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CANADIAN ASSOCIATION OF COLLEGE AND UNIVERSITY STUDENT SERVICESL’ASSOCIATION DES SERVICES AUX ÉTUDIANTS DES UNIVERSITÉS ET COLLÈGES DU CANADA

F A L L / A U T O M N E / 2 0 1 4 / I S S N 1 2 0 6 - 8 5 0 0

More highlights from CACUSS 2014

on pg 16!

Upcoming Important CACUSS dates!

See calendar at www.cacuss.ca for more details and current information.

November 17 Webinar on Preparing a Program Proposal for CACUSS

November 18 CACUSS Communities Information Session

November 20 Working with Graduate Students with Disabilities, Roundtable Discussion

November 24 RFP for CACUSS Needs Assessment

November 26 Making Your Mark, Reboot 101 Seminar

November 26 Applications due for CoPs/Networks

January 9 Call for Reviewers Close

January 15 Call for Proposals for CACUSS 2015 Closes

February Update your CACUSS profile online, Information about new CoP/Networks will be posted online

February Registration for CACUSS 2015 opens

March Membership renewal period

April Early Bird Deadline for CACUSS 2015—check website for actual date!

May 24-27 CACUSS 2015

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BLUEPRINT CONNECTIONS INVOLVEMENT ACADEMICS

Success in college and university is more than what you learn in a classroom...

2 / COMMUNIQUÉ / TOME 14 / NUMÉRO 3 / AUTOMNE 2014

Contents CommuniquéVolume 14, Issue 3, Fall 2014 /

Tome 14, Numéro 3, Automne 2014

Editor / Rédacteur

Mitchell Miller, [email protected]

Design / Conception graphique

Managing Matters Inc., 647-345-1116

CACUSS Board/Conseil ASEUCC

David Newman, President, [email protected]

Janet Mee, Past-President, [email protected]

Marcelle Mullings, Finance Director, [email protected]

Jack Dobbs, Director / Professional Development

[email protected]

Karen Cornies, Director / Professional Development,

[email protected]

Corinna Fitzgerald, Director / Communities of Practice,

[email protected]

Laurie Schnarr, Director / Communities of Practice, lschnarr@

uoguelph.ca

Kelli MacCulloch, Director / Research and Recognition,

[email protected]

Shawna Cunningham, Director / Policy,

[email protected]

Communiqué is published by the Canadian Association of College and University Student Services (CACUSS)/L’association des services aux étudiants des universities et colleges du Canada (ASEUCC). All material copyright CACUSS/ASEUCC unless otherwise noted. Material may not be reproduced without the express written permission of CACUSS/ASEUCC. The opionions expressed in Communiqué do not reflect those of the magazine or of CACUSS.

Le Communiqué est publié par la Canadian Association of College and University Student Services (CACUSS)/l’Association des services aux étudiants des universités et collèges du Canada (ASEUCC). Copyright pour le contenu : CACUSS/ASEUCC, à moins d’indication contraire. Aucune reproduction du contenu de cette publication sans l’autorisation écrite expresse de CACUSS/ASEUCC.Les opinions exprimées dans Communiqué ne reflètent pas ceux

du magazine ou de l’ASEUCC.

Jennifer Hamilton, Executive Director,

[email protected]

Advertising / La publicité

CACUSS Secretariat, [email protected]

Submissions / SoumissionsNews, articles, updates, opinion pieces, letters to the editor, artwork and photographs relating to college and university student services in Canada are all very welcome. Send submissions to:Nous acceptons les nouvelles, articles, mises au point, énoncés d’opinion, lettres aux rédacteurs, illustrations et photographies se rapportant aux services aux étudiants des collèges et des

universités. Faire parvenir vos soumissions à :

Mitchell Miller, [email protected]

CACUSS Secretariat/Secretariat ASEUCC

720 Spadina Avenue, Suite 202,

Toronto, Ontario, M5S 2T9 • 647-345-1116

Email: [email protected]

Website: www.CACUSS.ca

4 President’s Message

5 Message du président

6 Executive Director Update

7 Mise à jour de la directrice générale

9 Innovating Online with Stepped Care: A Research-Based Stepped Care

Mental Health Community of Practice Proposals by Dr. Peter Cornish

14 “How Do We Cope?”: A Creative Experiment

by Lucas Gobert

18 The McMaster Depression Initiative: Improving Depression Care at

McMaster’s Student Wellness Centre

by Jillian Halladay, Debra Earl, & Catharine Munn

22 Recent Literature in Student Affairs

by Mariam Hashemi & Freeman Woolnough

23 New Beginnings: Making the Move from On Campus to Corporate Life

by Kate McGartland

24 London Welcomes Students with New YourLondonCalling.ca Website

by Orest Katolyk

26 Supporting Vulnerable Students: Carleton University Offers a Student

Support Program to CACUSS Universities and Colleges

by Dr. John A. Meissner, C.Psych, FITA Project Leader

28 Bonnie Neuman of Dalhousie University Retires

by Darren Ferguson

29 The Disclosure Question: A Matrix for Decision-Making

by Barbara Roberts

30 8 Supervisory Lessons I (re)Learned While Being a Student Employee (again)

by Holly White

32 Vancouver Island University’s Exploring Best Practices in First-Year

Transition for Students with Autism Spectrum Differences (ASDs)

by Mary Stasiuk

COMMUNIQUÉ / VOLUME 14 / ISSUE 3 / FALL 2014 / 3

President’s Message

What did CACUSS just do by making a resolution? I’ve been reflecting on this question over the past several months. For many, a resolution is associated

with change and decisions: to make things better.

Each year, as the clock strikes midnight on December 31st, millions of people around the world commit to changing their circumstances by making resolutions. The new calendar year presents an opportunity for us to start fresh, clear the clutter, and put into action any contemplations about how life might be different, or even better. This ritual, however, has never worked for me. Every year I say I’m going to eat healthier, be more active, and take on a hobby. Like many of my fellow “resolutioners,” my dedication and drive make all my plans seem possible. I tell myself that I can resist temptation and stay focused. Unfortunately, also like many resolutioners, these commitments meet their demise, despite my best efforts. Clearly the formula isn’t working for me, but I think I’ve discovered why! I believe I’ve been working with the wrong cycle. We all work in postsecondary education, and our work and planning revolves around an academic year, not a calendar one.

Over the many years I’ve been involved in CACUSS, I’ve begun to look to the annual conference as my time of renewal, a time to make commitments on how I want to be and what I need to plan to make change happen. Ultimately, this timing has proved much more successful than my ill-fated January resolutions. Not only does the annual conference align with our work cycles, but it’s also a time when we are able to get together, share ideas, generate new ones, and bring back important learnings to our respective campuses. It is the ideal time to reflect back and put forward a plan of resolution.

I believe this strategy can also work for CACUSS itself. Over the past several months, we have made several resolutions: to change our by-laws, to revise our Board of Directors structure, and to re-imagine how we define our communities within CACUSS. We have important work ahead of us. The decisions made on the future of CACUSS require our collective input and dedication in ensuring that these commitments are realized. While celebrating and building on our past successes, there is great opportunity to revision how we consider our organization and how it best supports us (i.e., how we support each other) in the work we do.

It’s easy to find comfort in the familiar, revert back to the way things were. This unintended inertia is another reason why all too often resolutions fail. Let’s make sure that our current resolutions are not made in vain.

David Newman

The 2015 annual conference provides an excellent opportunity to re-imagine our future. The theme, “Whole Campus, Whole Student: Creating Healthy Communities,” nicely articulates a way forward. CACUSS needs to work as a whole organization so that we can collectively define our new identity and position ourselves as a nationally recognized entity of professionals who provide leadership on holistic student learning and development. We need to make sure that we are relevant to members by putting our focus more intently on the idea of supporting student success. To achieve this focus, we need to develop and realize our organizational commitments and resolutions around ensuring that we have robust, nimble, and healthy Communities of Practice and Networks.. We need to see ourselves as Whole CACUSS, Whole Student. That is one resolution I think we can – and should – all keep.

Message du président

Àquoi pensait donc l’Association des services aux étudiants des universités et collèges du Canada (ASEUCC) en prenant une « résolution »? Je me suis penché sur cette question au cours des

derniers mois. Plusieurs associent une résolution au changement et à la prise de décisions en vue d’améliorer les choses.

Chaque année, tandis que l’horloge marque minuit le 31 décembre, des millions de personnes partout dans le monde s’engagent à améliorer leur sort en prenant des résolutions. La nouvelle année constitue une occasion de recommencer à neuf, de mettre de l’ordre et de donner suite aux aspirations à une vie différente, voire meilleure. Cependant, en ce qui me concerne, ce rituel n’a jamais porté ses fruits. Chaque année, je prends la résolution de manger mieux, d’être plus actif et de me trouver un passe-temps. Comme pour bien des « preneurs de résolutions », tous mes plans

semblent possibles grâce à mon dévouement et à ma détermination. Je me dis que je suis capable de résister à la tentation et de rester concentré. Malheureusement, comme pour mes confrères preneurs de résolutions, ces engagements aboutissent à un échec malgré tous mes efforts. De toute évidence, la formule ne fonctionne pas pour moi, mais je crois savoir pourquoi! Je ne travaillais pas dans le cycle adéquat, apparemment. Nous évoluons tous dans le domaine de l’enseignement postsecondaire, et notre travail et notre emploi du temps s’articulent autour d’une année scolaire, et non d’une année civile.

Au fil de mes nombreuses années passées au sein de l’ASEUCC, j’en suis venu à considérer la conférence annuelle comme le moment de me renouveler, de m’engager à atteindre mes objectifs et à faire le nécessaire pour y parvenir. En fin de compte, cette période s’est révélée beaucoup plus fructueuse que celle de janvier, où mes résolutions sont vouées à l’échec. Non seulement la conférence annuelle s’accorde avec les cycles de travail de notre domaine,


mais elle nous permet de nous réunir, de partager nos idées, d’en créer de nouvelles et de tirer des enseignements importants que nous ramenons à nos campus respectifs. C’est le moment idéal pour prendre du recul et présenter un plan de résolutions.

Je suis convaincu que cette stratégie est applicable à l’ASEUCC. Au cours des derniers mois, nous avons formulé plusieurs résolutions : modifier les règlements administratifs, réviser la structure du conseil d’administration, revoir la définition des communautés dans le contexte de l’ASEUCC. Un travail important nous attend. Les décisions prises relativement à l’avenir de l’ASEUCC demandent notre apport collectif et notre dévouement, car nous devons nous assurer que ces engagements prennent forme. Tout en célébrant et en tirant parti de nos réussites antérieures, nous devons profiter de l’occasion pour revoir notre vision de l’organisation et les façons dont elle nous aide le plus dans nos tâches (autrement dit, les façons dont nous nous entraidons).

Il est facile de trouver du réconfort dans ses vieilles habitudes et de revenir en arrière. Cette inertie involontaire est l’une des raisons qui expliquent l’échec répété des résolutions. Ainsi, nous devons nous assurer que nos résolutions actuelles ne sont pas formulées en vain.

La conférence annuelle de 2015 constitue une excellente occasion de repenser notre avenir. Le thème « Vie de campus sainement nôtre : Pour la création de communautés saines » décrit bien la voie à suivre. L’ASEUCC doit travailler comme une organisation unie de manière à ce nous puissions définir collectivement notre nouvelle identité. Ainsi, nous pourrons nous positionner comme une entité de professionnels reconnue à l’échelle nationale qui offre une expertise globale en matière d’apprentissage et de développement des étudiants. Nous devons veiller à ce que nos actions soient pertinentes pour nos membres en mettant davantage l’accent sur l’appui de la réussite des étudiants. Pour ce faire, nous devons définir et mener à bien nos engagements et nos résolutions de nature organisationnelle afin de disposer de communautés de praticiens et de réseaux solides, flexibles et sains. Il faut que nous nous percevions comme une « ASEUCC sainement nôtre ». Voilà une résolution que nous pouvons – et nous devons – tous respecter.

