Tag Archives: Counselors Audience

Counselors Audience

ACA member’s passion for running evolves into something more for Alaskan inmates

Heather Rudow October 2, 2012

Tim Alderson, a member of ACA and the Alaska Counseling Association, turned his thesis paper into something more.

Tim Alderson, 37, has enjoyed running in marathons ever since high school. But he never thought he would be able to apply his hobby to an internship and graduate thesis paper at the Hiland Mountain Correctional Center, an all-female penitentiary in Eagle River, Alaska, and perhaps more surprisingly, eventually to a nonprofit organization.

“If you were to ask people who know me, I would be the last person to get caught up in something like this,” admits Alderson, a student member of the American Counseling Association and a member of the Alaska Counseling Association. “But sometimes the universe aligns and everything falls into the place. It’s really amazing when I think about it.”

In September 2011, Alderson read an article in Runner’s World about a group of volunteers in Topeka, Kan., who began a running club and held marathons for the female inmates at the Topeka Correctional Facility. The club, at least anecdotally, he says, seems to have had an extremely positive influence on inmates — especially on their mental health and behavior.

“I saw that article and a light bulb went off,” Alderson recalls.

Curious and inspired, he contacted the group, Running Free, and asked the volunteers how they got started. Alderson decided that for his thesis paper for Alaska Pacific University, where he was obtaining his master’s in counseling, he would copy the group’s profile and create a similar program. Then, he would quantify the impact of a structured running program on dimensions of prisoner mental health.

Alderson enrolled 25 inmates in the study in January of this year. He began by administrating questions from the World Health Organization Quality of Life Assessment Brief Form (WHOQOL-BREF), asking the women about their psychological health, their physical health, their environment and their social relationships. Then the women followed a 12-week running protocol for 5K races that was developed by the Furman University Institute of Running and Scientific Training and practiced within the confines of the penitentiary.

At the end of the 12 weeks, 21 of the 25 women had completed the entirety of the training. Two of the women who dropped out did so because they had been released from prison.

Alderson says the prison staff informed him that this retention rate was impressive in itself. However, his findings were equally inspiring:

  • The average improvement in 5K time among the inmates was 5:01 minutes.  One inmate even improved her time by 14 minutes, 58 seconds.
  • Inmates increased their mean scores on the WHOQOL-BREF by 21 percent from 77.52 to 94.1, consistent with what Alderson heard anecdotally during post-test interviews.
  • Four inmates self-reported discontinuation of their mental health medications.
  • Attendance over the 12-week program — a total of 36 workouts — was 89.9 percent.
  • Inmates lost a combined 46 pounds.

As a runner, Alderson says he intuitively expected to see some benefit when comparing the pre- and post-test scores.

“I thought running would be a way to bridge the gap for these women,” he says. “It’s three hours a week where they can just be thought of as runners and not as anything else.”

However, Alderson continues, “where it gets interesting is when you look at the individual domain scores for the WHOQOL-BREF.”

Alderson says he expected to see changes in the inmates’ psychological and physical scores, as those aspects are supported by research, but the changes he saw in the women’s social relationships and environment were more surprising.

Universally, the inmates reported a lack of close personal relationships during their pre-program interviews.  “Themes of mistrust, criminal thinking and fear were frequently cited as reasons for not forming close bonds with other inmates,” Alderson says.  “However, at follow-up, their tune had changed.”

The comments the inmates made to Alderson about growing closer and developing longstanding bonds with one another are “consistent with a statistically significant increase in the social relationship domain score on the WHOQOL-BREF,” he says.

Alderson says he could also tell from the way they started to spend time together as a group outside of workouts.  “You could often see them eating together and chatting in the common areas of the prison facility,” he says. “One staff member even told me that she had complaints from other inmates because the runners were always talking about their running.”

One added variable that Alderson didn’t expect was that the inmates would have to train through one of the harshest winters in Anchorage’s history, which required almost all of the runs to be held inside a gymnasium. During the inmates’ final 5k race, they had had to circle the gym 68.5 times.

But Alderson says he believes that, in some respects, the close quarters ended up being a positive. “It built cohesiveness in the group by being so close together,” he says.  “They really had to get to know each other and work out their differences.  It was one additional obstacle they had to overcome together, and there is value in that.”

When Alderson’s study and the 5k at the Hiland Mountain Correctional Facility were complete, he knew that the program had produced such positive results in the women that it had to continue.

So he created the nonprofit Running Free Alaska — 44 inmates are currently participating and preparing for a race on Oct. 6.  They train three days per week under the guidance of 12 volunteer coaches.  Through donations and a partnership with local running store, inmates are provided with appropriate running shoes, just as they were during Alderson’s study.

Running Free Alaska is the second program of its kind after the Topeka program, and it has since sprouted off others. A group in Colorado has said it is interested in using Alderson’s model, and Run Free Texas has recently launched its program.

Alderson says he can see why the model has caught on nationally.

“I think our program is elegant in its simplicity,” he says. “With nominal training and almost no cash outlay, this program can be added to the treatment milieu in all types of institutional settings. At the end of the day, we aren’t a social program nor a rehab program. At its heart, it’s a running program, run by runners for runners, for the express purpose of making better runners. All of the benefits we saw in the study from a rehab and mental health standpoint were really just byproducts of this running endeavor. I think that is incredibly liberating relative to some of the other treatment programs in the correctional system. By focusing on running, we don’t have to reconcile our own values with the crimes committed by the inmates. Our volunteers can think of the inmates solely as runners and not as a problem to be fixed. The accomplishment of completing a 5k gives [the runners] a sense of control that they can use in all aspects of their lives.”

For more information, visit facebook.com/RunningFreeAlaska

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

Seasons: They come, they go, they come again

Richard Yep October 1, 2012

Richard YepI like October. The weather here in the Washington metropolitan area begins to cool down after what normally has been a warm and humid summer, the leaves turn colors that I never saw growing up in California, and many of our members (as well as staff) begin to move into their academic-year routines and schedules. It is a wonderful time to reflect and think about where we are, what we plan to do and how we imagine our future.

The ACA staff now numbers 61 with the filling of positions in public policy, marketing, information technology, professional learning and our new Center for Counseling Practice, Policy and Research. I have been here for a long time, and I am not exaggerating when I say that this is one of the most professional, highly trained and dedicated staff teams we have had in our history. I am constantly impressed with their commitment to ACA and the profession. In addition, the new ideas and improvements they come up with in terms of serving our members are really quite remarkable.

As noted, I have been here for many years and have seen the good, the bad and the proverbial ugly. ACA is a complex organization, and as we strive to meet the 21st-century needs of our members, we have been compelled to look at our growth and development. In fact, I have challenged the staff this year to continue in their own professional development. We asked each staff member to obtain at least four hours of professional development last year. During the current fiscal year, we are committing to 40 hours of professional development for each staff member. Why? Because we can be better in our jobs only when we continue to develop ourselves as association managers and staff.

When I noted my longevity with ACA, I should have been more specific. It was October 1984 when I first entered ACA headquarters as a new employee. In those days, I had more hair (less of it gray) and might even have been called “slim.” Time changes many things. What has not changed is my interest and desire to work with staff to do the best we can for the counseling profession because we know how important your work is to millions of students, families, couples and adults, each and every day.

Looking back at those early days in the mid-1980s, I remember being the new kid and coming up with various “new ideas.” Rather than shooting those ideas down, my boss who hired me, Frank Burtnett, engaged me in discussion and helped me to build our government relations program. I have tried to emulate Frank’s style by supporting a whole new group of young and enthusiastic staff members who bring terrific ideas forward. I guess the process is cyclical, just like the seasons.

Speaking of Frank, he has just completed his “third” phase of being part of the ACA family. He first joined the association in 1964 as a graduate student. He next moved into a staff position in 1971, rising to associate executive director before leaving in 1984. And for the past seven years, he has served as the editor of ACAeNews, building the project from one to five unique electronic publications for our members. Although he just retired from that role, we are looking forward to celebrating his 50th year of ACA membership in the not-too-distant future. My personal gratitude goes to Frank for his support through the years and for his dedication to ACA and the profession.

