In the coming weeks, many students are excited to return to college, but with a youth mental health crisis at an all-time high — is every student ready to dive back in?
What many students may not know is that it does not have to be an “all or nothing” choice. With a custom supportive plan in place, young adult students can absolutely work up to full-time academics even if a leave of absence or staggered return helps ease the transition.
At The Dorm, we work with students on their individual goals and help them return to school when they are truly ready and set up for success. The most important thing is that a young person is clinically and personally supported in the ways they need to thrive on campus.
In the following case study, we outline an example client (like many individuals we see and support at The Dorm) and share how our team of interdisciplinary professionals weighs in on recommendations, and charts a path back to class.
Example Client Case Study | “Jack”
- “Jack” is a 21-year-old, male, cisgender young adult. He has been diagnosed with Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Major Depressive Disorder, and an Eating Disorder.
- He originally attended university a plane ride away from home and ultimately took a medical leave for treatment. He joined The Dorm as a step down from residential treatment, and resided in recovery housing while receiving intensive clinical care. Now he has stabilized and has made clinical gains. He has progressed, with time, from 30+ hours a week at The Dorm down to 4-6 hours of structured care a week while he prepares to return to school.
- Ongoing challenges: Jack continues to struggle with obsessive thoughts. Lethargy from depression and chronic pain has impeded his ability to connect with others and a belief that if he was in a different body, life would be better. He still experiences a great deal of anger and frustration with his family and other relationships, and continues to resort to binge/restrict cycles.
- Jack’s goals are to form healthy relationships and connect with others, and to better manage the stress of demands of school and social life. He also hopes to enhance his relationship with food and his body and eventually to return to college full-time.
Ready to Return to College? Mental Health Experts Weigh In
Dr. Seth Mandel, MD | Psychiatrist
Specific Considerations for Jack:
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- My recommendation would be for the client to ease his way back into school.
- Anticipating the increased stress of school, as well as potential exposure to substances, we would consider medication assisted treatment for substance use. Physical symptoms of lethargy and chronic pain should also be addressed. A stimulant can alleviate fatigue and improve focus. Stimulant medication can also treat binging but can cause significant reduction in appetite as well. The client’s weight should be monitored on an ongoing basis. An SNRI medication can have beneficial effects for pain as well as depression and anxiety.
- Regular follow-ups with a psychiatrist are needed to assess how the client reacts to the stress of school. The frequency of visits will temporarily increase to every 2 weeks as medications may require adjustment. Ongoing coordination with Dorm team members regarding the client’s progress or regression is essential to achieving the desired outcomes and goals.
Dr. Mandel’s General Considerations for All Young People Returning to School:
- I recommend that any young adult should be receiving adequate medication management to target their primary conditions as residual symptoms may significantly impact academic performance and social interactions.
- Managing the stress and demands of schoolwork and social life requires basic self care. A young person needs adequate rest and exercise, as well as proper nutrition to be successful. Proper clinical support is required as indicated.
- Streamlining medication regimens can maximize chances for full adherence. Medication side effects such as insomnia, sedation, and cognitive slowing can adversely affect a successful return academically. Other side effects such as weight gain and sexual dysfunction can lead to impaired social interactions and ultimately, non-adherence.
- A young person’s clinical condition may cause issues with focus and concentration, decision making, and initiating tasks. Consideration should be given to the potential need for special accommodations such as time-and-a-half on exams, the presence of a note taker, and use of a laptop during class.
Adrienne Frumberg, MA | Academic Advisor, The Dorm
- When considering Jack’s return to school, I would complete an academic assessment with him. During this time, I would learn about his comprehensive strengths and weaknesses, previous academic history, any learning concerns, and long-term goals.
- Based on this conversation, I would suggest that he utilize the resources available within The Dorm, such as Dorm U. This will allow Jack to revisit his student skills in an environment that will also prepare him to start college in a more traditional academic setting full-time at a later date.
- After taking a course within Dorm U, the next step I would take would be to consult his coach and therapist about Jack’s level of readiness for college.
- If his coach and therapist believe Jack is ready to return to college, I would suggest he start by taking one or two courses at a local college close to The Dorm as a non-matriculated or visiting student. With this status, Jack can take credit-bearing courses that can be transferred to another university to contribute to earning a bachelor’s degree.
- I would encourage Jack to utilize executive functioning tutoring to approach his academic courses in an organized manner. After taking a few courses with a non-matriculated or visiting student status, Jack would then be ready to consider applying as a transfer student (which can be started as full or part-time).
Alyssa Goldenberg, LMSW | Therapist & Clinical Coach, The Dorm
- My recommendation would be for Jack to ease his way into his return to school this semester rather than returning full-time. After coordinating with his full clinical team, I may suggest taking a few classes at a local college while maintaining his current clinical hours at The Dorm.
- Remaining part-time at The Dorm while slowly transitioning back into class will allow Jack to maintain his rapport with his treatment team and peers. He is still early in his recovery and needs significant services to maintain clinical gains and to help him practice the new clinical and life skills he has learned.
- What is unique at The Dorm is that Jack can map this progression while maintaining continuity of care with an interdisciplinary team he trusts and who has worked with him ever since he began intensive treatment. We will walk alongside him as he returns to school on his terms. When he is exposed to the very things that had triggered him in the past, he will already have a stronger skill set in place and the ability to practice those skills in real-time with a Dorm clinical coach.
- Some of the supports that will be most valuable during this time include:
- Wakeup calls and weekly checkins via text message and by phone, both when Jack is on-campus and off.
- Weekly toxicology screenings and the maintenance of a recovery record (through a meal support app).
- A mix of virtual and in-person treatment including maintaining sessions with his therapist and a few groups including The Dorm U, a simulated college class setting which offers a safe, supported place to practice matriculated coursework and experience the structure and expectations of a college class.
- Planned and coordinated Dorm study time for onsite accountability, as-needed sessions with an academic advisor, and coordinated Clubhouse time for social activities. Practicing socialization skills in a safe and supported setting is key.
- We will work with Jack on making sure he has access to and is aware of his university campus resources such as the counseling center and the disability center.
Overall Dorm Recommendation
From where Jack began at The Dorm, he has made immense gains and is slowly on his way to realizing his dream of returning to college full-time. At this time, The Dorm’s recommendation would be for him to ease back into classes with the strong scaffolding, structure and community support of his existing Dorm clinical team and peer group.
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