MentalIllnessandtheSchoolCounselor1

MentalIllnessandtheSchoolCounselor
Mentalillnessandmentaldisorderssurroundmanyindividualsandfamiliesalloverthe
world.IntheUnitedStatesaloneoneinfouradultsapproximately57.7millionAmericans
experienceamentalhealthdisorderinagivenyear(NAMI,2006).Onein17liveswitha
seriousmentalillnesssuchasschizophrenia,majordepression,orbipolardisorder,andabout1
in10childrenlivewithaseriousmentaldisorder(NAMI,2006).Someofthemajorknown
mentalillness/disordersare:anxietydisorders,autismspectrumdisorders,ADHD,ADD,
bipolar,borderlinepersonalitydisorder,depression,dissociativedisorders,eatingdisorders,
selfinjury,obsessivecompulsivedisorder,panicdisorder,PTSD,schizophrenia,schizoaffective
disorder,andtourette's.(ThesemajormentalillnessescanbeseeninTable2identifying
definitions,symptoms,andtreatments).
Itisimportanttolookatmentalillnessbecauseofthewayitdisruptsaperson'swayof
thinking,feeling,abilitytorelatetoothers,anddailyfunctioning(NAMI,2013).Justas
diabetesisadisorderofthepancreas,mentalillnessesaremedicalconditionsthatoftenresultin
adiminishedcapacityforcopingwiththeordinarydemandsoflife(NAMI,2013).Mental
illnessesshouldbetakenseriouslyasanyotherformofmedicaldiagnosis.Afterall,itaffects
manypeopleeveryday.Mentalillnessdoesnotdiscriminate.Itcanaffectanyage,race,
religion,income,upbringing,andeducationlevel(NAMI,2013).Thankfully,mentalillnesses
aretreatable.Withknowledge,treatment,andpreventiontechniquesmentalillnesscanbe
managed.
Autismandselfinjuryareamongmanymentalillness/disordersthatarearisingconcern
formanyadolescents,parents,communities,andschoolpersonnel.Schoolcounselorscanbean

MentalIllnessandtheSchoolCounselor2

importantassettoadolescencedealingwithbothautismandselfinjury.Schoolcounselorscan
helpwhenitcomestoresources,recognition,prevention,andinterventions.Thereisagrowing
numberofstudentspresentingthemselveswithmentaldisordersandmentalillnessthatare
capturingtheheartsandattentionofmanyschools.
AutismSpectrumDisorders
OneoftheimportantmentaldisorderstolookatandknowmoreaboutisthePervasive
DevelopmentalDisordersandAutismSpectrumDisorders.Thetermpervasivedevelopmental
disorders,alsoknownasPDDs,referstoconditionsthatdelaydevelopment(WebMD).Some
ofthesedevelopmentaldelaysareseenthroughsocialization,communication,andtheuseof
imagination(WebMD).Childrenwiththeseconditionsareoftenconfusedintheirthinkingand
generallyhaveproblemsunderstandingtheworldaroundthem(WebMD).WebMDlistsfive
typesofpervasivedevelopmentaldisorders:autism,asperger'ssyndrome,childhood
disintegrativedisorder,Rettssyndrome,andpervasivedevelopmentaldisordernototherwise
specified.
Whilesometimescalledpervasivedevelopmentaldisordersaslistedabove,itcanalsobe
calledAutismSpectrumDisorder.Thetermspectrumlooksatthewiderangeofsymptoms,
skills,anddisabilitythatchildrenwithASDmayhave(NIMH).Somechildrenmayhavemild
disabilitieswhileothersareseverelydisabledbyASD.(Therearemanysignsandsymptoms
listedinTable2aswellastreatment,services,andsupportagencies).
AutismSpectrumDisorders,affectthedevelopmentofbrainfunction.Thiscanaffecta
childsabilitythroughsignsofimpairedsocialinteraction,verbalandnonverbalcommunication,
andunusualactivitiesandinterestlevels(NAMI,2013).Thesesignsareoftennoticedwhenthe

MentalIllnessandtheSchoolCounselor3

childisyoungandearlyinterventionishelpful.WhilethereisunfortunatelynocureforASD,it
isthroughearlyinterventionsthatcanhavethemostpositiveeffectsandreduceundesirable
behaviors(2013).
Causes
AutismSpectrumDisordersareextremelycomplex,andsofartherehasbeennoknown
directcauseofASD.ResearchersdobelievethatASDsaremostlikelyacombinationof
geneticandenvironmentalfactors.StudiesofpeoplewithwithASDshavefound
abnormalitiesinseveralregionsofthebrain,includingthecerebellum,amygdala,hippocampus,
septum,andmamillarybodies.Neuronsintheseregionsappearsmallerthannormalandhave
stuntednervefibers,whichmayinterferewithnervesignaling(NAMI,2013).Sofromwhen
infantsarestillinthewombitisthoughtthatthesebraindevelopmentstakeplace.Someother
studieshavefoundthatsomepeoplemayhaveageneticpredispositiontoASDs(2013).
Demographics
Autismoccursinallsocioeconomicclasses.Boysareaffectedfourtofivetimesmore
thangirls.AccordingtotheU.S.DepartmentofEducation,duringtheschoolyearof19961997,
34,101studentsages6to21receivedspecialeducationservicesundertheIDEAcategoryof
Autism(Nielsen,2009,pg.66).In2007,theAutismSocietyofAmericastatedthatautism
occuredin1ofevery150births(Nielsen,2009).ASDsareagainofaspectrum,whichisthat
individualshaveASDstovaryingdegrees.ASDsdonotdiscriminateagainstrace,ethnic,or
socialbackgrounds.
Diagnosis
WhenachildisdiagnosedwithanASDtheyarenotfollowingthetypicalpatternsof

MentalIllnessandtheSchoolCounselor4

childdevelopment(NAMI,2013).Signsandsymptomscanarisefrombirthormayoccurlater
inagewhensocialskillsbecomemorenoticeable.Someparentsreportthechangesuddenand
thattheirchildrenstarttorejectpeople,actstrangely,loselanguageandsocialskillstheymay
havepreviouslyacquired(NAMI,2013).Insummary,childrendonotoutgrowASD,but
studiesshowthatearlydiagnosisandinterventionleadtosignificantlyimprovedoutcomes.
Signstolookforinclude(pleasealsorefertoTable2):
Lackofordelayinspokenlanguage(doesnotbabble,point,ormakemeaningful
gesturesbyoneyeardoesnotspeakonewordby16monthsdoesnotcombinetwo
wordsbytwoyearsdoesnotrespondtonameorloseslanguageorsocialskill)
Repetitiveuseoflanguageand/ormotormannerisms(e.g.,handflapping,twirling
objects)
Littleornoeyecontact
Lackofinterestinpeerrelationships
Lackofspontaneousormakebelieveplay
Persistentfixationonpartsofobjects
Doesnotsmile(NAMI,2013).
SelfInjury
Therearemanydifferenttermsanddefinitionsusedtodefineindividualswhoharm
themselvesintentionally.Sometermsincludeselfmutilation,selfinjury,deliberateselfharm,
parasuicidalbehavior,andselfwounding,tonamejustafew(Lukomski,Flomer,2004).Self
mutilativebehaviorreferstothedirectanddeliberatedestructionsofonesownbodywithout
suicidalintent(Shapiro,2008).Thisdefinitionisaccuratebecausesincetherearesomanyforms
ofselfmutilationitremainsopenandrespectfulofalloftheseforms.Anotherdefinitionstates,
Selfinjuryconsistsofselfinflicteddeliberatelydestructiveactsresultingintissuedamagethat
arenotintendedasanactofsuicide,arenotwidelysociallyacceptable,andarenotduetomental
retardation,autism,orotherdevelopmentaldisorders(Dorko,2012).Thevariousmethods
includethefollowing:abrading,biting,burning,bruising,constricting,cutting,hitting,gouging,

MentalIllnessandtheSchoolCounselor5

inhaling,picking,scalding,scratching,stabbing,andsevering(Shapiro,2008).Oftheseforms
cuttingisthemostcommonformofselfmutilationthatprofessionalsseetoday.Therearealso
varioustoolsusedtopartakeinselfmutilationsuchascigarettes,fingernails,paperclips,razor
blades,scissors,andteeth(Shapiro,2008).

