As EKU Faculty and Staff, you interact with students on a daily basis. Because of this high level of contact, you may be among the first to notice problems developing in a student. Making a referral to the Counseling Center can be an effective way to assist students in getting the help that they may need. This tip sheet is intended to help you identify students in distress and make a referral.

Signs of Distress 
When to Refer
How to Refer  
Should I Refer? 
Referring the Reluctant Student  
Confidentiality Guidelines  

 SIGNS OF DISTRESS  

• increased nervousness, agitation, or irritability 
• withdrawal from others (isolation) 
• sudden changes in academic performance 
• sudden changes in personal or classroom relationships
• undue aggressive or abrasive behavior 
• infrequent class attendance 
• marked change in personal hygiene 
• fearfulness 
• dependency (e.g., the student who always hangs around you or constantly tries to see you) 
• signs of depression (frequent crying, insomnia, oversleeping, sudden weight loss/gain, loss of pleasure) 
• drug and alcohol abuse 
• talk or threats of suicide 
• confusion - including bizarre, alarming, or dangerous behaviors 

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In cases when you are not sure whether or not to refer, please call the Counseling Center and ask to speak to a counselor regarding your concerns. The Counseling Center staff is available to assist with decisions about how to be most helpful. Sometimes referral is indicated and sometimes it is a matter that may best be addressed in another manner. Aside from the signs or symptoms that may suggest the need for counseling, there are other guidelines that may help you define the limits of your involvement with a particular student's problem. A referral is usually indicated in the following situations: 

1. You might note emotional or behavioral indicators that would suggest that the student is under stress (see list provided).

2. A student presents a personal problem or requests information about how to address the problem in situations that are outside your range of knowledge. The problem is more serious than you feel comfortable handling. 

3. A student is reluctant to discuss a problem with you for some reason. 

4. You have exhausted your resources in trying to be of help and believe the student needs more assistance than you have been able to provide.

If you are in doubt about whether or not to refer a student to counseling, or would like suggestions on how to approach a particular student, please call the Counseling Center and speak with one of our full-time staff. A telephone consultation may help sort out relevant issues, explore alternative approaches and identify other resources which may better serve the student's needs. 

If your consultation questions are of an urgent nature (suicidal, sexual assault, death of a loved one, etc.) inform the receptionist that your situation is of an urgent nature that requires immediate attention.

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• Ask to speak with the student one-on-one. A person is more likely to be open to a suggestion of counseling if you are not making that suggestion in front of others.

• Cite the specific behavior that you have observed and how it concerns you. Here is an example of something that you might say: "I've noticed that you haven't been participating in class much, your grades have dropped, and you look like you might be feeling down. I'm concerned about these changes, and I just wanted you to know that there are counselors at the Counseling Center who are trained to help you with the feelings you might be experiencing. What would you think about making an appointment to see one?" 

• Express confidence in the agency. If you have ever had a positive experience with a counselor, it can be helpful to share the experience. 
• Encourage the student to contact the Counseling Center directly to schedule an appointment. Sometimes it is helpful to have the student make an appointment from your office or in your presence. You may even want to consider walking the student over to the Center when it is time for the appointment. 
• Give the student one of our brochures. This will provide the student with our contact information and a reminder of the upcoming appointment. 

SHOULD I REFER?

Counseling is one of many options for students in distress and many can cope successfully on their own with the involvement of other positive resources. At any time that you are unsure of whether this student is in need of counseling services please contact the Counseling Center to discuss the situation and your concerns with one of our professionally trained counselors. They can discuss with you your options how to best assist the student.

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For various reasons, students are sometimes reluctant to see a counselor. If a student is reluctant, taking the following steps can help to ease some of the anxiety about counseling that a person may feel.

• Assure the student that counseling is confidential and does not go on their academic record. 
• Assure the student that asking for help is a sign of strength rather than weakness. 
• Sometimes the student feels that his/her problem is too small to bother a counselor with. Assure the student that counselors meet with students on all kinds of concerns----large and small. 
• Reluctant students are relieved to know that they can meet with a counselor on a one-time basis. There may not be the need to meet with a counselor over an extended period of time OR the student may CHOOSE to meet with a counselor only once. For students who seem interested but reluctant to go for counseling, a helpful strategy might be to suggest that they try it one time to see how it goes. 

When a student needs to be seen right away, we make every effort to see them as soon as possible. Call and communicate with the receptionist that there is a student who is interested in coming for counseling and needs to be seen right away. If the student makes the appointment in your presence it is important that we know the urgency and specifics of the situation. Speak with a counselor about your referral and provide the counselor with a description of the situation that has led to your concern.

While it is important to be helpful to others, we cannot make their decisions for them, and counseling should always be a personal choice. Occasionally even your best efforts to encourage a student to seek counseling will be unsuccessful. If the student resists referral and you remain uncomfortable with the situation, contact your department chair, the Counseling Center, and/or the Student Affairs Office of the Vice President (622-1721). 

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Once you have made a referral, it is normal to want to find out what happened and how you can continue to help the student. However, the staff at the Counseling Center are bound by the principles of confidentiality as defined by the American Psychological Association Code of Ethics and the laws of Kentucky. This means: