Monthly Archives: October 2007

Building on our abundance

Richard Yep October 25, 2007

Richard Yep

As is the case with a number of you, when I look around, I know I am blessed with many things that contribute to a fulfilling life. I have a supportive family, a good job, people I enjoy working with and a focus on issues that are both personally and professionally important to me. I place great value on many aspects of my life. In fact, I would say I have a life filled with abundance. From working, talking and interacting with many members of ACA for the past 20 years, I know many of you are also fulfilled and rich in the abundance that comes from helping your clients and students each and every day.

But we also know there are many others who are not so fortunate. Regardless of whether you live in an urban area or a rural one, in the North, South, East or West, within or outside of the United States, there are those who must constantly face life’s challenges and are in great need of the advocacy of professional counselors and other related human service professionals. While many people in our society look at what they can do as we near the end of the calendar year (perhaps by donating food, volunteering their time or contributing money to a worthy cause), professional counselors and counseling graduate students provide such valuable resources all year long. I want to thank you for all that you do. In fact, I think we should thank all who provide their time, effort and monetary resources on an ongoing basis throughout the year in hopes of alleviating the suffering that so many of our brothers and sisters face daily in their lives.

In many parts of the world, the end of the calendar year is celebrated with a season in which we think of our blessings, come together with friends and family, and look forward to a new year that is inclusive of a more peaceful world. These are certainly good things to contemplate and for which to hope.

Now what is it that we will do as we move into the new year to help make this world a better place? I don’t think there is any one correct answer to that question. When we all do what we can do, this results in positive change. Some of you will continue volunteer work in your communities. Others will simply be more deliberate about spending additional time with those you love. And some of you will, quite frankly, just open your checkbooks and give more of what you have. All of these actions are important and valuable, and contribute to meeting our hopes for a more peaceful, just and humane world.

As the American Counseling Association staff prepares for the end of the calendar year, we are involved with many activities and go through many actions. While we enjoy staff gatherings and perhaps a little extra time to share some good food and cheer, we will also continue to meet the needs of ACA members and the profession by registering you for our Annual Conference, processing book orders, developing new publications and online continuing education opportunities, responding to member needs and ensuring that our advocacy for the profession is made known by those in the public policy arena. If you have a few moments, I encourage you to visit us online at to learn about the new and ongoing efforts we are undertaking on your behalf.

As you close out the calendar year, I do hope that you will find time to reflect on all that you have accomplished during the past 12 months. I know you don’t always get the kudos that you deserve, so consider this column your own personal “thank you” citation for all the good work you do for the millions of children, adolescents, adults, couples, families and organizations that rely on your efforts. As a younger generation would say, you are “awesome.”

As always, please feel free to contact me with any questions, comments or suggestions by e-mailing or by calling 800.347.6647 ext. 231. Thanks and be well.

The elephant in the room

Angela Kennedy October 1, 2007

The controversy surrounding the Jena Six. Celebrities and media personalities such as Don Imus and Duane “Dog the Bounty Hunter” Chapman using racially offensive language. Multiple accounts of hate crimes taking place and racist symbols being displayed on school campuses. These and other racially charged incidents, some of which have received national media attention, might lead some to wonder whether race relations are actually improving as we enter 2008 or whether the United States has instead taken a step back to 1958.

Counseling Today asked some of the leading minds in the multicultural and social justice counseling movements for their thoughts on what is behind the seeming spike in high-profile hate crimes and racist incidents throughout the nation, as well as for their opinions on what the future holds.


Cirecie West-Olatunji
Cirecie West-Olatunji is an assistant professor of counselor education at the University of Florida and president of the Association for Multicultural Counseling and Development. Her research is grounded in multicultural counseling theory that focuses on the role of cultural identity in the psychological, emotional and educational development of marginalized students. Members of AMCD and Counselors for Social Justice, both divisions of the American Counseling Association, have teamed up to form a task force to respond to current acts of terror, bias and discrimination, West-Olatunji says. In addition, AMCD has updated its website with exercises and case studies addressing prejudice and discrimination, a bibliography on ending discrimination and talking points to facilitate discussion with others. “We are a resource, and people can feel free to contact us individually or collectively,” she says. “We are more than happy to help people try and deal with (racial tension) on their campuses.”

