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New class expectations, new living situations, and navigating newfound independence can give us all the feelsâfrom super psyched to super stressed. Even if youâre loving your student life, dealing with all the stressors that come with college can be a lot to handle. According to experts, the best time to handle that stress is now. âIf we donât take care of our mental health, we may not be able to reach our goals, maintain good relationships, and function well in day-to-day situations,â says Dr. Chrissy Salley, a psychologist in New York who works with students of all ages. âTaking care of mental health is one of the best things someone can do.â
Now really is the time to start tuning into your mental healthâthe majority of mental health issues appear to begin between the ages of 14 and 24, according to a review of the World Health Organization World Mental Health surveys and other research (Current Opinion in Psychiatry, 2007). But help is available. Along with methods like mindfulness and meditation, talking to a therapist (such as a counselor, psychologist, or psychiatrist) can be a super-effective way to manage any mental health issue you may be facing or just a way to get extra support during times of stress, challenge, celebration, or change.
Thereâs a ton of research on how effective therapy really isâa 2015 meta-analysis of 15 studies of college students with depression found that outcomes were nearly 90 percent better for those who received therapeutic treatment than for those in control groups, most of whom received no treatment (Depression and Anxiety).
One of the most common and effective therapies is cognitive behavioral therapy (CBT), a short-term, goal-oriented therapy where a pro helps you find practical ways to deal with specific problems.
The goal of CBT is to help you change or reframe certain thought processesâthe idea is that by changing your attitude about something, you can change your behaviors. For example, if you think something like, âIâm terrible at chemistry, so I know Iâm going to fail this testâthereâs no use studying,â you probably wonât ace your test. CBT can help you shift your thinking to something more like, âI know chemistry is really hard for me, but studying will help me do better.â
And it works. Thereâs strong evidence that this therapeutic technique can help you handle just about anything you might have going on, according to a 2012 analysis of over 200 studies on CBT published in Cognitive Therapy and Research. The researchers found that CBT was effective for people struggling with anxiety, bulimia, anger issues, stress, and a number of other mental health issues.
OK, so we know that therapy is an essential and effective tool for keeping your mental health at its peak, but making that first appointment can feel intimidating. It doesnât have to be. Our experts break down the therapy basics so you can embrace whatever you need to feel your best. Hereâs what the pros want you to know.
Surveys show itâs not out of the ordinary to see a therapistâ55 percent of college students have used campus counseling services, according to a 2012 report from the National Alliance on Mental Illness. If you feel uncomfortable with the idea of going to see a therapist, youâre not aloneâand thatâs totally OK, says Zachary Alti, a licensed social worker, psychotherapist, and professor at the Fordham University Graduate School of Social Service in New York. âFew people look forward to therapy, but students should be aware that therapy exists to help them, not to judge them,â he says. The process might not always be comfortable, but that doesnât mean itâs not worth it. âIâd encourage students to keep an open mind and try it,â says Dr. Salley.
âMany [young people] tell me they’re reluctant to participate in therapy because they donât want to talk about their feelings,â Dr. Salley says. Again, thatâs totally normal. But going to therapy isnât just about talking about how you feel; itâs also about walking away with real tools you can use in your life. âTherapy should also be action orientedâa time to learn new skills for coping and figuring out ways to solve problems,â Dr. Salley says.
âTherapy is like physical exercise,â says Alti. Just like hitting the gym is good for everyoneâs physical healthânot just those with diabetes or heart diseaseâseeing a therapist can benefit everyoneâs mental health.
But really, any time is a good time to go. While anxiety and depression are still the most common reasons students seek counseling, according to a 2016 annual report from the Center for Collegiate Mental Health, you donât have to be in the midst of a crisis or feel like youâre nearing a breakdown to see a proâseeing a therapist can be helpful even when things are all good. âThere are a lot of pink flags before you get to red ones,â says Dr. Dana Crawford, an individual and family therapist in New York. âKeeping things from becoming extreme is always better.â In other words, donât wait for an emergency to take care of your mental health. âWhen bad things do happen, mental health will protect against the impact of these unfortunate events,â adds Alti.
âBeing able to just have someone to really listen has promoted a lot of self-discovery. I trust my therapist with everything and I feel like he genuinely cares about what I have to say. He asks me questions that make me think about why I feel and do the things that I do. Once I know where something comes from, I can change it. Itâs easier said than done, but itâs not something I think I could do on my own.â
âSecond-year undergraduate student, University of Alabama
Real talk: College is full of huge life changes. âEven positive changes can be stressful,â says Dr. Salley. Luckily, therapists are particularly skilled at helping their clients deal with these transitions. âHaving someone to talk to can be helpful, especially as you encounter new situations and people,â she says. While youâre dealing with a new set of responsibilities and expectations (everything from picking the right major to sorting through awkward roommate issues), a therapist can help you pinpoint how all the changes are impacting you and sort through the onslaught of emotions that everyone feels during this time.
