Settle, W., Albers, S., Blake, E., Gaw, K., Hickman, L., Hogan, I., Newport, N., Shoup, J., & Utz., P. (2002, 2004) Mental Health and Crisis Management: Assisting University of Notre Dame Study Abroad Students, 2nd edition. University of Notre Dame Counseling Center, P.O. Box 564, University of Notre Dame, Notre Dame, IN 46556. Edited by Wendy Settle. Situations described in this manual are not based on actual cases. Language is intentionally gender-neutral or, when necessary, alternates between male and female pronouns. Last pdated: 3/29/05. Please send updates to Wendy Settle, Ph.D.

Introduction
The Study Abroad Student and Culture Shock
Helping the Study Abroad Student who is Depressed or Suicidal
Assisting Study Abroad Students with Eating Disorders
Assisting the Study Abroad Student Dealing with Grief and Mourning
Students Studying Abroad who Abuse Alcohol
The Study Abroad Student who has been Raped or Sexually Assaulted
Sexual Harassment and Notre Dame Students Studying Abroad

• Decline in the quality of work
• Frequent absences from class
• Inability to sit through classes
• Disruptive behavior in classes
• Assignments not completed
• Repeated requests for special accommodations such as extensions or postponed examinations
• Turning in coursework that has suicidal and homicidal themes
• Impaired speech or thought patterns

• Marked change in physical appearance and personal hygiene
• Dramatic weight gain or loss
• Chronic tiredness, headaches, gastrointestinal problems without a medical explanation
• Difficulties sleeping or sleeping too much
• Increase or decrease in appetite

• Extreme sadness and tearfulness
• Severe depression
• Irritability
• Hostility
• Marked anxiety Outbursts of anger
• Withdrawn
• Hyperactive
• Excessive dependency on others
• Mood swings

• Expressions of hopelessness, powerlessness, or worthlessness
• Verbal statements or notes that have a suicidal or homicidal tone to them
• Expressions of concerns about death or life after death
• Giving away important possessions
• Self-injurious or self-destructive behaviors
• Violent threats against others
• Out of control behavior

• Culture shock
• Lack of close, supportive friends, and family ties
• Increased isolation
• Death of a family member
• Sexual assault
• Break-up of a relationship
• Poor academic performance
• Intense academic pressures
• Serious illness
• Substance abuse issues
• Poor problem solving and coping skills

• Get to know your students and be available to them.
• Maintain a professional relationship.
• Establish clear and consistent boundaries.
• Ask to see the student in private.
• Acknowledge with care that you are concerned about the student's welfare.
• Express reasons for your concern in a calm and direct manner.
• When acknowledging your observations, use non-judgmental descriptions.
• Show interest and support.

• Listen respectfully to the student's thoughts, feelings, and concerns.
• Try to refrain from making quick judgements.
• Take the student's concerns seriously and try not to minimize his/her pain
• Be patient and allow time for the student to tell his/her story.
• Express that you understand that the student is going through a difficult time.
• Demonstrate that you understand what the student is disclosing by paraphrasing what the student has told you.
• Ask follow-up questions for better clarification and understanding.

• Assist the student in identifying several options and a plan for action.
• Review past coping strategies.
• Explore the possible consequences of the student's action and non-action.
• Develop a backup plan.
• Keep the lines of communication open.
• Arrange time to follow-up with the student.

"I've noticed that you appear to be having some difficulties in your life."

"Tell me more about the changes in your life."

"It sounds as though you feel overwhelmed."

"This appears to be hard for you to talk about. I appreciate your courage in sharing your feelings."

"I think that we all have had feelings like that at times."

"Let's explore some possible options for you."

University Counseling Service, University of Iowa. Helping Students in Emotional Distress: A Guide for Faculty and Staff: http://www.uiowa.edu/~ucs/helping.html

Teaching Support Services, University of Guelph. When A Student is in Personal Difficulty: A Guide for Faculty and Staff. http://www.tss.uoguelph.ca/tahb/tah7b.html

Counseling and Psychological Services, San Diego State University. Detecting Severely Depressed or Potentially Suicidal Behavior: http://www.sa.sdsu.edu/cps/faculty-staff.html

Counseling and Career Services, University of Tennessee at Martin. Helping Students in Distress: Tips for Faculty and Staff: http://www.utm.edu/~ccenter/counseling/distress.html

Counseling Center, New Mexico State University. Crisis and Referrals. http://www.nmsu.edu/~counsel/crisis.html

Counseling Center, Cornell University: http://www.dos.cornell.edu/dos/guide/

Counseling Center, Rice University: http://cohesion.rice.edu/campusservices/counselingcenter/resources.cfm?doc_id=2119

International Studies Office -- (574) 631-5882 -- http://www.nd.edu/~intlstud/
Consultations: Email office at International.Studies.1@nd.edu to arrange
Fax: (574) 631-5711
Director: Tom Bogenschild Thomas.E.Bogenschild.1@nd.edu

