Counseling Services

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• Scope of Practice

  • Mental Health Counseling

    Counseling is available to eligible students whose concerns fall within the following scope of practice and who reside within the state of Texas. Eligible students include individuals enrolled in degree granting programs that require the student to pay the usual tuition and student service fee.

    Brief individual or couples counseling includes therapeutic assessment and treatment of mental health concerns reasonably addressed through short-term services.  Appointments are typically scheduled every two to three weeks.  Clinicians work collaboratively with students to determine an appropriate plan and length for treatment, with an average of 3-5 sessions.  To serve as many students as possible, the Counseling Center focuses on developing a plan to meet goals that can be accomplished within a brief therapy time frame.  Because treatment is goal-based, formal mental health diagnoses are not provided. 

    Counseling groups are another form of services available to currently enrolled students and if appropriate, may allow longer term contact with Counseling Center services. Group sessions may be topic or theme based and are typically scheduled weekly.  Group leaders require brief consultations with all interested individuals to determine appropriateness for participation, considering factors such as group composition, client readiness, and presenting concerns.

    Concerns commonly treated include, but not limited to:

    • Academic-related issues: difficulty with attention, motivation, perfectionism, test anxiety, or self-management
    • Adjustment problems: difficulty with transitions or new life circumstances
    • Relationship problems: break-ups, interpersonal conflict, communication and assertiveness, family issues
    • Mood or anxiety issues: depression, general or social anxiety, body image issues, low self-esteem
    • Misuse or mild abuse of substances
    • Grief and loss
    • Developmental concerns: exploration or support focused on phase of life issues or concerns related to personal and/or community identity.
    • Coping with interpersonal trauma and traumatic events

  • Crisis Intervention

    Urgent appointments are available Monday through Friday from 10am to 4pm for students experiencing thoughts of harm to self or others or who have recently experienced a traumatic event. The purpose of urgent appointments is to provide immediate support, assess safety concerns, and discuss needs for ongoing treatment. Multiple crisis resources are available during non-business hours and can be found at the Counseling Center Website.

    Concerns appropriate for use of urgent appointments include recent:

    • Thoughts, attempt(s), plan, or intent to die by suicide
    • Thoughts of wanting to physically harm others
    • Sexual or physical assault
    • Death or terminal diagnosis of a loved one
    • Emergence of psychotic symptoms and/or mania

    Urgent appointments are not intended for:

    • Supplemental support between regularly scheduled sessions.
    • Immediate treatment of panic attacks and/or anxiety. These concerns are typically addressed through routine appointments.
    • Support around break-ups or other interpersonal conflicts when there is no threat to immediate safety.
    • Psychiatric hospitalization discharge.  Staff at treating hospitals should work with students to connect with the appropriate level of post-hospitalization care.  This after care typically does not include the short-term counseling provided by the Counseling Center.

  • Reasons for Referral Outside of the Counseling Center

    Often, students benefit from more frequent services, longer-term care, more intensive services, care beyond enrollment at the university, and/or services that extend beyond the end of academic semesters. Those needs which cannot be thoroughly or ethically served within our Center will be referred to community resources for care.  Referrals might occur immediately following the initial assessment or at any time during the treatment process based on assessed needs.  Referral assistance is available to help students connect to providers or resources outside of our Center.

    Clinical issues that will likely be addressed through a community referral include, but not limited to:

    • Assessed need or request for weekly or more frequent sessions
    • Assessed need or request for long-term treatment
    • Assessment that short-term services would not be adequate or appropriate for treatment of presenting concern(s)
    • Reliance on crisis intervention services, indicating need for more frequent sessions
    • Chronic mental health conditions that require specialized care including but not limited to:
    • active eating disorders
    • significant history of or ongoing substance abuse
    • severe symptoms consistent with posttraumatic stress disorder, as assessed by the Counseling Center
    • severe symptoms consistent with obsessive-compulsive disorder, as assessed by the Counseling Center
    • severe symptoms consistent with bipolar disorder, as assessed by the Counseling Center
    • psychotic symptoms with elevated risk of progressive deterioration
    • History of longstanding, maladaptive interpersonal behaviors, which indicate short-term therapy may be ineffective and/or detrimental
    • Chronic suicidality and/or recent history of suicide attempt(s)
    • Severe and chronic self-injury
    • History of extensive prior therapy in this or another setting
    • History of multiple psychiatric hospitalizations with ongoing risk of harm to self or others
    • History of violence or destructive behavior, behaviors that indicate characteristic violent patterns, destructive potential evident, and/or contact with police because of violent or destructive behavior
    • Organic disorders (e.g., head injury, stroke) affecting client's use of talk therapy

    Other reasons students may be referred to community resources include, but not limited to:

    • Unwillingness to complete client data entry or provide information sufficient for clinical assessment
    • Inability to identify a treatment goal appropriate for a brief counseling model
    • Inconsistent attendance (clients are provided the Center’s attendance policy)
    • Poor compliance or engagement with treatment recommendations
    • Ongoing treatment relationship with another mental health provider
    • Inappropriate behaviors towards any Center staff or within the Counseling Center
    • Mandated or required treatment, including but not limited to:

    Counseling ordered through legal or conduct proceedings, such as substance abuse treatment, alcohol education, anger management, parenting education, or domestic violence treatment

    Counseling required by external entities, such as employers, government agencies, or campus departments/classes

    • Comprehensive psychological evaluation of any type, including, but not limited to:
    • Psychoeducational (ADHD, LD) or neuropsychological evaluations
    • Custody or other forensic assessments/evaluations
    • Assessment and documentation for emotional support animals
    • Assessment for State/Federal benefit programs, including social security/disability
    • Fitness-for-duty evaluations
    • Pre-surgical mental health evaluations
    • Individuals not enrolled in certificate or degree granting programs, or in programs that do not require the student to pay usual tuition and service fees (e.g., summer institutes, language training programs, distance learning, etc.)                                       
    • Inflexible (or inappropriate) requests for specific counselor, counselor characteristics, or extremely limited/rigid schedule
    • No staff expertise in the area of the client's concern (e.g., head injury, organic disorder, language processing concerns, etc.)
    • Lack of available appointments, which tends to occur toward the end of academic semesters
    • Any situations in which a clinician, in consultation with Center Leadership, determines that treatment within the Counseling Center would not be beneficial for the student, disrupt functioning of the Center, and/or pose a risk to the Texas State campus

  • Scope of Practice Questions

    Thank you for reviewing this document.  We ask your understanding that the Counseling Center is working to provide the most appropriate services possible for our students and campus community while managing available resources.

    Questions about this Scope of Practice may be directed to the Counseling Center by email counselingcenter@txstate.edu or by calling the Counseling Center 512-245-2208.  Please note that confidential information should not be sent via email. 

• NOTICE OF PRIVACY PRACTICES

  This notice describes how physical and mental health information about you may be used and disclosed and how you can get access to this information. State and federal privacy laws require that we furnish you with this notice. Please review this information carefully.  

   

  Uses and Disclosures for Treatment, Payment, and Health Care Operations 

  The Texas State Counseling Center (CC) staff may use or disclose your protected health information (PHI) for treatment, payment, and health care purposes with your consent. 

  • PHI refers to information in your Counseling Center record that could identify you and that concerns your past, present or future health condition. 

  • Treatment includes when CC staff provide, coordinate, or manage your mental health care and other services related to your mental health care.  

  • Payment – The CC does not charge for services; no payment is involved 

  • Health Care Operations are activities that relate to the performance and operation of the CC.  

  • Use applies only to activities within the Counseling Center (including psychiatrists under contract with the CC) such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you. 

  • Disclosure applies to activities outside the CC such as releasing, transferring, or providing access to information about you to other parties. 

  Uses and Disclosures Requiring Authorization 

  Counseling Center staff may use or disclose PHI for purposes outside of treatment and health care operations when your appropriate authorization is obtained. An authorization is written permission above and beyond general consent that permits only specific disclosures. We will obtain an authorization from you before releasing information for purposes outside of treatment and health care operations. You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that it has already been relied upon in releasing PHI. 

   

  Uses and Disclosures with Neither Consent nor Authorization 

  CC staff may use or disclose PHI without your consent or authorization in the following circumstances: 

  • Child Abuse: If a staff member has reason to believe that a child has been, or may be, abused, neglected, or sexually abused, they must make a report of such within 48 hours to the Texas Department of Family and Protective Services (DFPS) or to any local or state law enforcement agency. 

  • Adult Abuse: If a staff member has reason to believe that an elderly or disabled person is in a state of abuse, neglect, or exploitation, they must immediately report such to DFPS. 

  • Health Oversight: If a complaint is filed against your therapist with their respective state licensing board, they have the authority to subpoena confidential mental health information from the CC relevant to that complaint. 

  • Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and it will not be released by the CC without written authorization from you or your personal or legally appointed representative, a subpoena, or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case. 

  • Serious Threat to Health or Safety: If a CC staff member determines that there is a probability of imminent physical injury by you to yourself or others, or there is a probability of immediate mental or emotional injury to you, they may disclose relevant confidential mental health information to medical or law enforcement personnel. 

  • Worker’s Compensation: If you file a worker’s compensation claim, the CC may disclose records relating to your diagnosis and treatment to your employer’s insurance carrier. 

  • Abuse or Sexual Exploitation by Therapist: Texas law requires a counselor to report client abuse or sexual exploitation by a previous therapist to the appropriate county district attorney and licensing board. 

  • As Otherwise Required by Law: For example, for national security or intelligence purposes. 

   

  Client’s Rights 

  You have the following rights regarding your PHI: 

  • Right to Request Restrictions – You have the right to ask the CC to limit how it uses and discloses your PHI. The CC will consider your request but is not required to agree to it. If the CC agrees to your request, it will put the agreement in writing and will follow the agreement unless you need emergency treatment, and the information that you asked be limited is needed for your emergency treatment. You cannot limit the uses and disclosures that the CC is legally required to make. 

