In my role in the Parent Programs office and as an academic adviser, I sometimes encounter students who seem to be struggling or unhappy in some way – could be academics, interpersonal relationships, family dynamics, etc. As we know, stumbles along the path towards graduation and beyond are a normal and expected part of the college experience. In those moments, I often offer up the University Counseling Center (UCC) as a potential resource for that student. I visited the UCC when I was a student and found it really helpful, and I sometimes share my own story with the student to show that counseling is not a scary process, it is one that can help you.
Normally I ask the student if he/she has ever been in a counseling setting and knows what to expect. More often than not the answer is no. In advising settings, I explain counseling to the student, but I also wanted to have something online as a reference for students and parents so they can understand what the UCC does, to demystify the process.
I sat down with Dr. James Raper, Director of the University Counseling Center, and asked him to walk me through how students access UCC services and what the counseling experience looks and feels like.
Appointments are only made by phone or in person, not via email, and need to be made by the person seeking counseling. To better understand the level of urgency when responding to a request for an initial visit, the UCC staff may ask a few clarifying questions. Some examples include:
Are you in crisis right now?
Is your safety, or the safety of someone else in danger?
Have you recently experienced a significant loss, sexual assault, or other trauma?
Have you stopped attending class?
In situations with greater urgency, there are emergency appointments available that day. If the student is not in a crisis situation, the typical wait for an appointment is 1-3 days. That can be longer if a student has a schedule that is packed with a lot of lengthy courses or labs, or if a student has particular requests for one counselor in particular, etc.
When making an initial appointment, a student can request a specific counselor by name, or could say he/she would prefer to see a male/female counselor, someone older/younger, someone with a faith tradition, etc. Students with detailed counselor requirements could take longer to fill depending on the counselor’s and student’s schedules. A student can also request to have the first available appointment with any counselor. While students can make appointments to talk about themselves and their own concerns, they can also use the UCC’s services to consult when concerned about a friend or loved one.
This is always a questions students have: ‘what if other people find out what I say in counseling?’ or ‘will this become a part of my record?’ Fear not. Students can feel completely free to confide in their counselor. For students who are 18 years old and older, NC state law requires that what a client says in session is confidential. Thus, any information that is shared in the counseling center, including whether or not a student has attended a session, is protected. The limitations to confidentiality are:
1) if the counselor is concerned about the abuse or neglect of a child/elderly person/disabled adult; 2) if the counselor is concerned about the imminent safety of the client; 3) if the counselor is concerned about the imminent safety of another identified individual; or 4) If subpoenaed by a judge. Of course the client can always voluntarily sign a release of information form to another person or office
Confidentiality extends outside the office as well. No counselor would ever see a student client on the Quad and say “hey Betsy, how’s your anxiety issue coming?” or give away the fact that they know a student.
What to Expect at the Initial Appointment
Paperwork – Upon arrival for the first appointment, the student is asked to fill out about ten minutes of paperwork. The one piece of actual paper is the Informed Consent. This includes information such as a description of the UCC’s services, provides the student with expectations for their experience, and describes confidentiality and its limitations.
The student then completes an electronic assessment on an iPad provided to them. This is a brief questionnaire and assessment of the student’s behaviors, concerns, eating and sleep patterns, etc. This questionnaire goes only to the counselor, who reads it and uses it to get a snapshot of the student’s situation before the session begins.
Initial visit with your counselor – The first meeting with a counselor typically lasts for about 25 minutes. When the student enters the counselor’s office, the counselor will introduce him/herself and invite the student to sit on a couch or chair. Each office attempts to mirror a small living room with warm lighting and comfortable furniture. The counselor will then invite the student to describe what is bringing them into the UCC. The discussion is typically conversational, though during the first session the counselor will enter information directly into their computer. While the content of each initial visit varies from student to student, the counselor will weave in some specific questions to help better assess the student’s needs. These questions cover topics such as:
Knowledge of harm to others
Recent traumas (recent loss, physical or emotional trauma, etc.)
Alcohol and/or drug use
A standard question in the protocol that may surprise students (or parents) is “When was the last time you thought of killing yourself?” That may seem to a layperson like it is very harsh question to ask, but it is a vital part of the assessment process. It is not uncommon for some college students to have had brief, or even more intense thoughts of suicide. Asking about suicidal ideation in this way helps to underscore to the student that their counselor is here to partner with them to manage and reduce these thoughts.
It is not unusual for students to become emotional or cry during a counseling session (many are often surprised by their tears). The reality is that the students are unburdening themselves of things that might have been weighing heavily on their minds, and/or acknowledging they need help in some way. This can make the student feel very vulnerable. Rest assured that the counselor will be very gentle and affirming and will help in those vulnerable moments by expressing care and concern and support. Again, everything the student says is confidential.
Recommendations and next steps – Towards the end of the session the counselor will ask the student to identify their goals for counseling, any questions they may have, and will then summarize what he or she thinks the client had said and provide any recommendations or “next steps.”
How a student might feel after the first session
Most of the time, students don’t go to counseling because everything in their world is working out just great. Most of us enter counseling because there is an issue or concern that is impacting our lives or our sense of enjoyment in life. Talking about those things can be very hard. Admitting difficult feelings, insecurities, worries, behavior you are struggling with – those don’t always feel good or comfortable.
Some students have told me that they left their first counseling appointment and “didn’t feel better” or “the counselor didn’t do anything for me really.” The truth is, for most of us, issues and problems are difficult knots to untie. It takes more than one session to dig into a problem and discover tools and strategies to get through that problem. So my advice is this: do not worry if you leave a session and don’t feel like everything is fixed. That is normal. Trust the process and keep going back. Rome wasn’t built in a day.
If for any reason the student has not clicked with his/her counselor, it is OK to request to see a different one. It does not hurt the counselor’s feelings at all – the counselors want the students to be with someone that makes them comfortable and where they can thrive. Better to change counselors and continue seeking help than abandon the process and lose the potential support and help a counselor can offer.
Part 2 of this series will continue tomorrow, covering what happens at the next counseling appointment and common questions.
The UCC has a comprehensive web site with information and resources for students as well as parents and families. Please use this resource whenever you need it.
117 Reynolda Hall
10 Mental Health Professionals, 3 graduate interns
Hours: 8:30am-5:00pm M-F
24-hour crisis availability by contacting the Student Health Service 336.758.5218