Counseling Today

It’s a small world

Lynne Shallcross January 17, 2011

The distance around the world remains almost 25,000 miles, but it doesn’t always feel that far today. The Internet, ever-evolving technologies, advances in travel and continuous immigration and emigration are making connections with once far-flung cultures a much more common reality.

Marcheta Evans has embraced that “smaller world” mind-set and is emphasizing a need for the counseling profession to focus on globalization and international collaboration. Midway through her term as president of the American Counseling Association, Evans says she is happy to witness the wheels rolling in that direction.

“In my recent travels, I have seen the wonderful work being done by our international colleagues and their interest in working with ACA collaboratively,” says Evans, associate dean of the College of Education and Human Development at the downtown campus of the University of Texas at San Antonio. “So many have asked to network with us as they are developing their own professional counseling identity in their respective countries. I think we can serve as a great resource, and they can learn from our development by taking the best of what we have done. Also, they can avoid some of the potential problem areas we encountered during our growth. We are receiving requests on a regular basis for various international organizations to affiliate with us through the Alliance of Professional Counseling Organizations, and I am hoping to have a strong number of international attendees at the ACA Conference in March.”

Counseling Today recently spoke with four ACA members who have a passion for bridging counseling work across countries and cultures.

Different ways to wellness

Cirecie West-Olatunji knows introductory counseling textbooks include tips such as sitting squarely, leaning forward toward your clients, looking clients in the eye and asking them to tell you more about a particular problem, challenge or situation. But she also knows important elements those texts don’t include — things such as dancing, singing and storytelling, which are prominent coping mechanisms for certain cultures and communities.

An associate professor and mental health track coordinator in the Counselor Education Program at the University of Florida, West-Olatunji has traveled all over the world to advance the cause of counseling. One message she hears frequently from counselors is that it’s difficult to apply a hard-and-fast Western approach to counseling in other cultures. “There’s a struggle everywhere I’ve been between what people bring as their lived experiences — about what works in life, about how to live well — and the training they receive through the textbooks and the courses.”

Counselors across the globe believe wholeheartedly in the effectiveness of counseling, West-Olatunji says, but sometimes there are discrepancies, such as when holding a session in an office and sitting squarely in a chair opposite your client doesn’t quite mesh with the client’s environment. Part of the message West-Olatunji imparts on her international trips includes embracing a wider definition of effective counseling that incorporates a community’s lived experiences. “Each society has its own ways of defining wellness and psychological health,” says West-Olatunji, the Association for Multicultural Counseling and Development’s representative to the ACA Governing Council. “These approaches to healing are founded upon the historical and sociopolitical contexts of a people.”

For example, she says, the lived experiences of people in Romania are different from those of people in Botswana. “The counselors [she met] in Botswana defined one indigenous intervention as the sharing of stories from their grandmothers and the meaning of ’passing on the blanket’ as a way to stay grounded when stressors cause uncertainty or disruption,” West-Olatunji says. “Within the Botswana culture, a grandmother is associated with the term ’small blanket’ [because] she always wears a blanket on her shoulders. When children play outside and one of them is hurt or is feeling cold, they often run to their grandmother, who is happy to comfort and cover the child with her blanket. Thus, the passing of a grandmother’s blanket is a symbol of solace and healing.”

“In Romania,” she continues, “the counselors defined one of their indigenous interventions as dancing in a circle until there was no more unhappiness. In our Western-oriented perspectives on counseling, we often focus on talk-based therapies and the need for insight in order for clients to move toward transformation and change. Neither of these interventions includes a cognitive component to them, a feature salient in our conventional counseling methods.”

In 2010 alone, West-Olatunji traveled to Singapore, the Philippines, Romania, China and India. The two main themes of her work during these travels were disaster counseling training and school counselor training. As counseling attempts to gain a foothold in many countries, it often finds itself competing with psychology and social work. In these instances, West-Olatunji explains, school counseling frequently offers an opening specific to the field of counseling. “For the most part, counseling is being advanced [internationally] within the track of school counseling,” she says.

West-Olatunji travels to Singapore once or twice per year to meet with school counselors, principals and even parents. Solution-focused school counseling and developing cultural competence are always hot topics, she says, as are many issues familiar to schools in the United States, including bullying, underperformance and interpersonal conflicts. School counselors in Singapore often ask her for help in reaching out to parents, dealing with family issues and addressing psychological symptoms that surface in the school setting.