Therapists arenât one-size-fits-allâsometimes you have to try a few before you find the right fit. Donât get turned off if your first therapy appointment isnât super helpfulâif something feels uncomfortable, listen to your gut, but donât give up, says Dr. Crawford. âYou would never go to the store, try on a pair of jeans, and say, âOh, those donât fit, I guess I wonât wear jeans.â You would keep trying jeans until you found the right fit,â says Dr. Crawford. Same goes for therapists.
Finding that fit with a therapist is just as important for the outcome as the actual therapeutic technique, according to findings presented in Psychotherapy Relationships That Work (Oxford University Press, 2004). The research analysis found that three key things had a measurable positive impact on the outcome of individual therapy: 1) the strength of your collaborative relationship with your therapistâaka are you on the same page and making goals for your treatment together?; 2) your therapistâs ability to empathize or see where youâre coming from; and 3) the degree to which you and your therapist outline goals and reevaluate them together.
In other words, to get the most out of a therapy session, take the time to find someone you feel like youâre on the same page with, who gets you, and who’s willing to listen to your goals for therapy and help you develop them.
To find a therapist, start on campusâmost schools offer a certain number of free counseling sessions through their counseling or psychological services.
Check with your insurance provider to see whether you need a referral to see a psychologist or counselor. If so, you may need to make an appointment with your primary care provider or the student counseling center to ask for one. Once you have the referral (if needed), you can seek out a therapist in a number of ways:
Once you have a name or a list of names and youâve checked that the providers are covered by your insurance plan, call each therapist and leave a message to ask if they’re accepting new patients and to call you back with their available hours. When you hear back from the therapist, you may want to discuss what you’re looking to get out of treatment, what days and times you’re available to meet, and what their fees areâconfirm that they take your insurance (it never hurts to double check this)âand ask about their training and make sure they’re licensed. Sometimes it can take a few tries to find someone whose schedule works with yours, but donât let that deter you.
âTherapy can be useful by helping people acquire a better understanding of themselves and develop healthy habits,â says Dr. Salley. For example, if you have trouble getting up in time to make that optional early-morning lecture, but then you beat yourself up about missing it, a therapist can help you identify what you really value and then help you make decisions based on that. âIt can be helpful to talk to someone whoâs objective and not a friend to bounce your experiences and feelings off of,â says Dr. Crawford. âA therapistâs only investment is for you to be your best self.â
Once youâve identified whatâs really important to you, a therapist can help give you the tools to make your value-driven goals a reality. âProblems that are unaddressed remain problems,â says Dr. Crawford. âWhen youâre ready for something different in your life, it can change. Therapy can help you create the future you want.â
You may be worried that all that talking might get out or that your therapist might tell your advisor or RA about what youâre struggling with. âA therapist isn’t allowed to do this unless the student poses a threat to themselves or others,â says Alti. âA therapistâs effectiveness is dependent on maintaining trust.â Bottom line: Unless they believe youâre in imminent danger (e.g., at risk of being seriously harmed or harming yourself or others), they canât share what you say.
In short, everyone can benefit from talking to a therapist. âIn the same way that everyone can benefit from going to the dentist, sometimes therapy is just a routine cleaning,â says Dr. Crawford. âSometimes itâs just a time to reflect on where you are and where you want to go.â Whether youâre wrestling with anxiety and depression or mildly stressed about finding a summer internship, seeing a therapist can helpâeven if itâs just for a few sessions. (According to the CCMH report, the average student who uses campus psychology services attends between four and five sessions.)
âTherapy was a good way to talk through anything weighing on my mind. My therapist was very understanding, kind, and, of course, confidential. I’d recommend going to counseling services to everyone.â
âThird-year undergraduate student, Elizabethtown College, Pennsylvania
[school_resource sh101resources=’no’ category=’mobileapp,counselingservices’] Get help or find out more
Find a therapist: American Psychological Association
A sample script for contacting a therapist: UC Davis
Your online resource for college mental health: ULifeline
Learn more about types of therapy: American Psychological Association
What you need to know before choosing online therapy: American Psychological Association
Zachary Alti, LMSW, clinical professor, Fordham University Graduate School of Social Service; psychotherapist in New York City.
Dana Crawford, PhD, individual and family therapist, New York.
Chrissy Salley, PhD, pediatric psychologist, New York.