CACUSS Awards 2015 / Prix 2015 de l’ASEUCC

CACUSS offers over $20,000 annually in awards, grants, and member recognition to recognize excellence, innovation and outstanding contributions to Student Affairs in Canada. Full details about awards are available online http://www.cacuss.ca/about_awards.htm. In particular, we encourage the membership to nominate for the following two recognition awards:

Award of Honour / Prix d’honneur (established in / créé en 1996)The CACUSS Award of Honour is the highest honour CACUSS gives to one of its members. The award is presented at the annual CACUSS conference.Le prix d’honneur de l’ASEUCC est la plus haute distinction que l’association puisse conférer à l’un de ses membres. Il est remis lors de l’assemblée générale annuelle de l’association.

CACUSS Life Membership / Adhésion à vie à l’ASEUCCIs someone at your institution retiring?

CACUSS members who have retired from their position in a post-secondary institution may be eligible for Life Membership in CACUSS. Such membership shall be granted to an individual by a vote of the CACUSS Board of Directors on the recommendation of a Network or Community of Practice. Life Members shall be exempt from payment of dues to the Association and the division but shall retain all of the rights and privileges of dues-paying members, except for holding office or voting.Les membres qui quittent le poste qu’ils occupent dans un établissement d’enseignement pour prendre leur retraite sont admissibles au statut de membre à vie de l’ASEUCC. Ce statut est octroyé par un vote du conseil d’administration de l’ASEUCC, sur recommandation d’une communauté. Les membres à vie sont exonérés du paiement de la cotisation à l’ASEUCC et à leur division mais conservent tous les droits et privilèges des membres en règle, à l’exception du droit de voter ou d’exercer une charge.

Nominations should be submitted to the Chair of the Awards Committee by February 15, 2015. La proposition doit parvenir à la personne responsable du comité des mises en candidature au plus tard le 15 février 2015.


Executive Director Update

Tools: From Kitchen to CACUSS

The weather has just turned from summerlike to autumnal very quickly in Toronto. It is the first days of October, and the fall is always a

time of resolutions and new starts for those of us that work in education-related fields.

My reflections this fall so far have been around the theme of “tools.” At first, I started thinking about the idea of “re-tooling” in relation to the organizational changes we have been engaged in this past year. Retooling involves reorganizing and revising, and that is exactly what we have been experiencing at CACUSS. The reorganization is in its final phase, but I imagine the revision will continue on for some time.

Our members have asked that the development of Communities of Practice and Networks be an “iterative” process, one that is open for reimagining and ongoing conversations. Whereas our former structure of “divisions” was somewhat rigid and inflexible at times, this new structure is meant to be more fluid and responsive. We appreciate, however, that change and the unfamiliar can be anxiety-provoking for some and that well-defined structure can be comforting to many of us. The re-tooling, then, continues.

With any tool, it takes some time to learn how to use it effectively and efficiently. Sometimes it takes hands-on practice, or reading an instructional manual, or watching an informational video to understand all its functions and uses. Tools are not just physical items we hold in our hands. They can be – and do – many things.

As someone who enjoys cooking, eating, and all things related to the culinary arts, it is also tempting to buy new kitchen gadgets. However, sometimes they are not necessary; they only serve one function or are not used often enough to warrant the space they take up on shelves and countertops. As new “tools” emerge in social media and technology, we should be constantly weighing their function and usefulness in meeting a particular need. Is th new iPhone so much better than its predecessor? Is managing another social media platform going to yield more results than the three with which we are already engaged? What function do these tools truly serve?

As the CACUSS Board of Directors has important conversations about our future in providing professional development (PD), I have also been thinking about our competencies as professionals. What tools do we need to do our job effectively? What knowledge and best practices do we need to attain and discover? To answer these questions, CACUSS has just gone to RFP (request for proposal) for a member needs assessment. We are interested in learning more about

Jennifer Hamilton

where our members get their PD, where there are gaps, and how CACUSS can most effectively and successfully fill those gaps. I believe that our professional competencies are our most valuable tools, and we need to learn more about how we get and use them.

Our process for building and supporting networks and communities of practice is developing this fall, and we are also working on building new tools to support the work of our volunteer members. We plan to develop an online platform and communication tools for the networks and communities. We have tools in place to support webinars, resources to support events, and workshops that our networks and communities wish to plan. We also have put aside significant financial resources (after all, money is an important tool!) to support communities of practice in delivering programs to the CACUSS membership. The intention is

that the Communities of Practice will be focused on knowledge development and transmission, resource building and sharing, advocacy work, as well as supporting members through networking and communicating.

As we continue to evolve as an organization, policy development is becoming an important aspect of CACUSS’s work. While not as exciting as a new laptop or tablet, or a shiny new kitchen appliance, clear and transparent policy is a key tool in any organization. As an organization evolves, with complex volunteer and staff roles involved in various levels of decision making, good policies help an organization become more sustainable and accountable. With my

involvement, we have been focusing on policy development through both the Finance Committee and the newly formed Policy Committee. We hope to complete the new policy development and existing policy review in the next 18 to 24 months.

Our strategic plan at a high level guides what functions we should be working towards as an organization. Determining the tools to support those functions is part of our operational plan and ongoing development. What are the tools that you use in your work every day that serve an important function?

What tools could CACUSS provide to support your professional work better?

Please be in touch.

[email protected]/cacuss@cacusstweets


Mise à jour de la directrice générale

O utils : de la cuisine à l’ASEUCC

À Toronto, les températures estivales ont très rapidement laissé place à un climat automnal.

Nous sommes aux premiers jours d’octobre, et l’automne est toujours une période de résolutions et de nouveaux départs pour ceux qui travaillent dans les domaines liés à l’éducation.

Jusqu’ici, mes réflexions automnales tournaient autour du thème des « outils ». Au début, je pensais à l’idée de « réoutillage » par rapport aux changements organisationnels que nous avons entrepris au cours de la dernière année. Un réoutillage exige une réorganisation et une révision, et c’est exactement ce que nous avons vécu à l’Association des services aux étudiants des universités et collèges du Canada (ASEUCC). La réorganisation est dans sa phase finale, mais, selon moi, la révision se poursuivra pendant quelque temps.

Nos membres ont demandé que le développement des communautés de praticiens et des réseaux soit un processus itératif, ouvert aux adaptations et aux discussions en cours. Alors que notre structure de « divisions » antérieure était plutôt rigide et inflexible par moment, notre nouvelle structure se veut plus fluide et souple. Cependant, nous sommes conscients que le changement et l’inconnu peuvent être une source de stress pour certains et qu’une structure bien définie est rassurante pour la plupart d’entre nous. Ainsi, le réoutillage se poursuit.

Quel que soit l’outil, il faut du temps pour apprendre à l’utiliser correctement et efficacement. Parfois, il faut acquérir de l’expérience pratique, lire un manuel d’instructions ou regarder une vidéo informative pour comprendre toutes ses fonctionnalités et utilisations. Les outils ne sont pas que des objets physiques que l’on tient dans ses mains. Ils peuvent avoir diverses formes et servir à bien des choses.

En tant qu’amateur de cuisine, de bonne chère et de tout ce qui a trait aux arts culinaires, je suis aussi tenté d’acheter de nouveaux gadgets culinaires. Il arrive toutefois que ces outils soient superflus, car ils ne remplissent qu’une fonction ou servent si peu que cela ne justifie pas l’espace qu’ils occupent sur les tablettes et les comptoirs. Alors que de nouveaux outils voient le jour dans le domaine des médiaux sociaux et des technologies, nous devrions toujours évaluer leur fonction et leur efficacité à répondre à un besoin spécifique. Le nouvel iPhone surpasse-t-il vraiment son prédécesseur? La gestion d’une nouvelle plateforme de médias sociaux produira-t-elle des résultats supérieurs à ceux des trois autres plateformes dans lesquels nous sommes présents? Quelle est la véritable fonction de ces outils?

Tandis que les membres du conseil d’administration de l’ASEUCC mènent des discussions importantes sur notre avenir dans l’offre de perfectionnement professionnel, je me suis penché sur nos compétences à titre de professionnels. De quels outils avons-nous besoin pour remplir nos tâches efficacement? Quelles sont les connaissances et les pratiques exemplaires que nous devons cibler et acquérir? Afin de répondre à ces questions, l’ASEUCC a récemment présenté une demande de propositions pour une évaluation des

besoins des membres. Nous souhaitons en savoir plus sur les points suivants : où se trouve l’offre de perfectionnement professionnel pour nos membres, où sont les lacunes et comment l’ASEUCC peut-elle combler ces lacunes de manière efficace et réussie? Je crois que nos compétences professionnelles constituent nos outils les plus précieux et que nous devons en apprendre davantage sur la façon de les acquérir et de les mettre à profit.

Le processus d’élaboration et de soutien des réseaux et des communautés de praticiens sera mis au point cet automne. De plus, nous sommes en train de créer de nouveaux outils pour faciliter le travail de nos membres bénévoles. L’élaboration d’une plateforme en ligne et d’outils de communication pour les réseaux et les communautés est prévue. Nous proposons des outils pour faciliter les webinaires, des ressources pour soutenir des événements et des ateliers que les réseaux et les communautés souhaitent organiser. Nous avons également réservé d’importantes sommes – après tout, l’argent est aussi un outil important! – pour aider les communautés de praticiens à offrir des programmes aux membres de l’ASEUCC. Le but recherché est que les communautés de praticiens se concentrent sur l’acquisition et la diffusion des connaissances, la création et le partage de ressources ainsi que les activités de sensibilisation, en plus d’appuyer les membres par l’entremise du réseautage et des communications.

Au fur et à mesure que notre organisation évolue, l’élaboration de politiques devient un aspect important de notre travail. Bien qu’elle ne soit pas aussi inspirante qu’un nouvel ordinateur portatif, qu’une nouvelle tablette ou qu’un appareil électroménager flambant neuf, une politique claire et transparente constitue un outil clé dans toute organisation. Au fil de son évolution, lorsque se complexifient les rôles des bénévoles et du personnel intervenant à différents niveaux du processus de prise de décisions, de bonnes politiques permettent à l’organisation d’être plus durable et responsable. Avec ma participation, nous avons mis l’accent sur l’élaboration de politiques par l’intermédiaire du comité des finances et du comité de politique, nouvellement formé. Nous espérons que l’élaboration de nouvelles politiques et la révision des politiques actuelles seront terminées dans les 18 à 24 prochains mois.

Notre plan stratégique de haut niveau fournit une orientation

quant aux fonctions sur lesquelles nous devrions nous concentrer en tant qu’organisation. Déterminer les outils à l’appui de ces fonctions fait partie de notre plan opérationnel et de notre développement à long terme.

Quels sont les outils que vous utilisez tous les jours dans le cadre de votre travail et qui jouent un rôle important?

Quels sont les outils que l’ASEUCC pourrait vous fournir pour mieux soutenir votre travail professionnel?

N’hésitez pas à communiquer avec nous.

[email protected]/cacuss@cacusstweets


Innovating Online with Stepped Care: A Research-Based Stepped Care Mental Health Community of

Practice Proposalb y D r . P e t e r C o r n i s h

I nnovative service delivery models are needed by ou tpa t i en t men ta l hea l t h c l i n i c s and university and college counselling services, as these settings face increasing demand for

treatment within a context of l imited resources. Wait times for secondary, outpatient mental health care in Canada exceed international norms, and New found l and and Labrador i s no excep t i on ( E s m a i l , 2 0 0 9 ; N e w f o u n d l a n d a n d L a b r a d o r Medical Association, 2011). University and college counselling services throughout North America are experiencing yearly increases of up to 15% in the demand for treatment, and students are increasingly wai t l i s ted or must exper ience longer in terva ls between sessions (Mistler, Reetz, Kyrowicz & Barr, 2012).

A stepped care model (O’Donohue & Draper, 2011) has been developed in the United Kingdom. It promises rapid access for face-to-face intake from mental health services within a primary care setting, followed by a systematic triage and monitoring system. The model offers the lowest level of intervention intensity warranted by the initial and ongoing assessments. Treatment intensity can be either stepped up or down depending on the level of patient distress or need.

Clinical trials conducted in primary care settings in Europe indicate that stepped care is at least as effective as traditional care (e.g., van Straten, Tiemens, Hakkaart, Nolen & Donker, 2006) and has the potential for health system efficiencies (Bower & Gilbody, 2005). No research has been published on the use of stepped care in secondary health care settings such as community mental health clinics or university and college counselling services. A stepped care model has not yet been implemented or evaluated in North America nor has it been employed in a university or college system. Identifying a safe, efficient, and effective system of care in college and university counselling services is crucial given that most students attending these institutions fall within the vulnerable age range where early signs of mental illness typically emerge.

