Personal Growth and Counseling Center

Openly acknowledging to students that you are aware of their distress, sincerely concerned about their welfare, and are willing to help explore their options can have a profound effect. We encourage you, whenever possible, to speak directly and honestly to a student when you sense that they are in academic and/or personal distress.

1. Request to see the student in private.1 This may help minimize the embarrassment and defensiveness. It also demonstrates a respect for privacy and sensitivity to the situation.
2. Briefly acknowledge your observations and perceptions of the situation and express your concerns directly and honestly.
3. Listen carefully to what is troubling the student and try to see the issues from their point of view without necessarily agreeing or disagreeing.
4. Attempt to identify the student's problem or concern, as well as your own concerns or uneasiness. You can help by exploring alternatives to deal with the problem.
5. Comment directly on what you have observed without interpreting or judging. Strange and inappropriate behavior should not be ignored.
6. Involve yourself only as far as you want to go. At times, in an attempt to reach or help a troubled student, you may become more involved than time or skill permits. Extending oneself to others always involves some risk, but it can be a gratifying experience when kept within realistic limits. If demands become too high or specialized, however, you may refer  and we will provide direct intervention and/or refer to an appropriate level of care.

Depression, and the variety of ways it manifests itself, is part of a natural emotional and physical response to life's ups and downs. With the busy and demanding life of a college student, it is safe to assume that most students will experience periods of reactive (or situational) depression in their college careers. Depressive symptoms may become so extreme or enduring that they begin to interfere with the student's ability to function in school, work, or social environments. Due to the opportunities that faculty and staff have to observe and interact with students, you are often the first to recognize that a student is in distress. Indicators include:

• Tearfulness/general emotionality
• Dependency (a student who makes excessive requests for your time)
• Markedly diminished performance
• Lack of energy/motivation
• Infrequent class attendance
• Irritability
• Deterioration in personal hygiene
• Alcohol or drug use
  

Students experiencing depression often benefit from validation, even if the interactions are short or simple. Early intervention increases the chances of the student's return to optimal performance.

Students with Depressive Symptoms: Do’s and Don'ts

DO:

• Let the student know you've noticed that they appear to be feeling down and you would like to help.
• Reach out and encourage the student to discuss how they are feeling.
• Offer options to further investigate and manage the symptoms of the depression (e.g., referral to PGCC).

DON’T:

• Minimize the student's feelings, even if it’s coming from an intention to reassure (e.g. "There’s no reason to worry. Everything will be better tomorrow.")
• Bombard the student with "fix it" solutions or advice, especially when the student did not specifically ask for advice.
• Chastise the student for poor or incomplete work.
• Be afraid to ask whether the student is suicidal if you think they may be.
  (See next section, e.g., "Have you thought of harming yourself?")

Suicide is the second leading cause of death among college students. According to the American College Health Association National College Health Assessment findings from 2021, 10.9% of CSUMB students reported they seriously considered suicide and 1.8% reported an effort to end their life. It is important to view all suicidal comments as serious and make appropriate referrals. High risk indicators include:

• An organized plan to end their life
• Previous suicidal behaviors/actions 
• Feelings of hopelessness, helplessness and futility
• A severe loss (experienced or perceived) or threat of loss
• Events that trigger humiliation, shame, or despair (experienced or anticipated)
• Feelings of alienation and isolation and/or withdrawing from others

There are four areas we explore with students who are depressed and are experiencing suicidal ideation to assess their suicide risk: 

1. Do they have an organized plan that includes an easily available method?
2. Do they have a history of suicidal behaviors/actions?
3. Has a family member, friend, or acquaintance completed suicide?
4. Is there a history of or do they have current issues with alcohol or drug abuse that can impair their impulse control?

Students with Signs of Suicidality: Do’s and Don'ts

DO:

• Take the student seriously. Most suicidal people communicate their intent.
• Be direct. Ask if the student is suicidal, if they have a plan, and if they have the means to carry out that plan. Exploring this with the student may actually decrease the impulse to attempt suicide, lower their anxiety level, or act as a deterrent.
• Be available to listen, but refer the student to the PGCC or a community hotline for additional help. Attempt to make sure the student actually gets some help by following up with them.
• Take care of yourself. Suicide intervention is demanding and draining work. Consult and debrief with the PGCC staff as needed.

