Monthly Archives: March 2006

Counselors advocate for worthy causes on Capitol Hill

Angela Kennedy March 27, 2006

The American Counseling Association Office of Public Policy and Legislation held its 2006 Legislative Institute in Washington, D.C., from Feb. 26-28. More than 50 ACA members from across the nation attended workshops and briefings on various aspects of legislative advocacy and public policy. As part of the institute, counselors also toured the U.S. Capitol building and made lobbying visits to their respective senators and representatives.

Legislative Institute sessions instructed attendees on the basics of the policymaking process and how to engage in state and federal advocacy. In addition, attendees took part in role-playing exercises that prepared them to conduct lobbying visits. Other sessions covered grant writing, media relations and how counselors can remain active as advocates after returning home. The institute also provided lobbying information on issues of concern to school counselors, rehabilitation counselors and mental health counselors.

“The importance of what professional counselors can do to impact public policy is hard to overstate in today’s policymaking environment,” said ACA Executive Director Richard Yep. “I was extremely pleased to see such a hard-working and dedicated group of professional counselors come to Washington.”

When participants visited their representatives’ and senators’ offices on Capitol Hill on the last day of the Legislative Institute, they lobbied on specific issues: Medicare coverage of licensed professional counselors, recognition of LPCs under TRICARE and other Department of Defense programs, funding for the Elementary and Secondary School Counseling Program and reauthorization of the Workforce Investment Act.

Bruce Dickinson, a retired LPC from Nebraska, said the practice lobbying sessions were especially helpful in preparing him to meet with Rep. Jeff Fortenberry to discuss Medicare issues. First-time attendee Deborah Braboy, a licensed associate counselor from Oklahoma, came away from the Legislative Institute with a new appreciation of the governmental process. “It’s vitally important for counselors to attend these types of opportunities, study the issues and speak to members of Congress to shed some light on mental health concerns and the population that we serve,” she said.

Braboy said she had an “awesome” visit with Rep. Dan Boren (D-Okla.). “He honestly gave me his undivided attention,” Braboy said. “He was attentive and asked some very pertinent questions. We talked about the TRICARE issue before the House right now, and he agreed to co-sponsor the bill. In fact, he said he would contact the appropriate offices and add his name to the bill that day.”

ACA Public Policy Director Scott Barstow said the association hosts the annual Legislative Institute as a way to encourage counselors to participate in the legislative process and become a voice for the profession on Capitol Hill. He noted that legislators are often more willing to listen to a counselor from their own state or district than to a paid lobbyist.

“The single biggest factor in getting a member of Congress or a state legislature to do something on a given issue is constituent contact,” Barstow said. “We need to get as many counselors as possible up to Capitol Hill making congressional office visits on a regular basis. We also need to get as many counselors as possible motivated to call, write and visit their legislators once they get back home. We can never have too many counselors doing this, and the more people we can train, the better.”

The award goes to …

Each year during the Legislative Institute, ACA recognizes a member of Congress who has demonstrated leadership on behalf of the counseling profession. This year, the Federal Legislative Service Award was presented to Rep. Robin Hayes (R-N.C.) for his hard work and leadership in support of establishing independent practice authority for licensed professional counselors under the TRICARE program.

In March 2005, Hayes introduced the TRICARE Mental Health Services Enhancement Act (H.R. 1358) in an effort to provide military personnel and their families easier and faster access to qualified mental health professionals. There is a significant need for improved access to mental health services for this population, but federal law still requires licensed professional counselors to see TRICARE beneficiaries only under physician referral and supervision.

“ACA is very grateful for Rep. Hayes’ successful work in gaining House passage of the language in H.R. 1358 within the Fiscal Year 2006 defense authorization bill,” said Yep, who presented the award to Hayes. “Mental health services for those in uniform and their dependents is not a Republican issue, and it’s not a Democratic issue — it’s a people issue. We are pleased to honor Rep. Hayes with our highest public policy commendation.”

Upon receiving the award, Hayes said, “I am honored to be recognized by the American Counseling Association, but the people we should really honor are our hard-working men and women in uniform. As a member of the House Armed Services Committee, I believe it is necessary to change our existing TRICARE system to include unfettered access by our soldiers and their families to licensed mental health counselors. Exposure to the type of prolonged stress our soldiers face in Iraq requires Congress to make it easier for soldiers to receive the mental health care they may need.”

Hayes is currently serving his fourth term in Congress and represents North Carolina’s 8th Congressional District. He is a member of the House Armed Services subcommittee on Military Personnel. Continuing the fight

Although the Legislative Institute’s attendees have returned home, their work is far from over. They are continuing their advocacy efforts on behalf of the counseling profession with calls, letters and e-mails to their state leaders. ACA staff members are coordinating follow-up contacts to the congressional offices visited by Legislative Institute attendees.

“Ultimately, all members of Congress should know a counselor in their community who can tell them about the profession’s policy needs,” Barstow said. “Ongoing contact with congressional offices by Legislative Institute attendees — and other counselors — is the surest way of keeping counseling issues firmly on their radar screen. All counselors should view it as both their right and their duty to regularly contact their elected officials.”

One of the reasons this is so important is that anecdotal information on how government policies affect their constituents is invaluable to legislators. Consequently, Brian Altman of ACA’s Public Policy and Legislation staff is encouraging ACA members to play a role in advocacy efforts by sending him personal stories about why Medicare reimbursement for LPCs is so important. “It was wonderful for our members to be able to go up to Capitol Hill,” he said, “but this is another way that ACA members can make our voices heard. I’m asking for members to provide me with quotes and anecdotes regarding why LPCs need Medicare reimbursement. We want to be able to share these with staff members on the Hill.”

He continued, “Have counselors had to reject clients because they can’t bill Medicare and they had no other way to pay? Are clients who once were seeing a counselor through private health insurance now paying completely out of pocket because they’re now Medicare beneficiaries? Have counselors tried to bill indirectly through the ’incident to’ clause and been unable to find a direct billing provider willing to take them on as an employee? We need to hear these stories.”

Altman requests that ACA members make their stories as concise as possible. “Capitol Hill staff have very little time, so I will have to boil down all the stories into a two-page document,” he explained. “Thus, if you can provide me a paragraph that you think will have the most personal and emotional impact, that would be great.”

Submission can be e-mailed to and should include “Medicare Story” in the subject line.

Announcements regarding next year’s ACA Legislative Institute will come out this summer and fall. Counselors interested in attending or learning more about legislative advocacy may contact ACA’s Christie Lum at or by calling 800.347.6647 ext. 354.

Nation caught in meth’s grip — Campaign launched in Montana to educate teens

Angela Kennedy

Crystal, crank, Tina, ice, glass — it’s all methamphetamine and, increasingly, it’s everywhere.

