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Counselors Audience

Helping military children navigate through grief

Heather Rudow June 1, 2012

Children attending the TAPS Good Grief Camp near Washington, DC over Memorial Day Weekend release balloons carrying messages for their loved ones who died.

When a military plane on a routine mission from Anchorage, Alaska, to Juneau crashed and killed all eight service members aboard in 1994, Judy Mathewson found herself thinking about the families of the deceased and their need to grieve.

“I knew the children who had lost their fathers that day would need support to help them along … on their grief journey,” says Mathewson, a member of the U.S. Air Force who is also a guidance and vocational counselor.

But Mathewson also noticed there weren’t any mental health support systems readily available for the grieving children. “There were a lot of children connected with those service members, and there was nothing in place for them to help them cope with their grief,” says Mathewson, a member of the American Counseling Association.

In those days, Mathewson recalls, few mental health professionals wanted to discuss the topic of grief with children. “They thought it was bad for them,” she says.

Despite the obstacles, Mathewson and other Alaska-based military families affected by the plane crash founded the Tragedy Assistance Program for Survivors (TAPS). Out of that program grew the TAPS national and regional Survivor Seminars and Good Grief Camps.

Now in their 18thyear, the camps provide support for youths ranging from infants to teens who have lost a parent or sibling in military service, whether as a soldier or as a military contractor. “This group includes kids of service members who died as a result of combat wounds [or] were victims of suicide, car crashes or illnesses,” says Mathewson. “Each child grieves in his or her own way, at their own pace, based on their relationship with their loved one.”

At the camps, children participate in special activities and facilitated support groups. The goal is to teach coping skills to help the children establish and identify support systems, thus creating an awareness that they are not alone in their grief, Mathewson says.

“Children and teens meet others of their own age group to share and learn together,” says Mathewson. “[They] have fun while discovering how to cope with the pain they are experiencing. They learn a lot from each other.”

Counselors and mental health workers spend one-on-one time with the campers. In addition, a military service member is assigned to each child or teen on the basis of the service member’s background matching or resembling that of the person whom the camper has lost.

“It offers [these campers] comfort and support,” Mathewson says. “We really try to find someone who can relate to their culture of the military service.”

Children and teens who cannot make it to the national TAPS Good Grief Camp over the summer in Washington, D.C, are able to attend one of the regional camps held throughout the year in areas such as Fort Riley, Kan.; Parkton, N.C.; Fort Hood, Texas; Ramona, Calif.; Indianapolis, Ind.; and San Diego, Calif. There is also a TAPS trip to Capetown, South Africa, for surviving widows and significant others of service members.

Says Mathewson of the growing popularity of the national Good Grief Camp, “We started out the first year with a dozen kids, and now that’s gone up to 465.”

Nawal Aboul-Hosn, a mentor at the national Good Grief Camp for the past eight years and a member of ACA, says her experience has been life-changing. In fact, the resilience she has witnessed from the way the kids deal with their grief at the camps inspired her to write her dissertation on the subject.

Opening up to one another seems to be one of the most effective methods for the children to come to terms with their feelings, Aboul-Hosn says. “The support groups we provide are a very positive way for the kids to overcome any obstacles they are facing,” Aboul-Hosn says. “The resiliency was really shining through in those support groups.”

“Being there in the group with other kids gives them a reality check,” she continues. “Being there and seeing other kids crying and sharing their stories makes it real for them and also makes them comfortable speaking when they might not have ever shared some of these thoughts with anyone before.”

The camps are also useful in helping many of the children to finally accept the death of their loved one, Mathewson says. She contends that this reality can be more difficult for children of military backgrounds to accept than it is for other children because of the geographical distance between the children and the service members as well as the nature of the deaths.

“Sometimes, they don’t have something they can see and touch [of that deceased loved one] except for that headstone,” she says.

The four-day experience of the national Good Grief Camp culminates in a ceremony at Arlington National Cemetery. This not only honors the lives of loved ones who have made what Mathewson calls the “the ultimate sacrifice for their country,” but it also helps the children actualize their feelings of loss by seeing memorials for fallen soldiers.

Additionally, campers visit the U.S. Air Force Memorial, the Pentagon Memorial, the U.S. Navy Memorial, the Marine Corps (Iwo Jima) Memorial and the Vietnam Veterans Memorial while attending the camp.

Both Mathewson and Aboul-Hosn contend that children who lose a loved one in the armed services typically navigate and cope with their grief in different ways than other youths.

“It encompasses a lot more than other losses because it deals with accepting reality,” says Aboul-Hosn. “Touching reality is a lot harder. They think, ‘My dad is going to go [overseas], but he’s going to come right back.’ It’s not real for them.”

She recommends that counselors working with military families dealing with loss employ use a storytelling technique — in which parents, siblings and children recall memories of the lost service member — to help them cope. She also stresses the importance of parents not hiding their feelings of sadness while grieving.

“It’s important for parents to share their feelings with their kids and let them know … they’re in the same boat,” Aboul-Hosn says. “When a loss is occurring, they don’t need to be tough.”

Mathewson says spending time helping military families through their grief summer after summer has helped her evolve as a counselor. “The experience of being a part of TAPS has been life-changing,” says Mathewson. “As a mental health counselor and military member, it is an opportunity to do crisis counseling, support families who are grieving a loved one’s death who has served our country, and to see the growth and resiliency of children and their surviving parent over a number of years. This special population helps me grow as a counselor and allows me to acknowledge that the next generation will be resilient and proud of their loved one’s service and sacrifice.”

Counselors interested in getting involved can go to taps.org to determine the location of the camp closest to them. Knowledge or experience working with military families and military members greatly enhances the experience for both the counselor and the grieving military children and teens.

Grief and loss are themes that run throughout so many clients lives. Interested in reading more on the topic? Click here to read the cover story of our June issue, “A loss like no other.”

Heather Rudow is a staff writer for Counseling Today. Email her at hrudow@counseling.org.

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Letters to the editor: ct@counseling.org


A loss like no other

Lynne Shallcross

Imagine this scenario: You are a counselor, and you have two clients. They are the same age and same gender, and both experienced the death of a partner at roughly the same period in life. So, you can reasonably expect that both will have similar reactions to that parallel loss and both will benefit from similar counseling techniques to deal with the residual grief, right? Not likely.

In fact, says Vincent Viglione, an adjunct professor of counseling at Kean University and Montclair State University in New Jersey, one of the most important things for counselors to understand about grief and loss is that although the experience of loss is universal, every individual’s grief process is unique. “We as counselors recognize that certain client responses are not necessarily pathological,” says Viglione, who is doing his doctoral dissertation on adult sibling grief and continuing bonds at Montclair State. “As such, we attempt to normalize our client’s feelings. In doing so, however, we must preserve the idea that their circumstance is unique to them. Normalizing, then, is never saying, ‘You’re just like everyone else.’”

