Tag Archives: Students Audience

Students Audience

The journey to counselor educator: Deciding to get your doctoral degree

By Makeba Boykins February 21, 2017

The moment you decide to pursue a doctoral degree is one of the defining moments of your career. You have decided that you want to go further, push yourself and obtain the skills needed for training new counselors. You begin to research schools and their doctoral programs. A glimmer forms of what you would like to write your dissertation on. You apply to your favorite schools, plus some that you don’t like as much to increase the chances of your dream becoming a reality.

But when the interviews start, reality kicks in. For some people, that reality is the amount of work it takes to become a counselor educator. For others, it’s the reality that their favorite school might be just out of reach for a variety of factors.

And if you are a minority student, a different kind of reality starts to settle in. One that tells you your dream might be far more complicated to reach than it is for other students.

Growing up as a black woman in the United States, I was aware of the implicit bias that can affect who gets opportunities and who doesn’t. My father was born in 1928 in the South, so the history of being black in America is forever cemented in me in ways that are hard to describe.

This knowledge becomes personal when you enter the workforce and experience implicit and explicit bias firsthand. Even while obtaining my master’s degree in community counseling, I could see how this bias played into higher education. Once I completed my master’s and went into the field, I worked in social services, attempting to make a dent in the systems and make life better for those who may not be able to do so on their own. When I decided to get my Ph.D., I felt accomplished. I felt ready to go on an academic journey.

 

Roadblocks

Upon starting the application process, I quickly realized how exclusive the “doctor” club is. Most schools accept six to 10 students for Ph.D. programs, and you are competing with students from around the world. What you want to do research on becomes extremely important because some universities want you to participate in or further research that aligns with the research interests of professors who are already in the program.

What I realized very quickly was that even if a professor has interest in multicultural issues or even race, it is rare to want to tackle implicit bias head-on. Diversity and social justice, even in the counseling profession, can be dirty words.

Some research has shown that students generally give poorer evaluations to professors who teach diversity. If those professors are minorities, their evaluations are often even lower. Depending on the university, those student evaluations can be the difference between getting tenure and not getting tenure, so these things matter.

You can imagine that several programs would proceed with caution if a student of color applied and stated that he or she wanted to do research on bias. There is a fine line between telling students that they must change their research ideas (which often change anyway over the course of study) or setting them up for a hard road that may lead to limited academic success. This was the first lesson I learned in my journey.

The first school to which I was accepted did so on the condition that I change my research topic. I had somehow been naive enough to think that in the world of academia, pushing the boundaries was encouraged. Entire bodies of research exist on implicit bias and how it affects almost every facet of society. Given the popularity of the online Implicit Association Test and the ever-growing body of research on the topic, I assumed that research on bias was no longer that controversial.

But when the program chair discussed concerns about my topic with me, I got a rude wake-up call. It shook me and made me question whether pursuing my Ph.D. was really the right course of action. I pushed on and eventually found a school that I am proud to call my academic home.

Upon starting classes, I realized this road could be a constant battle unless I had strategies for success. I hope that some of the skills I learned and implemented can be beneficial to other students, particularly minority students who are pursuing their doctoral degrees.

 

Strategies for success

Being accepted to a school that was interested in my research topic and supportive of my inclination toward social justice was the first hurdle. So, when applying and interviewing for schools, remember that you are reviewing those schools as much as they are reviewing you. It is important for any student, but particularly a student of color, to find an academic home that is supportive of your goals. Do not settle for the first school that accepts you. Review your options carefully, and make a choice that you will be happy with for the next several years to come.

The second step was becoming knowledgeable about the difficulties that African American students face. Per a 2011 research study by Malik Henfield, Delila Owens and Sheila Witherspoon in Counselor Education and Supervision, many African American doctoral students in counselor education programs feel that they face discrimination and a high level of stress. Many cite feelings of isolation, lack of support from faculty and treatment by other students as reasons for not continuing their programs. The article cited additional research done in 1996 that showed that as many as 49 percent of African American doctoral students felt at least partially, if not totally, negatively about their doctoral experience.

I was shocked to learn about these statistics and this research, but arming yourself with this knowledge will allow you to be prepared for the road ahead. So much of completing any graduate degree involves the subjective experience we have in our programs. Counselors, specifically, can forget to check in with themselves emotionally because we are used to caring for everyone else. So do your research and allow yourself to be sad about the extra set of hurdles ahead, but allow those hurdles to motivate you to achieve your goals.

Once you have been accepted to a doctoral program for counselor education, seek out professors and campus organizations that are supportive of and foster your passions. When I began school, I joined the campus diversity department, I stood strong in my passion for social justice and multicultural competency. Basically, I began the ongoing process of carving out my own space — one that is filled with support and is uniquely my own. Universities, particularly predominantly white institutions, might not have a ready-made space for you. If you begin creating your professional and collegiate identity early, it will allow you to start to set your own metric for success.

