A Survey of Demographic, Professional, and Clinical Characteristics of Clinicians in University Counseling Centers

Compared with counseling in other mental health service settings, college counseling has been identified as “the intersection of a professional activity and an environment … developed from the merging of several movements: vocational guidance, mental health, and student personnel work” (Dean & Meadows, 1995, p. 139). With recent trends demonstrating increasing rates of mental health difficulties (e.g., anxiety, depression, suicidal thoughts) among students over time (Xiao et al., 2017), college counseling as a field has attempted to address these and other problems by unifying through professional organizations (e.g., the American College Counseling Association), developing professional standards and accreditation (e.g., the International Association of Counseling Services), and defining college counseling centers’ roles and responsibilities (International Association of Counseling Services, 2017). These broad shifts toward honing the identity of college counseling have resulted in a level of unification across the field, which has been demonstrated in annual surveys conducted by organizations such as the Association for University and College Counseling Center Directors (AUCCCD; LeViness et al., 2019). Such efforts have served to unify a professional identity and scope of practice for college counseling.

Despite movement toward unification, university and college counseling centers (UCCs) operate in a variety of unique campus environments (e.g., rural vs. urban, small vs. large student body, residential vs. nonresidential, full‐time vs. part‐time), necessitating flexibility to meet the needs of students across these contexts. The broad array of campus environments and needs underscores the importance of evaluating the function of the UCC within the larger university system prior to determining a structure or service delivery model (Brunner et al., 2017; Mitchell et al., 2019). Pressures to provide mental health services to meet students’ needs have resulted in the use of a range of clinical service models, including a wide variety of interventions targeted at prevention, intervention, and postintervention (LeViness et al., 2019). For example, Brunner et al.'s (2017) comprehensive counseling center model identifies how UCCs can provide primary, secondary, and tertiary interventions across the domains of clinical work, consultation, outreach/prevention, and training. Such models encompassing primary, secondary, and tertiary interventions align with the values of counseling but, more so, holistically address the needs and wellness of increasingly diverse student populations (Gelso et al., 2014; Packard, 2010). In a differing approach to managing campus needs, some models posit that UCCs naturally align with ultrabrief, episodic treatment frameworks or may benefit from considering session limits (Coleman et al., 2021; Shefet, 2018). In addition, with an increasingly diverse student population (Espinosa et al., 2019), UCCs have sought to provide services that are sensitive to the needs of students who hold marginalized identities, with a focus on social justice and cultural sensitivity (Shelton, 2017). Thus, in many ways, UCCs continue to operate from a framework that suits the individual needs of their students and larger campus environment.

One way in which researchers can continue to examine the dynamic landscape of the college counseling field is through large, national surveys. Such surveys have been conducted in the broader field of mental health practice as well as college counseling more specifically. In the following section, we examine recent trends in mental health practice.

Current Trends in the Mental Health Field

Examining trends in mental health services can provide practitioners and scholars with a useful overview of a variety of factors, including clinical practices, service provided, and demographics of both clients and practitioners, and such data can provide researchers, administrators, and practitioners with information that contributes to the building of theoretical frameworks, the creation of practical operating models, and a means to address overarching problems in college counseling. A popular, decennial survey examining trends among clinical and counseling psychologists registered as members of Society for the Advancement of Psychotherapy (American Psychological Association Division 29) was most recently completed by Norcross and Rogan (2013). Findings from the 428 participants (401 after removal of participants who did not qualify) indicated that most practicing psychologists had earned a PhD (n = 368, 86%); were an average of 63 years old; and identified as heterosexual (n = 402, 94%), male (n = 267, 77%), and White (n = 379, 95%). The authors also indicated that diversity related to ethnic background had increased since the survey began in 1981. In terms of time spent providing services, participants reported spending the majority of their time engaging in psychotherapy (57%), followed by diagnosis and assessment (9%), teaching (6%), and clinical supervision (5%), among others. Psychologists reported spending most of their time devoted to therapy providing individual therapy (80%), followed by couples/marital therapy (13%), family therapy (4%), and group therapy (3%). Regarding theoretical orientation (N = 393), the top three approaches included psychodynamic/relational approaches (n = 106, 27%), followed by integrative/eclectic (n = 97, 25%) and cognitive (n = 66, 17%) approaches. Eighty‐eight percent (n = 345) of participants also indicated that they were satisfied with their career to some degree. These findings provide a picture of general characteristics of psychologists, although the results are not generalizable to other mental health professions (e.g., social work, counseling).

