Listening Always Comes First

So there's a great little video called It's Not About the Nail out in the electronic ether, all about the importance of listening.  Upon watching it one thinks about relationship contexts mainly, especially the oft-seen tendency of men to fix things instead of just empathizing and supporting their partners.

Ah but the video is a great object lesson for professional helpers.  There is a strong sense of urgency among many healthcare providers to quickly and efficiently apply the "intervention" to the "symptom", because that is what the diagnosing/insurance/billing industrial complex demands. The forces behind this complex are tremendous and so embedded in some helping systems that many don't stop and think for a moment about how this form of "helping" may be affecting the "helped".

Sometimes, it doesn't matter how "right" the helper is.  The one receiving the help must feel heard and understood first, as this facilitates acceptance and motivation to be helped in the first place.  I recall a story about a homeless woman, hungry and cold, who upbraided a good Samaritan for "throwing me a bone".  Before she received food and clothing, she wanted to be understood.  In particular she wanted her pain to be understood.  That was her primary need at the moment.  Her "helpers" assumed her physical needs were more fundamental than her emotional or spiritual needs.  This is where many of us go awry.

The video takes us back to the early days of our training.  We were first taught basic helping skills, such as empathy, genuineness, positive regard and active listening.  Somehow the systems we work in may distract us from these elemental approaches to human suffering.  Let's go back then, and learn this all over again.  If you are involved in training the next generation of helpers, consider showing them the video.  After the jokes subside, tell them to get serious about this one.

Vignette 2: What Would You Do?

Sarah, a depressed student

Imagine you are in the position of advising a college student about her classes.  She walks into your office unexpectedly, looking for help.

Background: Sarah is a junior and does well in class and is usually perky and energetic.  Lately though she appears fatigued, quiet, and withdrawn.  Instead of being her usual talkative self, her close friends notice she just keeps her head down and seems to mope around.  Others haven’t seen her in a while and don’t know what is going on.

Scene: Sarah meets with her advisor about next fall’s schedule of classes.

Mr. Hayes: Hey Sarah!  Haven’t seen you in a while.  (He notices her appearance, which is unkempt and tired) How are you?

Sarah: (Looks down, emotionally flat) OK.

Mr. Hayes: OK, well, what did you have in mind today?

Sarah: I guess I need to set up classes for the fall.  I am not sure though…what I want or need.  Or even it it’s important.

Mr. Hayes: I have to tell you, that surprises me.  You’re usually right on top of everything.

Sarah: (Angrily) I wish everyone would stop saying that!  I am so tired of doing what everyone expects me to do!

Mr. Hayes: Whoa, Sarah.  I’m not really telling you what to do.  I’m just surprised, that’s all.  What is going on?  You seem different.

Sarah: I’m not who you think I am…

Mr. Hayes: What do you mean?

Sarah: I’m bored.  I don’t care about anything anymore.  All this school stuff is stupid.  I just want to sleep and be left alone.  I’m tired of people calling me, asking me stuff.  (Tears start to flow) My boyfriend doesn’t deserve this, so I avoid him too.  He’s getting frustrated, just like you.  Just like everyone else.  I guess I can’t blame them…all I’ve done for a couple months is sleep and watch TV and eat junk.  But I don’t care.  Goodbye Mr. Hayes, you won’t be seeing me anymore.

Suggestions: First, that last statement requires clarification.  Ask Sarah exactly what she means by that before she leaves your office.  If safety appears to be an issue, contact your campus counseling service for assistance right away.  If safety does not appear to be an issue make an attempt to understand her obvious distress.  Say "Please tell me more about what is bothering you, I'd like to help."  Asking questions about basic things like eating, sleeping, going to class, family and friendships will often reveal a lot about the type of issues Sarah struggles with.  Once you have an understanding of her concerns, focus on empathizing and not judging Sarah.  Then offer to help her see someone who can help her further.  Say "We have a great counseling center and I'd like to help you get an appointment there."  Offer to make the call for her right there in your office.  But then hand the telephone to Sarah when it is time to set the appointment.  Or you could offer to walk with her to the center yourself.  Later, follow up with her and ask her about her appointment, and encourage her to go if she has not done so.  Benign encouragement and persistence can go a long way in getting students the help they need.

