Monthly Archives: August 2013

Technology in counseling: Keeping your marbles in the game

Michelle D. Stone August 16, 2013

Recently, I was part of a lively discussion regarding the use of technology in the field of counseling. As strikingly diverse opinions were exchanged, I was saddened to hear the closing statement of one practicing professional counselor. Walking away from the discussion and shaking her head, she stated that if the field was moving toward the use of technology in the counseling relationship through means such as email, video and virtual worlds, then she would leave the profession and move on to find another career.

Although I respect her right to choose her own path, I thought it tragic that a bright, competent counselor with generally well-considered opinions would possibly remove herself from the field and effectively silence her voice in the technology debate. The whole of the counseling profession can only benefit from dynamic discussion of controversial issues. We need everyone to be informed and stay in the game. We need disparate voices at the table to help sort out what technologies may be effectively used in the field, and how they may be safely and appropriately implemented.

Technology will not go away. It will only become more ubiquitous within the professional world. History has taught us that technology infiltrates professions and becomes integral to their practice. For example, accountants used to painstakingly fill out tax forms by hand and use long, manual calculations to accurately report information. In today’s world, they have software programs that prompt them for information and compute complex calculations for them. Another example is the advent of the less invasive robotic surgeries that are becoming more commonplace in operating rooms nationwide. I suspect each of these technological advances had their skeptics, but as time has moved on, they have become accepted methods within their fields.

Emergent and novel approaches are very often met with skepticism. Telephones and televisions had their share of naysayers when they began to land in homes. Today, we can hardly imagine a world without them. Leaving the comfort of what we know and venturing into the unknown can be frightening, especially when we must be concerned with the welfare of others and our own ability to remain above reproach, both ethically and legally.

However, technology is all around us and certainly now is entering our field. Journals such as Cyberpsychology, Behavior and Social Networking, Journal of Virtual Worlds and Education, and Journal of Technology in Counseling offer insight into the ways technology is at work in our professional world. The scholarly articles available in these publications offer good information that can help us critically assess the role of technology in our field.

In his 2001 article, “Digital Natives, Digital Immigrants,” Marc Prensky suggests the concept of two types of digital users. Digital natives are those individuals who were birthed and bathed in an environment of digital technology, while digital immigrants are those who have ventured into the technology landscape, though their use is still colored by the “accent” of their homeland of nonuse (Prensky suggests that the accent is defined by such behaviors as printing out emails, beckoning others to a computer screen to view a website instead of simply emailing a URL, and printing text to edit instead of editing onscreen; the thickness of the accent is determined by the number of these behaviors that exist). As in any melding of cultures, an attitude of openness and understanding is necessary to attain smooth blend lines. However, in the case of counseling professionals contemplating the use of various technological tools in their practice, more is required.

We must purpose to become digital explorers, willing to set out and take in the new territory, while equipping ourselves with sound information along the way. We must share insight with each other and be willing to retrace our steps and move along a different path when professional discernment tells us it is prudent to do so. We must be willing to step in the weeds of the faintly trodden road to cultivate and nurture the possibilities of technology that appropriately fit the profession, its responsibilities and its clients. By doing so, we demonstrate our commitment to offering the very best to those who depend on professional counselors.

This ideal is attainable, but only possible when we have full representation at the table. The legal and ethical issues facing counselors integrating new methods of digital communications and therapies into their practice are vast, and they must be addressed. To effectively do so requires a tapestry of opinions and perspectives. Technology in the field is not an all-or-nothing proposition. We must strike a balance in terms of what is appropriate, empirically proven to be beneficial and ethically sound.

It begins by becoming informed. As each of us strives to learn more about the ways technology may be used to further our work, along with the potential cautions and risks, the result is an educated body of professionals dedicated to the enhancement of our field and clients. Becoming informed requires both personal and professional commitment. The following steps are a great place to start:

• Work to integrate journals addressing technology in counseling into your professional reading schedule.

• Acknowledge the trend of technology use in the field and purpose to become aware of how colleagues across the discipline are implementing various forms.

• Recognize the often overwrought sensationalism of technology by the media (for example, a focus on the sexual aspects of virtual worlds), and seek out facts to assist in developing a well-informed and balanced opinion.

• Examine your own technology use, and set out to become a technology explorer.

• Consider volunteering to serve on a professional committee that is addressing technology in the field.

As opinions are developed and evolve over time, stay engaged to advocate for what you believe to be right and true. Volunteer to serve on committees that are exploring the various facets of implementing current technologies in the profession. Research uses and outcomes of technologically based approaches. The key is remaining open to novel and innovative methods of utilizing technology, while maintaining a critical and discerning stance that ensures balance. Stay in the conversation by remaining engaged.

Walking away from the table because we don’t agree with what we sense to be the trend only negates our ability to influence the future path of our field. Our profession needs the voice of each of us. Don’t be the kid who picks up his marbles and races home because he doesn’t like where the game is going. Let’s join our colleagues for a well-informed exchange of ideas and meaningful debate. An environment rife with unique and challenging opinions is an exciting place to be because it is the best breeding ground for growth.

