DISTRESSED, DISRUPTIVE, & DISTRESSED, DISRUPTIVE, & POTENTIALLY DANGEROUS STUDENTSPOTENTIALLY DANGEROUS STUDENTS

Helping Faculty & Staff Develop Effective Responses to Students of Concern

JOHN ACHTER, PH.D.

LICENSED PSYCHOLOGIST, DIRECTOR

UW-STOUT COUNSELING CENTER

Fall 2008

GoalsGoalsArticulate faculty & staff roles in

identifying and responding to student behavior of concern

Identify key areas and behavioral indicators of concern

Develop strategies for and comfort with responding

Know resources and mechanisms for consultation, reporting, and referral

Establishing a community of Establishing a community of caring: why?caring: why?

Student distress is real and on the rise—and it impacts academic performance and persistence in school

While more students are seeking help, many still do not due to stigma or other reasons

Often those with the most serious needs don’t seek help without encouragement

Those who seek help are more likely to persist in school—but they must stay with it

Faculty & staff are the front lines with esteemed status among students – in prevention parlance, you are “gatekeepers”

Because it’s the right thing to do?!

Establishing a community of Establishing a community of caring: how?caring: how?Resiliency factors we can control

◦ High expectations & clear boundaries◦ Caring/supportive environment and role models◦ Opportunities for meaningful engagement

Expect the best from students & focus on strengths

Tell students you care. . . And show themPromote appropriate faculty-student and

student-student relationshipsApproach students when you notice changes

or concerning patterns in behaviorIndividual approaches that work for you?

Distinguishing between Distinguishing between distressed, distressed, disruptivedisruptive, and , and dangerousdangerous behavior behavior

Distressed: Behavior that causes us to feel alarmed, upset or worried (most common)

Disruptive: Behavior that interferes with or interrupts the educational process of other students or the normal business functions of the university

Dangerous: Behavior that leaves us feeling frightened and in fear for our personal safety or the safety of others

General rule: If it doesn’t feel right, it’s usually not right! (trust your gut)

Common categories/causes Common categories/causes of student distressof student distress

DepressionAnxiety/stressDisordered eatingSelf-injuryAlcohol/drug problemsSleep problemsSerious mental illness

(e.g., bipolar, schizophrenia)

Serious illness/injuryRelationship violence/

assaultRelationship break-up

Academic pressure or failure

Career indecision Identify confusionAdjustment problemsUnplanned pregnancyFamily issuesDeath/lossDiscrimination/

alienationLegal difficulties

NCHA/ACHA Student DataNCHA/ACHA Student Data% within the past school year. 2000 2002 2004 2006

Felt very sad 80.6 82.0 80.9 77.8

Felt depressed 44.4 44.8 45.1 42.2

Been diagnosed with depression 10.3 11.8 14.9 14.5

Seriously considered attempting suicide 9.5 10.0 10.1 9.4

Attempted suicide 1.5 1.6 1.4 1.4

*75% of college suicides occur among students who have not accessed counseling services*Beginning fall 2008, Stout will be requiring 3 sessions of assessment for students making suicide attempts or threats

Signs of Distress - AcademicSigns of Distress - Academic

Excessive absences or procrastinationWithdrawal/fatigue/sleeping in classAvoidance of or change in participationExcessive anxiety regarding performanceUncharacteristically poor preparation or

performanceRepeated requests for special

considerationUnusual or inappropriate expressions in

writing, drawing, or other coursework (note: if content is violent in nature, notify SOC)

Signs of Distress - BehavioralSigns of Distress - Behavioral

Change in mood (e.g., depressed or irritable)

Hyperactivity or very rapid speech

Difficulty concentratingPhysical complaints

(e.g., headaches, stomachaches)

Deterioration in hygiene and self-care

Dramatic weight loss or gain

Unusual or exaggerated emotional expression

Impaired/disjointed speech

Swollen or red eyesSmell of alcohol,

marijuana or signs of other drug use

Observable signs of injury

Signs of Distress - Signs of Distress - InterpersonalInterpersonalProblems with roommates, family, or

romantic partnersSignificant death or other lossSocial withdrawalDifficulty get along with othersFrequent conflicts with othersDependency on peers, staff or facultyConcerns and complaints from other

students

Video clip – Everything’s a Video clip – Everything’s a MessMess

Notice what signs and symptoms this professor sees and hears from the student that leads him to encourage the student to seek counseling services

http://www.sa.psu.edu/caps/distress/distress/recognizing_video.html

Responding to the distressed Responding to the distressed studentstudent

Observe – Take note of verbal & non-verbal behavior that suggest signs of distress

Trust your gut – It is better to error on the side of safety and concern by doing something

Reach out – Ask to talk in private and share your observations in a direct and nonjudgmental manner

Listen – Encourage the student talk and listen to both thoughts and feelings

Offer support – Your care, interest and listening may prove pivotal in the student seeking help

Give hope – Let them know things can get better and you will help identify options for assistance

Responding to the distressed Responding to the distressed studentstudent

Consult – If you feel unsure or “in over your head,” utilize the Counseling Center or other resources for assistance

Refer – To counseling or other campus resources, if appropriate. Frame seeking help as a sign of strength

Maintain boundaries – Be clear and consistent about expectations and honest about the limits to your ability to help

Follow-up – Arrange a time to check back with the student. This communicates continued care and interest

Boundaries: Consider referral when . Boundaries: Consider referral when . . . . .

