Tag Archives: Counselors Audience

Counselors Audience

What becomes of the brokenhearted?

Stacy Notaras Murphy November 1, 2012

Before they understand the various diagnoses and treatment options available, many clients present to counseling because of trouble navigating the same human phenomenon: heartbreak.

Under this label fall countless events such as a painful breakup, the death of a loved one or the failure to attain a major life goal. Counselors are in daily contact with clients struggling with some form of heartbreak, and many counselors initially focus on treating the symptoms, which might include sleeplessness, anxiety about the future and hopeless thoughts. But some in the field are conceptualizing this presenting problem as more complicated than major depression or adjustment disorder. By considering heartbreak through new diagnostic lenses, counselors are developing integrated approaches to treat this universal human experience.

One counselor delving into these nuances is Joanne Vogel, whose résumé reads like a catalog of the varieties of heartbreak. The American Counseling Association member and director of counseling and psychological services at Rollins College in Winter Park, Fla., began her career serving at-risk female adolescents, followed by five years working with children and families navigating the foster care system. She later directed a federal grant program aimed at strengthening couples’ relationships, and then she went on to become a certified sex therapist.

“I think that many people have expertise in the area of love and heartbreak whether they wish to or not,” Vogel says. “I began focusing on this area due to a combination of life circumstances, interest and advanced training in sex therapy. Certainly not every person experiencing heartbreak needs sex therapy, but I approach the mental health discipline with the knowledge that intimacy and love — and the ability to love after heartbreak — undergird healthy sexuality and attachment.”

Applying descriptions from a variety of sources, Vogel defines heartbreak as “an intense, overwhelming, crushing grief or distress over the loss of something or someone.” She notes this definition covers more than simply romantic relationships, including the death of loved ones; abandonment, abuse and/or neglect from caregivers or others; and major changes in life course, such as sustaining physical injury or moving and feeling uprooted. Vogel says the impact of heartbreak varies depending on the person or situation. “I try hard never to minimize the experience and its potentially devastating effects,” she says.

To that end, Vogel has likened heartbreak to posttraumatic stress, acute stress and even substance withdrawal. “For posttraumatic stress, the similarities stem from experiencing a traumatic event that overwhelms coping skills [in which] a person experiences threat of or actual injury. [In treating clients struggling with heartbreak] I have noticed the reliving, avoidance and arousal associated with posttraumatic stress,” she says. She notes that heartbroken clients may have upsetting memories, flashbacks,
re-experiencing, lack of interest in normal activities, inability to concentrate, irritability, angry outbursts or sleep disruption.

Clients dealing with heartbreak may also have reactions similar to individuals experiencing substance withdrawal, including obsessions, cravings and relapselike behaviors, such as getting back into an unhealthy relationship, Vogel says. She says the comparison of heartbreak to grief or bereavement “may be the easiest one for people to accept since it recognizes the loss component of heartbreak in addition to some of the familiar [Elisabeth] Kübler-Ross stages such as denial, anger, bargaining, depression and acceptance.”

Conceptualize the problem

Viewing heartbreak as a kind of posttraumatic stress, substance withdrawal or grief can help counselors in considering treatment options, Vogel says. “I suppose some may critique this approach for pathologizing the natural and normal experience of heartbreak in life. However, I would like to see all of the above notions and categories depathologized and used to have a common language about conditions and experiences that affect many of us and the people whom we counsel or love,” she says.

Kalpana Murthy, a licensed professional counselor in private practice in Atlanta, also has observed heartbreak produce symptoms similar to posttraumatic stress and grief. “When a relationship ends — particularly if it ends suddenly or because of an affair — the client could experience shock, loss of control or a sense that what has happened isn’t real,” she explains, adding that these clients may re-experience conversations, images or events related to the breakup. Murthy also notes these clients may experience physical or emotional distress triggered by moments that run the gamut from calendar dates to social media postings.

Vogel points out that social media has become a new venue for retraumatizing heartbroken clients. “Working in a college setting, I am acutely aware of how a ‘status change’ or update affects heartbreak in romantic relationships and the difficulties inherent in limiting information dissemination,” she says. “Furthermore, the ease of information discovery on the Internet makes such things as stalking after relationship dissolution a concern.

“The addictive quality of cyberspace and relationships creates a bit of a perfect storm for those who might obsess or ruminate. I have worked with clients to limit their use of Facebook, Google, Twitter and the Internet until the emotionality and reactivity decrease. I prepare clients for the likelihood that they will discover or hear information about an ex, and we do some imaginal rehearsal to prepare for situations, people and places that may evoke emotion or trigger certain memories.”

Psychoeducation: Heartbreak 101

John Ballew is an ACA member who has been in private practice in Atlanta for 25 years. He has found that a significant number of his clients enter treatment due to the heartbreak associated with the end of a relationship. He explains that the breakup often makes it difficult to ignore long-term intimacy issues, which may manifest as a state of personal crisis. Although this can present a good opportunity for the counselor to educate the client about how relationships really work, Ballew emphasizes that the client should always set the pace for this work.

“If a client is in a place to hear it, I will let the client know that personal crises can be opportunities for personal growth,” Ballew says. “Obviously, it is important not to offer glib reassurance or clichés about life when a client is in distress. Clients are often troubled by feeling overwhelmed in the face of loss. I find it helpful to normalize their experience and to talk about it in the context of grief.”

Murthy agrees that providing such context can be useful when dealing with heartbreak. “Psychoeducation helps them understand why people have different reactions to a relationship ending and different timelines for heartbreak recovery and grief,” she says. “It also helps them understand why they feel the way they do and normalizes their experience.”

Ballew notes that working with men regarding heartbreak often presents special challenges but adds that psychoeducation can help. “Men can be very uncomfortable with the feelings of hurt and vulnerability that are intrinsic to heartache,” he explains. “The hurt may emerge as anger instead of pain. And the therapist should be alert for signs that a male client may be experiencing shame regarding his emotional distress. The therapist is in a great position to help the client learn more about how emotions work and to become more comfortable with his interior landscape.”

Ballew adds that care ought to be paid to the physical well-being of all clients experiencing heartbreak, including helping these clients to tune into the possible physical manifestations of the experience. “The intense distress is likely to be experienced in the body, especially if the distress goes on for a while,” he says. “There is risk of hypertension, chest pain and other physical manifestations of grief. Trouble sleeping is very common, and that can precipitate other problems, from anxiety and depression to distraction at work. [Also] be alert for changes in drug and alcohol use for the purposes of self-medication.”

In treatment: Watch your language

For Vogel, the first step in helping clients through heartbreak is allowing their experience to be individualized and contextualized. “I ask questions about the person, the pet or the situation, to know — really know — that person, pet or event in a way that helps me to understand the meaning, role and symbol of such in the client’s life,” she says. “I find people are willing and relieved to share these things because many in their social support network — if one exists — may be tired of hearing about the loss and may become frustrated in the amount of time it takes to recover and heal.”

When doing this work, Vogel says she focuses on three subjects: the role of language, creative techniques and learning to dream, live and love again.

The language piece is important, Vogel says, because subtle changes in how counselors speak to clients can expedite treatment. “For instance, I begin to add words like heartache or heartsickto the discussion about heartbreak. When we think of something broken, we are unsure if it can be fixed. When I use ‘heartsick’ or ‘heartache’ in place of ‘heartbreak’ as soon as it may be appropriate, it indicates subtly that wellness can be achieved from sickness and aches often go away as we use the muscles more frequently or give them a rest,” she says.

Applying a language technique she learned through a Rapid Trauma Resolution training with Jon Connelly, Vogel speaks in the present tense about the positive remembrances of the lover, person, pet or situation, while placing the negative or conflicted memories about these things in the past tense to create distance. She also pays attention to how other people may be speaking to the client.

“In the case of relationship breakups, I tackle the ‘other fish in the sea’ idea and the tendency to tell someone simply to go out and find another person, or the idea of ‘just go out and get laid’ to forget the other person or feel better,” Vogel says. “I find that these things may be well intended but dismiss the experience or attempt to distract the person from the actual grieving process. Rarely do we find someone who tells you to go out and find another mother after the loss of a parent or to distract yourself with some other feel-good chemical. Certainly, people do this, but it fails to address the issue.”

Vogel goes on to warn that the very human response of normalizing or promoting the universality of the heartbreak experience may not provide actual comfort to the client. “You will often hear back [from individuals going through heartbreak] that you do not understand how different, unique or special this relationship was in comparison with others,” she says. In trying to comfort someone, especially a friend, it can be tempting to tell the person that he or she can “do better” next time, she adds. “While the phrase ‘you deserve better’ might be acceptable, this idea of ‘doing better’ reminds me of a coach or teacher who wants me to perform something more perfectly and somehow suggests that I am responsible for my own pain because I could have done better.

“Likewise, any notion that ‘it would not have lasted anyway’ is equally distressing because it seems equivalent to a funeral condolence of someone being ‘in a better place.’ Perhaps some will find solace in this, but most clients struggling with heartbreak or heartache will not respond to thinking that it was going to end at some point anyway.”

Vogel also cautions friends against reminding the person that the lost partner wasn’t really fun or was never available during the relationship. “This feedback may be appropriate at some point in the future,” she says, “but it is better to focus more on your friend in the short term than on what you lacked when your friend was in the relationship.”

EMDR options

Trina Welz, a counselor in private practice in San Antonio, became interested in helping clients facing the trauma of heartbreak after many years of walking clients through other sorts of trauma, including that experienced by military personnel and their families. She trained in eye movement desensitization and reprocessing (EMDR) to help that population, but has found success in applying that treatment approach to clients dealing with grief and loss as well.

“If we look at the end of a relationship as a traumatic event, there are several ways in which the EMDR protocol can be applied based on the client’s needs [and] treatment goals, and the clinician’s assessment and case conceptualization,” Welz says. “If the client is struggling with overwhelming depression and sadness, that emotion can be targeted with EMDR. If the client is struggling with the memory of a terrible argument they had with their partner, that can be an EMDR target.”

Welz notes an EMDR technique called resource development installation that can help clients recognize, access and reinforce their own resources to address the situation. “For example,” she says, “if your client is struggling with feelings of sadness after their partner has left, you can explore earlier times in [the client’s] life when they struggled but were able to be successful. Whatever resources the client identifies — courage, determination, the ability to be empathetic, spirituality, etc. — I can then use EMDR to reinforce that resource so that it becomes more readily available.

“So, instead of the client thinking, ‘I feel so sad and hopeless. Things will never get better,’ the client can think and feel, ‘Life was really hard when I was going to college and working two jobs, but I made it. I can use that same strength to get through this breakup.’”

Further, EMDR can be used to desensitize the client to the places or things that activate the person’s grief, Welz says. “After a particularly painful divorce, my client continued to live and work in the same neighborhood. Driving past the children’s school triggered his feelings of sadness and anger and the negative belief, ‘I’m a loser.’ With the use of EMDR, we were able to desensitize this trigger so that driving past the school stopped evoking those same negative thoughts and emotions, and his negative belief was replaced by the more positive belief, ‘I was the best parent I could be.’”

Murthy, also a certified EMDR therapist, finds that an integrated therapy approach helps her clients who are facing heartbreak. “My approach includes psychoeducation, ego state work to increase a sense of security, EMDR therapy, grief work, mindfulness meditation and cognitive approaches to help with resisting the urge to contact the spouse [or] significant other when further contact would not be beneficial,” she explains. “After the acute symptoms have been reduced, I then work on helping the client address relationship patterns or other issues that may stand in the way of a healthy relationship with someone new. When the client decides to discontinue therapy sessions, an effective transition process and closure session is especially important with [those] who have just gone through a relationship ending. For some clients, this may be their first experience of a healthy way to end a relationship.”

Get creative

Clearly, counselors can use many different methods to help clients get through heartbreaking circumstances. Vogel emphasizes that creative techniques can help clients transition from mourning their loss to envisioning a brighter future, while simultaneously incorporating lessons learned from the previous relationship. “I try to learn about the types of creativity the client already uses in life,” she says. “I adapt activities frequently and allow the client to help determine what type of creative medium: writing, dancing, sewing, songwriting, making a music mix, creating a collage, painting, gardening, etc.”

For example, Vogel uses a trauma desensitization technique from researchers James Pennebaker and Sandra Beall that invites clients to write about their heartbreak for 15-20 minutes on three to four consecutive days. In the process, Vogel says, clients may be able to take more or less personal responsibility for the breakup and become less sensitive to thoughts about the relationship. Clients also can bring in photos of the relationship, create a scrapbook and even create a different ending to the heartbreak, she says.

Vogel avoids talking specifically about the client moving on or finding a “replacement” for the lost relationship, but through the counseling process, she says, that end result often happens on its own. Says Vogel, “I find that using creative approaches and honoring the loss allows clients to think about the things and people that they want in their lives in the future.”

