VIU Flashcards

1
Q
  1. There is increased concern and discussion around the rise of mental health challenges at post-secondary institutions. Why do you think this is happening and how do you think college counsellors can influence student , campus, and community well-being?
A

WHY?
Technology shift
Economics (wealth gap, rising costs, student debt, poor job outlook)
Competing pressures for students
Changes to family structure and parenting styles
Lack of coping and resilience skills
Increased awareness of and reduced stigma around mental health
Psychopharmacology
Shift in function of college/university
Geopolitical destabilization

What we as counsellors can do?
Lead by example
Health of the team (immune system analogy)
Share information (introspective consciousness)
Support, empower, and train staff / faculty (e.g., boundaries, not fixing)
Outreach to programs (speak their language, e.g., optimal performance, flow)
Innovate support and empowerment for students
Groups (e.g., leading skills, branching points)
Teach them coping and resilience skills (e.g., “Mind Hacks”)
Enlist students as mental health point-persons
Encourage clients, support them in helping others
Frame efforts in context of the Student Mental Health and Well-Being Strategy

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2
Q
  1. Take 5-minutes to highlight the key personal qualities, knowledge, skills, and experiences that make you a preferred candidate for this position
A

I have many years experience as a student in higher education, and have overcome struggles similar to those faced by students

I completed practicum and clinic years at UBC and Douglas College.

I care about students and can relate well with them.

I continually seek professional development.

I grew up in the fraser valley

I am self-reflective.

I am curious.

I am compassionate.

I consider myself a student.

I have been successful in school.

I have been through personal counselling and therapy.

I have been through career counselling.

I have changed careers. I have studied a range of subjects.

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3
Q
  1. Which counselling theories have influenced, and are represented in , your counselling approach / method?
A
Attachment
Behavioural / CBT / DBT
Trauma-informed theory
Psychodynamic
Strengths-based, solution focused
Cultural Competence Model

Paradoxical theory of change - radical acceptance - nonattachment

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4
Q
  1. Clinical Example: Describe in a recent example how you counselled a student presenting with depression and suicidal ideation. Include in your example, the work you did with the student, services you engaged, and what you learned in the process?
A

Suicide assessment including risk and protective factors.
Normalize suicidal thoughts, validated experience
Safety plan
Attempt to determine what prompted suicidal thoughts
Attempted to remove prompting events
Anxiety BC
Services: crisis line

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5
Q
  1. Many students accessing our services have been given one or more mental health diagnosis from a professional outside the college. Where do you see diagnostics and the DSM fitting into your therapeutic practice?
A

The DSM and related diagnostic instruments are important and powerful tools that can help determine appropriate treatment. I continue to study the DSM.

In my therapeutic practice,

Care should be taken with an existing diagnosis. What does it mean to the person who has it? Did it help them? Hinder them? Confuse them? Stigmatize them?

If there is any stigma, I would work to find ways of destigmatizing that. If there is any indication of overpathologizing on the part of the client, I would look to reduce that.

DSM can guide evidence-based treatment.

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6
Q

What is the nation upon which VIU sits?

A

Situated on the traditional territory of the Coast Salish Peoples. Snuneymuxw Territory (Snoo-NAI-muk / Snuh-NAY-mow)

Read more at: http://www.first-nations.info/pronunciation-guide-nations-british-columbia.html

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7
Q
  1. Scenario: Describe how you might work with an Indigenous student who has experienced a recent death and the considerations you would have in approaching this work?
A

Investigate the possibility of having a support person attend session
Investigate possibility for community based healing
Allocate extra time for story telling
Consider the use of indigenous healing model :

Mental: Connection, healing, freedom
Spiritual: Elders, identity, traditions, smudges
Emotional: Connecting with others, understanding trauma
Physical: Stories, voice, grounding meditation

Wisdom, Love, Truth, Respect, Bravery, Humility, Honesty

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8
Q

What are some VIU services?

