BIPOC Specific Textline/The Steve Fund – Text “STEVE” to 741741 for a BIPOC therapist
• Trans Lifeline – Call (877) 565-8860
• Trevor Lifeline (LGBTQIA+ Individuals) – Call (866) 488-7386
• Veterans Crisis Hotline – Call (800) 273-8255, press “1”
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Duty to Protect
Ohio law requires therapists take certain steps to document their plan to address a client’s
suicidal and self-destructive behavior. The law also gives the therapist immunity from lawsuit or
damage by the client when acting in good faith to protect the client, other individuals, or
structures threatened by the client. The law also establishes a duty for mental health
professional or organizations “to warn of or protect against a threat made by a client or patient
if the client or patient communicates an explicit threat of serious harm against a readily
identifiable individual or structure and there is reason to believe the client or patient has the
intent to carry out the threat.” Furthermore, therapists may be held liable for damages or be
subject to disciplinary action for serious harm resulting from our failures to warn or protect.
The law also specifies how therapists are to discharge this duty.
Rule 5122-3-12 – Ohio Administrative Code | Ohio Laws
First, the threat should be serious. Passive suicidal ideation or threats against others that are in
the context of “blowing off steam” may not be serious threats. If the seriousness of the threat is
unclear, seek consultation with an administrator or senior staff therapist.
1) Exercise any authority the professional has to hospitalize the client on an emergency basis.
2) Exercise any authority the professional has to have the client involuntarily or voluntarily
hospitalized.
3) Establish a documented treatment plan that is reasonably calculated, according to
appropriate standards of professional practice, to eliminate the possibility that the client
will carry out the threat.
4) Collaborate with law enforcement/campus security with jurisdiction over the area in which
the potential victim(s) reside or where the threatened structure is. The therapist may also
communicate to a law enforcement agency where the client resides. If feasible,
communicate with each potential victim (or parent or guardian). The following information
should be communicated: the nature of the threat, the identity of the client making the
threat, and the identity of each potential victim.
The form is designed to facilitate compliance with these four choices. The therapist must
respond to all four choices, stating specifically why each one was chosen or not chosen. The
forms must be signed by a supervisor (if applicable) within 24 hours after the threat is made
and by the Lead Mental Health Therapist within 48 hours after the threat.
Ongoing Services Procedures for Individuals
Ongoing services will be provided for all clients as outlined in the clinical eligibility
procedures. Therapists are responsible for contacting clients or making arrangement to contact
them for scheduling appointments. Clients are assigned to therapists based on appropriate
level of care and availability. Therapists are responsible for providing individual or group
therapy as recommended and agreed upon with the client. If a client needs services outside of
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the therapist’s scope of practice, the therapist is responsible for providing an appropriate
referral and linkage to recommended services for the client.
The process for ongoing individual and group therapy delivery includes the following:
• Clients will fill-in the brief counseling request form on the OSU-N or COTC Counseling
Services webpages. Students can also email a therapist directly to request an
appointment.
Counseling Services | The Ohio State University at Newark (osu.edu)
Welcome to Counseling Services - Welcome to Central Ohio Technical College (cotc.edu)
Counseling Services Appointment Request Form (office.com)
• A therapist will email the student consent for treatment forms, demographics form,
DSM-V Crossing Cutting Symptoms form, and a safety plan.
• Students can fill-out the forms electronically, send them back to the therapist, and
receive scheduling times for their intake.
• Clients then participate in a Diagnostic Assessment session or intake for the purposes of
treatment planning and assessing their needs.
• A diagnosis may or may not be rendered at the time of the intake given the diagnostic
presentation of the client.
• Following the intake, clients may be scheduled for ongoing appointments by their
therapist or the therapist who completed the intake if there is a clinical need for the
client to change therapists.
• A client is not to see more than one therapist at a time unless clinically indicated and is
encouraged to discuss any transfer of services with their present therapist.
• Client sessions will be conducted during scheduled business hours (M-F, 8am – 5pm)
either in-person or virtually through Microsoft Teams or Zoom.
• Clients are eligible for ten free sessions per academic year if the client is enrolled in
school during the same semester they are working with their therapist.
Levels of Care and Disposition
Level of risk will be determined as follows:
• Low risk: with moderate to high functioning, no acute crisis, appropriate for weekly to
biweekly outpatient treatment
o Consider for Counseling Services individual and/or group or refer out to
community-based weekly individual therapy treatment.
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• Moderate risk: with lowered functioning, ability to plan for safety and seeking ongoing
treatment.
o Consider referral to PHP/IOP.
o Could be for eating disorder symptoms, AOD, or severe Mental Health issues.
• High risk: with impaired functioning or high-risk behaviors, could benefit from
immediate comprehensive medication evaluation.
o Consider Emergency Department or urgent follow-up appointment with
consultation.
• Imminent Risk: to self and/or others or unable to care for self. Consider for voluntary or
involuntary.
o Assist with linkage to Emergency Department or Detox Treatment.
Telehealth Services
Telehealth (also referred to as remote) services were initially offered as both Ohio State
University and COTC declared a state of emergency during the COVID-19 global pandemic in
March 2020. All licensed staff members can provide telehealth services to clients physically in
the state of Ohio during service delivery (Rule 5160-1-18 – Ohio Administrative Code | Ohio
Laws) based on allowances through the State Board of Psychology, the Therapist, Social Work,
Marriage and Family Therapist Boards, and The State of Ohio.
It should also be noted that The State of Ohio has ended the state of emergency as of June 2,
2021; however, the Therapist, Social Work, Marriage & Family Therapy Board has continued the
following conditions as of June 21, 2021:
With the end of the state of emergency, CSWMFT Board licensees providing teletherapy must
immediately begin:
1. Using a face-to-face session when meeting with a new client for first time. Video is
considered “face to face”. Following an initial face to face session, services may transition
to telephone sessions, if appropriate confidentiality can be established and maintained.
