A Trauma Education

The shootings at Virginia Tech push counselors to consider whether the techniques used to deal with trauma in secondary schools will prove equally effective on college campuses

By Stacy Notaras Murphy

As the news of mass shootings at Virginia Tech unfolded on April 16, few were better equipped to appreciate the tragedy’s impact than American Counseling Association member Nancy Miller. A former licensed school counselor who is now in private practice, Miller understood the mental anguish created by such an event. With disaster mental health training from the American Red Cross, she also possessed knowledge of what would occur on the campus in the aftermath of the violence. But perhaps what most drew Miller to the tragedy was her role as a Hokie parent.

“My daughter graduated from Virginia Tech the year before,” Miller says. “So here I am with this specialty (training), and there was this immediate need. I was at my office in Northern Virginia when the crisis occurred, and I found myself thinking, ‘I’ve got an expertise. I don’t just want to sit here. I’ve got to help.’”

Miller volunteered three days of service through the New River Valley Community Services Board, beginning the day after the shootings. She was stationed at the hotel that served many of the victims’ families who were arriving to collect their children’s belongings. Partnering with the Virginia State Police as they helped the families make positive identifications of the victims’ bodies, Miller provided immediate grief counseling and facilitated student support groups.

Before the tragedy at Virginia Tech, colleges and universities mainly were familiar with traumas relating to the loss of individual students, such as death from a car accident, an illness or even suicide. The school’s staff would focus on recognizing the student’s contributions, peers would participate in a memorial and those closest to the student might seek counseling support on or off campus.

In retrospect, shootings at the middle and high school levels might have made the tragic migration of this type of violence toward colleges inevitable. As a result of the Virginia Tech massacre, universities nationwide have started an intensive review of their disaster planning, with counseling support playing a significant role in that preparation. While there are many transferable lessons from the ways that middle and high schools have dealt with mass shootings in recent years, important nuances also exist that separate those adolescent groups from their college-aged counterparts.

A foot in each camp

Responsible for their day-to-day activities, if not completely financing them, many college students enjoy a quasi-independence that eases the transition from adolescence to adulthood. Sam Gladding, a past president of ACA and counseling department chair at Wake Forest University in Winston-Salem, N.C., notes that those involved in caregiving after a tragedy must be willing to see college students as occupying a unique developmental space and tailor support to that distinctive position.

“There is more of a responsibility for college students to take initiative along with the officials in terms of healing and doing things that are constructive in regard to the trauma, whereas in high school and middle school, initiative is much more from the top down, from the administration down,” Gladding explains. He twice traveled to Blacksburg to provide support for students, first as they returned to classes the week after the shootings and again for their graduation in May.

“There’s just more freedom to respond to a tragedy in different ways at a college,” Gladding says. “At Virginia Tech, while the administration did an incredibly good job of bringing the community together to heal, the students themselves would be out giving ‘free hugs’ to one another. You probably wouldn’t find that at a middle school. There’s more initiative and responsibility at the college level. The memorials, whether makeshift or otherwise, tend to be more spontaneous at that level.”

Perry Francis, an ACA member and associate professor of counseling at Eastern Michigan University in Ypsilanti, agrees, adding that college students’ routines are very different and necessitate different approaches to trauma treatment. “In high school, you’ve got kids who are still living at home for the most part, and they have a very structured environment with regular daily routines,” he says. “It might be easier for a school counselor to make a specific, post-trauma presentation to all the freshman English classes, explaining what they might be going through and where to get help. Comparing that to a college campus, you see there is very little structure beyond when you go to class. (After a tragedy) they might offer a room where kids can drop in or out and counselors might set aside certain hours for group sessions, but the onus to find help is more on the student at the college level. If you’re in a residence hall, you can isolate yourself more readily than in a K-12 environment. At a high school setting, the teacher may interact with you and say, ‘Go talk to a counselor.’ Can that happen in a college setting? Yes, but the students certainly have more freedom to turn that down.”

