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Identifying and
 Referring
 Students in
 Distress
Dr. Laura Ebady, CMHC
Christa López, SES/BCAL
Overview
 Warning   signs

 Response   strategies

 Campus    resources
Warning Signs
 Commits    or threatens violence against self
 or others
 Out   of touch with reality
 Extreme   emotional reaction
 Noticeable   change in appearance
 Decline   in performance
 Decline   in social involvement
Responding to Distress
 Provide    opportunity to express concerns
 Initiate   problem-solving
 Help   the person take action
Making a Referral
 Be   direct
 Provide   information
 Encourage     and suggest, don’t insist
Setting Limits
 Stay   within your comfort zone

 Maintain   boundaries

 Seek   support
Situations Requiring Immediate
Action
 Immediately  report threatening behavior
  or violence to UTPD.
 Focus   on severity, not intent.
 Trust
      your instincts - err on the side of
  caution.
Counseling Center Services
 Walk-in   appointments
 Individual   & couples counseling
 Group   counseling
 Medication    evaluations
 Telephone    counseling 24/7
 MindBody     lab
SES/BCAL
 Advise   of options and resources
 Help   develop a plan of action
 BCAL    is available 24/7/365; 512-232-5050
 http://www.utexas.edu/safety/bcal/
 SES   can be reach at 512-471-5017 or
 studentemergency@austin.utexas.edu
UTPD
 911
 Can perform welfare checks for on-
  campus
 Crime prevention 512-471-4441
Case scenario 1
   Abby is a sophomore in your college
   Abby arrives in your office 10 minutes prior to
    her appointment; the front desk alerts you of
    her arrival and that she is crying in the lobby
   Abby enters your office and begins sobbing
   She has bruises on her face and arms
   She is visibly shaken
   What are your thoughts?
Case scenario 2
 You   hear loud commotion at the front
  desk area
 You step out of your office to investigate
  and see that there are some papers
  thrown on the floor
 The front desk staff state and irate student
  just left after yelling at the staff, punching
  the door then took off down the hall
 What do you do?
Case scenario 3
A  faculty member shares with you that
  they have not seen Joe in class for 4
  weeks, you learn that another faculty
  member has had the same concern
 You send Joe a SAN with no response
 What do you do?
Case scenario 4
 Students and staff report they have seen
  someone sitting on top of the roof’s edge
  of the UA9 building (between Kinsolving
  Hall and the SSB)
 The person looks to be a student’s age
  and is not dressed in a UT uniform/not a
  Physical Plant staff member
 Who do you call?
Final Considerations
 No   single “right” way to respond

