College students today often experience considerable personal and school-related stress. In addition to the pressure to achieve and work out a path to professional success, students must cope with a variety of personal stressors and pressures. Many of these personal stresses are age-related developmental factors, some are situational and some are psychological.
In an attempt to juggle the demands of college and their personal lives, student sometimes act out aggressively or self-destructively. Strong feelings of anger, depression and anxiety are common. Sometimes just one added situation or stressor can precipitate a crisis.
Studies indicate that in a group of 100 college students with equal numbers of men and women at least:
- 25 students will have divorced parents
- 15 students will have a substance-abusing parent
- 10 students will themselves have a substance abuse problem
- 15 female students will be victims of rape or sexual abuse
- 6 female students will have an eating disorder
- 4 male students will be victims of sexual abuse
- 3 female students will become pregnant during their college years
Other common stressors that students experience include:
- Isolation and loneliness
- Death of a loved one
- Break-up of an intimate relationship
- Serious illness
- Perceived rejection by family
- Academic pressure or failure
- Identity confusion
- Cultural oppression/discrimination
- Low motivation or inability to establish goals
- Outside work pressures
- Parenting responsibility
Faculty and Staff as Helping Resources for Students
Students experiencing this level of distress may turn to you for help, due to your position, status and visibility on campus. Consequently, you may find yourself confronted by a disturbed or disturbing student who needs assistance. Your response in these situations could impact significantly on the student’s ability to deal constructively with his/her problems.
There are specific guidelines you can use to help troubled students get the assistance they need. The guidelines are categorized into the following sections: 1) recognition; 2) intervention; and 3) referral.
Recognizing Troubled Students
Everyone feels stressed, depressed or anxious from time to time. However, some behaviors occurring over a period of time can suggest that the problems with which the student is dealing are beyond his/her ability to cope. The following three levels of behaviors indicate relative severity of distress.Level 1: Although not disruptive to others, these behaviors may indicate that intervention is needed:
- seriously poor grades or a change from consistently good to unaccountably poor performance;
- despite satisfactory performance, a student who appears anxious, constantly seeks you out, concerned about grades;
- excessive absences, especially if the student previ-ously demonstrated consistent class and/or work attendance;
- unusual or markedly changed pattern of interaction, e.g. totally avoiding participation, becoming exces-sively anxious when called upon, dominating discus-sion, withdrawal from social contact, etc.;
- depressed mood, excessive crying; inability to make transition to school environment;
- other characteristics such as lethargic behavior, excessive activity and very rapid speech; swollen, red eyes; marked change in personal dress or hygiene; anxious behavior; and falling asleep in class or at work.
- repeated requests for special consideration, such as deadline extensions (especially if the student appears uncomfortable or highly emotional disclosing the circumstances prompting the request);
- new or consistent behavior which pushes the limits of decorum and which interferes with the effective management of your class, work setting or living arrangements;
- an unusual or exaggerated emotional response that is obviously inappropriate to the situation;
- a student with no apparent physical illness loses a dramatic amount of weight in a short time period;
- a student seems agitated and restless in class, constantly argues with you, and is shunned by classmates.
- highly disruptive behavior (hostile, aggressive, violent, etc.);
- inability to communicate clearly (garbled or slurred speech, disjointed thoughts);
- loss of contact with reality (seeing/hearing things that are not present, beliefs or actions greatly at odds with reality or probability);
- overtly suicidal thoughts (referring to suicide as current option);
- homicidal threats.
What You Can Do (Intervention)
In any of these situation your calmness, your willing¬ness to help, and your knowledge of whom to call is important. You may choose to approach the student or the student may seek your help with a problem. Below are some suggestions which might be helpful for you in dealing with a troubled student.
Listening and Talking (at all levels):
- Demonstrate your respect for the student by talking to the student when both of you have sufficient time and are in a private place free from disturbance by others.
- Be matter-of-fact. Controlling your emotions may help the student to do the same.
- Give the student your undivided attention.
- Express concern for the student in clear, direct, be-havioral, non-judgmental terms (e.g., “I’ve noticed you’ve been absent from class lately and I’m con-cerned,” rather than “Why haven’t you been in class?” or “Where have you been lately?”).
