This section gives a summary and conclusion to the results displayed in chapter four and brings the first three research questions to further discussion.

CHAPTER FIVE DISCUSSION

The final chapter of the thesis summarizes the results of the research, provides detailed discussion and conclusion to the research questions proposed, and give recommendation for the university and college counseling centers and for future research.

I. Discussion

This section gives a summary and conclusion to the results displayed in chapter four and brings the first three research questions to further discussion.

The first question to address is the appropriateness of the accreditation standards from the International Association of Counseling Services (IACS) to be used as the evaluation criteria of Taiwan’s university and college counseling centers. Even though the survey was revised in order for the convenience of participants to answer, it was based on the accreditation standards with strict assessments.

As we have reviewed in the literatures for chapter two, the accreditation standard covers every aspect of the counseling centers and their services. From the responses of the survey, most of the questions were answered properly, and the results show that Taiwan’s counseling centers are on the right track and do meet majority of the accreditation standards.

Furthermore, the accreditation standard has been revised periodically to ensure

that it reflects the changes we face in the counseling field. For example, the last

revision was carried out in 2000, focused on three major targets: counseling service

should be combined with other units of the institute, such as career development or

health services; the most recent developed counseling service theories should be applied to the Center’s services, and; continue to keep the standardization, uniqueness, and categorization of the standards. These revisions were based on the increasing complexity and seriousness of students’ problems, cutting down of budgetary supports, the trend of university education and other factors (Boyd et al., 2003).

The second question to address is between the institute types of Taiwan’s higher education, whether the universities or the colleges fulfill the most criteria of the accreditation standards of the IACS. The third question to address is when looking at Taiwan’s university and college counseling centers as a whole, and concludes whether they have the potentials to be accredited by the IACS. These two questions are discussed together in the following paragraphs since the results showed that are no major significant differences between the two institute types. The discussion follows the order of the results from chapter four, and also simultaneously with the accreditation standards.

1. Relationship of the counseling center to the university or college community

Counseling services are an integral part of the educational mission of the

institution and support the mission in a variety of ways. Besides direct services with

students, such as clinical and counseling services, academic, career, or personal

problems, counselors are also involved in consultation with faculty and staff in

enhancing the education environment. The most critically important is that the

service be administratively neutral. Around 75.7% of the institutes rated themselves

to be neutral and independent in its functions, and about 94.6% of the institutes have

promotional or publicity efforts. Looking at the level of interaction between the

counseling centers with other units of the institute, all institutes answered mostly high

or medium level of interactions. These results show that most counseling centers are putting efforts in working with other units, while maintain neutrality and independency at the same time.

Typically, counseling services are administratively housed in the student affairs unit of the institute and are acknowledged as a valuable component of the overall student services effort. Also, it is essential that the counseling service works closely with the chief student affairs officer and other key administrators to ensure the accomplishment of institutional goals and objectives. The chief student affairs officer, as well as other senior administrative staff, should be fully aware of and appropriately supportive of the complex role of the counseling service. Similar to the accreditation standard, the University Act of Taiwan (Ministry of Education, 2004) states that counseling center should be housed in the student affairs unit, and the management of funding and personnel are responsibilities of the student affairs unit.

Other units within the student affairs usually include campus life and dormitory unit, overseas student office, extracurricular unit, health center, and so on. The counseling center’s resources and promotion work need to work in cooperation with other units. In other words, counseling centers that are independent have better liberty and flexibility in managing funding and personnel. Around 87.8% of the institutes have the counseling centers housed in the student affairs unit, or listed as second degree administratively of the institute. Therefore, about 84.3% of the institutes answered that the chief student affairs officer is whom that the center is administratively responsible to, and to the president for the other institutes. Regard the level of support from the upper administrative unit, 74.3% of the institutes are receiving high level of support, while 17.6% have medium level of support.

However, 68.5% of the institutes think funding or budgetary support for the Center is

adequate. Being housed in the student affairs seems to bring more support to the Centers administratively, where there are more interaction and better communication between the units on campus. On the other hand, it sometimes takes away the independence that the Centers need and may come across problems such as budgetary adequacy.

A significantly sampled survey conducted by Cooper and Archer in 2002 showed that in the United States, about 64% of counseling centers are independent from other units of the institute, 15% are combined with career services, 2% are with health centers, and 17% are housed under other administrative units.

With the merge of different units in mind, we can see that the United States are moving toward the direction of combining the counseling center with other units of the institute. On the other hand, counseling centers are already mostly housed under the house of student affairs office. The administration structure seem to be established more clearly regarding the position of the counseling center within the institute.

