CAPS Information for Faculty & Staff

Throughout the year, Counseling and Psychological Services (CAPS) receives many telephone calls from parents, administrators, faculty, staff, student advisors, residence life staff, and friends. Typically the individual who calls has observed some of the signs and symptoms that could be indicative of the need to refer for professional assistance.  

If you are concerned about a Pacific student and are uncertain how to refer them to CAPS, or would like to talk to someone about this concern, please call 209.946.2315, ext. 2 and ask to speak with an available CAPS staff member. You cannot make the appointment for the student, however, if they are in the room with you, you can call and put them on the phone.

If you are comfortable approaching the student about your concerns please encourage them to call 209.946.2315, ext. 2 or, on the Stockton Campus, stop by CAPS in the Cowell Wellness Center to make an appointment. If they are hesitant to come to CAPS alone, you might offer to accompany them to CAPS at the time of their initial meeting.

For more information please see Working with the Emotionally Distressed Student and consider enrolling in our Kognito training. This is a 30 to 40 minute interactive training sponsored by CAPS that teaches and/or refines your skills for working with and referring an emotionally distressed student.

The following are some of the general symptoms of distress:

• References to suicide
• Isolating self from others
• Significant decrease in energy and motivational level
• Marked change in behavior
• Erratic class attendance or class performance
• Sudden unwillingness to communicate
• Drop in grades
• Alcohol and/or other substance abuse
• Body image and / or eating concerns
• Excessive self-criticism and guilt
• Statements reflecting a sense of worthlessness, hopelessness or helplessness
• Tension-induced headaches or nausea
• Change in appetite and / or sleeping habits
• Anxiety, depression, stress and "burnout"
• Feelings related to changes in personal relationships, such as break-ups, divorce, or death
• Academic problems, such as career indecision, dissatisfaction with academic major, inability to concentrate, and difficulty with workload
• Threatening bodily injury or harm to others
• Violent behavior
• Being overly suspicious and fearful

If you think someone is in need of emotional/mental health assistance, please refer them to CAPS. However, if you are concerned that they are at risk for imminent harm to themselves or someone else please call Public Safety.

• Nervousness
• Agitation
• Increased irritability, undue aggressive or abrasive behavior
• Excessive procrastination, poorly prepared work
• Infrequent class attendance, little or no work completed
• Depression, lack of energy
• Marked change in personal hygiene
• Withdrawal, fearfulness
• Dependency (e.g., the student who hangs around you or makes excessive appointments to see you)
• Indecisiveness, confusion
• Bizarre, alarming, or dangerous behaviors

Openly acknowledging to the students that you are aware of their distress, that you are sincerely concerned about their welfare, and that you are willing to help them explore their alternatives can have a profound effect. Whenever possible, we encourage you to speak directly to a student when you sense that they are in academic and / or personal distress.

1. Request to see the student in private.
2. Briefly acknowledge your observations and perceptions of their situation and express your concerns directly and honestly.
3. Listen carefully to what the student is troubled about and try to see the issue from their point of view without necessarily agreeing or disagreeing.
4. Strange and inappropriate behavior should not be ignored. The student can be informed that such behavior is distracting and inappropriate.
5. Your receptivity to an alienated student will allow them to respond more effectively to your concerns.

Involve yourself only as far as you are willing to go. At times, in an attempt to reach or help a troubled student, you may become more involved than time or skill permits. Extending oneself to others always involves some risk but it can be a gratifying experience when kept within realistic limits.

If you are unsure how to respond to a specific student, consult with one of the professional staff at Counseling and Psychological Services (CAPS). Suggestions will be made for approaches you can take with the student. The counseling staff can also assist with the referral process.

CAPS is committed to helping students increase their skills and resources in meeting their academic and interpersonal challenges and in becoming responsible and productive adults. The professional staff consists of psychologists and doctoral psychology interns with diverse backgrounds and training.

Our services include individual, group, and couples therapy, as well as numerous workshops on topics such as stress management, eating disorders, substance abuse, coping with grief and loss, and healthy relationships. Staff also offer training and consultation services to student organizations, academic departments, and other university departments that have a high degree of contact with students.

If you feel that professional therapy might be beneficial, refer the student to CAPS. Be direct in letting the student know that you believe a therapist would be of help in this situation. Inform the student that the service is both confidential and free of charge. A mutual decision is best. Don't force the issue if the student takes a defensive posture - simply restate your concerns and recommendations. If the student is receptive, you can suggest that they call for an appointment at 209.946.2315, extension 2. You may even offer to contact a therapist and provide background information. If the situation seems urgent, you can call the CAPS office coordinator and request to speak with the staff member on call. You may also consider walking the student over to CAPS. An Emergency hour is available as needed during the weekdays.