Similarly, Barth and Moody (2019) sought to explore trends in the use of theoretical orientation among mental health counselors. Their sample (N = 140) consisted of a majority of female (n = 89, 64%), White (n = 128, 91%), and licensed counselors (n = 129, 92%) who averaged 22 years of experience and worked mostly in private practice. Findings indicated that the top four theories used among mental health counselors were cognitive behavioral therapy, person‐centered therapy, strength‐based therapy, and solution‐focused therapy. The researchers also examined self‐report data of the most frequently used counseling skills, which included demonstrating empathic understanding, providing general encouragement, encouraging self‐care, conveying genuineness, and demonstrating unconditional positive regard. Skills associated with Rogers's (1957) core conditions scored highly across participants regardless of their theoretical orientation, and the majority of respondents reported being influenced by multiple theories rather than one theory alone (Norcross, 2005). Compared with Norcross and Rogan's (2013) findings with psychologists, counselors also endorsed using a variety of therapeutic frameworks, although they were much less likely to endorse using psychodynamic approaches. Consequently, there may be similarities and differences across mental health practitioners regarding their use of treatment approaches.

Current Trends in College Counseling

In the realm of college counseling, compared with other areas of counseling, there has been less of a focus on practitioners’ personal and clinical characteristics, with researchers instead focusing on larger trends, including service delivery models and client characteristics. The paucity of research regarding personal and clinical characteristics of practitioners leaves a gap in the literature, eluding a more complete understanding of college counseling. One exception to this pattern is a study conducted by Worthington and Atkinson (1993), who surveyed 208 UCC staff psychologists regarding their responsibility and etiology attributions, theoretical orientations, and counseling strategies. Results indicated that participants identified as primarily White (n = 162, 78%) women (n = 116, 56%) with degrees in counseling psychology (n = 139, 67%). Furthermore, the theoretical orientation of the participants was primarily eclectic (n = 71, 34%), followed by “other” (n = 57, 27%), psychoanalytic (n = 20, 10%), cognitive behavioral (n = 19, 9%), person centered (n = 14, 7%), existential (n = 11, 5%), Adlerian (n = 5, 2%), and Gestalt (n = 3, 1%). (Percentages do not total 100 because of rounding.) This study, albeit outdated, provided the first overview of how college counselors were practicing within UCCs. More recently, Rosenbaum and Weatherford (2019) described how a shift in the field from generalist practitioners toward specialization can blur the understanding of scope, responsibilities, and characteristics within UCCs, highlighting the utility of a more detailed overview of how college counselors operate in current‐day UCCs.

Over time, larger annual surveys have been conducted to provide an overview of UCC trends, such as that conducted by AUCCCD. LeViness et al. (2019) collected a variety of data from UCC directors, including the average time spent providing services by full‐time staff counselors. Findings indicated that the majority (64%) of time was spent providing direct services, followed by indirect services (21%), administrative services (13%), and other services (2%). UCC directors also reported that their staff primarily identified as White (n = 1,595, 72%), cis‐female (n = 1,712, 74%), and heterosexual (n = 1,560, 84%), which is similar to the findings of broader demographic surveys of mental health practitioners outside of UCCs (e.g., Barth & Moody, 2019; Norcross & Rogan, 2013).