Childhood Disability Rates Rising For The Past 10 Years

A recent study shows a rise among children with disabilities over the past 10 years. The same study also revealed that disabilities relating to physical health conditions have decreased, while disabilities relating to neurodevelopment and mental health have increased dramatically. In addition, the most significant increase has occurred among children from higher-income families.

Lead author Amy J. Houtrow, MD, PhD, MPH, chief, Division of Pediatric Rehabilitation Medicine at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center and associate professor of physical medicine and rehabilitation and pediatrics at University of Pittsburgh School of Medicine admits that previous studies have already demonstrated that the prevalence of childhood disability is on the rise. "Nearly 6 million kids had a disability in 2009-2010 -- almost 1 million more than in 2001-2002" says Houtrow.

Results were derived from the analysis of data gathered from 102,468 parents of children ages 0-17 years of age that participated in the National Health Interview Survey conducted by the Centers for Disease Control and Prevention in 2001-2002 and survey data from 2009-2010.

The surveys questioned parents on whether their child…

• had any limitations in play or activity
• received special education services
• needed help with personal care
• had difficulty walking without equipment
• had difficulty with memory
• had any other limitation

If parents responded yes to any of the preceding questions, the surveys questioned whether their child's limitations were due to…

• a vision or hearing problem
• an asthma or breathing problem
• a joint, bone or muscle problem
• an intellectual deficit or mental retardation
• an emotional or behavioral problem
• epilepsy
• a learning disability
• a speech problem
• attention-deficit/hyperactivity disorder
• a birth defect
• an injury
• some other developmental problem

Meanwhile, researchers classified conditions into three groups:

1. Physical
2. neurodevelopmental/mental health
3. other

Their research uncovered that “the prevalence of disability increased by 16.3% from 2001-2002 to 2009-2010”. In particular, the neurodevelopmental and mental health-related disabilities increased while those disabilities resulting from physical conditions had decreased over the decade. Remarkably, the increase was most significant among children less than 6 years of age, as their rate of neurodevelopmental disabilities nearly doubled over the decade.

Furthermore, results demonstrated higher rates of disabilities among children living in poverty over the entire period of study without any real increase; however the highest rate of growth was identified among children living in higher income households (i.e. household incomes at or above 300% of the federal poverty level or $66,000 a year for a family of four).

Unfortunately, Dr. Houtrow states: "the survey did not break out autism, but we suspect that some of the increase in neurodevelopmental disabilities is due to the rising incidence or recognition of autism spectrum disorders".

Evidently this study has put a broader perspective on an area in desperate need of research. The study leaves the several unanswered questions. Why are rates of disabilities rising among children? What could these demographics really mean? Could it be that children living in poverty are simply being undiagnosed? Could it be that affluent families are more persistent in obtaining a diagnosis? Could there be other reasons or factors yet to be revealed?

Childhood Disability Rate Jumps 16 Percent Over Past Decade

© www.mentalhealthblog.com

Cyberbullying Continues To Rise

Research shows that about 5 out of every 30 high school students report being victims of cyberbullying within the past year. In addition, roughly 10 of those 30 students spend about three or more hours per day playing video games or using a computer for other purposes than school work.

These numbers arise from the analysis of data gathered from the 2011 Youth Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention, where 81% of schools and 87% of students from the 15,425 public and private high schools responded. The survey represents a national sample of high school students and takes place every two years “to monitor six types of health-risk behaviors that contribute to the leading causes of death, disability and social problems among U.S. youths”.