Selfinjuryisusuallyperformedonthearms,wrists,andlegs,butthebreasts,thighs,
stomach,andgenitalsarealsositeswherepeopleselfinjure(Conterioetal.,1998).Mostpeople
whoselfinjurehidetheirinjuries(e.g.,wearinglongsleevedpantsorshirtsevenonawarmday
Conterioetal.)andtheywillavoidinjuringthemselvesinthepresenceofotherpeople(Gallop,
2002).Itisimportanttonotethatthereisanimmediate,butnotpermanentdamagedonetothe
body.Selfmutilationisusuallyarepetitivebehavior.Withitsmanydefinitionsandformsbeing
usedselfmutilationisabehaviorthatisdoneinordertorelieveemotionalstress.Whenpeople
taketheradicalstepofharmingtheirbodies,theyshouldbetakenseriouslyandthesourcesof
theirstressaddressed(Walsh,pg.38,2006).
Causes
Therearemanycontributingfactorsthatmayleadtoselfinjury.Itisimpossibleto
pinpointtheexactcauseofselfmutilationbecauseitcanbefromanumberoffactorsinone's
life.Selfmutilationisacomplexbehaviorthatresultsfromavarietyoffactors.Adolescents
oftenhavedifficultytalkingabouttheirfeelingsandinsteadbegintoshowemotionaltension,
physicaldiscomfort,pain,andlowselfesteem(AmericanAcademyofChildandAdolescent
Psychiatry,2009).Althoughsometeenagersmayfeellikethesteaminthepressurecookerhas
beenreleasedfollowingtheactofharmingthemselves,othersmayfeelhurt,anger,fear,and
hate(AmericanAcademyofChildandAdolescentPsychiatry,pg.1,2009).Itisnotclearwhy

MentalIllnessandtheSchoolCounselor6

selfmutilationseemstoworksowelltoachievesuchfeelingsandcures,butscholarshave
theoriesthatitmayhavetodowiththechemicalsthatmaybeproducedbythebodyasa
responsetoinjuryoranticipatedinjury.Ifthisisthecasethenonecanviewselfmutilationasa
formofselfmedication(Nock&Prinstein,2005).
Amajorityofthecausescomefromdealingwithstress,childhoodhistorywithabuse,
mentaldisorders,andsocialmodeling.Sinceselfmutilationisanegativecopingpatternifitis
notdealtwithitcancontinueonintoadulthood.Alotofitsnegativecopingskillshavetodo
withnotbeingabletoappropriatelydealwithstress.Childrenwithahistoryofabuse,sexual
abuseespecially,isoneoftheleadingcausesofselfmutilationbecausethesechildrendonot
havetheskillstodealwiththepowerfulemotionsthatcomealongwithsuchtraumaticevents
(Shapiro,2008).Withafamilyhistoryofalcoholabuse,drugabuse,orotherpopular
selfdestructingbehaviorsputschildrenatriskforalsodevelopingpoorcopingskillswhich
couldcauseselfmutilation.Selfmutilationcanalsooccurwithmentaldisorderssuchas
anorexia,anxiety,depression,obsessivecompulsivedisorder,borderlinepersonalitydisorder,
andothermajorpsychiatricdisorders(Shapiro,pg.126,2008).Lastly,socialmodelingplays
alsoplaysamajorroleinselfmutilation.Eightyonepercentoftheadolescentsstudiesreported
havingafriendwhoalsohadanincidentofselfinjuryinthelast12months(Shapiro,pg.126,
2008).Theinternetcreatesanotherformofsocialmodelingorcamaraderieforselfinjurers
thatmayencouragethosestartingselfmutilationortocontinuetheirbehavior
(www.educatiorsandselfinjury.com).
Demographics

Selfmutilationdoesnotdiscriminate.Thereisnosingleselfinjurerprofile.Statistics

MentalIllnessandtheSchoolCounselor7

andstudiesshowthatselfinjuryislargelyanadolescentphenomenon.Thereisbroadagreement
thattheaverageageofonsetis1416,butitisalsotruethatindividualscanbegininjuringin
childhoodandadulthood.Atleasttwocollegestudiesshowthataboutaquarterofthose
reportingselfinjurystartedinthecollegeyears(Jacobson&Gould,2007Whitlock,
Muehlenkamp,etal.,2009).

Whenitcomestogenderstudiesandselfmutilationstudiesaremixed.Moststudies
showthatitiswidelymorecommonamongfemaleswhileotherstudiesarguethatitisprevalent
inmalestoo.Itiswidelyagreed,though,thatselfinjuryismuchmorevisibleamongfemales
thanamongmales(Whitlock,Muehlenkamp,etal.,2009).Therehavebeenfewstudiesof
socioeconomicstatusandselfinjury,butsofartherehavebeenfewsignificantdifferences
shown(Jacobson&Gould,2007).Oneofthemaindemographicsthatcanbesignificantly
linkedtoselfmutilationisthatofsexualorientation.Youthwhoidentifythemselvesare
bisexualorevenquestioningtheirsexualityhavebeenshowntobeatsignificantlyelevatedrisk
forselfmutilationcomparedtotheirheterosexualpeers(actforyouth.net).
Purpose
NockandPrinsteinhavedevelopedamodelthatproposesfourprimaryfunctionsofself
mutilation.Thesefunctionsare:1.tostopbadfeelings,2.tofeelsomething(evenifitispain),
3.toavoidsomethingthatisunpleasant,and4.togetattention(2005).Thismodelrepresents
howmanyfeelandthereasoningbehindtheirpurposetoparticipateinselfmutilation.Self
mutilationoffersindividualsawaytodealwithnegativefeelingsandputthemtowardstheself
whichisone'swayofcopingwiththestressorsoflife.Thistheoryseemstosupportmanyother
theoriesinsayingthatthemotivationbehindselfmutilationisawaytobeemotionallystable

MentalIllnessandtheSchoolCounselor8

(Lukomski,Folmer,2004).Cuttersdescribeanincreasingfeelingoftension,which
immediatelydiminishesafteroftheactofselfmutilation.Inmostcasestheselfmutilationactis
notmotivatedbyinterpersonalmanipulation,butratherbytheindividualsattempttomanage
themselves(Lukomski,Folmer,pg.92,2004).
Itisimportanttoremembertopurposeofselfmutilationandsuicide.Thegoaland
purposeofthosewhoselfmutilateisdifferentthanthosedealingwithsuicide.Thedifferenceis
this:Thegoalsistoendemotionalpainbyendinglife.Conversely,selfinjuriousbehavioris
aimedatcopingandmanaginglife,notendingit(Shapiro,pg.126,2008).Selfmutilationis
notrelatedtosuicide.Rarelydoesthepersonwhoselfmutilatesreportsuicideideationorgive
anykindofearlywarningsignsorevenverbalwarningofhisbehavior(Lukomski,Folmer,
2004).
MentalIllness/DisorderandtheSchoolCounselor
AccordingtotheNationalAllianceonMentalIllness,Mentalillnessisamedical
conditionthatdisruptsapersonsthinking,feeling,mood,abilitytorelatetoothersanddaily
functioning(2006).Mentalillness/disordersisamajorpartofthelivesofmanystudents,
parents,andthecommunity.Asschoolcounselorsitisimportantthatweknowandlearnabout
mentalillnessandmentaldisordersbecausewearetosupportalltypesofstudentsandtheir
needs.Schoolcounselingisusuallytoaddressprevention,intervention,anddevelopmental
concerns,assistwithmilddisordersineducationalordevelopmentalsettings,andengage
studentsindealingwithpersonal,social,emotional,career,andeducationaldecisionsand
behaviors(Dahir,Stone,2012,pg.32).Whenover50percentofstudentswithamental
disorderage14andolderdropoutofhighschool(NAMI,2006),thenwemightwanttostartto