Most recently, the Center for Collegiate Mental Health (CCMH, 2020) published demographic data of college counselors across a large sample, among other data collected from the annual survey. As with other research findings with general mental health practitioners (e.g., Barth & Moody, 2019; Norcross & Rogan, 2013) and findings from practitioners working in UCCs (e.g., LeViness et al., 2019; Worthington & Atkinson, 1993), college counselors identified as primarily female (n = 1,291, 71%) and White (n = 1,256, 69%). Additional findings indicated that the majority of college counselors had earned a PhD (n = 575, 32%), that they had earned their highest degree in counseling psychology (n = 555, 34%) or clinical psychology (n = 537, 33%), and that they were fully licensed (n = 1,317, 73%).

Whereas AUCCCD annually surveys directors of both 4‐year institutions and community college counseling centers (CCCCs) and the CCMH annual report focuses exclusively on data from 4‐year institutions, other researchers have focused specifically on the demographics and operations of clinicians working in CCCCs. The American College Counseling Association (2015) surveyed 159 professional counselors who provided personal counseling in community college settings regarding their professional activities and characteristics. Eighty‐two percent (n = 131) of participants indicated that their institutions provide mental health counseling services, and the majority of participants held master's degrees (n = 108, 81%). The majority of respondents also identified that they were licensed as a licensed mental health counselor or licensed professional counselor (n = 62, 47%), followed by licensed psychologist (n = 13, 10%) and licensed independent clinical social worker (n = 12, 9%). (Depending on the question, the number of participants who responded varied from 131 to 159.). The results of the survey support the idea that clinicians working in CCCCs may differ professionally from clinicians working at 4‐year institutions (CCMH, 2020). Furthermore, although limited data were collected from directors of CCCCs, data from the most recent AUCCCD survey (LeViness et al., 2019) indicated that CCCCs reported providing fewer hours for clinical services and serving a lower percentage of students than did counseling centers at 4‐year institutions.

Although providing more nuanced information regarding practitioners’ demographic and professional characteristics, both the AUCCCD annual survey (i.e., LeViness et al., 2019) and the CCMH (2020) annual report do not explore the primary theoretical approaches used by college counselors. Whereas the AUCCCD survey explores directors’ perceptions of time spent on various activities, a self‐report measure of college counselors is not used. In addition, neither survey addresses job satisfaction of college counselors, which can be a valuable metric of UCC climate and rate of burnout. Our study sought to address questions not answered by the extant literature.

The Current Study

The purpose of this research study was to provide a broad overview of demographic and professional characteristics from a diverse sample of college counselors who worked at 4‐year institutions using self‐report data, including the primary theoretical approach of college counselors, time spent engaged in professional activities, time providing services, and overall job satisfaction. We chose to survey 4‐year institutions for two reasons. First, the majority of extant research on our variables of interest has been conducted with 4‐year institutions, thus lending to comparison of data (e.g., CCMH, 2020; LeViness et al., 2019; Worthington & Atkinson, 1993). Second, CCCs seem to function differently from counseling centers at 4‐year institutions, in that data from CCCs represent outliers in national surveys (i.e., LeViness et al., 2019). The following research questions guided this study:

Research Question 1: What are the demographic and professional characteristics of college counselors?

Research Question 2: What are the primary approaches and/or theoretical orientations used by college counselors?

Research Question 3: How much time do college counselors spend engaging in various professional activities?

Research Question 4: How much time do college counselors spend providing various services?

Research Question 5: What is the overall job satisfaction of college counselors?

Method

Procedure

We used a descriptive cross‐sectional design that used multimethod survey research data collection methodology (Gall et al., 2007). We were interested in examining a sample of mental health practitioners working in UCCs. Thus, we first identified a list of all 4‐year institutions of higher education using the Integrated Postsecondary Education Data System (National Center for Education Statistics, 2017). Then, we applied a simple random sample procedure in Microsoft Excel to select institutions for which we would identify potential participants. Using the randomized list, we visited each institution's web page and attempted to obtain the name and physical address of a college counselor. If multiple counselors were available, a random number generator (Urbaniak & Plous, 2013) was used to select a clinician from the list of available practitioners. After the participant was selected, their name and physical address were identified and entered into a Microsoft Excel spreadsheet.

