Identifying Identifying Emotionally Emotionally

Troubled StudentsTroubled Students

Maria Bartolomeo-Maida, Maria Bartolomeo-Maida, Ph.D.Ph.D.

Coordinator of CounselingCoordinator of CounselingCounseling Resource CenterCounseling Resource Center

Kingsborough Community CollegeKingsborough Community College

Goals Of This Presentation:Goals Of This Presentation:

1. 1. To provide a context that offers insight as to why To provide a context that offers insight as to why problems may arise. problems may arise.

2. To differentiate between normal adolescent 2. To differentiate between normal adolescent developmental issues & more serious developmental issues & more serious psychological problems among college students.psychological problems among college students.

3. To provide basic education about symptom 3. To provide basic education about symptom patterns & warning signs of emotional problems.patterns & warning signs of emotional problems.

4. To inform staff about how to assist & refer 4. To inform staff about how to assist & refer troubled students. troubled students.

How Do We Define How Do We Define “Emotionally Troubled” ?“Emotionally Troubled” ?

• Post Virginia Tech- large focus on campus Post Virginia Tech- large focus on campus safety & the ability to identify violent behavior. safety & the ability to identify violent behavior.

• Perception by counseling staff- increase in Perception by counseling staff- increase in severe pathology on campus severe pathology on campus (but is this actually (but is this actually true?). true?). 85% of85% of counselingcounseling center directors have center directors have reported seeing students with more serious reported seeing students with more serious mental health problems in recent yearsmental health problems in recent years (Gallagher, Gill & Sysco, 2000).(Gallagher, Gill & Sysco, 2000).

• Methodology in many studies have limitations. Methodology in many studies have limitations. • Helpful to have an operational definition of Helpful to have an operational definition of

what “severe psychopathology” is.what “severe psychopathology” is.

Normal Developmental Issues Normal Developmental Issues Facing College StudentsFacing College Students (Kadison & (Kadison &

DiGeronimo, 2004)DiGeronimo, 2004)

• Identity DevelopmentIdentity Development (Who am I?, Where (Who am I?, Where do I fit in?).do I fit in?).

• Relationships and SexualityRelationships and Sexuality (anxiety (anxiety about sexual freedom, STDs, peer pressure, about sexual freedom, STDs, peer pressure, body image, intimacy & gender differences).body image, intimacy & gender differences).

• Interpersonal IssuesInterpersonal Issues (conflict resolution, (conflict resolution, acceptance of different cultures, etc.)acceptance of different cultures, etc.)

Typical Challenges Among College Typical Challenges Among College Students Students (Kadison & DiGeronimo, 2004)(Kadison & DiGeronimo, 2004)

• Academic pressure to succeedAcademic pressure to succeed• Balancing extracurricular activitiesBalancing extracurricular activities• Parental expectationsParental expectations• Racial and cultural problemsRacial and cultural problems• Financial worriesFinancial worries• Social fears Social fears (terrorism, campus safety, sexual (terrorism, campus safety, sexual

assault)assault)

• Pressure to find workPressure to find work

More On Financial Worries…More On Financial Worries…

• College Tuition is expensive-between 1981 and 1994 College Tuition is expensive-between 1981 and 1994 costs increased 153 percent at public universities & costs increased 153 percent at public universities & over 200 percent at private universities.over 200 percent at private universities.

• Students from divorced families have increased Students from divorced families have increased financial stress- student must gather tax forms from financial stress- student must gather tax forms from both parents, sometimes a parent becomes estranged.both parents, sometimes a parent becomes estranged.

• Academic progress gets strained with a part time job Academic progress gets strained with a part time job that student feels necessary to have. that student feels necessary to have.

• Loans are not always an option students want to take Loans are not always an option students want to take due to being indebted.due to being indebted.

• Uncertain economic times (Recession, gas prices, Uncertain economic times (Recession, gas prices, etc.)etc.)

(Kadison & DiGeronimo, 2004)(Kadison & DiGeronimo, 2004)

More On Social Fears…More On Social Fears…

• Social climate in which we live creates Social climate in which we live creates uncertainty for students. This includes:uncertainty for students. This includes:

1. Increase in campus violence in 1. Increase in campus violence in recent yearsrecent years

2. Post 9/11, bombing of trains in 2. Post 9/11, bombing of trains in MadridMadrid

3. For women, the fear of being raped 3. For women, the fear of being raped is a crime more feared than being is a crime more feared than being murdered. murdered.

