Adapting Stepped Care: Changes to Service Delivery Format in the Context of High Demand

Impact Statement With high demand for services at university counseling centers, adjustment was needed to how the treatment was delivered to clients. Adapting an established system of stepped care-planning treatment to match each client's need and in our case prioritizing weekly sessions over-can be enacted in an entire center. This way of delivering services may be more efficient and allows for there to be limits in place to prevent therapists getting burned out. Given the ongoing dilemma for college counseling centers to meet steady increases in demand for services, this study outlines the implementation of an adapted stepped care model in a university counseling center. Our adapted model focused, as do other stepped care models, on treatment planning and lower-intensity interventions, with the addition of the intensive therapy option being provided on a weekly basis. We adopted our stepped care model across a large center and hypothesized that after implementation we would be able to serve a similar number of clients as our previous model and that treatment outcomes for these clients would improve. Descriptive data and regression analyses demonstrated support for our hypotheses, including an increased likelihood of clinically significant improvement for clients postimplementation. Implications for adapting service delivery models using practice-based evidence are discussed.