Contributing writer Stacy Notaras Murphy is a licensed professional counselor and certified Imago relationship therapist practicing in Washington, D.C. To contact her, visit stacymurphyLPC.com.

Letters to the editor: ct@counseling.org

NBCC awarded federal Minority Fellowship Program grant

Lynne Shallcross

(Thomas Clawson)

In August, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded the National Board for Certified Counselors (NBCC) a Minority Fellowship Program grant. The grant provides NBCC as much as $1.6 million over the next two years to “expand the behavioral health workforce in order to reduce health disparities and improve health care outcomes for traditionally underserved populations.”

Thanks to a move by Congress, eligibility for the program was expanded to include professional counselors for the first time this year. Thomas Clawson, president and CEO of NBCC, calls this inclusion hugely significant. “Over the past 40 years, SAMHSA has awarded funds to other mental health professions to help bring more minority professionals into positions of practice and education,” he says. “NBCC has sought federal legislative requirements for many years so that counseling would benefit from new dollars set aside specifically for minority doctoral counseling students. It’s a big deal because it immediately brings $600,000 a year to support minority students in Council for Accreditation of Counseling and Related Educational Programs (CACREP) doctoral programs. And we have to assume that this funding will continue for decades, thus helping prepare hundreds of quality doctorate-holding counselors by the decade.”

SAMHSA Administrator Pamela S. Hyde says the Minority Fellowship Program, created in 1973, operates with the mission of addressing and rectifying long-standing disparities in access, availability, quality and outcomes of mental health and substance abuse treatment for minority populations.

As outlined by Hyde, that mission includes three aspects. First, she says, it aims to increase the focus on minority behavioral health issues in professional development through curricula and training opportunities in institutions of higher education. These institutions must focus on the needs and conditions of minority populations; the evidence for culturally adapted engagement, services and interventions; and the compilation of knowledge to strengthen the workforce serving minority communities.

The second aim, Hyde says, is to increase the number of minority behavioral health providers so those in need of professional care will have a diverse range of practitioners to choose from. And third, it aims to increase the number of researchers who focus on the behavioral health issues of minority communities and generate evidence-supported approaches to improve services to those populations.

“The MFP (Minority Fellowship Program) is a signature workforce development program that has created a significant cadre of behavioral health professionals in each of these disciplines focusing on services and research for minority communities,” Hyde says. “Graduates who have received MFP fellowships have gone on to become leading researchers, policymakers and practitioners committed to reducing the disparities and the excessive burden of mental health and substance abuse care for diverse racial and ethnic populations.”

An ‘ecosystem’ to serve diverse clients

(Pamela S. Hyde)

NBCC plans to award as many as 24 doctoral fellowships per year in professional counseling, with a focus on culturally competent mental health and substance abuse counseling, Clawson says. Through the Minority Fellowship Program grant, he says, NBCC will be able to help strengthen the infrastructure that engages diverse individuals in the counseling profession and increase the number of professional counselors skilled in providing effective services to underserved populations.

“The NBCC Minority Fellowship Program will strategically promote and provide fellowships to doctoral students in the counseling profession,” Clawson says. “The fellows will obtain training in mental health and substance abuse, with specialty training in culturally competent service delivery. Fellows will provide leadership to the profession through education, research and practice benefiting vulnerable underserved consumers. The fellowship program will increase system capacity by increasing the number of culturally competent professional counselors available to underserved populations through engaging 24 doctoral fellows per year, by promoting national standards in culturally competent care and by providing online and conference-based training to practicing professional counselors. We like to project this yearly number over a decade to imagine more than 200 doctoral-level counselors and counselor educators being added to our ranks.”

NBCC is well-positioned to implement the Minority Fellowship Program, Clawson says, because it has already established the infrastructure needed to award NBCC Foundation scholarships to counseling master’s students who make commitments to serve underrepresented populations.

Individuals chosen for the Minority Fellowship Program will receive training in multicultural issues and will have access to experts in the counseling profession for consultation and development, Clawson says. Fellows will increase access to mental health and substance abuse services for ethnic minorities by taking on leadership roles in counseling practice education and research, he adds.

“NBCC will also reach out to counselor educators, counseling programs, minority organizations and consumer groups to find qualified counselors, obtain guidance and feedback to develop the program, and achieve the program objectives,” Clawson says. “The MFP will share new and innovative research and evidence-based treatments relating to ethnic minorities in an effort to improve the behavioral health delivery system. Fellows will serve as emissaries and leaders at conferences and public events where information and resources identified by the MFP can be shared. The MFP community will serve as an ecosystem where information is jointly shared and developed to facilitate better behavioral health care for ethnically diverse populations.”

Meeting a longtime need

Historically, Hyde says, the mental health and substance abuse treatment needs of racial and ethnic minority communities in the United States have been underserved, in part due to a lack of practitioners properly trained to work with these communities. “This has led to a disproportionate burden of care for these communities,” Hyde says. “In 2003, the president’s New Freedom Commission on Mental Health released its report, ‘Achieving the Promise: Transforming Mental Health Care in America.’ In its recommendations, the report highlighted the need for eliminating disparities in mental health services, including the provision of culturally competent, recovery-based care and the need to address workforce shortages. In particular, the commission noted that ‘… many providers are inadequately prepared to serve culturally diverse populations, and investigators are not trained in research on minority populations.’ In 2011, the secretary of the Department of Health and Human Services released the ‘Strategic Action Plan to Reduce Racial and Ethnic Health Disparities,’ which similarly called for an increased focus on workforce development to better serve minority communities. And in the coming months, it is anticipated that the department will propose a plan for improved language access in health care delivery. The MFP addresses each of these key national plans.”

Clawson echoes the need for the Minority Fellowship Program. “In spite of the significant role of counselors in providing care to U.S. populations, only 12 percent of national certified counselors (NCC) identify as members of an ethnic minority,” he says. “There is a significant discrepancy between minority representation in the overall U.S. population and among NCCs.” Too few minority students are being drawn to counseling, Clawson says, so he believes targeted outreach needs to occur and that fellowships and scholarships need to be offered. He is hopeful that the Minority Fellowship Program grant is a big step in the right direction.

Attracting more minority counselors to the profession is one piece of the puzzle. Another, Clawson says, is training all mental health providers, regardless of race or ethnicity, to better serve minority populations. “The surgeon general’s 2001 report on culture, race and ethnicity found that cultural misunderstandings and communication problems may prevent ethnic and racial minorities from using mental health services,” he says. “Training professional counselors to provide culturally appropriate care will decrease misunderstandings and increase demand, accelerating the need for more culturally competent providers.”

The Minority Fellowship Program implements objectives from SAMHSA’s eight strategic initiatives and the Affordable Care Act, Clawson says. “The need for more culturally competent mental health counselors is consistent with SAMHSA’s strategic initiative to address workforce shortages and provide recovery-based services,” he says. “As the Affordable Care Act expands health care insurance to ethnic minorities and lesbian/gay/bisexual/transgender/queer [clients], and as counseling services become more affordable, it becomes increasingly important that available counselors are culturally competent and trained in the best evidence-based, culturally sensitive practices. Further, addressing this need for increased numbers of culturally competent providers of mental health care directly corresponds to SAMHSA’s mission to reduce the impact of substance abuse and mental illness on communities.”

Finding the right candidates

The primary barrier to successful implementation of the program, Clawson says, is an insufficient pool of qualified doctoral candidates. “Underserved minority populations targeted for this project are underrepresented in master’s degree counseling programs and in current national counseling organizations,” he says. “This is a systems issue that the Minority Fellowship Program is designed to address.” Clawson says NBCC is planning a vigorous outreach program to ensure that all qualified candidates are aware of this fellowship opportunity.

Making sure that counselors funded through the grant go on to serve ethnically diverse populations after graduation will be a top priority, Clawson says. “The eligibility criteria will require a demonstrated history or commitment to serving the identified populations. [We] will prioritize candidates who come from underserved categories and demonstrate a desire to give back to their communities,” he says. “Moreover, the program will be designed to foster cultural competency and delivery of services to these populations. Fellows will be required to prepare a dissertation with a focus on the mental health and substance abuse needs of ethnic minorities. Internships and clinical practicum will require service to underserved populations in the public sector. The program will highlight the opportunities and benefits of providing services in the public sector and in federally recognized underserved areas, including, but not limited to, loan forgiveness programs.”

Although minority counselors will be given preference for the fellowships, individuals do not necessarily have to be minority counselors to be eligible. All individuals receiving a fellowship must be committed to serving a minority population, however.

