Counseling Today, Cover Stories

Counseling in a time of economic upheaval

By Jonathan Rollins March 15, 2009

The numbers keep rolling in, and they all point to the same conclusion: The economy is down, and feelings of fear, panic and disillusionment are way, way up.

  • A report released by ComPsych in October found that 92 percent of respondents are losing sleep over economic worries.
  • A December “financial crisis” study by global market information group TNS found that one-third of Americans fear losing their jobs, and 11 percent fear losing their homes; only 18 percent of respondents still believe the economic crisis will have “no direct effect” on their personal situation.
  • In comparison with October 2007, calls to the National Domestic Violence Hotline rose 18 percent in October 2008 (after the stock market took a major dive). Various reports have also noted that calls to suicide hotlines have increased dramatically since the onset of the recession.
  • In its sixth annual State of the Dream report released on Martin Luther King Jr. Day, the advocacy group United for a Fair Economy stated: “While the general population has been in recession for one year, people of color have been in recession for five years. By definition, a long-term recession is a depression.”
  • In a USA Today article published in early February, an Illinois psychologist was quoted as saying she had never in her 22 years of practice witnessed the level of anxiety and depression now being exhibited by clients. She went on to state that the “mental health fallout (from current economic woes) has been far worse than after 9/11.”

The question for counselors, of course, is what role they can play in helping clients, even as counselors deal with their own anxieties over the potential economic fallout. Eight American Counseling Association members agreed to talk about the impact the economy is having on them and their clients. They didn’t pass themselves off as “experts” with neat and tidy solutions to their clients’ problems; rather, they honestly recounted the struggles they are facing and the strategies they are using to try and make a difference in clients’ lives during these uncertain times.

Although each presented a unique perspective on how to approach the economic crisis, they all agreed that counselors have a very important role to fill and that the profession must do a better job of making the public aware of exactly how counselors can be of service. Two areas in particular received repeated mention when these ACA members talked about ways that counselors can provide the most assistance: client career issues (not just limited to finding a new job) and helping clients cope with anxiety and stress.

Coincidentally, in January, Yahoo! HotJobs named counseling and career counseling as two of its “10 Hot Professions for 2009,” primarily because of the way the economy is affecting people. Yahoo! predicted counselors and career counselors would be in high demand for their expertise in helping people to reengineer their careers, rebuild their self-esteem and self-confidence and improve their mental health.

 

Nina K. Flowers
Promoting client strengths, imagery and networking

Nina K. Flowers has a client who originally came in for counseling because her boyfriend was not being good to her. The client recently told Flowers, who is counseling her pro bono, that she was down to her last $800, had lost her job and didn’t have insurance. She also revealed she was now planning to move in with that same boyfriend. “We’ve talked a lot about how that’s unhealthy emotionally, but she’s too desperate to do anything else,” says Flowers, who owns Counseling Solutions Inc., a private practice in Lansdowne, Va.

While all her clients aren’t in such desperate straits, Flowers is seeing more people who are either dealing with job loss or stressed out at the thought of losing their job. “They’re in a panic state because they feel threatened by the possibility of layoffs,” she says. “They’re living in that horrible anxiety of not knowing. … I’m kind of a perpetual optimist. I tell my clients, ‘Let’s not worry about something until it actually happens, then we’ll handle it. Let’s work with what we’ve got.'”

But Flowers doesn’t simply try to convert clients to a “don’t worry, be happy” philosophy. “I help clients search for their strengths and skills that can be transferred to jobs outside of their current or last career,” she says. “I also recommend the local career center and explain how it can best be used — abilities and interests surveys, exploring career handbooks, etc.” Clients who attended college should also be reminded that they can take advantage of career resources at their schools long after they graduate, she adds.

“I also explain what stress is and how it can affect their lives,” Flowers says. “I teach them to understand their symptoms of stress and to react to those symptoms quickly. I teach imagery and other relaxation techniques to help them calm things down on an immediate level.”

In one of her imagery exercises, she guides clients through a field of flowers and to the edge of a pond. She then instructs them to put their fear of losing a job (or another anxiety) into a bag. They then place the bag on a lily pad and watch it float away on the pond. “I tell them, ‘For now, let’s just let that worry go.’ When they’ve got a lot of worries on their plate, I always put them in the bag to give the client a break from their anxieties for a couple of minutes. They seem relieved, at least for a little while.” Some of her male clients are resistant to imagery exercises, Flowers admits, but women are usually receptive and find the techniques useful.