Keren Humphrey, a retired professor of counseling at Texas A&M University-Commerce, agrees about the unique nature of each person’s grief experience, not only because of her work with clients but also because of her own experience with grief and loss. “In the last two years, I have experienced a number of significant losses, including breast cancer with a double mastectomy, my husband’s extended illness and death, [and] my mother’s decline from Alzheimer’s and her death only a month after my husband’s death,” says Humphrey, whose book, Counseling Strategies for Loss and Grief, was published by the American Counseling Association in 2009. “These experiences have certainly reiterated my view that each person’s experience of loss and grief is unique. The meanings I attach to my losses and my ways of grieving are specific to me.”

Understanding that notion of uniqueness and applying it in session as a counselor means there is no one “right” approach to grief-related counseling work, Humphrey asserts. Rather, to work effectively with these clients, practitioners must be capable of drawing from a variety of counseling skills and techniques and tailoring a therapeutic approach that is custom fit to the client’s specific personality, situation and needs.

A good starting point for counselors is to take the role of “witness” and realize that the client is the expert, Humphrey says. “It’s a time for you to shut up and facilitate the client in telling [his or her] story. We too often in counseling jump too quickly into reflecting feelings and attending and worrying about the next thing we’re going to say to the client. That interferes with [clients] telling their story. Back off of those automatic responses and just allow clients to tell their story of loss.”

A loss is the absence of something we deem meaningful, Humphrey explains, while grief is our response to that sense of loss. People normally associate loss with the death of a family member or close friend, but it can also be inclusive of the loss of a house, a relationship, a job or any number of other things. Sometimes, says Anne Ober, an assistant professor in the Department of Counseling and Human Development at Walsh University, it can even be the loss of a particular feeling. For instance, Ober points out that after 9/11, even people who weren’t directly affected by the terrorist attacks might have felt a loss of the sense of security they had presumed previously.

Elizabeth Doughty Horn, an assistant professor in the Department of Counseling at Idaho State University, says grief can also stem from the loss of expectations that weren’t met. From the outside, to those observers who aren’t experiencing the loss personally, the loss might not appear particularly significant — for example, a high school student failing to make the cheerleading squad. Many of the losses people experience are disenfranchised, Horn says, meaning they aren’t recognized or appreciated as losses by society. Hallmark doesn’t make cards for disenfranchised losses, she notes.

In some instances, only certain aspects of loss get recognized, while other often more complicated aspects go overlooked. Consider a person recently diagnosed with cancer. “Once someone has been diagnosed with cancer, his or her identity is often linked with the disease,” says Horn, a member of ACA who has researched, published articles, taught classes and presented at conferences on the topic of grief and loss. “The bulk of their day-to-day life is spent focused on cancer — scheduling, getting to and from doctor appointments, reassuring well-wishers, letting people know about their illness, processing their own emotions as well as their family’s. Obviously, people acknowledge grief and loss associated with getting cancer, but they may not view it in terms of the loss of self.”

Many times in cases of disenfranchised loss, clients themselves don’t recognize the issue as one deserving of feelings of grief. They come to a counselor saying, “I shouldn’t be so upset about this,” Horn says. One of the most helpful things counselors can do is to acknowledge the extent of the losses clients have experienced and assist them in connecting the way they are feeling with those losses.

Even in situations in which loss is generally recognized by society at large, counselors say it is common for clients to come into counseling feeling unsure about why they are struggling. “It happens so often,” Horn says. “People come in and recognize there has been a major change, but they’re not seeing it in terms of grief. They might say, ‘I know I lost my job, but I have a new job, so why am I still focused on the job I lost a year ago?’”

Society often emphasizes getting over things and moving on, Horn says, but in many situations of loss, the process of “getting over it” doesn’t happen quickly, if ever. One of the newer trends in grief and loss counseling is the rejection of the idea of “closure” as a completed process, Horn says, especially as it relates to death. But many times, she says, clients either think they should be “over” something already or they don’t even recognize that their pain stems from an issue of grief and loss.

“I believe that once counselors begin to view transitions in terms of grief and loss,” Horn says, “they really won’t have to look for these issues in their clients. Rather, they will see an aspect of them in almost every client issue. I’m not suggesting that everything in life is grief and loss — how depressing — but there can be an element of these in much of day-to-day life in varying extremes.”

Viglione, an ACA member who runs a private practice in Denville, N.J., agrees. “For every client that I see, I find an element of loss in what they’re presenting if I look closely enough.”

Stepping away from the stages

Counselors say one of the more significant changes in the area of grief and loss counseling in recent years has been the move away from using Elisabeth Kübler-Ross’ stages of grief model. Ober, a member of ACA who has researched, counseled and taught on the topic of grief, points out that Kübler-Ross herself said her stages were misapplied and that she originally designed them to be used with individuals coming to terms with their own death. Although Kübler-Ross’ work was very beneficial and started a larger societal conversation about death and dying, Ober says applying the stages to clients going through grief and loss isn’t very helpful and in some cases can even be harmful.

The problem is that the stages model doesn’t fit everyone’s experience, Horn says, especially in light of how each person’s reaction to loss is unique. Humphrey agrees, saying the model suggests that everyone experiences grief the same way. “That just simply is not true,” Humphrey says. “It does not respect the differences among people in terms of personality, social-cultural influences and that kind of thing. We need models that allow us to focus on uniqueness of people. It also ignores process. Instead, we need to understand that clients are in a process of adapting, renewing and reviewing. They’re in a process, not in a stage.”

Horn says research conducted on how the stages were used in therapy has shown that counselors were doing harm to some clients by trying to shoehorn them into stages. For example, if a client wasn’t having the particular experience the counselor thought he should be having according to the stage model, the client may have tried specifically to have that experience, she explains. “And that’s when people get into trouble — when they’re not following their own natural process, when they try to do something that doesn’t fit into who they are,” Horn says.

The stages also gave the impression that if clients went all the way through each of the stages — denial, anger, bargaining, depression and acceptance — they would encounter an end point to their grief, Horn says. “But grief is an ongoing process of adaptation,” she says. “The idea of closure is no longer seen as being possible for most people. Rather, it’s ‘How do I adapt or integrate this loss into who I am and into everyday life?’”

Humphrey again emphasizes that the trend in grief and loss counseling in the past decade or two has been toward realizing there is no one-size-fits-all model or therapeutic approach to helping clients. “Instead, the counselor helps clients focus on useful material and implements therapeutic strategies appropriate to the uniqueness of a given client,” she says. “For example, I would use nondirective methods with a client who is uncomfortable with more directive approaches. I might use narrative therapy strategies to help a client explore cultural influences and later use solution-focused or behavior-based strategies for specific problems or to increase awareness of personal strengths for the same client. I might use cinematherapy to highlight multiple issues, but not with people who hate movies. It is important that counseling professionals remember that effective grief counseling is not about the counselor’s specialty. … Rather, it is about selecting and adapting various therapeutic approaches to the particular needs, preferences, personal history, grieving style and multiple contexts of a given client. Using only one approach with every client is ineffective and, worse, very disrespectful.”

