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Concerns Addressed in Counseling For concerns such as relationship issues, anger or stress management, family dynamics, sexual topics, and academic goals, the counselor acts as a guide and mentor for students in their academic, personal, and professional lives. Since students may be referred by school officials, family members, or other students, the counselor should anticipate varying levels of openness by the student and/or the family. It is vitally important for counselors to be trained in the strategies for recognizing and addressing issues in a manner that will capitalize on the counseling session to the maximum benefit of the student. The first step in this process is recognition of the key issue or issues, which may take more than one session to identify. Beyond that, counselors can use various strategies focusing on the particular situation as well as the idiosyncrasies of the student.
At-Risk Students
Factors and Behaviors It is important for counselors to be aware of the events and influences that place students at risk, as well as the potential ramifications of unstable behavior and mental state. Counselors should be aware of changes in student behavior that may signal depression or other mental or emotional fragility. It is worth mentioning that the leading cause of death for young people is suicide, and therefore that counselors are in a pivotal position to notice and respond to these symptoms. Some students may need more intensive treatment than school counseling. Some of the factors that can contribute to emotional vulnerability for at-risk students are rising levels of poverty, substance abuse of the student or parents, domestic violence, and community violence. Other kinds of behavior problems may be a result of ADHD or other behavior disorders, and may indicate the need for the student to be referred to special education resources in the school.
Including Needs of At-Risk Students When Delivering Curriculum Counselors are generally responsible for addressing the academic as well as the career and social development needs of students. To that end, they should be well versed in the areas of leadership, advocacy, systemic change, and collaboration. Also, they should develop and continually refine the skills to teach these subjects to diverse groups of students, including at-risk students. Within the category of at-risk students are included those students whose behavior and performance are a result of family or socioeconomic factors, as well as students who come from a more stable background but suffer from physiological disabilities.
At-Risk Although the behaviors of at-risk students fall within a rather large spectrum, there is an umbrella definition that can be used to identify at-risk students. Generally speaking, if a student shows decline in any or all of the areas of physical, mental, social, spiritual or economic health, then the student is considered at risk. In addition, community and social circumstances may contribute to a student's sense of isolation, increasing the possibility of deterioration in one or more of these areas. Students who are at risk in any or all of these areas have a diminished likelihood of becoming productive members of society. Counselors are encouraged to refer to guidelines from professional organizations or literature to identify and appropriately respond to at-risk students. Counselors can provide the support, resources, and encouragement that can significantly mitigate deteriorating factors.
Cautions When Identifying a Student as At-Risk There are five key areas of caution to consider when identifying a student as at-risk:
Difficulty of Assessing At-Risk Youth from Culturally Diverse Backgrounds When a student is identified as at-risk, the identification is usually based on overt behaviors or shortcomings. These may include poor academic performance or inappropriate behavior. An initial assessment may point to the need for more native language materials or conflict resolution workshops. However, for some first- or second-generation immigrants, these outward circumstances may be noticeable, but not the underlying or most problematic issue. Often, the underlying issue can be masked by overt behaviors, until the need for treatment is long past due. Students from diverse cultures may be contending with issues related to isolation, sadness for loved ones left behind, bridging the gap between cultures, and other issues directly related to poor cultural assimilation. Although there are no clear guidelines for identifying such cultural factors, counselors should be aware of the possibility of precipitating circumstances when dealing with at-risk students from other cultures.
Peer Association Adolescent students between the ages of 14 and 17 are particularly susceptible to peer association and influence. Youth in this age group generally gravitate to peer groups besides their family. Often, young people join groups that are formed around a common ethnicity. Unfortunately, if some of the members of the group engage in violent or illegal activities, those who join the group often mimic this activity in order to be accepted. Consequently, students who participate in violent behavior or drug use engage in a lifestyle that leads to the decline of their physical, mental, social, spiritual, and/or economic health, which places them clearly in the at-risk category. Although counselors need to refrain from making assumptions based on associations, they nonetheless should be aware of a student's associations, particularly as they relate to at-risk behaviors and attitudes.
