Assisting The Distressed Student

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A Practical Guide for Administration, faculty and staff.

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ASSISTING THE DISTRESSED STUDENT A PRACTICAL GUIDE FOR ADMINISTRATION/FACULTY/STAFF WEST VALLEY COLLEGE

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Table of Contents Introduction............................................................................2 President's Message........................................................................ 2 Your Role.................................................................................3 Signs of Distress.............................................................................. 3 Crisis Intervention.................................................................4 Examples of Crisis............................................................................. 4 Personal Counseling...............................................................5 Identifying Students in Need of Assistance.........................6 The Depressed Student....................................................................6 The Suicidal Student......................................................................... 7 The Anxious Student........................................................................8 The Student in Poor Contact with Reality.....................................9 The Verbally Aggressive Student...................................................10 The Violent Student........................................................................11 The Demanding Passive Student...................................................12 The Student Under the Influence.................................................13 The Suspicious Student..................................................................14 The Sexually harassed Student......................................................15 The Student Who Submits Disturbing Writings..........................16 Responding to Disturbing Writing................................................17 Guidelines for Intervention.................................................18 Steps for Addressing Students of Concern...................................19 Personal Counselors on Campus........................................20 Instructions for Students.....................................................21 Personal Counseling Referral Form...................................22 Off Campus Emergency Resource Contact List...............23 WVC Student Conduct Policy............................................24 Quote by Dr. Karl Menninger..............................................26 WVC Guide 2013-2014 Assistng the Distressed Student 1

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Part 1 Introduction Dear Colleagues, Pursuing one’s educational goals should be a journey of wonder, exhilaration, and discovery. Our role as educators is to not only fuel the mind but to support the development of each student so that the vital learning processes of intellectual inquiry and cognitive engagement are supported by a healthy physical and mental outlook. At West Valley College, we have a strong program of support in place for our students in need of mental health counseling and intervention. The high caliber of this program is due to the commitment of our dedicated faculty, staff, consultants, and interns who provide these important services. We are proud to be able to serve students in such a holistic manner and to provide high quality support. Addressing the needs of the “whole” student requires collaboration between you, our colleagues in student support services, and our students in need. Please use this guide to assist you in responding to students who may need counseling or support. I encourage you to contact any of the individuals listed on Page 18 of this guide for assistance in handling difficult situations arising in the classroom, computer labs, athletic fields, or anywhere else our students may need us. On behalf of West Valley College, I thank you for your empathy, support, and steadfast commitment to each student’s development as they pursue their educational dreams. Together, we can create our future. Warm regards, Bradley J. Davis, J.D. President West Valley College Acknowledgements This guide is a result of the collaborative efforts of many community college educators throughout the state dedicated to providing an optimal learning environment for all students. Special thanks to The World Health Organization, Virginia Polytechnic Institute & State University, and Utah Valley University. WVC Guide 2013-2014 Assistng the Distressed Student 2

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Part 2 Your Role "Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community. Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time." - The World Health Organization As a faculty, staff or administrator interacting with students, you are in an excellent position to recognize behavior changes that characterize the emotionally distressed student. A student’s behavior, especially if it is inconsistent with your previous observations, could well constitute an inarticulate attempt to draw attention to his/her plight…“a cry for help”. Your ability to recognize the signs of emotional distress and to acknowledge your concerns directly to him/her is often noted by students as the most significant factor in their successful problem resolution. Signs of Distress  Missed classes/assignments  Inability to concentrate  Confusion  Persistent worrying  Social isolation  Increased irritability  Restlessness  Bizarre behavior  Procrastination  Dangerous behavior  Disheveled appearance  Mood swings  Indecisiveness When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 3

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Part 3 Crisis Intervention The Mental Health Services Advisory Committee (MHSAC) is a formal college-wide committee whose charge is to link students of concern to campus and community resources (see schematic, Pg. 19.) This includes assisting in an Imminent, Urgent, or Uncertain situation involving anyone on campus. The MHSAC includes staff/faculty with training and experience in crisis intervention. If there is an Imminent, Urgent, or Uncertain situation, a call for intervention must be made. When in doubt, err on the side of making that call. EXAMPLES OF CRISIS Imminent Danger Call 9-1-1 or 408-299-3233 Threats of Physical Violence Witness to Physical Assault Witness to an Accident Threats of Suicide Under the Influence: Drugs/Alcohol Urgent District Police 408-299-3233 AND Health Services 408-741-4000 Injury Due to Medical Condition Fear for Life: of Self or Other Abuse: Child, Spousal, Elder Sexual Assault Loss of Control Uncertain Call Health Services 408-741-4000 Recent Death of Friend Recent Death of Family Member Anger or Hostility Disoriented/Confused Daytime Hours: M – TH 8:30 am to 5:00 pm Activate response by calling Student Health Services, (408) 741-4000 Early Evening and Friday Hours: M – Th 5:00 pm to 7:00 pm; F 9:00 am to 2:00 pm Activate response by calling Counseling, (408) 741-2009 Outside Operational Hours: If a crisis occurs outside the above hours, contact the District Police, 9-1-1 or 299-3233. For non-urgent consultation M-Th 6:00 pm to 10:00 pm contact Evening Administrator, (408) 593-2086. Strategy During A Crisis When dealing with most students in crisis, conveying your concern and willingness to help in any way you can, including referral, is probably the most important thing you can do. WVC Guide 2013-2014 Assistng the Distressed Student 4

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Part 4 Personal Counseling Personal Counseling Services WVC Personal Counseling Services are designed for students who can benefit from short-term mental health intervention. If the initial assessor determines the student requires longer term counseling, s/he will likely be referred to a more appropriate off-campus resource. Early intervention is preferable to crisis intervention. When you do discuss a referral for personal counseling services with a student, it is helpful for the student to hear in a clear, concise manner your concerns and why you think counseling would be helpful. Share information about on-campus services available: all services are free to regularly enrolled students; all discussions are confidential except when the student presents a danger to self or others or when the counselor has reasonable suspicion that child or elder abuse is occurring. These situations mandate reporting. Placing the initiative on the student to seek an appointment increases his/her personal responsibility and commitment to come in for counseling. There may be urgent times, however, when it is best for you to call to make an appointment with him/her or to accompany the student to a counselor on campus (e.g. crisis situation.) To refer a student for personal counseling, please complete the “Personal Counseling Referral Form” (Pg 22.) Staff persons are available as follows to insure prompt attention to begin the process: During Daytime Hours: M – Th 9:00 am to 5:00 pm Student Health Services, (408) 741-2027 During Early Evening and Friday Hours: M – Th 5:00 pm to 7:00 pm; F 9:00 am to 2:00 pm Counseling, (408) 741-2009, press 2 Outside Operational Hours: Call either number above, leave a message, and a counselor will return your call the next business day. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 5

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Part 5 Identifying Students in Need of Assistance The Depressed Student Depression, and the variety of ways it manifests itself, is part of a natural emotional and physical response to life’s ups and downs. With the busy and demanding life of a college student, it is safe to assume that most students will experience periods of reactive depression in their college careers. When the depressive symptoms become so extreme or are so enduring that they begin to interfere with the student’s ability to function in school, work or social environment, the student will come to your attention and be in need of assistance. Because faculty and staff have varied and ongoing opportunities to observe and interact with students, they are often the first to recognize that a student is in distress. Look for a pattern of these indicators:  Tearfulness/general emotionality  Markedly diminished performance  Dependency (a student who makes excessive requests for your time)  Infrequent class attendance  Lack of energy/motivation  Increased anxiety/test anxiety/performance anxiety  Irritability  Deterioration in personal hygiene  Significant weight loss or gain  Alcohol or drug use Students experiencing depression often respond well to a small amount of attention for a short period of time. Early intervention increases the chances of the student’s rapid return to optimal performance. Do:    Let the student know you’re aware she/he is feeling down and you would like to help. Encourage the student to discuss how she/he is feeling with someone they trust. Offer to assist student in referring him/her for personal counseling. Don’t:  Minimize the student’s feelings, e.g., “Don’t worry.” “Everything will be better tomorrow”.  Bombard the student with “fix it” solutions or advice.  Chastise the student for poor or incomplete work.  Be afraid to ask the student whether he/she is suicidal. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 6

