As a UWG staff or faculty member, you are in an excellent position to recognize behavioral changes that characterize the emotionally troubled 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 or her plight, (i.e., a "cry for help"). Your ability to recognize the signs of emotional distress, and the courage to acknowledge your concerns directly to the student, are often noted by students as the most significant factor in their successful resolution of their problems.
Signs of Distress
Look for and be aware of any of the following signs of distress:
- Bizarre or dangerous behavior, mood swings
- Traumatic Change in personal relationships
- Missed class/assignments, procrastination
- Change in prior level of functioning, such as sleep patters, appearance, eating, classroom attendance
- Increased irritability, restlessness
- Social isolation, depression
- Drug and/or alcohol abuse (new onset)
- Persistent Worrying
- Confusion, indecisiveness, inability to concentrate
- Disheveled appearance
- Reports by university, social, and family contacts
Involve yourself only as far as you are willing to go. At times, in an attempt to reach or help a troubled student, you may become more involved than time or skill permits. It is important to know the boundaries and limitations of your intervention. If you decide to take action, you should follow these guidelines when approaching a distressed student:
- Request to see the student in private. This may help minimize embarrassment and defensiveness. If you feel imminent danger, interview with a partner.
- Openly acknowledge to the student you are aware of their distress.
- Speak directly and honestly and acknowledge you are sincerely concerned about their welfare and you are willing to help them explore their alternatives.
- Strange or inappropriate behavior should not be ignored. Question directly, but be sensitive about what you have observed. Be careful not to provoke aggressive behavior.
- Listen carefully to what the student is troubled about and try to see the issue from
his/her point of view without necessarily agreeing or disagreeing.
Attempt to succinctly identify the student's problem or concern and explore alternatives to deal with the problem.
- Refer the student to professional help when appropriate.
- Inform the Counseling Center
- If you determine suicidal risk is present, do not leave the student alone until physically with the Counseling Center, Public Safety, or Health Services.
Supporting Different Types of Students:
The Anxious Student
For these types of students, danger is everywhere, even though what makes students anxious is often unknown. Not knowing what is expected and conflict are primary causes of anxiety. Unknown and unfamiliar situations raise their anxiety; high and unreasonable self-expectations increase anxiety also. These students often have trouble making decisions.
- let them discuss their feelings and thoughts - this alone often relieves a great deal of pressure.
- reassure when appropriate.
- remain calm.
- be clear and explicit.
- offer referral to the Student Development Center for counseling and biofeedback training.
- make things more complicated.
- take responsibility for their emotional state.
- overwhelm with information or ideas.
The Depressed Student
Typically, these students get the most sympathy. They show a multitude of symptoms, e.g., guilt, low self-esteem, feelings of worthlessness, and inadequacy as well as physical symptoms such as decreased or increased appetite, difficulty staying asleep, early awakening, low interest in daily activities. They usually show low activity levels because everything is an effort and they have little energy.
- let student know you're aware he/she is feeling down and you would like to help.
- reach out more than halfway and encourage the student to express how she/he is feeling, for he/she is often initially reluctant to talk, yet others' attention helps the student feel more worthwhile.
- tell student of your concern.
- Offer referral to the Student Development Center (678-839-6428) or Health Services (678-839-6452).
- Minimize the student's feelings, (e.g., "Don't worry," "Crying won't help," or "Everything will be better tomorrow.")
- be afraid to ask whether the student is suicidal if you think he/she may be.
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, disturbed; they may coin new words, see or hear things which no one else can, have irrational beliefs, and exhibit bizarre or inappropriate behavior. Generally, these students are not dangerous and are very scared, frightened and overwhelmed. However, they can become dangerous if provoked by argument or debate.
- respond with warmth and kindness, but with firm reasoning and attempt to not show fear or shock.
- remove extra stimulation of the environment and see them in a quiet atmosphere (if you are comfortable in doing so).
- acknowledge your concerns and state that you can see they need help, (e.g., "It seems very hard for you to integrate all these things that are happening and I am concerned about you. I'd like to help.")
- acknowledge the feelings or fears without supporting the misperceptions, (e.g., "I
understand you think they are trying to hurt you and I know how real it seems to you,
but I don't hear the voices (see the devil, etc.).") This should be done in a sensitive
rather than argumentative manner.
reveal your difficulty in understanding them (when appropriate), (e.g., "I'm sorry but I don't understand. Could you repeat that or say it in a different way?")
- focus on the "here and now." Switch topics and divert the focus from the irrational to the rational or the real.
- speak to their healthy side, which they DO have. It's O.K. to joke, laugh, or smile when appropriate. Remind them they are stronger than their irrational thoughts (e.g.voices or images).
- Refer them to Student Development (678-839-6428) or Health Services (678-839-6452). If after hours, call University Police(678-839-6000).
- argue or try to convince them of the irrationality of their thinking for it makes them defend their positions (false perceptions) more.
- "play along", (e.g., "Oh yeah, I hear the voices (or see the devil).")
- encourage further revelations of craziness.
- demand, command, or order.
- expect customary emotional responses.
- attempt to hug, restrain or touch the patient without the student’s express permission.
- chase if the student flees, but, rather, call University Police (678-839-6000).
The Suicidal Student
Suicide is the second leading cause of death among college students. UWG advocates a team approach involving trained professionals. Suicide attempts or serious contemplation should always be addressed by trained professionals. Always refer. Most people who contemplate suicide are ambivalent about killing themselves and typically respond to help. Suicidal students usually attempt to communicate their feelings prior to attempting suicide.
High risk indicators include:
- Talking about death.
- A detailed suicidal plan.
- History of a previous attempt.
- Giving away personal possessions.
- A severe loss or threat of loss.
- History of alcohol or drug abuse (especially new onset or increased use).
- Feelings of hopelessness, helplessness, and futility.
- Feelings of alienation and isolation
- Always report conversations about suicide to professionals at the Student Development Center or Health Services (DO NOT agree to keep it a secret).
- Take the student seriously - 80% of suicides give warning of their intent.
- Reassure the student that there are always options and help available.
- Acknowledge that a threat of or attempt at suicide is a plea for help. Thoughts about suicide do not constitute a threat.
- Be available to listen, to talk, to be concerned, and contact a professional team member as soon as possible. ContactUniversity Police (678-839-6000) or Student Development (678-839-6428). They can get you immediate help while you remain with resident (as long as it is safe for you to do so).
- Take care of yourself. Helping someone who is suicidal is hard, demanding, and draining work. Talk to a counselor after your experience.
- Try to physically struggle with or attempt to disarm a student.
- Minimize the situation or depth of feeling, e.g. "Oh it will be much better tomorrow” or “You don’t really mean that…."
- Over commit yourself and, therefore, not be able to deliver on what you promise.
- Respond beyond your training; always refer.
- Leave the student alone if concerned there is substantial or imminent risk.
Confronting a Student
Confronting a student does not require judging, blaming, or attacking the person. It does not require demeaning or forcing the person to take action. Confronting someone means that you have the courage to let the student know what you have seen and heard, that you are concerned about them and that you are willing to help. Listed below are some practical tips on confronting a resident, a friend, or anyone else you care about.
Be HONEST and SPECIFIC:
Explain why you want to have a serious talk and what you hope will happen (and what you hope doesn't happen). Example:" I am really worried about your drinking and I hope you won't just blow me off or think I am just putting you down...I don't want to wreck our friendship..."
Describe your OBSERVATIONS:
Describe your non-judgmental observations if the student’s behavior in a way that expresses concern. Example: "I am concerned that since last Friday night you have come back to our room really drunk four times, twice you said you drove home drunk and last night you threw-up all over our floor...".
Express your FEELINGS:
Example: "I am really worried about you...I am scared to talk to you in a serious way because I think you don't realize you have a problem...and bringing it up might just piss you off..."
Offer your RECOMMENDATIONS:
Example: "I really wish you would go talk to someone about your [specific behavior]...see if you do have a problem. You could either talk with a physician at Health Services (6787-839-6452) or a counselor at the Student Development Center (678-839-6428)... whoever you would be most comfortable with...I'll go with you... The services are free and they are on campus."
LISTEN actively to what your resident says:
Listening "actively" does not require that you necessarily agree or disagree with your friend. The important part is that you accurately hear what your friend is saying so he or she feels heard and understood. One way to communicate that you are listening and understand is to paraphrase what your friend says, from their point of view, and to then to restate your observations and recommendations.
Always call for help:
Never put yourself in an unsafe position. Always get help. Your supervisor is your first line of assistance and support.ALWAYS share your concerns about students with your supervisor. ALWAYS work with your supervisor when you need support for yourself. In addition, consult with the Counseling Center for a counselor, who can speak with the student.