Students sometimes become verbally abusive when confronted with frustrating situations that they perceive as beyond their control; anger and frustration may become displaced from those situations to you. Typically, the anger is not a personal attack, although it may be directed at you.

Do:

• Acknowledge their anger and frustration (e.g., "I hear how angry you are.")
• Rephrase what they are saying and identify their emotion (e.g., "I can see how upset you are because you feel your rights are being violated and nobody will listen.")
• Allow them to "vent," get the feelings out, and tell you what is upsetting them
• Reduce stimulation; invite the person to your office or other quiet place if this is comfortable
• Tell them that you are not willing to accept their verbally abusive behavior (e.g., "When you yell and scream at me that way, I find it hard / impossible to listen.")
• Tell them they are violating your personal space and to please move back if they are physically getting too close (e.g., "Please stand back - you're too close.")
• Help the person problem-solve and deal with the real issues when they become calmer

Don't:

• Get into an argument or shouting match
• Become hostile or punitive yourself (e.g., "You can't talk to me that way!")
• Press for explanation or reasons for their behavior (e.g., "Now I'd like you to tell me exactly why you are so obnoxious.")
• Look away and not deal with the situation
• Give away your own rights as a person

Violence related to emotional distress is very rare and typically occurs only when the student is completely frustrated, feels powerless, and is unable to exert sufficient self-control. The adage, "An ounce of prevention is worth a pound of cure," best applies here.

DO:

• Prevent total frustration and helplessness by quickly and calmly acknowledging the intensity of the situation (e.g., "I can see you're really upset and really mean business and have some critical concerns on your mind.")
• Explain clearly and directly what behaviors are acceptable (e.g., "You certainly have the right to be angry but hitting and breaking things is not okay.")
• Stay in open area
• Divert attention when all else fails (e.g., "if you hit me, I can't be of help.")
• Get necessary help (other staff, Public Safety, CAPS staff.)
• Remember that student discipline is implemented by Student Conduct.

DON'T:

• Ignore warning signs that the person is about to explode (e.g., yelling, screaming, clenched fists, statements like, "You're leaving me no choice.")
• Threaten, dare, taunt, or push into a corner
• Touch

These students have difficulty distinguishing fantasy from reality, the dream from the waking state. Their thinking is typically illogical, confused, disturbed; they may coin new words, see or hear things which no one else can, have irrational beliefs, and exhibit bizarre or inappropriate behavior. Generally, these students are not dangerous and are very scared, frightened, and overwhelmed.

DO:

• Respond with warmth and kindness, but with firm reasoning.
• Remove extra stimulation of the environment and see them in a quiet atmosphere (if you are comfortable in doing so)
• Acknowledge your concerns and state that you can see they need help (e.g., "It seems very hard for you to integrate all these things that are happening and I am concerned about you; I'd like to help.")
• Acknowledge the feelings or fears without supporting the misconceptions (e.g., "I understand you think they are trying to hurt you and I know how real it seems to you, but I don't hear the voices (see the devil, etc.)")
• Reveal your difficulty in understanding them, when appropriate (e.g., "I'm sorry but I don't understand. Could you repeat that or say it in a different way?")
• Focus on the "here and now." Switch topics and divert the focus from the irrational to the rational or the real
• Speak to their healthy side, which they have. It's okay to joke, laugh, or smile when appropriate

DON'T:

• Argue or try to convince them of the irrationality of their thinking, which may lead them to defend their position (false perceptions) more ardently
• Play along (e.g., "Oh yeah, I hear the voices (or see the devil).")
• Encourage further revelations of craziness
• Demand, command, or order
• Expect customary emotional responses

Typically, these students complain about something other than their psychological difficulties. They are tense, anxious, mistrustful, loners, and have few friends. They tend to interpret minor oversights as significant personal rejection and often overreact to insignificant occurrences. They see themselves as the focal point of everybody's behavior and everything that happens has special meaning to them. They are overly concerned with fairness and being treated equally. Feelings of worthlessness and inadequacy underline much of their behavior.

DO:

• Express compassion without intimate friendship. Remember, suspicious students have trouble with closeness and warmth
• Be firm, steady, punctual, and consistent
• Be specific and clear regarding the standards of behavior you expect
• Be aware that humor may be interpreted as rejection

DON'T:

• Assure the student that you are their friend; agree you're a stranger, but even strangers can be concerned
• Be overly warm and nurturing
• Challenge or agree with any mistaken or illogical beliefs
• Be ambiguous

These students are highly anxious about the unknown and may perceive danger is everywhere. Uncertainty about expectations and interpersonal conflicts are primary causes of anxiety. High and unreasonable self-expectations increase anxiety also. These students often have trouble making decisions.