  • Right to Receive Confidential Communications by Alternative Means and at Alternative Locations –You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations (e.g., you may not want your roommate or parents to know that you are being seen and may ask to receive your appointment reminder calls on your cell phone). You must be specific about where/how to contact you. 

  • Right to Inspect and Copy – You have the right to inspect and/or obtain a copy of the PHI contained in your official CC record for as long as the PHI is maintained in the record. The CC may deny your access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, CC staff will discuss with you the details of the request and denial process. 

  • Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. CC staff may deny your request under certain circumstances. On your request, CC staff will discuss with you the details of the amendment process. 

  • Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization. On your request, CC staff will discuss with you the details of the accounting process. 

  • Right to a paper copy – You have the right to obtain a paper copy of this notice upon request. 

   

  Counseling Center’s Duties: 

  The CC is required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI. The CC reserves the right to change the privacy policies and practices described in this notice at any time and to make the new notice provisions effective for all PHI that it maintains. 

   

  Questions and Complaints 

  If you have questions or feel your privacy rights have been violated, please contact the Counseling Center Director at 512-245-2208. If you believe your privacy rights have been violated, you may also file a complaint directly with the United States Department of Health and Human Services at https://www.hhs.gov/hipaa/filing-a-complaint/index.html. We will not retaliate against you in any way for filing a complaint.  

   

• CONFIDENTIALITY POLICY

  The following information is posted here for reading review only. If a form needs to be completed/signed, Counseling Center staff will guide a student through the process.

  Federal and state regulations require that we explain your privacy rights and how we maintain the confidentiality of your information. All aspects of your participation in counseling at the Counseling Center, including the scheduling of appointments, content of counseling sessions, all contents of counseling records, and outcomes of counseling, are confidential as required by federal and state law. The Counseling Center maintains a confidential record of your counseling services and you have access to your own file only. If you are participating in couples/relationship counseling or group counseling, a separate record is kept for each individual, and all confidentiality policies apply independently to each record. Each person has access to their own file and records only.

  Counseling records consist of an electronic file and database components. All parts of your record are highly secured and are protected by the same confidentiality and privacy laws. Clinicians within the Counseling Center may share your personal health information with each other. In addition, in order to provide the most effective and comprehensive services, Counseling Center clinical staff may consult with the providers in the Student Health Center when the student has been or will be referred from one center to the other.

  Only professional counseling staff may access clinical progress notes, test data, or other clinical information in your file. Support staff only have access to contact and demographic information and diagnostic codes for the purpose of statistical tracking and reports. No record of counseling is made on an academic transcript. The Counseling Center retains ownership of all physical records and is responsible for establishing policies regarding the retention of counseling records. At this time, we retain counseling records for 7 years after service is terminated. We do not release your information to anyone without your written permission, except when required and allowed by law. Exchange or release of any document(s) contained in your counseling record to the Student Health Center will require you to submit a Release of Information request. Please contact the Counseling Center at 512-245-2208 for further assistance.

  Exceptions to Confidentiality

  • Texas law requires that clinicians who learn of or have strong suspicions of child abuse or neglect report this information to Department of Family and Protective Services or law enforcement personnel. This pertains specifically to knowledge of abuse or neglect of a client who is younger than 18 years of age; any child younger than 18 years of age suspected of being at risk of abuse or neglect;  or abuse or neglect by a client toward a person who is younger than 18 years of age.
  • Texas law requires abuse or neglect of elderly or disabled persons to be reported to the proper authorities.
  • If a clinician assesses that you pose an imminent danger to yourself or others, the clinician may do what is necessary to protect life within the limits of the law. Appropriate university officials and staff (e.g. University Police, Vice President for Student Success, Housing and Residential Life staff, etc.) who bear responsibility or may incur liability for the welfare of Texas State students may be notified about the student's situation. Only university officials and staff who have a "need to know" to protect the safety of students will receive this information.
  • A legal subpoena can require the release of records kept at the Counseling Center or require a clinician to give testimony at a court hearing.
  • Texas law requires a clinician to report client abuse or sexual exploitation by a previous therapist to the appropriate county district attorney and licensing board. Client anonymity will be preserved if requested.
  • Nonidentifiable demographics and statistical client data may be used for research studies and institutional reports.

  Email

  Confidentiality is essential to the counseling process and cannot be assured with email.

  We cannot guarantee that the contents of an email message will remain confidential. While we will do our best to keep your communication private, email usage can be monitored and the content of your personal messages may be read by others. Staff access to email is limited to the Counseling Center business hours. Also, you have no way of knowing if a specific staff member is unavailable due to illness, vacation, or other reasons. This means that your message may not be read immediately. If time is of particular concern for you, please consider calling our office when requesting information.

  Email is not an appropriate medium for individual questions regarding personal or career counseling. It is most appropriate for requesting general information regarding services, resources, or other campus information. Our staff does not respond to inquiries from our clients regarding specific counseling issues.

Licensing Board Complaints and Contact Information

Consumer Complaint RE: Privacy and Security of Health Information

Request for Counseling Center Records