Last month, the Substance Abuse and Mental Health Services Administration released a report stating that admissions to treatment for methamphetamine abuse have increased significantly across the nation, moving from West to East. States in the Midwest and South, where meth rates were relatively low only a decade ago, are now experiencing high rates of treatment admissions. In the National Survey on Drug Use and Health issued three years ago, more than 12.3 million Americans indicated they had tried meth, and 1.5 million said they were regular users. The Federal Drug Enforcement Administration reported that it had seized 17,033 methamphetamine labs in 2004, an increase of 129 percent from five years earlier.

This widespread surge in meth use is affecting more than just addicts. Law enforcement agencies nationwide rank meth as the No. 1 drug they are battling today. Meth addicts are filling the U.S. prison system, while their children are flooding the social services system. Meth even affects the environment. For every pound of meth that is created (or “cooked”), as much as eight pounds of toxic waste are produced. In an effort to stem the tide of meth abuse, President George W. Bush on March 9 signed the Combat Methamphetamine Epidemic Act, which limits the retail distribution and sale of pseudoephedrine, a legal ingredient that is found in many cold medicines but is also an essential element for making meth.

Methamphetamine is a powerfully addictive stimulant that dramatically affects the central nervous system. Clandestine laboratories easily produce the drug, using relatively inexpensive ingredients available at the local hardware store and pharmacy. Meth can be ingested, snorted, smoked or injected. Regardless of how it enters the body, the effects are the same: intense anxiety, nervousness, paranoia, mood swings and depression.

American Counseling Association member Brian Dew has studied the effects of methamphetamine use in Georgia and is presenting an Education Session, “Behind the Eyes of Methamphetamine Dependents: Critical Perspectives on Achieving and Maintaining Abstinence,” at the ACA/Canadian Counselling Association Convention in Montréal. “Atlanta has the fastest-growing rate of meth use in the country,” Dew said.

Dew, an assistant professor in the Department of Counseling and Psychological Services at Georgia State University, and his research team conducted qualitative interviews with more than 70 recovering meth users. They were specifically interested in three things: how users defined being dependent, factors that impacted their decision to quit using meth and factors that contributed to their staying off the drug. Seventy-five percent of the interviewees were male, and they ranged in age from 18 to 53. The participants had maintained their sobriety anywhere from two weeks to eight years.

In defining their dependency on meth, many of the former users made the same observation: loss of control. They were unable to function while on the drug, and the factors that most influenced their decision to seek treatment were the harm done to family relationships and the loss of employment. Many also had mounting legal problems and were in failing health because of complications from HIV infection, which they had contracted during their drug use. The former meth users stated that family support was essential in their efforts to stay clean, as was the determination and dedication to make very significant lifestyle changes.

Many of those interviewed said treatment facilities were not viable options. “Their perception was that the treatment programs were not capable or knowledgeable of the meth problem here in Atlanta,” Dew said, “so therefore, they didn’t see treatment as an alternative. That has some implications on what we need to do as far as the community and education. That is a major finding.” He noted that longer term treatment is needed to help this specific population.

“One system that is working fairly well is the drug courts,” he said. “If you are found to be in possession and brought into the court system, you are bound to be in that system for 18 months.” During that time, Dew added, offenders are expected to pass urine tests and must attend mandated counseling sessions. “That keeps them clean longer than a month or six weeks,” he said.

Meth is unique, Dew said, in that it spans cultures, ages, sexual orientation and geographic location. “States need to recognize the need for research in this area,” he said. “Treatment programs are recognizing the need to specialize programs for meth dependents and their withdrawal systems. But a lot needs to be done.”

Counselors may request complete research findings and session materials distributed at the convention via e-mail at

Montana Meth Project

Many people still remember the image: an egg sizzling, hissing and bubbling in a skillet as a voice-over pronounced, “This is your brain on drugs.” Or the boy next door telling his father, “I learned it by watching you!” Twenty years ago, these were edgy, provocative antidrug messages that targeted adolescents and parents alike. But with today’s Generation Wired teens, those messages come across as lame attempts at drug lectures. That’s why the Montana Meth Project is revamping the teen drug prevention and awareness genre by presenting gritty, harrowing, true-to-life commercials, billboards, magazine ads, posters and websites.

Founded in February 2005, the nonprofit organization’s primary objective is to significantly reduce first-time methamphetamine use among teens in Montana. The Montana Meth Project is also trying to raise awareness about the scale, depth and critical nature of the methamphetamine problem by mobilizing communities across the state to get involved in prevention, education and treatment efforts.

One out of five Montana adolescents ages 12-17 currently reports having close friends who use meth. The admission rate for methamphetamine/amphetamine use in Montana increased 520 percent between 1992-2002. With the majority of the state being rural, it busts the myth that drug use is more prevalent in urban areas.

In attempting to get inside the minds of teens, the Montana Meth Project developed the “Montana Meth Use and Attitudes Survey.” The online questionnaire provided rich insight, both qualitative and quantitative, into young people’s attitudes and behaviors related to methamphetamine. Additionally, the Montana Meth Project utilized a series of teen focus groups to gain more perspective. The information gathered was key to developing the project’s media blitz of hard-hitting, anti-meth messages. The campaign kicked off last

September and represents the largest cause-marketing effort of its kind in the state’s history. Initial survey data are available on the Montana Meth

Project website at; the organization is currently processing data collected in the second wave of the survey.

Peg Shea is executive director of the Montana Meth Project as well as a licensed addictions counselor and social worker. She previously served as executive director of Western Montana Addiction Services and as program director of Turning Point in Missoula. Shea has been working in the field of addictions and mental health for more than 28 years.

Shea said the organization’s campaign is different from most other anti-drug messages in that it views meth use as a consumer marketing problem. Basically, she said, it boils down to the fact that most kids who try meth don’t really know what it is or understand what they are getting themselves into. In the last six months, the Montana Meth Project has purchased 25,000 minutes of TV commercial airtime and 25,000 minutes of radio airplay in addition to numerous billboards and posters. “I think we have been successful in raising the dialog about methamphetamine and the horrific nature of the drug,” Shea said.

The multimedia ads are just one facet of the project’s anti-meth crusade, which also includes community action and public policy. “I travel around the state to talk to anybody and everybody about the campaign and deepen the conversation on meth addiction, prevention and awareness,” Shea said. “I speak to middle schools, high schools, businesses, service clubs, PTAs, churches — whoever will invite us to have a conversation about our project, our product and our strategies.” Since last October, she has averaged approximately three presentations a week, speaking to more than 10,000 individuals at 75 different venues.

“This is a very youth-informed campaign,” she said. “We learned from the focus groups and surveys that kids don’t want lectures by adults. They want to hear from other kids telling their stories. They told us in almost a daring way, ‘If you do a television commercial, it has to be edgy. It has to catch our attention and focus because we are a pretty media-savvy group of kids.’ So that’s why you see what you see. Universally, the feedback from the kids is that the ads are a home run, that the television ads, in particular, get their attention. Even though they find some of the ads disturbing emotionally, they watch them.”