2. Obtaining written acknowledgement of informed consent from all new clients. Provided
an existing client’s verbal consent to treat is clearly documented in the client’s file, a
written consent is not necessary from existing clients receiving services through
teletherapy.
3. Implementing HIPAA-compliant platforms for providing services to new and existing
clients.
Rule 4757-5-13 does not provide a transition period as the COVID-related provisions are directly
related to the establishment of new client relationships. Licensees do not have to terminate any
existing teletherapy services because of the termination of the state of emergency. Additionally,
licensees are not required to obtain a signed written consent from any client who consented
verbally under Rule 4757-5-13 while the state of emergency was in effect. If the licensee is using
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a non-HIPAA compliant platform, they must establish a plan to transition quickly to such a
platform.
Counseling Services utilizes telecommunication platforms as adopted by the institutions.
Currently, there are business contracts in place for the use of Microsoft Teams and Zoom for
videoconferencing. In addition to the Counseling Services intake forms, students scheduled for
a diagnostic assessment must complete the Informed Consent for Remote Services form within
one hour of the start of the appointment. Clients must also complete a Safety Plan (or update
an outdated Safety Plan) which the therapist will email to the client as a Word Document.
Counseling Services therapists will review and send any information to the student regarding
education to telehealth services which is not limited to:
• Review limits of confidentiality with telehealth services.
• Risks and benefits of telehealth services (ex: technology failure, privacy, ease).
o Client must be physically located in Ohio at the time-of-service delivery.
o No recording of sessions is permitted without the client’s explicit consent.
o Discuss safe word or visual cue if confidentiality is compromised.
o Safety Plan must be completed, on file, and a copy is provided to the client.
• Discuss use of technology – computer or laptop preferred.
o Prop a tablet or phone so it is stable.
o Camera is about eye level.
o Headphones or earbuds may help reduce excessive noise or echo.
o Well-lit and no light source directly behind either participant.
o Helpful to have light in front of participant if possible.
o Test sound and camera before first appointment.
o Ensure stable internet connection (ex: near Wi-Fi router? Are others streaming
or playing games or videos online? Close other browsers.)
o Texting, Skyping, or communication with others is discouraged during the
appointment.
• Ensure student’s location is private, including the following considerations:
o Identify a confidential space for appointments to occur.
o Is it possible for the client to lock the door to prevent interruptions?
o Can the client schedule a session when others are not home?
o Can others hear student when they talk?
o Do people in the home know about mental health conditions and are they
supportive?
o Ensure no one is in the room with the student.
o Therapist will only communicate with the client and no one else in the home
about the client’s treatment unless there is a completed release of information
(ROI).
• Develop a plan for re-connecting with the student if there is a technology failure.
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Telehealth Procedures
Counseling Services follows eligibility guidelines for all students in addition to The State of Ohio
guidelines previously listed.
Intake Forms
• Therapist who is scheduling the appointment emails the intake forms to the student.
These intake forms can be completed by filling in the Word Documents and emailing
them back to the therapist within one hour of the diagnostic assessment at the latest.
Safety Plan
• A Safety Plan must be completed by the client; the therapist can assist the client to
complete the Safety Plan if needed. Client must identify emergency services in their
area and list appropriate individuals for support. Therapist must ensure that the client
has a copy, and the Safety Plan has been filed into their chart.
Client Location
• The client’s exact location must be obtained at the beginning of each session and
specified in documentation for each session. Services can only be provided if the client is
physically located in the State of Ohio during the delivery of the appointment.
Appointment
• Therapists are responsible for sending telehealth communication links (Microsoft
Teams/Zoom) to the client in a timely manner.
Self-Report Measures
• These may be administered during sessions and placed in the client’s file. They can be
emailed and sent back prior to the session. All data, specifically sensitive data, should be
reviewed and acted on in a timely manner.
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Telehealth Crisis Protocols
Several potential safety issues to consider include suicidal ideation, homicidal ideation, non-
suicidal self-injury, access to firearms, domestic violence, and medical emergencies.
During all appointments:
• Verify physical location of student at start of appointment.
• Safety Plan is completed, on file, and updated regularly.
• At the beginning of the session, therapist and student should discuss plan should there
be a technology interruption during the appointment.
Urgent Appointments:
• Prior to the start of the appointment, email the PDF version of the Safety Plan to the
client.
• At the beginning of the appointment, therapist and student should discuss a plan in case
there is a technology interruption in session.
• Complete/Update Safety Plan during the appointment.
o The hospital on the Safety Plan should be local to the student’s physical location.
Student will email a signed copy of the Safety Plan to the therapist upon
completion and this copy should be added to the student’s file.
• Safety Planning is an ongoing process and risk assessment should be completed at every
session.
• Thoroughly document all emergency planning efforts.
• If all other less restrictive resources are inappropriate and voluntary hospitalization is
deemed necessary, contact Campus Public Safety via Skype, email, or phone call (740-
366-9237) for support.
o Instruct student to go to the nearest emergency room.
o Verify method of transportation to hospital. Use police as needed for transport.
o Notifying an emergency support is recommended, document efforts thoroughly.
• If all other less restrictive resources are not appropriate and involuntary hospitalization
is deemed necessary, contact Campus Public Safety via Skype, email, or phone call (740-
366-9237) and police will be dispatched to student’s location.
Domestic Violence
• Please verify that student will have a safe and confidential space for appointment.
• Safety planning should include identification of a “safe word,” should the appointment
need to end.
• The National Domestic Violence Hotline has trained advocates who can support
students in developing a safety plan. This resource is available 24/7. Online chat is also
available. https://www.thehotline.org/
Medical Emergencies:
• Therapist to call 911 for ambulance if student is located off campus; if student is on
campus, contact Campus Public Safety via Skype, email, or phone call (740-366-9237).
• Contact Lead Mental Health Therapist/colleague as needed for support.
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Referrals & Linkage
While Counseling Services does not provide case management/care management services to
students directly, Counseling Services staff can provide appropriate referrals to students to a
community-based provider if needed.
