Troubled Students What To Do In A Crisis: Part I Crises You May Encounter A crisis situation occurs when the student feels unable to cope with the circumstances of his/her life. The more helpless the individual feels, the greater the crisis will be. A psychological emergency occurs when a person is: Suicidal Homicidal Gravely impaired: Confusion Extreme hyperactivity Hallucinations Not in control of his/her behavior Disorientation Procedure The procedure for crisis intervention is as follows: Contact Security (extension 2400) for an assessment or assistance. Security will contact a Personal Counselor or other crisis team member and respond appropriately. Until help arrives: Listen: Avoid any physical contact and allow student to talk. Assist: Provide a quiet atmosphere and minimize environmental stimulation. Recognize: Know your limitations and clearly convey this to the student. SBCC provides crisis intervention as needed. Assessment is to be made by a college Personal Counselor during the following hours: Monday through Thursday 8:00 AM to 6:30 PM and Friday 8:00 AM to 3:00 PM, or by a member of the Security Office if a Personal Counselor is not available. Personal Counseling or Security will contact the student's family or significant other if it is necessary to protect the health and safety of the student or other persons. If the student is under 18 years old, parents MUST be contacted. (Information may be released based upon the Family Rights and Privacy Act of 1974 if the knowledge of such information is necessary to protect the health or safety of the student or other persons.) After the incident has been resolved, the college Personal Counselor or Security Officer will notify in writing the member of the crisis team. The Crisis Team consists of: Personal Counselor, Director of Health and Wellness, Director of DSPS, Director of Security and Dean of Educational Programs/Student Discipline. What To Do In A Crisis: Part II How To Recognize And Deal With Specific Types Of Behavior THE AGGRESSIVE STUDENT Description Aggression can take many forms, from very subtle, passive acts to violent outbursts. Aggression is the result of being frustrated and feeling out of control. Some aggressive people express hostility immediately without regard for their circumstances or the people around them. Other aggressive students express their hostility through explosive outbursts and the rest of the time deny their anger and frustration. Many times students who are verbally or physically aggressive feel inadequate and use the hostile behavior as a way of building up their self-esteem. Often they feel that you will reject them so that they become hostile and reject you first to protect themselves from being hurt. They may see you as attempting to control them and lash out to try and gain a sense of control. It is important to remember that the student is generally not angry at you personally but is angry at his/her world, and you may be the object of the pent-up frustrations. Response The following may be helpful guidelines in dealing with the aggressive student: Reduce stimulation. Invite the person to your office or another quiet place, if you feel safe doing so. Allow the student to ventilate and tell you what is upsetting him/her. Tell the student that you are not willing to accept abusive behavior. You may want to explicitly state what behaviors are acceptable. Stick to the limits you set. Try to prevent total frustration and helplessness by quickly and calmly acknowledging the intensity of the situation. Rephrase what they say, keeping your voice volume down. Focus on diffusing the situation rather than seeking resolution right away. Call for help when necessary (co-workers, Personal Counselor, Security). Do not be a hero! Open door, call for help, stand up at the door. Do not jeopardize your own safety. The following will not be helpful: Getting into an argument Pressing for explanations for their behavior Looking away and not dealing with the situation or ignoring warning signals Touching the student Making threats, dares or taunts If the student appears to be threatening or dangerous: Call Security, ext. 2264 days (after 4:00 PM, ext. 2400) If the student's behavior is disruptive, but there is no imminent danger: Call Dean of Students, ext. 2278 (Call Operator for phone number for Evening Dean). THE DEPRESSED STUDENT Description Typically, a depressed student may feel guilty or angry at him/herself; has trouble concentrating or remembering, loses interest in schoolwork or other activities, and/or feels worthless or inadequate. Physical symptoms include: changes in appetite (increase or decrease), sleep disturbances (or excessive sleeping), low energy level. The more depressed student will convey a greater sense of helplessness and hopelessness. Often these feelings are expressed verbally or in writing. Suicide Many depressed students feel suicidal. It is important to take all suicidal comments seriously and appropriate referrals should be made. Suicidal Indicators: Talking of ending things (e.g., quitting school, work) Giving things away Taking care of business Statements of hopelessness A lift in depression, surge of energy Facts about suicides: College students have higher suicide rates than non-college people of the same age. More men commit suicide, but more women attempt. There are more attempts at the beginning and end of semesters. People committing suicide rarely want to die. They really want to end the pain they experience. Talking about suicide will not plant the idea in a person's mind but will probably relieve some of the tension they experience. Suicides rarely occur without warning. Feeling isolated (no support group) increases the likelihood for suicide. The more developed the suicide plan, the greater the likelihood for suicide. If the student has made attempts in the past, he/she is at higher risk for future (and possibly more serious) attempts. Response If you encounter a depressed student, the