Current and Declining Trends Within a large student body, there will be a small percentage of students engaging in at-risk behaviors. Counselors should be on alert for this type of behavior. At-risk youth commit various crimes after school, generally between the hours of 3 and 8, and especially right after school. Robberies are sometimes committed by youth, usually during the week and usually after 9 p.m. Today's students still face problems with premarital sex and unwanted pregnancies, which can put them at significant risk of poor academic performance. However, the incidence of student suicide is on the decline, as are the incidences of students riding with drunk drivers and carrying weapons to school. Although these activities and behaviors still occur, counselors should be aware of rising and declining trends in at-risk behavior in order to be aware of the signs and symptoms associated with them.
Rejection of At-Risk Students by the School System Students who are displaying at-risk behavior often pose a challenge to educators who are striving for academic success and good classroom management. The at-risk behavior can cause a disruption on both fronts. This can be exaggerated when there are multiple at-risk students in multiple class periods. Teachers and school counselors faced with this disruptive activity will first attempt to remedy the behavior using known strategies. However, if this proves unsuccessful and the disruptive, at-risk behavior continues, teachers may become discouraged and begin to develop an attitude of complacency about the behavior. This can grow into complacency about teaching in general. Consequently, faced with this possibility, counselors will sometimes make the decision to remove a student or students from the school. Unfortunately, this solves the short-term problem by creating a longer-term issue of underserved youth becoming unproductive adults. Counselors can provide a valuable service by preventing this downhill slide in at-risk youth.
Designing Programs for All Students to Benefit the Larger Community Since schools are the primary focal point for issues relating to adolescents, counselors and educators often work with other community entities in discussing and developing strategies for addressing the needs of youth. Some of these entities are libraries, police departments, private schools, recreation centers, and other organizations. One of the ways that counselors can work as liaisons between students and these entities is by dispelling the idea that the burden of at-risk behavior lies with the student. They can work with community representatives who feel that students are solely or primarily to blame for their behavior. Counselors can collaborate with educators to develop programs that are designed to address the needs of not only mainstream students, but also at-risk students. These programs can incorporate the needs and concerns of the larger community as well as the academic goals identified for the student population.
Reasons Educators Have Not Addressed Needs of At-Risk Youth Many educators have not addressed the needs of at-risk youth for some or all of the following five reasons:
Government Funding and Allocations for Assisting At-Risk Youth Federal and state departments of education and mental health have developed the 1967 Elementary and Secondary Education Act (ESEA), which provides for continuing public education through grade 12. There is also funding allocation for disadvantaged children, focused on the goal of drug-free schools and available after-school care. The National Defense Education Act (NDEA) of 1958 authorized schools to hire counselors who encouraged students in the areas of math and science. Counselors and other educators who are committed to assisting at-risk youth can find government support that relates to a guaranteed education for all youth, safer schools, and improved academic performance.
Counselor's Role After a School or Community Trauma Numerous kinds of trauma can affect a student population, from individual crises to those affecting the entire student body. Counselors need to be aware of the types and levels of trauma and how they impact students. It is prudent for them to be aware of the possible ramifications of trauma, how to identify these effects, and the strategies for intervention. Counselors need to be aware of the scope of trauma, and the scope of the needed intervention. School-wide traumas can include natural disasters, school shootings, and widespread gang activity. Individual traumas can include family illness, depression, domestic abuse, and even suicide. Sometimes an individual crisis can escalate into a school-wide trauma like a school shooting or suicide. Counselors should be well versed in the types of trauma and how to assess and treat victims.
Crisis A crisis is defined in part by the event, and in part by the response to the event. Generally speaking, a crisis is a situation that is perceived as overwhelming and intolerable by the individuals facing it. Crises can affect people cognitively, psychologically, behaviorally, and even physically. Although full-scale disasters necessarily affect entire populations and inherently pose overwhelming circumstances, counselors also need to be aware of how individual students are equipped to cope with a crisis. For most crises, which fall significantly short of full-scale disaster, counselors can employ intervention strategies that help students through the present crisis and help them develop coping skills for future challenges. Early intervention will minimize the possibility of traumatic response to a crisis.