Appropriate situations for referring a student to a community-based provider:
• After completing a drop-in session with a therapist or an intake the student could
present the need for a higher level of care such as Partial Hospitalization (PHP),
Intensive Outpatient Counseling (IOP), Detox, a Drug and Alcohol program (AoD) or a
specialized program for the treatment of eating disorders.
• Student elects to obtaining a referral for a community-based therapist.
• Student is seeking psychiatric medication management.
External based community mental health resources in Coshocton, Knox, Licking, Muskingum,
Fairfield, Delaware, and Franklin counties including therapists/therapists, prescribers, AOD
treatment providers, and local hospitals can be found on the Counseling Services websites at
the following links:
External Community-based Mental Health Resources | The Ohio State University at Newark (osu.edu)
External Community-based Resources - Welcome to Central Ohio Technical College (cotc.edu)
Information regarding emergency resources can be found on the Counseling Services websites
for The Ohio State University-Newark and Central Ohio Technical College at the following links:
Counseling Services | The Ohio State University at Newark (osu.edu)
Welcome to Counseling Services - Welcome to Central Ohio Technical College (cotc.edu)
Counseling Services recognizes that some students may request services related to the
LGBTQIA+ population. A LGBTQIA+ resource list is also provided on the Counseling Services
websites on the links below:
Copy of LGBTQ_ Local National Resources (osu.edu)
Copy of LGBTQ_ Local National Resources (cotc.edu)
For students who request BIPOC community-based providers the following links can be found
on each of the Counseling Services websites:
BIPOC Resources (osu.edu)
BIPOC Resources (cotc.edu)
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*It should be noted that the listed community resources are provided for informational purposes
only and are not “approved” or “endorsed” by Ohio State Newark or COTC.
MindWise Screening Tool
A brief, online questionnaire that students can voluntarily take listed on the Counseling Services
website which is anonymous and confidential. MindWise has screening questionnaires based
on various mental health-related diagnoses, such as depression, bipolar disorder, anxiety, and
many more. Students can also take a general well-being questionnaire. At the end of the
completed questionnaire, students are provided with individual results and local/national
resources.
https://screening.mentalhealthscreening.org/counselingservicesosuncotc
Group Counseling Procedures
Group counseling may be an ideal choice for addressing concerns and making positive changes
in your life. Counseling Services may offer open and/or closed group counseling to enrolled
students based on the current trends/needs. Students may already be connected with a
therapist on campus, but it is not required. Students who are interested in group counseling,
will need to at least complete a screening to determine eligibility and if a group format is
appropriate. An open group is a continuous group that is constantly open to new members. A
closed group excludes new members from joining during the duration of meetings. Typically,
closed group members will have commonalities. An open group may have an adjustment period
while getting to know the other group attendees as this is continuously evolving.
Examples of appropriate groups may include a specific skills-based topic learned over several
weeks (DBT), or a drop-in style that is on an as-needed basis.
Important notes:
1) There must be at least 3 students to determine it as group counseling.
2) Group facilitators will determine the number of sessions and the length of each of their
group meetings. The recommendation is that groups begin with a minimum of 6 committed
members. Group facilitators should use their clinical judgement regarding the opening and
closing of their groups and adding new members.
3) Group facilitators are responsible for providing information about the group to appropriate
staff members.
4) Group facilitator will need to determine a confidential space for student members to meet
on a regular basis.
5) Group members will have to sign consent for treatment forms prior to their participation in
the group.
6) Documentation for the group will be kept in Titanium.
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7) Student will be self-referred and participate in a brief screening process prior to entering
the group.
8) Groups will be facilitated by a licensed therapist and can be co-facilitated by an intern
when or if available.
9) Group members will complete an evaluation at the conclusion of the group.
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CONFIDENTIALITY
PROCEDURES
& PRIVACY PRACTICES
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Confidentiality & Privacy Practices
Counseling Services is an entity that operates under the Family Education Rights and Privacy Act
(FERPA).
Counseling Services records are classified as “treatment records” under FERPA and as such are
excluded from the “education records” regulation of FERPA. Counseling Services records are
kept separate from all other OSU-N and COTC student records.
• A Privacy Officer shall be established and listed in the notice of privacy practices.
• Privacy Practices will be reviewed will all staff annually.
• Changes to Privacy Practices will be reviewed will all staff.
Notice of Privacy Practices
• All students will be asked to review the Notice of Privacy Practices/Informed Consent for
Treatment and acknowledge that they have been offered a copy of the form. This
acknowledgement will be filed in their client record.
• Please see Appendix A to review the Notice of Privacy Practices as stated on the
Informed Consent for Counseling Services.
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Accessibility & Access to Client Records
• Staff should only access records needed to perform their job responsibilities.
• All client records will be maintained in the electronic health records system Titanium
and stored within that system.
• Accessing records for any other reason is considered an unauthorized use and subject to
discipline.
• Clients have the right to access their records by completing a release of information
(commonly also known as a written Authorization for Disclosure).
o Nonetheless, clients should be made aware of the inherent risks involved in
possessing physical copies of their records as confidentiality cannot be
maintained by the therapist once records would be released to the client
directly. Despite the client’s right to have access to their records if requested,
when possible, clients should be encouraged to sign a written release of
information to transfer their records from office to office to ensure
confidentiality can be maintained.
o The Student Records Request form can be reviewed and signed by the client and
their therapist to acknowledge the inherent risks involved when requesting
records to take home as the therapist cannot maintain confidentiality of records
no longer in the office.
Information Requests
• Sometimes a relative, parent/guardian, or a close friend of the client will contact
Counseling Services for information regarding the client’s progress. No information
should be released without the client’s written consent.
• Clients may request information from their files, including the entire file by reviewing
and signing the Student Records Request form.
• Clients may request information from their files including the entire file be released to a
third party with a completed and current release of authorization (ROI).
o For example, letters made on behalf of the student when a student needs
supporting documentation of their appointments or their treatment history. A
signed release of information (ROI) is required. A copy of the letter and the
authorization should be kept in the client file.
