Reflection: Crisis

As we all have been, I have been deeply saddened and shocked by the events of Friday morning.  As school counselors, we all tend to be fairly empathetic, and so my thoughts have constantly been turned to the parents of those children who have been lost, the families of those school staff members who died, and to the larger community of Newtown who will need support long after the media trucks and national focus have left as the depths of grief, loss, and trauma begin to manifest themselves in the months to come.

Many years ago, when I was still teaching, I was at a school where, for the first time, I had to go through a lockdown drill with my students.  In going through the procedures of covering my window and trying to keep 30 energetic 7th graders quiet as security came by to check that our door was locked, the thought flashed through my head, "What if this was real?"  Instinctually, I immediately knew that I would put the kids into the instrument storage closet (I taught this choir class in the band room) and would put myself outside if need be to protect those kids.  This was not a question I wrestled with, this was not something where I thought about all the possible consequences.  I knew what I would have to do in the breath of an instant.

Perhaps for this reason, I keep thinking the most about the principal and school psychologist who attempted to stop the gunman as well as the 1st grade teacher who hid her students and gave her own life to protect them.  When you go into education as a career, you do not necessarily think that you may have to give your life as part of your profession.  Yet, that is what the six adults who died on Friday did.  I think all of us who work in schools know that when it comes to the safety of our students, dare I say, "our kids", that chances are pretty high that we would do the same.  Our educational professionals have taken quite a few hits in the public arena in the last decade.  However, the vast, vast, vast majority of adults in schools that I have met in the last thirteen years are highly committed individuals who work excessively long hours, nights, and weekends, often making difficult choices between their own work and personal lives.  They are in education because they love kids, they love watching kids learn, and they love helping to facilitate that process.  They would do anything for their students, and I think we should take a moment to really acknowledge just what that could mean.

I have been inspired in the last several days by the school counseling community and their quick response with regards to sharing resources so that we all have support in working with our students, families, and school communities through this time.  The mother of all school counselor bloggers, Danielle Schultz, began to collect resources at School Counselor Blog and share them with her followers.  I am inspired by this, and believe that all of us who are school counseling bloggers have a responsibility, as collectors and sharers of information, to have these resources at hand to share with our followers whenever they are needed.  As such, I have created a page on my blog dedicated to crisis resources, and would love if other bloggers did the same, so that no matter where a school counseling professional turns, they find information to support them in their work talking to students, staff, and families in these difficult moments.  In this way, as school counselors we can continue to be prepared to lead in times of great challenge.

Transgender Kids: Inspiration and Advocacy

I am a little obsessed with NPR.  I listen to it in the car on the way to work, on the way home from work, and subscribe to multiple podcasts.  It is my secret dream to someday do something worthy of being interviewed on Fresh Air by Terry Gross.  However, my favorite hour of radio is Tell Me More, a program that seeks to explore modern life, issues, and news from a multi-cultural perspective, and multi-cultural from the broadest possible lens.  Not coincidentally, it is also my secret dream to do something worthy of being interviewed by Michel Martin, the host.  So many secret dreams, so little time.

I was driving to a meeting on Monday at just the time that Michel Martin was doing an interview that pulled me in from the moment it started.  Andy Marra is a transgender woman who was adopted by an American family from South Korea.  She recently wrote a blog entry at the Huffington Post about her experience of finding and coming out to her birth mother in Korea.  As she was going through the coming out process, she chose to delay her full transition (hormones, surgery) until she found her birth mother:

"I could never find the will to move forward with my transition -- taking hormones or surgery -- despite the opportunity to do so. And my hesitation was largely due to my unknown family living far away in Korea.  Like me, more than 200,000 Korean babies and children have been sent overseas. But less than 3 percent of us are able to find our families. The odds were clearly not in my favor. But what if I did find my family after all these years? And how would they handle meeting a young woman instead of a baby boy who should have grown into manhood? I was left with few ideas to reconcile my concerns." (source: www.huffingtonpost.com)

