1、Identifying Distressed StudentsAs an RA your residents will view you as a source of both friendship and support. Youll share your residents joys and successes as well as their everyday stresses, anxieties, and pressures. Only a few students will show signs of being emotionally troubled, and some of
2、these students would rather seek you out first than come to the University Counseling Center. They know you and may see you as trustworthy, knowledgeable, and caring, so you become a potential resource in times of trouble. You are in an excellent position to recognize potentially serious behavior ch
3、anges that characterize emotionally distressed students so that you can refer them to a counselor or other specialized treatment provider. Your ability to recognize signs of serious emotional distress and your courage to acknowledge your concerns directly are often noted by students as the most sign
4、ificant factor in their successful problem resolution. So, how do you know who is OK and who is not? Signs of Distress:Inability to concentrate, confusion, indecisivenessPersistent worrying, anxietySocial isolation, depression, references to suicideIncreased irritability, restlessnessAnger escalates
5、 to violencePsychosomatic symptomsDrug and alcohol abuseDisordered eating: restricting, bingeing, purging, over-exerciseTraumatic changes in personal relationshipsChanges in mood or behaviorBizarre or dangerous behavior, mood swingsMore talkative than usual, pressure to keep talking, thoughts are ra
6、cingMissing classes, assignments, procrastinationDisheveled appearanceThere are many types of crises that are likely to involve referrals to sources for help such as the University Counseling Center. Your other RA orientation training sessions will teach you about alcohol and drug abuse, eating diso
7、rders, sexual assault, sexuality, negotiating conflict, and multicultural awareness. Later this year you will also attend some in-service training sessions at the Counseling Center on topics such as stress management and grief and loss. Therefore this manual and our initial UCC RA orientation sessio
8、n will focus on one of the most worrisome types of student crises that you will encounter this year, namely, the student who is depressed and possibly suicidal. We will also focus on how to handle your role as a student peer counselor/helper. Depression: When Its Beyond the BluesSigns and Symptoms o
9、f Depression At least five of the following symptoms, most of the day every day, for at least two weeks Represents a significant change from previous functioningChanges in Physical Health: Changes in appetite; significant weight loss/gain when not trying to diet Disturbed sleep (too much or too litt
10、le) Physical agitation or slowness Fatigue; loss of energy Possible headaches, stomachachesChanges in Feelings: Depressed, melancholy mood Loss of interest or pleasure in all, or nearly all, activities Feelings of hopelessness or worthlessness Feelings of excessive or inappropriate guilt Irritabilit
11、y/anxietyChanges in Behavior: Excessive crying Social withdrawal Neglect of personal hygiene Indecisiveness; diminished ability to concentrate Recurrent thoughts of death; suicidal ideation or gesture of any kind Examples: I wish I were dead; It would be better if I hadnt been born; It will all be o
12、ver soon; Theres no point / its hopeless; I dont deserve to live; I wish I could make it all stop.Guidelines for Helping a FriendWho is Depressed and Possibly SuicidalDONTS FOR HELPING A FRIEND WHO IS DEPRESSED / SUICIDAL Dont minimize feelings, or try to cheer him/her up. Dont try to analyze or int
13、erpret your friends behavior. Dont criticize or shame. Try not to get angry. Dont be afraid to ask if your friend is considering suicide. Dont dismiss or discount any suicide threat. Dont argue about whether or not he/she should live or die; just focus on your friends reasons for living. Dont get sc
14、ared by the intensity of your friends emotion. Dont become depressed yourself. Set limits on your own time and energy. Seek outside help for yourself if needed.DOS FOR HELPING A FRIEND WHO IS DEPRESSED / SUICIDAL Do tell your friend how much you care and what specific changes in behavior are causing
15、 your concern. Do listen - allow your friend to express feelings. Acknowledge your friends distress. Do reinforce positive thinking and responses. Do invite your friend to do activities with you. Do ask if your friend is considering harming him/herself or considering suicide. If your friend is suici
16、dal, theres no need to panic. Go ahead and talk about it. Your friend will probably be relieved to have a chance to be open about it. Evaluate the immediacy and severity of the crisis. Do offer hope by suggesting that your friend will feel better if he/she talks to a professional about what is troub
