Monthly Archives: May 2011

Wish you were here

Marcheta Evans May 1, 2011

Wow! More than 4,300 people attended the 2011 American Counseling Association Annual Conference & Exposition in New Orleans, making it our most well-attended conference in 10 years. Reflecting on my March column, in which I mentioned being on the precipice of a dream fulfilled, I just smile. I am pleased to report that I am basking in the joy of that dream fulfilled, and it is even better in reality.

First, let me say that this year’s conference was absolutely fantastic! If you were not there this year, you were greatly missed, and I hope you will plan on coming next year. I’d like to share a little snippet about why it is important for you to attend the annual conference.

To see your Governing Council in action

The first half of conference week involves working with your Governing Council. You have one of the hardest-working and most committed boards ever. Everyone does her or his extreme best to represent you and the counseling profession. Budget needs, strategic planning initiatives, branch development, graduate student needs and services, international collaborations and development, and crisis response protocols are just a few of the issues discussed. Stay tuned to see the wonderful ways in which these initiatives will be operationalized over time.

To strengthen the profession through unity and collaboration

About a year and a half ago, I met with the region chairs-elect and division presidents-elect during our Council of Presidents and Region Chairs (COPARC) meeting. We discussed ways to demonstrate our unity and commitment to the growth of our profession and to one another. A significant moment occurred when we discovered the many ways we are similar and how important it is to work as a team for the betterment of all. As a group, we agreed to invest in a Giving Back to the Community day, a concept one of our divisions developed a number of years ago. This year, all divisions and regions committed to getting involved in some aspect or another. At many conferences in the past, numerous divisions had worked on ways to positively impact the host community, but there had never been a coordinated effort to engage all divisions and regions under a single umbrella.

You see, in previous years, I felt as though we would go in and do what I call “drive-by” service with no meaningful, lasting impact on the community. However, when I discussed this with COPARC, every president-elect and region chair-elect was committed to the idea. The Giving Back to the Community Day morphed into an event involving 900 participants. Some of the sponsored events included refurbishing historic Holt Cemetery, the Social Justice Leadership Development Academy, working with Catholic Charities, the New Orleans Recovery School District Project, and the Association for Multicultural Counseling and Development/International Association of Addictions and Offender Counselors Juvenile Justice Intervention Project and Wellness In-Service Intervention.

In addition, the Association for Adult Development and Aging sponsored the New Orleans AIDS Task Force, while the Association for Creativity in Counseling, the Association for Counselor Education and Supervision, the Association for Specialists in Group Work and the National Employment Counseling Association also sponsored events. Other entities, divisions and regions contributed to this day — and beyond — as well.

To hear the keynotes and take advantage of educational opportunities

We had two phenomenal keynote speakers. The first was Soledad O’Brien, who stole our hearts with the way she weaved the “Giving Back to the Community” theme into her story. I was already a fan, and I walked away knowing that she is a woman of great substance — not just beautiful on the outside but genuinely a beautiful person on the inside. Then, there was Dr. Judith Beck, who shared a wealth of practical knowledge related to cognitive behavioral approaches. My only disappointment was that she did not have more time to spend on the weight loss information. I was waiting patiently to see if she could give me more insight on my struggles with this issue! LOL, I guess I will have to buy her book on that topic.

Beyond the keynotes, there was an array of educational sessions and ancillary events. I am still looking through the Program Guide at all the events I missed. Additional reasons for attending ACA’s annual conferences include social and networking opportunities, career advancement, rejuvenation and — especially if you are a graduate student — exposure to leadership. Again, there was something great happening for everyone at this year’s conference.

I hope I have given you a brief view of the wonderful time we had in NOLA. I am hoping to see all of you next year in San Francisco, where new memories will be made. Thank you again to everyone! If I missed someone or something in my brief summary, please forgive me in advance! I look forward to your continued involvement.

Revisiting a key pillar of the profession

Richard Yep

Richard Yep

One of the hallmarks that define a profession is its code of ethics. The code lets consumers, public policymakers and peer organizations know that members of a profession have committed to adhering to rules that protect those whom they serve. The code of ethics means the profession is serious about maintaining and policing itself.

Every seven to 10 years, the American Counseling Association begins the process of reviewing and revising its code of ethics. Given the changes in society, both structurally and technologically, it is critical that we look at where revisions should be made so that the code will meet the needs of those whom it is designed to protect.

This past month, ACA President Marcheta Evans announced the formation of an ACA Ethics Revision Task Force. This is the first step in the revision process. President Evans issued a “call for participants” (see page 4) because she is committed to forming a task force that is representative of the profession and inclusive of both academicians and practitioners. The current version of the ACA Code of Ethics was completed in 2005, and the revised code is slated for completion by spring 2014. If you are interested in serving on this task force, the application deadline is May 15.

The ACA Code of Ethics will continue to serve as professional counseling’s moral and professional practice “compass” as you move forward in the work you perform for millions of clients and students. Every week at ACA headquarters, we field calls and e-mails from members and consumers that relate to ethical practice. During one month earlier this year, we hit an all-time high with more than 500 inquiries about the ACA Code of Ethics.Please understand that the nature of these calls is about more than just consumer complaints. The communications we receive are from many of your colleagues who want to ensure that they are practicing and meeting the high standards set forth in the ACA Code of Ethics.

For those of you who call and seek advice, I appreciate your willingness to check in with us to find out how best to maintain your work in line with the code. Your commitment to professionalism and ethical practice is commendable.

I am pleased to let you know that your Governing Council recently approved a budget that will allow us to add additional staff resources to aid in responding to calls we receive about ethical issues. From my vantage point, that is truly “leadership in action.” The Governing Council realized the need and met the challenge with a commitment to find the resources to address the desires of the ACA membership. Meeting the needs of professional counseling practice is one of our main goals.

Speaking of professional practice, some of you are celebrating a very special milestone this month — you are graduating from your counselor education programs. On behalf of the staff and leaders of ACA, we express a resounding “Congratulations!” for reaching such an important goal. As you make your way into “life after graduate school,” our gift to you is acknowledging that you may have some student loans to pay off and understanding that you are just entering the job market.

For those of you just graduating, please let us know so we can ensure you only pay the “New Professional” rate for ACA membership. This provides a discount of more than $60 for those of you entering this category. It is our way of saying, “We know what it is like to start out after grad school!”

As always, I hope you will contact me with any comments, questions or suggestions that you might have. Please contact me via e-mail at ryep@counseling.org or by phone at 800.347.6647 ext. 231.

Thanks and be well.

‘Come and be who you are’

By Lynne Shallcross

Michael Chaney knew from a very young age that he was gay, a fact that meant he also had years to process what it meant to be gay. “People who don’t grow up that way didn’t need to go through that HeartinHandsprocess,” says Chaney, who is president of the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling, a division of the American Counseling Association.

Chaney says heterosexual counselors who haven’t walked the path of lesbian, gay, bisexual or transgender (LGBT) clients might not fully understand the significance of processing that experience. It’s important to gain that understanding, Chaney says, not only because counselors have an ethical responsibility to learn about diverse cultures, but also because at some point in their careers, counselors will almost assuredly come across clients who identify as LGBT, and they need to be prepared to work with this population.

