A Sea of Trouble: A Relational Approach to the Culturally Sensitive Treatment of a Severely Disturbed Client

In this article we will show how a relational approach provides a conceptual framework that shapes and informs culturally sensitive practice with a severely disturbed client. We argue that a relational approach facilitates therapeutic action through the intense focus on countertransference, the close attention to enactments, and the therapist's authenticity and self-disclosure. Additionally, we emphasize that a therapeutic matrix that includes the cultural, racial, socioeconomic, and institutional factors, increases the likelihood clinicians will attend to what Perez-Foster calls their dissociated and disavowed personal values. We present a case that had a less than satisfactory outcome where the therapist found herself in a sea of trouble. The case illustrates how a relational approach enhanced the therapist's understanding of the case and allowed her to continue to work with a difficult and challenging client. We conclude by suggesting that our conceptual understanding of this case exemplifies a necessary and appropriate focus for future social work research and practice.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Walking the Tightrope: Directing a Student Health Center at a Research Institution With an Academic Medical Center

Reporting lines for directors of student health centers (SHCs) at colleges and universities are a matter of continuing interest for those of us who must follow them. SHC directors at institutions with academic medical centers face a greater number of reporting choices that also have the potential of being more politically charged. The author describes his experience at 2 such institutions and offers some cautious advice.     

Providing Student Health Services at Sea: A Survey of Chief Complaints Onboard a Maritime Academy Training Ship

Abstract. Objective: The authors describe the epidemiology of infirmary chief complaints aboard a collegiate maritime training ship. Participants: They assessed patients (N = 646 visits) evaluated by the USTS Enterprise medical department during a 44-day sea term from January to February 2007. Methods: The authors conducted a retrospective chart review of infirmary use and extracted information on age, sex, rank, chief complaints, and frequency of visits. Results: Overall, 646 visits were made. The most common complaints were dermatologic (30.1%): rash, skin infection, laceration, and sunburn. Together, ear, nose, and throat and dermatologic complaints accounted for 57.6% of all visits. Work-related complaints accounted for 12.5% of recorded visits. Compared with the ship population, senior and female cadets had more visits than the average. Port departure days were typically the busiest. Conclusions: Among healthy, college-aged cadets at sea, typical primary care constitute comprise the majority of visits.     

The Self-Care Center for Cuts: A Model for Student Development

Abstract

We conducted a study to determine whether an intervention using self-care information would change college students' attitudes and beliefs concerning personal responsibility and involvement in their own health care. Individuals entering a student health service were randomly assigned to a treatment or control group. Members of the treatment group (n = 187) received the intervention and completed the survey instrument. Members of the control group (n = 204) completed the survey instrument only. The intervention consisted of one page of general information about the benefits to individuals of taking responsibility for their own health and a booklet containing excerpts from a consumer-oriented health care book. The survey instrument was composed of a measure of attitudes toward information and behavioral involvement in health care and a measure of beliefs regarding control over one's health. Results indicated that the intervention was able to change the treatment group's attitudes regarding active participation in health care. The treatment group's responses also reflected less belief that health was outside of the individual's control. The study showed that a positive change in health-related attitudes and beliefs can result from a relatively uncomplicated informational intervention.     

Results of a Recent Survey of Funding Patterns of Student Health Services

The authors sought to determine whether a greater academic incentive would improve the effectiveness and student adherence to a 12-week voluntary exercise program designed to decrease students' percentage of body fat. They randomly assigned 210 students to 1 of 2 groups with different academic reward structures. The group with the greater reward structure showed better exercise adherence and lost more body fat than those without the additional incentive. These findings suggest that an academic incentive can increase overall student adherence to a voluntary exercise program and can boost the effectiveness of the program in a university environment. The findings also have potential implications for on-campus promotion of physical activity.     

Impediments to Health Care for the Foreign Student

Abstract

Today's college students occupy a “window” between older adults, whose need for hepatitis B vaccination is minimal, and younger people who receive the vaccine as part of their childhood immunization series. However, because of the high-risk activities that are often part of student behavior, college students are among the individuals who are at the highest risk for this disease; 75% of all reported hepatitis B cases occur in persons between the ages of 15 and 39 years. It is therefore imperative that college health professionals take seriously their responsibility to educate students about issues related to hepatitis B and make available programs that enable the students to receive immunizations. This article briefly describes a successful hepatitis B education and immunization program at an institution that has no mandatory prematriculation immunization requirements.     

The Utilization of Technological Innovations to Support College Student Mental Health: Mobile Health Communication

The purpose of this systematic review was to investigate the use of mobile health (mHealth) for communicating wellness-related resources and mental health interventions to college students. An extensive review was conducted of electronic databases and the annual reviews from randomly selected college counseling centers across the United States. Results revealed that mHealth is a promising resource for infusing technology into the delivery of mental health support services. Recommendations for integrating mHealth into the delivery of mental health support services on college campuses are provided.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Notes from the Field: Gender Issues in the Management Curriculum: A Survey of Student Experiences

A major Australian report recently criticized the relationship between the gendered culture of management education and business management practices, in an effort to reduce impediments to equal representation of women in management. It recommended a major overhaul of university management education, whereby institutions would review their own role in shaping corporate management cultures and practices, and raise awareness of gender issues in the classroom. This article reports on a subsequent survey that explored postgraduate business students' perceptions of gender issues in the management curriculum, and their effects on learning experiences. It suggests that a masculine ethos is perceptible in management education, which can disadvantage female and male students in different ways. The study suggests that greater awareness of gender issues should be a major consideration for management educators, to enable future managers to recognize and harness gender diversity in the workplace.     

Providing Medical Information to College Health Center Personnel: A Circuit Librarian Service at the University of Illinois

Abstract

College health center personnel are no different from other health practitioners in their need for medical information. To help meet this need, the McKinley Health Center, University of Illinois Urbana-Champaign, developed a partnership in 1997 with the Library of the Health Sciences-Urbana, a regional site library of the University of Illinois at Chicago campus. This partnership led to the adoption of circuit librarianship, a dynamic outreach model, to enhance access to health information for McKinley Health Center personnel. A circuit librarian consults with health center personnel during regularly scheduled on-site visits to the center and its satellite office. Upon returning to the resource library, the circuit librarian conducts research for clinical information on behalf of the center's personnel, then sees that articles, books, and relevant Web sites are identified and delivered to assist in answering questions regarding disease management, drug therapy, wellness, and health administration.     

Student Assistance Program: A New Approach for Student Success in Addressing Behavioral Health and Life Events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

The College Mental Health Center: A Report After Ten Years

Abstract

The College Center is a unique mental health facility providing care for thousands of students from many colleges in the Greater Boston area. The authors report on data collected during the 1975–76, 1976–77 school years regarding patient variables such as: gender, year in school, academic major, presenting problem, and others. The center's handling of these patients is reported in terms of diagnoses, treatment recommendations, and numbers of visits. Several commonly held staff assumptions and hypotheses are tested, and from the data available in this study, are not generally confirmed. The impressions, however, of a more recent decrease in antisocial acting out behavior and drug abuse (other than alcohol) and an increase in patients presenting with more classical neurotic and adjustment symptoms are confirmed.     

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

Abstract

Objective: This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood. Participants: The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200). Methods: An online questionnaire (collected 2013–2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health. Results: Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology. Conclusions: This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.