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UIC TA Handbook - Recognizing and Dealing with Students in Emotional Distress

By Geraldine Piorkowski

Former Director

and

Robert Lees

Former Clinical Director
UIC Counseling Center

 

University students typically meet with a great deal of stress (i.e., academic, social, family, work, financial) during their educational experience. While most students cope successfully with the demands of college life, for some the pressure can become overwhelming and unmanageable. Students in difficulty have several resources available to them. These include close friends, relatives, counselors, clergy, coaches; anyone seen as caring and trustworthy may be a potential resource in times of trouble.

The Counseling Center staff believes teaching assistants are vital resources in identifying distressed students. As a TA, your expression of interest and concern may be critical in helping a struggling student establish the emotion­ al equilibrium necessary for academic survival and success.

Your willingness to respond to students in distress will undoubtedly be influenced by your personal style and by your particular philosophy about the limits of your responsibility for helping students grow, emotionally as well as intellectually. We hope the following information will help you make these decisions as you work with your students.

Tips for Recognizing Troubled Students

At one time or another, everyone feels anxious, depressed, or upset. Apart from these normal levels of stress, we can identify two general levels of distress that indicate more serious problems for students.

Level 1: These behaviors, although not disruptive to others, suggest something is wrong and help may be needed:

  • serious grade problems or a change from consistently good grades to unaccountably poor performance; and Dealing with Students in Emotional Distress
  • withdrawn or preoccupied manner in class most of the time;
  • a roommate reports a student is spending a lot of time alone in his/her room;
  • series of physical problems;
  • written assignments contain many angry, hopeless and/or suspicious comments;
  • change in usual behavior (gentle to hostile; quiet to loud; talkative to silent);
  • more frequent absences;
  • other characteristics suggesting the student is having trouble managing stress include: depressed, sad mood; being excessively active and talkative (very rapid speech); swollen, red eyes; crying in class; marked change in personal dress and hygiene; sweaty (when room is not hot); falling asleep in class.

Level 2: These behaviors usually reveal the student is in obvious crisis or is experiencing serious emotion­ al distress and needs help:

  • highly inappropriate and disruptive behavior (hostile, aggressive, violent, etc.):
  • inability to communicate clearly (garbled, slurred speech; unconnected or disjointed thoughts);
  • loss of contact with reality (delusions--believes some­ one is persecuting him/her; hallucinations--seeing or hearing things that are not real);
  • overtly suicidal remarks (referring to suicide as a current option);
  • homicidal threats;
  • repeated episodes of crying or tearfulness in class.

Now What?

Level 2 problems are the easiest to identify and the most straightforward to handle, at least to the extent specific procedures for helping students in crisis have been clarified (see the next sections on Making a Referral and Emergencies).

In dealing with a student who shows Level 1 behaviors, you may decide to talk with the student alone or seek consultation with your faculty supervisor. You already provide academic help for some students in a natural, easy manner. We encourage you to continue giving that kind of personal attention to students whose behavior indicates they may be experiencing more than the normal stress of campus life. Students may bring these "extracurricular" problems to you because your proximity provides convenient opportunities for a student to "safely" seek you out. You may appear to be the only person who is available and willing to provide an opening for communication--the student may not need a great deal of help to begin to resolve problems.

If you choose to approach a student you're concerned about or if a student seeks you out for help with personal problems, here are some suggestions to make the opportunity more comfortable for both of you.

  • Talk to the student in private when both of you have time and are not rushed or preoccupied. Give the student your undivided attention.
  • If you approach the student, express your concern in behavioral, non-judgmental terms--"I've noticed you've been missing classes lately (haven't been participating in class as much as before/have missed turning in assignments) and I'm concerned," rather than," "Where have you been lately? Trying to flunk out?"
  • Listen to thoughts and feelings in a sensitive, non­ threatening way. Communicate understanding by repeating back the gist of what the student has told you. Try to include both the content and the feelings you heard ("It sounds if you're not used to UIC and you're feeling left out of things.")
  • Help the student brainstorm possible options or solutions, or offer tentative suggestions that open up new alternatives ("Have you thought of joining a campus organization...?")
  • Help students clarify the costs and benefits of each option for handling the problem from the students' point of view. It is important to respect their value system. Try not to judge, evaluate, criticize, or try to solve the problem for them. Such behavior is apt to close students off from you and keep them from getting the help they need.

Consultation about Students with Problems      

After you have spoken with your faculty supervisor, you may want to talk directly with the student. Before speaking with the student, you might be interested in consulting with someone from the Counseling Center about how best to handle the situation. If needed, we can assist you to:

  1. assess the situation, its seriousness, and potential for referral;
  2. learn about resources, on campus and elsewhere, so you can have options available when talking with the student;
  3. clarify your own reactions and consider how you can be most effective.

To request a consultation, call the Counseling Center. If no one is available, you may leave a message, specifying that this is a consultation about a student, asking the receptionist to arrange for the first available counselor to call you back.

