Gap Year Programs for Students with Autism
They exist, and I am not referencing community mental health-type group homes. I am talking about college support programs that specifically work with young adults with an Autism Spectrum Disorder (ASD) diagnosis. There are young adult transitional programs that focus on this population. There are community-integrated programs that specialize in working with this population. There are even vocationally focused or internship-based gap year programs that focus on working with young adults with ASD. If you are a parent of a young person with an ASD diagnosis, I need you to know that options are available outside your home for your emerging adult.
Now, the programs aren’t completely easy to find. Some may fall under “gap year” programming, or some may direct their marketing efforts to “failure-to-launch” search engine optimization (SEO) to help direct families to their programming. Every program does it differently, and now with COVID-19 that has shifted programming. Whereas work-based programs may have focused on jobs within the community, now it’s just a little more complicated in finding work that isn’t overwhelming or over-stimulating. Not to mention, everyone has a baseline of anxiety when it comes to continue social distancing. If your child has lost all motivation and started to regress at home, this may just be the ticket you need to help get them back-on-track to being independent.
Each of these types of programs is different. The differences include the number of participants, location, focus, collegiate involvement, clinical programming, executive functioning coaching, family involvement, life skills, student profile, and community engagement. There is no single website where you will find any of these either. Some of them overlap on one site, while you may find a handful of others on another site. The best way to get connected to this type of resource for your young adult is to hire a professional to help. It takes a lot of work originally to find these places, let alone to do the research on who is admitting new participants and whether your child would be appropriate for their current community. Most recently, I have been encouraging families to also be direct in asking about the financial stability of the program they are inquiring about. These are things families may not even realize to ask unless they were working with a professional to help guide them.
Know that if college is a no-go in the Fall, that your young adult doesn’t have to remaining at home until “COVID-19 is over.” In that case, your child will never leave the nest. You need to have a plan in place to have them launch, and there’s nothing better than exploring that now while the rest of the world feels like they have to pause on their life plans. Young adults with an ASD diagnosis deserve the opportunity to continue to flourish.
For questions or comments contact Joanna.
The difference between Sobriety and Recovery
Co-authored by Brennon Moore, Joanna Lilley, and Patrick Devlin
When it comes to addiction, you may hear the terms sobriety or recovery being used synonymously. And if you ask someone entering substance abuse treatment for the first time what the difference is between sobriety and recovery, they will likely not have an answer for you, or they'll just say, “they’re the same thing.” However, there is a big difference. Sobriety is at best, especially initially, just an idea. It’s a theory; an understanding of elevated liver enzymes or cognitive impairment. Sometimes it’s the shocked look of seeing one’s detox photo 30-days later. It’s learning concepts like relapse warning signs, or the different stages of readiness, or perhaps one’s denial patterns. Sobriety is often the natural aftermath of a diagnosis or a confrontation. For most, it’s a checklist of do’s and don’ts. Like this:
Do go to meetings.
Don’t hang out at the old bar or old neighborhood.
Do work with a therapist and find a sponsor.
Don’t hang out with your ex that you used cocaine with all the time, or the friend you always seem to be with when you make bad choices.
Do learn new ways of seeing yourself and the world.
Don’t get stuck in the “stinking thinking,” or any other sloganism you can think of.
When most people leave treatment, they leave with sobriety. They leave with a discharge plan and a new theory to apply to life. Recovery is taking that theory and making it a lifestyle.
If sobriety is theoretical, then recovery is truly experiential. It’s when you find your tribe; a group of fellows that you want to spend time with because they mirror a way of being that aligns with who you want to be. It’s not about avoiding people or places that are on relapse warning cards. It’s about the true connection with self and others. It’s the first time you go for a hike just to see the view from the top, rather than smoke a joint or drop LSD. Recovery is when you learn how to meditate or just go to lunch alone because you don’t mind the company that you keep with yourself. Recovery is when you choose to be sober, that act of not inviting substances in your life, not because you’re afraid of getting financially cut off or losing a relationship but because you like who you are with a clear mind and heart. Clear eyes, full hearts, can’t lose.
Below, Brennon shares an insightful story of when he fully grasped the difference between sobriety and recovery:
“I remember a clear example early in my rehab journey. We were doing an afternoon group and the focus was relapse warning cards; a cerebral exercise where you created the blueprint for potential relapse and how to identify and avoid pitfalls. I remember one card read like something like this:
Trigger- Old college friends
Feelings- Anxiety, shame/embarrassment (being sober, how I acted in the past)
Thoughts- “They won’t like me if I’m sober.” “I don’t like who I am without drugs and alcohol.”
Intervening behavior: Call sponsor or sober friends.
This all made sense to me as I sat in the overly lit conference room surrounded by white boards filled with all the different types of denial patterns and other slogans for how to avoid a bad idea. If I just remembered to watch out for these warning signs, I had a clear outline on what to do if I ever encountered trouble. I decided I’d even carry these cards in my favorite coat pocket so I’d never forget.
Three months later I was invited to a birthday party at an old college friend’s house. The anxiety, embarrassment, and shame were bigger than I could have ever imagined when I wrote them on those relapse warning cards. I felt like I was crawling out of my skin as people my age (early twenties) drank and smoked and snuck off to back rooms seemingly having the time of their lives. I felt myself shrinking. I felt myself lose my voice. I felt my voice replaced by that all too familiar critic that had been my dark passenger ever since I was molested at five, and then grew in volume incrementally from the moment I started drinking at twelve. I couldn’t stand it anymore. I just wanted to feel okay. I’ve always just wanted to feel okay. So I drank a beer. Then started taking shots. Then smoking pot. Then sneaking off to those back rooms and doing coke. I was wearing my favorite coat and never once looked at those relapse warning cards. I didn’t even think about them.
The problem was that those cards never stood a chance. I shouldn’t have even been at that party and I knew it. I was invited three weeks earlier and ruminated about it daily and never told a soul. Rehab was great. It was like another college course I had taken. The information all made sense to me and I even liked the majority of it. However, after seven years of college I had really liked history classes and never became a historian. I loved astronomy but never became an astronaut, and even really liked a physics class I once took on the theory of sound waves and music and yet I hadn’t played an instrument since junior high. I went to rehab and never walked out as a sober young man in recovery. It was just some good information that I had gotten. I merely walked out sober, and yet passed with a gold star.
Recovery was finding a tribe. It was the moment when I realized I no longer needed to go to parties where people looked through me with dilated pupils and probably never even wondered where I had gone when I disappeared to treatment for months on end. Recovery was connection; a connection to other young people that listened when I talked, cared when I struggled, and showed up when I needed them to. Recovery was a broader definition of who I was as a person, and the problem was that I didn’t know who I was. Recovery was the process of figuring that out.
Brennon’s story is all-too-common for the post-rehab high (no pun intended) that young adults walk away with. This notion that they’re filled with all the tools they need to stay clean and “just say no.” When it comes down to it, it’s not a matter of if, but when, they will be tested and only those who are in recovery will pass. Sobriety alone doesn’t stand a chance.
Patrick also shared a bit of his personal experience, and thoughts on the difference between sobriety and recovery:
“I know for me as a person who got clean and sober at age 20 years old, I had no idea what it took to have my life be different; not to mention every being truly happy, feeling comfortable in my own skin, or a lasting sobriety. It turns out that it took everything.
When I started going to treatment one of the things that I was the most afraid of was that I would have to become a boring and brainwashed person and that I would lose myself. Paradoxically it required me to become more myself. This is the key difference for me between sobriety and recovery. Sobriety is the checklist that is required in the beginning of the journey to just put those first few steps together. The only way for it to transform your life and find the other gifts of peace, security, growth, and inspiration is through creating your own individual recovery path that is unique only to you.”
SAMSHA defines recovery as a
“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
By this definition everyone’s picture of health and wellness is going to look different. An important thing to note here is that nowhere in this definition of health and recovery does it say anything about drugs, alcohol, self-harm, or eating disorders, it is ultimately about a lifestyle of authenticity, accountability and connection. Sobriety is about handing someone a fish and recovery is about teaching them how to fish. If that quote doesn’t sound familiar, go ahead and read it so you can say you’re familiar.
There is a term called “bio-individuality” that comes from nutritional therapy that basically says that everyone’s microbiome and digestive system processes things differently and it is a myth that there is some kind of perfect diet out there. Really everyone has their own “perfect diet” that comes from their genetics, part of the world they live in, exercise, etc. It’s the same with our individual paths of recovery. You have to find what makes you your best self.
The way to do this is through creating your own recovery definition and it needs to address every part of the bio-psycho-social-spiritual model of the self. Patrick’s recovery definition for example is total abstinence from drugs and alcohol (12 years), attending some 12-step meetings, working with a sponsor, regular individual therapy, yoga, running, and nature based ceremonies that include fasting and time alone in the wilderness. It is important to remember that your recovery path is always changing! What worked for him to lead the best and fullest version of his life at 22 years old with 2 years sober does not work at 33 years old and almost 13 years.
To strive solely for sobriety is cutting your nose off despite your face. It’s only a matter of time before you find yourself in a situation like Brennon from his story above. Dealing with the tidal wave of emotions that comes with the growing voice of your inner critic. Recovery is letting go, and looking within. It’s about growing into who you are meant to be, not wearing the mask to fit in with the people you are hiding with and from. If you have a loved one who is struggling with addiction, remember it’s not just about going to rehab and getting sober. Recovery is a journey, and being sober is only just the beginning.
For questions or comments contact:
Brennon Moore via email.
Patrick Devlin via email.
Top 5 reasons students may fail classes post-COVID-19
If you just learned that your young adult is struggling with their spring semester coursework, it’s hard not to attribute it to the disruption from COVID-19. If they are not doing well academically, stay calm and investigate what happened. Even with colleges gong Pass/Fail for their students, some students will find themselves failing those classes. Lucky for your child, colleges and universities are also changing most of their Academic Policies, including Academic Probation and Suspension. This is something that can happen to any student during any semester during their collegiate years. Thinking optimistically and making changes for future semesters will encourage your young adult to know it’s possible to get back in good academic standing.