Jane Webber, director of the mental health/school counseling campus programs at Seton Hall University in South Orange, N.J., experienced the aftermath of the disastrous dormitory fire that took three students’ lives there in 2000. She notes the importance of realizing that college students occupy a limbo-type space, with one foot in adolescence and another in adulthood.

“College students are on their own,” says Webber, an ACA member. “They do their own laundry, they date who they want to, they get up when they want to. But when there’s a real tragedy like a shooting, part of them wants to snuggle back underneath their blankets at home because parents really are their safety zone. They really step back, as we all do in a tragedy. We go to our comfort zones — our parents, our peers, our spiritual resources. There’s a dance between individuation and going back to where it’s safe. College students go back to the safety zone for a shorter period of time than high school students. We want to provide support while still making sure that we’re affirming the fact that they’re young adults. Home is the retreat, a hassle-free zone where they’re safe for a few days. But you want to get them right back to college, because they have more of a foot in the college than at home.”

Webber, who served as the lead editor for the second edition of ACA’s Terrorism, Trauma and Tragedies: A Counselor’s Guide to Preparing and Responding, advises emphasizing college students’ more adultlike, resilient qualities to help them reestablish their normal routines. “How many kids went home after Virginia Tech and lasted a day or two, then said, ‘I have to be back; that’s    where I belong’? That is where they belong. They really do return to normal, as much as possible. Trauma is a very normal response to a very abnormal situation. But you get right back in and you go to a memorial, you go back to class and you talk about it. You do it much faster than you would in high school.

“High school students, in contrast, often become very dependent in a crisis. We have to affirm college students’ adulthood and individuation, but we also know we absolutely have to bring in their support community, which is peers, parents, etc. As far as counseling and support, we have to validate that college students are really young adults, and we affirm the best in their adulthood. That is, connecting with them and providing a variety   of situations in which they can receive help, but not dragging them to it.”

In contrast to approaches at the high school level, where students tend to stick to their cliques in times of crisis as well as in times of normalcy, Webber recommends decentralizing support groups at the college level. Allowing college students to move in and out of peer support groups mirrors the way those students move in and out of peer groups under normal circumstances, she explains. “College students are always creating new programs. You have to be ready to have counselors or personnel available to consult with them but not to take over,” she advises. “There’s a very fine line between consulting and taking over the process. They don’t want that.”

Brooke Collison, a past president of ACA and professor emeritus at Oregon State University in Corvallis, agrees that the scattered nature of a college campus requires special consideration when formulating post-traumatic support responses. “In a school that is K-12, you have encapsulated groups. Everybody reports to the one building, it’s easy to see who is present and who is not present, and it’s easier to organize group responses,” he explains. “At a university, other than students living in a dormitory, they are loosely connected. You may have classrooms in the university where instructors don’t particularly know students or where students may not know each other because (there is) no other bond or connection. So a difference is getting to know the university’s unique landscape and trying to find those specific groupings where students can develop mutual support.” This may include sports teams, student clubs or Greek organizations, he says.

Collison has been on the front lines as a counselor after a number of tragedies impacting either high school or college students, such as the plane crash that killed 31 people, including members of the Wichita State University football team, in 1970 and the 1998 shootings at Thurston High School in Springfield, Ore. He suggests that college-level caregivers take a post-trauma approach that is both supportive and educational in nature.

“One of the important counselor functions is to normalize the feelings and experiences that come from being close to or involved in a shooting,” he says. “It’s OK to be frightened, OK to feel less secure. It’s not strange or weird that you don’t want to go into certain buildings. That’s a part of the process.”

Trauma true to type

Still, counselors need not create a brand new trauma counseling script just because college-level students exist in an unstructured space between adolescence and adulthood. According to Gladding, who worked with 9/11 victims prior to volunteering his services at Virginia Tech, unexpected adversity often elicits predictable reactions across all age groups.

“An act like this always shakes people up because it’s so abnormal, out of the norm of what one would expect or think about,” he says. “It doesn’t matter where you are that that occurs. It’s also common to realize you’re not in control of what’s happening or how it’s happened. Some of the stages of grief and recovery are very much similar. They may manifest themselves differently at the college level, but going through recovery is just something that people of all ages and stages of life have in common.”

