Encouraging PreHealth Students to Develop Realistic Expectations Julie

Encouraging Pre-Health Students to Develop Realistic Expectations Julie R. Nelson, Kate Karacay and Emily Brunner Academic Advising Center The University of Iowa

• Counseling and Advising • How Counseling Theories Inform Advising • Intentional Advising Interventions

The Same, But Different

ON THE ONE HAND ON THE OTHER HAND • Advising is NOT Counseling § Advisors are First to Know • Different Purpose § Advising as Problem Solving • Ethical Practice § Affective Nature of Advising See Crookston, B. B. (1972). A developmental view of academic advising as teaching. Journal of College Student Personnel, 13, 12 -17.

• Counseling: • • Teaches Problem Solving Encourages Communication Values Process Orientation Provides Context

Pre-Health Challenges • • • No Guarantee Highly Competitive Few Second Chances Advising Priorities, Student Realities Beginning Well = Accurate Assessment

Problem-Solving Ability and Coping Skills • Ask Yourself, Notice: • Is this a Problem-Focused Problem? • Is this an Emotion-Focused Problem? D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

• • Problem is Solvable Problem is a Challenge (apart from self) Problems can be Successfully Resolved Problems Take Time (and that is okay) D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

• Problem Definition • Ability to Generate Alternative Solutions • Making Decisions • Solution Implementation is Realistic D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

• Student Mindset: • • Problems Threaten Well Being or Identity Create Doubt about Ability to Succeed Have Low Tolerance for Uncertainty Problems Take Time (and that is not okay) D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

Situation or problem is not changeable • Focus on student’s reaction • Advising support = helping student cope + helping student respond more effectively • D'Zurilla, Nezu, & Maydeu-Olivares, 2002; Dobson, 2010; Cormier & Nurius, 2003.

• • • “How did it feel? ” [Affective] “What did you tell yourself? ” [Cognitive] “What were you doing? ” [Behavioral] “Who supported you? ” [Relational] Describe where you were. [Contextual] Cormier & Nurius, 2003.

A Light by Which to See

• Grief and Loss • Transtheoretical Model of Change

• Elizabeth Kubler-Ross • J. William Worden Kubler-Ross (1969); Worden (2009).

• • • Denial Anger Bargaining Depression Acceptance Kubler-Ross (1969).

• Accept the Reality of the Loss • Process the Pain of Grief • Adjust to a World Without the Deceased • Find an Enduring Connection to the Deceased in the Midst of New Life Worden (2009).

• Loss of Identity—Personal & Social • Things Are Not What They Seem

• • Making Room for Grieving Normalizing Uncertainty Acknowledging Embarrassment Building Network of Support

• Prochaska & Di. Clemente (1982) • Five Stages of Change • Resolving Feelings of Ambiguity See Prochaska, J. O. & Di. Clemente, C. C. (1982) Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research, Practice, 19, 276 -88.

See Prochaska, J. O. & Di. Clemente, C. C. (1982) Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research, Practice, 19, 276 -88.

• Motivational Interviewing Aims to Stimulate Intrinsic Motivation to Change by Exploring and Resolving Ambivalence. • Effective with Advisees Who Contemplate Change but Feel Hindered by Uncertainty. Miller, W. R. & Rollnick, S. (2013). Motivational interviewing: Helping people change. 3 rd Ed. New York: Guilford.

• How Does the Student Feel about Change? • Would the Student Give You Permission to Explore Options?

• • • Ambivalence Hinders Adaptive Behavior Resistance Likely w/ Loss of Freedom or Choice Resistance is a Product of Interaction Resistance is a Barrier to Change Talk Advisor Allows Resistance Reduce Resistance to Avoid Rupture w/ Advisee Moyers, T. B. & Rollnick, S. (2002). A motivational interviewing perspective on resistance in psychotherapy. JCLP/In Session: Psychotherapy in Practice, Vol. 58(2), 185 -193.

• Establish a Relationship • Set an Agenda • Determine Multiple Behaviors in Need of Change • Student Decides on Single Behavior to Change • Importance + Confidence + Readiness Scaling • Explore Importance/Build Confidence See Miller, W. R. & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behaviors. New York: Guilford. See also Rollnick, S. , Mason, P. , & Butler, C. (1999). Health behavior change: A guide for practitioners. London: Churchill Livingstone.

Getting Them to Say It

-Soren Kierkegaard

• Beginning the Advising Relationship with Acknowledgement of Challenges • Frontloading Information without Overwhelming Students • Reflecting in Real Time: Advising as Collaboration

Getting the Conversation Started • Using Open-Ended Questions • Helping Students Develop Insight • Empowering Students to Change • Cormier & Nurius, 2003.