Set small, achievable goals that remind you that you are making progress. Setting your own standard for success is crucial, particularly for minority students, because feelings of isolation and a lack of support can make it hard to recognize how far you have come. This is where your family and friends can come in because they don’t have to understand what you are writing about to celebrate that you have finished a huge paper. They can constantly give you encouragement, and although their emotional support may not equal an A in the classroom or create a more inclusive environment in your school, it can mean the difference between feeling completely isolated on your journey and feeling supported.

My next step was having frank conversations with family and friends. I had already done this prior to applying to my doctoral program, but after becoming more knowledgeable about all the hurdles that minority students can face even after acceptance, it was important to talk again. I let my partner, my family and my friends know that I might need additional support because I wouldn’t necessarily be able to get it consistently at school. I feel completely supported by my school and faculty, but I wanted to ensure that I possessed multiple levels of support.

As mentioned previously, counselors can be hard pressed to practice self-care. Do not wallow in feelings of guilt when you need help or support, and don’t feel bad about telling your support network early on that you might need them to help lift you up.

Directly correlated with creating your support network is learning to be patient and gentle with yourself. Obtaining any degree is difficult, and the higher you go, the harder it is. You must deal with life’s challenges, and if you are a minority, you may face extra hurdles.

For most people, it will be a year from the time you start submitting applications to the time you actually enter school. During that year, begin practicing your self-care techniques, and then take them with you into the program. If possible, attend campus and association events to begin connecting yourself to your colleagues. Research divisions of the American Counseling Association that you might be interested in joining; these divisions can provide opportunities to expand and affirm your interests.

Also remember that pursuing your doctorate is as much about your learning as it is your grade. Talk with your adviser and take the course load that makes the most financial and emotional sense for you.

Finally, stand strong and proud in your interests and in who you are as an individual. Getting your doctorate should be about more than calling yourself a doctor. You should pursue a doctorate to do scholarly work that matters to you and to be a part of training future counselors.

What drew me to this path and program was a desire to learn more and further the discussions on implicit bias and mental health. Shying away from that path would have been detrimental to my ability to complete my studies and feel fully engaged in my profession. Although it is possible that I will change my topic down the road, it is important for me to pursue what interested me. My end goal is always “scholar” and “educator” first, not “doctor.” So unless your goals or interests change, don’t back away from your passions.

 

Conclusion

The challenges that students face when applying for and entering a doctoral counseling program can be great. Those stressors can be compounded when issues of diversity and inclusion arise. Arm yourself with all the tools and supports available to you to make your journey as smooth and successful as possible. Always be kind to yourself and, remember, we are our ancestors’ wildest dreams.

 

 

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Makeba Boykins has been working in the field for more than a decade. She obtained her master’s degree in community counseling from Argosy University Chicago and is currently pursuing her Ph.D. in counselor education from the Chicago School of Professional Psychology. Contact her at mboykins@ego.thechicagoschool.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Document like a clinician: The ins and outs of documenting your training supervision

By Brian Carnahan and Margaret-Ann Adorjan January 17, 2017

Supervision is critical to the career development and advancement of many mental health professionals, including counselors, marriage and family therapists, and social workers. The boards responsible for licensure set standards regarding the number of hours, frequency and nature of the supervision necessary for licensure as an independent professional. Various professional organizations also set standards for other credentials and certifications. For example, the National Board for Certified Counselors requires national certified counselors to earn 100 hours of supervision and work as a counselor a minimum of 3,000 hours.

Given the centrality of supervision to the mental health professions, it is surprising how often it is treated casually. Clinicians who must document client files are often lax in how they treat the supervision they receive. One can understand why. Supervision can feel like a break from work, even though work is discussed. Unfortunately, supervision is not the time to relax.

It helps to understand the supervision requirements in the jurisdiction in which you are receiving supervision. Some jurisdictions have limited requirements for documentation, but most jurisdictions require some tracking of supervision. Although it should go without saying, it bears repeating: It is your responsibility as the professional receiving supervision to know what is required. Too often, the professional in supervision relies on more seasoned professionals for guidance. But rules and requirements can change, making it important for the professional seeking independent licensure to remain up to date, including verifying with the appropriate board what must be done to earn supervision hours.

Think about treating supervision sessions as you might a session with clients. In this situation, you are the person receiving a service — namely, supervision. Take notes, and follow up after the session with additional notes and thoughts. The notes and comments you retain will help to make clear that appropriate training supervision occurred. This can be particularly important if any questions arise regarding the type of supervision provided. Occasionally, the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board has to consider whether supervision should be classified as work supervision or training supervision. The details in the training log, along with the applicant’s explanations, can help answer those questions.

If a supervision form is required, use the form prescribed by the licensing board. If one is not available, create one that covers, at a minimum, the supervision date, the length of the session, name of the supervisor, topics discussed, required follow-up and similar entries. Consult your jurisdiction rules regarding supervision to make sure nothing is missed.

It can help to seek templates from supervisors or colleagues, but beware. Just because someone else is using a template does not mean that it is sufficient. Too many professionals have found themselves in trouble because they relied on the work of others instead of seeking guidance from their respective licensing board. Where supervision is concerned, it pays to confirm with the appropriate board what format, if any, is required.