Flowers also focuses on getting clients stabilized in their lives so they won’t take their problems to work and increase their likelihood of being fired. “As counselors, we sometimes have to ask, are the client’s problems circumstantial, or is it something that they’re doing? I don’t think you can resolve the here and now unless you show them how the past has affected their life,” she says. In these instances, she helps clients explore their inner child and how that child can be soothed and reined in. This process, Flowers says, empowers clients to tell their child, “We are now adults. We can stop making decisions like a child and stop acting like a child.”

Flowers, who purchased her private practice in 2005 and does not take insurance, admits that the economic downturn has affected her business. “I never had too much trouble getting clients before,” she says, “but now, with the economic problems, people are saying, ‘Oh, you’re not in my insurance plan?’ … I use imagery and other relaxation techniques to cope with the stress of slow client times. I also go to lunch when possible with one of three colleagues, and we share concerns, ideas and encouragement.” Flowers highly recommends this practice for all counselors, but particularly for private practitioners. “Our business is not easy, even when economic pressures aren’t there,” she says. “We are so isolated when we’re in private practice. I find getting away with others really helpful.”

Flowers also advises counselors to consider branching out beyond their counseling silos, both for the health of their businesses and for their own mental and emotional health. Flowers is one of only two counselors who belong to the chamber of commerce in the county where she practices. “And there are a lot of counselors in our area,” she notes. She actively participates in one of the chamber’s “lead share” groups, in which members from various professions help one another with referrals. While Flowers picks up new business this way, she finds the lead share group equally valuable for another reason. “It gives me another aspect of life that I don’t get when I just hang out with other counselors,” she says. “I find that group really helpful to me emotionally.”

Flowers also networks with doctors to build her business. “I go door-to-door in medical buildings, leaving my business cards, chocolate prescription bars and chocolate Band-Aids for the staffs. At Thanksgiving, I have a basket professionally made for the doctors who refer to me, and I add one or two new doctors each year. … I also met a doctor at a chamber breakfast whom I called for a one-on-one meeting. He now gives me the most leads among all the doctors.”

Chris Tuell
Examining the impact on identity and families

From Chris Tuell’s viewpoint, counselors should take an ecological approach when examining the impact the economy is having on clients. “That means looking at the various systems within that person’s life,” he says. “How does this situation with the economy affect the person’s belief system, culture, family, job and so on?”

Tuell gets a glimpse of these various elements in his work at Family Service of the Cincinnati Area, an agency founded in 1879 that provides a variety of services, including clinical counseling. In addition to running groups and seeing clients, he serves as director of the organization’s EARN (Employee Assistance Resource Network) program. Tuell identifies two areas in particular where the economy is taking a dramatic toll: jobs/careers and family units.

Tuell has visited a number of companies that are downsizing and asking employee assistance programs (EAPs) to provide help. “Many of these people have been at their companies for years,” he says, “so it’s like a family to them. It’s a major loss in their lives.” But, Tuell points out, even as growing numbers of employees are losing their jobs or feeling burdened by the stress of job insecurity, many companies are looking to eliminate EAPs in hopes of saving a little money in the short run.

Given the current realities, counselors searching for effective avenues to help clients don’t need to look very far, Tuell says. “This economic climate gives us the chance to revisit the roots of our field — career counseling,” he says. This is particularly important right now, he notes, because so many people’s identities are wrapped up in their work, and when they lose their jobs, they oftentimes feel a corresponding loss of control and purpose in their lives.

These issues of identity and meaning commonly spill over into family life as well, Tuell says. “For some families, the way their system is structured at home, the male might see himself as the breadwinner. Without a job, his identity is now in jeopardy. He might translate that as being a failure.”

And, of course, Tuell says, even in the best of times, financial issues are one of the chief reasons behind marital discord. “The state of the economy today is going to make that issue even larger,” he says. “Some couples certainly see the economic realities as the final straw in their relationship.”

One challenge for counselors trying to help clients deal with stresses and problems related to the economy, Tuell says, is coming up with a plan that makes people feel they are still moving forward despite their circumstances. “Clients facing economic struggles can become stagnant and defeated,” he emphasizes.