As she continues with her story, she finds her mother literally in the span of a few hours, and the two are reunited.  Like so many kids who are contemplating the coming-out process, she is nervous to share her gender-identity with her birth mother, a woman she has just met.  However, the turn in this story is that it is her birth mother who first broaches the subject.  She instinctually knows that there is something weighing Andy down, and after some questioning, Andy tells her that she is a transgender woman.  Her birth mother responds:

"'Mommy knew,' she said calmly through my friend, who looked just as dumbfounded as I was by her response. 'I was waiting for you to tell me'...'Hyun-gi," she said, stroking my head. 'You are beautiful and precious. I thought I gave birth to a son, but it is OK. I have a daughter instead.'" (source: www.huffingtonpost.com)

It is this moment, in this highly-charged situation of a reunited birth mother and daughter, that Andy begins to find her own self-acceptance and an ability to move forward in her own life.  You can listen to the full audio interview here.

As I've written about before, finding acceptance and support is key to the well-being of our transgender students, and, right now, the deck is stacked against them:

• More than half of all transgender students have been physically harassed (pushed or shoved) because of their sexual orientation and gender identity.
• More than a quarter of all transgender students have been physically assaulted because of their sexual orientation and gender identity.
• Almost half of transgender students report missing at least one class in the last month and one full day of school in the last month because of concerns for their safety.
• Transgender students who experience high-levels of harassment have an average GPA that is .5 lower than that of transgender students who experience low-levels of harassment. (source: www.glsen.org)

These students are at a higher-risk of truancy, bullying and harassment, assault, and poor academic performance.  Additionally, parent reactions to LGBT students makes a huge difference.  According to the Centers for Disease Control and Prevention, those students who experienced high-levels of parental rejection were:

• Nearly six times as likely to have high-levels of depression
• More than eight times as likely to have attempted suicide
• More than three times as likely to have used illegal drugs
• More than three times as likely to engage in unsafe sexual behaviors that put them at risk for sexually transmitted diseases (source: www.cdc.gov)

For students who experience more acceptance from family, such as Andy, they have a support system in place regardless of their school environment.  However, for those students who are experiencing high-levels of rejection at home and are thus at higher-risk for depression, suicide, and substance use, the school environment can be make-or-break for that child.  Transgender kids in schools can be a highly emotional issue, as currently being played out in the East Aurora School District, but the data shows that this is an issue of school safety, student achievement, mental health, and even life and death.  We, as school counselors, are charged with advocating for all students, with a focus on creating an equitable and safe environment so that every child can learn.   Our transgender students fall into this category.

For resources, I would recommend taking a look at the previously mentioned CDC website, which has tips for making schools safe places for all LGBT students.  Additionally, the Gay, Lesbian, & Straight, Education Network (GLSEN) has a sample transgender policy that can serve as a conversation starter amongst your stakeholders and give you ideas about what issues need to be addressed, from bullying/harassment policy to bathrooms and locker rooms.  All of our students should have the opportunity to do well in school and have access to supports that allow them to figure out their identity for themselves, just like Andy.

Resource: Children in Poverty

The PBS documentary program, Frontline, takes time to really go in-depth and explore topics, often filming over months or even a year to get a more thorough view of an issue.  A few weeks ago, they aired a program about poverty amongst American children.  Did you know that:

• 1 in 5, or 21.6%, of America's children were living in poverty based on Census figures
• Federal spending on children in 2011 fell for the first time since the 1980's by $5 million 
• 47.6% of children living with a single mother live in poverty
• The poverty rate for White and Asian children is below the national average (21.6%), while the rate for Black children is at 38.2% and Hispanic children is at 32.3%
• 45% of those who spent at least half of their childhood in poverty were still in poverty at age 35 (source: 2011 Census Report)
• Only three other countries in the developed world have child poverty rates higher than that in the United States (source: 2011 OECD Report)

The documentary, Poor Kids, follows six children and their families in the Quad Cities of Iowa and Illinois.  Through the program, you follow their struggles with housing, food, clothing, unemployment, and depression.  Additionally, there are some themes that emerge that directly pertain to our work as school counselors:

