APPENDIX J - LET'S TALK PROCEDURE

Effective Date: 
Mon, 06/01/2015
Policy: 

 

  Philosophy

 Let's Talk is an outreach program designed to engage students by providing informal walk-in consultations with CAPS counselors at sites across campus.

Let’s Talk is intended to reach students in distress who might be unlikely to seek traditional mental health services at CAPS. This service is called "informal consultation" and is different from formal counseling. One difference relates to its accessibility. There is no clinical paperwork to fill out, no formal intake, no appointments, and no fees. Students are encouraged to drop by and talk about whatever is important to them, much as they might talk with a TA, residence hall director, or academic advisor and students can choose to remain anonymous if they prefer.  Let’s Talk is advertised to students as a 10-15 minute consultation.  However, CAPS staff may use their clinical judgment to lengthen the time of meeting with the student if necessary.  When the meeting lasts much longer than 15 minutes, staff should let the student know that this is an exception, since Let’s Talk is understood to be a brief consultation.

The goal of a Let’s Talk consultation in general is engagement. The clinician listens, empathizes, problem-solves, provides mental health and general health information, conducts informal needs assessments, offers advocacy and referrals, and -- most importantly -- plants the seeds of a relationship to facilitate the student seeking additional help if necessary. It is akin to the kind of pre-counseling conversation one might have with a student after giving a stress management presentation on campus. As such, it is not considered a "clinical" service.

A number of students are served by a one-time consultation. Others benefit from intermittent, as-needed visits. Some are referred to CAPS for treatment following a brief assessment. Having made a positive, informal first contact with a clinician is usually sufficient to mitigate any lingering barriers to accessing mental health services at CAPS.

Though Let's Talk is designed to be a short-term intervention, occasionally a student may visit more than once or twice when barriers are robust. For example, some students need more help than one visit can provide but find accessing services at the health center very uncomfortable. They may need multiple visits at Let's Talk to be ready to accept a referral. However, Let's Talk is not a substitute for regular counseling and should not be treated as such.

Though the primary mission of Let's Talk is to reach students who do not conventionally seek mental health services, many other students come simply because of the convenience and immediacy. A Let's Talk consultation can often head off a crisis before it happens, facilitate a quick referral to CAPS, and, in many cases, prevent the unnecessary use of CAPS intakes for students who need a simple, brief intervention.

Sites:

Let’s Talk is held at different locations across campus, with emphasis on reaching student communities who may have difficulties accessing traditional mental health services or have a hard time accessing CAPS because of tight schedules or geographic location.  Examples of target of student communities include students of color, first-generation college students, and students in Science, Technology, Engineering, and Math.  Despite the emphasis on hosting Let’s Talk at sites convenient to particular communities, every site is open to all UCSC students. Indeed, many students access a site for other reasons, including fit with one's schedule and interest in talking with a particular counselor. Students find out about counselors by reading their biographies and seeing their pictures on the Let's Talk website.

For a complete list of current Let's Talk sites and times, refer to the CAPS web site: http: caps.ucsc.edu

Procedures

Material Necessary when Conducting Let’s Talk:

Telephone. Most sites provide one for you.
Clock or watch for monitoring time.
Emergency phone numbers: CAPS (9-2628 for the front desk) and UCSC police (9-2345 Emergency; 9-4856 Dispatch).
CAPS laptop with remote access Point and Click
"Let's Talk FAQ"
“Let’s Talk Sign-in Sheet
"Let's Talk Busy Notice"*
"Let's Talk Leaving Early Notice"*
Billboards pointing students to location
5150 procedures, Crisis assessment form, 5150 form, informed consent form to be used only in an emergency.
Site Contact Person for support and to hang notices on door PRN
Advertising Post Card or Brochure

Information to Obtain from Students at Let’s Talk:

Ask students for first and last name at beginning of consultation time, and inform them of option to meet anonymously if they prefer.
After consultation is complete, if counselor has a student’s full name and it seems clinically appropriate, may check the student’s PNC record to see if any other action is warranted.   (For example, it might be appropriate to notify other CAPS staff of the student’s consultation with Let’s Talk. ROI is not needed since let’s talk is part of the CAPS services).

Documentation:

No documentation is required for Let’s Talk consultation meetings with a student.  Remember that let’s talk is considered an informal consultation and not a formal counseling session.
If the Let’s Talk counselor receives information about a student from a third party who has contacted Let’s Talk that may be useful to document in PnC, encourage that person to call the CAPS Crisis Counselor to relay that information.  The CAPS Crisis Counselor can then document in PnC using the Third Party Consultation note.
Let’s Talk counselors do not provide written documentation or case management for students. If a student is requesting written documentation, they should be preferred to phone triage and a formal intake.
Let’s talk counselor collects demographic data about each individual scene for consultation (see demographic sheet) which is aggregated at end of year.

Transferring Care to CAPS:

Once students have engaged with you, they may be interested in becoming a regular client at CAPS.