 Need    for consultation &/or support

 Consider   scope of your role in advance

 Avoid   making promises you can’t keep

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Students in Distress

  • 1. Identifying and Referring Students in Distress Dr. Laura Ebady, CMHC Christa López, SES/BCAL
  • 2. Overview  Warning signs  Response strategies  Campus resources
  • 3. Warning Signs  Commits or threatens violence against self or others  Out of touch with reality  Extreme emotional reaction  Noticeable change in appearance  Decline in performance  Decline in social involvement
  • 4. Responding to Distress  Provide opportunity to express concerns  Initiate problem-solving  Help the person take action
  • 5. Making a Referral  Be direct  Provide information  Encourage and suggest, don’t insist
  • 6. Setting Limits  Stay within your comfort zone  Maintain boundaries  Seek support
  • 7. Situations Requiring Immediate Action  Immediately report threatening behavior or violence to UTPD.  Focus on severity, not intent.  Trust your instincts - err on the side of caution.
  • 8.
  • 9. Counseling Center Services  Walk-in appointments  Individual & couples counseling  Group counseling  Medication evaluations  Telephone counseling 24/7  MindBody lab
  • 10. SES/BCAL  Advise of options and resources  Help develop a plan of action  BCAL is available 24/7/365; 512-232-5050 http://www.utexas.edu/safety/bcal/  SES can be reach at 512-471-5017 or studentemergency@austin.utexas.edu
  • 11. UTPD  911  Can perform welfare checks for on- campus  Crime prevention 512-471-4441
  • 12. Case scenario 1  Abby is a sophomore in your college  Abby arrives in your office 10 minutes prior to her appointment; the front desk alerts you of her arrival and that she is crying in the lobby  Abby enters your office and begins sobbing  She has bruises on her face and arms  She is visibly shaken  What are your thoughts?
  • 13. Case scenario 2  You hear loud commotion at the front desk area  You step out of your office to investigate and see that there are some papers thrown on the floor  The front desk staff state and irate student just left after yelling at the staff, punching the door then took off down the hall  What do you do?
  • 14. Case scenario 3 A faculty member shares with you that they have not seen Joe in class for 4 weeks, you learn that another faculty member has had the same concern  You send Joe a SAN with no response  What do you do?
  • 15. Case scenario 4  Students and staff report they have seen someone sitting on top of the roof’s edge of the UA9 building (between Kinsolving Hall and the SSB)  The person looks to be a student’s age and is not dressed in a UT uniform/not a Physical Plant staff member  Who do you call?
  • 16. Final Considerations  No single “right” way to respond  Need for consultation &/or support  Consider scope of your role in advance  Avoid making promises you can’t keep