Counselors also need to be aware of the influence that process addictions (including gambling, surfing the Internet, shopping or sexual activity) and substance abuse can have in exacerbating clients’ conditions and making them unproductive. “It’s easy to escape into that (addiction) and alter one’s mood instead of connecting with the real world,” says Tuell, an adjunct professor in addiction studies at the University of Cincinnati. “As counselors, we need to help them with better ways of coping and get them to talk about what they are going through.” One effective coping technique involves prompting clients to stay in contact with their support system of family and friends, he says.

Counselors should also let clients know they are not alone in the challenges they are facing and validate what is happening to them, Tuell says. “We also need to encourage clients to be aware that change can be good. This might open up opportunities for new things. Some people come out of challenges stronger than they were before. Giving a sense of hope to clients is essential.”

Of course, providing this sense of hope is even tougher during tough economic times. “People are seeking treatment, but the economy influences their attendance and ability to pay,” says Tuell, who adds that some clients can no longer afford their copays or are spreading their counseling appointments out instead of attending weekly sessions. Other clients are struggling to pay for gas or transportation to get to the agency’s offices. “And as an agency, the challenge for us is to provide services with less money or to find funding in this economy,” he says.

Still, the agency is doing what it can to reach those feeling the economic crunch in their day-to-day existence. For example, one of the agency’s programs provides employee assistance-type services, including anger management, assertiveness training and résumé writing, to low-income workers. Another program offers in-home clinical counseling to low-income clients who can’t afford or don’t have reliable transportation. “It’s a different model than 10 years ago, when everybody came into the office,” Tuell says.

In fact, Tuell is a proponent of counselors and other helping professionals getting out of their offices, especially in economically difficult times, to provide outreach and education — and to learn how to better meet the needs of people. “If we’re working in our silos, we’re not really seeing some of the things that can augment the services we’re providing,” he says. “Getting out into the community as counselors is a good thing.”

Patty Katzfey
Reclaiming counseling’s career focus

Patty Katzfey graduated in December with a master’s degree in community counseling (career emphasis) from the University of Missouri-St. Louis. While recent graduates in all career fields are concerned by the limited opportunities in the current job market, Katzfey remains excited by the possibilities.

“Personally, I feel like the economic situation is going to create real opportunities for counselors who understand what is happening and how to serve different populations,” says Katzfey, who will be working part time in the career center at Washington University as well as with a private group. “I think it’s an important time for counselors to do some self-reflection and see how we can be more instrumental in helping people find promise and empowerment and renewal.”

Katzfey, who also has a master’s in business administration, owned her own business and worked in the corporate world before deciding to become a counselor. “For me, moving into career counseling is a really natural transition,” she says. “It’s a way for me to link my experiences to help people who are experiencing some type of career transition and trying to redefine themselves.” As a self-described “corporate wife,” Katzfey had to modify her career path each time she and her husband moved. “That experience alone was so impactful to me,” she says. “It made me think a lot about career stuff — moving away from family, having children and how that affected my adaptability and career. I know from my own experience that career transition is an emotional and fearful period.”

Based on her experiences, Katzfey believes she has a good understanding of what people who have lost jobs or are facing job insecurity in this economy are going through. “I have some idea of how people are responding emotionally to change, and that includes feelings of fear and grief,” she says. “Counselors really have to assess how that sense of grief and concern is affecting clients. If we don’t, I think people will just spin their wheels. It may be that anxiety and depression are there. Let’s put that on the table and deal with it, and then lift that fog and look at the opportunities clients still have.”

Katzfey also believes counselors need to step up and let people know what a valuable resource the counseling profession can be during tough economic times. “I’m running into people all the time who have concerns about their careers and the economy,” she says. “They’re very uneasy, and they don’t know where to reach out. Counselors have to get out in the community and educate people about what we do and how we can help — how we can be facilitators and help clients draw out their strengths.”

The emergence of career coaches has muddied the waters a bit for clients who have both employment and emotional needs in times of economic stress, Katzfey says. “I think people are fearful and just want to get their résumé out and get back on track instead of dealing with what’s really going on in their lives,” she says. “Clients come with more stuff in those sessions than coaches can address. I think a good counselor will say, ‘Where do you want to start?’ and let the client drive the process.”