Instead of talking about how to get off Academic Probation since most students won’t officially be on it in the first place, I wanted to highlight the top five reasons that college students typically find themselves on Academic Probation. Without reflection and understanding, the solutions for implementing change will fall short of what your student needs once they return to campus this summer or fall.
Top five reasons students may end up on Academic Probation:
First and foremost, unexpected grief and loss. The shock of returning home mid-semester to finish out coursework is a loss for thousands of students. Focusing on academics due to the immediate change in schedule, structure, and social network can be devastating to a young adult’s academic progress.
Not requesting accommodations prior to COVID-19. If your student struggled during high school but opted not to request accommodations before leaving campus, it may be no wonder they are struggling with the online learning requirements.
Living with an undiagnosed mental health condition. What was “drive and determination” in high school could now have morphed into perfectionism and generalized anxiety. Realistically, preexisting or budding mental health concerns could play a significant role in a student’s success on campus. How they are thriving socially, emotionally, and physically now that they returned home will absolutely impact their academics.
If they didn’t attend class or were already behind academically before moving home due to COVID-19, that could play a significant role in their ability to catch-up while at home. It’s hard to stay consistent with motivation while in a new environment, especially your childhood home. If they were already failing, there’s a strong chance they won’t be able to hide this while living under your roof.
Having an unbalanced and inconsistent schedule can impact academic performance. With the sudden change in class schedule and required coursework, it’s easy for a student who struggles with prioritization and time management to immediately fall behind on coursework.
In reading causes for Academic Probation, it allows you, as a parent, to prepare yourself. Give your young adult space to complete their coursework on their own time. If they tell you they are passing all their classes, congratulate them. Once final grades are released for the spring term, make sure to verify their final grades. This is not coming from a place of distrust, yet rather concern for the trauma they endured in spring.
If they do end up failing their classes but luck out on not officially being on Academic Probation, remember it’s just a hiccup in their collegiate experience. Life isn’t always smooth sailing! Help them create SMART goals and have realistic expectations for the next semester will help them. If you aren’t certain your young adult can do it on their own, consider hiring professionals to help. Tutors, Mentors, College Coach, Individual Therapist are all professionals who could be of assistance in supporting your young adult. If they don’t change their habits for the fall, they will most-certainly find themselves on Academic Probation after the fall term. That is, of course, if fall is even an option.
Most importantly, if your child doesn’t want to return to school either, that’s their choice. You just need to make sure they have a plan for what they’ll be doing instead. Years down the line if they decide to go back to school, they certainly can. College isn’t going anywhere!
For questions or comments contact Joanna.
Higher Education Moving Forward: Some Questions for the Future
Part 5 of a 5-part Series
Co-authored by Adam Wouk, Jake Weld, and Joanna Lilley
This series of articles has addressed a variety of factors which apply directly to diverse learners and those with learning disabilities of all kinds. We have proposed a new paradigm for evaluating college readiness, explored the intricacies of federal law as it applies to IDEA and ADA, discussed some of the hidden curriculum of college, and discussed some of the details of accommodations and a holistic view of college success. Each of these articles is designed to help students and families understand the current landscape of post-secondary education, as well as provide both a theoretical framework for interfacing with the unique bureaucratic system that is a college campus and also provide some nuts-and-bolts tips that can lead to student success.
In our final article we are going to take the next step into the evolution of post-secondary education. While it may be true that brighter minds are busy addressing these issues, doing so through the lens of working with students with disabilities and diverse learners may provide students, parents, and educators with some food for thought as we launch into the next decade of higher education. We do not profess to have all of the answers, but do hope that by noting some of the areas of opportunity we can generate thought, discussion, and meaningful solutions for students and parents. Please note, some of this will inevitably be topical, due to the 2020 COVID-19 pandemic, while other elements are intended to be much more far-reaching.
Access to Information and the Relevance of College: As we referenced in our previous article, the history of the university goes back to 1088 in Italy, when these institutions were generally glorified labor guild apprentice shops combined with medieval libraries. The university was where education was to be found, and one had to go there to get it. Not so anymore. We each hold in our pocket a tool with truly staggering access to information - a smartphone with internet capabilities. No longer is the same value attributed to knowing the periodic table’s symbol for iron (Fe, if you are curious), we simply look it up wherever we are, whenever we need it. Colleges have not yet found all the ways they need to respond in order to be relevant in a world where all of the world’s known knowledge is already in your pocket. Critical thinking still matters, as does source evaluation, and those that learn how to process, deconstruct, and reconstruct information and ideas in new and compelling ways will always lead. Colleges will be well-advised to tackle this challenge head on, including re-thinking how they assess college readiness, how they (de)compartmentalize academic departments, the construction of required course threads, and all other areas of the college machine. Reorganizing the critical components will keep it relevant, but access to “secret knowledge” needs to be replaced with meaningful student-centered solutions.
Online Options, Decentralized Learning, and Accommodations: While it is a trend that has been steadily gaining steam for 20 years, COVID-19 forced every college professor in the country to go online, overnight. Some did it gracefully, some grudgingly, some with success and some with abject failures. Colleges thought they had another 10 years to ease into online as a revenue stream, as a content delivery model, as a modus operandi, as an option. Then it was swim or sink for everyone, and all at once. The skills, approaches, and techniques of online teaching are not universally distributed and as we have mentioned in almost every one of our articles, most college professors are masters of content, not pedagogy. The shift to online highlights that fact tenfold. Colleges and college professors will have to learn how to operate in our brave new world, where even education is a form of “content.”
Students, too, were not fully prepared for this switch, and the move into online learning has been a major challenge for students with learning disabilities of all kinds. Accommodations which took generations to fight for in the classroom are not yet second nature online. Using a computer (a tool for entertainment) as the singular tool for education has been a hard shift for many students. Does this lead us to having a distinct school/work laptop as well as having one for media/social time/ gaming? Maybe. Where does the smartphone and Smart TV and the tablet fit into that array? Who will take on teaching professors how to teach, how to teach online, and how to teach diverse learners? Will colleges who make the shift emerge as winners, while those who cannot slowly fall by the wayside? If access to education is the great equalizer will it drag us all toward a least common denominator or will it be the rising tide that lifts all ships?
Education as a Right, a Privilege, a Valuable Product, and as Customer Service: This is a double-edged sword, a Catch-22 conundrum which has been vexing Deans and Provosts for generations. This generation’s challenge is no different, but it is ours, and it needs attention.
Colleges and universities are barreling toward an existential crisis in which the value proposition is inverted to the point of preposterous proportions (and disproportions). The number of students who will willingly choose to accrue $250,000 in college loan debt in order to qualify as an hourly-wage barista manager and an unpaid intern in a start-up tech firm that has cool t-shirts and a break room with Foosball will continue to go down, and even faster if the pandemic of 2020 results in a widespread and long-lasting economic recession, or worse.
Meanwhile, the number of colleges who will posture and pose and claim unimpeachable standards and rankings will continue to go up while they shovel acceptance letters out the front door at unprecedented rates in order to attract new students; largely to fill the holes left by their atrocious freshman retention rates that are streaming out the back door. A portion of the country will clamor for some version of affordable or free college. Some states already offer it. College students (and worse, their parents), will continue to feel entitled to whatever it is they want, however it is they want it, because... “do you know how much I am paying for this class!?” That process threatens to suck the joy from teaching and erodes any collegiate culture of academic rigor or institutional prestige. Meanwhile, colleges who do not realize that they are, in fact businesses, with a product and customers and a bottom line, are going to cease to exist. In fact, the COVID-19 pandemic is already accelerating this trend across the country.
Moving Forward: At first blush, all of these elements may seem to be equal yet opposing forces which threaten to keep the entire system locked into a self-defeating stasis, but we are convinced creative solutions will emerge. Better funding, public-private partnerships, a focus on employ-ability, education as applied innovation, more-not-less liberal arts, and more-not-less integration of technical skills may all play a part. Colleges can begin to take back the streets by providing quality service and meaningful education at an affordable price, which will give them the institutional standing to redefine their role with students and families. Likewise, colleges will undoubtedly find creative ways to meet the needs of diverse learners, as well as those with social, emotional, or other needs.
Great education has always been defined by the ability of a teacher or institution to meet a student where they are, not where they want them to be, and then move them forward. Colleges and universities have this ability. By embracing diversity of all kinds, promoting scholarship, and rewarding creativity, colleges have the ability to respond to the needs of today while providing the answers for tomorrow. The solutions exist, and we are excited to see the future emerge from the present.
For questions or comments contact:
Adam Wouk via email.
Jake Weld via email.
College Success With Learning Disabilities: More Than Just Academic Accommodations
Part 4 of a 5-part Series
Co-authored by Adam Wouk, Jake Weld, and Joanna Lilley
Navigating college with a learning disability can be daunting. There is an extensive process for accessing academic accommodations, and then students need to manage ongoing requests for accommodations throughout their academic tenure. This has to be done for every single class, for every single term, every single year. Most students do not realize they have to do this. And it might sound overwhelming, but it is certainly not impossible.
Understanding the type of accommodations that students can receive is an important step in succeeding in college. While each school and student situation is unique, typical academic accommodations in college may include:
Extra time on tests
Occasional absences
A quiet testing space
Use of a keyboard
Speech-to-text or text-to-speech technology
Access to professor notes, the ability to record lectures, or an in-class scribe (aka someone offers to share their notes with you after class).
While there may be other accommodations available, these tend to be the most common accommodations granted students with learning disabilities. The specifics of accommodations are always at the discretion of the colleges, and are often dependent on having updated academic testing or records which demonstrate a need. Students and families can learn lots more about this topic in the recently-published Taking Flight, by Dr. Perry LaRoque.
Accommodations can help level the playing field, but it is important to also remember that accommodations do not make college easy. For instance, accommodations do not replace the need to study or write multiple drafts of a paper, nor do they make sub-par teaching suddenly more amazing. In fact, it is important to remember that college professors are primarily chosen because they are masters of their content not because they know how to help other people learn it. Very few college professors have received more than the most rudimentary training in curriculum design, curriculum delivery, designing assessments, or any of the pedagogical arts. This may come as a surprise to many students, but with the exception of a few standouts, be prepared for some of your best teachers to be behind you. No, not every college professor is lacking, and yet you have now been warned. The more you learn about a subject the more you will have to become your own best teacher. It is important to learn how you learn and to learn how to support yourself in that learning.