Karin Jordan, head of ACA’s Traumatology Interest Network and chair of the graduate department of counseling at George Fox University in Portland, Ore., recommends several guidelines regardless of the population affected by the tragedy. These guidelines include discouraging individuals from making major changes, such as moving, and encouraging them to maintain pre-disaster daily routines. She also encourages psychoeducation to normalize the counselee’s experiences, consultation with a psychiatrist if post-traumatic stress disorder is suspected and assessment of self-destructive behaviors. Jordan suggests working with the counselee to name supports and coping techniques.

Sue Pressman had to put such trauma counseling skills to intimate use with her daughter, Lianna Dosik, a Virginia Tech freshman who was asleep on the same floor of the dorm where the first shootings took place on April 16. After having Dosik home in Arlington, Va., for the week after the shootings, Pressman, an ACA member and career management counselor, helped her daughter move back into the residence hall.

“She had given us restrictions before we got there, like she didn’t want to use the elevator, because the shootings took place right near the elevator,” Pressman says. “As a counselor, I decided that I’m going to take my ‘mother hat’ off right now and put on all those skills that I went to school to learn. I said, ‘I do not want my kid to be living in fear about walking in and out of this dorm.’ So as we walked in I said, ‘Why don’t we use the elevator? Let’s do it together.’ We got on the elevator, and it was fine.

“Then she decided that she wasn’t going to look down the hall where the shootings took place. So later I said I would go look and just see what they had done to the area. I was trying to make it so that it was not the end of the world for her. I walked to that side and she started tiptoeing behind me, and then we saw the wall they had built.” Pressman explains that the university had built a wall isolating the rooms of the two slain students. Other students had written messages to them on the wall. “She saw that and then was able to feel safe coming and going from her room,” Pressman says.

Campus as community

Pressman notes that the most difficult part for her daughter was the presence of so many strangers on campus — most there for support and safety — during those first days back at school. “Normally, if you were on the drill field, you were on your way to classes or playing games or having some kind of event, but never a memorial,” Pressman says. “But that day, they had all these church groups that were singing ‘Amazing Grace.’ They were just everywhere with candles. It was just so much. She didn’t want to see all those people there anymore. They were all there to try and do good, to help and offer services, but it was really hard, because that’s not the purpose of a college campus.”

Miller adds that those working with a college-level tragedy must take care when placing counselors in supportive roles. Whereas high schools are often more established within a larger community and school system, universities tend to be more isolated communities within themselves and may attract a larger number of “drop-in” responders following a tragedy. “This was so complicated,” she says. “I spoke to one student who was angry with the intrusion on campus of all the outside people, and I could completely understand that point of view.”

Being on-site as a short-term counselor, Miller notes that it was important for her to be matched with a population that would not form an attachment, only to have that attachment broken when her volunteer commitment was over. “I think it was wise for them to station me at the hotel with the families as they came, as opposed to stationing me at the hospital with the injured, because that’s more long term,” she explains. “I was very impressed that they had lined up so quickly so many resources. We had fliers and information to hand out about where they could go for counseling at Virginia Tech and back home in their hometowns.” (The Virginia Tech counselor education program also contacted ACA about coordinating free counseling for students who were going to be away from campus for the summer; for more on this initiative, see “ACA members rally to provide free counseling to VT students” on p. 3.)

Collison points out that advanced crisis planning ought to include volunteer screening if at all possible. “At the time of a crisis or catastrophe, many well-meaning people come out of the woodwork to ‘help.’ That is not the time to be screening who you have working in the school as a volunteer crisis counselor,” he says, noting that within the flood of volunteers  there are often people who may do more harm than good in a crisis. “For example, some clergy may respond to crisis with evangelizing speeches or belief statements about death that do not set well with the people grieving. If community volunteers are to be included in crisis response groups, then the first time they come into the school should not be the day of the crisis. They need to be recruited, trained and should spend time in the school.”

