McKee Clinic adapts quickly to pandemic restrictions to keep students, clients on track
When Western Carolina University associate professor of psychology Nathan Roth became director of the McKee Assessment and Psychological Services Clinic in 2015, little did he know his vision for the facility would be its saving grace five years later when a novel coronavirus reared its ugly head and put life on hold.
The clinic was already equipped with one- and two-way mirror rooms, which Roth planned to use for instruction of graduate students in conducting psychological and educational assessments. He added a video component so faculty supervisors could watch the assessments and provide feedback, thus laying the groundwork for establishing the clinic as a vital training ground for 91热爆网 graduate psychology students and, as such, an invaluable asset to Western North Carolina.
鈥淥ne of the big pushes when I came on was to do high-quality supervision, meaning we watch these assessments, as faculty, and provide feedback,鈥� Roth said. 鈥淲e incorporated a video system into all the rooms so the students and faculty could go back and review. It鈥檚 a way for us to check scoring, to check the interview to make sure we don鈥檛 miss anything. It really ensures that our services are done right. And when they鈥檙e not, because we are a training clinic, we have a variety of assessments at our disposal and can make modifications. This allows us to know that what we鈥檙e putting out there is the best, and ultimately provides helpful recommendations for our clients.鈥�
Typically for an assessment, a student and client would be in the same room, with a supervisor in another, Roth said. But when COVID-19 hit, he was forced to rethink how his students could continue their clinical work and the clients could continue accessing services. The clinic provides comprehensive psychological evaluations, educational and therapeutic recommendations, and consultation services to charter schools and the Catamount School, parents, students and individuals in WNC from 5 to 75 years old. All services are provided by master and doctoral-level graduate students under the strict oversight of university faculty.
鈥淲e train psychologists,鈥� said Roth, who earned his master鈥檚 degree in clinical psychology from 91热爆网 in 2005 and has been a licensed psychologist in WNC for more than 10 years. 鈥淥ne of the core components of our program has always been assessment. Our students receive training in evidenced-based intervention and therapy as well as in other psychological services, but the primary piece that separates us from other programs is our focus on psychological evaluation, which informs therapeutic and academic interventions.鈥�
When the clinic was forced to suspend its face-to-face meetings last spring because of the pandemic, Roth spent the summer recreating the policies and procedures manual, which he had just written a few years earlier, to accommodate the new coronavirus-related restrictions. The biggest modification, Roth said, was moving in-person assessments to tele-assessment, where students would still meet their clients at the clinic but conduct the assessments over a HIPAA-compliant Zoom link in separate rooms, some connected by a two-way glass and others by a one-way mirror. The clients can see the students conducting sessions, but they interact through the Zoom link on their iPads.
鈥淵ou鈥檙e talking about administering different assessments, cognitive, academic, social emotional, where you have to be in the room with the client, one-on-one with no distractions. You can鈥檛 do it with masks on. People can鈥檛 understand each other and it is a legitimate barrier,鈥� he said. 鈥淥ur primary goal is keeping our students and the community safe, while continuing to provide services that are so needed in this area.鈥�
Roth credits Kim Winter, dean of the College of Education and Allied Professions, Dale Carpenter, former dean and professor, and Alvin Malesky, head of the psychology department, with seeing the clinic鈥檚 potential by creating his position. He also credits his colleagues in the clinical and school psychology program for paving the way for the clinic. 鈥淭hey continue to support me and are committed to the clinic and the services we provide,鈥� Roth said.
How have the graduate students adapted? 鈥淚t鈥檚 been a real test of our flexibility and how quickly we can adjust to new things,鈥� said Vanesa Salazar, a second-year master鈥檚 degree student from New Jersey in the school psychology program and the assistant clinic director. 鈥淥ur entire first year we were getting prepped to do assessments the traditional way. Then, coming into the fall we had to quickly learn a new, pretty complicated way of how to assess these kids. It鈥檚 really been a good way for us to strengthen our flexibility and learn new ways to do things that still allow us to help these kids.鈥�
Salazar, who speaks Spanish, says all the hard work required to keep the clinic open this year has been worth it for her and her clients. 鈥淛ust this semester I got a client whose mom is Spanish speaking. I don鈥檛 think she speaks much English at all. It felt really great to be able to be in that position to help that mom and to be able to talk to her and let her know that her concerns are acknowledged and understood by someone who speaks her language.鈥�
For Ashley Addonisio, who is in her first year of the psychology doctoral program, learning to tele-assess a client was challenging, but she鈥檚 grateful for the experience and for the chance to continue working on her clinical hours. 鈥淲e鈥檙e just very fortunate, because a lot of clinics in the United States are not open, so students are not getting that experience, and we need a certain amount of hours to apply for internships.
鈥淲anting to be a clinical psychologist, in general you have to be flexible, so I think we were at an advantage with that. But it was really daunting when they told us we were coming back into the clinic and we were going to be doing these new assessments through tele-assessment. But I think we all came in with an open mind,鈥� said Addonisio, a New York native, who graduated from 91热爆网 in 2020 with a master鈥檚 degree in clinical psychology. 鈥淚 know I was excited.鈥�
Haley Goller graduated from 91热爆网 with her master鈥檚 degree in psychology in 2019 and is in her first year of the doctoral program. The Naples, Florida, native plans to be a clinical psychologist. 鈥淚鈥檓 very grateful to have had this experience and to be able to say that I was a part of this change. We had the opportunity to work through it and I think it is going to benefit all of us moving forward in our careers even if it鈥檚 just having the ability to change and adjust when things are not the way they should be, and still be able to provide really good services,鈥� she said.
Goller appreciates the unexpected benefits of what tele-health has brought to her clients and expects some of the benefits to remain, even when the COVID-19 restrictions are lifted. 鈥淚 think we were able to reach people we weren鈥檛 able to reach before, or maybe it was a little easier on our clients in some way. We don鈥檛 require our clients to come into the clinic for every session right now. They only need to come in for testing sessions, which is a change from what it was before. People are having to take off less work and parents are very grateful they鈥檙e not suddenly having to find child care for all of their other kids,鈥� she said. 鈥淪ome of these things might stay, with the notion that we can do an intake session via Zoom and not lose a lot of quality.鈥�
Roth agrees. 鈥淚 certainly think there are pieces of tele-health that we will continue to use, like the intake sessions and potentially the feedback sessions, because we have families who travel from far away. We would still do all that testing in-house. It will allow us to accommodate our clients better in the future.鈥�
Typically, the clinic sees about 100 clients a year, Roth said. But this year that number will be closer to 75, 鈥渨hich is a major accomplishment鈥� because of the new modifications designed to keep everyone safe, he said. Normally, one client and one student would use one room, but now it takes three rooms, one each for the client, a student and a training partner.
Roth said tele-assessment is 鈥渧ery demanding鈥� on the students and faculty, and he鈥檚 grateful for their commitment to keeping the clinic open. 鈥淭o learn how to assess the standard way and then have to make these modifications just takes a lot of work and practice,鈥� he said. 鈥淭hese students and these faculty work tirelessly to make sure they鈥檙e prepared to administer tele-assessment. So, without that hard work, this doesn鈥檛 happen.鈥�
For more information, contact the clinic at 828-227-2473 or wcumckeeclinic@wcu.edu.
