Students with Emotional Disturbances: How Can School Counselors Serve?.

Students with Emotional Disturbances (ED) possess unique characteristics that require additional care from school counselors, teachers, and other school personnel. Information pertaining to the prevalence of ED among students and the common characteristics of students with ED is reviewed. Additionally, ideas and effective approaches that will aid school counselors in meeting the various needs of these students are presented. The purpose of the presented information is to broaden the skill repertoire of school counselors and to enhance the level of service they provide to students with ED. Students With Emotional 3 Students with Emotional Disturbances: How Can School Counselors Serve? Students with Emotional Disturbances (ED) possess unique characteristics that require additional care from school counselors, teachers, and other school personnel. The preparation and additional training that many school counselors receive in the realms of career, personal/social, and academic concerns of students can aid in helping school counselors provide services to students with ED. In addition to this training, the following information associated with the prevalence of ED among students, common characteristics of students with ED, and effective approaches to meet the needs of students with ED may assist in broadening the skills possessed by school counselors and enhance the services they provide to students with ED. In 2001 2002, special education and related services were provided to 482,702 United States (U.S.) students with ED (U.S. Department of Education, 2004). Because of the historical practice of under-identifying students with ED, this number may represent only a small fraction of students with ED (U.S. Department of Education, n.d.). It is estimated that 1.3 to 3.8 million students could be identified with serious ED (Kansas Career and Technical Education Resource Center [KCTERC], n.d.). Therefore, school counselors are likely to serve many unidentified students with mild to severe ED. The Individuals with Disabilities Education Act (IDEA) described ED as . a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance—(a) an inability to learn that cannot be explained by intellectual, sensory, or health factors, (b) an inability to build or maintain satisfactory interpersonal relationships with peers and Students With Emotional 4 teachers, (c) inappropriate types of behavior or feelings under normal circumstances, (d) general pervasive mood of unhappiness or depression, or (e) a tendency to develop physical symptoms or fears associated with personal or school problems. The IDEA requires that the characteristic(s) must be evidenced frequently and intensely, as well as have a negative impact on students’ academic functioning. An additional requirement under the IDEA includes schizophrenia as an emotional disturbance, but does not include children who are socially maladjusted unless it is determined that they have an emotional disturbance (IDEA, 2004; Sect. 300.8[c] 4 [i, ii]). Students with ED often have disorders classified in the Diagnostic and Statistical Manual of Mental Disorders – 4 edition – text revision (DSM-IV-TR) such as adjustment disorder, generalized anxiety disorder, attention–deficient/hyperactivity disorder, obsessive compulsive disorder, or depression and often experience serious disturbances in functionality (Reddy, 2001; Erk, 2004; Gacono & Hughes, 2004). Students who meet the eligibility criteria for ED typically experience significant behavioral, social-emotional, and academic difficulties in a multitude of settings (Reddy). Students classified with ED have serious, long-term, learning deficits that are not linked to other disability categories such as mental retardation, learning disabilities, hearing/vision problems, or traumatic brain injury (Connecticut Department of Education, 1997). It is challenging to determine whether difficulties in learning are the result of ED or vice versa. In either case, it is apparent that students classified as ED struggle in school and have many barriers that impede their success (Melton, 2004). Students With Emotional 5 In addition to inherent characteristics, ED may result from external factors. Young, Merchant, and Wilder (2004) outlined internal characteristics as well as three external factors that may increase children’s risk for emotional and behavioral disorders. The external factors include (a) family characteristics such as poverty, family violence, lack of rules, and inconsistent or coercive parenting; (b) school characteristics such as non-clarified or inappropriate expectations or lack of individualized and appropriate instruction; and (c) cultural conditions such as the negative influence of peer groups or the media (e.g., gangs, pornography, and violence). Society’s increasing promotion of aggression (Walker, Colvin, & Ramsey, 1995) to solve problems