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Article 54

Using the 2WHO-SCAN Mnemonic to Respond to Bullying Survivor’s Needs

Gerald A. Juhnke, Brenna A. Juhnke, and Kathryn L. Henderson

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Bullying Frequency and Effects of Bullying

Existing research suggests between 20% and 28% of 6th through 12th grade students in the United States (U.S.) are bullied (Centers for Disease Control, 2012; DeVoe & Bauer, 2010; Schneider, O’Donnell, Stueve, & Coulter, 2012). Bullying is a major health threat and negatively affects students, classrooms, and schools (Dao et al., 2006; Due & Holstein, 2008; Pozzoli, 2009; Srabstein & Piazza, 2008). For professional counselors, the implications of the above research are clear. Counselors need a means to quickly assess and respond to the needs of bullying survivors and stop the bullying perpetrator.

Mnemonics

Mnemonics are words or combinations of letters, numbers, or symbols used to aid recall and memory. Typically, each mnemonic letter, number, or symbol relates to a specific assessment or intervention factor. Patterson, Dohn, Bird, and Patterson’s (1983) and Juhnke’s (1994) seminal research demonstrated the effectiveness of mental health trainees utilizing mnemonics within the suicide assessment process. Their findings indicated counseling students who used mnemonic memory aids (e.g., SAD PERSONS, Adapted-SAD PERSONS) were clinically and statistically better able to recall important risk factors than those who simply learned multiple assessment factors. These researchers further found that students who utilized mnemonics facilitated more thorough assessments and more accurately scored clinical vignettes.

Today, mnemonics are broadly utilized as a means to recall important factors and sequences, and to remember relevant instructions. For example, the American Association of Suicidiology (2013) encourages counseling professionals to utilize the mnemonic, “IS PATH WARM” when assessing suicide risk. Medical professionals frequently use mnemonics such as, “Every Little Boy Must Pray,” to remind providers the specific order of drugs to be given when attempting to resuscitate patients’ whose hearts have stopped (Epinephrine, Lidocaine, Bretylium, Magsulfate, Procainamide; C. Weiner, personal communication, February 6, 2012). Law enforcement professionals use mnemonics such as GO WISELY to help them thoroughly investigate a crime scene (Grounds, Object, Warrant, Identification, Station, Entitlement, Lawfully, Year; D. Macintosh, personal communication, February 7, 2012). Given research demonstrating the benefits of mnemonics, the widespread application of mnemonics within many professions to aid factor recall and memory, and the absence of published mnemonics specific to bullying, the authors believed creating and utilizing the mnemonic 2WHO- SCAN would help counselors better remember important bullying assessment factors and intervene with survivors of bullying.

2WHO-SCAN Mnemonic

To address the first author’s supervisees’ concerns specific to bullying assessment and intervention, the authors developed an easily memorized mnemonic, 2WHO-SCAN. The mnemonic is a memory aid and pronounced “too scan” or “tü skan.” It was designed to help counselors remember critical steps in the assessment and intervention process (Balkin & Juhnke, 2013; Juhnke, Granello, & Granello, 2010). Each mnemonic letter corresponds to a specific step when assessing a bullying survivor and intervening in a bullying situation (i.e., 2What, How, Options, Stop, Charge, Another [Survivor], and Notify). 2WHO-SCAN reminds counselors of seven critical assessment factors and intervention steps. Counselors are strongly encouraged to utilize additional assessment and intervention measures depending upon the client’s specific needs and the exact bullying situation. The 2WHO-SCAN mnemonic and each of the seven stages are presented below.

Step One: 2What is Necessary to Physically Stabilize the Bullied Client and What Happened

This step has two ‘What’ questions. The first is “What is necessary to physically stabilize the bullied client?” This question is used to ensure immediate client safety. Here, counselors ask themselves what the client needs in order to stabilize from the bullying. Thus, immediate medical care is sought if bullied clients have experienced physical injuries and warrant medical attention. Only after medical needs have been addressed and the client’s physical condition has stabilized, do counselors move to the second ‘What’ question, “What happened?” This second question reminds counselors to gather the facts about the bullying incident and understand the presenting details of what happened. Minimally, this question includes: (a) who bullied the survivor, (b) where did the bullying occur, (c) when did the bullying occur, and (d) what other bullying has the client experienced? Thus, Step One of the assessment and intervention might go something like this:

Counselor:      Sonja, are you hurt? Do you need me to call an ambulance?

