Faculty Guide: Assisting The Emotionally Distressed Student

Faculty/Staff Role

As a faculty or staff member interacting daily with students, you are in an excellent position to recognize behavioral changes that characterize the emotionally troubled student. A student’s behavior, especially if it is inconsistent with your previous observations, could well constitute an attempt to draw attention to her/his plight as “a cry for help.”

Your ability to recognize the signs of emotional distress, and your courage to acknowledge your concerns directly to the student, often are noted by students as the most significant factor in their successful problem resolution. Often times our own feelings (i.e. uneasiness, anxiety, fear) can be excellent indicators that something is not quite right.

If you ever have these types of feelings and are not quite sure what to do, this guide can be helpful. You are also welcome to call Counseling and Psychological Services (CAPS) for a consultation whenever you are unsure of a situation.

Distinguishing between distressed, disruptive, and dangerous student behavior

Distressed: Behavior that causes us to feel alarmed, upset, or worried (most common).

Disruptive: Behavior that interferes with or interrupts the education 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 doesn't feel right, it's usually not right! (Trust your gut.)

Signs of Distress Include:

• Inability to concentrate
• Confusion
• Persistent worrying
• Social isolation
• Increased irritability
• Bizarre behavior
• Missed classes / assignments
• Procrastination
• Restlessness
• Disheveled appearance
• Mood swings
• Indecisiveness
• Depression

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

1. Request to see the student in private.1 This may help minimize the embarrassment and defensiveness.
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 her/his 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 the burden becomes too heavy, however, you may refer to CAPS and we will provide direct intervention, and / or refer to an appropriate facility.

¹How to accomplish this will probably vary by the circumstances, and by the nature of the student's distress. Although it is beyond the scope of this handbook to go into depth on how to do this for all situations, this is discussed in a little more depth under the specific categories of student distress.

Consultation is Available

If you are unsure of how to handle a specific student, we encourage you to consult with one of the Counseling Psychologists on our staff. Call us at 562.985.4001 , inform the receptionist who you are (faculty, staff, administrator) and ask to speak with one of our Counseling Psychologists. A brief consultation may help you sort out the relevant issues, explore alternative approaches and suggest new ways to cope with the anxiety or stress the student may be experiencing. Overall, when dealing with most students in crisis situations, conveying your concern and willingness to help in any way you can (including referral) is probably the most important thing you can do. Your support, encouragement (including referral), and reassurance will be particularly valuable to a student in crisis.

When you have determined that a referral to Counseling and Psychological Services (CAPS) is appropriate, you can be most helpful by clearly and concisely telling the student why you think counseling would be helpful. You might also tell the student a few facts about our services. For instance, all services are free to regularly enrolled students, and professional counselors and psychologists provide counseling Monday through Friday from 8 AM to 5 PM All discussions are confidential except when the student presents a danger to self, others, or when certain kinds of abuse is involved. Early intervention is preferable to crisis intervention. To ensure prompt attention, it is best to call in advance for an appointment. Having the student make the call increases her/his responsibility and commitment to come for counseling; however, there may be times, especially if the student is in crisis, when it is advantageous for you to call and make the appointment and/or accompany the student to our office. We will schedule the student with one of our staff as quickly as possible. Please do not ask for a specific counseling psychologist, as we have a rotating on-duty crisis counselor available.

— DO —

• Have the student call 562.985.4001 .
• Inform the receptionist who you are (student, faculty, staff, administrator).
• Identify the need for an assessment (indicate if it is urgent).
• Ask to speak with the on-duty (OD) crisis counselor.

In some situations, it may be imperative to request the student be seen as soon as possible. If a student's situation is urgent, she/he will probably have concerns involving:

•  Suicide/Fear of losing control and possibly harming/hurting someone
•  Sexual assault
•  Physical assault or witness to an assault or accident
•  Fear for her/his life or for the life of someone they know
•  Abuse/Recent death of a friend or family member

— DO —

• Call or have the student call 562.985.4001 .
• Inform the receptionist who you are (student, faculty, staff, administrator).
• Identify the need for an urgent assessment (indicate if it is urgent) and
• ask to speak with the on-duty (OD) crisis counselor.
• The OD will make a professional assessment of how quickly the student needs to be seen and appropriate action will be taken.

• When you believe that you or another person is in immediate danger.
• When you believe that the student is about to harm her/himself.
• When you believe that the student is out of control and is disrupting the classroom.

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.