When West-Olatunji was informed that a noose had been found hanging from the office door of Madonna Constantine, an ACA member and African American professor at Columbia University’s Teachers College, the AMCD president flashed back 30 years ago to when she was a student at Teachers College. Her professor at the time, Anna Duran, received death threats every semester for being a Mexican American woman who spoke out against racism and discrimination in the workplace, West-Olatunji says,.

“These acts have been going on for some time,” West-Olatunji says. “The difference is that in our political climate, it’s more newsworthy today and we find (these types of actions) to be unacceptable behavior as a society.” She notes, however, that as an African American women in academia, she continuously faces acts of microaggression — subtle, covert or unintended forms of racism — whether it’s being passed over for writing or research opportunities or students openly challenging her expertise. “That’s reflective of the literature on microaggression,” she says. “It’s not anything unique about me. It’s what most people of color experience.”

Courtland Lee
Courtland Lee is a professor of counselor education in the Department of Counseling and Personnel Services at the University of Maryland. He is a past president of both ACA and AMCD. Recently, students found a three-foot rope ending in a noose hanging near the cultural center at the University of Maryland — a presumed attempt to copycat the act that fueled the Jena Six incident in Louisiana. The discovery of the noose shocked the campus community, Lee says, but also provided an invitation to open up dialogue about questions of race and diversity.

“I think as much as possible, counselors, whether they are in schools or university settings, should use their skills as facilitators to bring people together and really talk about issues of diversity,” he says. “Race is the big dead elephant in the room. We are still so reluctant as a nation to talk about it. It’s really important for counselors to lead that process of getting people to see that dead elephant and deal with it. We need to help people deal with what I call cultural baggage — the prejudicial assumptions and preconceived notions about people. We have to counsel to combat prejudices.”

Hugh Crethar
Political involvement and advocacy represent the backbone of the Counselors for Social Justice division. According to the CSJ website (, social justice counseling represents a multifaceted approach to counseling in which practitioners strive to simultaneously promote human development and the common good through addressing challenges related to both individual and distributive justice. The principle of distributive justice concerns diverse groups within society receiving their fair share of goods, resources and opportunities. Social justice counseling includes empowering the individual and actively confronting injustice and inequality in society. Social justice counselors promote four critical principles that guide their work: equity, access, participation and harmony.

“I talk to my students about how, when it comes to privilege in society, we are either in the category of an agent or a target,” says CSJ President Hugh Crethar. “What I support is that the more agent statuses you have, you shouldn’t feel guilty; you should feel a greater sense of responsibility to use those statuses to change the world and make things better. So if I — being a white male, upper middle class, educated — have access to open doors, I shouldn’t just open them for myself, I should find ways to hold them open to those who aren’t being given access or equal treatment in society. It’s more than equality; it’s having equitable access to opportunities.”

Eric Green
“I think that racial bigotry is prevalent and has been prevalent in our society. There has been a surge in the amount of publicity because recent ignorance by public figures and celebrities has put the media’s attention back on the issue of race in our country,” says Eric Green, the president-elect of CSJ and an assistant professor of counselor education at Johns Hopkins University. “We should engage in advocacy counseling and teach our clients and also mental health practitioners to engage in exploring their own cultural backgrounds. You have to explore your own background before you begin to understand the cultures of others.”

Adhering to multicultural competencies set out by CSJ is the starting point for counselors to move toward becoming more ethical and culturally sensitive, he says. “We need to start advocating and speaking out on behalf of those who have no voice, those who are marginalized and those who are oppressed. I don’t think it’s enough for us to teach cross-culturalism at our university counselor education program. We should be advocating a step beyond that by promoting social activism. We need to get students involved in politics and policies that relate to the sociopolitical climate in today’s society.”

Green adds that CSJ has been very active on its Listserv decrying the recent acts of racism and encouraging its members to contact their legislators to let them know that bigotry and hatred will not be tolerated. “I have a lot of hope for our profession and our society,” he says. “We are moving in the right direction. I believe that in the next 10 years, we are going to be a lot closer to a society that is racially unified.”

Edil Torres Rivera
Most ethnic minorities experience microaggression every day, says Edil Torres Rivera, associate professor of counselor education at the University of Florida. “This has been happening for a long time. People think that because we are talking about multiculturalism and cultural competency that racism and discrimination are dead. But these horrible incidents prove the social reality that racism and oppression are still alive and well. We cannot rest on our laurels. We must continue to work against that.” Rivera, a past president of CSJ, says at his university, counselors have hosted a series of brown bag luncheons to discuss such topics as gender equality and racism.

