The polite refusals became all too familiar to counselors at Loyola University Maryland when they offered help to students who had lost a parent, endured an assault or lived through some other kind of trauma.
"Thanks so much for reaching out," the student might say. "I'm doing fine, but I'll call if I need something."
The conversations were always pleasant, said Jason Parcover, who oversees outreach at the university's counseling center. But it became obvious to him that a large percentage of students felt little inclination to engage. Even the ones going through the roughest patches seemed to regard counseling as taboo.
So Parcover and the counseling staff decided to meet students where so many of them chat, opine and forge friendships — on the Internet.
"They're communicating in different ways than we grew up with," Parcover said. "So we have to evolve with them."
In November, Loyola launched REACT, an interactive online program that simulates the guidance a student might receive on an initial visit to the counseling center. About 1,500 people used the web-based program in its first two months, including students from other campuses around the country.
Loyola students say it makes perfect sense for people their age to look to computer screens in times of trouble.
"In the life of a student, it's easy to find excuses to never make an appointment to go to the counseling center, and sometimes, when there is that moment of clarity, it's midnight and you no longer have your family around to run and talk to," said Bianca Monaco, a junior from New Jersey who has helped counsel classmates through illness and personal loss.
"REACT is on the Internet, it's well organized and always available. My generation demands these aspects of everything we do, so why not demand it for self-help?"
Outside trauma experts also see promise in the online approach.
"I think it has a lot of potential to be helpful, even beyond young people," said Richard Loewenstein, medical director of the Trauma Disorders Program at Sheppard Pratt Health System. "One of the major inhibitors for people of all ages is shame. In particular, kids think they can just talk to their friends about it, that it'll just go away on its own."
But he said students might be more apt to get help if they're able to go online privately, get good information and see that their responses to trauma aren't unusual.
Loyola is not alone in offering components of counseling online. The University of Maryland, for example, offers a link for students to e-mail questions to counselors. The Johns Hopkins University provides a link to an online screening survey to help diagnose depression.
But Loyola's online program goes much further in trying to replicate the experience of a live counseling session. In videos, counselors talk about everything from the basic definition of trauma to tips for relaxing the mind. Users respond to questions about the symptoms they're experiencing and are steered to graphics showing them how common their experiences are.
"One of the nice things they did was anticipate the questions people might have and then provide the answers," said Jeffrey Lating, a clinical psychology professor at Loyola who wasn't involved in creating REACT.
"That's actually my favorite part," said Dan Kelly, a Loyola senior who coordinates peer counselors on campus. "You can see that your reaction is similar to what a lot of other students are going through."
Parcover said he has already received positive feedback from counselors around the country, who see REACT as a potential way to reach students who might have avoided face-to-face sessions.
Rene Monteagudo, a clinical psychologist in the University of Illinois counseling center, said he used REACT in the aftermath of an off-campus shooting last semester.
"Loyola did a fantastic job," he said. "The feedback I got was that people were so pleased to have a tool that gave them information immediately. It's available 24-7 and it's a rapid way for students to understand the physical, emotional and cognitive symptoms they're experiencing."
Loyola has experienced its share of campus trauma in recent years.
In 2005, then-President Harold E. "Hap" Ridley died suddenly, followed shortly by the unexpected death of a popular campus ministry leader. In 2009, sophomore Stephanie Parente was murdered by her father in a Towson hotel room, along with her sister and mother. The next year, senior business major Evan Girardi was found unresponsive in his dorm room and later died. Last year, recent graduate Emily Hauze was found dead in a trash bin outside a Baltimore apartment building.
Parcover said such events, along with more personal traumas such as sudden deaths of loved ones, disrupt feelings of personal security and impede learning. Though more than one-third of Loyola students attend some sort of counseling while in college, he said, the ones least likely to seek help are those who have experienced traumas.
In response to the bad news on campus, Loyola counselors offered pro-active education on coping. They didn't call it therapy for fear of stigmatizing the effort.
But students saw it as therapy anyway and largely stayed away. "We discovered that this generation is really reluctant to seek help, especially when you call it counseling," Parcover said.
"Students think they can only go if they're crazy, if they have really serious problems," Kelly said. "They think that if other students see you walking up the ramp to the center, you'll be labeled as crazy."
REACT is an attempt to take such thoughts out of the equation.
Today's college students have grown up using the Internet to vet everything from new video games to potential dates. So for them, Monaco and Kelly said, it's natural to search online for an understanding of trauma's treacherous aftermath.
Monaco describes coping with trauma as a "very personal" process and said REACT does a good job of posing the questions that a student might be uncomfortable answering in front of another person.
"I think it's most effective when it is used as a starting point for a student to learn about themselves, how to identify their troubles and needs, and then more importantly be able to articulate them," she said. "When someone can say with certainty, 'This is how I have changed, and this is how I used to be,' maybe it's at that point they are ready to reach out to someone."
Sheppard Pratt's Loewenstein said getting trauma victims to treatment must remain the ultimate goal, because without it, they're likely to get worse. But the introduction of sound information is a vital first step, he said, and that's where REACT comes in.
The program is not meant to be a total solution, Parcover said, noting that more intensive, face-to-face counseling is still recommended for many trauma victims.
"But it allows them to start healing on their own," he said, "from the comfort of their rooms."