2. Counseling services roles and functions

The counseling service should play three essential roles in serving the university

and college community. The most prominent is providing counseling and/or therapy

to students experiencing personal adjustment, vocational, developmental and/or

psychological problems that require professional attention. Second is the preventive

role of assisting students in identifying and learning skills that will assist them in

effectively meeting their educational and life goals. The third role involves

supporting and enhancing the healthy growth and development of students through

consultation and outreach to the campus community. The eight basic program

functions that a counseling service must provide in order to be eligible for accreditation are individual and group counseling or psychotherapy, crisis intervention and emergency services, outreach interventions, consultation interventions, referral resources, research, program evaluation, and training.

Looking at the data acquired from the surveys, all counseling centers in Taiwan provide individual counseling, whereas around 97.3% of the institutes provide group counseling. Around 98.6% of the counseling centers have crisis intervention and emergency services. Also, besides the Center, there are other agencies available both within (93.2%) and near (63.5%) the institutes that provide crisis intervention and emergency services. All institutes provide some forms of outreach interventions, such as workshops, presentations, informational programs, self-help resources, minority or non-traditional students, and some institutes (15.9%) even have credited courses. Consultation interventions are provided by 98.6% of the institutes.

Referral resources are well-utilized between 77% of the institutes and the community, and 94.6% of the institutes have psychiatric resources available through the Center.

Also, over 93.2% of the institutes have referral resources available within the

institution and the local community to meet the needs of students whose problems are

outside the scope of services provided by the Center. About 50% of the institutes are

involved in researches, which is consistent with the low percentage (13.9%) of

involvement in academic or research publishing. About 61.6% of the institutes

conduct regular evaluation of its services and among these institutes, 54.3% uses

comparative data from other institutions in the evaluation process. Around 65.8% of

the institutes provide for the training and supervision of practicum or internship

students and approximately 32% of the Center’s direct counseling services is provided

by the trainees. The other trainings that the Center provide for staff or professional

developments are mostly on regular or irregular bases, with a few institutes that answered no or uncertain. These trainings include individual, group, and general supervision, case conference, Center meeting, workshop, seminars, and off-campus or community seminars. Other related information includes the Center’s total hours in service each week, which is the mean of 48.5 hours per week. The client populations that the Center serve are mainly students, faculty, staff, alumni, and few institutes (21.6%) serves the public.

As we can see, counseling centers across Taiwan are carrying out a lot of activities in concordance with the accreditation standards. However, a higher percentage of self-evaluation and participation in research are in need in order to ensure the quality of counseling services provided, which is the key point of this thesis.

With another look at Cooper and Archer’s research in 2002, it included the order of counseling services that are ranked by counseling centers in the United States.

Primary services include individual counseling, group counseling, consultation, internship training,, and promotional activities. Secondary services include psychological assessment, drug abuse counseling, career counseling, academic advising, and research participations. Similar to this research, counseling centers in Taiwan provide more sufficient services in the primary services category, and also covers the items in the secondary services.

3. Ethical Standards

Professional ethical practice forms the cornerstone of the counseling service.

Maintaining ethical standards and abiding by related laws in the administration of a

counseling center is a very complex and important task. Clear definitions of ethical

and legal questions are not universally applicable, so an understanding of ethical

codes and relevant case and statute law is essential.

Few ethical issues were covered in the survey. Most importantly, 78.9% of the institutes include agency policies and ethical or legal issues as part of the Center’s procedure for training. Other ethical issues acquired are written statement on policies regarding handling of imminent danger (87.3%), policy that case records belong to the Center (31%), and regarding the disposing of confidential materials (44.4%). In addition, confidential materials or case records are also an important part of the ethical standards. Contents of a case folder mostly consist of client’s basic information (97.3%), counseling consent form (60.8%), intake record (56.8%), counseling record (98.6%), and other information such as transcript, psychological assessments, clinical record with on-site psychiatrist, case termination record, client referral sheet and counseling feedback sheet. Moreover, the average length of the case records maintained at the Center is 7.6 years, which is similar to the accreditation standards, where the complete record should be maintained for a minimum of 7 years from the last date of service.

From the above results, we see the counseling centers’ efforts in maintaining and abiding to the ethical standards. However, as mentioned above, it can sometimes be ambiguous about the definitions and may vary among the Centers. From this point we can be even more certain of the necessity for a universal set of evaluation or accreditation standards.

4. Counseling service personnel

The staffing of the Center can be divided into four types: director, professional staff, trainees, and support staff.