Consultation
Staff and faculty members are often concerned about a student. Therefore, staff and faculty
may refer students to Counseling Services with the expectation that the therapist will provide
information which will help the staff/faculty individual take appropriate action to the student’s
situation.
• It is the therapist’s responsibility to evaluate the situation carefully regarding the client’s
needs. The client should be consulted about such requests and no information which the
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client considers confidential should be shared to the staff/faculty without their knowledge
and written consent.
Procedures for Subpoenas
• If there is a request made to subpoena records the Lead Mental Health Therapist will be
notified to be made aware of what is being requested as well as to review any questions or
concerns with the therapist working with the student related to the records request.
• The Lead Mental Health Therapist and therapist working with the student if different will
ensure that records being sent out match the subpoena.
• A note in Titanium will be added under the student’s file to attach the subpoena, as well as
to indicate when the subpoena was fulfilled.
• If a therapist is subpoenaed to court, the therapist will discuss the request with the Lead
Mental Health Therapist to discuss what can be discussed without violating the privacy of
the student or what would be in violation of HIPAA law.
Procedures for Communication
• Staff will confirm who they are speaking with when receiving phone calls.
• If leaving messages, staff will identify the caller source as Ohio State Newark or COTC – not
Counseling Services.
• Staff will not leave individually identifiable health information on a voicemail message.
• The front desk staff will confirm the client’s identity when in person with a photo ID.
Releasing Individually Identifiable Health Information
• Therapists should not release individually identifiable health information without a
completed and active ROI.
o Expiration dates of ROI’s need to be checked, as well as any restrictions, and
signature of the client.
• Consult with the Lead Mental Health Therapist prior to release of information if there
are concerns or questions with an ROI or ethical concerns with releasing the information
being requested.
• Release the minimum information necessary to comply with authorization both
internally and externally.
Communication and Environment
• Staff will limit their presence in the front desk reception workspace area.
• Staff will not use the computer or phones at the front desk.
• Staff refrains from discussing client or other clinical issues in the front desk area as this
is a public space. Clinical discussions are best in the privacy of offices behind a closed
door such as during clinical supervision.
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• Staff will maintain an office environment where individually identifiable health
information is not visible or accessible to others.
Electronic Communication
Email is not always a secure method to transmit information though it is necessary to
communicate and document communication with students at times.
• Therapists will make sure that they have permission to use email communication with
students which will be reflected in the initial intake packet.
• Staff will blind copy clients with all initiated emails.
• Staff will limit service information on emails when possible.
• Personal emails are strongly discouraged.
• When other secure options are not available, staff can send an encrypted email by
adding the word “osusecure” in the subject line on their university email (for more
information go to View Knowledge Base Article | IT Service Desk (service-now.com)
• Staff should not sync Outlook contact with their personal smart phones to reduce the
probability of mistaken emails being sent to clients.
•
Therapists will document email communications with clients in Titanium linked to their
clinical record.
•
Therapist’s will not use email as a substitute for therapy but to answer brief questions,
arrange appointment times, rescheduling, to send surveys, necessary forms, screening
tools, or to fulfill a records request with a signed Release of Information.
•
The student’s OSU-N or COTC email address will always be used to enhance the security
of electronic communications within the institutional network.
•
Personal Health Information should be disclosed at a minimum through email
communication and only with the student’s written consent by a signed Release of
information to fulfil a records request.
Faxing
Faxing maybe a preferred method of communication at times, but it has potential for errors.
• Staff will verify with the entity receiving the fax whether fax machines are in public or
private spaces. If not in a private space, ensure that access to faxes will be limited to the
receiving party.
• Frequently used numbers are to be stored in the fax machine for easy use. Staff will
verify all numbers entered to avoid errors.
• A fax cover sheet must be always used when faxing individually identifiable health
information.
• The electronic clinical file shall contain a copy of the fax cover sheet, confirmation of
receipt and include a notation of what material was faxed in Titanium. Clients have a
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right to request information regarding the summary of all individually identifiable health
information released.
• Mail – a copy of the envelope with the correct address will be scanned into the client’s
electronic file in Titanium (verify the information on the ROI).
• Staff will review client information that is either being scanned and kept in the client’s
electronic record within Titanium.
Breaches
• If a breach in confidentiality is discovered, the Lead Mental Health Therapist will be
notified to discuss a brief plan of action.
• The student involved in the breach should be notified to explain what happened with
full disclosure.
• The accidental receiving party of the Personal Health Information for a client will be
notified to explain that a breach of confidentiality has occurred with further instructions
to delete all information associated with the client record that was sent. This would also
include the destruction of physical documents associated with the client record.
• Further instructions will be conveyed to the accidental recipient of Personal Health
Information to not disclose anything further that was shared in misdirected
documentation that was received.
• The client will be notified when the breach of confidentiality has been rectified and a
note will be placed in Titanium documenting the breach and steps that were taken to
correct and resolve it.
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DOCUMENTATION
PROCEDURES
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Client Files & Clinical Documentation
When a student wishes to engage in therapy, the student will sign consent forms, fill out brief
demographic information, DSM-V Scales, and a safety plan. Occasionally, a client might wish to
not complete the intake paperwork and/or not to have notes kept. In such a case, clients should
be assured of confidentiality and informed that we must keep a file for every client receiving
treatment from Counseling Services. If the client still refuses to provide information, the Lead
Mental Health Therapist will be consulted before further services will be rendered as a standard
of practice must be maintained.
Therapists are expected to keep appropriate and up-to-date ongoing progress notes, including
correspondence and communication with third parties based on their client’s needs. All clinical
documentation, including email correspondence, intake paperwork, ROI’S, accommodation
letters, and forms such as diagnostic assessments, progress notes, and termination summaries
will be maintained in Titanium, an electronic record keeping and scheduling system.
