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second World Trade Center tower had just collapsed and the Pentagon
was in flames when Duke's Counseling and Psychological Services
(CAPS) went to work staffing a special bank of phones set up to
provide psychological assistance. "Although we answered general
calls," says CAPS director James Clack, "our staff members
handled some calls where people were having a hysterical response."
From morning until midnight for the next several days, he and the
other counselors worked the phones. The crisis counseling in the
hours and days after the September 11 terrorist attacks was unexpected,
but not altogether unusual work for the staff of eleven professional
psychiatrists, psychologists, and clinical social workers at CAPS.
From their offices in Page, in the shadow of Duke Chapel, the staff
works to help students enhance their personal strengths and develop
their abilities to deal with the experiences of living, learning,
and growing at Duke. CAPS offers limited individual counseling and
psychotherapy, consultation, couples and group counseling, and assistance
with referrals; and it coordinates personal development groups and
outreach education programs.
In spite of all of the effects of the terrorist attacks, counseling
services last fall saw more of the same. "What we found out,"
says Clack, "was that the situation exacerbated the more typical
kinds of things we get." The primary "presenting symptoms"
students bring to the counselors at CAPS are anxiety and depression:
They're down, unhappy, and dissatisfied about something, the counselors
say, or they're extremely anxious, panicky, or upset. Rarely are
those presenting symptoms actually the problem, says Clack. "In
general, a college counselor will ask a student, 'What are you being
treated for?' and they'll say, 'I'm being treated for depression'
or 'I'm being treated for anxiety.' But we need to find out, what's
the problem that lies behind the symptoms?"
For most Duke students who use the services of CAPS--some 12 to
13 percent of the entire student population in a given academic
year--the underlying problem has to do with the normal developmental
struggles facing today's teenagers and young adults. That can mean
difficulties in relationships with parents, siblings, roommates,
boyfriends or girlfriends, husbands or wives, faculty members. It
might mean trouble meeting expectations, whether the expectations
are real or perceived, academic or social, self-imposed or parental.
"Even such things as not getting into the 'right' fraternity
or sorority can be very troubling," says Clack.
Students caught up in these struggles find safety in the broad net
cast by CAPS. Clack uses that analogy to describe his department:
"On one end," he says, "we are part of the safety
net, but we are also like the primary-care physicians. We take care
of the urgent matters that are occurring right now. But we are not
the specialists who pick up those students and then carry them for
the rest of their college life."
The list of groups that make up the larger safety net at Duke is
long. It extends to minority groups all across the university--the
Duke Women's Center, the Mary Lou Williams Center for Black Culture,
the Office of Intercultural Affairs, the Center for Lesbian, Gay,
Bisexual, and Transgender Life, and various religious-life groups--and
the lines can blur between counseling functions and social or peer
groups that simply provide support and community for students. CAPS
itself typically offers counselor-facilitated group meetings such
as a coping-skills training group and a support group for dissertation
writers.
There is hardly a campus corner, or a demographic, untouched by
some aspect of counseling services. And that's the way Jeff Barrow
at CAPS works to keep things. Barrow, an assistant clinical professor,
helps direct CAPS's outreach education programs. "We try to
influence the psychological growth of a wide range of students,
not only those inclined to seek appointments at a counseling center,"
he says. "It's important for us to respond [in advance] to
student difficulties and have an active voice in the campus culture."
By maintaining a high profile within the campus community, he says,
counseling services can become better known among students and members
of the faculty and staff--and can work to counteract the stereotypes
some students have about CAPS. If students are more open to counseling
opportunities, the reasoning goes, they'll be more likely to make
an appointment for themselves--or accept the recommendation of counseling
from a friend or faculty or staff member--earlier in the development
of a problem.
Toward that end, CAPS coordinates or conducts a full schedule of
educational programming. Immediately after September 11, CAPS sponsored
a discussion, "Understanding Loss." Last year, Barrow
and Clack coordinated "Sons, Daughters, and Parents: Let's
Talk About Change," and CAPS staff Mazella Hall and Laura Wagner-Moore
made presentations at "Sisters Beneath the Skin," a conference
for women from Duke, the University of North Carolina at Chapel
Hill, North Carolina State, and North Carolina Central University.
CAPS also sponsored three presentations on the multiracial nature
of eating disorders, with help from members of the Eating and Body
Image Concerns Network. Last fall, Jeff Kulley coordinated Alcohol
Awareness Week events, co-sponsored by CAPS, Student Health Services,
and other organizations. And CAPS co-sponsored, along with the Center
for Lesbian, Gay, Bisexual, and Transgender Life, a coming-out group
for students interested in understanding their sexual orientation.
Besides these campus-wide programs, Barrow says, CAPS focuses outreach
efforts on training students to play a peer-counseling or peer-education
role. CAPS works with resident advisers, Health Peer Educators,
and Peer Educators in Eating and Body Image Concerns. "Staff
members in other offices who oversee these groups are pleased to
have us contribute to the training," Barrow says. "Time
that we spend in enhancing their skills pays dividends, since they
interact with so many other students."
Grades, a major element in that pressure-cooker that is Duke, regularly
prompt students to seek counseling. "Not that they come to
us for tutoring, because we don't offer tutoring at CAPS,"
says Clack, "but because they're not doing as well as they
would wish, or as their parents or someone else would wish."
Academic pressure and the desire to excel seem to manifest themselves
in opposing behaviors: perfectionism and procrastination. As a lecturer
in the University Writing Program and a pre-major adviser, Christina
Askounis frequently sees students who put off their work for fear
of under-performing, or not performing flawlessly. "It's tough
for Duke students, because many of them have powerful perfectionist
tendencies," she says, "which can work for you if you
know when and how to put them to use, but can hobble you terribly
as a writer--and as a person--if you don't."
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