Tag Archives: Counselors Audience

Counselors Audience

What will YOU make of YOUR ACA?

Richard Yep January 1, 2013

Richard YepIn last month’s column, I said that although our official recognition of ACA’s 60th anniversary was coming to a close, the celebration would continue. This celebration includes how we will be honoring you, our members. You are the ones, along with those who came before you, who have made ACA the world’s largest organization exclusively dedicated to the many diverse facets of professional counseling. We also want to add to our ACA family by bringing to the table graduate students and other professional counselors, academics and researchers who have yet to add “ACA Member” to their résumés.

For months, I have been alluding to new products and services that the staff and I have been working on to benefit you, our members. In the latter half of January, I would call your attention to the new ACA website at counseling.org, which I can assure you is much more than “just another pretty website.” The new functionality and resources you will be able to access truly take us to a whole different dimension in terms of online capabilities.

Another example of a new product is the ACA webinar series. For those who were part of our inaugural year of providing this service, I want to thank you for helping us go far beyond our expectations. We had hoped for 50-75 attendees at each of these online workshops. You and your colleagues responded with 100, 300, even 700 participants at various sessions!

We all know that ACA is more than just workshops and websites, however. Members have a connection with ACA for other reasons as well.

Through the years, I have heard ACA described in many ways. Some remember the “old” ACA and how it brought together four unique counseling organizations to form a better, stronger, more unified entity that would advocate on behalf of the profession. Others have expressed appreciation for our ability to find a way to include professional liability insurance for our master’s-level student members at no additional cost to the students. Some have acknowledged our efforts to build a strong grass-roots movement that can educate public policymakers about professional counselors. And, of course, there are those who think ACA isn’t doing enough for the profession, including some who see us as nothing more than a “slick marketing organization.”

If nothing else, I am always assured that our members are willing to voice their thoughts, appreciation and criticism of ACA. I can’t say that I always agree with each opinion, but this open dialogue lets me know that members feel this really is their organization. During my almost 25 years with ACA, I have tried to practice with the mindset that this has never been “my” organization. Rather, I serve as a steward of the professional aspirations and interests of our members. My job — and that of our very talented and committed staff — is to fulfill the professional needs of those who are ACA members, leaders and volunteers.

I encourage you to maximize your “ACA experience” as a volunteer, a leader or a participant in some type of ACA activity. I believe it is our members’ diversity of opinion and thought that has helped us to build a better, stronger and more vibrant organization.

Looking forward, what can you expect to read in this column over the next several months? I hope to go into more depth about those who have made an impact on the profession and ACA. However, I also want to share stories about those who are “up and coming” — individuals who are likely to be written about several years from now by some future ACA executive director because they have had an impact on 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 e-mail at ryep@counseling.org. You can also follow me on Twitter: @RichYep.

Be well.

School-based mental health services: What can the partnership look like?

By Christina Baker

Three years ago, I was asked to leave my position as a therapist and take a leadership role as a supervisor of school-based mental health services. At the time, I was seeing a small caseload of children at their school because of problem behaviors in their classroom environment. When I accepted the role, I had no idea how expansive and demanding school-based services would become. I quickly learned a new branch of treatment was developing: clinical intervention provided in an environment where children often struggle the most, and consultation and support for educators to increase awareness on the effects of childhood mental health in the schools.

As funding dollars and financial resources diminish, an increased need exists for partnerships and collaborative efforts between mental health professionals and community resources. One such example is the partnership that has been cultivated between public school systems and deskcommunity mental health agencies. New programming has developed in the form of school-based mental health service teams. These teams are formulated as an extension of outpatient services, provided to the child and family within the school environment through individual and family therapy, case management and access to psychiatric services. Providing mental health services in the community encourages systems to work in collaboration to address the complex issues and diagnoses that we see in child and adolescent mental health.

The necessity for additional support, training, consultation and clinical intervention within the academic environment has grown as school funding shortfalls have reduced the number of school counselors, school social workers and school psychologists available to address the emotional and behavioral needs of school-age children. Economic difficulties, lack of transportation and the growing need for two-income households has increased the rate of noncompliance to appointments in the office setting. However, in my experience, it is relatively easy for many parents to walk to or secure a ride to their child’s school. To this end, mental health agencies are finding that meeting the client in the comfort of his or her environment — home or school — leads to greater success in maintaining consistent clinical contact and achieving greater outcomes.