following actions may be helpful: Reach out and encourage the student to express his/her feelings. Tell the student of your concerns. Talk about suicide if that's on the student's mind. Encourage utilizing or developing a support network (e.g., groups on campus, family, friends, religious affiliations, 12-step programs). Make appropriate referrals. The following actions may not be helpful: Saying "don't worry," "crying won't help," or "everything will be better tomorrow" may only make the student feel worse. Becoming overwhelmed by students' problems may only provide them with more evidence that they should feel helpless. Trying to take responsibility for them and solve their problems will again provide evidence that they are helpless. Trying to ignore their feelings Continuing to see the student without referral develops dependency and may impede resolution via trained personnel. If you are concerned about a student's suicidal intent, call one or more of the following for help immediately: Personal Counselor, Student Health Services and Wellness Program, ext. 2298 for assessment and referral 911 (Medical Assistance Team) for psychiatric evaluation 3. A family member, roommate or friend of the student THE STUDENT IN POOR CONTACT WITH REALITY Description This student may appear withdrawn, frightened, unaware or unconcerned with classroom protocol or acceptable social behavior, disruptive, confused or illogical. Written or verbal communication may be disjointed with little or no connection between topics. Their speech may be rapid or slowed down. They may also pay a great deal of attention to some unimportant detail that is being discussed or may be generally scattered and incoherent. The student may make inappropriate emotional responses. He/she may overreact to his/her feelings with excessive anger, sadness or exuberance. Others may demonstrate a complete lack of emotional expression and speak in monotone. These students tend to distort their perceptions of the world in such a way that innocent occurrences have special meaning to them (e.g., interpreting an innocent facial expression or tone of voice as being hostile or persecutory). They may experience themselves as especially powerful or important or may believe that people are trying to control or harm them in some way. The student may experience hallucinations, most commonly voices speaking to them. They may appear to be on drugs; however, that assumption should not be made. Response When interacting with someone who is in this disturbed state, the following may be helpful: Respond to them with warmth and kindness but with firmness. If you are comfortable in doing so, see them in a quiet atmosphere to remove extra stimulation from the environment (rather than dealing with them in front of the class). Acknowledge their position or feelings without supporting the misperceptions (e.g., I understand you think they are trying to hurt you and I know how real it seems to you, but I didn't perceive them trying to humiliate you.). Reveal when you have difficulty in understanding them and ask that they repeat or rephrase their communication. Focus on the "here and now" (e.g., "you seem very tense, short of breath"). Acknowledge your concerns and state that you can see they need help. Referral is very important for these students. The following will not be helpful to this student: Arguing or trying to convince them of the irrationality of their thinking, as it may just make them defend their position (false perceptions) more Playing along with their beliefs to not upset them (e.g., maybe you are a prophet) Encouraging further revelations of craziness. It is more helpful to switch topics and divert focus to reality issues. Demand that they change their ideas or behavior. Limits on their behavior may need to be imposed but this is best done in consultation with others. Call Student Health Services/Personal Counselors, ext. 2298 for assessment, counseling and/or referrals (See Part III for help in making referrals.) THE ANXIOUS STUDENT Description We have all experienced anxiety in response to a perceived stressful situation. Anxiety becomes heightened as the situation becomes more vague and less familiar. A panic attack is an overwhelming sense of dread and fear and is the extreme result of feeling anxious. Some of the physiological and psychological components of general anxiety and a panic attack are: rapid heart palpitation sweating fear memory distortions dizziness worry easily distracted choking cold, clammy hands difficulty concentrating chest pain or discomfort trembling or shaking anticipating misfortune trouble sleeping The student may experience feelings of worry, fear, and anticipate some misfortune. He/she may complain of difficulty concentrating, being always on edge, being easily distracted, memory distortions, or trouble sleeping. The student may also state unreasonably high self-expectations and be very critical of his/her present performance. This student may constantly think about and discuss his/her problems and possible solutions but be too fearful to take action. Response The following may be helpful in dealing with an anxious student: Let them discuss their feelings and thoughts. This alone may relieve a great deal of pressure. Help them define their stressors (which may be difficult to do) and their ineffective and effective coping strategies. Be clear and explicit about what you are willing to do. It may be helpful to have the student repeat what you have said to ensure that he/she understands. Talk slowly and remain calm. Encourage them to use a support system (e.g., family, friends, students, religious affiliation) to ventilate. When anxiety becomes counter-productive (e.g., cannot take exam, go to class, etc.), refer student to a Personal Counselor. The following will not be helpful in dealing with an anxious student: Taking responsibility for their emotional state Trying to solve their problem as if it were your own Becoming anxious