It is also important to remember that college success goes far beyond accessing the curriculum. All students, and especially those with disabilities or learning differences, need to take the time to tend to social and emotional needs as well. Make good friends, and make healthy choices. Learn how to manage your weekly intake of Netflix, pizza, impromptu dance parties, sleep, exercise, alone time, and time connecting with friends and family. Explore. Join. Participate. Rest. Regroup. Explore some more. Being connected to a social network in college is one of the most important factors for continued success!
It is increasingly common for students to pre-emptively secure the support of a tutor, executive functioning coach, therapist, or other ancillary support provider. Depending on your school, most of these services may even be available on campus. If they are not, you will want to seek these out. Doing this early, so you have time to build healthy habits as well as the connection and relationship needed to get you through the tough times, can be exceptionally important. It is not a matter of if you struggle, but when.
Considering academic accommodations in college is important, but success in college is dependent on not just academics, but a wide range of factors. Academic tasks need to be balanced with personal health, diet and exercise, social connections, mental health, and other non-academic factors. It can be said that overall success is dependent on a student’s ability to tend to each of these domains concurrently. Proactive support solutions can help students mitigate against risk and keep them focused on holistic success during college.
In the end, a student with learning disabilities can be a successful college student and ultimately a college graduate. There is no doubt about that. However, it’s going to take a significant amount of work. An enormous effort, and a team supporting that student every step of the way. If they aren’t engaged, if they don’t feel like they belong, and they don’t see themselves as successful in the classroom, even with accommodations, it’s only a matter of time before they drop out. We want to avoid that experienced failure, if at all possible.
For questions or comments contact:
Adam Wouk via email.
Jake Weld via email.
College Is Hard Enough Without A Learning Disability: An Insider’s Guide To Navigating College’s Hidden Curriculum
Part 3 of a 5-part series
Co-authored by Adam Wouk, Jake Weld, and Joanna Lilley
Higher education vernacular sometimes references students having cultural capital. Where you will most-often hear this phrase is in distinguishing the difference between a first-generation student or a young person whose parents are college graduates. To have cultural capital in higher education means that you were raised to believe you would attend college as well, and that you may have had help preparing for the college transition. In a nutshell, those with cultural capital have an advantage. So why do incoming college students with learning disabilities, who have cultural capital, still struggle on campus? Let’s talk about it.
First, college is full of hidden rules, and many of them are flexible. Except for the ones that are not. For students who love explicit rules, acknowledging that hidden rules exist could be incomprehensible, and understanding that some of them may be flexible is inconceivable. For instance, one hidden-but-generally-accepted rule in higher education is that what is stated on a class syllabus is law. What this means is that students should figure out what a syllabus is, read it, put dates in their calendar, and not lose their syllabus. It also means that assignment deadlines with specific details can be followed religiously by those who thrive with structure. What magnifies this problem is that students who have five classes have five different syllabi. Each syllabus has a different set of rules, with variability ranging from strict interpretation to the other end of the spectrum which is loosely followed expectations. All the while, knowing which professors will deviate from their own previously stated rules and which will not takes trial, error, and a judicious use of either after-class or scheduled office hour time. Knowing which approach to use is another hidden rule.
After Class and Office Hours: Professors have unique schedules, and while they may not be in class all day long they often have somewhere else they either need to, or want to, be after class is dismissed. Even so, it is advisable to introduce yourself, briefly and succinctly, after the first or second class meeting. An initial brief introduction is great, but take the time to inquire about preferred office hours. That is the time a professor has set aside for chatting with students. Make an appointment and go meet a professor during their assigned office hours. If you have accommodations, you will want to share this paperwork with your professor during this time. The reality is that professors want to see students do well, and they take an interest in students who show (any) effort, especially those with learning disabilities. College faculty expect you to seek them out when you need help which greatly differs from the K-12 setting. An after-class conversation followed by one or two strategically-scheduled office hour meetings could be the X-Factor in whether or not you have to take Descriptive Statistics a second time, or not.
Self-advocacy is important, but it only comes after self-awareness. It sounds simple, but it’s the furthest from it. High school students have been hammered with “the need to self advocate” without much thought to the critical components of self advocacy, which include:
knowing what you need
knowing how to ask for it
knowing how to use it once you get it.
Self-advocacy only comes after awareness, and asking for help does not mean that expectations evaporate only that you might get some support in meeting them. Get ready to get honest with yourself, be brave, and practice applying support. We excel when we accept our weakness, build on our strengths and focus on reaching our goals.
Awareness of resources: Colleges do a great job during recruitment and outreach describing all the great amenities and services that exist on their campus. That they exist is great, but to seek out and utilize the resources on campus is an entirely different animal. Honest self-assessment and having the self-awareness for what you need as a student are important steps. Once you know what you need, how do you go about finding those resources available to you?
For instance: if you are struggling with math, you may want to see if there is a Math Lab or Math tutor available. Does your professor offer a study guide? Is there a study group that has formed, even if it means studying with students from another section of the same class? If you try one avenue for support and it wasn’t a good fit, do you have the drive to seek out a different resource? Campuses can often feel like a maze too. You may know immediately what you need, but not know how to find the staff or the location, and college buildings can feel like you are lost in the minotaur's labyrinth. Pro Tip: Always start inquiries with the Secretary of an academic department, because they are usually the smartest person in the building and take notes of every tip they give you. This will go even better for you if you have introduced yourself to them, with a glaze donut or homemade banana muffin, before you actually need their help.
For a student struggling with mental health challenges self-advocacy can be the make or break of remaining on campus. Students may know they are anxious or depressed and need to seek counseling, or a student may be in complete denial of their situation. Regardless, most students do not know how to advocate for academic support when facing mental health challenges, and nothing in college is provided unless you ask for it!
Understanding Departments, Offices, and Bureaucracies: Need a waiver on your student loans so you can pre-register for classes? There is a form for that. Need your course list so you know which books to buy? Go get in line for the form. Not allowed to buy books without a course listing? Go get the form. Cannot get a course listing without your student loans? Go get a form. Cannot get your student loans unless you can prove you are registered for classes? Cannot register for classes without the student loan block lifted from your account? Ready to quit yet? Don’t. You will figure it out.
Even small colleges have big bureaucracies. And big universities, well, let’s just say that the words “Kafkaesque” and “Orwellian” were not coined by a contentedly-meditating fly fisherman along a quiet trout stream. They were created by academics and professors who, like few others, know the true meaning of the words. Bureaucracies extend throughout every corner of a college, and yet college bureaucracies are made up of people who really do want to figure out a way to help you. Take your time, take a deep breath, acknowledge that this is a part of your college education, and unravel the puzzle one office at a time. The nicer you are, the quicker it will go.
How to Get Your Accommodations: Some offices play nice in the sandbox with other offices and departments, and some do not. While not universal, there is a longstanding and often contentious relationship between Academic Affairs and Student Affairs. This conflict dates back to roughly 1088 AD, when the first university was founded in Bologna, Italy, and it has absolutely nothing to do with you or your challenges. Learning how to navigate this hidden (un)rule(liness) is a part of making it through college with a learning disability.
Students who had Individualized Education Plans (IEPs) in high school are encouraged to request accommodations in college. If you aren’t familiar with the difference between high school IEPs and college’s ADA accommodations, circle back to this earlier article. If students want to take the step to get the accommodations they have to submit paperwork and a written request. If accommodations are granted, students have to then present a letter to each professor at the beginning of the semester. Then, students have to advocate (aka ask) to ensure that the professor is supporting them by following their accommodations. Not every professor is supportive. And if the professor is not supportive, the student has to advocate for themselves, which could include going up the food chain within the appropriate departments. They need to know who to advocate to, and what to say to get the support. And this will, inevitably, put them in the center of a conflict which dates back almost 1000 years.
To summarize, there are a lot of steps a young person has to do to get accommodations for classwork in college. There’s a lot of steps along this path where they could get tripped up. And this process must be repeated for every class, every semester, the entire time a student is in college. All of this bureaucracy and red tape can feel very daunting. You do not have to do this alone. When you are registered with a disability office, they can help you navigate these confusing processes and empower you to learn how to balance all of it.
The Goal Is Healthy Interdependence, Not Isolated Independence. Too often students confuse autonomy with independence. Being a successful independent young adult does not mean “doing it alone,” but rather knowing how to access and utilize the support that is available. Asking for help is not a sign of failure or weakness or an acknowledgement that you are not “good enough.” It is the sign of a brave, wise, and confident young adult (or at least one who is faking it until they make it) who also realizes that being connected is what is critical to growth and development. Get your adult on, and ask for help!
No one will wake you up! Although a big part of college is all about the cerebral and higher learning, some students struggle with basic adulting skills. Unless your intention is for your freshman roomie to be your parent, you need to start waking up on your own. And Parents, if you are still waking up your high school senior, please, for the love of god and the sake of their success as a freshman in college - stop it!
Additionally, unless a student signed FERPA or HIPAA releases, university personnel cannot provide parents with information regarding your sleep habits, your class attendance habits, or anything else. Colleges push hard for students to be able to function independently once they step foot on their campus, but the reality is that we are dealing with a generation of young people who are very dependent on adults. This naturally came about when the focus shifted to grade production, instead of skill building. Now, we are dealing with a generation of young people with 5.0+ GPAs, but who may not have internalized skills of independence or resiliency. High School and College students need to be able to wake themselves up. Period. Once out of bed there are plenty of other hidden rules to learn, bend, break, and live within, but none of that matters if you are still in bed!
For questions or comments contact:
Adam Wouk via email.
Jake Weld via email.
Transitioning out of IDEA and into ADA
Part 2 of a 5-part series
Co-authored by Adam Wouk, Jake Weld, and Joanna Lilley
In our previous article we briefly touched on the challenge that high school students and their parents have when they are evaluating a college’s support system. In their defense, this is a landscape littered with homonyms (and if you have not taken the SAT lately: homonyms are “words that have the same pronunciation and spelling, but different meanings”). We are all familiar with the obvious homonyms (is band a ring or a musical group? does right mean correct or just the opposite of left?), and we rely on context and situational meaning to differentiate between the possibilities. In fact, we navigate these linguistic riddles so seamlessly that we barely recognize their existence.