On a personal note, he recalls a time early in his career when he faced discrimination because of the color of his skin. Newly assigned to his first place of employment as an assistant professor at the University of Nevada, Reno, Rivera received a threatening message on his answering machine. “It said for me to get the hell out of here and go back to the country I came from,” he says. Instead, he kept the message and listened to it several times as a reminder to stick to his beliefs and become a counselor educator dedicated to multiculturalism and social justice issues. “It just solidified my convictions. I knew I was in the right place, doing the right thing.”

Phyllis Mogielski-Watson
Phyllis Mogielski-Watson is the associate director of training at the Chicago School of Professional Psychology and president of the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling. She believes the recent media spotlight on racial aggression isn’t due to a sudden onslaught of racially motivated crimes, but rather because more people are unifying to speak out against such acts. “I think racially aggressive situations have occurred across this country’s history and continue to occur, unfortunately,” she says. “It is my belief that the increased media attention is driven by people who have been marginalized and are tired of such actions. Rather than sit quietly and take the aggression, people are supporting each other to speak out about the actions and intolerance of differences. Advocating for hate to stop is occurring more globally and, because of this advocacy, the media is catching on.”

She notes that ALGBTIC is a division that promotes unity and understanding through education and advocacy. Division members advocate for marginalized populations or people who may not feel they have a voice. “We do this by offering an open sense of community, sharing resources through our webpage at, educating through our workshops and joining forces with ACA divisions to advocate for unity and equality,” she says

It’s the ethical and professional responsibility of all counselors to advocate for multicultural respect, she adds. “By the nature of what we do, we should teach tolerance, but more importantly, acceptance and understanding of individualism. Tolerance is not enough; true understanding and acceptance have to be the goal. Only through true understanding will we be able to see change.”

Mogielski-Watson says she has personally experienced the hurt brought on by acts of intolerance. “I have been the victim of hate based on the racial makeup of my partner and I. What I would say is hate hurts and I believe no one has the right to tell me who to love.”

Derald Wing Sue
ACA member Derald Wing Sue coauthored Addressing Racism: Facilitating Cultural Competence in Mental Health and Educational Settings with Madonna Constantine. He says growing up as a Chinese American youth in a predominately white area of Portland, Ore., was a real challenge for him. Early in his career, he was inspired by his African American and Latino colleagues who were advocating for their communities. They motivated him to do the same for Asian Americans. Today, Sue, a professor of psychology at Columbia University’s Teachers College, is considered a pioneer in the multicultural movement.

“What’s happening is a massive change in diversification in the United States,” he points out. “Studies have shown that by 2030-2050, people of color will be the majority. When you talk about racism, you are pushing society to think about the issue of equality, and that hasn’t been dealt with adequately.” Many people feel threatened by the changing demographics, he says, and there has been a backlash against the multicultural and diversity movement. “This outbreak of overt acts is the upshot of deep issues within our society,” Sue says. “Much of racism has gone underground. The old-fashioned racism has moved to aversive racism. It’s now about the slight indignities perpetrated by well-intended white individuals. They are unaware of their racist actions.”

While hate crimes are illegal and draw the scorn of most people, Sue points out that racial microaggressions do not incite the same type of opposition. “The most harm is caused not by the overt acts, but by the well-intentioned. We will never overcome this unless the invisible is made visible. None of us are immune to the racial bias of our ancestors. None of my white brothers and sisters born into society want to be a racist or bigot — it’s their socialization and culturalization.”

Madonna Constantine
Madonna Constantine, an African American professor of psychology and education at Columbia University’s Teachers College, specializes in the study of race and racial identity. She is a revered author and multicultural activist, but on Oct. 9, she also became the target of a hate crime. Someone who has yet to be identified hung a noose from her office door.

“This despicable act signals that we are at the brink of change and a significant evolution in society and the world,” she says. “I believe when there is a regression in behavior to acts that were basically preformed many years ago — lynching and nooses in particular — that signifies in some degree that there is a group within our society that is more comfortable with things the way they were then. What they perceive is that African Americans are gaining too much power — not that African Americans feel that way.” She says that these symbols are used as tools to intimidate and scare minorities.

