	Abrupt/unexpected changes in behavior		Outbursts of anger
	Spending more time alone and withdrawing from others		Depressed mood
	Poor class attendance		Suicidal thoughts or feelings
	Eating too little or eating too much		Thoughts of death and/or dying
	Sleeping too little or sleeping too much		Irritability
	Increase in alcohol and/or drug use		Fatigue or low energy
	Difficulty paying attention		Low self-esteem
	Changes in study habits		Talk of failing or leaving the university
	Changes in communication		Low self-esteem
	Periods of crying		Anxious/panicked
			Engaging in behaviors that jeopardize his/her health and/or safety

If you observe any of these signs in a student, you may want to consider referring them to Counseling & Consultation (C&C).

How to Refer a Distressed Student to C&C*
Below are considerations and steps necessary for effective referrals:

1. Clearly identify and specify the problem and/or behavior.

2. Determine the student's motivation for seeking help.

3. Identify the resources or counseling agency or the person most appropriate for alleviation of the problem behavior.

4. Consult with the appropriate agency/person to accurately determine if assistance is available. This step prepares the agency as well as provides you with ideas for making a good referral. This step is most effective if taken before the problem becomes urgent.

5. Present to the individual your perception of the problem behavior. With tact and understanding, indicate your concern that, in your judgment, something is amiss. Be straightforward with your perceptions and how you see the problem affecting the individual involved and affecting others. A significant principle of referral is being honest and sincere about the problem observed. Evasion will only complicate the referral process.

Some things to avoid at this step in the referral are:

a. implying to the student that he or she is "too hot" to handle;
b. giving the student the feeling of getting "the runaround", and
c. communicating to the student a subtle message of rejection.

Straightforward common sense honesty works best.

6. Present the positive aspects of seeking help, e.g., stressing:

a. that seeking counseling is a sign of strength, not weakness;
b. that there exist competent, trustworthy helping persons;
c. that having an "objective" perspective can be helpful, and
d. that counseling is confidential.

7. If appropriate, present to the student the known limitations of the counseling service. For example, effective counseling requires collaboration on the part of the client. Also, for example, there are no "magical answers" with respect to counseling.

8. Arrange for the referral. Some students are ready at this stage to go to the counseling service on their own. Other students may need additional assistance. You can have the student call C&C for an appointment from your office or residence hall room. In some instances, students will need the added assurance of your accompanying them to the counseling agency and introducing them to the helping person.

9. Once the referral has been made, it is your responsibility to ask the student if they kept the appointment. Confidentiality considerations prevent agencies from informing you without the written permission of the student.

10. Once the student has begun counseling, indicate your on-going concern for the student and your continued availability to the student.

11. Make yourself available to the counselor if you can be of assistance to the student. Also be available for follow-up, if necessary.

Appointments at the Counseling Center
Students may schedule an initial personal consultation appointment either by visiting the C&C office or calling C&C at SSV, Room 334 (480) 965-6146, Monday-Friday, 8 a.m.-5 p.m. After office hours, EMPACT Suicide Prevention Center, Inc. is available for crisis consultation by calling (480) 921-1006.

*Material taken from a handout prepared by University Counseling Services, Ohio Wesleyan University.