Documentation Time Parameters:
• All crisis paperwork must be completed by the therapist within 24 hours or one business
day of the phone screening or meeting/appointment.
• All clinical documentation should be completed and entered into Titanium within three
business days.
Record(s) of Previous Treatment
Sometimes students will come to Counseling Services with a previous history of mental health
treatment. Reasonable efforts should be made to obtain clinical record(s) of a client, if needed.
Efforts should be documented in a case note and/or attachment within Titanium. Releases of
information (ROI) should be obtained if there are outside providers who serve the client.
Termination Guidelines
• Individual clients who have not been seen by Counseling Services staff for at least 60
days should be terminated. Terminations may be requested prior to the 60-day period.
• The termination of clients will be completed by the therapist of record or the last
therapist to work with the client.
• A termination form will be completed within Titanium on the client’s record.
• If the client has been referred directly to a group, and the client has not participated in
adjunctive individual therapy during the same time period, the group facilitator will
complete the termination note and add it into the client’s Titanium record.
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QUALITY ASSURANCE
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Quality Assurance
Once a semester, therapists will fill-out a quality assurance form on three different case files
of another therapist that will be assigned to them. The items reviewed will be to ensure
that the file is complete and intact including initial intake paperwork completed, diagnostic
assessments, progress notes, and appropriate collateral information attached to the record
based upon the clinical documentation. The quality assurance form will be shared with the
clinician in Titanium and will be reviewed with them by the Lead Mental Health Therapist.
Counseling Services Survey
The quality of treatment provided by Counseling Services is of the upmost importance. To
give students who have completed/received treatment through Counseling Services, a brief
survey is shared with students to gather their feedback. This survey was created through
the Qualtrics platform. The survey is completed entirely anonymously and is confidential.
The analysis of the data is used as an effort to pivot transmission of services, if needed,
based on client/student feedback.
Surveys for drop-in student sessions were also created to receive immediate feedback as
well as a survey for presentations given by Counseling Services to staff, faculty, and student
groups.
The QR code is listed below for the Counseling Services Survey for students who can provide
feedback on their experience as a client while engaged with therapy:
The following questions are listed in the survey:
1. Overall, how would you rate your experience with Counseling Services at Ohio
State Newark/COTC?
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2. How easy or difficult was it for you to schedule your first Counseling Services
appointment at a time that was convenient for you?
3. How satisfied are you with the flexibility of your Counseling Services therapist's
schedule?
4. I experienced improvement in the condition or problems for which I sought
Counseling Services.
5. My Counseling Services therapist helped me develop better ways of coping with
my concerns.
6. I would recommend Counseling Services at Ohio State Newark/COTC to a friend.
7. I feel that my Counseling Services therapist listened to me.
8. I feel that my Counseling Services therapist is culturally competent (for purpose
of this question, we define cultural competence as the ability to understand,
communicate with and effectively interact with people across cultures).
9. By participating in Counseling Services, I am better able to function academically.
10. Do you have any other questions, comments, or concerns about Counseling
Services?
The QR code is listed below for Counseling Services drop-in sessions:
The following questions are listed in the survey:
1. Overall, how would you rate your drop-in experience with Counseling
Services at Ohio State Newark/COTC?
2. I experienced improvement in the condition or problems for which I used
the drop-in option through Counseling Services.
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3. I would recommend Counseling Services at Ohio State Newark/COTC to a
friend.
4. The therapist I met with for a drop-in session, helped me connect to
other on-campus and/or off-campus resources to assist my needs.
5. How easy or difficult was it for you to meet with a Counseling Services
therapist during a drop-in and time that is convenient for you?
6. Do you have any other questions, comments, or concerns about
Counseling Services or your experience with the drop-in sessions?
The QR code is listed below for presentation provided to staff, faculty, and student groups:
The following are questions listed in the presentation survey:
1. What is your level of satisfaction with this presentation?
2. My knowledge on the presented topic have been enhanced since
participating in the presentation.
3. The presenter was easy to follow and communicated their ideas
appropriately.
4. What did you like most about the presentation?
5. What, if anything, did you like least about the presentation? No
suggested changes, please type “N/A.”
6. Please share any additional topics you may be interested in having
presented from Counseling Services.
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SAFETY & CRISIS
INTERVENTION PROCEDURES
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University Crisis
A university crisis is a situation where there is a temporary state of trauma and disorganization
characterized by accidental or unexpected precipitating events. The event may involve an
individual, a subgroup, or a larger group of individuals. A university crisis usually requires
multiple interventions at the individual and larger system levels for those most traumatically
affected by the crisis.
A clinical emergency occurs when an individual who presents in a visible agitated and/or
disorientated state, or who presents as threatening harm to themselves or others. This
individual may be present on the phone, to a third party who contact Counseling Services, or in
session. We must remember that what is termed an emergency in clinical terms may be
recognized otherwise by the student or referring individual.
After Hours Procedures
In the case of a university crisis or clinical emergency after business hours, a clear
determination of what is being asked or expected of Counseling Services staff should initially be
assessed in all situations. The counseling team follows hours of operation for offices at OSU-N
and COTC. If there is a clinical emergency outside daytime hours of 8 a.m.- 5 p.m. on campus
the following steps should be taken:
• Contact Campus Public Security 740-366-9301 so that safe transport to Licking Memorial
Hospital can be provided to the student for further assessment.
• Contact the Lead Mental Health Therapist so that further steps can be evaluated such as
checking in with the student to see if they have therapeutic support following their
assessment at LMH, contacting their instructors, housing, and/or advisor with a signed
Release of Information.
On Site Emergency Procedures
An onsite emergency is unpredictable. The goal is to provide guidelines for keeping staff and
clients safe and recruiting supports as much as possible. Each Counseling Services staff office is
equipped with an alert button. Once the alert button is pushed this will notify Public Safety
who can send officers to the location for further assistance.
• If a therapist is working with a student in crisis a safety plan will be developed and
reviewed if the student is in a state of mind where they are not presenting an
immediate risk to themselves or others and agrees to following the safety plan.