Constantine believes society is on the cusp of a new era in which more and more people will respond and embrace the reality of a multicultural society. “There are multiple perspectives and multiple ways of valuing people’s cultures,” she says. “One paradigm or one vision isn’t the only vision. We are giving honor and a voice to (multiculturalism), and there are some people who don’t like that. And that’s too bad, because it’s going to happen anyway.”

In the wake of what happened to her, Constantine says she has received several letters, e-mails and calls from people all across the nation telling her of similar experiences at their schools or workplaces. “Now we have collectively, as a society, said that this is unacceptable and we will not tolerate it. We stand firm in saying this isn’t OK, and we will do whatever it takes to continue our efforts to promote issues of multicultural diversity.”


Angela Kennedy is a senior writer at Counseling Today. Contact her at Letters to the editor:

By any other name, it’s still fraud

Robert J. Walsh and Norman C. Dasenbrook

Q: I have just joined an established private practice. The majority of clients in this practice want to use their third-party (insurance) benefits. I am applying to get on insurance and managed care panels. In the meantime, I have two new clients who have insurance that won’t cover me. The practice has offered to bill under another therapist’s name until I can get paneled. What do you think?

A: Fraud is what we think. You cannot treat a client and submit a bill to a managed care or insurance company using another therapist’s name and National Provider Identifier number. Only the therapist who actually performs the counseling and has been accepted as a provider can bill for services for that client. The practice could have a corporation contract with the managed care company, but each therapist in that practice has to be approved by the managed care or insurance company individually.

Q: Could you give me some direction on this? On more than one occasion, I have been contacted by a “potential client” who is covered by a major insurance company, only to discover that the person’s “mental health and addictions” coverage is by a managed care company for which I am not a provider. Why am I listed as an option for them when they are seeking a counselor if their particular plan does not allow me to provide services to them?

A: The problem is that some insurance companies have what they call a “carve out,” or a separate managed care company that provides mental health coverage for some of their members. For example, some Blue Cross plans have Magellan administer the mental health portion of their coverage. You may be a Blue Cross provider, but not be on Magellan’s list of approved providers.

A way to get around this is to have the client send a letter (for an example of these letters, see the “Private Practice Pointers” section of ACA’s website at; the link is on the “Counselors” page). A call by the client to the human resources benefits manager has also worked to get counselors on a panel. Companies’ benefits managers are good levers because they want employees to be satisfied, and the benefits manager’s job is to service them.

Q: I attended your seminar on starting a private practice about five years ago. Since then, I’ve gained a lot of knowledge and experience working in a large group private practice — for somebody else. Now I’m really ready (seriously) to get out there on my own. Any pointers on locating office space? I have to be seven miles from the offices I work in now (for my current employer). Also, I’m interested in supervising new grads that need (licensure) supervision. Any ideas on that one?

A: Try calling established mental health providers in the area that you’re interested in to sublet space. Another idea is to take a chance and contact an M.D. who may have open office space. If you choose the first route, try to contact a counselor who is not in your niche so you can avoid competing over clients. If you choose the second route, try to choose a doctor who is in your niche so you can share clients. The worst thing that can happen by attempting either of these approaches is that you’ll get told “no.” But maybe you’ll get a “yes” instead. Take the risk — isn’t that what we encourage our clients to do?

As far as providing supervision, it’s a good idea as long as you are licensed and qualified. Many newly licensed graduates need supervised hours, and it’s an added income stream for you. Both you and the students will benefit.

We hope to see you in Hawaii at the ACA Conference & Expo, where we’ll be presenting our preconference workshop “Starting, Maintaining and Expanding a Successful Private Practice” on March 27, 2008. Onsite private practice consultation will be available. Come visit us in the exhibitor center and preview our book, The Complete Guide to Private Practice for Licensed Mental Health Professionals (

ACA members can e-mail their questions to Robert J. Walsh and Norman C. Dasenbrook at and access a series of “Private Practice Pointers” on the ACA website at

Virginia Tech walks path to healing

Angela Kennedy

As the first full semester since the mass shootings that rocked their campus last April 16 comes to a close, Virginia Tech students, staff and faculty are still attempting to recover. In the process, they are also finding new ways to honor the victims and working to ensure that a tragedy of that nature and magnitude never happens again.