Challenges Facing Challenges Facing International Students in International Students in

ParticularParticular• 1995 survey of students at CUNY reported that 1995 survey of students at CUNY reported that

51% of students attending the 6 community 51% of students attending the 6 community colleges were born outside of the U.S. colleges were born outside of the U.S. (Brilliant, (Brilliant, 2000)2000)

• Issues of acculturation.Issues of acculturation.• International students might view counseling as International students might view counseling as

a sign of weakness, it is stigmatized in their a sign of weakness, it is stigmatized in their country.country.

• Students might feel depression and mourning Students might feel depression and mourning with the realization of the struggle of with the realization of the struggle of immigration (typically after the 1immigration (typically after the 1stst yr. in new yr. in new country). country). (Brilliant, 2000)/ (Brilliant, 2000)/ language barriers, language barriers, homesickness, etc. homesickness, etc.

International Student Challenges International Student Challenges Continued…Continued…

• Somatic complaints, family problems, the loss of Somatic complaints, family problems, the loss of loved ones, adjustment to food and climate, loved ones, adjustment to food and climate, finances, culture shock finances, culture shock (In Grayson & Stowe, 2005)(In Grayson & Stowe, 2005)

• Non-support at times from their ethnic Non-support at times from their ethnic counterparts- “acting white” or the opposite-counterparts- “acting white” or the opposite-these students are first in family to attend these students are first in family to attend college and there is significant pressure to excel.college and there is significant pressure to excel.

• Different learning styles- (i.e. in Asian countries, Different learning styles- (i.e. in Asian countries, students are not allowed to challenge or disagree students are not allowed to challenge or disagree with the instructor but very different in the U.S.) with the instructor but very different in the U.S.)

• Legal issues- temporary student visas, etc. Legal issues- temporary student visas, etc. • Effects of Terrorism- i.e. students of Muslim Effects of Terrorism- i.e. students of Muslim

countriescountries (Kadison & DiGeronimo, 2004) (Kadison & DiGeronimo, 2004)

Other Challenges/ Possible Other Challenges/ Possible Causes of Problem Behavior…Causes of Problem Behavior…

• Students are lacking role models at home.Students are lacking role models at home.• Students may become very sensitive to Students may become very sensitive to

perceived criticism (reminder of earlier perceived criticism (reminder of earlier trauma).trauma).

• Many students may feel embarrassed, Many students may feel embarrassed, powerless or invalidated if smallest thing powerless or invalidated if smallest thing goes wrong.goes wrong.

• Anger in particular can be fueled by a loss or Anger in particular can be fueled by a loss or conflict in their personal lives.conflict in their personal lives.

• Important to think about students’ Important to think about students’ environmental and cultural background when environmental and cultural background when trying to understand behavior. trying to understand behavior.

(Hernandez & Fister, 2001)(Hernandez & Fister, 2001)

Differences in College Differences in College Students TodayStudents Today

• Students are more isolated-they rely more on Students are more isolated-they rely more on peers than on family, cultural norms, etc. peers than on family, cultural norms, etc. Isolation from web & other technology leaves Isolation from web & other technology leaves students w/poor social skills.students w/poor social skills.

• Students have blurry perceptions of boundaries Students have blurry perceptions of boundaries between themselves & faculty and staff (seen as between themselves & faculty and staff (seen as peers).peers).

• Decrease in students attending college for Decrease in students attending college for intrinsic, moral value. Seen only as a means for intrinsic, moral value. Seen only as a means for employment.employment.

(Hernandez & Fister, 2001)(Hernandez & Fister, 2001)

Differences Continued…Differences Continued…

• A more diverse cross section of our A more diverse cross section of our society is attending college more than any society is attending college more than any other time in history (Gilbert, 1992)other time in history (Gilbert, 1992)

• Students are more nontraditional- age, Students are more nontraditional- age, socioeconomic status, mental illness, etc. socioeconomic status, mental illness, etc. (Benton & Benton, 2006)(Benton & Benton, 2006)

• There are more veterans returning to There are more veterans returning to college than ever before.college than ever before.

Common Disruptions in Common Disruptions in ClassroomsClassrooms

Are these typical adolescent issues or Are these typical adolescent issues or something we should worry about??something we should worry about??