Parents, on the other hand, often want to know what makes up good parenting, West-Olatunji says. “Many of the parents ask about how to manage mainstream perceptions of good parenting versus the parenting that they’re doing, which stems from their own experiences.” She answers those questions with talk about outcomes. If parents want their children to be autonomous, for example, their parenting style might differ from that of parents who want their children to be interdependent.

West-Olatunji’s most recent travels to Thailand and China were focused on disaster-response training both with school and community mental health counselors. In November, she also led an ACA-sponsored People to People delegation in India with a focus on disaster mental health counseling. The delegation met with senior government disaster response officials, heads of psychiatric hospitals and leaders in community-based agencies, such as UNICEF and Save the Children, in the cities of Delhi and Jaipur.

“Mostly, they want to know what to do when a disaster hits,” she says. “They want to be able to, and are expected to, respond. They want to know what some of the best practices are in responding to disasters.” West-Olatunji distributed literature about crisis and disaster counseling, talked about the skills required to work on interdisciplinary teams and shared the model of culture-centered disaster counseling that she has created.

West-Olatunji says she makes good use of her passport because she believes in the value of counseling and its adherence to the wellness model rather than the medical model. “I believe what we do is meaningful and valuable to people in their everyday lives, so I’m happy to spread that message around the globe.”

Increasing awareness

Yegan Pillay points to the recent mining disaster in Chile as a reason U.S. counselors need to think internationally. In the effort to rescue the 33 miners trapped underground, Chile looked to the United States and other nations for help, he says. In a world that’s constantly getting smaller, that’s a sign to counselors that they should be prepared to offer assistance as well, says Pillay, an assistant professor in the Department of Counseling and Higher Education at Ohio University in Athens.

“It’s important for us in the counseling profession to start thinking more broadly. We will be called upon because the U.S. is seen as the global leader,” says Pillay, who chairs ACA’s International Committee. “We’re not adequately prepared at this stage to make a significant impact globally, nor are we as an organization having discourse about advancing the global counseling agenda.” With that as a motivation, Pillay is hard at work within the International Committee trying to expand the global reach and abilities of ACA and U.S. counselors.

For the past few years, the committee has been working to increase awareness of the counseling discipline internationally, Pillay says, because “counseling is in the shadows of psychology in many parts of the world.” One of the committee’s goals is to enhance collaborations with ACA divisions and other ACA committees that have a global agenda. “The objective is to broaden the scope of the globalization of counseling and then to use as many potential resources within ACA and its affiliates as possible,” he says. Another goal is to better utilize the ACA website, perhaps to develop an online international events calendar in the future.

At the upcoming ACA Annual Conference & Exposition in New Orleans, the International Committee is coordinating a panel of experts to talk about ACA’s global agenda. The panel discussion will be held March 26 at 2 p.m. “We hope that what comes out of that would be a white paper that would guide the ACA leadership with regard to the role ACA can play in the advancement of counseling internationally,” Pillay says.

Also planned for the conference (March 25 at 5 p.m.) is a panel of international students who will speak about counseling in their home countries as well as their counseling experiences in the United States. “The objective is to harness the energy of emerging mental health professionals,” says Pillay, adding that counselor educators and practitioners can learn through this forum how to work with international students and become more knowledgeable about issues pertinent to the international community.

Pillay, who grew up in South Africa before coming to the United States to study counseling, directs the HIV/AIDS in Africa program at Ohio University. Each year, he takes a group of 15 to 20 students for approximately six weeks of service in Africa. Pillay points out that the number of counseling students involved has increased since he’s been involved in the program. The groups have previously traveled to Botswana each year but will be going to South Africa this coming summer.

The students spend the spring quarter at Ohio University in an orientation program researching the nongovernmental organizations (NGOs) with which they’ll be working and the NGOs’ role in the eradication and treatment of HIV/AIDS. On past trips, the students’ first week in Africa was spent role-playing with university faculty and researchers from the University of Botswana. This coming summer, the students will do the same with personnel from Nelson Mandela University in South Africa. The students then spend three to four weeks with one of the NGOs whose work focuses on those affected by or infected with HIV/AIDS, such as a residential facility for orphaned children, hospice-type organizations or crisis counseling centers.