Consider tracking work hours, particularly client contact hours. Also, be sure to confirm whether there are requirements to log separate direct client contact hours or “relational” hours. This distinction can be important depending on the license type or certification being sought, particularly if the supervision is earned by a marriage and family therapist. Documenting and retaining these hours can make a difference in obtaining a license in another state. Even if your jurisdiction does not have specific requirements for documenting supervision, you may wish to maintain it anyway, because other jurisdictions may require evidence of supervision when you apply for a license.

Some jurisdictions require persons seeking a supervision designation (such as Ohio for its licensed professional clinical counselor with training supervision designation) to complete supervision of supervision. Supervision of supervision is when a professional is supervised while providing training supervision. These sessions should also be carefully documented. Check with your licensing board to determine how (or whether) these hours can be used by each of the professionals involved because some jurisdictions limit who can claim the hours as supervision.

Retain an electronic version of all your supervision documentation. This log could be in a Word or Excel file, or you could regularly scan and save the written log to a file sharing service. A number of free and low-cost cloud storage solutions can help with this task. Your ability to use the supervision hours is only as good as your ability to document the fact that you completed the supervision.

Turn in supervision logs or evaluations as required. In Ohio, we recommend turning in evaluations at the end of the first year of supervision and the end of the second year, when the independent license is sought. We also recommend submitting evaluations whenever supervisors change. This helps to ensure that the supervision is documented fully. Although Ohio does not require submission of the logs, they must be available and up to date in case there are any questions about the supervision and the logs are requested to confirm any details.

Completing supervision requirements does not have to be stressful. By knowing the requirements, retaining good records and completing required documentation in a timely manner, a licensed professional can secure his or her independent license.

 

 

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Brian Carnahan is executive director of the state of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact him at brian.carnahan@cswb.ohio.gov.

 

Margaret-Ann Adorjan is the marriage and family therapist licensure coordinator and investigative compliance officer for the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact her at margaretann.adorjan@cswb.ohio.gov.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

 

Why you should incorporate volunteering into your training: A student’s perspective

By Eleanor Rector October 17, 2016

You’re about to start a graduate counseling program. You’ve likely traveled to a new place, so you’re trying to adjust and find a new go-to burger joint. You have your priorities straight.

The last thing you want to do is research places to start volunteering. Besides, you’re already training for a career in which the focal point is helping people. Do you really need to go out of your way to do more? Sure, volunteering sounds good, and you would like to do it, but you’ve worked so hard to get here, and you don’t really have the drive to begin something that won’t further your career.

I have been there. You’re talking to a professional promise-maker here. I’ve organized groups to bring food and hygiene products to homeless individuals, but I’ve also made a thousand promises to myself or to other groups with good missions to volunteer, and when the time came, there was always a great excuse not to follow through. Maybe my cat was being extra cute, or my murder mystery suddenly took an interesting turn.

Whatever the excuse is, it seems important at the time. Besides, I tell myself, if I’m not there to help, someone else will take my place. And sometimes the amount of hurt in the world feels like photo-1469398718052-b9d13df0d7c9too much for me to bear. And I wonder, even if I am there to help, will it really make any difference?

Fortunately, I attend a university that removes the hard part from the equation. At Adler University, volunteering in your first year is a mandatory part of every program. Students fill out a form about their experiences, strengths and interests. Then, in a process I have been promised is not random, they are assigned volunteer positions in underserved communities.

Some individuals are placed in nonprofit organizations they find interesting; others remain confused about their placement throughout the experience. I have watched one particular thing happen across the board, however. Those individuals who complete their volunteer hours with as little effort as possible don’t really gain much from the experience. On the other hand, those who complete their placements by really getting involved and being passionate about serving the underserved ultimately grow immensely.

This experience is so pedestrian that a saying developed around it: “You get out of it what you put into it.” However, clinicians, and especially those of us studying to become clinicians, may not understand how vital this volunteer experience is to our clinical practice. If we are to be guided by the ethical principle of beneficence, then we must do more than simply our jobs to help our communities and the individuals within them.

We must find ways to integrate our pledge to help the community into our everyday lives. Otherwise, we are following only the principle of nonmalfeasance. That is an essential principle, but simply doing no harm is not enough. Doing actual good reaches much further.

Yes, we are “doing good” when we are effective and ethical practitioners. But at the same time, we are simply doing our job well. To fulfill the principle of beneficence, we must go beyond the minimum of being effective clinicians and do good that effects change outside of our own personal spheres. Involving ourselves in our communities, in whatever way one chooses, will also benefit our practices immensely and allow us to be much more effective clinicians.

 

Acknowledging privilege

This, of course, requires a brief discussion on privilege. Luckily, the program at my university that organizes this volunteer placement to underserved populations also provides training sessions that help students understand the oppressive systems at work in the world, specifically inside the United States, and confront the privilege that we all possess.

This is incredibly helpful because acknowledging our own privilege is uncomfortable for many of us. All of us have faced struggles in one form or another throughout our lives. Some of us may not feel that we possess privilege in many respects. And this may be true, because privilege comes in multitudinous forms. But no matter the lack of Master Statuses we may possess, being able to afford (or even have the good standing to take out loans) to go to graduate school and become a counselor is a privilege in its own right.

Many people are afraid of acknowledging their privilege because they think that having privilege is a shameful thing. That’s a logical, although untrue, line of thought. There is often unnecessary guilt inherent in being born with privilege because we live in a world that works to keep the privileged on top while oppressing the underserved.

I am a Caucasian woman. So, even though I am a woman, I still carry the Master Status of “whiteness.” No matter what I’ve experienced or how difficult life may have been, I still carry that one Master Status. I can do my best to understand the experiences of other individuals and empathize with them. But there has to be a point at which each of us acknowledges that some individuals have had experiences we simply cannot understand.

This isn’t something to be ashamed of because no one can control the circumstances into which she or he was born. However, it is our responsibility to confront these circumstances and subsequent biases head-on if we are going to be socially conscious clinicians who are dedicated to following ethical principles. Furthermore, those of us with privilege have a responsibility to help those without privilege and without a voice.

I think the writer Toni Morrison expressed this sentiment particularly effectively: “I tell my students, when you get these jobs that you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just a grab-bag candy game.”

 

Giving empathy another dimension

Acknowledging our privilege is important for many aspects of our work and a vital component of volunteerism. For starters, it helps us form empathy.

Although most (hopefully all) clinicians and clinicians-in-training possess some amount of empathy, acknowledging privilege gives our empathy another dimension. For instance, when working with homeless individuals as a teenager, I clearly had empathy for the population. Especially during the Great Recession, I understood that circumstances beyond these individuals’ control had led them to this place of desperation.

But this empathy needs to be multidimensional. Acknowledging one’s own privilege, and therefore the societal systems of oppression at play, allows one’s empathy to extend not only to the individual directly before you, but also to a whole group of individuals who have been affected by these systems. Now instead of feeling empathy only because of a particular individual’s immediate circumstances, I’m able to understand that clients’ lives have often been controlled by societal systems that existed long before these people came to be. These systems were created to oppress classes of individuals, leaving upward mobility out of the question for many and, too often, making simple survival an enormous feat.

 

Understanding community

In addition to growing our empathy, acknowledging our privilege is an essential part of understanding our own communities. Because we all experience privilege, we simply remain unaware of certain parts of our communities. These sections of our communities don’t concern us, so we often don’t bother to get involved in them.

This isn’t a lack of empathy. Rather, it is simply a lack of knowledge. Acknowledging our privilege means opening ourselves up to learning about the underserved of our communities and the problems that plague those with less privilege than us. Because we are clinicians, learning often sparks passion in us, and when we become passionate about changing an issue and providing voice to the voiceless, we can be unstoppable.

This deeper understanding of my community took place for me at my volunteer site, where I took notes at a monthly meeting for the Harm Reduction Coalition, which aims to provide prophylactic availability in prisons to stop HIV transmissions both inside and outside of prison. By being in a meeting of this kind, I ended up learning far more about the correctional system than prophylactic availability. Simply by being involved, I was able to meet so many individuals whose lives had been touched by the general lack of health care within prisons. In the process, I was forced to let go of my preconceptions.

I logically had assumed that when individuals in prison became sick, they were provided with the health care to which they have a right. That is until I met a woman whose husband had been diagnosed with cancer in prison but was refused knowledge of his diagnosis and treatment. His family only learned that he had cancer when he died behind bars in the arms of his friends and an autopsy revealed the truth. I met another man who had been so deprived of sensory stimulation that he had to relearn how to talk, read, write and interact with individuals upon being released from prison. I heard horror stories of treatment being denied again and again and again so that the cost wouldn’t cut into the profits of privatized correctional healthPeople Hands Holding Colorful Word Volunteer care corporations. When you are in prison, you are still supposed to have certain rights. But when those rights are violated, you are voiceless and powerless.

When I started volunteering, I thought I understood the population I was working with and the system by which they are controlled. But when you have the privilege to not automatically be aware of these systems, you find that they are far more intricate than you ever could have imagined. Often, simply learning about the populations who live within these systems and cannot escape makes it impossible to not want to be involved.

As clinicians, we need to understand that we have preconceived beliefs that are inaccurate about many parts of our society. And the reality is, we are going to have clients who are part of these populations or have been touched by these systems. To be truly responsible clinicians, we need to confront these preconceptions head-on by involving ourselves with populations with which we would not generally come into contact.

I still struggle with the idea that what I do doesn’t really make a difference — that the oppressive systems at work are so big and so concrete that anything I do can only make a dent. That’s true in a way. After all, I’m only one person. There’s only so much I can do. But I can help educate others so that they too can begin to make chinks in the armor around this system. And they can educate the people around them about the reality of the world in which we live. At the end of the day, no matter how small the things I’ve accomplished are, they’re still there. And they still make a difference.

Don’t be afraid to admit that your preconceptions are wrong. Instead be afraid of keeping those preconceptions rather than confronting them. Identify an area of society that sparks your interest and passion, and find ways to get involved. Only through accepting your privilege and confronting your biases and beliefs can you deepen your understanding of society and strengthen your abilities as a clinician.

So force yourself to get off the couch. Find a nonprofit that works in an area that interests you. Schedule a time to volunteer, and then follow through. You won’t regret it.

 

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Eleanor Rector is a second year master’s counseling student specializing in forensic psychology at Adler University in Chicago. Originally from South Florida, she studied poetry and psychology at the University of Miami. She hopes to continue her education by pursuing a Ph.D. in applied neuropsychology. Contact her at erector@my.adler.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

 

 

Preparing for the NCMHCE

By Alyson Carr October 3, 2016

In January, I shared the experience that influenced me to pursue a career in counselor education with an emphasis on preparation for the National Clinical Mental Health Counseling Examination (NCMHCE). Since the article was published at CT Online, I have received many emails from interns with questions about the most effective ways to prepare for the NCMHCE and how to know when they’re ready to take the exam. This article is geared toward addressing these questions.

 

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You thought the time would never actually come, but here it is: You’re ready to start preparing for the counselor licensure exam. Getting to this point in your career is an enormous accomplishment, but figuring out what to do in terms of adequately preparing for the NCMHCE can be quite confusing.

Some people wonder, “Do I really even need to study for the NCMHCE? I did pretty well in grad Abstract grunge rubber stamp set with the text Fail - Pass writtschool, so I’m sure this test will be a breeze.” I would like to kibosh this line of thinking right out of the gate and hopefully save you from losing the NCMHCE registration fee of between $100 and $195 (the fee is less for national certified counselors in good standing).

The NCMHCE covers content areas from assessment administration and treatment planning to supervision and group counseling theories. The format of the NCMHCE is unlike any test you have probably ever taken and, unfortunately, 40 to 45 percent of test-takers fail the exam. So, in short, yes, you do need to study for the NCMHCE. But with such a comprehensive examination, where do you begin?

 

Step 1: Determine if the NCMHCE is the required test for licensure in your state.

To do this, visit the National Board for Certified Counselors’ (NBCC) state board directory (http://nbcc.org/directory), click on your state, and then look at “credentials” on the right side of your screen. This will tell you whether a passing score on the National Counselor Examination for Licensure and Certification (NCE) or the NCMHCE is required to become licensed.

If the NCMHCE is required, register to take your exam. This process takes time, so you’ll want to get the ball rolling right away. Also, know that you can postpone your test date to any day within your six-month eligibility period with no additional fees as long as you reschedule at least eight days prior to your originally scheduled test date. (See “Additional Information” on the NCMHCE Registration Form for more details: http://www.nbcc.org/assets/registrationform/ncmhceregistrationform.pdf.)

 

Step 2: Start doing research on NCMHCE study materials.

There are lots of resources available to help you prepare for the NCMHCE, and some are better than others. Talk to NCMHCE test-preparation vendors at conferences about the materials they provide. Sign up for as many free resources and trials to different websites as possible so you can evaluate the content before actually spending your hard-earned money. See which study programs align best with your learning style.

Also, take a look at what is offered in the event that you don’t pass the NCMHCE the first time. Some websites offer a money-back guarantee, whereas others will renew your membership for free if you are unsuccessful on your exam attempt(s).

 

Step 3: Consult with your licensed colleagues.

Talk to your licensed colleagues about how they prepared for the NCMHCE. Ask them what they liked and didn’t like about the resources they used — and why. If you know anyone who failed the NCMHCE, ask them what they wish they had done differently when they were preparing.

Learning from those professionals who have already had some experience preparing for the NCMHCE may save you a headache in the long run.

 

Step 4: Become best friends with the DSM-5.

When I tell test-takers that they do need to memorize diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in order to successfully navigate through the NCMHCE, most react as if I have suggested that they move to a foreign country and learn six new languages. (The diagnostic criteria are the part in each section that look like an outline of symptoms.) This task feels overwhelming to many test-takers — something that can’t actually ever be accomplished.

Rest assured, it can be accomplished. As with anything new or daunting, how test-takers experience this task depends largely on their attitude. If you dread learning the DSM-5 material, the entire study process will probably feel like a tedious nightmare, and it’s likely you won’t even retain the information you’re studying, which means the nightmare will just drag on forever because you can’t pass this test without knowing this stuff.

See? Not a fun scenario. If, on the other hand, you approach this task as a challenge that you are eager to overcome because you know how important it is to be able to accurately diagnose or debate a possible misdiagnosis on behalf of your client(s), you will probably enjoy the experience and retain the material because you’re doing what you were made to do — work hard for the clients you serve and lead by example when it comes to tackling challenges with enthusiasm.