“One of the most important things counselors can do [to prepare] is engage in the process of self-reflection on their own sexual orientation and gender identity,” says Chaney, an associate professor in the Department of Counseling at Oakland University in Rochester, Mich. “Until you understand your own sexual orientation and gender identity, there’s no way a clinician will be able to understand and work with an LGBT client.” He suggests that counselors think about what their sexuality means to them, how it influences their life and how it influences relationships with their clients.

“Part of the self-awareness is identifying one’s heterosexual privileges [and] understanding how that might affect the therapeutic relationship with clients who are not heterosexual,” Chaney says. One example is the privilege of marriage. For instance, a heterosexual counselor might display a photo of her husband in her office. “Something as small as that could influence the relationship, possibly making the client feel less than,” Chaney says. “I am not suggesting that counselors remove photos of spouses. I am just using that as an example that counselors need to recognize the privileges they may bring into a counseling session — the right to marry being one privilege. Because many heterosexual counselors do not typically feel the experiences of living in a heterosexist society, it is often difficult for them to recognize their heterosexual privilege.”

In addition to reflecting on their own experiences, Chaney says, “Counselors should put themselves into the LGBT communities and talk to LGBT folks to find out what their needs are, give LGBT people a voice and, after listening to the needs of these communities, advocate on their behalf.”

It’s also essential for counselors to understand that the LGBT community is diverse, Chaney says. “I think most people’s perception is that we’re one big homogenous group, but we’re actually a very diverse group, and we have very diverse needs and unique values.” The community does share a history based on oppression, however, which has led its members to develop a variety of coping skills. “It’s important to know that as communities, we’re a very resilient group of people,” Chaney says. “From a counseling perspective, that’s great information to have because we can use that resiliency in our counseling sessions.”

The ALGBTIC website (algbtic.org) is a good resource for all counselors, Chaney says. It offers a set of competencies for working with LGB clients, another set of competencies for working with transgender individuals and a host of other helpful tools.

Although counselors have a personal responsibility to learn more about the LGBT community, Chaney says counseling programs also have a responsibility to teach their students in a broader way. The existing requirement of a multicultural course doesn’t necessarily mean in-depth teaching on LGBT issues, he says. Depending on who is teaching the course, students might have a couple of class sessions focused on LGBT issues based on one chapter in a textbook, or LGBT issues might be infused throughout the course.

Chaney thinks training programs should provide more student exposure to LGBT communities, such as through internships in partnership with community organizations. He says research has shown that exposure makes the greatest difference in changing people’s attitudes concerning the LGBT community.

In the past, Chaney says, homoprejudice tended to be open and blatant, meaning it wasn’t uncommon for people to call LGBT individuals derogatory names to their faces. Today, the negativity is generally more covert, which Chaney contends can be even more damaging. It’s challenging, he says, because LGBT individuals are left questioning the meaning and genuineness of certain conversations and interactions. Counselors can see these effects, he says, in depressed, anxious clients who might be lacking self-esteem or struggling with substance abuse, for example.

But Chaney returns to the resiliency that historically has been a part of this group. “Tap into our clients’ strengths and the resilience of the community, and build up a client’s coping skills to better handle those types of situations,” he suggests.

Additional advice from Chaney: Don’t pathologize the client, don’t attempt to “cure” a client through reparative therapies, don’t assume the sexual orientation or gender identity of a client and, above all else, use affirmative counseling techniques that offer clients a safe, positive place.

All are welcome

When Megan Mahon, an assistant professor of counseling at Heidelberg University in Tiffin, Ohio, gives presentations to her fellow counselors on improving their interactions with LGBT clients, her first piece of advice is to start at the door.

“From the minute they come in, let them know that they are accepted, that they are welcomed,” says Mahon, a member of ACA. Drawing on three years of experience at the University of Toledo’s counseling center, Mahon suggests that counselors display “Safe Zone” stickers and include reading material in the waiting area from LGBT groups in the community.

The intake paperwork is also crucial in making a first impression, Mahon says, so it should feature inclusive language. For instance, instead of making “single,” “married” and “divorced” the only available options on paperwork, it could read “single,” “married or significant other” and “divorced or relationship dissolved.”

“It’s simple things like that, but they can make a big difference when clients are coming in [and] they’re scared and they’re not sure how they’ll be treated,” Mahon says.

Once a client gets into session, counselors need to be keenly aware of the language they use during the diagnostic assessment and make every effort to minimize heterosexual bias. Addressing whether clients are in a sexual relationship and how they identify are important parts of the assessment that often get left out, Mahon says. She suggests that a thorough evaluation might include assessing for sources of support, spirituality, history of violence or abuse, level of internalized homophobia, sexual history, sexual orientation, intimate partners and high-risk behaviors for sexually transmitted disease and substance abuse.

“The reality is, many counselors are not asking some of these questions — to heterosexual or sexual- and gender-minority clients — because it makes them uncomfortable,” Mahon says. “These are areas that you must be willing to explore if you are working with any population but especially with sexual- and gender-minority clients because they come to counseling with some unique experiences.”

Asking clients how they self-identify is a good idea, Mahon says, because this allows counselors to learn and use the same language that clients use to describe themselves. “We are prone to want to fit people into a box or category that makes sense to us, and we have been socialized to see men and women as behaving, dressing, speaking, etc., in a certain way. Counselors working with sexual- or gender-minority clients must be prepared to challenge some of their own preconceived notions about sex, gender and relationships and understand the client from their unique perspective.”

As is the case with many other clients, LGBT clients often come to session seeking help with relationship problems, whether family, social or personal, Mahon says. While working in the university counseling center, Mahon heard many stories about her LGBT clients coming out to their families and how their parents reacted by cutting off all communication, or how clients came out to a roommate only to have the roommate move out. “What a rejection,” Mahon says. “To come out to someone you think is your friend. You’re living in a small room with them and they [no longer] want to live with you or change in front of you. And then they say, ‘I’m moving out or you’re moving out.'”

LGBT clients might also present with occupational issues related to the risks of coming out at work. One of Mahon’s friends, a lesbian with a partner, revealed that during a recent job interview, she was asked whether her husband would be moving with her. The woman struggled with whether to answer yes and risk being caught in a lie later or saying no and having to come out to the interviewer on the spot.

Spirituality is another area in which LGBT clients seek assistance, Mahon says, because although their spirituality might be a meaningful source of support for them, many of these clients have also experienced rejection from religious communities.

Mahon also suggests that counselors be knowledgeable about addictions as well as HIV/AIDS and not shy away from engaging in conversations about those topics with LGBT clients. Both affect the LGBT community, and it can be helpful for counselors to assess clients’ risk factors and offer education, she says.

Mahon stresses the importance of counselors possessing a foundation in affirmative therapy to address the wide range of issues with which LGBT clients might present. Part of affirmative therapy is creating a welcoming physical environment in the counseling office, Mahon says, but beyond that, it also means avoiding harm to clients and focusing on offering unconditional positive regard.

With affirmative therapy serving as a base, Mahon says a host of other therapies can prove helpful in different instances with LGBT clients. In her work, she often integrates feminist, Gestalt and existential theories. Mahon likes the assertiveness component of the feminist perspective, as well as its demystification process, which encourages counselors to explain clearly to clients what they’ll be doing and working through together, thus eliminating any elements of possible surprise.

