Mental Health on Campus
Amar, A. F. and S. Gennaro (2005). "Dating violence in college women: associated physical injury, healthcare usage, and mental health symptoms." Nurs Res 54(4): 235-242.
BACKGROUND: College-aged women report experiencing violence from a partner within the dating experience. OBJECTIVES: This study used a correlational design, to report physical injury, mental health symptoms, and healthcare associated with violence in the dating experiences of college women. METHODS: A convenience sample of 863 college women between 18 and 25 years of age from a private, historically Black university in the South, and a private college in the mid-Atlantic completed the Abuse Assessment Screen, a physical injury checklist, and the Symptom Checklist-R-90. Data analysis consisted of frequencies, ANOVA, and MANOVA. RESULTS: Almost half (48%) (n = 412) reported violence and, of these, 39% (n = 160) reported more than one form of violence. The most commonly reported injuries were scratches, bruises, welts, black eyes, swelling, or busted lip; and sore muscles, sprains, or pulls. Victims had significantly higher scores on depression, anxiety, somatization, interpersonal sensitivity, hostility, and global severity index than nonvictims. Victims of multiple forms of violence had significantly higher mental health scores and reported greater numbers of injuries than victims of a single form of violence. Less than half of those injured sought healthcare for injuries and less than 3% saw a mental health professional. DISCUSSION: Study findings suggest the importance of screening and identification of victims of violence. Knowledge of physical and mental health effects of violence can guide intervention, prevention, and health promotion strategies. Future research is needed to describe barriers to seeking healthcare, screening practices of college health programs, and programs to identify victims.
Carmody, D., et al. (2009). "Needs of sexual assault advocates in campus-based sexual assault centers." College Student Journal 43(2): 507-513.
Most campuses have sexual assault crisis centers that are designed to assist victims and educate the college community about this crime. While much is known about sexual assault victimization patterns on college campuses, there is still a lack of understanding about the needs of those working to prevent sexual assault. In the current study, campus sexual assault advocates define what is needed to better serve college and university students. Based on focus group data of seventeen advocates working with campus sexual assault centers, specific needs were highlighted. Advocates emphasized the need for increased funding for prevention and counseling programs, improved strategies to assist international students, and coordination of college sexual assault programs at the state level.
Cermele, J. (2010). "Telling our stories: the importance of women's narratives of resistance." Violence Against Women 16(10): 1162-1172.
While more research is emerging on women's capacity for successful resistance and the benefits of self-defense training for women, "resistance" to the idea of women's resistance remains high. In this note, I describe the importance of bringing true accounts of successful resistance to both academic and lay communities, and the benefits to women of recounting their own experiences of successful resistance to violence and harassment. Such accounts provide new scripts for women's options in responding to violence, mark attempted but thwarted rape as a visible event, and remind women of their own agency in the face of assault.
Chelf, C. M. (2004). "An intervention model for recruiting rape victims into treatment." Dissertation Abstracts International: Section B: The Sciences and Engineering 65(2-B): 1023.
The percentage of rape victims who do not seek social support after rape is alarming, particularly given the potential consequences of not seeking help. The present study attempts to address the dilemma of rape and attempted rape victims' lack of support seeking through a two-phase online intervention designed to encourage them to seek treatment. The study manipulates factors involved in characterizing oneself as a rape victim and in seeking help for problems resulting from rape. It was hypothesized that victims who received the intervention would seek counseling more than victims in a wait-list control group. Participants were 1322 women ranging in age from 17 to 39 from a large, southeastern university. Of these women, 344, or 26% of the sample, reported an experience consistent with a legal definition of rape or attempted rape. Unfortunately, it was not possible to fully examine the proposed model in this study, as hypothesized differences between intervention and control subjects did not exist. However, interesting trends developed collapsing across treatment groups. While few participants sought formal help, almost three-fourths sought informal help and almost half sought information about counseling. These findings are made even more salient by the large number of non-recent victims who sought help for the first time. Taking part in the study itself appeared to encourage victims who had gone without help for some time to actually seek help. In addition, higher levels of distress were associated with seeking help, as were higher levels of negative social reactions, stigma, and self-blame. Perceived need for help was found to mediate the relationship between distress and intent to seek help. Limitations and suggestions for future research are discussed.
Conley, C. S., et al. (2013). "An Evaluative Review of Outcome Research on Universal Mental Health Promotion and Prevention Programs for Higher Education Students." Journal of American College Health 61(5): 286-301.
Objective: This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. Participants/Methods: The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. Results/Conclusions: Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocialand thus ultimately academicdomains.
Finn, J., et al. (2011). "Volunteer and user evaluation of the National Sexual Assault Online Hotline." Eval Program Plann 34(3): 266-272.
PURPOSE: The National Sexual Assault Online Hotline (NSAOH) is a new model for delivery of rape and sexual assault crisis services through a secure, confidential chat-based online hotline. This paper presents a program evaluation drawn from volunteer counselor and user perceptions and experiences during the second year of operation of the NSAOH. METHOD: Outcome data are presented from 731 session evaluations submitted by 94 volunteers and session evaluations from 4609 user sessions collected between June 1, 2008 and May 30, 2009. Evaluation includes ratings of usefulness, topics discussed, length of sessions, services provided, and session difficulties. RESULTS: The results indicate that the model is viable and useful, and the majority of volunteers and users are satisfied. Volunteer knowledge and skills are strongly associated with satisfaction with the hotline. Nevertheless, one-fifth of volunteers rate their session as not useful and users rate 8.2% of volunteers low in knowledge and skills. DISCUSSION: NSAOH is reaching many who have not previously sought services or did not resolve issues through other means. Findings suggest the importance of preparing volunteers in both crisis intervention and a wide variety of long-term issues related to sexual assault. Recommendations for program development, evaluation, and further research are presented.
Kress, V. E., et al. (2007). "Counseling College Students Who Have Been Sexually Assaulted." Lippincott, Joseph A [Ed]: 129-141.
(from the chapter) This chapter integrates research and theory from the general literature on working with sexual assault survivors and applies it to college counselors' work with sexually assaulted students. In addition, original research and experts' perceptions of the most efficacious practices to use when counseling trauma survivors are described and applied specifically to counseling college students. It is hoped that this review will provide college counselors with an understanding of what specific interventions they might use when counseling sexual assault survivors at different stages of their recovery process.
Macy, R. J., et al. (2013). "Directors' opinions about domestic violence and sexual assault service strategies that help survivors." J Interpers Violence 28(5): 1040-1066.
Little evidence is available regarding recommended practices for domestic violence and sexual assault services. Although there is a literature concerned with these services, few studies have investigated recommended practices from the perspective of community providers. In addition, researchers have not yet investigated the utility of specific domestic violence and sexual assault service delivery strategies. To help address these knowledge needs, the authors investigated agency directors' perspectives on six types of services typically offered by domestic violence and sexual assault agencies including crisis, legal advocacy, medical advocacy, support group, individual counseling, and shelter. The authors also examined the extent to which directors' opinions about service delivery practices differed based on key agency's characteristics, specifically the services offered (i.e., domestic violence, sexual assault, or both) and agency location (i.e., rural, suburban, or urban). A sample of 97 (94% response rate) North Carolina agency directors completed a survey on recommended service delivery practices. The authors conducted descriptive analyses to identify directors' overall opinions about service delivery practices and used multivariate analysis of variance to examine whether directors' opinions about service delivery practices differed according to agency characteristics. Findings showed differences in directors' opinions about service delivery practices based on their agency's service location. Practice recommendations were garnered from the study's results.
Meilman, P. W., et al. (1993). "Use of the mental health on-call system on a university campus." J Am Coll Health 42(3): 105-109.
Over the course of 1 calendar year, clinicians at a university mental health service collected data on every clinical case in which students presented after normal business hours or on weekends for urgent mental health consultation. During the year, 50 such incidents were recorded, which translated to a rate of 6.6 on-call events per year per 1,000 students. Students were primarily self-referred or referred by the student health center or residence life staff. Suicidal concerns, panic/anxiety, and depressive states were the three most common presenting complaints. Average clinician time per case was 1 1/2 hours, with sexual assault cases taking the most time per case, followed by substance abuse and suicidality. Follow-up outpatient counseling was employed in 76% of the cases. The results highlight the importance of on-call mental health services on college campuses.
Orzek, A. M. (1983). "Use of rape crisis center services by a university community." Journal of College Student Personnel 24(5): 465-466.