Go with what’s natural

The main goal in working with clients who have experienced a loss is to help them experience and express their grief in the style that is most natural to them, Horn says. That might mean encouraging clients to disregard outside influences or the internal “shoulds,” she says. For instance, a person who has just experienced the death of a loved one might get the message from his church that the death was “meant to be” and that it is time to let the person go. “Maybe that ends up making the client feel they should be happier this has happened or that they shouldn’t be feeling so sad,” Horn says. When clients refer to what family members, their religious community or some other outside influence thinks, Horn suggests counselors raise clients’ awareness of this and ask what they are experiencing.

Helping clients find their natural grieving style starts with listening to them and supporting what they say they’re thinking or feeling. “A client might say, ‘I’m really sad, but I haven’t cried and I feel guilty for not crying. I’m more focused on the logistical details of what led up to the person’s death,’” Horn says. “So we try to help foster that rather than putting pressure on them to cry or telling them that they’re in denial.”

In fact, Horn says, one of the newer models some counselors are using in loss and grief work, the adaptive grieving styles model from Terry Martin and Kenneth Doka, recognizes that certain clients will be more affective in their grieving style, some will be more cognitive and others will find themselves along the continuum in between. Understanding that different grieving styles exist and encouraging clients to grieve in the way that’s most natural to them is key, Horn says. For instance, grief groups are often helpful to affective grievers, who might want to share and cry with others, she says. On the other hand, cognitive grievers might want to focus on problem-solving associated with the loss and could find talking about the loss repeatedly with a group to be overwhelming.

“Counselors use this model to help better conceptualize and work with clients,” Horn says. “They educate clients about the uniqueness of grief and help them to identify their personal style, [which is] usually blended, with one more prominent than the other [affective versus cognitive]. This helps to normalize their natural style and helps to remove some of the perceived pressures to grieve in a particular way. Counselors can then use techniques that complement a client’s predominant style, allowing them to experience and express [their grief] more naturally.”

Horn also mentions Margaret Stroebe and Henk Schut’s dual-process model as potentially beneficial because it focuses on different aspects of the loss. It looks at both loss-oriented stressors, which deal with thoughts and feelings related directly to the loss, and restoration-oriented stressors, which refer in part to the life roles that have been changed after the loss. The model suggests that people experiencing a loss will oscillate between the two, Horn says.

Ober’s take on the dual-process model is that people need to move between the emotional impact of the loss and the day-to-day logistical impact of the loss. For example, a recent widower might have an intense emotional response in which he cries and talks about his deceased wife, but he may also have to figure out how to cook because she previously prepared all of their meals. “What this theory suggests is that it’s healthy for the person to move between those two [responses] and have a balance,” Ober says. “People who are able to do both fare better in the long run than people who focus on one or the other research shows.”

Meaning-making, which Robert Neimeyer, Thomas Attig and Michael White have researched, is another potentially helpful concept, Ober says. It provides a way of helping clients determine what the loss means to them in their life and their life story, she says, and has similarities to narrative therapy. However, Ober says, counselors need to let clients guide them before using this technique. Clients need to indicate on their own in some way that they are trying to make sense of why the loss happened and what it means to them. “That won’t be the case for everyone,” Ober says. “You shouldn’t apply it unless your client is really at that place.”

Ober also points to continuing bonds theory as potentially helpful. The theory is in contrast to Sigmund Freud’s idea that a person needs to cut ties with whomever has died and focus instead on the here and now. The continuing bonds theory suggests that a person who has lost a loved one can still have a nonphysical relationship and some sort of communication with the deceased person. Letter writing, putting up photos at home, returning to a special place that was important to the deceased person and celebrating the deceased person’s birthday or death anniversary are a few examples of ways to continue the bond, Ober says.

Viglione recommends William Worden’s tasks of grief approach as another potential tool for helping grieving clients. The tasks take clients through accepting the reality of the loss, working through the pain of the grief, adjusting to the new environment and reinvesting in life.

A life story that continues

Humphrey says helping clients to explore and tell their story of loss is important, as is helping them create a new story of who they are today. “Sometimes people can be stuck with their old story, looking at the past as if time stops,” Humphrey says. “They’re living physically in the present and the world is moving on, but they’re stuck. That brings them into counseling. What you’re trying to do as a counselor is help them create a narrative that builds onto their old story by taking into account their losses.”

“Creating a post-loss story of one’s life involves making sense of the losses; dealing with disrupted beliefs, assumptions and expectations; and developing revised but enduring bonds with the loss object,” she continues. “Many clients respond positively to simply introducing the notion of building or creating a post-loss story, so it becomes an ongoing theme in treatment. Thematic genograms, therapeutic writing, objections of connection, loss timelines, decisional balance, client-generated metaphors and wisdom letters are particularly useful strategies here.”

The difference between primary and secondary losses is an important distinction for counselors to make, Humphrey says, and one that can help guide the course of treatment. For example, in a scenario in which a client’s spouse has died, the primary loss is the spouse. The secondary losses might include companionship, a sexual partner and expectation of a future together. “The secondary losses are really the guts of the loss, and that’s where the focus of counseling should always be,” Humphrey says. “When you focus on the secondary losses, it helps you understand what the client sees as meaningful and what should be addressed in counseling.”

“Counseling professionals focus on secondary losses because this reveals the unique meanings, influences, individualized adaptive processes, client strengths and potential problematic issues that constitute client grieving,” Humphrey continues. “I ask a lot of open-ended questions that invite exploration and that recognize the client as the expert on their grief. ‘What does that mean to you? Tell me what works and doesn’t work for you. What feelings/thoughts/behaviors go with this or that? What should I know about you that will help us understand your experience? Tell me the story.’ Their responses provide clues to potential issues and direction for therapy.”

Jane Newman, an ACA member who runs a private practice in Portland, Ore., says one of the first steps she takes with grieving clients is to validate their loss and express empathy for the difficulties they are experiencing. Counselors have to be sure never to minimize or diminish a client’s loss in any way, she cautions.

After validating their loss and pain, Newman says she asks clients, “Now what?” In her current caseload, Newman has a male client recently diagnosed with terminal cancer. He is a respected scientist who has been forced to sideline his career because of the cancer. “He’s mad and unhappy because within weeks, his whole identity changed,” says Newman, who previously worked as a hospice counselor and in a cancer center as a bereavement counselor. “As a scientist, he doesn’t operate much on a feeling level. He’s mad because he’s not productive right now. I need to honor that and talk to him about how that must feel and not try to take any of those feelings away. And then the [conversation] is, ‘So, now this is part of your life too. This is a new phase of your life. Let’s talk about what you think you might want from this part of your life.’ I want to help him identify those things so that he can get closer to making this part of his life productive, even if that means having some wonderful conversations with his family. I wouldn’t say, ‘How do you make the most of it?’ I would say, ‘Let’s talk about what you might want from this part of your life.’”