Although existential theory can be applied to all clients, it works especially well with some LGBT clients because it addresses their existential crises and the elements that give their lives meaning, Mahon says. “For a lot of us,” she adds, “getting married and having children is what gives life meaning.” Oftentimes, those options aren’t available to LGBT clients.

Mahon leans toward Gestalt techniques because LGBT clients can come to counseling feeling “split,” meaning they know who they are but have been told their whole lives that their identity and lifestyle is wrong. Helping them learn to accept themselves and feel whole again is important, she says, and Gestalt techniques can effectively address such issues.

Many counseling interventions are applicable to LGBT clients, Mahon says, even if counselors sometimes need to reconceptualize the approaches. She has requested that LGBT clients make genograms as homework so she can see all of their family members presented and then inquire what the relationship is like with each person. Mahon believes that Vivienne Cass’ identity model is also worth reviewing with LGBT clients. As homework, Mahon will sometimes ask clients to journal or make a collage about where they are in the identity model, where they want to be and how counseling can help.

Reflecting on her time in the campus counseling center, Mahon adds that group work can often be helpful. “Group counseling for LGBT students in a university setting is important because it not only provides a place for support and community, but it also gives clients a safe space for self-exploration. Developmentally, building a support network and self-exploration are things that most college students are working through. For LGBT students, this may be more of a challenge depending on the community they live in.”

Mahon suggests that counselors working with or planning to work with LGBT clients review a sexual orientation counselor competency scale. “An important part of the education and training considerations is how knowledgeable and how comfortable you are working with this population,” she says. Among her other recommendations: Visit the ALGBTIC website for resources, take advantage of professional development opportunities at conferences and workshops, keep up with research and journal articles, and get supervision from someone with experience. “Even if you’re no longer required to be under supervision,” she says, “it’s important to seek supervision when you’re working with a new group of people in general, not just LGBT clients.”

Taking a stand

Ask Erin Binkley why her work as a heterosexual ally to the lesbian, gay, bisexual, transgender, queer and questioning (LGBTQQ) community is so important, and she’ll share how it became crystallized for her one morning. A sexual minority high school student in a nearby community had died recently by suicide. Binkley describes the fallout from the event as “terrible,” adding that the reaction from parts of the community toward the student’s family was less than supportive. During her visit to a local dog park one morning, she started talking with a friend of the family.

“She came to the park terribly distraught,” remembers Binkley, an assistant professor of counseling at Oakland University and a member of ACA. “She looked at me with pleading eyes and said, ‘Where was the school counselor in this?'” In response, Binkley could only offer that, yes, in a perfect world, the school counselor would have been there to intervene. The encounter struck Binkley so deeply that it propelled her to do more than stand on the sidelines.

“I think back to that woman looking at me and the expression on her face when she asked, ‘Where was the counselor?’ and me, as a counselor, not having an answer for her,” Binkley says. “That was when I realized I wanted to be more involved in advocacy for this group.”

Binkley, who has been at Oakland since August, decided to join the LGBTQQ community as a heterosexual ally, an important role she says the community needs more people to fill. Binkley admits that when she first arrived on campus, she assumed being accepting of all races, genders and cultures was synonymous with being an ally to those groups. “What I started realizing was that being an ally means more than being supportive,” she says. “I had thought that if I wasn’t part of the problem, I was part of the solution. But being part of the solution means taking an active role in finding solutions. Not being against a certain group doesn’t necessarily mean I am for a certain group.”

As part of her commitment to getting more involved, Binkley is participating in a sexual orientation and gender identity initiative being implemented by Oakland’s School of Education and Human Services. “The idea behind it is to open the conversation about how we can be a more open and affirming community to people of all different sexual orientations and gender identities,” she says. As part of the initiative, lecturers are being invited to campus to speak on the topic. That exhibits greater acceptance to the entire campus, Binkley says, while also offering examples the LGBTQQ community can identify with and relate to. Moving forward, she says, the intent is to plan more events that inspire open discussions about LGBTQQ topics.

Binkley acknowledges that in the past, she thought LGBTQQ members had their own groups and that those groups held the responsibility of advocating for them. But the LGBTQQ cause can use help from the outside, she says, adding that she has realized she might have unique advantages that can help. “In this society, being a heterosexual person, I have an acceptance from the general population that is easy to take for granted. Being straight is the norm, and people for the most part probably won’t hate me for that. If a gay person goes out into society, that’s something they may have to worry about on a daily basis. I can use that advantage to take a stand.”

The LGBTQQ community has a variety of needs that heterosexual allies can help to meet, Binkley says. One of the most important is providing a “safe space” where LGBTQQ members can go to feel safe and accepted, she says. The need is present wherever counselors work, whether in agencies, schools, hospitals or elsewhere, she adds. Another substantial need is advocating for gay rights. “It’s really important to advocate for LGBTQQ people having the same rights that I have as a straight person,” Binkley says.

On the Oakland campus, students, faculty and staff can participate in a two-hour Students, Administrators and Faculty for Equality (SAFE) ally training to learn about accepting differences, how to talk to someone in need of help and other topics. Individuals who complete the training are given a rainbow triangle and their names are put on a list that is accessible through the university’s website. If LGBTQQ students need help, they can look on the list and might find that a fellow student down the hall or one of their professors is an ally to whom they can talk.

The ways in which counselors can serve as heterosexual allies to the LGBTQQ community might look different for each individual person and situation, Binkley says. But as general advice, she suggests that counselors join ALGBTIC as ally members. Next, she advises that counselors find out about the different types of LGBTQQ community support programs available in their localities and get involved. If there is a lack of community support, counselors can investigate what the needs are and get a support effort started, she says. Counselors on university campuses can take part in an ally training. And for school counselors, Binkley suggests considering the possibility of starting a group, perhaps for LGBTQQ teens or the parents of teens who identify as LGBTQQ.

For Binkley, becoming a heterosexual ally has meant taking part in and even initiating conversations about LGBTQQ issues with coworkers, identifying the needs in the community and seeking out other allies. Even when concrete answers aren’t available, Binkley says just getting involved in the conversation is a form of advocacy.

Counselors can let clients know they’re a heterosexual ally by something as simple as including sexual orientation and gender identity issues in a scope of practice or mission statement, Binkley says, while school counselors might include the topic in a brochure of services that they offer. “Tell your clients this is not something [you’re] afraid to talk about,” she advises.

Being an ally to the LGBTQQ community is in alignment with the foundation of the counseling profession, Binkley says. “By the nature of what we do, we want to offer a space for all people to come and be who they are. Counseling treatment, no matter what venue it’s in, rests on the assumption that people can come and talk openly and honestly about who they are and what’s going on in their lives. This is just another way to say this is a safe place.”

Beyond the open conversations and letting clients know they’re safe to be themselves, Binkley believes the advocacy that goes along with being an ally is also a natural fit for the counseling profession. “I think that is the mission of a counselor — to help people find their voices and to be that voice when someone can’t do it for themselves. We’ve advocated for groups that have been beaten down by society, and this is certainly one of those groups. I would hate to think that there’s a teen or an adult out there hurting themselves and that I could have made a difference but didn’t speak up.”