On average, children spend six to eight hours per day in an academic setting for at least nine months a year. Academic personnel, who are already faced with limited time and resources, experience the effects of routinely working with children who have externalizing and internalizing behaviors of varying frequency and intensity and who may have diagnoses such as oppositional defiant disorder, anxiety disorder, depression and posttraumatic stress. This could result in increased suspensions and expulsions for students and higher rates of burnout among educators. The school-based mental health model is a collaborative approach that brings clinical knowledge and services to the child and consultation, training and intervention support to educators.

Success within the collaborative approach

Several well-known school-based support models have been developed across the country through the advocacy efforts of local school systems and community mental health agencies. The Baltimore City Public Schools’ expanded school mental health program provides a framework for the most common design for school mental health programming. Baltimore city schools invited the inclusion of comprehensive mental health services such as individual, family and group therapy, and consultation and assessment services into their building through a partnership with community mental health providers.

Similarly, the Charlotte-Mecklenburg public school system in Charlotte, N.C., partnered with Behavioral Health Centers, a division of the Carolinas HealthCare System. Through this cooperative process, mental health services were provided to 24 public elementary schools.

The Salt Lake City public school system partnered with Valley Mental Health, a behavioral health care provider, to develop a treatment program that is similar to off-site day treatment programs. The program was designed to increase inclusion and support within the school environment for children with serious emotional disturbances. The integration of services within the public school setting reduces the risk of stigma for the child, while providing treatment and effective coping mechanisms in the least restrictive natural environment.

What diagnoses are schools seeing?

In 2011, Kathleen Ries Merikangas and colleagues published statistics on the utilization of services for adolescents with mental health disorders in the United States in the Journal of the American Academy of Child & Adolescent Psychiatry. They found the prevalence of childhood mental health issues in the United States estimated to be as high as 20 percent of all children. For a variety of reasons — financial, environmental, personal and cultural — underserved children were not receiving needed services an alarming 75-80 percent of the time. Considering the disparity between children identified for services and children who actually receive services, providing care in a natural environment such as a school could dramatically increase the number of children who receive therapeutic support.

At the elementary and middle school levels (ages 5-12), Merikangas and colleagues found that among children who received mental health services, 60 percent were diagnosed with attention-deficit/hyperactivity disorder, while one in every eight children experienced some form of anxiety, with the median onset occurring at age 6. Anxiety in young children is often manifested in behaviors such as fidgeting, distraction, poor concentration and irritability. These symptoms mirror those of attention deficit and can be difficult for educators to tease out without further assessment and training.

In 2010, the National Institutes of Health (NIH) reported that anxiety-related disorders are most common at the high school level (ages 13-18). The Centers for Disease Control and Prevention’s 2005 Youth Risk Behavior Survey reported that 6 percent of students missed school due to anxiety related to feeling unsafe either at or on the way to school. The NIH says incidents of depression are also highly prevalent at this age, with eight of every 100 adolescents experiencing symptoms such as a drop in grades, social isolation, diminished interest in activities of previous enjoyment and change in eating or sleeping patterns. According to the National Alliance on Mental Illness, mental health issues during adolescence contribute to more than half of all instances of students dropping out at the high school level. During their high school years, it is critical that adolescents are linked to additional therapeutic support, including external service providers and programs that can increase their sense of self. Teaching educators and administrators about early identification and increasing their knowledge of community resources can be critical to a student’s success in treatment.

During the 2010-2011 school year, outcomes from the school-based program at my agency (N = 359) found the most common diagnoses for children enrolled were posttraumatic stress disorder, major depression (single episode), dysthymic disorder and attention deficit disorder. During the past two years, we have seen dramatic results in reducing anxiety and increasing resilience among children by teaching educators about early warning signs and the identification of hypervigilance versus hyperactivity, as well as providing educators with classroom management techniques.

By working in collaboration with the schools, treatment providers can reach those children and families who may not otherwise feel they have a trusting adult to advocate for them. Parents often view teachers, school counselors or principals as advocates for the best interests of their children and will trust these professionals’ opinion if they say additional supports may be needed. Community clinicians can assist with bridging the gap between the schools and external resources through services such as case management, mentor programs, wraparound services and psychiatric consultation.