Likewise, Katzfey says, counselors have to be careful not to overstep their bounds during these tough economic times. “Counselors need to understand their capabilities in serving clients with career issues — the ethics of trying to provide services when they may not have the professional background,” she says. “We don’t want to turn any business away, and there is sometimes that feeling that we can do everything, even when we really can’t.” She urges counselors who aren’t genuinely qualified to handle career issues to refer clients or to partner with others in working with those clients.

While the economic crisis and rampant job loss are currently major sources of fear, Katzfey believes those conditions may eventually serve as motivation to many clients who feel stuck. “Given the circumstances, I think people are going to be more ready for change and ready to put themselves out there a little more.”

Maddie Blomgren
Adapting in private practice

When Maddie Blomgren started the Anger and Relationship Institute in Princeton, N.J., in 2002, she decided not to take insurance from clients. Her private practice filled such a strong niche — providing counseling specifically for anger and relationship issues — that she never second-guessed her decision until the economy went into a tailspin.

“This is the first time I’ve really had to worry about filling slots since I started,” she says. “In fact, it’s the first time I’ve been without a waiting list. My clients have lost jobs and been downsized, some have lost homes, some have moved because it’s a very expensive area to live in and, of course, some clients have finished their therapy. New inquiries are more likely to go elsewhere to avoid the cost of ‘out-of-network’ fees.

“In our area, the agencies are getting many, many more calls from clients than normal. Private practitioners, we’re all hurting. Even people who take insurance are biting their nails. I’m in a building with all therapists, and we’ve lost many of them.”

Blomgren is 64 and says she was considering scaling back her practice even before the economy got bad. Now she’s thinking about subletting and says she will likely move into a home office within the next year.

In the meantime, she’s taking steps to ease the financial burden on her existing clients and looking for creative ways to draw in new clients. “I have formed cost-effective (therapy) groups, given a reduced fare to clients who are willing to be seen during ‘off hours’ and gone to every-other-week appointments with some weekly clients,” she says.

Upon opening her practice, Blomgren did a lot of public speaking to help build her name recognition and client base. Now, because of the economic downturn, she plans to ramp up her speaking efforts again. She is also advertising again, attempting to have a presence at health fairs and actively contacting women’s organizations and nonprofits to market her practice.

Blomgren is also offering free, nondiagnostic anger and depression screenings. “I’ve done this before, but now I’m really pushing it and advertising it,” she says. “If I can get people to come through the door and start talking with me about their anger, I usually get a pretty good response, and they often become regular clients.”

Blomgren says the economy is having a dramatic effect on many of her clients — and not just related to their ability to pay for counseling. “Clients who are in recovery are slipping,” she says. “Anger that they had been doing pretty well with is suddenly flaring, and it’s very economically related. Normally, they’ll come in and tell me their economic circumstances, so the subject is already out there. I’m doing a lot of anxiety work — anxiety and anger being married, of course.”

To help clients better handle their anxieties related to the economy, Blomgren gives them two CDs that contain relaxation techniques. She also offers hypnotherapy to help certain clients enter a state of deeper relaxation. In addition, she conducts groups for clients with financial stresses, both to reduce their fee for therapy and to help them normalize their struggles.

Blomgren also talks with clients about what they can do outside of therapy to relieve their economic anxieties. “I’m not a financial counselor,” she says, “but I will recommend books on saving and managing money for clients.”

Given the current state of the economy, counselors are facing their own economic pressures and anxieties, Blomgren says, which might mean making some tough ethical decisions along the way. For example, counselors might be tempted to retain clients who aren’t progressing under their care rather than referring them to another helping professional. “But ethically,” she says, “we can’t just keep someone on to pay the bills.”

Sandra Lopez-Baez
Connecting counseling programs and the community

Stories of people watching their stock portfolios take a nosedive or their retirement savings almost completely disappear have proliferated ever since it became clear the United States was in a recession. There is no question the downward spiraling economy has delivered a stiff punch to the gut of America’s middle class. But harder to find is coverage of what is happening to those people who were living on the edge financially even before the economy took a tumble. It’s probably safe to assume, however, that these individuals are now even more likely to fall through the cracks as funding for social service programs grows tighter and the number of people requiring assistance grows larger.

