If you know a student in distress - whether a student in your class, a roommate, teammate, or friend - you may be able to help. The following information and tips are offered to help you be a good helper.
Family problems or other interpersonal difficulties (for example: conflicts, illness or death of someone important to the student, divorce, abuse)
Problems with a romantic partner or spouse (for example: sexual problems, communication problems, abuse, coping with a partner in distress for any of the reasons listed here)
Financial difficulties (for example: juggling work and school, providing for dependents, economic hardship in family/country of origin)
Significant changes in circumstance (for example: adjusting to a new place, new people, and/or a new life situation)
Academic or work difficulties (for example: trouble getting to work or class, poor grades or performance reviews, over-placement, interpersonal conflicts with authorities or peers)
Over-commitment, performance anxiety
Grief or loss
A traumatic event or situation (See our handout: "Coping with a Sudden Terrible Event")
Problems with alcohol or drugs
COMMON SIGNS AND SYMPTOMS OF DISTRESS
Significant changes in eating, sleeping, grooming, spending, or other daily activities
Significant changes in performance or involvement in academics, sports, extracurriculars, or social activities
Acting significantly withdrawn, volatile, tearful, or odd
Acting out of character, differently than usual
Talking explicitly about hopelessness or suicide
Difficulty concentrating, difficulty carrying on normal conversation
Excessive dependence on others for company or support
Feeling out of control of one's emotions, thoughts, or behaviors
HOW TO HELP SOMEONE GET HELP
Let the student know why you are concerned about them in terms of the student's own worries or needs. For example:
"I often hear you mention your worries about X, and I think that's something you are right to be concerned about."
"It seems from our recent conversations that this is something you really need to talk about."
"When you mention that you are thinking of suicide, I know it concerns you and it concerns me, too."
Let the student know what they will gain from meeting with a therapist. For example:
"I think you will find it very helpful to discuss all this with someone impartial, someone who can help you sort out your thoughts and feelings."
"This is just the thing to consult with a therapist about - a therapist will know more about this than either one of us."
"You and I just don't have enough time together to address these concerns the way they deserve, and I think you'd get a lot out of talking them over with someone at greater length."
Avoid labeling the student or their behavior. For example, don't say "You're depressed," or "You have an eating disorder," or "You should be in therapy." Labeling, whether accurate or inaccurate, can frighten or discourage a student from getting help. And remember that different families and cultures have different ways of expressing their distress; what looks unusual to you may be "normal" for the other person.
Reassure the student that making a referral isn't a rejection. For example:
"Even though you will be talking with your therapist about this, I want us to keep in touch about how things are going for you."
"Come back and let me know how your meeting with the therapist goes -- you don't have to tell me details, but I'd like to know that you've found someone helpful to speak with."
Offer to keep the student company while they call for an appointment, or to call with the student while they are sitting there with you. Offer to come with the student to their first appointment. Suggest that the student learn more before making an appointment and refer the student to our website, which has information about all our services as well as links to helpful websites on a variety of topics.
Let the student know what to expect if they come talk with a clinician. For example:
Clinicians are here to help all AU students make the most of their university experience - consulting a therapist doesn't mean you are "crazy" or "sick."
The student can either call or stop by the Counseling Center to make a first appointment or "initial consultation," which can usually be scheduled within a few days - if it's an urgent situation, the student should say so, and they will be seen sooner.
In a first appointment, the student will discuss with the clinician the situation or feelings that are troubling them, and what sort of assistance the student might find helpful.
The clinician and student will work together to locate and access whatever the student needs, whether that is a brief consultation, ongoing counseling, a specialized treatment program, a support group, psychiatric medication, etc.
For more information on the nature and limits of confidentiality, call the Counseling Center at x3500.
Follow up with the student. For example:
Ask the student to let you know how their appointment went (you don't need to know details, just that they found someone helpful to talk with).
Remember that the student's contact with the Counseling Center is confidential, so the student's clinician will not be able to give you any information without the student's explicit permission.
If you hear that the student's appointment with a clinician wasn't helpful, invite the student to make an appointment with a different clinician, or to bring their concerns to the attention of the Director so a better match can be made.
IF A STUDENT IS TALKING ABOUT SUICIDE, VIOLENCE, OR IS BEHAVING IN SELF-HARMING OR VIOLENT WAYS
It's never a good idea to ignore a student's comments or behavior regarding suicide or violence. You should never assume that these will pass, that the student is only kidding, or that the student just "wants attention." If you are not comfortable bringing your concerns to the student or you feel the student is not responding, bring your concerns to a professional helper in your community (the Office of the Dean of Students, your Resident Director or Resident Assistant, a Counseling Center clinician, a professor, etc.). Similarly, it is never a good idea to assume that all a student needs is your sympathy and support. A student who talks or behaves in suicidal or violent ways certainly needs your sympathy and support, but that may not be all they need. Students who are unable to control their feelings or impulses may also require counseling and/or medication.
IF YOU ARE NOT SURE WHAT TO DO
If you are wondering whether or how to bring up the issue of a referral with a distressed student, or you have already suggested it but the student is not responding, feel free to call and consult confidentially with a Counseling Center clinician, x3500.