MentalIllnessandtheSchoolCounselor9

payattentiontoatopicthataffectssomanystudents.
Theschoolcounselorhasmanyrolesandoneistobeknowledgeableandskilledin
workingwithstudentswhomaybestrugglingwithdevelopmentalormentalhealthissues
(schoolcounselor.org).Allschoolcounselorsshoulddevelopaschoolcounselingprogramthat
offerseducation,prevention,andinterventionservicestopromotepositivementalhealth.
AccordingtotheASCA,Professionalschoolcounselorsshould:
Provideresponsiveservicesincludinginternalandexternalreferralprocedures,
shorttermcounselingorcrisisinterventionfocusedonmentalhealthorsituational(e.g.
grief,difficulttransitions)concernswiththeintentofhelpingthestudentreturntothe
classroomandremovingbarrierstolearning
Delivertheguidancecurriculumwhichenhancesawarenessofmentalhealthpromotes
positive,healthybehaviorsandseekstoremovethestigmaassociatedwithmentalhealth
issues.
Provideindividualplanningwithstudentsthataddressestheiracademic,careerand
personalsocial(includingmentalhealth)needs
Educateteachers,administrators,parents/guardians,andcommunitystakeholdersabout
thementalhealthconcernsofstudents,includingrecognitionoftheroleenvironmental
factorshaveincausingorexacerbatingmentalhealthissues
Advocateandcollaboratewithschoolandcommunitystakeholderstoensurethat
studentsandtheirfamilieshaveaccesstomentalhealthservices(schoolcounselor.org).

Sincestudentswithmentaldisordershavemanybarriersthatschoolcounselorsshouldbe
awareoftheselearninganddevelopmentaldisabilities.Whileschoolcounselorsdonotprovide
longtermtherapytheschoolcounselingprogramshouldmeettheneedsofallstudents.Itis
importanttoalwaysworkwithotherprofessionalsandresourcesinthecommunitytoassistwith
studentmentalhealthandwellness.
Conclusion
SelfinjuryandASDarenotexactlyanewphenomenon,butisbecomingmoreandmore
evidentinschools.Whatisnewisthegrowingtrendofselfinjuriousbehavioramong

MentalIllnessandtheSchoolCounselor10

adolescents(Shapiro,2008)andthatthenumberofpeoplewithAutismcouldreach4million
Americansinthenextdecade(Nielsen,2009).Whilewemaynotknowthepurposeorreason
forAutismitaffectsourchildrenandthosewhoworkandlivewiththem.Throughknowledge,
resources(pleaserefertoTable1forAutismandSelfInjuryresources),andrecognitionschools
andschoolcounselorsareabletohelpcommunitiesandstudentswithAutism.Thepurposeof
selfmutilationisoftentomakethestudentfeelbetterbecauseofemotionalpain.Withthe
currenttrendofselfinjuriesontheriseitisnowonderthatschoolnurses,counselors,and
administratorsareseekingmoreinformation.Theyneedinformationanddirectionthatwill
leadtoearlydetectionandtreatmentforthosewhoselfinjure(Shapiro,pg,125,2008).School
counselorsareavaluableresourcewhenitcomestoselfinjuryandAutism,andthereforehaving
aprograminplacethatwillhelptheschoolcounselortaketherightstepstowardsprevention,
treatment,andeducationalawarenessabouttheissueisimportant.

References

AmericanAcademyChildandAdolescentPsychiatry.(2009).
FactsforFamilies.SelfInjuryin
Adolescents.
No.73.Retrievedfrom:www/aacap.org.

Author(2006).
WhatismentalIllness?
NationalAllianceonMentalIllness.Retrievedfrom

MentalIllnessandtheSchoolCounselor11

http://www.nami.org

ASCA(2009)TheProfessionalSchoolCounselorandMentalHealth.Retrievedfrom:
http://www.schoolcounselor.org/asca/media/asca/PositionStatements/PS_Student
MentalHealth.pdf

AutismSpeaks.(2013).ResourceLibrary.Retrievedfrom:
http://www.autismspeaks.org/familyservices/resourcelibrary

Conterio,K.,&Lader,W.(1998).
Bodilyharm:Thebreakthroughtreatmentprogramfor
selfinjurers.
NewYork:HyperionPress.

Dahir,C.A.andStone,C.B.(2012).TheTransformedSchoolCounselor(2nded).Belmont,CA:
Brooks/ColeCengageLearning.

Dorko,L.A.(2012).
Educators&SelfInjuryHowtorecognize,understand,andrespondtoself
injury.
Retrievedfrom:educatorsandselfinjury.com

Gallop,R.(2002).
Failureofthecapacityforselfsoothinginwomenwhohaveahistoryof
abuseandselfharm.
JournaloftheAmericanPsychiatricNursesAssociation
,8,
2026.

MentalIllnessandtheSchoolCounselor12

Jacobson,C.M.,&Gould,M.(2007).
Theepidemiologyandphenomenologyofnonsuicidal
selfinjuriousbehavioramongadolescents:Acriticalreviewoftheliterature.
ArchivesofSuicideResearch,11(2),
129147.

Lukomski,J.FolmerT.(2004).
SelfMutilation:InformationandGuidanceforSchool
Personnel.

NationalInstituteofMentalHealth.(2013).AutismSpectrumDisorders.Retrievedfrom:
http://www.nimh.nih.gov/health/topics/autismspectrumdisorderspervasivedeve
lopmentaldisorders/index.shtml

Nielsen,L.B.(2009).BriefReferenceofStudentDisabilities....withStrategiesforthe
Classroom.SecondEdition.ThousandOaks,CA:CorwinPressASAGE
Company.

Nock,M.KPrinstein,M.J.(2005).
ContextualFeaturesandBehavioralFunctionsof
SelfMutilationAmongAdolescents.
JournalofAbnormalPsychology,114,
140146.

Shapiro,S.(2008).
AddressingSelfInjuryintheSchoolSetting.
TheJournalofSchoolNursing
V24,N3.retrievedfrom:
http://allenpress.com/pdf/scnu_24_305_124_130.pdf

MentalIllnessandtheSchoolCounselor13

Walsh,B.(2006).
TreatingSelfInjury.
NewYork,NY:GuilfordPress.

WebMD(2013).PervasiveDevelopmentalDisordersPDDs.Retrievedfrom:
http://www.webmd.com/brain/autism/developmentdisorder

Whitlock,J.,Muehlenkamp,J.,Purington,A.,Eckenrode,J.,Barreira,J.,BaralAbrahms,G.,
Marchell,T.,Kress,K.,Girard,K.,Chin,C.,&Knox,K.(2009).
Primaryand
SecondaryNonSuicidalSelfInjuryCharacteristicsinaCollegePopulation:
GeneralTrendsandGenderDifferences.
Manuscriptsubmittedforpublication.

Appendix A
Table 1: Resources for Autism and Self-Injury

MentalIllnessandtheSchoolCounselor14

Resources for Autism

Resources for Self-Injury

AspergerSyndrome
http://www.autismspeaks.org/familyservices/resourceli
brary/aspergersyndrome

Technology
http://www.autismspeaks.org/familyservices/resourceli
brary/assistivetechnology

AutismApps
http://www.autismspeaks.org/autismapps

AutismInfo
http://www.autismspeaks.org/familyservices/resourceli
brary/generalautismtreatmentinformation

Blogs
http://www.autismspeaks.org/familyservices/resourceli
brary/blogs

Books
http://www.autismspeaks.org/familyservices/resourceli
brary/books

DietandNutirtion
http://www.autismspeaks.org/familyservices/resourceli
brary/dietnutrition

Films
http://www.autismspeaks.org/familyservices/resourceli
brary/filmsanddocumentaries

MagazinesandNewsletters
http://www.autismspeaks.org/familyservices/resourceli
brary/magazinesnewsletters

OnlineLearningTools
http://www.autismspeaks.org/familyservices/resourceli
brary/onlinelearningtoolssoftware

Organizations
http://www.autismspeaks.org/familyservices/resourceli
brary/otherautismorganizations

SafetyProducts
http://www.autismspeaks.org/familyservices/resourceli
brary/safetyproducts

SpanishMaterials
http://www.autismspeaks.org/familyservices/resourceli

Websites:
AboutSelfHarm:WhyYouSelfHarmandHowto
SeekHelp

http://www.mind.org.uk/help/diagnoses_and_conditions/
about_selfharm_a_guide_for_young_people
MentalHealth
TheTruthAboutSelfHarm
(PDF)
http://www.mentalhealth.org.uk/content/assets/PDF/publ
ications/truth_about_self_harm.pd
TeensHealth
Cutting

http://kidshealth.org/teen/your_mind/mental_health/cutti
ng.html
RoyalCollegeofPsychiatrists
http://www.rcpsych.ac.uk/mentalhealthinfoforall/proble
ms/depression/selfharm.aspx
U.S.DepartmentofVeteransAffairs
SelfHarmand
Trauma:ResearchFindings

http://www.ptsd.va.gov/professional/pages/selfharmtra
uma.asp
SelfInjury.net
HowtoStopHurtingYourself

http://selfinjury.net/print/18168
ScarTissue
http://www.scartissue.net/stopping.htm
Psyke.org
http://www.psyke.org/coping/coping_skills/
S.A.F.E.Alternatives(SelfAbuseFinallyEnds)
http://www.selfinjury.com/
1800334HELPSelfInjuryFoundations24hour
nationalcrisisline.