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, but for others it is difficult to pinpoint the source of stress. Regardless of the cause, the resulting symptoms are experienced as similar and include rapid heart palpitations; chest pain or discomfort; dizziness; sweating; trembling or shaking; and cold, clammy hands. The student may also complain of difficulty concentrating, always being "on the edge," having difficulty making decisions, or being too fearful to take action. In more rare cases, a student may experience a panic attack in which the physical symptoms occur spontaneously and intensely in such a way that the student may fear she/he is dying. The following guidelines remain appropriate in most cases.

— DO —

• Let the student discuss her/his feelings and thoughts.
• Often this alone relieves a great deal of pressure.
• Provide reassurance.
• Be clear and directive.
• 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" his/her condition.

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 depression in their college careers. It is when the depressive symptoms become so extreme, or are so enduring, that they begin to interfere with the student's ability to function in school, work, or social environments, that the student will come to your attention and be in need of assistance.Due to the opportunities that faculty and staff have to observe and interact with students, they are often the first to recognize that a student is in distress. Look for a pattern of those indicators.

• Tearfulness / general emotionality
• Dependency (a student who makes excessive requests for your time)
• Markedly diminished performance
• Lack of energy / motivation
• Infrequent class attendance
• Increased anxiety/test anxiety/performance anxiety
• Irritability
• Deterioration in personal hygiene
• Alcohol or drug use
• Students experiencing depression often respond well to a small amount of attention for a short period of time. Early intervention increases the chances of the student's rapid return to optimal performance.

— DO —

• Let the student know you've noticed that she/he appears to be feeling down and you would like to help.
• Reach out and encourage the student to discuss how she/he is feeling.
• Offer options to further investigate and manage the symptoms of the depression (e.g., referral to CAPS).

— DON'T —

• Minimize the student's feelings, e.g., "Don't worry. Everything will be better tomorrow."
• Bombard the student with "fix it" solutions or advice.
• Chastise the student for poor or incomplete work.
• Be afraid to ask whether the student is suicidal if you think she/he may be.
  (See next section, e.g., "Have you thought of harming yourself?")

Sexual harassment involves unwelcome and unwanted sexual attention and/or advances, requests for sexual favors, and other inappropriate verbal or physical conduct. It is usually found in the context of a relationship of unequal power, rank or status. It does not matter that the person's intention was not to harass. It is the effect it has that counts. As long as the conduct interferes with a student's academic performance, or creates an intimidating, hostile or offensive learning environment, it is considered sexual harassment.

Sexual harassment usually is not an isolated one-time only case but a repeated pattern of behavior that may include:

• Comments about one's body or clothing
• Questions about one's sexual behavior
• Demeaning references to one's gender
• Sexually oriented jokes
• Conversations filled with innuendoes and double meanings
• Displaying of sexually suggestive pictures or objects
• Repeated non-reciprocated demands for dates or sex

Sexual harassment of students is covered by the California Education Code, section 89535. Common reactions by students who have been harassed is to doubt their perceptions, wonder if it was a joke, or wonder if, in some way, they have brought it on themselves. A student may begin to participate less in the classroom, drop or avoid classes, or even change majors.

— DO —

• Separate your personal biases from your professional role.
• Listen carefully to the student, and assure the student you understand.
• Encourage the student to keep a log or find a witness.
• Help the student seek informal advice through a department chair, supervisor or advisor. If unresolved, help the student approach a dean or vice president on campus.
• Inform the student that informal and formal complaints can begin in the Affirmative Action Office (BH-238).

— DON'T —

• Ignore the situation:
• Taking no action reinforces the student's already shaky perception that she/he has been wronged. Ignoring the issue can also have legal implications.
• Overreact.
  (Listen, support, and guide the student to appropriate channels.)

Suicide is the second leading cause of death among college students. It is important to view all suicidal comments as serious and make appropriate referrals. High risk indicators include feelings of hopelessness, helplessness and futility; a severe loss or threat of loss; detailed suicide plan; a history of a previous attempt; history of alcohol or drug abuse; feeling of alienation and isolation; and preoccupation with death.

— DO —

• Take the student seriously--80 % of suicides give warning of their intent.
• Be direct--ask if the student is suicidal, if she/he has a plan, and if she/he has the means to carry out that plan. Exploring this with the student may actually decrease the impulse to commit suicide.
• Be available to listen, but refer the student to Counseling and Psychological Services or a community hotline for additional help. Attempt to make sure the student actually gets some help.
• Take care of yourself. Suicide intervention is demanding and draining work.