• Loss: In the documentary, one family has to take their young girl's dog to the pound as they can no longer afford to keep her, plus they are moving from a house into a hotel room where they can only have one pet.  Children in poverty are constantly having to say goodbye, whether it is to their home, friends in a neighborhood they are leaving, pets, or even family members.
• Hunger:  Almost every child talks about being hungry at points in the program.  We know that children who are  hungry do not perform as well in school, thus we have a national school breakfast and lunch program.  However, those programs only go so far, and are not always able to address meals outside of school and on weekends.  Thus, while a student may be full and able to focus in school, homework to be done on the evenings and on the weekends may be more of a struggle, as children need a lot of nourishment through their growing years.  One program that is highlighted is a backpack food program where kids get food on Friday that can fit into their backpacks to take home over the weekend.
• Educational Impact: They do not really get to this until the end, but if you have worked in a school long enough, you have probably observed this directly.  Kids in poverty are often moving around, as they are able to get into a house but are then evicted, move into a hotel, back into a house, then an apartment, etc.  Thus, they can be in one school or school district's boundaries one minute, then in another one the next.  One of the young girls in the documentary does not go to school for a few weeks, knowing that they are in a hotel for only a short time and will be moving into another housing situation, which puts them in a different school district.  Thus, kids in poverty run a higher risk of missing pieces of their education while they move around, even if it is within the same general area.  It is vitally important that you check with your school system to see what provisions have been made for students that may fall into the category of homeless.  There are Federal guidelines for homeless students that clearly define what constitutes a student as homeless as well as guidelines for specific concerns such as registrations, transportation, and looking out for the "best interests" of the students in these particular situations.
• Educational Aspiration: Several of the kids in this documentary speak to the fact that they know, even at the young ages of 8 or 9 years old, that education is their ticket out of poverty.  They look to school and good grades as a pathway to college and a good job.  As school counselors, we are tasked with helping all of our students succeed academically and move on to a post-secondary option that is congruent with 21st century skills and careers.  This is reassurance that our children in poverty expect and deserve no less from us than any of our other students.

You can watch the documentary for yourself below:

  

Watch Poor Kids on PBS. See more from FRONTLINE.

Watch Poor Kids on PBS. See more from FRONTLINE.

Watch Poor Kids on PBS. See more from FRONTLINE.

Watch Poor Kids on PBS. See more from FRONTLINE.

College: Where Are We Now?

The National Association of College Admissions Counseling (NACAC) released their annual report this week that evaluates statistics and movement over the last 10 years with regards to college admissions.  There are a few trends that are important for school counselors to note.

I've written this year about the early application process, and that there is a perception out there that applying early increases your chances of admissions into a school.  Well, as this Education Week blog post discusses, this may not always be the case:

• For students who applied Early Decision in the fall of 2011, there was an acceptance rate of 59%, versus 53% for the total applicant pool, giving Early Decision applicants a 6% advantage.
• For students who applied Early Decision from 2007-2009, there was an advantage over the total pool ranging from 12% to 15%. (source: blogs.edweek.org)

Thus, students who applied Early Decision, meaning that if accepted they were committing themselves to attending that one school and rescinding all other offers of admissions, only saw a slightly higher acceptance rate than everyone else, different from past years.  For those students who applied through the non-binding process of Early Action:

• For students who applied Early Action in the fall of 2011, there was an acceptance rate of 65%, versus 63% from the total pool, giving only a 2% advantage.
• The advantages were higher in 2006 and 2007. (source: blogs.edweek.org)

Early Action allows students to get a decision early, usually in December, but they are allowed to apply to multiple schools without committing to one until May 1st.  Thus, it seems like the advantage that may have once been perceived to exist for students who chose to apply either Early Decision or Early Action may be eroding.