Books:
Nixon,M.K.,&Heath,N.L.(2009).
Selfinjuryin
youth:Theessentialguidetoassessmentand

MentalIllnessandtheSchoolCounselor15

brary/materialenespa%C3%B1ol

ToolsforProfessionals
http://www.autismspeaks.org/familyservices/resourceli
brary/toolsprofessionals

ToysandGames
http://www.autismspeaks.org/familyservices/resourceli
brary/toysgames

VideoTools
http://www.autismspeaks.org/familyservices/resourceli
brary/videotoolsdvds

Websitesforfamilies
http://www.autismspeaks.org/familyservices/resourceli
brary/websitesfamilies

OrganizationsandAgencies

TheAmericanAcademyofPediatrics
www.aap.org

AutismResearchInstitute(ARI)

AutismSocietyofAmerica
www.autismsociety.org

CouncilforExceptionalChildren(CEC)
www.cec.sped.org

IndianaResourceCenterforAutism
www.iidc.indiana.edu/irca

NationalAutismAssociation
877NAAAutism

NationalInstituteofMentalHealth
www.nimh.nih.giv

intervention
.NewYork,NY:Taylor&FrancisGroup.
Gratz,K.L.,&Chapman,A.L.(2009).
Freedomfrom
selfharm:OvercomingselfinjurywithskillsfromDBT
andothertreatments.
Oakland,CA:NewHarbinger
Publications.
Nock,M.K.(2009).
Understandingnonsuicidal
selfinjury:Origins,assessment,andtreatment.
Washington,DC:AmericanPsychologicalAssociation.
Schmidt,U.,&Davidson,K.(2004).
Lifeafter
selfharm:Aguidetothefuture
.NewYork:
BrunnerRoutledge.
Hollander,M.(2008).
Helpingteenswhocut:
Understandingandendingselfinjury.
NewYork,NY:
GuilfordPress.
Conterio,K.,Lader,W.,&Bloom,J.K.(1998).
Bodily
Harm:TheBreakthroughHealingProgramfor
SelfInjurers.
NewYork:HyperionInc.
Heath,N.L.,Toste,J.R.,Sornberger,M.J.,&Wagner,
C.(2011).Teachersperceptionsofnonsuicidal
selfinjuryintheschools.
SchoolMentalHealth,3,
3543.
Lewis,S.P.,Heath,N.L.,StDenis.,J.M.,&Noble,R.
(2011).Thescopeofnonsuicidalselfinjuryon
YouTube.
Pediatrics,127,
552557.
Toste,J.R.&Heath,N.L.(2010).Schoolresponseto
nonsuicidalselfinjury.
ThePreventionResearcher,17,
1417.
WhiteKress,V.E.,Gibson,D.M.,&Reynolds,C.A.
(2004).Adolescentswhoselfinjure:Implicationsand
strategiesforschoolcounselors.
ProfessionalSchool
Counselling,7,
195201.

Articles:
YouTubeSelfMutilationVideosShockParents,
Therapists
CBSNews,February22,2011
AfterAbuse,ChangesintheBrain
TheNewYorkTimes
,February23,2009
'Cutters'LearnHowtoHealTheirScars
LosAngelesTimes
,April6,2002

MentalIllnessandtheSchoolCounselor16

CuttingSignalsNeedforEmotionalHelp
ABCNews
,March16,2001
SelfInjuryNoLongerRareAmongTeens
WebMDMedicalNews
,November21,2000
SelfInjuryPoorlyUnderstoodProblem
CNN
,September5,2000
SelfInjuriousBehaviorinChildren&Adolescents:
NowWhat?TheTreatmentofSIB
Healing
,Fall/Winter1998
SelfInflictedViolence:HelpingThoseWhoHurt
Themselves
SelfHelpandPsychology
,May21,1998
SelfInjuriousBehaviorinChildren&Adolescents:
WhatisSIB?
Healing
,Spring/Summer1998
SelfInjuryInAdolescents
FactsheetfromtheAmericanAcademyofChild&
AdolescentPsychiatry.

AppendixB
Table2:MajorMentalIllnesses

MentalIllness/Disorder

DescriptionIncluding
SignsandSymptoms

Treatment,Services,Support
Agencies

AnxietyDisorders

Thisdisorderinvolvesexcessive,

Whentreatingpanic/anxietydisorders

MentalIllnessandtheSchoolCounselor17

unrealisticworryandtension,evenif
thereislittleornothingtoprovoke
theanxiety(UniversityofMaryland
MedicalCenter,2013).
PanicDisorder/AnxietyDisorders
Symptoms:
Overwhelmingfeelingsofpanicand
fear
Uncontrollableobsessivethoughts
Painful,intrusivememories
Recurringnightmares
Trembling,Shortnessofbreath,
Rapidheartbeat
Drymouth,Dizziness,Nausea,
Irritability

withtherapy,onestandardapproachistalk
therapy,suchascognitivebehavioral
therapy(CBT)(Capuzzi&Gross,2011).
Capuzzi&Gross(2011)goesonto
articulatethatbehavioralinterventions
focusprimarilyonchangingspecific
behaviorshowever,cognitive
interventionsfocusontheroleof
cognitionsinthelifeofclients.
Cognitivebehavioraltherapieshavebeen
developedandusedwithclientwitha
widerangeofclinicalproblems.
National
StressutWeek2013:Nov.
1016.11/4/2013.
National
Stress
NIMH
AnxietyDisorders

National
InstitutesofHealth

NationalAnxietyDisorders
Organizations
Network|Reconnexion

Inabilitytoconcentrate

www.reconnexion.org.au/nationalanxiety
disorders.../w1/i1028003/

Physicalsymptomssuchasfeeling
sicktothestomach,butterflies,heart
pounding,startlingeasily,and
muscletension:

Anxietydisorders
|UniversityofMaryland
MedicalCenter
umm.edu/health/medical/reports/articles/a
nxietydisorders

MentalHealth|Health
Services

UniversityofNewHampshire
www.unh.edu/healthservices/services/me
ntalhealth
National
Programs&
Services
UTHarris
CountyPsychiatricCenter
hcpc.uth.tmc.edu/pages/help/nationalhelp.
htm
TheInstituteofLiving
AnxietyDisorders
Center
www.harthosp.org/instituteofliving/anxiet
ydisorderscenter/.../default.asp..
TheSubstanceAbuse&MentalHealth
ServicesAdministration(SAMHSA)
OfficeofCommunications
ParkLawnBuilding,Room13C05
(301)4438956

MentalIllnessandtheSchoolCounselor18

PanicAttacks
and
PanicDisorder

WrightCenterforWomen'sHealth
thewrightobgyn.com/womenshealthview/
?DOCHWID=hw53796

NIMH
PanicDisorder
Beachside
Therapy
&AssessmentCenter
www.beachsidetherapy.com/pdf/NIMH_
Panic_Disorder_Pamphlet.pdf

Attention
Deficit/Hyperactivity
Disorder(ADD/ADHD)

Difficultypayingattention
Frequentlydaydreaming
Difficultyfollowing
throughoninstructions
andapparentlynot
listening
Frequentlyhasproblems
organizingtasksor
activities
Frequentlyforgetfuland
losesneededitems,suchas
books,pencilsortoys
Frequentlyfailstofinish
schoolwork,choresor
othertasks
Easilydistracted
Frequentlyfidgetsor
squirms
Difficultyremaining
seatedandseemlyin
constantmotion
Excessivelytalkative
Frequentlyinterruptsor
intrudesonothers'
conversationsorgames
Frequentlyhastrouble
waitingforhisorherturn

Medication,varioustypesof
psychotherapy,educationand
training,oracombinationof
treatments.
Stimulantssuchas
methylphenidateand
amphetaminesarethemost
commontypeofmedication
usedfortreatingADHD.
Behavioraltherapyaimstohelp
achildchangehisorher
behavior.
SmartKidswithLearningDisabilities
http://www.smartkidswithld.org/

RedWigglerFarmCommunity
http://www.redwiggler.org/

ADDitude
http://www.additudemag.com/

HealthyPlace
http://www.healthyplace.com/adhd/

KidsHelp
http://kidshealth.org/parent/growth/learnin
g/

AutismSpectrumDisorders

Symptomsofautismspectrum
disorder(ASD)varyfromonechild
tothenext,butingeneral,theyfall
intothreeareas:
Social
impairment
Communication
difficulties
Repetitiveand
stereotyped
behaviors
(NIMH).

Whilethere'snoprovencureyetfor
autismspectrumdisorder(ASD),treating
ASDearly,usingschoolbasedprograms,
andgettingpropermedicalcarecan
greatlyreduceASDsymptomsand
increaseyourchild'sabilitytogrowand
learnnewskills.
Thereisnosinglebesttreatmentforall
childrenwithASD,buttheAmerican
AcademyofPediatricsrecentlynoted
commonfeaturesofeffectiveearly
interventionprograms.Theseinclude:

MentalIllnessandtheSchoolCounselor19

Startingassoonasa
childhasbeen
diagnosedwithASD
Providingfocusedand
challenginglearning
activitiesattheproper
developmentallevelfor
thechildforatleast25
hoursperweekand12
monthsperyear
Havingsmallclassesto
alloweachchildto
haveoneononetime
withthetherapistor
teacherandsmallgroup
learningactivities
Havingspecialtraining
forparentsandfamily
Encouragingactivities
thatincludetypically
developingchildren,as
longassuchactivities
helpmeetaspecific
learninggoal
Measuringand
recordingeachchild's
progressandadjusting
theintervention
programasneeded
Providingahighdegree
ofstructure,routine,
andvisualcues,suchas
postedactivity
schedulesandclearly
definedboundaries,to
reducedistractions
Guidingthechildin
adaptinglearnedskills
tonewsituationsand
settingsand
maintaininglearned
skills
ResourcesfromAutismSpeaks:

AspergerSyndrome
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/aspergersyndrome
Technology

MentalIllnessandtheSchoolCounselor20

http://www.autismspeaks.org/familyservi
ces/resourcelibrary/assistivetechnology

AutismApps
http://www.autismspeaks.org/autismapps

AutismInfo
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/generalautismtreatm
entinformation
Blogs
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/blogs
Books
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/books
DietandNutirtion
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/dietnutrition
Films
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/filmsanddocumentar
ies
MagazinesandNewsletters
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/magazinesnewsletter
s
OnlineLearningTools
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/onlinelearningtools
software
Organizations
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/otherautismorganiza
tions
SafetyProducts
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/safetyproducts

MentalIllnessandtheSchoolCounselor21

SpanishMaterials
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/materialenespa%C3
%
ToolsforProfessionals
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/toolsprofessionals
ToysandGames
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/toysgames
VideoTools
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/videotoolsdvds
Websitesforfamilies
http://www.autismspeaks.org/familyservi
ces/resourcelibrary/websitesfamilies

BipolarDisorder

Changesinmoodincludingepisodes
ofbeinghigh(hyperactivity,extreme
happiness,littletonosleep)tobeing
depressedormanic(lackofenergy,
extremesadness,andlossofinterest
inactivitiesthatwereexciting)
(Grohol,2013).

Treatment:
Medicationtostabilizemoods
suchaslithiumandatypical
antipsychotic
Counseling
Combinationofcounselingand
medication
Negativetreatmentself
medicatethroughalcoholand/or
drugabuse
(Bessert,2013)

SupportAgencies/Groups
DepressionandBipolarSupport
Alliance(alsolocalchapterin
WinstonSalem)(DBSA,2013)
TheMoodTreatmentCenter
(WinstonSalem)
NationalAllianceonMental
Illness
InternationalBipolarFoundation

BorderlinePersonality
Disorder

Individualswhohaveproblems
regulatingthoughtsandemotions,
displayimpulsiveandrisky
behavior,anddevelopunstable
relationships(NIMH,n.d.)

WarningSigns:
Displaynegativeand
extremereactionsto
abandonment

Treatment:
Therapy
BehavioralTherapy
DialecticalBehavior
Therapy
Schemafocused
therapy
AdministrationofOmega3
FattyAcidtoreduceangerand
depressioninwomen

MentalIllnessandtheSchoolCounselor22

Unstablerelationships
withfamilyandfriends,
includingextreme
closeness(idealization)
andintenseangerand
dislike(devaluation)
Distortedselfimages
Impulsivebehavior(i.e.
unsafesex,substance
abuse,bingeeating)
Suicidalthoughtandself
harmingbehavior(i.e.
cutting)
Feelingsofemptinessand
boredom
Observingselffrom
outsideoftheirbody
Losttouchofreality
(NIMH,2013).

SupportGroups:
DuetoBPDbeingan
under/misdiagnosedmental
disorderitdoesnothaveas
manyinpersonsupportgroups
howeverthereafewonline
communitiesavailabletohelp
sufferersandfamilies.
BPDRecovery
BPDCentral
BorderlinePersonality
DisorderSupport
Group
BorderlinePersonality
ResourceCenter

DissociativeDisorders

DualDiagnosisand
IntegratedTreatmentof
MentalIllnessand
SubstanceAbuseDisorder

DualDiagnosisisaconditionin
whichapersonsuffersfrom
cooccurringdisordersmental
illnessandsubstanceabuse(2003).
Whenapersonsuffersfrommore
thanonedisorder,itispertinentthat
bothofthemareaddressed
individuallyandcollectively.

Integratedtreatmentprogramsconsistof
thesamehealthprofessionals,workingin
onesetting,providingappropriate
treatmentforbothmentalhealthand
substanceabuseinacoordinatedfashion
(2003).

Assertiveoutreach
Motivational
interventions
Counseling
SocialSupport
Beinglongterm,
communitybased
Beingcomprehensive
Beingculturally
sensitiveand
competent(2003)

EatingDisorders

AnorexicSymptomsforatypical
patientinclude:

Refusalto
maintaina
normalbody
massindexfor
theirage
Amenorrhea,the
absenceofthree
consecutive

Thereisnoconclusiveevidencethatany
particulartreatmentforanorexianervosa
workbetterthanothers,however,thereis
enoughevidencetosuggestthatearly
interventionandtreatmentaremore
effective.Treatmentforanorexianervosa
triestoaddressthreemainareas(2008).

Restoring the
persontoahealthy
weight

MentalIllnessandtheSchoolCounselor23

menstrualcycles
Fearfulofeven
theslightest
weightgainand
takes
all
precautionary
measurestoavoid
weightgainand
becoming
overweight
Obvious,rapid,
dramaticweight
loss
Preoccupation
withfood,
recipes,or
cookingmay
cookelaborate
dinnersfor
others,butnot
eatthefood
themselves
Dietingdespite
beingthinor
dangerously
underweight
Rituals:cutsfood
intotinypieces
refusestoeat
around
othershidesor
discardsfood
Purging:uses
laxatives,diet
pills,ipecac
syrup,orwater
pills:mayengage
inselfinduced
vomitingmay
runtothe
bathroomafter
eatinginorderto
vomitand
quicklygetridof
thecalories
Mayengagein
frequent,
strenuous
exercise

Treating
the
psychologicaldisorders
relatedtotheillness
Reducing or
eliminatingbehaviors
orthoughtsthat
originallyledtothe
disordered eating

Thereareseveralempiricallysupported
psychosocialtreatmentsforbulimia
nervosa.Cognitivebehavioraltherapy
(CBT),whichinvolvesteachingclients
tochallengeautomaticthoughtsand
engageinbehavioralexperiments(for
example,insessioneatingof
"forbiddenfoods")hasdemonstrated
efficacybothwithandwithout
concurrentantidepressantmedication.
Researchsuggeststhat
cognitivebehavioraltherapy(CBT)is
themosteffectivepsychotherapeutic
treatmentforbulimianervosa
(Griffiths,1995).Oneexceptionwasa
studythatsuggestedthatinterpersonal
psychotherapy(IPT)mightbeas
effectiveasCBT,althoughslowerto
achieveitseffects.