American Psychological Association. (2017). How to find help through seeing a psychologist. Retrieved from https://www.apa.org/helpcenter/therapy.aspx
American Psychological Association. (n.d.). Protecting your privacy: Understanding confidentiality. Retrieved from https://www.apa.org/helpcenter/confidentiality.aspx
APA Practice Organization. (2017). Psychologist locator. Retrieved from https://locator.apa.org/
Brown, H. (2013, March 25). Looking for evidence that therapy works. New York Times. Retrieved from https://well.blogs.nytimes.com/2013/03/25/looking-for-evidence-that-therapy-works/
Center for Collegiate Mental Health. (2017, January). 2016 Annual Report. (Publication No. STA 17-74). Retrieved from https://sites.psu.edu/ccmh/files/2017/01/2016-Annual-Report-FINAL_2016_01_09-1gc2hj6.pdf
Cuijpers, P., Cristea, I. A., Ebert, D. D., Koot, H. M., et al. (2016). Psychological treatment of depression in college students: A meta-analysis. Depression and Anxiety, 33(5), 400â414. doi: 10.1002/da.22461
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., et al. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427â440. doi: 10.1007/s10608-012-9476-1
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J. et al. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinions in Psychiatry, 20(4), 359â364. doi: 10.1097/YCO.0b013e32816ebc8c
Martin, B. (2016, May 17). In-depth: Cognitive behavioral therapy. Psych Central. Retrieved from https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/
National Alliance on Mental Illness. (2012). College students speak: A survey report on mental health. Retrieved from https://www.nami.org/About-NAMI/Publications-Reports/Survey-Reports/College-Students-Speak_A-Survey-Report-on-Mental-H.pdf
National Alliance on Mental Illness. (n.d.). Mental health facts: Children and teens. Retrieved from https://www.nami.org/getattachment/Learn-More/Mental-Health-by-the-Numbers/childrenmhfacts.pdf
Norcross, J. C., & Hill, C. E. (2004). Empirically supported therapy relationships. Psychotherapy Relationships That Work, 57(3), 19â23.
UC Davis. (n.d.). Community referrals. Retrieved from https://shcs.ucdavis.edu/services/community-referrals
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Most of us have supported friends through difficult times, such as a break-up, academic pressure, or family issues. But how do we step up and provide support when friends and loved ones experience sexual assault and other forms of sexual violence? Especially when the person who experienced the assault is male?
Social pressure and stereotypes about gender can make it particularly challenging for men who’ve been assaulted to talk about their experiences. If one of your male friends or loved ones is assaulted, itâs important that you know youâre in a position to help.
Many of the challenges men face reflect social pressure: ideas that sexual assault makes them less masculine, that women canât assault men, or that âreal menâ donât talk about or get help for painful experiences. âSome men fear that they’ll be seen as less of a man,â says Dr. Jim Hopper, a researcher, therapist, and instructor at Harvard Medical School. âIf theyâre heterosexual, they may fear people will doubt their sexuality. And if theyâre gay or bisexual, they may blame the assault on their sexuality in a way that further stigmatizes their being gay or bisexual.â
A common belief is that sexual violence only affects women. In fact, many men have unwanted sexual experiences, as both children and adults. One in six men in the US is sexually assaulted before age 18, according to studies from the 1980s to the early 2000s. In 2015, seven percent of men reported being sexually assaulted while attending college, according to a study by the Washington Post and the Kaiser Family Foundation. Regardless of the targeted manâs sexual orientation, both men and women perpetrate these assaults, according to the Centers for Disease Control and Prevention (CDC) (2013).
âSex, gender identity, and race can all influence how an experience like this affects someone, but itâs very important you have no presumption about what it feels like to your friendâso listen,â says Dr. Melanie Boyd, assistant dean of student affairs and lecturer in womenâs, gender, and sexuality studies at Yale University in Connecticut.
Everyone is different. Peopleâs varying personalities and circumstances affect how they respond to an unwanted sexual experience and what we can do to help. For example, some people want lots of hugs, while some prefer verbal support. The most important thing is to relate to your friend in a way that can help him feel empowered and connected. As a friend, youâre in a great position to do this.
When a friend discloses an experience of violence, itâs normal to feel a wide range of emotions, such as shock, confusion, sadness, or anger. In the moment, keep the conversation focused on your friendâs emotions, not your own.