In fact, Shea said, many of the teens are so taken by the TV spots that they instantly recall the names of the ads and recite the lines word for word. “They can literally describe the actors and actresses, the scenes, language, the take-away messages,” she said. “That recall is what we are shooting for.”

The Montana Meth Project continues to collect feedback and is further refining the campaign later this month with a new series of ads. Shea encourages other states to take a more aggressive stance with their anti-drug programs and hopes the Montana Meth Project will be viewed as a template for those changes. “If another state wants to replicate this program, that would be great — most importantly, great for that state,” she said. “The impact that this has had on increasing awareness and communication is just phenomenal. I know for certain that parents and kids are talking about methamphetamine because these teaching moments are in their face.”

For more information about the Montana Meth Project, visit The project’s sister site, aimed directly at teenagers, is at Counselors and other interested parties can download the print ads, commercials and radio messages on both sites for free. All the ads may be viewed, aired and reproduced in any forum, with the exception of paid media outlets. For example, any school may air the commercials for students, but the commercials cannot run on another state’s TV network or cable station.

Caitlin, 22

Caitlin is well known in Montana. People hear her voice on the radio in between pop songs and traffic reports. But she’s not a local disc jockey; she’s one of the many voices of meth. As a former meth addict, she volunteered her story to be aired as one of the Montana Meth Project’s four radio segments.

At the age of 15, Caitlin was a normal teen with loving parents and lots of friends. She was an above average student who played soccer, volleyball and basketball. Like many of her peers, she had occasionally experimented with alcohol and marijuana, but she describes herself as “a good kid.” One day at lunch, however, her drug experimentation took a sinister turn while in the back seat of a friend’s car.

“(My friend) pulled out this little baggie of powder and asked me if I had ever tried it,” Caitlin recalled. “I had no idea what it was. I asked her, and all she said is that it would make me feel really good and excited. So I did it, and I felt on top of the world — fantastic. Little did I know that was methamphetamine.”

From that moment on, her world shifted. Caitlin began asking around school for more of the drug, which was nonchalantly referred to as “speed” by many of the students. “For me,” Caitlin said, “it wasn’t cocaine, which kind of had a scarier sound to it. I wasn’t informed about meth and what speed was. So I thought it wasn’t that bad.”

In fact, she thought it was pretty good at first. She was able to concentrate harder in school and do her schoolwork twice as fast as before. But her casual use quickly turned into full-blown addiction within a few short months. To score more meth, she withdrew from her social groups and started to hang around people who sold and cooked the drug. With the drug now readily available to her, it began to take control of her life. Her addiction quickly escalated from snorting the drug to smoking it. She and her new friends would do meth before, during and after school, but somehow she managed to keep playing sports and passing her classes. Because she was at least semifunctional at school and at home, Caitlin’s parents were oblivious to what was happening to their daughter.

“The last thing on their minds was that I would possibly be doing drugs,” Caitlin said. “It just wasn’t in the cards for my life. It wasn’t in their head that this would ever possibly be something I would be involved in.” Her parents did notice a difference in her attitude and behavior, Caitlin said, but because she had been diagnosed with depression and attention deficit disorder prior to her drug addiction, they associated the changes with her mental conditions.

Caitlin became a skilled manipulator to hide her habit and obtain more drugs. She constantly fed excuses to her parents. All too soon she was six months into her addiction; for the last half of that time she largely did meth alone every night in her room.

“(Meth) makes you want to really focus on a certain task and do it for hours and hours,” she said. “I liked to do it alone so I could do my own thing. I would draw or spend three hours slowly putting on make-up. I would pick at myself — at my face, my legs or arms — thinking there were things in my skin.” Caitlin would also meticulously clean her room and bathroom. She would do her homework but not really get much accomplished because she would fixate on perfecting her handwriting rather than on what she was writing about. “It’s super-concentrating on silly little things for long periods of time,” she said.

Meth is odorless, so it was easy for Caitlin to smoke it in her bedroom without getting caught. She often stayed up all night doing the drug, so she began to fall asleep in class. “All of the changes were happening, but I could care less,” she said. “I could care less about my family or my friends, school — all I cared about was the drug. How am I going to get it and how am I going to pay for it?”

At that point, an anonymous student went to the school counselor and informed her that Caitlin was a meth addict. Her parents were called in to meet with the school staff. That afternoon when Caitlin returned home, her parents confronted her about the counselor’s accusations. “I denied the entire thing,” she said. “Meanwhile, I was coming down off of it (meth) and I actually fell asleep in the middle of (our conversation).”

While she was passed out, her parents searched her room and found dozens of small empty baggies, burnt tinfoil and several empty lighters. With the drug paraphernalia as solid proof, they had to accept the fact that their only child had a drug problem.

Caitlin was sent to an outpatient program for six months and attended 12-step meetings. She stayed clean the entire six months, but the very day she was released from the program, she met up with her old friends and got high. “I wasn’t planning on using again is the funny thing,” Caitlin said. “I really liked the 12-step meetings. Being clean was feeling good and things weren’t so crazy, but I just really loved the drug and the way it made me feel. I started all over again.”

For the next nine months, Caitlin had a daily drug habit. She conned her parents with a series of lies. Her athletic build disappeared as she lost more than 30 pounds in a matter of weeks. Her face and legs broke out with sores, which she covered with excessive make-up and clothes. Now a senior in high school, her grades began to plummet, and for the first time she was failing classes.

Even with all the telltale signs of drug use, Caitlin found ways to explain everything away to her parents. She was seeing a counselor on a regular basis for her ADD and depression, but she never disclosed anything about her drug habit. “I had all these excuses,” she said. “It sounds so stupid (of my parents), but they are actually really smart, educated people. They still wanted to believe that I was clean. And I was a crazy manipulator. I could talk them into anything. I’m breaking out because I bought a new kind of make-up. I’m losing weight because I’m on a new diet. I’m not doing well in school because of the ADD, and the senior level work is just really hard. I’m depressed, so it’s making me sleep and I’m on this new medication that makes me tired. Those are the reasons — I’m not doing drugs again.”

She even went as far as daring her parents to drug test her. “I was living this one big lie,” Caitlin said. Her parents bought into that lie, at least for a little while. But her grades were slipping so much that it appeared she might not graduate. That’s when her father confronted her again about using drugs. This time Caitlin didn’t deny it, although she immediately regretted telling him the truth and left the house to go get high.

Acknowledging that outpatient treatment programs wouldn’t work for her, Caitlin was sent to a wilderness treatment center, where she spent the next five weeks confronted by the elements of a Utah winter. Her next step was another inpatient treatment center for five months. While in treatment, Caitlin was approaching her 18th birthday, so she was given intense counseling in the event she elected to leave on her own. Instead, Caitlin signed herself back in as an adult. She was determined to stay clean and even earned her high school diploma while in the treatment center.