A
Disability Access Services
International Student Sevices
Aboriginal Education Office
Aboriginal Gathering Place (Aboriginal Student Services; Elders in Residence, Smudges, Meals)
Advising
Recreation
Centre for Experiential Learning
Student Success Services
Success Coach
Writing / Math Centres
Financial Aid
Student Health Clinic
Human Rights
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9
Q
  1. Please describe some of the primary strategies your would use with a student presenting with moderately generalized anxiety?
A

Assess environmental factors, assess behavioral factors. Check sleep patterns, exercise, etc.

Validate, normalize, and depathologize experience of anxiety symptoms.

Psychoeducation around stress response, self-regulation, distress tolerance, basic CBT triangle, effective worrying

Introduce and practice mindfulness skills, relaxation skills

Look into making changes in the environment to increase sleep, social connection, exercise

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10
Q
  1. In an initial counselling session, a student reveals that they have been spoken to in a ‘sexually suggestive and offensive manner’ by an instructor on a number of occasions. The student presents this as ‘no big deal’ but their friends are urging them to do something about it. What are your considerations and approach? What specific actions do you take, and why?
A

Explore with the student what their options are, what not saying something would mean, what saying something would mean
Provide emotional support
Validate their experience, explore the option of reporting it with them
Explore what kind of support they have
Advocate for the student
There is no immediate threat of serious harm, abuse of a vulnerable person
Seek supervision

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11
Q
  1. Scenario: Describe how you might work with an Indigenous student who has experienced a recent death and the considerations you would have in approaching this work?
A

Investigate the possibility of having a support person attend session
Investigate possibility for community based healing
Allocate extra time for story telling
Consider the use of indigenous healing model :

Mental: Connection, healing, freedom
Spiritual: Elders, identity, traditions, smudges
Emotional: Connecting with others, understanding trauma
Physical: Stories, voice, grounding meditation

Wisdom, Love, Truth, Respect, Bravery, Humility, Honesty

Not probing or digging. Rather, addressing things as they come up. Working to establish trust and safety in the relationship.

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12
Q
  1. How would colleagues / coworkers describe the way you contribute towards a cooperative and positive workplace? How would your colleagues / coworkers describe your approach to managing conflict?
A

I support team members. I communicate proactively. I encourage colleagues. I check in on colleagues.

I resolve conflict with conscientious, direct, preferably face to face communication. I rely on the feedback model to ensure understanding. If a conflict escalated, I would follow appropriate channels, reporting to a supervisor.

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13
Q

What are some emotion regulation skills?

A

Opposite action
Check the facts - does my reaction match the situation
Pay attention to positive events

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14
Q

What are some mindfulness skills?

A
Gratitude
Body scan
Guided meditations
Object oriented mediation
Eating meditation
Moving meditation

Gratitude

Body scan - short version, long version
Progressive muscle relaxation

Meditation - walking, open awareness, visualization, mountain meditation

Diaphramatic breathing

5,4,3,2,1 - 5 things you see, 4 you hear, 3 you smell, 2 you touch, 1 you taste

Raisin exercise

Mindful seeing / nonjudgmental seeing

Mindful listening: 1 stressful thing, 1 looking forward to, thoughts feelings, sensations

Triangle of awareness

Personal boundaries and stress response

Back body meditation

Object oriented meditation

Observe thoughts for 15 minutes - label as thought, i am not my thoughts,

Bell dissipation exercise

Depression: Sorting thoughts, sensations, emotions into mental boxes

Attitudes or intentions: beginners mind, patience, letting go of judgment, compassion, equanimity

Acknowledging cravings like passing thoughts

Wheel of awareness: 5 senses, interoceptive sense, mental activities, interconnectedness

ACT: Cognitive difusion: I am not my thoughts, attachment to thoughts, acceptance, presence, values, actions

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15
Q

What are evidence based treatments for depression, anxiety, PTSD, and substance use?

A

Depression: Problem solving, social skills and assertiveness, increase pleasant activities, problem/solution focus,

Panic, Phobias, OCD: exposure, applied relaxation, problem solving, cognitive restructuring, meta-cognitive awareness, ACT, mindfulness: present moment focus, values guided behaviour

PTSD: Imaginal exposure: psychoeducation, breathing, relaxation, recounting trauma aloud; invivo exposure; addressing maladaptive thinking patterns; strategies for perspective shift; breathing retraining, muscle relaxation, negative-thought stopping, and restructuring/challenging maladaptive cognitions.

