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LIZ LAU STUDENT COUNSELLING & DEVELOPMENT SERVICE OFFICE OF STUDENT AFFAIRS Hurdles Our Students Face Developmental Tasks managing change relationship with family relationships with peers, the opposite sex, faculty, supervisors, etc. academic and career development normal, transitional; primary & secondary intervention Crisis and Trauma bereavement, accident, illness, legal problem, family crisis, academic failure unexpected, transitional; secondary intervention Psychopathology and Mental Illness personality problem, interpersonal difficulties clinical depression, anxiety disorder abnormal, chronic or acute; tertiary intervention Psychological factors that mediate responses to life’s hurdles Phase of event Family responsibilities Age Previous experience Gender Socioeconomic status Religious or spiritual beliefs Education Expected response Inner Resources - Resilience Relationships, activities & spirituality are linked to build my person & inner resources. The capacity to use these inner resources is my RESILIENCE. Resilience is: • the capacity to manage oneself when faced with difficult circumstances • the capacity to recover or rebound • the capacity to transform oneself in a positive way When I fall, I am able to get back up & stand on my feet. Needing Help Try to recall a time when you experienced a crisis & needed help Did someone actually help you? What was your helper like? In what way did your helper help? Did the helper meet with your expectations? Use of Self as a Helping Tool The Ideal Helper Friendly face Discerning eye Sympathetic ear Soothing voice Warm smile Comforting shoulder Open mind Genuine heart Steady nerves Helping hand composed, approachable, attentive, sincere, understanding, accepting, responsive, supportive, confident, competent…… The Real Helper Human & vulnerable - has strengths & weaknesses, good & bad days, blind-spots & limitations Multiple tasks & competing pressures Can’t be perfect, can expect to make mistakes Can’t offer instant cures & results Won’t succeed with everyone Can be anxious about being a helper Need to be self-aware Need to be realistic Need to pursue continuous training & personal development Need to be ready to seek help when necessary Help-Seekers The girl who was rejected by her boyfriend The boy whose studies had to be terminated The girl who discovered that her brother is suffering from mental illness The boy who was involved in a legal offence The boy whose brother had committed suicide Symptoms Emotional (feelings) shock anxiety fear grief anger numbness guilt shame depression helplessness Cognitive (thinking) confusion indecisiveness poor concentration rumination mental block flashbacks irrational thoughts Physical (bodily) tension fatigue sleep disturbance loss of appetite aches and pains self-neglect disruption of daily routine Spiritual (meaning) low self-esteem wondering why why me reality is cruel life is meaningless Interpersonal dependency irritability withdrawal feeling of rejection aggression attention-seeking Psychological First Aid Doesn’t need highly trained professionals Restore emotional equilibrium a.s.a.p. Reduce likelihood of developing subsequent mental health problems PFA involves immediate, basic, non-intrusive & pragmatic care. Protect Direct Connect listening but not forcing talk facilitating emotional ventilation assessing & meeting basic needs being direct, informative, & problem-solving oriented protecting from further harm encouraging but not forcing company from significant others connecting to trained health professionals if necessary The Counselling Process Assessment & Exploration Evaluation Relationship Building Intervention & Action Goal Setting Major Counselling Goals Facilitate behaviour change Enhance coping skills Promote decision making Improve relationships Develop client’s potentials Strengthen Resilience & Rebuild the Person Rebuild relationships I HAVE Re-establish trust & sense of belonging I CAN Rebuild the Person Resume activities Rebuild confidence & competence through activities I CAN Strengthen spirituality I AM • Rediscover hope in the future • Make sense or find meaning of what happened • Find spiritual support Counselling Tasks - 8 Rs Reach out Attend to physical comforts Establish trust & rapport, engage the person in the helping process Reappraise Focus on the precipitating event & assess impact Promote objectivity, accurate appraisal & proper perspective Release Facilitate emotional ventilation Normalize emotional