Other data to come from this report discussed the growing number of colleges to which each student is applying.  This post from Inside Higher Education shines the spotlight on the following statistics:

• The percentage of students applying to 3 or more schools is up from 67% in 2010 to 79% in 2011.  The percentage of students applying to 7 or more schools is up from 25% in 2010 to 29% in 2011.
• In the last 10 years, the yield of students, meaning the percentage of students who are admitted who accept that offer of admissions, has gone from 51.4% to 42.6% at public colleges and universities, and 47.8% to 36.4% at private schools. (source: www.insidehighered.com)

Thus, more students are applying to college, and more and more colleges, at that.  As school counselors, we feel this in the longer lists of transcript requests and the more involved conversations of to which schools our students are thinking of applying.  There is a perception, though, that admissions has become tougher, and this is not necessarily the case.  While the percentage of acceptances has dropped very slightly, the majority of schools are still admitting almost 2/3 of its applicants. (source: www.insidehighered.com)  Part of this is because with more students applying to more schools, schools have to admit higher percentages of their admissions pools in order to yield enough students who accept those offers to populate a class.  It is important to note this to students and families--while there are certainly a top-tier of colleges and universities that have become more competitive, the vast majority of schools are admitting similar percentages of students to those from 10 years ago. (source: www.insidehighered.com)

The top factors that go in to college admissions decisions remain grades in college prep classes, rigor of a student's curriculum, and standardized test scores.  The importance of class rank, however, has declined over the last 10 years. 

The Road to RAMP: Data Mining

This is the second in a series of reflections on the RAMP process.

A few weeks ago I was teaching a class of new counselors and one of the topics was "data."  What are the different types of data that school counselors use?  Why do school counselors need to use data in their practice?  Where do you start?

I've learned over the years that school counselors, new or otherwise, are all at very different places with this topic.  Our comfort level with finding, using, and analyzing data seems to be dependent on a wide variety of factors, such as when you were in graduate school, the specific graduate program that you were in, the comfort level of your professors with data-driven practice, and the professional development that you received after graduation supporting the use of data in your counseling program.  Yet, if you are at all interested in working towards RAMP (Recognized ASCA Model Program) certification, it is a world with which you will need to become familiar.  Quickly.

As I wrote about in a prior post, at my school we have really been working towards RAMP for several years.  A large part of that process has been spent in developing a comfort level, as a team, with data.  What I am finding, though, with the RAMP process, is that we are really being forced to go deeper into our data, both to justify our interventions and define our goals (a topic for a later post), as well as to analyze the effectiveness of our programming.  This process is really helping us to tie together our mission, vision, and beliefs with what we do and how we do it, as well as making us ask the question as to what impact all of our programs are having on academic achievement, post-secondary outcomes, attendance, and school safety.  Where, though, do you begin?

First, it is important to know the three types of data that we will work with:

• Process Data:  Process data literally tells us two things--who is effected by the intervention and what did they do?  Thus, 97% of 9th graders wrote a post-secondary goal.  320 seniors took part in a lesson about dating violence.  56 parents participated in an evening program that focused on supporting students' study-skills at home.  This type of data is a place to start--it is helpful in that it can help to show people that you are taking an active role in the school community and are working with students and parents, oftentimes in large groups.  If you are in a situation where you have concerns that your community is unsure of what it is that you do or have the impression that you don't do much, this type of data can help to inform them of your role.  However, it is lacking in that it does not demonstrate the change or impact that your interventions may have.
• Perception Data:  Perception data comes in a variety of shapes and sizes.  Basically, you are getting a snapshot of people's thoughts, or "perceptions," on a program at a given time.  One way that you might use perception data before a program is to do a needs assessment to see what the perception of your students, parents, teachers, administration, or any combination thereof might be with regards to what they need from you.  For example, if you are trying to determine what groups might be the best use of your time in your elementary school, you can develop a brief questionnaire that asks students to pick their top two out of several options, and maybe follow up with a questionnaire to the teachers and parents, as well.  In this way, you are making decisions about how to utilize your time and resources that reflect what your school community needs, not just what you think they need or what you like to do.  Thus, you may learn that 70% of your students want groups on study-skills and that this is supported with 80% of teachers and parents, versus only 2% of students, teachers, and parents that feel a group on social-skills would be beneficial.  Now, this does not necessarily mean that  you will throw a social-skills group out the window, but it would warrant looking into it further and finding additional sources of data that might support the need.  We also use perception data quite often to see what change has occurred in students feelings, thoughts, or knowledge as a result of our interventions.  Often this is done through either a pre and post test combination, or simply a post test.  These can come in many forms, but asked in developmentally appropriate ways (a choice of two pictures, such as a smiley face and a frowny face for younger students versus a five-point Likert scales for older students) how someone believes they have changed because of your lesson, group, or program.  Thus, there was a 50% increase in 10th graders knowledge of career options as a result of your lesson.  After your lesson on bullying and harassment, 98% of 8th graders could correctly identify the bully, the victim, and the bystander and their roles in the bullying cycle.  Thus, perception data is more powerful than process data in that it can demonstrate change and growth as a result of your program.  However, it is subject to self-reporting, which is not always the most reliable, and does not address the direct impact that the program  has on the academic process.
• Outcome Data: This data was previously known as "results" data, so if you see that term used in prior publications, articles, or entries, realize that they are referring to the same general idea.  Outcome data refers to academic information such as grades and test scores, but also enrollment in rigorous courses and post-secondary planning outcomes.  It also refers to attendance and school-safety.  This is the most powerful data that we can use, as these are the hard numbers that administrators, communities, and state and national entities are tracking.  If you can show that through your intervention grades have improved, test-scores have gone up, enrollment in advanced coursework has increased, more students are applying and being admitted to two and four year colleges, students are coming to school more, or disciplinary incidents have decreased, you are demonstrating that your program is having a direct effect on the academic process, success, and "outcome" of the students in your community.  80% of students who participated in the year-long "Student Success" program saw an increase of .5 or better in their GPA.  Students with five or more unexcused absences that participated in the student-parent program targeting school engagement saw a 65% drop in truancy after two months.  As a result of a school-wide, comprehensive bullying and harassment campaign led by the school-counselors, reported incidents of bullying and harassment were down by 50% from the previous year.  Ultimately, we want as many of our programs to show a change in this data category, as it speak to the true power that school counselors can have on the success of our students.