Now, five years later, she is still sober and has earned a degree in social work. She is a drug addictions counselor at a residential treatment facility in Missoula and has applied to a master’s program. Her journey of addiction is a profound one, and she is using her experiences to help those like her — the “normal” kids.

“Many parents think that their kid isn’t going to do meth,” she said. “Little Jane over there who gets straight A’s and plays basketball, she’s never going to do it. But I was that girl. People need to be constantly aware that anybody can do it. There are no stereotypes of what kind of kid will do meth. It can be any kid.”

While working for the treatment center, Caitlin was approached to tape the radio spot for the Montana Meth Project and agreed. “A big part of my story is that I had no idea what I was getting into,” she said. “I had no clue what it was. I was totally uneducated and uninformed about meth. These commercials will help present an awareness that I didn’t have. Hopefully these kids will take this message, and if they are ever presented with meth, they will be able to make the right decision.”

Caitlin believes that if she had only known more about meth that day at lunch — if she had seen or heard anti-meth messages such as the ones being presented by the Montana Meth Project — her life might have been different.

Unveiling China

Angela Kennedy

When Kelly Duncan was chosen by People to People Ambassador Programs to lead a school counseling delegation to China in partnership with the American Counseling Association, she knew she would encounter a vastly different culture and worldview. Still, said Duncan, executive director of the South Dakota Counseling Association, a branch of ACA, “It was a huge surprise to find out that (China) didn’t have anything equivalent to a school counselor.”

Despite that revelation, Duncan returned from the trip confident of one truth: Although separated by thousands of miles, the people of China and the people of the United States are more alike than different.

That point was driven home when Duncan’s delegation visited an elementary school in Beijing and the students were allowed to ask the U.S. school counselors questions. When the students found out Duncan had children of her own, they were curious to know what books her daughters read. When Duncan mentioned Harry Potter, “There was an eruption of excitement,” she said. “I just thought, ’How universal.’”
President Dwight D. Eisenhower believed that international understanding would increase the chances of peace among nations and established the People to People Ambassador Programs to facilitate that process. He also decided that private citizens would be more effective than government entities in carrying out People to People’s mission.

As Mary J. Eisenhower, CEO of People to People International and President Eisenhower’s granddaughter, states on the organization’s website: “(He) believed that ordinary citizens of different nations, if able to communicate directly, would solve their differences and find a way to live in peace. This simple thought — that people can make the difference where government cannot — is People to People’s foundation. He believed that if people could visit each other’s homes, attend their schools and see their places of worship, then the misunderstandings, misperceptions and resulting suspicions — which were making war a viable option — would disappear. He wanted people to know and understand that while we are all very different, our values, goals and day-to-day issues are very much the same.”
The relationship between ACA and People to People began when ACA Chief Professional Officer David Kaplan led a delegation of counselors to China in October 2004. Near the end of 2005, two additional delegations co-sponsored by ACA visited China, one led by Duncan that focused on school counseling and another led by Amy Benedict-Augustine that focused on career counseling.
Kelly Duncan, school counseling delegation.

Duncan’s delegation included 11 other school counselors from across the United States, plus a graduate student. After arriving in China, the group members spent two full days at Beijing Normal University, where they joined 11 other education-related delegations at the 2005 U.S.-China Joint Education Conference. The delegates received an overview of China itself and then heard presenters speak on various aspects of education in both the United States and China.

Duncan, an assistant professor of counselor education at Northern State University in Aberdeen, S.D., presented on the role of the school counselor in the United States. Her counterpart from China presented on the Asian nation’s mandatory moral education program, which is part of its school system. “What I can closely liken it to is the character education programs we offer in elementary schools in the United States,” Duncan said. “But it was very, very clear to us that day that they didn’t utilize school counselors the way we do (in the United States).”

Three of the delegates from Duncan’s group also gave presentations on counseling programs taking place in their individual schools. “That day we had a lot of dialogue with our Chinese counterparts,” Duncan said. “They were just like sponges, wanting to soak up everything we told them. School counseling is in its really early birth there as a profession, so there is much opportunity for dialogue, sharing of ideas and collaboration.”

Beijing Normal recently became the first university in China to offer a school counseling study track to its students, Duncan said. The program is in its infancy and is not yet equivalent to a full-blown master’s program, she said. In fact, Duncan has been invited to help Beijing Normal develop an appropriate curriculum for its school counseling track.

While the interactions and idea exchanges at the education conference were rewarding, Duncan said, “By that third day we were just itching to get into school settings.” The time spent with students at two Beijing elementary schools ended up being Duncan’s favorite part of the trip.

Duncan and her fellow delegates fielded questions from students at both schools. Interest among the students, most of whom were 10 to 12 years old, picked up noticeably when Duncan revealed that she was not only the mother of multiple children but of four daughters. China has practiced a one-birth policy — highly discouraging couples from having more than one child — since the late 1970s in an effort to control its population growth. In addition, in general, sons are still more valued in China than daughters because sons traditionally assume the role of working and taking care of their parents as they age.

One student even asked Duncan what she thought of China’s one-birth policy, which Duncan admits she answered “very delicately.” But the focus of the questions soon shifted to Duncan’s daughters themselves — what they liked to read and how they spent their “pocket change” (or allowance, as Duncan eventually figured out).

While Duncan and the rest of her delegation had to rely on translators in most instances to communicate with their Chinese counterparts, she came away impressed that China has recognized the benefit of bilingualism. English is now being taught in many classrooms, beginning in kindergarten, she said. In fact, many of the elementary school students the delegates talked to already spoke English better than their teachers, she noted.

The closest equivalent in China to an American-style school counselor was the teacher in charge of the moral education program, Duncan said. Otherwise, she said, the lead classroom teacher tended to handle tasks and situations in Chinese schools that school counselors or administrators would handle in the United States.

From what Duncan witnessed, children with severe emotional or learning problems are not placed in China’s public school system. She also received the impression that China’s schools do not have as many discipline problems as U.S. schools. However, she said, classroom teachers, who handle most of the disciplinary matters in Chinese schools, reported that more of these problems are beginning to crop up. According to Duncan, teachers ascribed this in some part to China’s one-birth policy, saying that children tend to be “spoiled” by receiving the undivided attention of their parents. Schools in China are also beginning to deal with the issue of bullying, Duncan said, which they believe has to do with their students’ exposure to Western media.

There is a strong emphasis on academic preparation and achievement in the Chinese school system, Duncan said, because all students who want to continue on to a university must take a national entrance exam. “That exam really kind of charts their future,” she said. But there is also growing recognition among school personnel that this pressure-packed environment causes students stress, Duncan said. She expects more steps will be taken in the future to help students cope.

