One of the professionals that I routinely collaborate with to help students is Wendy McSparren. Wendy is a Licensed Independent Clinical Social Worker in my area, and we complement each other’s work. She will identify and treat the clinical disorders, like depression and anxiety, while I address how they can manifest in the academic realm during high school and college. Because of our synergy, I can communicate the impact of these clinical issues on the student’s school work to her, and she incorporates my feedback in to the strategies that she uses for psychotherapy.
A phenomenon that Wendy and I have both seen is that there are certain factors or conditions that can begin in high school, and if not addressed, can lead to problems in college. There’s a certain amount of predictability for specific factors that are present during high school which have implications for college decisions. Also, when it comes to helping college students who are doing poorly, there are many different approaches, with some being more effective than others. Wendy’s answers are below.
What common types of clinical disorders do you see affect high school and college students?
As a group, college students can suffer from a variety of disorders. The traditional ages of college students, 18 to 24 years, is typically the age of onset for many adult conditions. In my practice I frequently see college students who suffer from mood disorders, such as unipolar or bipolar depression. Anxiety disorders and the manifestations of anxiety are also common. Being able to differentiate between what is the onset of an adult disorder and what arises from the stress that college students face can be a challenge.
What concerns during high school can manifest as problems later in college?
There are definitely some “risk factors” for later problems in college. One factor that can signal possible problems during college is the presence of a condition or formal disorder during high school that is not adequately treated or taken seriously for college. Some students want to downplay their condition to ensure that they get in to the school they want, only to have it arise and affect their grades once they get in. Another risk factor is the complication or further evolution of a disorder that was detected in high school. For example, a student who has depression during high school may find it gets worse as they they move in to their young adult years, or the stress of college can trigger more intense symptoms or more frequent episodes.
There are also “behavioral” factors that may or may not be part of a specific diagnosis. Many students have maladaptive coping strategies, such as avoiding or procrastination on school work because they lack confidence or it causes them anxiety. There are many forms of poor coping strategies, and these can include learning from family coping styles, drug and alcohol use, or acting out. A young adult’s ability to have successful interpersonal relationships is also very important, and poor social skills is also a risk factor. To be successful later in college, students need to be able to have productive relationships with peers and adults, as well as the ability to form attachments and relate to others. One of the lesser known risk factors that I see in my practice is that of separation anxiety in childhood, which can evolve later in to social phobia, anxiety issues, panic disorder, or generalized anxiety disorder. Problems in any of these areas are known risk factors for attending college.
Do you think students can improve on their own or do they need intervention? If so, what kind?
In general, I think most will need intervention. Only in some circumstances do the problems that high school and college students face correct themselves. College-aged young adults who don’t improve during high school can waste a great deal of time having to learn from their own mistakes rather than getting help from others. If they don’t receive intervention during high school, students can get labeled as stupid, lazy, or bad. Intervention during high school is necessary to both prevent the emotional damage that can come with an untreated condition as well as to build a strong foundation for college success. Also, careful and specialized planning for college for these students is critical to both continue their progress and to find the right environment where they will be supported and succeed. This is definitely a key element and one of the ways that Jeff and I work together. He can help families find a college that will fit their student, arrange for accommodations, work directly with the student while they attend classes, and intervene quickly if a student’s condition begins to affect their grades.
What treatment options and strategies are available for college or high school students who face problems?
There are a number of treatment options for students who are just beginning to seek help, and I strongly believe that the least intrusive efforts at intervention should be tried first. The very first effort should always be a thorough assessment of the problem, and this can take different forms. I do psychosocial evaluations that can assess the student from a holistic perspective, but I refer to colleagues for psychological, neuropsychological, or psychiatric evaluations. Second, individual psychotherapy can be used, and I’ve seen Cognitive-Behavioral Therapy and Dialectical Behavior Therapy produce good results, with the latter reaching the emotionality of many conditions. In addition, stress management, exposure therapy for anxiety, and a number of other methods can be useful. Finally, pharmacotherapy can be considered for those students who do not respond or are not appropriate for psychotherapy. Parents and students must realize that for some conditions, the combination of pharmacotherapy and psychotherapy had consistently produced good results.
Combined methods that deal with the clinical and educational aspects seem to be highly worthwhile. Using psychotherapy, pharmacotherapy if appropriate, plus academic planning and intervention can produce optimal results. Many parents seem to think “study skills” will be the key issue for a student to succeed in college, but that’s only one of many factors. Especially for students with a disability, finding the right college, providing transitional support, arranging for accommodations, and using academic methods by an qualified person can often be key actions for college success. In this case, “qualified” means someone who both the understanding of academic skills but also the clinical disorders, how they can impact a student’s studies, and what research-based methods can correct for the impact. This type of comprehensive and “informed” education-side effort to helping students with a disability succeed in college is what I’ve seen produce results, which is why I collaborate with Jeff to help students.