- There is increased concern and discussion around the rise of mental health challenges at post-secondary institutions. Why do you think this is happening and how do you think college counsellors can influence student , campus, and community well-being?
WHY?
Technology shift
Economics (wealth gap, rising costs, student debt, poor job outlook)
Competing pressures for students
Changes to family structure and parenting styles
Lack of coping and resilience skills
Increased awareness of and reduced stigma around mental health
Psychopharmacology
Shift in function of college/university
Geopolitical destabilization
What we as counsellors can do?
Lead by example
Health of the team (immune system analogy)
Share information (introspective consciousness)
Support, empower, and train staff / faculty (e.g., boundaries, not fixing)
Outreach to programs (speak their language, e.g., optimal performance, flow)
Innovate support and empowerment for students
Groups (e.g., leading skills, branching points)
Teach them coping and resilience skills (e.g., “Mind Hacks”)
Enlist students as mental health point-persons
Encourage clients, support them in helping others
Frame efforts in context of the Student Mental Health and Well-Being Strategy
- Take 5-minutes to highlight the key personal qualities, knowledge, skills, and experiences that make you a preferred candidate for this position
I have many years experience as a student in higher education, and have overcome struggles similar to those faced by students
I completed practicum and clinic years at UBC and Douglas College.
I care about students and can relate well with them.
I continually seek professional development.
I grew up in the fraser valley
I am self-reflective.
I am curious.
I am compassionate.
I consider myself a student.
I have been successful in school.
I have been through personal counselling and therapy.
I have been through career counselling.
I have changed careers. I have studied a range of subjects.
- Which counselling theories have influenced, and are represented in , your counselling approach / method?
Attachment Behavioural / CBT / DBT Trauma-informed theory Psychodynamic Strengths-based, solution focused Cultural Competence Model
Paradoxical theory of change - radical acceptance - nonattachment
- Clinical Example: Describe in a recent example how you counselled a student presenting with depression and suicidal ideation. Include in your example, the work you did with the student, services you engaged, and what you learned in the process?
Suicide assessment including risk and protective factors.
Normalize suicidal thoughts, validated experience
Safety plan
Attempt to determine what prompted suicidal thoughts
Attempted to remove prompting events
Anxiety BC
Services: crisis line
- Many students accessing our services have been given one or more mental health diagnosis from a professional outside the college. Where do you see diagnostics and the DSM fitting into your therapeutic practice?
The DSM and related diagnostic instruments are important and powerful tools that can help determine appropriate treatment. I continue to study the DSM.
In my therapeutic practice,
Care should be taken with an existing diagnosis. What does it mean to the person who has it? Did it help them? Hinder them? Confuse them? Stigmatize them?
If there is any stigma, I would work to find ways of destigmatizing that. If there is any indication of overpathologizing on the part of the client, I would look to reduce that.
DSM can guide evidence-based treatment.
What is the nation upon which VIU sits?
Situated on the traditional territory of the Coast Salish Peoples. Snuneymuxw Territory (Snoo-NAI-muk / Snuh-NAY-mow)
Read more at: http://www.first-nations.info/pronunciation-guide-nations-british-columbia.html
- Scenario: Describe how you might work with an Indigenous student who has experienced a recent death and the considerations you would have in approaching this work?
Investigate the possibility of having a support person attend session
Investigate possibility for community based healing
Allocate extra time for story telling
Consider the use of indigenous healing model :
Mental: Connection, healing, freedom
Spiritual: Elders, identity, traditions, smudges
Emotional: Connecting with others, understanding trauma
Physical: Stories, voice, grounding meditation
Wisdom, Love, Truth, Respect, Bravery, Humility, Honesty
What are some VIU services?
Disability Access Services International Student Sevices Aboriginal Education Office Aboriginal Gathering Place (Aboriginal Student Services; Elders in Residence, Smudges, Meals) Advising Recreation Centre for Experiential Learning Student Success Services Success Coach Writing / Math Centres Financial Aid Student Health Clinic Human Rights
- Please describe some of the primary strategies your would use with a student presenting with moderately generalized anxiety?
Assess environmental factors, assess behavioral factors. Check sleep patterns, exercise, etc.
Validate, normalize, and depathologize experience of anxiety symptoms.
Psychoeducation around stress response, self-regulation, distress tolerance, basic CBT triangle, effective worrying
Introduce and practice mindfulness skills, relaxation skills
Look into making changes in the environment to increase sleep, social connection, exercise
- In an initial counselling session, a student reveals that they have been spoken to in a ‘sexually suggestive and offensive manner’ by an instructor on a number of occasions. The student presents this as ‘no big deal’ but their friends are urging them to do something about it. What are your considerations and approach? What specific actions do you take, and why?
Explore with the student what their options are, what not saying something would mean, what saying something would mean
Provide emotional support
Validate their experience, explore the option of reporting it with them
Explore what kind of support they have
Advocate for the student
There is no immediate threat of serious harm, abuse of a vulnerable person
Seek supervision
- Scenario: Describe how you might work with an Indigenous student who has experienced a recent death and the considerations you would have in approaching this work?
Investigate the possibility of having a support person attend session
Investigate possibility for community based healing
Allocate extra time for story telling
Consider the use of indigenous healing model :
Mental: Connection, healing, freedom
Spiritual: Elders, identity, traditions, smudges
Emotional: Connecting with others, understanding trauma
Physical: Stories, voice, grounding meditation
Wisdom, Love, Truth, Respect, Bravery, Humility, Honesty
Not probing or digging. Rather, addressing things as they come up. Working to establish trust and safety in the relationship.
- How would colleagues / coworkers describe the way you contribute towards a cooperative and positive workplace? How would your colleagues / coworkers describe your approach to managing conflict?
I support team members. I communicate proactively. I encourage colleagues. I check in on colleagues.
I resolve conflict with conscientious, direct, preferably face to face communication. I rely on the feedback model to ensure understanding. If a conflict escalated, I would follow appropriate channels, reporting to a supervisor.
What are some emotion regulation skills?
Opposite action
Check the facts - does my reaction match the situation
Pay attention to positive events
What are some mindfulness skills?
Gratitude Body scan Guided meditations Object oriented mediation Eating meditation Moving meditation
Gratitude
Body scan - short version, long version
Progressive muscle relaxation
Meditation - walking, open awareness, visualization, mountain meditation
Diaphramatic breathing
5,4,3,2,1 - 5 things you see, 4 you hear, 3 you smell, 2 you touch, 1 you taste
Raisin exercise
Mindful seeing / nonjudgmental seeing
Mindful listening: 1 stressful thing, 1 looking forward to, thoughts feelings, sensations
Triangle of awareness
Personal boundaries and stress response
Back body meditation
Object oriented meditation
Observe thoughts for 15 minutes - label as thought, i am not my thoughts,
Bell dissipation exercise
Depression: Sorting thoughts, sensations, emotions into mental boxes
Attitudes or intentions: beginners mind, patience, letting go of judgment, compassion, equanimity
Acknowledging cravings like passing thoughts
Wheel of awareness: 5 senses, interoceptive sense, mental activities, interconnectedness
ACT: Cognitive difusion: I am not my thoughts, attachment to thoughts, acceptance, presence, values, actions
What are evidence based treatments for depression, anxiety, PTSD, and substance use?
Depression: Problem solving, social skills and assertiveness, increase pleasant activities, problem/solution focus,
Panic, Phobias, OCD: exposure, applied relaxation, problem solving, cognitive restructuring, meta-cognitive awareness, ACT, mindfulness: present moment focus, values guided behaviour
PTSD: Imaginal exposure: psychoeducation, breathing, relaxation, recounting trauma aloud; invivo exposure; addressing maladaptive thinking patterns; strategies for perspective shift; breathing retraining, muscle relaxation, negative-thought stopping, and restructuring/challenging maladaptive cognitions.
Substance Use: Pros and cons, coping strategies, self-monitoring, motivational interviewing,
Which assessments might you use in session?
Patient Health Questionnaire - 9 for depression
Generalized Anxiety Disorder - 7 for anxiety
RIASEC
Strong Interest Inventory
Myers Briggs Type Indicator
What are some important basic skills?
Normalize experience Address shame Build safety Skills training / education Values clarification Motivational interviewing Breathing
Talk about a strengths based approach?
Emphasize that defenses are adaptive to a point, and that perhaps instead of trying to change the defence, work on cultivating its opposite
- Have members brainstorm resources in the practical, physical, psychological, social,
- Have everyone list every resource, thing they have going for them, and list everything they have going against them. Choose one list to focus on in the morning, and one list to read once a month to check up on.
- Talk about shame, worthiness, belonging (Brene Brown)
Tell us about a trauma-informed approach
This means I prioritize your safety and recovery from trauma, I focus on your strengths, and I collaborate with you to develop coping skills and to build resilience.
Talk about a strengths based approach?
Emphasize that defenses are adaptive to a point, and that perhaps instead of trying to change the defence, work on cultivating its opposite
- Have members brainstorm resources in the practical, physical, psychological, social,
- Have everyone list every resource, thing they have going for them, and list everything they have going against them. Choose one list to focus on in the morning, and one list to read once a month to check up on.
- Talk about shame, worthiness, belonging (Brene Brown)
How would you treat self-harm?
DBT model - ending parasuicidal behaviours are a priority. Validate experience. Approach self-harm as a coping strategy. Acknowledge client is using it to solve a problem. Reframe self-harm: when you feel like self-harming, there is a problem to be solved. Distress tolerance. Commitment. Mindfulness Skills. Emotion regulation skills. Remove precipitating events. Chain analyses on what leads up to self-harm. Pros and cons. Irreverance.
Referral to treatment.
How would you treat trauma?
Build safety. Body awareness, body as resource. Anchoring, safe place. Exposure - invivo, informal, imaginal. Writing trauma story.
What are steps you would take to asses risk in a crisis?
Risk assessment:
IS PATH WARM History of attempts Current intent Means or method available Any lethal means available Plan and preparation in place Precautions against discovery Substance use Isolated, alone Prompting events match previous prompting events Sudden loss Clinical change: pos or neg Indifferent to therapy Hopelessness Depression Anxiety / Panic Insomnia Anhedonia (inability to feel pleasure) Concentration problems Command voices Chronic pain Impulsivity increase
What would you assess for in crisis for protective factors?
Hope for future Self-efficacy in problem area Attachment to life Responsibility to others Attached to therapist Will contact therapist Protective social network Fear of suicide, death No method available Fear of disapproval / immoral act High spirituality Commitment to live Willing to follow crisis plan