Despite the lack of “American-style” school counselors, Duncan was impressed by many components of the Chinese school system. In fact, she said, in many instances China’s teachers were meeting the main planks of the American School Counselor Association National Model — academic achievement, social/personal development and career development.

“There is quite an emphasis in China on getting parents involved (in their children’s education) and in recognizing these parents for their efforts,” Duncan said. In return, there appears to be a huge investment in education among the parents, she said.

In addition, she said, the profession of teaching is cherished in China. “Teachers are highly, highly respected in ways that I think we’ve lost here in the United States,” Duncan said. “That’s probably why they don’t have as many discipline problems. And the teachers desire to give extra because they feel so appreciated.”

Duncan also noted that Chinese students have far more global perspective in general than U.S. students. They have a firm grasp not only of Chinese history, she said, but also the history of the rest of the world.

The students also have a strong belief that each individual plays an important role in making up a healthy family and nation, Duncan said. “Their thinking is, ’If we prosper, our country prospers,’” she said. “They don’t take as individualistic a view of things. They believe in working collaboratively and cooperatively.”

In her final address to the Joint Education Conference, Duncan discussed her delegation’s experience in China: “As I reflect upon the time spent with our Chinese counterparts and experiences at the Chinese schools we visited, it is apparent to me that we have far more in common than in terms of differences. We all share as a goal the desire that children be happy and well-adjusted. We share in common our desire to instill an excitement and love for learning that helps children be successful academically. We hope the children with which we work will learn to love themselves and others so they can have harmonious personal and social relationships. And we hope we can assist them to choose a career or calling for their life that is the right fit and can continue to add to the harmony in their lives. We have much to share and learn from each other as this profession grows in both the United States and China. New techniques combined with ancient traditions can create a next generation filled with individuals who understand self and others and share a passion for collaboration and cooperation.”

Since returning from China in December, Duncan has been asked if she would lead another counseling delegation to either China or Russia. She’s also been in regular contact, via e-mail, with three Chinese university students who spent time with her delegation and were particularly excited about school counseling practices and theories. Duncan is exploring the possibility of bringing the students to the United States or of organizing a teacher exchange between China and the United States.

“Regardless of where we live, we get caught up in the narrow view of what’s just outside our kitchen window,” Duncan said. “But encountering other cultures enhances our ability to understand differences in worldview and reminds us that, ’Oh yeah, there are different ways to look at things.’ It also enhances our own work when we come back home.”
Amy Benedict-Augustine, career development
Benedict-Augustine was a member of the first ACA-led People to People counseling delegation to China in October 2004. Amazed by the experience, she commented to David Kaplan while on the trip that she would love to return to China with a delegation of career development professionals. He encouraged Benedict-Augustine, director of the Career Development Office at the College of Agriculture and Life Sciences at Cornell University, to pitch the idea to People to People.

She followed through, and in November 2005, with help from the National Career Development Association, ACA and the National Association of Colleges and Employers, she returned to China leading a People to People delegation focused on career development. Her group included 18 people, including 16 who worked in college career offices or as career consultants.

The delegation visited a variety of settings and people associated with career development in China, including:

  • The deputy director of legal affairs for the nation’s Ministry of Labor and Social Security
  • The Guiding and Servicing Center for Student Employment at Beijing University
  • Personnel from the School of Psychology and the Career Guidance Center at Beijing Normal University
  • CBP Career Consultants
  • The Shanghai Community Aid Center for Employment

Delegation members also gave copies of NCDA’s journal, The Career Development Quarterly, to their Chinese counterparts. The journal issue focused on career development topics from an international perspective. “Career development is really in its infancy in China,” explained Benedict-Augustine, a member of ACA, NCDA and the Association for Spiritual, Ethical and Religious Values in Counseling. “Many of our career development theories don’t translate because of cultural and governmental reasons. … But generally speaking, the people we talked to were very pleased by the information we shared. Everyone we met was very excited to develop collegial relationships and wanted to continue the conversations.”

The potential growth of the career development profession in China is particularly intriguing, Benedict-Augustine said, because of the dramatic social and economic changes taking place. Career choice is still something of a foreign concept in China, she pointed out, because until relatively recently, people had their jobs assigned to them by the government. They often remained in the same job throughout the course of their working life.

Today’s university students are very excited about the prospect not only of choosing their own jobs but also mapping their own career paths, said Benedict-Augustine. However, both students and career development professionals in China still face unique obstacles. For instance, she said, high school students must take a national entrance exam that largely dictates which college or university they can attend and what they can study.

Currently, high school students must also determine their majors before entering college — usually with little or no career guidance — and are given only one chance to change their majors. “They also face family pressure to choose a ’suitable career’ and ’save face’ for the family,” Benedict-Augustine said. Zhi-Jin Hou, an associate professor of psychology at Beijing Normal University and the person leading the charge for career development in China on the academic front, explained to the delegation that parents often pressure their children to select high-prestige areas of study such as medicine or law. As delegate Brian Schwartz, a consulting psychologist and expert in the field of career management, pointed out in his summary of the meeting, this pressure means “many pursue those degrees without any interest in their studies.”

University students in China are also in great need of career counseling because during their senior year they sign employment contracts. These contracts can last from one year to several years and must be fulfilled before they can change jobs. And again, culture plays an influential role in job choice. “Students are drawn to professions by status and how it will help the country,” wrote delegate and career management consultant Jon Sakurai-Horita in his summary of the presentation at the Beijing University Guiding and Servicing Center for Student Employment. “A career is not just a way to make a living but a way to be a ’pillar’ to help China do more for society.”

The delegation also learned about China’s residency cards. Chinese citizens cannot simply “move where the jobs are,” Benedict-Augustine said. An employer must be willing to hire you and help you get a residency card for that particular area before you are allowed to move, she said. This policy severely limits people living in rural areas, where there is less job choice and resources, she said. To complicate matters further, many employees must leave their families behind to accept a new job. Their partners are forced to remain where they hold residency until they can also secure employment and a new residency card. “It’s a very interesting challenge,” said Benedict-Augustine.

Another area Benedict-Augustine found especially intriguing was the explosive growth of private career consulting firms in China. “There is fierce competition in China between these organizations,” she said. “They’re realizing that there’s a need to be filled here, and they’re all clamoring to be the best.” CBP Career Consultants was the first career consulting firm in China, established in June 2004. Less than two years later, more than 300 competitors have entered the marketplace. CBP explained the many challenges it is facing to the delegation, including resolving how to combine Eastern and Western cultures and values in the field of career development, determining what factors will impact career development in China in the future and trying to establish some type of required qualifications for career consultants.

Despite the obstacles, Benedict-Augustine is encouraged by the work already taking place in China. She came away particularly impressed by Zhi-Jin Hou’s work at Beijing Normal to develop career development theories and services. The two have developed an e-mail correspondence and have discussed working on a joint research project focused on the differences in the ways Chinese nationals and Chinese-Americans make career decisions.