The overall goal is to develop counselors who are multiculturally competent, Pillay says, and these trips go far in showing the students a unique environment, taking them outside of their comfort zones and exposing them to strategies they might use in the future. “It provides a different vantage point than they would otherwise be exposed to,” he says.

On one of the trips, two African American students told Pillay through tear-filled eyes that it marked the first time they truly felt as though they belonged. On the flip side, Pillay says, Caucasian students learn firsthand what it feels like to be in the minority. The students’ counseling skills are unquestionably strengthened through the work they do on the trips, Pillay says, but just as important is the effect the experience has on their empathy. “When they go into the professional world and see clients who might be different for many reasons, I believe they will be more sensitive to understanding that experience,” Pillay says.

When it comes to counselors thinking more globally, Pillay insists there’s no substitute for experience. “The only way you can become aware of individual differences is through contact. It’s through contact that we can challenge some of our stereotypes. Learning transcends the boundaries of the classroom.”

Crossing borders

Fred Bemak has worked as a counselor in 36 countries — emphasis on worked, not simply traveled to or through.

With a passion for international counseling, Bemak, professor and director of the Diversity Research in Action Center at George Mason University, founded Counselors Without Borders in 2005. The catalyst for the organization’s creation, Bemak says, was witnessing the great underserved need for culturally responsive counseling in the Gulf Coast region in the months after Hurricane Katrina.

When an earthquake devastated Haiti this past year, Bemak immediately recognized that same need. With an invitation from Partners of the Americas and funding from the U.S. Agency for International Development, Bemak mobilized a team of counselors who traveled to the country for two and a half weeks in April. The one thing Bemak says counselors must have before working internationally is an invitation. “You should never go and create more chaos,” he says. “You have to have the infrastructure first.”

Once Bemak’s Counselors Without Borders team, composed of himself and two others, arrived in Port-au-Prince, they began intensive training at a school that remained partially standing. They worked with school administrators and staff members from throughout Port-au-Prince, as well as students and even parents. “One hundred percent of the people in Haiti were affected by the earthquake,” Bemak says. “We heard stories hundreds of times about children who watched a parent, sibling or friend die. People just don’t know how to deal with that kind of trauma.”

Bemak helped school staff members work through their own issues, while also teaching them how to effectively assist the traumatized children. “People had an intuitive sense, but they didn’t have the counseling skills,” he says.

“We had Haitian teachers sit in and observe us running counseling groups with children, followed by debriefing and clinical supervision training meetings with staff after the groups,” Bemak continues. “In one of the groups, we had children draw their most powerful memories of the earthquake and then had them share and discuss the drawings within the group context. The drawings and discussions were powerful, and staff learned how to facilitate painful discussions conducive to healing.”

Bemak and his team also traveled to the town of Jacmel, where they trained psychologists and social workers in trauma counseling. “The emphasis is on building capacity in a culturally responsive way and on helping the people there learn the skills to deal with trauma,” he says. “We don’t want people to become dependent on us; we want to transfer the skills.”

Adds Bemak, “The visit was also to assess for continued work in Haiti, which has led to the development and submission of a major grant that would involve significant Counselors Without Borders teams going to Haiti for the next three years if funded.”

For the past two summers, Bemak has also traveled to Uganda to conduct training for staff members of Invisible Children, an organization that aims both to assist children affected by war and to stop the use of child soldiers. With so many children traumatized by civil war, the staff struggles to deal with the children’s issues, he says. Through a combination of classroom and field training, Bemak trains staff members in trauma counseling, both supervising them and modeling techniques for them.

Bemak says the organization chose the most traumatized youths with whom it was working and asked him to help. Many of the youths were former child soldiers, which is “one of the most horrible things people can be subjected to in the world,” Bemak says. Other children he was asked to help were HIV-positive, rape victims, torture victims, child mothers and orphans. “There’s a tremendous breakdown in the community,” he says. “In the past, the community would have taken care of these children, but now their resources are stretched so thin that they don’t have the capacity to continue family and community traditions.”

Invisible Children focuses on helping children succeed in school and eventually become skilled and financially stable individuals. Bemak’s role is training the staff to better understand how to help deeply traumatized children. “We would talk with the students, siblings, parents, caretakers, extended family members, etc., and discuss what was going on in the child’s life,” he says. “The staff would be present and, after each session, we would process the experience and talk about the intervention strategies and how to effectively help traumatized children heal.”