Program development: What is needed

A population to serve: The development of a successful program depends on a model that meets the needs of the clients it serves. The school-based mental health program I have been developing for the past three years is located in Butler County, Ohio. Butler County is a mix of urban and rural living outside of Cincinnati; school-age children and adolescents make up 24.7 percent of the population, and the median household income is $53,543. The population our agency serves is Medicaid eligible, and we receive reimbursement through a combination of Medicaid and subsidy dollars from the local mental health board.

Since the development of this program, we have seen tremendous growth. In 2008, our agency supported the need for therapy in six schools. In 2012, our school-based program supported the need for services in almost 40 schools in Butler County. Currently, we serve 300 children in eight public school systems through a delicate marriage of collaboration, community, advocacy and education about mental health services in the school environment. The needs of the clients we serve support a model designed to include therapists, case managers, psychiatrists, trainers and consultants.

I would argue that aligning with the community has increased the trust level for our agency’s services among the families we serve. I also believe our agency’s ability to educate and train educators on the importance of addressing mental health concerns has provided them with new insights concerning what they see in their classrooms each day.

A referral process:

Each school we serve has an identified referral person such as the school counselor or school psychologist. This person has the necessary knowledge of the signs and symptoms needed to support an appropriate referral. Once the referral is made (with consent from the child’s parent or guardian), our centralized intake department meets the parent or guardian and child in the school to complete the diagnostic assessment. The school staff is supportive of our need for a confidential space to assess and treat the children they refer, oftentimes offering staff offices if needed. Therapist caseloads and placements are based on the number of referrals received from each school and can vary from one to five days per week. Once treatment begins, therapists work with individual children in a confidential office space and coordinate with teachers to pull children for therapy only during “specials” (for example, gym, music or art) or nonacademic time. Part of the process includes monthly family therapy sessions in an effort to provide continuity of care across environments. The therapist, case managers and school staff work to assist parents with transportation to the school. We have had principals and school psychologists pick parents up and bring them to appointments if needed.

 A collaborative effort: “Turf wars” between community therapists and school counselors have not been a reality in our county. Unfortunately, the need for individual and specialized treatment among our county’s students is greater than the time and resources our school counselors have available to them. Our school counselors are deeply invested in the success of the children referred and work with our therapists to provide a link between the child and the classroom, as well as additional support for the child and parent. When they are not on the school property, our therapists look to the school counselors for updates on behavior, grades and successful interventions. The counselors with whom we work often ask us for consultations when needed or to recommend behavioral goals for students’ individualized education plans. Collectively, our approach is that the more supportive services we can provide to children and their families, the greater the outcomes will be.

Program development to meet the needs of the community: Unlike previously established programs, our program continuum provides training and consultation to educators and administrators on identified mental health topics. An annual summer institute designed for educators is geared toward continuing education on intervention strategies, classroom management and psychotropic medications. Additionally, clinicians meet with their school treatment teams monthly to debrief on progress, strengths of the child, changes in behavior and how to carry over successful interventions from the office to the classroom environment. My staff also attends weekly training sessions focused on trauma- and anxiety-related interventions in an effort to clinically address the needs of the students receiving the most frequently occurring diagnoses.

The growth and success of our model is based on the clinical care we provide and the belief that it takes a systemic effort to create lasting change. Clinical progress would not be possible without building a trusting and lasting relationship with the clients and the community we serve, and this has been made easier by the successful collaboration between our schools and community mental health.



Christina Baker, a professional clinical counselor supervisor, is the school-based services coordinator at St. Aloysius in Cincinnati and a doctoral student in counselor education at the University of Cincinnati. Contact her at chrissy.phibbs@gmail.com.

Letters to the editor: ct@counseling.org

Q&A: Empathy fatigue

Lynne Shallcross

MarkFor counselors, self-care is an ongoing and necessary endeavor in order not only to maintain their own wellness but also to provide the best care possible to clients. A feature story in the January issue of Counseling Today addresses exactly this topic — click here to read “Who’s taking care of Superman?”

As an online exclusive sidebar to the feature story, Counseling Today explores empathy fatigue, one of the handful of fatigue syndromes that can have a detrimental impact on counselor wellness. Mark Stebnicki, a professor in the Department of Addictions and Rehabilitation at East Carolina University who has been researching, writing about and presenting on empathy fatigue for more than a decade, talks about where empathy fatigue comes from and what counselors can do about it.

