An Overview of Common Counseling Issues in College Helping distressed and distressing students attai

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An Overview of Common Counseling Issues in
CollegeHelping distressed and distressing
students attain their academic goals.Tacy
Costanzo, M.Ed.U.C. Santa BarbaraCollege of
Engineering
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Workshop Goals

• Increase advisors awareness of counseling issues
  and appropriate responses to distressed student
  behaviors
• Share resources to help advisors and students
  cope with anxiety, stress, depression and the
  symptoms associated with those conditions

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Introduction

• The recent surge in mental health needs on campus
  is interfering with the academic mission of the
  university.
• College is a challenging time when individual
  vulnerabilities are often exposed.
• Proactive education on mental wellness during
  college can reduce future student crises
  educate parents too

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• Multiple campus resources are required to help
  students with counseling issues attain their
  academic goals
• Immediate and comprehensive intervention may
  lessen the impact of these psychological
  disruptions on a students well-being
• Long-term wellness requires treating the cause
  rather than just the symptoms
• Trust your instincts and observations and take
  action
• Address counseling issues FIRST, integrate
  academic advising in follow up appointments

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Three Basic Questions students grapple with
during college

• Who am I?
• Identity development is a complex journey
• Who will I be with?
• Relationship issues friends and family
• What will my future hold?
• Major field of study
• Career aspirations

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College Student Challengesthat complicate
answering those 3 questions

• Leaving home
• Making/managing new relationships
• Acclimating to a new environment
• Experiencing (learning) autonomy
• Developing personal identity
• Cultural
• Sexual
• Spiritual

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Challenges continued

• Selecting an academic/career path
• Managing finances
• Juggling school and work
• Worrying about post college debt
• Exposure to new ideas and ideals
• Navigating relationship changes with parents,
  siblings and friends
• Cultural mores and family attitudes vary greatly
  and have substantial impact on how a student
  deals with counseling issues

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• Distinguishing developmental struggles from
  mental health issues can be difficult
• Moderate levels of stress are necessary for
  motivation
• But unmanageable levels of stress can cause
  dysfunction
• Everyone feels sad once in awhile
• but clinical depression requires intervention
• Demanding and Irrational Behavior
• Advisors need to recognize the difference

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Some current counseling issues in higher
education

• Anxiety
• Stress
• Depression
• Demanding behavior
• Irrational behavior
• Substance abuse
• Psychiatric disabilities

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• Warning signs that may indicate more than
  developmental concerns
• Dramatic changes in physical appearance or
  hygiene
• Decline in academic performance
• Negative fluctuations in self-perception
• Loss of focus on academic goals or plans
• Unusual behavior
• Verbalization of distress
• Excessive or inappropriate anger
• Extreme emotional or mood swings
• Withdrawal
• Alcohol or drug abuse

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Responding to a distressed student

• Know your campus protocol for responding to
  distressed students
• Immediate intervention may keep a situation from
  escalating
• Refer (or walk) the student to the appropriate
  campus resource
• Follow up with the student
• The student will benefit from knowing you care
  about them
• Assist with immediate academic actions
• Deficit load
• Leave of Absence
• Make a long term schedule, showing how the
  student can complete their requirements
• ONLY share information with others on a NEED TO
  KNOW BASIS
• Encourage distressed students to talk to their
  parents about their struggles when appropriate

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ANXIETY

• Most common psychiatric condition in US with
  multiple distinct diagnostic categories
• General anxiety
• Social anxiety
• Panic disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Multiple phobias

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Common Manifestations of anxiety in college
students

• Tension or fear in the absence of danger
• Feelings of confusion and loss of control
• Excessive worry and irrational thoughts
• Withdrawal and avoidance behavior
• Physical and psychological agitation
• Change in eating habits
• Inability to sleep

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Academic impacts

• Fluctuations in concentration
• Decreased information processing
• Loss of information recall
• Decreased comprehension
• Lack of time management
• Increased test or performance anxiety

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Advisors should

• Talk to student in private
• DO NOT promise confidentiality
• Focus on core issue
• Speak calmly and make simple, yet specific plans
• Help student prioritize actions
• Make an appointment at the Counseling Center
• Attend study skills and test-taking workshops
• Add physical exercise to daily routine
• Stress the importance of healthy eating habits
• Request student check-in with you as the term
  progresses
• Follow up with student in subsequent terms

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Advisors SHOULD NOT

• Overwhelm student with information
• Encroach on students personal space
• Taking a walk with the student has been a good
  method for me
• Be judgmental or minimize the students feelings
  or perception of the situation
• Rush the student or put words into the students
  mouth
• Assume that the students family and friends are
  aware of their struggles
• Assume the students angst will resolve without
  assistance

