1. Effectively Managing Classroom Behavior Dr. Diana Brecher Counselling Centre

2. OUTLINE Distinguishing between depression and grief Impact of panic attacks on academic performance Making timely and appropriate referrals Confidentiality

3. DEPRESSION (1) Depressed mood (2) Markedly diminished interest or pleasure (3) Significant weight loss (or gain) (4) Insomnia or hypersomnia (5) Restlessness or slowed down speech & body movements (6) Fatigue or loss of energy (7) Feelings of worthlessness or excessive or inappropriate guilt (8) Diminished ability to think or concentrate, or indecisiveness (9) Recurrent thoughts of death

4. GRIEF Feelings: Sadness, anger, guilt and self reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, numbness Physical sensations: Hollowness in stomach, tightness in chest, tightness in throat, over sensitivity to noise, “nothing seems real”, breathlessness, weakness in muscles, lack of energy, dry mouth Cognitions: Disbelief, confusion, and preoccupation with the deceased Behaviours: Sleep disturbances, appetite disturbance, absent minded behaviours (‘spacing out’), social withdrawal, dreams of the deceased, avoiding reminders of the deceased, sighing, restless over activity, crying

5. DEPRESSION GRIEF (1) Depressed mood (2) Markedly diminished interest or pleasure (3) Significant weight loss (or gain) (4) Insomnia or hypersomnia (5) Restlessness or slowed down speech & body movements (6) Fatigue or loss of energy (7) Feelings of worthlessness or excessive or inappropriate guilt (8) Diminished ability to think or concentrate, or indecisiveness (9) Recurrent thoughts of death (1) Feelings: Sadness, anger, guilt and self reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, relief, numbness (2) Physical sensations: Hollowness in stomach, tightness in chest, tightness in throat, over sensitivity to noise “nothing seems real”, breathlessness, weakness in muscles, lack of energy, dry mouth (3) Cognitions: Disbelief, confusion, and preoccupation with the deceased (4) Behaviours: Sleep disturbances, appetite disturbance, absent minded behaviours, social withdrawal, dreams of the deceased, avoiding reminders of the deceased, sighing, restless over activity, crying

6. CRITERIA FOR A PANIC ATTACK A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes

7. PANIC ATTACKS  heart palpitations, pounding heart or accelerated heart rate  sweating  trembling or shaking  sensations of shortness of breath or smothering  feeling of choking  chest pain or discomfort  nausea or abdominal distress 8.  feeling dizzy, unsteady, lightheaded, or faint  feelings of unreality and/or being detached from oneself  fear of losing control or going crazy  fear of dying  numbness or tingling sensations  chills or hot flushes

8. WHAT YOU CAN DO… During a presentation (the student will likely leave or freeze as a way of managing their symptoms) Reassure the student, encourage him or her to return to class and continue or offer another opportunity to redo the presentation at another time or in a different context

9. WHAT YOU CAN DO… During a test or exam (the student will likely leave early as a way of managing their symptoms) Offer the student an opportunity of either returning to the task or refer the student to the appropriate resource depending on the time of year

10. ROLE OF FACULTY Support the distressed student by knowing the right referral resource on campus and how and when to make that referral Access Centre Counselling Centre Medical Centre

11. COUNSELLING CENTRE Provides counselling and psychotherapy for: anxiety, depression, grief, trauma, eating disorders, family issues Career counselling and educational planning Ryerson Safe House Ryerson Crisis Team

12. LANGUAGE TO USE “You seem to be fairly upset about this and I think that you could use some help in sorting out these issues. I’m concerned about you and I would like you to consider talking to one of the counsellors in our Counselling Centre”

13. ACCESS CENTRE Provides academic accommodations and support for disabilities: Temporary: broken bones, bereavement, post- concussion side effects, aftereffects of a car accident Intermittent: depression, anxiety,PTSD Permanent: physical disabilities, LD, ADHD, Aspergers, chronic illnesses, mental illness

14. LANGUAGE TO USE “You have raised several important concerns with respect to your need for academic accommodation. I would encourage you to contact our Access Centre to speak with a disability counsellor who can assist you this matter

15. MEDICAL CENTRE Provides medical services and documentation for: Physical and mental illnesses Injury, pain, discomfort Referrals for psychiatric care and/or other specialists

16. CONFIDENTIALITY in Counselling Centre All contact information, including appointment times. No information regarding the client’s counselling appears in his/her academic file. No one outside of the Counselling Centre staff has access to any information about what was discussed in the counselling sessions, unless the client gives his/her signed permission for specific information to be shared. The client may revoke his/her signed permission to release information by informing his/her counsellor within a reasonable time frame.

17. LIMITS TO CONFIDENTIALITY Counsellors are required by law and/or the College of Psychologists of Ontario to waive confidentiality under the following circumstances: The client is at imminent risk of harming him/herself or others There is a reasonable suspicion of emotional and/or physical neglect of a minor or a reasonable suspicion of emotional, physical, or sexual abuse of a minor The client reports having been sexually abused by a regulated health professional and provides the counsellor with the name of that professional There is a court subpoena for the counselling records (e.g. in criminal court cases; in contentious child custody cases)