Tracking the troubled

Not surprisingly, student gunman Seung-Hui Cho’s violent rampage at Virginia Tech has heated up the debate over privacy rights and public safety on college campuses. In particular, difficult questions have been raised about the ability of universities to track the mental health histories of their students in an effort to better protect their communities. Again, there are nuanced differences between using such information at the high school and college levels.

“High schools tend to notify the parents quicker (about mental health issues) than we would at the college level,” explains Sylvia Shortt, past president of the American College Counseling Association, a division of ACA, and assistant director of student development at the University of West Georgia in Carrollton. “Many times, notifying certain students’ parents would be absolutely the worst possible thing for the students because of their relationships with the parents.”

Shortt also notes that some students have come to link the counseling process with loose confidentiality. “Many have had negative experiences with counseling in middle school or high school, with counselors notifying parents of everything they were doing,” she says. “So when we get them into counseling in college, they don’t trust the process because their confidentiality has been compromised in the past. Building that trust back can be difficult at times. We certainly wouldn’t hesitate to break confidentiality for danger to self or others, but you have to be very careful because of trust issues to not take confidentiality lightly.”

Tracking a troubled student at the college level is also challenging compared with the high school level. “They are captive audiences in public (high) schools, but in college they’re not — they’re legal adults,” Shortt says. “Certainly if a professor notifies us about a troubled student, we most definitely follow up on it, but the difference is that we still can’t force somebody to have counseling unless they have behavioral problems on campus. If they have discipline problems and have been through the process, we can. If their behavior is affecting their roommate or other people in the residence halls, then certainly you have more of a legal right to tell them they have to come in. But if their behavior is just a little bit strange, but they’re not affecting anyone or they’re not breaking any laws or rules on campus, you can’t force anyone to come into counseling.”

Pointing to the Family Educational Rights and Privacy Act, which governs most private and public universities and colleges, Jordan notes that privacy rights provisions are challenging in situations where students present with negative emotions. “Universities are challenged in maintaining the privacy and rights of students, but at the same time have a responsibility to respond proactively to the student’s needs, especially in light of the existing research that has shown that preventive mental health services work,” she says. “Administrations might also be challenged regarding possible legal obligations to individual students and those potentially at risk for harm. In this litigious time, the threat and potential for lawsuits might be part of the decision-making process.”

Collison sees counselors playing an important role in protecting students’ rights at both the high school and the college level. “Anytime there is a shooting like this, there is a tendency to start doing profiling of potential shooters,” he says. “We run the risk of interfering with people’s rights. If we start looking at every person who is isolated, noncommunicative and a student, and begin to get jumpy, maybe even invading their privacy, then there’s a real risk. I think counselors ought to be on the line to help protect the rights of students, while at the same time being on the watch for people who are isolated, disconnected. It’s kind of a double line for the counselor, whether at the high school or university level.”

The road ahead

In the aftermath of any tragedy, people find some comfort in taking stock of what happened and thinking about ways to prevent similar situations in the future. Counselors are in a unique position to assist universities as they inevitably ask, “What if this happens here?” Jordan says all university/college disaster preparedness plans ought to consider a variety of issues when updating their crisis protocols, including:

• Ease of use
• Training of the crisis team
• Partnerships with community service agencies
• Regular crisis drills
• Strengthening relationships with local law enforcement
• Developing specific plans for a variety of scenarios, such as bomb scares, intruder threats and stalking situations

“It might be helpful to involve counselors, especially those with trauma or disaster training, in the intervention and postvention designing and/or updating of the disaster/trauma preparedness plan, as they can provide valuable feedback regarding the mental health services that can/should be provided,” Jordan notes.

Francis also suggests that counselor education programs consider whether they are providing their students with the proper skills for dealing with such a violent crisis. “The question is how much training can we provide to students within the model of counselor education that’s currently in place,” he says. “I can make the case for having a two-credit course on suicide assessment, while others can make a case for how to do trauma counseling. The question is how much can we pack into a program that first has to teach them how to do counseling at a very basic level.”

This article first appeared in Counseling Today on July 7, 2007. www.counseling.org