Stacking the Deck in Everyone’s
Favor: Best Practices for Advising
Students with Depression
Julie E. Preece, Ph.D.
Scott D. Hosford, Ph.D.
Ron Chapman, Ph.D.
Michael Brooks, Ph.D., J.D.
Brigham Young University
“Caveats”
• Session’s Purpose: To enhance awareness of best advisement
practices; not prepare psychological service providers.
• Psychological disorders may vary in their signs and symptoms
from person-to-person.
• Recognition, Reconnaissance, Respect, and Referral (4R’s)
help a majority of students experiencing psychological concerns.
• In the United States, by law, students with disorders that rise to
the level of a disability may receive reasonable accommodations
that do not violate the essential elements of the academic
programs.
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Session Walk About Overview
• Mental health issues among college age students
• Data: Impact of mental health issues on the work of advisors and
faculty on college campuses
• Signs and symptoms of depression
• Video’s
• Cases, discussions, and recommendations:
• Accommodations in the advisement office and classroom
• Resources for advisement
• Concluding comments & questions
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Studies on Depression
 Almost 50% of college students will
experience depression during their
years of college (Kadison &
DeGermino, 2004)
 10% have had passive suicidal
ideation within past year
 1% have had a suicide attempt within
the past year (National Research
Consortium, 2006)
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Have You Ever Had a Student Confide in
You Thoughts About Suicide?
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Have You Ever Had a Student Confide in You Thoughts
About or Experiences with Other Self Destructive
Behaviors?
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Depression
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Depression Symptoms
• Depressed mood
• feel sad or empty
• appear tearful to others
• in children and adolescents—irritability
Depression Symptoms
• Depressed mood
• Loss of pleasure/interest in activities
• most of the day
• nearly everyday
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Depression Symptoms
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Depressed mood
Lack of pleasure in activities
Significant weight loss when not dieting (or weight gain)
Diminished ability to think or concentrate, or indecisiveness
Problems falling/staying asleep or early morning awakening
Being slow and sluggish
Fatigue
Feelings of worthlessness or guilt
Recurrent thoughts of death
• thoughts of killing or harming self
• with or without a plan
• Medication may affect ability to focus, concentrate and/or memorize
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The SIGE-CAPSS Mnemonic
SIGE
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Disrupted Sleep
I
Loss of Interest
G Feelings of Guilt
E
Decreased Energy
CAPSS
C
A
P
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Decreased Concentration
Decreased Appetite
Slowing Down Physically
Lowered Sexual Interest
Suicidal Ideation
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Gender Differences—
Relative Frequency
34%
26%
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Gender Differences—
Presenting Complaints
Sadness
Worthlessness &
Excessive guilt
Fatigue
Irritability
Loss of interest in
work or hobbies
Sleep disturbances.
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Gender Differences—
Other Expressions of Depressive Symptoms
Increased appetite &
weight gain
Anxiety and somatic
symptoms
Comorbidity – eating
disorders and anxiety
Neurovegetative
symptoms
Alcoholism &
substance abuse
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Depression
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What do you see happening between the advisor and the student?
What is the advisor attending to?
Where is the student’s attention?
What would you do if this was your session/visit?
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Depression
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What do you see happening between the advisor and the student?
What is the advisor attending to?
Where is the student’s attention?
What would you do if this student was in your office?
What resources could/would you call on?
What issues need to be addressed?
How have you worked with students with this issue?
What concerns do you have contemplating working with students
with this concern?
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• Where
Does
Depression
Fit?
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How Might this Look in the
Classroom / Your Office?
Observations
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Poor sleep habits
Non-attendance
Incomplete assignments
Lack of expressed interest
Distracting activities
• Gaming
• Internet surfing
• Videos
• Negativity
Assumptions
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Lack of discipline
Lack of clear goals
Poorly prepared
Immature
Poor study habits
Poor study skills
Poor work ethic
Irresponsible
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Signs in the Advisement Session or Classroom
• Difficulty getting up in the morning and attending early morning classes or appointments (some
may have problems attending before noon)
• Problems with concentrating in class, or in an advisement session, or information the
teacher/advisor is giving him/her
• Problems with memorizing information in a class or homework, forgetting appointments even
with you
• Loss of desire to study or attend class or your office
• With an increase in absences from classes or missed assignments, the more difficult it may be
to attend class or advisement session
• Medication for depression may also interfere with focus, concentration and memorization
• Thoughts of ending life or hurting oneself (cutting or burning); Such thoughts may be disclosed
to a trusted teacher or advisor
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Helping Students with Depression
1. Check your attitudes towards depression
2. Learn signs and symptoms of depression
3. Have a list of resources—know professionals by name
4. Network with counseling center on or off campus
5.Network with Disability Services, International, Multicultural
Student Services
6. Have a list of after-hours resources on and off campus
7.Have a professional on campus that you can trust to
consult with
8.Have a plan in case you need support NOW
9.Practice the plan often with your colleagues
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In Advisement Sessions
Be Willing To . . .
Empathize
Paraphrase
Restate
Ask direct questions
Refer
Be willing to call or walk with the student to set up an
appointment
• Follow-up visits
• Staff the case
• Know your resources
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Know Your Resources
• Add/drop/discontinuance policies
• Absence policies in your department
• Your department personalities
• Counseling Services on/off campus:
Policies and phone number
• Liaison name and phone
number/email
• Emergency system
• Refer to an individual if possible
• Disability Services: Procedure, phone
number
• Liaison name and phone number
• Know intake system—who to
connect with
• International Student Services or
Multicultural Student Services
• Know contact information—who to
talk with
• Know professionals in the
community
• Disruptive Student Committee on
campus
• Discontinuance Office
• College Security/Campus Police
• Security procedure on campus and in
your department
• Back up—do you have a system already
in place?
• College Heath Services/ER or Instacare
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Possible Accommodations for
Students with Depression
• Sleep Problems?
Schedule classes or appointments later in the day
• Problems with focus and concentration?
Extended time for assignments and/or test taking
Note takers or copies of other students’ notes
Taped lectures
Reduced course load
• Time out to enter a treatment facility?
Excused absences
Late work
Withdrawal from courses
Informed decisions regarding college policies
• Academic training
e.g., time management, test taking strategies, memorization skills etc.
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More Possible Accommodations for
Individuals with Depression
Letters to teachers
Additional time for exams/quizzes (1.5 x time limit)
Volunteer note takers
Course load reduction
Deadline extensions for assignments (used very sparingly; 3-5
days max)
• Leniency with absences (used sparingly)
• Flexibility with exam dates (used sparingly)
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Questions Anyone?
bridger_talbot@byu.edu
Julie_preece@byu.edu
Scott_hosford@byu.edu