Although Bemak made the past two summer trips alone, he’s pursuing a three-year grant for Counselors Without Borders. “This would involve exchanges by Ugandan staff coming and spending time training with Counselors Without Borders staff here in the U.S. and Counselors Without Borders team members periodically visiting Uganda to provide counseling and training,” he says. “We are now exploring funding to establish an international prototype for psychosocial support and mental health as a major initiative within nongovernmental organizations.”

Even if counselors are working solely within U.S. borders, they still need to expand their worldviews, says Bemak, remarking that one in 10 people living in the United States is foreign-born. “In Haiti, they believe in voodoo. You can’t just say, ’I don’t believe in that.’ You have to weave it into treatment. I think we have to be more attuned not only to cultural diversity within the U.S., including cultural healing practices and beliefs, but also the impact that globalization has on an international population. What’s going on in other countries is now affecting us in multiple ways, and counseling needs to get on board with that.”

A nation in need

Daya Singh Sandhu, distinguished professor of research and former chair of the Department of Educational and Counseling Psychology at the University of Louisville, spent the first five months of 2010 working on mental health issues in India. As a Fulbright-Nehru senior research scholar, Sandhu traveled to the country where he grew up to survey suicide ideations there.

The title of Sandhu’s project was “The Effects of Cross-Cultural Worldviews and Coping Response Styles on Suicidal Ideations: A Comparative Study of Gender and Cultural Correlates of Risk Factors and Reasons for Living Among Americans, Asian Indians and Indian College Students.” In India, suicide rates have increased nearly 60 percent during the past 35 years, reaching 10.8 deaths per 100,000 people. Between 2006 and 2008, Sandhu says more than 16,000 college students ages 19 to 24 died by suicide. He traveled to India, he says, to “find out what’s going on” by talking to college students.

Sandhu, the immediate past president of AMCD, conducted focus groups with roughly eight students at a time. One of the students cried, Sandhu says, because she was haunted by the suicides of two girls involved in a lesbian relationship whose parents wanted them to marry men. Sandhu says his study led to many other stories involving lovesick students, the daunting aspect of forced marriages and intense academic pressure. After meeting with the students, Sandhu says it became obvious that people are experiencing significant multiple stressors in their lives because of rapid economic and social changes in India.

There is a shortage of mental health professionals available in India to those in need, according to Sandhu. He estimates that 95 percent of India’s universities lack counseling centers, and the number of private mental health practitioners is very low. Those actually able to locate a professional must deal with the prevailing stigma against getting help for mental health issues, Sandhu says. “People will think you are crazy,” he explains, adding that if the community finds out the person is seeking counseling, it can severely damage his or her chances of getting married and obtaining a good job.

While conducting research in India, Sandhu also attempted to make inroads in advancing mental health for the nation as a whole. In May, with the help of Guru Nanak Dev University and the U.S.-India Educational Foundation, New Delhi, Sandhu convened a meeting of mental health scholars from various areas of the country, and the group decided to launch the Association of Mental Health Counselors. As the founding executive director, Sandhu’s hope is that the association will prove successful in increasing the availability of counseling centers and mental health professionals, which now stands at one psychiatrist for every 400,000 people in India. The association has already opened its first counseling center in Punjab, and another is set to open at Guru Nanak Dev University in early 2011.

Another accomplishment was the creation of a postgraduate degree program in mental health counseling at Guru Nanak Dev. Thanks in large part to Sandhu’s efforts, the program began its inaugural semester this past July. The program is the first of its kind in India, but according to Sandhu, at least three other universities are planning to begin offering similar degrees this year.

Increasing globalization brings people with a variety of different cultural backgrounds to counselors’ offices, Sandhu says, and a Eurocentric model of counseling won’t work for all of these clients. “We can benefit by learning what is going on in other countries,” he says. Realizing that certain problems and situations are culturally specific and that addressing them effectively takes a culturally unique approach is imperative, Sandhu says. He believes making that realization will lead to a more inclusive, comprehensive approach to mental health counseling. Says Sandhu, “We have a lot to learn from each other when we are at the global level.”

Lynne Shallcross is a senior writer for Counseling Today. Contact her at lshallcross@counseling.org.

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