• Leaving class frequentlyLeaving class frequently• Copying work/ plagiarism or lyingCopying work/ plagiarism or lying• Refusal to participateRefusal to participate• Continued tardinessContinued tardiness• Disruptions from electronic devices/ from foodDisruptions from electronic devices/ from food• Sleeping in classSleeping in class• Off topic conversationsOff topic conversations• Any others???Any others???

(Amada, 1999)(Amada, 1999)

Common Psychological Common Psychological Problems Among College Problems Among College

StudentsStudents • DepressionDepression• Sleep DisordersSleep Disorders• Substance AbuseSubstance Abuse• Anxiety DisordersAnxiety Disorders• Eating DisordersEating Disorders• Impulsive Behaviors (cutting)Impulsive Behaviors (cutting)• SuicideSuicide

(Kadison & DiGeronimo, 2004)(Kadison & DiGeronimo, 2004)

Some Alarming StatisticsSome Alarming Statistics• 25% of college students are now being 25% of college students are now being

prescribed medications compared to 7% 14 years prescribed medications compared to 7% 14 years ago. ago.

• 17% of students engage in self injurious behavior 17% of students engage in self injurious behavior on college campuses compared to 12% national on college campuses compared to 12% national average. average.

• In the most recent ACHA survey, almost 20% of In the most recent ACHA survey, almost 20% of students indicated that during past year, they students indicated that during past year, they had become so concerned about a friend that it had become so concerned about a friend that it interfered with their academics.interfered with their academics.

Statistics Continued…Statistics Continued…

• In research conducted over 13 year span (1988-In research conducted over 13 year span (1988-2001) at Kansas State University, researchers 2001) at Kansas State University, researchers found that anxiety disorders doubled and found that anxiety disorders doubled and depression as well as suicidal ideation and intent depression as well as suicidal ideation and intent tripled (Benton et al., 2003).tripled (Benton et al., 2003).

• Of 16,000 students in 2002 by the ACHA, 54.6% Of 16,000 students in 2002 by the ACHA, 54.6% reported feeling hopeless in the past year, 37.6% reported feeling hopeless in the past year, 37.6% reported feeling so depressed 3 or more times in reported feeling so depressed 3 or more times in past year that they could not function, 9.5% past year that they could not function, 9.5% reported seriously considering suicide, 1.4% reported seriously considering suicide, 1.4% made an attempt (Benton & Benton, 2006).made an attempt (Benton & Benton, 2006).

Statistics, p 3.Statistics, p 3.

• A 10 yr study on suicides at Midwestern A 10 yr study on suicides at Midwestern University Campuses shows that students ages 25 University Campuses shows that students ages 25 & over were at greater risk for committing & over were at greater risk for committing suicide (Silverman, 1997).suicide (Silverman, 1997).

• Overall, however, the student suicide rate is one Overall, however, the student suicide rate is one half of the national rate (Silverman, 1997).half of the national rate (Silverman, 1997).

• Studies suggest that 80% of students who commit Studies suggest that 80% of students who commit suicide have not visited their campus counseling suicide have not visited their campus counseling center (Hanover Research Council, 2008). center (Hanover Research Council, 2008).

Demographic InformationDemographic Information

• Onset period for mental disorders = 20 yrs old for Onset period for mental disorders = 20 yrs old for schizophrenia (males), mood disorders, and schizophrenia (males), mood disorders, and substance abuse, 30 years old for schizophrenia substance abuse, 30 years old for schizophrenia (females). (females).

• Depression is more prevalent in females. Eating Depression is more prevalent in females. Eating disorders are more prevalent in females though disorders are more prevalent in females though there is an increase in males (athletes) and there is an increase in males (athletes) and transgendered students in recent years.transgendered students in recent years.

• 80% of mental illness in men occurs between ages 80% of mental illness in men occurs between ages 20-27.20-27.

• Onset for eating disorders = bulemia during Onset for eating disorders = bulemia during college years, anorexia develops somewhat earlier.college years, anorexia develops somewhat earlier.

Suicide In ParticularSuicide In Particular

• Suicide is the 2Suicide is the 2ndnd leading cause of death on leading cause of death on college campuses.college campuses.

• The odds that a student will commit suicide The odds that a student will commit suicide are 1,000 to 1 (Pavela, 2007)are 1,000 to 1 (Pavela, 2007)

• 7.5/100,000 college students commit 7.5/100,000 college students commit suicide/ National Average is 15 per 100,000 suicide/ National Average is 15 per 100,000 (Silverman et al., 1997)(Silverman et al., 1997)

• Males are 4x more likely to commit suicide/ Males are 4x more likely to commit suicide/ Caucasians are more likely to commit Caucasians are more likely to commit suicide. suicide.

