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Developing an Embedded Counselor Program

The Graduate Student Experience Initiative recognized that many academic departments are interested in an embedded counselor but unsure how to develop a plan. This content was created by a subcommittee within the GSEI and is also available in a downloadable pdf.

What are Embedded Counselors?

Embedded Counselors are Counseling and Psychological Services (CAPS) counselors who serve specific schools and programs at UNC-Chapel Hill. While they are CAPS employees, their positions are funded by the school or program they serve. They are housed within and provide services only to students in that school or program.

Who decides which schools and programs get Embedded Counselors?

Embedded Counselors are established at the request of individual schools and programs. A school or program that wants an Embedded Counselor must secure the funding for one itself, then contract with CAPS to hire, manage, supervise and support the Embedded Counselor. In collaboration with the funding school or program, CAPS will then search for and hire an Embedded Counselor for that school or program.

What services do Embedded Counselors provide to students in their host school or program?

Embedded Counselors provide a variety of services to the students in the schools and programs they serve, including initial assessments, crisis support, brief individual therapy and referrals for long-term or specialized therapy. When appropriate, they schedule students for medication management and referral coordination services at main CAPS. They run therapy groups specifically for students in their school or program and connect students with other therapy groups at main CAPS. Counselors work with students on a range of issues including anxiety, adjustment, academic stress, imposter syndrome, relationships, grief, and other concerns. They also participate in new student orientations, provide workshops on topics of particular interest to the students in their host schools and programs, and offer other outreach services to those students as needed. Appointments are offered in person and through telehealth. Services are available during the summer if the student is physically located in North Carolina. Students do not have to pay the summer campus health fee to see an Embedded Counselor during the summer.

How does CAPS support Embedded Counselors?

Embedded Counselors use the CAPS electronic medical records system, which are not accessible by anyone outside of CAPS, except the student themselves. These records are not contained within or accessible through the UNC Health Care System’s electronic medical records system (EPIC), so students in clinical programs do not need to worry about their counseling records being accessed by their faculty, preceptors, clinical supervisors or co-workers.

Are services confidential?

Yes. Like all CAPS counselors, Embedded Counselors are required by state and federal law to protect the confidentiality of the students they see. They may not reveal the identity of or any other confidential information about those students to the school or program they serve unless there are serious and immediate safety concerns.

What are the advantages of having an Embedded Counselor?

Easier access to mental health services. Because Embedded Counselors have offices within their host schools and programs, students typically do not have to leave their school or program to meet with an Embedded Counselor in person. They can also meet with an Embedded Counselor virtually, as long as they are physically located in North Carolina.

  • Greater variety in appointment times. Graduate and professional students often have very busy schedules that make it difficult for them to access services at main CAPS. If requested by their host school or program, an Embedded Counselor may offer some evening and/or weekend hours to alleviate this problem.
  • Program-specific knowledge and understanding. By working with students in a single school or program, Embedded Counselors develop special knowledge and understanding of the challenges that those students face. This allows them to provide more effective treatment.
  • Tailored programming. Because of their program-specific knowledge and understanding, Embedded Counselors are able to offer therapy groups, workshops and other programming tailored to meet the program-specific needs of the students in their host schools and programs. In addition, Embedded Counselors are able to provide information about program-specific challenges and trends anonymously to the school or program’s administration, so that the administration can take steps to address them.

How do students access the services of an Embedded Counselor in their school or program?

Two options:

  • Email the Embedded Counselor directly to set up an initial assessment. Embedded Counselors see students for initial assessments throughout the work week. Walk-in appointments with Embedded Counselors are not available. Same-day appointments are occasionally available, depending on the counselor’s schedule. At the conclusion of initial assessment, the Embedded Counselor will set the student up with appropriate services.
  • Walk-in or call main CAPS during normal business hours for an initial assessment. No appointment is necessary. If a student cannot come to CAPS in person, CAPS staff can do the initial assessment over the phone. When appropriate, CAPS staff will connect the student with the Embedded Counselor in their school or program for further services.

How much does it cost to fund an Embedded Counselor?

In terms of cost, it varies by experience, but right now a starting salary would be somewhere between ~$98,000-$111,000, including benefits.

Who provides the funding for an Embedded Counselor?

A school or program that wants an Embedded Counselor must secure the funding for one itself, then contract with CAPS to hire, manage, supervise and support the Embedded Counselor.

Are Embedded Counselors available to provide support to staff and/or faculty?

They are available to consult with faculty and staff but not available to provide clinical services. They are student focused only.

Are Embedded Counselors available to provide support to graduate students, undergraduate students, or both?

They provide clinical services to whatever students are within that department, be it graduate, undergraduate or a mix of both. The population the Embedded Counselor serves is limited to the school/program.

What guidance is available to estimate the service need for a program and the most efficient allocation of the Embedded Counselor’s time?

CAPS, in consultation with the determined needs of the program, determines the allocation of time for each therapist, but these allocations are largely in line with the typical allocation of a CAPS therapist.

If a program chooses to do so, can an Embedded Counselor be assigned specifically to graduate students or specifically to undergraduate students?

Yes, the school can determine the census for the Embedded Counselor.

Do Embedded Counselors have a universal position description, or is the position description specific to each individual Counselor?

There is a general description that could potentially be adjusted depending on program needs and within the guidelines set by HR. For access to samples of these descriptions, please contact the Director of CAPS, Avery Cook.

Is there a minimum percentage of time that Embedded Counselors are required to spend in therapy with students?

Like main CAPS therapists, each embedded counselor is responsible for 30 clinical hours. These hours are broken down into time with individual and group therapy, initial assessments, outreach, and clinical meetings.

Is there a minimum number of students needed to justify a full-time Embedded Counselor? What is the maximum number of students that could be supported by an Embedded Counselor?

Each embedded position has a cap on the number of individuals they can support at any given time, holding a case load of 18 ongoing clients and additional slots for initial assessments. For a bigger program, this means that it’s likely the Embedded Counselor will reach capacity rather quickly and then students would be referred to main CAPS. Bigger programs find that the Embedded Counselor generally stays full but haven’t had to refer many individuals to main CAPS. In terms of a minimum, it does depend on the program. A very small program with high needs could keep the counselor with a full caseload, even if that’s unlikely. CAPS does not support sharing Embedded Counselors across multiple programs or schools.

Are Embedded Counselor positions permanent positions, or are they term-limited?

These are permanent positions and so must also be attached to permanent funding.

What is the minimum requirement for funding an Embedded Counselor?

A program would need to have the appropriate funding for staff salary, benefits and associated fees of the program as outlined in the MOU. For access to a sample Embedded Counselor memorandum please contact the Director of CAPS, Avery Cook.

Can a department fund a percentage of an Embedded Counselor and share the total cost of the Embedded Counselors with another department?

We have determined that a shared position is not viable. It does not end up meeting program needs and becomes burdensome for the counselor in that position, leading to higher levels of burnout and consequently higher turnover. We are not able to provide an overview of the current utilization of CAPS services for students in specific departments. The identifying data we collect is set by the Center for Collegiate Mental Health and it does not break it down specifically by department or program. We do ask folks to self-disclose if they are undergraduate or graduate students, but not down to specific areas of campus.

Additional Reading

Developing an Embedded Counselor Program Fact Sheet
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