Crisis Intervention Since crisis by definition is a situation that is overwhelming and intolerable, crisis intervention serves to provide immediate support and help victims develop coping skills. It is good to remember that one of the factors that can contribute to a crisis is that the situation or event poses a new challenge to the individuals. Some of the components of crisis intervention include:
Crisis Response Plan Counselors can work with school staff and counselors, both at the school and district levels, to develop a crisis response plan. Counselors should facilitate regular meetings with school personnel, parents, and other professionals as appropriate, to educate them on crisis intervention both at the school and at the community levels. Crisis response teams should coordinate campus-wide and community-wide services as part of the critical response team. Counselors can educate and prepare the team on strategies and methods for handling the crisis. The team should be versed on methods for crisis prevention, strategies to employ during a crisis, and post-crisis needs. The team should work together, with the counselor acting as facilitator, to develop a well-organized, systemic response plan. The coordination of the team and the crisis response plan should be implemented as a matter of preparation, and not in response to an immediate crisis.
Logistical Considerations in School Crisis Intervention Plans Crisis response plans need to address the possibility that normal logistical operations may be suspended, particularly in the case of a school-wide or community-wide crisis. Therefore, a good crisis intervention plan will address the following needs: Locations should also be established for communications, first-aid treatment, emergency personnel, storage of supplies/food, and a break room or safe room. Communication needs: Crisis response teams will need to communicate with one another. They may also need to communicate with parents, as well as with the press. Part of the communication requirement will be the oversight and monitoring of team activities. Other considerations: An overall plan, including assigned assessment personnel and assigned intervention tasks.
Identifying and Addressing Suicidal Behaviors School counselors need to be educated on potentially suicidal behaviors, and need to be prepared to intervene if necessary. These behaviors can include ideation, or any other behavior that indicates a student is contemplating suicide. All threats of suicide should be taken seriously. Counselors should consult institutional directives and state laws regarding responsibility for notification. In some cases, parents should be notified immediately, and may even need to pick up their children from school as soon as possible. In any case, students who are at risk for suicide should be in the presence of an adult at all times during the school day. Since the possibility of suicide can be extreme and immediate, intervention may include referral to an outside agency or institution. Counselors can work with parents and consultants in order to transition to treatment facilities, and should be familiar with the community services available.
Addressing the Possibility of Suicide Suicide is all too prevalent among young people, and has been deemed the most common cause of death for adolescents. School counselors working with youth need to be well versed on the factors and behaviors contributing to suicides. There is no guaranteed strategy to prevent suicide and, in fact, suicide may occur despite the best efforts of the student's support network. However, counselors should still be informed and prepared in the event of suicidal behavior. It should be noted that suicidal ideation may be expressed differently in different cultures, and therefore counselors should respond to every potential ideation seriously. Some of the common circumstances precipitating suicide are alcoholism, depression, and a sense of hopelessness or helplessness. Counselors who observe suicidal tendencies should meet with the student regularly to discuss and work on the student's problems and state of mind.
Helping Students Recover Emotionally from Suicide Ideation Working with students who are presenting suicidal ideation includes reconnecting the student to his or her network of support. In the process of working with a student, a counselor can determine which activities and people in his or her life provide meaning, and can contribute to an attitude of hope and resiliency. If a counselor deems that suicide is an imminent threat, the first consideration is the student's safety. This may include the involvement of the parents, within the parameters of relevant privacy mandates. Counselors can also encourage the student to reach out to his or her network of support for encouragement. This network could include parents, friends, church, and coworkers. As the student's ideation begins to subside, this network can also provide a grid upon which the student can reestablish positive connections. Counselors can remind students of their responsibility, purpose, and place in this network and in the larger community.
Warning Signs of Suicidal Ideation Although there are innumerable manifestations that suicidal thoughts can take, there are seven key identifiers that counselors should take note of:
Indicators for Violent Behavior in a School Environment Often, students who feel disenfranchised will act out by bullying or otherwise victimizing other students. This sense of separation can result from a student feeling isolated from peer groups, cultural groups, family, or other groups from which the student feels excluded. This sense of exclusion may precipitate the student attacking, bullying, ignoring, or otherwise harassing other students. This sense of isolation may also be a precipitator of suicide, or attacking the self. Students may intensify this attacking behavior by bringing weapons on campus, or by inciting physical violence. Recent years have seen more covert and violent victimization on school campuses. Counselors and other school personnel need to be attentive to any incidents of bullying, which can escalate into more intense behaviors. Bullying and other victimization may be more prevalent among certain groups of students, and should provide the counselor with the opportunity to address the prevailing attitudes and behaviors.
