SIGNS AND SOLUTIONS Intercultural Adjustment, Re-entry Shock, Mental Health Concerns

1. SIGNS AND SOLUTIONSIntercultural Adjustment, Re-entry Shock, Mental Health Concerns UTSA Study Abroad Program Shawanda Woods, PsyD UTSA Counseling Services RWC1.810 210-458-4140

2. What is Intercultural Adjustment?A.K.A. Culture Shock • The emotional and behavioral reaction to living, studying, and working in another culture. It usually involves anxiety that results from losing familiar signs and symbols of social interaction. Culture Shock occurs when one’s values and ways of viewing the world clash with the values and viewpoints of the new cultural environment. • The Cross Cultural Adjustment Cycle-each stage in this process is characterized by “symptoms” or outward and inward signs representing certain kinds of behavior. “Culture Shock-Expectations For Going Abroad and Returning.” Gortner, Eva-Maria, Rice University Counseling Center. www.isc.sdsu.edu/study_abroad/accepted-culture-shock.html

3. Common Signs • Extreme homesickness • Feelings of helplessness/dependency • Disorientation and isolation • Depression and sadness • Hyper-irritability, may include inappropriate anger and hostility • Sleep and eating disturbances • Loss of focus and ability to complete tasks • Excessive critical reactions to host culture/stereotyping • Feeling sick much of the time • Excessive drinking • Recreational drug dependency • Extreme concerns over sanitation, safety, and being taking advantage of

4. Cross Cultural Adjustment Cycle

5. Stages of Intercultural Adjustment • Honeymoon Period: Initially, you will probably be fascinated and excited by everything new. Usually, visitors are at first overjoyed to be in a new culture. • Culture Shock: You are immersed in new problems: housing, transportation, food, language and new friends. Fatigue may result from continuously trying to comprehend and use the second language. You may wonder, "Why did I come here?" • Initial Adjustment: Everyday activities such as housing and going to school are no longer major problems. Although you may not yet be perfectly fluent in the language spoken, basic ideas and feelings in the second language can be expressed. • Mental Isolation: You have been away from your family and good friends for a long period of time and may feel lonely. Many still feel they cannot express themselves as well as they can in their native language. Frustrations and sometimes a loss of self-confidence result. Some individuals remain at this stage. • Acceptance and Integration: You have established a routine (e.g. work, school, social life). You have accepted the habits, customs, foods and characteristics of the people in the new culture. You feel comfortable with friends, associates, and the language of the country. • Return Anxiety, Re-Entry Shock, Re-Integration: These stages should be mentioned, even at Orientation, because of the very important part they play in a visitor's stay in the new culture. It is interesting to note that REENTRY SHOCK can be more difficult than the initial CULTURE SHOCK. Resource material: The International Services Office, The George Washington University, Washington D.C. Original source unknown.

6. Remedies and Solutions Communication Ease Stress Work on understanding the language Pay attention Set your assumptions and values aside Withhold judgment Be complete and explicit Keep Active Introduce Yourself/Make Friends Read Exercise Community Activities Remember your Family BE PATIENT

7. Solutions (cont’d). • Keep in touch with friends and family at home. • Try to look for logical reasons why things happen. This may help you view your host culture in a more positive way. • Try not to concentrate on the negative things about your host culture and do not hang around people who do. • Make an effort to restore communication by making friends in your host culture. • Keep your sense of humor! • Set small goals for yourself as high expectations may be difficult to meet. • Speak the language of the country you are in and do not worry if you sometimes make a fool of yourself doing it! (Talk to children. Their language level will be similar to yours!) • Take care of yourself by exercising, getting enough sleep, eating properly and doing things you enjoy. • Try to fit into the rhythm of life in your host culture. Adjust to their time schedule for meals and work. • Find out where people meet and socialize. Make an effort to go to those places and observe. • Draw on your own personal resources for handling stress. You have done it many times before and you can do it again!

8. Depression SIGNS SOLUTIONS Significantly depressed mood or absence of mood Inability to experience please or feel interest in daily life Insomnia or Hypersomnia nearly every day Substantial change in appetite, eating patterns or weight Fatigue or energy loss Diminished ability to concentrate Feelings of hopelessness or worthlessness Inappropriate feelings of guilt or self-criticism A lack of sexual desire Suicidal thoughts, feelings or behaviors Seek early intervention which may modify the severity of your depression Reduce or eliminate use of alcohol or drugs Exercise or engage in physical activity Eat a proper, well balanced diet Obtain adequate sleep Seek emotional support from family and friends Focus on the positive aspects of life Pace yourself, modify your schedule, set realistic goals Eliminate or reduce unnecessary tasks Consult with a physician if you are experiencing any medical problems

9. Suicide Prevention Signs Solutions 70% of all people committing suicide give some clue as to their intentions before they make an attempt. Giving away possessions Putting affairs in order Making a will Withdrawal Changes in eating, sleeping patterns, loss of interest in prior activities or relationships **SUDDEN Intense lift in spirits** Remain calm Deal directly with the topic of suicide Encourage problem solving and positive actions Get assistance Most suicides can be prevented by sensitive responses to the person in crisis.