Newman says part of a counselor’s role in working with clients who are experiencing loss and grief is to illuminate the strengths and support systems they might be overlooking. Ask how they have coped with stressors in the past and what has helped them get through hard times before, she says.

When grief and loss hit close to home

Of course, counselors aren’t immune to experiencing loss and grief in their own lives. Dealing with that reality goes hand-in-hand with all types of counselor self-care, Horn says. “We need to be acknowledging our own grief and loss and allow ourselves to have that unique experience and expression,” she says. “We tend to feel that we’re above it all or should be immune to losses. We also tend to believe that as counselors, we’re supposed to be so together and that with all of our coping skills, we’re not supposed to hurt.” These misguided beliefs can lead counselors to discount their own grief and loss, Horn says, even as they carefully guide clients to do otherwise.

One of the best things counselors can do is to raise awareness of their own loss histories and their thoughts surrounding grief and loss, Ober says. Ober uses an exercise from Humphrey’s book, Counseling Strategies for Loss and Grief, to help her counseling students become more mindful of their personal experiences of loss and grief, which in turn will lead them to better assist future clients. The exercise involves the counselors-in-training making a timeline of grief and loss through their lives by detailing specific losses. Ober then asks the students to write about what it was like to complete the exercise, including if anything bothered them while exploring past losses or whether they identified something that provided them with encouragement and hope during tough times.

The exercise is one that these counselors-in-training might choose to repeat with future clients. But the main objective, Ober says, is to get the students to build their personal awareness of grief and loss, which can help them avoid countertransference with future clients and become knowledgeable of their own cultural backgrounds and biases related to grief and loss. For instance, she says, students might learn that their families had specific rules related to grief and loss, such as not talking about the deceased person or not crying about the loss. “We can’t impose those [rules] on clients,” Ober says.

Ober suggests that practicing counselors seek supervision or consultation with other professionals so they can talk through what’s going on with their clients and in their own lives. This process can help counselors become aware of how losses might be affecting them and their work, Ober says.

Most people deal with loss in an effective way, Humphrey says. However, if counselors are feeling “stuck,” Humphrey says they should consider seeking counseling for themselves, just as they would recommend that clients do.

Getting prepared to address grief

Because there are no CACREP standards that deal specifically with grief and loss, Horn says it’s rare that graduate counseling programs require a course on the topic. “It’s really criminal to a certain extent that we do not require students to learn about grief and loss when every client we see will likely present with some element of grief and loss,” she says. “More likely than not, counselors are graduating without having taken formal training on grief and loss. There is preliminary research showing that having some type of formal education on death and dying or grief and loss does reduce anxiety around working with these issues.” For the very reason that it might not have been part of their training, Horn urges counselors to educate themselves on the topic by going to workshops, reading current literature and taking continuing education classes on the topic.

Counselors need to educate themselves not only on how to work with clients experiencing grief and loss but also how to identify it in the first place, Horn says. “Almost every client we see is going to have an element of grief and loss within their story. [When counselors] don’t have the lenses of being able to identify aspects of their story as being grief and loss, I think we miss a larger picture with that client.”

Humphrey recommends that counselors who are just starting out stay theoretically grounded so they will be ready and able to integrate any number of theories into grief work depending on the client’s particular needs. Meanwhile, Humphrey urges more experienced counselors to keep current with work in the field because the thinking concerning how best to address grief and loss has changed through the years.

The advice Newman offers to counselors, regardless of experience level, is to remember that work with grief and loss issues remains tied to the fundamentals of counseling. “It’s not about what I have to say to them, it’s about what they have to say to me. It’s really listening, being as present as you can be with that person, not judging, not thinking I’m the expert,” she says. “It’s giving that respect that [clients] have the expertise for what they’re going through.”

In combination with that expertise, it’s trusting that clients also possess the strength and resilience to carry on, Newman says. “Doing this work gave me so much faith in the human spirit,” she says. “I was face-to-face with people who had to find the strength to get themselves through probably the hardest times of their lives, and I don’t think I’ve met the person yet who curled up in a ball and didn’t do that. There’s sadness attached to it, but it’s inspiring the way that people find their way through. It’s about the resilience of the human spirit. People find strength that they didn’t know they had, and that is inspiring. We’re survivors and we are resilient. And at times, when it looks like it’s the worst time ever, it is the worst time ever — but when you feel that pain, then you begin to find your way through it.”

To contact the individuals interviewed in this article, email:

Interesting in reading more? Click here to read our online exclusive, “Helping military children navigate through grief,” which highlights an organization cofounded by an ACA member that offers camps for kids who have lost a loved one in military service, among other programs.

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

Letters to the editor: ct@counseling.org


Countering Fear and Inertia in the Job Search: A Call to Action for Counseling Students, Counselors, and Counselor Educators

Elaine J. Casquarelli May 30, 2012

(Photo:Flickr/US Department of Labor)

The economic crisis of 2008 is still with us. Jobs for mental health and school counselors have been – and continue to be – cut. We hear about the possibility of more terminations to come in the media. Among the rumors of downsizing are some that indicate the trend will soon reverse, but graduating students need jobs now. It is indeed a scary time for professional counselors to be looking for work in their chosen profession. There is hope, however. It is the perfect time for students, counseling professionals, and counselor educators to be working together to strengthen our professional community and create opportunities to do what we do best – provide a forum or our students and clients to heal their pain and suffering.

I have a particular lens through which I enter this conversation. I am a doctoral student in Counseling and Counselor Education who also has the privilege of working with counseling students as a career advisor and coach. In my work, I am confronted with students’ fear every day. Their fear and anxiety are pervasive. Students are afraid there won’t be jobs. They are anxious about competing with their friends and colleagues for the few positions that do exist. They fear they don’t have enough experience. They worry they won’t do well in an interview. If they live in New York, they fear that they will not be able to get a job in which they will be able to earn licensure, or even worse, that they will not be able to find work at all. Some have responded by giving into their fears, and inertia has set in. The fear and anxiety, coupled with the rigor of the last semester of studies, also keeps students from seeking services that will help them find post-graduate counseling positions. Often, the situation feels hopeless.

I contend the situation is not hopeless, but it does necessitate a communal response within the counseling profession. Fostering hope and realization of vocational opportunities requires a clear vision, a willingness to confront our own fears and anxieties, and an unwavering commitment to work together as students, counselors, and counselor educators to promote the wellness of our profession – and ultimately of our students and clients. After all, we have defined our work as, “a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education, and career goals” (American Counseling Association, 2010). Further, as counselors, we are often tasked with being the holders of hope when our students and clients cannot find hope in their own lives. So, let us commit to the task at hand.