Only six types of mental health and substance abuse organizations are eligible to receive the Minority Fellowship Program grant. When the program began four decades ago, the first set of eligible organizations included the American Nurses Association, the American Psychiatric Association, the American Psychological Association and the Council on Social Work Education. “In 2007, Congress expanded eligibility to the American Association of Marriage and Family Therapy, and in Fiscal Year 2012, to professional counselors,” Hyde says. “These organizations recruit and support doctoral-level students who are trained to teach, administer, conduct services research and provide direct mental health/substance abuse services for underserved minority populations in the public sector, consistent with congressional intent.”

For more information on the Minority Fellowship Program, visit nbcc.org or samhsa.gov. Fellowship availability is scheduled to be posted by the end of November.

NBCC would like to thank the following organizations for the support they provided as NBCC pursued the Minority Fellowship Program grant:

  • Council for Accreditation of Counseling and Related Educational Programs
  • American Counseling Association
  • Association for Counselor Education and Supervision
  • Chi Sigma Iota
  • American Mental Health Counselors Association
  •  National Association of Alcoholism and Drug Abuse Counselors u

Lynne Shallcross is the associate editor and senior writer for Counseling Today. Contact her at lshallcross@counseling.org.

Letters to the editor: ct@counseling.org

Diversity and depression

Lynne Shallcross October 23, 2012

Counseling Today asked Carlos Zalaquett, professor and coordinator of the clinical mental health counseling program at the University of South Florida, to weigh in on the role of diversity in depression. Zalaquett, the associate editor of the Journal of Multicultural Counseling and Development, has researched depression among different client populations.

Counseling Today: How does diversity play into the topic of depression?

Carlos Zalaquett: In several ways. Here are some examples. Some epidemiological studies suggest that major depression is reported at a higher rate by African Americans (4 percent) and Hispanics/Latinos (4 percent) than European Americans (3.1 percent). Persons with less than a high school diploma (6.7 percent) and high school graduates (4 percent) are more likely to report major depression than those with at least some college (2.5 percent).

Ethnicity still influences the diagnosis and treatment of depression. Some studies suggest that African Americans are significantly less likely to receive a depression diagnosis than European Americans. And those diagnosed with depression were less likely to be treated.

Thus, it is central to develop counseling and public health initiatives to address this persisting disparity in care because if untreated, depression [can] impact the individual’s quality of life in major ways: physically, emotionally, behaviorally, socially, spiritually and job- or work-wise. Furthermore, the importance of depression becomes central as America ages. Depression is a significant public health problem for older Americans because approximately 6.6 percent of elder Americans experience an episode of major depression each year.

CT: Are there cultural or racial risk factors that can propel depression?

CZ: Some of the key aspects are tensional race/ethnic relationships, stereotyping, discrimination, lack of access, education and poverty, just to name a few.

CT: Are there different ways of handling or identifying depression that can vary based on culture or race?

CZ: Interestingly, I have observed depression across cultures. But, remember that culture affects how a client communicates their emotional or mental health needs, how they describe and understand the symptoms they are experiencing, how open they are to counseling or psychotherapy, and the kind of interventions they are willing to accept and the resources they may be willing to use.

CT: Are there multicultural aspects counselors need to be aware of in order to best treat depressed clients depending on their culture, race, ethnicity, etc.?

CZ: I believe there are many, but for the sake of time I will say that awareness, knowledge and skills in working with a diverse clientele will facilitate the process of identifying and counseling clients experiencing depression. The known multicultural competencies would critically assist in understanding how diverse clients understand, experience and describe depression. For example, clients from low socioeconomic status tend to provide somatic complaints as expression of their depressed mood (e.g., headaches, pain). Also, in some cultures, depression may be described as physical sensations (e.g., “heaviness” felt in parts of the body), while in others, depression is described in more general ways (e.g., having “nerves”). In addition, in some cultures it is considered inappropriate or taboo to discuss depression or mental health issues outside of the immediate family. Furthermore, some clients may view it as shameful or dishonorable to discuss personal issues with a counselor. Last example, men may have more difficulties than women speaking about their mental health; they may see depression as a sign of weakness.

Click here to read our November cover story, “Eyes wide open,” which focuses on diagnosing depression in clients, even those who are often the most “invisible,” and treating what is a very treatable illness.

Reader viewpoint: The consequences of social mobility

Mashone Parker October 19, 2012

(Photo: Wikimedia Commons)

As a child living in public housing on Chicago’s South Side, I never realized that what I experienced growing up could be considered “abnormal,” “high-risk” or a “community failure” by other people.

I could not play outside after dark because this is usually when the shooting started. I very often had to run in the house as a child and stay away from windows. I assumed that most children my age, at least the ones who looked like me — black — had shared similar experiences. The truth is, I did not know many people who were not black. My neighborhood was 99 percent black. I read about the dangers of being a poor, black male and the risk of adolescent girls of color. Those risks personally pertained to me when I was growing up. You will always be affected by the violence in your community, even if indirectly. The black boys or young men that statistics refer to as being at greater risk for violence, incarceration or violent death were our brothers, fathers, sons, significant others or spouses. The struggle of being a black girl, someday a black woman, had its countless risks.

You see, in counseling research we talk a lot about privilege, marginalization, diversity and cross-cultural experiences. But what happens when you are the “other,” the minority as the counselor? The textbooks I read talked a lot about ways to work with minority clients, and most of the traditional theories were based on middle-class white people. However, most counselors are white women. “So, who exactly were the authors referring to when they talked about cross-cultural experiences in counseling?” I often asked myself.

Back to the basics: I lived at home with my mom, dad and one sister, who is seven years younger. My parents were never married. As the oldest child, I had a lot of responsibility with helping my parents with my sister. Both my parents worked full-time jobs. They were even lucky enough to afford to send my sister and me to the local Catholic school in our public housing neighborhood where my dad worked as a janitor. I now understand that we were a part of what is called the working class. I always felt offset from the other kids in the neighborhood. My parents were not on drugs, which many other children’s parents were. My parents worked, and my parents invested a lot into my education. I enjoyed school and learning was fun for me. My sister and I always had nice material things, and therefore I was quite unaware of my social class status. Other kids in the neighborhood often called me “different” because I went to Catholic school and did not get into the drugs and gang activity in the community. I often felt they were right and chose not to try to fit in.

Many researchers write about the invisible privilege that comes with being white or being wealthy. My poorness was invisible to me because my violent community and overpriced clothes and shoes were assumed normal. I had protective factors as well. My grandmother was active in my life, and she valued the church. My family was pretty large, and we all supported one another in the community. But what happens to the “average” child who views these negative behaviors, mannerisms and culture as normal? These children usually repeat the behaviors as the only way they know to live. Having gone to the local Catholic elementary school, I was able to go to any Catholic high school in Chicago on a scholarship with my full tuition paid. Going to college was discussed from the day I entered high school. This was not the case with my friends who attended the local public schools. By the time I started high school, my parents had split up, and it was my mom, sister and I. Things were different then, being raised in a single-parent home. However, we maintained our “status” with our fashion. A couple of years later, my mom had another child — my brother, who is 16 years younger — and at that point, she became a single mother of three. However, our “status” as we knew it was maintained.

My mother chose an all-girls Catholic school as the high school of choice. This school was located in a middle-class suburban neighborhood not too far away from my public housing neighborhood. The girls at this school mostly lived in two-parent homes with married parents. Their parents usually were college-educated and owned their homes and vehicles. These young ladies had cars by their junior year of high school. Although I never really felt as though I completely fit in with the children in my neighborhood, there was something different about being around those girls. First, I enjoyed being there because they all accepted me for who I was — or maybe who they assumed I was? The girls said I didn’t act like I was from the projects, and they were quite surprised that I had been there my entire life. I remember one girl said, “Those girls are rough and loud, and you’re quiet and smart.” Other experiences at school included girls asking about the violence in the projects and stating how scary the projects were. Again, I was usually surprised by the feedback I received from others and was surprised that they had not experienced the same things.

So many people say that children who grow up in the “projects” are likely to drop out of school, fail or end up in negative life circumstances. Because none of these things happened to me, I must be the “exception” to that rule. I heard that a lot, and I started to dislike the fact that people viewed me as an exception because to me, what that meant was that they felt that I should have failed because of my socioeconomic status.

