Encouraging Pre-Health Students to Develop
Realistic Expectations
Julie R. Nelson, Kate Karacay and Emily Brunner
Academic Advising Center
The University of Iowa
• Counseling and Advising
• How Counseling Theories Inform Advising
• Intentional Advising Interventions
The Same, But Different
ON THE ONE HAND
ON THE OTHER HAND
• Advising is NOT Counseling
 Advisors are First to Know
• Different Purpose
 Advising as Problem Solving
• Ethical Practice
 Affective Nature of Advising
See Crookston, B. B. (1972). A developmental view of academic advising as teaching. Journal of College Student
Personnel, 13, 12-17.
•
Counseling:
•
•
•
•
Teaches Problem Solving
Encourages Communication
Values Process Orientation
Provides Context
Pre-Health Challenges
•
•
•
•
•
•
No Guarantee
Highly Competitive
Few Second Chances
Advising Priorities, Student Realities
Beginning Well = Accurate Assessment
Problem-Solving Ability and Coping Skills
• Ask Yourself, Notice:
• Is this a Problem-Focused Problem?
• Is this an Emotion-Focused Problem?
D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.
•
•
•
•
Problem is Solvable
Problem is a Challenge (apart from self)
Problems can be Successfully Resolved
Problems Take Time (and that is okay)
D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.
• Problem Definition
• Ability to Generate Alternative Solutions
• Making Decisions
• Solution Implementation is Realistic
D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.
• Student Mindset:
•
•
•
•
Problems Threaten Well Being or Identity
Create Doubt about Ability to Succeed
Have Low Tolerance for Uncertainty
Problems Take Time (and that is not okay)
D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.
Situation or problem is not changeable
• Focus on student’s reaction
• Advising support = helping student cope +
helping student respond more effectively
•
D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.
•
•
•
•
•
“How did it feel?” [Affective]
“What did you tell yourself?” [Cognitive]
“What were you doing?” [Behavioral]
“Who supported you?” [Relational]
Describe where you were. [Contextual]
Cormier & Nurius, 2003.
A Light by Which to See
• Grief and Loss
• Transtheoretical Model of Change
• Elizabeth Kubler-Ross
• J. William Worden
Kubler-Ross (1969); Worden (2009).
• Denial
• Anger
• Bargaining
• Depression
• Acceptance
Kubler-Ross (1969).
• Accept the Reality of the Loss
• Process the Pain of Grief
• Adjust to a World Without the Deceased
• Find an Enduring Connection to the
Deceased in the Midst of New Life
Worden (2009).
• Loss of Identity—Personal & Social
• Things Are Not What They Seem
•
•
•
•
Making Room for Grieving
Normalizing Uncertainty
Acknowledging Embarrassment
Building Network of Support
• Prochaska & DiClemente (1982)
• Five Stages of Change
• Resolving Feelings of Ambiguity
See Prochaska, J. O. & DiClemente, C. C. (1982) Transtheoretical therapy: Toward a more integrative
model of change. Psychotherapy: Theory, Research, Practice, 19, 276-88.
See Prochaska, J. O. & DiClemente, C. C. (1982) Transtheoretical therapy: Toward a more
integrative model of change. Psychotherapy: Theory, Research, Practice, 19, 276-88.
•
Motivational Interviewing Aims to Stimulate
Intrinsic Motivation to Change by Exploring
and Resolving Ambivalence.
•
Effective with Advisees Who Contemplate
Change but Feel Hindered by Uncertainty.
Miller, W. R. & Rollnick, S. (2013). Motivational interviewing: Helping people change. 3rd Ed. New York: Guilford.
• How Does the Student Feel about Change?
• Would the Student Give You Permission to
Explore Options?
•
•
•
•
•
•
Ambivalence Hinders Adaptive Behavior
Resistance Likely w/ Loss of Freedom or Choice
Resistance is a Product of Interaction
Resistance is a Barrier to Change Talk
Advisor Allows Resistance
Reduce Resistance to Avoid Rupture w/ Advisee
Moyers, T. B. & Rollnick, S. (2002). A motivational interviewing perspective on resistance in
psychotherapy. JCLP/In Session: Psychotherapy in Practice, Vol. 58(2), 185-193.
• Establish a Relationship
• Set an Agenda
•
•
Determine Multiple Behaviors in Need of Change
Student Decides on Single Behavior to Change
• Importance + Confidence + Readiness Scaling
• Explore Importance/Build Confidence
See Miller, W. R. & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behaviors. New York:
Guilford. See also Rollnick, S., Mason, P., & Butler, C. (1999). Health behavior change: A guide for practitioners. London:
Churchill Livingstone.
Getting Them to Say It
-Soren Kierkegaard
• Beginning the Advising Relationship with
Acknowledgement of Challenges
• Frontloading Information without
Overwhelming Students
• Reflecting in Real Time: Advising as
Collaboration
Getting the Conversation Started
• Using Open-Ended Questions
• Helping Students Develop Insight
• Empowering Students to Change
•
Cormier & Nurius, 2003.