What is empathy fatigue and why can it happen to counselors?

Empathy fatigue is a phrase I coined and concept I posed in various articles and books I have written after being a member of the crisis response team in the aftermath of the Westside Middle School shootings in Jonesboro, Ark., on March 24, 1998 where an 11-year-old and a 13-year-old shooter took the lives of four students, one teacher and injured more than 15 others.

The experience of empathy fatigue I believe is different than compassion fatigue and burnout. Empathy fatigue results from a state of psychological, emotional, mental, physical, spiritual and occupational exhaustion that occurs as the counselors’ own wounds are continually revisited by their clients’ life stories of chronic illness, disability, trauma, grief and loss.

Empathy fatigue and the other various fatigue syndromes (e.g., compassion fatigue, secondary traumatic stress, burnout, vicarious traumatization) are natural artifacts of working in “high touch” professions such as ours. Counselors are trained in the facilitative skills of empathy. The nature of the client-counselor relationship requires a below-the-surface level of intense and compassionate listening. It requires us to be deeply involved in our client’s woundedness and to respond empathically.

What is empathy fatigue’s role in the greater idea of counselor wellness?

The cumulative effects of multiple client stories throughout the week may lead to a deterioration of our resiliency, coping and empathic abilities. In traditional Native American teaching, it is said that each time you heal someone you give away a piece of yourself until at some point, you will require healing. The journey to become a medicine man or woman (or a professional counselor) requires an understanding that the healer at some point in time will become wounded and require healing.

Jane Myers and Tom Sweeney I believe provide an excellent, comprehensive and enlightened view of human wellness in their “wheel of wellness” model. Stated in the most parsimonious way, the wheel of wellness integrates an individual’s emotions, sense of control, problem solving, creativity, realistic beliefs, social support and self-care into a holistic framework — all designed to increase personal wellness. It also provides opportunities for healthy spiritual development, which is where empathy fatigue may vary from the other fatigue syndromes. Thus, paying attention to our “cosmic consciousness, divine consciousness and unity consciousness,” as Deepak Chopra suggests, can provide a spirit-guide for purpose, meaning and connectedness to wellness.

What is the risk involved with empathy fatigue?

Risks involved with the experience of empathy fatigue I believe are best summed up in Sandra Ingerman’s work as a shamanic practitioner and are referred to by indigenous groups as “soul loss.” Soul loss involves a major shift in the mental body, emotional body, physical body and spiritual body.

In shamanic practices, the shaman performs the ancient rituals of a “soul retrieval,” which brings wholeness back to the person that is affected. In the Reiki tradition, this would be considered “blocked chakra energy.”

The modern day soul retrieval, I believe, requires a personal understanding of who is available to be our healing partners — others who can cultivate our mind, body and spirit. Soul retrieval may take the form of eating right, exercising often, having healthy thoughts and feelings, personal growth through individual or group counseling experiences, or consulting with a family elder, priest, minister or rabbi. Ultimately, when we are not well, our clients are not well. It is difficult to be empathic towards our clients’ pain and suffering.

 Which counselors are most at risk?

Because empathy fatigue and other fatigue syndromes range on a continuum of low, moderate or high, the empathy fatigue reaction is highly individualized. I believe that empathy fatigue for some is a counselor trait; for others, it may be a counselor state.

The cumulative effects of working with persons who have chronic and persistent mental health issues may be an empathy fatigue trigger for some professionals. This may be because the counselor may not know how to handle their experience of countertransference in dealing with certain client issues. Other counselors work in organizations, agencies and systems that do not support the goals of wellness which actually increase ones’ organizational burnout.

Regardless of the counselor’s work setting and clients they serve, it is of paramount importance to know how to cultivate self-care approaches, resiliency and understand the cumulative effects that empathy fatigue has on one’s mind, body and spirit.

How might counselors know they’re experiencing empathy fatigue?

The most accurate depictions of the level, quality and degree of empathy expressed by counselors during therapeutic interactions are those observations involving a triad of raters, primarily the client, counselor, and expert rater or clinical supervisor. Carl Rogers spoke eloquently about empathy and hypothesized that clients who perceive their therapists as facilitating positive regard, empathy and congruence demonstrate a more positive outcome. So, we have years of research and observations suggesting what high levels of empathy are and how it is expressed in professional client-counselor interactions.