MentalIllnessandtheSchoolCounselor24

Thesearesomeofthemanysigns
thatmayindicatewhethersomeone
hasbulimianervosa:

fixationon
numberof
calories
consumed
fixationonand
extreme
consciousnessof
weight
lowselfesteem
lowblood
pressure
irregular
menstrualcycle
constant
tripstothe
bathroom
depression
returning
frombathroom
withredeyesas
thoughtheyhave
beencrying(from
vomiting)
returns
frombathroom
andeatsmore
food,returnsto
bathroomagain
scarsor
marksontop
ofhands/knuckles
fromteethhitting
theirhandfrom
purging
smallcutsatthe
cornersofthe
mouthusually
causedby
cramminghand
furtherdownthe
throatasthegag
reflexdiminishes

MentalIllnessandtheSchoolCounselor25

MajorDepression

Alsoknownas
clinicaldepression
and
majordepressive
disorderisan
illnessthatbasicallyaffectstheway
apersonthinks,feels,andbehaves.
Itisfurtherdescribedasbeinga
chronicillnessthatusuallyrequires
longtermtreatment,likediabetesor
highbloodpressure(MayoClinic,
2012).Inordertobediagnosedwith
majordepressionMedlineplus
(2012)statesthatyoumusthave
fiveormoreofthesymptoms
associatedwithdepressionforat
least2weeks.
Alossofpleasureinusual
activities
Loworirritablemoodmostofthe
time
DifficultyconcentratingTrouble
sleepingorsleepingtoomuch
Lackofactivityandavoidingusual
activities
Tirednessandlackofenergy
Repeatedthoughtsofdeathor
suicide
Sloworfastmovements
Feelinghopelessorhelpless
Feelingsofworthlessness,selfhate,
andguilt
Abigchangeinappetite,often
withweightgainorloss

Thereareseveralverydifferenttypesof
treatmentsavailableforpeoplewith
depression.Thechoiceoftreatmentmade
woulddependona)theperson,b)typeof
symptomsbeingexperienced,andc)the
severityofthesymptom.Thetreatments
consistofmedicines,psychotherapy,
electroshocktreatment,alternative
methods,andadditionaltypesofother
therapymethod.

Followingareafewservicesandsupport
agenciesthatprovidewonderfulresources
thatcanhelp,treat,orprovidesupportfor
peoplewithdepression.
AnxietyandDepressionAssociationof
America(ADAA)(2013).Website:
https://www.adaa.org/findinghelp/getting
support
DepressionandBipolarSupportAlliance
(2013).Website:
http://www.dbsalliance.org/site/PageServe
r?pagename=peer_support_group_locator
HelpGuide.org(2013).Website:
http://www.helpguide.org/mental/depressi
on_tips.htm
MentalHealthAmerica(2013).Website:
http://www.mentalhealthamerica.net/findi
ngtherapy
MentalHealthAssociationinGreensboro
(MHAG)(2011).Website:
http://www.mhag.org/programs.cfm
PsychCentral(2013).Website:
http://psychcentral.com/
PsychologyToday(2013).Website:
http://therapists.psychologytoday.com/rms
/prof_results.php?city=Burlington&state=
NC&spec=2
TheCenterforCounseling&Health
(2013).Website:
http://www.aplaceofhope.com/intensedepr
ession.html
WebMD(2013).Website:

MentalIllnessandtheSchoolCounselor26

http://www.webmd.com/depression/guide/
depresssionsupport

ObsessiveCompulsive
Disorder(OCD)

1.ObsessiveCompulsiveDisorder
isananxietydisordercharacterized
byanxietyprovokingthoughts
thatwillnotgoaway(obsessions),
and/orirresistibleurgestoperform
repetitive,ritualisticbehaviors
(compulsions),whichhelprelieve
theanxietycreatedbytheobsession
(Huffman,2012,p.501).

2.Signsandsymptoms:
Havingrepeatedthoughts
orimagesofvariousthings
suchasthefearofgerms,
beingextremelytidy,etal.
Performingthesame
ritualsrepeatedly
Havingnocontroloverthe
unwantedthoughtsor
behaviors
Havingalackofpleasure
fromperformingthe
rituals,butgettingrelief
fromtheanxiety
associatedwithit
Spendingatleastonehour
adayperformingrituals
thatultimatelycause
distressandinterference
withdailylife(NIMH,
n.d.a)

Treatment:

1.ObsessiveCompulsiveDisordercanbe
treatedwithpsychotherapy,medication,or
acombinationofthetwo.

2.Psychotherapyapproachesusedfor
treatingOCDincludethefollowing:
a.CognitivebehaviortherapyThis
approachteachesapersontobehave,
think,andreactdifferentlytosituations
withlessanxiety,lessobsessivethoughts,
andlesscompulsivity(NationalInstitute
ofMentalHealth[NIMH],n.d.a).
b.Typesofcognitivebehaviortherapy:
Systematicdesensitization
Flooding
Saturation
Thoughtstopping
Deepbrainstimulation(NIMH,
n.d.a)
3.Medication:
AntiAnxietymedication
Antidepressants
*Somemedicationsmaytakeweeksto
beginworkingandsomemaycauseside
effectssuchasheadaches,nausea,and
problemssleeping(NIMH,n.d.a).

ServicesAvailable:

1.Onlineservicessuchasvideo
conferencing
2.Telephoneconsultations
3.Individualpsychotherapy
4.Grouptherapy
5.Homevisits
6.Psychologicaltesting

SupportAgencies:

1.OCDonlineat
http://www.ocdonline.com/
Provides:
Videoconferencing,telephone
consultations,individualpsychotherapy,
grouptherapy,homevisits,and
psychologicaltesting

2.InternationalOCDFoundationat
http://www.ocfoundation.org/
Provides:
Generalsupport,locationspecificgroups,
phonesupportgroups,religiousgroups,

MentalIllnessandtheSchoolCounselor27

hoardingsupport,parentsandfamilies
support,kidsandteenssupport,comorbid
disordersupport,PANDAS

3.OnlinesupportgroupsusingGoogle
Hangoutat
www.cognitivebehavioralcenter.com
Eachgrouplastsapproximatelyonetoone
andahalfhours.Groupsconsistofsixto
eightpeople.Objectivesarethesameas
thoseforinpersonOCDsupportgroups.
Cost:$45.00persession

PostTraumaticStress
Disorder(PTSD)

1.Description:PostTraumatic
StressDisorderisananxiety
disorderthatischaracterizedby
flashbacks,nightmares,andimpaired
functioningfollowingexposure
toalifethreateningorotherextreme
eventthatevokedgreathorroror
helplessness(Huffman,2012,p.
109).

2.Symptomsarecategorizedinto
threecategories:
A.Reexperiencingsymptoms:
Flashbacks
Baddreams
Frighteningthoughts
B.Avoidancesymptoms:
Stayingawayfromplaces,
people,andeventsthat
remindoneofexperiences
Feelingemotionallynumb
Feelingstrongguilt,
depression,orworry
Lossofinterestinformer
enjoyableactivities
Troublerememberingthe
dangerousevent
C.Hyperarousalsymptoms:
Beingeasilystartled
Feelingtenseoredgy
Troublesleeping
Angryoutbursts(NIMH,
n.d.b)
3.Otherprimarysymptoms:
Cryinguncontrollably
Relyingonalcoholor
drugstogetthroughthe
day
Experiencingfear,asense
of
helplessness/hopelessness
(Huffman,2012).