reactions Reassure Convey hope but avoid false reassurance Restore sense of control, change role from victim to actor Counselling Tasks - 8 Rs Re-educate Teach effective coping skills Develop rational thoughts & beliefs Resolve Resolve inner conflicts Facilitate decision making & crisis resolution Rebuild Reinforce personal resources & positive coping Reaffirm positive self-image Refer Direct to other sources of support Assess need for professional health care Positive Indicators Self-perceptions Stop self-deprecation, re-establish sense of self-worth Emotional world Ventilate & release negative emotions, understand & accept own emotions; pursue positive feelings/experiences Thinking Think rationally & objectively, envisage positive change Physical state Take care of personal needs, ensure physical well-being Behaviour More focused on active coping, resume normal routine/activities Interpersonal relationships Resume connection with others, rebuild trust & sense of belonging Experiences of the world Develop greater optimism, increase feeling of control, focus on present & future The Art of Helping DON’TS Be patronizing Get distracted Be insensitive Ignore feelings Get emotional Talk, talk, talk Impose own values & opinions Be subjective & judgmental Be defensive & rigid Be negative Focus on assigning blame Provide ready solutions Become opponents DO’S Be friendly & considerate Be attentive Be sensitive Acknowledge feelings Stay calm Listen, listen, listen Respect other’s needs & values Be empathic & understanding Be open-minded & flexible Be positive Focus on problems & solutions Help others’ explore options Form partnership Operational Guidelines Operational Guidelines for Handling Problematic or Critical Cases Operational Guidelines for Handling Suicidal Risks www.cuhk.edu.hk/osa/scds Multifaceted implications – psychological, health, academic daily living, familial, etc. More than 1 unit/staff involved in case management Cross-unit communication & coordination necessary Provide guiding principles & general operational procedures, not universally applicable formulas Operational Guidelines for Handling Problematic/Critical Cases CONTENT 1. Students’ Seek Help Page http://www.cuhk.edu.hk/content/stdinfo.shtml 2. Support services for undergraduate students 3. Support services for postgraduate students 4. 3 major categories of problems: Psychological/psychiatric Academic Conduct/disciplinary 5. General procedures, relevant staff/units involved & their responsibilities at different stages 6. Case illustrations – flowcharts 7. Signs & symptoms of psychological or psychiatric disturbances - detection & referral 8. Do’s & Don’ts in initial helping & crisis intervention Operational Guidelines in Handling Suicidal Risks Early Detection & Intervention CONTENT 1. Detecting warning signs & symptoms 2. Assessing risk factors 3. Assessing the suicidal plan & potential danger 4. Steps in ensuring safety & arranging for treatment 5. Operational procedures in handling different scenarios: suicidal risks & suicidal attempts 6. Seek-Help information 7. Important points to note in crisis intervention When to Refer A student asks for help that is beyond your expertise or responsibility. Helping the student would compromise or change your relationship with the student. The student is reluctant to discuss his/her problem with you. The help you have provided so far doesn’t seem to be effective. You feel overwhelmed & overly responsible for the student’s well-being. You & the student have personality differences or conflicts which cannot be resolved. Referrals must be made with the student’s knowledge & consent. Motivating Someone to Seek Professional Help Don’t try to make a referral when a person is too upset or confused. Suggest in a caring, supportive manner that he/she may benefit from discussing his concerns with a professional helper. Reassure the person that personal information disclosed will be kept confidential under normal circumstances. Explain that help-seeking is voluntary and he/she can decide on whether to pursue help based on the encounter & experience. Be well informed of helping resources available & the necessary referral procedures. Student Counselling & Development Service Guidelines for Making Referrals CONTENT 1. Services provided by the Student Counselling & Development Service 2. Identifying signs & symptoms of disturbance 3. Common concerns & problems presented by students 4. Considerations in making referrals 5. Referral form & procedures 6. Other support services