The same is not true of demonstrating the absence of empathy. I developed a theoretical measure of the holistic experience of empathy fatigue: Global Assessment of Empathy Fatigue (GAEF). I hypothesized in the GAEF that there are five levels of functioning as a therapist. Level five indicates the highest, while level one the lowest level of empathy fatigue. I further hypothesized that professional helpers may experience and project empathy fatigue in seven distinct areas that are rated on the five levels. These include cognitive, behavioral, spiritual, process/counseling skills, emotional, physical and occupational levels of fatigue.

Counselor fatigue and impairment appears to involve a constellation of states, traits, behaviors and other factors that encompass the person’s experience of empathy fatigue. The intent and purpose of the GAEF, in its early stage of development, is to provide a means of viewing the overall level of functioning as the professional helper experiences empathy fatigue.

 Is there a solution to empathy fatigue?

One cannot provide a “solution” for empathy fatigue because it involves an ongoing commitment to self-care, wellness and conscious awareness of one’s empathy fatigue triggers. I am also beginning to understand that it does not matter how close one is to the epicenter of extraordinary stressful and traumatic events in order to be affected by empathy fatigue. Critical incidents such as the recent catastrophic effects of Hurricane Sandy in the Northeast, wars, civil unrest, tsunamis and other epidemics all impact our mind, body and spirit.

So, it is important to understand the occupational choice we make and the cumulative long-term issues that we will have to deal with in the present and future. I have become aware that empathy fatigue is an experience of journalists who cover stories involving catastrophic events as well as global relief workers. As fire, rescue and law enforcement workers prepare for the physical rescue, professional counselors must prepare for the mental health rescue.

I am sure that you have spoken with counselors who on some days would rather work at Trader Joe’s than deal with their clients’ pain and suffering. So, once the occupational choice has been made by the individual then it is up to the individual, counselor educators and supervisors, professional counseling associations and professional counseling practices to help cultivate resiliency and wellness approaches specific to counselor impairment and other fatigue syndromes.

 Can you share any practical tips for avoiding empathy fatigue to begin with?

I believe that one cannot “avoid” empathy fatigue working in our profession for it would be unnatural to ignore, suppress and avoid the natural feelings and emotions that arise as a result of our professional role. However, if we are conscious of our empathy fatigue triggers then this should be empowering news to us so we can then take action to cultivate wellness approaches.

Breathing meditation, visualization, relaxation and mindfulness approaches have been shown to be effective for dealing with occupational stress, counselor impairment and other fatigue syndromes. Making a commitment to lifestyle changes such as nutrition, exercise, and social and individual support can bring meaning and purpose to our life. To nurture the mind, body and spirit requires us to practice the strategies and approaches we facilitate with our clients. Knowing how to show up, pay attention and be mindful of the outcomes and fruits of our personal journey should be intentional, not just for ourselves but for the counseling profession.

To contact Mark Stebnicki, email stebnickim@ecu.edu.

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



NPR interviews ACA member about Sandy Hook

Heather Rudow December 19, 2012

(Photo: Wikimedia Commons)

ACA member Jane Webber was interviewed Tuesday on NPR‘s Morning Edition regarding the shooting at Sandy Hook Elementary in Newtown, Conn. Webber is an associate professor in the counseling program at New Jersey City University, former president of the New Jersey Counseling Association and current member of the ACA Crisis Response Planning Task Force. She also coedited the third edition of the book Terrorism, Trauma and Tragedies: A Counselor’s Guide to Preparing and Responding, which was published by the ACA Foundation in 2010.

Click here to listen to the interview

When the unthinkable happens: Counseling children following the Sandy Hook Elementary School shooting

Heather Rudow December 18, 2012

(Photo: Wikimedia Commons)

When the lives of six educators and 20 children between the ages of 6 and 7 were cut short in a mass shooting at a Newtown, Conn., school Dec. 14, the entire country found itself reeling.

The tragedy at Sandy Hook Elementary School is the second deadliest school shooting in U.S. history, following only the 2007 Virginia Tech massacre. It is, however, the most deadly shooting to take place at an elementary school.

Deb Del Vecchio-Scully, the executive director of the Connecticut Counseling Association and trauma expert, says the ages of the victims and the fact that the shooting took place at a school make the tragedy resonate with people in every corner of the country.

