DISTRESSED, DISRUPTIVE,

1
DISTRESSED, DISRUPTIVE, POTENTIALLY 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

2
Goals

• Articulate 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

3
Establishing a community of caring why?

• Student distress is real and on the riseand 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 dont
  seek help without encouragement
• Those who seek help are more likely to persist in
  schoolbut they must stay with it
• Faculty staff are the front lines with esteemed
  status among students in prevention parlance,
  you are gatekeepers
• Because its the right thing to do?!

4
Establishing a community of 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 them
• Promote appropriate faculty-student and
  student-student relationships
• Approach students when you notice changes or
  concerning patterns in behavior
• Individual approaches that work for you?

5
Distinguishing between distressed, disruptive,
and dangerous 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 doesnt feel right, its
  usually not right! (trust your gut)

6
Common categories/causes of student distress

• Depression
• Anxiety/stress
• Disordered eating
• Self-injury
• Alcohol/drug problems
• Sleep problems
• Serious mental illness (e.g., bipolar,
  schizophrenia)
• Serious illness/injury
• Relationship violence/ assault
• Relationship break-up

• Academic pressure or failure
• Career indecision
• Identify confusion
• Adjustment problems
• Unplanned pregnancy
• Family issues
• Death/loss
• Discrimination/alienation
• Legal difficulties

7
NCHA/ACHA Student Data
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
8
Signs of Distress - Academic

• Excessive absences or procrastination
• Withdrawal/fatigue/sleeping in class
• Avoidance of or change in participation
• Excessive anxiety regarding performance
• Uncharacteristically poor preparation or
  performance
• Repeated requests for special consideration
• Unusual or inappropriate expressions in writing,
  drawing, or other coursework (note if content is
  violent in nature, notify SOC)

9
Signs of Distress - Behavioral

• Unusual or exaggerated emotional expression
• Impaired/disjointed speech
• Swollen or red eyes
• Smell of alcohol, marijuana or signs of other
  drug use
• Observable signs of injury

• Change in mood (e.g., depressed or irritable)
• Hyperactivity or very rapid speech
• Difficulty concentrating
• Physical complaints (e.g., headaches,
  stomachaches)
• Deterioration in hygiene and self-care
• Dramatic weight loss or gain

10
Signs of Distress - Interpersonal

• Problems with roommates, family, or romantic
  partners
• Significant death or other loss
• Social withdrawal
• Difficulty get along with others
• Frequent conflicts with others
• Dependency on peers, staff or faculty
• Concerns and complaints from other students

11
Video clip Everythings a Mess

• 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/recog
  nizing_video.html

12
Responding to the distressed student

• 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

13
Responding to the distressed student

• 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

14
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

15
Signs 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

16
Why address suicide risk 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)!

17
Addressing suicide

• Think QPR (Question, Persuade, Refer)
• Q If concerned, ask directly about suicidal
  thoughts and feelings
• P - If the answer is yes, obtain agreement to
  seek help
• R Refer for professional assessment
• Dont promise secrecy
• As always, listen, show concern, and follow-up.
  Also take care of yourself!

18
The Disruptive Student

• Problems with boundaries and expectations pushes
  the limits
• Incivility/verbally lashing out or intimidating
  others (including online)
• Overly demanding of faculty, staff, or peers
• Makes hostile remarks out of turn
• Dominates discussion/takes over class
• Over reaction to changes in policies or setting
  reasonable limits

19
The Disruptive Student what to do

• Confront directly and early by verbally
  requesting that the student stop the behavior
• If behavior is in public and persists or
  escalates, ask the student to leave the class or
  area
• Establish 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)

20
The potentially dangerous student

• Verbal or written threat of suicide, homicide or
  assaultive behaviors
• Displays a firearm or other weapon
• Unusual interest in weapons, security, or targets
• Approval of violence to resolve problems
• Attempts to harm self
• Physically confronts or attacks others
• Stalks or harasses others
• Sends threatening emails, letters, and other
  correspondence

21
The potentially dangerous student 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

22
Students of Concern Team

• Chaired 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

23
Resources

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

24
Resources

• Internet
• Counseling 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/703020S
  tudent20Crisis20II.pdf)
• Responding to Disturbing Creative Writing
  (VATech) http//www.colorado.edu/studentaffairs/v
  ictimassistance/quickassist/disturbingwriting.pdf
  
• Writing in the Margins (UCDavis)
  http//caps.ucdavis.edu/resources/staff/margin/Mar
  gin.pdf
• Half of Us.com student and celebrity videos on
  mental health issues.