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Case Study: One Client’s Confident Return to College After a Medical Leave of Absence

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Posted Under: Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW

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Returning to college after a medical leave of absence can be nerve-wracking, but with the right support in place, it can also mark the beginning of an exciting new chapter. At The Dorm, a common goal for our young adult clients is to return to full-time college following time spent focused on their mental health. Currently, 77% of our client population are either attending school part-time or planning their return to their chosen college, and the results speak for themselves: hundreds have achieved success on this journey. 87% of our alumni are either full-time students or gainfully employed leading thriving, fulfilling lives.

In this case profile, we demonstrate the many ways in which our treatment model worked to set one of our clients, Kris*, up for a smooth transition back to campus.

Case Profile: Kris

Kris was a 21-year-old young adult diagnosed with major depressive disorder, recurrent generalized anxiety disorder, and social anxiety disorder. They had taken a leave of absence from college and their stated goals at the start of treatment included: 

  • Returning to college full-time
  • Making better peer connections (their ongoing social anxiety was interfering with their ability to engage with peers freely and comfortably)
  • Finding a balance in both social and academic pursuits

*client name changed to protect anonymity

The Integrated Treatment Approach

For Kris to be optimally supported, an integrative approach was necessary. Beyond addressing clinical challenges The Dorm’s treatment team recognized the importance of fostering social skills in a secure, guided environment and honing academic and executive functioning skills to enhance Kris’s on-campus success long term.

a diagram of the dorm's integrated treatment approach

1:1 Therapy & Coaching 

For Kris, both therapy and clinical coaching helped lay the foundation for a strong return to college.

In therapy, they were able to focus on social anxiety, isolation, and academic burnout through the dialectic behavioral therapeutic modality. DBT helped Kris monitor and mitigate symptoms of major depression that stood in the way of focusing on goals, engaging with others, and experiencing joy.

Complementing this work were weekly coaching sessions. At The Dorm, a coach’s role (fulfilled by a licensed clinician) is to help clients take control of the various aspects of life that are important to age and culturally-appropriate development and independence. Coaches use modalities such as Brief Strategic Therapy, executive function coaching, and Motivational Interviewing to support the clients in taking action steps toward their goals. This can look like creating schedules, setting goals to complete tasks and assignments, or even assigning clients the task of interacting with a new peer. 

Weekly coaching involved supporting Kris with:

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  • Challenging certain obsessive-compulsive tendencies that had previously made schoolwork debilitating
  • Learning how to switch gears and attention as needed to be able to nourish the various aspects of a balanced life which includes social connection and fulfilling hobbies
  • Learning how to strike a balance between being productive and incorporating an appropriate amount of rest, relaxation, and social interaction into a busier schedule
  • Increasing the accuracy of time estimation was a focus to help Kris identify how to accurately plan their schedule and balance responsibility with social plans. 

clinical coaching

Simulated College Class Group: The Dorm U

Early on in treatment, Kris was deemed a great fit for The Dorm U, a unique 8-10 week course that simulates a college classroom and is facilitated and run by licensed professionals. 

Clients get to practice the executive functioning skills necessary for succeeding in school including:

  • Working Memory
  •  Recall
  •  Focus
  • Attention
  • Interpersonal skills
  • Task initiation and follow-through

Centered around discussion and debate, The Dorm U includes a syllabus with homework to foster skills related to time management,  research, presentation and delivery, and, of course, responsibility. Clients work together in a supportive and curious environment that allows opportunities for making friends and acclimating to The Dorm outside of treatment-specific groups. 

Throughout their 10 weeks in The Dorm U, Kris emerged as a friendly and curious student who began to find themselves very enthusiastic, participating and eventually leading discussions. They became friendly with other students and learned to foster connections with them through shared experiences and interests. They began to take more initiative,  collaborating with peers on group lessons, which evolved into greater confidence presenting with newfound friends. 

Some of the tangible skills Kris began to display while in this group which  indicated greater college readiness included:

  • The ability to move past general opinions and assumptions, and develop robust arguments that could be backed up succinctly with evidence
  • Showing that they were comfortable defending their arguments in a formal environment after the DormU experience ( helpful beyond just academics but also in professional and social settings)

Many clients who graduate from The DormU report developing confidence in discussing and defending their stance on important topics, which previously may have been daunting in a school or social setting. 

Sam Coggeshall, LMSW Lead Senior Therapist and Dorm U Director, reports:

“In the thick of healing, The DormU offers clients like Kris the opportunity to engage in a humorous and welcoming learning environment where opinions and personalities can flourish.”

Dorm U

Skill-based Support Groups Including Executive Functioning

In addition to The Dorm U, Kris participated in the Dorm’s executive functioning group. This group focuses on the eight core skills of executive function: impulse control, emotional control, flexible thinking, working memory, self-monitoring, planning and prioritizing task initiation, and organization. Kris was able to gain skills to help with managing their emotions, monitoring their time accurately, and planning and prioritizing. This allowed the client to look beyond concrete tasks such as finishing assignments, and start to prioritize new goals like social interactions and relationship building. 

Medical Management & Psychiatry 

Kris worked with a consulting psychiatrist to figure out a plan of action that would allow them to have a clearer mind to do the therapeutic work necessary to achieve their treatment and academic goals.  Psychiatric consulting support at The Dorm can be considered a resource, such that medication acts as an accessibility tool to give clients an increased opportunity for the best chance of successful recovery.

Health & Wellness Programming

Throughout programming, Kris worked weekly with a Dorm Yoga Instructor to practice deep and isolated stretches that are each held for a few minutes, to open the lower and upper body. 

The client reported that the strong benefit of their yoga practice is the impact it has on their body and ability to connect with themselves. 

Before starting yoga, Kris had reported a strong dissociation between mind and body in times of stress and throughout daily functioning. Through 1:1 work with a Dorm Yoga Instructor where Kris has the opportunity and open space to practice deep yoga stretches, they have learned the ability to forge a connection between mind and body. 

Even further, Kris reports that the ability to connect with themselves is useful beyond the mind-body connection, as it has manifested into better social connectedness and daily interactions. Kris is now efficiently able to connect to themselves (mind and body) and in the return to college, comfortably navigate conversations with professors and peers more seamlessly.

Research supports the success of Kris’s return to college, such that achieving high levels of well-being is shown to be directly related to improvements in academic achievement in young adults.

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