DepressionDepression5 or more of the following symptoms are present 5 or more of the following symptoms are present over a two week period:over a two week period:

- depressed mood most of day- depressed mood most of day-diminished interest in almost all activities-diminished interest in almost all activities- significant weight loss, weight gain- significant weight loss, weight gain- insomnia or increased sleeping- insomnia or increased sleeping

- restlessness- restlessness- fatigue/ loss of energy- fatigue/ loss of energy- reduced concentration/ indecisiveness- reduced concentration/ indecisiveness- feelings of worthlessness/ excessive guilt- feelings of worthlessness/ excessive guilt- recurrent thoughts of suicide- recurrent thoughts of suicide

Bipolar DisorderBipolar Disorder

• Students experiencing a manic episode may Students experiencing a manic episode may exhibit the following:exhibit the following:- poor judgment- poor judgment -reckless behavior-reckless behavior- impulsivity- impulsivity - sexual promiscuity- sexual promiscuity- grandiosity- grandiosity - rapid speech- rapid speech

This is often followed by period of depression This is often followed by period of depression and withdrawal. There is a strong genetic and withdrawal. There is a strong genetic component.component.

AnxietyAnxiety• According to the NIMH, anxiety affects According to the NIMH, anxiety affects

approximately 19 million adults and 9.1% of approximately 19 million adults and 9.1% of college students.college students.

• Anxiety disorders include: panic disorder, Anxiety disorders include: panic disorder, OCD, PTSD, Phobias, and GAD.OCD, PTSD, Phobias, and GAD.

• Symptoms can range from exaggerated Symptoms can range from exaggerated worries, fear of humiliation and worries, fear of humiliation and embarrassment, to many physical embarrassment, to many physical complaints such as headache, nausea, complaints such as headache, nausea, shortness of breath, etc. shortness of breath, etc.

PTSDPTSDSymptom criteria according to the DSM-Symptom criteria according to the DSM-IV:IV:

1.1. The traumatic event is persistently The traumatic event is persistently reexperienced.reexperienced.

2.2. There is persistent avoidance of stimuli There is persistent avoidance of stimuli associated w/ the trauma and emotional associated w/ the trauma and emotional numbing.numbing.

3.3. Persistent symptoms of increased arousal (not Persistent symptoms of increased arousal (not present before the trauma)- i.e. hypervigilance, present before the trauma)- i.e. hypervigilance, difficulty falling asleep, irritability, etc.difficulty falling asleep, irritability, etc.

Substance UseSubstance Use

• 1400 college students between 18-24 die 1400 college students between 18-24 die each year from alcohol related injuries each year from alcohol related injuries (MVA).(MVA).

• 31% of college students met criteria for 31% of college students met criteria for alcohol abuse in the past 12 months.alcohol abuse in the past 12 months.

• Alcohol problems are highest among Alcohol problems are highest among young adults ages 18-29.young adults ages 18-29.(National Advisory Council of the National Institute on (National Advisory Council of the National Institute on

Alcohol Abuse and Alcoholism, 2002)Alcohol Abuse and Alcoholism, 2002)

Substance Abuse DiagnosisSubstance Abuse Diagnosis

• Criteria for substance abuse, according Criteria for substance abuse, according to the DSM-IV, is at least 1 or more of to the DSM-IV, is at least 1 or more of the following during 12 mth pd.= the following during 12 mth pd.= recurrent use resulting in failure to recurrent use resulting in failure to fulfill major obligations at work, school, fulfill major obligations at work, school, etc., recurrent use in situations in which etc., recurrent use in situations in which it is physically hazardous, recurrent it is physically hazardous, recurrent substance related legal problems, substance related legal problems, continued use despite having persistent continued use despite having persistent social or interpersonal problems.social or interpersonal problems.

Other Substance ProblemsOther Substance Problems

Are we seeing the impact of being on drugs Are we seeing the impact of being on drugs such as Adderrall & Ritalin?-these drugs keep such as Adderrall & Ritalin?-these drugs keep you awake longer & have the following you awake longer & have the following negative side effects: lack of appetite, negative side effects: lack of appetite, paranoia, dry mouth, aggression, sleep paranoia, dry mouth, aggression, sleep deprivation deprivation (Kadison & DiGeronimo, 2004).(Kadison & DiGeronimo, 2004).

Are we seeing alcohol withdrawal?- the Are we seeing alcohol withdrawal?- the following may develop w/in several hours to a following may develop w/in several hours to a few days: insomnia, anxiety, nausea, few days: insomnia, anxiety, nausea, hallucinations, autonomic hperactivity hallucinations, autonomic hperactivity (DSM-IV, (DSM-IV, 2000).2000).

Sleep DifficultiesSleep Difficulties• The most common physical The most common physical

complaint of college students.complaint of college students.• Sleep problems often become self-Sleep problems often become self-

fulfilling prophecies.fulfilling prophecies.• The costs of sleep deprivation: The costs of sleep deprivation:

cognitive difficulties, anxiety, cognitive difficulties, anxiety, depression, reduced physical health, depression, reduced physical health, irritability, etc. irritability, etc.

• 80% of depressed people have sleep 80% of depressed people have sleep disorders- disorders- which one comes first?which one comes first?

(Kadison & DiGeronimo, 2004)(Kadison & DiGeronimo, 2004)

Asperger’s SyndromeAsperger’s Syndrome

On the autism spectrum of development On the autism spectrum of development disorders.disorders.

Symptoms may include any of the following:Symptoms may include any of the following:• Impairment in the use of nonverbal behaviorImpairment in the use of nonverbal behavior

(body posture, eye to eye gaze, etc.)(body posture, eye to eye gaze, etc.)• Failure to develop peer relationshipsFailure to develop peer relationships• Lack of social reciprocityLack of social reciprocity• Inflexible adherence to specific routines, ritualsInflexible adherence to specific routines, rituals• Repetitive motor mannerisms (hand flapping, Repetitive motor mannerisms (hand flapping,

etc.)etc.)

PsychosisPsychosis

• 50% of individuals who are psychotic do 50% of individuals who are psychotic do not think they are.not think they are.

• Individuals may be exhibiting delusions Individuals may be exhibiting delusions or hallucinations:or hallucinations:DelusionDelusion- firmly held false beliefs (most - firmly held false beliefs (most common are being controlled by someone common are being controlled by someone else, being persecuted by someone else)else, being persecuted by someone else)HallucinationHallucination- perceiving things that do - perceiving things that do not actually exist (can be auditory and not actually exist (can be auditory and visual)visual)

SchizophreniaSchizophrenia

• Refers to a class of disorders in which severe Refers to a class of disorders in which severe distortion of reality occurs. distortion of reality occurs.

• According to the DSM-IV, 2 or more of the According to the DSM-IV, 2 or more of the following are present during a 1 month period:following are present during a 1 month period:

- delusions- delusions -hallucinations-hallucinations

- disorganized speech (incoherence)- disorganized speech (incoherence)

-disorganized behavior-disorganized behavior

-negative symptoms (flat affect, alogia, -negative symptoms (flat affect, alogia, avolition)avolition)

Personality DisordersPersonality Disorders

Enduring patterns of behavior/ personality Enduring patterns of behavior/ personality characteristics that are inflexible and pervasive characteristics that are inflexible and pervasive across a broad range of personal/ social across a broad range of personal/ social situations. DSM –IV defines 10 distinct ones.situations. DSM –IV defines 10 distinct ones.

Paranoid PD-Paranoid PD- distrust and suspiciousness of others distrust and suspiciousness of othersSchizoid PD-Schizoid PD- detachment from social detachment from social

relationships, restricted range of expression/ relationships, restricted range of expression/ emotionemotion

Borderline PD-Borderline PD- instability of self image, instability of self image, interpersonal relationships, impulsivityinterpersonal relationships, impulsivity

Organic/ Neurological Organic/ Neurological ProblemsProblems

• Frontal Lobe Brain problems (tumor, Frontal Lobe Brain problems (tumor, injury, stroke): impulsivity, poor injury, stroke): impulsivity, poor judgment, reduced reasoning ability.judgment, reduced reasoning ability.

• Medical issues such as Medical issues such as HyperthyroidismHyperthyroidism

• Mental RetardationMental Retardation• Tic Disorders/ TourettesTic Disorders/ Tourettes

How do these psychological How do these psychological disabilities manifest?disabilities manifest?