For more in depth explanation of this information, refer to the ASCA National Model, 3rd Edition.  

So, why do school counselors need to speak this language and use data?  I have been involved in many conversations over the years with practitioners who state that finding data, developing instruments to measure interventions, and analyzing and presenting data takes time away from our direct work with students, which is what we have been trained to do and which is what is most beneficial to students and communities.  There are those that feel that the data-driven movement has taken the humanity out of our profession.  My counter to this is that first, we need data to better make use of our limited time. We all have high case-loads, and some of us in various parts of the country have extremely high case-loads.  By looking at information such as grades and test-scores, broken down by subgroups, as well as needs assessments, we can better target our time with those who may benefit the most from more direct interventions.  Secondly, we need to invest our time and resources on programs that have an impact.  This scenario happens all the time:  You have a speaker come in.  You think the speaker is wonderful.  Other adults think the speaker is wonderful.  No one ever asks the kids what they learned from the speaker, and no one ever follows up to look at academic, attendance, or school-safety data to see if there was any strong, long term impact from the speaker.  Are you really getting the bang for your buck with this intervention, especially if you have taken away from instructional time and spent money to bring this speaker in?  By using data to measure the effectiveness of programs, either with perception data, outcome data, or both, you will quickly determine which programs work and which do not.  This empowers you to justify cutting some things, changing some programs, and developing others based on the true needs of your school.  It also will allow you to ultimately spend more time with students if you are able to do away with some things that have no impact whatsoever on your school community.  Lastly, we need to collect and use data in order to promote, defend, and expand our profession.  As the latest 2012 National Survey of School Counselors from the National Office of School Counselor Advocacy (NOSCA) tells us, both school counselors and school principals believe that school counselors are ready to take the lead in helping develop students who are college and career ready and chart them on a path to strong post-secondary options.  However, for better or for worse, we need to show our local, state, and national communities just how strong an impact that we are able to have on the academic achievement and outcomes of our students in order to receive the necessary resources and reasonable case-loads that will allow us to do this important work.

So, where do you start?