Implications of Bullying Any act of bullying or other victimization implies a power hierarchy. The victim is perceived and treated as powerless against the perpetrator, and each act of victimization further endorses that hierarchy. Often, social injustices and inequalities in a community or school environment provide fertile ground for bullying and victimization, which perpetuates the inequalities. If a comprehensive program to balance inequalities is not implemented, the bullying and victimization will most likely continue. Counselors can begin to address chronic victimization problems by educating students and relevant adults about how to effectively break the cycle of victimization. Victimization can also take the form of gossiping or excluding certain individuals from group activities. Although some schools have rules specifically prohibiting victimization, counselors can provide a valuable service by working with the parties involved to recognize and stop the cycle of victimization.
Impact of Abuse or Neglect on At-Risk Students Students who have been abused, neglected, or who have been witness to abuse within their own family are inherently at risk of decline in any or all of the areas of physical, mental, social, spiritual, or economic health. Often students with a history of neglect or abuse display chronic behavior problems including anxiety, depression, substance abuse, and/or other emotional or mental disturbances. Furthermore, victims of childhood abuse or neglect often feel a deep-rooted sense of shame or embarrassment, which translates to chronic social and emotional isolation. They often exhibit poor academic performance and retreat from normal activities with friends and fellow students, particularly if they have been helpless bystanders to abuse perpetrated against a parent or siblings. Counselors find that there is often a clear correlation between at-risk behavior in school, and abuse or neglect in the home.
Growing Incidence and Impact of Dating Violence The definition and parameters of dating violence vary between studies. However, the overall incidences of dating violence have been steadily increasing in recent years. The figures of violence occurring in a dating situation range from a few incidences to a significant portion of the student body. As indicated by the term dating violence, the general parameters define an individual victimizing another individual in a dating environment. This can occur with middle school, high school, or college students. Most of the victims are women. The impact of this dating violence is felt at the individual level, often throughout the students' school, family and community network. The victim often is left with feelings of helplessness, which can expand into depression, substance abuse, and risky sexual behavior. Counselors need to be aware of the possibility of dating violence in a student who is presenting at-risk behavior.
Preparing for Campus-Wide Student Violence Counselors should first be assured that the frequency of campus-wide student violence has declined in recent years. Nonetheless, there is always some possibility of a student or students committing violent acts that harm the campus as a whole. Unfortunately, there are not always clearly identified indicators of potential campus-wide violence. Most experts agree that this type of wide impact violence is usually the culmination of several factors in at-risk students. The best preparation strategies for counselors include both individual interventions for at-risk students and an intervention plan for the school. On the individual level, counselors should always work with students to mitigate their violent tendencies or fantasies, regardless of whether or not they appear to pose a threat to others. On the campus-wide level, counselors can work with school officials to develop a rubric for threat assessment, as well as an intervention plan to minimize the casualties should a campus-wide event occur.
Factors Associated with Violent Tendencies in Students One of the factors that makes it difficult to predict violent incidents is that many students who display violent behavior do so on an impulse, meaning that most violent incidents are unplanned. Generally speaking, students who feel disenfranchised, helpless, or threatened may act out by perpetrating violent acts or behaviors. Often, violence will be motivated by feelings of desperation or an irrational fear that others may be threatening harm. Males are generally more likely to commit violence than females, and the highest incidence of violence falls between the ages of 15 and 24. Lower socioeconomic status is also a common factor in violent tendencies. In addition, if a student has a history of violence, he or she will be more likely to commit violence. Lastly, students who have disorders related to conduct, ADHD, hallucination, delusions, etc., will be more likely to commit violence.