or overwhelmed THE MANIPULATIVE STUDENT Description Typically, the utmost time and energy given to this student is simply not enough. He/she often seeks to control your time and unconsciously believes that the amount of time received is a reflection of personal worth. In many instances, these people feel incompetent to handle their own life. Usually, they are immature and self-centered. Response When interacting with a manipulative student, the following actions may be helpful: Set clear and precise limits with them and stick to the limits no matter how much the student protests. Let the student, to the extent possible, make his/her own decisions. Don't take responsibility for them. If you do, they may attempt to trap you into solving more and more of their life problems. Set limits to your contact with the student (e.g., "I am able to spend 10 minutes with you now. My regular office hours are..."). However: Do not let them use you as their only source of support. Refer them to other students in class, their friends or some particular group on campus. THE PARANOID STUDENT Description Usually, these students complain about something other than their psychological difficulties. They are tense, cautious, mistrustful and have few friends. These students tend to interpret minor oversights as significant personal rejection. Often, many overreact to insignificant occurrences. They see themselves as the focal point of everyone's behavior and everything that happens has special meaning. Usually, they are overly concerned with fairness and being treated equally. They project blame onto others and will express anger in roundabout ways. Many times they feel worthless and inadequate. Response When interacting with a paranoid student, the following may be helpful: Send clear, consistent messages regarding what you are willing to do and what you expect. Express compassion without intimate friendship. Remember, paranoid students have trouble with closeness and warmth. It would not be helpful to be overly warm or nurturing or to assure the student you are his/her friend. Let him/her know that you can still be concerned without being intimate. However: Do not try to flatter the student or be cute or humorous to try to relieve your own anxiety. This will probably distance the student from you. Do not reinforce their beliefs or try to argue against them. Instead, you may rephrase with, "your perception of this situation is..." without judgment. THE STUDENT UNDER THE INFLUENCE Alcohol is the most widely used psychoactive drug. It is common to find alcohol abusers in college populations also abusing other drugs, both prescription and illicit. Fads and peer pressure affect patterns of use. Currently, alcohol is the preferred drug on college campuses. The effects of alcohol on the user are well known to most of us. Student alcohol abuse is most often identified by faculty when irresponsible, unpredictable behavior affects the learning situation (i.e., drunk and disorderly in class), or when a combination of health and social impairments associated with alcohol abuse sabotages student performance. Because of the denial that exists in most substance abusers, it is important to express your concern about the student not in terms of suspicions about alcohol and other drugs but in terms of specific changes in behavior or performance. Do: Confront the student with their behavior that is of concern. Address the substance abuse issue if the student is open and willing. Offer support and concern for the student's overall well-being. Maintain contact with the student after a referral is made. Don't: Convey judgment or criticism about the student's substance abuse Make allowances for the student's irresponsible behavior Ignore signs of intoxication in the classroom What To Do In A Crisis: Part II When And Where To Make Referrals Refer a student when: The problem or request for information is beyond your level of competency. You fear for the safety of a student or others. You feel like you cannot work with a student for whatever reason (e.g., you feel overwhelmed, you have reached your limit of energy or patience, or you feel manipulated or frightened). Referral to SBCC Personal Counselors Referring a student for counseling may be threatening for various reasons. Education and general information about our services can make the difference in a successful referral. It is helpful to remember that you are doing what you think best for the student and that knowing your limits is important and commendable rather than something negative. When you do discuss a referral to a Personal Counselor, it would be helpful for the student to hear in a clear, concise manner your concerns and why you think counseling would be of benefit. You might also tell them a few facts about Student Health Services. All services are free to enrolled students. Licensed Marriage, Family, and Child therapists and interns are available Monday through Thursday from 8:00 AM to 6:30 PM and Friday from 8:00 AM to 3:00 PM. Counseling sessions are generally 45 minutes once a week for up to six weeks. If long-term therapy is indicated, a community referral is made. All information is held confidential. No information will be released without the student's consent except when the student presents a danger to him/herself or others. Having the student call for an appointment increases his/her responsibility and commitment to come in for counseling. There may be sometime, however, when it is more advantageous for you to call and make an appointment with him/her (e.g., student in crisis). If you want to discuss ways of dealing with students needing assistance, call the Personal Counseling staff for a phone consultation. Some common presenting problems that our counselors work with are: Stress/Anxiety Relationship issues Depression Eating disorders Anger Test anxiety Substance abuse     Discover | Read | Explore | Apply | Measur

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