Substance Use: Pros and cons, coping strategies, self-monitoring, motivational interviewing,

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16
Q

Which assessments might you use in session?

A

Patient Health Questionnaire - 9 for depression
Generalized Anxiety Disorder - 7 for anxiety
RIASEC
Strong Interest Inventory
Myers Briggs Type Indicator

17
Q

What are some important basic skills?

A
Normalize experience
Address shame
Build safety
Skills training / education
Values clarification
Motivational interviewing
Breathing
18
Q

Talk about a strengths based approach?

A

Emphasize that defenses are adaptive to a point, and that perhaps instead of trying to change the defence, work on cultivating its opposite

  • Have members brainstorm resources in the practical, physical, psychological, social,
  • Have everyone list every resource, thing they have going for them, and list everything they have going against them. Choose one list to focus on in the morning, and one list to read once a month to check up on.
  • Talk about shame, worthiness, belonging (Brene Brown)
19
Q

Tell us about a trauma-informed approach

A

This means I prioritize your safety and recovery from trauma, I focus on your strengths, and I collaborate with you to develop coping skills and to build resilience.

20
Q

Talk about a strengths based approach?

A

Emphasize that defenses are adaptive to a point, and that perhaps instead of trying to change the defence, work on cultivating its opposite

  • Have members brainstorm resources in the practical, physical, psychological, social,
  • Have everyone list every resource, thing they have going for them, and list everything they have going against them. Choose one list to focus on in the morning, and one list to read once a month to check up on.
  • Talk about shame, worthiness, belonging (Brene Brown)
21
Q

How would you treat self-harm?

A

DBT model - ending parasuicidal behaviours are a priority. Validate experience. Approach self-harm as a coping strategy. Acknowledge client is using it to solve a problem. Reframe self-harm: when you feel like self-harming, there is a problem to be solved. Distress tolerance. Commitment. Mindfulness Skills. Emotion regulation skills. Remove precipitating events. Chain analyses on what leads up to self-harm. Pros and cons. Irreverance.

Referral to treatment.

22
Q

How would you treat trauma?

A

Build safety. Body awareness, body as resource. Anchoring, safe place. Exposure - invivo, informal, imaginal. Writing trauma story.

23
Q

What are steps you would take to asses risk in a crisis?

A

Risk assessment:

IS PATH WARM
History of attempts
Current intent
Means or method available
Any lethal means available
Plan and preparation in place
Precautions against discovery
Substance use
Isolated, alone
Prompting events match previous prompting events
Sudden loss
Clinical change: pos or neg
Indifferent to therapy
Hopelessness
Depression
Anxiety / Panic
Insomnia
Anhedonia (inability to feel pleasure)
Concentration problems
Command voices
Chronic pain
Impulsivity increase
24
Q

What would you assess for in crisis for protective factors?

A
Hope for future
Self-efficacy in problem area
Attachment to life
Responsibility to others
Attached to therapist
Will contact therapist
Protective social network
Fear of suicide, death
No method available
Fear of disapproval / immoral act
High spirituality
Commitment to live
Willing to follow crisis plan
25
Q

What actions would you take for someone in high risk

A
Safety plan
Get commitment to go to next session
Address prompting event, remove if possible
Remove means
Trouble shoot action plan
Plan to contact a social support
Alert network to risk
Plan  a follow up call
Refer to crisis line
26
Q

What does IS PATH WARM stand for?

A

Ideation
Substance

Powerlessness
Anxiety
Trapped
Hopelessness

Withdrawal
Anger
Recklessness
Mood changes

27
Q

Talk about an indiginous healing framework?

A

28
Q

What is the difference between band, nation, tribal council?

A

A band is a system of government, usually a single First Nation, single community. May comprise more than one reserve (parcel of land). A tribal council is a grouping of more than one band.

29
Q

What are some local resources?

