The stepped care model 2.0* is based on a hierarchical structure of mental health services, with each step offering a different intensity of service, from prevention to self-management to specialized interventions. This type of model also incorporates “single-session” therapy, rather than prolonged consultation. The emphasis is on problem-solving, building on the person’s individual strengths, and helping them choose the service that best suits their needs at the time.
* This is the stepped care model 2.0 as developed by Dr. Peter Cornish. In the remainder of this article, the term “stepped care” will be used, and refers systematically to stepped care model 2.0. To find out more about this model, click here.
The stepped care model has only been implemented in a handful of higher education institutions in Quebec, including Cégep de Matane, John Abbott College and McGill University. The Station SME team met with Jérôme Forget, Director of Student Services at Cégep de Matane, to find out more about their implementation of the model.
Quick overview of model implementation
For Mr. Forget, there are two main factors behind this desire for change: the COVID-19 pandemic and the appropriation of the Canadian Mental Health Standard for post-secondary students. These respectively highlighted the shortcomings of a model focused primarily on crisis management and individual consultations, as well as the possibility of looking at mental health support differently, i.e. from an ecosystemic approach in which everyone can play a role.
After researching tiered care models in Quebec and Canadian higher education institutions, Mr. Forget retained the services of an organization whose mission is to support care teams in this type of organizational change. As part of this support, the staff and students of the Cégep de Matane were first mobilized as part of a wide-ranging consultation aimed at taking stock of the situation and the specific needs of the student population. This resulted in :
- Reveal local strengths, such as the importance of the natural spaces surrounding the cegep, and shortcomings, including communication and information on available services.
- To support the collaborative design process, enabling services to be structured in the tiers of their model (see illustration below).
- Lay the foundations for a data collection system on service use to support evaluation of the model’s impact.
At the same time, a 15-hour training course was offered to student services practitioners to adopt the “single-session” therapy intervention model.
Single-Session Therapy is a treatment approach that focuses on a single session as the primary intervention. While it does not exclude further follow-up if necessary, it is designed to maximize effectiveness and offer immediate help in a single encounter. In this type of session, the practitioner focuses on a specific difficulty identified by the person. The aim is to work with the person to find practical, tailored solutions that can be implemented quickly, building on the person’s strengths.
Challenges
The Cégep de Matane is a small institution, which limits the human and financial resources available for a project of this scale. Practitioners’ time is mainly devoted to urgent consultations, making it difficult for them to get involved in long-term consultation and co-design activities. The same applies to the student population, where high turnover complicates the continuity of their involvement and participation in committees.
The second challenge concerns the change in approach to intervention, as “single-session” therapy has upset the habits of trained therapists. Although they have undergone training, it takes time to become comfortable with this new approach.
Un troisième défi réside dans la communication du changement en temps opportun à l’ensemble du personnel et auprès de la population étudiante.
Conclusion
A few months into the implementation of this model, it is clear that we need to give ourselves the time we need to ensure that it is appropriated by both staff and students. To continue moving in this direction, Mr. Forget identifies the following elements:
- Integrate “single-session” therapy more fully into practices
- Ensure a smooth transition between the different levels, notably by facilitating collaboration between departments within the facility, but also externally and with partners when the level of care requires it.
- Develop communication tools to inform students of the services available to them under this new model.
- Maintain and even increase student participation to support this change and remain close to the needs and perspectives of the student population.
- Monitor the progress of the model’s implementation and its impact using a data system.
Thanks to Mr. Jérôme Forget of Cégep de Matane for his collaboration on this article.
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