Student health

Counselling services in college and university settings cater for students with a wide range of problems. These include financial problems, difficulties with studying, interpersonal problems, and psychiatric presentations. Student counselling services are often arranged so that practical (e.g. financial guidance or careers counselling) and psychological problems are catered for separately. The latter facility is usually sited in a position that affords discreet and confidential access, so as not to deter those who are ashamed of seeking help. Services may accept referrals from academic staff or the student's doctor, but the usual expectation is that students will refer themselves.

Student counselling services encounter the full range of psychiatric presentations characteristic of young people, although mature students may present differently. Services need to include or work closely with psychiatrists and other mental health professionals in order to meet the needs of the minority of students with mental illness. The majority present with less severe emotional or psychological problems, but these may be highly disruptive to their studies and social integration.

By virtue of their age and developmental stage, many students present with problems of adjustment to the new freedoms and demands of college life. The developmental challenges of adolescence and young adulthood include negotiation of dependence-independence conflicts and psychosexual development, so the psychological problems of students are often associated with interpersonal and sexual difficulties. Dependence and conflicts with parental figures may become transference issues within the counselling relationship, and student counsellors would be expected to recognize and work with such developments regardless of their preferred model of counselling.

A short time-frame is usually appropriate for counselling young people, partly because of the impatient urgency of youthfulness and the structure of the academic year, but also because their natural developmental potential enables most young people quickly to achieve substantial momentum towards change. This process may be accelerated even more by the intelligence inherent in students, though emotional development lags far behind intellectual development in some. The task of counselling has been likened to helping the young person back on to the track of normal psychosexual development. More severe derailments, however, may require longer counselling, specialized psychotherapy, or other psychiatric treatment.

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