• If a student does present as a risk to themselves or others and cannot follow a safety
plan, Public Security will be notified to provide transportation to Licking Memorial
Hospital for further assessment and possible stabilization.
• If hospitalized, a student can also choose to fill-out Releases of Information so that
therapists can inform their instructors and advisor of recent developments.
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SCHEDULING GUIDELINES
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Scheduling Overview for Therapists
All staff therapists are responsible for maintaining accurate and timely documentation of client
contacts and services in addition to their schedules in Titanium. Therapists should synch their
Titanium schedule to their Outlook calendar at the beginning of each business day.
Scheduling Guidelines:
• Each therapist is responsible for ensuring their schedules are updated by close of
business (ex: 5 p.m.) for the following day.
• Therapists are responsible for rescheduling their own clients as they need to. They may
ask the front desk staff to assist if they are unable to reach a student or might be
unavailable to do so given illness or vacation leave.
• Therapist’s schedules should be kept current so front desk staff know their whereabouts
in case they need to be contacted.
• Therapists should check their Outlook email daily as most student’s schedule through
their school email accounts or might need to reschedule or cancel an appointment.
Scheduling Process for Clients
• All students/clients must check in with the front desk staff whenever they come into
the office for an appointment.
• After checking in the client, the front desk staff will notify the therapist via Skype or
Teams Message that their client has arrived.
• Any changes in scheduling must be reflected by the therapist’s schedule in Titanium
and making sure it is synched to the Outlook calendar using the Quick Sync feature.
• If your meeting is scheduled but not indicated in the Outlook calendar, you may be
interrupted by front desk staff due to scheduling errors.
• If you are going to be working with a client longer than scheduled, please
communicate this to the front desk staff via Skype or Microsoft Teams so that they
can inform the next client and not interrupt the appointment.
• Clients may only be scheduled during current office operating hours (M-F, 8am –
5pm).
Scheduling Initial Appointment
There are many ways a student can schedule an intake to meet with a therapist:
• The student can call the Office of Student Life at (740) 364-9578 to request an
appointment. A therapist can be connected with them or when available.
• An email can be sent to any of the therapists at depriest.17, hughett.12, or harris.137.
• A student can complete the Counseling Services Appointment Request form.
o A therapist will reach back out to the student with intake paperwork to complete
upon receiving the referral so an appointment can be scheduled.
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• Staff and faculty can refer a student through the Staff/Faculty referral form.
o Staff/Faculty will be informed by counseling staff that the referral was received, and
the student will be provided intake paperwork to complete via email to schedule an
appointment.
Student request forms as well as Staff and Faculty referral forms can be found on the following
websites:
Counseling Services | The Ohio State University at Newark (osu.edu)
Welcome to Counseling Services - Welcome to Central Ohio Technical College (cotc.edu)
Student request forms as well as Staff and Faculty referral forms can be found at the following
links:
Counseling Services Appointment Request Form (office.com)
Counseling Services Staff & Faculty Referral Form (office.com)
Returning Client Guidelines for Therapists
When a client who has been seen in individual counseling by Counseling Services in the past
contacts the office to reschedule with a certain therapist, they are to be given an appointment
with that therapist, provided the therapist has availability, and the student/client meets
eligibility requirements. Keep in mind that a client is closed/terminated after 60 days of no
contact with a therapist. A client is not to see more than one therapist at a time and is
encouraged to discuss a transfer of providers with their present therapist if the client is
currently receiving outpatient counseling.
The therapist will discuss the necessity of a transfer of providers with the client to discuss
recommendations as to what would be the most clinically sound and ethical course of action
regarding continuity of care. If a client’s case has been closed, the client can be scheduled with
their most recent therapist if available. The client will automatically be scheduled with the
assigned therapist unless the client requests a change of therapist. Reasons for this change
should be discussed with their prior therapist at OSU-N/COTC. If a client file is re-opened as the
student/client re-engages with services, the therapist will fill-out the assessment update form
in Titanium to document reasons that client is re-engaging in services and possible changes
since the last date of service. The assessment update form should be used when it has been
less than a year since the last date of service. If more than a year has passed, the therapist
should complete a new intake. Consent forms and the intake packet should be renewed as well
if the last date of service has been over a year.
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Client Reassignment Guidelines for Therapists
Clients may request a reassignment from their current therapist. We consider each
reassignment on an individual basis to ensure quality of care, responsiveness to client concerns,
continuity of care issues, and coordinated care. Ideally, there would only be one request for
reassignment per client. In most cases, a client will be encouraged to maintain counseling with
their current therapist as there could be therapeutic value in this as well as to avoid a waiting
period for reassignment given the schedule of other therapists. If a client is re-assigned to a
new therapist given the therapeutic necessity of such a change rather than a preference on the
part of the client, the transition will be documented by the current therapist in Titanium. Prior
to the change taking place, the Lead Mental Health Therapist will be consulted regarding
reasons the client is asking for the change. If approved, rationale for such a transition will also
be included in the note in Titanium.
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COUNSELING SERVICES
OUTLOOK FORMS
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To become more accessible to students and staff/faculty inquiring about Counseling Services,
the department has created various Microsoft Outlook Forms for specific needs. Please note
that none of these Forms should be use in a crisis or emergency. A therapist will outreach to the
student or staff/faculty member within 24-48 business hours by either phone or email. This
form/link is currently monitored by the Counseling Services team.
There are currently three Forms, and they are outlined below:
Appointment Request Form
Counseling Services Appointment Request Form (office.com)
This form is to be used by Ohio State Newark and COTC students who are interested in
Counseling Services and would like to request an initial appointment. Some demographic
information is collected such as name, affiliated school, student email, phone number, address,
referral source, If accessibility accommodations are needed, appointment availability, and
method of contact preference (email or phone).