Following the identification of the sample, we followed the tailored design method recommendations for survey research (Dillman et al., 2014). We physically mailed three rounds of notices through the U.S. Postal Service to selected participants inviting them to complete the survey materials through Qualtrics (https://www.qualtrics.com/). Inside the initial letter, participants were provided with a $1 incentive to participate in the study. If participants elected to complete the study in response to the first letter, they then completed the survey online per a URL found in the invitation letter directing them to the Qualtrics survey. Participants were then asked to read the consent form, enter their personal access code, and make a decision regarding their participation in the study. Participants also had the option to opt out of the study at any time, which removed them from future invitations to participate. If participants did not opt out of the study or complete the study, they were mailed a reminder after 3 to 4 weeks. A second, final reminder was sent 4 weeks after the initial reminder to remaining participants. Of the 500 participants identified, 23 of the letters were returned because the clinician no longer worked at the institution. The final total sample size was 477, with 205 participants completing the study in its entirety (43% response rate).

Participants

Participants identified as primarily female (n = 154, 75.1%), followed by male (n = 48, 23.4%); one participant (0.5%) preferred not to disclose their gender identity. The ethnic background of the participants was identified as primarily White (n = 166, 81.0%), followed by Black/African American (n = 17, 8.3%), Asian (n = 6, 2.9%), Hispanic/Latino (n = 5, 2.4%), multiracial (n = 5, 2.4%), Native Hawaiian or Other Pacific Islander (n = 1, 0.5%), African (n = 1, 0.5%), Eurasian (n = 1, 0.5%), and White/Latina (n = 1, 0.5%). The average amount of postgraduate counseling experience was 13.6 years (SD = 9.58), and the average amount of college counseling experience was 9.2 years (SD = 8.42). The average caseload of the sample was 23.2 clients (SD = 18.57), and the average number of clinicians working in the participants’ UCC was 6.1 (SD = 6.42). The highest education level of most participants was a master's degree (n = 115, 56.1%) or a doctoral degree (n = 85, 41.5%), while one participant (0.5%) had achieved a specialist’ s degree and two (1.0%) described themselves as ABD.

The majority of participants were fully licensed (n = 183, 89.3%); 12 participants (5.9%) were working under an initial provisional license. Seven participants (3.4%) identified other licensure statuses, such as licensed professional counselor supervisor, no license, or resident. Furthermore, most participants worked full‐time in their institution's counseling center (n = 178, 86.8%), some worked part‐time (n = 22, 10.7%), and three (1.5%) identified other employment arrangements. Most participants worked at 4‐year public (n = 73, 35.6%) or private (n = 72, 35.1%) universities, whereas a smaller number worked at 4‐year private (n = 43, 21.0%) or public (n = 9, 4.4%) colleges. In terms of institution size, 74 of the participants (36.1%) worked at small institutions (1,000–2,999 students), followed by 54 (26.3%) working at medium institutions (3,000–9,999), 47 (22.9%) working at large institutions (10,000 or more students), and 28 (13.7%) working at very small institutions (<1,000 students).

Measures

Demographic form. Basic demographic data were collected, including age, gender identity, race/ethnicity, sexual orientation, highest educational level, licensure status, years of experience practicing, average caseload size, number of clinicians in center, institution type, institution size, involvement and percentage of time spent in various professional activities, involvement and time spent providing services, and personal therapy incidence and length.