Sure, reading about the specifiers for bulimia nervosa may not be your favorite leisure activity, but it can be made fun, especially if you recruit members of your support system to join you in your efforts. Consider asking your partner or kids to quiz you on two disorders per day. Challenge yourself by trying to diagnose characters on your favorite TV shows or movies — think about Frank or Ian in Shameless, Tara in United States of Tara, Carrie in Homeland, Walter in Breaking Bad, etc. Even if your agency doesn’t require you to document diagnoses for your clients, formulate provisional diagnoses anyway. Weave the learning of DSM-5 diagnostic criteria into your daily life.

Just like with the NCMHCE study materials, many tools out there are designed to simplify the diagnoses in the DSM-5. Do some research and see which resources best align with your learning style.

 

Step 5: Plan study time in advance and stay accountable.

Don’t wait to see how your day goes before determining if and when you’re going to get any study time in. Instead, be proactive and plan your study time in advance. Think of it as time that you are unavailable for anything else, just like you would do if you were attending a class.

If you’re like many people, your professional and personal obligations will likely dictate your prescheduled study time. Consider a regimen such as one hour of DSM-5 review in the morning and one hour of working through practice simulations in the evening, or four straight hours of studying on a day when you may be off work. Perhaps your employer will allow you an hour or two of study time a few times per week to support you in your licensure efforts. Maybe you will have to schedule your study time on the weekends. Regardless of when you do your studying, make sure that you carve that time out in advance so that preparing for the NCMHCE is a priority rather than an afterthought.

Also, consider planning regular study groups with your colleagues or classmates who are also preparing for the NCMHCE. This type of support and accountability can make all of the difference in the way you experience this process.

 

Step 6: Take a prestudying baseline assessment of your readiness.

Before you get too heavily immersed in your studies, complete a practice simulation and rate your level of readiness as it relates to your ability to pass the NCMHCE on a scale of 1-10 (1 = you are nowhere near ready; 10 = you are totally ready — you could have passed the NCMHCE yesterday). This score will come in handy later.

 

Knowing when you’re ready

You’ve been eating, drinking and breathing nothing but NCMHCE test-preparation materials, and now you’re wondering if you can stop this madness and finally sit for the test.

Many test-takers ask me how long they should study before evaluating their readiness. The answer to this question really depends on how much time you are able to dedicate to preparing for the exam. Generally speaking, in my experience, the first-time test-takers who are most pleased with their performance on test day commit to consistent studying (two to three hours per day, five days a week) for about three months.

In determining your readiness, ask yourself the following questions.

 

1) What is your current readiness score?

As you’re preparing for the NCMHCE, you will experience a spectrum of emotions ranging from happiness to frustration and everything in between. You may even consider switching careers just to avoid the licensure exam. This process is rigorous, and it can push you to some pretty discouraging places. Throughout this studying endeavor, it’s easy to lose perspective and forget how much you’ve grown since you started all of this.

Remember your prestudying readiness score? It’s time to compare that score with how you’re feeling today. So, take a deep breath, complete a simulation you’ve never done before, and do a little self-assessment by rating your readiness on a scale of 1-10. Push yourself by exploring if your readiness score is based on the knowledge and skills you’ve developed during your studies or if it reflects any false sense of confidence.

If your score has increased, and if it reflects true confidence, this is an indicator that you are moving in the direction toward being ready.

 

2) How are you performing on practice tests with a series of 10 consecutive simulations?

Remember that the passing score needed on the NCMHCE is based on your cumulative performance. So, theoretically, you could do poorly on one simulation but really well on another simulation and still pass the NCMHCE. I advise test-takers that scoring around a 90 percent average in both the Decision-Making and Information-Gathering sections of a simulation is one quantitative indicator of readiness.

Although performance on a single simulation is important, an overall score based on a series of 10 consecutive simulations is even better (given that the NCMHCE has 10 simulations). I encourage test-takers to wait until they are a few weeks from their test date to begin completing a series of 10 consecutive simulations so they can truly assess the knowledge they have absorbed up until that point (doing this a total of three times, with a couple of days in between, is ideal).

It is really important to approach each of these three separate, 10-consecutive-simulation sessions as if they are the actual test. Block out three hours of uninterrupted time, try to complete the task during the time of day you intend to schedule your actual test, take breaks in the way you intend to for the real deal and pay close attention to how you’re feeling throughout the process.

This is a time to learn about yourself. Do you feel exhausted, as if you can’t go on after the third simulation? If so, tweak your approach next time. Do something like eating a granola bar right before you start the test and take breaks after simulations one and two to see if this helps to increase your stamina. Does your mind feel like mush at simulation 10? If so, try taking a five-minute break after simulation nine to see if it makes a difference.

Earning overall passing scores on each of the three 10-consecutive-simulation sessions is the most reliable quantitative method I use to determine a test-taker’s readiness. In more than four years, I have never had a test-taker fail these three 10-consecutive-simulation sessions and pass the actual NCMHCE.