Benedict-Augustine was also impressed by representatives of a Peking University student association interested in conducting and promoting career development research. The students wanted to continue a dialogue with Benedict-Augustine, and upon returning to the United States, she set up a “pen pal” exchange of career development issues between these students and student peer advisers in her career development office at Cornell. She is in the process of expanding the exchange to include other career development offices at Cornell.

Benedict-Augustine said she would highly recommend that all counselors participate in a People to People delegation. “It broadened my understanding of the issues in other cultures,” she said. “I got new ideas, but the trip also made me realize the effectiveness of many of our existing ideas. As the group has kept in touch (after returning to the United States), many have said it was a life-changing experience, both personally and professionally.”

Psst … pass it on

Angela Kennedy

When it comes to building a thriving referral base, there are two words every private practitioner’s marketing plan should include: niche and networking.

Niche marketing is the opposite of mass marketing in that counselors target a specific segment of the population. Deliberately narrowing the client field sounds counterproductive, but successful private practitioners have done just that. By serving a select group or population, counselors can focus their marketing plans and network with people who are the “gatekeepers” to that population.

Lucy MacDonald, author of Start and Market a Successful Private Practice, recently shared these strategies in a packed Learning Institute at the American Counseling Association/

Canadian Counselling Association Convention in Montréal. “Not having a niche is often the mistake that new practitioners make, myself included,” she said. “I think underlying that is the fear that you will be turning away clients. However, the reality is as practitioners, we cannot be qualified to offer counseling in all areas.”

Having a counseling niche is important for a number of reasons, MacDonald said. “First, it will help set you apart from the other private practitioners, and it allows the consumer to find you more easily. It helps you find your ideal client or the person whose needs fit with the services you are offering and, most importantly, it helps you to focus your advertising efforts and your advertising dollars.”

To illustrate her point, she used a typical networking situation in which several individuals are introducing themselves and describing their work. “Nine people say, ’I’m a counselor working with individuals, families and couples,’ and one person says, ’I work with newly divorced fathers.’ When someone asks you about a counselor for a divorced father, who are you going to remember?”

MacDonald asked. “That doesn’t mean the other nine counselors can’t offer that service, but because they didn’t highlight it, chances are when it comes to making referrals — even among ourselves as counselors — who are you going to go to? That is the benefit of niche marketing. Is it counterintuitive? You bet! Does it work? Almost always.”

When people start out in private practice, MacDonald said, it’s very important that they take some time to consider where their passions lie and to examine their potential niche. Private practice niches can be based on:

  • Geography (serving clients in a rural area, for example)
  • An age group (women 50 and older who are considering a second career; teenagers)
  • Professional groups (lawyers who are struggling with burnout; first-responders at risk of suffering post-traumatic stress disorder)
  • Special interest groups (grieving pet owners)
  • Life stages (marriage, pregnancy, retirement)
  • Specific industries (entertainment, technology)
  • Demographics (divorcees, singles, single parents)

Often the niche is based on something the practitioner feels passionate about, but a specific passion doesn’t guarantee a successful business. Before choosing a niche, consider the following questions:

  • Is the niche large enough to support a flourishing client base?
  • Will the niche continue to grow?
  • Do you have the skills, knowledge and experience to work with the specific population you want to target?
  • Is the niche already overserviced by other practitioners?
  • MacDonald pointed out that counselors considering the move to private practice should do some market research before selecting a niche to learn who else is working with those clients. “If it’s overserviced,” she said, “then by definition it is no longer a niche. As a private practitioner you have a choice — you can be one of hundreds of practitioners or one of a kind.”
  • But there are several other benefits and values to selecting a niche aside from simply standing out from the crowd:
  • A niche sends the message “I’m an expert in …”
  • A niche will increase referrals from colleagues
  • Working in a niche demographic makes it easier to develop long-term relationships with clients
  • In some cases, a niche will allow the practitioner to charge more for services
  • A niche allows the practitioner to focus marketing messages and efforts
  • Finding a niche that you’re passionate about makes it more likely that you’ll find fulfilling and meaningful work

“It’s also important that the people in your niche have the financial resources to pay for your services,” MacDonald advised. “For example, if you have a passion for helping young single mothers, you may find that this group may not have the financial resources to pay.” In that case, she said, private practitioners may have to look at other ways of supporting that work, such as getting corporate sponsorship or pursuing another niche that keeps their practice stable while at the same time allowing them to remain involved in the niche about which they feel most passionate.

On the other side of the coin, MacDonald said counselors shouldn’t choose a niche just because it’s lucrative. “You have to have a genuine interest and passion for your niche,” she said. “Otherwise you won’t survive emotionally and psychologically. The satisfaction won’t be there for you.”

On occasion, a counselor can walk backward into a niche that proves to be just as beneficial. ACA member Pat McGinn is a perfect example. When she started her private practice on the South Side of Chicago, she visited many of the local churches and seminaries. Having been a Roman Catholic nun for nine years, she thought her religious background might help her attract clients. She met with rabbis, ministers and people in charge of student life at seminaries to talk about her past experience and to discuss her counseling practice. She left a few business cards and hoped for the best. Today, more than 20 years later, she is still receiving referrals from those sources.

“My experience turned out to be very useful in the fact that I understand what these young people are going through in terms of getting prepared to be ministers and that I have studied theology and church history,” McGinn said. “I know the background, Scripture and theology. And once you’ve taken two or three people through their ordination process, the technicalities and emotions, you know the system.” Her familiarity with the process put many of her clients at ease, she said, because they realized they didn’t have to explain every detail. “I didn’t set out for that to be my marketing niche,” she said, “but it did evolve that way.”


The gatekeepers

Once private practitioners have selected their niche, they must identify important “gatekeepers” — people who have access to that specific population. “Gatekeepers are able to refer clients to you that you normally wouldn’t have direct access to,” MacDonald said. “For example, if your niche market is parents of special needs elementary school children, then you would connect with school principals, school nurses and counselors about your services.”

After meeting and forming a professional relationship with these school officials, MacDonald suggested taking it a step further. For instance, offer to attend a parent-teacher night and give an informal presentation on reducing homework stress or improving study skills. She also advises practitioners to partner with gatekeepers for continued referrals.

The number of gatekeepers depends largely on the niche. Keep the following examples of gatekeepers in mind as you look to build your referral base:

  • Clergy members
  • Physicians
  • Attorneys
  • Employee assistance programs and human resource managers
  • Members and administers of academic communities
  • Social service agencies
  • Family support centers
  • Professional organizations and
  • associations

Peer and social networking

Many counselors, especially those in private practice, cringe at the thought of networking, afraid they will come off as the cheesy car salesman type. However, networking can be not only the best but also the cheapest way of getting the word out about a new private practice.