Sonja:             No, I am fine. I just hurt my arm when I got pushed down.

Counselor:      Tell me what happened?

Sonja:             Summer and Ginger have been bullying me. Today, they called me names and pushed me down.

Counselor:      When did that happen?

Sonja:             It started on the bus. Ginger grabbed my purse, and Summer made fun of the way I talk. Then, when I walked inside the school at first bell, Summer pushed me to the ground, and Ginger spit on me and laughed at me.

Counselor:      Where did this happen?

Sonja:             At the entrance to the dance studio.

Counselor:      How long has this been going on?

Sonja:             It all started about two weeks ago when I started dating Summer’s old boyfriend, Oscar.

Counselor:      Is this the first time you’ve been bullied?

Sonja:             Yeah! I don’t like it.

As we read above, the first ‘What’ question was specific to stabilizing the client. The second ‘What’ question was specific to gathering simple facts rather than focusing on client emotions or symptoms. Specifically, counselors need to understand the survivor’s bullying experiences within the context of what occurred.

Step Two: How Has the Bullying Affected the Client

After ensuring the client’s safety and understanding the facts of the bullying, counselors learn how the client has been affected by the bullying. Here, the counselor will seek to determine potential emotional, cognitive, or interpersonal struggles specific to the bullying and any coping behaviors the client has found helpful. Thus, the counselor might say something like:

Counselor:      Sonja, tell me a little about how the bullying has affected you. Sonja: I hadn’t really thought about it.

Counselor:      So, you haven’t really taken the time to think how the bullying has affected you?

Sonja:             Well, I have been crying a lot, and skipped dance class, because I am scared to attend.

Counselor:      Tell me about the crying.

Sonja:             I have dance first period. I get so scared about Summer beating up on me that I start to cry. I can’t concentrate or do my homework, because I know Summer and Ginger are just going to push me around, steal my dance bag, or ridicule me.

Counselor:      That sounds pretty rough.

Sonja:             It has been really bad. I get so scared my body literally shakes.

Counselor:      Tell me what things you have done to stop the shaking and move through the fear?

Sonja:             I tell myself that I am going to get through this and say, “What doesn’t kill me makes me stronger.”

Counselor:      It sounds like your self-talk makes you stronger. Sonja: It has been very helpful.

Counselor:      So, what are you saying to yourself right now?

Sonja:             That I am safe and I am not going to let Summer or Ginger bully me any longer.

Counselor:      Good. I want you to be safe. Besides the crying and skipping dance class, have you noticed any other ways the bullying has affected you?

Sonja:             I have noticed my friends have left me. Summer and Ginger bullied them when they were around me. So, they have kind of left me to protect themselves.

Counselor:      Which friends? (Bullied friends will be addressed in Step Six).

Sonja:             Clare and Anna. They stopped hanging around me because Summer and Ginger bullied them too.

Counselor:      Have others left you because of the bullying?

Sonja:             No. Just Clare and Anna, but I bet they will start hanging around me again once Summer and Ginger stop bullying me.

Counselor:      So I have heard you say that since the bullying began you’ve cried a lot and that Clare and Anna have stopped hanging around you. Has the bullying affected you in other ways or have you noticed anything else?

Sonja:             No. That’s about it.

In the above vignette, the counselor simply asks the survivor how the bullying has affected her. He also responded to Sonja’s statements in a very factual manner. The intent is to focus on the facts vis-à-vis emotions about the bullying. The counselor validates the client throughout the vignette and helps the client identify her coping behaviors and strengths. Also, the counselor continues to ask how the client has been affected by the bullying until the client reports all the effects she has noticed. The counselor finally summarizes the overall effects noted by the client.

Step Three: Options for Intervention

Counselors in this step identify available counseling options for the bullied survivor. Here, counselors may wish to consider different combinations of counseling modalities such as individual, group, or family counseling. Given the differences in children’s and adolescent’s developmental needs along the life-span continuum, family counseling may be particularly important for younger clients and their parents. Some schools may not provide necessary moderate to long-term counseling options, or group or family counseling options. Thus, depending upon the survivor’s immediate needs and available counseling services within the school district, counselors may need to identify treatment availability within the community and help facilitate a seamless and supportive referral.