“At a time like this, there is more demand for counseling, both personal and career. But social services and education are among the first things to get cut,” says Sandra Lopez-Baez, an associate professor and coordinator of the mental health counseling program at the University of Virginia and the Counselors for Social Justice representative to the ACA Governing Council. “Our (counseling) programs have to rise to the occasion and look for creative ways to fund free clinics and training centers to ensure that these services remain available.”

Without these free or low-cost resources, Lopez-Baez worries that the barriers to access services will be too great for those most in need. “In these economic conditions, people will wait until their problems are much more serious before coming to counseling,” she observes. “When they come for services, they are really, really hurting. The current economic conditions increase levels of stress and make people more reactive. The focus goes to short-term rather than long-term planning. People are more depressed, more negative, less productive. You see more despair. That doesn’t make for good mental health.”

Lopez-Baez challenges counseling programs to meet the needs of those who might otherwise fall through the cracks, especially during tough economic times. She believes taking up that challenge will have the reciprocal benefit of grooming the next generation of counselors to champion social justice issues within the profession.

“Counseling programs can look at themselves as community resources, especially for the underserved,” she says. “And in doing so, we should be looking at counseling interns as resources — hidden resources who can help meet needs and fill the gap during this crunch. Doing this awakens in the students a consciousness and awareness for the community and helps them to view themselves not just as students, but as tremendous resources. Activism involves getting the students worried about these underserved populations.”

Lopez-Baez is also a proponent of incorporating service learning projects into counseling courses so students can give something back to communities even as they learn to be better counselors.

Counseling programs can also examine partnership opportunities with community groups, Lopez-Baez says. For example, in her community of Charlottesville, a consortium of churches has joined together to help the homeless during the winter. Each church takes in individuals for several days or a week at a time. Among the services being offered is crisis counseling, provided by supervised interns. “We need to recognize and cultivate the link between our counseling programs and the community,” she says.

Lopez-Baez teaches students (and encourages other counselors) not to dismiss what they can do to help underserved populations, even if the surroundings are imperfect or they are unlikely to see the client again. “As I get to know the client, what I’m trying to assess is what do you need most?” she says. “Can I do a quick career assessment even in the homeless shelter at a church? Connecting them to other community resources is also invaluable, and if it’s a little more personal, that’s even better. For example, ‘You know what? I know Cindy over at the women’s center …”

Barbara LoFrisco
Starting out in a tough climate

Barbara LoFrisco, a registered mental health counselor intern and a registered marriage and family therapy intern, went into private practice in Tampa, Fla., last April. She rents space at the agency where she interned and still volunteers there to get practicum hours.

She’s lost almost half of her clients since before Christmas. At first, she assumed they were simply busy with the holidays and would return after the new year. “But I have received calls from a few clients saying they can no longer afford counseling,” she says.

LoFrisco, who was a software engineer in corporate America for 20 years before deciding to become a counselor, says she probably still would have gone into private practice even if she had seen the economic storm clouds looming. She remains optimistic she will be able to make her practice viable. “I am somewhat concerned, but I’m also pretty new at this, and people have told me that it takes a year and a half to two years to show a profit. I had been in the black the last couple of months (before the holidays).”

In January, LoFrisco updated the front page of her website (counselorbarb.com) with a box that reads: “Can’t afford counseling?” She then lists several bullet points to entice potential clients, including:

  • Having trouble in your relationship? Call and ask about the relationship skills group I am forming this March.
  • Untreated mental conditions and/or stress can lengthen treatment time, costing you more money in the long run.
  • Improving and maintaining your mental health is an investment in yourself that will pay off for the rest of your life.
  • Therapy can help you deal with the additional stress you may feel due to the poor economy.

LoFrisco also offers free initial consultations to clients and is trying to be sensitive to the financial pressures they are facing. “I’m giving clients more tools up front so that they can see progress quicker,” she says. “I also encourage my clients to participate in homework assignments so they can take the therapy home with them and pay less in session. I’m also in the process of putting together the couples communication skills group, which will teach a lot of what I would cover in the individual sessions but for much less money.”

At the same time, LoFrisco is careful not to assume that all clients want or need to talk about economic pressures. “I’ve been waiting for clients to bring it up,” she says. “I don’t want to put something in their heads that isn’t there already. I want to be focused on what they think is important. But if we were having a conversation about stressors, I would probably bring it up in that context.”