Same-sex parents

If you think parenting can be hard, take a moment to consider the pressures thrust upon parents who are in the spotlight because of their minority status as LGBT individuals. Jason Patton, a core faculty member at Walden University, did just that in researching same-sex-oriented fathers for his dissertation.

After interviewing five couples who were full-time parents to biological or adopted children under the age of 18, Patton says he found each of the men and their stories to be unique. At the same time, he says, recurring themes of struggle and success emerged, as did abundant opportunities for counselors to help. He believes much of his research on same-sex-oriented fathers can apply to other LGBT parents as well.

The first bit of advice Patton shares based upon his research is for counselors to leave their expectations at the door and to avoid anticipating that all same-sex parents will be alike. “I think it is easy for counselors to assume that once they have worked with one same-sex family, they know all there is to know about what might present itself in future counseling relationships,” says Patton, a member of ACA and ALGBTIC. “To me, this is dangerous territory.”

Counselors’ presumptions could prevent them from exploring clients’ true experiences and inhibit them from forging a true connection with clients, Patton says. “If I am only connecting with who I believed you to be, I may never be able to get past this and come to understand you to be who you are.”

Patton also says counselors should never assume a level of dysfunction in the family. “It’s not always that there’s an issue within their family,” he explains. “They might be coping with the stress of the environment and people not being ready to accept them.”

Patton recalls a couple who resorted to avoiding restaurants in one part of town because they sensed an increased level of scrutiny from members of the community. The family, composed of an African American father, a Mexican American father and their children of other ethnicities, became the focus of comments and stares when they went out to eat, and the parents explained to Patton that it was just too much for them to handle. “It’s easy to become overtaxed by always being aware,” Patton says.

Counselors working with clients feeling the weight of scrutiny can help them identify when they’re becoming overwhelmed and how it affects their life. Then, Patton says, counselors should support ways for clients to recharge and take care of themselves.

In doing his research, Patton discovered what he thinks is an important paradox. Despite almost all of the men saying they had anticipated marginalization but hadn’t noticed it much, in the next breath, Patton says, they would share experiences of overt discrimination or isolation.

“It would be easy for a counselor to say, ‘Oh, wait, you’re wrong. You said you don’t experience this, but I’m hearing you say you do,'” Patton says. But he doesn’t believe that’s the correct course of action. Instead, he suggests, counselors need to realize the paradox might be a self-protective mechanism. “To immediately lambaste this without fully thinking through the potential functionality of it could cause potential harm,” he says. “I think it’s OK to say, ‘I’m hearing a couple of different things. I just want to go there with you.’ Adopt a stance of curiosity instead of authority. Don’t take the expert role.”

The transition period that occurs when same-sex parents are waiting to adopt a child can be especially challenging. In his research, Patton found that working through the adoption system was incredibly stressful, particularly when the prospective parents anticipated being denied parenting rights because of their sexuality.

The time after the adoption goes through can also be challenging, in part because same-sex parents often lack role models to look to for guidance. One of Patton’s interviewees said it felt as though he and his partner were writing the rules as they went along. “They had good models of what it was to be a good parent,” Patton explains, “but they didn’t have models for how to negotiate roles in same-sex couples.” To help LGBT clients struggling with this transition, Patton says counselors should be well informed of resources within their local communities as well as books or movies that speak to the experience. Another important role for counselors is helping these clients feel understood and appreciated, he says.

Among the same-sex fathers he interviewed, Patton discovered another challenge that arose when they became parents — they often felt isolated from the greater LGBT community, effectively assuming minority status even within their own larger minority group. “When clients are cut off from their natural communities of resistance that have helped them to cope and manage negativity from society at large, they may feel demoralized and discouraged,” he points out. To assist these clients, Patton says counselors should model supportive, responsive and optimistic connection. Encourage clients to connect with other same-sex parents; even in isolated communities, that can be possible through social networking opportunities. Another strategy he recommends is helping clients identify the social support systems that are currently working in their lives.

Above all else, Patton says the role of the counselor with same-sex parents is to be supportive and to cultivate resilience that will help them rebound when they experience marginalization. “Identify psychological, emotional, familial and various other resources that clients already have in place,” he says. “These are, hopefully, things that have helped them succeed in the past despite any number of challenges. They are, after all, parents and lovers, so they have been doing something well. What has worked in the past, and what efforts are they currently making to persevere or excel? Ask how to best bolster these things. Validate and encourage, but also do not shy away from identifying those things that do not work or are counterproductive to the clients’ efforts.”

During his research, one of Patton’s most memorable experiences came when a gay man he interviewed, once stoic and unsure of his ability to be vulnerable, described finding and embracing his softer side after becoming an adoptive father. “He felt transformed by the experience and said he became a better man for it,” Patton says. “Too many same-sex couples might not think they’re able to be parents. There is this whole world that could be open to them if counselors, institutions and families supported them.”

A space for spirituality

Spirituality can be both an important and challenging topic when it comes to LGBT clients, says Robert Dobmeier, an assistant professor and coordinator of the mental health program in the Department of Counselor Education at the College at Brockport, a campus of the State University of New York. Dobmeier notes that he has engaged in many conversations on the topic with Brockport colleagues Summer Reiner, Kathleen Fallon and Elaine Casquarelli, and he offered to share some collective thoughts that have emerged from their discussions.

Dobmeier, an ACA member, points to a white paper on spirituality from the Association for Spiritual, Ethical and Religious Values in Counseling, a division of ACA, that states spirituality is “innate and unique to all persons.” Although religion is the institutional organization of common beliefs, spirituality can encompass personal aspects, including the search for love, meaning and hope. Religion is a major form of spiritual expression, he says, but the teachings of some religions have amounted to LGBT individuals being rejected by various religious communities.

“The individual is often forced to make a choice between practicing their sexuality and practicing their religion,” Dobmeier says. “This can cause distress in the individual, as well as self-doubt, resentment and anger. In reflecting on one’s life, the individual may feel positively about his or her developmental process that has culminated in an identity as lesbian, gay, bisexual or transgender. On the other hand, the individual recognizes messages and forces in the larger culture, and possibly from a religious community in which she or he has grown up, that deny the authenticity of one’s developmental experience.”

Likewise, LGBT communities can be a source of rejection for LGBT clients who wish to maintain their religious identity, Dobmeier points out. He explains that these clients might encounter antireligious sentiment within some LGBT communities because its members have been rejected by certain religious groups. This may leave the client feeling forced to choose between being accepted by an LGBT community that is hostile to religious involvement or remaining alienated as a member of the religious community, he says.

An additional source of stress can present itself if LGBT individuals fear retribution from God or have feelings of guilt due to religious messages that proclaim gay and lesbian sexual orientation as sinful, Dobmeier says. Tensions related to prioritizing one’s sexual practice or religious practice can also play out in a relationship with a partner, leaving one partner feeling dissatisfied with the other.

At the same time, spirituality as a search for meaning, hope and forgiveness, as mentioned in the ASERVIC white paper, can serve as a source of strength and wisdom for LGBT individuals who frequently cope with antagonistic cultural values and responses, Dobmeier says. Although LGBT clients may seek counseling for a variety of issues, if a client wishes to address spirituality, Dobmeier says counselors should be open to the experience of the individual and respond in a way that is therapeutic for the client. The ACA Code of Ethics ASERVIC’s Spiritual Competencies and other professional documents specify the need for counselors to be capable of responding to the client spiritually, Dobmeier says.