As always, I look forward to your comments, questions and thoughts. Feel free to contact me at 800.347.6647 ext. 231 or via email at ryep@counseling.org. You can also follow me on Twitter: @RichYep.

Be well.

Addressing challenging behaviors for individuals with autism spectrum disorders

Chris Mann Sullivan

As of this past February, the Centers for Disease Control and Prevention continued to estimate that the rate of autism in the United States was on average one in every 110 children. “Challenging behaviors” is a broad term generally used to refer to any behavior that is a barrier to an individual achieving a specific outcome or goal. For an individual with autism, an outcome or goal might be as broad as inclusion in a general education classroom or as specific as walking independently from the car to the front door of a residential setting.

Individuals with autism may exhibit a range of challenging behaviors. These may include aggressive behavior toward others such as hitting or biting, self-injurious behaviors such as head banging or eating dirt, noncompliance such as throwing oneself on the floor or screaming during a class activity, and property destruction such as punching windows or breaking educational materials. Other common behaviors include spitting, nose picking, repetitive reciting of lines from movies or TV shows, obsessions with specific topics such as trains or animals, and restricted food preferences. Self-stimulatory actions or “stims” may also become challenging behaviors if they serve as barriers to reaching the desired goals for the individual. Stims include but are by no means limited to hand flapping, rocking, toe running, head shaking and teeth grinding.

A challenge for community and school counselors

Community and school counselors are often called on to address the challenging behaviors of individuals with autism despite having little to no training in this area. With a major push in the field to focus on “proven” therapies for this population, the National Standards Project, a primary initiative of the National Autism Center, addressed the need for evidence-based practice guidelines for autism spectrum disorders (ASDs) by reviewing the available research regarding treatments currently being used. The National Standards Project sought, among other things, to “provide the strength of evidence supporting educational and behavioral treatments that target the core characteristics of these neurological disorders.”

Various treatments were rated as:

  • Established: Sufficient evidence is available to confidently determine that a treatment produces favorable outcomes for individuals on the autism spectrum and is thus effective.
  • Emerging: Although one or more studies suggest that a treatment produces favorable outcomes for individuals with ASDs, additional high-quality studies must consistently show this outcome before drawing firm conclusions about treatment effectiveness.
  • Unestablished: There is little or no evidence to draw firm conclusions about treatment effectiveness with individuals with ASDs.
  • Ineffective/harmful: Sufficient evidence is available to determine that a treatment is ineffective or harmful for individuals.

According to the report, “Approximately two-thirds of the established treatments were developed exclusively from the behavioral literature (e.g., applied behavior analysis, behavioral psychology, and positive behavioral supports). Of the remaining one-third, 75% represented treatments for which research support comes predominantly from the behavioral literature.”

The utilization of behavior therapy is often a very small part of counselor training programs. Based on the proven effectiveness of this type of treatment, teaching counselors how to apply basic behavioral principles with this population and their families is important. This knowledge is absolutely imperative for a counselor practicing in a rural area where the availability of specialists in the field of applied behavior analysis is limited or nonexistent. For a comprehensive overview of treatment interventions, counselors can download a copy of the National Standards Project report at nationalautismcenter.org.

Respecting individual needs and unique paradigms

In professional and popular literature, individuals with “classic” autism and other ASDs such as pervasive developmental disorder or Asperger’s disorder may be divided into distinctly different population categories. Thus, it is important when reading published literature to understand clearly the population to which the authors are referring. For the purpose of simplicity, in this article, individuals diagnosed with autism will be included under the umbrella of ASDs.

Individuals with ASDs demonstrate a wide range of symptomology depending on which areas of the brain have been affected. Distinct differences also exist depending on whether the onset of symptoms was apparent from birth or regressive in nature. Thus, counselors at intake should gather information related to the client and the family’s interpretation of the diagnosis and future prognosis.