If the Problem is Beyond Your Ability to Help

Although a student may be asking for help with a problem and you are willing to assist, there are times when you should suggest another resource for the student. For example:

  • the problem or request for information or action is one you know you can't handle;
  • you believe personality differences will interfere with your ability to help;
  • you know the student personally (e.g., a friend, neighbor, friend of a friend), and think you can't be objective enough;
  • the student acknowledges a problem, but is reluctant to discuss it with you.
  • you've worked with the student for a while, but you feel your communication has not been effective and you don't know how to proceed;
  • you feel overwhelmed, pressed for time, or otherwise highly stressed yourself.

This may be the time to seek consultation with a colleague or the Counseling Center to identify appropriate referrals.

Making a Referral

Faculty and TAs who believe that a student should talk to someone else about his or her problem often feel reluctant to suggest this to the student, mostly because they're not sure how the student will react. It is true that some people accept referrals, especially for professional help, more easily than others. It helps, in talking with a student at such a time, to:

  • be frank with the student about the limits of your ability to assist -- limits of time, energy, training, or objectivity;
  • assure the student that seeking help does not mean that one has serious problems.

If you're thinking about the Counseling Center as a possible referral, you might want to mention common reasons undergraduates and graduate/professional students seek help there, including:

Recognizing and Dealing with Students in Emotional Distress

  • feeling low on energy or motivation, or difficulty in concentrating
  • difficulty in relationships with friends, family, or boy/girl­ friends;
  • feeling anxious or depressed;
  • concerns about future goals or plans.

It is also important for students to realize that they don't necessarily have to know what is wrong in order to get help.

There are many kinds of referrals in addition to the Counseling Center. Other referrals which might be considered, depending on the situation, include:

  • other UIC faculty or staff (to whom the student feels close);
  • community agencies;
  • other campus offices (like Family Practice, Department of Psychiatry, Office of Applied Psychological Services (OAPS), Deans' Offices, or the Office of the Ombudsperson);
  • clergy (including members of Campus Ministry).

If you wish, the Counseling Center can help explore these and other options with you, including what students might expect if they take your suggestion. That way, you can help prepare them for what might happen.

Students Going to the Counseling Center for the First Time

UIC Counseling Center - http://counseling.uic.edu/

Usually, students call the Counseling Center (312-996-3490) or stop by the reception area (Suite 2010 Student Services Building, 1200 West Harrison, mc 333) between 8:30 am and 4:45 pm to arrange an appointment. (Many faculty members and TAs have found it helpful to make the initial call along with the student, and/or to walk over to the Center with the student.) Because many students use our services, there can be a wait from a few minutes to a few days before an appointment can be arranged. In urgent situations, we will assist the student the same day, often within an hour. All services of the Center (except for certain specialized tests) are free to students.

At the student's first visit, there are some information forms to fill out (which can be delayed in emergencies) before the student sees a counselor. During this first appointment, the counselor begins to assess the student's needs and the ways in which the Center can help. It usually helps a student to know that services at the Center fall under all relevant confidentiality laws.

Should the Counseling Center be the most appropriate setting for the student to address her/his issues, the counselor will assess the services that best meet an individual's needs. Due to increasing demands for services, it is sometimes necessary for the Center to use a waiting list for people seeking individual counseling who are not in crisis. The counselor might also discuss group counseling; at times, group counseling may be more immediately available and may be more appropriate for a student's particular concerns.

The counselor might also discuss a referral to another campus or community agency. It is also not unusual that the student leaves the first appointment feeling able to handle the problem on her or his own, and does not wish additional appointments.

Emergencies

  1. If a student is threatening to harm him/herself or someone else, acting in a bizarre way, or highly disruptive to the university process, you may want to arrange to have the student taken for a psychiatric evaluation (at the UIC Hospital Emergency Room). This might be a serious consideration when the student seems to be making no sense, or tells you that they want to kill themselves, or is making a direct threat to harm someone else -- notify your faculty supervisor immediately.
  2. If you have any questions about this (i.e., whether or not to have the student evaluated, or how to go about doing it), you may wish to consult with one of us at the Counseling Center by phone first. If the student is very distressed, so that you feel reluctant to leave the individual alone, it's okay to stay and try to be calm and comforting while someone else calls the Center.
  3. If you wish, you may instead walk the student over to the Center. We would appreciate your calling ahead to let us know that you're coming! We will talk with the student--along with you, if you wish--and decide whether a psychiatric evaluation is warranted.
  4. If the student clearly needs to be hospitalized and is willing to go on their own, you can arrange to get the student to the hospital without referring them to us. However, you might want to consult with us about steps the student needs to take.
  5. If the student is dangerous to their own or someone else's well-being, and for whatever reason the above procedures don't seem to apply, the UIC Police (312-996-HELP) are available for 24-hour assistance. They have proven to be very reliable and sensitive to handling these situations appropriately.
  6. Keep your faculty supervisor informed about all emergency situations.

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