17、ling him/her (sharing a personal anecdote, e.g., someone you know who found it helpful in a similar situation, may or may not be helpful; use your judgment). Do refer, ideally to a mental health practitioner; and if resisted, refer to a trusted and respected figure such as a rector, priest, or physi
18、cian.Steps to Take to Help a Friend Who is SuicidalSTEP 1: Evaluate the immediacy or severity of the crisis by assessing the potential risk. Remember the acronym, “PLAID PALS“PlanDo they have a plan? How specific are thedetails of the persons plan?LethalityIs the plan lethal? Can they die?Availabili
19、tyDo they have the means to carry it out?IllnessDo they have a mental or physical illness?DepressionChronic or specific incident(s)?Previous attemptsHow many? How recent?AloneAre they alone? Do they have a support system? Partner?LossHave they suffered a loss? Death, job, relationship, self esteem?S
20、ubstance Abuse (or use)Drugs, alcohol, medicine? Current, chronic?STEP 2: Discuss your friends reasons for wanting to take his/her life and your friends reasons for livingPeople who are suicidal havent killed themselves yet because they are ambivalent about it. Focus on your friends ambivalence. Ask
21、, “If youve been thinking about hurting yourself since date, what has kept you from killing yourself so far?“ Listen carefully to his/her answer, and then stress the reasons s/he has offered for living.STEP 3: Discuss your friends coping strategiesAsk what your friend has done so far to cope with th
22、e problem, find out what has worked before and what hasnt.STEP 4: Negotiate a “No Suicide“ AgreementAsk your friend to agree not to commit suicide at any time. If your friend will not agree to this contract or tries to change it to a certain time, call the University Counseling Center (631-7336). ST
23、EP 4: Assess the availability of others to help and referSources of help include your friends roommate, friends, rector, Campus Ministry, and the University Counseling Center. See the Counseling Center Referral Guide.STEP 5: Help your friend determine a positive course of actionAssess the problem. B
24、rainstorm alternatives and consider the consequences of each. Determine a time table. Schedule another time to meet with your friend. Summarize what has been accomplished and feedback the actions your friend will take to help alleviate the crisis. REMEMBER: You cannot take responsibility for the act
25、ions of another individual, but you can assist him or her in making a positive decision to live.Preventing Burnout and Maintaining the Balance: Your Role as an RA Peer Helper Top Ten Stress-Causing Beliefs Held by R.A.s1. I should always work at my peak level of enthusiasm and competence.2. I am “on
26、 call“ 24 hours a day.3. I should be able to handle any student emergency 4. I should be able to work with every student.5. I am never able to leave my role as an R.A.6. I should be able to help every student.7. I should be a model of mental health.8. I should be a model student.9. I feel responsibl
27、e for my students well being.10. I always put students needs ahead of my work. How to Know When Your Style of Helping is Out of Balance You get too worried; you obsess about the problem. You start avoiding or distancing yourself. You start resenting being asked to help. You notice a pattern of peopl
28、e becoming dependent on you. You experience extreme emotional reactions. You are taking responsibility for other peoples lives. Youre not taking care of yourself. Youre getting swept away in someone elses “emergency feelings.“ You blame yourself when someones problem worsens. You begin to believe th
29、at self-sacrificing is healthy living. Counseling Center Referral GuideHow to interact with a distressed student Acknowledge openly to the student that you are aware of their distress, that you are sincerely concerned about their welfare and you are willing to help them explore their alternatives. R
30、equest to see the student in private to minimize embarrassment and defensiveness. Use constructive self-disclosure & feedback to acknowledge your observations of their situation and express your concerns directly and honestly. Strange or inappropriate behavior should not be ignored. Comment directly
31、 on what you have observed. Use active listening skills and provide empathy without necessarily agreeing or disagreeing with the students point of view. Consider referring the student or consulting with a UCC counselor about how to help the student.When should you make a referral? The student is sho
32、wing signs of distress, serious depression, expressions of suicide or inappropriate / bizarre behavior and you feel that you do not have expertise to help them. You know the student or the students friends personally and you know that you wont be able to be “objective“ in helping them. You are conce
33、rned that you could get involved in “triangles“ between this student and other residents. By helping this student you are afraid you could risk hurting other residents feelings (e.g., you look like you are “taking sides“). You and your staff or you and other residents start talking frequently about