Describes the history, services, educational program, and liaison functions of a sexual assault crisis agency in Lawrence, Kansas. It is noted that services provided to the University of Kansas and reciprocal support from the university together served to reduce the incidence of sexual assault and helped victims deal more effectively with the aftermath. (3 ref)
Ottens, A. J., et al. (2005). "Crisis Intervention at College Counseling Centers." Roberts, Albert R [Ed]: 416-438.
(from the chapter) This chapter's focus is on the application of Roberts's (1990, 1996) seven-stage crisis intervention model to the delivery of crisis intervention services at college and university counseling centers. Roberts's model is especially relevant, given several compelling reasons for providing crisis intervention as a therapeutic modality in this setting and with this particular clientele. First, traditional-age (18-24 years old) college students often encounter crises--death of a parent, dating violence, relationship dissolution, and threats to academic performance, to name a few--that threaten their accomplishing critical developmental tasks. These tasks include concretizing personal values, establishing emotional control, acquiring self-confidence, achieving independence, and shaping relationship skills. Second, college counselors are witnessing the encroachment onto campuses of social problems like sexual violence, the AIDS epidemic, rape trauma, alcohol and drug abuse, suicide, and racism. The chapter is organized around two composite case examples of relatively common types of crises encountered by college counselors. We discuss the particulars of each case and present clinical information relevant to the crisis issues. Finally, using the case examples as templates, we guide the reader through the seven stages of the Roberts (1996) model, demonstrating how the model can be adapted for brief, crisis-oriented therapy in the college context.
Rye, M. S. and K. I. Pargament (2002). "Forgiveness and romantic relationships in college: Can it heal the wounded heart?" Journal of Clinical Psychology 58(4): 419-441.
This study evaluated the effects of two versions of a six-week group forgiveness intervention for college women who had been wronged in a romantic relationship. Participants (N = 68) were randomly assigned to a secular, religiously integrated, or no-intervention comparison condition. Participants completed a variety of forgiveness and mental health measures at one-week pretest, one-week posttest, and six-week follow-up. Participants in both intervention conditions improved significantly more than did those in the comparison condition on two measures of forgiveness and a measure of existential well-being, Program effects were maintained at six-week follow-up. Contrary to hypotheses, there were no differential treatment effects when comparing participants in the secular and the religiously integrated conditions. Participants generally rated the programs favorably. Forgiveness strategies utilized by participants also were examined, (C) 2002 Wiley Periodicals, Inc.
Sarvela, P. D., et al. (1992). "Designing a safety program for a college health service." J Am Coll Health 40(5): 231-233.
Although accidents are the leading cause of death among college students, literature about developing student health safety programs is limited. In this article, we present preliminary recommendations based on literature review, epidemiologic data, and Nominal Group Process (NGP) activities, for developing university student safety programs. Our recommendations include appointing a coordinator to oversee all on-campus safety activities, providing for university-wide education programs dealing with alcohol and drug use, promoting personal safety efforts in areas such as family violence and rape prevention, and encouraging students to use safe transportation alternatives.
Segal, D. L. (2009). "Self-reported history of sexual coercion and rape negatively impacts resilience to suicide among women students." Death Stud 33(9): 848-855.
A substantial literature has documented that sexual abuse relates to suicidal behaviors but relatively less is known about resilience to suicide, especially cognitive deterrents to suicide. The present study investigated the effects of a history of sexual victimization on reasons for living. Female participants (N = 138; M age = 24.4 years; SD = 7.3 years; range = 18 to 53 years; 79% Caucasian) completed the Sexual Experiences Survey (SES) and the Reasons for Living (RFL) Inventory. According to SES responses, participants were classified into 5 mutually exclusive groups: no victimization, sexual contact, sexual coercion, attempted rape, and rape. Analyses of variance showed that degree of sexual victimization had a significant effect on the RFL Total scale and 2 subscales (Survival and Coping Beliefs; Moral Objections). The general pattern was that mean RFL scores in the no victimization group were significantly higher than the mean scores in the sexual coercion and rape groups. An implication is that having a history of sexual victimization, especially sexual coercion and rape, limits one's later reasons for not committing suicide. Bolstering these modifiable deterrents to suicide should be part of suicide prevention efforts among at-risk women.
Sorenson, S. B. and V. B. Brown (1990). "Interpersonal violence and crisis intervention on the college campus." New Directions for Student Services 49: 57-66.