The Mental Health Commission of Canada has concluded that this country has no accessible, organized, or effective mental health system (Mental Health Commission of Canada, 2013). An efficient system is needed that can provide early and rapid assessment as well as systematic and monitored access to the

most effective, but least intensive, treatment (Mental Health Commission of Canada, 2013). Such a system promises to reduce the chronicity of mental illness in Canada throughout the lifespan. We propose that stepped care would be especially valuable in secondary care systems, such as university and college counselling centres and outpatient mental health clinics where demand for service far outweighs supply (Reetz, Barr & Krylowicz, 2014).

A Stepped Care Model for Mental Health in Secondary Health Care Settings

We have developed a unique but untested model of stepped care for secondary mental health care settings (see Figure 1 on page ). Patient intake is handled through a decentralized case management approach in which all providers assume responsibility for at least one half-day of scheduled and walk-in intakes. Each provider is responsible for managing all cases that present during their coverage times. Referrals to other providers or trainees are permitted, but typically provider availability is scarce. As such, providers are motivated to refer patients to lower steps of care unless patient presentation severity warrants “stepping up.”

Given that up to approximately 20 percent of people seeking mental health services experience a spontaneous recovery within the first week of initial contact (Patten, 2006), the proposed first step in this care model is “watchful waiting” during which service providers simply monitor the mental health of patients through the use of screening instruments without delivering an intervention. The OQ-45 outcome monitoring system (Lambert, et al., 2004) is first administered at intake on computer tablets in the waiting room and then accessible online so that students can complete these when prompted through email reminders at various points in treatment.

The second step involves providing access to self-help materials in the form of books, pamphlets, or online resources. Although research on the effectiveness of self-help for mental health reveals mixed results, most studies indicate that it can be effective when used within a treatment context (Gould & Clum, 1993). There is currently considerable private sector development of online programming in the self-help field, but access is often expensive and geared to institutional users such as EAP firms. Free or inexpensive smartphone apps have less sophisticated mood management capabilities. With additional funding, some of the more comprehensive online mental health educational self-help resources will be made available to patients who do not recover spontaneously during the watchful waiting period.

Step three involves face-to-face, interactive, psychoeducational skill-building workshops. A wide variety of face-to-face programs (both mental health and academic skill-building) will be offered on a drop-in, single-session basis or through a short, rolling series of workshops (see Figure 1 on page 11). Psychoeducational sessions have been found to improve coping for patients with mild to moderate symptoms (Van Deale, Hermans, Audenhove & Van den Bergh, 2012). For patients with higher levels of stress, the increased mental health literacy afforded by such sessions has been found to improve treatment adherence and outcomes (Greenberg, Constantino & Bruce, 2006; Swartz, Zuckoff, Grote, Spielvogle, Bledsoe, Shear & Frank, 2007).

Like several other universities across the country, Memorial University is planning to implement a campus-wide, community-development approach to wellness promotion (e.g., Budgen, Callaghan, Gamble, Wiebe, Reimer, Feddersen, Dunn, Johnson, McHugh, Morrison, Sullivan, Cull & Abd-El-Aziz, 2011; Burwell, Dewald, & Grizzell, 2010), which may include mental health first


aid training, a wellness audit of University policies and processes, and a review of curriculum design practices with the aim of integrating universal course design across campus. Psychoeducation in the stepped care model would be an integral component of this proposed healthy-campus direction. The Counselling Centre will participate fully in the healthy-campus activities in order to build capacity across campus for delivery of mental health psychoeducation beyond the walls of our clinic space.

Step four involves therapist-assisted, e-mental health programming. Cognitive behavioural and Interpersonal therapy modules have been developed in Australia (e.g., Mewton, Wong & Andrews, 2012) and are being modified for use in the United States (e.g., Therapist Assisted Online Treatment for Anxiety (TAO-anxiety), 2013) and Canada (Hadjistavropoulos, Thompson, Ivanov, Drost, Butz, Klein, & Austin, 2011). Clinical trials indicate that therapist-assisted. e-mental health is effective in primary and secondary health care settings (e.g., Kessler, Lewis, Wiles, King, Weich, Sharp, Araya, Hollinghurst & Peters, 2009; Hedman, Ljotsson, Kaldo, Hesser, El Alaoui, Andersson & Lindefors, 2014). A Swedish study employing a randomized controlled trial of therapist-assisted. internet-based cognitive behavioral therapy (ICBT) concluded that ICBT is more cost-effective than face-to-face therapy (Hedman, Andersson, Ljotsson, Andersson, Ruck & Lindefors, 2011).

Patients enrolled in e-mental health programs are typically assigned to a provider who spends up to twenty minutes per patient per week providing online (email) coaching and support as participants work through the modules. Outcome monitoring is built into these programs. Although therapist-assisted online programs have being evaluated with favourable results in Australia, Europe, and Saskatchewan (Hivert-Bruce, Rossouw, Wong, Sunderland & Andrews, 2012; Kessler et al., 2009; Pugh, Hadjistavropolous, Klein & Austin, 2014), a fully integrated stepped care model (as proposed by O’Donohue & Draper, 2011) has yet to be tested anywhere in the world.

Step five involves the provision of traditional face-to-face group psychotherapy designed to respond to the trending needs observed at intake or on therapist caseloads. For example, when more patients present with depression, additional sections of a depression group are offered. Mindfulness group sections are expanded when stress or anxiety become more prevalent at intake. When relationship conflict and family of origin issues prevail, additional Yalom-style interpersonal process groups are offered (Yalom, 1995). Although research on group therapy over the past 50 years has consistently indicated outcomes on par with, or exceeding, one-on-one treatment (Fuhriman & Burlingame, 1994), both patients and providers seem reluctant to make use of this efficient service modality (Strausss, Spangenberg, Brähler & Bromann, 2014). We argue that successful referrals to group therapy will improve within a stepped care framework, which reduces risk of referral error given the systematic monitoring and capacity to step up the intensity of care.

Step six involves one-on-one therapy. Session duration and frequency is a matter of clinical judgment and ongoing outcome monitoring. Counsellors are encouraged to use time creatively and with some flexibility. Some patients with severe symptomatology will be seen weekly for 30-minute sessions. Others are seen for brief check-ins on a bi-weekly basis. Patients who are stabilized may be seen only every three or four weeks with self-help resources (typical of Step 2) assigned as homework. Students with chronic mental health conditions requiring longer-term or prolonged intensive treatment are referred to community-based services, which typically have a 12-to-16-month waiting list. Limited ongoing support is provided to students on this community waitlist.

Step seven involves limited outpatient psychiatric consultation with follow-up care provided by family physicians for those patients who fail to show progress by step six. A thorough psychiatric assessment is conducted, and follow-up consultation is provided to the primary care physician.

The highest level of intervention, step eight, involves inpatient admission to a hospital psychiatric ward. This is coordinated by the in-house consulting psychiatrist with support from a case manager who together liaise with the local psychiatric ward to ensure appropriate community or campus-based follow-up upon discharge. A key function of both the psychiatrist and case manager is to ensure a smooth hospital admission process and appropriate follow-up care upon discharge. Coordinated case management is key to risk management for patients in crisis and or/with severe psychopathology.

Proposed Methodology

An examination of the literature shows that stepped care often involves randomized clinical trials. The relevant control group in such cases is the currently provided standard treatment, sometimes referred to in the literature as treatment as usual. This study will be conducted in two phases. In phase 1, the stepped care program described above will be delivered at Memorial University of Newfoundland’s Counselling Centre and evaluated through a clinical trial comparing stepped care to treatment as usual. Also in phase 1, additional funding will be sought through both corporate sponsorship and federal granting agencies to support clinical trials in other treatment settings during phase 2. In phase 2, programming informed by the first phase and adapted to other colleges, universities, or community clinic sites will be evaluated through similar trials.

In phase 1, patients (i.e., university students) who agree to participate will be randomly assigned to either stepped care (as described in detail above) or treatment as usual conditions. Patients in both conditions will be assessed through a 30-minute walk-in intake session with an individual therapist. Continuing care in the treatment as usual control condition will involve 50-minute, one-on-one, face-to-face counselling sessions as availability permits (typically within two to four weeks after the initial intake). Continuing care in the stepped care condition will be provided at the lowest level of treatment intensity appropriate to the student’s needs. In order to ensure patient wellness, all students participating in the research trial (in both treatment as usual and stepped care conditions) will be monitored weekly using sensitive, reliable, and valid mental health progress measures. These measures include critical items that identify suicidality and risk of harm to others. Students in either condition who endorse these items would be stepped up to the appropriate level of care (typically steps 6, 7, or 8).

A Research-Based Stepped Care Community of Practice

Consumers of mental health services, representatives of the Canadian Mental Health Association, mental health policy specialists, and student service professionals will be active participants on the research team. Program, research, and funding partners are currently being sought to launch phase 1 of the project. If phase 1 of this project is successful (i.e., stepped care achieves better outcomes than treatment as usual, or it achieves comparable outcomes with cost efficiencies) we will use additional funding from other sources to launch, evaluate, and sustain stepped care in other primary and secondary care settings in the province and the Atlantic region. We envision the emergence of a research-based stepped care community of practice that could extend through


Atlantic Canada and possibly across Canada. We invite interested practitioners, student service administrators, and researchers from across the country to joinwith us as we form a stepped care community of practice.

Peter Cornish is an Associate Professor and the Interim Director of the Counselling Centre at Memorial University of Newfoundland

References

Bower, P., & Gilbody, S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency: narrative literature review. British Journal of Psychiatry, 186(1), pp 11-17.

Bugden, C., Callaghan, D., Gamble, D., Wiebe, R., Reimer, C., Feddersen, M., Dunn, S., Johnson, R., McHugh, N., Morrison, H., Sullivan, K., Cull, I., Abd-El-Aziz, A. (2011). Creating a healthier campus community using action research and health promotion strategies: Students and organizational leaders as partners. The International Journal of Health, Wellness and Society, 1. Retrieved from: http://HealthandSocietyJournal.com/,ISSN2156-8960

Burwell, C., Dewald, L., & Grizzell, J. (2010). Healthy campus 2010: midcourse review. American Journal of Health Studies, 25(2), 102-110.

Esmail, N. (2009). National Psychiatry Waiting List Survey, 2009. Waiting Your Turn: Hospital Waiting Lists in Canada. Fraser Institute.

Fuhriman, A., & Burlingame, G. M. (1994). Group psychotherapy: Research and practice. Handbook of group psychotherapy: An empirical and clinical synthesis, 3-40.

ClinicalTrials.gov, NIH (2013). Therapist assisted online treatment for anxiety (TAO-anxiety). Retrieved from: http://clinicaltrials.gov/show/NCT01816204 (Identification No. NCT0816204).

Gould R. A. & Clum G.A. (1993). A meta-analysis of self-help treatment approaches. Clinical Psychology Review 1993;13,169-86.

Greenberg, R. P., Constantino, M. J., & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26, 657-678.

Hadjistavropoulos, H. D., Thompson, M. Ivanov, M. Drost, C., Butz, C. J., Klein, B., & Austin, D. W. (2011). Considerations in the development of a therapist-assisted internet cognitive behavior therapy service. Professional Psychology: Research and Practice, Vol 42(6), 463-471.

Hedman, E., Andersson, E., Ljotsson, B., Andersson, C. R., & Lindefors, N. (2011). Cost-effectiveness of internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: Results from a clinical trial. Behavioral Research and Therapy, 49, 729-736.

Hedman, E., Ljotsson, B., Kaldo, V., Hesser, H., El Alaoui, S., Kraepelien, M., Andersson, E., Ruck, C., Svanborg, C., Andersson, G., & Lindefors, N. (2014). Effectiveness of internet-based cognitive behaviour therapy for depression in routine psychiatric care. Journal of Affective Disorders, 155, 49-58.

Hivert-Bruce, Z., Rossouw, P. J., Wong, N., Sunderland, M., & Andrews, G. (2012). Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders. Behaviour Research and Therapy, 50, 463-468.

Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S., Sharp, D. J.,

Araya, R., Hollinghurst, S., & Peters, T. J. (2009). Therapist-delivered internet psychotherapy for depression in primary care: a randomized controlled trial. The Lancet, 374, 628-634.

Lambert, M. J., Morton, J. J., Hatfield, D, Harmon, C., Hamilton, S., Reid, R. C., Shimokawa, K., Christopherson, C, & Burlingame, G. M. (2004). Administration and Scoring Manual for the OQ-45.2 (Outcome Measures). Brigham Young University.

Mental Health Commission of Canada (2013). Toward Recovery and Well-Being: A Framework for a Mental Health Strategy for Canada. Retrieved July 30, 2014, from http://www.mentalhealthcommission.ca

Mewton, L., Wong, N., and Andrews, G. (2012). The effectiveness of internet cognitive behavioral therapy for generalized anxiety disorder in clinical practice. Depression and Anxiety, 29, 843-849.

Mistler, B. J., Reetz, D. R., Krylowicz, B., & Barr, V. (2012). The Association for University and College Counseling Center Directors Annual Survey. Retrieved February 13, 2014, from http://www.aucccd.org/support/Monograph_2012_AUCCCD%20Public.pdf.

Newfoundland and Labrador Medical Association (2011). FACT SHEET – Psychiatry. Retrieved July 30, 2014, from http://www.nlma.nl.ca/documents/document_23.pdf

O’Donohue, W. T., & Draper, C. (2011). The case for evidence-based stepped care as part of a reformed delivery system. In W. T. O’Donohue and C. Draper (Eds.), Stepped-Care and e-health. New York: Springer Science.

Patten, S. B. (2006). A major depression prognosis calculator based on episode duration. Clinical Practice in Epidemiological Mental Health, 2, 1-8.

Reetz, D. R., Barr, V., & Krylowicz, B. (2014). The Association of University and College Counseling Center Directors Annual Survey (Reporting period: September 1, 2012 through August 31, 2013). Retrieved July 31, 2014 from: http://files.cmcglobal.com/AUCCCD_Monograph_Public_2013.pdf

Seekles, W., van Straten, A., Beekman, A., van Marwijk, H., & Cuijpers, P. (2011). Stepped care treatment for depression and anxiety in primary care. A randomized controlled trial. Trials, 12, 1-10.

Strausss, B., Spangenberg, L., Brähler, E, & Bromann, B. (2014). Attitudes Towards (Psychotherapy) Groups: Results of a Survey in a Representative Sample. International Journal of Group Psychotherapy, 64(5): 1–20.

Swartz, H. A., Zuckoff, A., Grote, N. K., Spielvogle, H. N., Bledsoe, S. E., Shear, M. K., & Frank, E. (2007). Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation. Professional Psychology, Research and Practice, 38(4), 430-439.

Therapist Assisted Online Treatment for Anxiety (TAO-anxiety). (2013). Retrieved from: http://clinicaltrials.gov/show/NCT01816204.

Van Daele, T., Hermans, D., Van Audenhove, C., & Van den Bergh, O. (2012). Stress reduction through pyschoeducation: A meta-analytic review. Health, Education & Behavior, 39(4), 474-485.

van Straten, A. Tiemens, B., Hakkaart, L., Nolen, W. A., & Donker, M. C. M. (2006). Stepped care vs. matched care for mood and anxiety disorders: a randomized trial in routine practice. Acta Psychiatrica Scandinavica, 113, 468-476.

Yalom, I. D. (1995). The theory and practice of group psychotherapy. Basic Books


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“How Do We Cope?”: A Creative Experiment

b y L u c a s G o b e r t

I t’s an experiment, really, dealing with the question “How do we cope?”

Let me explain by telling you a story. It’s a familiar story.

The alarm goes off at 6:00 a.m., rousing a student from her deep slumber so that she may shower, dress, and be on the bus to make it for that 8:00 a.m. class. She grumbles at the interruption to her rest as thousands of other students do across our cities, reaches out, and swats the snooze button. A very familiar story, one each of us has once lived out. But there’s a fundamental difference to this tale, one we did not live. The difference? Clasped in her hand, the one she uses to smack the button that will grant her that ever-so-important ten more minutes in bed, is her smartphone.

Before she’s cognizant enough to say “I’m awake,” before she’s rubbed the sleep out of her eyes, and before she’s even silenced the annoying intruder upon her restful slumber, she has reached out for her smartphone, her rectangular gateway to... everything. From the very second she wakes up, her smartphone is within reach, and it will not leave her side until she crawls back into bed that night. For the entire day, every second, she is plugged in, constantly connected to a host of information, ads, celebrity gossip, apps, social media, friends, work, school, media, movies, television, and music; in other words, that smartphone has become the native home of the Digital Student.

From the second our student wakes up until she steps onto campus, she has been bombarded with at least 200 touch-points to the Internet, which is really to say at least 200 touch-points to the world. And all before she even reaches campus. Her senses and her mind are already reaching information overload, and now, only now that she has stepped onto campus, does she see that poster for the Writing Centre advertising their ability to hone the skills she needs to succeed as a student. Did I write “see”? I meant “walked by,” oblivious, because she just saw her best friend’s TwitPic selfie of him meeting Benedict Cumberbatch, and all the while a new Iggy Azalea single beats in her ears.

There’s the question: As Student Affairs professionals, in our post-secondary worlds, how can we hope to cope with multi-billion dollar companies in vying for our students’ attention? When there are thousands, literally thousands, of videos of ridiculous goats on the Internet, what hubris do we have to think our students will want to see our posters, click on our links, or utilize our services? Student Affairs is great, but let’s be honest, we’re no goats.

So what do we do? How do we continue to function, to be relevant to our students in this Digital Native world?

Enter Student Affairs Creative, Ryerson University’s attempt to answer that question.

On paper, we’re a “unit at the forefront of creative multimedia and technology,” one “powering Ryerson Student Affairs through digital storytelling,

innovative technology, and creative multimedia.” On August 1, 2014, after many months of talking, rumours, planning, hearsay, and waiting, the Executive Director of Student Affairs, John Austin, finally lifted his head from the drawing board, looked us in the eye, and said, “Do it.” Two golden words that, we hope, will set us up for success with tomorrow’s students.

Student Affairs Creative exists within Student Affairs at Ryerson, with one simple goal: to tap into our student’s digital consciousness and be there when they come looking for us. We exist to lead our colleagues from departments across campus, to offer the strategy and direction that will allow Student Affairs to be an active, effective, sought-out service to our students.

The idea is not to force our way into our students’ lives, because that approach is not going to work. We’re looking at a huge paradigm shift in the concept of one person’s time, in that it completely belongs to the student. Once upon a time, we controlled when and where they went to class, and once on campus, what they could access (study, food, entertainment). Nowadays, the only thing a student can’t control is their schedule (though, with more distance courses and online learning being developed, even that is changing). Students bring their world with them; they are constantly connected to friends back home, family, media, and entertainment… the entire world! All from the palm of their hand.

As passive as it may seem, we need to wait (while preparing ourselves), to let them come to us. All we can do is be ready to receive, to build the networks, communities, and tools students need – that they want – so that when they do come searching, we’re there.

And they will come searching, which is the beauty of the Creative Unit’s plan. The nature of students and the way they do things may have changed, but their ultimate goal remains the same: get the paper, get a job. Along that path they will discover they need help, whether it’s in writing a paper, receiving emotional support, or establishing themselves as a student leader. They will search us out, and when they find us - or rather, if they can find us and if we have made ourselves findable - we will show them what it is that they need (both short-term and long-term), provide the service, and, we hope, have them stick around for more. What we do in Student Affairs is still relevant and always will be. Our goal to develop the whole person, no matter what that “whole” may be, remains true. What we need to change is how we are available.

And that is the Creative unit’s vision for all Student Affairs at Ryerson: the seamless melding of the digital and physical worlds and the evolution of our services on campus into an effortless-to-find, easy-to-access array of tools to support academics and build students into the whole person. Our students already have a story, and they are sharing it with one another across the globe. We’re just trying to tap Student Affairs into those stories, to let students know we are available to help them tell their story. At our core, the Creative unit is all about storytelling, and we are all storytellers.

So this is our great experiment. Will it work? I like to think so (but to be fair, I am a little biased). Over the next year, Creative will be proving its mettle, going big as it can, making what we do - what all of us do - valuable and noticeable to our students. When, at the end of the day, they lay their heads down to sleep, we want the last image glowing on that smartphone screen, by their choice, to be a picture of Student Affairs.

Lucas Gobert is the Communications Specialist at Ryerson’s Student Affairs Creative and a member of their larger team. He is an editor/writer and manages the RyersonStudentAffairs.com community.


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The McMaster Depression Initiative Improving Depression Care at McMaster’s

Student Wellness Centre

b y J i l l i a n H a l l a d a y , D e b r a E a r l , & C a t h a r i n e M u n n

Many of us are aware of the increased demand for mental health services on our campuses. This has been clear over the past decade or more. The

reasons for this demand are less clear but may relate to success in reducing st igma and other barriers to seeking help, changing demographics in the student population, and improved treatment and accessibility in primary and secondary schools as well as post-secondary settings. Some have also suggested that increased demands (e.g., academic, f inancial) are being placed on students or that students may have insufficient coping skills to meet the current demands of college or university and the challenging economic and employment climate in Canada. Regardless of the cause, it is clear that student services are increasingly being asked to help students experiencing challenges with the transition and stress of university, as well as support those who are highly distressed or may be developing or suffering mental illness. It should also be noted that the age of most undergraduates and many graduate and professional students coincides with the age of onset for most major mental illnesses.

Mental illness is the primary cause of disability worldwide (WHO, 2012) and the second most common cause of disability and death in Canada (CAMH, 2012). Depression and anxiety disorders are the most frequently diagnosed mental illnesses. It is accepted that 4.7 percent of Canadians over the age of 15 suffer from major depressive disorder, the most common mental illness in Canada (Stats Canada, 2013). In 2012, the prevalence of depression was 8 percent in Canadian post-secondary institutions, as measured by the National College Health Assessment (ACHA, 2013). Symptoms of depression include depressed mood, inability to feel pleasure, feelings of worthlessness or guilt, decreased concentration, inability to remain still or moving slower than usual, sleeping too much or too little, decreased libido, changes in weight or appetite, and thoughts of death or suicide (Hannon, Pooler, & Porth, 2010).

In depressive illness, these symptoms are persistent and disabling, different from a depressed mood or stress response.

Research indicates that depression can lead to lower grade point average and is associated with a high probability of drop-out from university (Eisenberg, 2009). Less than half of students with depression seek out mental health treatment (Blanco, 2008). Even among those who do receive treatment, this treatment may be inadequate. In a study of American college students (with accessible health and counselling services), minimally adequate treatment (or more) was received by only 22 percent of students (Eisenberg, 2011). Furthermore, depression is the most frequently associated mental illness present in those who attempt or complete suicide (Cavanagh, Carson, & Sharpe, 2003). Identifying and helping students who are depressed is a task that requires the awareness and support of the entire campus, including staff and faculty as well as peers and families. Campus health and counselling centres are increasingly focused on providing appropriate care to students with depression and other mental health challenges.

How can we better help students with depression in health and counselling services?

According to the literature, current management approaches and support for depressed students in post-secondary health and counselling settings appear to be insufficient. However, collaborative chronic care models focused on enhancing the quality of depression care have been demonstrated to improve care in many other primary care settings in the community. Collaborative depression care involves medical and counselling services working together in order to create individualized care plans to address depression. Collaborative care is a proven method not only to decrease symptoms of depression, but also to improve patient quality of life and increase patient satisfaction (Archer, et al., 2012; Katon, 2009; Richards, et al., 2013).

The National College Depression Project (NCDP) is an evidence-based program run by New York University (NYU). It is designed to assist colleges and universities in developing and improving their collaborative care practices for students with depression. The NCDP is an 18-month program of education, support, and collaboration with other colleges and universities through monthly webinars, internet communication, and in-person conferences. The NCDP aims to help schools improve the identification, management, follow-up, and overall care of students with depression through systematic tracking, healthcare integration, and care management. Since 2006, 30 schools have completed the collaborative and 12 schools are currently participating, including McMaster University. McMaster is the first and only Canadian school to participate in the collaborative to date.