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The Suicidal Student Suicide is the second leading cause of death among college students. It is important to view all suicidal comments as serious and make appropriate referrals. High-risk indicators include: feelings of hopelessness, helplessness and futility, a severe loss or threat of loss, a detailed suicide plan, a history of a previous attempt, history of alcohol or drug abuse, feelings of alienation and isolation. Do:      Take the student seriously – 80 percent of suicides give a warning of their intent. Be direct – ask if the student is suicidal, if he/she has a plan and if he/she has the means to carry out that plan. Exploring this with the student actually decreases the impulse to use it. Be available to listen. Activate the MHSAC by contacting Health Services at ext. 4000. Advise District Police if threat of suicide is imminent Don’t:  Assure the student that you are his/her best friend; agree you are a stranger, but even strangers can be concerned.  Be overly warm and nurturing.  Flatter or participate in their games; you don’t know their rules.  Be cute or humorous.  Challenge or agree with any mistaken or illogical beliefs.  Be ambiguous. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 7

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The Anxious Student Anxiety is a normal response to a perceived danger or threat to one’s well being. For some students the cause of their anxiety will be clear but for others it is difficult to pinpoint. Regardless of the cause, the resulting symptoms maybe experienced as rapid heart palpitations, chest pain or discomfort, dizziness, sweating, trembling or shaking, and cold, clammy hands. The student may also complain of difficulty concentrating, always being “on the edge,” having difficulty making decisions or being too fearful to take action. In rare cases, a student may experience a panic attack in which the physical symptoms occur spontaneously and intensely in such a way that the student may fear he/she is dying. The following guidelines remain appropriate in most cases. Do:       Let them discuss their feelings and thoughts. Often this alone relieves a great deal of pressure. Provide reassurance. Remain calm. Be clear and directive. Provide a safe and quiet environment until the symptoms subside (refer student to Health Services for rest). Offer to assist the student in referring her/him for personal counseling. Don’t:  Minimize the perceived threat to which the student is reacting.  Take responsibility for their emotional state.  Overwhelm them with information or ideas to “fix” their condition. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 8

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The Student in Poor Contact with Reality These students have difficulty distinguishing fantasy from reality, the dream from the waking state. Their thinking is typically illogical, confused or irrational; their emotional responses may be incongruent or inappropriate; and their behavior may be bizarre and disturbing. This student may elicit alarm or fear from others, they are generally not dangerous and are more frightened and overwhelmed by you than you are by them. If you cannot make sense of their conversation, they may be in trouble. Do:        Respond with warmth and kindness, but with firm reasoning. Remove extra stimulation from the environment, (turn off the radio; step outside of a noisy classroom). Acknowledge your concerns, state that you can see they need help. Activate the MHSAC by contacting Health Services at ext. 4000. Acknowledge their feelings or fears without supporting the misperceptions, e.g., “I understand you think someone is following you, but I don’t see anyone and I believe you’re safe.” Focus on the “here and now.” Ask for specific information about the student’s awareness of time, place and destination. Speak to their healthy side, which they have. It’s OK to laugh and joke when appropriate. Don’t:  Argue or try to convince them of the irrationality of their thinking. This commonly produces a stronger defense of the false perceptions.  Play along, e.g., “Oh yeah, I hear the voices (or see the devil).”  Encourage further discussion of the delusional processes.  Demand, command, or order.  Expect customary emotional responses. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 9