Theoretical Orientation Profile Scale–Revised. The Theoretical Orientation Profile Scale–Revised (TOPS‐R; Worthington & Dillon, 2003) is an 18‐item instrument that was developed to measure theoretical orientation among counselors and trainees. Respondents rate items on a 5‐point Likert‐type scale ranging from 0 (not at all) to 4 (completely), with six factors that correspond to six dominant theoretical orientations. Worthington and Dillon (2003) reported through an exploratory factor analysis that the six factors accounted for 87.5% of the variance in their data and that factor loadings for all items ranged from .86 to .96. In a later study, Demir and Gazioğlu (2016) translated the TOPS‐R into Turkish and added three items related to a postmodern/solution‐focused orientation. In this study, we decided to include the revised version of the instrument that includes the addition of the postmodern/solution‐focused orientation (Demir & Gazioğlu, 2016). In a recent study using the TOPS‐R with school counselors, researchers found Cronbach's alphas ranging from .88 to .98 across the seven subscales (Mullen et al., 2019). Reliability coefficients in this study for scores on each subscale were as follows: Psychoanalytic or Psychodynamic (α = .95), Humanistic or Existential (α = .96), Cognitive or Behavioral (α = .95), Family Systems (α = .96), Feminist (α = .93), Multicultural (α = .95), and Postmodern or Solution‐Focused (α = .97).

Job satisfaction. Andrews and Withey's (1976) Job Satisfaction Questionnaire is a five‐item scale designed to measure general job satisfaction. Respondents rate items regarding their job satisfaction on a 7‐point Likert‐type scale ranging from 1 (terrible) to 7 (delighted). Rentsch and Steel (1992) reported that this instrument had an acceptable reliability (α = .81) and that the instrument indicated a high degree of convergent validity with two other scales of job satisfaction, the Job Descriptive Index (Smith et al., 1969) and the Minnesota Satisfaction Questionnaire (Weiss et al., 1967). The Cronbach's alphas for the Job Satisfaction Questionnaire have ranged from .79 to .85 in recent research (Chang et al., 2015; Mullen et al., 2018, 2019). Scores on this instrument indicated good reliability with this sample (α = .83).

Data Analysis

Following the data collection process, the data were entered into a database and analyzed using SPSS Statistics for Windows (Version 25.0). Descriptive analyses were used to examine theoretical approaches, primary approach to counseling, time spent in various professional activities, and percentage of time providing services. Prior to comparing TOPS‐R total scores across gender and highest degree earned, we performed tests of normality. The Shapiro‐Wilk statistic (Shapiro & Wilk, 1965) indicated that these data violated the assumption of normality. Therefore, a nonparametric analysis of differences was indicated. Mann‐Whitney U tests (Mann & Whitney, 1947) were used to compare differences in theoretical orientation using TOPS‐R scores across gender identity and highest degree earned.

Results

Research Question 2

The results of the TOPS‐R indicated that participants identified primarily with cognitive or behavioral orientations (M = 7.38, SD = 2.60), followed by multicultural (M = 6.89, SD = 2.78), humanistic and existential (M = 5.79, SD = 2.86), postmodern and solution‐focused (M = 5.33, SD = 3.18), family systems (M = 4.23, SD = 2.91), psychoanalytic/psychodynamic (M = 3.95, SD = 3.04), and feminist (M = 3.83, SD = 3.04) orientations. Along with completing the TOPS‐R, participants were asked to identify their primary way of counseling. Most clinicians identified their primary way of counseling as cognitive behavioral, integrative, humanistic, mindfulness based, psychodynamic, and solution focused, respectively. The frequencies of participants’ primary approach to counseling are presented in Table 1.

Table 1

Primary Approach to Counseling

Note. N = 205. For brevity, primary approaches with fewer than five responses and nonresponses are not included. REBT = rational emotive behavior therapy; ACT = acceptance and commitment therapy; DBT = dialectical behavior therapy; MBCT = mindfulness‐based cognitive therapy.

A Mann‐Whitney U test was conducted to determine whether there were differences in theoretical orientation on the TOPS‐R scores between male‐identified and female‐identified participants. No statistically significant differences were found at the p < .05 level. A second Mann‐Whitney U test was conducted to determine whether there were differences in theoretical orientation between participants who had earned a master's degree and participants who had earned a doctoral degree. There was a significant difference in the scores for cognitive behavioral orientations for those with a master's degree (Mdn = 9) and a doctoral degree (Mdn = 6), U = 4,097, z = –2.02, p = .04, r = .14. There was also a significant difference between the scores for family systems orientations, with master's‐level clinicians (Mdn = 6) reporting the use of this model more than those with a doctoral degree (Mdn = 3), U = 3,275, z = –4.06, p < .001, r = .28. Finally, master's‐level clinicians (Mdn = 6) reported using postmodern and solution‐focused orientations significantly more than did those with a doctorate (Mdn = 4), U = 3,258, z = –4.11, p <.001, r = .29.