“In anticipation of this need, the counselor may want to reflect on where he or she is at spiritually,” he says. “Specifically, how have the counselor’s cultural and spiritual traditions of origin influenced how she or he might work with an LGBT client? Does the counselor’s spiritual or religious life bring healing in the life of the counselor that can be used in counseling an LGBT client?”

Dobmeier points to narrative therapy as helpful in working with LGBT individuals who want to explore aspects of spirituality because the approach invites clients to tell their stories. When they share their stories of their search for self and sexual identity, the difficulty of coming out, conflicts with family and rejection by religious and other communities, he says clients can find support from the counselor and potentially gain perspective on where they have been and where they want to go. Getting in touch with feelings of hurt, rejection and anger can also allow healing to begin, he adds.

Working with LGBT clients whose experiences with religious or spiritual communities have been negative requires that counselors listen carefully to these individuals’ stories, Dobmeier says. Counselors may find that clients are asking for assistance in deciding whether to change churches or religions or even exploring the possibility of ceasing religious practice altogether. Dobmeier suggests that counselors help these clients to recognize available options and provide support as they work through the decision.

Dobmeier’s overriding advice to counselors working with LGBT clients on spiritual issues: Educate yourself and remain open-minded. “The counselor can prepare for spiritual work with LGBT clients by becoming aware of one’s own spirituality, seeking knowledge about problems encountered by LGBT clients and being open to listening to the client’s story so as to understand his or her hurts and needs. The counselor should support the client in his or her search for identity, not make assumptions about what is best for the client in terms of his or her identity and facilitate the client’s making her or his own decision about sexual identity.”

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Lynne Shallcross is a senior writer for Counseling Today.

Letters to the editor: ct@counseling.org

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No more sitting on the sidelines

Michael P. Chaney, Joel M. Filmore & Kristopher M. Goodrich

There has been growing discussion within our profession about the need for competent counselors to work with lesbian, gay, bisexual, transgender, queer, questioning and intersex (LGBTQQI) clients in an affirming manner. Largely, the discussion has focused on the inadequate training many counselors receive related to counseling these populations.

The purpose of this article is to discuss three pertinent issues counselors might encounter in session with LGBTQQI clients and to provide pragmatic, affirming strategies to facilitate successful therapeutic outcomes. We chose to focus on the deleterious consequences of heterosexism and transphobia and coming out because almost all LGBTQQI individuals have experienced these two issues. We also discuss bullying because, as we have recently seen, the consequences can be fatal.

Healing the consequences of heterosexism and transphobia

Significant changes have occurred in the past 20 years in terms of quality of life for LGBTQQI individuals. Despite these changes, LGBTQQI communities continue to experience discrimination and oppression, much of which is socially and legally sanctioned. For clinicians to work effectively with LGBTQQI clients and treat some of the mental health consequences associated with heterosexist oppression, it is important to understand the nature of this discrimination and hostility. In 2009, Gregory M. Herek and colleagues hypothesized that children internalize the ideals of heterosexuality during early socialization processes and are expected to grow up to be heterosexual. During school-age years, many children are apt to have strong, negative reactions to other children who are perceived to be LGBTQQI. This can cause LGBTQQI youth to be more vulnerable to homophobic harassment and victimization. Additionally, research has shown that these experiences contribute to psychological, behavioral and academic problems ranging from substance abuse to high-risk sexual behavior and suicide.

Herek and colleagues described sexual stigma as the view that any sexual behavior that is not heterosexual is inferior, relegating individuals who engage in non-heteronormative behavior or whose gender expression transgresses traditional boundaries to a “less than” status. Oftentimes, to avoid being stigmatized, many LGBTQQI individuals censor the things they say and modify their behaviors so as not to be identified as LGBTQQI. These modifications can manifest in a number of ways, such as a gay man talking about a fictitious girlfriend with coworkers, a lesbian teen dating someone of the opposite sex to avoid being “discovered” by family or peers, or a transgender individual being forced to use a restroom that is not gender appropriate for the individual. These actions can lead to feelings of anxiety, guilt, depression and fear.

Although much of the research examining the influence of heterosexism on LGBTQQI folks has focused on Caucasian populations, the mental and physical health consequences are even greater when sexual orientation and gender identity intersect with race and ethnicity. Consequently, LGBTQQI individuals of color become double or triple “minorities” depending on which oppressive “categories” are applied to them. Studies have shown that LGBTQQI identities in combination with racial or ethnic identities have an additive, as well as interactive, effect and can lead to even more extreme negative psychological effects and high-risk behavior. As counselors, we should be dedicated to improving the quality of our LGBTQQI clients’ lives. Therefore, it is vitally important that we not only assess and reassess our own biases, but that we consider and understand the experiences of those who are culturally different from us.

When working with LGBTQQI clients, it is important to maintain an affirming position that normalizes and validates their identities because many of these clients have experienced various forms of oppression and discrimination. Competent counselors should not be afraid to ask clients about those experiences. At the same time, competent counselors should not assume that a client’s presenting issue is necessarily related to the client’s sexual orientation or gender identity.

Additionally, due to living in a heterosexist and transphobic (negative attitudes and oppression toward transgender individuals) society, LGBTQQI clients regularly hear and internalize negative messages about themselves, which can lead to feelings of shame and depression. Clinicians should work with clients to process and replace those negative messages with positive affirming messages. This usually can be done with cognitive behavioral strategies and by providing clients with accurate information about LGBTQQI communities and values. For LBTQQI clients affected by heterosexism and transphobia, culturally competent clinicians should explore the client’s feelings of isolation and loneliness because discrimination can result in a person feeling no sense of belonging. To remedy this, counselors should work with clients to identify a support network.

Some clients struggle with whether their LGBTQQI identity is “right” or “wrong” and might request reparative/conversion therapy. Counseling professionals should consider how being raised in a heterosexist and transphobic society might contribute to the client’s struggle, whereby messages of a less-than status and abnormality may be internalized. Competent counselors must remember that the American Counseling Association Governing Council adopted a resolution in 1999 opposing the promotion of reparative therapy for use with LGBTQQI clients. Additionally, effective clinicians should never label, categorize or define a client’s identity. The competent counselor will support and empower clients through the process of self-discovery. With the help of affirming counselors, the experience of self-empowerment and the process of self-discovery will lead most LGBTQQI clients to come out.

Coming out

One of the most important life tasks many LGBTQQI individuals face is coming out. Coming out is a process of acknowledging same-sex feelings, attractions and/or gender identity or expression to one’s self or others. For some LGBTQQI individuals, the initial awareness of same-sex feelings or struggles related to gender identity might cause feelings of shame, guilt, fear and self-hatred, leading them to seek counseling services to assist with the coming out process. What follows are general guidelines that might foster a meaningful and empowering coming out experience for clients, as well as help forge an affirming, therapeutic relationship.