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The Verbally Aggressive Student Students may become verbally abusive when in frustrating situations that they see as being beyond their control. Anger and frustration may result in explosive outbursts or ongoing belligerent, hostile behavior - this student’s way of gaining power and control in an otherwise out-of-control experience. It is important to remember that the student is generally not angry with you personally, but is angry at his/her world and you are the object of pent-up frustrations. This behavior is often associated with the use of alcohol and other drugs. Do:      Acknowledge their anger and frustration, e.g., “I hear how angry you are.” Rephrase what they are saying and identify their emotion, e.g., “I can see how upset you are because you feel your rights are being violated and nobody will listen.” Reduce stimulation; invite the person to a quiet place if this is comfortable and the place is safe Allow them to ventilate, get the feelings out, and tell you what is upsetting them; listen. Be directive and firm about the behaviors you will accept, e.g., “Please stand back, you’re too close.” “I cannot listen to you when you yell and scream at me that way.” “Let’s step outside to discuss this further.” (Refer to WVC Student Conduct Policy, Pgs. 24-25) Activate response by contacting Health Services at ext. 4000 or District Police 299-3233 Remember, Safety First. If threat increases call 9-1-1. Prohibit the student from entering your work area/classroom/office if behavior is repeated.    Don’t:  Get into an argument or shouting match.  Become hostile or punitive, e.g., “You can’t talk to me that way!”  Press for explanations for their behavior.  Ignore the situation.  Touch the student. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 10

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The Violent Student Violence due to emotional distress is rare. It typically occurs when the student’s level of frustration has been so intense or has such an enduring nature as to erode all of the student’s emotional controls. The adage, “An ounce of prevention is worth a pound of cure,” best applies here. This behavior is often associated with the use of alcohol and other drugs. Do:     Prevent total frustration and helplessness by quickly and calmly acknowledging the intensity of the situation, e.g., “I can see you’re really upset.” Explain clearly and directly what behaviors are acceptable, e.g., “You certainly have the right to be angry but breaking things is not okay.” Stay safe; maintain easy access to a door; keep furniture between you and the student. Immediately seek assistance; contact District Police at 9-1-1 or 408-299-3233 and ask for “a West Valley College police officer”. Don’t:  Ignore warning signs that the person is about to explode, e.g., yelling, screaming, clenched fists, threats.  Threaten or corner the student.  Touch the student. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 11

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The Demanding Passive Student Typically even the utmost time and energy given to these students is not enough. They often seek to control your time and unconsciously believe the amount of time received is a reflection of their worth. You may find yourself increasingly drained and feeling responsible for this student in a way that is beyond your normal involvement. It is important that this student be connected with many sources of support on-campus and in the community in general. Do:     Let them make their own decisions. Set firm and clear limits on your personal time and involvement. Offer referrals to other resources on and off campus. During repeated interactions, stand while speaking with student. Limit discussion time to 3 minutes. Don’t:  Get trapped into giving advice, special conditions, etc.  Avoid the student as an alternative to setting and enforcing limits. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 12

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The Student Under The Influence Alcohol is the most widely used psychoactive drug. It is common to find alcohol abusers in college populations also abusing other drugs, both prescription and illicit. Patterns of use are affected by fads and peer pressure. Currently, alcohol is the preferred drug on college campuses. The effects of alcohol on the user are well known to most of us. Faculty most often identifies alcohol abuse by a student. Irresponsible, unpredictable behavior affecting the learning situation (i.e., drunk and disorderly in class), or a combination of the health and social impairments associated with alcohol abuse noticeably sabotages student performance. Because of denial that exists in most substance abusers, it is important to express your concern to the student in terms of specific changes in behavior/performance rather than terms of suspicions about alcohol/drug use. Do:     Confront the student with the behavior that is of concern (Refer to WVC Student Conduct Policy, Pgs. 24-25). Address the substance abuse issue if the student is open and willing. Offer concern for the student’s overall well being. Refer student to the Community Resource Coordinator in Health Services, ext. 2612. Don’t:  Convey judgment or criticism about the student’s substance abuse.  Make allowances for the student’s irresponsible behavior.  Ignore signs of intoxication in the classroom. When in doubt, consult. WVC Guide 2013-2014 Assistng the Distressed Student 13

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