Are college counseling center clients presenting with more severe psychological problems? A case study of one university counseling center

During the 1980s and 1990s, literature on the population of college counseling center clients has reported a shift toward increases in the severity of presenting problems among college counseling center clients. The research literature reflects a consensus among observers, but has not demonstrated empirically that severity is increasing, nor offered a context for understanding this reported shift.;This study investigated the severity of presenting problems (problems that students volunteer during their initial counseling sessions) at one college counseling center. A relevant and time-specific conceptual framework--generational differences--was proposed to understand these hypothesized increases in the severity of presenting problems. A multiple cross-section design, analyzing existing client data, was used to answer the question: Do levels of the severity of college counseling center clients' presenting problems differ over a specific period of time (1979-1980 to 1994-1995), by academic year, by gender, and by selected types of presenting problems? A 10 percent probability sample of 269 randomly selected client intake reports was collected from six academic years (1979-1980, 1982-1983, 1985-1986, 1988-1989, 1991-1992, and 1994-1995). Intake reports were read without knowledge of the academic year in which they were written because increases in severity by year were hypothesized. The outcome variable, severity, was measured with the Global Assessment of Functioning (GAF) (American Psychiatric Association, 1994).;Multiple regression was used to analyze these data because the cell sizes were unbalanced by year, gender, and presenting problems. Regression analysis revealed that there were no increases in the severity of college counseling center clients presenting problems by academic year for women or men, no increases by academic year in depressive concerns for women or men, and no increases by academic year in eating concerns for women. The frequency of reports of depressive concerns among women and men and eating concerns among women were low, and the results of these subgroup analyses should be interpreted with caution.;In the discussion, issues of generalizability, measurement precision, and interrater agreement, are considered. Three speculative interpretations of the findings are explored and recommendations for further research are offered.