What to Do When Everyone "Needs" Counseling

When Every Concern Becomes Counseling

Why are you allowing your staff to diagnose your students? Seriously. When a teacher catches you before the bell and they say, Can you go check on him? I think he has anxiety. Or you get an email that says, She's completely shut down. I think she needs counseling. Or someone catches you and says, That kid needs coping skills. And then the nurse has a kid they're worried about. And so does admin. And then a parent calls. And every one of those people is genuinely worried about one or two kids. But the problem is all of those kids converge onto the same counseling office. Yours. And before you know it, you're adding names to an endless list. You're trying to squeeze in check-ins and you're trying to figure out where the heck you're going to put one more kid. So as you're trying to determine all that and get all of your plates spinning and your ducks in a row, I want you to stop for a second and just ask, how do we know? How did we get from I'm concerned about this student to this student definitely needs counseling? Because those are not the same decision. And there has to be something in between. If you're a few weeks into the school year and your inbox is already filling up with requests like, can you talk to him? I think this kid needs counseling. Can you check on her? Today's for you because once those referrals start coming, they pile up fast. And before you know it, you've got a list of students you're supposed to see without anybody being especially clear about what the problems are you're supposed to be solving. Y'all, send them to the counselor is not a decision-making process. So if you're ready for some straight talk, my friend, some clarity on your work and maybe a little bit of rebellion, you are in the right place. I'm Steph Johnson, and this is the School for School Counselors podcast.

Concern Is Not A Treatment Plan

So here's my hot take for the day. A referral tells you somebody is concerned. It does not tell you what the student needs. That's it. Concern is information. It is not a requirement. And somewhere along the way, I think a lot of schools have kind of melded these two into one thing. Student is struggling, therefore they need to see the counselor. And that shortcut is where we get ourselves into a lot of trouble. Imagine you go to the doctor because your knee really hurts and you tell the doctor, my knee has been killing me for three weeks. And the doctor says, All right, surgery. Wait, wait, wait, wait, wait. Hold on. Could we maybe figure out what's wrong with my knee before we decide the intervention? Because the symptom is real, but it does not get to prescribe the treatment. And we understand that for almost everything else in our lives. But for some reason in schools, we kind of jump past that. The kid cries, we send in the counseling. Kid won't work, counseling. Kid gets angry, counseling. Kid looks sad, counseling. Kid gets sent out of class three times, counseling. And sometimes, absolutely, counseling is what that student needs. But sometimes we don't know yet. I may have mentioned before a student that I had who looked like he had all kinds of things going on. He was irritable and he couldn't focus and he wasn't doing much work and just kind of generally seemed off. So of course, everybody started doing what people in schools do. They started guessing. Maybe it was motivation, maybe it was behavior, maybe he needed coping skills, maybe he just needed somebody to check in on him and build that relationship. But I didn't just jump into an intervention. I tried to figure out what was really going on. And you know what it was? The kid was hungry. He was hungry. That was it. He was not dysregulated or oppositional or disengaged. He was hungry. And he just needed a snack. And the thing is, I could have built the coolest intervention plan in the world for that kid. And we could have talked about feelings and practiced breathing and worked on regulation. We could have had a check-in schedule and relationships galore, but he still would not have been his best self because he was hungry. And that's the kind of thing I don't want to slip past us. A student who supposedly has anxiety may be falling apart in one class but just acting weird in all the others. So why is that? A kid that everybody says needs regulation skills may actually be getting pulled into power struggles with adults who are escalating right along with him. These are not insignificant details. And they could completely change what we think the problem is.

Look For Context Before Labels

And this is one of the reasons that you hear me talk so much about consultation. Thomas Gutkin has argued for years that school-based psychological work gets really distorted when we start placing the problem entirely inside the kid. He has an ecological approach. And he says that we should look at the interaction between the student and the environment around them rather than just assuming that the student is the location of the problem. So in addition to considering what's happening, we have to consider where, when, with who, what seems to happen right before it, who else is seeing it, and who isn't. Because sometimes the best answer we can have in these initial conversations is, I don't know. And that's not communicating that you don't care or that you're incompetent. It could be the smartest thing that anybody could say, because the goal isn't to make referrals faster, it's to make them smarter. So the person referring the student your direction may be completely right, but they also may not have the whole picture. And here's where it gets a little bit complicated because I don't want to turn this into, well, teachers really don't know what they're talking about. No, that is not what I'm saying. A teacher can be absolutely right about what they're seeing. A student may be crying in her class every day. They may be refusing work or putting their head down. Those observations can be 100% accurate, but they can also be incomplete. Andre de los Reyes and his colleagues have spent years looking at what happens when different people report on the same child's emotional or behavioral functioning, where parents report one thing, but teachers report something different, and the student tells us something else entirely. In those situations, it is very tempting to ask, okay, so who's right? But sometimes the disagreement is the information. Maybe the student is having tremendous difficulty in one environment, but almost no difficulty in another. That's important. Maybe the student is telling you something that nobody else has noticed yet. That matters too. One person's view of the situation can be accurate, but also be incomplete. And that's another reason that I get super nervous when we start jumping too quickly from I'm seeing this to this is what's wrong, to this is what the school counselor needs