“School is supposed to be a safe place,” says Del Vecchio-Scully, a member of the American Counseling Association. “Not just [Sandy Hook Elementary] is going to be affected but also other schools in the area. There are going to be long-reaching effects on parents and children that we are going to see in the days, weeks, months and years to come.”

And as the community of Newtown grieves, Del Vecchio-Scully says the initial question is how the tragedy should be discussed with children.

“You want parents to be the source of information,” she says. “Not other kids, not the news.  Be honest and direct, take your cues from your child and respond accordingly.”

Del Vecchio-Scully recommends keeping children away from news reports, as studies have shown they can increase the risk of posttraumatic stress disorder.

She says counselors, parents and teachers will need to be mindful of the way they help children cope with the tragedy because kids are still mentally and emotionally maturing.

“The younger child’s brain  is not developed to understand the permanence of death, and that’s going to add a difficult layer to it,” Del Vecchio-Scully says. “[Children] are the ones who are going to ask ‘What happened? Why can’t I go back to school?’”

In addition, Del Vecchio-Scully says, it’s often hard for children to find the right words to describe how they feeling about what they’ve experienced.

Del Vecchio-Scully recommends giving children a creative outlet as a way to express their feelings. “Kids act out their worries and concerns through play and their artwork,” she says.

Because the event is still recent, Del Vecchio-Scully says most reactions a child may exhibit for the next week or two can still be considered normal. This may include regressive behaviors such as wanting to sleep in bed with parents, bed-wetting or acting out.

“Normalizing and fostering a sense of safety and routine is important right now, and that’s going to start at home,” she says.

It is also important for parents to foster open communication and to be open and honest about their feelings as well.

“Kids are very sensitive,” Del Vecchio-Scully says, “ and they’re going to get their cues from their parents.”

Similar to parents, teachers should also focus on maintaining a daily routine and should aim to answer questions from students to the best of their ability.

Del Vecchio-Scully says the impact of the trauma and the mental health needs of communities are layered like concentric circles.

“The inner circle includes the children, school staff and first responders who witnessed the event and/or the crime scene, as well as the officials who informed the families of the death of their loved ones,” she says. “Next are the parents of the surviving children and those whose children were killed. On the more outer rim of the circle is the rest of the greater Newtown community and the entire Connecticut community.”

The fourth layer includes the general public watching the tragedy unfold in the news media and through social media who are vicariously impacted, Del Vecchio-Scully says.

Crisis intervention is already occurring in Newtown, and for most counselors, Del Vecchio-Scully says, “our services will be needed once the crisis period passes and a void in caring for the community is evident.”

Although Del Vecchio-Scully says that now may not be the time for therapy, counselors, too, can take on the role of listener for those impacted by the shooting if the situation calls for it.

But in the months to follow, Del Vecchio-Scully says, “the crisis intervention teams will withdraw, creating a void of support, which will result in a shift of responsibility of the ongoing mental health needs of the community to local agencies and volunteer counselors.”

Counselors should be on the lookout for individuals who are at risk of re-traumatization.

“Newtown was one of the towns that was hit by Hurricane Sandy,” Del Vecchio-Scully explains. “They went without power for a week. As traumatic events get layered, the ability to cope gets less.”

This is also the time for counselors to focus on individuals in the outer concentric circles — those who may not have been directly impacted by the events in Newtown but are having trouble coping.

The shooting at Sandy Hook Elementary will have an especially far-reaching impact because a school setting is something that all children share and experience, Del Vecchio-Scully says.

Del Vecchio-Scully says the events mirror the attacks on 9/11. “The world watched in real-time, and individuals will be impacted in some way that we can’t really know right now,” she warns counselors.

Del Vecchio-Scully stresses the importance of the role of counselors in helping children and communities cope and move forward in the months following a tragedy such as this.

“Kids are extraordinarily resilient,” she says, “and we have to give them the chance to be.”

The Connecticut Counseling Association is creating a list of licensed professional counselors in Connecticut who would like to provide their services to the Newtown community. Interested therapists should contact cca_exec_dir@msn.com with their name, address, email and telephone number, along with their license number. In addition, the state of Connecticut is recruiting mental health clinicians as well. Counselors can register at surveymonkey.com/s/YLGXFBJ

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