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DISTRESSED, DISRUPTIVE,

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Suicide planning behavior/access to lethal means ... Suicide is the 2nd leading cause of death in college students (after accidents) ... – PowerPoint PPT presentation

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Title: DISTRESSED, DISRUPTIVE,


1
DISTRESSED, DISRUPTIVE, POTENTIALLY DANGEROUS
STUDENTS
  • Helping Faculty Staff Develop Effective
    Responses to Students of Concern
  • JOHN ACHTER, PH.D.
  • LICENSED PSYCHOLOGIST, DIRECTOR
  • UW-STOUT COUNSELING CENTER
  • Fall 2008

2
Goals
  • Articulate faculty staff roles in identifying
    and responding to student behavior of concern
  • Identify key areas and behavioral indicators of
    concern
  • Develop strategies for and comfort with
    responding
  • Know resources and mechanisms for consultation,
    reporting, and referral

3
Establishing a community of caring why?
  • Student distress is real and on the riseand it
    impacts academic performance and persistence in
    school
  • While more students are seeking help, many still
    do not due to stigma or other reasons
  • Often those with the most serious needs dont
    seek help without encouragement
  • Those who seek help are more likely to persist in
    schoolbut they must stay with it
  • Faculty staff are the front lines with esteemed
    status among students in prevention parlance,
    you are gatekeepers
  • Because its the right thing to do?!

4
Establishing a community of caring how?
  • Resiliency factors we can control
  • High expectations clear boundaries
  • Caring/supportive environment and role models
  • Opportunities for meaningful engagement
  • Expect the best from students focus on
    strengths
  • Tell students you care. . . And show them
  • Promote appropriate faculty-student and
    student-student relationships
  • Approach students when you notice changes or
    concerning patterns in behavior
  • Individual approaches that work for you?

5
Distinguishing between distressed, disruptive,
and dangerous behavior
  • Distressed Behavior that causes us to feel
    alarmed, upset or worried (most common)
  • Disruptive Behavior that interferes with or
    interrupts the educational process of other
    students or the normal business functions of the
    university
  • Dangerous Behavior that leaves us feeling
    frightened and in fear for our personal safety or
    the safety of others
  • General rule If it doesnt feel right, its
    usually not right! (trust your gut)

6
Common categories/causes of student distress
  • Depression
  • Anxiety/stress
  • Disordered eating
  • Self-injury
  • Alcohol/drug problems
  • Sleep problems
  • Serious mental illness (e.g., bipolar,
    schizophrenia)
  • Serious illness/injury
  • Relationship violence/ assault
  • Relationship break-up
  • Academic pressure or failure
  • Career indecision
  • Identify confusion
  • Adjustment problems
  • Unplanned pregnancy
  • Family issues
  • Death/loss
  • Discrimination/alienation
  • Legal difficulties

7
NCHA/ACHA Student Data
75 of college suicides occur among students who
have not accessed counseling services Beginning
fall 2008, Stout will be requiring 3 sessions of
assessment for students making suicide attempts
or threats
8
Signs of Distress - Academic
  • Excessive absences or procrastination
  • Withdrawal/fatigue/sleeping in class
  • Avoidance of or change in participation
  • Excessive anxiety regarding performance
  • Uncharacteristically poor preparation or
    performance
  • Repeated requests for special consideration
  • Unusual or inappropriate expressions in writing,
    drawing, or other coursework (note if content is
    violent in nature, notify SOC)

9
Signs of Distress - Behavioral
  • Unusual or exaggerated emotional expression
  • Impaired/disjointed speech
  • Swollen or red eyes
  • Smell of alcohol, marijuana or signs of other
    drug use
  • Observable signs of injury
  • Change in mood (e.g., depressed or irritable)
  • Hyperactivity or very rapid speech
  • Difficulty concentrating
  • Physical complaints (e.g., headaches,
    stomachaches)
  • Deterioration in hygiene and self-care
  • Dramatic weight loss or gain

10
Signs of Distress - Interpersonal
  • Problems with roommates, family, or romantic
    partners
  • Significant death or other loss
  • Social withdrawal
  • Difficulty get along with others
  • Frequent conflicts with others
  • Dependency on peers, staff or faculty
  • Concerns and complaints from other students

11
Video clip Everythings a Mess
  • Notice what signs and symptoms this professor
    sees and hears from the student that leads him to
    encourage the student to seek counseling services
  • http//www.sa.psu.edu/caps/distress/distress/recog
    nizing_video.html

12
Responding to the distressed student
  • Observe Take note of verbal non-verbal
    behavior that suggest signs of distress
  • Trust your gut It is better to error on the
    side of safety and concern by doing something
  • Reach out Ask to talk in private and share your
    observations in a direct and nonjudgmental manner
  • Listen Encourage the student talk and listen to
    both thoughts and feelings
  • Offer support Your care, interest and listening
    may prove pivotal in the student seeking help
  • Give hope Let them know things can get better
    and you will help identify options for assistance

13
Responding to the distressed student
  • Consult If you feel unsure or in over your
    head, utilize the Counseling Center or other
    resources for assistance
  • Refer To counseling or other campus resources,
    if appropriate. Frame seeking help as a sign of
    strength
  • Maintain boundaries Be clear and consistent
    about expectations and honest about the limits to
    your ability to help
  • Follow-up Arrange a time to check back with the
    student. This communicates continued care and
    interest

