FEATURE — Fall 2004


Supporting Students' Growth and Well-Being

Staff members of Counseling Services—a division of Student Health and Counseling Service (SHCS), directed by Alan Glass, M.D.—provide an accessible, student-focused environment. Tom Brounk (center), Ph.D., associate director of SHCS, is assisted by (from left) Craig Woodsmall, Psy.D., Peg McMullen, Ph.D., Kalyn Coppedge, M.S.W., Emily Knotek, Psy.D., Cathy Vander Pluym, R.N., Lisa Sinden-Gottfried, Ph.D., and Linda Cohn, M.S.W. Members not pictured are Matt Breiding, Ph.D., Jackie Miller, M.S.W., and Sarah Shia, Ph.D.

When students need guidance with the demands of academics, relationships, or managing college life in general, the University provides a strong, campus-wide safety net.

by Nancy Mays

By the time students enroll at Washington University, they're already well-versed in the language of stress. After all, these are top achievers; students whose high school "to-do" lists were crowded with big ambitions.

So even though they've landed a spot on the campus of their choice, few allow themselves a sigh of relief. They've moved on to the next set of worries: a new living environment, confusing self-discoveries, and, of course, greater academic demands.  

"These students were among the brightest in high school," says Justin Carroll, assistant vice chancellor for student affairs. "But now, though they are smart, all cannot be in the top 10 percent of the class—and that can be a big problem for some students."

College campuses everywhere are struggling to find meaningful ways to manage a surge in student stress. A recent study published by the American Psychological Association showed college students have more complex problems than they did 10 years ago, with cases of depression, anxiety, and sexual assault rising.

"If we can show students how to manage their stress now, we're teaching them something they can use throughout their adult lives," says Karen Levin Coburn.

"Nationally, students in increasing numbers are utilizing health and wellness services on college campuses, including mental health services. Our mission at Washington University's Student Health and Counseling Service (SHCS) is to provide these services in an accessible, student-focused environment that recognizes the unique needs of the university student community," says Alan Glass, director of SHCS.

SHCS helps students manage the typical problems that emerge in young adulthood—personal identity issues, separation struggles, for example. But all of that is exacerbated by what Tom Brounk, associate director of student health and counseling, calls "perfectionism anxiey."

Campus outreach groups include "Black Men/White Men," where students come together for heartfelt discussions and activities.

"Students here are dealing with very high expectations for their performance—maybe their own expectations, maybe their parents'," says Brounk. "But if they don't do as well as they'd hoped, they're stressed. And that can manifest itself in any number of ways."

Alcohol or drug abuse. Debilitating anxiety. Eating disorders. ("They're rampant," says Karen Levin Coburn, assistant vice chancellor for students and associate dean for the freshman transition.) Acquaintance rapes. Depression. Suicidal thoughts. The perception may be that a campus like Washington University—a private school with high-achieving students—is protected by privilege from such concerns, but that's not the case. Last year, nearly 900 students sought help from a campus counselor.

And that figure doesn't reflect the number of students helped by Student Health and Counseling's outreach programs. At Washington University, administrators have taken a bit of a "build-it-and-they-will-come" approach to mental health issues. Raise awareness about the value of tending to emotional and mental health, and students are likely to tap into available resources.

The goal: Teach students that mental health services aren't just about fixing breakdowns. They're about preventing them.

"If we can show students how to manage their stress now, we're teaching them something they can use throughout their adult lives," says Levin Coburn. "These competitive students are going to be tomorrow's high-achieving adults. They need to know how to deal with stress."

Washington University's services are diverse and far-reaching, ranging from wellness programs in the residence houses to men-only discussion groups on sexual assault.

Uncle Joe's Peer Counseling is a student-staffed referral service. Student volunteers undergo 80 hours of training to prepare how to best help those seeking assistance. Peer counselors are advised closely by Craig Woodsmall (right), a member of the Counseling Services staff.

At the heart of the University's efforts is the umbrella organization Student Health and Counseling Service. Counseling Services, an integral part of SHCS, offers free to low-cost, one-on-one counseling for up to 15 sessions. Students who need more extensive help are referred to practitioners in the community. Counseling Services helps students define the problem and identify the best resources available. Some students are referred to the University's biofeedback clinic. There, students can see the physical manifestations of their stress, from rising skin temperature to a quickening heart rate.

Staff counselors spend about half their time in one-on-one or group sessions and the other half reaching out to students through student organizations, residence houses, and fraternities and sororities. The counselors raise awareness about a host of issues: race relations, eating disorders, anxiety-related sleep disturbances—as well as effective ways to manage stress.

