The referral process utilized by the Counseling Center at Suffolk University is characterized by two types of referrals. The first, internal referral, occurs when potential clients have established prior contact with a member of the faculty, administration, or staff and are directed to the Counseling Center for assistance. In some cases, the counselor to whom the client is referred will acknowledge to the referring person that the client has requested assistance and is being helped. No further information regarding the relationship between client and counselor will be divulged unless requested or approved in writing by the client.
The referral process also includes external referrals of clients by the Counseling Center to other agencies or professionals outside the University. Clients are referred by the Counseling Center when the presenting problem is deemed inappropriate for the Center to manage, either because of limited resources or because the necessary treatment requires specialized skills or training beyond the scope of that available in the Center. Referrals are made only after clients are informed of the process and have given their consent for the referral. In such instances, clients assume financial responsibility for continuing treatment outside the University. If medication is indicated as an adjunct to therapy, or in crisis or emergency situations, arrangements will be made through the psychiatric consultants affiliated with the Counseling Center.
It has been estimated that 10-12% of those students enrolled in urban universities suffer from some form of disabling mental health disorder. At Suffolk University, that means that approximately 600 undergraduate and graduate students suffer from generally mild and/or moderate forms of emotional distress. It is clear that poor, diminished, or erratic academic performance is one of the hallmarks for assessing personal difficulties encountered by students. Faculty members who interact daily with students are clearly in the most advantageous position to observe changes in academic performance, as well as initial outward signs of personal stress.
At any particular time, up to 25% of a university's workforce will experience some mild-to-moderate emotional or personal problem which is likely to affect their performance on the job. In addition, approximately 8% of a university's employees will experience difficulties of a more serious nature. The role of the supervisor in developing and maintaining a work environment which maximizes the potential of each employee is a critical one. The manner in which a supervisor interacts with colleagues can often have a significant effect on both personal lives and careers.
Awareness of the more visible indicators of distress can be helpful to faculty, supervisors and colleagues in making referrals to the Counseling Center. If you encounter a student or colleague experiencing a crisis, there are a set of helpful responses which generally will assist them as they attempt to cope with personal difficulties.
- Be clear about your willingness to become involved as a helper and convey to the student the extent and limits of your ability to help.
- Be available as a listener to help the student discuss his/her situation and to reach a decision regarding the best course of action.
- Be aware of, and knowledgeable about, the full scope of referral sources on campus. Help the potential client decide which resources to use, make a direct referral, and follow-up to assure that the student/colleague has followed your recommendation.
- The fact that a student or colleague has approached you is an indication of trust in you. Appreciate the real importance of your role as a "selected helper". You may be the first person in whom they have confided.
Behavioral Signs For Potential Referrrals
Potential clients may make direct or indirect requests for help. Indirect requests are more difficult to "read", for they tend to be hidden among a variety of stated concerns or potentially problematic behaviors. For example, students or employees may bring issues of an academic nature or specific work-related problems (i.e.: vocational concerns) to faculty advisors or to supervisors. They often do so because those problems seem to be more "acceptable" and perfectly appropriate as a means of establishing initial contact with selected "helpers". At times, the presenting issues hide, or delay discussion of, real problems. A willingness on the part of "designated helpers" to discuss and explore issues beyond those initially presented by students or colleagues is frequently critical in establishing a meaningful helping relationship. The following is a list of behaviors which might indicate that a student or colleague might benefit from a referral to the Counseling Center. It should be noted, however, that it is more useful to look for clusters or combinations of indicators before making referrals. The list is provided to serve as a guide for assessing coping patterns and, as such, is not exhaustive.
- Problems with concentration, memory, attentive skills.
- Loss of interest in schoolwork, employment, social activities, absence from class, tardiness, increasingly poor time management.
- Feelings of guilt, worthlessness, self-recrimination, personal inadequacy.
- Erratic, diminished academic performance.
- Poor study habits, sudden and acute performance anxieties.
- Dissatisfaction with academic major.
- Unrealistic expectations/confusion regarding personal and career goals.
- Expressed difficulties in family and/or marital relationships.
- Expressed concerns regarding death (or divorce/separation) of family members or close friend.
- Marked withdrawal, unwillingness to communicate.
- Problems with interpersonal relations, especially in dating or intimacy situations.
- Irrational worrying, excessive fears.
- Loss of appetite, sleep disorder, lack of stamina, persistent fatigue.
- Undue concern with physical health.
- Indications of increased/excessive drinking or drug use.
- Unexplained crying and/or seemingly impulsive outbursts of anger.
- Plagiarism, cheating, lying, and other asocial behaviors.
- Acute increase in activity levels (i.e.: excessive talking and rambling, physical restiveness, hyperactivity).
- Unusual or frequent irritability, suspiciousness, irrational feelings of being persecuted or slandered.
- Thought disorders (ie: non-sensical and bizarre conversation or written communications).
Deciding to Refer
Even though the decision to refer is a difficult one, there is no clear formula which is appropriate for all situations. Generally, it is better to err on the side of making an unnecessary referral than in waiting too long before making an active intervention.
A referral is usually appropriate when:
- A student or colleague presents a problem or requests information which is beyond your scope of knowledge, competency, or interest.
- Personality differences exist between you and the student/colleague which appear unresolvable and which interfere with your helping.