Counseling Students

As a counseling student, you are being initiated into a vocation that includes great responsibilities, difficult challenges, awe-inspiring transformations, and the privilege of walking with others through their struggles and successes. Continually, I am inspired by the compassion, caring, and determination of counseling students in my program. Many come to this profession with a natural desire to help others experience growth, success, meaning, and healing in their lives. I do not think our program is unique in this regard. We spend a lot of time learning to help others move through their struggles and, many times, connect with and feel their pain and suffering. The obstacles our clients face are many, including violence, neglect, and personal and systemic discrimination. Our task is to promote wellness as we invite them to face their concerns, doubts, and insecurities. Regardless of our theoretical perspectives, most of us do this by some combination of (1) promoting insight, (2) eliciting alterations in thoughts, behaviors, and/or emotions, (3) providing access to resources, (4) nurturing connections to supportive communities, and (5) advocating for our students/clients. As counselors in development, we must do what we ask of our clients/students.

In seeking a professional position, we are in essence asking an agency, school, or organization to pay us for the privilege of helping students and clients face their fears and overcome the obstacles life has placed before them. If we are to be bold and courageous enough to walk this walk with students and clients, we must also be courageous enough to do so ourselves. That means, we need to become aware of our own fears and the way they are impacting our lives; challenge and move through the thoughts and emotions that keep us stuck in inertia; seek out the resources available to us through our departments, colleges, universities and communities; nurture supportive connections to the local, regional and/or national counseling communities as well as our personal communities of support; and engage in advocacy on behalf of ourselves and our profession.

Professional Counselors

Most counselors I have been privileged enough to meet enjoy the opportunity to connect with students and promote mentoring relationships. In the past, building such relationships may have felt like a meaningful activity; however, the current economy has rendered mentorship absolutely necessary to the success of students and new professionals, and to the continued vibrancy of the counseling vocation. As professional elders, we have a responsibility take the initiative to cultivate relationships with those who are new to the field and help them navigate their own developing occupational identity, skills, and endeavors.

Mentorship can occur in a variety of venues. We can connect with students through our participation in local, regional, or national counseling organizations. It is often suggested that students attend organizational meetings to connect with counselors. Some students excel at meeting and interacting with others in social and professional settings; however, some students can feel intimidated or anxious about doing so. Therefore, when students do attend organizational meetings it is incumbent upon us to take the initiative to reach out to them, inquire about their interests, foster a professional relationship, and introduce them to other professionals with similar interests. We are often quick to recommend that students take on leadership positions and it is a wonderful treat when they do. Yet, it is important to cultivate relationships with students even when they don’t take on such positions. We have a plethora of professional gifts to offer students, so let us share enthusiastically and unabashedly.

We can also assist students by actively creating job opportunities for them. That is quite a bold statement to make in our current economic state of affairs, isn’t it?  Yet it is possible, particularly for those of us who are mental health counselors in private/group practice.  Let me explain. I’ll begin by recognizing that private practice is not the best setting for some graduating students. Therefore, it will be important for students to consult with their faculty, supervisors, and site hosts to determine the best setting for their own development. However, private practice is a very viable option for some graduating students provided that there is appropriate support for them as they develop their counseling skills. This is where we come in. I encourage those of us in private practice settings to provide invitations and opportunities for new graduates to join the practice and then offer the appropriate supervision and clinical support for their work to continue to flourish. In some states, that means that we need to earn a supervision credential. In other states, it means that we have to incorporate our practice as an LLC with the central mission and activity of providing mental health counseling. It can be helpful to engage in conversations with private practice counselors across state lines to determine the most effective ways to support the growth of new counselors in private practice while simultaneously supporting the wellness of their clients.

Counselor Educators

Again and always, mentorship and advocacy are the primary tasks. Just as counselors are being called to mentor students through attendance and participation in professional organizations, so must we. Counselor educators can require that students attend meetings of local counseling organizations. We can then teach students how to connect with other professionals by attending the meetings ourselves and introducing them to members who have similar interests. It is also essential to teach students about the importance of nurturing community connections within the counseling profession during their first semester of academic training. That will give master’s students the most time to meet other counselors in the field, learn about the mental health needs and services in their communities, and gain a better grasp of the professional requirements of their work. In the end of this process, graduating students will be better informed about the needs of their students and clients and more knowledgeable about the upcoming clinical, administrative, and systemic demands of their work.

We must continue to engage in both legislative and educational advocacy initiatives that result in the creation of more jobs for graduating students. We can do this by engaging in organized efforts to meet with our legislators and by selecting research topics that provide implications for policy development. For example, we might design a research project that investigates the impact of employing fewer school counselors in our K-12 schools. Participation in the development and nurturance of collaborative relationships among students, counselors, and counselor educators can constitute a ripe topic for research. We can only help students and strengthen our professional community by gaining a better understanding of the ways in which collaboration and mentorship impact occupational wellness and competence. We can investigate, articulate, and integrate into training the best practices or competencies for keeping our own occupational fears at bay so that we can indeed be the holders of hope for our clients.

Working Together

We all – students, counselors, and counselor educators alike – need to get out of our comfort zones, walk with or through our fears, connect with one another, and promote wellness in our profession. A commitment to doing so can serve to transform fear into a strong community of learning, practice, research, and advocacy. So let us take a collective deep, centering breath and move forward together in hope and courage.

The wise words of poet Audre Lorde can guide us during this critical time in our professional growth. She wrote the poem in the singular and I have changed her words to the plural, but the message remains the same:

When we dare to be powerful,
To use our strength in service of our vision,
Then it becomes less and less important whether we are afraid.

Elaine Casquarelli is a counselor specializing in career development, LGB concerns and spiritual issues in counseling.  She is currently a doctoral student in Counseling and Counselor Education at the Warner School of Eduction, University of Rochester, and works as a career advisor for graduate students enrolled in counseling and education programs at her institution.  She can be contacted at Elaine.Casquarelli@Warner.Rochester.edu.

Letters to the editor: ct@counseling.org

The need for advocacy with African American parents

Dana Griffin May 1, 2012

African Americans are a complex cultural group. Although considered to be one culture, many cultural differences exist within this group. That same statement could be applied to any culture, but it is African Americans who have one of the most historically oppressive pasts and who continue to face numerous microaggressions along the lines of colorism, sexism and classism.

African Americans must continually strive for perfection in a society that holds onto policies and systems originally developed to keep them from crossing the invisible line of success. Yet, African Americans have been successful. One of the greatest successes of our time is the election of Barack Obama as president of the United States — at least this is what I continue to hear today, right after the statement that racism no longer exists. Those who assert that racism no longer exists may believe that Martin Luther King Jr.’s hopes and dreams finally have been realized — that children of color are now judged on the content of their character and not by the color of their skin.

This belief that racial inequality no longer exists is untrue. In fact, it continues to permeate every aspect of our lives. Indeed, one of the largest American institutions in which racial inequality exists and thrives today is our educational system. This is evidenced by the achievement gap, a phenomenon in which Black boys and girls continue to lag behind their White and Asian counterparts in academics.