“Networking is a great way to advertise, especially when first starting out, because you usually have more time than money,” MacDonald said. “When you are in private practice you are your business, so wherever you go you are networking and marketing, whether you like it or not.”

MacDonald encourages counselors to network with their fellow counselors as well as other individuals outside the mental health professions. “Networking with your peers is often an overlooked area,” she said. “Many people just starting out avoid networking with their peers because they believe there is competition. However, if you have a niche you don’t have to worry about that. We want to set each other up in having areas of expertise. It’s a two-way street. Don’t neglect networking with peers, especially if you have a niche and you are able to articulate what that niche is in a very clear way.”

To help counselors do that, MacDonald suggests that they develop a “verbal business card” — a brief marketing message that explains what they do. The sound bite serves to highlight the practitioner’s niche and will help others to remember the counselor’s specialty. She tells counselors to practice presenting the verbal business card aloud with people they know and with others who are unfamiliar with their occupation. Counselors should then ask these individuals what they think the sound bite means and use the feedback to make changes accordingly.

An effective verbal business card will create a good first impression and make it easier for newbies to get over their fear of marketing, MacDonald said. “Because part of creating a good verbal business card is putting something in writing, practice it until you feel comfortable and confident saying it,” she said.

When networking in social situations, counselors should remember to avoid using mental health jargon and terminology, MacDonald said. She suggested that counselors develop a layman’s version of their verbal business card to answer that most common of cocktail party questions: “So, what do you do?”

MacDonald also encourages counselors to continue networking even after their practice takes off. They should set aside regularly scheduled time to attend a networking function or meet one-on-one with referral sources, she said. “It’s important to have networking incorporated into your weekly and monthly work cycle,” she said. “This is part of the work that you do.”

Seminars and workshops

One way to network on a broad scale, gain the public’s trust and avoid the sales pitch is to present free seminars or workshops. “It’s a fair exchange,” MacDonald said, “and everyone walks away feeling win-win instead of that you have hoodwinked them into something. It’s an ’attraction approach’ as opposed to a ’pursuing approach’ in marketing.”

Look for free space to present seminars in local churches, community centers, libraries or schools. Hosting free screenings or workshops will help private practitioners not only to present themselves as experts but to attract ideal clients as well.

Follow these tips for holding a successful seminar:

  • Keep it under an hour
  • Bring plenty of business cards
  • Provide handouts with tips, facts, answers to frequently asked questions and contact information
  • Collect contact information from attendees (“Would you like to subscribe to my monthly newsletter or
  • e-mail list?”)
  • Take seating reservations so you will know how many people plan to attend, and then prepare accordingly
  • Create an easy-to-follow presentation
  • Don’t worry about giving away too much (or not enough) information
  • Don’t be afraid to start off with the basics
  • Always hold the event at the beginning of the week instead of later in the week or on the weekends
  • Advertise by placing announcements in the free community events listings of local newspapers, posting fliers on bulletin boards, etc.

But what if you’re a bit shy around new people or still have nightmares about giving your valedictory speech in your underwear? Public speaking is daunting to many people, so MacDonald suggests that counselors attend Toastmasters or some other public speaking skills workshop.

“We aren’t trying to sell something that people don’t want, nor are we selling something with an inflated dollar amount,” she reminds counselors. “As a private practitioner, you can legitimately take the approach that you have expertise in a specific area and you are offering a valuable service.”


Once referrals start coming in, practitioners can do several things to make sure they don’t stop. Most important, MacDonald said, is to make good, appropriate referrals to fellow counselors. They will remember and reciprocate, she said. When making referrals, give the client the referred counselor’s business card with your name on the back: “Referred to by …” Thank-you cards may be appropriate in the beginning, but after a referral network has formed between two practitioners, a quick e-mail will do.

MacDonald also suggested that private practitioners strive to become the go-to resource for other counselors. “People may know that you might not be able to help (a specific client), but you know who can,” she said. MacDonald described herself as a hub (“with many spokes”) within her community. “That’s a very valuable position to be in,” she said. “Colleagues will want to return the favor, and the work will come back to you.”

For more information about niche marketing and networking, or to purchase MacDonald’s book, visit

Keynotes praise, challenge counselors

Jonathan Rollins

Editor’s note: Both audio and video downloads of the keynote addresses delivered at the ACA/CCA Convention are available on the ACA website at

If counselors occasionally feel that their work goes unnoticed or underappreciated by the world at large, those in attendance at the American Counseling Association/Canadian Counselling Association Convention in Montréal received a healthy dose of both gratitude and encouragement. Both Stephen Lewis and Mary Elizabeth “Tipper” Gore, the convention’s keynote speakers, readily and enthusiastically acknowledged the pivotal role that counselors play in society.

“It’s a tremendous privilege to speak (at this convention),” said Lewis, the U.N. secretary-general’s special envoy for HIV/AIDS in Africa and one of TIME magazine’s “100 most influential people in the world” for 2005. “I have a huge admiration for the profession of counseling. … You are people who care deeply about the human condition.”

Gore, the mental health policy adviser to former President Bill Clinton and the wife of former Vice President Al Gore, told the audience, “Professional counselors have a very special place in my heart. … I know how very important your work is.” She told the assembled counselors that they perform a variety of important tasks, from saving lives to making sure that people live their lives more fully, from keeping families intact to helping people from all walks of life reach their potential. “You are not choosing an easy road in life when you decide to work in the mental health field,” said Gore, who asked the counselors in attendance to think about the victories they had achieved and to celebrate each other’s indispensable contributions with a round of applause. “I know sometimes we don’t do that enough,” she said.

But neither keynote speaker came to the ACA/CCA Convention solely to pat counselors on the back. Lewis in particular made a passionate plea for counselors to stand up and fill the void as “moral anchors” for a world that oftentimes seems adrift. Lewis, the former deputy executive director of UNICEF and former Canadian ambassador to the United Nations, said he was particularly disturbed that nations in the Western world are spending billions of dollars to sustain wars but can’t seem to find a “microscopic smidgen of that to sustain the human condition.”

A ‘call for action’ in Africa

Much of Lewis’ address on April 1 focused on what he termed the “almost hallucinatory nightmare” of the HIV/AIDS pandemic in Africa. Based on current projections, he said, by 2012, the disease will have killed or infected approximately 100 million people. In his travels throughout Africa, Lewis regularly witnesses the devastation wrought by HIV/AIDS. One person told him, “My country is living with a holocaust.” Another simply declared, “My country is on its knees.”

In reviewing the program guide for the ACA/CCA Convention, Lewis noted that he saw one session for counselors that discussed feminist theory and another that focused on grandparents who are raising their grandchildren. Both topics have relevance to the current climate in Africa, he said.

