Referral Guide for Staff & Faculty

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Identifying Students Who May Benefit from a Referral

People dealing with personal concerns or problems tend to show signs that they are struggling in some way. The following indicators may be useful in assessing whether or not a referral should be made:

Talking about Suicide: If a student talks or writes about suicide, this should be taken seriously. Suicidal thoughts are in themselves not necessarily dangerous but, if they include actual plans for suicidal behaviors, the severity of the danger to the student increases dramatically. Suicide is often considered as an option when the person feels hopeless, trapped, out-of-control, and/or depressed. To make the assumption that talk of suicide is aimed solely toward getting attention can be a potentially fatal mistake. If you become aware of a student who is thinking about suicide, please make an immediate referral to Counseling Services. You can also call us for a consultation if you are unsure of an appropriate intervention or if the student is reluctant to take your referral. If a student clearly states the intent to commit suicide, call University Police (645-2222) or Crisis Services of Erie County (834-3131).
Stating a Need for Help: Students will often come to faculty or staff members with direct requests for assistance. Through talking with the student, you may feel the problems are beyond your scope of knowledge or power to change. Listening carefully to students and their concerns can provide ample evidence to support your decision to refer. If a student comes to you, he/she obviously feels that the relationship with you is important enough to value your opinion and response.
Observable Changes: Some students do not directly tell you that there is a problem but their behaviors can be telling indicators. Distinct changes in academic performance, withdrawal from others, changes in class participation, crying, outbursts of anger, increased or decreased activity, and poor attendance are examples of behavioral changes that you may observe. Severe depression, extreme activity level, conversations that do not make sense, and a marked decline in personal hygiene are examples of possibly serious psychological problems. Any of these observable changes may merit a referral to Counseling Services.
Psychosomatic Complaints: Students who report physical illness or symptoms that cannot be supported by medical evidence may be experiencing psychological problems. Psychosomatic symptoms are very real for the student and should not be treated lightly. Tension headaches, changes in eating patterns, sleep disturbances, fatigue, stomach aches, and other physical pain symptoms are some examples of psychosomatic complaints.
Alcohol and Drug Abuse: Coming to class or a meeting when intoxicated or high is a sign that drug and/or alcohol abuse is a serious problem. Often people drink or take drugs as a way to cope with and alleviate other problems in their life. Unfortunately, the substance abuse itself becomes a problem, one that interferes with social, academic, and work functioning.
Academic Problems: Students who have noticeable negative changes in their academic performance also may be feeling overwhelmed with other areas of their lives. Some students come to classes with difficulty concentrating, performing well on exams, and achieving academically. If the possibility of a learning disability exists, a counselor can meet with a student for a consultation appointment to discuss evaluation and treatment options.
Additional Considerations in Making a Referral: Along with the factors listed above, faculty and staff members should also take into account the following situations when considering making a referral:
- A student asks for assistance with a problem that is outside of your range of knowledge.
- Helping the student with the problem would compromise and/or change the status of your relationship with the student (e.g.: a student asking for money, a place to live, access to contacting you at home if in crisis)
- The student feels uncomfortable talking to you about the problem.
- The assistance and support you have already provided does not seem to be addressing the problem effectively.
- You and the student have personality differences or conflicts that cannot be resolved and would interfere with the help you might provide.
- You find yourself feeling overwhelmed, overly responsible for, and worried about the personal safety of the student.
- The student is disrupting others. A referral to Counseling Services is appropriate if the student is a significant and ongoing disturbance to others.

How to Make a Referral for Psychological Counseling

If a student approaches you with a problem, take the time to listen in a non-judgmental and respectful manner. If you wish to approach the student with your concerns, do so directly and state your concerns clearly. The following recommendations may help to make the process of providing a referral easier:

Do not attempt to make a referral when the student is so upset and confused that he/she cannot understand or listen to you. Wait until the student has calmed down enough to be able to converse and respond to your suggestions.
Talk to the student in private when both of you have time and are not rushed or preoccupied. Give the student your undivided attention. It is possible that just a few minutes of effective listening on your part may be enough to help the student feel confident about what to do next.
If you have initiated the contact, express your concern in behavioral, nonjudgmental terms (e.g., "I've noticed you've been absent from class lately and I'm concerned," rather than "Where have you been lately? Goofing off again?").
Listen to thoughts and feelings in a sensitive non-threatening way. Communicate understanding by repeating back the gist of what the student has told you. Try to include both the content and feelings ("It sounds like you're not accustomed to such a big campus and you're feeling left out of things."). Let the student talk.
Work with the student to clarify the costs and benefits of each option for handling the problem from the student's point of view.
Avoid judging, evaluating, criticizing, unless the student asks your opinion. Such behavior is apt to close the student off from you and from getting the help needed. It is important to respect the student's value system, even if you don't agree with it.
Help the student see there are options - that there are professionals on campus that can assist him/her.
Suggest in a caring, supportive manner that the student may benefit from meeting with a counselor at Counseling Services. You may want to explain the following:
- Counseling at Counseling Services is confidential. This means that information about the student cannot be released to other UB offices, family, professors, etc. without the student's written permission (the exception being if the student is in danger of harming him/herself or others).
- The services are free to currently registered, full-and part-time students.
- The first meeting is an intake/consultation session where the counselor listens to concerns and then helps the student to identify ways to effectively address these concerns.
Give the student Counseling Services phone number (645-2720). The student can call from your office or from home. No appointments can be made for a student by a third party without the student directly speaking to the secretary and asking for an appointment.
If you feel that the student is in crisis, you can call Counseling Services or have the student call from your office. Tell the Counseling Services secretary that this is an "emergency" and she will connect you with a counselor immediately. If needed, the student can be seen for a crisis appointment that day.

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Counseling Services