Direct Clinical Service

Students interested in starting services with PAWS must attend a same-day appointment. These are offered regularly throughout the week; 3 hours each Monday through Thursday, 12pm-3pm. Students may physically come to the PAWS office or call/email prior to 1 pm to schedule a same-day appointment. The interview typically lasts 30 minutes and is done in a triage format. The purpose of the same-day appointment interview is to provide students with a prompt mental health consultation resulting in appropriate recommendations. For students whose needs may be best met by a community provider or other campus or community service, appropriate referrals are made. If referred for in-house services, students either leave with a next appointment scheduled or they are added to a triage list from which we attempt to assign clients equitably, based on a variety of factors (e.g., acuity, access to insurance, availability). After an initial period of training, interns are assigned a three hour same-day block each week to gain experience with initial assessment and intervention, crisis assessment and intervention, and referral. Interns are encouraged to consult as needed with the senior staff supervisor who is assigned to provide backup during their same-day coverage. The supervisor is also available to take overflow clients during periods of high volume. 

Interns gain experience with crisis assessment and intervention during their same-day coverage (there is no after-hours emergency coverage). Trainings regarding suicide and homicide risk and prevention, as well as safety planning, are provided during orientation. Students may also present in crisis outside of same-day hours, at which time they may be seen as soon as a senior staff member or intern becomes available. Interns also gain experience with crisis assessment and intervention through their own caseloads, as they monitor suicidal ideation or other risk among their individual clients. In keeping with our practitioner-developmental model of training, supervisors are involved in crises as a first line of consultation for interns, providing support as needed, from step-by-step assistance early-on in training (and potentially joining trainees in session) to eventually providing support and any needed direction as a consultant. 

Interns provide therapy to students who present with a wide range of issues such as mood disorders, anxiety disorders, interpersonal relationship problems, grief and loss, suicidal ideation, trauma, identity and self-esteem, substance use concerns, disordered eating, and personality disorders. Typically, all students receive preliminary assessment through the same-day appointment service. Students who participate in individual therapy at PAWS are further assessed and diagnoses are made during their First Session with their assigned provider. PAWS uses an intentional model for individual therapy. Rather than setting session limits, clinicians work with clients in a purposeful manner to meet identified therapy goals. Clients are typically seen weekly or every other week. If students opt in, they are also sent a text reminder of their appointment (this also applies to group therapy). 

Interns co-facilitate a therapy group during the autumn, winter, spring, and/or summer quarters, as demand allows. During orientation, interns have an opportunity to choose from several group facilitation opportunities. Interns are paired with a member of the senior staff to co-lead group in the autumn and winter quarters. Depending on their competency in group facilitation, interns may co-lead a group with another intern or facilitate a group on their own during spring and/or summer quarters. Interns may develop a group based upon their individual interests for the spring and/or summer quarter, if such a group meets the center’s needs. Groups are recorded for the purpose of discussion during Supervision of Groups.
Students are allowed to participate in either individual or group therapy, but not both concurrently. For the most part, group members are referred to group after completing at least one quarter of individual therapy. This helps prepare them for the group experience and can help to deepen group conversation more quickly, which can be important when operating on the academic quarter system whereby groups tend to meet for 7-10 weeks. Common group offerings include Understanding Self and Others (interpersonal process for any/all students), Therapeutic Dungeons & Dragons (focused on self-exploration, character development, and social connection), Build Your Social Confidence (for those with social anxiety to learn and practice skills through various structured activities), and Rest as Resistance (a drop-in group for those struggling with doomscrolling, political exhaustion, and stress where participants enjoy relaxing art projects, cozy shows, and chill music).

The practicum program is a 9-month training experience for two doctoral students in counseling or clinical psychology programs. Because the University of Washington does not have a clinically-focused doctoral program in psychology, our practicum trainees come from other universities in the region. We require these students to have at least one year of clinical experience before joining us so that they can jump right into the work with our unique student population (providing individual therapy and occasional outreach). Interns are responsible for providing individual supervision 1.5 hours per week for PAWS practicum trainees, under the supervision of a psychologist. Essentially, we offer interns the experience of co-supervising practicum trainees. A senior staff psychologist sits in with the intern during supervision of the practicum trainee, with the psychologist taking the lead early in the year and the intern taking the lead later in the year. 

Our rationale for this system relates to Washington’s rules for practicum supervision, which state that at least 75 percent of the supervision of a practicum trainee must be by a licensed psychologist. While we confirm that practicum guidelines are followed, we are committed to offering interns the opportunity to provide supervision. We strive to ensure that all trainees receive high quality supervision. Because we are reliant on interest from outside programs, this supervision experience is dependent on the availability of practicum trainees each year. 

In the absence of practicum trainees, a peer supervision model would be implemented. Interns would receive the same education about models of supervision. Then, during Group Supervision/Case Conference, where interns take turns presenting on one client and showing video, interns would also take turns providing supervision to one another, focused on that case. A supervisor would be present to evaluate the effectiveness of the supervision and to provide supplemental supervision.

The outreach work of PAWS is considered an essential service. The Outreach Coordinator is responsible for handling outreach requests, communicating outreach opportunities to the staff, maintaining an updated database of presentations, and posting relevant PAWS activities, such as available groups and workshops or self-care tips, to our social media. Our staff provides outreach to the UW Tacoma campus consistent with demonstrated need and requests. Outreach topics include, but are not limited to: introduction to our services, responding to distressed students, managing stress, coping with imposter syndrome, and improving sleep quality. PAWS frequently collaborates with departments across campus in order to provide pertinent outreach and best meet the needs of our students. 

Interns are expected to engage in all forms of outreach, including the design, implementation, and evaluation of effective outreach programs in response to campus requests. Interns are required to participate in all tabling events prior to the start of classes. Interns participate in at least two outreach activities per quarter other than tabling events. Interns are welcome to observe outreach presentations during orientation or early in the year prior to participating themselves, depending on their level of experience and comfort. Next, interns pair with a senior staff member to co-facilitate outreach presentations. Eventually, interns are expected to either present on their own or assume the lead role. If, after completing the requirements, an intern’s skills in this area do not meet minimum competency requirements, an intern may be assigned additional outreach presentations to help develop these skills.