crisis intervention katherine l. morris, ph.d., l.p. jean baribeau-thoennes, msw william long, l.p

CRISIS INTERVENTION

Katherine L. Morris, Ph.D., L.P.

Jean Baribeau-Thoennes, MSW

William Long, L.P.

MISSION OF CRISIS INTERVENTION

• HS is Accessible to you in an emergency with a student.

• The best crisis intervention is prevention & early detection.

• Dealing quickly with emotional & health crises reduces the negative impact on academic progress.

• Students are more likely to handle crises & stay in school if they establish interpersonal connections.

National College Health Association Survey, Spring 2004

Academic Effects Due to Various Factors

Problem: Performed poorly on

test

Lowered course grade

Drop a class or

incomplete

Alcohol 15.1% 4.3% 1.1%

Stress 22.71% 5.6% 0.7%

Depression/Anxiety/SAD

7.1% 3.6% 0.7%

Relationship Conflict

12.1% 2.7% 0%

National College Health Association Survey, Spring 2004

UMD Alcohol & Drug BehaviorActual

BehaviorAttributed Behavior

7+ drinks at most recent party

46.5% 53.3%

Within the Last 30 Days:

•Alcohol 78.9% 99.1%

•Marijuana 26.4% 86.8%

•Cocaine 3.5% 34.4%

•Amphetamines 4.3% 45.1%

•Other Drugs 3.9% 44%

•Cigarettes (daily) 8.9% 95.1%

National College Health Association Survey, Spring 2004

Top 10 Academic Impediments at UMD

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0

StressSleep Difficulty

Cold/Flu/Sore ThroatAlcohol

Concern over Friends/FamilyDepression/Anxiety/SAD

Internet use/Computer gamesDeath of Friend/Family

DrugsStrep/Sinus/Ear Infection

TYPES OF EMOTIONAL CRISES

• Depression

• Suicidality

• Anxiety / Stress

• Abusive Relationships

• Alcoholism & Drug Abuse

• Eating Disorders

Symptoms of Depression• Feelings of hopelessness• Fatigue / exhaustion• Sleep difficulties• Eating disturbances• Poor concentration• Loss of interest in activities• Thoughts of suicide • Difficulty functioning

Give HOPE - 80% get better

Suicidality (3rd cause of death for ages 15 - 24)

• Shows signs of depression• Increased use of alcohol or high risk behavior• Getting the means to kill oneself• Giving away prized possessions• Indicating a desire to get even with significant

others• Discussing suicide or issues• Have made past attempts

ASK

Anxiety / Stress

• Anxious mood & overreacting to situations

• Inability to concentrate or pay attention

• Inability to get organized

• Increased procrastination

• Anxiety attacks: weakness, dizziness, shortness of breath, increased heart rate

• Difficulty making decisions

Anxiety / Stresscontinued

• “Going blank”: forgetting & losing things

• Frequent headaches, backaches, tightness in stomach

• Frequent indigestion or diarrhea

• Overpowering urges to cry or run & hide

• Increased use of alcohol

• Increased illnesses & accidents

BE CALM

Symptoms of Alcohol & Drug Abuse

• Odor of alcohol or marijuana• Slurred speech• Rapid speech• Incoherent• Bizarre behavior: acting out or non-

compliance to requests• Irrational thought process, verbal or

written• Inconsistent class attendance

Eating Disorders Danger Signals

• Losing a significant amount of weight

• Continuing to diet (although thin)

• Feeling fat, even after losing weight

• Fearing weight gain

• Losing monthly menstrual periods

• Preoccupation with food, calories, nutrition and / or cooking

• Exercising compulsively

• Bingeing and purging

Common Symptoms

• Excessive procrastination and / or poorly prepared work

• Frequent class absences

• Nervousness, agitation, impaired speech, excessive fingernail biting

• High levels of irritability including undue aggressive or abrasive behavior

• Excessive demands on your time

• Inability to make decisions

Common Symptomscontinued

• Strange behavior, paranoia, hostility

• Marked change in personal hygiene or appearance

• Sleeplessness, lethargy

• Sadness or fearfulness

• References to harming self or others

• Evidence of excessive drug or alcohol use

• Crying

• Dizziness or fainting

Dealing with Crisis Behavior

• Be supportive

• Be calm

• Be honest & direct

• State your concern

• Don’t act shocked or surprised

• Gather pertinent information

• Refer to counseling

Counseling Satisfaction Surveys

Counseling Improved My Academic Functioning

01020304050607080

90100

'99/00 '00/01 '01/02 '02/03 '03/04

UMD Freshmen to Sophmore Retention for Students Seen in Counseling

50%

55%

60%

65%

70%

75%

80%

85%

2000-01 2001-02 2002-03 2003-04 2004-05

Fall Returning as Sophmore

% E

nro

lle

d

Counseling

UMDBenchmark

Iowa State

Counseled students enjoy 14% retention advantage over non-counseled counterparts.

Counseling Satisfaction Surveys

Students Deal More Effectively With Problems

01020304050607080

90100

'99/00 '00/01 '01/02 '02/03 '03/04

Counseling Satisfaction Surveys

I Would Come Back If I Needed Help

01020304050607080

90100

'99/00 '00/01 '01/02 '02/03 '03/04

Counseling Satisfaction Surveys

I Would Recommend to a Friend

01020304050607080

90100

'99/00 '00/01 '01/02 '02/03 '03/04

Overall Quality of Servicesat UMD Health Services

4

4.25

4.5

4.75

5

2000 - 01 2001 - 02 2002 - 03 2003 - 04

Quality of Care

Would Recommend toa Friend

Advice was Useful

Would Come Back ifMore Help wasNeeded

REFERRAL PROCESS• Call 7913 or 8155 (you, the student,

or the student in the office).

• Identify level of crisis (today, tomorrow, next week).

• If there is danger: In an emergency call 911, in a non-emergency call campus police (7000).

• If you want to explain the details, ask to speak with a counselor.

REFERRAL PROCESScontinued

• If you want feedback, ask the student to sign a release or bring back note.

• If the student is hesitant, address the concerns.

• If the student won’t come . . . .

• Good Samaritan Law

BARRIERS TO REFERRAL

• I should be able to do it myself.

• Someone will see me.

• My parents will find out.

• It will cost too much.

• I don’t have time.

• No one can understand.

• It will pass.