An interesting article titled “The Embedded Counseling Model: An Application to Dental Students” written by David Francis Adams appears in the January 2017 edition of the Journal of Dental Education (vol. 81, no. 1, pp. 29-35). The article discusses a study performed at the University of Iowa College of Dentistry to study the impact of a counseling program. The study was motivated by prior studies that have shown that high rates of stress, anxiety, and mood problems are prevalent among dental students and and can lead to health issues and substance abuse. Similar types of issues were previously addressed in the post titled Designing a Predoctoral Dental Curriculum To Help With Therapy Issues such as Stress Management and Suicide Prevention.
In the article, at the University of Iowa collaboration occurred between the dental school and the university counseling service that led to a full-time psychologist to direct a counseling office within the dental school to provide psychological services to dental students. By establishing such a counseling office dental students did not have to worry about the geographic distance from the regular university counseling center and the limited evening hours typically offered. The psychologist reported directly to the associate dean for student affairs at the dental school. The counseling office was designed to address concerns at the individual, group, and organizational levels; however the primary concern was to provide individual counseling. The counseling services were made available for free to full time students with no cap on the number of sessions.
For the first three semesters the counseling office was open 55 students attended 251 counseling appointments, with 67% of those attending being women and 97% of those attending being Caucasian. The ages of those who attended ranged from 21 to 55 years. Students attended counseling for many different reasons including
academic concerns, low self-esteem, time management, self-care issues, interpersonal conflicts, stress management, substance abuse, body image concerns, work-life balance, financial issues, sexual concerns, anxiety, and depression. To monitor counseling progress and gather psychological outcomes data two different inventories were used: 1) the Counseling Center Assessment of Psychological Symptoms-34 (CCAPS-34) and 2) the Outcome Rating Scale (ORS). Based on the CCAPS-34 45 of the 55 (82%) of the students had at least one clinically significant symptom. Based on the ORS data, the 55 dental students had high levels of psychological distress. After a few counseling sessions dental students increased overall functioning. The authors state:
“…the…counseling office was instrumental in reducing symptoms of psychological distress and increasing overall functioning of the students. The positive relationship between number of appointments and overall functioning was also consistent with psychotherapy outcome studies.”
The researchers note that a limitation of the study was not incorporating a long-term follow-up to determine if the changes observed were maintained over time. The authors point out that psychological stress management behaviors persist from the first to the last year of dental school, and then into professional practice. Thus it would seem that by establishing good stress management behavior while in dental school the future dentists may set themselves up to be able to better deal with stress throughout the career as a dentist. Further another limitation was that only one dental school was used in the study. Other dental schools may not necessarily have the flexibility to employ a full-time psychologist on site at their school such as the University of Iowa in this study . Thus some dental students may be limited to be able to easily physically go to counseling services at a time convenient for them. However, nowadays there is online therapy which allows for anyone to seek counseling on their own schedule. Therefore dental students and even other medical professionals students, should take the results of the study by Adams discussed above and seek counseling while they are young if they suffer from symptoms to improve their ability to function and allow themselves to be better prepared for life challenges in their careers. If students are limited by geography, costs, or even have privacy concerns perhaps they can consider online therapy if their college does not offer the same services like those offered to dental students at the University of Iowa as discussed in the study.
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