FBI Classifications for Threats of Violence Most of the research on the violent tendencies of students has been completed by governmental and FBI profilers and analysts. This research is made available to counselors and other educators to mitigate the possibility of future occurrences. There are four basic classifications of threats of violence identified by the FBI: Vague threats that imply violence. The threat is implied in the terminology, but not specified. Time and place are not generally specified. Veiled threats of violence. The terminology is more specific, but time and place are still not specified. Conditional threats of violence. The terminology refers to violence if certain conditions are not met. A common example of this is extortion. Direct threats of violence. These threats are clearly stated and straightforward. The terminology is in the form of a warning which specifies a target, time, and place.
Levels of Threat Seriousness According to government publications, the likelihood or seriousness of a threat can be classified according to three sets of criteria: Low-level threats are generally characterized by vagueness or a lack of specificity. Students may make a general, indirect statement of threat with little or no detail and little or no specific plan of action. Minimal risk is associated with low-level threats. Medium-level threats are more direct and plausible but do not appear to be realistic. They may contain details about time and place, but lack evidence of comprehensive planning. A medium-level threat may include phrasing that indicates seriousness, but lack the specificity to make it happen. The risk level for a medium-level threat is higher than for a low-level threat, but generally does not indicate imminent danger. High-level threats are distinguished by their high levels of specificity, and by the comprehensiveness and plausibility of the plan. High-level threats should be taken very seriously, and school officials should always contact the local authorities when they are discovered.
FBI's Four-Pronged Assessment Model for Threat Assessment The FBI has developed a four-pronged model of threat assessment that focuses on the specific characteristics of the student making the threats: Prong 1 assesses the behavior and emotional dynamics of the individual, including signs of alienation, poor anger management, poor coping skills in general, lack of trust, or marked changes in behavior. Prong 2 assesses the circumstances of the family and home of the student, including a lack of limits or lack of monitoring, access to weapons, lack of intimacy, and/or volatile relationships within the family, particularly between the student and parents. Prong 3 assesses the student's perceived marginal place in the school community, evidenced by bullying, a lack of attachment to the school, inflexibility about culture, and hierarchy among the students. Prong 4 assesses the student's other connections, including peers at school, use of drugs or alcohol, and other outside activities or interests.
Intervening with At-Risk Youth and Mitigating the Possibility of Violence Counselors can provide at-risk students with opportunities to develop healthy dynamics and self-validating experiences among their peers as well as with significant adults. Threat assessment teams can be formed and trained to focus on preventative strategies. Peer mentor groups should be established so that at-risk students and students not considered at risk can interact under the guise and facilitation of the counselor. These groups can provide an insulated environment for learning healthy strategies for coping with bullying, neglect, and other forms of abuse. Counselors can teach healthy interpersonal skills within these groups. Counselors can also collaborate with local authorities and community groups to provide opportunities for at-risk youth to have positive experiences with adults and outside groups. At-risk students can be encouraged to join community support groups such as Big Brother/Sisters. Counselors can also encourage family members to develop connections with available support groups and resources.
Identifying At-Risk Behavior Associated with Substance Abuse Since the prevalence and diversity of substance abuse among youth is increasing, counselors should be at least generically educated on common legal and illegal substances and behaviors associated with substance abuse. Counselors should also be aware of the local resources available for students involved in substance abuse. Although school guidance counselors cannot be expected to be experts on substance abuse, it is nonetheless a good idea to be aware of the behaviors and other signs of possible substance abuse. However, many students will not admit or discuss substance abuse, so the counselor should be prepared for referral if necessary. In addition, counselors should be aware of how substance abuse affects academic performance and mental ability, in order to best address these issues with students for whom substance abuse appears to be a contributing factor.
Encouraging Students to Self-Report Substance Abuse Although students may be hesitant to self-report or even to recognize substance abuse, counselors can facilitate this recognition and self-reporting through a series of questions. The following questions target alcohol abuse and are identified by the acronym CAGE: C – Questions about cutting down. Ask the student if he has thought he should cut down on alcohol/substance use. A – The annoyance factor. Ask the student if he becomes annoyed when people criticize his drinking. G – The guilt factor. Ask the student if he ever feels guilty about the amount of alcohol/substance consumed. E – Alcohol as the eye opener. Ask the student if he ever needs alcohol to get going in the morning or to calm his nerves. Counselors should also have regular access and referral to the Physician's Desk Reference to maintain current knowledge about drugs and alcohol, including possible side effects.
Alcohol and Prescription or Other Drugs The following questions can be used as a guide for encouraging students to recognize and self-report substance abuse. Counselors can ask students that may have a substance abuse problem:
Loss That Students May Experience One thing that counselors should remember is that a loss is still a loss, even though it may be as severe as the loss of a parent or as seemingly trivial as failing a class. Divorce of parents can be a particularly devastating but unfortunately a commonly experienced loss for young people. In addition, friendships are very important at this age, and the loss of a friendship can be very upsetting and can be experienced as a major loss. What is significant about these different types of losses is that young people feel loss just as intensely as adults, and that each loss needs to be grieved and processed. Students need to move through the grief, and on to acceptance. By understanding that a sense of loss can be experienced regardless of the precipitating event, and by knowing about the grief process, counselors can provide the support and the guidance to move students through the loss and on to acceptance.
Stages of Grief Process The grief process encompasses the following five major stages: Shock and denial usually define the first stage of the grief process. Counselors can help students identify their fears. The second stage is usually anger, which involves indignation and questioning of why this loss was perpetrated on them. The student may argue that he or she did not deserve this loss. Guilt is generally the third stage, evolving to a sense that the student's actions or inaction may have caused the event leading to the loss, and that therefore they did deserve the loss. The fourth stage is hopelessness and depression. This tends to be the longest stage, and may include feelings of sadness. As this stage becomes less intense, this is usually a signal that the student is almost ready to move on to acceptance. Acceptance is the fifth stage, in which the student adjusts to his or her new life circumstances.
Assisting Students Through the Grief Process Throughout the grief process, counselors can assure and remind students that their feelings are normal, and that eventually life will improve for them. This is not intended as a denial of their feelings, but rather as an assurance that grief is a process, and not a permanent state. Counselors can work with students in the grief process, remembering that there are four major tasks to be accomplished during grief:
Counselors should be watchful for the stages and tasks involved with the grief process and be prepared to refer to the student to outside or specialized resources if the situation becomes overwhelming or too complicated for the counselor to be of assistance.
Dropping Out of High School
Precipitating Factors and Preventative Measures Counselors should be particularly alert and responsive to the possibility of students dropping out, especially if students present any or all of the following:
The following are recommended:
Key Areas to Be Addressed and Intervention Strategies for At-Risk Students During all interventions with at-risk students, counselors should address interpersonal skill-building and self-reflection. It is important for counselors to encourage students to develop strong relationships with peers and school staff/counselors, in order to increase their sense of community and belonging. Throughout the intervention, counselors should always assure students that they can discuss personal issues in both individual and group sessions. Often, at-risk students are struggling with numerous issues in several areas of their lives.
There are four key areas that are possibly involved when students are at risk of dropping out: Personal/Affective – counselors can offer retreats or other groups to encourage interpersonal participation Academic – counselors can arrange for tutoring and/or other individualized methods of instruction Family Outreach – encompassing increased feedback to parents School Structure – possibilities include class size reduction or alternative school options Work/Career – vocational training
Collaborating with Community Resources to Develop a Network of Support Many schools will have ongoing relationships with community groups as a part of a general philosophy of community outreach. However, for at-risk students to receive any direct benefit from these groups or relationships, counselors may have to initiate and coordinate auxiliary relationships for addressing the specific needs of at-risk students. Understanding that at-risk students are often overwhelmed by a variety of life challenges, counselors can collaborate with a number of community resources, including:
Counselors should cultivate these relationships, possibly in tandem with existing school relationships. With the counselor's facilitation and coordination, these resource groups can cooperatively address many of the needs posed by at-risk students. This comprehensive coordination of resources can provide a significant hedge against students dropping out.
