Concern about a Friend

Friends are usually the first to notice when a peer is in distress.  You may notice that your friend is excessively sad, worried, irritable, withdrawn, or just “not themselves”.  Perhaps you are concerned about a pattern of unhealthy behaviors (e.g., drug or alcohol abuse, eating disorder, self-injury) or that they have stopped going to class and are sleeping much of the day.  Expressing your concern to your friend and encouraging them to seek help may well be the first step in their healing.  Helping a friend can often be challenging, though.  They may dismiss your concern or they may be depending on you more than you feel comfortable with.  

How can I help?

• Describe what you observe. Be objective by stating what you observe and are concerned about and avoid making assumptions about why your friend is distressed (e.g., you seem pretty upset…, unhappy…, anxious; you said you were missing class…, I am worried about how much you’re drinking…not eating…etc.)
• State your concern for your friend. Indicate that you are concerned about their well being and that you want to help.  Patiently repeat your concern if necessary.
• Inquire. Ask about what seems to be wrong or how you could help.
• Listen. Just listen, carefully, sensitively, without judgment.  Give them your undivided attention.  Accept what they are saying without agreeing or disagreeing with his/her behavior or point of view.
• Empathize. Sincerely communicate your understanding of the issue as they describe it, in both content and feeling.
• Ask this question: “What have you tried or planned to do about this concern?”
• Offer Hope. Help them understand that the situation can improve, and that things will not always seem so bad.  Do not try to fix too quickly, criticize, moralize, correct, or make decisions for them.  
• Encourage. Encourage your friend to continue to talk about their issues, and remind them that it is normal to talk with someone he/she can trust when in need of help.  Talking is a natural way to relieve stressful emotions.
• Offer Options. Your friend may find it helpful to talk also with their R.A. or Community Director if they live on campus.  They may want to talk with a trusted faculty member, administrator or staff member.  They may want to talk with a family member, family physician, or family clergy
• Suggest speaking to a therapist at Counseling and Psychological Services.Remind them that it’s free and confidential.  Tell them that talking to a CAPS therapist is a mature, healthy step to take, and is not a sign of weakness.  Offer to help them call for an appointment or walk over to CAPS with them.

What if the person is reluctant or refuses to visit CAPS (and it is not an emergency)?

• Don’t force the issue. simply restate your concerns and the available options.
• Suggest that confronting a problem is a positive sign of health and maturity.
• Acknowledge, validate, and discuss the person’s concerns about visiting CAPS.
• Remind them that CAPS is free and confidential and that the therapists have years of experience
• Be friendly, remain open and available to help in the future.
• Suggest they take some time to think it over.

What if this is an emergency (i.e., suicide threat or dangerousness to self or others)?

• Call CAPS at 966-3658 and speak with the Urgent Consultation Team
• Call 911
• Call Campus police
• or go directly to the emergency room (see Know Who To Call)

If your friend has made indirect statements, perhaps verbally or in an email, and/or shows warning signs that they are feeling hopeless or contemplating self harm, you must take this very seriously.  Your awareness and willingness to inquire and express concern may save a life.

The S.I.R.E.N. Model

• SEE - the warning signs [hypertext] that your friend is expressing
• INQUIRE - don’t be afraid to ask how your friend is feeling and what they are thinking about in regards to any hopeless thoughts or self harm wishes
• REFLECT - your concern in a caring, nonjudgmental way.
• ENCOURAGE - them to seek help
• NETWORK - and refer them to the appropriate resources on campus and in the community.

Become familiar with the SIREN Model for suicide prevention.

How else can I help?

• Know who to call
• Don’t bargain or keep secrets.  Don’t let the person convince you that it is not serious or that they can handle it on their own. Don’t bargain – people who have made suicidal threats or attempts can often be very effective at persuading their friends to keep silent about what they have done.
• Know your limits.  If you find yourself feeling too responsible, overwhelmed, and over-extending yourself, trust these feelings and realize you must encourage your friend to talk to a therapist or someone in a professional role on campus.  Admit that you don’t have the expertise to help sufficiently but that you are concerned and will help them arrange to talk to a therapist.  
• Make sure you have enough support for yourself.  You don’t have to deal with such a situation on your own.  If you are concerned about someone, you can call Counseling and Psychological Services and consult with a professional about how to proceed.