In class or during advisement sessions, In class or during advisement sessions, students may:students may:

- show signs of cognitive and processing - show signs of cognitive and processing difficulties.difficulties.- have trouble following directions and - have trouble following directions and processing information.processing information.- seem socially awkward or unfriendly.- seem socially awkward or unfriendly.- uninterested or dazed/ confused- uninterested or dazed/ confused- have difficulty remembering something- have difficulty remembering something- seem hostile or defensive/ easily agitated and - seem hostile or defensive/ easily agitated and argumentativeargumentative

Warning Signs Of ViolenceWarning Signs Of Violence

• Loss of temper Loss of temper • Frequent physical fighting or other current Frequent physical fighting or other current

violent behaviorviolent behavior• Increase in use of drugs or alcoholIncrease in use of drugs or alcohol• Increase in risk taking behaviorIncrease in risk taking behavior• Has access to weaponsHas access to weapons• Has detailed plans to commit acts of violenceHas detailed plans to commit acts of violence• Announcing threats or plans of hurting Announcing threats or plans of hurting

othersothers• Psychiatric historyPsychiatric history

More on Violence…More on Violence…

• For the period from 1995-2002, colleges students For the period from 1995-2002, colleges students ages 18-24 experienced violence at average ages 18-24 experienced violence at average annual rates lower than those for non-students in annual rates lower than those for non-students in same age group same age group (East Tennessee State University (East Tennessee State University Memorandum to Faculty, 2008).Memorandum to Faculty, 2008).

• Overall, violence is difficult to predict.Overall, violence is difficult to predict.• The best predictor of violence is prior violence.The best predictor of violence is prior violence.• Violence risk increases with use of alcohol.Violence risk increases with use of alcohol.• School violence in recent years are often shooting School violence in recent years are often shooting

sprees for which perpetrator commits suicide.sprees for which perpetrator commits suicide.• Recent research has shown that the vast majority Recent research has shown that the vast majority

of people who are violent do not suffer from of people who are violent do not suffer from mental illness mental illness (American Psychiatric Association, 1994).(American Psychiatric Association, 1994).

Americans with DisabilitiesAmericans with Disabilities

• Section 504 of the Rehabilitation Act of 1973 and the Americans Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, prohibit universities from with Disabilities Act of 1990, prohibit universities from discriminating against individuals with disabilities (including discriminating against individuals with disabilities (including mental disabilities).mental disabilities).

• Discrimination is prohibited against “otherwise qualified Discrimination is prohibited against “otherwise qualified individuals”- one who with or without reasonable modifications individuals”- one who with or without reasonable modifications meets the essential eligibility requirements.meets the essential eligibility requirements.

• ““Disability” includes a mental impairment that substantially limits Disability” includes a mental impairment that substantially limits a major life activity.a major life activity.

• Under these acts, universities can take disciplinary action when Under these acts, universities can take disciplinary action when behaviors are disruptive but they can not take disciplinary action behaviors are disruptive but they can not take disciplinary action when the person is ill and the behavior is not disruptive.when the person is ill and the behavior is not disruptive.

(Benton & Benton, 2006)(Benton & Benton, 2006)

Specific Cultural Issues Not To Be Specific Cultural Issues Not To Be Overlooked When Determining a Overlooked When Determining a

Behavior “Troubled”Behavior “Troubled”

• According to the DSM-IV, there are According to the DSM-IV, there are culture bound syndromes that denote culture bound syndromes that denote locality specific patterns of troubling locality specific patterns of troubling experience that may or may not be experience that may or may not be linked to a particular DSM-IV category. linked to a particular DSM-IV category.

• According to the DSM-IV, many of these According to the DSM-IV, many of these patterns are indigenously considered to patterns are indigenously considered to be “illnesses”.be “illnesses”.

Why Might Staff Be Reluctant Why Might Staff Be Reluctant To Intervene?To Intervene?

• Literature seems to focus on faculty in Literature seems to focus on faculty in particular vs. other staff. particular vs. other staff.

• Some faculty feel they could handle Some faculty feel they could handle situations on their own.situations on their own.

• Faculty might feel embarrassed that there Faculty might feel embarrassed that there are problems in their classroom.are problems in their classroom.

• Might feel fear of harming the Might feel fear of harming the psychologically fragile student.psychologically fragile student.