Autism does not discriminate on the basis of factors such as race, ethnicity, socioeconomic status, religion, culture or age, although “pocket” locations where increased diagnoses are reported do exist. Behavioral strategies must be developed and implemented based on the individual’s needs in the context of his or her unique paradigm.

For example, while working with a family that recently had relocated from India, our team of practitioners initially neglected the importance of taking the experimental research and applied behavioral instruction and making it “translational” by accounting for the other contextual factors not necessarily included in a functional behavioral analysis. The behavior therapists initially perceived this particular family to be noncompliant with treatment. Upon further investigation, however, we discovered that in the family’s culture, the norm was for “children to be children.” This meant behaviors that the majority culture might consider unacceptable, such as climbing on the couch or eating while running around instead of at the table, were expected and even relished as “good” behaviors typical of children in their culture. We adjusted our behavioral goals to take into account the family’s paradigm, and we achieved the projected success rates for behavioral change.

A significant body of research also shows that the rate of divorce is higher among parents of children with autism than among parents of children with disabilities such as Down syndrome or parents of typically developing children. Therefore, marital status often plays a role both in developing behavior plans and in implementation of effective techniques in terms of logistic concerns and the level of support a parent or guardian might need to follow through successfully.

There is also the controversial issue of whether individuals with autism constitute their own culture and should be treated accordingly rather than being the focus of efforts that try to “fix” their behaviors to fit in with the norms of the majority (non-autistic) culture. Depending on the upcoming revisions to the Diagnostic and Statistical Manual of Mental Disorders, much more may be written about this specific topic.

Before developing a behavioral intervention, counselors should check with clients and their families regarding which behaviors they see as important to achieving the overall goals. For example, although the majority culture perceives the issue of peer interaction as critical, some higher-functioning clients with ASDs may not want to engage in more social behaviors. They may want to focus on treatment to reduce symptoms related to anxiety in public places rather than on appropriate socialization in those settings. The key is working as a team to decide which changes in behavior would produce the most significant perceived change for clients and their families.

Assessing the function of a behavior

The objective assessment of the function of a behavior prior to treatment is imperative to ensure ethical treatment. This can be challenging because clients with ASDs have inherent difficulties stating their needs, either because they are nonverbal or lack effective conversational skills. Although the family or other caregivers can provide subjective guesses as to why a particular behavior is occurring, it is important for counselors to collect some baseline data and to conduct some important rule-outs.

After the initial intake and preliminary goal setting, counselors should clearly define the behavior and gather some basic data to determine factors such as function and frequency. Clearly defining a behavior, or set of behaviors, means taking the initial descriptions from the client, family, caregivers or other professionals and then writing out the targeted behavior so that all parties agree. For example, a parent or teacher might commonly define a behavior as a “tantrum” or a “fit.” It is important to determine the specific behaviors being targeted because a tantrum for one person might involve screaming and throwing himself or herself to the ground; for another individual, it might mean stomping his or her feet and throwing items while crying.

Terms such as baseline data and functional analysis are outside the repertoire of many counselors, but they are important skills to acquire. Taking some basic preliminary data (for example, how many behaviors occurred per day prior to starting the intervention?) and subsequently following up with post-treatment data (how many behaviors occurred per day after two weeks of continuous treatment?) provides counselors with documentation regarding whether the treatment they recommended or implemented for measurable behaviors is resulting in the desired change.

In the field of behavior analysis, it is generally agreed upon that all challenging behaviors have some basic functions. These include escape or avoidance, access to a tangible item or activity, attention from others or self-stimulation. To determine the function of a behavior, counselors can teach parents or staff to take “ABC” data. In the most simplistic terms, this involves writing down the antecedent (what happened before the behavior), the behavior (exactly what happened) and the consequence (what happened after the behavior). This information will drive your treatment.

For example, if Bob engages in screaming and throwing things when brought to the table for breakfast and a staff member stops the behavior by immediately giving Bob attention (talking to him or hugging him), Bob may have paired screaming and throwing things as ways to get positive attention from staff. So, the function of screaming becomes to gain attention. The treatment might be to ignore the screaming and teach Bob to request a hug either by pointing to a picture or signing/saying “hug.”

If, on the other hand, you take data and discover that after Bob engages in screaming and throwing things, a staff member removes the food from the table and brings him something else to eat, then the function of the behavior is to gain access to a tangible item (in this case, a preferred food item). So, the treatment might be to offer Bob choices prior to coming to the table. If he still engages in screaming and throwing things when preferred food is not available, you might ignore these actions and teach Bob to say or sign that he wanted mac and cheese or point to a corresponding picture. This teaches Bob that indicating what he wants gets him the preferred food, while screaming and throwing things does not.

In a third scenario, Bob screams and throws things at the table after eating when he hears the announcement “Time to clean up.” A staff member removes Bob and takes him back to his room to play video games and calm down. The function of Bob’s behavior may be to escape the task of having to clean up. In this case, he also receives the positive reinforcement of getting to play his video games. The treatment might be to teach Bob, at a time not paired with meals, how to perform the expected cleaning duties (take his plate to the sink, put his glass in the dishwasher, wipe his mouth, wash his hands and so on). Giving Bob access to his favorite video games can heavily reinforce this good cleaning behavior and the absence of screaming and throwing things. For example, for every two minutes of cleaning, Bob earns 15 minutes of playing his favorite video game. When he screams and throws things, the video games go away.

In each of the scenarios, Bob’s challenging behavior was the same, but it functioned in three different ways: gaining attention, gaining access to something tangible and escaping from a demand.

After you have collected your baseline data and before beginning treatment, it is also advisable to consider reviewing the least restrictive treatment strategies for addressing challenging behaviors. These might include a medical rule-out for a coexisting condition. For example, a child might not be crying and hitting during music class because he doesn’t like the music but rather because he has developed an ear infection and the frequency and confined space hurt him. Similarly, a young girl with autism who has been toilet trained for a long time begins having accidents when she is in class. She might not be trying to escape classwork but rather has a urinary tract infection.

Conclusion

In summary, providing effective treatment for challenging behaviors for individuals with ASDs begins by conducting a comprehensive intake that includes looking at contextual variables, collecting baseline data and ruling out any coexisting conditions such as an illness, side effect from medicine or seizure activity. Next design a treatment and communicate it clearly to your client, the client’s family or caregivers, and other staff. Then collect data to ensure that the targeted behaviors are being significantly affected by the treatment that has been implemented. Finally, revise the treatment, if necessary, on the basis of the data you collected.

Working with individuals with ASDs to develop effective treatment is as varied as working with any other counseling population. But for many of us, the outcomes produced are worth the little bit of extra effort required.

 

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“Knowledge Share” articles are based on sessions presented at ACA Conferences.

Chris Mann Sullivan, a licensed professional counselor and Board Certified Behavior Analyst, has more than 18 years of experience working directly with adults and children with autism and related disorders. In addition to her work in public schools and community agencies, she served as a program director for a private day school for children with autism spectrum disorders. She has also worked on teams conducting research studies related to families and autism. She trains and presents nationally and internationally. Contact her at dr.csullivan@ymail.com.

Letters to the editor: ct@counseling.org

Simple therapeutic interventions for rewiring the maladaptive brain

By Nicholette Leanza

When taking my undergraduate and graduate classes many moons ago, my least favorite courses were Biopsychology and Cognitive Processes, during which our professors would lecture at great length about the structure and function of the brain. As a student embarking on a new career in mental health, I was aware I needed to know this important information, but I just couldn’t get into it. So, I skipped along in my career, content to understand the basics of the traumabrain without really applying this knowledge in any useful manner.

But a few years ago, while researching ways to keep my counseling techniques fresh, I came across several articles that covered the most recent discoveries in neuroscience. That research ignited my current love affair with the most complex organ in the universe — the human brain — and helped me to understand how people really change their behaviors.

Let’s take a moment and ponder that question: What really causes an individual to change his or her behavior? You might answer that question in many ways depending on your theoretical perspective and on your specific observations and experiences dissecting human behavior. Regardless of how you answer, one fact is that change must first occur at the neurological level before we will see it at the behavioral level.

Understanding the biology of the human brain can also assist clinicians with understanding how and why people change. Clinicians are successful at their craft when they can produce a physical change in their clients’ brains. Obviously, they cannot get inside and rewire a brain, but they can set up conditions that favor this rewiring and create an environment that nurtures it (see The Art of Changing the Brain by James E. Zull). This article will explore how individuals change their behavior neurologically and examine some therapeutic techniques to stimulate this fascinating process.

Neural networks

The human brain is constructed of a vast amount of neural networks that form every thought or experience people have in their lives. Neuroscientists have found that these networks are interconnected as an intricate web of memories, thoughts and experiences. Hearing a special song can kick-start a flurry of recollections; a particular scent can guide an individual toward a memory of a particular person or place. This phenomenon indicates how the brain is circuited for memory.

For example, take the word teacher. Each person has a specific neural net that was created on the basis of experiences with the various teachers in his or her life. Another way to look at this is as a type of associative memory. Thoughts, ideas and feelings are constructed and interconnected in a neural net that may also have a potential relationship with another network of neurons. So, mention the word teacher, and one individual may automatically picture her lovely fifth-grade teacher, while another person might think of his difficult college math instructor.

Feelings and emotions are also entangled within neural networks. For example, the word love is stored in a vast neural net that is based on an individual’s experience with that term. Subsequently, the concept of love is also created from many other ideas. For some people, love may be connected to the memory of disappointment, pain or anger. Anger may be linked to hurt, which may be linked to a specific person, which then is connected back to love (for more on this, see What the Bleep Do We Know!? by William Arntz, Betsy Chasse and Mark Vicente). Therefore, when a person thinks of “love,” she may remember the person who broke her heart and still be angry about it. In essence, the enormous number of neural nets that each human possesses color all of his or her perceptions and interactions with other people.

Neurocounseling

Insights in the field of neuroscience reveal that many emotional and behavioral disorders previously believed to be the product of environment or experiences can be rooted in neurobiology. This is what synchronizes us to the idea of “neurocounseling,” the term I use to describe therapeutic interventions that assist people in changing their maladaptive neural connections. Other terms that also describe these types of techniques are “brain-based therapy” (John B. Arden and Lloyd Linford) and “neural pathway restructuring” (Debra Fentress).

When one thinks of his or her life experiences, what is being contemplated is really the experience of that person’s neurons. The experience cannot be predicted because it comes from the complex and random events of one’s life, and it cannot be programmed. Counselors strive for their clients to understand their maladaptive behaviors, and this is accomplished through the changing of the individual’s neural connections. Unless some change in these connections takes place, no progress or understanding will occur.

One important note is that counselors cannot remove specific neural nets that already have been established in a person’s brain. According to Zull, these nets actually leave a physical imprint on the brain. Instead, counselors must let clients use the neural nets they have already built — and which are related to clients’ own life experiences — and then use those as the foundation for motivating new neural nets to blossom. This is the only way a person learns new information and changes his or her behavior.

People must be able to relate to something before they can understand it, which is why the set neural nets are so important. If no established net exists, the individual has no reference point to understand or to change. Counselors may wish for clients to have more positive connections that cradle their self-esteem in the specific neural networks or fewer connections when it comes to their addiction to gambling, but unless some change takes place in these connections, no progress or change in behavior will occur.

Changing neural networks

The first step to facilitating change in neural nets is to identify them. One way to figure this out is simply to have clients talk about previous life experiences. The counselor’s job is merely to listen and pay attention to what clients say about themselves. Even in the first therapy session, as we build rapport and gather information about the client’s history, we can begin to identify his or her neural networks. By asking numerous questions, we generally get a feel for the individual’s overall issues such as difficulty trusting others, low self-esteem or poor anger control. As we identify the client’s established neural networks, we also can begin to work within the realm of the client’s experiences.