Facilitating Change in Intervention Policies to Better Accommodate Cultural Diversity Counselors who work with at-risk youth from diverse cultures are in a good position to reduce the gap between intervention strategies designed for the dominant culture and those that address the needs of minorities. Counselors need to communicate to school officials that under the umbrella of at-risk students may be ethnic groups whose problems are defined or exacerbated by their marginalized status. Counselors can consider the cultural differences of at-risk students and how they will interpret different activities when creating preventative and intervention programs. If necessary and when appropriate, counselors can act as liaisons on behalf of students from diverse cultures, making recommendations for program changes to better accommodate cultural diversity. Counselors can make significant and important changes in the school system, which will benefit present and future students.
Modeling and Advocating Empowerment for At-Risk Students Recognizing that at-risk youth are generally overwhelmed and under-supported, counselors can be particularly effective by providing students with numerous opportunities to develop empowerment and self-confidence. When setting goals, it is important to set achievable, short-term goals to best ensure success by the students. Each success should lead to further and larger successes, and counselors can provide scaffolding goals and challenges. Counselors can also encourage listening and cooperation among family members through their own willingness to take a back seat and emphasize the importance of collaboration and teamwork, facilitating when appropriate. In terms of advocacy, counselors may be aware of policies or procedures within the school system that inherently pose an obstacle or inequity for at-risk students, and may need to intervene on behalf of the students. This is another way that counselors can model empowerment.
Authentically Documenting Intervention Outcomes In the absence of available success/failure rates for many intervention strategies, the onus is often on the counselor to document the outcomes of the strategies used. In order to authentically and effectively produce this outcome assessment, it is at first important to document student responses during and/or after an intervention. In keeping with the assessment model, counselors should produce documentation that either quantifies or clearly identifies specific outcomes. Counselors should also be mindful of their role as advocates for the students by realistically reporting successes and failures, so that program improvements can be made if necessary. By doing so, they can also provide a model for reflection and willingness to change. Counselors who provide authentic documentation and are willing to revise strategies are excellent candidates for added funding or other resources, and can provide comprehensive parameters for the role of school guidance counselor.
Various Roles When Working with Disabled Students
As defined by the ASCA, the school counselor should address the following functions in his or her role as facilitator and advocate for student needs:
Multiple Disabilities, Specific Learning Disability, Orthopedic Impairment, and Other Health Impairment The term 'multiple disabilities' refers to a combination of impairments, such as intellectual disabilities with either blindness or orthopedic impairments, whereby the student's educational needs cannot be accommodated in the traditional classroom. Excluded from this group is deaf-blindness. Specific learning disability refers to a disorder whereby a deficiency in one or more of the basic psychological processes inherent in using or understanding spoken or written language causes a person to have difficulty communicating linguistically or performing mathematical calculations. Orthopedic impairment refers to physical impairments that adversely affect a student's academic performance. Included in this category are loss of a limb, clubfoot, cerebral palsy, and disease-related conditions like poliomyelitis and bone tuberculosis. Other health impairment describes the presence of such chronic or acute health problems as diabetes, epilepsy, ADD, heart conditions, or sickle-cell anemia, that adversely affect the student's educational performance.
Intervention Strategies for Eating Disorders Eating disorders in youth commonly manifest as either bulimia nervosa (BN) or anorexia nervosa (AN), or both. Because both of these disorders result in extremely poor nutrition, and bulimia nervosa can result in esophageal injury, students who are suffering eating disorders are at risk for poor health, poor intellectual and social development, and in some cases death. Counselors can implement intervention strategies through a complete medical assessment and multifaceted therapeutic assessment. In particular, the combination of behavioral therapy and cognitive therapy can be very effective in treating eating disorders. Cognitive therapy can address issues of control and self-esteem, while behavioral therapy can promote healthy eating habits and discourage destructive behaviors like purging. Group therapy may also be quite helpful and in some cases, family therapy may be indicated. Medical assessment may also be indicated, to ascertain if the student is in immediate physical danger from an eating disorder.