No other communicable disease has ever focused on women to the extent that HIV/AIDS has, Lewis said. In sub-Saharan Africa, he explained, 60 percent of those infected are female. “The struggle to empower the women of Africa … is one of the greatest struggles we have today,” Lewis said. “You can’t imagine how frightened and anxious these large numbers of women are.”

Lewis said African mothers regularly ask him, “What’s going to happen to my children when I die?” Lewis admitted to the audience that he doesn’t know the answer to that heart-wrenching question, but he does know that Africa has a tremendous need for counselors.

“Counseling has become one of the most crucial components of treating this pandemic,” he said. Some African nations are now requiring that their citizens be tested for HIV/AIDS, Lewis said, and this testing requires both pre- and post-counseling. “The best counselors I have seen in Africa actually accompany the woman back home for the moment of disclosure to their husband,” Lewis reported. As can be imagined, the atmosphere surrounding these encounters is often intense. Counselor mediation between the partners “is becoming increasingly important,” he said.

Orphans are another group in desperate need of counseling, Lewis said. No one anticipated the number of children that would be left behind by the onslaught of HIV/AIDS in Africa, he said, and “the deluge has become an almost irreversible torrent.” Millions of African children have been left to crave not only nurturance and love, Lewis said, but simply a tactile connection with an adult. When he travels in Africa, children regularly grab on to him, Lewis said, clinging to the slightest opportunity for physical contact. Children as young as 8 are now heading sibling households, he said, while many others are reduced to wandering the landscape, overwhelmed by their circumstances. “These kids are desperate for some type of thoughtful, sensitive, therapeutic response,” Lewis said.

The communities are too poor and the numbers too staggering to absorb all the orphans, Lewis reported. In many cases, young girls are persuaded to have sex for pennies, while young boys are convinced to enter into egregious child labor because they believe it offers them their only hope of survival.

Under these most trying of conditions, Lewis said, grandparents — in particular, grandmothers — have emerged as Africa’s unsung heroes. At an age when “they should be looked after by their own children,” he said, “instead they are starting to parent again.” And in trying desperately to meet the children’s needs, these grandmothers have their own need, Lewis said. They often report to him that they desire counseling even more so than medicine or money, he said.

While the efforts to find a vaccine or develop drugs to treat HIV/AIDS are intense, Lewis said, what are not adequately taken into account are the African societies raw with loss. That’s why he told the assembled counselors that they “have an extremely important contribution to make” to the ongoing battle against HIV/AIDS. Lewis said he could envision a “Counselors Without Borders” type of program and charged those in attendance with fashioning some type of solidarity with Africa and the developing world.

“The opportunity, the possibility of the counselors of the world united … in the decency that pounds in your hearts,” Lewis said, “you can’t imagine the difference you could make.”

CCA President David Paterson told convention attendees that Lewis’ address should be “taken as a call for action.”

When life skips a beat

When ACA President Patricia Arredondo started thinking about possible speakers for the convention, Tipper Gore was at the top of her list. “She is a tireless advocate in eradicating the stigma of mental illness,” Arredondo said. “She is someone who is so humble about what she does yet has made such an impact on our society.”

Indeed, Gore’s career has been the embodiment of activism, including founding such groups as the Congressional Wives Task Force, the Parents’ Music Resource Center and Families for the Homeless. But in addressing ACA/CCA Convention attendees on April 2, Gore said she didn’t originally set out to blaze a trail as an advocate and activist. An avid photographer, she shared not only her personal story with the audience but also family photos that marked her life’s journey.

Married at age 21, Gore envisioned herself becoming a family counselor and thought her husband would become a writer. She went on to earn her bachelor’s degree in psychology from Boston University and then her master’s degree in psychology from George Peabody College at Vanderbilt University. Her interest in family and mental health issues was born in part from personal experience. Her parents divorced when she was 4, and her mother struggled with clinical depression. “At the time,” Gore said, “mental illness was something that wasn’t discussed” outside of the home.

Her plans to become a counselor changed, however, when “life skipped a beat” — a theme repeated throughout Gore’s life and incorporated into her keynote speech. In this instance, the change in life’s rhythm came about because of Al Gore’s decision to end pursuit of a writing career and to instead enter politics. Soon after he was elected to Congress, Tipper Gore established the Congressional Wives Task Force, which focused in part on the effect that TV violence had on children.

Gore’s own children inspired her to take on the challenge of advocating for the homeless. One day, as she and her children were out walking, they saw a homeless woman. Curious, the children asked Gore why the woman was talking to herself, and she explained that the woman probably had a mental illness. The children next asked a question that spoke to Gore’s concern for the human condition: “Who’s going to take care of her, Mom?”

Gore went on to co-found and chair an organization to help the homeless, focusing especially on those who are mentally ill, and to raise public awareness of homeless issues. Gore herself often spent time talking with the homeless population in Lafayette Park, across from the White House, and helping them to attain services. Having asked one woman what she could do to help, Gore vividly remembers her response: “You can help me get my reality back.” Today, Gore reported to the audience, that same woman is living independently and working full time.

During her time in Washington, Gore made personal connections with many of the city’s homeless. “This isn’t what I dreamed of when I said I wanted to be a professional counselor,” Gore confessed to the audience. Nevertheless, she said, building those relationships and playing some part in helping others improve their lives has proved to be both a satisfying and transformative experience.

Despite Gore’s personal belief in the importance of mental health services, it took a near tragedy close to home and a tragedy that shocked the entire nation a decade later before she embraced her role as an outspoken advocate and revealed her own story. In 1989, the Gores’ son, Albert III, was struck by a car and almost killed. Following that accident, Tipper Gore said, she realized she was suffering from clinical depression, which was successfully treated with the help of professional therapy and medication. However, Gore was too worried about the stigma attached to mental illness to reveal her struggle publicly.

But an experience shortly after the nation’s most infamous school shooting convinced Gore that she needed to speak out. In the aftermath of Columbine, she met with students and teachers to talk about the issue of suicide. When asked if they or someone they knew had ever considered suicide, a majority of the students in the room raised their hands, to the dismay of all the adults present. When asked why they were hiding their feelings instead of reaching out for help, many students responded, “We’re afraid. We don’t want to be labeled.” Gore quickly realized that she was doing the same thing. Unless she and others in the public eye found the courage to step forward, she decided, yet another generation would suffer in silence because of the stigma of mental illness.

From that point forward, she publicly acknowledged her own struggle with depression and became one of the nation’s most visible advocates for mental health care services. In addition, she served as chair of the first White House Conference on Mental Health.

In preparing her talk for the ACA/CCA Convention and in reviewing the pictures she had chosen for her presentation, Gore said she was reminded of opportunities — both those she had seized and those she had missed. When life skips a beat, she told the assembled counselors, it is wiser to embrace the change instead of mourning the best laid plans. “It’s the journey,” she said. “The journey is the reward. Make the most of the unexpected twists that have come your way.”