DO:

• Let them discuss their feelings and thoughts. Often this alone relieves a great deal of pressure
• Reassure when appropriate
• Remain calm
• Be clear and explicit

DON'T:

• Make things more complicated
• Take responsibility for their emotional state
• Overwhelm with information or ideas

Typically, the utmost time and energy given to these students is not enough; they often seek to control your time and unconsciously believe the amount of time received is a reflection of their worth.

DO:

• Let them, as much as possible, make their own decisions
• Set limits on the time and energy you are willing to spend with the student

DON'T:

• Let them use you as their only source of support
• Get trapped into giving advice (e.g., "Why don't you, etc.?")

People with an eating disorder think about food, weight, and body shape in distorted ways. This leads to ways of eating and managing weight that:

1. are harmful to the mind and the body, and can be deadly
2. make the person feel anxious and miserable most of the time
3. are often upsetting to others

Eating disorders are very prevalent:

1. More than 5 million Americans suffer from an eating disorder
2. This includes 5% of young women; 1% of young men
3. College women ages 18-22 have a higher incidence than those younger, older, or not in college
4. 15% of young women have substantially disordered eating attitudes and behaviors
5. An estimated 1000 women die each year of anorexia nervosa
6. Eating disorders is a men's issue, too. A study of college men (Journal of American College Health, 2002) showed that 20% "had significant worries about their weight and shape and regularly employed restrictive eating behaviors, such as limiting food intake and following specific rules about eating."  Most men are affected in some way by the distorted body image or distorted eating behavior of a significant woman in their lives (e.g., sister, mother, and / or girlfriend.)

Eating disorders can last from months to years. If left untreated, they disrupt social relationships, school, and work. They cause psychological and medical problems that can be permanent and can even lead to death. All eating problems are damaging to a person's self-esteem. If the problem lasts long enough, the person feels trapped and hopeless and is afraid that they will never recover.

Some of the warning signs of an eating disorder include:

1. Marked increase or decrease in weight that is not related to a medical condition
2. Abnormal eating habits, such as secretive bingeing, absence in dining halls, and eating peculiar combinations of food
3. Intense preoccupation with weight and body image; this may be evidenced by frequently weighing self and constant self-criticism of body
4. Compulsive or excessive exercising, as evidenced by expressions of extreme guilt if the person doesn't exercise; rigid routine unrelated to athletic training; exercising when injured; or exercising when it is having negative effects in other areas of life (e.g. missing classes to exercise.)
5. Restrictive eating or purging through vomiting, fasting, laxatives, diet pills or diuretics
6. Emotional instability, such as moodiness, depression, loneliness, and/or irritability

When working with a student who may have an eating disorder:

DO:

• Establish rapport with the student
• Focus on specific behaviors that concern you. Behaviors are difficult to deny
• Express concern for the student in a caring, supportive and non-judgmental manner
• Understand that the student may deny the problem. At this point you may want to consult with either Pacific Health Services or with CAPS staff. If the student's behaviors appear to be life threatening, then definitely seek assistance
• Reassure the student that help is available and change is possible
• Try to get the student to make a commitment to contact a therapy and / or medical referral. If the student expresses reluctance, find out why and address the concerns
• Follow-up; show continued support; ask about the referral

DON'T:

• Confront the student when you do not have privacy
• Get into a battle over whether or not the student should label the behavior an "eating disorder"
• Argue with the student
• Give advice about weight loss, exercise, or appearance
• Attempt to force the student to eat

According to the Bureau of Justice Statistics Research Report (December, 2000), 5% of college women nationwide experience a rape or attempted rape in a given academic year. Men can also be the victims of rape and sexual assault. It is important to respond sensitively to students who disclose having experienced a sexual assault or an attempted assault.

The Bureau of Justice report also tells us that 95% of the assaults of college women go unreported in any formal way. One-third of women do not tell anyone of their experience, and two-thirds tell a friend or other trusted individual. Complicating the issue of reporting is the fact that most assailants are persons known to the victim; they are not strangers.

If you are the person trusted with this information, what can you do?

