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B. Jean Haefner, Ph.D.
The University of Toledo Counseling Center
2801 W. Bancroft, Toledo, Ohio 43606-3390
419-530-2426
The "GRAB-A-PSYCH" concept began in 1991 at the University of Toledo Student Medical Center. The Medical Center was housed in the basement of a Resident Hall at the time. Exams rooms a, Id offices were arranged off a central hallway. When a mental health issue arose, a medical staff person would literally vocalize, "GRAB-A-PSYCHOLOGIST". A consultation would commence between the medical staff personnel and the psychologist. The consultation phase included several options based on the individual situation. Options included (a) consultation with medical personnel only; (b) meeting the student in the medical area to make an appointment for a later date; (c) immediate intervention lasting from several moments to several hours. The Student Medical Center moved into a new, state of the art building in 1993. The building incorporated a counseling area which is physically separate from the medical area. The GRAB-A-PSYCH concept has remained an integral service at the Student Medical Center.
There are philosophical differences between Psychology and Medical models. The Student Medical Center operates on a Medical Model emphasizing prevention and cure of medical conditions. The Psychology Model emphasizes the integration of medical conditions and emotional conditions.
"Boundaries" is an ongoing concept which is addressed when the medical and psychology models conflict. There has, at times, been a power struggle between the medical and psychology staffs. Historically, in a medical model, the Physicians are at the top of the hierarchy, then nurses, then followed by staff. It has been a challenge to educate the medical staff on mental health issues, hence readjusting the hierarchy. The medical staff makes decisions as to the seriousness of a condition and may "knock on doors" of the mental health staff. Ongoing education and changing procedures arc necessary to protect the integrity and the authority of the mental health staff.
Protecting confidentiality is an ongoing process: (a) the Medical and Counseling charts are kept separate; (b) charting needs to be in both Medical and Counseling charts; (c) Medical personnel chart the request for GRAB-A-PSYCH; (d) Counseling personnel progress/process notes in counseling chart; (e) a release of information signed between Medical and Counseling areas. The Medical personnel may request information which Counseling personnel feel violates confidentiality.
The GRAB-A-PSYCH client is usually `'involuntary". The client arrived at the Student Medical Center for a physical problem and is referred to counseling. It is a challenge to "bond" with a GRAB-A-PSYCH client. This is accomplished by: (a) Medical and Counseling personnel meeting with clients together in medical area; (b) medical staff walking client to counseling area to meet a counseling person or to make an appointment.
There is an observed difference between clients that can take advantage of GRAB-A-PSYCH. Variables include (a) the subset of their cultural background in accepting counseling (b) the clinical issue they are facing anid it's time lines for acceptance. International students are particularly sensitive to being referred for counseling services. They may agree with the medical doctor but "no show"' for counseling appointment.
The successful GRAB-A-PSYCH therapist must be a "good-fit" for a medical model. Personal characteristics which make a "good-fit" include, (a) comfort in a medical setting; (b) credible medical staff; (c) flexible orientation.
Facilitation of a GRAB-A-PSYCH concept: when the Medical and Counseling areas are separate requires careful planning. Counselor personnel need to be physically placed near/in the Medical area at least part-time. "Informal" credibility bonding between Medical and Counseling personnel is a key component to success of GRAB-A-PSYCH. "Formal', credibility of a Counseling personnel is expected by the Medical personnel.
Long term benefits for a GRAB-A-PSYCH program include: (1) Enhanced collaboration and mutual respect between Medical personnel and Counseling personnel, and (2) financial and political support within the University.
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