DON’T:

• Minimize the situation (e.g. “It can’t be so bad that you’d seriously consider this.”)
• Ignore indirect comments like “Nothing matters. It’s no use.”
• Be afraid of planting the idea of suicide in an already depressed mind by inquiring about it. Research has shown that thoughts of suicide aren’t “planted” simply by someone asking about it. As a matter of fact, they will very likely feel relieved that someone notices and is willing to acknowledge them.
• Get too involved with the student. Instead: Consult, refer, and document.
• Be too busy to intervene.

Students may become verbally abusive when they encounter frustrating situations which they believe are beyond their control. They can displace anger and frustration from those situations onto the nearest target. Explosive outbursts or ongoing belligerent, hostile behavior are sometimes a student’s way of seeking power and control in an otherwise out-of-control experience. It is important to remember that the student is often not angry at you personally, but is angry at their world and you are the object of pent-up frustrations. This behavior is often associated with the use of alcohol and other drugs.

Students Displaying Verbal Aggression: Do’s and Don'ts

DO:

• Acknowledge the student's anger and frustration (e.g., "I hear how angry you are.")
• Rephrase what the student is saying and identify their emotion (e.g., "It appears you are upset because you feel your rights are being violated and nobody will listen.")
• Reduce stimulation; invite the student to a quiet place if this is comfortable.*
• Provide space for the student to tell you what is upsetting them.
• Be clear and firm about the behaviors you will accept. (e.g., "Please stand back; you're too close," and/or "I cannot listen to you when you yell and scream at me that way.")
• Help the student problem-solve and address the issues when they are calm enough to discuss (e.g., "I'm sorry you are so upset; I'd like to help if I can.")
• Be honest and genuine; do not placate aggression.

*Do not do this if you fear for your safety. In all instances, ensure that a staff or a faculty person is easily accessible to you in the event that the student behavior escalates.

DON’T:

• Get into an argument or shouting match.
• Become hostile or punitive yourself (e.g., "You can't talk to me that way!")
• Press for explanations for their behavior.
• Ignore the situation.
• Touch the student, as this may be perceived as aggression or otherwise unwanted attention.
• Make threats or dares.

Violence because of emotional distress is rare and typically occurs when the student's level of frustration has been so intense, or of such an enduring nature as to erode all of the student's emotional controls. Broadly speaking, individuals managing mental illness are more likely to be victims of violent crimes rather than engage in violence themselves. The adage, "an ounce of prevention is worth a pound of cure," best applies here. This behavior is often associated with the use of alcohol and other drugs.

Students Engaging in Violence: Do’s and Don'ts

DO:

• Prevent total frustration and helplessness by quickly and calmly acknowledging the intensity of the situation. (e.g., "I can see you're really upset and may be tempted to lash out.")
• Explain clearly and directly what behaviors are acceptable (e.g., "You certainly have the right to be angry, but breaking things is not OK.”)
• Get necessary help (send a student for other staff, University Police, etc.).
• Stay safe. Have easy access to a door. Keep furniture between you and the student. Keep the door open if at all possible/appropriate. As with the verbally aggressive student, make certain that a staff or faculty person is nearby and accessible. In some instances, you may wish to see the student only with another person present.

DON’T:

• See the person alone if you fear for your safety.
• Ignore warning signs that the person is about to act out (e.g., yelling, screaming, clenched fists, threats).
• Threaten or corner the student.
• Touch the student.

You may notice that some students have difficulty distinguishing fantasy from reality - the dream from the waking state. Their thinking is typically illogical, confused or irrational. Their emotional responses may be incongruent or inappropriate, and their behavior may be bizarre and disturbing. They may experience hallucinations, often auditory, and may report hearing voices. While this may elicit alarm or fear from others, they are generally not dangerous and are more frightened and overwhelmed by you, others, and their perceptions. If you cannot make sense of their conversation, they may be in trouble and you should consult with the PGCC as soon as possible.

