The Mindfulness-Informed Educator

Building Acceptance and Psychological Flexibility in Higher Education

Jennifer Block-Lerner, LeeAnn Cardaciotto, Jennifer Block-Lerner, LeeAnn Cardaciotto

• Publisher: Routledge
• Year: 2016
• eBook ISBN: 9781317747970
• Topic: Education
• Subtopic: Higher Education

The Mindfulness-Informed Educator moves a growing body of evidence related to the efficacy of mindfulness- and acceptance-based approaches to the context of higher education, suggesting ways to foster psychological flexibility within and outside of the classroom. In the book, professionals across education and psychotherapy will find best practices for teaching, treating, researching, and serving their communities in ways that are sensitive to context, consistent with their values, and mindful of the diverse array of mental-health and behavioral difficulties experienced by college and university students. Chapters incorporate the most cutting-edge research across disciplines and span educational levels and contexts within higher education, provide strategies for strengthening mindfulness- and acceptance-based pedagogy and program development, and provide user-friendly supplemental materials such as transcripts and sample assignments.

Part I

Setting the Scene

1

Making the Case Mindfulness- and Acceptance-Based Interventions in Higher Education Jennifer Block-Lerner and LeeAnn Cardaciotto

Need I say it? The curricula offered by our institutions of higher education have largely neglected this central, if profoundly difficult task of learning to love, which is also the task of learning to live in true peace and harmony with others and with nature.

(Zajonc in Palmer & Zajonc, 2010, p. xi)

Introduction

In the day-to-day of tasks related to teaching, scholarship, service and all the other hats that educators wear; to accreditation, retention, and budgets that administrators’ days revolve around; to the suicide, sexual violence, and hazing that counseling center, residential life, and other student support staff find themselves battling, how many professionals within higher education connect with what Zajonc (in Palmer & Zajonc, 2010) considers this “central, if profoundly difficult task” (p. xi), helping students learn to love? To, even if not feeling peaceful and harmonious in every moment, realize their interconnectedness with one another? Yet research suggests that these students, at institutions of higher education of all shapes and sizes, desperately need all of those who serve them—faculty, staff, administration—to connect with this purpose, and maybe even to embody it.

Indeed, colleges and universities, as multifaceted entities with the potential to engage in evidence-based practice at many levels, have significant potential to serve as what Biglan, Flay, Embry, and Sandler (2012) deem “nurturing environments.” Biglan et al. describe these as environments that foster successful development and prevent (and/or ameliorate) the development of behavioral/psychological problems. While this work has emphasized influencing the trajectory of children and adolescents, Biglan and colleagues have spoken to related possibilities for higher education (Biglan, Hayes, & Pistorello, 2008). Also addressing this enormous potential, Eisenberg, Golberstein, and Hunt (2009) speak to “the many ways in which college settings can reach young people,” and go on to state “college represents the only time in many people’s lives when a single setting encompasses their main activities, social networks, and a range of supportive services and organizations” (p. 1). Further, as large institutions and microcosms of broader communities, colleges and universities provide fertile ground for studying processes of engagement and transformation (DiGiuseppe, 2014).

Given that students are at the core of higher education activities, this chapter will “set the scene” to provide a rationale as to why increased attention needs to be paid to intervention and prevention for this population. Specifically, this chapter provides an overview of behavioral health difficulties college students often struggle with; discusses help-seeking in these students; presents innovative services that have been developed to target the behavioral difficulties and what is known about help-seeking; speaks to the theoretical rationale for and promise of mindfulness- and acceptance-based approaches in this context; and provides a roadmap of the parts of the book to come.

College Student Mental Health

Psychological Disorders and Symptomatology

Years spent in college are brimming with opportunity and challenge. Students often live away from their families for the first time, have much more control over their schedules than they have had previously, get to set and work toward career goals, find new and/or nurture existing hobbies and passions, and develop formative and intimate relationships with peers and supportive and guiding connections with new mentors. However, they are also often engaging in part-time if not full-time employment (American College Health Association, 2009), balancing family responsibilities, engaging in high-risk health behaviors, and navigating often fragmented systems within the institution. Further, students in institutions of higher education face many of the same challenges that all members of the population in developed countries are facing, including the barrage of media on difficult (and often out of the viewer’s direct control) situations all over the world and pressures and pulls to be “on” at all hours of the day via increasingly sophisticated technology (e.g., Rosen, Carrier, & Cheever, 2013).

Indeed, college students facing these opportunities and challenges are vulnerable to a host of mental health difficulties, including depression, anxiety, substance use, and disordered eating, which often result in subsequent impairments in academic and social functioning (e.g., American College Health Association, 2009; Eagan et al., 2014). Blanco et al.’s (2008) widely-cited study comparing college students and their non-college-attending peers found that approximately half of college students met DSM-IV criteria for one or more mental disorders in the previous year (comparable to young adults not attending college). A recent large-scale study found somewhat lower, but still substantial percentages: Approximately 17% of college students screened positively for depression, 4% for panic disorder, 7% for generalized anxiety disorder, 6% for serious suicidal ideation, and 15% for nonsuicidal self-injury, with many experiencing co-occurring mental health difficulties (32% of students total screened positively for one or more mental health problems; Eisenberg, Hunt, & Speer, 2013). Variations across demographic groups as well as campuses were described (most notably that all other ethnic groups relative to white students had a higher likelihood of screening positively for depression), and those who reported struggling or having struggled financially were particularly at risk for depression, anxiety, and suicidal ideation (Eisenberg et al., 2013). Buchanan (2012) summarizes the results of many studies that speak to implications of depression for college students, including decreased grade point average (GPA) and academic productivity, increased levels of smoking and alcohol consumption, and self-injurious behavior and suicidality.

In addition to research that speaks to diagnosed or potentially diagnosable mental health conditions, other studies address psychological issues more generally that may play a role in the college experience. For example, the American College Health Association (ACHA; 2009) found that 33.9% of its over 80,000 student participants reported that stress affected their academic performance. Sleep difficulties were similarly named as contributors to academic performance for 25.6% of participants, alcohol use for 7.8% and the following falling somewhere in between in terms of the percentage of students endorsing the impediment to academic success: depression and anxiety, relationship difficulties, death of a friend or family member, and concern for a troubled friend or family member. Further, 43% reported feeling so depressed it was difficult to function on at least one occasion over the past academic year, and 9% seriously considered attempting suicide at least once in the past school year (ACHA, 2009).

Changes in Symptomatology Over Time

Directors of counseling centers, those who oversee the individuals treating many students with mental health concerns, tend to believe that there has been an increase in the number of students with severe psychological problems (Barr, Rando, Krylowicz, & Winfield, 2010; Gallagher, 2005; Watkins, Hunt, & Eisenberg, 2011). For example, Barr et al. (2010) found that 71% of the 385 counseling center directors who responded to their survey believed that the number of students with psychological problems had increased in the past year. This belief is supported by a birth cohort study of over 63,000 college students that found a large generational increase in psychopathology over the long time span between 1938 and 2007 (Twenge et al., 2010). Hunt and Eisenberg (2010), however, acknowledge and address the complexities of this topic, drawing on epidemiological data related to the prevalence of mental health problems as well as help-seeking in the general population across the lifespan. These authors conclude that the overall prevalence of mental health disorders has likely remained stable or possibly increased by a small amount. It is probable, however, that the increased use of mental health services among children and adolescents has allowed a broader range of young adults to enter college than was the case in previous years, supporting counseling center staff’s experience of increased severity within their caseloads (Hunt & Eisenberg, 2010). Interestingly, in a study that involved review of archival data of a random sample of students seeking treatment at a large college counseling center across seven years, Jenks Kettmann and colleagues (2007), simultaneously considering client self-report and clinician ratings, found that diagnosis severity ratings did not meaningfully increase over time. However, the complexity of student issues (i.e., presence of multiple disorders) did increase. This increasing complexity (if borne out by studies with more attention to external validity; Jenks Kettman et al.’s data were from one university), coupled with increased use of mental health services in younger populations discussed above (Hunt & Eisenberg, 2010) and the substantial needs of diverse millennial students (Watkins et al., 2011) likely all contribute to the overall impression of increasing severity among professionals working in this area. At the very least, data converge to indicate that the numbers are not moving in the directions of better health for today’s college students.

