The School Counselor's Role in Student Mental Health
Share
Author(s): Wendy Rock, Ph.D.
September 1, 2022
A student who experiences frequent panic attacks comes to my office for support when her anxiety is bad. I have suggested an outside provider, but she and her mom only want her to work with me. Is it okay for me to continue to provide weekly individual counseling for her anxiety?
Today’s students are experiencing an increase in mental health concerns. Over the past two decades, there has been a steady increase in youth anxiety, depression, substance use and suicide, according to the CDC. As a school counselor, you have unique training and a key role in supporting student mental wellness. That’s not to say, however, that school counselors are the only ones responsible for helping students with their mental health concerns, especially when spending an excessive amount of time with one student leads to not having enough time to support all students.
What is the school counselor’s most appropriate role in addressing students’ mental health concerns?
School counselors work in three broad domains to enhance student learning and support postsecondary readiness: academic, career and social/emotional development. Social/emotional instruction, in particular, can promote protective factors that shield against mental health risks. In addition, school counselors work to support mental wellness on a continuum of care, or a tiered system, using evidence-based practices. Tier 1 services and interventions are intended for all students, are developmental in nature and are aimed at prevention. Some students with mental health risk factors might need Tier 2 interventions directed at specific concerns (e.g., divorce/separation, bullying, conflict resolution, emotional regulation, grief/loss). Tier 2 interventions may be proactive or reactive. The most intensive support is Tier 3. School counselors respond to students in crisis and participate in teams to provide wraparound services. However, students who need Tier 3 mental health counseling support are referred to another mental health practitioner in the school or the community for ongoing help.
A student with frequent panic attacks who comes to your office whenever she needs help would, most likely, need Tier 3 services, which in this case would be ongoing and therapeutic. Regardless of whether the student and parent say they only want to work with you, it’s unfair to the rest of your students for this practice to continue. Additionally, it’s a disservice to the student, as most school counselors aren’t trained to provide clinical or long-term therapeutic services.
Challenges and Solutions
In addition to their training to implement a comprehensive school counseling program, school counselors are trained to recognize developmental concerns and mental health risk factors and to provide counseling.
There are many reasons why school counselors might feel compelled to see students experiencing mental health challenges routinely, but it is important to perform duties within the school counselor’s scope and training. School counselors do not diagnose students and provide ongoing therapy for a variety of reasons. First and foremost, is the necessity to be available to all students throughout the school day. If ongoing therapy sessions were the expectation, school counselors would would spend a disproportionate amount of time on a very small subset of the student population. Additionally, the students who required therapeutic services would also be at a disservice when their school counselor would inevitably be pulled away during any number of situations that can occur during a normal school day. Thus, practicing within the framework of a comprehensive school counseling program is paramount.
As school counselors, we must lead, advocate and collaborate to promote equity and access for all students by implementing a comprehensive school counseling program. The ASCA Ethical Standards for School Counselors guide us in this work. Standard B.2.c reminds us to advocate for a school counseling program free of non-school-counseling duties, including “providing long-term counseling in schools to address psychological disorders.” The school counselor’s appropriate role in addressing student mental health concerns is through our school counseling program’s preventative and early intervention efforts and through referring students who need long-term counseling to outside resources.
The ASCA position statement The School Counselor and Student Mental Health speaks directly to the school counselor’s role in student mental health. As outlined in the position statement, school counselors:
Wendy Rock, Ed.D., is an assistant professor at Southeastern Louisiana University and chair of the ASCA Ethics Committee. Send your ethics questions to ethics@schoolcounselor.org.
Today’s students are experiencing an increase in mental health concerns. Over the past two decades, there has been a steady increase in youth anxiety, depression, substance use and suicide, according to the CDC. As a school counselor, you have unique training and a key role in supporting student mental wellness. That’s not to say, however, that school counselors are the only ones responsible for helping students with their mental health concerns, especially when spending an excessive amount of time with one student leads to not having enough time to support all students.
What is the school counselor’s most appropriate role in addressing students’ mental health concerns?
