University Times

I understand that you provide up to six sessions of "brief counseling" to Pitt employees and members of their households. What can you do in this short time?

Certainly not all problems can be quickly resolved, but brief counseling which is focused on solutions can often help people in practical ways to change a behavioral style, better understand a work system, manage stress more effectively, learn new communications skills, etc. How does the process works? First, the counselor will ask questions to determine the client's issues or difficulties. Then the counselor will want to know the goals of the client — what he or she would like to change or explore. Finally, the client and counselor develop a plan. For example, the plan may include the client reading packets of materials supplied by the FSAP or reading recommended books. Support groups such as Alanon, AA, Debtors Anonymous, etc., might be suggested. Other tasks might be for the client to monitor his or her self-defeating thoughts and practice changing them, or for the client to practice new behaviors, e.g., using assertiveness skills.

The counseling focuses on one or two attainable goals, is based upon what the client wants to change, and involves "homework" or tasks so that as much as possible is accomplished in the sessions. If the problem has been bothering the person for a long time or is really serious, what do you do? The counselor will help the client find an appropriate resource. Health insurance benefits generally are used to help cover the cost. The FSAP counselor will also help with any difficulties that may be encountered with Green Spring, the managed care company that authorizes use of in-network mental health providers. Can you give examples of the kinds of problems about which people call? To protect confidentiality, the following cases have been constructed out of bits and pieces of actual cases. Any resemblance to any particular person is purely coincidental.

1. A married couple sought counseling because the wife, who was a staff member, was afraid that her husband was having an affair, even though he assured her that he was not. After a joint interview, each was seen separately. In her session, the wife talked about her father having had an affair, as did her grandfather. The couple had several more joint sessions in the FSAP with the goals of helping them regain trust and improve communications skills. When last contacted the couple said that their marriage was doing well.

2. A client who held a professional position on campus told a counselor that he was drinking two glasses of wine with dinner and having two drinks of scotch after dinner. The client said that he used to drink very little but now suspected that he was abusing alcohol; the counselor concurred. The plan agreed upon was for the client to attend regular out-patient counseling sessions with a substance abuse counselor and to go to AA meetings. The client was also told that his wife, who had expressed concern about his drinking, could use the FSAP for herself, which she later did. Her counselor provided her with information about alcohol and suggested Alanon. With help, the client was able to sharply curtail his drinking, and his family life became more satisfactory for his wife, his children, and himself.

3. The client, a professor, said he needed help in managing the stress of trying to balance research, teaching, office hours to see students, committees, grant-writing, spending time with his wife (who also had a busy career), working out, and trying to devote a little time to photography, his favorite hobby. During the assessment, the client, who seemed overwhelmed, began to talk about symptoms of depression. He was having trouble sleeping, had lost weight, was irritable, felt sad, and was beginning to be unable to function well at work and at home. In this case the original problem sounded as if it were a stress issue, but further assessment uncovered depression. Options for treatment were discussed with the client, who eventually decided to see a private provider for psychotherapy; that provider then recommended a psychiatrist for consultation about an anti-depressant medication. In about five weeks, the client felt better and was again able to manage his active lifestyle.

4. Another client, also a professor, asked for help in coping with grief. She had come to Pittsburgh fairly recently (loss of a familiar place), her father had died a year ago (an anniversary reaction to a death often causes feelings of grief to re-emerge), her husband's promotion had resulted in his traveling often (he was not available for support), and her youngest daughter had just gone to an out-of-state university (many parents have trouble adjusting to this). The plan was for the client to use FSAP sessions to resolve some of the grief issues with the goal of regaining her former sense of equilibrium. She was given reading materials about grief and loss, and her many role transitions and their implications were discussed at length. With more insight, and a realization that it was normal for her to feel sad and temporarily depressed, the client gradually began to look forward to the next phase of her life.

5. A client came to the FSAP to talk about work-related issues. The client was worried about confidentiality, but was assured that FSAP counselors abide by all confidentiality rules and ethics of their profession and that no one in his/her department would know about anything that was discussed. The client was worried about job security and concerned that guidelines for continued employment were not clear. There was pressure to do more and more, and the person was feeling an enormous amount of stress. The counselor and client agreed to use the FSAP sessions for the client to learn stress management skills and devise a way to talk to the administrator about job expectations.

6. A man who was an administrator and his wife were worried about their 15-year-old daughter. The daughter was getting good grades and was on her school swim team. However, she often said that she was too fat, Also, although she usually ate little, two or three times a week she would eat large amounts of food. Then she would exercise fiercely. At other times, the exercise was more moderate but always a regular part of the daughter's routine. When the family bathroom scale broke, the daughter became almost hysterical. The counselor suspected that the girl might have an eating disorder and suggested that the parents have her assessed; a resource was provided. The daughter was diagnosed with bulimia and began treatment. Is the FSAP really confidential? We never reveal any information about a client without a written release unless there is a legal obligation to do so, e.g., if someone is threatening to harm self or someone else. We never talk about who uses the FSAP, nor will we answer telephone queries about whether someone has been here. All records stay in our office. We have private waiting areas and a back door. Confidentiality is of the utmost importance to all FSAP staff.

To schedule an appointment or to talk to a counselor at the Faculty and Staff Assistance Program, call 647-3327 or 1-800-647-3327.