But make no mistake, she says, the economy has become an important topic for many clients. “For some, the goal of what they wanted in life has changed because of the economy,” she says. “I have noticed that couples are staying together because of economic reasons, so the focus of individual counseling becomes ‘How do I manage my stress in a bad situation?’ instead of ‘Should I stay in this relationship?’ The counseling becomes ‘What kind of coping mechanisms can you help me with?’ In some instances, that may be a good thing because they have to live through their problems and work them out. Otherwise, they may have been giving up on their marriage too soon.”

One of the ways LoFrisco believes she can help clients is to use a cognitive approach to confront irrational thinking about the economy. “You can’t change the economy,” she says, “but you can change the way you’re thinking about it.” Clients also benefit from being reminded of general coping and stress management skills that are free or low cost, she says, such as taking a walk or calling a friend.

Economic pressures, job loss or job insecurity may also cause clients to question the meaning of their life, LoFrisco says. In these instances, she finds it beneficial to ask clients about their spiritual beliefs and to draw on those strengths. In the absence of strong spiritual beliefs, she might introduce clients to logotherapy and Viktor Frankl’s Man’s Search for Meaning. “It just depends on who the client is and how they process things,” she says.

As bleak as the economy is right now, LoFrisco can also see an upside. “For one, couples are going to need to rely less on distracting themselves with shopping, vacations and fancy dinners and gain more depth and strength in their relationships. Two, when we overconsume, we lose our appreciation for things. If we have to cut back on our spending for a while, when things loosen up again, those dinners out and other indulgences we now take for granted will regain their specialness.”

Donna Howland
Struggling to help women find work

Donna Howland serves as a combination mental health and career counselor for the Lifespan agency’s Women in Transition Services program in Rochester, N.Y. “We help women who are widowed, divorced, separated, have been caring for a family member or are single mothers on social services to get back into the workforce and become self-sufficient,” she explains. “And the economy is affecting us greatly.”

First, economic conditions are driving more clients to the Women in Transition program, which does not charge for its services. In many instances, Howland says, clients’ financial burdens have placed increased stress on relationships, leading to more separations and divorces. In other cases, women who had marginal jobs have lost them in the tightening economy or ex-husbands have stopped paying child support. Each circumstance brings women to Howland’s program for help reentering the workforce or finding a better-paying job.

Second, while economic conditions have increased the program’s client load, they have also decreased the number of available jobs. “As the jobs become more scarce, it’s getting harder to place people,” Howland says, “but given the economy, our clients are desperate to find work faster. We used to be able to move women through the program and hook them up with at least an entry-level job in six months. Now we’re seeing people who are making their second trip through our series of classes — and these are women who have a skill set. They just can’t find a job. We’ve been seeing more of that in the last year.”

Third, Howland says staff members are spending a lot more time and effort finding funding for the program. The economy has tightened state budgets and dried up much of the grant money that was previously available. In addition to providing services such as résumé preparation, interview training and job market information, Women in Transition used to obtain items such as used computers, new glasses and even clothes to help clients in their job search. “But we can’t provide any of those extras anymore,” Howland says.

Despite the program’s focus on job search assistance, Howland is doing less career work with clients these days. Instead, she’s often helping them access social services so they can ensure basic needs such as food and heat are met. In addition, Howland finds it necessary to dedicate more time to caring for clients’ emotional and mental health needs, which are being brought to the surface by economic hardship. She is leading classes on topics such as self-esteem, resiliency and stress reduction. “And I’m always available to do one-on-one counseling work as the program’s mental health counselor,” she says.

Many of the program’s clients were already living close to the edge even before the economic downturn. Current conditions only add to their challenges. “A lot of our clients have several strikes against them as far as getting employed again — their age, their need for child care, their financial situation,” says Howland, who adds that the program’s average client is in her mid-40s to early 50s. “Many of our clients have a bachelor’s degree, and they want to know why they’re sending out 20 résumés a week without any response. I’ve had clients get on the phone with me and scream. You just listen to them, let them vent and try to encourage them, but the longer it takes them to find a job, the harder it is to keep them moving. And in this economy, it’s definitely harder than it was before.”