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DEPRESSION

• Depression is more than passing sadness and can
  include severe and long-term symptoms
• Hopelessness
• Helplessness
• Worthlessness
• Inability to experience pleasure in daily events
• Irregular sleep and eating patterns
• Difficulty concentrating and retaining
  information
• Sense of social isolation

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Depressed students can experience

• Anxiety
• Agitation
• Extreme or irrational anger
• Thoughts of destruction
• Preoccupation with death
• Thoughts, threats of suicide

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Academic Advisors should

• Validate the students feelings
• Actively listen
• Instill hope (over 80 of patients respond to
  medical intervention for depression)
• Explicitly express your concern for the student
  well-being
• Ask if the student has thoughts of suicide
• Assist the student in making a specific, yet
  simple action plan, starting with a visit to the
  Counseling or Health Center
• Provide Counseling/Health Center pamphlets for
  the students future reference

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Advisors SHOULD NOT

• Minimize the situation
• Disagree with the students perspective
• Offer solutions
• Provide more information than the student can
  retain at the time
• Assume that the students family and friends are
  aware of their struggles
• Assume the students depression will resolve
  without assistance

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Demanding Students(and demanding parents)

• Some students feel entitled to treatment,
  services and privileges beyond what is
  reasonable. Some have had much of their life
  facilitated by overly helpful parents.
• The enabling/disabling parent or advisor
• Helping too much disserves the student
• It is important to distinguish between demanding
  and irrational or delusional behavior.

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Advisors should

• Remain calm and speak respectfully to student
  despite the tone or volume of their speech
• Insist that student behave/speak in a civil
  manner
• Get emergency assistance if you feel threatened
• Set clear and reasonable limits and expectations
  hold the student accountable
• Be aware of potential manipulative behavior

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Advisors should NOT

• Argue with the student
• Accommodate inappropriate demands
• Ignore the problem
• Feel obligated to take care of the student
• Allow the student to intimidate you

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Psychiatric Disabilities

• Persistent psychological conditions can impair
  students ability to function academically and
  socially
• It is critical that both the CAUSE and the
  symptoms are treated.
• Treatment and accommodations can help students
  stay in class
• Some students will need time away from campus
  during treatment

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Advisors should

• Speak to the student in private, but be aware of
  your own safety
• Do not promise confidentiality
• Be sensitive, as the student may be
• Nervous, angry, scared, lack self-esteem, out of
  touch with reality
• Acknowledge the students difficulties
• Refer the student to Counseling Services and to
  the DSP office
• IF the student seems to be a danger to self or
  others CALL for emergency assistance

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Advisors SHOULD NOT

• Assume situation will improve without
  intervention
• Appear judgmental
• It is possible that the stigma of mental health
  issues is already complicating their life
• Pressure student to disclose details of their
  situation
• Share information with others except on need to
  know basis
• Assume that the student wants accommodations for
  special needs

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Irrational or Inappropriate Behavior

• Warning signs that a student might be out of
  touch with reality
• Disorganized or unrecognizable speech
• Odd or eccentric behavior
• Inappropriate or NO emotions
• Bizarre statements and thoughts that are out of
  touch with reality
• Social withdrawal
• Hallucinations

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Advisors should

• When student needs immediate help
• CALL emergency personnel if the student seems to
  be a danger to self or others
• Remain calm while waiting for help
• Tell the student you are getting them to a safe
  environment
• Understand that student may not retain what you
  say
• Attempt to keep the student engaged while waiting
  for help
• Get counseling for yourself if you feel
  overwhelmed after working with a student in
  crisis

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Advisors should

• When student needs help but is not in eminent
  danger
• Call Counseling Services hotline to secure an
  appointment for the student
• Walk student to Health or Counseling Center (if
  you are comfortable with doing so)
• Speak concretely to student, do not make the
  student make academic decisions prior to
  counseling
• Be aware that the student may be paranoid and
  fearful
• Speak calmly and quietly, be flexible

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Advisors should NOT

• Crowd the student or argue with them
• Pacing, nervous movement and gestures, and
  inability to sit still are common physical
  manifestations
• Assume the student can take care of themselves
  without assistance
• Presume the student will remember your
  conversation
• Write down the Counseling Center phone number and
  appt time for the student
• FOLLOW up with the student
• DO NOT chase after a student who runs off, call
  for help

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Substance Abuse

• Alcohol and drug use is a problem on most
  campuses across our nation
• The UC Mental Health Report showed
• 44 of undergrads had indulged in binge
  drinking that term
• 58 had experience problems due to drinking
• 39 used marijuana during the current quarter
• 14 used other illegal drugs during college

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Advisors should

• Withhold judgment, but treat the situation
  seriously
• Substance abuse is illogical behavior, so
  lecturing is ineffective
• Hold students accountable for their actions or
  inactions
• Academically
• Behaviorally (in ResHalls and at Campus
  Activities, etc.)