Students Who Appear in Poor Contact with Reality: Do’s and Don'ts

DO:

• Respond with warmth and kindness, but with firm reasoning.
• Remove extra stimulation from the environment (e.g. turn off the radio, step outside of a noisy classroom).
• Acknowledge your concerns and state that you can see they need help.
• Acknowledge their feelings or fears without supporting the misperceptions (e.g., "I understand you think someone is following you, and I understand that is scary. But I want you to know that I don't see anyone else, and I believe you're safe.")
• Acknowledge your difficulty in understanding them and ask for clarification or restatement.
• Focus on the "here and now." Ask for specific information about the student's awareness of time, place, and destination.

DON’T:

• Argue or try to convince them of the irrationality of their thinking as this commonly produces a stronger defense of the false perceptions. It can also increase distrust or invalidate their emotional experiences.
• Play along or placate them by pretending (e.g., "I totally hear the voices, too.")
• Encourage further discussion of the delusion processes.
• Demand, command or order.
• Expect customary emotional responses.

Anxiety is a normal response to a perceived danger or threat to one's well-being. For some students, the cause of their anxiety will be clear. For others, it may be difficult to pinpoint the source of stress. Regardless of the cause, the resulting symptoms are often similar and include rapid heart palpitations, chest pain or discomfort, dizziness, sweating, trembling or shaking, and cold or clammy hands. The student may also share that they have difficulty concentrating, always feel "on edge," have difficulty making decisions, or are too fearful to take action. In more rare cases, a student may experience a panic attack in which the physical and mental symptoms occur spontaneously and intensely in such a way that the student may fear they are dying. The following guidelines remain appropriate in most cases.

Students with Anxiety: Do’s and Don'ts

DO:

• Let the student discuss their feelings and thoughts. Often this alone relieves a great deal of pressure.
• Provide reassurance.
• Talk slowly and remain calm.
• Be clear and direct.
• Provide a safe and quiet environment until the symptoms subside.

DON’T:

• Minimize the perceived threat to which the student is reacting.
• Take responsibility for the student's emotional state.
• Overwhelm the student with information or ideas to "fix" their condition.
• Become anxious or overwhelmed.

Sexual assault is any forced, coerced, unwanted sexual contact.  While there are specific legal definitions of rape and sexual assault in the California Penal Code, it is best that we understand sexual violence as a broader continuum of unwanted non-mutual sexual activities that range from subtle to extremely violent. According to the California Coalition Against Sexual Assault, 1 in 5 women will be sexually assaulted while in college. Men are also victims of rape and sexual assault. In addition, transgender, non-binary, and other gender diverse individuals are at a high risk of being victims of sexual violence. It is important to respond sensitively to students who disclose having experienced a sexual assault or an attempted assault. The Bureau of Justices reports that most assaults go unreported in any formal way. If you are the person trusted with this information please consider the following guidelines. 

Students Who Have Been Sexually Assaulted: Do’s and Don'ts

DO:

• Inform the student if you are a designated reporter and follow the Title IX guidelines.
• Offer to connect them with the confidential campus advocate to discuss their options.
• Let them know you will have to share with the Title IX Office, who can support them in identifying resources and determining options for response. 
• Let the student disclose their account and discuss their feelings and thoughts. 
• Let them know you care about their well-being. 
• Validate any feelings disclosed as appropriate and normal under the circumstances. 

Ask the person if you can provide assistance in obtaining additional support and help such as the Campus Advocate, PGCC, Title IX, or UPD. (Asking and joining with them is important as they may already feel disempowered.

DON’T:

• Relate your own experience or story in any detail. 
• Pursue specific or additional details, except to clarify what you are hearing. 
• Offer judgments about what might have been done differently (e.g. victim-blaming). 
• Make decisions for the person.