"Electronic bullying of high school students threatens the self-esteem, emotional well-being and social standing of youth at a very vulnerable stage of their development," said study author Andrew Adesman, MD, FAAP, chief of Developmental and Behavioral Pediatrics at Cohen Children's Medical Center of New York. "Although teenagers generally embrace being connected to the Web and each other 24/7, we must recognize that these new technologies carry with them the potential to traumatize youth in new and different ways."

In 2011, the Centers for Disease Control and Prevention surveyed students about whether they had been bullied in the past 12 months either through email, chat rooms, instant messaging, websites and/or texting. In addition, students were questioned on the number of hours they spent playing video games or using a computer for any other purpose than school work.

Results showed that 1 in 6 high school students or 16.2% reported being a victim of electronic bullying within the past 12 months. More specifically, results revealed that 22.1% of girls reported being bullied electronically while only 10.8% of boys reported being victims of electronic bullying, making girls more than twice as likely to report being victims of cyberbullying. In addition, “whites reported being the victim of cyberbullying more than twice as frequently as blacks”.

Furthermore, thirty-one percent of high school students reported playing video games or using a computer for something other than school work for 3 or more hours each day. Interestingly, boys (35.3%) were more likely than girls (26.6%) to report playing video games for more than three hours per day.

"Electronic bullying is a very real yet silent danger that may be traumatizing children and teens without parental knowledge and has the potential to lead to devastating consequences," said principal investigator Karen Ginsburg, also at Cohen Children's Medical Center of New York. "By identifying groups at higher risk for electronic bullying, it is hoped that targeted awareness and prevention strategies can be put in place."

Unfortunately, cyberbullying will only become more and more common in society, especially teens, as technology continues to advance. More research should help to spread awareness and develop legislation that may succeed in decreasing the number of victims of cyberbullying, thereby reducing the rising number of extreme cases that often result in fatalities.

Cyberbullying Rampant Among High School Students: Nearly One-Third of Youths Also Report Playing Video/Computer Games for More Than 3 Hours a Day

© www.mentalhealthblog.com

A Brief Word on ADHD

Attention-Deficit/Hyperactivity Disorder, or ADHD, is a pattern of persistent inattention and/or hyperactivity, most often evident before age seven. The symptoms cause impairment in at least two settings, such as school and work, and it is more severe than what is usually seen with others of the same age and developmental status.

Many students experience periods of time when they are restless or have trouble concentrating. In fact, almost all students will go through some adjustment strains from the time they arrive at college, and may have very similar attention problems as a result. Also, there are other problems that can mimic ADHD, such as anxiety disorders, traumatic stress, alcohol or drug abuse, overuse of social media and gaming, and even ordinary family conflict.

If you have arrived on campus with a history of ADHD, it is important to continue with your treatment and to provide your local psychologist with documentation of your past diagnosis and treatment. This will improve continuity of care and perhaps prevent unnecessary problems in school.

It is unlikely that ADHD will suddenly appear in a student's adulthood. Yet sometimes students are convinced they have ADHD and take medications offered to them by friends. And some know they don't have ADHD but choose to take amphetamines as a performance enhancement drug.  Please know this may do you no good at all and, in some cases, can actually cause you harm. Diagnosing an adult with ADHD involves a sophisticated and comprehensive evaluation by psychologists, and should be undertaken with great care so that other possibilities are ruled out.  One should avoid evaluations based on checklists and self-report measures alone, as these are likely to lead to over-diagnosing.

If you suspect you have ADHD but you have never been formally diagnosed or treated, call your campus counseling service for assistance.

Ode to the Campus Police

There are many campus departments deserving of praise, and many that work silently toward enhancing the well-being of campus communities without receiving a shred of positive attention.  The campus police department is one of these.

College counseling centers often work very closely with the police, especially in the area of crisis intervention services and various teams whose purpose is to prevent and respond to disruption and violence on campus.  Collaborations such as these were once infrequent but soared after the Virginia Tech tragedy and statutes requiring them were developed in that state.  A great many institutions have adopted collaborative models and, as of this writing, at least two others states have either adopted similar legislation or are considering it.