The challenge is that college websites and view books are littered with homonyms that high school students and parents might not yet know how to recognize:
Small
Student centered
Nurturing
Accommodating
Designed for students who learn differently
Flexible
Responsive
Personalized
These are just a few words or expressions one might hear that are inviting to potential students.
These are great words, and the colleges are being completely honest and totally accurate when they describe themselves with these, among other descriptors. But beware: they are homonyms. Even though they are spelled and pronounced on a college campus in the exact same manner as the way they are spelled and pronounced on your high school campus, the context of college fundamentally changes their definitions and they mean completely different things in each place. This is not fair , but understanding this reality is vitally important to successfully navigating the college search.
First, let’s give some background on how we got to where we are now.
On November 29, 1975, President Gerald Ford signed into law the Education for All Handicapped Children Act (Public Law 94-142), now known as the Individuals with Disabilities Education Act (IDEA). This measure allowed Congress to “open public school doors for millions of children with disabilities and laid the foundation of the country’s commitment to ensuring that children with disabilities have opportunities to develop their talents, share their gifts, and contribute to their communities.” To date, IDEA is what ensures students with physical, cognitive, and emotional disabilities their right to an education.
On March 12th 1990, a group of disability activists took to the capitol. More than 60 activists abandoned their crutches and chairs to climb the 80 stone steps of the capitol. This act of courage was a major turning point in accessibility for Americans with disabilities. Can you imagine seeing this display of solidarity with your own two eyes? As captivating as the visual of the capitol crawl may be, almost 30 years later, the visual of Americans with disabilities struggling up an inaccessible set of stairs continues to exist in the barriers that students with disabilities face in both K-12 and higher education.
The capital crawl was paramount for the passage of the Americans with Disabilities Act (ADA) in 1990. While ADA law had a great effect on accessibility in many facets of public life, the transformation of accessibility in higher education challenged professors and universities to close the gap between their curriculum and the students with disabilities.
That event helped create a world where equal access became a reality. However, this law was written during a time when college was optional in order to participate in the economy. Today, our economy has shifted and now demands a degree in higher education in order to get good paying work. As it stands now, our laws for people with disabilities do not extend far enough to support them as students beyond the K-12 system.
What separates how these laws affect our education systems is that ADA is a right and IDEA is an entitlement. A rights law allows fair and equal access to something in our society. An entitlement law goes further and provides funding and programming to ensure those rights are protected. What this means in higher education is that the college is responsible to ensure equal access to education. While in K-12, the entitlement provides resources to help bolster, not just access, success.
Entitlement laws typically come from rigorous data reporting to hold institutions accountable for student success. In higher education, colleges only have to show that they are providing platforms to level the playing field. They are not held responsible for a student's success. College accommodations are set up to provide pathways to information which is very different from helping students effectively learn. To put it simply, this means there are even less accommodations available to college students. Students are expected to meet all benchmarks of a class and there cannot be an accommodation that fundamentally alters those benchmarks. This difference in the laws creates two completely different cultures for students with disabilities. And as long as a college is meeting the bare minimum of the law by providing access, they are not responsible for providing resources to create success.
The information below expands on other specific differences in the educational environment set by these laws. (It can also be seen as a table via the link below.)
High School & IDEA
In K-12 education, it is a reasonable expectation that the adults are there to educate and watch over the students, including taking an active interest to intervene should a student not be meeting minimum expectations.
Adults identify those in need and bring services to them.
Student learning is generally expected to happen in the classroom and under the direction of a teacher.
Work and progress is graded often and regularly, with lots of time to adjust study practices
Teachers are trained in curriculum design and delivery, which means they know how to effectively teach
IDEA states that every student is entitled to a Free and Appropriate Public Education (FAPE) in the "least restrictive environment" possible.
Requires the school to initiate and provide an annual meeting of general education teachers, special education teachers, and ancillary service personnel to set goals and discuss progress (i.e. 504 or Individualized Education Plan (IEP) meetings).
College & ADA
In post-secondary education the responsibility of the institution is to provide access to learning, but successful engagement with those opportunities, and any ongoing progress monitoring is the sole responsibility of the student.
Students independently identify their own needs and seek out services as needed.
Student learning is generally expected to be self-directed and happen outside the classroom. It’s recommended to plan for 2 hours of studying per 1 hour spent in a classroom.
Grading greatly varies from class to class. Some courses may have as few as three tests for an entire semester
Professors rarely have any curriculum design or delivery training. Their expertise is in subject matter, not content delivery or assessment.
College students compete for admission and must be "otherwise qualified" to enter college, without consideration of their disability and if admitted, students participate in the standard curriculum of the college.
The student is responsible for initiating any meeting with on-campus disability services and/or with instructors to discuss needs and concerns.
When we understand how these laws differ, we can begin to understand the importance of finding a college that is a good match for a student with disabilities. In truth, there are some colleges that are only seeking to simply meet the requirements of ADA law. However, there are others who understand the importance of additional programming to support these students beyond accommodations. This is exactly why we opened the article about the danger of homonyms. There is a difference between how a college describes itself on paper and what they actually do on campus to support students with disabilities. When students are visiting potential colleges, they should set up a meeting with the disability office. It is imperative to know what they offer. The student should feel comfortable working with the case managers and feel as if they are providing resources beyond accommodations to help them find success. This is a chance for families to know the details of what a disability office does for students.
To help you with this process, we have provided you with some questions to ask disability offices during your visits.
What accommodations does your university offer?
What is the role of the case manager in the disability office? How often do they meet with students registered with the office? What is their student caseload?
How does your office support students during their first semester when they transition into college?
How well trained are the faculty when it comes to supporting students with disabilities?
What are the resources the disability office provides beyond accommodations?
How does your office approach a situation where a faculty member is not honoring an accommodation?
We hope this helps you navigate this difficult transition.
For questions or comments contact:
Adam Wouk via email.
Jake Weld via email.
Students with Learning Disabilities: Rethinking How We Assess College Readiness
Part 1 of a 5-part Series
Co-authored by Adam Wouk, Jake Weld, and Joanna Lilley
We generally think about GPAs, SAT, ACTs, APs, and cacophony of other alphabet soup acronyms when we consider “College Prep” and whether or not a student is demonstrating college readiness. They are tried, true, time tested, canon. And they predict graduation within 6 years about 62% of the time - which, by any grading scale, is an “F.”
It may be time to completely rethink how we assess a student’s readiness for college.
The preponderance of the traditional measures are designed to evaluate one thing, in a vacuum: academic accomplishments achieved while in high school. That academic snapshot is then used as a tool to evaluate a student’s likelihood of academic success their freshman year of college. On the surface this approach makes some sense: if a student knows a couple of the causes of the Russian Revolution in high school (autocratic rule by the Tsars, working conditions of the peasant class), it stands to reason they can learn a few more reasons (the rise of industry, war in Europe, food scarcity) if they are in college.
This model is relatively adept at predicting academic prowess - and if academic prowess were the only barrier to college success then a continued reliance on these scales and indicators would be warranted. Alas, students do not drop out of college because of an inability to comprehend or recite additional causes of the Russian Revolution.
While wholesale research on this issue is surprisingly lacking (or not surprisingly lacking, considering who we rely on for widespread research...), most statistics point to finances being the primary reason students do not make it through school. While finances (including high tuition, too much time working, etc.) are primary, the next set of reasons have to do with behaviors, choices, experiences, expectations, adulting, etc. None of these reasons have anything to do with academic prowess, intelligence, or the ability to learn.
Content knowledge is important – having a foundation in reading, writing, and mathematics is a valuable ingredient for college success, but even brilliant students eventually face things they don’t know which is, of course, the point of college. It is at that point that internalized and transferable skills become more important than knowledge.
Rather than relying only on the old standby tests for evaluating college readiness, consider these three questions:
Can the student identify if they are struggling (accurately, early, and independently) in all of the core domains (academically, socially, relationally, in independent living skills, executive functioning, etc.)?
Can the student independently access available supports and services?
Can the student independently apply the supports and services that are available?
If a student (and family) can answer “YES!” to all three of the above, then curriculum challenges like anti-derivatives, iambic pentameter, and thermodynamics quickly become irrelevant. That is because the skill set exists to turn challenges into learning, and barriers into the building blocks of long-term success.
However, if the answer to any one of those questions is not “YES!” (across multiple domains) then a student’s academic capacity or potential may never have a chance to thrive.
What if the challenges are about solving roommate issues, managing a budget, making friends, or navigating the red tape of campus bureaucracies? What if the challenges are social, relational, or in domains of executive functioning or independent living skills? What if they have to do with self-care, healthy choices, substance use or abuse, anxiety, or depression?
Any one of these areas can conspire to upend a brilliant or smart-enough student’s transition to college. Does that mean a student should not go to college? That they are not ready? That they should give up on their dreams? Absolutely not. But it does mean that students and parents will be well-served by honestly assessing the entire landscape of college readiness holistically, and not just relying on the narrow view provided by looking through the soda straw of academic prowess - or worse, “where a student is accepted.”
Even students and families who take this holistic view of college readiness into account in their college search often fall into a second set of traps - reading college websites with high-school-eyes and listening to college admissions counselors with high-school-ears:
“The college we’re looking at is incredibly small and nurturing,” you say.
“The professors will know my student by name,” you remark.
“They have an incredible learning and student support office,” you exclaim!
In each case, colleges and families are mostly, and most-likely correct. In fact, some colleges do a great job at creating low-friction environments where students can quickly and easily access services with limited bureaucratic entanglement.
And yet, students and families cannot forget: The fundamental paradigm of college is that regardless of what support or service is available, the student must first be able to independently answer “YES!” to all three of the questions in order to get the support they need.
To learn more about this critical paradigm shift, coming out of high school and into college, please stay tuned for Part 2, which addresses the paradigm shift from high school to college.
In the meantime, when considering college readiness an honest evaluation of a student’s interests, strengths, and needs is a good place to start. The next step is to identify what a student is reliably able to do independently, and an honest assessment of the external structures (school, family, coaches, tutors, etc.) that contribute to a student’s success. How much of that will continue? How much can they begin to do for themselves?
Do not forget: skills can be taught, learned, and practiced, and while a student certainly does not need to have independence mastered before they leave for college, they will be well served if they have the self-awareness and honesty to recognize when they need help, and the strength to ask for it on their own.
For questions or comments contact:
Adam Wouk via email.
Jake Weld via email.
How to Navigate life after a Title IX accusation
This is not an easy topic to write. Anyone who has been a survivor of a sexual assault on a college campus may not be fond of what I’m sharing. Please know, this comes from a place of caring about every single human being. For those who are currently in the midst of a Title IX investigation and your world has been turned upside down, know that you have resources.
First, if you haven’t connected with an Attorney you need to do so immediately, and it needs to be someone who specializes in Title IX cases. To just bring in any local Criminal Defense attorney may hurt your case in the long run. This is a mistake you cannot afford. Have a Title IX attorney lined up before speaking with University personnel. Their on-campus proceedings may present like a criminal investigation, which can feel overwhelming. Whether it be to support you with the on-campus proceedings or whether filing a lawsuit against your college or university, you will need to hire an expert. Whatever you say and whoever you’re saying it to, say it with your lawyer present.
Do not, and I repeat, do not erase anything on social media or your phone. Do not communicate directly with the person who is accusing you, whether they initiated the outreach, or you have an impulse to apologize or seek-to-understand. Anything online or on the phone can be evidence. Although you will hate to see it, and naturally want to delete their contact or messages, you must think proactively about how saving this could ultimately save you.
Know that college will still be an option moving forward. Would I recommend you remain at the same university? Probably not, and for several reasons. First, the university will probably ask you to take a break from their campus for one or semesters anyway. Secondly, you will be surrounded by people who are aware of the case and will treat you based on their own assumptions. This will impact your academics, your mental health, and your overall progress towards a degree. That is why you are in college after all, right? Hire someone who can help you navigate this process, especially if you are trying to transfer.
During all of this, you’ll want to connect with mental health care. You may not have had any pre-existing conditions prior to this, but you most certainly will now. From moving through the stages of grief, experiencing symptoms of post-traumatic stress disorder (PTSD), to spiraling into a depression that transforms in suicide ideation. These are all very real responses. Your Attorney may advise you to not speak with any individual therapist during the case, as that Therapist and their notes on your sessions could be subpoenaed. Work with your attorney to know what to do. You will also want to do some extensive research on a Therapist that can work with you. Someone who will not be biased to your situation, and is trained and well versed in trauma and grief. It may help to hire a Consultant to help you get connected to a Therapist that can truly help.
If alcohol was involved during the night in question, it may be valuable for a young adult to participate in a treatment program. By participating in a treatment program, this could be something your Attorney works out with the University. Substance abuse education can help any college student better understand what is consent, and how substances influence people cognitively, behaviorally, and physically. If going to treatment is recommended, you absolutely need to hire a Therapeutic Consultant. These are the professionals who know, inside and out, treatment programs. They know which clinical teams would be able to work with you to begin healing. Going to any local intensive outpatient program (IOP) that is insurance-driven is doing you a disservice on getting the high-caliber treatment you need.
You will live your life again, especially if you take seriously the above recommendations. You will learn to smile again, and be physically intimate with someone again, if you get connected to the above resources. In addition to linking up with an Attorney immediately, I can’t emphasize enough that the rest of the resources listed above need to be prioritized. The longer you wait to get help, the harder it’ll be to start to heal. Get connected now!
For questions or comments contact Joanna.
Now is the best time to go to treatment
Co-authored by Jake Summers and Joanna Lilley
There is no reason anyone can give to not go to treatment now. Most people are sitting at home, just waiting, anxiety increasing and becoming more and more socially isolated. For someone struggling with substance abuse, there is no better time to go to residential treatment than now. While there is no convenient time to go to treatment, the current environment has certainly changed how we evaluate that decision. The increased risks of SUD due to isolation and lack of community combined with the fact we are already in a period of major life disruption make the case for treatment now pretty compelling.
For any parent who is concerned about the safety of your young adult traveling to enroll in a treatment program, your fears are justified. How can you ensure the safety of your young adult? Well, there is no guarantee. Ask each program what they’re doing regarding quarantining incoming patients, how they’re continuing to protect the safety of their current community, and how they’re managing staff who live off-site. No one can guarantee complete safety from COVID-19. What everyone in the addiction industry can guarantee though is that the isolation caused by the pandemic has made substance abuse skyrocket! We can guarantee that by staying home and not getting help now, it could be a matter of life or death in the near future.
We will go through some of the common reasons people don’t go to treatment, if we have missed some big ones please let us know! The biggest reason people do not seek treatment is obviously a lack of willingness to become and stay sober. While that persists no matter what is going on in the world, we know that the ‘other reasons’ are usually what can convince someone to continue avoiding treatment.
Fear of missing out (FOMO)
For individuals knowing that the world is still moving forward while they’d be “taking a break” to go to treatment is usually a significant barrier. Most of us can hardly find time for a dentist appointment, much less weeks of residential treatment. However, right now the world is already taking a break! This is one of the biggest barriers to treatment, and this is one of the few times where it just doesn’t apply.
Employment
With jobs lost, the financial stress is a big factor in increased usage. Oftentimes, people put off going to treatment because they can’t step away from their job, or don’t want to. Walking into your employers office, explaining you have a substance use disorder, and asking for time away from work is an incredibly scary conversation. Now, with so many people laid off or furloughed, there’s no excuse related to employment that’s holding someone back. In fact, now is a unique time to highlight the pandemic as an eye opening experience that shed light on the magnitude of your addiction.
Finances
Treatment is expensive. That is a fact we all have to deal with, and one of the main barriers to seeking treatment in the first place. In a time of increased financial insecurity, the costs of treatment might seem like an unsolvable problem. Green Hill has increased its scholarship program and maintained a high level of financial flexibility with existing and incoming clients. Programs around the country are making financial concessions in light of the current circumstances. Don’t rule out treatment because of finances, and be sure to have an honest conversation with programs about your current financial situation.
Family responsibilities
For many adults, the thought of taking time away from family responsibilities is not a possibility. If you have a family, the pressure your active addiction places on the family system is likely at an all time high. Now is a great time to have a conversation with your spouse or loved ones and figure out if there is a way to make time for treatment.
School
For college-aged young adults, going to treatment is pushed off because they don’t want to leave school. Well, now that college is currently online and looking to be that way again in the fall, there’s no reason that a young person who needs treatment can’t enroll in treatment. We can all assume that academics isn’t the reason that these students don’t want to leave. It’s usually related to their social engagements. Since those are also online right now, someone going into treatment will actually have more social interactions right now than staying at home and waiting to get back on campus with friends.
Why else?
If we just look at the numbers, only 19% of those who needed treatment for SUD received it in 2017. That means that 80% of those in active addiction did not receive treatment. There have to be reasons we missed, big or small, but that does not mean that now is not a uniquely opportunistic time to head to treatment.
It’s hard to push back on the idea of going to treatment now, when all the reasons listed above no longer apply. If you or a loved one is on the fence, there truly is no better time than now to take the first step in a life of recovery. You will feel much safer and more socially connected in a treatment setting. More importantly, you will feel more hopeful about the future and what we all need is more hope during these trying times.
For questions or comments contact Joanna.
Questions to ask a Program during COVID-19
It is not a matter of if, but when a program will have to deal with COVID-19 exposure. It could be an incoming client, or current staff, but regardless families need to know what the protocols are to ensure their loved ones’ safety. If your child needs treatment, now is the best time to enroll. But this is a tricky time too. How do you know if a program is being honest about their exposure? How can you guarantee that your loved one stays safe? If a program guarantees anything, I would be wary. If they are open to a realistic dialogue and want to share information with you based on the questions you ask, you may want to know which questions are imperative to ask!
When a family hires me to help them find a mental health or addiction treatment, I provide a list of potential questions they can ask each program when they call. The only caveat that I give is that they need to select the eight most important questions they need to know, and they must ask the same questions to both programs. If they don’t it’s comparing apples to oranges when looking at program options. Now with the COVID-19 pandemic, there is an addendum to the list of questions I typically share with families.
Whereas before topics asked around financials, communication, tech access, and family therapy might be top of the list of what is important to ask. Now, families are stalled by asking questions around the safety to their child. Here are the top ten questions I would ask if you were looking at treatment programs now:
Have you had any current or former clients (or staff) that have tested positive for COVID-19? If yes, what were the steps you took after learning about this?
Are you currently admitting new clients? If yes, how often are you admitting new residents, and do you have restrictions on admissions from certain geographic regions?
What are the restrictions on modes of transportation to get to your program?
What will the first two weeks look like for my child once they enroll?
What are the accommodations and access to communication during the quarantine transition?
What are your current (as of this morning) protocols surrounding COVID-19, for day-to-day programming?
If there is a confirmed case while my child is enrolled, how and when will I be notified?
Does your program have financial security to handle a dip in milieu and/or if there is a confirmed case on-site and you lost admissions from it?
If you shut your program down, what is the refund policy and timeline for current participants?
Can you speak to the local hospital and medical capacity in your community?
Adding a “pandemic” category to my list of questions to potentially ask programs for parents is a still very new to me. Without hiring a Therapeutic Consultant, by at least having these questions you are armed with attempting to secure the safety of your loved one. By no means can a Consultant guarantee your child’s safety, but they can certainly steer you away from some programs who are being dishonest about their exposure, implementing haphazard protocols, and those who are making false promises by providing COVID-19 testing. Those tests are not readily available, so do not believe a program in telling you they are providing that. It is like hearing from a Warden that they are providing PPE for inmates. Do not believe it to be true.
If your child needs to be in treatment, now is the time. Do not wait. Be cautious in seeking out treatment. Ask typical questions yet know to ask direct questions regarding COVID-19 and programmatic protocols. If they cannot answer your questions, be concerned. It is one thing to enroll your loved one in a treatment program right now. It is another to enroll them in a program that’s a petri dish inviting COVID-19.
For questions or comments contact Joanna.
The reason why Extended Care matters
Co-Authors: Jake Summers and Joanna Lilley
When clients participate in residential treatment, often the countdown until they “complete the program” begins the moment they enroll. There is a level of grit and determination that a patient can hold onto when they know that after a certain number of days or weeks they’ll be living freely out in the world again. Variations between length of stay, clinical focus, and continued care recommendations ultimately determine a lifetime of chronic relapse, or starting a life of recovery. Extended care matters for a life of recovery.
The most common treatment approach for substance use disorder (SUD) is still the 28 day ‘rehab’, or inpatient facility model. This is an outdated approach, although still commonly used, and mainly insurance-driven. Patients enter a facility and go through a 5-7 day detox program to treat for symptoms of withdrawal, and then begin clinical and group work for SUD. In this model, patients often abruptly pause their career and home life, and enter a treatment facility with little or no resemblance to normal living.
The assumption inherent in this model is that a month without use and an introduction to some tools for recovery is an adequate foundation for lifelong sobriety. While experience has shown that this model undoubtedly works for some, a study published in the Journal of the American Medical Association found that relapse rates in the first year of sobriety are 40-60%. Another point to mention is that often those discharged from a 28-day program are often recommended to a sober living facility. Without the clinical foundation (read: extended care program) sandwiched in between residential and sober living, solely moving into a sober living program is not enough.
Treatment programs have started to realize that extending the length of treatment increases the overall chance of success. Many 28 day rehab programs have started to change their model towards 60-90 days of care. While this provides an even stronger foundation for sobriety, it still forces patients to re-enter life with little to no transition. Without a step-down the shock of the reintroduction with a lack of support could really force the hand of the newly sober individual to self-medicate to cope with the stress. Insert the need for recommending an extended care program.
Extended care, also referred to as continued care, recovery programs, or transitional living programs, are designed to give patients a safe and healthy environment to begin their transition back into everyday life. This includes rejoining the workforce, restarting academic studies, rebuilding romantic and familial relationships, and relearning basic life skills. These programs generally last for 6-12 months, and gradually step down the clinical care and structure over time.
In the first month, a patient may be singularly focused on not drinking or using. As time in recovery increases life becomes more complex, and recovery is, like all things in life, not a linear journey. The job you lost is replaced with a new career, the children you weren’t allowed to see are back in your life, the college that kicked you out has allowed you to start classes again. Recovery gives you a life again, and with that comes responsibilities. Each time life expands, you have to take a step back and extended care programs exist to provide you clinically grounded support during the first year of sobriety.
For example at Green Hill Recovery, when a patient enters extended care, they may not have a phone or car, or privileges to leave the recovery house without staff. By the end of their stay, they will have completed our academic and career counseling tracks, started working part time, completed visits home to family, and developed relationships in the community. Goals are set and pursued with the help of a robust clinical curriculum. Mistakes and setbacks are used as opportunities for growth and learning with the help of licensed therapists. Extended care is a vital step in helping an increasingly younger population in recovery build a strong and lasting foundation.
Another important factor to consider for extended care treatment comes with the increase in comorbidity in patients. A study from HHS showed that 36-40% of young adults with mental health disorders also meet the criteria for SUD. Essentially treatment providers acknowledged the need to simultaneously treat two conditions; both SUD and mental health. Common comorbid diagnosis might include addiction, anxiety, depression, and trauma. To be direct, these disorders must be managed alongside SUD to prevent relapses. By only focusing on one single issue (i.e. addiction), we are playing a game of whack-a-mole. Once you think you have one issue taken care of, another issue rears its ugly head. It’s an endless, and exhausting game if that’s the approach taken. By focusing on mental health, extended care programs can now provide a spectrum of clinical modalities that could include Dialectical Behavioral Therapy (DBT), Somatic Experiencing (SE), Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, Mindfulness, and Experiential therapies just to highlight a few. Additionally, extended care programming cannot be a cookie cutter for every participant. With individualized treatment plans and more clinically specialized programs, providers have the ability to treat these disorders in harmony.
For someone who finds themselves in a residential treatment program for SUD, if they are genuinely interested or curious about a life of sobriety they need to understand extended care.
Extended care programs vary by the population they serve, geography, and type of program. While Green Hill focuses on academics, there are other excellent programs that have different specialty approaches to treatment. If you are uncertain about which type of extended care program would be most appropriate for your loved one, you may want to consider working with a Therapeutic Consultant. These are professionals who have visited and vetted each program and will be able to best match your loved one to the most appropriate extended care program for them.
For questions or comments contact Joanna.
Social isolation is relapse
This article is not about substance abuse, however if you want to read it with that lens that is entirely your choice. My intention is to highlight how during a time of physical distancing and sheltering in place, we are unintentionally socially isolating. For someone who struggled with social anxiety before, returning or remaining home can be on par with relapse. We are on the cusp of witnessing thousands of young adults spiraling into a depressive state.
Prior to this pandemic, many of my clients would self-identify as having stalled out at home. Either they never launched to begin with after high school, or they launched and then quickly returned to the nest. My work involved helping the parents getting connected to their own resources to help their child launch (i.e. Parent Coaching or reading “How to Raise an Adult”) and supporting the young adult themselves to leave the nest. This job is never easy, as the world outside of the comfort of a parent’s home can be a terrifying place.
For those who did get out, they may have found establishing a friend network in their new environment harder than anticipated. They were paralyzed with fear regarding making friends, speaking with faculty, advocating for themselves, or just finding anything to be engaged with. Even on a large, bustling campus, a young person can feel extremely alone. Now, factor in COVID-19 and colleges shuttering doors and we’ve got the perfect storm for young people returning home.
Parents are simultaneously grateful to have their children under their roof during this public health scare, but just as concerned of what’s to come after. If your student was struggling socially and you were giving advice while they were on campus, now that they are home it is time to sit down and create a plan. If they are not planning to return to school in the fall, make sure they have something else lined up. If they don’t, you’ve just invited them back into the womb and it’s going to be extremely hard to help them relaunch again once the sheltering in place has lifted.
Normalize that we all are feeling socially isolated. Do not let them stay in their room with the door closed 24/7 while you place meals outside their door to ensure they are fed. Draw them out. Link them up with a telehealth provider and be open to communicating the stress of uncertainty that we are all experiencing. The expression “these are uncertain time” is an understatement. Make sure your young adult is not alone, literally and figuratively. If they are, this is equivalent to a relapse. Get them reconnected. And help them see the light through this very dark time.
For questions or comments contact Joanna.
How Community-Integrated Programs are adjusting to COVID-19
Co-authored Andre Wright and Joanna Lilley
With everything changing so rapidly in the world around us as a byproduct of COVID-19, reinventing what our “new normal” looks like is quite the task. Daily occurrences like getting dressed for work, picking up your fancy cup of overpriced coffee, and eventually having lunch at your favorite restaurant have become things many of us barely remember doing. Our former routines are a thing of the past, so here we are attempting to create a sense of normalcy while practicing a pair of words we have all become very familiar with - Social Distancing.
In one way or another, we have all been impacted by this pandemic but for individuals living in community-Integrated programs the impact of COVID-19 is even larger. The need for social interaction is noticeable. For long-term residents, it’s hard to not only explain but also hard to implement the CDC recommendations for sheltering in place. Programs with older populations are also needing to take into consideration those who are immuno-compromised, and those who may be most at-risk. The time to buckle down on protocols and health safety precautions has never been more necessary.
What were key features of Community-Integrated Programs prior to COVID-19:
Immediate sense of purpose and social acceptance
For so many young adults, primarily those living with developmental delays, integrating within their local community offers a sense of acceptance which is essential to their overall development.
Feeling like a valued member of society boosts confidence!
Authentic Independence
Experiencing the joys of navigating their environment and the beauties that come along with community-integrated living.
Organic relationships with neighbors and other community figures. Whether it be petting your next door neighbor’s dog, or waving hi to the mail carrier, these actions are huge.
Vocational opportunities
Unlimited options for meaningful employment (not limited to program connections) which enhances one’s resume and confidence.
Volunteering opportunities are also available which builds transferable skills for gainful employment in the future.
What changes have been made to accommodate clients during COVID-19:
With anxieties heightened, teletherapy is a great way for individuals to receive mental health support while sheltering in place.
Practicing social distancing
While promoting safety and adhering to federal guidelines, also sharing with residents the difference between social distancing and social isolation.
Engagement through technology
Continuing daily programming between staff and residents through video and conference calling.
Limiting face-to-face interactions while still encouraging peer participation and engagement, enhancing social thinking.
Upsurge in hygiene and housekeeping protocols
Residents are encouraged to wash their hands continuously throughout the day and educated on the importance of avoiding touching their face.
Professional cleaning services now scheduled to clean personal living spaces
For programs with large populations of residents that are integrated within a community, the spread of COVID-19 has been crippling to pre-existing programming. Residents are struggling to shelter at home alone, and eager for this to be lifted so they can return to social engagements and group activities in-person. Life as we know it because of COVID-19 will shift for the foreseeable future. Residents are integrated into a community that is socially distancing, which no person regardless of enrolled in a program or not, is thoroughly enjoying. Community-integrated programs are getting creative in how to continue the integration while keeping each person safe!
For questions or comments contact Joanna.
Residential Treatment during the COVD-19 crisis
Co-Authors: Aaron Oliver and Joanna Lilley
The first priority of residential treatment right now, is to keep the current residents and staff safe. We must minimize risk of exposure. For a program that is privately funded and small, the decision to halt admissions temporarily may have a devastating impact, while others who hunker down may be able to weather the storm. Regardless, programs are getting creative with how to protect those that need their services most.
To be blunt, residential treatment was not designed for social distancing, and we can all agree that there would never have been an opportune time for COVID-19. For those who were previously struggling with mental health and/or addiction issues, the added stress of a public health crisis only makes matters worse. Know that access to treatment is still available during this time, and that residential programs are doing the best they can to protect the existing safety of their community and potential new members.
Below, we identify the ways in which residential treatment programs were already safe prior to the COVID-19 outbreak, and we also highlight programmatic details that have been adjusted for the overall safety of the community.