Do

• Listen to the person's account
• Let the person know you care about their well-being
• Appreciate any feelings disclosed as normal under the circumstances
• Assist the person in obtaining additional support and help (see resources below). In particular, the Student Victim Advocate can be of support to the student and explain all of the options available to the student
• Ask about the person's physical condition (i.e., the possibility of physical injury or exposure to disease or, for women, pregnancy)
• Ask about the person's current experience of safety; if they do not feel safe in their environment, offer assistance in increasing their sense of safety by contacting the Student Victim Advocate

Don't

• Relate your own experience or story in any detail
• Pursue specific details, except to clarify what you are hearing
• Offer judgments about what might have been done differently
• Make decisions for the person

Resources

• Student Victim Advocate: 209.403.0250 (Victim Advocacy Program website)
• Counseling and Psychological Services: 209.946.2315 ext. 2 (CAPS website)
• Pacific Health Services: 209.946.2315 (Pacific Health Services website)
• Public Safety Department: 209.946.2537 or 209.946.3911 for emergencies (Public Safety website)
• Women's Center of San Joaquin County 24-hour hotline: 209.465.4997
• St. Joseph’s Hospital: 209.461.2000
• San Joaquin County General Hospital 209.468.2000

The student may need and want to seek medical attention, even some time after the assault, to check for physical damage and to test for sexually transmitted disease and pregnancy. Medical assistance at San Joaquin General Hospital includes a comprehensive medical exam, and a forensic exam, if desired. Medical assistance at Pacific Health Services includes treatment for non-life-threatening injuries, non-evidentiary exams, offering the option of the morning after pill (when the student is seen within 72 hours of the sexual assault), and provision of follow-up medical tests for sexual assault victims.

Note that if the person who reports an offense requests a change in academic, living, or work arrangements as a result of the offense, the college will make reasonable efforts to accommodate such requests. The Student Victim Advocate can be of assistance with these requests.

The student should be advised of the right to make a formal complaint of the assault to the police department in the city where the assault occurred. If the assailant is a student member of the campus community, a complaint can be filed with the Department of Public Safety. If the assailant is a faculty or staff member of the University, a complaint can be filed with the Human Resources Department.

The Sexual Assault and Harassment Policy, which includes details of the adjudication process is available in the Tiger Lore Student Handbook.

As mandated by law, if a student discusses the sexual assault with a member of the staff or faculty, all campus personnel (with the exception of therapists in Counseling and Psychological Services) are required to file an anonymous sexual assault report form with the Student Victim Advocate.

Given the stresses of university life, students are especially susceptible to drug abuse. A variety of substances are available that provide escape from pressing demands. These drugs soon create their own set of problems in the form of addiction, accident proneness, and poor health. The most abused substance, one that is so commonplace that we often forget that it is a drug, is alcohol. Alcohol and other drug-related accidents remain the greatest single cause of preventable death among college students.

DO:

• be on the alert for signs of drug abuse: preoccupation with drugs, inability to participate in class activities, deteriorating performance in class, periods of memory loss (blackouts)
• share your honest concern for the person
• encourage to seek help
• get necessary help in instances of intoxication

DON'T:

• ignore the problem
• chastise/lecture
• encourage the behavior

Typically, these students get the most sympathy. They show a multitude of symptoms such as guilt, low self-esteem, feelings of worthlessness, and inadequacy, as well as physical symptoms such as decreased or increased appetite, difficulty staying asleep, early awakening, and / or low interest in daily activities. Depressed students are frequently lethargic, but sometimes depression is accompanied by agitation.

DO:

• Let student know you're aware they may be feeling down and you would like to help
• Reach out more than halfway and encourage the student to express how they are feeling, for they are often initially reluctant to talk, yet others' attention helps the student feel more worthwhile
• Tell the student of your concern

DON'T:

• Say, "Don't worry," "Crying won't help," or "Everything will be better tomorrow"
• Be afraid to ask whether the student is suicidal if you think they may be

Suicide is the second leading cause of death among college students. The suicidal person is intensely ambivalent about killing themselves, and typically responds to help; suicidal states are definitely time limited and most who die by suicide are neither crazy nor psychotic. High risk indicators include: feelings of hopelessness and futility; a severe loss or threat of loss; a detailed suicide plan; history of a previous attempt; history of alcohol or drug abuse; and feelings of alienation and isolation. Suicidal students usually want to communicate their feelings, therefore any opportunity to do so should be encouraged.

DO:

• Take the student seriously; 80 percent of suicides give warning of their intent
• Acknowledge that a threat of or attempt at suicide is a plea for help
• Be available to listen, to talk, and to be concerned, but refer the student to CAPS or other appropriate agencies when you yourself are getting overwhelmed
• Administer to yourself. Helping someone who is suicidal is hard, demanding and draining work

DON'T:

• Minimize the situation or depth of feeling (e.g., "Oh it will be much better tomorrow.")
• Be afraid to ask the person if they are so depressed or sad that they want to hurt themselves (e.g., "You seem so upset and discouraged that I'm wondering if you are considering suicide.")
• Over commit yourself and, therefore, not be able to deliver on what you promise
• Ignore your limitations