Step Four: Stop the Bullying Behaviors

This step is focused on stopping the identified perpetrators from bullying again. The information gathered in Step One provides information about who the perpetrators are, the location of their bullying behaviors, times the bullying occurred, and what the perpetrators did. Here, counselors need to share information with the school principal, campus police, teachers, and other administrators and staff (e.g., bus drivers, custodians, etc.) regarding what happened and ensure a jointly developed intervention designed to stop the identified perpetrators from repeating their bullying behaviors. Additionally, safety procedures are implemented in the location(s) where the bullying occurred and at the times the survivor was bullied (e.g., at first bell, etc.). In the case of Sonja above, she reported that she experienced bullying on the bus and at the entrance to the dance studio at first bell. Minimally, Step Four requires Sonja’s school bus driver and her dance instructor to be informed of the bullying. Campus police, faculty, or other appropriate staff should also be placed on the bus, at the bus arrival point, and at the entrance to the dance studio at first bell to ensure safety and protection of all students. Such placements will likely diminish once administrators determine bullying behaviors are no longer occurring at the identified locations and times. However, continued monitoring of these locations should continue (e.g., security cameras, etc.).

Step Five: Charges and Interventions for the Bully

Most schools have zero tolerance policies for bullying behaviors. Additionally, depending upon the severity of the incidence and the injuries to survivors, bullying behaviors may result in criminal or civil charges. As in Step Four above, it is imperative that school administrators, legal counsel, and police be notified of the bullying behaviors and incident. However, unlike Step Four, this step is focused upon ensuring the school district’s policies as well as corresponding local laws are followed. The intent is not to seek punishment. Instead, the intent is to ensure the survivor’s safety and rights, and make certain all students within the school are safe. Depending upon the outcome of those policies and laws, but before the bullying perpetrator is allowed to return to school, the perpetrator should be required to participate in psychological assessment and counseling. The outcomes of those assessments and the counseling experience should find the perpetrator at minimal risk of continued bullying behaviors before allowing his/her school return.

Step Six: Another Bullying Survivor

Step Six is specific to identifying Another Bullying Survivor. Bullying perpetrators typically do not limit bullying behaviors to one person. Often friends of the bullying survivor or others the bullying perpetrator has frequent contact will also be bullied. In Step Two above, Sonja reported her friends Clare and Anna possibly were intimidated by the bullying perpetrator. Counselors would want to speak with Clare and Anna to provide them an opportunity to discuss being bullied should they wish. This is demonstrated below.

Counselor:      Hi Clare, I am Mr. Acousta. I am the counselor for seventh and eighth graders at James Madison Middle School. I think I saw you Thursday afternoon at the basketball game. How are you?

Clare:              Oh! Hi, Mr. Acosta, yes, that was a good game. Counselor: I like it when we win.

Clare:              Me too.

Counselor:      How are things going?

Clare:              Pretty good. I am having some struggles in Science, but who isn’t.

Counselor:      Seventh grade Science can be challenging, is there anything I can do to help?

Clare:              Nah, I just need to pay attention and read Mr. Bryce’s required handouts.

Counselor:      I bet that will help. Hey, Clare, I have heard stories about some kiddos intimidating or bullying others here at Madison. Have you heard about any bullying or experienced anything like that?

Clare:              I don’t know if I should say anything, but I think Sonja Jones had a couple things happen. Don’t tell her I said anything, though.

Counselor:      What kinds of things?

Clare:              Well, ever since Sonja started dating Summer Smith’s old boyfriend, Oscar, Summer and her friend Ginger have been really picking on Sonja.

Counselor:      How about you, Clare? Has anyone been picking on you? Clare: Not really.

Counselor:      ‘Not really’ means…

Clare:              Well, Anna Arnold and I used to hang around with Sonja a lot. But, Summer and Ginger have been causing so much trouble, Anna and I don’t ride the bus anymore. We try to stay away from Sonja, Summer, and Ginger. It is really their thing, not ours.

Counselor:      Did Summer or Ginger ever threaten or hurt you? Clare: No.

Counselor:      Is that a ‘no, they never threatened or harmed you’ or a ‘no, I don’t want to talk about it?’

Clare:              (Giggles) It is a ‘no they never did anything to me.’

Counselor:      How would you let me know if they ever threatened or harmed you?

Clare:              I would come to your office. But really, they have never done anything to me.

Counselor:      Okay, Clare. Thanks for being so helpful to me. You know if you ever want to talk or if you ever need any help, come down to my office or speak with Ms. Kimmons at the front desk.

Clare:              I know. Everything is fine. I just don’t need anything. But, if I do need something, I will talk with you. I know where your office is.

