Extending counseling & psychological services to distance education: A Delphi exploration of institutional options and opportunities from the perspective of college mental health practitioners and decision-makers at a large research university

The numbers of students choosing to pursue their education at a distance is steadily growing. Distance education, often understood as a means for adults to further or diversify their educational attainment, is increasingly courting the demographic often referred to as "traditional age students" (18-24 yr. old). These students are choosing distance delivery of education for a myriad of life issues and circumstances, but there is increasing speculation that there may be an overrepresentation of students with mental and emotional concerns choosing distance delivery of education to avoid the social environment of an on-campus educational experience.;There are no statistics that clearly pinpoint the number of students with diagnosable concerns in distance education nationwide, however, looking at the broad scope of mental health issues nationally, the National Institute of Mental health in 2008 reported that over 13% of the entire U.S. population sought mental health services or treatment. More importantly, they indicate that as much as 40% of adults with serious mental illness do not receive treatment for their mental health problem. Furthermore, there is no reason to believe that the distance learners, who represent the most diverse student population (age, race, etc.), would experience mental and emotional health concerns at a lower rate than the national statistics. Therefore, there is clear need to explore counseling and psychological support services to improve student access to expert opinion, improving students' quality of life, promoting distance learner retention, and bolstering academic success among the distance learner population.;This study is an exploratory qualitative study guided by four research questions with a 3-phase approach. Phase I was a pilot of a literature generated Delphi protocol. The Delphi protocol sought to generate expert consensus through an iterative process focused on the guiding research questions. The guiding questions focused on the potential challenges and benefits of providing some form of counseling and psychological service expansion to online learners. The research questions also sought to illuminate practitioner perspectives on institutional responsibility to provide services and generate potential strategies that might be employed to meet distance learner needs. Each of the rounds of the Delphi survey built on the data received in the previous round through data aggregation, feedback to participants, and subsequent revisions to the Delphi survey. Upon completion of the Delphi phase targeted interviews were conducted with two of the panelists and two senior "decision-makers" for the purpose of expansion of the dataset and triangulation of data.;Through holistic and thematic coding of the data this study indicates that college counseling practitioners experience a high degree of conflict over expanding counseling services to the distance learner population. Student safety, individual and institutional liability and cost top the list of concerns, but those are balanced by the realization that access to services, retention of students, and academic success are all benefits of counseling to residential learners that are important for the distance learner as well.;The results of this study imply that the time is right to begin the conversation around expanding student services to distance learners. This, however, does not mean that we are currently at a point where we can confidently establish counseling and psychological services in the distance learner environment. This study suggests a more incremental approach that consistently asks, "what can we reasonably do right now" to meet the needs of students in the distance learning environment. The findings of this study imply that future expansion of counseling and psychological services will need to include honest conversations about the merits of technology integration in counseling practice and technological education for mental health counseling students and staff. Additionally, experimental implementations of technology in counseling practice and a slight shift in focus from attempting to translate counseling and psychological services into the distance learning environment to first finding ways to effectively identify distance learner needs and help them make appropriate connections to campus support services, their local community support services, a peer network for student support, and psycho-educational support mechanisms will be critical. And finally, a concerted effort to promote a national conversation around licensure and professional liability balanced with expanding access to services will likely be necessary before any large scale changes can occur.