Tow Yee Yau, Ph.D. Director of Health & Wellness Counseling & Psychological Services (CAPS) And Student Wellness Center Division of Student Affairs, University

Tow Yee Yau, Ph.D. Director of Health & Wellness

Counseling & Psychological Services (CAPS) AndStudent Wellness Center

Division of Student Affairs, University of Cincinnati

October 16, 2014

Understand roles as faculty & staff in managing students who are disruptive and in distress

Describe different types of concerning student behaviors

Learn skills to use when talking with students in distress

Learn how and when to refer students for psychological assistance and learn about CAPS Services

Important Role

Not mental health professionals

Limited but important responsibility

Eyes and Ears

Today: (a) Increase understanding of problems

(b) Learn options for engaging students

(c) Learn to refer

(d) Review CAPS services

If feeling overwhelmed by student’s needs you might be outside of your professional role

Support Containment Helping within limits Safety first Discretion ≠ confidentiality Balancing limit setting and disciplinary

actions with support and caring

Set boundaries You’re not expected to resolve distress or

solve crises Consult and refer Self care

General Signs of Distress

These are non-specific; they do not necessarily signify a disorder

Appearance

BehaviorSkipping class, odd behavior, crying

spells, withdrawal

Mood changesArgumentative, irritable

aggressive/violent, depressed, anxious

Eating habitsIncrease/decrease, rapid weight changes

Sleep habitsIncrease/decrease, disruption, tiredness

Substance use/abuseFrequent use/need, intoxication,

hangovers

Disorderly behavior, disciplinary action

Other students’ having concerns

Deterioration in quality/quantity of work

Missed assignments or exams

Repeated absences from class or lab

Continual seeking of special consideration

Identifying and Handling High Risk Behaviors

Irrational, talking “crazy” Hard to follow, disorganized speech Rapid speech Suspicious attitude Fixed false beliefs (delusions) Visual or auditory hallucinations Deterioration of personal care

Significant weight loss, extreme thinness Vomiting Binging Excessive concern with food or dieting Excessive need to be thin Excessive exercise Food restriction Other students’ concerns

Loud, rapid speech Flight of ideas, pressured speech Argumentative, irritable Rapid mood swings, intense moods Excessive energy; can‘t stay still Little sleep Excessive spending or other risky or

indulgent behaviors (including sex) Extreme over-confidence

Signs of intoxication/ repeated intoxication◦ Change in sleeping and/or eating◦ Missing classes◦ Hung over◦ Dilated pupils, blood shot eyes◦ Pressuring peers to use◦ Money problems◦ Not fulfilling role/responsibilities◦ Denial of the problem

Verbal threats or talk about killing oneself

Talk about or looking for ways to procure weapons or other means of suicide; Collecting Pills

Writing about death, dying, or suicide when this is out of the ordinary

Giving things away

Self-cutting/Self-harm

If in doubt, consult! Follow your chain of command

Respond Immediately -Tell the person you’re there to help

Ask the student if there is someone you may call to provide help or support

Escort them to UC CAPS or call us for a consultation

If UC CAPS is closed, or if the risk is imminent, talk to the student about going to the hospital

Call UC Public Safety (513-556-1111) if you are concerned about immediate safety or for transport to the hospital

If in doubt, consult! Follow your chain of command

How to make referrals and talk with students about referrals

Before you initiate contact

Plan for your conversation with student in person

Think about open-ended questions

Have referral sources in mind

Remember to stay calm

As you engage the student:◦ Undivided attention◦ Put phones on silent

Consider physical communication◦ Good eye contact, open body language, respect personal

space, friendly face

Show empathy and care◦ Tone and rate of speech◦ Label emotions observed◦ Non-judgmental stance → normalize student experience

Use “listening skills”◦ Active listening◦ Paraphrasing and reflecting◦ Use the words/labels the student uses

Most Important!◦ Understand your scope of practice and limitations◦ Recognize/set limits and refer

“See Something”

“Say Something”

“Do Something”

◦ Source: Adapted & Modified from the University of California, Santa Barbara, Counseling & Psychological Services (CAPS)

What to expect:◦ Support, information, and guidance◦ Clarification of the problem◦ Clarification of your role◦ Problem-solving◦ Formulating a response◦ Possible on-going assistance◦ Confidentiality

Developmental problems or concerns Adjustment problems Relationship problems Trauma or violence Stalking or harassment Depression or anxiety Mood problems Thought problems Substance abuse Social service needs Risk of harm to self or others

“I know you’re feeling really bad and can’t see a solution right now, but help is available. You can talk to a counselor at Counseling and Psychological Services. They can help you figure out what you can do to make things better and give you support. I can give you their phone number.”

