Behavioral mental health in and for the community - The University of Tulsa
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Behavioral mental health in and for the community

Since its foundation in 2015, The University of Tulsa’s True Blue Neighbors Behavioral Health Clinic (TBN-BHC) has served a twofold purpose: Providing evidence-based psychotherapy and psychological assessments for a variety of concerns as well as giving TU’s clinical psychology graduate students an opportunity to engage in therapy and assessment training.

two women with long hair standing in front of a photographic mural
Clinic Director Jennifer Steward with clinical psychology PhD student and Associate Clinic Director Amber Sitz

According to Jennifer Steward, the clinic’s director, “our mission is to provide high-quality, evidence-based community services. In addition, we have a specific mission to deliver free services to underserved areas of our community and to help individuals and families who may otherwise not be able to receive services.”

Located in the Kendall-Whittier neighborhood, a part of Tulsa that is home to a thriving and growing Hispanic population, TBN-BHC offers limited therapy and assessment services in Spanish. “We definitely hope to grow this capacity in the future to meet the high community need,” noted Steward.

Over the nearly six years it has been open, approximately 493 clients have received more than 13,054 hours of service – all free of charge, thanks to a grant from the Ascension St. John Foundation. Working with figures provided by the Association of Psychology Training Clinics, Steward calculates that TBN-BHC has provided the equivalent of over $130,000 worth of behavioral health services to people in Tulsa and surrounding areas.

Services for the community

Children, adolescents and adults turn to the clinic for psychological evaluations. The aim of these, Steward explained, is to clarify diagnostic presentation, learning disabilities, attention-deficit/hyperactivity disorders, personality assessments, behavioral dysfunction and outbursts, and intellectual or developmental concerns. Reports can illuminate and/or identify problem areas, describe personal strengths and provide clear recommendations to help with any areas of concern. With clients’ permission, staff are able to share these reports with schools or other clinical providers.

True Blue Neighbors Behavioral Health Clinic

“We also provide individual therapy for children, adolescents and adults for many common stressors and mental health symptoms,” Steward noted. These may include academic performance concerns, anxiety, depression, phobias, adjusting to health problem and chronic health concerns, post-trauma symptoms, lifestyle adjustments and transitions, stress management, parenting problems, conflict resolution, relationships, sexuality and identity and social skills. “When needed or preferred, we involve families and romantic partners in the therapy process.”

But TBN-BHC does not limit its care to individuals, offering group psychotherapy on a limited basis for a number of concerns, including parenting issues, depression and anxiety, chronic pain, and social and emotion regulation skills. “Based on client need, we are certainly interested in expanding our group offerings,” remarked Steward. “On that front, we also provide consultations with schools, physicians, allied health personnel and community agencies.”

Training future clinicians

Two women seated at a table facing each other
Clinical psychology PhD student Brooke Pangelinan practices a psychological assessment

“TBN-BHC plays a vital role in ensuring TU’s clinical psychology graduate students receive exceptional foundation-training experiences,” said Steward. Employing a generalist clinical model, the aim is that the students will feel confident when conducting therapy and assessment for diverse clientele and a wide variety of concerns.

When they are working at the clinic, these trainees operate under the supervision of psychologists licensed in Oklahoma, most of whom are TU faculty members. Supervision entails meeting individually with each student at least weekly, reviewing all their notes and clinical documentation, and providing additional support and training as required. In addition to overseeing the clinic’s day-to-day operations, Steward, who is herself a graduate of TU’s clinical psychology doctoral program, supervises about a third of the students who are seeing clients at the clinic while also teaching practicum courses.

A young man pointing to a chart and a young woman seated on a chair
PhD student Jack Stimson engages in therapy-skills role play with Associate Director and PhD student Amber Sitz.

Amber Sitz is one of those students. Currently in her fourth year in the doctoral clinical psychology program at TU, Sitz initially went through the clinic as a trainee and then moved into her current more advanced role assisting other students in their training. “TBN-BHC has endless training opportunities for students yearning to become clinicians,” remarked Sitz. “The assessment inventory the clinic has is a huge advantage, not only of what students can be trained in but the types of assessments clients can receive free of charge. My favorite part of my role as an associate director is consulting with peers as they are developing their therapeutic and assessment skills. I’m wrapping up my third year at the clinic and I’ve learned so much from my supervisors, peers, and clients that I’ll take with me to future sites.”

Responding to the pandemic

When the COVID-19 pandemic hit in March 2020, Steward and her colleagues acted swiftly to compile new trainings and resources specific to telehealth; establish and implement new policies, procedures and forms; and provide additional safety protocols so that the student trainees could receive the supports they needed. “I am so proud of the work my team did to respond to and bring about this monumental transition,” remarked Steward. “From creative problem-solving to the sheer volume of labor involved in implementing these changes, not to mention the many uncertainties surrounding the pandemic, we banded together to offer each other support and encouragement.”

Made possible by the support of generous community partners

TBN-BHC not only gives to the community. Its very existence is the result of community backing. Funding for the clinic is through a generous grant from the Ascension St. John Foundation. This covers operational costs as well as staff and graduate assistant positions. “Without this level of support,” said Steward, “we would not be able to do what we do.”

In December 2020, Steward and her colleagues were thrilled to receive a grant from BlueCross Blue Shield of Oklahoma’s Healthy Kids, HealthyFamilies® program. These funds are enabling the expansion of the clinic’s telehealth services to reach a wider area of potential clients through upgrades to equipment and software as well as funding for an additional supervisor, which will allow the clinic to increase the number of student trainees who are providing services for an academic year.

This glowing evaluation does not mean that the move to a telehealth format was not without its challenges. As Steward points out, the vast majority of TBN-BHC’s clientele come from economically disadvantaged backgrounds, and many did not have the resources (e.g., computer or other electronic device, fast internet for video sessions) to facilitate telehealth at the beginning of the pandemic. Additionally, Steward underscores, ensuring privacy and confidentiality, both of which are paramount for behavioral health care services, can be more difficult to navigate with clients and student clinicians alike in a virtual environment.

Steward also notes the fact that several psychological assessments are not able to be conducted virtually due to test security, testing validity and training concerns: “This restriction provided a significant delay in being able to provide these services to the community and to ensure our students received the comprehensive training in assessment that our clinic has done previously.” After almost a year of the pandemic, TBN-BHC was able to hold its first in-person assessment sessions in March 2021 to meet this important community need in a way that is safe and ethical for all involved.

Learning from the telehealth “big leap” and planning the way forward

While the clinic’s adaptation to telehealth has been challenging in a great number of ways, it is not without benefits. “I am most excited about how telehealth will allow us to expand our potential reach throughout the state of Oklahoma,” said Steward. “This is a really important issue, as there is a significant disparity in behavioral health services in our state, and this is more pronounced in rural areas. Through this big leap into the virtual landscape, we can offer our services to a number of people who may not otherwise have access or be able to afford behavioral health care.”

For the clinic’s students and staff, the shift to telehealth has enabled several clinical and administrative processes to be moved to a virtual format, thereby reducing the workload for students and staff and being friendlier to the environment through reduced paper consumption. And, as Steward commented, “it has also resulted in greater flexibility for our student trainees in a number of ways. I will be discussing their experiences and preferences with them as we make decisions about what changes have greatly benefited the training and clinical experiences we offer.”

Visits with TBN-BHC counselors are by appointment only. Learn more about the clinic online or call 918-631-3342 to speak with a representative about the services offered or to schedule an appointment.