Chapter 4.

Abstract

Anxiety disorders are the most common mental health concerns in the United States and they tend to be among the most frequently reported in college mental health. While efficacious research for the psychotherapy treatment of specific anxiety disorders (e.g., social phobia, panic disorder, etc.) exists, the picture is more complex in clinical practice especially with students who are treated as a whole person, usually involving multiple co-existing disorders as well as normal developmental challenges of adjusting to college. This chapter reviews the evidenced-based research for anxiety disorders in both the general population and the college student population, as well as evidence for therapist/relationship factors. It examines the numerous challenges for conducting effectiveness studies in college mental health, suggestions for working with chronically anxious college students, and future directions for research and practice in this area.     

Academically Successful Students with Serious Mental Health Difficulties: A Psychodynamic Developmental Perspective

Abstract

This commentary discusses Robert May's reflections on policy for student mental health services on college and university campuses. The Report of the Harvard Provost's Committee on Student Mental Health Services is the impetus for his reflections. While May suggests that the student mental health unit be taken out of the medical unit, the Committee recommends that the variety of services be maintained, but out of the grip of managed care, and that there be greater collaboration and coordination among the services. While noting the psychiatric orientation of both the Committee and its Report, this author sees that the Report emphasizes the institutional context for students' emotional problems and the neglect of that context by recent Harvard University Health Services policies. The present author urges better collaboration between the services located in counseling services and those located in medical services.     

Community Colleges: Rethinking STD Prevention for the Nontraditional College Campus

ABSTRACT

As increased attention and proposed funding are being directed toward community colleges, it is important to consider the sexual and reproductive health care needs of this growing population. Existing data suggest there are significant sexual health needs among this population and often insufficient provision of services. Some community college students are more likely than students at 4-year colleges to test positive for sexually transmitted diseases (STDs). Given resource constraints, creative solutions are required. These may include campus-wide policies addressing STD/HIV (human immunodeficiency virus) prevention, referral systems to connect students to care in the community, and partnerships with local health departments, Federally Qualified Health Centers, or community-based organizations to assist with the provision of services. Colleges have the unique opportunity to provide students with valuable information about sexual health and services. Community colleges, in particular, are uniquely positioned to reach at-risk community members for STD testing and sexual health care who might otherwise be lost to care. More research is needed on the sexual health needs of community college students, especially on factors such as geographic location, how embedded the school is into the community, social norms around sexual health on college campuses, and health services offered. New and innovative ways to promote linkage to care for testing and counseling could offer potential health benefits to this growing at-risk population.     

Supporting Veteran Transitions to the Academic Setting: VA on Campus

In this case study, we assessed academic functioning, service satisfaction, and needs of student veterans at a community college who had accessed the Veterans Health Administration (VHA) Student Veteran Health Program (SVHP) (n = 36). The SVHP provides outreach and behavioral health services directly on a large community college campus to overcome common barriers to engagement in mental health care (e.g., distance from a VA medical center). Academic difficulties that were most commonly reported were in the areas of retention of information, meeting deadlines, and cooperation with other students. Overall, the majority of student veterans who received services in the SVHP were satisfied (76.5%). Services targeting attention and concentration and utilization of educational benefits were highlighted as important by student veterans. This case study of VA services delivered within the community college setting provides important insights into how to design VA services to target the needs of student veterans. Specific recommendations for supporting student veterans on a community college campus are discussed.     

Staff Development Needs of Public Community College Department/Division Chairpersons

Abstract

No administrative position appears to be more pivotal in facilitating grassroots change in the community college than that of the department or division chairperson. However, no one, until the present effort, has systematically assessed two-year college chairpersons to determine what they perceive their staff development needs to be. The results of the present study indicate that preservice and inservice training received by chairpersons was generally nominal, and that self-improvement activity appears weak. Further, the respondents reported extensive and serious needs related to knowledge of the community college, managerial skills, personnel matters, administrative matters, curriculum and instruction, student personnel services, and some 18 other possible training needs ranging from the law and higher education to the effective use of a secretary. Chairpersons were also asked to indicate what they consider to be the most convenient times and conditions for inservice training. They suggest that they would seek out substantially more training than they do if better funding, time, and site configurations were made available. Finally, concrete recommendations are made to increase the availability of training of two-year college chairpersons.     

Autobiographical Counternarratives from the Community College to the PhD

ABSTRACT

Historically, community colleges and those they serve have been relegated to the margins of academe. Community colleges’ critics argue that students starting at two-year institutions are less likely to earn bachelor’s degrees and have lower student outcomes. This CCJRP Exchange Article draws upon counternarratives in highlighting multiple truths of the community experience through use of scholarly personal narratives (SPN) of those that moved in, through and out the community college to the PhD. The faculty member and doctoral students reflect on how their community college experiences influenced their career trajectories. Further, implications for community college practice, policy, and research are shared as the authors make a case for applying SPN in an effort to see community colleges as sites of deep growth that have lasting effects on the personal and professional lives of their students.     