The University of Notre Dame's London Program -- (574) 631-7414 --
All London programs (Law, Summer, Undergraduate): http://www.nd.edu/~ndlondon/
Director of the Undergraduate Program: Paul Bradshaw bradshaw.1@nd.edu
London: london@nd.edu Notre Dame campus: ndlp@nd.edu

Student Affairs -- (574) 631-5550 -- http://osa.nd.edu/
Consultations: Email office at coffin.1@nd.edu to arrange
Vice President for Student Affairs: Rev Mark L. Poorman, CSC Mark.L.Poorman.1@nd.edu

Office of Residence Life and Housing -- (574) 631-5878
Consultations: Email office at orlh@nd.edu to arrange
Director: Jeffrey Shoup Shoup.1@nd.edu

Campus Security -- (574) 631-5555 -- http://www.nd.edu/~ndspd/
Director: Rex Rakow Rex.J.Rakow.2@nd.edu

Health Services -- (574) 631-7497 -- http://www.nd.edu/~uhs/
Director: Ann E. Kleva, R.N., M.S.A. Ann.E.Kleva.4@nd.edu

Campus Ministry – (574) 631-5242 -- http://www.nd.edu/~ministry/
Director: Rev. Richard V. Warner, CSC Richard.V.Warner.2@nd.edu

Office of General Counsel -- (574) 631-6411
Vice President and General Counsel: Carol Colby Kaesebier, J.D. Carol.C.Kaesebier.1@nd.edu

Risk Management and Safety - (574) 631-5037 -- http://www.nd.edu/~riskman/
Director: Robert M. Zerr Robert.M.Zerr.1@nd.edu

Office for Alcohol and Drug Education – (574) 631-7970
Consultations: Email office at: ND.aldrug.1@nd.edu to arrange
Director: Gina Firth Gina.M.Firth.3@nd.edu

University Counseling Center -- (574) 631-7336 -- http://www.nd.edu/~ucc/
Emergencies/consultations: Call between 9:00 - 4:00 EST to arrange to telephone the on-call therapist between 9:00 - 5:00 EST at (574) 631-7336.
Director: Susan Steibe-Pasalich, Ph.D. Susan.Steibe-Pasalich.1@nd.edu

Office of Public Affairs and Communication -- (574) 631-6798 -- http://opac.nd.edu/
Associate Vice President: Hilary Crnkovich crnkovich.1@nd.edu

Victim's Resource Advocate for Sexual Assault- (574) 631-7728
University appointed advocate: Ava Preacher, Ph.D. preacher.1@nd.edu

Academic Deans and Department Heads -- http://www.nd.edu/colleges/

Internet Mental Health: Sponsored by the World Assembly for Mental Health. Includes descriptions of disorders, medications, online "diagnosis," and research.
http://www.mentalhealth.com/

Mental Health InfoSource: Source of information on mental health disorders and more.
http://www.mhsource.com/

Student Counseling Virtual Pamphlet Collection: An extensive collection of over 600 self-help articles written by university counseling center professionals.
http://www.dr-bob.org/vpc/

Psychopharmacology:
http://www.psychwatch.com/psychopharm_page.htm

Self-Help Newsgroups Online:
http://www.selfgrowth.com/newsgrp.html

National Institute for Mental Health Online Information:
http://www.nimh.nih.gov/publicat/index.cfm

American Psychological Association HelpCenter: Online self-help brochures
http://www.apahelpcenter.org/

Psychology Self-Help Resources on the Internet: A "mega-site" of links.
http://www.psychwww.com/resource/selfhelp.htm

Center for Global Education's Resources for Study Abroad: http://www.lmu.edu/globaled/index.html Recommended links:

Study Abroad Safety Handbook: Handbook written for study abroad students
http://studentsabroad.com/

Emergency Planning [Guide]: Includes printable materials such as an Emergency Information Card (to carry with you), a Personal Emergency Action Plan, and an Emergency Action Plan Steps form (a strategy card to carry with you). http://studentsabroad.com/planning.html

SAFETI Resources for Clearinghouse: Safety Abroad First - Education and Travel Information http://www.globaled.us/safeti/ Recommended links:

English Speaking Psychologists, Psychiatrists, and Doctors Abroad
Locate treatment providers via U.S. Embassies and Consulates:
http://usembassy.state.gov/
http://travel.state.gov/travel/tips/emergencies/emergencies_1195.html
London's list of medical treatment providers: http://www.usembassy.org.uk/cons_web/acs/uk/medfac.htm

NAFSA's Guide to Education Abroad for Advisors and Administrators, Link below is for Chapter 13: Health and Safety Issues for Study Abroad. Call Call1.800.836.4994 to order the whole book. http://www.secussa.nafsa.org/educator/edabroad13.html

Crisis Management in a Cross-Cultural Setting Revised edition, 2001. Edited by Patricia A. Burak and William W. Hoffa. NAFSA: Association of International Educators. Go to http://www.nafsa.org/publication.sec/working_with_international/crisis_management_in
or call 1.800.836.4994 to order this book. .