 

3) Can you differentiate between disorders that have similar diagnostic criteria?

One of the many things the licensure exam measures throughout each simulation is your ability to narrow down a diagnosis. What this means is that you need to know when a client better meets the criteria for persistent depressive disorder than major depressive disorder, for example. Ask yourself questions such as: What separates oppositional defiant disorder from conduct disorder? How are bipolar I and bipolar II different? What questions do you need to ask to determine if a client is experiencing a phase-of-life problem or an adjustment disorder?

Being proficient in your ability to differentiate between disorders that have similar diagnostic criteria is another great indicator of your readiness to sit for the NCMHCE.

 

Tying it all together

When it comes to preparing for the NCMHCE, do your research about what study materials are going to be the most effective for you, and commit to the process. When it’s time to determine if you’re ready to sit for and pass the NCMHCE, do some critical self-exploration and measure your performance using practice tests.

If you still need to put more time into your studies before you feel confident enough to take the NCMHCE, no biggie; just consider postponing your exam date rather than going into the test feeling unprepared. Most important, use the support system around you — whether it’s your dog, your friend or your boss — and remember that everyone who cares about you wants to see you succeed.

 

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Alyson Carr is a licensed mental health counselor with a doctorate in counselor education from the University of South Florida. Contact her through her website at dralysoncarr.com.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling interns get firsthand exposure to immigrant experience

By Bethany Bray September 26, 2016

An innovative partnership in North Carolina is pairing counseling graduate students from the University of North Carolina at Charlotte with clients of a free medical clinic nearby. Many of these clients are recent immigrants.

According to those involved with the effort, the partnership provides the student interns with a chance to hone their counseling skills while also offering them a firsthand lesson in advocacy and social justice issues.

The Bethesda Health Center (BHC) provides free primary care, diabetes and hypertension management, and health education for low-income and uninsured residents of Charlotte and the surrounding county. The UNC Charlotte counseling interns offer mental health care alongside these physical health services.

The partnership provides much-needed care to minority populations who are, statistically, the least likely to seek or access mental health services, says Daniel Gutierrez, an assistant professor of counseling at UNC Charlotte, as well as a licensed professional counselor, licensed mental health counselor and member of the American Counseling Association.

It has also provided counseling students with some valuable learning that transcends the typical textbook lessons, says Katherine Wilkin, an ACA member and clinical mental health counseling student at UNC Charlotte. Wilkin, who was born in Venezuela, is able to offer counseling to BHC clients in Spanish and English.

The experience has opened Wilkin’s eyes to the cultural factors that often increase risks for mental health struggles, including the stress of navigating a language barrier and acculturation to a new location.

“My experience at Bethesda Health Clinic has enriched my training and has strengthened my passion for providing mental health services to the Hispanic population in their native language of Spanish,” Wilkin says. “… This program exposes counselors and students to a diverse population with unique issues. The [U.S.’s] growing Hispanic population calls for mental health professionals to be sensitive and aware of the cultural considerations when working with this population.”

UNC Charlotte’s work at BHC was highlighted recently by National Public Radio (NPR). CT Online reached out to Gutierrez for a Q+A to find out more.

 

CT: In your own words, how does this program meet a need?

DG: Latinos are the fastest-growing and largest minority in the U.S., and they experience mental health disorders at the same rate — some argue at higher rates — as the majority culture. Yet, when compared to the majority culture, they are the least likely to access mental health treatment. They, on average, receive a lower quality of care and end up presenting with more severe symptoms.

There is no doubt that there is a great need for effective and accessible mental health care for this population. However, there are numerous barriers that keep Latinos from accessing mental health treatment, such as language difficulties, a lack of appropriately trained mental health workers, stigma and an overall difficulty trusting providers.

On the other hand, counselor educators everywhere preach the importance of teaching our students to work with underserved and vulnerable populations, but we don’t always have the opportunity to give our students quality learning experiences doing this work. This program meets two needs: a) it creates access to appropriate mental health services for an underserved population; and b) it creates a diverse and dynamic learning experience for our students.

 

What have you learned from this program?

I don’t think you have enough room [in this article] to describe what I’ve learned. I learned how complicated it is to set up a program like this. I learned the importance of doing work with the I_learnedcommunity and not just in the community. This program has also reaffirmed my belief that understanding people is more important than understanding illness.

 

 

Talk about the logistics of how this program came together. What did it take to get started?

First off, the real credit goes to people like Wendy Mateo, the executive director of the Bethesda Health Center. Before all the publicity from NPR, and with limited resources and under some very challenging circumstances, Wendy was wholeheartedly serving the Latino community by providing medical care and chronic health management to the low-income and uninsured immigrant families in Charlotte. She does an amazing job and is an inspiration to helpers everywhere.

When we met with Wendy, she expressed that although they were making considerable strides in improving the physical health of Latinos in Charlotte, there was a great need for mental health services for their patients. We quickly realized that serving at a clinic that helps the underserved in Charlotte would be an amazing opportunity for our counseling students, and that our counseling students could provide the services that Bethesda truly needed. So, we brought together a team of faculty from different departments and began conversations about building counseling capacity at this free clinic.