Disqualifying Specified Students from the Campus Psychological Service

Abstract

Inasmuch as college mental health programs are ordinarily mandated and designed to provide a wide range of services, modalities of treatment, and a competent professional staff determined to assist students in various states of crisis, there is usually little thought or attention given to denying services to particular students. Nevertheless, most college mental health programs are, from time to time, beset by students who attempt to utilize their services in a manner that is highly inappropriate, sometimes quite disruptive, and, in extreme cases, even dangerous. This article will provide certain guidelines and criteria that may be used, when and if necessary, for disqualifying such students from utilizing the campus psychological service.     

Community College Attendance and Socioeconomic Plans

Using data from the National Education Longitudinal Study, 1988 (NELS: 88), this paper documents differences in the socioeconomic plans of students in two-year and four-year colleges. We found attendance at a two-year college led to a modest but statistically significant disadvantage in socioeconomic plans. However, the impact of attending a community college on educational and occupational goals are conditional rather than general. That is, the negative impact on socioeconomic plans of attending a two-year college held for women but not men. Finally, according to our research, the negative effect of attending a two-year college differed in magnitude by an individual's tested cognitive preparation. In particular, attending a two-year college significantly reduced subsequent socioeconomic plans only for students with relatively high precollege test scores.     

Chapter 11.

Abstract

This chapter presents answers to the twenty questions asked at the beginning of this volume, articulates a number of generally poor current practices of pharmacotherapy, makes suggestions for improvement in treatments combining medication and psychotherapy, and proposes important research at colleges and universities to gain understanding of use and misuse of psychotropic medication. We suggest that institutions of higher learning are primary places to reform and improve mental health services and are among the best proponents of community mental health theory, practice and research.     

Developing an Eating Disorder Peer Advocate Program on Campus: A Report on the Eating Disorder Awareness and Advocacy Program (EDAAP)

ABSTRACT

This article describes the development and implementation of a peer advocate program for eating disorders and body image outreach on a college campus. Empirical and conceptual literature on the use of peer educators and peer advocates in college student mental health is reviewed. Peer advocate program mission, history, implementation, and training components are described. Learning outcome assessment findings of peer advocate learning are discussed. A counseling center perspective on benefits, challenges, and limitations of facilitating this peer advocate program is shared.     

Utilizing Partnerships to Maximize Resources in College Counseling Services

Research indicates an increasing number of college students are experiencing severe psychological problems that are impacting their academic performance. However, many colleges and universities operate with constrained budgets that limit their ability to provide adequate counseling services for their student population. Moreover, accessing off-campus mental health services can be difficult for college students, in particular community college students, for a variety of reasons. This article describes a partnership between a community college and university that utilizes a graduate training program to provide on-campus counseling to both student populations enabling both institutions to maximize their resources.     

Patterns of alcohol use: a two-year college and four-year university comparison case study

With more than 12 million students enrolled in over 1,150 two-year institutions, enrollment at these institutions constitutes approximately 44% of all undergraduates in the United States. Despite this, research and prevention efforts related to drinking behaviors among college students attending two-year institutions are limited, with similar information regarding students at traditional four-year institutions readily available. This study sought to examine alcohol use patterns among students at a two-year college compared to a four-year institution. It was conducted at a large (20,000+ students), public, four-year institution and a medium (8,000+), public, two-year institution located in the same community. The Core Alcohol and Drug Survey, a 39-item instrument used by colleges and universities for assessing the nature, scope, and consequences of high risk drinking behaviors in college students, was administered to students at both a two-year (n = 581) and a four-year institution (n = 928) (Cremeens & Chaney, 2012).

The prevalence estimates of current alcohol use among students at the two-year institution in this study are comparable to national estimates for students attending four-year institutions (67.5% and 69.0%, respectively). Estimates of high-risk alcohol use at the four-year institution in this study were higher than national prevalence estimates for similar colleges. Current drinkers and binge drinkers at both institutions experienced the same negative consequences. While the study results provide insight into the need for alcohol prevention efforts at community colleges, there are important factors and practical considerations related to these efforts presented here for community colleges and administrators to contemplate.     