Objectives and Methods of the McMaster Depression Initiative

The NCDP utilizes the Personal Health Questionnaire 9 (PHQ-9). The PHQ-9 is a nine-item self-assessment screening tool designed to help diagnose and assess symptom severity in depression. The items are scored from 0 (not at all) to 3 (nearly every day). The scores are summed with higher scores indicating greater severity of depressive symptoms. A score greater than 10 has been associated with a diagnosis of depression (APA, 2014); however, it should not be used alone to diagnose depression. The PHQ-9 includes a tenth question assessing functional impairment, which is associated with the patients’ quality of life, functional status, and their health care usage. The NCDP uses this tool to screen for depression and track symptom severity throughout treatment.


Individuals scoring 11 or greater with a functional score of very difficult (2) or extremely difficult (3) whom clinicians suspect are suffering from a depressive disorder are entered into the clinical registry for systematic tracking. This registry is a customized spreadsheet managed by each school to track the follow-up and treatment of identified patients. The primary objectives of the project are to improve detection, treatment, and follow-up with regards to specific benchmarks at 4, 8, and 12-week follow-up appointments:

By 4 weeks, the aim is to create an individualized management plan. This could include:

• Individual Counselling • Group Counselling • Medication

• Self-Management (e.g., exercise, peer support)

By 8 weeks, the aim is to see a significant reduction in depressive symptoms indicated by a reduction in their PHQ-9 score of 5 points or greater.

By 8 weeks, the care provider helps to engage the patient in their recovery through the development of a self-care goal. A self-care goal is a specific goal that the individual sets in discussion with their care provider to improve their mental wellbeing (e.g., exercise, healthy eating, sleeping, socializing.) Involving the student in the creation of goals enables the student to participate in their own recovery.

By 12 weeks, the aim is to achieve remission, meaning the student is not (at this time) experiencing any debilitating depressive symptoms. This achievement is indicated by a score of less than 10 on the PHQ-9 with a functional score of not at all difficult (0) or somewhat difficult (1).

The care manager role is a key component of the NCDP to reduce the risk of students getting lost or not receiving follow-up after being identified. The care manager ensures that students are getting the help they need by proactively reaching out to students who have not returned for a follow-up visit. The care manager can help students book an appointment or simply remind the student that the services are available for them and they can return at any time they wish.

System Changes

The NCDP promotes the use of Plan-Do-Study-Act (PDSA) cycles to make health system changes to improve depression care within each individual school. PDSAs are used to test change on a small scale before implementing the change universally. This can save money, time, and risk. Examples of PDSAs at McMaster include:

• Targeted screening (those presenting for a mental health appointment) versus universal screening (everyone who has an appointment) using the PHQ-9

• Development of a single-session depression education group

• Electronic tracking of PHQ-9s

• Templates for visit documentation

(Images courtesy of the NHS Institute for Innovation and Improvement (www.institute.nhs.uk))

McMaster Findings

At McMaster University we created a “champion team” at the Student Wellness Centre comprised of two family physicians, one counsellor, one mental health nurse (care manager), one administrator and one registry manager (data input and tracking), and one psychiatrist as the team leader. McMaster currently has over 350 students in the registry; approximately 275 have completed the 12-week follow-up, and 75 students are currently active in the registry. Universal screening using the PHQ-9 has been adopted by the American schools participating in the NCDP; however, at McMaster we have chosen to selectively screen in primary care (those presenting as struggling or with symptoms suggestive of depression) and to screen universally in counselling (all students attending first counselling appointments). This choice was based on our interpretation of the depression screening literature. Initially,


only champion team members were performing screening, but gradually all of the family doctors and counsellors have started to perform screening as described.

On average, the rate of follow-up visits has been 60 percent, but completion rates for follow-up PHQ-9s has been about 30 percent. Various methods are currently being implemented to improve PHQ-9 follow-up rates, such as electronic reminders, paper reminders, and education sessions for care providers. Most students who “fall through the cracks” do so at the beginning of treatment, failing to return for a four-week follow-up visit. Improvements are being made to ensure students are phoned at four weeks if they have not returned for an appointment. This role, which was initially completed by the care manager, is now being shared between the nurses, counsellors, and care manager.

We have found that setting self-care goals with a provider appears to increase the likelihood of symptom improvement on the PHQ-9. Setting a self-care goal has been shown to increase the chance of remission at 12 weeks and having a functional score of 0 or 1 at 12 weeks.

Engaging in the NCDP at McMaster has been an excellent learning experience. Primary care physicians have found that tracking of PHQ-9 scores in depressed students is a very helpful practice. Many physicians are now using the PHQ-9 (as well as other screening measures) to monitor student progress over time, particularly as a means of gauging treatment response. Students, counsellors, primary care physicians, and the mental health nurse and psychiatrist are better able to communicate about a student and the severity of that student’s depression. We are able to identify and proactively follow students of concern, some of whom may have been missed prior to the project. This has resulted in changes to our methods of triage and referral of students. By working through the process, we have identified many barriers and gaps for students accessing care, and we have made changes within our systems at the Student Wellness Centre to address these issues.

The Depression Initiative will officially be complete in December 2014 at which time we will determine which components of the program we will adopt for ongoing use. It is clear to us that our practices have already changed in numerous ways. We are confident that participation in the NCDP has improved, and will continue to improve, the quality of care we are providing for students with mental health concerns at McMaster University.

Dr. Catharine Munn is the McMaster Student Wellness Centre psychiatrist and NCDP team leader. Debra Earl is the mental health nurse, and Jillian Halladay is a nursing student and the registry manager.

Champion Team Members include:

Dr. Catharine Munn, M.Sc., M.D., F.R.C.P(C), Lead Psychiatrist, Team Leader

Dr. Jan Young, M.D., C.C.F.P., F.C.F.P., Medical Director

Debbie Nifakis, Ph.D., Psychologist and Associate Director, Counselling

Dr. David McLeod, PEng, M.D., Family Physician

Debra Earl, BScN, R.N., Mental Health Nurse, Care Manager

Rosanne Kent, R.N., B.A., M.H.Sc.(M), Student Wellness Centre Director, Administrator

Jillian Halladay, BScN Student, Registry Manager

For further information on the NCDP and how to implement the program at your institution, go to ncdp.nyu.edu or contact [email protected]

References

American College Health Association (ACHA). American College Health Association-National College Health Assessment II. Hanover, MD: American College Health Association; 2013.

Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., Dickens, C., & Coventry, P. (2012). Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD006525.pub2

Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S., & Olfson, M. (2008). Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry, 65(12), 1429-1437. doi:10.1001/archpsyc.65.12.1429

Cavanagh, J.T., Carson, A.J., & Sharpe, M. (2003). Psychological autopsy studies of suicide: a systematic review. Psychological Medicine, 33, 395-405.

Centre for Addiction and Mental Health. (2012). Mental illness and addiction statistics. Retrieved from: http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/pages/addictionmentalhealthstatistics.aspx

Eisenberg, D., Chung, H. (2012). Adequacy of Depression Treatment in College Student Populations. General Hospital Psychiatry. 34(3), 213-220. doi:10.1016/j.genhosppsych.2012.01.002

Eisenberg, D., Hunt, J., Speer, N., & Zivin, K. (2011). Mental health services utilization among college students in the United States. The Journal of Nervous and Mental Disease, 199(5), 301-308. doi:10.1097/NMD.0b013e3182175123

Eisenberg, D., Golberstein, E., Hunt, J. (2009). Mental Health and Academic Success in College. B.E. Journal of Economic Analysis & Policy 9(1) (Contributions): Article 40. DOI: 10.2202/1935-1682.2191.

Hannon, R., Pooler, C. & Porth, C. (2010). Porth Pathophysiology, First Canadian Edition. Philadelphia: Lippincott, Williams & Wilkins.

Katon, W. J. (2009). Collaborative care: evidence-based models that improve primary care depressive outcomes. CNS spectrums. 14(12 Suppl 14): 10-13. DOI:20448516

Richards, D. A., Hill, J. J., Gask, L., Lovell, K., Chew-Graham, C., Bower, P., … Barkham, M. (2013). Clinical effectiveness of collaborative care for depression in UK primary care (CADET): Cluster randomised controlled trial. BMJ. 347 (7922). doi: 10.1136/bmj.f4913

Statistics Canada. (2013). Canadian community health survey: Mental health 2012. Retrieved from: http://www.statcan.gc.ca/daily-quotidien/130918/dq130918a-eng.htm

World Health Organization. (2012). Depression. Retrieved from: http://www.who.int/mediacentre/factsheets/fs369/en/index.html


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Recent Literature in Student Affairs

b y M a r i a m H a s h e m i ( R y e r s o n U n i v e r s i t y ) & F r e e m a n W o o l n o u g h ( Q u e e n ’ s U n i v e r s i t y )

C A C U S S 2 0 1 4 w a s a h u g e s u c c e s s f o r both f irs t - t ime at tendees and seasoned pro f e s s iona l s a l i ke . We a t t ended one session in particular, OPEN BOOK: Recent

Literature in Student Affairs, and thought that it would be beneficial to share some of the content with the wider CACUSS community. In this session, a number of engaging panelists provided compelling reviews of recent literature in student affairs and higher educat ion. This art ic le provides a brief summary of books reviewed by Deanne Fisher, Rob Shea, Tricia Seifort, Ross McMillan, John Austin, and Tamara Leary. If you are looking for a good read or to expand your professional library, look no further!

Here are the seven recommended works:

1. What is College For? by Elaine Tuttle Hansen

This book is a collection of essays that discuss the purpose of education and how it has essentially become a means to get a job. The reviewer sang the accolades of the author, sharing that both the content and writing style would be engaging for student affairs professionals.

2. The Heart of Higher Education by Parker Palmer

This book pushes us to think about embracing beyond linear and rational thinking to evaluate what is valuable in economy and society. It has an

interesting definition of student engagement, which makes the read worthwhile. The book combines ideas around higher education with quantum physics, and it emphasizes a shift toward studying complexities rather than looking at individual parts. It concludes with practical applications of the topics covered, both in the classroom and beyond.

3. How Learning Works by Susan A. Ambrose et al.

This book was written by and for the faculty perspective; however, it is definitely relevant for student affairs professionals. There are many practical tips and the book successfully and clearly integrates research around learning with hands-on ideas for presentations and workshops.

4. Completing College: Rethinking Institutional Action by Vincent Tinto

This book provides 90 practical tips for student affairs administrators, with a focus on student retention. Ideas for assessment, frameworks, and programming are included.

5. Student Academic Services by Gary L. Kramer

This is a good and definitely shareable book for a student affairs/services team. Reading similar to a textbook, it covers a wide range of topics and gives readers an idea of the most up-to-date student development frameworks and how these can relate to effective practices.

6. Generation on a Tightrope by Arthur Levine & Diane R. Dean

The third in a well-received series, this book examines the typical post-secondary student in the context of current generational realities. Based heavily on research, it is still very engaging and highly recommended for anybody looking to get a different perspective on today’s student population.

7. The App Generation by Howard Gardner

This book is about the identity, intimacy, and imagination of the current youth population. It is not dismissive or demonizing, but very respectful, and has an optimistic tone and balance. It talks about a technological “generation” that may actually be defined very differently than other generational definitions - that is, not defined chronologically or based on major events.


New Beginnings: Making the Move from On Campus to

Corporate Life

b y K a t e M c G a r t l a n d

I recently made the move off campus to the private education sector, to serve as Director o f S tuden t Suppor t Serv ices for Pearson Embanet. Here, I will share my thoughts on

transi t ioning to the private sector and provide some perspective on the opportunities that exist in higher education outside of the traditional campus environment.

I was not actively looking for a new career, but the opportunity to lead a department, impact student retention in a positive way, and work with an innovative team focused on growth and development made it impossible to turn down. This past year has also brought a significant amount of life change for me, so this was just another chance to step outside of my comfort zone and do something different. In the spirit of “why not,” I took a leap and haven’t looked back once.

Obtaining a director-level position has always been a career goal I have aspired to; I just did not imagine it would not be on a physical college or university campus. However, the similarities definitely outweigh the differences, and my work and educational experience from the past 10 years have served me well in my transition. Working in student affairs prepares you to be successful in a number of roles, although we do not always think about this on a day-to-day basis. When you move out of a traditional student affairs setting, it forces you to think about the transferable skills that apply to your new role. While not easy to narrow down, the top five skills I believe I have brought with me from my background in residence and student life include critical thinking, strategic planning, data analysis, staff management, and relationship building with key stakeholders. My new role requires me to analyze historical data to forecast for the upcoming year, motivate a team of professional staff (some of whom have 10+ years of tenure with the company), anticipate the impact of policy and program changes and make adjustments as necessary, and maintain positive relationships internally with our cross-functional team and externally with our academic partners. This role also requires me to wear many hats and seamlessly switch between tasks throughout the day; having worked in the constantly changing environment of student affairs has definitely helped me easily acclimate.

Many have asked me about the work environment, or culture of working in a corporate office. This was something I was most apprehensive about before I began at Pearson. After all, I was leaving a supervisor who treated me as an equal and respected the work I did, colleagues who were more like friends, and staff and students who made everything (even the trying and stressful moments) worthwhile. While the physical set-up of our Toronto office is

what you would expect in a corporate environment (think Office Space), it truly is the people that make the difference. The people that work at Pearson Embanet are incredibly collaborative, supportive, and dedicated. There is also a lot of pride in the work that we do and the academic partners that we work with. A quick walk around the floor and you know when you are in the Boston University zone versus the Kent State zone. Seeing the swag from our academic partners makes this place feel a lot like home.

Making the move to Pearson Embanet has allowed me to see higher education from another perspective, one that exists on every campus but isn’t always at the forefront of a student affairs practitioner’s mind. Colleges and universities are businesses and need to meet financial targets in order to effectively operate. Students are customers and have options when it comes to their education. What makes a particular institution or program stand out may be enough to initially attract a student, but the level of support provided, the opportunity to work with and learn from subject matter experts, and the likeliness of achieving career goals all contribute to retaining the student. As such, student retention should be a concern for everyone. At Pearson Embanet, we take a collaborative approach to retention and feel just as much pride as student affairs professionals feel when one of our students crosses the stage at graduation.

Kate currently serves as the Director of Student Support Services within the Online Learning Services division of Pearson North America where she provides leadership to the Student Services team, analyzes results, and strategizes to improve student retention. Prior to this, Kate worked in Residence Life and Student Services at four different institutions across Ontario, Canada.

Update:On Organizational Change

CACUSS is currently consulting with former divisions and members interested in forming new networks and Communities of Practice.

We plan to launch new ways to connect online in the new year. Members will be able to choose their areas of interest and connect with other members with similar interests. As CoPs and Networks emerge we will post regular updates on our website.

We have located some information and resources about this process online at www.cacuss.ca, click on “Communities”.


London Welcomes Students with New

YourLondonCalling.ca Website

R e p o r t b y O r e s t K a t o l y k f r o m t h e C i t y o f L o n d o n

T ogether with the Western University Students’ Council (USC) and the Fanshawe Student Union (FSU), the City of London has launched a new web site at YourLondonCalling.ca.

The website was built by students for students as a way to welcome post-secondary students to London, Ontario, and encourage them to explore every aspect of their city.

Thank you to the 2014 Conference Team!CACUSS would like to thank the 2014 Program Committee and our hosts and St. Mary’s University for a successful and engaging conference! We had 684 delegates join us from across the country for over 14,000 minutes of learning and engaging conversations.

Here are a few folks who deserve special thanks:

• Laurie Schnarr, University of Guelph

• Patty Hambler, University of British Columbia

• Lillian Lake, Nova Scotia Community College

• Tracey Rollins, University of British Columbia

• John Austin, Ryerson University

• Sarah Morris, St. Mary’s University

• Keith Hotchkiss, St. Mary’s University

And thanks to the following folks who participated on the sub-committees of the Program Committee:

Jessi Calberry, Mark Solomon, Jeffrey Burrow, Robert Giardino, Jane Lee, Cora Dupuis, Kate McGarland, Shannon Travers, Sara Wills, Lindsey Hudson, Carmen Burke, Kelly White, Tracey Mason-Innes, Kim Mortreuil, Pat Pardo, Darran Fernandez, Chauncey Kennedy.

A special shout out to our enthusiastic hosts from St. Mary’s University: Sarah Hildebrand, Donnie Jeffery, Matt Robinson, Ysaac Rodriguez, Kathy MacFarlane.

The student-focused website functions as a one-stop shop with all relevant information to support students and engage them in London’s community. The website features six sections for students to explore: Settling In, Getting Around, Getting Involved, Earning Money, Having Fun, and a Bucket List of activities to try while living in London.

“Students were telling us there’s a lot of good information out there, but it’s just in too many places and hard to find. If there’s one website to favourite, this is it,” said Orest Katolyk, Chief Municipal Law Enforcement Officer.

The development of the site was a recommendation of the Town and Gown Committee. A group of students from Western and Fanshawe, as well as City staff, met bi-weekly during the summer months of 2014 to build the website and its content.

“The USC is excited to have worked alongside the city and the Fanshawe Student Union to build a website that will be a one-stop informational hub for students in London. We are looking forward to the launch of yourlondoncalling.ca and hope this website will tackle some of the informational barriers for students, as well as encourage students to become more involved with the city,” said Jen Carter, Vice President of the USC.

“The Your London Calling website is an excellent resource for students who are new to the region. It has been wonderful to see how well the students and the City could work hand-in-hand on such a positive initiative,” said Alan Bushell, Vice President External of Athletics and Residence Life for the FSU.

Take a look at the new website at www.yourlondoncalling.ca and start the conversation about Your London Calling by using the hashtag #yourlondoncalling on Twitter.


Supporting Vulnerable Students:

Carleton University Offers a Student Support Program to CACUSS

Universities and Colleges

b y D r . J o h n A . M e i s s n e r , C . P s y c h , F I T A P r o j e c t L e a d e r

T he mental health issues that are emerging on campuses across North America are more demanding, numerous, and complex than in the not-so-distant past. Some have

described this change as a general, emerging, post-secondary pattern that we are all seeing; students are more anxious and less resilient, overwhelmed by cho ice and f ear fu l abou t en te r ing in to an increasingly uncertain world.

We have developed a program called From Intention To Action (FITA) to support the most vulnerable of these students. We would like to share this program with other universities and colleges that have a sincere interest in developing this program on their own campuses. This article provides some condensed background information regarding our experience since we first piloted this program with a small group of students in 2010. We have developed a manual in the hopes of providing a turnkey program that could be used to start this initiative on other campuses.

Background

The (FITA) program was developed at Carleton University and received support in 2013 from the Ontario Ministry of Training Colleges and Universities (MTCU) Mental Health Innovation Fund. FITA seeks to support psychologically vulnerable and overwhelmed students with the aim of improving their sense of stability, psychological wellbeing, and academic standing (factors also associated with improvements in mental health). Students commit to a minimum of 12 consecutive weekly meetings with their assigned FITA coordinators to address both academic and personal issues. They are provided with an assessment battery consisting of psychological and learning-based tests with face-to-face and written feedback. FITA makes extensive use of graduate-level interns who have completed the first year of their counselling program and seek practical counselling experience under supervision from FITA’s project leader.

FITA’s principles are based on the central elements of the Ontario Learning Opportunities Task force, which discovered that students with learning disabilities graduate (with support from disabilities services offices) at levels that well exceeded provincial and national averages (see Larry McCloskey’s

seven-year longitudinal study at www.carleton.ca/fita). These key principles are:

• Commitment – Students must commit to an assessment following intake and at least 12 counselling sessions.

• Working Alliance – Students are matched with coordinators based on MBTI preferences.

• Assessment – Most of our assessments are done online (Strong Interest Inventory, MBTI, LASSI, BASC2-CSR, Nelson Denny Reading Comprehension, and WJ-III writing and math)

• Academic Advising – Students meet with academic advisors to discuss their course plans, to provide a road map to graduation.

Previous years’ (2011-2012 and 2012-2013) research results show that:

• FITA students facing possible suspension made significant improvements in major and overall grade point averages, while a comparison group on Academic Warning did not make the same gains.

• Students demonstrated significant improvements in study skills.

• Students returning to FITA for a second year continued to make improvements in overall grade point average over and above the significant grade improvements made the previous year.

• FITA students who scored below the average range on the Mental Health Composite measure (SF-36 MHC) demonstrated significant improvements in psychological wellbeing after attending 10 or more meetings with their coordinator. Students with fewer meetings showed some improvements that were not statistically significant. The SF-36 is brief and undemanding to administer, and it is the most wide used quality-of-life measure currently being employed.

Current research (2013-2014)

FITA sought to recruit the most vulnerable students applying to our program. Students entering the program this year reported significantly weaker SF-36 MHC scores, a measure that correlated with lengthier measures of depression. As a group, they scored below the normal range compared to the general population. On the BASC-2 College Self-Report measure of adjustment, incoming FITA students showed significantly more symptoms of depression, anxiety, social stress, internalizing problems, somatization, emotional symptoms, inattention-hyperactivity, school maladjustment, and low self-esteem than the FITA cohort of the previous year.

In 2013-2014, FITA students completed information upon intake and again in an exit interview in late March prior to final exams when academic pressure remained high. This exit interview occurred in the context of a three-week strike on campus that saw local bus drivers honouring picket lines. The strike required most Carleton students to walk an extra kilometre to and from campus during the coldest winter Eastern Ontario had seen in 25 years. Earlier in the fall, the Carleton community was shaken by a bus/train collision that resulted in the fatalities of two Carleton students.

In 2013-2014 more than 250 students met with their FITA coordinators with a median of 12 sessions, resulting in a total of almost 3100 sessions. As FITA is a flow-through program, these students entered and left the program at various points throughout the year.


Despite working with a more distressed group of students during a challenging year, the FITA program replicated the successes of the previous two years.

• Pre-post comparisons showed significant improvements in Mental Health Composite (SF-36 MHC) scores despite this year’s cohort being more severely symptomatic than previous FITA cohorts. Indeed, the most severely distressed students made the greatest improvements.

• Qualitative ratings of the program were high with 97.5 % of students saying that the program met their needs, 100% saying that they would refer FITA to a friend, and comments indicating broad acceptance of FITA and appreciation of its ongoing support.

• All FITA students showed significant improvements in study skills, increased the time spent in studies by four or more hours per week, and demonstrated more behaviours associated in the research literature with university graduation.

An outreach to high school guidance counsellors, and resource and student success teachers yielded a referral of 24 students directly from Grade 12 into university. This group completed the year with average grades that met program requirements.

Subgroups of FITA students:

• Different groups within FITA had different results with grades and Mental Health Composite scores that indicate that FITA met students’ needs in relation to each individual’s situation.

• Students on Academic Warning (AW), as in previous years of the FITA program, had significantly improved major and overall GPAs. This same group, which comprised a higher proportion of males, was in the average range on the SF-36 MHC and showed less distress than students who had self-referred as being overwhelmed. For the AW students, change came in the form of improved grades, while mental health scores did not vary but remained in the average range.

• Students returning to the FITA program from the previous year showed significant improvements in overall GPA, in addition to having shown improvements the previous year. This record of grade improvements was also seen in our previous years’ cohorts.

• Students who self-referred because they felt overwhelmed tended to be female, had better grades than the AW group, and were the most distressed subgroup. This group made significant (P=.002) improvements in psychological wellbeing as measured by the SF-36 MHC that accounted for differences in pre-post changes for the entire group. These students did not show significant improvements in grades nor did they need to because they were not at risk of failing to meet academic requirements.

Positive changes take place with effort over time, with the ongoing effects of a therapeutic alliance.

• Students demonstrated significant improvements in psychological wellbeing after attending 10 or more meetings with a coordinator. Students with fewer meetings showed improvements but at a level that was not yet statistically significant. The greatest positive changes emerged with students from the ‘Overwhelmed’ group who were predominately female, entered the program with the lowest mental health scores, and were in the most need of psychological support.

• In 2013-2014, FITA students attended a median number of 12 sessions; students flowed into and out of FITA with ongoing intakes and exits throughout the year. Students who attend 12 sessions, as is stipulated in their FITA contracts, achieve the benefits of a therapeutic alliance with their coordinators that builds over time.

Conclusion

Research results present a reliable profile of outcomes over three years in terms of (a) improved psychological wellbeing for the most distressed students, (b) improved major and overall GPAs for students on Academic Warning, (c) improved study skills overall, and (d) high ratings of students’ trust in and acceptance of FITA.

Current Initiatives:

• FITA is a front door for overwhelmed students at Carleton. All students who self-refer to FITA are either accepted into the program or are referred to services at Carleton University appropriate to address the issues brought forth by the student.

• FITA now has its own dedicated office space at Carleton University’s recently expanded MacOdrum Library with active support from the office of the Associate Vice-President (Students and Enrolment) and the Ontario Ministry of Training Colleges and Universities.

• In partnership with the Masters of Educational Counselling programs at the University of Ottawa and St. Paul’s University, we have recruited seven new graduate-level interns working as coordinators for the 2014-2015 academic year. Our goal is to provide a high-quality experience for our interns that will result in successful employment as well as initial accreditation for CCPA and movement towards accreditation with the upcoming College of Registered Psychotherapists of Ontario (CRPO).


• We will continue to recruit vulnerable students through high school teachers and counsellors with our partners at the Ottawa Carleton District School Board, and we have contacted staff in all regional high schools whose student bodies represent more than one half of Carleton University’s first-year enrollment.

FITA seeks to assess program scalability and transferability.

Programs such as FITA, which work well on one campus, can be transferrable to other campuses; however, the initial effectiveness is not always assured. Likewise, small programs may work effectively to achieve student service goals, but when scaled up, they seem to lose their impact.

Scalability over time

FITA started small at Carleton University (n = 33), moved to 100 students the following year, and was able to maintain positive results the following two years while providing a more intensive service to 250 students. FITA is a program that can start small and build up as circumstances and resources allow.

Within institution transferability

Over the history of FITA, parts of the program were offered in one part of campus as an offshoot of our disability services office and in another area of campus as an offshoot of our academic advising service. Both offerings were successful in improving students’ major and overall GPAs and provided much needed support to FITA students, with much of the individual counselling provided by graduate students.

A proposition

We are interested in offering a detailed map of the FITA program to student services staff at other universities and colleges, to determine whether the same findings could result on other campuses. To offer this map, we have developed a manual as part of our support from the MTCU that can be used as a detailed guide for replicating FITA on other campuses. Many appendices are included in the manual, such as contracts with students, consent forms for data collection, job descriptions, recruitment posters, and assessment feedback sheets. In addition, we have included program design flow charts, intake questionnaires, and a variety of handouts for students, interns, and staff.

For staff at selected institutions that demonstrate a strong interest, we will offer consultation services. We offer the use of all materials with the FITA logo (that could be combined with the college or university’s logo) and all of the other materials we use. In return, we ask that institutions collect and share pre-post SF-36 data, pre-post major and overall GPA data, and end-of-year academic standing data. We also ask that the sources of FITA (Carleton University and MTCU) be acknowledged. While being adapted to the needs and resources of your institution, the structure of the program should be maintained in order to uphold the four core principles of the program: student commitment, focus on therapeutic alliance, assessment, and academic advising.

For more information, please contact [email protected] (The information provided in this article was developed over time by other members of the FITA team: Larry McCloskey, Director of the Paul Menton Centre for Students with Disabilities; Dana Truelove, FITA Team Leader; and Robert Konecki and Andrea Thompson, Program Evaluators).

References

DeBerard, M. S., Spielmans, G. I., & Julka, D. L. (2004) Predictors of academic achievement and retention among college freshmen: a longitudinal study. College Student Journal, 38(1), 66-80.

El Ansari, W., & Stock, C. (2010) Is the health and wellbeing of university students associated with their academic performance? Cross sectional findings from the United Kingdom. International Journal of Environmental Research and Public Health, 7(2), 509.527.

Horvath, A. O. (2001). The alliance. Psychotherapy: Theory/Research/Practice/Training, 38(4), 365-372.

Bonnie Neuman of Dalhousie University

Retires b y D a r r e n F e r g u s o n

D r. Bonnie Neuman, V ice-Pres iden t o f Student Services at Dalhousie University, has retired after nine years. During her tenure, Bonnie championed numerous

initiatives that changed the face of Student Services at Dal and fostered a unique student life experience on its campuses.

One of her great joys at Dalhousie was working with, and nurturing, student leaders. Of particular importance to her was ensuring that Dal’s students become active members of the outside community. She was a strong supporter of student societies and was instrumental in establishing the Student Impact Awards and the Student Co-Curricular Record to formally recognize students’ volunteer activities and achievements outside the classroom.

“Nothing happens because of just one person,” she says. “Things happen because people get together, decide there’s some merit, improve ideas, and implement them together. It’s about all of us working together: the staff, the faculty, the students, the administration. That’s how we got so much done together. Yes, I love our students, and I am so pleased and proud to have a lifetime career where I hope my presence has made a difference in their lives. It has been an incredible privilege to work in universities because that’s really what we do at the end of the day.”

Bonnie now plans to move to Victoria, B.C., to be closer to her siblings and her son and daughter-in-law (who are expecting Bonnie’s first grandchild).


The Disclosure Question:

A Matrix for Decision-Making

b y B a r b a r a R o b e r t s

S hould I disclose my disability?”

Throughout the course of their evolving studies, work, and career exploration, students ask counsellors, career services staff, disability service providers, physicians, and many others what,

how, and when to disclose. It is hard to respond to this question, because there is no single answer. While disclosure of a disability or other sensitive information can certainly facilitate prompt and appropriate accommodation, disclosure can also incur risks of discrimination and erroneous assumptions about a person. Students struggle with what to disclose, whom to disclose to, and how to come to any conclusion. Advisory personnel struggle with how to guide students with different disabilities and needs for accommodation in different situations.

Disclosure is an intensely personal decision. It depends on the nature of the condition, personal and political feelings about the condition, perceptions of stigma that might pertain, the needs associated with the condition, and the environment in which the person is participating. We cannot make this decision for anyone else; we can only guide them towards coming to their own conclusion. What’s more, the conclusion for one person may be different when facing different situations. Disclosure dilemmas are not just for students with disabilities either; students with histories of trauma, sensitive financial or family circumstances, or criminal histories may also struggle with questions about disclosure.

One way to approach disclosure decisions is based on four basic considerations: the pros and cons of disclosure and the pros and cons of non-disclosure. These four considerations lend themselves well to what has become known as the “disclosure matrix.” Originally shared with me many years ago by Dr. Terry Krupa of Queen’s University’s School of Rehabilitation Therapy in our work with clients with mental illness, the disclosure matrix has become instrumental in my practice of advising people about disclosure issues. The pros and cons of disclosure include the following considerations: Pros of disclosure may include openness, candor, establishment of rapport, setting out the expectation of a positive response to accommodation requests, and successful accommodation; alternatively, cons of disclosure may include risk of negative reaction, discrimination, stigma, and rejection.

By contrast, the pros of non-disclosure (in favour of keeping quiet) may include protection of privacy, retention of control of information, avoidance of stigma or discrimination; cons of non-disclosure (against keeping quiet) may include absence of accommodation, lack of understanding, and the rupturing of an established relationship following postponement of a request for accommodation.

The chart below illustrates some of the pros and cons in relation to one another. It can be a useful exercise to ask a student to go through each of the four cells, think about the possible choices they could make in any given situation, and fill in what they feel are the pros and cons of disclosure and non-disclosure for them in their own life and situation. Left blank, the four cells make a convenient worksheet for students to fill in with their own ideas on disclosure and non-disclosure. The “Should I tell them?” question is often best answered with, “It depends; here’s a way to look at it…”

Barbara Roberts is the Human Rights Officer at the University of New Brunswick in their Office of Human Rights & Positive Environment.

©BRoberts 2008

“

Disclosure Non-disclosure

Pros

• Promotes openness and trust

• Facilitates accommodation

• Educates the employer about accommodation and disability

• Honest

• Pro-active

• Sets out an expectation of fair treatment

• Acting in good faith

• Protects against risk of discrimination

• Safer to request accommodation later, when needs become apparent and employment is secure

• Protects private information

•Retain control/release personal information when/if needed

• Protects dignity

• Take a chance and try tasks without accommodation

• Avoid assumptions made about you, stigma

Cons

•Risky because of potential discrimination

•Might not be necessary (work might not require accommoda-tions)

•Risk of stigma

• Loss of privacy

• Loss of control of personal information

• Seems untrusting

• Appears to be in bad faith

•No accommodation

•No knowledge or understanding of disability or needs

•Reactive rather than pro-active

• Seems like “pulling a rabbit out of a hat” when trouble or need arises

•Risks rupture in the employer/employee relationship when needs become known


1. Be a quality supervisor

This means taking your supervisory role seriously. Reflect on your personal supervisory style, and consider how that style falls within the nature of your job and the student’s. Set aside the time necessary to be a quality supervisor. If you don’t have the time to supervise well, then either rearrange your schedule, adjust priorities, or possibly delegate out the duty of supervision. It is not only frustrating and demotivating to have a supervisor who can never seem to find the time to provide direction and feedback; it is also ultimately unproductive for the both of you.

2. Clearly articulate expectations and duties

If a position has an out-of-date job description, update it. Let the student know what they can expect from the position, from you, and from the office in which you are both working. Ask your student what their expectations are. Setting an open and respectful tone from the very beginning puts you off to a great start. Stay honest and upfront; don’t hide the potentially less attractive aspects of the position only to spring it on the employee later. Give examples as to what “other related duties” may entail. It’s important to do this at the beginning but also all throughout their position, particularly should there be issues with the student employee or their work performance.

3. Make a connection; personalize the experience and build your team

Learn as much as you can about your employee. Ask your student what skills and experiences they hope to gain from this position and what their long-term goals are. If possible, expose students to opportunities for them to develop said skills. Create an environment where your student employees want to come to work. If you have a group of students working together, or even just using the same workspace, plan a team-building session for them to get to know one another. It’s natural for us to want to feel a sense of group identity, and if the students are comfortable working together, then they will lean on one another for perspective and support. Of course, this also means being weary of when time during shifts turns from building relationships to being unproductive and distracting. Make sure to stay aware of the working environment in your office.

4. Beclearwhendelegatingprojectsandtasks;findabalance between direction and freedom to be creative

Sometimes a job task can be wide open to interpretation and have room for innovation and creativity. What better way can you elicit a student perspective than from a student? Take advantage of these opportunities if you can. Allow a sense of individual ownership. With this comes a sense of pride and dedication to the work; however, if there’s no room for it in a particular task, be clear about that.

5. Give a soft deadline and a hard deadline, and explain the importance of and difference between the two

Often, when I delegate a task to a student employee, I give a soft deadline that allows me the time to review, comment, and make changes to whatever the task is before the true, hard deadline of when my supervisor needs it done. I find that when I inform my students of the soft and hard deadlines, it helps to give them an understanding of the big picture of both our work and indicates if there is any wiggle room for flexibility.

8 Supervisory Lessons I (re)Learned While

Being a Student Employee (again)

b y H o l l y W h i t e

I love working with students. Their energy, outlook, different perspectives, and practical knowledge are helpful, inspiring, challenging, and fun. As a Leadership Programs Coordinator,

I value the opportunity and growth (for them and for me) that can come from working with students as program participants, volunteers, and paid staff. They benefit and so do I; the assistance that my students provide makes my job much easier.

Ultimately, we have programs, projects, and events that need to be planned, delivered, and evaluated, but there’s no reason why this shouldn’t happen alongside the personal growth and development of the participating students. That’s what we are here for, right? Building relationships and a sense of community. Seeing your charges prepare, learn, and improve. Successfully implementing programs. These all bring a great feeling, and it’s all in a day’s work. In my current role, I supervise about ten paid student staff, thirty senior volunteers, and about two-hundred program volunteers. As a supervisor, I expect high-quality work and I try to be fair, open-minded, and supportive. I try to prepare my students for the work that needs to be done and attempt to create a positive learning environment where they can reflect and, if need be, fail forward. That’s not to say I’m the perfect supervisor and that I don’t have room to grow. On the contrary, as I say to my students, there’s always room to learn from whatever situation you find yourself in.

