In this weekly feature, the editors of SpringBoard highlight one career in the health care professions–including a basic description, educational requirements, core competencies/key skills needed, and related web sites and professional organizations where you can find more information!

Counseling in a large-university counseling center means working in a large-university setting. For practical purposes, I will consider that “large” means university enrollment of 15,000 FTE or higher. Large institutions usually have more counseling staff (usually 10 or more counselors), though there is much variation among counseling centers.

Degree Required

In large institutions, the requirement will be some type of doctorate, typically a PhD in counseling or clinical psychology, or any another doctoral degree (MD in psychiatry, EdD in psychology, PsyD in psychology, and, occasionally, PhD in counselor education). Any counselor interested in working in a large-university counseling center should plan on earning a doctoral degree in counseling psychology or clinical psychology. Many of the larger university counseling centers also require a postdoctorate in an American Psychological Association (APA) accredited university counseling center (usually, a 1-year paid experience).

Issues to Understand in Large-University Counseling Centers

Working in a counseling center at a large university is likely to be very different from that in small colleges and community colleges. Counseling center staff at large institutions will be, with few exceptions, composed of doctoral degree staff including a psychiatrist for medication issues. The counseling center will often be APA accredited (sometimes accredited by the International Association of Counseling Services) and composed almost entirely of psychologists, with occasional doctorate-level social workers and counselors. Some large centers will hire master’s-level counselors, though this currently is the exception at large institutions. Many large universities will also have a medical school, and faculty may hold appointments in the medical school or the psychology department, and doctoral students in psychiatry and psychology will serve graduate internships in the counseling center. Because of the nature of large counseling centers where almost all staff holds doctoral degrees, where doctoral students serve internships, and where a psychiatrist may be employed full time, treatment may resemble more an outpatient treatment setting than treatment at the traditional developmental college counseling centers. Diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSMIV- TR; APA, 2000) is likely to play a big role, and treatment planning will be evidence based and measurable. A large counseling center will focus more on psychotherapy and much less on career counseling and advising. Psychological assessment using instruments such as the Minnesota Multiphasic Inventory-2 and other tests will be a large part of the services provided as well. In essence, counseling in this setting is likely to be based on the traditional medical model. Students may even be referred to as “patients” as opposed to the traditional “clients” in many other collegiate settings.

Best Aspects of the Job

Working in a large-university counseling center will mean working alongside a highly trained professional staff many of whom are graduates of top ranked programs. The standard of care and performance is very high, and there may even be an expectation that the staff publish scholarly articles and books (especially, if the staff hold appointments in psychology or psychiatry departments). The staff are likely to be very professional and creative, and some may be leaders in their professional associations (APA, Association of College and University Counseling Center Directors, American Psychiatric Association). Students at some large universities will represent some of the brightest students in the country and are likely to be highly motivated and goal oriented, though this will vary among individual students. The student population at large institutions will be more multicultural and have a greater age range (because of large graduate enrollments); the counseling center will likely be a very busy place also due to the level of stress among the students in competitive programs, such as medicine, graduate, and professional programs (e.g., engineering, doctoral programs in the sciences).

Challenging Aspects of the Job

Working in a large, high-volume university counseling center at a large campus is not for everyone. Counselors at this setting will deal with a large number of suicidal students; diagnosis and medical therapy will be the driving forces, and the staff are likely to be very busy and feel a higher level of stress. Despite the apparent need for additional on-campus psychological services, counseling centers are often not staffed to meet the demand (Kadison & DiGeronimo, 2004). Readers interested in working in a large-university counseling center would need to earn a doctorate in clinical or counseling psychology and work a 1-year postdoctorate in an APA-accredited counseling center. Counselors should also serve an internship in a large-university counseling center during their master’s and doctorate programs.

Occupational Outlook and Salary

Getting hired in a large-university counseling center is likely to be very competitive due to the setting. Though exact figures are difficult to come by due to the BOLS grouping all college counselors together, the median salary is $43,980, with larger centers paying higher salaries. It can be assumed that the growth rate of university counseling centers is not expanding at an appreciable rate due to budget constraints. Salaries will likely be higher than at community mental health centers because university counseling centers mostly are composed of doctoral degree staff and the probability that some staff also hold academic appointments in psychology or psychiatry. The BOLS projects the growth rate at only 2% for the next several years.

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