may decrease students’ abilities to form interpersonal connections. Students who handle conflicts with aggression may lead to stressful educational environments (Young et al., 2004), thus increasing the anxiety experienced by students. Additionally, discrimination may play a factor. Minority students and students in poverty are more likely to be classified with emotional or behavioral disturbances (Young et al.). Heathfield and Clark (2004) suggested that children and adolescents are under increased pressure resulting from “poverty, child abuse and neglect, substance abuse, and violence in our communities” (p. 912) which may increase the need for mental health services. School responses to misbehavior in the forms of expulsion and suspension have aided in increasing the intensity of emotional disturbances in students (Dwyer, 2002). By using these approaches schools are not addressing problem behaviors and are not providing proactive and preventative interventions for students classified with ED (Heathfield & Clark). Additionally, students may react negatively to their environment when it is ill-equipped to effectively meet their needs (Dwyer). Students With Emotional 6 The U.S. Department of Health and Human Services (1998) reported that when compared to students with other disabilities, students with serious ED have lower grades, more absences, and more failed classes. Additionally, students with ED drop out of school more frequently and do not meet minimum competencies on exams by comparison. Their graduation rate (42%) falls 29 percentage points below other students (KCTERC, n.d.). The poor academic performance of students with ED may be related to the depletion of internal resources. The energy used to meet emotional demands leaves little to meet academic and social needs (Theodore, Akin-Little, and Little, 2004). Students with ED may internalize and externalize emotions that could manifest in feelings and behaviors that are not appropriate for their age and are not explained biologically or physiologically (Connecticut Department of Education, 1997; Kehle, Bray, Theodore, Zhou, & McCoach, 2004). For example, internalized emotions include depression, withdrawal, anxiety, excessive fear (National Information Center for Children and Youth with Disabilities, 2004), excessive remorse, feelings of inadequacy, or guilt (Clarizio, 1992). They may have auditory or visual hallucinations, somatization, or gastrointestinal or cardiopulmomonary difficulties. Hyperventilation and avoidance of activity due to extreme anxiety is not uncommon (KCTERC, n.d.). Behaviors associated with externalized emotions include aggression, temper tantrums, impulsiveness (KCTERC; National Information Center for Children and Youth with Disabilities), noncompliance, or destructiveness (Epstein, Cullinan, & Rosemier, 1983). Whereas behaviors associated with externalized emotions may be associated with ED, Clarizio noted that individuals with ED were uncomfortable receiving attention and were Students With Emotional 7 restrained and subdued more frequently. When compared to others, students with ED often appeared more sad, lonely, or depressed (Cullinan, Osborne, & Epstein, 2004; Miller, 1994). Students with ED may be unable to build or maintain satisfactory interpersonal relationships with others (National Information Center for Children and Youth with Disabilities, 2004). They may have difficulty in communicating verbally and non-verbally and experience trouble expressing sympathy, warmth, or empathy toward others. When placed in situations with culturally similar students they act inappropriately or incongruently with social norms. They sometimes express unhappiness or depression through aggression, irritability, or withdrawal. They may also engage in inappropriate touching and other offensive behaviors which negatively impact friendships. These feelings and behaviors are not temporary or situation specific, but span all life situations (Connecticut Department of Education, 1997). Furthermore, students with ED exhibit poor coping skills and have preferences for few transitions and habitual events (Clarizio, 1992; National Information Center for Children and Youth with Disabilities). It is clear that students with ED face many academic, career, and personal/social challenges. Unfortunately only a small percentage of students with these difficulties are identified as such. Many students with ED have difficulties in the personal/social domain. School counselors are one of a few school professionals equipped to work with students in the personal/social domain; therefore, it is appropriate that school counselors work with students with ED, whether officially identified or not. Students With Emotional 8 Suggestions for Practice Roberts et al. (1998) suggested that in order to become more effective in serving students with serious ED, more training and experience is needed by mental health professionals. Myers (2005) foun