Parental involvement

When viewing educational inequality, I argue that inequalities also exist when it comes to inviting and encouraging the involvement of African American parents. Parental involvement is a proven technique in helping children mitigate barriers to academic success, and with the achievement gap still in existence, many school stakeholders have banked on parental involvement to bridge this gap. However, the bulk of research and literature on African American parents continues to depict them as uninvolved in their children’s education.

Parental involvement has been studied extensively in the literature, and it is considered an evidence-based practice, especially when using models such as the Epstein Model of Parental Involvement or the Hoover-Dempsey Model of Parental Involvement. But when looking through a school lens, African Americans are viewed as uninvolved in their children’s education, especially in comparison with White parents.

Because I am an African American mother, this conundrum holds great interest for me. Why do African American parents continue to remain distant from the schools? Is it true that we are not involved? The schools with which I get the chance to interact continue to preach parental involvement as a practice in helping to reduce the achievement gap or as a way to help meet the needs of their school populations. But the notion of parental “uninvolvement” as it relates to African American parents remains a theme across K-12 educational systems.

In my work, I often hear that African American parents are not involved in their children’s education. Even I — an African American mother, a former school counselor and now a counselor educator — am deemed uninvolved in my child’s education. When viewed through one lens, this is true — I do not volunteer in school, I do not donate money for various funds, I am not a part of the PTA, I do not chaperone my child’s field trips, nor do I help out in the classrooms. For all intents and purposes, I am an “uninvolved” parent. Despite this perception, I feel I am a very involved parent. This discrepancy, among other factors, has led to my current research interests concerning parental involvement of African American and Latino families.

Although the overall parental involvement literature depicts uninvolvement by African Americans, the research using solely African American participants tells a different story. To summarize this literature, African Americans are involved in their children’s education in a variety of ways, but their involvement centers more on home- or community-based activities — activities that schools might not recognize as parental involvement. Further, African Americans typically do not hold leadership roles in the schools, which may further alienate these families from involvement in more school-based activities and can also limit the voice of African American parents. Could it be that African American uninvolvement actually stems from the lack of voice that African Americans have in the schools, which in turn leads to less presence in the schools? This question led me to conduct a qualitative study of parental involvement with African American mothers.

‘Unsilencing’ the voices of Black mothers

Using a focus group of 16 African American mothers of elementary and middle school students from an urban-suburban school district, I asked questions centered around parental involvement, including “How are you involved in your child’s education?” and “How do you define and demonstrate parental involvement?” I also asked questions relating to the achievement gap, such as “What do you know about the achievement gap?” and “How can we eliminate the achievement gap?” Because I am a counselor educator of school counselors, I also asked these mothers what they perceived the role of the school counselor to be in helping increase the academic achievement of African American students.

Because of my own personal experiences with the education system, I chose to work only with African American mothers in this focus group, and the framework of Black Feminist Thought,by Patricia Hill Collins, was used to guide the study. Black feminist thought is a critical social theory built on the premise that although Black women have knowledge and a voice, oppression continues to silence their voices. In my study, I argue that although current models of parental involvement are indeed effective in understanding and increasing parental involvement, the voices of Black women, as a whole, continue to remain unheard. My study was designed as a way to “unsilence” the voices of Black mothers.

Findings from my study demonstrate that African American parents are involved in their children’s education but also reveal several factors related to why this involvement is more active at home than it is in the schools. First, as shown in the literature, a fundamental lack of trust continues to exist. The mothers in my study did not feel that the teachers and schools had their best interests at heart. They also did not feel welcomed in the schools. No one in the study could speak to experiencing any overt actions or comments to validate these perceptions; instead, they said it was a gut reaction that began when they walked into the schools. Basically, the African American moms felt the welcomes and greetings they received were different — more reserved and less cordial — than those given to the White moms. The moms in my focus group also felt the teachers were less open with them, that they did not receive the same type of communication or, as one mother stated, “the inside scoop.” According to one mother, although her child’s school was excellent about sending home correspondence, some parents received information that was not made available to all parents. The only way she found out about this was through conversations with different mothers.

Second, the moms felt that their children’s schools did not want their input and did not value their contributions, which left them with the impression that they were not really wanted in the schools. Mothers from one school said that although their elementary school espoused the need for more parents to come out and run for leadership roles, they believed this was insincere rhetoric. These same mothers commented that they were not invited to be room mothers, to run for parent advocacy boards or to plan grade-level outings. Instead they were sent general invitations to volunteer for menial tasks such as setting up for or cleaning up after events, bringing food, stuffing envelopes and counting papers — all tasks that anyone could do. When they asked other mothers (meaning White mothers) how they happened to be involved with grading homework or serving on the school advisory board, these mothers said the teachers had approached them personally. The entire group of African American mothers in this study felt insulted and slighted because personal invitations such as these had never been extended to them.

Other results showed that the African American mothers in the focus group understood the achievement gap but believed it was a problem experienced only by those families living in poverty. Interestingly, the mothers in my group were all highly educated, financially stable, very articulate and well-dressed. I add this to point out that my focus group was not composed of a population of parents that usually has difficulties being a part of the school. But here, in the safe environment of this group, 16 African American mothers, all with bachelor’s degrees or higher and fairly affluent, acknowledged feeling devalued and cast aside by those put in charge of educating their children. These mothers, all with academically and emotionally successful kids, did not feel welcomed in their children’s schools, nor did they trust the schools to educate their children.

So what does this mean for school counselors? The mothers in this study said school counselors should take a more proactive role in helping African American children and their families and in advocating for equality in the schools. These mothers want someone on their side — someone on the “inside” who can fight for them and their children — and they thought school counselors could take on that role.

Advocacy strategies that build trust

Taking this and other research to practice, I teach my students to advocate not just for African Americans, but for all underserved populations. Because advocacy can take many forms and the needs of different populations can vary, school counselors should first provide a forum for parents to voice their opinions on happenings in the school. This forum needs to take place in a safe and confidential environment and with similar cultural groups. When I talk about this with my students, they are resistant to this idea and question the need to have separate groups. I explain that having separate groups at this point can foster more open communication, allowing those voices that are normally silenced to be unsilenced. Such groups can also cultivate a sense of trust and camaraderie that might not happen otherwise. Out of these forums, an advisory board could be developed that includes at least two parents from each cultural group represented in the school.

School counselors should also work in conjunction with cultural brokers. Cultural brokers are minority individuals who are part of the culture and who can serve as a bridge to assist the school in understanding the family culture, while also helping the family to understand the school culture. Cultural brokers may also possess insight into community resources that families can use. In working with a cultural broker, school counselors can begin to go out into the community and garner the trust and respect of families who are deemed to be uninvolved in the schools.

