Nigel White suggests some techniques and strategies for university teachers faced with getting agitated and stressed students through vital exams
Many problem students need not be referred to a counsellor or doctor if a supervisor who knows them well can make a judicious intervention
If your student is panicking, do not panic! We all know that the secret of coping with exams is preparation and that a well thought-out schedule of revision, with breaks, will be most likely to leave a student feeling confident as the big day approaches. But what if the student has neglected to prepare, or circumstances have intervened, or for whatever reason they are having a crisis coping in the weeks before exams?
Let us say that Sarah, a capable student who has always got good marks, starts talking to you about an assignment, but gets more and more emotional. She is soon in tears as she tells you that she is not sleeping, is no longer eating, cannot study, is having panic attacks and knows she is going to make a mess of her exams. You feel she is expecting you to do something. Do you:
* Bring the conversation to a close as quickly as you can
* Let her have her say while you listen
* Give her advice
* Refer her to the counselling service.
* A combination of these?
The answer will depend on what you have found to work in the past. Many tutors have a collection of strategies they have built up over time: this is your main resource in fashioning a response.
You also know that what works is different from one student to another and you have to make use of whatever relationship you have built with Sarah. The fact that she is speaking to you shows she holds you in trust and respect.
What you say is probably less important than your manner. Sarah is panicking. She needs to see you being calm, so she can begin to feel calm herself. If you take in what she says and remain calm, she will feel reassured that it is not as bad as she feared.
A student was referred to me for counselling who felt she had messed up an exam. She was in despair because she was sure she would mess up the others. Having clarified that she did know the material, we spent some time planning what she would do in the next exam and she went away with a set of procedures.
I met her a while later, before her results, and she was full of thanks because the other exams went well. What had helped was not a magic set of procedures, as she may have believed, but the fact that the procedures had re-established her sense of being competent.
It is this sense of being competent that is temporarily lost when someone is panicking and the best anyone can do is to help the student rediscover their own sense of competence.
How to do this? Again, there is no magic set of procedures but in general, talking about competence will increase a person's sense of competence, whereas talking about disaster will increase the fear of failure.
So the challenge is to get Sarah to remind herself that she does have abilities. To do this you will need to distract her from thoughts of disaster for long enough to think of solutions. A few things to try are:
* Confirm, in a matter of fact way, that exams are tough and that there is no comfortable way through. This will reassure her that what she is feeling is normal
* Remind her of something specific you have seen her do that shows an ability to function under stress
* Compliment her on her strengths, giving specific examples
* Ask how she coped with past stressful situations and get some detail on this: be impressed and say so.
If none of this is calming her down, then maybe you need to listen some more. One of the most helpful things that one human can do for another is to listen in a calm and accepting way. If the feeling of hopelessness continues to grip her, then ask how she is managing to cope, a question such as "So, with all this going on, how on earth are you managing? What does it take to even get in here today?" This may surprise her into mentioning a few of her strengths. Get her to elaborate as much as you can.
Once she is able to think, move on to asking what would help her perform at her best. This is a deliberately hard question, so give her time to find an answer and come back to it if she gets side-tracked. Be patiently persistent. "So, knowing yourself as you do, what do you think would help?" Once she gets a hunch, whatever it is, help her amplify it in detail.
Other good questions are, "How will you know when you are beginning to cope with it better?" "What will be a small sign that you are getting on top of this?" "Suppose I meet you after the exams have finished and all has gone well. I ask you, 'How did you get through?' What will you be saying?" Some students will be wanting you to listen and some will be wanting advice. Where you know the student responds well to advice, then give some. This can be a re-wording of what the student has already said would help, or it can be received wisdom about coping with exams, or it can be something you have found useful in the past. From your position, advice has weight and may be very reassuring.
One key principle is, "If it's not working, try something different." This can encourage you both to think of something new and set up an experiment. This needs to be acceptable to the student and something the student can do.
So, for example, if a student is obviously trying too hard, you could say, "I advise you to try less hard", but they would be unlikely to succeed. A better way of putting it would be, "It's very important to relax and recharge your batteries, so I advise you to give yourself a strict timetable with one hour a day when you have to think about something else."
One student I saw recently complained that she could not stop crying and that this was interfering with her revision. She was angry with herself for crying and not being able to study: this made her more upset and she cried all the more. Stopping the crying was something she had tried already, so I asked her how much time she could waste during the day without worrying. She said two hours. I said, "I advise you, for two hours a day, to let yourself cry without worrying. Can you do that?" If she does, she will be doing something different and will have taken an active step.
If you're stuck for advice you can always say, "Notice what's happening in your life that is helping you get through." Once the student starts to notice the helpful things, they can do them more often.
Use the same language the student uses to describe their situation and feelings, but remember you do not know what the student means by "depression" or "panic attack" or "stress" until you check it out with them. Just because they are using terms like "depression" or "panic attack" does not necessarily mean anything medical is going on: these terms are used very loosely by the student population.
Getting a behavioural description of what is happening can be helpful in itself as, "I cry when I try to study" offers more scope for developing solutions than "I get panic attacks".
Finish the interview with some compliments about how the exams obviously mean a lot to them, how much effort they are putting in and how you appreciate them coming to talk to you about them. Also mention other positive aspects that have come to light during the discussion.
We have all been conditioned to express emotions in certain ways and this differs between genders and cultures. Some students may be more reserved, or show more hostility, but anger and fear and sadness can all be assumed to play some role. The expressing of these emotions does not necessarily mean the situation is getting out of hand or becoming more than you can manage.
So when should you refer to a counsellor or a doctor? If the student can be helped by one interview, then you are the person to help. This is because you are already in that one interview with them - an appointment with a counsellor or a doctor may take days to arrange. Also you are the one who knows the student, so you have an advantage.
If you feel one interview will not be enough, or you know of other things going on in the student's life, or if the student has mental health problems, then it may be worth the wait to see another professional. In the meantime, none of the approaches described above can do any harm.
Nigel White is a counsellor at Leeds Metropolitan University.