10. Helpful Resources • http://www.medilexicon.com/hospitalsdirectory.php • International Society of Travel Medicine • StudyAbroad.com Handbook • US Center for Disease Control and Prevention: Travelers Health • US Department of State Consular Services: Medical Information for Americans Traveling Abroad • The Center for Global Education: Study Abroad Student Handbook: Medical Care and Insurance • U.S. Centers for Disease Control and Prevention, CDC, Travel Health Tips for Students Studying Abroad • World Health Organization, WHO, International Travel and Health • NAFSA Optimizing Health Care in International Educational Exchange • U.S. Department of State Students Abroad

11. Loneliness SIGNS Solutions You’re alone and you don’t feel you have a choice not to be You feel that you’re lacking attachments you had in the past; You are facing changes in your life You feel there’s no one in your life with whom you can share your feelings and experiences; Your self perceptions are that you’re unacceptable, unlovable, not worthwhile even if others don’t share those perceptions Develop Friendships Loneliness will not last forever Put yourself in new situations Look for ways to get involved (eat, sit, study) Develop Yourself Follow habits of good nutrition, regular exercise, adequate sleep Use alone tome to enjoy yourself rather than just existing until you will be with others Keep things in your environment that you can use to enjoy alone time (books, puzzles)

12. Anxiety Signs Solutions Rapid hear beat Chest pain or discomfort Dizziness Sweating Sleeping problems Trembling or shaking Cold clammy hands Hyperventilation Being too fearful to take action Difficulty concentrating Always being “on edge” Having a difficult making decisions Exercise or engage in some form of daily physical activity, Eat a nutritious, well balanced diet Don’t engage in “emotional reasoning” Obtain an adequate amount of sleep Seek emotional support from friends and family Focus on the positive aspect of your life Establish realistic, attainable goals which do not rely on perfectionist values Monitor how you think about stress and reduce negative thoughts Don assume responsibility for events which are outside your control

13. Re-entry Shock What is Re-entry Shock? Common Re-entry Expectations Re-entry shock is a term that describes the shock people go through when returning home after an extended stay abroad. Everything will be the same Everything will be great People will be interested in my stories I will fit back into life with no problems I can pick up my relationships where we left off People will be open minded People around me will recognize and applaud my personal growth I will have the same needs and goals as before

14. Stages of Re-entry Shock • Stage 1: Departure: Characterized by mixed feelings of sadness to end your adventure abroad and excitement to see family and friends again. • Stage 2: Honeymoon: Lasts one hour up to a couple of weeks. You may be excited to see family and friends again, tell everyone your stories, get your pictures developed, eat your favorite American meal, chew your longed-for favorite flavor of gum, etc. • Stage 3: Reverse Culture Shock: The length of this stage depends on factors such as duration of stay, depth of involvement with host culture, variance between cultures, and your personal disposition. It ranges from several weeks to over a year. • Stage 4: Readjustment: You have found your balance again. You have created a new sense of home and have established routines in your work, school and social life. “Reverse Culture Shock,” University of Iowa. www.uiowa.edu/~uiabroad/returning/handbook.htm

15. Re-entry Remedies • Realize the Transition may be Hard. Give your self time to reflect on your overseas experiences and re-adjust to life at home. Keep a journal and make a scrapbook while the memories are fresh. Avoid making major life decisions until you feel more grounded. If you need to, spend time regaining your mental-spiritual balance by going for walks, meditating, or praying. • Create a Support System. Talk to other people about your experiences and those who might understand what you are going through. This can be your family, your friends, or your peer study abroaders. Join the Facebook Group MU Global or talk with the Center for Global Education about how to stay connected with program alumni. • Stay Connected. Keep in contact with the new friends you made while overseas! Just because you are an ocean away doesn’t mean that they have forgotten you! Send letters, write e-mails, or even call every once in a while! • Continue to be a multi-cultural person. Watch the BBC at home! Head out for some Indian food every once in a while! Remember that now you know how it feels to be the outsider. • Volunteer Locally. You probably gained a different perspective on how things are done regarding many issues while abroad. Try volunteering with a local or national group to help other people and also bring your unique perspective to the group! “Coming Home: Life After Study Abroad,” Middlebury College Study Abroad www.middlebury.edu/~sap/re_entry/coming_home.html (10/12/01) and “Coming Home: Surviving the Transition and Staying Involved,” Collins, Joseph, Stefano DeZerega, and ZaharaHeckscher; Transitions Abroad, Nov/Dec 2001.

16. Resources • UTSA Counseling Services • Dept. of State Travel Information for Students: • HTH Students: • Health Check for Study, Work, and Travel Abroad: • Travel Safe: • CDC: • World Health Organization: • Travel Health Online: • Intl. Assoc. For Medical Assistance To Travelers: • http://www.utsa.edu/counsel/index.htm • studentsabroad.state.gov • hthstudents.com • ciee.org/healthcheck.cfm • ciee.org/travelsafe.cfm • cdc.gov/travel • who.org • tripprep.com • iamat.org

17. SELF SURVEY • Many study abroad students experience re-entry shock. • People will be interested in my study abroad experience. • Studying Abroad will help me escape and things will be great when I return. • The Honeymoon period related to fascination and excitement about a new culture. • Feeling lonely in a new country is normal and it will go away when I adjust to being away from home. • Fatigue, difficulty concentrating, and a change in eating patterns can be signs of Depression. • I know how to and when to access resources during my study abroad experience.

18. ENJOY YOUR STUDY ABROAD!! THE END