67 The Professional Counselor | Volume 13, Issue 2 issues (71.0%, n = 147), poor mental health (64.7%, n = 134), sleep deprivation (41.1%, n = 85), limited technology during virtual learning (33.3%, n = 69), lack of space to work at home during virtual learning (30.4%, n = 63), poor physical health (17.9%, n = 37), and other (3.9%, n = 8). The Freeman-Halton exact test revealed a significant relationship between grade level (n = 183) and lack of motivation (p = .001, ϕ = .265), poor mental health (p = .001, ϕ = .269), and attention issues (p = .009, ϕ = .232), all with positive moderate associations. For lack of motivation, 96.7% (n = 58) of high school counselors and 88.1% (n = 37) of middle school counselors reported this issue as compared to 75.3% (n = 61) of elementary school counselors. For poor mental health, 78.3% (n = 47) of high school counselors and 69.0% (n = 29) of middle school counselors reported this outcome as compared with 49.4% (n = 40) of elementary school counselors. For attention issues, 79.0% (n = 64) of elementary school counselors and 73.8% (n = 31) of middle school counselors reported concerns as compared to 55.0% (n =33) of high school counselors. Table 2 School/Program Characteristics Characteristic n % Location Urban 31 15.0 Suburban 95 45.9 Rural 72 34.8 Unsure 9 4.3 Title I Status Yes 121 58.5 No 57 27.5 Unsure 29 14.0 Grade Level Elementary 81 39.1 Middle 42 20.3 High 60 29.0 Other 24 11.6 Follows 80% Direct Service Guideline Yes 112 54.1 No 65 31.4 Unsure 30 14.5 School Counselor-to-Student Ratio (caseload) 1:1–1:300 29 14.0 1:301–1:550 144 69.6 1:551 and higher 31 15.0 Other 3 1.4 Note. N = 207
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