Virginia Tech counselor educators Gerard Lawson and Nancy Bodenhorn, both members of the American Counseling Association, played instrumental roles in the immediate aftermath of the shootings and continue to guide students and fellow staff members through the healing process. “Things are different,” Lawson says. “It’s odd, because I doubt things will ever be the same, but a lot of that is OK. As counselors, we know the first year in particular brings challenges. Returning to school this semester, the first football game and the Concert for Virginia Tech were all positive emotional experiences, but they also keep the energy of that day alive. That is positive for most, but can be challenging for others.”

Lawson adds that after the investigation and recommendations made by the Virginia Tech Review Panel, the university is moving forward, though often with an abundance of caution. “Sometimes it feels like we are planning for the possibility of another meteor hitting. The odds are extraordinary, but we will do whatever we can,” he says. “We are in the early stages of (implementing) some prevention efforts for the whole campus in identifying and destigmatizing mental health issues. We are aware that the world is watching, and we want to get it right.”

This semester, Bodenhorn says, faculty members have been more alert to potential warning signs that a student may be troubled and, likewise, more vocal about sharing their concerns. “We, as faculty, need to be aware and communicative, but not extend into fear and overreaction. There has to be a balance,” she says.

Counselors on campus are hoping to partner with the Substance Abuse and Mental Health Services Administration to bring the Mental Illness: What a Difference a Friend Makes awareness campaign to Virginia Tech. The campaign, launched last year, encourages young adults to support friends who are struggling with mental illness. Additionally, Tom Brown, the university’s dean of students, is working with the campus counseling center to provide undergrad students with additional programs that promote well-being.

Bodenhorn says she is still recovering from the events of last April, both personally and professionally. In an interview with Counseling Today soon after the shootings, she explained how the act of smacking a tennis ball around the court was playing a major role in helping her relieve stress. And today? Well, she is fighting a mean case of tennis elbow, she says with a laugh.

“I have a much better respect for what trauma means to people now,” she says. “That’s important, both personally and professionally, to me. I’ve been reading a lot about resiliency and post-traumatic growth as opposed to post-traumatic stress. And despite my tennis elbow, it’s still very important for me to keep active and be aware of my physical health as well as my mental health.”

Celebrating life

Virginia Tech students, faculty, staff, family, friends and alumni are pledging volunteer service hours as part of VT-ENGAGE, the university’s new initiative to honor the victims of April 16 and reaffirm its motto, Ut Prosim (That I May Serve). The challenge is for each student, faculty and staff member to participate in at least 10 hours of community service by graduation next May, with a total goal of 300,000 hours. The Virginia Tech Alumni Association challenged its members around the world to donate an additional 300,000 hours of community service, for a grand total of 600,000 hours. The stated purpose of VT-ENGAGE is to link the university and community through service.

“This (initiative) ties into the post-traumatic growth process,” Bodenhorn says. “They really want to establish meaning and provide a positive legacy for what happened as opposed to focusing on the grief and loss.” Bodenhorn has personally pledged to volunteer at a local women’s shelter.

“The idea is that every Tech student, faculty and alum agrees to volunteer for 10 hours over the next six months to make their community a better place,” Lawson says. “So many of the victims were volunteers and lived by community service, and I heard one of the parents saying that this was an effort to make them (the victims) as proud of us as we were of them.”

Cook Counseling Center

Immediately after the shootings at Virginia Tech, Virginia Gov. Tim Kaine appointed a panel to review the events leading up to the tragedy; the handling of the incident by public safety officials, emergency services providers and the university; and the services subsequently provided to families, survivors, caregivers and the community. The panel conducted more than 200 interviews and reviewed thousands of pages of records. Following are some of the major findings pertaining to the mental health aspects of the case. (The full report is available online at

“During Seung-Hui Cho’s junior year at Virginia Tech, numerous incidents occurred that were clear warnings of mental instability. Although various individuals and departments within the university knew about each of these incidents, the university did not intervene effectively. No one knew all the information and no one connected all the dots.”

“University officials in the office of Judicial Affairs, Cook Counseling Center, campus police, the Dean of Students and others explained their failures to communicate with one another or with Cho’s parents by noting their belief that such communications are prohibited by the federal laws governing the privacy of health and education records. In reality, federal laws and their state counterparts afford ample leeway to share information in potentially dangerous situations.” (See sidebar on new brochures explaining the Family Educational Rights and Privacy Act on page 39.)