Things that make residential treatment safe during the COVID-19 crisis:
Housing is already set for social distancing
Testing and screening prior to admission
Daily temperature and wellness screenings for staff and patients
Protective masks and gloves for staff and patients
Consolidation of treatment housing
Limiting exposure outside of the treatment household container
Things that are slightly changed during this time of public health concern:
Redefining what protocols exist on a daily basis
Taking temperatures of clients and staff as they arrive each day
Adjustments to the daily schedule; only allowing residents to come during certain times
Admitting, and doing additional screening.
Following all CDC changes
Discussing all policies & procedures on the front-end with families during admit calls.
Non-essential staff aren’t allowed near the programming; shifting to working remotely
More creative means of getting patients to the facility for admission (ex: driving instead of flying)
Significant increase in communication to families and referents regarding programmatic changes and safety of clients
Although some programs have made the painful decision to temporarily suspend operations, sending clients home while providing virtual support, other programs are still operating business-as-usual with some additional COVID-19 protocols. Please know that help, that treatment, is still available during this time! You, or your loved one does not need to suffer at home in quarantine. Access to mental healthcare and treatment is essential. If you are not sure where to find real-time information on program protocols or closings, the best advice would be to seek out and hire a Therapeutic Consultant.
For questions and comments contact:
Aaron Oliver via email.
College Support Programs expand to support college students across the country
Co-Authors: Traci Stluka, Joanna Lilley, and Jon Baker
College Support programs were designed to help students who were taking a break from their home academic institution, to experience academic success at a different school with wraparound support. With a lot of programs being forced now to continue to provide resources during a time of social distancing, it makes it easier for programs to structurally work with clients who are returning home to hunker down with families, or who haven’t left home in the first place.
Currently, programs are still open, and college students around the country have suddenly found themselves taking exclusively online courses, unable to return to their college campus. College students need to know about these resources.
Prior to COVID-19, young adults would relocate to areas where these College Support Programs existed to spend a semester or two getting reacquainted to the academic environment while being involved in a strong therapeutic community. These targeted programs exist in Idaho, Illinois, New York, Oregon, Utah, and other states. The premise is that collegiate academics are reintroduced, while staff clinically process any anxiety, post-traumatic stress disorder (PTSD), attention deficit-hyperactivity disorder (ADHD), autism spectrum disorder (ASD), executive functioning (EF) deficits, shame, or depression that a young adult may be experiencing. The goal is to help them navigate being successful on a campus again, and allow them to return to their home institution, or consider transferring to another school with more therapeutic support. Either way, students walk away feeling like they can be college students again!
Now, in the time of COVID-19 these programs are adapting and encouraging students to engage with them a little differently.
How a College Support Program can provide your college student support during the COVID-19 crisis:
Virtual tele-health for students and families
At Northwest College Support (NWCS), college students will participate in virtual individual therapy sessions and possibly group therapy sessions. The notion is that once the shelter in place order is lifted, participants who are local to the program will return to in-person therapy. NWCS can also provide therapeutic and family support as needed.
College Excel continues to have nearly half of their students participating in private practice therapeutic sessions within the community of Bend, Oregon. At this point those are conducted remotely but can easily transition back to in-person once the social distancing order has passed. College Excel provides the same comprehensive parent support services as they always have prior to the COVID-19 crisis.
Shifting to distance programming
Northwest College Support now offers a Distance Program for college students needing support, but who cannot leave home or may be sheltering in place. Students participating in this Distance Program receive regular video conference calls from our Educational Coaches who are trained in helping students organize, prioritize, create goals, find resources, and develop self-advocacy. Importantly, NWCS’ Educational Coaches provide a level of non-judgmental accountability and structure for students who may struggle with self-directed learning.
College Excel offers coaching remotely to current students who are at home in our housing in Bend or out of state with family. In addition to Academic and Life coaching, they are continuing to provide coaching within their housing. This is especially important while the students are spending nearly all of their time in their house with their housemates. College Excel has developed effective systems to provide house coaching almost entirely remotely to avoid unnecessary interaction. They continue to provide social activities for students to engage in that don’t violate social distancing practices. College Excel can also serve a student who wasn’t a College Excel student before the COVID-19 crisis but is in need of coaching now that they are at home engaged in distance learning.
Adjusting to provide support to students who are enrolled in any college or university
Prior to COVID-19, NWCS worked with students who were enrolled at Northern Idaho College (NIC), or participating in a distance program through the NIC satellite office. Each student had already attempted college coursework at another institution. Northwest College Support developed educational and therapeutic support packages that can be delivered to any college student around the country, no matter the institution they are currently completing coursework with.
As mentioned above, College Excel is well equipped to serve a student who needs coaching despite not having been a College Excel student before the crisis. They have a structured offering that provides a motivated student the needed support and accountability to manage the demands of distance learning. For many students, they are just now realizing the challenges of a 100% distance learning curriculum at their College or University and this is creating overwhelming anxiety and stress.
Online social and academic groups
NWCS hosts group activities such as social watch parties, live-streaming mediation and mindfulness groups, and online group study sessions are regularly available to Distance Program students.
College Excel continues to provide social engagement opportunities throughout each week. These include online yoga classes from a local studio, online personal trainer workouts by another local studio, and countless games, online clubs, and more. College Excel also provides weekly remote cooking classes to students.
Please know that your young adult doesn’t have to stumble through their college coursework alone. Their support system is now limited or non-existent, so it’s easy to get behind and feel hopeless academically. Connecting with a College Support Program during this time can allow your young adult to thrive!
Both College Excel and Northwest College Support are working intentionally on making sure the mental health needs of students continue to be met, and the life skills coaching department has put extra emphasis surrounding self-care, hygiene, and planning.
Some other College Support Programs across the country include:
For questions or comments contact:
Traci Stluka via email.
Virtual Meeting Etiquette
Most of our work worlds drastically shifted overnight. We now live in the world of virtual meetings and remote networking. We have never been more exposed, and the need for self-awareness has never been more necessary. If you’re like me, you’ve already been privy to (no pun intended) some surprising etiquette situations. Common sense for virtual meetings is not so common. Considering the new normal for communication, I wanted to spotlight how to remain professional when we’re working in our private spaces. Take this all tongue-in-cheek.
Be mindful of mute. If you aren’t on mute, we can hear everything. That includes the construction behind your house, your typing, your coughing, your dog, your microwave, your chewing, and when you fart. Not even kidding. If you are multi-tasking during a webinar, make sure that you are on mute! If you learn just one thing from this writing, let this be it.
Dress to impress. Unless you typically roll into work wearing your hunter plaid pajamas (that was me drinking coffee this morning), or wearing a sweatshirt with no pants, you need to wake up and “get ready for work.” Business casual is totally okay! Even if “going to work” means that you are now walking 15 feet from the kitchen to your home-office, you still need to go through the motions. Some of that has to do with just shifting your mindset from being relaxed at home, to being engaged in your workday.
Be on time! Back-to-back virtual meetings means that there’s little-to-no time between calls for you to take care of personal needs. If you can, try to space out your calls. Plan for breaks! Or if you can’t do that, log on on-time, but keep your video off. When you show up “late” and apologize to the group, it’s stops the momentum of the presentation.
Visibility. If you haven’t already, please clean your camera lens. Regardless of if you’re using your laptop, iPad, or cell phone to participate in a video call you need to make sure you’re visible on camera. No one wants to see just your ear, or only your ceiling. The reason we’re on a video call is to make sure we can see each other, face-to-face. If your placement is off, it makes the call extremely weird. Also know, if you wear glasses we might be able to see the reflection from your screen.
Being stationary. To piggyback off being visible, we also need to highlight movement. If you need to walk away from your laptop, or what to change locations, please temporarily turn off your camera. The rest of us on the call will be extremely distracted with your movements. If you cannot be visible, then don’t use video at all. Just be on audio. And please, revert to #1. And whatever you do, don’t take your laptop around with you. Especially if you need to go to the bathroom.
Pay attention to nonverbals. We can see you. We can all see you (if your video is on). If you are rolling your eyes, waving your hands, making funny faces, or clearly texting on your phone, this is all sharing valuable information about who you are as a person to all the other participants in the video call. Be self-aware.
Know your environment. Do you have a mirror behind your camera, and you don’t have pants on? Is the kitchen right behind your desk and your kids are now on camera? Do you have artwork that may be offensive to others? Or are you sitting on a couch with your laptop on your lap and the camera angle is highlighting what’s up your nose? We need to switch up locations so we aren’t getting bored, however it’s important to do a test run and know what will be visible to anyone else who can see you!
Understand the purpose of the meeting. Is this a consultation call? Is it a professional-member organization webinar? Is it a lecture for a college class? Is it a tour and meet & greet of a mental healthcare program? Is it a panel on a trending topic within your industry? Or is it a family happy hour? It doesn’t matter what it is, just keep in mind the purpose of that meeting. In knowing the purpose, also know whether the presenter is expecting to see you. If yes, please be on video! All of these can be fun or informative. Regardless, just know which one is which at the appropriate times and be present.
Now for those of us hosting, we need to get creative too! Your leadership during this time will be paramount to the success and productivity of your meeting. There is nothing worse than hearing several folks in the background while someone is giving a presentation. Here are some great tips for facilitation and managing your video calls:
Give a quick tour. This may sound silly, but it needs to be done. For someone who is new to Zoom, Google Hangouts, etc. they may not know where things are. Show them before you get the presentation started! This needs to include how they mute/unmute, how they turn on/off video, the “raising a hand” button, or where the chat feature is. We’re all going to be pros with this before too long!
Establish ground rules. You can whip out Robert’s Rules of Order, or you can simply state: “Please keep on mute, the purpose of the meeting is x, and we’d like to spend x amount of time listening, then leaving x amount of time for questions. If you have a question, please type it in the chat box. And thank you for being here!”
Have an agenda. If you are only hosting a meeting, but not a panel, you need to have an agenda. Either have it created and distributed prior to the meeting or ask for audience participation within the first few minutes. If there are specific topics that participants want to discuss, make sure they’re discussed.