Research Question 3

As shown in Table 2 and Figure 1, participants spent most of their time engaging in therapy with clients (49%) and administrative duties (13%). The next most frequent activities included diagnosis and assessment (9%), clinical supervision (7%), consultation (7%), and training (6%). Participants spent 5% of their time or less teaching, doing research, or completing other activities.

Figure 1

Percentage of Time Spent Engaging in Professional Activities

Note. Percentages do not total 100 because of rounding.

Table 2

Percentage of Time Spent on Professional Activities and Services Provided

Note. N = 205. Percentages do not total 100 because of rounding.

Research Question 4

As shown in Figure 2, participants indicated that they spent over half (53%) of their time providing individual counseling services, followed by crisis services (8%); outreach (8%); consultation with faculty, staff, or parents (6%); and single‐session consultation with students (6%). Participants spent 5% of their time or less collaborating with other departments, providing group therapy, conducting workshops, providing career counseling, providing couples counseling, performing psychological testing, providing family therapy, or completing other activities (see Table 2).

Figure 2

Percentage of Time Spent Providing Services

Note. Percentages do not total 100 because of rounding.

Research Question 5

Overall, participants reported feeling mostly satisfied to pleased regarding their overall job satisfaction (M = 5.60, SD = 0.86). Participants reported the highest satisfaction with the work they did on the job (M = 6.05, SD = 0.86), followed by their coworkers (M = 5.8, SD = 1.15), overall feelings about their job (M = 5.63, SD = 1.09), the overall work environment (M = 5.39, SD = 1.16), and the resources available at their job (M = 5.15, SD = 1.28).

Discussion

The results of the present study contribute to the literature by providing a better understanding of personal and clinical characteristics of mental health providers in UCC settings. Furthermore, the present study offers novel findings through obtaining a diverse sample of self‐report data from college counselors that include factors such as the primary theoretical approach of college counselors, time spent engaged in professional activities, time spent providing services, and overall job satisfaction.

Several similarities and differences exist between the results of this study and the findings from literature previously referenced. As with the study by Barth and Moody (2019), the majority of participants reported identifying as White, female, and fully licensed as clinicians. Important to note is the racial/ethnic makeup of our sample, given that researchers have supported the theory that the number of therapists of color in UCCs predicts the percentage of students of color who seek services (Hayes et al., 2011). Intentionally engaging in hiring practices that promote diversity among the staff at UCCs may thus reduce the barriers to help seeking that students of color often encounter when seeking mental health services on campus.

Furthermore, cognitive or behavioral, humanistic (e.g., person‐centered), and solution‐focused approaches were found to be popular among participants in the current study. A range of factors may provide additional context for the findings related to counselor theoretical orientation and primary approach to counseling. For example, given the high demand for services at UCCs previously referenced, there may be pressure for practitioners to rely on theories or approaches of the cognitive or behavioral variety that align with outcome measurement and short‐term treatment models. As a result, UCC practitioners may be more hesitant to apply insight‐oriented approaches to treatment (e.g., psychoanalytic/psychodynamic) that are historically associated with longer term therapy.

The results of the present study may also reveal biases in graduate‐level training programs, such that cognitive and behavioral theories are prioritized over alternative conventional theories of counseling. Finally, the findings indicated higher scores for master's‐level practitioners compared with doctoral‐level practitioners in the use of cognitive/behavioral, family systems, and postmodern and solution‐focused orientations. Such responses may indicate stricter adherence to a single framework for those with master's‐level training or a higher rate of technical eclecticism or theory integration among practitioners with doctoral credentials. This finding could also support the idea that certain approaches are more of a focus in master's‐level training programs than in doctoral‐level training programs. Further considerations related to theoretical orientation and primary approach to counseling are expounded upon in the Limitations section.