Substance Use

Substance use and abuse, mentioned above as a student-reported impediment to academic performance, is of particular concern for individuals on college and university campuses. Johnston, O’Malley, Bachman, and Schulenberg (2011) indicate that 65.8% of full-time college students reported engaging in some alcohol use in the past 30 days. While this may not necessarily be problematic or illegal, 42.4% report being drunk within that same timeframe, suggesting increased vulnerability to alcohol-related problems including risky sexual behavior (e.g., Turchik, Garske, Probst, & Irvin, 2010). Further, 36% of full-time college students report using any illicit drug (including marijuana) in the last year; 20.7% within the last 30 days (Johnston et al., 2011). Kolek (2009) studied recreational use of prescription drugs in a generally representative college sample, and found that 12.8% of students endorsed having engaged in such use within the last year, with 23.7% of those reporting using their own prescription for such use. Finally, according to the most recent ACHA-National College Health Assessment, discussed in ACHA (2012), 18.3% of students identify as tobacco smokers (have smoked at least once in the last 30 days).

To some degree, substance use is a normative behavior for individuals in the age groups of individuals who form the majority of those who attend college (e.g., 18–24 years). Authors of the large-scale rigorously conducted ongoing study Monitoring the Future (Johnston et al., 2011) specifically compared substance use rates in college students with those of their non-college-attending peers. While rates of illicit drug use tended to be higher in young adults not attending college, college students specifically report higher levels of many indicators of alcohol use (i.e., lifetime, annual, and last-30-days use, as well as occasions of heavy drinking or five or more drinks in a row in the previous two weeks; Johnston et al., 2011). These high levels of substance use may be problematic for many reasons, especially those related to impact on academic and other elements of success during one’s college years.

Implications of Mental Health and Substance-Related Issues for Students’ Success

Psychological difficulties as well as substance use and abuse can be strongly related to students’ success in college. In a longitudinal study with a random sample of students, Eisenberg, Golberstein, et al. (2009) found depression to be a significant predictor of lower GPA and a higher probability of dropping out, especially among those students who also screened positively for anxiety disorders. Symptoms of eating disorders were also correlated with lower GPAs. Ruthig, Marrone, Hladkyj, and Robinson-Epp (2011) also employed longitudinal methods and found that binge drinking negatively predicted academic performance for females, and tobacco use predicted the same for males. Additionally, Arria and colleagues (2013) found that both mental health issues and substance use were associated with lower levels of persistence in college, albeit at different times in the college experience. Studying “discontinuity” (a gap in enrollment of one or more semesters) specifically, Arria et al. reported that higher scores on a measure of depression predicted discontinuity within the first two years of college, while alcohol and cannabis use predicted late discontinuity (i.e., in the second two years of college). Finally, Hartley (2013) found that mental health and resilience variables, both as main effects and an interaction between them, predicted the amount of credits completed over time (but not GPA, which may be attributable to the unreliability of measuring this via self-report).

Taken together, these findings are concerning for all involved in higher education in terms of apprehension for students’ own well-being; consideration of how these issues shape classroom, cohort, and program-related experiences; and implications for the financial health of the institution (Eisenberg, Golberstein, et al., 2009). This is especially so, given increased attention to and pressure on colleges and universities related to 4- and 6-year graduation rates (e.g., Carr, 2015)¹ and the implications for students of earning versus not earning a college degree in terms of employment and salary rates (Pew Research Center, 2014).

Campus-Based Resources for College Students

Considering this picture of substantial mental health and substance-related issues facing students attending colleges and universities, as well as the impact of these on functioning, understanding the resources available to these students, as well as their use of them, is extremely important. College counseling centers, as the designated place for students struggling with behavioral difficulties to go, offer an obvious starting place. While the numbers vary a great deal based on type and size of institution, a relatively recent survey reports an average ratio of paid staff members to students of 1:1738.4 (Barr et al., 2010). Even based on low estimates of students struggling with psychological difficulties and/or substance-related concerns, these numbers suggest very high caseloads and/or long waiting lists for students in need. Brunner, Wallace, Reymann, Sellers, and McCabe (2014) summarize literature that suggests that approximately 60% of counseling center professional staff time is devoted to direct service, and they (along with Schwartz, 2013) speak to the many ways that counseling center professionals aim to help their student bodies, both directly and indirectly (e.g., outreach, consultation with faculty and staff, workshop leading) in their remaining work hours. It is important to ensure that the time of these staff members is put to g...

Table of contents

• Cover Page
• The Mindfulness-Informed Educator
• Title
• Copyright
• Dedication
• Contents
• Contributors and Affiliations
• Acknowledgments
• Part I Setting the Scene
• Part II Mindfulness- and Acceptance-Based Approaches in the Training of Behavioral Health Professionals
• Part III Application of Mindfulness- and Acceptance-Based Approaches in Higher Education: Special Populations and Contexts
• Part IV Conclusion
• Appendices
• Index