• Examine data sources that are already available.  Most schools across the country have public "report cards" that breakdown testing data by subgroups.  This can give you an idea pretty quickly of where students are and are not doing well, academically.  You can take this information to your team, administration, or advisory council to begin to develop a program that can address this.  Additionally, look at student grades, graduation rates, attendance, and school-safety data.  This information alone should help to give you some ideas of where there are needs for your services within your building.
• Consider doing a needs assessment.  Take a deep breath--this does not mean do a needs assessment of every student, teacher, or parent in your building.  Target a small population--pick a grade level, do a random sampling, or look at a subgroup that you've found based on information you've gleaned from the previous bullet-point.  In this way, before you develop a program, you can get a better handle on what those students need most.  You may think that your group targeting 7th grade attendance needs help with study-skills, but your needs assessment of them prior to starting may point you in a different direction.
• Find ways to collect data on your programs.  If this is overwhelming, start with one or two, and over the course of a few years add more until you are examining your entire program.  It is important to begin to ask yourself and your team what changes in perception and student outcomes are occurring as a result of your interventions.  You can use paper-pencil pre and post tests or you can use online tools like Survey Monkey and Naviance to gather perception data, and you can go into your school's database to gather the outcome data.  Once you start taking a look at some of the programs that may have been in place for years, you may be surprised by the results.  This can begin some important conversations within your school as to how to best utilize your time and resources.  Some of them may be difficult conversations, but with data you are always able to bring the discussion back to student success and outcomes.
• Share your data.  Regardless of what the data shows, whether effective or ineffective, share your data with stakeholders.  This can be a great thing to do during your advisory council meetings, but you should also feel free to share it with teachers, administrators, and parents as appropriate.  This can be done informally through e-mails, presentations, or newsletters, or you can develop more formalized reports.

If these steps seem like they are just scratching the surface and you are looking for more information on how to compile data and make more formalized DATA reports, I would highly recommend taking a look at Making DATA Work by Dr. Anita Young and Dr. Carol Kaffenberger and available through the ASCA Bookstore.  This book will go into much more detail and give you step-by-step instructions on compiling data, developing instruments to measure programs, and writing a DATA report to share with your stakeholders.  It also includes samples for you to look at that can serve as models.  

Once you begin this process and develop a comfort level with data, you will not only be on your way to RAMP, but you will have begun to find ways to maximize your time with students as well as demonstrate just how powerful the role of a school counselor can be within a school and community.

Depression: 'Tis The Season

I am still not used to the fact that it is getting dark outside around 4 o'clock in the afternoon.  There are times when I wonder about having gone into a career where I go to work in the dark, spend almost the entire day in my windowless yet tastefully decorated office, and then leave work just as the sun is beginning to set.  My already pale skin moves from its typical cream with a hint of pink to full-on pasty white.  I could easily be considered for a role as an extra in any one of the plethora of television shows and movies featuring vampires.

Sigh.  Welcome to the dog days of winter.

It has begun--the winter season.  Not only is there less daylight, but it is colder, making people less likely to partake of natural sunlight outdoors even if they could.  The holidays are coming, which means hectic travel schedules and more time with family.  This much togetherness can be positive but also has the potential to aggravate and enhance any already existing conflict or discord.  For those families who are already struggling financially, emotionally, or both, this time of year can be a true challenge.  If you've been in school counseling for a while, you know that these stressors are not confined simply to adults, but that they also can have quite a large impact on our students.

A recent article by Lynne Shallcross in Counseling Today discussed the topic of depression, and a large section of it highlighted the often invisible high-risk group of adolescents, especially adolescent girls.     According to the National Institute of Mental Health, about 11 percent of adolescents have a depressive disorder by the time they are 18 years old, and according to the World Health Organization, depression is the leading cause of disability amongst people ages 15-44.  Additionally, depression can lead to suicide, which is still the third leading cause of death amongst youth ages 10-24 years old.  You may think that this is something that you will not really address as a school-counselor.  After all, we do not provide therapy, and surely if a student is depressed, then they will be taken care of by an outside clinician.  While this may be true, it does not mean that we do not still play a key role in assisting students and families who are working through depression.  More importantly, we are in a position to be able to work towards prevention and education.