Treatment:

1.PostTraumaticStressDisordercanbe
treatedwithpsychotherapy,medication,or
acombinationofthetwo.

2.Psychotherapyapproachesusedfor
treatingPTSDincludethefollowing:
a.Cognitivebehaviortherapyandgroup
psychotherapy
b.Typesofpsychotherapytechniquesand
cognitivebehaviortherapyusedinclude:
Exposuretherapy
Cognitiverestructuring
Stressinoculationtraining
EMDREyemovement
desensitizationandreprocessing
Hypnotherapy
Grouppsychotherapy(Cohen,
2006).

3.Medication:
Antidepressants
Antipsychotics
Antianxietymedication
Minortranquilizers
Sleepingmedications

ServicesAvailable:

1.Veteranservices
2.Onlinecounselingservices
3.Assistanceinfindingatherapistfor
PTSD

SupportAgencies:

1.PTSD:NationalCenterforPTSDat
http://www.ptsd.va.gov/
Providescareforveterans,civilians,
veteransfriendsandfamily,military
personnel
2.Helpguideathttp://www.helpguide.org/
3.U.S.DepartmentofHealthandHuman

MentalIllnessandtheSchoolCounselor28

Servicesathttp://www.hhs.gov/
4.U.S.DepartmentofVeteransAffairsat
www.va.gov

SchizoaffectiveDisorder

Amentalconditionthat
causeslossofcontactwith
realityandmoodproblems
(U.S.NationalLibraryof
Medicine,2013)
Affectsapproximatelyone
ineveryonehundred
people(NationalAlliance
onMentalIllness,2012).
Rareinchildren,more
commoninwomenthan
men(U.S.National
LibraryofMedicine,
2013).
Noexactcauseofthe
disorder,buttiesto
exposuretocertaintoxins
orviralillnesswhileinthe
wombmayplayarole
(MayoClinic,2010),as
wellaschangesingenes
andchemicalsinthebrain,
neurotransmitters(U.S.
NationalLibraryof
Medicine,2013).
Itconsistsofawiderange
ofsymptoms,sosome
peopleareinappropriately
diagnosedwithit(National
AllianceonMentalIllness,
2012).
Symptomsinclude:
Changesinappetiteand
energy
Disorganizedspeechthat
isnotlogical
Falsebeliefs(delusions),
suchasthinkingsomeone
istryingtoharmyou
(paranoia)orthinkingthat
specialmessagesare
hiddenincommonplaces
(delusionsofreference)
Lackofconcernwith
hygieneorgrooming
Moodthatiseithertoo
good,ordepressedor
irritable
Problemssleeping
Problemswith
concentration
Sadnessorhopelessness
Seeingorhearingthings
thatarenotthere
(hallucinations)

Treatmentstrategies
include:antipsychoticandmood
stabilizingmedication,family
involvement,psychosocial
strategies,selfcarepeersupport,
andpsychotherapy(National
AllianceonMentalIllness,
2012).
ThereareFDAapproved
medications(HaldolDecanoate,
RisperdalConsta,andInvega
Sustenna)thataregiveninthe
formofaninjectiononceor
twiceamonthtodecreaserates
ofrelapse
A
critical
importanceinthe
wellbeingofpeoplewiththis
disorderismaintainingahealthy
lifestyle,includinggoodsleep
hygiene,exercise,andbalanced
diet(NationalAllianceon
MentalIllness,2012).
Ifleftuntreated
,peoplewiththis
disordermayleadlonelylives,
relyheavilyonfamilyorgroup
homes,andhavetrouble
attendingschoolorholdingjobs
(MayoClinic,2010).

Localsupportgroupsandservicescanbe
foundthroughsocialservices,Child
ProtectiveServices,andHealth
Departmentagenciesinyourlocalarea.

MentalIllnessandtheSchoolCounselor29

Socialisolation
Speakingsoquicklythat
otherscannotinterruptyou
(NationalAllianceon
MentalIllness,2012).

Schizophrenia

Apsychiatric
illnessthatcausesstrange
thinking,strangefeelings,
andunusualbehavior
(AACAP,2013).
Childrenwith
schizophreniaoften
experienceparanoid
delusionsseeinghostile
intentwherethereisnt
anyandtheirresulting
behaviorismisinterpreted
asconductdisorder
Childrenmaybelieveother
peoplecancontroltheir
thoughtsorreadtheir
minds,orbelievethatthere
arespecialmessagesfor
theminthingslike
televisionshowsor
coincidences(ChildMind
Institute,n.d.).
Whileitemergesgradually
inchildren
(schizophrenia.com),itis
uncommoninchildrenand
hardtorecognizeinits
earlyphases(AACAP,
2013).Thebehaviorof
childrenwith
schizophreniacanchange
overtime,suchasachild
whousedtobeasocial
butterflyturningmore
introvertedandshy
(AACAP,2013).The
causeofschizophreniais
unknown,butresearch
pointstowardsa
combinationofbrain
changes,biochemical
causes,andgeneticand
environmentalfactors
(AACAP,2013).

Symptomsinclude:

Positivesymptoms
includedistortedthinking,
hallucinations,and/or
delusions
Negativesymptoms
includesocialisolationand

Earlydiagnosisand
medicaltreatmentareKEYto
thislifelongdiseasethatcanbe
controlledbutnotcured
(AACAP,2013).
Childrenwhohaveafamily
historyofschizophreniaareata
higherriskforthedisorder,
thoughmostchildrenwith
parentswhohaveschizophrenia
nevergetit(ChildMind
Institute,n.d.).
Symptomsandbehaviorsof
childrenandadolescentswith
schizophreniacandifferfrom
adultswithschizophrenia
(AACAP,2013).
Schizophreniaisverydifficultto
diagnosebecausethereareother
psychiatricdisorderssuchas
Bipolardisorder,Obsessive
CompulsiveDisorder,andeven
depressionandsubstanceabuse
thatcanpresentsimilar
symptomsifmanifestedin
psychosis(AACAP,2013).
Itisentirelypossiblefor
childrenwhohaveschizophrenia
tobefalselydiagnosedwith
conductdisorder(because
paranoiamakesthemrespond
withhostilityandopposition)or
oneofthepreviouslymentioned
psychiatricdisorders(AACAP,
2013).
Treatmentof
children/adolescentsincludesa
combinationofmedication,
individualtherapy,family
therapy,andspecialized
programs(AACAP,2013).
Psychiatricmedicationcanbe
helpfulformanyofthe
symptoms,butthese
medicationsrequirecareful
monitoringbyachildand
adolescentpsychiatrist
(AACAP,2013).
Therapeutictreatmentinvolves
individualtherapyandsocial
skillstraining,whichteaches
childrencopingmechanismsand

MentalIllnessandtheSchoolCounselor30

flataffect(ChildMind
Institute,n.d.).
Problemspayingattention
impairedmemoryand
reasoning,speech
impairments
inappropriateexpression
ofemotion
poorsocialskills
depressedmood
(schizophrenia.com).
seeingthingsandhearing
voiceswhicharenotreal
(hallucinations)
oddandeccentricbehavior
and/orspeech
unusualorbizarrethoughts
andideas
confusingtelevisionand
dreamsfromreality
confusedthinking
extrememoodiness
ideasthatpeopleareoutto
getthemortalkingabout
them(paranoia)
severeanxietyand
fearfulness
difficultyrelatingtopeers,
andkeepingfriends
withdrawnandincreased
isolation
worseningpersonal
grooming(AACAP,
2013).

communicationskills(Child
MindInstitute,n.d.).
Onetypeofindividualtherapy
thatthatwouldbehelpfulin
workingwithchildrenand
adolescentswithschizophrenia
iscognitivebehavioraltherapy.
Familytherapyisusedbecause
ithelpsensuresteadytreatment
andenablesthefamilytocope
withtheissuesofthechildwith
schizophrenia,aswellbeingable
toaddresstheissuesalso
enablesthechildssymptomsto
improvebecauseofastable
homeenvironment(ChildMind
Institute,n.d.).