Slow The Ladder Of Assumptions

to do. Those are three different moves: observation, interpretation, and obligation. And schools tend to climb that ladder in about three seconds flat. She cries every morning, so she must have anxiety, she needs counseling. Yeah? Okay, so slow that down a little bit. She cries every morning, observation. She has anxiety, interpretation. She needs counseling, obligation. Maybe we should hold our horses a little bit and describe the student before we try to explain the student. Tell me what you're seeing. Tell me when it happens, tell me what it looks like, and then we can work from there. So now we've gotten to the part that might make you a little uncomfortable because it would be very easy to hear this and decide. Okay, great. So from now on, nobody can send a kid to the counseling office until they answer these seven questions and provide two weeks of documentation. Please don't do that. Your teachers do not need another four. They will probably hate you forever, and they definitely do not need to become amateur diagnosticians. Honestly, we actually need them to do a little less diagnosing. So if a teacher is worried about a kid, I want them to come tell you. The question is, what happens next? Because teachers don't know what the intervention should be, right? They should just be telling us what they're seeing. And then your professional judgment enters the conversation. Even if they've told you what they think should happen, you can slap a pause in there and you can go talk with the teacher or observe the student or talk to the student and get their perspective. Or maybe you call home or we change something in the classroom environment, or maybe you just go check in with the student once or twice. And maybe in one or two of those, you determine there really is a counseling need and this kid really does need to see you. Great. But we also have to remember that being a responsive counselor does not mean an automatic yes. And I think this is a weird spot where a lot of us can feel really uncomfortable because we know our caseloads are exploding, but we also don't want people thinking, well, don't bother asking the counselor, she's just gonna tell you no. The good news is those are not your only two options. This is not a this or that decision. There is a space between, yes, I'll pull them in for counseling, and no, that's not appropriate. And that space is where your expertise lives. Your job is not to be the automatic next stop. Your job is to help figure out what the next stop should be.

Better Referral Questions That Work

Okay, so how do we actually do this? And especially how do we do this without ticking people off? Because sometime soon somebody's absolutely gonna catch you in the hallway and say, I think this kid has anxiety. Now, you don't have to launch into a protocol and explain the ins and outs of anxiety and what you need to look at, right? Nobody's probably interested in that. But you can say something like, interesting, what's making you think that? Simple as that. Or someone says, She needs coping skills. You say, Okay, well, tell me where you think she's having trouble coping. Or sometimes you just get that blanket demand that sounds like a request where they say, She needs counseling. And you can say, maybe, tell me what's going on. Notice what you're not doing. You're not immediately jumping into action, you're not arguing, and you're not rejecting their concern. You're just trying to get closer to what's actually happening before you promise the intervention. And that is a very different conversation than the ones you typically have. And honestly, this speaks to something I think we could all teach our staffs that would make our lives infinitely easier, which is I don't want you to ever feel like you have to label a kid for me. If you're worried about them, just tell me what you're seeing, and then we can figure out the rest. How much easier is that than putting a kid on your caseload blindly because someone thinks they might need counseling? And then your staff doesn't have to figure out if it's anxiety or regulation or coping skills or motivation or trauma or just a simple this kid needs counseling and we don't know why. Y'all bring me what you see. We'll work together from there.

Check Your Own Snap Judgments

And before I let you go, there is one more thing we need to talk about because we've spent this whole episode talking about what happens when everybody else is trying to fill in the blanks too fast. Teachers, parents, administrators all want the fast solution. But sometimes we do it too. You sit down with a kid who's barely looking at you, giving you one-word answers, they're just shrugging their shoulders at everything, and they're generally just kind of checked out. And in those situations, your brain starts working before the kid even gives you any information. You start thinking things like depression, avoidance, trauma. And the longer you've done this kind of work, the faster your brain fills in the blanks. But that doesn't mean your answers are correct. So before you apply the theory or the label or you decide what you think the kid needs, stop and reflect. What do I actually know? Because a request for help is a request for help. It is not a prescription for counseling. Maybe the kid needs you. Maybe they 100% do. But just be sure that when you say yes, you know what you're saying yes to. Take care.