First, what is depression?  The DSM-IV-TR defines Major Depressive Disorder as having had the presence of at least one Major Depressive Episode.  A Major Depressive Episode needs to have had at least five or more of the following symptoms present during a two-week period as well as a change from previous functioning, and at least one symptom is either the first or second on the list below:

• Depressed mood most of the day, almost every day.
• Diminished interest or pleasure in typical activities
• Significant weight loss or gain
• Insomnia or hypersomnia
• Observation by others of either psychomotor agitation or excessive slowing down
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness or excessive guilt nearly every day
• Diminished ability to think or concentrate nearly every day
• Recurrent thoughts of death, suicide ideation, or suicide attempts (APA, 2000)

The symptoms also need to cause significant distress in their social and/or academic functioning (APA, 2000).  It is important to note that these are the symptoms for adults.  There are some variations among children and adolescents.  First, as is discussed in the Counseling Today article, depression can often be a challenge to diagnose in adolescents because they are already typically undergoing a lot of mood shifts.  We often chalk up extreme sadness in teens to simply been a teenager.  However, if a student's sadness about a situation continues to linger over time about an event that occurred, this may be a warning sign.  Additionally, you may begin to see other areas of concern.  For example, we should also look for changes in attendance, grades, peer groups, and peer relationships, in addition to the mood alterations as well as any physical symptoms like a change in sleeping and eating habits.  Further, in children you may not see so much the diminished interest or depressed mood, but rather instead irritability and defiance.  Also, because of adolescents' quick-to-change moods, strong desire to fit-in, and a need to show a certain "face" in public, students may be depressed and yet also be observed in some situations to appear as if nothing is wrong.  It is not uncommon to have a student who will seem to be outgoing as ever in school, but when they are home by themselves report that they do nothing but cry, sleep excessively, and hide from family and friends.  Thus, often it can take some probing conversations and a careful examination of all the possible symptoms to really get at the heart of the matter.  It is important to note that, as previously stated, girls are at a higher risk of depression than boys, as are children who have suffered trauma or who have conduct or attention disorders.  Additionally, LGBTQIA children are also at a higher-risk for suicide and mental health concerns.  

So, what is your role, as a school counselor, in all of this?  First, we have a real opportunity to do preventative work with regards to depression:

• Build resiliency in all students.  While there is certainly a physical/chemical component to depression, there is often an event of some kind that will trigger an episode.  Students with few coping schools and resources are more likely, in this instance, to slip into depression.  As a high-school counselor, we often talk to our new students and our 9th graders about participating in sports, clubs, community service, and additional extra-curriculars and stress the impact this can have when they fill out college applications.  However, participation in these activities also helps to build connectivity to the school as well as assisting them in forming positive relationships not only with other students but also with the coaches and sponsors.  It is these links to other people, both peers and adults, and the trust between them, that can be invaluable when a stressful life event occurs.  Rather than feeling like he/she is alone, a student will have a network of trusted friends and mentors to go to.  School counselors can help to connect students with these activities through group orientations, through their counseling website/Twitter feed/Facebook page, or through individual meetings with students.  Further, if the activities are related to physical activity, such as club or school sports or dance, these can add another positive coping mechanism and mood-enhancer to the student's life.  Additionally, school-counselors can educate their students on the role of the school counselor as someone who can help them problem solve social/emotional issues in addition to academic and career/college concerns.  If students have a relationship with the school counselor that is based on trust, they will be more likely to come to you if they are struggling with an issue.  The goal is to build a network of support around all students before an episode of depression begins.
• Educate the school community about the signs of depression and suicide.  We do many lessons with our students, most of them focused on academic and career/college skills.  How about throwing in one or two on the warning signs of depression and suicide?  If the students know about the signs--changes in behavior with regards to attendance, grades, extra-curriculars, friends, sleep, diet, talking about harming themselves, saying goodbye to others, and giving away possessions, etc--then they will be more able to clue adults in when they become worried about their friends.  Additionally, let students know what to do if they are worried about their classmates.  They should talk to a parent, teacher, counselor, or other trusted adult about their concerns.  Honor the confidentiality of the student that reports unless there are some extreme circumstances which would make disclosure a necessity.  In this way, students will feel more comfortable with letting staff know if they have a friend about whom they are worried.  Additionally, train the staff on warning signs and develop a procedure for reporting any students of concern to the school-counselors.  This is where strong relationships with your teachers and staff can come into play.  I am always very thankful when a teacher contacts me to ask me about a student who has been missing their class, suddenly not turning in work and failing tests, or who exhibits some other extreme behavior change.  This information allows me to check in with the student to determine what the situation may be and to develop a plan of action to address the presenting issue.