Staff/Faculty Referral Form
Counseling Services Staff & Faculty Referral Form (office.com)
This form is to be used by any Ohio State Newark or COTC staff/faculty who is concerned about
a current enrolled student, and they would like to make a referral for possible services. Some
information is collected such as student name, student’s email, student phone number,
staff/faculty member’s role and contact information, whether the staff/faculty member has
already spoken to the student about Counseling Services, and an open-ended section for any
other concerns regarding the student.
Counseling Services Q&A Form
Counseling Services Q&A Form (office.com)
This form is to be completed by an Ohio State Newark or COTC student who may have any
questions about Counseling Services or mental health. There is only one open-ended question
on this form, and it states, “What would you like to ask a Counseling Services therapist?”
Presentation Request Form
This form is to be completed by an Ohio State Newark or COTC staff or faculty member who has
a presentation request for the Counseling Services team. There are many topics that our
department covers in the field of mental health. The form provides presentation topics that
currently exist in our library which can be fulfilled sooner, as well as an option to create a new
presentation topic with language which indicates that these presentation requests might take
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APPENDIX A –
STAFF/CLIENT USE FORMS
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Office of Student Life
1179 University Drive
Newark, Ohio 43055
740-364-9578
740-364-9646 (Fax)
Student Records Request Form
I _______________________________ (Please print first & last name with
middle initial) am requesting the following records from my clinical
counseling file:
Diagnostic Assessment
Diagnostic Assessment Update
Progress Notes
DSM-V-TR Diagnosis
Termination Summary
Letter of accommodation for Disability Services
Other __________________________________ (Please specify)
I have spoken with my therapist about this records request including the
purpose for the request. Yes or No?
My therapist explained to me the inherent risks associated with taking my
own records from a secure location outside of the Office of Student Life
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including an increased likelihood that a breach of confidentiality can occur
outside of the control of Counseling Services. Yes or No?
I __________________________________ (Please print first & last name
with middle initial) am willing to assume all risks associated with having my
clinical records leave the Office of Student Life and will not hold Counseling
Services or my therapist liable for any breach of confidentiality should my
written records be compromised in any way while in my possession. Yes or
No?
*By signing this document, I confirm that I have received the requested
records corresponding with the following date(s):
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Signature of Client: _____________________________________________
Date: ________________________________________________________
Signature of Therapist: __________________________________________
Date: ________________________________________________________
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*Please allow 1-3 business days for a records request to be fulfilled
depending upon what is being requested. Certain times of the year can be
high volume periods with heavy student traffic which can also lead to
longer waiting periods for fulfilling requests. A copy of the records request
form will be attached to the client’s chart in Titanium. The client will
receive the records requested in a non-descriptive plain envelope directly
from their therapist after signing for them.
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Clinician Chart Review Form
1. Informed consent for treatment is present, signed, and dated by the clinician and
client? Yes or No
2. Informed consent for remote services is present, signed, and dated by the clinician and
client? Yes or No
3. Demographics information in the intake packet is present and signed by the clinician?
Yes or No
4. DSM-V Self-Rated Cross Cutting Symptom Measures are present and have been
completed by the client? Yes or No
5. The safety plan is present and has been completed by the client, signed, and dated by
both the client and clinician? Yes or No
If any questions were answered as a “no” please provide an explanation and recommendations
for corrections:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. If a client had engaged in counseling an intake was completed and signed by the
therapist? Yes or No
7. All fields of the intake were filled out to indicate that they were viewed by the clinician
even with an “N/A” in fields that did not apply to the client? Yes or No
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8. Progress notes were complete based on appointments viewed in Titanium and signed by
the clinician? Yes or No
9. Progress notes contained three sections to outline the note-Presentation, Progress, and
Plan? Yes or No
10. Progress notes were written in complete sentences and were understandable and clear?
Yes or No
11. A termination summary was present if applicable, completed, and signed by the
clinician? Yes or No or NA
If any questions were answered as a “no” please provide an explanation and recommendations
for corrections:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12. Documents such as letters referring clients for accommodations to Disability Services
were present? Yes or No or NA
13. Releases of Information were present if the clinician had contact with other offices on or
off campus? Yes or No or NA
14. Email correspondence was attached to the file in Titanium which contained pertinent
client information such as a records request, request for a therapist to contact another
office regarding the student’s mental health presentation, or sensitive information sent
to the clinician by the client related to their treatment? Yes or No or NA
15. Faxes received were attached to the file in Titanium if coming from another office? Yes
or No or NA
16. A fax cover sheet and confirmation of documents sent is attached to the file in Titanium
along with a brief note as to what was sent to another office or agency? Yes or No or
NA
If any questions were answered as a “no” please provide an explanation and recommendations
for corrections:
______________________________________________________________________________
______________________________________________________________________________
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
*Once reviewed, please sign, and send to the clinician who was being reviewed. The clinician
being reviewed will sign to acknowledge that they have read the feedback provided and will
forward the document to the Lead Mental Health Therapist for further review and add the final
signature. Any concerns will then be addressed during 1:1 supervision between the Lead
Mental Health Therapist and the clinician. The clinician will attach this document to the client
folder inside of Titanium once all signatures have been gathered.
Signature of Reviewer: ____________________________________________
Date: _______________
Signature of Clinician: ____________________________________________
Date: _______________
Signature of Lead Mental Health Therapist: __________________________________________
Date: _______________
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Informed Consent for Services
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Informed Consent for Remote Services
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General Demographic Intake
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DSM-V Cross-Cutting Measures Questionnaire
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Safety Plan
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Missed Appointment Guidelines
• Students will be sent appointment reminders through Titanium at least one to three
days prior to their appointment via their student email and text if permissions have
been given.
• If a client misses an appointment, the client is ultimately responsible for contacting the
therapist and rebooking the appointment.
• A courtesy email will be sent to the student after a missed appointment or a “no show”
to try and rebook and check-in with the student. The email will be attached into the
student’s clinical record in Titanium.