A FEW WORDS ABOUT BEING A GOOD HELPER
Monitor your own reactions/feelings. It can be stressful to interact with someone in distress. In addition to feeling that you want to help, you may find yourself feeling helplessness, fear, frustration or anger, empathy (feeling the other person's sadness, anger, hopelessness, etc.), impatience, or "compassion fatigue." Helpers need support, too; call the Counseling Center, x3500, to arrange for a confidential consultation with a clinician.
Recognize your limits. It is not your responsibility to solve the problem for the other person, but rather to try to help them solve it or help them get help. Remember that although you may be a special and irreplaceable helper for this person in some ways, there are also other caring helpers available who may offer forms of help that you cannot.
Don't give someone in distress an absolute promise to keep a secret. It is not unusual for someone in distress to be concerned about their privacy and self-control, and to ask you to promise to keep what they tell you a secret. The problem is that if you agree to such a promise, you may put yourself in a terrible dilemma: it may be that in order to seek out essential - perhaps life-saving - support for you or the student, you will have to betray that promise. Promise the student that you are a trustworthy person, who cares about their well-being and their autonomy, and won't divulge a confidence unless you have no other choice. Promise them that if they want to share something very personal with you, you will do everything you can to safeguard it and help them deal with whatever it is. Promise them that you won't divulge their secret to anyone without talking it over with the student first. Promise them that you value their confidence in you and won't use anything they tell you to hurt them. But try not to give an absolute promise to keep a secret.
A FEW WORDS ABOUT "ENABLING"
Be aware that your helping behavior may either positively or negatively "enable" a distressed student. Positive enabling happens when you respect a student's views and struggles, while working to help the student solve their problems and get the help they need. Negative enabling happens when you allow or accept a student's problematic perceptions or behaviors and fail to question or challenge them, with the result that the student doesn't get the help they need. With either kind of "enabling," your efforts may not change the way the student is seeing things or result in the student getting help -- but negative enabling will almost certainly prolong the student's difficulties. Here are some common situations and examples of negative enabling and positive enabling:
Situation 1. The student repeatedly minimizes a serious problem. For example, the student says, "It's really no big deal" or "It's none of your business" or "I don't want to bother anyone with this - other people have much bigger problems."
Negative enabling: Agreeing or being silent; allowing the student to avoid dealing with a significant problem.
Positive enabling: "I understand you don't think it's a big deal, but I want you to know I think it's a big deal. If you ever want to talk about it, I'll try to help you out." "Sometimes it helps to talk with a therapist even about 'small deals.' If you want to make an appointment, I'll walk over there with you." "It's my business only in that I care about you and hate to see you in distress. I know it's not my problem, but if it would help to talk things out, let's go out for a cup of coffee."
Situation 2. A distressed student wants to repeatedly "vent" to you about a problem but will not seek more appropriate help. For example, a student consistently says, "I can't talk with anyone else, you're the only one I trust." "Tell me what to do." "I don't want to go to sleep, I don't want to be alone, I just want you to stay here with me."
Negative enabling: Agreeing or being silent; allowing the student to depend on you for things they eventually will have to do themselves or for things that they need to rely on others for.
Positive enabling: "I'm glad you trust me, because I want to help. That's why I am telling you we need to consult with a therapist to help you figure out what to do." "It seems like this is an issue that really deserves the time you are devoting to it, but I can't stay up any later talking with you or I'll fall asleep in class tomorrow. Why don't you switch to writing in your journal now, and I'll meet you tomorrow for breakfast." "The strong feelings you are experiencing - being afraid to be alone, wanting me to solve this for you, feeling desperate - are all indications of how important an issue this is for you. I think a consultation with a clinician will help you cope with it all. Shall we call and make an appointment?"
Situation 3. A distressed student repeatedly lies, fails, or hurts someone (including you) because they themselves are hurting. "I can't help it, I'm so angry/helpless/sad." "I was drunk, that's all, it didn't mean anything." "I know I said I'd be there, but I was too hung-over to move."
Negative enabling: Agreeing or being silent; allowing the student to "act out" their distress rather than facing it and dealing with it.
Positive enabling: "I want you to know that what you did was hurtful/alarming/dangerous in ways I don't think you really intended. If you are getting so angry/drunk that you can't keep from behaving in hurtful/alarming/dangerous ways, it's time for you to call for some help." "As your friend, I need to tell you that what you did hurt/alarmed/frightened me. And made me concerned about how you're doing. Can we talk about it?"
Situation 4. A distressed student "blackmails" you. For example, a student says, "I won't tell you unless you promise..." "If you were my friend you'd .... (lie for me, keep my secret, talk/stay with me for as long as I need, do my schoolwork/housekeeping for me, etc.)" "I'll never speak to you again if you don't...."
Negative enabling: Agreeing or being silent; allowing the student to manipulate your good will in ways that ultimately don't help you or the student.
Positive enabling: "As your friend I am telling you I won't lie for you, but I'll stand by you while you face this." "I value our friendship and I want to be a good friend to you. Can we find a creative alternative? How about if I keep you company while you... How about if..."