Identifying a client’s neural networks and inspiring a physical change in the client’s brain involves seeing counseling in a different light, which can likewise encourage new counseling techniques. Remembering how personal and individual a person’s neural nets can be allows counselors to experiment in different sensory avenues such as art therapy, music, therapeutic stories, psychodrama and other creative techniques. Each of these avenues can help facilitate the process of engagement and provide interesting ways to stimulate the senses. This type of sensory input will engage the networks to be active and open to learning new information. Neurons that are repeatedly used grow stronger. The more these neurons fire, the more they send out new branches looking for fresh and useful connections. Neural networks are also flexible, meaning new experiences can be added to old ones and old ones can be blended with the new. As new and different networks fire, the brain will form new connections and will physically begin to change.

One of the best approaches good clinicians can take is to help clients feel they are in control. One way to do this is to allow clients to draw from their own experiences. Clients often come to therapy with some positive networks already established, and once those networks are understood, clinicians can build on them. As previously mentioned, engaging clients’ senses through creative therapeutic techniques can be helpful in stimulating their interest in therapy and in generating new neural networks. Furthermore, cognitive behavior techniques such as “thought stopping” and “thought replacement” can be useful in creating the framework for new nets. When fresh neural nets bloom because of an insight gained into a situation or a behavior, the counselor can be assured that the client is on the path to healing.

Case example

I recently worked with a client who was referred with issues of anger and depression. She struggled with controlling her temper and often would have outbursts of anger toward others at her job, at home and at school. She also had a tendency to become easily frustrated. In gathering information about her background and experiences, I deduced that many of her neural networks were dedicated to anger over the physical and emotional abuse her mother had perpetrated on her as a child. As I began to understand her realm of experiences and relate them to the biology of her brain, I recognized that her brain was essentially wired for anger.

During one of our initial sessions, this client shared that her mother had also been a victim of physical and emotional abuse as a child. Because the client already had an established net for what it was like to be abused, I was able to guide her toward the insight that her mother was also most likely struggling with anger and depression stemming from her own abuse issues. The client was able to identify this insight because of her already established neural net and was able to begin to work on seeing her mother from a different perspective. She blended her old neural net — anger toward her mother — with a new neural net of being able to empathize with her mother.

Because networks grow stronger the more they are used, I knew it was important to keep the client seeing things from a new perspective. Building on the foundation of several important insights, I was able to help the client continue to change her thinking and reactions toward her mother, which in turn led to a decrease in her own anger. The biological change of her neurons directed the change in her thoughts, which ultimately changed the wiring in her brain. My role was to help her identify the neural net maintaining her anger, assist her to build a new neural net based on insight and empathy, help her to continually reinforce this healthier neural net and then help her to make the net stronger through use and application.

Conclusion

Teaming the fields of counseling and neuroscience demonstrates how these two disciplines can enhance each other. The human brain is a learning organ, and by exploring the biology of the brain, mental health professionals and neuroscientists can discover new and innovative approaches for the advancement of both fields. Mental health professionals who understand the biology of the brain will find it a valuable asset in also understanding how change occurs in human behavior. The practice of identifying established neural networks and then building on them to form positive connections will lead clients to change their maladaptive behaviors. In essence, a person’s neural nets are the building blocks that construct their thoughts, which ultimately create their reality and perceptions.

To increase the likelihood that new connections will form, it is important to work with clients’ current established neural nets, which will enable clients to gain greater insight into themselves or their situations. Therapy techniques that engage the sensory brain are often helpful in facilitating the neural creation process. Furthermore, cognitive behavior techniques can help clients use more effective and adaptive networks.

As neuroscience continues to unlock the mysteries of the human brain, it is imperative that mental health professionals pay attention to these revelations so that a more thorough understanding of the secrets to human behavior can be discovered.

 

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Nicholette Leanza is a supervising professional clinical counselor and licensed psychotherapist with substantial experience working with children, adolescents and adults in a variety of treatment settings. She works as an adjunct instructor of psychology and sociology at the University of Phoenix, Cleveland Campus. Contact her at nleanza1@gmail.com.

