for Middle School

Course Summary

What is psychological distress?

Psychological Distress:

going through a rough time

starting to show signs of a mental health disorder

A study in 2010 showed that 13.1% of 8- to 15-year-oldsthats one out of eighthad a mental
health condition in the past year, most of whom suffered severe impairment in their ability to
function at home, at school, in the community, or with peers.i

A poll in 2011 showed that 7% of middle school students had seriously considered suicide in the
past year, and 4% had taken the next step and actually attempted suicide.ii

Identifying students who are at-risk for psychological distress

This means noticing whats going on with your students: noticing worrisome behavior and
worrisome changes in behavior.

Here are a few warning signs that might indicate psychological distress. While not always indicative
of an underlying mental-health problem, students exhibiting these signs do warrant attention.

ACADEMICS BEHAVIORS APPEARANCE

Pattern of missed/late/ Withdrawn; lack of social Disheveled or worsening

incomplete assignments interaction appearance; poor grooming/
hygiene

Failing/falling grades Anger; crying; emotional Unusual, bizarre appearance

outbursts

Diminishing participation Behavioral issues in class Drastic weight gain/loss

Diminishing attendance Change in personality; mood Avoidance of eye contact

swings

Statements about feeling

helpless or hopeless

Constant or excessive
worrying

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Course Summary

ACADEMICS BEHAVIORS APPEARANCE

Excessive demands for your

time and attention

Frequent complaints of
insomnia, stomachaches, or
headaches

Recent impulsiveness or
unnecessary risk taking

Sometimes we notice a warning sign like one of these because it stands out as extreme. Other
times, we might notice a significant change in behavior that worries us. The important thing is to
follow your instincts. If youre worried about a student, approach him or her to see whats going
on. It cant hurt to let the student know that youve noticed and that you care.

Approaching students who are at-risk for psychological distress

Once you identify, you need to approach. That means letting students know youre concerned
and trying to better understand why theyre behaving the way they are. This conversation should
happen when you have time to talk, in a place where you will not be overheard by others.

You can skip the approach and go straight to the school counselor to refer the student; however,
students are often more motivated to see the counselor when theyre personally referred by
someone they know and trust.

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 for Middle School
Course Summary
Here are three effective techniques for having conversations like this.
Discuss specific, observable
behaviors (instead of
exaggerating, generalizing,
or negatively labeling).
Instead of
You always freak out over
exams.
Try
Last week, when you made a
B on that exam, you asked a
lot of questions about it and
your voice was shaking. You
seemed upset.
Instead of
Youre texting the yearbook
sponsor all the time.
Try
Ms. Sandifer told me you seem
worried about your yearbook
articles, that you text her a lot
of questions.
Discuss specific, observable
behaviors (instead of
exaggerating, generalizing,
or negatively labeling).
Instead of
You have some weird ideas
about suicide.
Try
You wrote some things
about suicide on last weeks
homework that concerned me.
EFFECTIVE TECHNIQUES
Use I statements
(with terms like I think, I
feel, or it seems) to soften
your observations.
Instead of
Youre being more quiet than
usual.
Try
I feel like youre being more
quiet than usual.
Instead of
You put too much pressure on
yourself.
Try
I think you put too much
pressure on yourself.
Use I statements
(with terms like I think, I
feel, or it seems) to soften
your observations.
Instead of
Youre having trouble
concentrating.
Try
It seems like youre having
trouble concentrating.
Paraphrase what you think
the student is saying,
thinking, or feeling.
It sounds like youre under an
awful lot of pressure.
So you think a lot about whether
or not your parents will stay
together.
Youre saying its harder to
connect with people because
you feel different from them.
I guess the way your mom
expresses her concern is
frustrating.
So youve dealt with it and you
feel youre totally over it.
Reflect on what you think
the student is saying,
thinking, or feeling.
You mean, you would talk more
if you had more to say.
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Course Summary

Here are three ineffective techniques for having conversations like this.

INEFFECTIVE TECHNIQUES

Give advice. Judge the student or his / Disagree or try to change

her actions. the students mind.

Instead of Instead of Instead of

You need to toughen up a little.
Otherwise, high school is going
to be hard for you.
Try
Im concerned that the stress
you feel might continue when
you get into high school, or
even get worse.
Its really irresponsible to miss I disagree. Grades are very
so much school. important.
Try Try
Why do you miss so much Youre right that grades arent
school? everything, but they could help
you when you get into high
school.

Instead of Instead of Instead of

I think you should go to Its not normal for a student to Youre wrong. Unhappiness
college. want so much feedback. doesnt last forever.

Try Try Try

What do you think about You seem to like a lot of Sometimes when we feel
going to college? feedback. Are you worried unhappy, it can seem like it will
about your performance? go on forever. But over time
things do change.

Give advice. Judge the student or his / Disagree or try to change

her actions. the students mind.

Instead of Instead of Instead of

You should see the guidance
counselor.
Try
Have you considered seeing the
guidance counselor?
Youve got a real attitude.
Try
You said a few things in class
last week that I wanted to
talk to you about.
No, the counselor can help you.
Try
You may be right. The
counselor might not be able
to solve all your problems. But
he might be able to help with
some of them.

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Course Summary

Referring
Referral can mean:

referring the student to the counselor

referring the counselor to the student
both

Here are some effective tactics for talking to students about the school counselor.

EFFECTIVE TACTICS

Describe the Explain how talking Let them know Offer to personally
benefits of talking to the counselor the counselor introduce them to
with the counselor. could help them has helped other the counselor.
meet their goals. students with
similar issues
(without naming
names).

Sometimes talking If you can learn to She has a lot of I could introduce you
about things like this channel the pressure experience working and tell him a little
helps release some of in good ways, I think with students who are about what we talked
the pressure. youll do really well in under pressure. about today.
high school.

Describe the Explain how talking Let them know Offer to personally
benefits of talking to the counselor the counselor introduce them to
with the counselor. could help them has helped other the counselor.
meet their goals. students with
similar issues
(without naming
names).

The counselor isnt It sounds like your Weve had other Id like to introduce you
part of your regular mom isnt going to students here whove to the counselor. That
life, so you dont stop worrying until lost parents or way, you know her and
have to watch what she knows youre brothers or sisters if you decide you do
you say. going to be okay. to suicide. And the want to talk to her you
Maybe if she knows counselor has worked can.
youre willing to talk with them. So she
with the counselor, knows the kind of
shed feel better. pain that people can
feel when theyre left
behind.

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Its confidential, so no You could play The counselor works Ive worked with him
one has to know that basketball for the with a lot of students for a long time. Lets
youre seeing him. team, but youd have who find theyre go down now, just
to learn to manage getting blocked by for a second, and Ill
your temper a little anger or stress or introduce you.
better. things like that.

Finally, instead of telling a student that he should see the counselor, its often more effective to
phrase it as a question, for example: How would you feel about talking to the counselor? This
can increase the students ownership over the idea, which can make him more receptive to it.

Of course, if you fear the student may be a danger to himself or others, you must be very direct
and act quicklydont let the student out of your sight until youve connected him with the
counselor or another administrator whos prepared to help.

After reaching out to a student, follow up in the coming days, weeks, and months to see if things
are improving. These dont have to be long conversations. Even a quick question like Hows
everything going? lets them know youre still thinking about them.

Resiliency
A student who faces challenges and has the coping skills to get through them with self-esteem
intact has resiliency.

They are able to maintain perspective.

They feel empowered to solve their problems or ask for help if necessary.
They know that they are connected to a support system of at least one friend,
teacher, or family member whom they can go to for help.

Whenever you help your students maintain perspective, feel empowered to cope with stress
and adversity, and feel connected to others who care about them, you help them become more
resilient.

Bullying
Bullying is characterized by three criteria:

Unwanted, aggressive behavior

An imbalance of power
Actions carried out repeatedly over time, or with the potential to reoccur

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 for Middle School
Course Summary

Forms of bullying:

Physical hitting, shoving, facial expressions, obscene gestures

Verbal threatening, name calling, rumor spreading
Social intentionally ostracized, socially isolated from their friends and peer groups

As with any at-risk student, aggressors, victims, and bystanders need school adults to be
authorities and positive role models. You can do that by setting clear expectations at the
beginning of the year--for example, making a class contract--and consistently reinforcing those
expectations through firm but non-hostile, non-physical consequences.

Suicide
Within the past year, seven out of every 100 middle school students across the country have
considered suicide.iii

If you fear that a student is considering suicide, talk to him or her immediately and be direct.
Asking about suicide will not put the idea into a students head.

1) Gather as much information as the student is willing to share, such as:

Are they thinking about suicide?

Do they have a plan?
Do they intend to act on the plan?
Do they have the means to act on the plan?

2) Connect the student immediately and in person to a supportive counselor or staff member.

If you have questions on how to handle a particular situation and you cannot reach anyone in
your school administration, you can call: The National Suicide Prevention Lifeline 24/7 at 1-800-
273-TALK (8255).

Where can I go for more information?

If youre unsure how to handle a particular situation, you can talk to:

the school counselor

the principal
a colleague

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In an emergency, you should call:

school security
911

If you ever realize that a friend, family member, or you yourself may be at-risk, seek a
referral for a mental health professional from:

your doctor
someone you trust
the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

If you want to explore these topics further, visit these sites:

National Suicide Prevention Lifeline

1-800-273-TALK (8255)
www.suicidepreventionlifeline.org/
The National Suicide Prevention Lifeline provides immediate assistance to individuals in
suicidal crisis by connecting them to the nearest available suicide prevention and mental
health service provider through a toll-free telephone number.

Suicide Prevention Resource Center - Teachers Resource Page

www.sprc.org/basics/about-suicide
SPRC has information for teachers on recognizing and responding to warning signs.

HelpGuide
www.helpguide.org/mental/depression_teen.htm
HelpGuide has information on the signs, symptoms, and effects of teen depression, as well as
information on how to talk to a depressed teen.

StopBullying.gov
stopbullying.gov
StopBullying.gov provides information from various government agencies on what bullying is,
what cyberbullying is, who is at risk, and how you can prevent and respond to bullying.

i
Merikangas, K. R., He, J.-P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010). Prevalence and treatment
of mental disorders among US children in the 20012004 NHANES. Pediatrics, 125(1), 7581
ii
2011 Health and Risk Behaviors of Massachusetts Youth (2012). Massachusetts Department of Elementary and
Secondary Education, Massachusetts Department of Public Health. http://www.doe.mass.edu/cnp/hprograms/
yrbs/2011Report.pdf
iii
Ibid.

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