We began by first evaluating the mental health needs for the current patients. We conducted chart reviews, spoke with staff at Bethesda and began to develop an understanding of what kind of mental health needs they were facing. We then had a series of meetings evaluating space needs; developing the right type of forms; discussing issues related to supervision, ethics, confidentiality, HIPPA compliance, how to manage interpreters; and examining the whole process for providing services.

I think we were all very aware that starting this program had many moving parts and that it wasn’t going to be as easy as just putting two chairs in a corner and assigning clients to students. It was a long and complex process, if we were going to do this right. These clients are already underserved by the community and are statistically more likely to receive substandard quality of care. It was important that we gave them the best care we could and that our students were going to have a positive experience.

After establishing a format and structure for the services, we recruited two doctoral-level counseling students who were licensed professional counselors to begin seeing clients. We called this our pilot study. We evaluated the progress of these initial students and used this data to inform the placement of master’s students. That following semester, we began placing master’s counseling students in their internships and practicums at the site. Thus far, the clients and the students both consider this program a great success.

 

Based on your experience, what advice would you give to counselors who might want to get involved in something similar in their local area?

One of the key members of our team, Mark DeHaven, is known for saying, “Collaboration is good, but partnership is better.” Too often we try to collaborate with community sites because they are great places to get data or place students, and that has merit. However, when you partner with a community agency, you begin to share responsibility and work together toward common goals, and that’s a whole other wonderfully beautiful thing.

I invite those who want to start these kinds of programs to begin by building strong community partnerships. It is complicated and sometimes cumbersome to partner with community agencies, but it has to be less about you and your agenda, and more about the needs of the people you are serving.

It’s also important that you develop a strong team of like-minded people [who are] willing to not just talk the talk but also walk the walk. I am lucky to work along some great and passionate people from different departments. Our team consists of Edward Wierzalis, a fellow Department of Counseling faculty member and the UNCC counseling program clinical coordinator; Mark DeHaven, a distinguished professor in public health science; Roger Suclupe, a lecturer from social work; Amy Peterman, an associate professor and director of clinical training in the Health Psychology Department; and a counseling Ph.D. student, Carolina Benitez.

This team made this project come together. So, my second piece of advice for future counselors is to build a good team.

 

The NPR piece says this came about because you were “looking to get more involved in the community.” Can you elaborate? Why is that important to you?

Well, I think this is probably a pretty personal question. I think everyone on our team serves in the community for different reasons. For me, I am driven by the spiritual ideas of welcoming the stranger, reaching out to those deemed the least and doing justice. I was also mentored by people who continually stated that in a world with so many health disparities, economic disparities and so much need, counselor educators should strive to go beyond mere talk and do impactful work.

After the NPR story went national, the first words from my mentor’s mouth were, “Some people got help — and that is the important thing.” I hang that email by my desk at work because it keeps me focused. Those of us with counseling training are equipped to do good in this world. Doing nothing seems like a mistake to me.

 

What type of nontextbook lessons have you seen your students learning?

Probably what I’ve enjoyed the most about this process is the surprising reactions I’ve seen from students. Our program has an emphasis on multiculturalism and diversity, so the students are well-versed in textbook knowledge. However, the internship experience [at BHC] offeredtears_in_eyes them a real quality experience working with a population that was culturally different from their own.

I have had students come to me during their experience and sit in my office with tears in their eyes, and say things like “I just didn’t know” and “I love working with these people.” I think it raised student awareness to some of the struggles Latino immigrants face, such as having to cope with the traumas they experienced before entering the U.S., the stress and anxiety of leaving loved ones behind, and trying to care for family with limited resources. They also expressed new levels of multicultural awareness and realized that there was much they had taken for granted, such as the ability to speak the same language as their clients.

At the end of the most recent semester, we had students describe their experiences, and most stated that what [they had] learned most form the program was “working with people who are culturally different from you,” “understanding that most Latinos are very different and come from different countries, even though they are all labeled as Latino” and “learning the challenges of working with translators and the importance of tuning into body language.” Students also stated that this site [BHC] provided them with experiences that many of the other sites could not.

 

What do you want counselors to know about this program and your experience with it?

I would want my colleagues across the country to know one thing: This is worth doing. Latinos and other racial ethnic minorities are not receiving services at the same rates as the majority population. There is a need for helping professionals willing to reach out to our communities.

This kind of work might be complicated to set up and require more energy than you want to expend, but it’s good work and it is worth doing. It’s a great experience for the students and the community. It’s not simple work; you will most likely make a lot of mistakes getting this kind of a program off the ground – I know we did – but it is so much better to dance and miss a few steps than to never dance at all.

 

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From NPR: “Students Fill a Gap in Mental Health Care for Immigrants

Find out more about the Bethesda Health Center at caminocommunitycenter.org

 

Contact Daniel Gutierrez at DGutierrez@uncc.edu

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.