On average, people come out between the ages of 19 and 23, although LGBTQQI individuals are increasingly coming out at even younger ages. Coming out is not a onetime event; it is a lifelong process of negotiating when and to whom to disclose. A common belief exists that if a person comes out, that individual will be happier and more satisfied with life. This might ultimately be true for most people, but counselors must understand that during the initial phases of coming out, self-esteem, happiness and life satisfaction decrease, while feelings of loneliness increase. Therefore, it is crucial to identify what stage the client is at in the coming out process because this will help determine which counseling tools will be most beneficial. Is the client just beginning to come out to himself or herself, or is the client preparing to disclose to significant others? For clients just beginning to recognize their own LGBTQQI identity, counselors should process the meaning of those feelings as they relate to the individual’s self-concept.

One of the most valuable things a counselor can do is to assess the multiple identities of clients who are coming out. This includes exploring how a client’s race, ethnicity, age, relationship status, social and economic status, ability, spiritual beliefs and so on intersect with the individual’s sexual orientation and/or gender identity/expression and how these intersections influence the coming out experience. For example, the counseling needs of a 14-year-old Mexican lesbian who is coming out will be very different than the needs of a heterosexually married Southern Baptist male who is coming out as gay.

As a culture, we love labels. Sometimes, counselors with the best of intentions unknowingly push away clients who are coming out by forcing them to self-label, asking questions such as, “Are you gay? Do you think you might be bisexual?” What is most helpful for clients is to provide validation and support, which might mean encouraging them not to adopt labels at this stage. Similarly, effective counselors should not advise or push clients to come out. This is often a challenge for some LGBTQQI counselors who have gone through their own coming out process. Most important, culturally sensitive counselors should not pathologize clients who are coming out by recommending sexual orientation change therapies. As mentioned previously, ACA “opposes the promotion of reparative therapy to cure homosexuality.” The counseling environment should be a safe escape from the heterosexism, homophobia and transphobia that LGBTQQI people experience.

For clients deciding whether to disclose, counselors can utilize a decision matrix listing the pros and cons of coming out. If a client decides to come out, a counselor can assist by helping to plan the disclosure. Counselors might role-play with clients about what to say and how to say it. Together, they can explore the most effective time to disclose. Counselors must also ensure that clients have mechanisms in place to handle either positive or negative reactions.

It is imperative to assess risk of potential harm once disclosure is made because it is not uncommon for some individuals to be assaulted after coming out. For clients who do not receive the positive response for which they had hoped, counselors should explain that this could be a normal part of the coming out process and that significant others might be going through a grieving process. Supporting clients during the coming out process is a unique opportunity for counselors to empower LGBTQQI individuals to recognize their own truth and to share that truth with others.

LGBTQQI bullying

Media attention to recent teen suicides has highlighted a phenomenon long known about within LGBTQQI communities: anti-LGBTQQI bullying in schools. Although the media primarily focused on the deaths of several young men in late 2010, there are other stories of LGBTQQI bullying and harassment leading to suicides that have received little or no media attention. In addition, media attention usually focuses on a specific subsection of our community: White gay males. Although this group certainly represents one face of this issue, countless others have also experienced bullying and other types of harassment leading to negative academic, personal/social and career-related outcomes.

LGBTQQI bullying is an insidious issue. A 2009 national survey by the Gay, Lesbian and Straight Education Network found that 84.6 percent of responding LGBTQQI students reported being verbally harassed, 40.1 percent reported being physically harassed and 18.8 percent reported being physically assaulted at school because of their sexual orientation. In addition, 63.7 percent reported being verbally harassed, 27.2 percent reported being physically harassed and 12.5 percent reported being physically assaulted at school due to their gender expression. Understandably, a majority of these students (61.1 percent) felt unsafe in school because of their sexual orientation, while more than one-third (39.9 percent) felt unsafe because of their gender expression. Researchers noted that increased levels of reported victimization were related to increased levels of depression and anxiety and decreased levels of self-esteem for reporting students. In addition, grade-point average, school attendance and reports of continuing their education were lower among students who had been harassed.

How can we help students be successful if they don’t feel safe in schools? First, counselors should validate the feelings and experiences of victims of bullying. A great deal of research has been performed on microaggressions and how marginalized groups often feel invalidated and reoppressed when others do not recognize the challenging situations that they face on a daily basis. This often happens in bullying situations when counselors ask questions that challenge the students’ perceptions of their experiences and the chronology of the events. Counselors need to recognize how difficult it is for students to report bullying and recognize their need for validation and support.

Second, counselors should consider systemic interventions as opposed to working only with individual students. By focusing solely on the LGBTQQI student, counselors may inadvertently pathologize the student or label the victim. This approach also does little to address the larger bullying environment in the school. Instead, psychoeducational programming for all students about bullying might better address this issue. This could be accomplished by training peer mediators and working to empower other students to intervene if bullying behavior is witnessed. This might be the most powerful intervention school counselors can introduce in their schools.

Finally, it is important to recognize the need for advocacy on behalf of all students, including at the district and state levels. Policy documents should be reviewed to ensure LGBTQQI students are identified and protected, and bullying policies should include sexual orientation and gender identity/expression. Counselors should also use their skills to act as educators and consultants for administrators and teachers, who might be contributing — consciously or unconsciously — to a hostile school environment for LGBTQQI students.

Although LGBTQQI bullying is classified as a school phenomenon, it should be known that all counselors, and not just school counselors, have the ability and responsibility to intervene for our youth. The ACA Advocacy Competencies articulate the need for all counselors to speak for the needs of historically and culturally marginalized communities. A somewhat recent movement in school counseling, School Family Community Partnerships, addresses the need for school personnel to consult and collaborate with family members and community stakeholders, as well as provide a role and place for community members (including professional counselors) to work with and for the needs of all students. All counselors have the ability and potential to utilize their individual and group development skills to consult, collaborate, educate and intervene to ensure the success of all our students, including those who identify as LGBTQQI. The question is, given all that we know about the risk factors and concerns faced by this population, why haven’t we all done this yet?

The need exists for knowledgeable and skilled counselors to work effectively with LGBTQQI clients. Clinicians will see LGBTQQI populations seeking counseling in greater numbers as these individuals are discriminated against, come out or are bullied. No longer will it be acceptable to refer LGBTQQI clients out. Rather, counselors need to acquire appropriate training and accurate information concerning how to best meet the needs of LGBTQQI clients. The aforementioned strategies are a starting point from which counselors might work. We encourage counselors to implement the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling Competencies for Counseling LGB Individuals and Transgender Clients (algbtic.org/competencies.html).

Our LGBTQQI clients are ready to be helped. Are you ready to help?

Michael P. Chaney is president of ALGBTIC and an associate professor in the Department of Counseling at Oakland University in Rochester, Mich. Contact him at chaney@oakland.edu.

Joel M. Filmore is a doctoral student at Northern Illinois University.

Kristopher M. Goodrich is an assistant professor in the Department of Individual, Family and Community Education at the University of New Mexico.

This article was written on behalf of ALGBTIC’s LGBTQQIA Affirmative Counseling and Social Justice Task Force. All authors contributed equally.

Letters to the editor: ct@counseling.org.

 

Navigating life’s learning curve

Lynne Shallcross

Picture this: You’re a college student cramming for finals in a campus lab late one Sunday night when you see a lanky, 6-foot-2-inch, long-haired man striding toward you wearing a red polka-dotted hat and carrying a tower of pizza boxes. You could be excused for thinking you’ve ingested one too many cups of coffee and that you’re finally hallucinating. But if you’re a student at the Savannah College of Art and Design (SCAD), you shriek with delight because the Pizza Fairy has arrived.