Normalize the need to get help Call with the student while they are in your

office—with permission Offer to let the student use your phone or

walk them over Ask them to follow up with you Think about and discuss how involved you

will be in their use of services at UC CAPS

Identifying and Handling Disruptive, Threatening, & High Risk Behaviors

Disruptive students interfere in UC’s learning environment with behavior that is:

reckless, disorderly, paranoid, aggressive, defiant, destructive, threatening, dangerous to self or dangerous to others

Refusal to comply with faulty/staff direction Challenges to authority Behavior that distracts the class from the subject

matter or discussion Loud, distracting or erratic behavior inappropriate to

the setting Answering cellular phones or allowing them to ring in

class Overt hostility, defiance, insults Computer and Social Media

Acknowledgement to Kyle Linnemann, Compass Counseling Center, UC Clermont

Verbal or physical threats to self or other

Verbal assault or abuse (cursing or foul language)

Sexually explicit language or behavior Physical intimidation Excessive e-mail, phone calls or demands for attention outside of class

Consider this situation at Florida Atlantic University (FAU):

http://www.youtube.com/watch?v=lxjlk6Lv4jg1.What behaviors do you see?2.What are some realistic options for the

teacher?3.How do you address the impact of this (or

any similar) behavior on other class members, during & after the incident?

Is there danger to self or others?

YES, or student No or not sure but I No, but student is

Needs immediate am concerned having academic or attention personal issues

Call 911 Call CAPS @ (513) 556-0648 Refer student to an appropriate campus resourceAfter speaking with police: CAPS 24/7 HelplineCall CAPS @ (513) 556-0648 @ (513) 556-0648 (With Effect On Aug. 25, 2014)



Needs immediate am concerned having academic or attention personal issues Call 911 Call CAPS @ (513) 556-0648 Refer student to an appropriate campus resourceAfter speaking with police: CAPS 24/7 HelplineCall CAPS @ (513) 556-0648 @ (513) 556-0648 (With Effect On Aug. 25, 2014)



















Needs immediate am concerned having academic or

attention personal issues

Call 911 Call CAPS @ (513) 556-0648 Refer student to an appropriate campus resourceAfter speaking with police: CAPS 24/7 HelplineCall CAPS @ (513) 556-0648 @ (513) 556-0648 Source: Adapted & Modified from University of California Santa Barbara, CAPS

Women’s Center LGBTQ office Campus Ministry Disability Services Office University Health Services Student Wellness Center International Students Services African American Cultural and Resource Center Academic Excellence and Support Services Center for Exploratory Studies Career Development Center Veterans One Stop Center

CAPS Services

Services: Confidential counseling for UC students – individual, group,

psychiatric services

Brief Screening and Consultation for UC students

Emergent Care services during business hours

24/7 Helpline

Consultation with faculty, staff, family, and friends concerned about a student

Workshops and presentations – stress management, communication, relationships and balancing demands, mindfulness and other life-enhancing topics

On-line mental health screenings

http://www.uc.edu/counseling.html

www.uc.edu/counseling

Faculty, staff, family, friends

for more advice on how to help students

225 Calhoun Street, Ste. 200 Ph: 513-556-0648 225 Calhoun Street, Ste. 200 Ph: 513-556-0648 Cincinnati, OH Cincinnati, OH 45219 Go online:45219 Go online:

www.uc.edu/counseling

Entrance To CAPS: Between Rue 21 & Body CentralEntrance To CAPS: Between Rue 21 & Body Central

Additional Questions, Comments,

or Thoughts?

Documents

Tow Yee Yau, Ph.D. Director of Health & Wellness Counseling & Psychological Services (CAPS) And Student Wellness Center Division of Student Affairs, University