A
Nanaimo area food services
Vancouver Island Crisis Line 
Nanaimo youth services
Nanaimo and Cowichan food services
Kuu'us crisis line
Brooks Landing Walk-in Counselling Clinic 
Haven Society for women who have been sexually assaulted 
Vancouver Island Health Authority
30
Q

What are the 4 VIU campuses?

A

Nanaimo
Parksville-Qualicum
Cowichan
Powell-River

31
Q

What are some VIU programs?

A
Visual Art
Music
MBA
MEd
BA
BSc
Natural Resource
First Nations Studies
Languages
Earth Sciences
32
Q

What is tr-phasic model of trauma recovery

A

Three Phase Trauma Therapy (Tri-Phasic treatment)

Judith Herman is a psychiatrist in the Boston area who has written extensive about traumatic response and therapy. She recommended an approach to trauma recovery that includes three stages. The Traumatology Institute most recommends this approach, as seen in the book Trauma Practice: Tools for Stabilization & Recovery (Baranowsky, Gentry & Schultz, 2010, 2nd Ed.)

Using a comprehensive three phase approach, the client is:

given a sense of emotional and physiological Stabilization prior to moving into
Remembrance and Mourning, which we will now refer to as Trauma Memory Processing, and then
Reconnection with communities and with meaningful activities and behaviors.

Phase 1: Safety and Stabilization

The central task of recovery is safety. People who have experienced trauma often feel betrayed both by what has happened to them as well as their own bodies. Their symptoms become the source of triggers that result in re-traumatization. This can leave the individual feeling both emotionally and physically out of control. Getting the right help to regain internal and external control is a primary focus of this phase. This is accomplished through careful diagnosis, education and skills development. The safety section of phase one, is focused on skills development to aid you to practice self-soothing and care skills to increase emotional and behavioral stabilization. In cases where you remain in an unsafe environment, plans to establish personal and practical safety remain the focus prior to delving into trauma memory processing work. The overriding goal is to make a gradual shift from danger that is unpredictable to a situation where you can rely on safety both in your environment and within yourself. Accomplishing this goal depends on the circumstances as well as your internal ability to cope with exposure to trauma memories and may take days, weeks, or months to achieve. In some cases, individuals may remain in the emotional safety and stabilization phase indefinitely while they work on establishing physical safety. Although we do encourage clients to work through their trauma memories this must be done in a respectful manner with the mutual consent of both client and therapist.
Phase 2: Trauma Memory Processing

In the second phase of recovery you will begin to work more deeply with exercises to work-through trauma history bringing unbearable memories to greater resolution. Because of the nature of traumatic memories, this process is rarely linear. Bits and pieces of the traumatic events emerge and can be processed. The objective is to create a space in which you can safely work through traumatic events and begin to make sense of the devastating experiences that have shaped your life. A good therapeutic relationship should provide you with a compassionate companion who will “bear witness” to your experiences, and help you to find the strength to heal. Using exercises that are designed for trauma memory processing.

There are many excellent Cognitive Behavioral Therapy techniques that fit well within this stage of trauma memory processing. In addition, there are newer approaches such as Eye Movement Desensitization and Reprocessing (EMDR), Time-Limited Trauma Therapy (TLTT), Layering, and Traumatic Incident Reduction (TIR) that have proven to be helpful in trauma memory processing.
Phase 3: Reconnection

The final stage of recovery involves redefining oneself in the context of meaningful relationships and engagement in life activities. Trauma survivors gain closure on their experiences when they are able to see the things that happened to them with the knowledge that these events do not determine who they are. Trauma survivors are liberated by the conviction that, regardless of what else happens to them, they always have themselves. Many survivors are also sustained by an abiding faith in a higher power that they believe delivered them from oppressive terror. In many instances survivors find a “mission” through which they can continue to heal and to grow. They may even end up helping others with similar histories of abuse and neglect. Successful resolution of the effects of trauma is a powerful testament to the indomitability of the human spirit. Once Phase 2 of Trauma Practice is completed, personality that has been shaped through trauma must then be given the opportunity for new growth experiences that offer the hope of a widening circle of connections and the exploration of a broader range of interests.