Assessment and Treatment of Patients with Borderline Personality Disorder in the College and University Population

The assessment and treatment of students with borderline personality traits or disorders poses specific challenges for clinicians at college and university mental health centers complicated, frequently, by a model of brief treatment frameworks and high patient volumes. Students with borderline pathology will be well represented in student health centers and will likely generate unusually complex and concerning situations for clinicians and administrators. Accurate diagnosis of borderline pathology, avoidance of iatrogenic complications related to misdiagnosis, and referral to informed and evidence-based interventions can guide clinicians’ management. Risk management concerns are best addressed by a clear and realistic understanding of the borderline pathology. The author proposes a variety of interventions for college and university mental health clinicians with the goal of accurate diagnosis of borderline personality, management focusing on safety for both students and clinicians, and targeted referrals for both borderline symptomatology and co-occurring conditions.     

Chapter 13 Homicide in the University Residence Halls:

On May 15, 1990, two students were murdered by a third student in the residence halls of a public university. The campus counseling center's attempt to assist the university community to adjust in the aftermath, including services to students, resident halls' staff and residents, university officals, and victims' families, is discussed. Responses to the anniversary of the homicides a year later, recommendations for counseling centers, and a stress management handout for students are provided.     

A Short-Term Dynamic Psychotherapy Approach for College Students

Abstract

This article explores the need for university counseling centers (UCCs) to implement brief therapies and describes one such treatment, intensive short-term dynamic psychotherapy (ISTDP), as a particularly viable therapeutic approach in this setting. Because ISTDP is not appropriate for all students seeking therapy, a careful assessment of the client is conducted prior to deciding which treatment approach is best suited for the client. The different restructuring techniques that comprise ISTDP are discussed. The article ends with a brief vignette from a therapy session with a student involving ISTDP techniques.     

关于学生心理危机干预网络的建构问题

建构覆盖大中小学和幼儿园的学生心理危机干预网络,既是常规性学生心理危机干预的需要,也是应对重大灾害性危机事件后学生群体对心理干预的需要的必然选择。学生心理危机干预网络应以现有学生心理咨询、心理治疗机构为基础建构。为此,我们必须从现在起尽快建立市心理危机干预中心、区（县）学生心理咨询中心等机构,使常设的学生心理干预机构得以完善,并建立保证学生心理危机干预网络高效运行的管理制度。     

Alcohol Use,Psychopathology, and Treatment Utilization in a University Mental Health Clinic

In the general population, alcohol use disorders and psychiatric disorders co-occur. Despite ample evidence of the adverse effects of alcohol use on treatment outcomes, these relationships have not been examined among college students presenting at counseling centers. The purpose of this study was to assess the prevalence of hazardous drinking among students receiving counseling at a university counseling center and to examine relationships between alcohol use, symptomatology, and treatment utilization. Participants were 214 students who had terminated therapy within a 3-year period. Intake assessments of alcohol use, anxiety, depression, and perceived stress were harvested from client files. Analyses indicated that 33% of the sample screened positive for hazardous alcohol use. Findings provided preliminary evidence that hazardous drinking is negatively related to both mental health and treatment utilization in university clinics. In light of this association, coupled with high base rates of risky alcohol use among college students, university counseling centers might consider implementing screening and brief intervention for hazardous drinking.     

Sleep Quality and Academic Performance in University Students: A Wake-Up Call for College Psychologists

Both sleep deprivation and poor sleep quality are prominent in American society, especially in college student populations. Sleep problems are often a primary disorder rather than secondary to depression. The purpose of the present study was to determine if sleep deprivation and/or poor sleep quality in a sample of nondepressed university students was associated with lower academic performance. A significant negative correlation between Global Sleep Quality score (GSQ) on the Pittsburgh Sleep Quality Index and grade point average supports the hypothesis that poor sleep quality is associated with lower academic performance for nondepressed students. Implications for both the remedial (assessment and treatment) and preventive (outreach) work of college and university counseling centers is discussed.     

高校学生管理面临的新问题

当前，越来越多的大学生到校外租房，给传统的学生管理工作带来了新的问题。新时期高校的学生管理工作应与时俱进，针对现代大学生的特点，创新工作思路，做到服务育人，管理育人。     

Community Consultation and Intervention: Supporting Students Who Do Not Access Counseling Services

Although the severity of psychological problems among college students and the demand for campus counseling services has increased, many students who could benefit from mental health services still do not access them. This article describes Community Consultation and Intervention, a program designed to support students who are unlikely to access professional help despite the best efforts of traditional counseling center outreach. Community Consultation and Intervention reaches into the campus community to intervene by advising faculty and staff who may be the only contact for a distressed student, taking on a nontraditional “student support” role in direct interactions with students, offering advocacy when university systems or other environmental stressors precipitate psychological problems, and providing case management and crisis intervention services on behalf of the university when troubled students are especially concerning and disruptive to their communities. The most novel element of the program—the student support role—is distinct from conventional counseling in that it privileges problem solving, support, advice, and advocacy over focusing on emotions and other traditional mental health interventions. Case studies and programmatic challenges are described.     

Interpersonal Violence and Sexual Assault: Trauma-Informed Communication Approaches in University Counseling Centers

A university in the United States Mountain West utilized grant resources to track counseling services for students who were currently experiencing or who had historically experienced relationship violence, sexual assault and/or stalking. This report reflects on the first 2 years of this program, including an overview of prevalence and reporting rates of interpersonal violence from university students. Given the prevalence of recent and historic interpersonal violence among university students, suggestions are offered for bringing a trauma-informed and communication-focused perspective to the solution-focused brief therapy model used in many university counseling centers. A case study outlining these approaches is offered.     

The Acceptability of Therapist-Assisted,Internet-Delivered Treatment for College Students

University and college counseling centers struggle with rising service demands without a corresponding increase in resources. Consequently, counseling centers must seek creative ways to not only maintain the status quo, but expand capacity while preserving effectiveness. In other countries, therapist-assisted, Internet-delivered treatment has been effective in treating several common disorders while conserving one third to one half the per client therapist time, suggesting that Therapist-Assisted Internet Based Cognitive Behavioral Treatment (TAI-CBT) could be an alternative treatment option offered through counseling centers in the United States and one possible solution to increase the number of students effectively treated per therapist hour for certain students seeking services. In this study, 334 students were surveyed to assess the acceptability of this mode of treatment; 217 of these students were currently in counseling or had received counseling in the past. TAI-CBT was endorsed by 34% of the students with past counseling and 16% of the students with no history of receiving counseling. These proportions were comparable to the rates for those who expressed interest in group therapy, which is commonly offered in counseling centers.     

Meditative Training Improves Undergraduate Executive Functioning

The experience of attending college can be a stressful experience for many students, one that college and university counseling centers may have limited resources of time and finances to assuage. For instance, decision making may deteriorate during times of stress and result in a narrowed perceptual set. The present study sought to determine through a novel design whether meditative training could effectively address the situation. Results indicated that classroom-based meditative training improved executive functioning among college students regarding stress, cognitive flexibility, and insight. Such an approach to intervention may provide college and university counseling centers with greater opportunities to better meet student emotional and academic needs.     

高校大学生就业心理困扰的个案研究与对策

大学生就业问题一直备受社会关注,而由各种心理问题所带来的就业困扰已成为目前高校心理健康教育的重要内容．本文从实际案例出发,运用心理辅导理论技术,对大学生的就业困扰心理进行辅导和分析,探讨解决高校大学生心理困扰的途径和方法．     

College Counseling Today: Contemporary Students and How Counseling Centers Meet Their Needs

There is evidence that today’s college and university students are struggling with emotional and behavioral health problems at higher rates than in past generations. This article explores the various ways, utilizing a range of models, that college and university counseling centers have mobilized to respond to these challenges. We examine literature about the characteristics and concerns of the current student generation along with what counseling centers are doing to respond to the challenge of student needs. We describe a survey (N = 408) of members of the Association for University and College Counseling Center Directors (AUCCCD) and American College Counseling Association (ACCA) that elicited the kinds of services, functions, structures, and organizational relationships found in today’s counseling centers. In addition to confirming the core mission of providing counseling and psychotherapy, the survey revealed widespread counseling center collaboration and consultation activities beyond the counseling room. The survey also indicated a variety of administrative and structural arrangements in the way counseling centers are placed on their individual campuses. Finally, we suggest a framework for planning, executing, and evaluating counseling center and campus initiatives.     

Take Two Pills and Call Me in December

Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including Prolonged Exposure Therapy, have the potential to be offered within counseling center services, however. Prolonged exposure consistently provides significant symptom relief to patients with the most severe PTSD symptoms within 10–12 sessions. This article presents and examines two case examples of students who participated in a full prolonged exposure protocol within a counseling center clinic.     