This is an important aspect and a much-needed first step in working with African American parents. Parents might not come into the schools, but that should not prevent school staff — counselors, teachers or administrators — from venturing into the community. Indeed, when applying a historical lens, African American parental school involvement was very high during segregation. The school staff lived in the same community as the children they taught and worshipped at the same churches where these families attended. Only after segregation did school staff stop being a part of the communities in which they taught. Although I do not believe that we must all live in the same communities where we teach, I do believe that community involvement moves us one step closer to parental involvement because it facilitates the fundamental level of trust that largely seems to be missing today.

One way to meet new parents and begin building trust is to engage with the parents of transitioning students — those first entering kindergarten, middle school or high school. Schools typically hold open houses for these parents, and school counselors generally set up a booth and wait for parents to approach them to ask questions. School counselors should be more proactive and involved at these meetings, going to the parents, introducing themselves and starting conversations. Handing out questionnaires that ask parents to discuss any concerns or issues they might have may be a good start as well. Follow-up is also important. One parent in my group mentioned that she does not advocate because “nothing will ever change.” It is important that the school staff attempts to address the issues of parents who do respond and voice their concerns. This will demonstrate to parents that 1) you did listen, 2) you care about their issues and 3) you will follow through.

School counselors can also host focus group meetings with parents to uncover their concerns about the school and then use that information to propose systemic changes. In these meetings, school counselors are also modeling how families can advocate for themselves. Indeed, the mothers in my research group mentioned the need for advocacy but lacked a clear vision of what that might look like in the schools. Likewise, in my yearlong research with 20 Latina mothers, they also voiced the need for advocacy but also lacked a clear conceptualization of what advocacy looks like in the schools. As school counselors, teaching parents how to advocate for themselves could entail showing them how to draft petitions, how to communicate with school stakeholders about their concerns or even how to research and write an argument. This is important because we want parents to be empowered rather than to rely on someone else to advocate for them.

What would you do for your child?

Feedback from my students and other professional school counselors concerning these suggestions has been lukewarm at best. I have been told that advocacy strategies sound good in theory, but in practice, they could never be implemented in the schools. As school counselors, they have no time, no support and a myriad of other duties that must be completed just to keep the day-to-day operations of the counseling department up and running. Although I hate to admit it, eight years have passed since I last worked in a public school, and I wonder if I am too far removed from actual practice. But I am reminded that the people who develop and implement the policies and procedures of schools might be resistant to change, especially if that change does not have a direct link to educational outcomes, such as implementing a new program that focuses on math and literacy achievement. I also remind myself that when good things happen in schools, it is because a major change occurred, such as implementing a new way of overcoming systemic inequalities and opening the doors to success for all students. So, when I hear the number of reasons that school counselors cannot participate in more advocacy and leadership roles, I ask them one question: If your only option was to send your child to one particular school but your child’s needs were not being met, what would you do?

Advocacy is one of our most difficult duties as school counselors, especially when our jobs and livelihoods are on the line. Even if we do not feel we can advocate on behalf of others, we still need to teach and empower the parents with whom we work to advocate on behalf of their children. In school systems, parents have power and they have a voice. Typically, the parents who use that voice have the most power. We need to teach those who are traditionally underserved, including African American, Latino and low socioeconomic status families, how to properly raise their voices and advocate on behalf of their children.

Advocacy is not something that should be done independently, however. Parents need to come together and work in unity. I have conducted research with a majority White rural sample of parents, a Black urban and suburban sample of parents, and a Latina suburban sample of parents. They all have the same perceptions and the same issues and problems with the schools — namely, a lack of trust in the schools and a lack of communication and acceptance from the schools. These groups of parents all say they want to advocate for their children but that nothing ever changes. But they choose to fight separately and to stay within their own cultural groups. This makes it easier for those in charge to look at the problem in isolation and to conclude that the concern is isolated to the African American population, for example, and doesn’t affect the school population as a whole. I wonder what might happen if all parents came together and raised their voices as one.

“Knowledge Share” articles are adapted from sessions presented at past ACA Annual Conferences.

Dana Griffin is an assistant professor and clinical coordinator of the school counseling program in the School of Education at the University of North Carolina at Chapel Hill. Contact her at dcgriffi@email.unc.edu

Letters to the editor: ct@counseling.org

A family affair

Lynne Shallcross

According to the Centers for Disease Control and Prevention, obesity now affects 17 percent of U.S. children and adolescents, which adds up to roughly 12.5 million kids. Since 1980, obesity prevalence among this group has almost tripled. Among children and adolescents ages 2 to 19, being overweight translates to a body-mass index (BMI) at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex, while obesity signifies a BMI at or above the 95th percentile.

Mandy Perryman, coordinator of the counselor education program at Lynchburg College in Virginia, calls childhood obesity the No. 1 physical and mental health concern facing kids today. “We know about the physical damage, how kids are not expected to outlive their parents and other statistics, but these kids are suffering from more social isolation, more depression and more anxiety than other kids,” says Perryman, a member of the American Counseling Association who has been studying the topic for close to a decade.

In fact, the emotional side of childhood obesity can trap young people in a vicious circle. As Perryman explains, kids who are experiencing emotional vulnerabilities, including isolation and depression, sometimes end up eating more in an effort to cope. This can lead to them becoming even more isolated and sedentary and increase their risk of facing potential weight issues. “[And] when they become overweight,” Perryman says, “then those same issues become compounded.” Perryman became interested in the topic of childhood obesity while earning her doctorate at the University of New Mexico. She explored the relationship between parents’ weight-related perceptions and behaviors and their children’s body image and composition for her dissertation, and she has continued researching the topic of childhood obesity ever since.

Although physicians and nutritionists are perhaps more visible when it comes to addressing childhood obesity, Perryman contends that counselors can and should play a vital role as well. That’s because there is no better profession to understand and champion the family — especially from a wellness perspective — than counseling, Perryman says.

The original catalyst for a family appearing in a counselor’s office might be one child struggling with obesity, but helping the entire family achieve better health is often the main thrust of the counseling process, Perryman says. “The counselor can relate with the family and give a different perspective based on the wellness model,” she says. “We’re not looking at the deficits. We’re looking to enhance what the family can do.”

Ginny Gross, a counselor in private practice in Greenville, S.C., who specializes in weight-related disorders, says her young clients are often brought to her by concerned parents or referred to her by doctors or school counselors. Although an overweight or obese child might be her official client, she agrees with Perryman that the best counseling solution is to work with the entire family. In fact, Gross prefers to take a holistic approach that aims for lifestyle changes and includes working with others even beyond the parents. “I work with the children, their families, their doctors and a registered dietician,” says Gross, a member of ACA. “It is important to find a qualified registered dietician who is educated about eating disorders in order to help the child and parents learn about healthy lifestyle changes rather than ‘dieting’ techniques.” (Gross clarifies that she does not view obesity itself as an eating disorder. However, she says, many clients who are obese also struggle with eating disorders.) “Also, teachers can be incorporated into the mix if bullying or ADHD [attention deficit/hyperactivity disorder] are involved. It is important that the child’s pediatrician is involved in treatment to manage medications, to make sure labs and blood work are in a healthy range and to ensure they are not suggesting diet pills or a diet for the child.”