International Journal of Intercultural Relations: conduct your own search for full text articles available on the University of Notre Dame Library's Electronic Resources Gateway (requires access to Notre Dame's network) Copy and paste the link below:
http://www.sciencedirect.com/science?_ob=JournalURL&_issn=01471767&_
auth=y&_acct=C000022718&_version=1&_urlVersion=0&_userid=489835&md5=
e033f11e695b1953e3f6611b492e0bfa

Study Abroad Research Online: Bibliographies and Abstracts:
A database on study abroad research, housed at University of Southern California. http://www.usc.edu/dept/education/globaled/ro/index.html

SAFETI Clearinghouse Online Newsletter: Articles on sexual assault, alcohol, drugs, etc.
http://globaled.us/safeti/newsletter.html

International Student Affairs Websites:
http://www.studentaffairs.net/web/intern.html

Wendy Settle, Ph.D. edited this handbook and may be contacted to provide suggestions and feedback. She is a licensed counseling psychologist and coordinator for outreach and consultation at the University of Notre Dame's University Counseling Center, as well as a Concurrent Assistant Professor in Psychology. She specializes in the treatment of depression and anxiety, obsessive compulsive disorder, recovery from trauma, stress management, and women's issues. She has a special interest in providing self-help and training materials on the web. She created and maintains the Notre Dame Counseling Center's web page at http://www.nd.edu/~ucc

Susan Albers, Psy.D. is a psychologist at the Cleveland Clinic Women's Health Center who specializes in relationship and weight issues. She is a College of Wooster graduate and obtained her masters and doctorate degree from the University of Denver. Susan completed her APA internship in 2001 at the University of Notre Dame in South Bend, Indiana and her post-doctoral fellowship at Stanford University in California. She was invited to submit a chapter for this handbook due to her expertise in the treatment of college students with eating disorders. Dr. Albers is the author of the book, Eating Mindfully: How to End Mindless Eating and Enjoy a Balanced Relationship with Food (2003), New Harbinger Publications.

Elissa Blake, Psy.D. is a licensed clinical psychologist at The Citadel Counseling Center in Charleston, South Carolina. She completed her doctoral internship at the University of Notre Dame Counseling Center in 2001-2002. She was invited to co-author our chapter on reverse culture shock drawing upon her experiences as a consultant to the International Studies Office when she was at Notre Dame as well as her own experiences as a study abroad student while living overseas for four years.

Kevin Gaw, Ph.D. is a licensed psychologist and Director of the Career Center at the University of Nevada, Reno. Most recently, Dr. Gaw provided clinical services as a psychologist in the Counseling Center at UNR. He was invited to submit two chapters for this handbook due to his extensive experience as an author, researcher and a practitioner for the study abroad student population. Dr. Gaw's interest in intercultural issues arose from his living experiences in Malaysia and Indonesia and his encounters with other cultures and self during his travels and work.

Leonard Hickman, Ph.D. is a licensed counseling psychologist at the University of Notre Dame's University Counseling Center and a Concurrent Assistant Professor in Psychology. He is the UCC's Practicum Student Coordinator and the Coordinator of Professional Development. He specializes in the treatment of anxiety disorders; depression; men's issues; grief and loss; and substance abuse.

Indira Hogan, Ph.D. was a staff counselor at the University of Notre Dame's University Counseling Center and a Concurrent Assistant Professor in Psychology from 1996 to 2003. She specializes in the areas of multicultural counseling, diversity training, empowerment issues, and prejudice reduction.

Nancy Newport, L.P.C, L.M.F.T is a psychotherapist in private practice in Fairfax, Virginia. She was invited to submit chapters for this handbook due to her extensive experience in providing the Peace Corps Medical Officer Training on sexual harassment and assault treatment. She has been a counseling consultant to the Peace Corps since 1992 and has a specialty in treating trauma, especially sexual and physical assault. Ms. Newport is a Returned Peace Corps Volunteer (Brazil). Her web site is: http://www.nancynewport.com/

Jeffrey Shoup, M.A., is the Director for the Office of Residence Life and Housing at the University of Notre Dame. He serves as one of the Contact Persons for Notre Dame for students who have been sexually harassed by students. He has presented at numerous conferences on the topics of sexual assault, harassment, and stalking. He is one of the few male volunteers for the South Bend community mental health agency's Sex Offense Services Program.

Patrick Utz, Ph.D. was the Director of the University Counseling Center (1983-2003) and Concurrent Associate Professor in Psychology. Dr. Utz specializes in the areas of college student counseling and brief psychotherapy. He served on the Editorial Board of the journal, the Counseling Psychologist, from 1991-93. Licensed Psychologist; National Register of Health Service Providers in Psychology.