From the Let’s Talk Meeting, the counselor can schedule the student for a Phone Triage appointment in PnC. In the phone triage block on PnC, please note the student was referred from Let’s Talk.
A student must not be referred directly to an Intake appointment from Let’s talk. They must complete a phone triage because risk questions are not asked during a Let’s Talk contact.
A student may be scheduled for an in-person phone triage (versus phone triage) with the Lets Talk counselor at their office (not at the Let’s Talk location).
If the Let’s Talk Counselor is unable to schedule the Phone Triage appointment (via PNC or by phone with the front office), the student can contact the Central Office to schedule a Phone Triage appointment.

Informed Consent:

Because we do not consider Let's Talk a clinical service, students are not required to sign a "consent for treatment" and "limitations of confidentiality" statement.  Let’s Talk counselors do not have formal conversations about confidentiality at the beginning of the Let’s Talk consultation, as Let's Talk is akin to a conversation one might have with a student after a stress management outreach presentation

Students coming into Let’s Talk are provided a Professional Disclosure statement which describes the service and guidelines for confidentiality, but the student is not asked to sign this form. 
Students are encouraged to read the "Frequently Asked Questions" section of the Let's Talk website, which explains the difference between Let's Talk and formal counseling and outlines the limits of confidentiality. Counselors are also provided with a paper copy of the "Let's Talk FAQ"* to give to students as necessary.
It may be necessary to discuss and clarify the limits of confidentiality with a student utilizing a Let’s Talk consultation in certain circumstances. For example, if a student was on the verge of disclosing something that might require breaking confidentiality, the clinician would stop the process to discuss the issue.

Repeated Visits:

On average, the yearly average of Let’s Talk visits is one-to consultations per year.  Occasionally, a student may be reluctant to accept a referral to more formal counseling.

If a student continues to use Let’s Talk repeatedly (more than 2x per year):

Gently discourage the student from using Let’s Talk as a substitute for counseling
If a period of more extensive engagement with Let’s Talk let’s talk may be warranted, please consult with a member of the Let’s Talk team or management.

Assessing Risk:

Students who utilize Let’s Talk are not asked directly about suicide unless clinical judgment indicates it is warranted. Let’s Talk is not a clinical service and its goal is to provide access to students who may be reluctant to seek traditional mental health services because of its associated stigma.
For students who voluntarily reveal imminent risk, the student is referred to the Central Office for assessment in same day Crisis Services and asked to walk to the Central office at that time (the Let’s Talk counselor should call ahead and alert the on-call CAPS clinician).
In rare cases, the Let’s Talk Counselor may need to walk the student over, or call the Central Office for a CAPS clinician to come to the Let’s Talk location to assist in an on-site assessment.  Calling the campus Police is also an option in urgent cases.

Emergencies:

If the student is psychotic, actively suicidal or homicidal, or might warrant emergency help for other reasons, the following options can be utilized:

If the student needs immediate counseling follow-up but does not need hospitalization. Make a short-term safety and coping plan with the student and schedule a Priority CAPS Intake.
If the student may need hospitalization. If you are concerned that the student needs to be hospitalized:

Call the CAPS Central Office for consultation with management
The Let’s Talk counselor may need to walk the student over to the CAPS Central Office of Campus Police can be contacted for transport
Call the Central Office for a CAPS clinician or management to come to the Let’s Talk location to assist in an on-site assessment and possible hospitalization. .

Unexpectedly Leaving Early from Let’s Talk:

If you have to leave the site early, either to facilitate a hospitalization or for any other reason, leave a copy of the "Let's Talk Leaving Early Notice" on the door.

Absences from Let’s Talk:

Planned absences:

Contact your site to inform them you will be absent and forward a copy of the "Let's Talk Absence Notice" *.  Please have your contact person post the notice on the door of your site during the scheduled Let’s Talk hours

Unplanned absences:

When you call the CAPS front desk to inform them you will be out for the day, please ask them to contact your Let's Talk site. The front desk has a list of all sites and contact names.

Front desk guidelines for unplanned absences:

In the event a Let's Talk clinician calls in sick, please call the person listed under "contact in the event of absence" on the "Let's Talk Master List"* and inform them that Let’s Talk” will not be offered that day.

Follow up with an e-mail with the "Let's Talk Absence Notice"* attached. The contact person should post this on the door.

Responsibilities of Campus Offices Which Host Sites:

Provide an office for the scheduled Let’s Talk time;
Provide a phone, unless arrangements have been made for you to use your own cell phone
Have someone nearby in case of an emergency.  It's occasionally helpful to remind site personnel of this need; we can be easily forgotten in our offices as people go home for the day.

Let's Talk Documents:

All documents are also located in the "Let's Talk Administration" folder on the K drive.  Since the K: drive is not accessible at Let’s Talk sites, it is important that you bring these materials with you to the site.