Notably, participants reported that they used nearly two thirds of their time to engage in therapy with clients and complete administrative tasks (e.g., clinical documentation). The distribution of professional activities found in the current study appears to prioritize direct services to students, which may be due to some UCCs not having formal training programs (e.g., programs for practicum students or interns) or embedded resources such as prevention services that further diversify professional activities. Brunner et al. (2017) comprehensive counseling center model is one example for how UCCs can extend beyond tertiary intervention (e.g., clinical services) to also provide primary (i.e., promotion of well‐being) and secondary (i.e., crisis intervention) services with the goal of increasing student well‐being and retention. Such a model may serve to diversify task variety for clinicians beyond direct services to clients (e.g., individual counseling).

The description of professional activities also highlights a trend toward a narrowing scope of practice within UCCs to accommodate higher acuity of presentation and demand for services on campuses. As suggested in the most recent CCMH annual report (CCMH, 2020), prioritizing access to individual counseling services above the dosage of treatment may diminish treatment outcomes or extend the window of treatment for clients. In addition, as Mitchell et al. (2019) posited, it is important to consider the function and role of the UCC in relation to the rest of the community. For example, some UCCs may have strong resources for community referrals to help manage clinical load and provide an appropriate level of care, whereas UCCs in rural areas might have fewer options for referring students off campus for services. Accordingly, UCCs may benefit from consideration of allocating resources for more campus‐wide, systemic approaches toward student mental health and well‐being when possible.

Despite the potential pressures faced by college counselors to provide direct services in a time‐limited, effective manner, participants in this study reported a high level of overall satisfaction with their jobs. Such findings seem to contradict the idea that counselors in UCCs are experiencing high levels of burnout (e.g., Wilkinson et al., 2017) because of an increased need for services and higher severity of client presenting problems. Further data, particularly qualitative data, are needed to expand on factors that increase a sense of satisfaction in working at UCCs and how this affects clinicians’ effectiveness in their clinical and administrative practice.

Data from our study regarding specific services provided highlight the dominance of individual counseling at contemporary UCCs in comparison with other services that college counselors provide. The limited time allocated to services such as group therapy, workshops, and collaboration with campus partners underscores potential pressures for UCCs to prioritize individual approaches to treatment over the systemic, developmental, and culturally attuned models inherent in the origins of counseling (Gelso et al., 2014). Accordingly, UCC administrators and stakeholders within higher education will be presented with an opportunity to reassess organizational missions, visions, and values as they relate to student well‐being and to more thoroughly evaluate the environment that practitioners operate within.

Limitations

Several limitations of the current study should be noted in an effort to inform future research. Foremost, although an advantage of the study was the self‐report data collected directly from UCC staff, a limitation exists with respect to potential gaps between self‐report approaches and actualized clinical practice. That is, the current study offers no means of confirming the congruence between self‐report theoretical approach to counseling and true implementation of the respective framework. Accordingly, the current study was unable to measure the participants’ fidelity to theory application or the degree of theory integration or eclecticism that may be applied.

A second limitation concerns sampling methodology. Although the use of simple randomization potentially increased the generalizability of the findings, the multitiered sampling process could have skewed toward the selection of specific clinicians who worked at smaller institutions. The most recent data support that there is a trend toward smaller institutions employing fewer staff at their counseling center (LeViness et al., 2019), meaning that if a small institution was randomly selected, clinicians working at this center would have a higher chance of being selected for the study than a clinician working at a center with a larger number of employees. Another limitation relates to the instrumentation of the study. Whereas the TOPS‐R has received support for validity and reliability, it neglects to include alternative approaches to clinical work, such as the common factors approach (Wampold, 2015), or other contemporary approaches, such as emotion‐focused therapy (Greenberg & Watson, 2006).