“We thought you were just an urban legend!” students tell Pat Mooney, who takes “flight” as the Pizza Fairy three times a year. Otherwise, Mooney can be found working as a counselor with SCAD’s Counseling and Student Support Services. Though slightly nontraditional, the Pizza Fairy is one of the counseling center’s most effective outreach initiatives.

Because SCAD is an art school, many of its students can’t sit in the comfort of their dorm rooms to study and complete projects, Mooney explains. This leaves them up late at night working in buildings spread across campus. So at 11:30 on the Sunday night before finals, Mooney hops in his van, picks up 73 large pizzas and distributes them to hundreds of lucky (and overworked) students. For every group of roughly 10 students that Mooney comes across, he delivers a pizza as well as a flier that reads, “You have been visited by the Pizza Fairy, whose motto is, ‘The road to good mental health is paved with pizza!'” The flier also contains information about how to access SCAD’s counseling services.

Mooney says the director of the counseling center first proposed the idea of taking pizza to studying students approximately seven years ago. When Mooney, a member of the American Counseling Association, volunteered for the job, he decided to make the outreach effort a little more fun, and soon it morphed into the Pizza Fairy concept. In retrospect, pizza turned out to be a wise choice, says Mooney, who notes that the “Arugula Fairy” probably wouldn’t possess the same cachet. “We [the counseling center] also sponsor Donut Divas, who do their thing in the morning,” he adds. “Some other departments, such as residence life, have picked up on the concept and take other kinds of snack foods around on nights when the Pizza Fairy is sleeping.”

But if the local Pizza Hut delivers, why does Mooney go to all that trouble? For one thing, Mooney says, it’s fun and uplifting, both for the students and for him personally. Delivered in this way, the pizza also seems to entice the students away from their computers, even if only for a few minutes, to talk with their peers and to feel a sense of connection. But the larger goal of the initiative, Mooney says, is to reach out to the campus community and remove the stigma of utilizing the counseling center.

“For years, various agencies and organizations have been making efforts to ‘destigmatize mental illness,'” says Mooney, who is also a member of the American College Counseling Association, a division of ACA. “We didn’t feel that quite hit the mark in terms of the message we wanted to get out. Though destigmatizing mental illness is certainly a good thing to work toward, we felt that there was a certain stigma to even coming to the counseling center or seeking therapy in the first place. That’s what we began to focus on in our discussions of how best to serve our students, and the nature of our outreach changed as a result.”

SCAD’s counselors still engage in many traditional outreach activities, such as depression, anxiety and eating disorder screenings, Mooney says, but they try to focus even more on fun activities. “We want to connect with students in such a way that if they run into problems that they’re having trouble solving utilizing their regular resources, they’ll think of us and not hesitate to contact us. We take great pains to not have a waiting list and to be a resource 24/7/365. Our sense is that in terms of service to the SCAD community, we’re able to do a better job because more students come to us before things get out of hand.”

When students get help early on, it might help them head off larger problems down the road, Mooney says. “People will try to solve their own problems, but when that begins not to work, we want folks to see us not as a place of last resort, but as a first stop. If they come to us initially, we might be able to prevent further deterioration.”

New low for mental wellness

Nationwide, more pizza fairies might be needed. A recent study by the Higher Education Research Institute at the University of California, Los Angeles puts the emotional health of college freshmen at its lowest level in 25 years. “The American Freshman: National Norms Fall 2010″ surveyed more than 200,000 full-time students at four-year colleges and universities and found that the number of students who reported their emotional health as above average had declined 3.4 percent since 2009 and 11.7 percent since the survey began tracking emotional health in 1985.

The survey’s results are on par with what many college counselors are seeing on their own campuses. Although Central Wyoming College’s once-rising enrollment leveled off for the first time in four years this year, Lance Goede, director of counseling and career services at the two-year community college, says his caseload has almost doubled. Meanwhile, at SCAD, Mooney and his colleagues have had conversations about how stressed the students seem in comparison with past years.

The economy is one likely factor, Mooney says. “Not only is the current situation with many students and their families stressful, [but] the prospects for new grads aren’t as rosy as they have been in the past. More students are having to work at jobs” — in addition to attending school — “and work longer hours to make ends meet, expenses are rising, family economic support is dwindling, competition for jobs is increasing and so on.”

“Consequently,” Mooney continues, “I think it’s more important than ever to help our students develop life skills that will serve them well when the chips are down. Deliberately paying attention to and acting in ways that promote good mental and physical health is important. Being able to think and solve problems creatively and with flexibility is useful, as is being able to collaborate, connect and network. Being able to tap into and maximize personal assets while compensating for deficits is helpful, too.”

ACCA President Brian Van Brunt agrees that the economy is a major factor in increased stress on campus. “Many college students are struggling with the idea of college being worth the investment on the other end,” says Van Brunt, who serves as director of counseling and testing at Western Kentucky University. “I think they often worry about having a job after college and if spending upward of $30,000 on a college education is something they will earn back over time. This can be particularly difficult for students who are watching their friends enter the workforce after high school and earning a paycheck while they are saving and working their way through college.”

But an alternative way of looking at the results of “The American Freshman” study, Van Brunt says, is that school counselors have grown more effective at supporting students in high school, enabling struggling students who wouldn’t have gone to college in the past to now achieve that goal. “We’ve supported more at-risk students to reach for college in ways they never have before,” he says. “Part of why they’re struggling [in college] is because they’re reaching higher than they have in the past.”

At Central Wyoming College, the student population is split equally between traditional students and those returning to school at a later age. Goede, a member of ACA and ACCA, has noticed an increase in students coming to campus with learning disabilities, particularly straight out of high school. He acknowledges there is a push in high schools to give students as many options as possible. Adding to that, Goede says, Wyoming has an open-door policy dictating that state community colleges must admit any Wyoming high school graduate who applies.

When students aren’t properly prepared to meet the demands of college classes, it leads to a buildup of stress and frustration, Goede says. To help alleviate that, Goede works in conjunction with disability services to assist struggling students. He also offers career counseling services so students are aware of their choices. For instance, if a particular student is focusing on a career that requires calculus but is struggling with basic math, Goede helps the student look at alternatives and set realistic goals.

Age-old issues

Looking beyond the economy and learning disabilities, counselors say the issues college students bring with them to the counseling center run the gamut. According to Van Brunt, some of the most prominent issues tend to be depression, anxiety, relationship problems and academic stress. “I think the age-old problems of school are still first and foremost on college students’ minds,” he says. “They worry about paying for college, about trying to [strike] a balance between finding enough time to study and to have fun, and there is that old fear of finding Mr. or Mrs. Right. While many of the ways college students experience stress have changed” — for instance, having to decide whether to invest in a life coach to choose a college, being bombarded with marketing from different schools and dealing with the added pressures of social media — “the underlying issues remain the same.”

In his experience at SCAD, Mooney has found that certain issues seem to ebb and flow throughout the year. For instance, in the fall, there’s a fair amount of homesickness and anxiety over time management and balancing the workload. In the second quarter, students aren’t generally as anxious about the adjustment, but the winter blues can set in. Mooney also points out that many mental disorders, such as bipolar disorder, schizophrenia and depression, often rear their heads during the college years and begin to interfere with daily functioning. There are various ideas about why this happens, Mooney says, but it’s one of the reasons they encourage students not to wait until things get dire before coming to the counseling center.

