UI telepsychology training clinic serves 200 Iowans, eyes expansion

IOWA CITY — Before COVID-19 upended everything — forcing innovation and ingenuity in maintaining some semblance of services, resources, and everyday life — one department in the University of Iowa College of Education already was there, wading into mostly-untested telepsychology training territory for both its students and state.

“We submitted the grant before COVID, were awarded the grant before COVID,” UI professor Martin Kivlighan told The Gazette about being at the forefront of telepsychology as both an outreach and training ground for counselors in the making.

“And then COVID happened, and everyone did therapy over telehealth.”

But the foresight of the UI Telepsychology Training Center — conceived and supported in 2018 with a three-year $1.3 million grant from the U.S. Department of Health and Human Services — positioned it perfectly to respond to statewide needs during the pandemic, especially in rural communities, and the mental health demands that ensued.

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“We already were facing a mental health crisis, and then COVID came along,” said Kivlighan, who codirects the five-year-old training center — which officially launched in 2019. The center received a second three-year grant for $1.3 million, and is preparing to apply for a third round of federal funding and possible expansion within the College of Education.

“We're having talks of expanding this to be collegewide, be able to serve more folks, and be able to train more mental health providers in a lot of these specialty areas to really try to help increase that pipeline of rural therapists going out,” he said.

COVID, he said, not only made the mental health crisis more visible but also exacerbated it “through loss of employment, isolation — all those things that we lived through.”

And for the nearly 90 percent of Iowa counties considered “mental health care professional shortage areas” according to the federal government, the added stressors and pressures were especially aggravating.

More than 200 Iowans

For years, the UI College of Education’s graduate student-focused Department of Psychological and Quantitative Foundations conducted projects and initiatives reaching into rural Iowa — offering services and conducting research to better understand its needs and the impact of service-area shortages.

Once the department landed its telepsychology grant six years ago, it formalized a Rural Psychology Collaborative with a mission to “better serve rural Iowans through community-based research and practice.”

The collaborative’s goals include:

Under the collaborative’s umbrella emerged the Telepsychology Training Clinic — offering free, short-term counseling from doctoral students in the UI counseling psychology program.

Using a student-teacher-type model for the therapists in training — supported by faculty supervision and oversight — the clinic to date has served more than 200 Iowans in 17 counties.

And even with COVID and its impacts tempered and fading from the state of urgency that crippled communities for so long, Kivlighan said mental health needs persist. There is the polarizing political climate, inflation, and climate change, among other things.

“It's not one thing,” he said.

‘Spoke and hub model’

Iowa ranks 46th in number of psychologists per capita, and the UI Telepsychology Training Clinic uses community partnerships to extend the reach of its two co-directors, postdoctoral student, and three doctoral practicum students.

“We use a spoke-and-hub model, where our clinic is the hub and then we have spokes out to other community partners,” Kivlighan said.

Partner agencies include Student Health and Wellness at Grinnell College, with the UI clinic offering counseling to Grinnell faculty and staff; The Robert Young Center for Community Mental Health, a UnityPoint Health-Trinity affiliate offering mental health, substance abuse, and crisis services to children, teens, and adults in the Quad Cities and Muscatine-area; and The University of Iowa Mobile Clinic, a 22-year-old student organization offering free health screening, prevention, education, and basic health services to underserved populations.

From a services perspective, the telepsychology clinic provides both individual and group counseling, career services, and psychoeducation workshops using videoconferencing. Counselors address concerns including depression, anxiety, grief, conflict, discrimination, and trauma.

The free short-term offering could include five to 10 sessions focused on "specific concerns, rather than engaging in open-ended and ongoing counseling.“

“TPTC counselors can also assist with getting connected to a longer-term counselor in the community,” according to a program description.

From a training and research perspective, topics of focus include Latino immigration trends, cultural health behaviors, health psychology, and challenges to effective service.

The goal from a training perspective is to get students providing comprehensive behavioral health service to rural residents; learning care strategies for treating underserved populations; and pursuing job opportunities in rural areas. ​

‘Flip the script’

Jennie Spencer, a second-year UI doctoral student in counseling psychology, last year participated in the Telepscyhology Training Clinic as a student therapist — serving both rural communities and low-income clients under the guidance of a licensed psychologist.

“So I was having an expert oversee things and help me give good quality care,” she told The Gazette, characterizing her experience as valuable for its “boots on the ground” lessons.

“There were several people who lived in communities where there were no psychologists, or where they weren't able to access therapy, and I think a lot of them had a good experience working with us,” Spencer said. “So I think we're kind of meeting a need. And it felt really good to be able to help.”

Originally from Indianapolis, Spencer — who has several more years of training before entering the workforce as a psychologist herself — said she would consider staying in Iowa after graduation.

“I have had a really good experience in Iowa City,” she said. “And there’s definitely a lot of need for psychologists here.”

JJ Kapur, 24, from West Des Moines, recently returned to Iowa for his doctorate after graduating from Stanford University.

“I want to make Iowa a better place than where I left it,” said Kapur, who’s enlisted to participate in the training clinic as a student therapist.

“I think it's so beautiful that we're offering free therapy to folks where they might not be able to get therapy,” he said. “And what I'm hoping to get out of it is training on how to do therapy with folks from all parts of our state.

“I'm a storyteller,” Kapur said. “I love to hear people's stories. And I think, with a clinic like this, you've got folks from smaller towns sharing parts of their lives that feel hard. And I'm genuinely interested in what's challenging if you live in a smaller town, compared to a bigger city.”

He’s hoping the program marries his dual interest in learning more about how to best help people and actually doing the work of helping.

“I'm eager to learn how not only to listen to people's stories, but through this program also help people change their stories and flip the script on their stories,” he said. “I think this program has the ability and the power to do that.”

Vanessa Miller covers higher education for The Gazette.

Comments: (319) 339-3158; vanessa.miller@thegazette.com