Currently as a doctoral candidate, I understand my experiences as being part of social mobility. My becoming educated had everything to do with me not wanting to live in the projects forever. I yearned for the nice things educated people seemed to have. Also, as my mother always said, I was smart, so it seemed inevitable for me. As a counseling intern working with very few minority students and going to predominately white institutions, I often wonder how many young, black girls could be sitting exactly where I am but are not. If only they had parents who, although they were not educated themselves, valued education and saw it as a “way out.” Maybe those girls lacked the motivation, or maybe they just simply lacked the availability of resources that I had received despite what the statistics say?

So, does that make me an exception? Most children in my neighborhood went to the local public school and then the military high school. Some individuals, even at my Catholic elementary school, did not take advantage of the free scholarship to private high school because of uniform, transportation and book costs.

Now, when I read an article that relates to social mobility and the price you pay for it, I think of myself. When I visit my old neighborhood, I am admired, yes, but I am also shunned. Somehow, I am not like everyone else because a majority of my childhood friends are still there. To say the very least, I am the only one I know pursuing a Ph.D. There were a few who went on to college and many who went back home. The point of clarification is that I lost a lot of people who I was close to because of my social mobility. I have other friends who I share more values and goals with. I live in an environment with low crime rates where I would not typically worry about gunshots or being robbed. You see, although I am very proud of my accomplishments, they came with a price. I am still me, and I always will be. However, apparently, I am a different sort of me. I have privilege that others do not share. My son goes to private school, he wears preppy clothes, he speaks proper English, he vacations with family — many of these things individuals from my community see as “acting white.” My son understands that education is valued. Fortunately, he will not have the same struggles that his dad and I once had. The funny part is that those struggles went mostly unnoticed by me. I thank my parents for protecting me from the violence in the neighborhood, for creating morals and values in our home, and for helping me gain respect for others and myself.

As a counselor and counselor educator-in-training, I oftentimes have to receive supervision to decrease the risk of countertransference when I work with young women who come from poor backgrounds. I develop a soft spot and have been told a few times that my sensitivity to my clients is genuine, almost as if I had experienced what they were going through. Maybe at times this was the case, but mostly I am humble. I am humble because I grew up with many “have-nots” and I’ve worked hard to “have.” I am humble because, despite the adversities I have faced, I am successful and my family is proud. I understand that there is pressure behind my successes; however, I am proud of me as well. I admire the first-generation college student who decided to come to counseling to work through her personal issues in order to maintain her academic success. So yes, there is sensitivity, and yes, it is genuine, and no, I will not apologize for that. It is what makes me a great counselor. My counseling textbooks did not discuss many of the experiences I’ve had myself as a counselor, but I have had many good supervisors to thank for helping me understand my emotion as it relates to my counseling.  So I appreciate the supervisors who have encouraged me through positive feedback on my clinical skills and have made me comfortable with my personable and sometimes non-traditional style of counseling.

Mashone Parker is a doctoral candidate in counselor education and supervision at the University of Iowa. She earned her master’s degree in clinical counseling from Eastern Illinois University. Her clinical background is in college counseling and counseling adults with developmental disabilities. She has been awarded the Dean’s Graduate Fellowship at her institution. Throughout her studies, she has developed a passion for researching best practices in career counseling and social justice for minority youth and social class issues in school settings. Parker serves on multiple committees relating to diversity across campus, such as the diversity committee and the Society of Black Graduate & Professional Students. She is committed to multicultural issues. Parker can be reached at mashone-parker@uiowa.edu.

ACA Midwest Region comes together at Leadership Institute and NCA Annual Conference

Heather Rudow October 15, 2012

More than 200 members from the 13 states making up the Midwest Region of the American Counseling Association convened in Council Bluffs, IA,
with the goal of promoting leadership and cooperation between branches of ACA as well as the association as a whole at the Midwest Leadership Institute and Nebraska Counseling Association Annual Conference.

The three-day conference, which ran from Oct. 3-5, promoted the word “synergy” and touted “Thinking out outside the box” as a catchphrase for up-and-coming leaders to remember.

During his keynote ACA President Bradley Erford discussed his involvement in ACA in the last 15 years, ranging from what he called “glamorous” chairing positions to “not-so-glamorous” ones. But throughout his speech Erford stressed to conference attendees – one-third of those being students – that all of them are capable of reaching the same level of leadership as him– so long as they have the desire to do so.

The key, he told attendees, “Is to have the attitude of servitude. Advocacy is not just a word. It is a way of life.”

Along with having presentations on leadership, session topics included addiction, gambling (the conference was held on Harrah’s casino), healthy communities and current trends in the counseling profession.

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