As a child, Xiomara Garcia, now 21, never imagined attending a four-year college. Her parents hadn’t finished middle school, and finances were tight. Yet, here she was – a bioengineering major at Santa Clara University, supported by a generous scholarship. The cultural shift was immense; often, she was the only person of color in her classes. This “biggest culture shock of my life,” as she described it, coupled with the loss of a family member, a demanding course load, and unresolved childhood trauma, made controlling her emotions a constant struggle.
Traditional online therapy proved difficult. Finding a private spot to connect, away from her roommate, was nearly impossible. She once resorted to taking a video call with her therapist from under a stairwell near a bustling campus cafe. Eventually, she decided to seek in-person support.
Her new therapist’s office was located right in the dorm where Xiomara had lived during her freshman year. This inviting space, decorated with calming elements like shells and rocks, soft lighting, comfortable chairs, and a basket of snacks — a welcome change from the anonymity of a busy campus building or the sterile feel of a main counseling center, she said.
This is the essence of a growing trend in higher education: “embedded counselors.” These mental health professionals work directly out of dormitories and academic buildings, making support more visible and accessible. Colleges are embracing this model to break down the stigma associated with seeking help, especially as a significant portion of students, around 37 percent, report struggling with depression. A recent survey revealed that nearly one-third of university counseling centers now employ embedded counselors, a notable increase from just 20 percent five years ago. This innovative approach reflects a broader re-evaluation by colleges, aiming to provide mental health care proactively, before students reach a crisis point.
The office door to one of Ms. Tappan’s residential counseling spaces, and her laptop adorned with encouraging stickers like “Love is Love is Love” and “I Heart My Therapist,” visually communicate her welcoming philosophy even before a conversation begins.
“I used to come in crying every week,” Ms. Garcia shared, reflecting on her initial therapy sessions. Two years later, she feels much more self-assured and capable of managing her emotions. She firmly believes that if she hadn’t found such a warm, accessible therapist, she might not have continued her healing journey.
Late-night drop-ins
For universities like Virginia Tech, nestled in a rural landscape between the Blue Ridge and Allegheny Mountains, readily available mental health support is crucial. Off-campus therapists are scarce, and the main counseling office’s traditional hours and 15-minute walk from dorms often pose a challenge for busy students.
Now, Virginia Tech offers four embedded counselors who hold office hours in a campus dorm, accepting drop-ins as late as 10 p.m.
As assistant director Claire Cabellos explains, when a student’s busy day concludes, “everything else is kind of coming to the surface.” She emphasizes that “Mental health crises don’t happen on a 9 to 5 schedule.”
Xiomara Garcia, a student at Santa Clara University, utilized the free, unlimited therapy sessions offered by the school’s embedded counselors. She noted, “Therapy doesn’t exist in my household or really in my culture. It’s something that’s very frowned upon.”
The introduction of embedded counselors, alongside other campus mental health initiatives, has yielded positive results. There’s been a decrease in after-hours crisis calls, and student leaders (resident assistants) are more willing to continue their roles, having previously felt overwhelmed by students’ urgent mental health concerns, she said.
During the 2024-25 academic year, five embedded counselors at Virginia Tech conducted 1,805 sessions with 391 students, a significant jump from 504 sessions with 200 students in the program’s inaugural year (2022-23). Some students even feel comfortable enough to “show up in their pajamas.”
Rosi Escobar, a 21-year-old student leader in a dorm primarily housing first-year students, has found the nearby, late-night counselors immensely helpful. She has directed many students to them, including one experiencing a panic attack and another who hadn’t left their bed for a week.
“I’m not the person who has to catch all these problems and fix it myself,” she expressed, highlighting the relief this system provides to student staff.
Providing prompt and accessible mental health care to a vast student body remains a significant hurdle for colleges. A recent Healthy Minds Survey, involving over 84,000 students nationwide, revealed that less than half of those who screened positive for anxiety or depression received counseling in the past year.
Barriers cited included lack of time, uncertainty about where to seek help, financial concerns, and difficulty securing appointments, among other issues.
A friendly dog and an open door
Kristin Tappan, a Santa Clara University alumna now serving as a therapist there, is a well-known figure on campus. Often accompanied by her Maltipoo, Tiramisu, she might even be found distributing homemade lemon bars to students, a friendly way to introduce herself. This helps “make things feel a little bit more like home,” she notes.
She believes that “The doors are just a lot more open than I think they ever have been before.” At Santa Clara University, students can choose between the main counseling center for one-on-one therapy or one of the four therapists working out of six residence halls, providing flexible and convenient options.
In one of her offices, designed to resemble a cozy family room, students can relax in an armchair with Tiramisu nearby, openly discussing a range of issues: adjusting to life away from home, relationship challenges, academic stress, or anxieties about post-graduation life. Often, deeper issues emerge, such as family trauma, abuse, or problems with substance use. “There’s so much under the surface,” she reflects.
While placing therapists in academic and residential settings offers many advantages, the role can also present unique challenges.
Melissa Bottiglio, assistant director of the Embedded Program at the University of Colorado Boulder, co-led a 2024 survey of embedded providers across the U.S. and Canada. The survey found that counselors working alone in these settings sometimes experience isolation and find it harder to maintain professional boundaries when their workspace integrates deeply with campus life.
“Counselors have to be firm about where their scope of care begins and ends,” she emphasized.
Nevertheless, when a university successfully implements this model, embedded counselors effectively engage students who might otherwise hesitate to seek help. They can also develop specialized programs tailored to particular campus groups.
Currently, the University of Iowa has two embedded therapists serving 11 residence halls, and Ohio State University boasts 18 embedded clinicians across its campus.
The University of Arizona’s embedded counseling program, which began in 2020 with three counselors, has expanded to 12 counselors, strategically placed in various locations such as the Native American student affairs office, the medical school, and the veterinary college.
Sarah Heinzl, a licensed professional counselor at the University of Arizona, recounted an event where a student casually remarked to her, “We’ll talk about this on Friday.” Another student chimed in, “My counselor is also here.”
Later that week, inspired by their peers, several students visited Ms. Heinzl’s office to inquire about the services.
“This is what embedded counseling does,” she concluded. “It breaks down misconceptions about therapy and normalizes counseling as part of their world. And when they see that, more students step forward to ask for help.”