Encouraging Pre-Health Students to Develop Realistic Expectations Julie R. Nelson, Kate Karacay and Emily Brunner Academic Advising Center The University of Iowa

Counseling and Advising How Counseling Theories Inform Advising Intentional Advising Interventions

The Same, But Different

ON THE ONE HAND Advising is NOT Counseling Different Purpose Ethical Practice ON THE OTHER HAND  Advisors are First to Know  Advising as Problem Solving  Affective Nature of Advising See Crookston, B. B. (1972). A developmental view of academic advising as teaching. Journal of College Student Personnel, 13,

Counseling: Teaches Problem Solving Encourages Communication Values Process Orientation Provides Context

Pre-Health Challenges No Guarantee Highly Competitive Few Second Chances Advising Priorities, Student Realities Beginning Well = Accurate Assessment

Problem-Solving Ability and Coping Skills Ask Yourself, Notice: Is this a Problem-Focused Problem? Is this an Emotion-Focused Problem? D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

Problem is Solvable Problem is a Challenge (apart from self) Problems can be Successfully Resolved Problems Take Time (and that is okay) D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

Problem Definition Ability to Generate Alternative Solutions Making Decisions Solution Implementation is Realistic D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

Student Mindset: Problems Threaten Well Being or Identity Create Doubt about Ability to Succeed Have Low Tolerance for Uncertainty Problems Take Time (and that is not okay) D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

Situation or problem is not changeable Focus on student’s reaction Advising support = helping student cope + helping student respond more effectively D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

“How did it feel?” [Affective] “What did you tell yourself?” [Cognitive] “What were you doing?” [Behavioral] “Who supported you?” [Relational] Describe where you were. [Contextual] Cormier & Nurius, 2003.

A Light by Which to See

Grief and Loss Transtheoretical Model of Change

Elizabeth Kubler-Ross J. William Worden Kubler-Ross (1969); Worden (2009).

Denial Anger Bargaining Depression Acceptance Kubler-Ross (1969).

Accept the Reality of the Loss Process the Pain of Grief Adjust to a World Without the Deceased Find an Enduring Connection to the Deceased in the Midst of New Life Worden (2009).

Loss of Identity—Personal & Social Things Are Not What They Seem

Making Room for Grieving Normalizing Uncertainty Acknowledging Embarrassment Building Network of Support

Prochaska & DiClemente (1982) Five Stages of Change Resolving Feelings of Ambiguity See Prochaska, J. O. & DiClemente, C. C. (1982) Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research, Practice, 19,

Motivational Interviewing Aims to Stimulate Intrinsic Motivation to Change by Exploring and Resolving Ambivalence. Effective with Advisees Who Contemplate Change but Feel Hindered by Uncertainty. Miller, W. R. & Rollnick, S. (2013). Motivational interviewing: Helping people change. 3rd Ed. New York: Guilford.

How Does the Student Feel about Change? Would the Student Give You Permission to Explore Options?

Ambivalence Hinders Adaptive Behavior Resistance Likely w/ Loss of Freedom or Choice Resistance is a Product of Interaction Resistance is a Barrier to Change Talk Advisor Allows Resistance Reduce Resistance to Avoid Rupture w/ Advisee Moyers, T. B. & Rollnick, S. (2002). A motivational interviewing perspective on resistance in psychotherapy. JCLP/In Session: Psychotherapy in Practice, Vol. 58(2),

Establish a Relationship Set an Agenda Determine Multiple Behaviors in Need of Change Student Decides on Single Behavior to Change Importance + Confidence + Readiness Scaling Explore Importance/Build Confidence See Miller, W. R. & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behaviors. New York: Guilford. See also Rollnick, S., Mason, P., & Butler, C. (1999). Health behavior change: A guide for practitioners. London: Churchill Livingstone.

Getting Them to Say It

-Soren Kierkegaard

Beginning the Advising Relationship with Acknowledgement of Challenges Frontloading Information without Overwhelming Students Reflecting in Real Time: Advising as Collaboration

Getting the Conversation Started Using Open-Ended Questions Helping Students Develop Insight Empowering Students to Change Cormier & Nurius, 2003.