Howland says she is aware of some clients who have chosen to either remain in or return to domestic violence situations. “They say, ‘It’s just too hard to survive out here on my own.'”

But Women in Transition keeps plugging away with a variety of services. It provides spreadsheets to connect clients with all the area’s major employers, temp agencies, educational institutions and even thrift shops. “We have been doing a lot more outreach to try to set up affiliations with employers, reaching out into the community to make more contacts, informing them of the program and seeking additional considerations for our clients,” Howland says. “We are contacting libraries, schools, churches and other places to make sure information regarding our program is available for potential clients. And we have increased our workshops to include financial management, credit counseling and stress management in addition to the job search and résumé help.”

Dianne Joyce
Staying afloat by practicing diversification

“If I were just doing private practice, I think I would have to fold,” says Dianne Joyce, a Licensed Professional Counselor in St. Louis who also has her doctorate in psychology. Fortunately for Joyce, she doesn’t have all her eggs in one basket during these tough economic times. In addition to her private general counseling practice, she works as a corporate trainer, providing education on numerous psychological issues, including conflict management. She is also employed as a psychologist/counselor by a group of doctors who perform bariatric (weight loss) surgery. In this capacity, she conducts pre-surgical psychological evaluations of patients.

“Having these other outlets has worked really well for me,” she says. “These areas may be sliding too because of the economy, but they’re not gone. It seems that when client jobs go, counseling is, unfortunately, often one of the first things they drop. In light of the present financial situation, many see counseling as a voluntary, luxury-type service that they are unable to afford. However, given the current work and associated financial crisis, anxiety and depression are likely on the upsweep, so let’s hope people find a way to get the help they need.”

Joyce says 95 percent of the bariatric patients she sees are experiencing anxiety and sleep problems, and most blame those problems on concerns over finances, dwindling 401(k) plans and job security. In many cases, Joyce says, those concerns are causing depression. “That becomes the primary focus for some of these sessions — let’s get the anxiety under control first.”

In counseling clients who bring up concerns about the economy, Joyce is emphasizing stress reduction techniques such as deep breathing “so their bodies don’t run away with them.” She also tries to help clients reframe their thinking, telling them that choosing to be nervous and depressed over the economy will not solve anything and pointing out that the portion of the brain that focuses on problems (or potential problems) is different from the part that deals with solutions. Joyce also attempts to get clients to draw on their strengths and past history of resiliency. “I remind them that they’ve gone through other hard times in their life,” she says. “I encourage them to look at this as one more challenge. … You have to stay focused on what you do have and not on what you don’t have; on what you haven’t had to give up versus what you have given up.”

Counselors can also make financially strapped clients aware of resources in the community, including where they can go to get low-cost medications and free food, or even provide listings of consignment shops for clothing, Joyce says.

Although many clients assume they can no longer afford counseling and call in to cancel their appointments, or simply fail to show up at all, Joyce says many counselors will do what they can to continue seeing clients, even if it means offering reduced fee or pro bono sessions. She is currently doing more sliding scale fees herself. Joyce realizes, however, that counselors will have to make some tough decisions if the economy keeps struggling. “You never want to say to a client that ‘I only value you to the extent that you can pay me,’ but it is a balancing act,” she says. “There are only so many (pro bono or reduced fee clients) you can take.”

Counselors should also take a step back and make sure they are practicing what they preach, using the same techniques they are recommending to clients to help deal with anxieties related to the economic crisis, Joyce says. She believes the economic climate will force some counselors to leave private practice and look for lower-paying jobs in agencies or elsewhere. Other counselors, she adds, will likely have to make sacrifices to remain in the field as well. “Even as counselors,” she says, “we have to learn to deal with our own disappointments. Some of us might have to settle for doing this on the side or even taking another job for a little while.”

Joyce says she is fortunate to have a husband with a good job, so the slowdown in her business isn’t affecting her the way it might others. In fact, after four years of balancing the three different parts of her counseling practice, she has come to regard the slowdown as something of a personal blessing in disguise. “It’s forcing me to take a break that my body was telling me I needed but that I wasn’t listening to,” she says.

 

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Jonathan Rollins is the editor-in-chief of Counseling Today. Contact him at jrollins@counseling.org.

Letters to the editor: ct@counseling.org