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Counseling Tips and Resources

TIME MANAGEMENT

One major change in the lives of most veterinary students is the amount of time they find they need to devote to veterinary school. Their academic schedule demands most of their attention due to the hours spent in class each day and the hours in the evening most students need to spend studying. These claims on their time mean the need for better time management and some creative ways to balance the personal and academic aspects of their lives. Time management involves considering your obligations and making choices about how to best utilize your time. Here are some suggestions for how to organize your time:

  1. Use a calendar or planner to record assignments, make lists and keep track of appointments.
  2. Take time each day to plan and organize by reviewing your calendar, updating your lists and making note of upcoming assignments and examinations.
  3. Break large assignments and tasks into smaller parts so that goals are simpler to achieve. For example, break up studying different assignments into manageable increments of different parts of a chapter or notes.
  4. Set realistic goals and deadlines for your goals such as having the goal of studying a certain amount of information each night.
  5. Prioritize your lists and tasks by looking at the “big picture” and deciding what you need to complete first or what is most important.
  6. Be flexible so that the unexpected distractions and interruptions that occur during the day or week do not cause you undue anxiety or stress.
  7. Know what works best with your personal style; for example, do you study better in the morning or at night? Plan your day accordingly and perform your most difficult tasks when you are at your best.
  8. Learn to say “No” so that you do not take on extracurricular activities, responsibilities or duties that cause or exacerbate stress or demands on your time.
  9. Make use of wasted time; for example, keep class notes with you so you can study if you are waiting for an appointment in a doctor’s office. Also, try to use time in the morning before class or during lunch to study or to get other work done.

Source:  http://gradschool.about.com/cs/timemanagement/a/time.htm 

LEARNING STYLES

There are different ways in which individuals perceive and process information, and this can influence the ways in which they learn. Often it is helpful for students to recognize their learning style so that they can better study and identify they ways in which they learn information.

To find out more general information on learning styles, review this website:  Learning Styles (NC State University-Felder)

There is an online questionnaire one can take to determine her or his own personal learning style. The questionnaire can be taken online at: Questionnaire (NC State University)

Background information regarding the interpretation of the questionnaire can be reviewed at: Background (NC State University)

Descriptions of the different learning styles is found at: Descriptions (NC State University)

STUDY SKILLS

How you study as opposed to how much you study may make a difference in terms of recalling and understanding information. If you want to make the most out of your study time, here are some websites that can provide you with some guidance:

STRESS: WHAT IT IS AND HOW TO MANAGE IT

Definition: Stress is when the perceived pressure on an individual exceeds that individual’s ability to cope. Stress is an excess of demands on an individual beyond their capability to cope. NOTE: Stress comes from life events, circumstances and situations outside of ourselves (and sometimes outside of our control). In essence, stress arises from a mismatch between perceived demands and perceived ability to cope. A myriad of influential factors in any individual’s development affect predisposition toward stress and ability to cope.

It is inevitable that everyone will, at some point, have to deal with stress as part of normal life circumstances. Manageable levels of stress for a reasonable duration serve an important function in motivating us to meet life’s challenges. Chronic stress, however, can have a severely deleterious effect on emotional, psychological and physical health.

Stress, of course, is not always bad. A little stress can be good for us, keeping us stimulated, active and creative. Stress associated with positive events, or “eustress,” helps us respond effectively in times of trauma. It also increases our performance or efficiency in ordinary times. In contrast, “distress” tends to block our performance, create health problems, increase anxiety and depression and reduce optimal efficiency. Extreme stress can also contribute to, or exacerbate, a number of anxiety disorders.

Some people are able to handle stress more effectively in a way that makes them less vulnerable to stress. Common characteristics of stress-hardy people include a strong commitment to self, a sense of meaningfulness, and an internal sense of control (“locus of control”).

Veterinary education is an intensive professional training program with a heavy workload and consequent demand on private time. While there are challenges implicit in every professional curriculum and in the concurrent life transition, veterinary education has a strong propensity to cause students to feel chronically pressured and overwhelmed. When students feel this way, there is a real risk of the educational experience becoming devalued – endured and survived rather than enjoyed.

Top 10 stressors identified by Ken-Arce [on the Veterinary Medical Stressors Inventory]:

  1. tests, the testing system, the number of tests
  2. an inability to absorb all of the information
  3. final exams
  4. lack of time for family, friends, and social and recreational activities due to the pressures of work and study
  5. the “number of hours one has to study to keep up”
  6. grades and the grading system
  7. experiencing the pace of the curriculum
  8. getting bad grades
  9. “how I usually feel this year while at campus”
  10. financial problems at school

 Journal of Veterinary Medical Education [Vol 32] – Stress Management Interventions for Veterinary Students.