The Center’s director should have an earned doctorate from a regionally

accredited university in counseling psychology, clinical psychology, counselor education, or other closely related discipline, with a minimum of 3 years work experience in a clinical and/or counseling setting. The director should hold appropriate licensure, registration, or certification within the period of his or her appointment. Non-doctoral directors should hold a master’s degree in an appropriate field, with a minimum of 5 years of work experience in a clinical and/or counseling setting. Looking at Taiwan’s data, 56.3% of the Center’s directors have a doctoral degree and 40.8% holds a master’s degree, and 72.9% of these degrees are in counseling or related field. However, only 28.2% of the directors are licensed as a counseling psychologist. Even though most directors do not provide direct service to students, qualification and competency should still be taken into consideration when choosing the candidates.

.The professional staff members should have the minimum qualification of a

master’s degree in a relevant discipline from a regionally accredited institution of

higher education. Duties of professional staff include provide individual and group

counseling and/or psychotherapy, assessment, and crisis intervention services, design

and conduct developmental and outreach program activities, provide consultation

services, to students, faculty, and staff within the institute, participate in research and

service evaluation activities, provide necessary training and supervision to trainees,

and perform other assigned functions that contribute to the service offerings of the

center and the academic mission of the institution. When we examine the

professional staffs of Taiwan’s counseling centers, we see some difference between

the full-time and the part-time professional staffs. Roughly two-thirds of the

full-time professional staffs hold a master’s degree, with the remaining having a

bachelor’s degree. Their workload is divided about 50-50 between direct counseling

service and administrative works. As for the part-time professional staff, about 75%

have either a doctoral or master’s degree and their workload (over 73%) are much more concentrated on providing direct counseling services. However, part-time professional staff works about 7.6 hours per week per person, thus explains the emphasis on direct counseling services.

These figures are similar to trainees’ qualification, work hours, and workload.

All of the students working as trainees in the counseling centers are currently in a master’s program. Full-time trainees work average 33 hours per week at the Center, and about 8 hours for the part-time trainees. Workload is divided 50-50 for the full-time trainee between direct counseling services and administrative work, and a higher percentage (over 70%) for the part-time trainees on direct counseling services.

In addition, supervision of interns should be regularly scheduled, at a minimum of 4 hours of supervision for a full-time trainee, at least 2 of which should be individual supervision. The hours of supervision for the interns were not specified in this survey, however, we can see that over 70% of the Centers provide either individual and/or group supervision, either regularly or irregularly.

According to the accreditation standards, staff members should have a balanced workload that affords time for all aspects of their professional functioning. Direct service responsibilities such as intake, individual, and group counseling and crisis intervention should not exceed 65% of the workload on a continuing basis. When we review these figures, we see that full-time personnel (professional staff and trainee) are more stable, yet they have a heavier burden to share the administrative workloads.

In another word, the quality of direct counseling services may be at risk if allocation of workload is not distributed properly to meet the needs of client populations.

Clerical or administrative staffs who deal directly with students should be selected

carefully because they play an important role in the students’ impression of the counseling service and often must follow decision-making protocols about student disposition. Student assistants employed in the Center should be selected carefully and trained sufficiently in confidentiality and privacy issues. They should be assigned tasks limited to their training that do not compromise the confidentiality of clients. All support staff should be given training concerning the operation and function of the counseling services, the limits of their functioning within the counseling service, and issues regarding confidentiality.

Last area to be discussed regarding counseling personnel is the size of staff. The human resources necessary for the effective operation of a counseling service depend, to a large degree, on the size and nature of the institute and the extent to which other mental health and student support resources are available in the area. The complexity of the service offering and training programs also influences staffing needs. It is recommended that staff levels be continually monitored regarding student enrollment, service demands, and staff diversity to ensure that program objectives are being met. Every effort should be made to maintain minimum staffing ratios in the range of one full-time equivalent (FTE) professional staff member, excluding trainees to ever 1,000 to 1,500 students, depending on services offered and other campus mental health agencies. However, the calculation from the survey revealed that the ratio of one FTE professional staff member is to about 4,800 students.

This is a serious problem that needs to be addressed. Without enough personnel to provide the necessary services, students would not be able to get the help that they need in time to resolve their problems.

However, a different condition that exists in Taiwan’s education system is that

besides the counseling centers and professional counseling personnel that provide

these services, there are also other personnel within the school who approaches or are being approached by students directly. The drillmasters and classroom teachers are the other faculties on campus that are in touch with the students on regular bases and their presence would be able to be accounted to compensate the insufficient staffing in the counseling centers. The impression that in Taiwan shows that students who seek help from drillmasters or classroom teachers do not have serious problems as compared to students who seek help from counseling centers. This cultural difference should also be noted. Whether more counseling personnel are required, or the increase of staffing would become a group of people standing by, would also depend heavily on the actual number of students seeking help.

When we look at the data from the United States (Cooper & Archer, 2002), about 41% of the counseling centers have 1 to 4 clinical or professional staffs, 18% of the centers have 7 to 8 professional staffs, and over 40% of the centers have more than 7 professional staffs. In comparison with the number Taiwan’s counseling center personnel, it appears that there is the lack of sufficient staff to share the workload.