And so it is that mental health and campus safety professionals work arm in arm, many times in the wee hours of the day, attending to critical student needs.  Many stakeholders are unaware of the fine-tuned responsiveness of campus police departments.  In this area of their work, they are not just certified law enforcement personnel with investigative and arrest authority, though they are certainly that as well; they are supportive educators providing students with valuable life lessons.  Beyond consequences for negative behavior, often delineated in institutional codes of student conduct, officers are a living example of institutional care for the student and community.  Through their actions one may experience powerful messages, such as: "we are paying attention to you", "we will respond to you", and "we will go to great lengths to see to your safety and the safety of others".  This level of responsiveness is many times not available in municipal police departments, simply because the missions are so decidedly different.

A campus police officer may, for example, conduct welfare checks on individuals suspected of being in acute distress.  He or she may knock on the doors of, say, 40 apartments, in a search for a student.  This could happen in the middle of the night, or even when the university is closed for a holiday.  On occasion they may transport a student to a counseling appointment, or to the hospital when situations warrant it.  They may accompany a counselor to the scene of a crisis event, without any expectation of being directly involved unless needed, just to raise feelings of security among all who are present.  All of this may happen without any further actions on the part of the officer and police department.

Much of this activity is invisible to the campus community.  But a great many adverse events are contained, and a great many students are assisted, in just this manner.  Well-trained campus police officers are not there just to get us into trouble, as some would have us believe.  They are a vital part of the overall welfare of the community, and they are deserving of our praise.

Facebook Assures Our Self-Worth

A Cornell University communication expert claims that Facebook can be used to reinforce our self-worth. Particularly, users that receive negative feedback in every day life, tend to be instinctively drawn toward their own profiles to enhance their self-esteem and reinforce their sense of self.  

According to co-author Jeff Hancock, "the extraordinary amount of time people spend on Facebook may be a reflection of its ability to satisfy ego needs that are fundamental to the human condition."  As opposed to the typical view that Facebook is merely an activity that wastes time and often leads to negative consequences.  

To test the hypothesis, 88 undergraduate students were asked to deliver a short speech.  Students were then offered to look over their own Facebook profiles or someone else’s for a few minutes while awaiting feedback on their speech.  Participants then received negative feedback regardless of their performance.  When asked to rate the accuracy of the feedback, those who had viewed their own profiles were less defensive than those who had viewed another person’s profile.

Participants were then given the option to browse Facebook or other online sites after receiving either negative or positive feedback about their speech. Results showed that those who received negative feedback were more likely to choose Facebook than those who received positive feedback.  

These results suggest that an ego boost from viewing their own profiles could lighten the blow from receiving negative feedback about one’s abilities.  Whereas viewing another profile may increase the need to feel self-assured.  Similarly, the need for reassurance of self-worth after receiving negative feedback may influence one’s need to browse Facebook. 

In essence, setbacks experienced in every day life may have less impact on self-esteem and self-worth if Facebook can be used to repair the damage caused by such threats to the ego.  "Perhaps online daters who are anxious about being single or recently divorced may find comfort in the process of composing or reviewing their online profiles, as it allows them to reflect on their core values and identity," Hancock says. 

Also, not only could Facebook supply the emotional benefits needed to repair deep-seated notions of self-worth, but “the research suggests that Facebook profiles could be used strategically in applied self-affirmation interventions”.  For example, campaigns aimed at reducing resistance to anti-smoking messages may be more effective in conjunction with Facebook as young adults may be more compelled to maintain their self-integrity.  

Unfortunately, this study suggests that a person’s Facebook profile offers assurance that they are valuable, worthy and good without touching upon the impacts on those who may receive constant threats to self-worth on Facebook, such as bullied teens.

Like It? We Love It! FacebookAssures Us We're Good Enough

© www.mentalhealthblog.com