The student expresses openness to receiving help

There is immediate danger to student or someone else

The problem or request is beyond your expertise or job role

Personality differences interfere with your ability to help

Your objectivity is compromised, perhaps due to a personal relationship

The student is reluctant to talk to you about the problem

You are feeling overwhelmed, pressed for time, or otherwise at a high level of stress

Signs of Distress – Suicide RiskSigns of Distress – Suicide Risk

Threatening to hurt or kill oneself; talking or writing

about death, dying, or suicide

Suicide planning behavior/access to lethal means

Overwhelming hopelessness & helplessness; feeling

trapped – like there is no way out

Past attempts or other self-injurious behavior

Dramatic mood changes; feeling rage, anxiety,

agitation

Reckless or risky behavior, incl. increased AOD use

Withdrawing from friends, family, society

Putting affairs in order/giving away possessions

Why address suicide risk Why address suicide risk factors?factors?

Suicide is the 2nd leading cause of death in college

students (after accidents); accounts for more

deaths than all illnesses combined

55% of college students report suicidal thoughts at

some point in their life; In a given year, 6-10% have

“seriously contemplated suicide”; 8% have made a

plan; 1-1.5% make an attempt (2007 ACHA; 2008 U of TX study)

◦ 50% consider counseling; only 40% seek it out (MTV/AP 2008)

75% of college suicides occur among students

who have not accessed counseling services

Effective treatment is available (and free on

campus)!

Addressing suicideAddressing suicideThink QPR (Question, Persuade,

Refer)Q – If concerned, ask directly about

suicidal thoughts and feelingsP - If the answer is yes, obtain

agreement to seek help R – Refer for professional assessmentDon’t promise secrecyAs always, listen, show concern, and

follow-up. Also take care of yourself!

The Disruptive StudentThe Disruptive StudentProblems with boundaries and

expectations; pushes the limitsIncivility/verbally lashing out or

intimidating others (including online)Overly demanding of faculty, staff, or

peersMakes hostile remarks out of turnDominates discussion/“takes over” classOver reaction to changes in policies or

setting reasonable limits

The Disruptive Student – what The Disruptive Student – what to doto doConfront directly and early by verbally

requesting that the student stop the behaviorIf behavior is in public and persists or escalates,

ask the student to leave the class or areaEstablish a time to talk privately, informing

student that their behavior needs to change and explaining consequences for not abiding

Postpone conversation if student is defiant or hostile

Document exact words and actions, including dates, times, & behaviors; keep emails, voicemails, etc.

Report concerns in a timely manner to DOS◦ “If you see something, say something” (NYC MTA)

The potentially dangerous The potentially dangerous studentstudent

Verbal or written threat of suicide, homicide or assaultive behaviors

Displays a firearm or other weaponUnusual interest in weapons, security, or

targetsApproval of violence to resolve problemsAttempts to harm selfPhysically confronts or attacks othersStalks or harasses othersSends threatening emails, letters, and

other correspondence

The potentially dangerous The potentially dangerous student – what to dostudent – what to do

Immediately contact University or Menomonie Police at 911

Contact department chair or supervisor for advice, support, and documentation

Inform the Dean of Students Office and consider filing a student behavior complaint

Consult with the Counseling Center to debrief and assist you, other staff, and students

Students of Concern TeamStudents of Concern TeamChaired by Dean of Students (232-1181)

with membership from Counseling Center, Disability Services, Student Health Services, University Housing, & University Police

They serve an important role as both a “vortex” for information, and also a multidisciplinary team of consultants

Can be of assistance with all three levels of concern, but most critically with the disruptive or potentially dangerous student

ResourcesResources

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

ResourcesResources

InternetCounseling Center (www.uwstout.edu/counsel)

Assisting Students During Emotional Distress: A Guide for Faculty and Staff (UW-RF document covers specific disorders & problem areas)

(http://www.uwrf.edu/counseling/documents/7030%20Student%20Crisis%20II.pdf)

Responding to Disturbing Creative Writing (VATech): http://www.colorado.edu/studentaffairs/victimassistance/quickassist/disturbingwriting.pdf

Writing in the Margins (UCDavis): http://caps.ucdavis.edu/resources/staff/margin/Margin.pdf

Half of Us.com – student and celebrity videos on mental health issues.