Letters to the editor: ct@counseling.org

Ch-ch-ch-changes: Leading by example

Bradley T. Erford

I wish you all had attended the Institute for Leadership Training in our nation’s capital in late July. The institute is a gathering of current and emerging leaders from ACA divisions and state branches. We learned. We laughed. We charged up Capitol Hill to advocate for veterans, seasoned citizens, school-aged youth, counselors and the diverse clients we serve. We were inspired to lead and to promote positive changes in the increasingly complex world that our clients, colleagues and citizens are navigating.

What made this event special for me was the keynote address, “Countdown to Teamwork,” presented by Col. Mike Mullane, a retired astronaut who flew several space shuttle missions and has used his experiences in the Air Force and NASA to bring a powerful message about how to function as a high-performing individual and a higher-performing team.Col. Mullane came from very humble beginnings and was driven to space exploration in spite of many limitations, including persistent nausea and subpar vision that resigned him to the second seat in fighter aircraft. None of this dissuaded him from his ultimate goal of becoming an astronaut.

Col. Mullane showed us pictures from his high school yearbook. He was not an athlete, he was not a scholar, and he was not popular — in fact, only one other student signed his yearbook. By his own report, he was the wiry little geek shooting off model rockets in the desert. Still, his presence in our meeting room was larger than life, his effervescent spirit vibrant and enthusiastic. And his effect on the 140-plus participants was palpable. He received a standing ovation not only at the end of his presentation (at which time he left the institute), but also the next day and the day after that — even though he was no longer in the building!

To be sure, it helped immensely that Col. Mullane had the spiffiest multimedia presentation I have ever witnessed — full of humorous, poignant and, yes, tragic video footage and pictures from the NASA archives. But it was his developmental story that fascinated me, how he focused like a laser on his goal and persevered through numerous hardships and challenges to transition and change into an American hero.

As I sat enthralled by this presentation, the indefatigable David Bowie started playing in my head, reminding me that we all experience challenges and hardships as we grow and develop; that we all experience normative and nonnormative transitions and ch-ch-ch-changes. But many people do not have supportive adult and peer influences, or they are held to disadvantages because of various inequitable societal “isms.”

Col. Mullane highlighted two main roadblocks to success. Too often, we tolerate the “normalization of deviance.” For example, in the case of the Challenger disaster, the O-rings had failed to perform within tolerable limits on several previous flights, and numerous warnings were issued that these failures could have disastrous consequences. But nothing bad happened on those previous flights, so the deviation became the norm. “If we got away with it once, we can get away with it again” … until a tragic disaster occurred.

We sometimes normalize deviance in our daily lives. We might turn a blind eye to others who are experiencing unfair treatment and are in need of an advocate. As counselors, we see that our clients and students often normalize deviance by habituating to unhealthy thoughts and behaviors. My colleague, Lynn Linde, once overheard a student express this observation quite succinctly: “I am comfortable in my misery.” The unusual is experienced over and over and soon becomes the “new normal.”

The second roadblock Col. Mullane discussed was the failure of individuals to take personal responsibility. He told us that his plane crashed the first time he went up in a fighter. He was brand new, and the pilot he was with had a thousand hours of experience. So when the pilot said, “Let’s get that last target,” even though it would take them past their safe return zone, Mullane deferred to the experienced commander. Instead of saying, “But we’re running low on fuel!” he responded, “Sure.” He and the pilot ran out of fuel just short of the runway and crashed.

The lesson Col. Mullane was sharing was clear, and we have seen the related quote from Edmund Burke a hundred times: “All that is necessary for evil to prevail is for good [people] to do nothing.” Opportunities for us to take personal responsibility, to “walk the walk,” occur every day. So as we infuse empathy, compassion and the desire to be a team player into our work, families and relationships, please continue to ask two critically important questions:

  • Did we take personal responsibility for our actions?
  • Did we point out that deviations from excellence are occurring and that the inevitable result of these deviations is a growing tolerance of actions that do not represent excellence?

After all, ch-ch-ch-change is inevitable … but growth is optional!