In Wyoming, Goede has noticed a consistent theme regardless of the students’ ages: relationship problems. “There’s a lack of communication between husbands and wives, boyfriends and girlfriends,” he says. “It seems like everything goes to an argument. Everything goes to an emotional response.”

Goede consistently hears from his student clients that they tend to react emotionally rather than analyzing the issue and considering how best to communicate. While the younger students sometimes have yet to develop more mature communication skills, the older students often need a refresher on those skills as well, he says. When Goede sits down with clients to help them analyze their situations, they often have “aha” moments in which they recognize that their significant others might have responded on the basis of something they said or didn’t say. “More than anything, it’s getting them to talk about what they are doing and giving them some insights about other ways to think about things or act,” Goede says.

College students experiencing relationship problems might not be aware there are options beyond yelling or making sarcastic remarks, Goede says, so he works with them to come up with other ways of reacting and then asks them to test drive these alternatives as homework. He says cognitive approaches can be effective in helping student clients analyze their thinking patterns, identify where they got off on the wrong track and see how they ended with an emotional rather than a rational reaction.

A fair number of Goede’s clients present with substance abuse issues. Many of these students are referred to him after violating rules in campus housing. Most of the issues stem from alcohol abuse, and Goede acknowledges it’s sometimes a matter of kids simply being away from home and pushing the boundaries. “But it’s definitely impacting their schooling,” he says. “There are definitely effects of substance abuse on their success.”

When students are referred to his office, Goede often uses one of two programs — eCheckup to Go (e-CHUG), an online program in which students answer a variety of questions and the program reports back on the physiological and mental health effects of alcohol on their lives, or Choices, a journaling program that helps students analyze how their behavior is affecting them personally. Both programs also include statistics that can help students realize they are in the minority as heavy drinkers, not the majority, Goede says.

A safe place

Heading off to college is a pivotal point in many people’s lives, and the nature of the transition can introduce or magnify issues of adjustment as young people reach independence and adulthood, Van Brunt says. The larger philosophical questions of “Who am I?” and “What am I living for?” often take center stage. “This transition phase from ages 18 to 22 is a significant one full of energy, questions, struggles and potential pitfalls — suicide, alcohol and drug problems, and balancing work and social needs,” Van Brunt says. “As with a young child, problems left untreated and needs left unmet can lead to lifelong difficulties in relationships and playing catch-up in certain developmental areas. College students are similar. Powerful relationship losses, abuse of alcohol and drugs and lack of hope and meaning during these developmental years can lead to cyclical broken ways of interacting with others and creating a happy life. College counselors are in a unique position to smooth over some of these rough spots, keep problems in perspective and, most important, inspire hope for a brighter tomorrow when things may look dark and without purpose.”

The counselor’s office should serve as a place where students can vent their frustrations and express their worries and fears about the future, Van Brunt says. “We help them place their concerns in a normative context, can often help reframe problems so they seem less overwhelming and assist students in obtaining a foothold to begin their climb out of the hole they find themselves in,” he says. “College counselors also offer direction and guidance in terms of managing stress, making decisions about medication and how to best manage symptoms of mental illness. Mostly though, we provide a caring, nonjudgmental place to work on their problems and worries. We listen, we care and we offer them support.”

At SCAD, Mooney works as a solution-focused therapist, which he says is particularly well suited to college students. Oftentimes, students actively want to solve their own problems, he explains, and solution-focused methods build on the assets they already possess. Mooney says he often can tell within the first five minutes of talking with student clients which of their skills will help them most in solving their problem.

In the case of one recent client, the solution was hidden in his athletic experience. The student came to Mooney expressing anxiety about the speech class he was required to take. He was very tall, a little self-conscious, and he would lose focus speaking in front of groups and end up talking in circles. Mooney asked the student a little more about himself and found out he was a swimmer.

Mooney told the student to imagine the moderate level of anxiety he might feel before a swim meet as opposed to the high level of anxiety he was experiencing before a speech. Mooney then encouraged him to try to plateau at that moderate state before a speech. Next, Mooney talked about how the student swam laps at meets and how he could use that concept to structure his speeches into a sequence rather than talking in circles. By working with Mooney and building on his existing skills, the student learned to manage his anxiety and went on to earn a good grade in the speech class.

Motivational interviewing (MI) and motivational enhancement therapy (MET) also tend to work well with college populations, Van Brunt says. “These approaches start with a therapist working with a student where they are and trying to help through harm reduction strategies. For example, if a student comes in and wants to cut back [his or her] drinking, an MI or MET therapist would start with where the student is currently drinking and help look at ways to cut back slowly. They would not frustrate or challenge the student but instead roll with any resistance and find ways to support the student’s successes and overcome any obstacles.”

Another of Van Brunt’s favorite tools is the humanistic existential approach to therapy. “Here, the therapist takes a stance related to the students’ humanity and essential ability to face obstacles and overcome challenges. The therapist engages students through rapport building, supports their choices and creates a safe place for them to explore and wrestle with dilemmas they may be struggling with.”

Van Brunt offers the example of one of his clients who has faced multiple suicide attempts, difficulties with her family and early childhood trauma. “Many think she doesn’t have what it takes to be successful on campus,” he says. “[But] home is worse for her, offering little support, and will likely lead to the worsening of her illness. The hospital holds no answers for her — she is in and out several times a semester. Her medications help stabilize her but don’t fix the underlying problem.”

As her counselor, Van Brunt focuses on giving her a place where she feels cared about and secure enough to talk. He advocates for her with different groups on campus, assists her with academic requests for accommodations on the basis of her illness and interacts with the conduct office on her behalf. “I help by giving her a stable, consistent place to come and talk when she needs to,” Van Brunt says. “This simple caring and understanding — and, dare I say, love — is what many college students are looking for. Therapy provides them a place to work through their problems in a nonjudgmental atmosphere with a therapist whose main goal is to help them feel more balance and peace in their lives.”

It’s important for college counselors to be broadly knowledgeable in varied techniques, Mooney says, because while cognitive behavior therapy might help with one student client, another might call for family systems or object relations work. “The thing that is key in my mind is that you tailor the approach to what the student needs,” he says. It’s important to skip a pathology-based focus, Mooney emphasizes, so that no matter what techniques counselors use, they look at the glass as being half full and focus on the client’s assets.

Van Brunt offers similar words of wisdom to counselors working with college students. “The main advice I would give is the importance of not overpathologizing problems that may be environmental and contextual in nature,” he says. “Many of the issues we see students for are related to struggles they are having with the normal, developmental adjustments to life away from home and moving toward independence.”

Van Brunt also acknowledges that college counselors will inevitably encounter more serious mental health problems that might require assessment, medication and ongoing treatment. In those cases, he says, it’s important to offer the same type of supportive and nurturing care and to understand that these students are often scared. Says Van Brunt, “Counselors and psychologists should always offer hope — the promise that tomorrow will be better.”

To see a video of the Pizza Fairy in action, visit http://vimeo.com/20717590.

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

Letters to the editor: ct@counseling.org