• If a student, misses two consecutive appointments or “no shows” twice in a row, the
student must have a conversation with the clinician before being able to rebook an
appointment. The therapist will also notify the Lead Mental Health Therapist if this
situation were to occur for additional feedback and direction to discuss whether a client
is a good fit for counseling at OSU-N/COTC given their circumstances or if referrals need
to be cultivated.
• If a student re-engages with counseling but misses a third appointment whether
circumstantial or a “no show” the client will be discharged from treatment and provided
referrals.
• It will be explained to the student that missed appointments take up valuable
appointment slots for other students wishing to seek clinical services during high
volume periods who might otherwise be waiting to see a therapist.
• If a client is discharged for lack of consistency in maintaining appointments, this will be
included in the discharge summary in Titanium along with any email correspondence.
• Referrals provided to the student will also be maintained in Titanium within the client’s
file.
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Release of Information (ROI)
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TEMPLATES
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Referral Letter for Office of Disability Services
• Please verify active ROI for ODS is on file and in client’s chart.
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Verification Letter
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Outreach Email to Students from Appointment Request Form
Good afternoon {Student’s Name},
I hope you are doing well so far today. I am reaching out to you as you recently completed a
Counseling Services Appointment Request form. I am here to help make the first point of contact
with you about on-campus Counseling Services!
I am one of the therapists in Counseling Services for students who attend either Ohio State
Newark or COTC. Please feel free to check out our website at the following link for more
information about our office: go.cotc.edu/counseling
A little bit about Counseling Services - we offer short-term (ten sessions per academic year) and
confidential outpatient counseling free to currently enrolled Ohio State Newark and COTC
students. We have three staff therapists: Megan Hughett (fulltime therapist), Charley DePriest
(another full-time therapist) and Stephayne Harris (part-time therapist). You can meet with any
of our staff for counseling services. Our office also helps students connect with local resources,
such as a prescriber or a community-based therapist. If this sounds like something you would be
interested in, we start counseling by scheduling a one-hour intake assessment.
This appointment does need to be held face-to-face, either in our office or virtually. We are
currently scheduling our virtual sessions using Microsoft Teams so if you do not have a
Microsoft Teams account, please create an account before the first virtual session. We do not
schedule the intake appointment until we receive the completed intake paperwork from the
student. I have attached our intake paperwork to this email (there are five forms total). Please
complete and email back the forms to us. Next, one of the staff therapists will reach out to you
via email to schedule an intake appointment. Lastly, please confirm that you are currently
enrolled for at least one class over {Fall/Spring/Summer} semester as this determines
eligibility to engage in our services.
Please do not hesitate to let us know if you have any questions or concerns at this time. We are
here for here for you!
Take good care,
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STUDENT INTERN
PROCEDURES
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Purpose & Guidelines
Counseling Services is committed to guiding and assisting students complete required
internships, specifically with a major in Social Work.
General Expectations –
1. Confidentiality – Within the Office of Student Life you will come into contact with
sensitive information and situations involving enrolled students. It is expected that you
treat individuals with respect and care, adhering to the confidentiality agreement.
Failure to adhere to these expectations will result in referral to The Ohio State
University Social Work program and recommendation for site removal.
2. Time Management – Assigned tasks and projects are important to the departments
within the Office of Student Life. To provide you with a beneficial experience, tasks and
projects have been carefully chosen to not only meet the needs of the division and
our students but are educational and purposeful for your internship. Timeliness and
adherence to deadlines and quality work is imperative.
3. Communication – All forms of communication are expected to be clear, timely and
professional. It is important to remember that you are representing yourself, the
program, the Office of Student Life and The Ohio State University. When you are
working in your internship or on related tasks/projects, you will be viewed as an
extension of our office and expected to act accordingly. It is vital that you ask relevant
questions and be able to communicate to your supervisors and other staff members
within the department your needs and concerns. If you do not understand, ask for
clarification.
4. Appearance – For your internship, as a student intern, casual (e.g., jeans, nice
tops/sweaters) or business casual attire (e.g., khakis, dress slacks, nice tops/sweaters) is
appropriate. More “dressy” attire may be needed for presentations, meetings with off
campus partners or more formal events, but honestly these will be infrequent. Clothing
should not be too revealing, provide appropriate coverage and be free from
unnecessary holes/rips/tears. Typically, on Fridays, staff members will wear jeans and
college/university apparel.
Duties & Tasks
Student intern duties and tasks will vary based on the requirements of the student’s internship
and needs of the department. In general, here are some outlines for duties and tasks that
student interns have completed in the past:
FOOD PANTRY
a. Design and market social media campaigns for promotion and awareness of services.
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b. Research best practices, potential resources, programs for further development.
c. Assist with the necessary functions for the operation of the food pantry.
d. Work on the promotion and awareness of SNAP benefits.
MEDITATION ROOM
a. Create a weekly wellness tip to be posted in the meditation room.
b. Assist with the monitoring of the space.
c. Work on organizing supplies and the upkeep of wellbeing materials.
MENTAL HEALTH
a. Working with community organizations/resources for outreach and service
opportunities.
b. Design and market social media campaigns for awareness and recognition months.
c. Create, develop, and potentially facilitate educational programming.
d. Facilitate tabling opportunities to promote departmental programs and awareness.
e. Assist with assessment efforts, potentially including, but not limited to focus groups and
surveys.
f. Providing intake paperwork to students seeking counseling, scheduling, and making
copies of worksheets and forms used in counseling or group sessions.
OFFICE RESPONSIBILITIES
a. Check buildings for relevant awareness postings to ensure current and good quality.
b. Cover reception area as needed to assist with the triage of student needs.
c. Assist with assessment efforts, including, but not limited to focus groups, surveys, and
data compilation.
d. Software and program onboarding – assisting with the facilitation of new student
resources.
TITLE IX
a. Assist the Director of Student Life/Dean of Students with outreach to community
organizations to establish MOUs.
b. Serve as a member of the Title IX committee to work on awareness & prevention
programming.
c. Develop and facilitate programs based on a community health model.
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Titanium Users Manuel &
Instructions