5. Center’s location and physical facilities

It is desirable that counseling centers be centrally located and readily accessible to

all students, including those who are physically challenged. Counseling centers

should be physically separate from administrative offices, campus police, and judicial

offices. Items that the Center should incorporate as part of physical facilities include

accessibility for disabilities, sound-proof measures, reception area, secured file

location, counseling and career material library area, assessment room, adequate

individual and group counseling rooms, computer equipment, recording or

observational tools, and website or homepage. Responses from the survey show that

most of the counseling centers in Taiwan meet the requirements of physical facilities.

When reviewing these data, we still need to keep in mind the cultural issues that might come across. For example, Taiwan is a denser populated place that often limits spacing physically and also among individuals. However, this limited spacing enhanced more rapid interaction and efficiency in certain conditions.

6. Limitations

Through the course of this research, some limitations were noted in the procedures. First of all, the return rate of survey only reached minimum sample size for analysis. We might be able to have a more reliable and valid data with higher sample size and might see more significant differences between the institute types.

Secondly, some of the feedbacks or suggestions that were collected along with the returned survey showed area of concern that some Centers were not sure of the purpose of the research and how the data would be analyzed or be put to use. Hence, the survey seemed to be answered with uncertainties.

Thirdly, the accreditation standard was not given to the Centers along with the survey, so the Centers would not have known what the researcher was looking for through the responses.

Lastly, the questionnaire is a subjective answer of individual counseling center’s services. The lack of on-site visit to validate the center’s responses is also a limitation that came across this research.

II. Conclusion

The purpose of this research is to review Taiwan’s university and college

counseling centers using the accreditation standards of the IACS. The answers to the

research questions proposed were generated through data analysis and discussion.

The research conclusion shows:

1. The accreditation standard of the IACS is appropriate for evaluating Taiwan’s university and college counseling centers.

2. There are no major significant differences between the university and college counseling centers in Taiwan regarding their services.

3. As a whole, Taiwan’s university and college counseling centers have the potential to be accredited by the IACS, with well-preparations in advance.

4. Qualification and the distribution of counseling personnel and their workload are the most problematic area in Taiwan’s university and college counseling centers.

III. Recommendation

Recommendation for the adjustments that need to be made in order to enhance the quality of counseling service provided on the university and college campuses of Taiwan and recommendation for future research are discussed in the following.

1. Recommendation for university and college counseling centers in Taiwan

First and most importantly, a clear set of evaluation standard is necessary.

Whether with the establishment of a new set of standards, or adapt an existing standard such as the accreditation standards for university and college counseling centers by the IACS, it will help to synchronize the counseling services across Taiwan and to bring all the Centers on the right track.

Secondly, a board of evaluation committee would be helpful in order to provide

reliability and validity for the evaluations. When standards are unclearly defined, or

when there are exceptional cases, discussion would be able to take place at the right place with the right people. It is suggested that an accrediting body be created within the Chinese Guidance and Counseling Association, where it would also be able to provide on-site visits when necessary in the future.

Lastly, as we have seen from the data presented, adequacy of professional personnel is the most serious problem of counseling centers. If we want to increase the number of staff members, it also means that sufficient funding would be required.

A better allocation of resources and personnel should be examined from all perspectives of the institute, the counseling center, the administrations, and the institute as a whole.

In addition, a study done in the United States in 1998 by Chisolm, criticized that counseling centers on campuses lack the clinical approach and professionalism.

However, a more précised sampled research came out in 2000 by Stone and others, did a analysis on the mental health services of the counseling centers. Stone’s research did not find enough evidence to support Chisolm’s criticisms, but Stone’s research made recommendations reflecting that even the United States are progressing towards professionalism. The recommendations include counseling centers should development a school-wide health information system, conducting researches on nation-wide mental health on school campuses, clearly identify the counseling center’s roles, functions, workload, and policies, such as clinical diagnosis, clinical records, referral follow-ups, and standardized psychological assessments, etc.

2. Recommendation for future research

The most significant improvement that this research need is the return rate of the

survey in order to reach more meaningful results. Provide responses to surveys are

never mandatory, but to achieve improvement in different aspects of the society, surveys help us to collect data and to review our problems. In addition, other methods to collect data could be considered, such as discussion seminars. More well-known organizations such as the counseling associations or even the Ministry of Education would make a better impact on collecting academic data.

Another recommendation is to provide the explanation of accreditation standards

to the respondents. This could be done by attaching the accreditation standards

along with survey, or hold seminars that for all related counseling personnel and

educational individuals, in order to decrease the uncertainties about the survey or

about the research.