  • Personal circumstances such as finances, family, life transitions, state of health.
  • Major life changes, such as starting veterinary school, changing jobs, getting married, having a baby.
  • Relationships with other people.
  • Expectations from others as well as from oneself.
  • Our own personality – high achievers and perfectionists [like many veterinary students are] are vulnerable to stress.

PHYSICAL SIGNS

  • Tiredness
  • Headache; Backache
  • Sleeping Disorders
  • High Blood Pressure
  • Tension
  • Digestive Disorders

All of these may contribute to heart disease, strokes, and autoimmune disorders

EMOTIONAL SIGNS

  • Being bad tempered
  • Anxious
  • Grouchy
  • Depressed
  • Apathetic
  • Defensive
  • Nervous
  • Fearful
  • Critical
  • Obsessed
  • Weepy
  • Ineffective

BEHAVIORAL SIGNS

  • Change in appetite [increase or decrease]
  • Withdrawal from social contact
  • Loss of judgment
  • Forgetfulness
  • Increased use of cigarettes, alcohol or other drugs

Effects of Stress

  • Lowers confidence and self-esteem
  • Lowers resistance to disease
  • Makes people prone to accidents
  • Increases the incidence of making mistakes
  • Causes breakdown in relationships
  • Creates more stress, and it keeps on escalating
  • Chronic persistent stress leads to burnout, exhaustion and depression
  • Day-to-day stress: “Oh, no – it’s Monday again.” What is it about Mondays?
  • Situational stress: Think of your feelings when you are really stressed and then identify the source of those feelings. What situations, what people stress you most? Studying for tests? Not having enough time to take care of personal needs such as paying bills, exercising, cleaning one’s home? Spouse, partner or family problems?
  • Life stress: Living by someone else’s rules such as, “I should” or “I must” or having a fear of what might happen if…

Take steps to try and change things which can be changed. Be realistic about how much you can do. You cannot work miracles. You can do your best to facilitate a return to health where possible, but you cannot cure everything.

  • Get enough sleep. Eight hours of sleep is best for optimum health and efficient work.
  • Exercise regularly, even if you are tired. Even as little as 20 minutes of hard exercise several times a week is beneficial.
  • Eat well, lots of fruits and vegetables.
  • Learn to relax through basic relaxation strategies such as breathing techniques, muscle relaxation, visualization, and meditation.

  • Try to have some fun. Develop an interest in something not associated with work.
  • Be an active member of your community in some way that appeals to you.
  • Try to have some sort of mutual support system with a friend (not a partner).
  • Keep work worries and family life separate, if possible.
  • Seek help if things get beyond you. Try counseling; contact CVM Counseling Services at 513.6008 to schedule an appointment.
  • Do Not Expect Miracles from Yourself
  • Just try your best; then acknowledge to yourself that you are doing your best. No one is perfect.
  • Exercise
  • Taking time out
  • Talking over problems with a supportive person
  • Time management
  • Prioritizing free time
  • Reducing excessive demands
  • Good communication skills and conflict resolution
  • Good study techniques
  • Processing of emotions
  • Budgeting

Stewart, Mary F. (1999). Companion Animal Death: A Practical and Comprehensive Guide for Veterinary Practice. Butterworth-Heinemann, Oxford, pgs. 153-161.

Gelberg, S. and Gelberg, H. (2005). Stress Management Interventions for Veterinary Students. Journal of Veterinary Medical Education, Volume 32, Summer 2005, pgs. 173-182.

Strand, E., Zaparanick, T. L., and Brace, J. J. Quality of Life and Stress Factors for Veterinary Medical Students. Journal of Veterinary Medical Education, Volume 32, Summer 2005, pgs. 182-192.

Kogan, L. R., MCConnell, S. L., and Schoenfeld-Tacher, R. (Summer 2005). Veterinary Students and Non-Academic Stressors. Journal of Veterinary Medical Education, Volume 32, pgs. 193-200.

Williams, S. M., Arnold, P. K., and Mills, J. N. (Summer 2005). Coping with Stress: A Survey of Murdoch University Medical Students, Journal of Veterinary Medical Education, Volume 32, pgs. 201-212.

  1. Get up fifteen minutes earlier in the morning. The inevitable morning mishaps will be less stressful.
  2. Prepare for the morning the evening before. Set the breakfast table, make lunches, put out the clothes you plan to wear, etc.
  3. Don’t rely on your memory. Write down appointment times, when to pick up the laundry, when library books are due, etc.
  4. Do nothing which, after being done, leads you to tell a lie.
  5. Make duplicates of all keys. Bury a house key in a secret spot in the garden and carry a duplicate car key in your wallet, apart from your key ring.
  6. Practice preventive maintenance. Your car, appliances, home, and relationships will be less likely to break down/fall apart “at the worst possible moment.”
  7. Be prepared to wait. A paperback can make a wait in a post office line almost pleasant.
  8. Procrastination is stressful. Whatever you want to do tomorrow, do today; whatever you want to do today, do it now.
  9. Plan ahead. Don’t let the gas tank get below one-quarter full; keep a well-stocked “emergency shelf” of home staples; don’t wait until you’re down to your last bus token or postage stamp to buy more; etc.
  10. Don’t put up with something that doesn’t work right. If your alarm clock, wallet, shoe laces, windshield wipers – whatever- are a constant aggravation, get them fixed or get new ones.
  11. Allow 15 minutes of extra time to get to appointments. Plan to arrive at an airport one hour before domestic departures.
  12. Eliminate (or restrict) the amount of caffeine in your diet.
  13. Always set up contingency plans, “just in case.” (“If for some reason either of us is delayed, here’s what we’ll do. . .” kind of thing. Or, “If we get split up in the shopping center, here’s where we’ll meet.”)
  14. Relax your standards. The world will not end if the grass doesn’t get mowed this weekend.
  15. Pollyanna-Power! For every one thing that goes wrong, there are probably 10 or 50 or 100 blessings. Count ’em!
  16. Ask questions. Taking a few moments to repeat back directions, what someone expects of you, etc., can save hours. (The old “the hurrieder I go, the behinder I get,” idea.)
  17. Say “No!” Saying “no” to extra projects, social activities, and invitations you know you don’t have the time or energy for takes practice, self-respect, and a belief that everyone, everyday, needs quiet time to relax and be alone.
  18. Unplug your phone. Want to take a long bath, meditate, sleep, or read without interruption? Drum up the courage to temporarily disconnect. (The possibility of there being a terrible emergency in the next hour or so is almost nil.) Or use an answering machine.
  19. Turn “needs” into preferences. Our basic physical needs translate into food, water, and keeping warm. Everything else is a preference. Don’t get attached to preferences.
  20. Simplify, simplify, simplify. . .
  21. Make friends with non-worriers. Nothing can get you into the habit of worrying faster than associating with chronic worrywarts.
  22. Get up and stretch periodically if your job requires that you sit for extended periods.
  23. Wear earplugs. If you need to find quiet at home, pop in some earplugs.
  24. Get enough sleep. If necessary, use an alarm clock to remind you to go to bed.
  25. Create order out of chaos. Organize your home and workspace so that you always know exactly where things are. Put things away where they belong and you won’t have to go through the stress of losing things.
  26. When feeling stressed, most people tend to breathe short, shallow breaths. When you breathe like this, stale air is not expelled, oxidation of the tissues is incomplete, and muscle tension frequently results. Check your breathing throughout the day, and before, during, and after high-pressure situations. If you find your stomach muscles knotted and your breathing is shallow, relax all your muscles and take several deep, slow breaths.
  27. Writing your thoughts and feelings down (in a journal, or on paper to be thrown away) can help you clarify things and can give you a renewed perspective
  28. Try the following yoga technique whenever you feel the need to relax. Inhale deeply through your nose to the count of eight. Then, with lips puckered, exhale very slowly through your mouth to the count of 16, or for as long as you can. Concentrate on the long sighing sound and feel the tension dissolve. Repeat 10 times.
  29. Inoculate yourself against a feared event. Example: before speaking in public, take time to go over every part of the experience in your mind. Imagine what you’ll wear, what the audience will look like, how you will present your talk, what the questions will be and how you will answer them, etc. Visualize the experience the way you would have it be. You’ll likely find that when the time comes to make the actual presentation, it will be “old hat” and much of your anxiety will have fled.
  30. When the stress of having to get a job done gets in the way of getting the job done, diversion – a voluntary change in activity and/or environment – may be just what you need.
  31. Talk it out. Discussing your problems with a trusted friend can help clear your mind of confusion so you can concentrate on problem solving.
  32. One of the most obvious ways to avoid unnecessary stress is to select an environment (work, home, leisure) which is in line with your personal needs and desires. If you hate desk jobs, don’t accept a job which requires that you sit at a desk all day. If you hate to talk politics, don’t associate with people who love to talk politics, etc.
  33. Learn to live one day at a time.
  34. Every day, do something you really enjoy.
  35. Add an ounce of love to everything you do.
  36. Take a hot bath or shower (or a cool one in summertime) to relieve tension.
  37. Do something for somebody else.
  38. Focus on understanding rather than on being understood; on loving rather than on being loved.
  39. Do something that will improve your appearance. Looking better can help you feel better.
  40. Schedule a realistic day. Avoid the tendency to schedule back-to-back appointments; allow time between appointments for a breathing spell.
  41. Become more flexible. Some things are worth not doing perfectly and some issues are fine to compromise upon.
  42. Eliminate destructive self-talk: “I’m too old to. . .,” “I’m too fat to. . .,” etc.
  43. Use your weekend time for a change of pace. If your work week is slow and patterned, make sure there is action and time for spontaneity built into your weekends. If your work week is fast-paced and full of people and deadlines, seek peace and solitude during your days off. Feel as if you aren’t accomplishing anything at work? Tackle a job on the weekend which you can finish to your satisfaction.
  44. “Worry about the pennies and the dollars will take care of themselves.” That’s another way of saying: take care of the todays as best you can and the yesterdays and the tomorrows will take care of themselves.
  45. Do one thing at a time. When you are with someone, be with that person and with no one or nothing else. When you are busy with a project, concentrate on doing that project and forget about everything else you have to do.
  46. Allow yourself time – everyday – for privacy, quiet, and introspection.
  47. If an especially unpleasant task faces you, do it early in the day and get it over with, then the rest of your day will be free of anxiety.
  48. Learn to delegate responsibility to capable others.
  49. Don’t forget to take a lunch break. Try to get away from your desk or work area in body and mind, even if it’s just for 15 or 20 minutes.
  50. Forget about counting to 10. Count to 1,000 before doing something or saying anything that could make matters worse.
  51. Have a forgiving view of events and people. Accept the fact that we live in an imperfect world.
  52. Have an optimistic view of the world. Believe that most people are doing the best they can.

Source:  Texas Woman’s University Counseling Center; http://www.twu.edu/O-sl/counselnig/SelfHelp001.html

Source:  The Anxiety and Phobia Workbook by Edmund J. Bourne, Ph.D.

PHYSICAL AND LIFESTYLE CHANGES

  1. Abdominal breathing and relaxation
  2. Low-stress diet
  3. Regular exercise
  4. “Downtime” [including “mental health days”]
  5. Mini-breaks [5 to 10 minutes periods to relax during the day]
  6. Time management [appropriate pacing]
  7. Sleep hygiene
  8. Choosing a nontoxic environment
  9. Material security

EMOTIONAL STRATEGIES

  1. Social support and relatedness
  2. Self-nurturing
  3. Good communication
  4. Assertiveness
  5. Recreational activities [“playtime”]
  6. Emotional release
  7. Sense of humor – ability to see things in perspective

COGNITIVE STRATEGIES

  1. Constructive thinking – ability to counter negative thinking
  2. Distraction – ability to distract yourself from negative preoccupations
  3. Task-oriented [vs. reactive] approach to problems
  4. Acceptance [ability to accept/cope with setbacks]
  5. Tolerance for ambiguity – ability to see shades of gray

PHILOSOPHICAL CHANGES

  1. Consistent goals or purposes to work toward
  2. Positive philosophy of life
  3. Religious/spiritual life and commitment

ANXIETY

Anxiety is something most everyone experiences at some point in their life. However, when a person’s anxiety interferes with their day-to-day functioning, the person needs to seek professional help. Anxiety is more than just fear or angst; it involves one’s whole being and exacerbates over time if it is not treated. Anxiety may involve physiological reactions such as a tightening of the chest, muscle tension, and sweating. Anxiety impacts one’s behavior such as avoiding certain places or things, having an inability to express oneself, or not being able to act in certain situations.

Psychologically, anxiety is a state of apprehension and uneasiness that can lead to thoughts of dying or going crazy to feelings of being out of control. Anxiety can appear in different forms and at different levels of intensity. There are many different anxiety disorders, and more information about them can be found at:

If you feel you are suffering from anxiety, seek help from a trained mental health professional. Most people do not overcome an anxiety disorder on their own, and seeking treatment is the first step to getting better. A combination of therapy and medication may be needed, so it is important to be evaluated by an appropriate professional, such as a counselor, psychologist or psychiatrist.

DEPRESSION

Depression is more than just sadness; it is a mental illness that interferes with a person’s day-to-day functioning. Most everyone experiences depressive feelings at different times in their life, but depression involves physiological, psychological and behavioral symptoms that negatively impact one’s life. Depression impacts one’s ability to sleep, to eat, to socialize with others as well as one’s energy level, thoughts and feelings. Depression is a mood disorder, and symptoms can last for weeks, months or even years.

Depression is NOT a sign of weakness; it is an illness that needs treatment. There are different types of depressive disorders, ranging from dysthymia to bipolar disorder. More information about depressive disorders can be found at:

If you think you may be suffering from depression, seek help from a mental health professional. Counseling is needed to overcome this illness, and medication may be needed as well. Therefore, it is important to get an evaluation by a counselor, psychologist or psychiatrist. Keep in mind that depression affects a lot of people – over 18 million Americans a year. Depression is a serious illness, but one can deal with it effectively when treatment is sought.