Place all participants on mute. In the beginning of the meeting, remind folks to remain on mute. You must be aggressively on top of making sure that those who aren’t talking, are muted. If they aren’t, you are dealing with extremely distracting call, especially if you have many participants.
Settings are important. If you are hosting a panel, make it so that the panelists are the ones that are visible and/or distinguished. You can change the settings to include only those who are presenting to be visible. If you do that, they encourage all participants to “say hi” in the chat feature so you know who was in attendance.
Keep time! If you are hosting a panel, it’s important to ensure there is plenty of time to facilitate all panelists answering predetermined questions, and then leave time for a participant Q&A directed towards the panelists.
Encourage participant engagement. This goes back to #1 for group facilitators. Have them raise their hand to be called on, or type in a question in the chat feature. If it’s a panel, meeting, or presentation you want to get participants involved.
Most importantly - be assertive! As the moderator or facilitator, you can’t be afraid to hurt people’s feelings. You can control turning people’s audio on or off. You can show who is visible on screen. You can redirect the discussion if it goes sideways. You can keep on task and on time. If you are the leader, you must take charge!
We were forced to shift to doing virtual interactions overnight. Now that we are in the thick of it, it’s important to make sure we don’t lose motivation for work, or lose respect for ourselves and others because of our online behaviors. Just because COVID-19 has working from home, doesn’t mean that we need to lose our professional selves in this madness! Speak up if you see someone who may need a little guidance in these areas. There is nothing more productive than an uneventful Zoom meeting!
For questions or comments contact Joanna.
Recognizing Substance Use Disorder in your College Student
Now that your young adult is home under your roof, you may be noticing some things about them that are a cause for concern. Either your young adult continues to leave the house at night, going against the shelter in place order, to party with friends, or you are fighting with them about their marijuana use. Substance use and experimentation is common for college students. What’s not common, is when they return home unexpectedly mid-semester and continue to self-medicate. As a parent, it’s important to acknowledge what you’re willing to enable in your house and recognize when your child’s behavior checks the boxes for Substance Use Disorder (SUD).
First, you need to know that 1 in 4 college students meets criteria for substance use disorder. When you respond to your young adult’s use with phrases such as:
“This binge drinking is just a phase. He’ll grow out of it. A lot of college students do this”
“She might be doing drugs, but she’s doing well in school. Why should I worry?”
“I’ve been smoking marijuana every day for years without a problem. I don’t see a problem with my son smoking.”
These are real-life examples you’ll find in Dr. Marcia Morris’ The Campus Cure parent guidebook. These are nearly identical stories I’ve personally heard from parents who inquire about my service in finding supports for their young adult. They acknowledge their kid probably needs some level of support, but they may not want to admit that their use is out of control. If you aren’t sure where your college student falls on the spectrum of substance use, here are some key indicators of when their use is impacting their collegiate experience:
Drop in grades
Mood disturbances
Increased spending
School discipline problems and/or legal problems
In general, substance use will show up in the following areas in one’s life:
Physical and mental health issues
Impaired control (i.e. impulsive verbally or physically)
Social issues (i.e. destroying relationships)
Risky behaviors (i.e. unprotected sex with strangers when blacked out)
Failing to meet responsibilities (i.e. waking up for work)
With your college student completing their spring semester from the confines of home, make note of their behaviors. Make note of their substance use. And make note of their overall mental health and well-being. If you are remotely concerned that their substance use is abuse, contact a professional to provide you help and guidance in how to navigate getting them connected to treatment.
For questions or comments contact Joanna.
Virtual Psychological Testing during COVID-19
Virtual Psychological Testing during COVID-19
Co-Authors: Joanna Lilley, and Tracine Smoot, Ph.D., Psychologist, Psychological Solutions
First and foremost, this is a difficult time, and it necessitates changes in how psychologists provide psychological services. Many psychologists are turning to telepractice to provide these services to clients who need therapy or a psychological evaluation. As Dr. Tracine Smoot of Psychological Solutions states,
“we maintained the position, in the past, that psychological evaluations should only be completed in person; however, because of this global pandemic, and advances in technology, we are now offering virtual psychological evaluations on a case-by-case basis and when a virtual evaluation can be provided in an ethical manner.”
This is the also case for several other Psychologists and group practices.
Psychological assessments are about much more than the test scores; they go beyond the numbers and diagnoses to really ‘tell the story’ of how a student has gotten to where they are at that exact point in time and what they need in order to move forward. The face-to-face interaction that occurs during testing sessions is an important and informative part of the evaluation process; however, during this crisis, online administration of psychological testing can be considered for students for whom face-to-face testing is not an option. Virtual testing is not ideal, yet if a client absolutely needs to be tested, there are ways to provide evaluations in an ethical manner.
For any referring professional, family, or client, a psychological evaluation can sometimes unveil a truth that redirects the ship that is therapeutic treatment. Prior to COVID-19, a lot of adolescent and young adult clients were being recommended for testing, as a way to rule in or out a diagnosis and provide information about functioning levels. Now, the concern of “how to test” is a buzz amongst referents and programs alike.
Below you will discover Psychological Solutions’ perspective on pre-COVID-19 practices, the current shifts, and ultimately the return-to-normal for Psychological testing. We encourage all referents, families, and clients to make the most informed decision regarding testing during this time.
How Psychological Testing existed prior to the COVID-19 crisis:
All of our psychological evaluations were individualized and conducted through face-to-face interactions; questionnaires; interviews with the student, parents, and therapist; and behavioral observations.
Our psychologists traveled to different programs to test students face-to-face for several hours at a time. When specialty testing was needed, face-to-face testing was typically completed over two days.
We still conduct evaluations in this face-to-face manner when we can do so safely.
How Psychological Testing has shifted during COVID-19:
Before jumping into the nuts & bolts of the changes, it’s important to highlight that the leaders in the field of psychological evaluations are recognizing the importance of providing a virtual administration option at this time. This includes leaders such as the American Psychological Association, Utah Psychology Licensing Board (where Psychological Solutions is based), and major publishing companies such as Pearson Assessments, and Riverside Publishing. These publishing companies, for example, have provided digital versions of their assessments that can be used during this crisis and have provided specific guidance on how to do so.
Based on information from these sources, here are ethical guidelines regarding virtual psychological evaluations during this crisis:
Virtual testing should be viewed as temporary and not the ‘new normal.’
Face-to-face testing is ideal and should be provided whenever possible. Once psychologists are able to provide face-to-face testing again safely, they should do so.
The measures were standardized and normed using face-to-face testing so the goal is for the virtual administration to be as similar to face-to-face testing as possible. It is important to consider how virtual administration impacted standardization and report any changes in procedures in the interpretation.
There are studies on some measures (e.g., Woodcock-Johnson IV) suggesting that scores on virtual administration are equivalent to face-to-face scores; however, equivalency studies have not been completed on all measures. This should be considered in choosing the measures.
The digital materials and procedures used during virtual testing should be provided by the publishing company to ensure that the tests are as close to standardization standards as possible. For example, psychologists using Pearson products should use the Q-Global or Q-Interactive platform rather than their own methods of digitizing the assessments.
The measures used should be carefully chosen to ensure that they are appropriate for virtual administration. The Pearson Q-Interactive tests are a good example of measures that can be used for a virtual administration.
Some types of specialty testing should be completed face-to-face; for example, neuropsychological and autism spectrum disorder evaluations need a face-to face component.
Not all programs have a setting conducive to virtual administrations; for example, virtual administration is not a viable option at many wilderness programs.
Virtual administrations should never be provided only because they are more convenient.
HIPAA requirements should be maintained during virtual administrations.
For another perspective, Dr. Joshua Cluff and his team at ClearView Psychological Services made an announcement about how they have shifted their work during this time, all the while upholding their ethical standards.
Can psychologists still do face-to-face testing during COVID19?
It depends on whether the program will allow psychologists access to the students during this time, and whether the psychologists feel safe testing face-to-face. At the time of this publication, many residential and wilderness programs are allowing psychologists to complete face-to-face testing as long as strict safety precautions are followed.
At Psychological Solutions, we are teaming with programs to follow or exceed CDC guidelines when we do test students face-to-face.
Best practices and the ethical guidelines are clear; completing psychological evaluations face-to-face is best. On the other hand, when virtual administration is done well, it can be a viable option for students who need a psychological evaluation during this crisis. The subjectivity therein lies on who needs the evaluation during this time, and which clients can wait.
For questions or comments contact:
Tracine Smoot via email .
Getting the Most of a Virtual Campus Visit
Prior to COVID-19, visiting colleges and participating in tours was like a rite of passage for high school students. Stepping foot on campus, meeting with current student, and trying to picture oneself thriving there was truly the best way for a student to make their choice on where to enroll for their future. Although most transportation is currently halted and colleges and universities remain closed through the end of this semester, high school Seniors are still following the timeline of committing to their future school. So, how can a young person get a sense of the institution that’s best for them from the comfort of their own home?
Traditional tours consist of the following:
Standing inside a residence hall,
Grabbing food or walking through at least one dining hall,
Quietly entering the library and learning about their services,
Walking through the Student Center and hearing about some student organizations,
Seeing the Recreation Center facilities,
Discussing collegiate athletics and while passing athletic facilities,
Walking through an academic building which includes seeing the inside of a classroom,
And all the while, getting a tour of the entire campus by foot!
College and universities are broadcasting the virtual tours that pre-existed on their website. Marketing teams are scrambling to share additional videos with prospective students. And although this is great in theory, there is still something that’s significant to the success of each college student that gets minimized during tours: mental health facilities and/or resources.
Prospective students may not necessarily think they need to hear about therapeutic groups for anxious students, or the need for mindfulness spaces to de-stress. The truth is that 40% of college students identify as anxious or depressed. That’s a lot of current and incoming students who are in need of additional support to thrive on campus!
College is a high-stakes environment, whether you enrolled with pre-existing mental health concerns or not. So, when you’re doing your virtual campus tour, make sure you research if your future college or university has an Active Minds Chapter, or if they are JED Campus. Find out what well-being, mental health, and/or psychological programming exists on campus. After all, you’ll be paying for it!
For questions or comments contact Joanna.