14
Boundaries Consider referral when . . .
  • The student expresses openness to receiving help
  • There is immediate danger to student or someone
    else
  • The problem or request is beyond your expertise
    or job role
  • Personality differences interfere with your
    ability to help
  • Your objectivity is compromised, perhaps due to a
    personal relationship
  • The student is reluctant to talk to you about the
    problem
  • You are feeling overwhelmed, pressed for time, or
    otherwise at a high level of stress

15
Signs of Distress Suicide Risk
  • Threatening to hurt or kill oneself talking or
    writing about death, dying, or suicide
  • Suicide planning behavior/access to lethal means
  • Overwhelming hopelessness helplessness feeling
    trapped like there is no way out
  • Past attempts or other self-injurious behavior
  • Dramatic mood changes feeling rage, anxiety,
    agitation
  • Reckless or risky behavior, incl. increased AOD
    use
  • Withdrawing from friends, family, society
  • Putting affairs in order/giving away possessions

16
Why address suicide risk factors?
  • Suicide is the 2nd leading cause of death in
    college students (after accidents) accounts for
    more deaths than all illnesses combined
  • 55 of college students report suicidal thoughts
    at some point in their life In a given year,
    6-10 have seriously contemplated suicide 8
    have made a plan 1-1.5 make an attempt (2007
    ACHA 2008 U of TX study)
  • 50 consider counseling only 40 seek it out
    (MTV/AP 2008)
  • 75 of college suicides occur among students who
    have not accessed counseling services
  • Effective treatment is available (and free on
    campus)!

17
Addressing suicide
  • Think QPR (Question, Persuade, Refer)
  • Q If concerned, ask directly about suicidal
    thoughts and feelings
  • P - If the answer is yes, obtain agreement to
    seek help
  • R Refer for professional assessment
  • Dont promise secrecy
  • As always, listen, show concern, and follow-up.
    Also take care of yourself!

18
The Disruptive Student
  • Problems with boundaries and expectations pushes
    the limits
  • Incivility/verbally lashing out or intimidating
    others (including online)
  • Overly demanding of faculty, staff, or peers
  • Makes hostile remarks out of turn
  • Dominates discussion/takes over class
  • Over reaction to changes in policies or setting
    reasonable limits

19
The Disruptive Student what to do
  • Confront directly and early by verbally
    requesting that the student stop the behavior
  • If behavior is in public and persists or
    escalates, ask the student to leave the class or
    area
  • Establish a time to talk privately, informing
    student that their behavior needs to change and
    explaining consequences for not abiding
  • Postpone conversation if student is defiant or
    hostile
  • Document exact words and actions, including
    dates, times, behaviors keep emails,
    voicemails, etc.
  • Report concerns in a timely manner to DOS
  • If you see something, say something (NYC MTA)

20
The potentially dangerous student
  • Verbal or written threat of suicide, homicide or
    assaultive behaviors
  • Displays a firearm or other weapon
  • Unusual interest in weapons, security, or targets
  • Approval of violence to resolve problems
  • Attempts to harm self
  • Physically confronts or attacks others
  • Stalks or harasses others
  • Sends threatening emails, letters, and other
    correspondence

21
The potentially dangerous student what to do
  • Immediately contact University or Menomonie
    Police at 911
  • Contact department chair or supervisor for
    advice, support, and documentation
  • Inform the Dean of Students Office and consider
    filing a student behavior complaint
  • Consult with the Counseling Center to debrief and
    assist you, other staff, and students

22
Students of Concern Team
  • Chaired by Dean of Students (232-1181) with
    membership from Counseling Center, Disability
    Services, Student Health Services, University
    Housing, University Police
  • They serve an important role as both a vortex
    for information, and also a multidisciplinary
    team of consultants
  • Can be of assistance with all three levels of
    concern, but most critically with the disruptive
    or potentially dangerous student

23
Resources
  • Campus
  • Students of Concern Team 232-1181
  • Dean of Students 232-1181
  • Counseling Center 232-2468
  • Health Services 232-1314
  • Stout Police 232-2222
  • Menomonie
  • Menomonie Police 911
  • Red Cedar Medical Center 235-5531
  • National
  • 1-800-SUICIDE (Hopeline network)
  • 1-800-273-TALK (Suicide Lifeline)

24
Resources
  • Internet
  • Counseling Center (www.uwstout.edu/counsel)
  • Assisting Students During Emotional Distress A
    Guide for Faculty and Staff (UW-RF document
    covers specific disorders problem areas)
  • (http//www.uwrf.edu/counseling/documents/703020S
    tudent20Crisis20II.pdf)
  • Responding to Disturbing Creative Writing
    (VATech) http//www.colorado.edu/studentaffairs/v
    ictimassistance/quickassist/disturbingwriting.pdf
  • Writing in the Margins (UCDavis)
    http//caps.ucdavis.edu/resources/staff/margin/Mar
    gin.pdf
  • Half of Us.com student and celebrity videos on
    mental health issues.
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