If you do have a student who you are concerned about, what can you do?  In a 2009 article in School Counselor Magazine, Adriean Mancillas, Psy.D gives some excellent tips:

• Do a suicide assessment and monitor the student.  It is important that if you have a student who presents with some of the signs of depression and/or suicide, that you assess them for risk.  If you are at all concerned or are not comfortable with this, please get additional support from another counselor, school psychologist, or school social-worker.  If there is cause to believe that the student may be suicidal, it is important to immediately contact the parent and ask them to take the student to be evaluated by a mental health professional.  Do not leave the student alone for any reason until the parents arrive.  When the student returns to school, make sure to follow-up with the student and family and check on the student frequently.
• If the student presents with some of the signs of depression, contact the family and refer to their physician or recommend mental health providers.  If you have a student whose grades have dropped, who is sleeping 12 hours a day, who has stopped engaging with friends and with activities they used to love, you have cause to be concerned about this student, and you think they might be clinically depressed.  How do you address this with the parents?  Remember: school counselors do not diagnose.  You should not say that their child is suffering from depression.  However, we can tell the parents what behaviors and changes we and other school community members are observing, state that we are very concerned by these observations, and recommend that they please follow up with a visit to a primary care physician or a mental health professional.  They should start with their insurance company, but you should also have on hand a list of local providers, some that will provide services on a sliding scale.  
• Educate and work with the parents.  All parents have dreams for their children, and when a student becomes depressed, it can really interrupt and impact both their academic and social lives.    This can be a challenge sometimes for parents who are worried that this is going to ruin their child's chances to get into a certain college or achieve certain goals.  We have come a long way in this country with regards to acknowledging the legitimacy of mental illness, but there is still a long way to go until we see it in the same framework as physical illness.  People will often wonder why someone cannot simply "snap out of it" when it comes to depression, and it can be our role as school counselors to help educate parents and the community that it is indeed an illness, that it takes time to heal and recover, and that the primary focus for a child who is depressed should be on getting well.  The grades and college plans will come when the child is feeling stronger.  Additionally, some parents may simply need more information about depression in adolescents, and if they have a relationship with you as their child's school counselor, they may be more comfortable seeking answers to their questions from you versus outside providers.
• Help accommodate the student's academic and school needs.  Students who are in the throws of depression and recovery may not be able to keep up with a full-course load, or may need to lessen the rigor of their classes.  They may need reduced work-loads or access to teacher notes.  Additionally, they may need more access to you, the school psychologist, or the school social worker than other students.  You can help to coordinate with the student, the parents, the teachers, and the outside clinicians to develop a plan that will best assist that student.
• Be a support to the student during the school day.  We, as school counselors, do not provide therapy, but we can be supports to our students while they are at school.  Building that relationship early with students can be key before an issue occurs, as it will make the student more comfortable seeking you out and trusting you during their recovery process.  It may be that you will check in with the student once a week, or it may be that the student can come to you if they are feeling overwhelmed during the school day and need a safe space to gather their thoughts before they go back to class.  Either way, you can be an invaluable resource in the building to that student while they are also getting outside assistance. (Adapted from Mancillas, 2009)

As they year goes on, we will see more cases of depression in our students.  As school-counselors, we can take the steps necessary to do some preventative work and education, as well as put supports in place ahead of time to help assist our students and their families who are working through this issue.

The following work was cited within this post:

APA. (2000).  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., Text Revision.  Arlington, VA: American Psychiatric Association. pg. 356, 375.

The following work was cited within this post and is available to members of the American School Counselor Association:

Mancillas, A. (2009) Supporting Students With Depression.  Retrieved from www.ascaschoolcounselor.org. 

From the Counselor's Office Named a Top Counseling Resource

This week From the Counselor's Office was recognized as one of the top 100 resources for counselors on the web by the website, Masters in Counseling.  I am honored to have been included with so many other excellent, informative, and inspiring school-counselor blogs!