Supportagenciescanbefoundat:

http://www.schizophrenia.com/c
oping.html#
NorthShoreScizophrenia
Society:
http://www.northshoreschizophr
enia.org/
Throughlocalsocialservices
andhealthagencies

Treatmentoptionsareavailableat:

ColoradoRecovery:
www.coloradorecovery.com
JohnsHopkinsSchizophrenia
Center:
http://www.hopkinsmedicine.org
/psychiatry/specialty_areas/schiz
ophrenia/
ThroughPCPreferrals,health
andsocialservicesagenciesin
yourarea.

SeasonalAffectiveDisorder

Fallandwinterseasonalaffective
disorder(winterdepression)
_______________
Winteronsetseasonalaffective
disordersymptomsinclude:
Depression
Hopelessness
Anxiety
Lossofenergy
Heavy,"leaden"feelinginthearms
orlegs
Socialwithdrawal
Oversleeping
Lossofinterestinactivitiesyou
onceenjoyed
Appetitechanges,especiallya
cravingforfoodshighin
carbohydrates
Weightgain

LightTherapy:alsocalledphototherapy,
yousitafewfeetfromaspecializedlight
therapyboxsothatyou'reexposedto
brightlight.Lighttherapymimicsoutdoor
lightandappearstocauseachangein
brainchemicalslinkedtomood.

Medications:
Somepeoplewithseasonalaffective
disorderbenefitfromantidepressant
treatment,especiallyifsymptomsare
severe.
Antidepressantscommonlyusedtotreat
seasonalaffectivedisorderinclude
paroxetine(Paxil),sertraline(Zoloft),
fluoxetine(Prozac,Sarafem)and
venlafaxine(Effexor).

Psychotherapy:

MentalIllnessandtheSchoolCounselor31

TourettesSyndrome

Difficultyconcentrating
Springandsummerseasonal
affectivedisorder(summer
depression)
_______________
Summeronsetseasonalaffective
disordersymptomsinclude:
Anxiety
Troublesleeping(insomnia)
Irritability
Agitation
Weightloss
Poorappetite
Increasedsexdrive
(MayoClinic,2011).

helpyouidentifyandchangenegative
thoughtsandbehaviorsthatmaybe
makingyoufeelworse.
(MayoClinic,2011).
SeasonalAffectiveDisorderClinic
TheSeasonalDisordersClinicAtUNC
providesanopportunityforthosewho
thinktheymightbesufferingfrom
SeasonalAffectiveDisorder(SAD)or
WinterDepressiontoreceivea
comprehensiveevaluationforthis
conditionandtoreceiveatrialofLight
Therapywhenindicated.

SignsandsymptomsofTourette
syndrometypicallyshowupbetween
ages2and12,withtheaverage
beingaround7yearsofage.Males
areaboutthreetofourtimesmore
likelythanfemalestodevelop
Tourettesyndrome.

Tics(MotorandVocal)

VocalTics:
Hiccuping
Yelling
Throatclearing
Barking

MotorTics:
Eyeblinking
Headjerking
Eyedarting
Shouldershrugging
Eyedarting
Stickingoutthetongue
(MayoClinic,2012).

Therapies
Psychotherapy.Inadditiontohelpingyou
copewithTourettesyndrome,
psychotherapyortalktherapycanhelp
withaccompanyingproblems,suchas
ADHD,obsessions,depressionoranxiety.
Behaviortherapy.Aformofbehavior
therapycalledhabitreversaltrainingmay
helptoreducetics.Withthistherapy,you
monitorticsandidentifypremonitory
urgesthoseuncomfortablesensations
thatoccurbeforethetic.
Deepbrainstimulation:DBSconsistsof
implantingabatteryoperatedmedical
device(neurostimulator)inthebrainto
deliverelectricalstimulationtotargeted
areasthatcontrolmovement.
(MayoClinic,2012).

NAMINorthCarolina:www.naminc.org

TheNationalOrganizationforRare
Disorders,Inc:
http://www.rarediseases.org

TrainingResourceNetwork:
http://www.trninc.com

WEMOVE:http://www.wemove.org/

References
AmericanAcademyofChildandAdolescentPsychiatryAACAP(2013).
Schizophreniain

MentalIllnessandtheSchoolCounselor32

children.
Retrieved11/22/13from
http://www.aacap.org/AACAP/Families_and_Youth/
Facts_for_Families/Facts_for_Families_Pages/Schizophrenia_In_Children_49.asp
x.
Author.(2003).
Dualdiagnosisandintegratedtreatmentofmentalillnessandsubstanceabuse
disorde
r.NationalAllianceonMentalIllness.RetrievedNovember22,2013from
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage
/TaggedPageDisplay.cfm&TPLID=54&ContentID=23049

AutismSpeaks.(2013).ResourceLibrary.Retrievedfrom:
http://www.autismspeaks.org/familyservices/resourcelibrary

Bressert,S.(2013).Whogetsbipolar?.Retrievedfrom
http://psychcentral.com/lib/whogetsbipolardisorder/000913

ChildMindInstitute(n.d.).
Schizophrenia.
Retrieved11/21/13fromhttp://www.childmind.org/
en/health/disorderguide/schizophrenia.

Cohen,H.(2006).TreatmentofPTSD.
PsychCentral
.Retrievedfrom
http://psychcentral.com/lib/anoverviewoftreatmentofptsd/000161

DepressionandBipolarSupportAlliance(2013).Depressionandbipolarsupportalliance.

MentalIllnessandtheSchoolCounselor33

Retrievedfrom
http://www.dbsalliance.org/site/PageServer?pagename=home

Griffiths,RosalynA.(1995)."TwoYearFollowUpFindingsofHypnobehaviouralTreatment
forBulimiaNervosa

Grohol,J.M.(2013).Anintroductiontobipolardisorder.Retrievedfrom
http://psychcentral.com/disorders/bipolar/

th
Huffman,K.R.(2012).
Psychologyinaction
(10
ed.).Hoboken,NJ:JohnWiley&Sons,Inc.

LangeKW,ReichlS,LangeKM,TuchaL,TuchaO(2010)."Thehistoryofattentiondeficit
hyperactivitydisorder".
AttentionDeficitHyperactivityDisorders.

MayoClinic,(2012).www.mayoclinic.org

NationalInstituteofMentalHealth.(2013).AutismSpectrumDisorders.Retrievedfrom:
http://www.nimh.nih.gov/health/topics/autismspectrumdisorderspervasivedeve
lopmentaldisorders/index.shtml
MayoClinic(2010).
Schizoaffectivedisorder.
Retrieved11/21/13fromhttp://www.mayoclinic.
com/health/schizoaffectivedisorder/DS00866.
NationalInstituteofMentalHealth(n.d.).Borderlinepersonalitydisorder.Retrievedfrom

MentalIllnessandtheSchoolCounselor34

http://www.nimh.nih.gov/health/topics/borderline
personalitydisorder/index.shtml
NationalInstituteofMentalHealth.(n.d.a).Obsessivecompulsivedisorder(OCD)?Retrieved
from
http://www.nimh.nih.gov/health/topics/obsessivecompulsivedisorderocd/index.
shtml

NationalInstituteofMentalHealth.(n.d.b).PostTraumaticstressdisorder(PTSD).Retrieved
from
http://www.nimh.nih.gov/health/topics/posttraumaticstressdisorderptsd/index.s
html

NationalAllianceonMentalIllness(2012).
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http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentMan
agement/ContentDisplay.cfm&ContentID=23043.

Smith,A.T.Wolfe,B.E.(2008)."AmenorrheaasaDiagnosticCriterionforAnorexiaNervosa:
AReviewoftheEvidenceandImplicationsforPractice

www.schizophrenia.com.
Childhoodonsetschizophrenia:symptoms,treatments,andcauses.

MentalIllnessandtheSchoolCounselor35

Retrieved11/21/13fromhttp://www.schizophrenia.com/family/childszsym.htm.

U.S.NationalLibraryofMedicine(2013).
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http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001927/.

WebMD(2013).PervasiveDevelopmentalDisordersPDDs.Retrievedfrom:
http://www.webmd.com/brain/autism/developmentdisorder