Notes de l'éditeur

  1. Give overview.I’d like to start by taking a quick poll. By show of hands, how many of you would be very concerned about a coworker or student with the following characteristics: experienced recent loss of a loved one (deaths of 2 children) depressed- anxious- possibly alcoholic unable to sleep mood swings ranging fr highly irritable to sad & hopelessThe person I just described is Abraham Lincoln. People can have serious issues/concerns & still be creative & productive members of society…so keep this in mind - want to avoid becoming alarmist & maintain perspective.In the wake of recent national events, we as a society are seeking to define who among us poses a risk to themselves or others.There is no definitive formula to determine who is troubled &/or dangerous. What we CAN do is to pay attention to risk factors and behaviors that indicate some level of distress, & respond accordingly (use this to lead into next slide).
  2. Give “real-life” examples of each.Indications person may be losing touch w/reality:- bizarre or paranoid beliefs/behavior (grandiose thinking, conspiracy theories)- seeing or hearing things that others don’t see or hearExtreme emotional rxn:Pay attn to responses that are obviously inappropriate to the situation (eg, becoming extremely anx, angry, or distraught; excessive confusion). May inc:- argumentative, loud voice, agitated gesturing.- verbal aggression, inc name-calling, discriminatory statements, verbal attacks.Also pay attention to extremes in energy level (hyperactivity or exhaustion), & to disturbing content in papers, reports, etc.Unusual appearance:- deterioration in personal hygiene or dress, indicating neglect. odd facial gestures & mannerisms-may indicate loss of touch w/reality. - observable signs of injury (cuts, bruises, burns).Decline in performance:- falling behind at work or in classes.- excessive absences or lateness.- repeated requests for special consideration, esp when this is a change fr previous beh.Social decline: more socially isolated, less spontaneous.
  3. Help relieve the distress by providing an opportunity for the person to talk abt their feelings. Give the person your undivided attention & let them talk with minimum interruptions. Ask the person what they need fr you, & be as calm & straightforward as possible. Acknowledge the person’s thoughts and feelings. Let them know you understand they’re upset. Respect the person’s value system, even if you don’t agree w/it. If you’re concerned abt the person, tell them! Be direct in letting them know you believe it’s important for them to get professional help in this situation. Initiate problem-solving. You don’t need to know the answers or exactly what to do, but you can offer hope. Avoid immediately reassuring the person or telling them not to worry - but you can: - Help them realize they have options and resources - this is where knowing campus resources & programs can be very helpful. - Provide enough hope to enable the person to consult a professional or other appropriate person (eg, they can talk to a counselor at CMHC if a student, or at EAP if a faculty or staff member). Point out that seeking professional help for problems is a sign of good judgment & a good use of resources.Don’t promise confidentiality unless you know this is a promise you can keep.If this is someone you have ongoing contact with, check back in w/them - conveys to person that you are taking this seriously & are concerned.
  4. Be direct in letting the person know that you believe it’s important for them to get professional help in this situation. If you’re concerned about the stud, let them know this (e.g., “I’ve noticed you’ve been looking tired & stressed. Are you going through a rough time?”). Point out that seeking professional help for problems is an indication of good judgment & a good use of resources (e.g., “If you had a broken arm, you’d go to the doctor rather than trying to set it yourself”).Educating studs abt the counseling process can address their misgivings & can reduce the barriers to their getting the help they need. Inform them that counseling is confidential & is available at a low cost at CMHC (most services are free or have a $5 charge). Make sure the student has contact name, number, & location of the referral. Prepare the student for what they might expect if they follow your suggestion – tell them what you know about the referral person or service. If the student is receptive, suggest they make an appointment.Except in emergencies, the option must be left open for the student to accept or refuse assistance – don’t force the issue or try to trick the student into going. Keep in mind that cultural factors may affect a stud’s openness to speaking w/a counselor (eg, may mistrust counselors due to discrimination, cultural beliefs abt mental health & counseling, cultural values around shame & pride & the importance of keeping fam probs w/in the fam). Offer to meet with the student again - this may help solidify their plan to obtain appropriate help, & also demonstrates your commitment to helping them with this process. However, it’s important to be sensitive to a student’s desire for privacy.
  5. Healthy limits:* It’s important not to extend yourself beyond your comfort level in terms of involvement, skills, and time commitment.* Maintain clear and consistent boundaries.* Dealing with students in distress can be a stressful and taxing experience. Seek out the support of your colleagues, supervisor,EAP, or other resources as part of your own professional self-care strategy.
  6. Threatening behavior/violence includes: stalking; alarming comments (verbal or written - eg, “You’d better watch out”); violence against UT property; threatening display of a weapon; threat or assault against anyone on campus, including threat to harm oneself.Indirect threats shd also be reported (eg, “someone is going to pay for this”). Focus on the severity of the behavior or situation, rather than the intent of the individual.Trust your instincts - never dismiss a threatening situation. Without intervention, less immediate signs of distress may escalate into an emergency situation. Intervening or offering assistance can help ensure the safety of the individual and others.If you’re ever unsure whether a situation merits involving UTPD, call the Behavior Concerns Advice Line (BCAL).
  7. $5 charge for walk-ins, ind, cpls, & psychiatric appts. No charge for grp, TCRS, or MB lab.Confidentiality
  8. The best way to reach UTPD is by dialing 911. When calling from a cellphone just note you are calling in relationship to the UT campus and UT dispatch will take over.UTPD officers are trained mental health deputies who can perform emergency commitments when deemed appropriate.UTPD can send officers out to look over office set-ups and discuss safety tips – ask to talk to the crime prevention unit
  9. You don’t need to know the “right” way to respond, b/c there’s often not one. You should, however, have at least an initial sense of the range of responsible, helpful responses that are possible.This is a confusing topic, and both consultation and support are sometimes necessary and desirable. You have important decisions to make about the role you want to adopt. It’s better to think abt this ahead of time rather than waiting until a situation presents itself. Each situation is unique, of course, but you can clarify some basic issues & values in advance. Also keep in mind that whether or not you want to take on the role of counselor or confidant, you may be the first person a student goes to when feeling distressed because they perceive you as knowledgeable, caring, and trustworthy. So you need to know how you’d want to respond.Don’t make promises you can’t keep (e.g., promising not to divulge any information they share w/you - you may be required to reveal info if, for ex, they say they’ve been thinking abt killing themselves or harming someone else).