Adjustment Difficulties and Caregiving Burdens Faced by College Students with a Parent with Bipolar or Depressive Disorders

College campuses often host students who come from families where one or more parent has been affected by a bipolar or depressive disorder. The present study sought to determine whether these students face unique challenges in college, including increased adjustment difficulties as well as greater caregiving burden associated with their parents’ illness. Participants (N?=?89) were undergraduate students at a large public university in the South (27 had a parent with bipolar disorder; 30 had a parent with major depressive disorder [MDD]; 32 had no parent history of a mood disorder). Semistructured interviews were used to assess student symptoms of mood disorders and mood disorder symptoms within their immediate family. Self-report measures were used to assess college adjustment and levels of caregiving burden faced by the students. We found that students with a family history of bipolar disorder and MDD had significantly greater difficulty adjusting to college. These difficulties persisted even after controlling for whether the student themselves had been affected by a mood disorder. The students of a parent with either bipolar disorder or MDD also reported significantly more burden associated with caring for their parents. College campus mental health professionals need to be aware that students with a parent with bipolar disorder or MDD face unique challenges adjusting to college that are only partially related to an increased risk for mood disorders.     

College Counseling and Student Retention:

Although it is commonly believed that college counseling positively affects student retention and further, that there are convincing data and evidence to support such a belief, an extensive literature search found no objective evidence at all on the relationship of a counseling center's conventional one-to-one counseling and therapy activities with short-term student retention. Two program evaluations which attempt to relate one-to-one individual counseling and psychotherapy to student retention rates at an urban regional state university are discussed. Changes in attendance rates, such as dropping out or retuning between quarters are the criteria used to evaluate program effects for both studies. The first study searched for discernible statistically significant effects. Three-quarters of comparisons of upperclassmen found conceivable retention advantages of students receiving counseling center services over a base-rate group. Yet the freshmen results suggest that counseling may be associates with student attrition, not retention. The second study investigated the relationship between retention and possibly relevant presenting problems and demographic variables of students undergoing individual counseling. No attendance differences among counseled students were found due to age, gender, or presenting problem. Following a discussion of the results, suggentions for future research are presented. A longitudinal, quasi-experimental controlled study of the impact counseling on student retention is clearly needed.     

Effects of a Brief Mindfulness Based Group Intervention On College Students

Increases in the number of college students seeking mental health services require counseling centers to explore innovative strategies to provide effective and efficient treatments. Group interventions offer an alternative to traditional individual counseling, allowing centers to serve more students with fewer clinical staff (Burlingame et al., 2016). Of current group modalities, mindfulness-based interventions (MBIs) have been growing in popularity as an effective approach for addressing college students’ increasingly complex needs. This study describes the evaluation of a three-session mindfulness-based intervention on students’ mindfulness, symptoms, and stress. Compared to a comparison group of 109 students not seeking counseling center services, 78 students who received the intervention reported increased mindfulness, and decreased symptoms of depression, anxiety, and stress at the end of the group. Furthermore, improvements in mindfulness mediated intervention effects on symptoms of depression and anxiety. These gains were generally maintained 3 weeks later. These findings support the benefits of brief group interventions for college students. Suggestions for modifications to the intervention and for future research are discussed.     

A case for routine involvement of threat assessment and management teams with college students at risk for suicide

ABSTRACT

Institutions of higher education and their counseling centers are under intense pressure to prevent student suicide. This article proposes that routinely using threat assessment and management teams in working with suicidal students would add value to existing suicide prevention efforts. The unique features of threat assessment and management provide several advantages over traditional clinical intervention. First and foremost, the majority of students who die of suicide do not seek services from campus counseling centers. These students may, nonetheless, come to the attention of campus constituents in a number of ways and may readily be referred to a threat assessment and management team. For students who are clients of the counseling center, a campus should still activate a threat assessment and management process. In this way, threat assessment and management may be useful for students who refuse to seek help as well as in providing assistance when students are engaged in treatment. Nonetheless, higher education in general and counseling centers in particular have not engaged in a standard practice of involving threat assessment and management teams with students who present at risk for suicide. Limitations to clinical approaches for suicide prevention are reviewed in contrast with the complementary advantages of threat assessment and management as applied to suicidal students. Regularly including threat assessment and management in working with suicidal students in higher education may provide synergy in improving the likelihood of desirable outcomes in preventing suicides.     

Readability of Informed Consent Documents at University Counseling Centers

The extent to which clients understand the nature and anticipated course of therapy is referred to as informed consent. Counseling psychologists often provide informed consent documents to enhance the education of services and for liability purposes. Professionals in numerous health care settings have evaluated the readability of their informed consent documents, but no such peer-reviewed research exists for university counseling centers. This study evaluated the informed consent documents for psychotherapy from university counseling centers using three readability formulas (Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and Simple Measure of Gobbledygook [SMOG] Grading). The findings support the authors’ exploratory hypotheses that informed consent documents in university counseling centers are rated as challenging to read for college students. Recommendations and implications for practice are discussed.