This vignette demonstrates how the counselor invites Sonja’s friend, Clare, to discuss any potential bullying that she may have experienced. Here, the counselor connects with the student by first introducing himself and then commenting on Thursday’s middle school basketball game. The student recognizes the counselor and responds to the counselor’s comment. Once the student engages in conversation, the counselor provides a very generic, non-leading question, “So, how are things going?” It is important to note that the counselor did not discuss the bullying first or those involved (i.e., Sonja, Summer, Ginger, Oscar, or Anna). Instead, the posed question is very general and nondescript. It has no hint of the bullying topic or the potentially involved students. This is done to maintain confidentiality and ensure Clare’s response is not driven by the counselor’s leading question.

Had Clare reported being bullied, the counselor would have immediately utilized the 2WHO-SCAN. However, given that Clare does not respond to the generic question, the counselor asks a more specific question related to bullying. This time Clare indicates Sonja may be involved. She further asks the counselor not to say anything to Sonja. Instead of promising confidentiality or anonymity, the counselor simply eclipses the request and asks, “What kinds of things?” Clare describes the situation with Sonja, but fails to indicate whether or not she has experienced bullying. The counselor then personalizes the question and asks, “How about you, Clare? Has anyone been picking on you?” Clare’s response is, “Not really.” The counselor gently challenges Clare’s response and seeks further clarification. As a result of this challenge, Clare divulges what she witnessed and how she responded to Summer and Ginger’s bullying of Sonja. This time the counselor asks Claire if she was threatened or hurt by Summer or Ginger. Clare response is “No.” Again, the counselor seeks clarification and Clare denies being threatened or harmed by Summer or Ginger. Instead of dropping the discussion, the counselor asks, “How would you let me know if they ever threatened or harmed you?” This is an excellent response and demonstrates a meta-communication intervention. Thus, Clare reports that if she needed help she understands how to contact the counselor and clarifies that she did not experience bullying. The counselor ensures Clare understands how to get help by indicating a potential alternate female counselor, Ms. Kimmons, should Clare feel uncomfortable speaking to the male counselor.

In addition to speaking with Claire and Anna, the counselor may consider other potential bullying survivors who rode the same bus as Sonja and the bullying perpetrator, or other potential bullying survivors who entered the school dance studio around first bell. School counselors should continue confidentiality and not divulge the identities of the bullying survivor or the accused perpetrator to students. However, counselors should interact with students at these identified locations and make themselves available to others who may have experienced the bullying behaviors.

Step Seven: Notify Parents and Guardians

This step is designed to ensure that both the parents of the bullying survivor and perpetrator are notified of the situation. Parents of bullying survivors can help provide vital information regarding their children and can aid in the monitoring of the survivor’s recovery. Often parents of the survivor want immediate resolution and a guarantee that the survivor will never again be bullied. Counselors need to be cautious in their response at this step. Promises of complete safety should not be made. Instead the counselor can report steps taken to protect the survivor from further bullying. Additionally, parents of bullying survivors can seek criminal charges or civil court actions.

Parents of bullying perpetrators should be informed of the bullying behavior and the school district’s policies regarding bullying behaviors. Although the senior authors of this article have experienced some parents of bullying perpetrators who are empathic towards their child’s victims, it has been the authors’ experiences that the majority of parents support their children who demonstrate bullying behaviors. Often these parents strongly advocate for their children and blame teachers, administrators, and staff for allowing the bullying behaviors to occur. On more than one occasion the senior authors have experienced parents who exhibited intimidating behaviors or refused to follow or support school district bullying policies. In such situations, when parents are failing to take parental authority and control of their children, counselors should speak with school legal counsel regarding involving Child Protective Services.

Conclusion

This article described the 2WHO-SCAN, a seven step assessment and intervention mnemonic. The authors utilized clinical vignettes to demonstrate how the 2WHO-SCAN can be easily and effectively used with bullying survivors and other potential victims. The 2WHO-SCAN provides a quick, broad-spectrum assessment and general intervention that can be used with elementary, middle, and high school bullying survivors. Supervisees utilizing the 2WHO-SCAN reported the mnemonic is easy to memorize and use. It has broad application for counselors working in a variety of settings (e.g., private practice, mental health clinics, hospitals, etc.) and can help counselors structure their bullying assessment and intervention processes in a logical, coherent manner. As in the case of all behaviors that demonstrate potential danger to others, additional assessment questions and intervention steps should be used as recommended by a committee of experienced and highly trained mental health counseling professionals, administrators, staff, and legal consultants.