âMany people who experience sexual violence also experience some degree of self-blame,â says Dr. Boyd. âPartially, thatâs just what people do when something bad happens: We go over the events in our head, hunting for things we could have done differently. Itâs a way of regaining a sense of control. In the case of sexual violence, though, survivors also have to contend with victim-blaming patterns that run through our culture. So itâs important that friends help them push back against that. Be careful not to say or ask anything that might suggest blameâand affirm for your friend that he did the best he could in a difficult, complicated situation.â
As challenging an experience as a sexual assault may be, itâs not as though your friend has become an entirely different person. The âotheringâ of people who’ve been assaultedâtreating them differentlyâcan be just as dangerous as ignoring or minimizing unwanted sexual experiences, according to researchers Nicola Gavey and Johanna Schmidt (Violence Against Women, 2011). Avoid thinking of the assault as something that cuts your friend off from the rest of the world; in fact, itâs up to you to be supportive and counteract that.
Make sure to listen and focus on your friendâs feelings. âPay attention to their specific issues,â says Dr. Boyd.
Avoid pronouns that assume the gender of the perpetrator or that make other assumptions about the experience. âI think one of the most important issues is breaking down the stereotype that only women are abused,â said Lena*, a second-year undergraduate at Tarrant County College in Texas.
âAs a friend, you want to relate to them in a way that gives them power, including by giving them choices and respecting whatever choices they make on whatever timeline,â says Dr. Hopper.
âSupporting someone through the healing process can be stressful, hard, and exhausting. That’s why it’s important for supports to take of themselves,â says Bella Alarcon, a bilingual clinician at the Boston Area Rape Crisis Center who facilitates a support group for partners, friends, and family of people who’ve experienced sexual violence. Paying attention to your own needs isnât selfish. âIf you’re exhausted and overwhelmed, you’re not going to be able to support the survivor,â says Alarcon.
Be mindful of your own needs, and make sure that youâre getting support.
*Names changed
Strategies developed by the Communication and Consent Educator program at Yale University.
[school_resource sh101resources=’no’ category=’mobileapp,titleix, counselingservices, suicideprevention, titleix’] Get help or find out moreHow to support a male friend: 1in6
Helpline and many other resources: RAINN
Resources for survivors: Living Well
Help for survivors: National Sexual Assault Hotline and Online Hotline
LGBTQ hotline and meet-up groups: Trevor Project
Information and resources for LGBTQ survivors of violence: Anti-Violence Project
Men share their stories of dealing with sexual violence: The Bristlecone Project
Bella Alarcon, bilingual clinician, Boston Area Rape Crisis Center, Massachusetts.
Melanie Boyd, PhD, assistant dean in student affairs; lecturer in womenâs, gender, and sexuality studies, Yale University, Connecticut.
Jim Hopper, PhD, independent consultant and clinical instructor in psychology, Department of Psychiatry, Harvard Medical School, Massachusetts.
1in6. (n.d.). Sorting it out for himself. Retrieved from https://1in6.org/family-and-friends/sorting-it-out-for-himself/
Abelson, M. J. (2014). Dangerous privilege: Trans men, masculinities, and changing perceptions of safety. Sociological Forum, 29(3), 549â570. https://doi.org/10.1111/socf.12103
Anderson, N., & Clement, S. (2015, June 12). Poll shows that 20 percent of women are sexually assaulted in college. Washington Post. Retrieved from https://www.washingtonpost.com/sf/local/2015/06/12/1-in-5-women-say-they-were-violated/
Anderson, S. S., Hendrix, S., Anderson, N., & Brown, E. (2015, June 12). Male survivors of sex assaults often fear they wonât be taken seriously. Washington Post. Retrieved from https://www.washingtonpost.com/local/education/male-victims-often-fear-they-wont-be-taken-seriously/2015/06/12/e780794a-f8fe-11e4-9030-b4732caefe81_story.html
Beres, M. A. (2014). Rethinking the concept of consent for anti-sexual violence activism and education. Feminism & Psychology, 24(3), 373â389.
Beres, M. A., Herold, E., & Maitland, S. B. (2004). Sexual consent behaviors in same-sex relationships. Archives of Sexual Behavior, 33(5), 475â486.
Brenner, A. (2013). Transforming campus culture to prevent rape: The possibility and promise of restorative justice as a response to campus sexual violence. Harvard Journal of Law and Gender. Retrieved from https://harvardjlg.com/2013/10/transforming-campus-culture-to-prevent-rape-the-possibility-and-promise-of-restorative-justice-as-a-response-to-campus-sexual-violence/
Carmody, M. (2003). Sexual ethics and violence prevention. Social & Legal Studies, 12(2), 199â216. https://doi.org/10.1177/0964663903012002003
Catalano, S. (2013). Intimate partner violence: Attributes of victimization, 1993â2011. Bureau of Justice Statistics (BJS). Retrieved from https://www.bjs.gov/index.cfm?ty=pbdetail&iid=4801
Colorado State University. (n.d.). A Guide for supporting survivors of sexual assault. Retreived from https://wgac.colostate.edu/supporting-survivors
Crome, S. (2006). Male survivors of sexual assault and rape. Australian Institute of Family Studies. Retrieved from https://aifs.gov.au/publications/male-survivors-sexual-assault-and-rape
Crome, S. A., & McCabe, M. P. (2001). Adult rape scripting within a victimological perspective. Aggression and Violent Behavior, 6(4), 395â413.