— DON'T —

• Minimize the situation.
• Be afraid of planting the idea of suicide in an already depressed mind by inquiring about it (they will very likely feel relieved that someone has suspected).
• Ignore your limitations.

Alcohol is the most widely used psychoactive drug. Alcohol abusers in college populations abuse other drugs, both prescription and illicit. Patterns of use are affected by fads and peer pressure. 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 class2), or when a combination of the 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.

²See The Verbally Aggressive Student section

— DO —

• Confront the student with her/his 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.

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 —

• Express compassion without intimate friendship. Remember, suspicious students have trouble with closeness and warmth.
• Be firm, steady, punctual, and consistent.
• Be specific and clear regarding the standards of behavior you expect.

— 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 cute or humorous.
• Challenge or agree with any mistaken or illogical beliefs.
• Be ambiguous.

These 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 student may elicit alarm or fear from others, they are generally not dangerous and are more frightened and overwhelmed by you than you are by them. If you cannot make sense of their conversation, they may be in trouble.

— DO —

• Respond with warmth and kindness, but with firm reasoning.
• Remove extra stimulation from the environment (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, but I don't see anyone 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.
• Speak to their healthy side, which they have. It's OK to laugh and joke when appropriate.

— 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.
• Play along, e.g., "Oh yeah, I hear the voices (or see the devil)." Encourage further discussion of the delusion processes.
• Demand, command or order.
• Expect customary emotional responses.

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 become this student's way of gaining power and control in an otherwise out-of-control experience. It is important to remember that the student is generally not angry at you personally, but is angry at her/his world and you are the object of pent-up frustrations. This behavior is often associated with the use of alcohol and other drugs.

— DO —

• Acknowledge the student's anger and frustration, e.g., "I hear how angry you are."
• Rephrase what the student is saying and identify her/his 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.3
• Allow student to tell you what is upsetting her/him.
• Be directive 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 deal with the area issues when she/he becomes calm, 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.
• ³Do 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.

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. 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.

— 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 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.
• Do not see the person alone if you fear for your safety.

— DON'T —

• Ignore warning signs that the person is about to explode, e.g., yelling, screaming, clenched fists, threats.
• Threaten or corner student.
• Touch the student.

Counseling and Psychological Services (CAPS) helps students meet the personal challenges associated with identifying and accomplishing academic, career, and life goals. Our services include short-term counseling for individuals, group counseling, career development counseling, referral services, psychoeducational workshops, and crisis intervention. Counseling is provided by mental health professionals and by advanced doctoral psychology interns under the supervision of licensed psychologists. CAPS welcomes students of all backgrounds, value systems, and lifestyles.

CAPS Directory

Call Counseling and Psychological Services for a more extensive referral list.

Our sincere thanks to the Career Development and Counseling Center at California State University, Fullerton, and the California Organization of Counseling Center Directors in Higher Education whose combined efforts we have liberally borrowed to include in this handbook.
CSULB, in compliance with the Civil Rights Act of 1964 (Title VI and Title VII), Title IX of the Education Amendments of 1972, the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and the Americans with Disabilities Act of 1990 et al, does not discriminate on the basis of race, color, national origin, ethnicity, religion, sex, handicap, age, or Vietnam era veteran status in any of its policies, procedures or practices; nor does CSULB discriminate on the basis of marital status or sexual orientation. The nondiscrimination policy covers all CSULB programs and activities, including employment. In addition to meeting fully its obligations of nondiscrimination under federal and state law, CSULB is committed to creating a community in which a diverse population can live and work in an atmosphere of tolerance, civility and respect for the rights and sensibilities of each individual, without regard to economics status, ethnic background, political views, sexual orientation, or other personal characteristics or beliefs.

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

1. Request to see the student in private.1 This may help minimize the embarrassment and defensiveness.
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 her/his 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 the burden becomes too heavy, however, you may refer to CAPS and we will provide direct intervention, and / or refer to an appropriate facility.

¹How to accomplish this will probably vary by the circumstances, and by the nature of the student's distress. Although it is beyond the scope of this handbook to go into depth on how to do this for all situations, this is discussed in a little more depth under the specific categories of student distress.

• When you believe that you or another person is in immediate danger.
• When you believe that the student is about to harm her/himself.
• When you believe that the student is out of control and is disrupting the classroom.