• Might feel fear of student retaliationMight feel fear of student retaliation• Might remain silent for fear of receiving Might remain silent for fear of receiving

inadequate administrative support.inadequate administrative support.(Amada, 1999) (Amada, 1999)

How To Assist StudentsHow To Assist Students

• 3 R’s = Recognize, Respond, Refer 3 R’s = Recognize, Respond, Refer (Benton & Benton, 2006)(Benton & Benton, 2006)

• It is appropriate to approach students It is appropriate to approach students anytime you have concerns.anytime you have concerns.

• Many students may feel relieved that Many students may feel relieved that someone cares.someone cares.

• Waiting to intervene may complicate the Waiting to intervene may complicate the situation.situation.

• Helpful to document behavior as you see Helpful to document behavior as you see it happening.it happening.

The Importance of Making The Importance of Making a Referral!a Referral!

• Research has shown that students Research has shown that students who reported having significant who reported having significant emotional problems over the emotional problems over the previous year and had more previous year and had more functional relationships with their functional relationships with their advisors were more likely to use advisors were more likely to use mental health services mental health services (Hanover (Hanover Research Council, 2008)Research Council, 2008)

In The Case of Suicide…In The Case of Suicide…

• Not helpful to tell students, “look on Not helpful to tell students, “look on the bright side” or “you’ll get over it”. the bright side” or “you’ll get over it”.

• Many students cry out for help Many students cry out for help through writing assignments, poetry, through writing assignments, poetry, etc. etc.

• We should always take this seriously.We should always take this seriously.• Remain with the student and walk Remain with the student and walk

them to counseling if possible.them to counseling if possible.• Contact public safety even if the Contact public safety even if the

student does not comply.student does not comply.

Language To Use When Language To Use When Making a Referral:Making a Referral:

• ““I’ve noticed that you’ve appeared sad and I’ve noticed that you’ve appeared sad and withdrawn during our last few meetings…”withdrawn during our last few meetings…”

• ““I’m aware that you have fallen asleep in class I’m aware that you have fallen asleep in class more often during the past few weeks…”more often during the past few weeks…”

• ““I’m concerned about your tendency to come I’m concerned about your tendency to come late to every appointment we have had so far late to every appointment we have had so far and I want to make sure you are okay…”and I want to make sure you are okay…”

• Be direct, supportive, and nonjudgmental.Be direct, supportive, and nonjudgmental.• Provide empathy vs. trying to fix or gloss over Provide empathy vs. trying to fix or gloss over

problem problem (i.e. “you’ll do just fine on the exam”)(i.e. “you’ll do just fine on the exam”)

Other Considerations When Other Considerations When Making a ReferralMaking a Referral

• Helpful to know about the counseling Helpful to know about the counseling center & services offered on your campus.center & services offered on your campus.

• Find out if students have resources at Find out if students have resources at home, etc.home, etc.

• Find out if they have ever used Find out if they have ever used counseling services in the past.counseling services in the past.

• If calling counseling directly, it’s best if If calling counseling directly, it’s best if you tell the student that you are referring you tell the student that you are referring them.them.

• Helpful to escort student. Helpful to escort student.

And More Considerations…And More Considerations…

• Ask for clarification if necessary (i.e. “I Ask for clarification if necessary (i.e. “I am not sure what you mean”)am not sure what you mean”)

• Invite the student to speak in a private Invite the student to speak in a private area. Might be helpful to see where the area. Might be helpful to see where the student is comfortable meeting.student is comfortable meeting.

• If the student refuses or is reluctant to If the student refuses or is reluctant to talk, indicate that your door is open talk, indicate that your door is open and that the student can return at a and that the student can return at a later time.later time.

(Hernandez & Fister, 2001)(Hernandez & Fister, 2001)

Managing Other Specific Managing Other Specific SituationsSituations

• Angry studentAngry student- try not to personalize their - try not to personalize their agitation, try to remain calm & model calm agitation, try to remain calm & model calm behavior, avoid challenging body language.behavior, avoid challenging body language.

• Paranoid student-Paranoid student- try to understand that most try to understand that most attempts you make at communicating with attempts you make at communicating with student might be fraught with defensiveness student might be fraught with defensiveness and feelings of personal attack by student.and feelings of personal attack by student.

• Disorganized student-Disorganized student- do not pretend to do not pretend to understand them. Try to get them to a safe understand them. Try to get them to a safe place (Counseling, Health Services, etc.)place (Counseling, Health Services, etc.)

• Withdrawn students-Withdrawn students- we must be creative in we must be creative in trying to engage them, sometimes this takes trying to engage them, sometimes this takes time and trust needs to be established.time and trust needs to be established.