Davies, M., Gilston, J., & Rogers, P. (2012). Examining the relationship between male rape myth acceptance, female rape myth acceptance, victim blame, homophobia, gender roles, and ambivalent sexism. Journal of Interpersonal Violence, 27(14), 2807â2823.
Davies, M., & Rogers, P. (2006). Perceptions of male victims in depicted sexual assaults: A review of the literature. Aggression and Violent Behavior, 11(4), 367â377.
Dube, S. R., Anda, R. F., Whitfield, C. L., Brown, D. W., et al. (2005). Long-term consequences of childhood sexual abuse by gender of victim. American Journal of Preventive Medicine, 28(5), 430â438. https://doi.org/10.1016/j.amepre.2005.01.015
Gavey, N., & Schmidt, J. (2011). âTrauma of rapeâ discourse: A double-edged template for everyday understandings of the impact of rape? Violence Against Women, 17(4), 433â456.
Gavey, N., Schmidt, J., Braun, V., Fenaughty, J., et al. (2009). Unsafe, unwanted: Sexual coercion as a barrier to safer sex among men who have sex with men. Journal of Health Psychology, 14(7), 1021â1026.
Graham, R. (2006). Male rape and the careful construction of the male victim. Social & Legal Studies, 15(2), 187â208.
Grand Rapids Community College. (n.d). Step-by-step. Retrieved from
https://www.grcc.edu/studentaffairs/sexualmisconduct/stepbystep
Harrell, M. C., Castaneda, L. W., Adelson, M., Gaillot, S., et al. (2009). A compendium of sexual assault research. RAND Corporation. Retrieved from https://www.rand.org/content/dam/rand/pubs/technical_reports/2009/RAND_TR617.pdf
Hopper, J. W. (2015, June 23). Why many rape victims donât fight or yell. Washington Post. Retrieved from https://www.washingtonpost.com/news/grade-point/wp/2015/06/23/why-many-rape-victims-dont-fight-or-yell/
Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the defense cascade: Clinical implications and management. Harvard Review of Psychiatry, 23(4), 263â287.
Maine Coalition Against Sexual Violence. (n.d.). Sexual violence against LGBTQQI populations. Retrieved from https://www.mecasa.org/index.php/special-projects/lgbtqqi
Masters, N. T. (2010). âMy strength is not for hurtingâ: Menâs anti-rape websites and their construction of masculinity and male sexuality. Sexualities, 13(1), 33â46.
Monk-Turner, E., & Light, D. (2010). Male sexual assault and rape: Who seeks counseling? Sexual Abuse: A Journal of Research and Treatment, 22(3), 255â265.
Paulk, L. (2014, April 30). Sexual assault in the LGBT community. National Center for Lesbian Rights. Retrieved from https://www.nclrights.org/sexual-assault-in-the-lgbt-community/
RAND Office of Media Relations. (n.d.). Complete results from major survey of US military sexual assault, harassment released. Retrieved from https://www.rand.org/news/press/2015/05/01.html
Rothman, E. F., Exner, D., & Baughman, A. L. (2011). The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: A systematic review. Trauma, Violence & Abuse, 12(2), 55â66.
Sleath, E., & Bull, R. (2010). Male rape victim and perpetrator blaming. Journal of Interpersonal Violence, 25(6), 969â988.
Stanko, E. A., & Hobdell, K. (1993). Assault on men: Masculinity and male victimization. British Journal of Criminology, 33(3), 400â415.
Strauss, V. (2014, August 29). Does ârestorative justiceâ in campus sexual assault cases make sense? Washington Post. Retrieved from https://www.washingtonpost.com/blogs/answer-sheet/wp/2014/08/29/does-restorative-justice-in-campus-sexual-assault-cases-make-sense/
Walters, M. L., Chen, J., & Breiding, M. J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/pdf/nisvs_sofindings.pdf
Weiss, K. G. (2010). Male sexual victimization examining menâs experiences of rape and sexual assault. Men and Masculinities, 12(3), 275â298.
Willis, D. G. (2009). Male-on-male rape of an adult man: A case review and implications for interventions. Journal of the American Psychiatric Nurses Association, 14(6), 454â461.