Alcohol is one of the most widely used psychoactive substances. Those who abuse alcohol in college populations often abuse other drugs, both prescription and illicit. Patterns of use are affected by fads, access, and peer pressure. Currently, alcohol is the preferred drug on college campuses. The effects of alcohol are well known to most of us. Student alcohol abuse is most often identified by faculty when irresponsible or unpredictable behavior affects the learning situation (i.e., drunk and disorderly in class), or when a combination of the health and social impairments associated with alcohol abuse sabotages student performance. Because of the stigma and complexity of addiction, students may often appear defensive or in denial. Therefore, it is important to express your concern about the student in terms of specific changes in behavior or performance rather than specifically about alcohol or other drugs.

Students with Substance Abuse/Addition: Do’s and Don'ts

DO:

• Address 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.
• Label the person or accuse them of being “an addict” or “an alcoholic”
• Make allowances for the student's irresponsible behavior.
• Ignore signs of intoxication in the classroom.

Typically, these students complain about something other than their psychological difficulties. They are generally tense, anxious, mistrustful, isolated, and have few friends. They tend to interpret minor oversights as significant personal rejection, and often overreact to insignificant occurrences. They see themselves as the focal point of everyone's behavior, and everything that happens has special meaning to them. They are overly concerned with fairness and being treated equally. Feelings of worthlessness and inadequacy underlie most of their behavior, even though they may seem capable and bright.

— DO —

· Be specific and clear regarding the standards of behavior you expect.

· Express compassion without intimate friendship. Remember, suspicious students have trouble with closeness and warmth.

· Be firm, steady, punctual, and consistent.

· Be aware of personal boundaries and space when interacting.

· Let them know you are concerned about specific behaviors of concern.

— DON'T —

· Assure the student that you are her/his friend.(Acknowledge that you are a stranger, if appropriate, but even strangers can be concerned.)

· Be overly warm and nurturing.

· Flatter or participate in their games. You don't know their rules.

· Be humorous.

· Challenge or agree with any mistaken or illogical beliefs.

· Be ambiguous.

Typically, even the utmost time and energy given to these students is not enough. They often seek to control your time and unconsciously believe the amount of time received is a reflection of their worth. You may find yourself increasingly drained and feeling responsible for this student in a way that is beyond your normal involvement. It is helpful if the student can be connected with the proper sources of support on-campus and in the community in general.

— DO —

· Let students make their own decisions.

· Set firm and clear limits on your personal time and involvement.

· Offer referrals to other resources on- and off-campus.

— DON'T —

· Get trapped into giving advice, special conditions, etc.

· Avoid the student as an alternative to setting and enforcing limits.

People with an eating disorder think about food, weight, and body shape in distorted ways. More than five million Americans experience an eating disorder. According to the National Eating Disorders Association, the rate of eating disorders among college students has risen to 10 to 20 percent of women and four to 10 percent of men. Eating disorders can last from months to years. If left untreated, they disrupt social relationships, school, work, and daily activities. They cause psychological and medical problems that can be permanent and cause death. Warning signs of an eating disorder can include:

· Marked increase or decrease in weight that is not related to a medical condition.

· Abnormal eating habits (secretive binging, absence in dining halls, excessive calorie counting).

· Intense preoccupation with weight or body image such as frequent weighing of self or constant self-criticism.

· Compulsive or excessive exercising.

· Restrictive eating or purging.

· Emotional instability – moodiness, depression, loneliness, irritability.

— DO —

· Express concern for the student in a caring, supportive and non-judgmental manner.

· Identify her/his behavior that is of concern.

· Offer support and concern for the student's overall well-being. Be mindful that there may be other psychological issues which are influencing the eating issue.

· Address the eating issue if the student is open and willing, but remember most people with eating disorders are highly secretive and sensitive to such discussions.

· Maintain contact with the student after a referral is made.

— DON'T —

· Discuss concerns without privacy.

· Overly focus on body image or weight, as this may be taken as criticism.

· Argue with the student, minimize their concerns, or convince them they look fine e.g., "But you are beautiful just the way you are."

· Force the student to eat.