Finally, although implications can be drawn with respect to participants’ professional identity on the basis of their highest earned degree, a question addressing professional identity (e.g., counselor, psychologist, social worker) or type of license (e.g., licensed professional counselor, licensed psychologist, licensed social worker) may have provided further information about the professional background of college counselors.

Implications and Directions for Future Research

Implications of the study include a better overview of which theoretical orientations and counseling approaches are endorsed in current UCCs. Such information helps provide a detailed portrait of the modern UCC setting, which is vital to informing policy and practice guidelines. Results from the current study may find practical use through informing higher education professionals and campus partners of the broad range of services offered within UCCs. Such applications of the present findings can also serve to shift public perception away from presumptions that individual treatment is the sole or superior service provided to students. The findings and framework of the current study may also be applied internally for UCCs to prepare for future unrealized strains and demands associated with the landscape of college counseling and higher education. Accordingly, UCC professionals may be able to better identify gaps in service or areas for continuing education and professional development as they relate to practitioner characteristics. For example, better understanding the characteristics of current practitioners has large‐scale implications in hiring and recruiting new cohorts of early career professionals, bolstering alignment with UCC values despite structural pressures, and offering theoretical and philosophical diversity to better serve training programs and students. Future studies may collect additional novel characteristic data that are historically excluded in large‐scale national surveys. For example, such information could provide a snapshot of how rates of practitioner burnout relate to higher acuity of presentation, demand for services, and reliance on short‐term individual counseling models at UCCs. Given that the role and function of UCCs often vary on the basis of institution size (LeViness et al., 2019), researchers may also benefit from exploring how the variables of institution size, professional identity of clinicians, hiring practices, and identification as a training center at various UCCs influence the operations and overarching goals of UCCs. Furthermore, the lack of extant literature on counseling centers at 2‐year institutions (e.g., community colleges) and institutions that serve particular populations (e.g., historically Black college and universities, women's colleges, tribal schools) highlights a need for future researchers to focus on how counseling centers operate within these settings.

With the ongoing impact of COVID‐19, future research could also include questions regarding telehealth practices and use of online self‐help resources. Methodology within future studies could be well served to include mixed‐methods design, including qualitative components assessing how well responses align with current research on individualized approaches. This choice of methodology could be informed by the work of Norcross and Wampold (2018), who described how individual differences, cultural disparities, and client preferences mean that it is not appropriate for clinicians to apply a universal approach to treatment.

Conclusion

Efforts to unify practice in UCCs can be seen across professional organizations (e.g., CCMH, 2020), standards for accreditation, and roles and responsibilities of practitioners (e.g., International Association of Counseling Services, 2017). Such efforts have led to an increased sense of identity and consensus regarding the scope of practice. However, within UCCs, considerable variance exists regarding function, clinical service delivery model, systemic framework, and range of interventions (Mitchell et al., 2019). In addition, UCCs differ in their ability to serve increasingly diverse student populations and engage in a commitment toward social justice and cultural sensitivity. Large national surveys help to provide an overview of current trends related to clinical practice, services provided, and demographics. Such surveys facilitate better understanding of the landscape of the mental health field and facilitate changes to policy and practice that serve to address problems. To date, national surveys of UCCs have varied in their diversity and size, with many relying on perspectives from UCC directors. The present study examined a diverse sample of self‐report data from college counselors that covered personal and clinical characteristics, including the primary theoretical approach, time spent engaged in professional activities, time providing services, and overall job satisfaction. Participants in the study mostly aligned with cognitive or behavioral approaches to treatment, reported spending the majority of time providing therapy or engaged in administrative tasks, and noted that over half of their time was allocated toward providing individual counseling. Results from the study also highlight how systemic pressures may have stymied an unrealized potential for UCCs to more fully integrate with campus partners, align with the values of counseling, enrich training programs, and celebrate the diversity of theory and philosophy of practitioners. Accordingly, UCC practitioners are presented with an opportunity to embrace the roles of advocate and activist in shaping the future of college counseling. Future research is encouraged to expand these findings and apply results to inform UCC literature and practice.