- If the problem is personal and your relationship to the student/colleague is limited only to professional/academic interactions.
- If the student/colleague addresses a problem, but is reluctant to discuss it further with you.
- When you feel uncomfortable dealing with the issues raised by the student/colleague.
Cases Where Potential Suicide is Raised
Potential clients may make oblique references to whether "life is worth living" or question the worth or meaning of their futures. Often, people use abstract conceptualizations to indicate being unhappy, uncertain, or "down in the dumps". However, if such conversations include the means of committing suicide (i.e.: how, when, and where of the act), an immediate referral is warranted. Additional clues that would reinforce an active referral to the Counseling Center include: a) prior suicidal ideation or gesturing on the part of the student/employee; (b) suicidal behavior on the part of family members; and (c) recent traumatic or unexpected loss or death in the student's/employee's immediate family or of a close friend.
Any direct reference to suicide, threat of suicide, or attempt at suicide should be judged as extremely serious. To analyze suicidal talk as a bid for attention is very risky. A judgment about the seriousness and possible lethality of a suicidal statement should be made by professionals responsible for making such determinations. In the case of a potentially suicidal student/employee, the typical "ground rules" for referrals (See below: How to Refer) should be disregarded. You may need to make a forced referral (i.e.: using University security personnel to accompany the student/employee to the Counseling Center) or request that a Counseling Center staff member come to your office. The bottom line in such cases is to use any of the resources available to assure that the student/employee receives immediate attention.
If you are concerned about a student or colleague but are unclear about how to provide assistance, call the Counseling Center at 617.573.8226. A psychologist will return your call and help determine an appropriate course of action. Consultation to the University community is an important part of our services. We provide them to concerned parents and to roommates as well as to faculty, staff and administrators.
How to Refer
When you have made the choice to refer a student or a colleague to the Counseling Center, present your recommendation in a direct and straight-forward manner. Never trick or deceive by masking your intentions. It is very important that the potential client be aware of your specific concerns and why you feel a referral to the Counseling Center is warranted. Sharing facts regarding the services available in the Counseling Center can also ease the process of referral. Clients will also be helped to overcome the stigma attached to the counseling process if they understand that no information will be released without their prior consent. The additional fact that such services are free should also facilitate the referral process.
Except in crisis situations, the student/colleague should be given the option of accepting or rejecting recommended referrals. If the potential client initially appears reticent or is resistant to a referral, faculty members/supervisors/colleagues should provide an opportunity to vent feelings and suggest that the possibility of a referral can be discussed at a later date, when more thought has been given to it. It is important not to rush or pressure the potential client into referrals. A premature, or forced, referral (except when confronted with an emergency situation) may make it virtually impossible to seek help in the future. If a student/employee accepts the need for a referral, the following steps should be considered:
With the student/colleague present, call the Counseling Center and make an appointment, referring by name to a specific counselor to whom you are comfortable making the referral.
- If given approval to do so, provide information to the counselor about the nature of the referral.
- If the initial attempt at referral cannot be completed due to schedule conflicts, the referral should be made to the first available counselor.
- In the event of an emergency, the Counseling Center will make every effort to provide an immediate and direct response to the request for assistance.
- Follow up after the referral has been completed to demonstrate continued interest in client's welfare.
- Having the student/colleague call for an appointment increases his/her responsibility and commitment to using counseling services. There are times, however, when it is more appropriate for "helpers" to call and to make an appointment on behalf of the student/employee.
Counseling Center appointments can be made through the staff administrators in 73 Tremont Street, fifth floor or by telephone (617-573-8226). Counseling services are offered from 9:00 - 5:00pm, Monday through Friday and evenings, by appointment. When possible, and appropriate, Counseling Center staff will also make arrangements for early morning appointments. Daily emergency walk-in hours are provided at 11:00 A.M. and 2:00 P.M. for non-scheduled appointments. If students cannot be seen at those times, please call the Counseling Center to see if other hours are available for urgent appointments. If none are available, students will be offered the next available opening and/or be referred off-campus. Requests for assistance or for information made after business hours are recorded by the Center's answering machine and/or are logged in at the University switchboard. Messages are checked on a regular basis by staff members and will be responded to as soon as possible, but no later than the following morning.
Counseling Center Staff
The Counseling Center provides a wide variety of services to students, staff and faculty which help members of the University community to successfully handle the numerous stresses and challenges which characterize college life. It is staffed by three licensed psychologists, one psychiatric nurse practitioner, three pre-doctoral interns and one case manager. The Center is accredited by the International Association of Counseling Services (IACS) and its Internship Program in Professional Psychology is accredited by the American Psychological Association (APA).
Jean M. Joyce-Brady, Ph.D.
Director of Health and Wellness
University of Maryland
Stephanie Kendall, Ph.D.
Associate Director/Coordinator of Training
University of Denver
Teresa Blevins, Ph.D., CLYL
Staff Psychologist Auburn University
Brian Harnsberger, Psy. D.
Staff Psychologist William James College
Psychiatric Nurse Practitioner
Zara Konarski, PMHCNS
MGH Institute of Health Professions
LCSW Boston University School of Social Work
Ellen Darling, M.A.
Oxana Kopeikin, M.Ed.
University of of Louisville
Natasha Torkelson, M.A.
Counseling, Health & Wellness Front Desk Administrative Coordinators