“The Cook Counseling Center and the university’s Care Team failed to provide needed support and services to Cho during a period in late 2005 and early 2006. The system failed for lack of resources, incorrect interpretation of privacy laws and passivity.”

“Records of Cho’s minimal treatment at Virginia Tech’s Cook Counseling Center are missing.”

Subsequently, several changes in policy, procedure and staffing have taken place at the Cook Counseling Center. Licensed professional counselor and ACA member Sherry Lynch Conrad has been employed with the Cook Counseling Center for the past 17 years. According to Conrad, the counseling center has stepped up the number of support groups and outreach programs to staff and faculty and has added two weekly grief and trauma group counseling meetings for students. Over the summer, the counseling center also presented a symposium to help faculty and staff identify at-risk students. The Cook Counseling Center also received a federal grant to provide for a full-time case manager (that position has yet to be filled).

But Conrad notes that the most significant change since the report was issued is improved coordination of services with outside mental health agencies. The Cook Counseling Center’s psychiatric nurse practitioner now attends mental competency hearings that determine whether a patient/student should be released from involuntary psychiatric care hospitalization in the local area. The nurse is also informed of the campus counseling center’s role in the student’s follow-up treatment plan.

“In the past, one of the challenges was students being hospitalized and then released, and we didn’t know anything about it unless the student called us,” explains Conrad, adding that in many instances, students didn’t bother to follow up with the counseling center. That was determined to be the case with Cho. “It’s been a very loose system. But talking with other counseling centers, that is a perennial problem,” she says. “There often isn’t good communication between psychiatric hospitals and university counseling centers.”

Many times, Conrad says, a psychiatric care unit will advise patients to continue treatment with an outpatient counseling program. With students, the hospital will recommend that they follow up with counselors at the university counseling center within 48 hours. “But (in the past), we at the counseling center may not know that we were part of the plan,” she says. Having a counseling center representative present at the hearings should now ensure that these at-risk students don’t fall through the cracks, she says. Additionally, personnel at the Cook Counseling Center will now know in advance if the recommended follow-up treatment is beyond their capabilities, Conrad says, and can better prepare to refer the student to an outside resource or agency.

“If they are asking that we meet with a student several times a week, that is just something we cannot do because we don’t have that level of staffing,” she explains. “But we want to help find another plan so these students can get the care they need.”

Conrad says the number of students seeking services at the campus counseling center is up 35 percent compared with this time last year. “Students are definitely aware of us, and they are coming in,” she says. “Sometimes it’s related to April 16, but most come in with personal concerns that they want to talk about. Some students are doing well and moving on, but the students that have symptoms of anxiety, depression or other mental health concerns, I think April 16 exacerbated those symptoms.”

ACA lends a hand

Because the shootings took place shortly before Virginia Tech let out for the summer, there was concern that students returning home might not know where to go to access counseling services to help them deal with the tragedy’s aftermath or might not seek services because of financial concern. In response, the Virginia Tech counselor education program approached ACA about organizing an initiative to provide pro bono counseling services for students who were away from campus for the summer. More than 1,000 ACA and Virginia Counselors Association members volunteered for the initiative. Volunteers came from all 50 states as well as Washington, D.C., and Puerto Rico. According to ACA Chief Professional Officer David Kaplan, 69 Virginia Tech students from 18 states used the free counseling to get the help they needed.

In a letter of appreciation addressed to ACA President Brian Canfield, Lawson wrote: “There are a few ways to consider these numbers; in fiscal terms, these counselors gave our students a ‘gift’ of over $20,000, a conservative estimate of the fee for those services. However, I prefer to think of this gift in the human terms. Sixty-nine of our students were supported by caring professionals when they were away from the friends, campus and community that they love. Sixty-nine of our students felt the compassion that was so present on our campus extend home with them through the compassion of our counselor colleagues. Sixty-nine of our students were able to continue to work through their grief and sadness and, hopefully, move on to recovery and healing because of the skill and kindness of these counselors, and 26,000 students knew that they were not alone.”

Angela Kennedy is a senior writer at Counseling Today. Contact her at Letters to the editor: