College counsellors increasingly seeing traumatised students

Nearly half of students who attend college counselling sessions say they have experienced trauma, according to the 2023 annual report from the Center for Collegiate Mental Health (CCMH) at Pennsylvania State University. That represents an increase of nearly 10 percentage points since the data were first reported in 2012, from 37.5 per cent to 46.8 per cent.

As a result, college counselling centres are looking to hire therapists with expertise in treating trauma and to make their centres friendlier to students who have experienced traumatising events.

While it’s hard to pinpoint the exact causes of the surge in trauma among college students, mental health counsellors suspect that the changing definition of trauma – as well as the declining stigma young people attach to it – have played a role.

“There’s a growing understanding that trauma doesn’t have to be this one catastrophic event,” said Katie Shade, a clinician with Florida State University’s Counseling and Psychological Services. She added that trauma could result from not having your needs met in childhood, for example.

According to CCMH’s report, the two types of trauma that have increased the most dramatically among college students in counselling are childhood emotional abuse and sexual violence.

Ms Shade also noted that clinicians were becoming better at determining when students have experienced trauma, even if the students themselves don’t necessarily see their experiences as traumatic.

In-house treatment

As the incidence of trauma among college students has risen, so too has the number of colleges that offer post-traumatic stress disorder (PTSD) treatment in their counselling centres.

At FSU, the majority of clinicians have been trained in a treatment called EMDR, including nearly 20 practitioners who received EMDR training on the college’s dime last spring. EMDR, or eye movement desensitisation and reprocessing, is a PTSD treatment that has grown in popularity in recent years. It involves guiding patients through bilateral stimulation, which they achieve by moving their eyes from side to side, for instance, or holding buzzers that send alternating pulses to the left and right hands. This is meant to ground them in the present as they recall traumas from their past.

The World Health Organization, the American Psychological Association and other similar bodies recommend EMDR as a treatment for PTSD, but controversy remains over how it stacks up against other forms of treatment and how effective it actually is, according to The New York Times.

The treatment is flexible in length and can have an impact on PTSD symptoms after only a handful of sessions. This allows it to fit into FSU’s counselling services model, which generally aims for a student’s treatment to last no more than one semester. That limit used to mean that students with trauma were referred to off-campus therapists for longer-term treatment. But now, in many cases, they can find relief from their sessions at the college counselling centre within the allotted time frame.

The treatment is in high demand, according to FSU counsellor Julia Coelho, and many students are already aware of EMDR before they show up for their first appointment.

“I’ve been here going on six years, and we have more students than ever who are requesting EMDR. They know what it is, they maybe heard someone talking about it and they’re calling us,” said Ms Coelho. “It’s really amazing when clients come and they’re ready to do the work.”

Viviana Urdaneta, chief of clinical affairs for the EMDR International Association and a former college clinician, said that many colleges had begun offering the treatment in recent years. Students liked it not only because it relieved PTSD symptoms relatively quickly, but also because it did not require them to do additional outside work, she noted.

“There is no homework, and that was a big draw for university students,” she said. “We want you to think about the trauma when you’re with me in the office, but when you’re not in sessions, your only job is to notice if there are changes. You don’t actually have to be doing journalling or a bunch of things.”

Beyond the counselling session

Offering treatments for trauma isn’t the only way counselling centres have adapted to the changing mental health landscape on campus. Trauma-informed care, a framework for providing a safe environment to people who have had traumatic experiences, dictates other elements of the counselling process, from the initial consultation to the layout of a centre's waiting room.

Western Carolina University’s Counseling and Psychological Services, which for the past several years has seen higher rates of students reporting trauma than the average college counselling centre, focuses on trauma awareness in its operations. Giving clients choices is an important element of trauma-informed care, since many traumatic events involve the victim feeling powerless, said Kim Gorman, associate vice chancellor for health and wellness. That means WCU’s counselling services offer a range of options, including a “menu” of treatment plans, the choice of virtual or in-person appointments, and even the ability to complete the intake form on paper or a tablet.

That element of choice, she said, “is one of those things we really thought deeply about – how can we implement that on all levels?”

WCU also reworked the lobby area of the counselling centre to remove a couch, which students sometimes avoided sitting on out of fear that they could be triggered by someone sitting close to them, Ms Gorman said.

Ms Coelho, of FSU, said that some principles of trauma-informed care come up in clinical sessions with virtually all students, such as respecting boundaries about what they may or may not want to share from their pasts.

“Forcing someone before they’re ready to talk about a traumatic experience is traumatic,” she said.

Trauma-informed care can reach beyond the counselling centre, as well; the pandemic drew attention to the concept of trauma-informed pedagogy, which calls upon professors to recognise that their students might have past traumas that affect their ability to succeed in class and to respond compassionately.

At WCU, clinicians from counselling services have worked with the campus’s recreation centre to offer trauma-informed yoga classes, which, according to a class description, work “to create a safer, supportive space in which students can learn emotional regulation skills through increased body awareness”. Another clinician is currently training to offer trauma-informed weight lifting.

College can be a fraught, stress-inducing time for many students learning to navigate a new environment and routine. But for those who have experienced trauma at home, it might be the first time they have been removed from that environment – which can be a major boon for the healing process.

“From a client’s side of things, coming into a centre, disclosing information that you’ve never shared with anyone and then hearing, ‘[You] could be noticing relief in some of your symptoms in a few weeks,’ instead of ‘[You] have to brace myself for years and years of therapy’ is empowering our students and helping them to feel better sooner,” Ms Coelho said.

This is an edited version of a story that first appeared on Inside Higher Ed.