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Stacking the Deck in Everyone’s Favor: Best Practices for Advising Students with Depression
Julie E. Preece, Ph.D.Scott D. Hosford, Ph.D.Ron Chapman, Ph.D.Michael Brooks, Ph.D., J.D.Brigham Young University
“Caveats”• Session’s Purpose: To enhance awareness of best advisement
practices; not prepare psychological service providers.
• Psychological disorders may vary in their signs and symptoms from person-to-person.
• Recognition, Reconnaissance, Respect, and Referral (4R’s) help a majority of students experiencing psychological concerns.
• In the United States, by law, students with disorders that rise to the level of a disability may receive reasonable accommodations that do not violate the essential elements of the academic programs.
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Session Walk About Overview
• Mental health issues among college age students
• Data: Impact of mental health issues on the work of advisors and faculty on college campuses
• Signs and symptoms of depression
• Video’s
• Cases, discussions, and recommendations:• Accommodations in the advisement office and classroom• Resources for advisement• Concluding comments & questions
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Studies on Depression
Almost 50% of college students will experience depression during their years of college (Kadison & DeGermino, 2004)
10% have had passive suicidal ideation within past year
1% have had a suicide attempt within the past year (National Research Consortium, 2006)
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Have You Ever Had a Student Confide in You Thoughts About Suicide?
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Have You Ever Had a Student Confide in You Thoughts About or Experiences with Other Self Destructive Behaviors?
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Depression
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Depression Symptoms
• Depressed mood• feel sad or empty• appear tearful to others • in children and adolescents—irritability
Depression Symptoms
• Depressed mood•Loss of pleasure/interest in activities
• most of the day• nearly everyday
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Depression Symptoms• Depressed mood• Lack of pleasure in activities• Significant weight loss when not dieting (or weight gain)• Diminished ability to think or concentrate, or indecisiveness• Problems falling/staying asleep or early morning awakening• Being slow and sluggish• Fatigue• Feelings of worthlessness or guilt• Recurrent thoughts of death
• thoughts of killing or harming self • with or without a plan
• Medication may affect ability to focus, concentrate and/or memorize
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The SIGE-CAPSS Mnemonic
SIGES Disrupted Sleep
I Loss of Interest
G Feelings of Guilt
E Decreased Energy
CAPSSC Decreased ConcentrationA Decreased AppetiteP Slowing Down PhysicallyS Lowered Sexual InterestS Suicidal Ideation
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Gender Differences—Relative Frequency
34%
26%
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FatigueIrritabilityLoss of interest in work or hobbiesSleep disturbances.
SadnessWorthlessness & Excessive guilt
Gender Differences—Presenting Complaints
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Neurovegetative symptomsAlcoholism & substance abuse
Increased appetite & weight gainAnxiety and somatic symptomsComorbidity – eating disorders and anxiety
Gender Differences—Other Expressions of Depressive Symptoms
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• What do you see happening between the advisor and the student?• What is the advisor attending to?• Where is the student’s attention?• What would you do if this was your session/visit?
Depression
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• What do you see happening between the advisor and the student?• What is the advisor attending to?• Where is the student’s attention?• What would you do if this student was in your office?• What resources could/would you call on?• What issues need to be addressed?• How have you worked with students with this issue?• What concerns do you have contemplating working with students
with this concern?
Depression
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• Where Does Depression Fit?
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How Might this Look in the Classroom / Your Office?
Observations
• Poor sleep habits• Non-attendance• Incomplete assignments• Lack of expressed interest• Distracting activities
• Gaming• Internet surfing• Videos
• Negativity
Assumptions• Lack of discipline• Lack of clear goals• Poorly prepared• Immature• Poor study habits• Poor study skills• Poor work ethic• Irresponsible
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Signs in the Advisement Session or Classroom
• Difficulty getting up in the morning and attending early morning classes or appointments (some may have problems attending before noon)
• Problems with concentrating in class, or in an advisement session, or information the teacher/advisor is giving him/her
• Problems with memorizing information in a class or homework, forgetting appointments even with you
• Loss of desire to study or attend class or your office
• With an increase in absences from classes or missed assignments, the more difficult it may be to attend class or advisement session
• Medication for depression may also interfere with focus, concentration and memorization
• Thoughts of ending life or hurting oneself (cutting or burning); Such thoughts may be disclosed to a trusted teacher or advisor
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Helping Students with Depression
1. Check your attitudes towards depression2. Learn signs and symptoms of depression3. Have a list of resources—know professionals by name4. Network with counseling center on or off campus5.Network with Disability Services, International, Multicultural
Student Services6. Have a list of after-hours resources on and off campus7.Have a professional on campus that you can trust to
consult with8.Have a plan in case you need support NOW9.Practice the plan often with your colleagues
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In Advisement SessionsBe Willing To . . .• Empathize• Paraphrase• Restate• Ask direct questions• Refer• Be willing to call or walk with the student to set up an
appointment• Follow-up visits• Staff the case• Know your resources
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Know Your Resources• Add/drop/discontinuance policies
• Absence policies in your department
• Your department personalities
• Counseling Services on/off campus: Policies and phone number• Liaison name and phone
number/email• Emergency system• Refer to an individual if possible
• Disability Services: Procedure, phone number• Liaison name and phone number• Know intake system—who to
connect with
• College Heath Services/ER or Instacare
• International Student Services or Multicultural Student Services• Know contact information—who to
talk with • Know professionals in the
community
• Disruptive Student Committee on campus
• Discontinuance Office
• College Security/Campus Police
• Security procedure on campus and in your department
• Back up—do you have a system already in place?
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Possible Accommodations for Students with Depression
• Sleep Problems? Schedule classes or appointments later in the day
• Problems with focus and concentration? Extended time for assignments and/or test takingNote takers or copies of other students’ notesTaped lecturesReduced course load
• Time out to enter a treatment facility? Excused absencesLate workWithdrawal from coursesInformed decisions regarding college policies
• Academic training e.g., time management, test taking strategies, memorization skills etc.
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More Possible Accommodations for Individuals with Depression
• Letters to teachers• Additional time for exams/quizzes (1.5 x time limit)• Volunteer note takers• Course load reduction• Deadline extensions for assignments (used very sparingly; 3-5
days max)• Leniency with absences (used sparingly)• Flexibility with exam dates (used sparingly)
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