Intervention Strategies for Tic Disorders Tic disorders are characaterized by recurrent, non-rhythmic sequences of movements and involuntary sounds from certain muscle groups. These disorders can include Tourette's tic, transient tic, and not-otherwise-specified (NOS) disorders. Counselors should initially garner enough information to accurately diagnose the condition, and should educate the student and the parents more fully about the disease. Therapy can include identifying any underlying stressors as well as assessing family interaction and understanding regarding the disease. Various therapeutic strategies can be effectively implemented for tic disorders. Cognitive-behavioral therapies can address stress management. Self-monitoring, relaxation training, and habit-reversal training are effective strategies to consider, once initial data about the tic have been collected. Habit-reversal training is more commonly indicated, requiring the student to relax the affected muscles and introduce a competing response. If students present with frequent or explosive outbursts, counselors should collaborate with a physician to determine if medication is indicated.
Intervention Strategies for Mood Disorders Mood disorders are generally defined as those in which students externalize feelings of depression, sadness, guilt, or other negative emotion, possibly including thoughts of suicide. Students with mood disorders may present with somatic complaints. Counselors should be wary of misidentifying a mood disorder when a student may just be experiencing temporary sadness. On the other hand, counselors should be cognizant of the signs of mood disorder, especially symptoms that may signal the risk of suicide. Effective therapeutic strategies for mood disorder include cognitive and behavioral interventions, as well as psycho-educational programs that focus on improving social skills and promoting rewarding activities. Some students suffering from mood disorders have improved with antidepressants. However, studies regarding the efficacy of medicinal treatment for depression are inconclusive, and therefore the use of antidepressants should not be immediately considered, if at all.
Intervention Strategies for Substance-Related Disorders One of the initial intervention steps for substance abuse is to identify the pattern of abuse and the substances involved. Parents may conduct drug tests at home, although students may also self-report. An important factor to remember is that students with substance abuse problems may have family members with substance abuse problems, since the correlation is very strong. In addition to individual counseling and education, counselors can conduct school and community workshops that address the benefits of early detection, the risk factors involved, and the treatment options available. Based on the type of substance abuse, duration, and intensity, various treatment models are available, ranging from outpatient therapy to intensive inpatient treatment. The spectrum of treatment options encompasses very restrictive models as well as more participatory models. Treatments include detoxification, contracting, self-help groups, behavior therapy, family therapy, social skills training, as well as nutritional and recreational counseling.
Intervention Strategies for Generalized Anxiety Disorder Generalized anxiety disorder (GAD) is defined as a pervasive anxiety that is characterized by excessive, uncontrollable, and often irrational worry about everyday things, which is disproportionate to the actual source of worry. Physical, somatic symptoms may include shortness of breath and/or muscle tension in other parts of the body, both of which can be difficult to control. Although GAD is not limited to adolescents, it does present problems particular to students, in that the physical symptoms and the irrational worry can overshadow attention to academics, and therefore negatively affect performance. Students who are chronically anxious are unable to focus on their lessons. Counselors can use cognitive-behavioral strategies to mitigate the intensity of the anxiety and the accompanying physical symptoms. Students can be taught coping strategies such as identification, modification of anxious self-talk, education about emotions, modeling, relaxation techniques, and related self-regulating models.
Drug Addiction In recent years, medical professionals have shifted from viewing drug addiction as a sign of immorality to seeing it as a legitimate physiological disorder, which can be treated by medicine and psychological therapy. Scientists believe that prolonged use of drugs can cause chemical changes in the brain that create addiction, and can endure for the entirety of the person's life. The most common traits of chemical dependency are loss of control over dosage and frequency of use, and continued use despite harmful consequences. Unfortunately, one of the other common characteristics of drug addiction is the refusal to admit that it exists. Many doctors believe that only by removing the stigma of drug addiction will it be possible to treat all those who need help.
Loss still a loss, despite whether it is as severe as the loss of a parent or as seemingly trivial as failing a class. Divorce of parents can be a particularly devastating but unfortunately a commonly experienced loss for young people. Also, friendships are very important at this age, and the loss of a friendship can be upsetting and be experienced as a major loss. What is significant about these different types of losses is that students and young people feel loss just as intensely as adults, and that each loss needs to be grieved and processed. Students need to move through the grief, and on to acceptance. Understand that a sense of loss can be experienced regardless of the precipitating event. Know about the grief process.
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