Anxious students' demand for help leads to lesson on single-session therapy

When Meredith Henry began working at the University of New Brunswick in Saint John in 2006, she could counsel a student within a day or two.

Now, students are waiting up to six weeks to see Henry, one of two counselling therapists on campus.

"I've noticed a huge difference in students wanting to seek help, and be willing to come to counselling as part of their path to wellness," Henry said. "We can't keep up with the demand."

Even though our students are adults, they're heavily reliant on parents to push the obstacles out of their way before they have to deal with it.- Meredith Henry, psychologist

Students, already overwhelmed by heavy course loads, are now coming forward with concerns about relationship breakdowns, harassment, family illness, and feeling pushed too far.

They're losing sleep, and in more extreme cases, missing classes and dropping out.

"They're worried about jobs, what options are available to them when they finish school, about, what am I going to do with [this degree] and how is it going to support me for the life I have in mind," said Henry.

"They're working full-time jobs. We have older students, or students who are single parents and have a lot of responsibilities outside of school, so they're under a lot of pressure."​

Earlier this month, Henry joined educational counsellors from across Atlantic Canada for a two-day workshop in Saint John on single-session therapy, which supporters say could ease the caseload.

It was hosted by UNB Saint John and the New Brunswick Community College.

The therapeutic approach, led by Israeli-based psychologist Dr. Moshe Talmon, operates under the assumption that clients will only come to one appointment — either because they got enough out of that appointment, or they are too busy and burdened to return.

Under a longer, get-to-know-you approach, the first session would delve into a person's health and family history, with an expectation of future sessions tailored to problem-solving and reflection. 

But with the solution-focused model, counsellors get right to work on the issue at hand to make the most of that first meeting. And they offer advice about outside support and self-responsibility in case the person doesn't return.

No free time

Kris Trotter, a career and well-being counsellor in Saint John at the New Brunswick Community College, has been operating under this premise for a while.

"It's — how is this problem preventing you from being successful at school, and what are you willing to do about it?" said Trotter.

Most of the college students needing her assistance end up staying for one session.

"College students don't have free time Monday through Friday to come in for their counselling sessions," she said.

"So it's very frequent for me in the college setting that I see this person one time, meet them where they're at, give them some ideas, then say, 'OK, you're on your own, I'm here if you need me.'"

One session sufficient

The more condensed visits have given all students timelier access to therapy, Trotter said. If necessary, she can see a student that same day.

"We worry about waiting lists of course, so if we can work, if we can recognize that one session can be sufficient for many people, let's do our best at providing that," she said.

"A lot do come back, but if they don't, we know they have an action plan for what's going on. Now the profession is waking up to — how we can change from long-term, problem-focused, to brief, solution-focused stay-in-school therapy."

At UNB, Henry said a single-session framework could work for students who don't need to be seen that often, allowing her to fit more people in.

But issues of anxiety, depression, self-esteem and self-identity tend to require more exploration, she said.

And students dealing with a past sexual assault, trauma, or grief would need much more attention.

Lacking coping skills

Henry tends to see students four times on average.

"Single-session works well for students coming in already having some basic [coping] skills," she said.

Students who can do basic problem-solving and brainstorming can take an idea offered to them and run with it.

"But because of the way our society interacts, with more technology use, students don't seem to have the basic skills they used to have," she said. "They can't solve the problem in the way they used to be able to.

"Even though our students are adults, they're heavily reliant on parents to push the obstacles out of their way before they have to deal with it."

Sick frog in the pond

When Henry describes the stress levels of post-secondary students, she uses an analogy of a frog that gets sick in a pond: treat the frog and put it back in the water; but if it keeps getting sick, and if more frogs become sick, take a closer look at the pond.

A national study of post-secondary student health published in 2016 found 44 per cent of students — almost half — felt so depressed that it was difficult to function at some point within 12 months of being surveyed.

"That's a clinical level of depression," Henry said.

"Yet if you look at the same age group not in post-secondary, you're looking at rates of 15 per cent, so that's more than double in this [academic] environment.

Overwhelmed, exhausted, anxious

The survey also found that at some point within a 12-month timeframe, 89 per cent of students felt overwhelmed by all they had to do, 88 per cent felt exhausted, 64 per cent felt overwhelming anxiety, and 59 per cent felt things were hopeless.

"So there's a lot of pressure and that increases stress," Henry said. "We know stress is one of the main causes of physical and mental health illnesses. That's what we're seeing in our student population."

In general, only 10 per cent of a school population attend counselling sessions. In Saint John, perhaps because university students have more free time between classes, Henry said it's upwards of 20 per cent.

Many students are likely falling through the cracks, said Kelly Wilson, executive director of Family Enrichment and Counselling Services in Fredericton.

The practice offers a free walk-in clinic every Friday from 1 p.m. to 4 p.m.

Wilson said she isn't surprised to hear mental health issues are higher in student populations.

"These are the students who may not know who can help them or even how to find the proper resource."

Over the past six months, 15 to 20 per cent of the agency's clients have been between 16 and 24 years old.

Supplemental counselling

Wilson has been working with her counterparts at the college and university level to make students aware of supplemental counselling available in the community.

Cost is often a barrier for outside counselling, but Wilson said many students don't know they can use their benefits to get three sessions at Family Enrichment.

It's another option for students who grapple with mental health support, with no sign of the academic pond looking any healthier.

"Our students are dealing with more on their plate, and having more mental health concerns because of that," Henry said.

"I have to think it's because of our environment. So what can we as a university do to look at our structure, our whole system to make it easier for students?"