Sympathy and solutions

Melissa Schorr

Monday, Nov. 23, 1998 | 9:54 a.m.

Rita Mecham never had to worry much about her older son. It was the younger one that had always been a handful.

So when both teenagers had brushes with the law in the past year, it was clear to her that something in her family was very wrong.

"I thought, I'll try anything," recalls Mecham, whose entire family was ordered by juvenile court to undergo counseling as part of the boys' punishment for their delinquent behavior.

"I don't know why they do this," Mecham says, "That's what we're here to find out."

The Mechams, who agreed to talk to the SUN about their therapy, are nearly through a semester's worth of weekly sessions at UNLV's Client Services Center, a training facility offering low-cost therapy from students studying to become full-time professional counselors.

They are just a few of the hundreds of people who are helped annually by the center, a facility that Director Tom Sexton describes as a win-win creation.

"It's a wonderful partnership between the university and the community," Sexton explains. "Our students get good experience, the community gets a great service."

With its affordable fee -- $25 per 50-minute session -- the self-supporting center provided 4,000 hours of therapy last year. The average cost for a session comes out to only around $10, Sexton says, once you factor in those who receive free, court-mandated service, which is paid for by the county.

"Bottom line is, we are affordable," Sexton says. "There's a lot of need for mental health services and there aren't many here, and they're very expensive. We've become a major provider of mental services for folks that can't get services anywhere else."

The center has been around since 1975, but this April, it moved into a new, half-million dollar facility in the Greenspun College of Urban Affairs, making it one of the most modern student-run psychology training labs around.

"It is probably the most state-of-the-art in the country," Sexton notes. "There isn't one like this anywhere else. There probably isn't one as large as this.

Patients are ushered into one of 16 private, soundproof counseling rooms, equipped with double-glass one-way viewing mirrors through which supervising instructors watch anonymously while their students conduct therapy sessions.

The session is videotaped, with the professor's critiques voiced over onto a tape which the student counselor views afterward. (All clients agree to the supervision.)

"We watch carefully," Sexton explains, "because this isn't just a biology lab, this is real people in real lives. We have an obligation to these people and take that obligation very seriously."

Patients either call the clinic on their own initiative or are referred from another mental health facility, the court system, or a local school.

Each patient fills out an referral form and comes in for an initial "intake interview" with a counselor. Often, they will be asked to take various computer "inventory" tests detailing their symptoms and levels of anxiety.

Those with more serious issues, such as suicidal behavior, or those requiring medication, such as manic-depressives, are referred to other agencies.

Those accepted fall into a few broad types: About a quarter of them are students ranging from age 5 to 18, a third are couples or families dealing with marital problems, and the rest are adults dealing with life choices, career counseling, or suffering from generalized disorders like depression, low-level anxieties, and obsessive-compulsive disorders.

The center also offers group therapy on topics such as relationship issues and over-eating.

The benefit for the 50 student counselors is gaining the experience of working in a professional environment. The center is operated like any private practice with a full-time staff, scheduled appointments and a waiting room. Students enter through a separate entryway than patients, to maintain the doctor-client mystique.

Perhaps the only drawback to patients is that, at the end of each semester, usually after around 15 sessions, those receiving ongoing care must switch to a new student therapist. In the past, the center would break for the summer as well, leaving patients in the lurch, but starting next summer, the clinic goes year-round.

Though the front office is completely professional, behind the scenes is a classroom environment with chalkboards, study rooms and students poring over textbooks.

Students are in fact graded -- any unethical or nonprofessional act is grounds for an automatic "F," while an "A" student must be able to create a treatment plan and implement it.

But what if a client refuses or simply fails to improve?

The student must at least show that they followed directions and used what they learned in class properly, Sexton says. "Clients are all different," he concedes, "the skill is to find a way that works."

The course is intense: students put in around 20 hours a week for the course.

Each group of five student counselors works with an instructor, plotting treatment plans and reviewing tapes of sessions for each of the three to four cases each student is assigned, around 20 for the group.

That comes out to four hours a week of preparing for each session, four hours of the actual therapy, and another four hours reviewing the tape with the instructors' voiced-over comments. In addition, students spend four more hours a week watching their peers' sessions to prepare for the group's two-hour weekly discussion.

"This is the most intense experience they have," Sexton notes. "They immerse themselves -- they live here, basically."

Students say the high-intensity program has prepared them well.

"When I first started, I was petrified," recalls Sharon Morris, a second year graduate student pursing her master's degree in marriage and family counseling. Morris has found working with actual clients this semester has reaffirmed her interest in the field.

"It's very frightening, but you become comfortable with it," agreed Josephine Bonomo, a recent graduate who received her master's in counseling. "We get a lot of support, rather than people just breathing down your neck."

For the Mechams, the suggestions made by Bonomo, their therapist, have proven helpful. Bonomo seems to have suggested the classic behavioral therapy technique of positive reinforcement, advising the Mechams to praise their sons whenever possible.

"I try extra hard to find anything he's doing right," Rita Mecham says, describing one strategy she has successfully implemented. "If he's doing his homework, I say 'Wow!"'

Just the act of entering therapy itself, Mecham adds, has done some good.

"A lot of times, (our sons) didn't see (our rules) as objective, they saw it as something a parent says, 'This is what you do.' But if they see you saying, 'Let's get counseling for it,' then they take it as something more serious."