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• Remember that denial is a powerful influence
• Students may lie unconsciously or consciously
• May be delusional
• Stress can INCREASE the need to engage in the
  addicting behavior
• Multiple treatment options are available and
  addictive behaviors can be overcome
• Instill hope as addictive behaviors can be
  overcome
• Refer the student to counseling
• Follow up with the student

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Advisors should NOT

• Minimize the situation with comments like most
  students experiment with drinking or drugs
  sometime
• Assume the behavior is harmless
• Assume that the students family knows of the
  behavior
• Be judgmental or condescending
• Some students are just bad decision-makers and
  can quit drinking or experimenting with drugs at
  will
• Some students struggle with addiction and can not
  just walk away from the substance they abuse

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Keeping them in school

• Learning to Accept Yourself
• Maintaining the Balance
• Get Organized
• How to Manage Stress
• Overcoming Test Anxiety
• Computer game or internet addiction
• Instant gratification

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Helping Students Learn to make positive self
reflections

• Self-judgment
• Measure productiveness verses non-productiveness,
  rather than good verses bad
• Do not over-generalize
• A low exam grade does imply dumb or bad or
  stupid
• Set reasonable standards

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Positive self reflections

• Dont compare yourself to others
• Reflect on own personal growth
• Learn to value who you are, rather than trying to
  be someone else
• Take an ACTIVE rather than passive approach to
  college
• Attend class and participate in supplementary
  academic offerings
• Get involved in community activities
• Form study groups
• Use campus resources to enrich your experience
• From http//www.counsel.ufl.edu /

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Juggling the demands of college

• Acknowledge and trust your feelings
• Some anxiety, sadness or anger is normal
• Understand your feelings and seek help when you
  are overwhelmed
• Talk honestly about your worries and feelings
  with family and trusted friends
• Youll see most other students have similar or
  other concerns

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The balancing act continuesHandouts

• Get organized 10 Steps to Organization in
  College
• Tips for Reducing Stress
• How to Overcome Test Anxiety
• Coping with Anxiety
• How to Approach a Professor for Help.
• Relaxation Exercises
• Handling Common Relationship Problems

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Campus Resources

• KNOW who to call before a crisis arises
• TEAM work is essential
• Build connections between the advisors network
  and the counseling center, with the residence
  hall directors, the health educators and the
  office of student life.
• ASK your supervisors for training and
  professional development workshops
• SHARE your new awareness of counseling issues
  with the faculty
• HELP is available for staff experiencing stress,
  anxiety and depression

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Remember that our capacity to nurture, counsel,
encourage and advise our students is diminished
when we do not take care of ourselves.
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• When health is absent,
• wisdom cannot reveal itself,
• art cannot manifest,
• strength cannot fight,
• wealth becomes useless,
• and intelligence cannot be applied.
• Herophilus
• A Greek physician, born in 335 B.C.

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Web Resources

• https//www.mentalhealthscreening.org/screening/we
  lcome.asp
• Online assessment for depression, anxiety,
  alcohol, and eating disorders
• http//ccvillage.buffalo.edu
• Numerous links to counseling resources
• http//www.ccs.ohio-state.edu/
• Counseling resources and Crisis response
• http//www.counseling.caltech.edu/
• Multiple counseling issues resources
• www.apa.org/topics
• Resources for coping skills that help keep
  students in school

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References

• Allen, Deborah and Ralph Trimble. Identifying
  and Referring Troubled Students a primer for
  Academic Advisors. NACADA journal, Vol 13, No 2,
  Fall 1993.
• Cai, Sean. Physical Exercise and Mental Health A
  content integrated approach in coping with
  college students anxiety and depression. The
  Physical Educator. Vol 57, Number 2, Spring
  2000.
• Farrell, Elizabeth. Taking Anxiety Out of the
  Equation. The Chronicle of Higher Education.
  Vol 52, No 19, January 2006.
• Heiligenstein, Eric., et al. Depression and
  Academic Impairment in College Students. Journal
  of American College health. Vol 45, Spring 1996.
• Kadison, Richard, and Theresa DiGeronimo. 2004
  College of the Overwhelmed. Jossy-Bass
  Publishers, San Francisco.

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• Kitzrow, Martha. The Mental health Needs of
  Todays College Students Challenges and
  Recommendations. NASPA Journal. Vol 41, No 1,
  Fall 2003.
• Marano, Hara. The Mental Health Crisis on
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  Fall 2004.
• Ranjita, Misara, et al. Academic stress of
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  faculty perceptions. College Student Journal,
  Vol 34, No 2, June 2000.
• University of California at Berkeley, Office of
  Academic Affairs. Prioritizing Mental Health A
  Campus Imperative. Proposal for a standing
  academic senate subcommittee on Student Mental
  Health 2003.
• University of California, Office of the
  President. Student Mental Health Report.
  October 2006.