Working with parents of overweight or obese children sometimes focuses on highlighting the messages parents might be sending to their children, Gross says. For example, she says, negative messages about food or restrictive eating rules may only serve to fuel the child’s struggle with weight. Gross includes the parents in almost every session she has with an obese child. Sometimes, she also works alone with the parents.

Gross strongly advises parents against putting their children on diets. “This instills low self-confidence and decreases self-esteem to a lower point than it probably already is before the diet,” she says. “Also, teaching children dieting behaviors increases the chance of disordered eating, and research shows that diets and disordered eating often lead to diagnosable eating disorders. Even more so, it teaches children yo-yo dieting behavior from a young age. Research has found that yo-yo dieting leads to metabolic syndrome, diabetes, heart disease and even obesity.”

Perryman also contends that diets are the absolute wrong approach to take with overweight or obese children. Even for adults, she adds, diets don’t lead to lasting change. What will lead to lasting change, she says, is helping kids and families focus not just on doing something differently but thinking about it differently. Diets mean restricting yourself until you just can’t refrain anymore, Perryman says. And when you do give in, you feel guilt and shame, which might lead to more overeating. “You have to change [clients’] thinking and do some cognitive restructuring if you want the behavioral changes to last,” she says.

The work a counselor does with families might include talking about preparing and cooking meals together, eating together and exercising together, Perryman says. Gross adds that research has shown that eating together as a family decreases the chances of disordered eating and eating disorders. As explained by Perryman, disordered eating is when people use food for reasons other than nourishment, including attempts to numb themselves from pain or buffer themselves from interacting with others.

Also worth covering with the family of an obese child is how the family likes to celebrate, Perryman says. If celebrations usually focus on unhealthy food, talk with family members about how they can change some of those habits but still feel rewarded. “If a cupcake is special to me and then you substitute a carrot, it won’t work,” she says. “You have to come up with what will work with the family to feel like it’s a good exchange.” Perryman also suggests counselors explain to parents that labeling certain foods “off-limits” can actually backfire and how enforcing that mindset isn’t healthy.

Gross concurs. “I advise counselors to work with parents as much as possible on teaching children how to have a healthy relationship with food,” she says. “For example, foods should not be labeled as ‘good’ or ‘bad.’ All types of food should be allowed in the house and kept in the pantry, because when foods are restricted from anyone, the reward value increases in the brain for that food. So, when the child is exposed to that [restricted] food, they want it even more and it has more meaning.”

When meeting in session alone with parents, a counselor can also inform them that weight gain is a normal part of development, especially during puberty, Perryman says. She finds it surprising how many parents are unaware of that fact and how often weight gain during this period can lead parents to put their children on a diet. Perryman adds that the counselor might then also open up that conversation with the child and his or her parents in a session in an effort to help normalize what the child is experiencing.

Another point of discussion when meeting with parents alone is how these parents feel about themselves and talk about themselves in front of their children, Perryman says. For example, a child might begin nitpicking the way she looks if she absorbs and then mimics that behavior from her mother, Perryman explains. “We’re quick to focus on our appearance, but we need to reinforce for children that we’re proud of their values and their efforts and their accomplishments,” she says. “When we compliment them on the person they are, it takes the power away from everything being based on appearance.”

A positive approach

In addition to working with the family on healthy eating habits and increasing physical activity levels, Gross and Perryman say counselors can use cognitive behavior therapy to help a child struggling with weight issues. Weight loss often focuses on eating and exercising behaviors, Perryman says, but adding the cognitive piece helps to create lasting change for the child and family.

Gross views the counselor’s role as assisting the child to feel less isolated, develop stronger self-esteem, gain greater body acceptance and also learn to become aware of and cope with overeating triggers.

Perryman suggests having children carry a pocket-size mirror with them. If they start feeling low, Perryman says they can take it out, look into it and tell themselves something positive they’ve learned about themselves in counseling.

Taking a positive approach in working with overweight and obese children and their families is key, Perryman says. “We know that dieting children is the absolute worst thing we can do,” she says. “Restriction isn’t good for anyone, and fear is not a long-term motivator.” Counselors should take their approach from the wellness model, she says, with families encouraged to build on the strengths they already possess and to continue moving toward better health.

Perryman and Gross say although it is beneficial to have a basic knowledge of nutrition, counselors do not need to be specially trained in nutrition to work with obese children and their families. “However,” Gross says, “it is helpful to be knowledgeable about the non-diet approach to weight stabilization and what types of food children should be consuming and [to know about] not cutting out any of the food groups.”

“It is highly important for counselors to make sure children are eating all of their meals and never skipping meals, even if they do not feel hungry, and eating breakfast daily,” Gross continues. “Many children on stimulants for ADHD have suppressed appetites and do not want to eat or feel sick when they eat on their medications, but it is very important for parents and teachers to monitor these children’s eating patterns to make sure they eat an adequate amount of food. If a person doesn’t eat breakfast, their metabolism doesn’t get jump-started to where it needs to be for the day, and then they are more likely to overeat at lunch. Also, if a person skips meals or restricts food, not only does their metabolism decrease, their body goes into what we call ‘survival mode,’ which means our bodies are preserving energy and not burning energy because of a lack of intake of energy.”

Gross contends that although childhood obesity is a situation deserving of attention by counselors and society as a whole, we also need to be careful about the wording we use as a society. “We throw around the word epidemic lightly,” she says. “By talking about what a big problem [obesity] is, it can make kids feel bad. It can give them guilt and shame and make them feel there is something wrong with them.”

Although Gross says it’s worth working with children and families on changing thoughts and behaviors related to eating and exercise, and also acknowledges that environment can play a big part in a child’s struggles with obesity, she points to research showing that 50 to 70 percent of weight is genetically determined. That means certain children will have a larger uphill battle against weight gain than other children, and Gross wants counselors and society as a whole to be mindful of making a child feel at fault for being overweight.

Perryman agrees that nothing is wrong with the character of a child who is obese and says society needs to be careful not to make these children feel bad. In that same vein, when working with these children and their families, Perryman says, counselors should avoid applying labels and instead focus on empowering families and children to obtain better health.

However, Perryman acknowledges, on a societal level, childhood obesity is a problem — one she says shouldn’t be sugarcoated or downplayed because then it won’t get the attention it requires. Counselors should advocate to bring more attention to the topic, she says, because the more attention it receives, the more potential there is for change in what’s being served in school lunches, in keeping physical education classes intact even during budget cuts and in offering better nutritional options at lower prices nationwide. “If you can feed a family of four on a bucket of fried chicken but you can’t buy a healthy alternative for the same amount,” she says, “then you can’t sustain change.”

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

Letters to the editor:  ct@counseling.org