Campus outreach and support groups help raise awareness about critical issues for students. "One in Four" is a men's support group devoted to understanding and educating others about the underlying dynamic of sexual assault. The name reflects the number of women (between 1 in 4 and 1 in 5) who (according to Bonnie Fisher, National Institute of Justice, 2000; and Mary Koss, 1987) will be raped during their college career. The figure includes attempted rape, which is part of the legal definition of rape.

"When I work with students, my mission is to address those issues that impede them from reaching their academic, social, and personal goals. In particular, sexual assault can arrest a person's development in a variety of areas, in that the time and energy it takes to deal with the trauma can be overwhelming," says Sarah Shia, staff psychologist at SHCS. "When time is not devoted to the healing process, difficulties can continue into the period of life when these same women are trying to be partners, mothers, and professionals. As a community issue, the importance of education, prevention, and treatment for sexual assault cannot be emphasized enough."

Yet another group brings together black and white men for heartfelt discussions on race and privilege. Brounk moderates this group with an eye toward building bonds between diverse groups on campus.

"Our staff members of the Student Counseling Service are really the University's unsung heroes," says Levin Coburn. "They're doing such important work on a daily basis. They're extraordinarily well-trained and highly skilled psychologists, clinical social workers, and licensed professional counselors. We're lucky to have each one of them."

Promoting Health
In many ways, our culture teaches children how to be stressed. But do we teach them how to "de-stress"? How to lead healthy lives?

At Washington University, the Health and Wellness Initiative was launched in 2000 to do just that: to ensure that students value and nurture their physical and emotional health.

Melissa Ruwitch, coordinator of health promotion and wellness, brings together stakeholders from across campus for regular meetings of the Health and Wellness Working Group. They discuss campus-wide trends, brainstorm health-enhancing initiatives—and work together to keep the students' safety net strong and growing.

Members include representatives from athletics, residential life, the Office for International Students and Scholars, the Student Health and Counseling Service, Office of Student Activities, as well as students representing a variety of groups.

"We try to tackle the issues that affect college students," says Ruwitch. "Most recently we've been discussing the 'overcommitted student.' We've been examining what role all of us play in contributing to a culture in which students feel they should have multiple majors and so many activities that it is tough to achieve depth or balance."

The motto—"Seek balance: live and learn well"—says it all, according to Karen Levin Coburn, assistant vice chancellor for students and associate dean for the freshman transition.

"We want to help students develop lifelong habits of health and well-being," Levin Coburn says.

Other topics the group works on include high-risk or binge drinking, sleep needs, fitness and nutrition, safety, and sexual health. During finals, the group co-sponsors stress-free zones on campus where students can get free chair massages, watch movies, and unwind by playing games before returning to their studies. The Health and Wellness Web site, www.wellness.wustl.edu, and e-newsletter are packed with practical, student-centered health tips.

For most students, the first time they learn about campus mental health services is in student housing, where residential advisors (RAs) are trained to manage the daily ups and downs—and look for signs that a student may need more serious intervention.

"For most of our students, living in a residential college is the first time they have had to share a room—learning to live with someone very different from themselves. This is also likely to be their first experience with living away from home for such an extended period of time," says Carroll. "It's hard."

RAs are required to organize programs each semester on topics including physical, emotional, cultural, and social wellness. The programs not only enlighten students about critical issues, they also help them feel connected to the University. Creating a sense of community, the programs let students know that if life gets overwhelming, there's a strong, campus-wide safety net ready to help them.

When students need that safety net, they have options. For students who are apprehensive about approaching Counseling Services, there is Uncle Joe's Peer Counseling, a student-staffed referral service. Uncle Joe's walk-in and phone-in service links students to counseling services, whether they are on or off campus. Students who volunteer at Uncle Joe's undergo 80 hours of training. They are able to recognize fellow students in need of immediate intervention and those who may benefit from one-on-one counseling.

Again, many problems stem from skewed expectations.

"We have students who've focused long and hard on a particular area of study, only to change their minds," says Levin Coburn.

"Students change their majors. They change their politics. They stretch themselves in unexpected ways."

Levin Coburn, author of Letting Go: A Parent's Guide to Understanding the College Years, recognizes that seemingly small shifts in view or focus can be monumental for students at schools like Washington University.

"The stakes are high," she says. "Many students are afraid of disappointing their parents if they change their plan to pursue a particular profession. It can cause incredible stress. Yet it's important for college students to be seen by their parents as the people they are becoming, not the people they used to be."

Counseling Services is spreading the word to administrators, faculty, and staff, too. An informational brochure—"What Can I Do?"—was distributed to help increase awareness of mental health services, and to help others make successful referrals for students in need.

"We want them to know how to intervene, how to spot a student with difficulties," says Brounk.

"Our overall goal is to help students succeed in school, and in life. The more we educate our campus community on the value of providing mental health services, the more we help our students.

"That's really what it's all about for us."

Nancy Mays is a free-lance writer based in Lenexa, Kansas.