Recently, I’ve reflected a great deal on student supervision. This summer, as part of the requirements for my graduate program in Education, I completed an internship in Blagoevgrad, Bulgaria at the American University in Bulgaria’s Office of Student Services. Once again, I found myself performing the duties of a student employee. The tables were turned; no longer was I the supervisor, dictating the parameters of the supervisor-employee relationship. As a graduate intern, I completed projects in different units of the Office of Student Services and thereby had a different supervisor for each project. Not one of these supervisors was the same, so I was exposed to a number of different styles and practices. The role reversal was refreshing, humbling, and a powerful learning tool. Here, then, are eight supervisory lessons I (re)learned during my experience abroad that helps me frame the supervisor I am today.


6. Follow up, and make sure your employee is on the right track

This is one that I’m guilty of not always following. It is easy to delegate a task, explain it as best you can in the moment, and then not follow up again until you expect the task to be completed. If you haven’t provided enough direction or guidance before the deadline date, you may end up with a product that does not meet your expectations.

7. Give feedback; timely, positive, and constructive feedback are imperative for growth and development (theirs and yours)

Many of my student employees are high-performing achievers. I am constantly blown away by the skill and dedication demonstrated by my workers; this keeps me motivated and energized as well. It’s important as a supervisor, and often times a role model, to give positive feedback and accolades when they are due. The flip side is just as important. You’re not doing your role justice if you are ignoring the limitations of your employees. Find an appropriate time and space to give timely feedback, both positive and constructive. Remember that it is important to have a positive working relationship with your employees, but also remember that you are in a position of authority and you both should respect that role. Don’t avoid giving constructive feedback because you do not want to hurt the feelings of your student staff; ultimately, it will hurt them more in the long run if you don’t address it. Lean on your safe space for growth and improvement. This also means being receptive to feedback about your performance as a supervisor; let others know you are open to this. Soliciting feedback from those you supervise can be tricky, so consider your options. You may want to create an anonymous or confidential feedback form, or encourage your own supervisor to circulate a message inviting those who would like to give feedback, positive or otherwise, to approach you or your immediate

supervisor. This invitation builds trust and gives us a gentle reminder that we all have room for improvement.

8. Show appreciation and recognition when it is due

If someone does a great job, let them know. There are many ways that, as supervisors, we can show appreciation and recognition. You could extend the student’s work role in the office, offer to be a reference, write a letter of reference or appraisal, offer a thank-you card, host a coffee break… the possibilities are endless! However, be cautioned to always be truthful. Often, I will write student staff and senior volunteers a letter of appraisal rather than a letter of reference. That way, I have the freedom to articulate what they did and how I felt about it. I don’t overhype students’ performance, and I never write something that I don’t firmly believe or support. Don’t forget that although it is your student’s name in the letter, your name is the one signing off on it.

As we transition into another academic year, I’m keeping these points in mind when I hire and supervise my student staff that help make my programs the great successes that they are.

Holly White is the Student Leadership Programs Coordinator at Memorial University of Newfoundland’s St. John’s Campus and in the final semester of her Master’s in Education (Post-Secondary Studies), also at Memorial.


Vancouver Island University’s Exploring

Best Practices in First-Year Transition for Students with Autism Spectrum

Differences (ASDs)

b y M a r y S t a s i u k

I hope this survey helps people adjust more to their transitions to university. It can be a scary thing!” - Final comment from student research participant

Introduction

Over the past seven years, I have been fortunate to have the opportunity to work with students with autism on two diverse campuses in Canada. Initially, I worked with this growing student population in Learning Disability Services at York University in Toronto, later moving to Nanaimo, British Columbia to work as an Educational Counsellor in Disability Services at Vancouver Island University (VIU). When I started at VIU three years ago, I was curious about recreating transition supports that were successful at York University, as well as conducting research to determine objectively their efficacy. From a more macro perspective, I wondered: How do we best focus our limited time and resources, with increasing numbers of students accessing services for students with disabilities? Although the participant sample size was small and each campus across Canada is unique, the following is an overview of the project, as well as the insights that emerged.

Pilot Research Project

With the collaboration and support of colleague Dr. Nancy Twynam, Student Affairs Co-ordinator, we received a special project funding grant from the Canadian Association of Disability Service Providers in Post-Secondary Education (CADSPPE) at the 2012 CACUSS annual conference. The original goals of the project were to evaluate our efforts, gain a better understanding from students and parents of the transition experience, and develop recommendations.

We worked closely with the Research Ethics Board (REB) at VIU to ensure that ethical standards for the participants were met, as they are a vulnerable population. One notable change the REB suggested for our project method and design pertained to parent involvement. Students were asked to provide written

consent allowing parents to respond to surveys. As a further precaution, we kept the research at arm’s length from participants’ direct service at Disability Services by directing participant correspondence through Dr. Twynam’s office, rather than our own. The survey was administered through Fluid Survey, rather than Survey Monkey, so the data would be stored on a Canadian server, eliminating ethical storage concerns.

The design was basic and involved surveying new students with ASD’s and their parents in September, December and April. The survey tool was tested by a second-year student with autism, to ensure it was accessible. Her insight regarding autism was very helpful, and she helped us rewrite prompts that required more context and specific examples. Our VIU Educational Planning Department also assisted in the development of the survey instrument, particularly by suggesting the use of branch logic programming to avoid leading questions. One technical issue that arose involved students being unable to return to surveys that were partially completed. Including, in the invitation email, a suggestion to complete the survey in one session seemed to resolve the issue. A portion of the project funding went towards honoraria offered to research participants, which, anecdotally speaking, appeared to positively impact participation.

Some Findings of Interest

The student participants consisted of six male-identified students whose majors included Visual Arts, Theatre, Geology, and Liberal Arts. Two students received entrance scholarships. Three parents completed surveys and were vocal about the need for more education about autism on campus. However, since the parents were overall satisfied with the services available, there were limited findings to gather from their responses. All six students successfully completed their first year, although half reduced their course load during the academic year.

Unsurprisingly, the data revealed that although there was a high level of awareness of the need to develop skills such as time management, overcoming procrastination, communication, and planning. Conversely, there was a low response about actually accessing resources, such as tutoring and personal counselling.

The survey also explored what students were most looking forward to at University. Interestingly, relatively minimal importance was given to looking forward to earning a diploma or degree. Students did not see degree completion as important, compared to gaining more independence from family or increasing knowledge.

Another question asked about the students’ level of acceptance of their autism, based partly on Tony Atwood’s Stage of Acceptance of Autism Diagnosis (2003). While one student was proud of his autism identity; two sought to modify their behaviours and symptoms to be accepted as “normal;” and two preferred not to think about their diagnoses, preferring instead to escape into activities that used imagination.

Participant responses to the autism identity question included “I don’t care what you label or call me. I am what I am,” and “I tend to feel stupid and awkward, especially around, but not limited to, people without learning disabilities.”

In evaluating our services, the responses showed that students were satisfied with support services, including disability funding, counsellor support, and

“


exam accommodation. The supports that were less well-received included the ASD Summer Transition Day and the bi-weekly social group. Correspondingly, the participants indicated that they had a slightly lower interest in making friends with other students with autism, as compared to making friends with “neuro-typical” students. Anecdotally, I have found that students on Vancouver Island reported fewer experiences of painful childhood bullying than the students in Toronto reported. Although I do not conclusively know why the students with autism at VIU were less interested in socializing with each other, I wonder if they do not feel the need to, as their social experiences in general have been more positive.

Best Practices Moving Forward

Over the three years I co-facilitated a support group at York University, participation appeared to ebb and flow. On some occasions, the dynamics were momentous, with students giving advice to their peers in a way that seemed more powerful and relevant than the more neuro-typical advice available from counsellors. I had observed that the group seemed to function well as long as there were two or more females participating. However, as participation was sometimes low, I left York wondering, “Is this more about my own neuro-typical social connection fantasy than what the students are looking for?”

The recent project at VIU partially answered this question for me – although I may not have liked the answer. Based on a combination of the survey responses and low turn-out to our ASD planned events, it appears that further efforts with such ASD-specific events are not merited at this time. Encouragingly, with enough education and knowledge about autism thinking and culture, it appears that overall we are meeting the needs of these students. What’s more, as suggested by the research participants, we have increased our campus outreach efforts in order to increase awareness about autism on campus this past year.

To encourage students accessing tutoring, I have started a practice of arranging for consenting students to meet with tutors in my office. This practice seems to be increasing the likelihood of students successfully connecting with tutors and achieving better academic success. It also helps students navigate the forms, receipts, and payment procedures, which are particularly challenging for students with autism.

As this project was exploratory and not statistically significant, it would be ill-founded to draw any definitive conclusions. However, it does lead to further areas of inquiry.

The responses around acceptance of diagnosis leads me to wonder, “Is there a relationship between acceptance of diagnosis and successful transition to post-secondary education?”

The successful university retention of all six participants was an unexpected finding. I wonder if students with autism are at less risk of dropping out than students with other disabilities.

Thanks to the ubiquity of popular media, such as films and books, based on characters with autism, there seems to be a growing awareness of autism among the general public. In the support group, we would often view these films and discuss how the media tends to exoticise stereotypical autistic characteristics for entertainment purposes. Although the media rarely portrays the challenging side of autism, it’s possible the media is doing a good job of increasing awareness of autism through portrayals of characters with stereotypical ASD characteristics, such as Abed Nadir in Community and Dr. Sheldon Cooper in The Big Bang Theory. This all begs the social model of

disability question, “As society becomes more ‘autism-friendly,’ are autism differences less of a disability?”

My hope is that an autism-friendly culture will foster more pride, such as that identified in this statement by one of our research participants:

“It makes me unique. I feel I am somewhat of a role model for others with autism.”

Acknowledgements

I would like to thank CACUSS, and specifically CADSPPE, for awarding us Special Project Funding to assist in exploring best practices for supporting students with ASDs during transition. I would also like to thank Nancy Twynam for her supervision, problem-solving, and support during the research project.

Mary Stasiuk, MSW, RSW, is an Educational Counsellor in Disability Services at Vancouver Island University in Nanaimo, British Columbia. She can be reached at [email protected].

Works Mentioned and Further Reading

Attwood,T. (2003). Frameworks for Behavioural Interventions. Child and Adolescent Psychiatric Clinics 12, 65-86.

Baker, J. (2005). Preparing for Life: The Complete Guide for Transitioning to Adulthood for those with Autism and Asperger Syndrome. Arlington: Future Horizons.

Grandin, T. (2013). The Autistic Brain: Thinking Across the Spectrum. Boston, New York: Houghton Mifflin Harcourt.

Perry, N. (2009). Adults on the Autism Spectrum Leave the Nest. Philadelphia: Jessica Kingsley Publisher.

Paxton K & Estay, I. (2007). Counselling People on the Spectrum: A Practical Manual. Philadelphia: Jessica Kingsley Publisher.


Tips to remember as you prepare your program proposal:

PLAN AHEAD: develop your ideas and engage with colleagues you plan to co-present with.

REVIEW and write your program proposal in advance and copy and paste it into the online submission form. This will allow you to work through the details of your program over time.

THINK about your audience and the program format that works best for your presentation.

ARTICULATE intended outcomes and knowledge as a result of attending your session.

ENGAGE your audience. How do you plan to build interactivity during your session?

Be sure to read the full tips, best practices, scoring rubric and more at

www.cacuss.ca/conference

Proposals Close on January 15!

PRESENT AT CACUSS 2015CALL FOR PROPOSALS NOW OPEN

May 24-27 · Vancouver 2015Call for Proposals and Call for Reviewers Now Open

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Mental Health and Well-Being inPost-Secondary Education

We have provided some minor updates to the “Post-Secondary Student Mental Health: A Guide to a Systemic Approach” to correct a few minor issues in the original version. It can be downloaded at www.cacuss.ca/current_projects_mental_health_report.htm


Get involved in CACUSS 2015

October 15 – January 15Call for Proposals

February 27Notification of Proposal Status

March 15Conference Program Announced

October 15 – January 9Call for Reviewers

January 15 – February 19Proposal Review and Scoring

Review the Learning Outcomes Development Guide and the Program Submission Rubric – then submit your presentation proposal.

We need experts in Student Affairs to review all proposals to decide who could present at the 2015 conference. All qualified applicants will receive a confirmation with their assigned proposals by January 29.

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