Outlines a general framework regarding violent victimization (e.g., rape) on college campuses and focuses on forms of violence that are likely to be perpetuated in ongoing relationships and that represent important prevention points. As outlined by B. Levy and V. B. Brown (1984), crisis intervention helps the victim in (1) regaining a sense of competence, (2) accepting any uncontrollable results of the assault, (3) taking adaptive actions, and (4) reestablishing a sense of continuity and meaning in life. The institutional response to violence is discussed in terms of prevention and intervention programs.
Steenbarger, B. N., et al. (1995). "Prevention in college health: counseling perspectives." J Am Coll Health 43(4): 157-162.
Such problems as sexually transmitted diseases, alcohol and other drug use, and acquaintance rape require college health professionals to function in primary and secondary preventive roles. In this article, the authors draw upon counseling literature and college health practice to identify the central elements of preventive programs, highlight specific intervention formats used in preventive work, and describe how interventions are assembled into coherent programs of prevention. To illustrate the structure and process of long-range, institutionalized preventive efforts, the authors describe an initiative addressing the primary, secondary, and tertiary prevention of substance use at a health sciences campus.
Ullman, S. E., et al. (2007). "Psychosocial correlates of PTSD symptom severity in sexual assault survivors." Journal of Traumatic Stress 20(5): 821-831.
This study's goal was to assess the effects of preassault, assault, and postassault psychosocial factors on current posttraumatic stress disorder (PTSD) symptoms of sexual assault survivors. An ethnically diverse sample of over 600 female sexual assault survivors was recruited from college, community, and mental health agency sources (response rate=90%). Regression analyses tested the hypothesis that postassault psychosocial variables, including survivors' responses to rape and social reactions from support providers, would be stronger correlates of PTSD symptom severity than preassault or assault characteristics. As expected, few demographic or assault characteristics predicted symptoms, whereas trauma histories, perceived life threat during the assault, postassault characterological self-blame, avoidance coping, and negative social reactions from others were all related to greater PTSD symptom severity. The only protective factor was survivors' perception that they had greater control over their recovery process in the present, which predicted fewer symptoms. Recommendations for intervention and treatment with sexual assault survivors are discussed.
VanDeusen, K. M. and J. L. Carr (2004). "Group Work at the University: A Psychoeducational Sexual Assault Group for Women." Social Work with Groups: A Journal of Community and Clinical Practice 27(4): 51-63.
This article describes an innovative psychoeducational support group for female survivors of sexual assault. The intervention model takes place in a University setting and is free, confidential and easily accessible. The psychoeducational format allows survivors at various levels of healing to gain information about common sexual assault effects, rape myths, and coping strategies, and to explore their feelings and thoughts in a safe environment. This article also includes a review of theoretical and empirical literature on group work with female sexual assault survivors. Methods for screening members and recruitment techniques are also discussed.
Health of College Students and Sexual Assault
Brener, N. D., et al. (1999). "Forced sexual intercourse and associated health-risk behaviors among female college students in the United States." Journal of Consulting and Clinical Psychology 67(2): 252-259.
This study analyzed data from the 1995 National College Health Risk Behavior Survey (NCHRBS) to assess the prevalence of lifetime rape among female college students and to examine the association between rape and health-risk behaviors. The NCHRBS used a mail questionnaire to assess health-risk behaviors among a nationally representative sample of undergraduate students. Twenty percent of female students reported ever having been forced to have sexual intercourse, most often during adolescence. When analyses controlled for demographic characteristics, female students who had ever been raped were significantly more likely than those who had not to report a wide range of health-risk behaviors. These results highlight a need to improve rape prevention and treatment programs for female adolescents.
Konradi, A. (2003). "A strategy for increasing postrape medical care and forensic examination - Marketing sexual assault nurse examiners to the college population." Violence Against Women 9(8): 955-988.
Despite the physical and emotional damage of sexual assault, most raped women do not receive postassault medical care. This article describes a social marketing strategy to sell sexual assault nurse examiner (SANE) services available on a college campus directly to matriculated students (potential victims and allies). Significant results found in postcampaign surveys were that the majority of students saw posters and generally retained the information in them, students exposed to more sources of information had more accurate knowledge of services, and students' recommendations concerning SANE usage reflected their exposure to information and their perception of assault risk. The article concludes with policy recommendations.