- Listen in a respectful, non-threatening way to the student’s description of the problems. Let the student talk.
- Convey support and understanding by summarizing what you hear the student saying by including both content and feelings (“It sounds as if the experience of moving away from home was a big change and now you’re feeling lonely and isolated.”)
Referring to CAPSLevel 1:
Suggest that the student call for an appointment during office hours.Level 2:
Suggest that the student use your telephone to arrange an appointment while the student is still in your office. When the call is made from your office, you know that at least an appointment has been made. By making the call him/herself, the student is more likely to follow through to get help. Your willingness to let him/her handle this part of the process affirms his/her positive coping capacities.Level 2 & 3:
Call CAPS yourself, while the student is still in your office, and arrange an appointment for the student. If you think this is an emergency situation, please indi-cate this when you contact CAPS. Indicate your will-ingness to the student to provide CAPS with informa-tion about the nature of the problem and the reason for your referral.Level 3:
In an immediate emergency, you may decide to accompany the student to CAPS in person so that he/she may be seen immediately by the counselor who is available to handle emergencies (Monday through Friday, 8 a.m. to 5 p.m.). If possible, a call indicating that you are bringing a student to CAPS would be helpful.
** In an emergency situation do not hesitate to contact the University Police for emergency assistance (472-3555).
After regular business hours during the academic year, you may call the Health Center at 472-5000, Monday through Friday until 6 p.m., Saturday 10:30 a.m. to 2 p.m. for instructions on how to get in touch with a counselor who will assist you in assessment and referral by telephone.
Call Ask-A-Nurse at 481-5499 (all other hours).When in Doubt, Consult
If you have specific questions about a student, or are unsure about whether or how to approach an individual to make a referral, call Counseling and Psychological Services (CAPS) at 472-7450, indicate that you are concerned about a student, and ask to speak to the counselor handling emergencies. The CAPS staff member can help you to:
- assess the seriousness of the situation;
- learn about resources, both on and off campus, so that you can provide the student with potential options for obtaining assistance;
- decide how best to initiate the referral process;
- clarify your own feelings regarding the student and consider how you can be most effective.
What Happens When a Student Visits CAPS
The first three counseling sessions are free. Psychiatric appointments are provided as needed at a low cost. Students should be encouraged to make their own appointments by calling 472-7450, or stopping by the University Health Center, Room 213, during office hours. Due to heavy service demands, there may be a wait for several hours to several days before an initial appointment can be arranged. In emergency situations, however, a student will be seen immediately.
At the student’s first appointment, he/she will fill out confidential information forms before meeting with a counselor. During this appointment, the counselor will assess the student’s concerns and needs. Communica¬tion with CAPS is confidential. A student’s situation, or even the fact that counseling is being received at CAPS, may not be shared without the student’s written permission. The main exceptions to this are imminent suicide, homicide or suspected child abuse.
If the counselor and student agree that individual counseling is appropriate, the student may choose to see a counselor on a regular basis, usually weekly for approximately 50 minutes each session. Other service options include couple or group counseling, stress management, eating disorder program, biofeedback training, or referral to another campus or community agency. It is possible that the student may leave the initial appointment feeling able to handle the problem on his/her own. CAPS has no authority to require a student to accept any suggestions that are made unless professional judgment indicates that psychiatric hospitalization is mandatory.
How to Follow Up After a Referral
Once a referral has been initiated, it may be reasonable and prudent to follow up with the student to determine if he/she actually has attended counseling. Depending on the nature of your relationship with the student, you may also find your-self wondering, “How is it going?” If it is done in a non-intrusive way, such a question may be well received. The student’s rights to privacy, however, should always be respected.
If you wish to share information with CAPS about a student you referred, you may do so. Please remember that the counselor-client relationship is confidential, so therapists will not be able to release information about a specific student without permission from the student unless there is a determination that the student or someone else is in physical danger.
If the behavioral warning signs of student distress are detected early and a positive, appropriate referral is made, there is good chance that the problem can be addressed effectively. As faculty and professional staff members having daily contact with student, you can make a difference.