Doing it the Community College Way: Community College-Specific Programming

ABSTRACT

Community colleges are often boxed into university models despite the unique nature of their institutional missions and student populations. We believe community colleges need to develop their own models, rooted in their distinctive missions, to encourage student success. We illustrate this through our experience with a short-term research assistantship program. The program created a brief, but important, way to enhance the student–professor relationship and engage students in applied research practices. It also provided a resource to assist community college faculty in conducting their own, original research. We hope others will not only develop similar programs, but perhaps more importantly, that this article will spur bottom-up, creative thinking to engage time-constrained, community college students in meaningful ways.     

Four-Year Degree and Employment Findings From a Randomized Controlled Trial of a One-Year Performance-Based Scholarship Program in Ohio

ABSTRACT

A college degree is often viewed as a key step toward better employment and higher earnings. Many community college students, however, never graduate and cannot reap the financial benefits associated with a college degree. Although existing research suggests that financial aid interventions can modestly improve students' short-term academic outcomes, there is little rigorous evidence on the critical question of whether such interventions improve graduation rates or employment outcomes. This study helps to fill that gap using a randomized controlled trial involving over 2,000 community college students in Ohio. It focuses on a student population composed predominantly of low-income mothers. The study includes four years of post-random assignment data to examine the long-term impact of a performance-based scholarship program—financial aid that is contingent on academic performance—on degree receipt, employment, and earnings. The findings provide evidence that the one-year program made a lasting impact on students' credit accumulation—still evident after four years—and decreased the time it took students to earn a degree, but the study does not provide evidence of impacts on employment outcomes.     

Serving Those Who Served: Evaluation of Evidenced-Based Veteran Programs at Community Colleges

ABSTRACT

The research and practice surrounding student service members/veterans has evolved over several decades. With a regeneration of veteran students’ enrollment, a need for increased attention to this special student population continues to be an institutional priority, especially for community colleges. The literature suggests that while greater attention has been paid to serving those that have served, there is little to support whether or not such efforts are considered evidenced-based. This discussion asserts that community colleges are ripe with examples of evidenced-based programming for student service members and student veterans.     

Students with Disabilities: Experiences Attending a Two-Year Community College

ABSTRACT

Students with learning disabilities tend to enroll in two-year community colleges more than they do four-year universities, have lower graduation and retention rates as compared to their non-disabled peers, and experience greater academic, social, and personal difficulties when pursuing a college degree. Yet, despite the higher number of students with learning disabilities in community colleges, and the challenges they face as a marginalized population, the literature pertaining to these students is still growing. Thus, the purpose of this phenomenological study was to explore the lived experiences of students with learning disabilities within a two-year community college.     

Examining Personal,Perceived, Treatment,and Self-Stigma in College Students: The Role of Parent Beliefs and Mental Health Literacy

ABSTRACT

Although college student mental health concerns are on the rise, many struggling students do not seek psychological treatment when needed. Stigma toward psychological treatment has been demonstrated to influence intent to seek treatment in college student populations. This study aimed to identify factors that predict treatment stigma in college students by examining other forms of student-held stigma, parent-held stigma, and mental health literacy. Results indicated that student-held personal, perceived, and self-stigma all predicted student attitudes toward treatment, while parent-held personal stigma was found to predict self-stigma in students. Those individuals who had received previous education about psychological disorders had lower levels of personal stigma, and, surprisingly, higher levels of self-stigma. Implications for campus outreach programming are discussed.     

Training Student Leaders in Reporting Sexual Misconduct Incidents at a 2-year College

ABSTRACT

Sexual misconduct is a major psychological, emotional, and public health crisis that manifests itself in social and academic arenas including community college campuses. Problems of sexual misconduct that emerge for women and men are not based solely on a difference in gender, but in silence once an incident occurs. The strife that emerges for students can be devastating and pervasive. College counselors, who provide counseling services and training programs, can offset the potentially negative consequences. This article highlights a training program for student leaders that underscores the significance of reporting sexual misconduct incidents at a 2-year college. This article provides percentage data to reflect the perceptions participants had following such training. The training discussed will further the understanding of how to take a proactive approach in reporting incidents of sexual misconduct. Prompting research along this line of training will provide important information to college-student personnel who are vested in creating a transformation to decrease incidents of sexual misconduct on 2-year college campuses.     

The Role of Unrealistic Optimism in College Student Risky Sexual Behavior

Abstract

The purpose of this study was to investigate the association between unrealistic optimism (UO) and risky sexual behavior (RSB) and related consequences in a college student sample. Participants believed they had significantly lower personal risk of engagement in alcohol-related sexual activity, unintended pregnancy, and STIs than the average college student (ps?<?0.01). Compared to national data, participants significantly underestimated likelihood of HPV and sexual engagement with four or more partners in the next year (ps?<?0.01). Findings support evidence of UO relating to RSB-related consequences, indicating need for improvements in sexual health education and intervention.