34、“what to do“ for this student. You find yourself being one of the students few sources of support, and you are feeling stuck, like you cant turn down the students requests for more time. You begin to feel resentful, angry, fearful or anxious whenever “that“ person is knocking on your door or calling
35、 on the phone You find yourself becoming overly involved in the students problems, and you are trying to “fix“ their problems, you are neglecting your own life/sleep/studying, you are burning out from interacting with the student and others regarding his/her problems.Making a Referral to the Univers
36、ity Counseling Center Use active listening and attending skills Acknowledge that the person is hurting. Communicate that you understand that the person wants to resolve their problems and alleviate their pain. Elicit their agreement and indicate that counseling is likely to help them feel better. Be
37、 positive, direct, and specificPoint out, in a non-judgmental manner, that seeking professional help is a positive step that can indicate strength. Be direct and let the student know that you believe a counselor can be of help in this situation. Be specific regarding the behaviors that have raised y
38、our concerns. Inform the student about confidentialityFederal and Indiana law, as well as ethics, require that all sessions at UCC are completely confidential. Information about attendance or the content of the sessions cannot be released except upon the students written request, in circumstances wh
39、ich would result in clear danger to the individual or others, or as may be required by law. The Counseling Center strictly adheres to this policy. The student has the option to accept or refuse counselingExcept in emergencies, the option must be left open for the student to choose whether he or she
40、wants counseling. If the student is skeptical or reluctant, simply express your acceptance of those feelings so that your own relationship with the student is not jeopardized. Give the student the opportunity to consider other alternatives by suggesting that he or she might need some time to think i
41、t over, or suggest that the student try just one session. If the student emphatically says “no,“ then respect that decision and again leave it open for reconsideration at another time. Give the student the UCC phone number and / or web page address (http:/www.nd.edu/ucc). If a students behavioral or
42、 psychological problems are so great as to cause disturbance to the community then a referral for a psychological assessment at the UCC may be helpful. Its best to let your rector or assistant rector make this kind of referral. If the student agrees to the referralThe student may call or go to the U
43、CC to make an appointment from 9 a.m. - 5 p.m. Monday - Friday. Intake appointments are usually available within three to five days. If the student is in a crisis situation needing more immediate attention then an on-call counselor is available. The students first contact with the Center will typica
44、lly be an intake interview during which the student and the intake counselor make decisions about the type of help needed. Emergency servicesStudents in crisis requiring immediate help who cannot wait to be assigned an intake are seen on a walk-in basis during the week. The Center is open from 9 a.m
45、-5 p.m. Monday through Friday. Ideally, students should try and come to the Center by 4 p.m. in order to allow enough time to fill out paper work and meet with the on-call counselor. You can offer to accompany the student to the Center if you wish. If possible, please call ahead of time to let us kn
46、ow about the students situation. After hours students in emergency can call the therapist who is on-call (via pager) by calling 631-7336 and leaving a message with their name and phone number. In emergency situations involving students who are unwilling or unable to seek help on their own, you can c
47、all the Counseling Center at 631-7336 and ask to speak to the therapist who is on-call. Consulting with a UCC CounselorYou are free to call 631-7336 to consult with a counselor either over the telephone or in person if you are concerned about a student or if you are concerned about how to help a stu
48、dent. If the situation involves a severe psychological emergency needing immediate assistance feel free to call the on-call counselor after hours or on weekends.Insert reduced copy of UCC pamphlet here (2 pages front and back)Crisis Intervention:Cases for Role Play and DiscussionTo Do List: Read the materials on depression and balancing your role. Come prepared to role play these three cases on Monday morning. Also complete the workbook questions following the case scenarios.Case Scenario #1: Depressed and Possibly SuicidalMale RAs, use “Kevin” - Female RAs, use “Kali”Kevin/Kali is a senior B