School counselors work in three broad domains to enhance student learning and support postsecondary readiness: academic, career and social/emotional development. Social/emotional instruction, in particular, can promote protective factors that shield against mental health risks. In addition, school counselors work to support mental wellness on a continuum of care, or a tiered system, using evidence-based practices. Tier 1 services and interventions are intended for all students, are developmental in nature and are aimed at prevention. Some students with mental health risk factors might need Tier 2 interventions directed at specific concerns (e.g., divorce/separation, bullying, conflict resolution, emotional regulation, grief/loss). Tier 2 interventions may be proactive or reactive. The most intensive support is Tier 3. School counselors respond to students in crisis and participate in teams to provide wraparound services. However, students who need Tier 3 mental health counseling support are referred to another mental health practitioner in the school or the community for ongoing help.
A student with frequent panic attacks who comes to your office whenever she needs help would, most likely, need Tier 3 services, which in this case would be ongoing and therapeutic. Regardless of whether the student and parent say they only want to work with you, it’s unfair to the rest of your students for this practice to continue. Additionally, it’s a disservice to the student, as most school counselors aren’t trained to provide clinical or long-term therapeutic services.
Challenges and Solutions
In addition to their training to implement a comprehensive school counseling program, school counselors are trained to recognize developmental concerns and mental health risk factors and to provide counseling.
There are many reasons why school counselors might feel compelled to see students experiencing mental health challenges routinely, but it is important to perform duties within the school counselor’s scope and training. School counselors do not diagnose students and provide ongoing therapy for a variety of reasons. First and foremost, is the necessity to be available to all students throughout the school day. If ongoing therapy sessions were the expectation, school counselors would would spend a disproportionate amount of time on a very small subset of the student population. Additionally, the students who required therapeutic services would also be at a disservice when their school counselor would inevitably be pulled away during any number of situations that can occur during a normal school day. Thus, practicing within the framework of a comprehensive school counseling program is paramount.
As school counselors, we must lead, advocate and collaborate to promote equity and access for all students by implementing a comprehensive school counseling program. The ASCA Ethical Standards for School Counselors guide us in this work. Standard B.2.c reminds us to advocate for a school counseling program free of non-school-counseling duties, including “providing long-term counseling in schools to address psychological disorders.” The school counselor’s appropriate role in addressing student mental health concerns is through our school counseling program’s preventative and early intervention efforts and through referring students who need long-term counseling to outside resources.
The ASCA position statement The School Counselor and Student Mental Health speaks directly to the school counselor’s role in student mental health. As outlined in the position statement, school counselors:
- Deliver instruction that proactively enhances awareness of mental health; promotes positive, healthy behaviors; and seeks to remove the stigma associated with mental health issues
- Provide students with appraisal and advisement addressing their academic, career and social/emotional needs
- Recognize mental health warning signs
- Provide short-term counseling and crisis intervention focused on mental health or situational concerns such as grief or difficult transitions
- Provide referrals to school and community resources that treat mental health issues (suicidal ideation, violence, abuse and depression) with the intent of removing barriers to learning and helping the student return to the classroom
- Educate teachers, administrators, families and community stakeholders about the mental health concerns of students, including recognition of the role environmental factors have in causing or exacerbating mental health issues, and provide resources and information
- Advocate, collaborate and coordinate with school and community stakeholders to meet the needs of the whole child and to ensure students and their families have access to mental health services
- Recognize and address barriers to accessing mental health services and the associated stigma, including cultural beliefs and linguistic impediments
- Adhere to appropriate guidelines regarding confidentiality, the distinction between public and private information and consultation
- Help identify and address students’ mental health issues
- Seek to continually update their professional knowledge regarding the students’ social/emotional needs, including best practices in universal screening for mental health risk
- Advocate for ethical use of valid and reliable universal screening instruments with concerns for cultural sensitivity and bias if state legislation or school board policy requires universal screening programs for mental health risk factors
Wendy Rock, Ed.D., is an assistant professor at Southeastern Louisiana University and chair of the ASCA Ethics Committee. Send your ethics questions to ethics@schoolcounselor.org.