Only time will tell whether the counselor mentioned earlier will choose to remain in practice. My hope is that she reconsiders her plan and offers her voice to the discussion surrounding the use of technology. Though I may not personally agree with her views, I wholeheartedly welcome her to the table. It is my belief that her voice, joined with others, can effectively mold and shape the future of professional counseling in such a way that it has the potential to benefit so many. There is a chair at the table for everyone. Allow me to be the first to offer one to you.

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With over fifteen years of experience in the helping professions, Michelle Stone has worked with a variety of populations and organizations, providing both direct services as well as consultation. She holds a degree in Psychology and intends to research computer-mediated human interaction while pursuing a graduate degree. She may be reached at michelle.d.stone@gmail.com.

Voices unheard

By Krystle Dorsey August 14, 2013

Photo: Flickr/ FrauSchütze

There’s this guy I know, let’s call him “Javier.” When he was 15, he had a life in Peru that he was not willing to leave. In Peru, Javier was surrounded by his family and friends. He was part of a community that spoke the same language he did and shared his values. Nonetheless, Javier’s mother felt her family could achieve more in the United States. She left for this country and then moved Javier here a year later. Javier had to say goodbye to his homeland where he was perfectly happy and come to a country that made him feel alone.

His loneliness was the result of a weekly, sometimes even daily, routine on his way to attend his American high school. He prepared himself to fight if one of the White kids randomly pushed him again in the hallway, despite Javier minding his own business. It could be the skinny one who had called him a “spic” the day before while he was waiting in the lunch line. Then again, Javier wouldn’t be surprised if he ended up having to fight the curly-haired kid who stood in front of his classroom doorway the week before and said, “Go back to where you came from. You don’t belong here.” He responded to the ignorance of these kids with his fists because he could not speak enough English to respond verbally. These situations, in addition to his loneliness, made Javier hate life here in America and everything associated with it. He wanted to go home.

Eventually, however, he made it through. Despite his resistance to American culture in the beginning, a final encounter with the law made it too risky for Javier to use his fists to communicate his anger and frustration any longer. He loved his mom, and he knew she wanted him safe in the United States. He got a night shift after school washing dishes to renew a green card his mother could not afford for him. Through soccer, he made more and more friends with whom he felt comfortable practicing English. He finished high school, continued to work other jobs and even took a couple of college classes. Today, he has a life he loves.

We go through life every day speaking the language of our environments. Sometimes we notice who isn’t speaking; a lot of times we don’t. Even when we do notice who isn’t speaking, we rarely consider the reasons why. We’re quick to say they are shy or simply not talkative. Some of us even think they’re dumb, lazy or lack the desire to speak our language. There are those who are even frustrated with these individuals’ accents; there are others who make fun of it.

Javier is a friend of mine. When we first got to know each other, I would listen to his stories about how hard it was for him to adapt to the United States, and I would wonder how he could have received more help. I wondered if there was truly something more that could have been done. What happened to Javier happened about 15 years ago. Although he’s all right now, I wonder about the many other immigrant and international students who slip through the cracks each day in cities all over the United States, especially in predominantly Caucasian, English-speaking communities.

Various social movements in the United States have made most Americans more aware and accepting of cultural differences. The consideration of these differences and how they can be used to better serve members of various cultural groups is called “multiculturalism” within helping professions such as counseling and social work. Multiculturalism traditionally comprises race, ethnicity, gender and religion. It has provided great insight to individuals in workplaces and schools about how people of different racial, ethnic and religious backgrounds have different values and needs in these environments. Nonetheless, other facets of diversity go relatively ignored within the scope of culturally competent services or social justice. Language is one of these topics.

Language is a social skill. Proficiency in a new language requires one to use it often and in different social contexts. In addition, one must receive the encouragement and possess the confidence to take risks without fear or worry of ridicule from others. Unfortunately, this may not always be available for immigrant youth in grade school such as Javier or for international students at colleges and universities. Although one might make the effort to acquire English through formal education, this is not always enough. For example, Javier was placed in English as a second language (ESL) classes when he arrived in the United States and stayed in them until he graduated high school, but he did not feel comfortable speaking the language until he found friends who would not make fun of him.

Language barriers experienced by immigrants and international students exacerbate normal challenges typical to most individuals when adjusting to a new environment, including homesickness and the inability or lack of opportunity to make new friends in the United States. I’m sure you’re thinking, “Isn’t that obvious?” but the connection between acknowledging what makes sense and putting prevention or intervention programs into action may not always be on the priority list for policy makers and school administrators. Some multicultural researchers have thus tried to shed some light on the language difficulties faced by immigrant youth in the United States so communities will be aware of specific risks that need to be addressed.

For example, Christine J. Yeh, a researcher on Asian immigrant cultural adjustment for the National Institute of Mental Health, and Marc Atkins, a leading researcher at the University of Illinois at Chicago on mental health services for grade school students, observed in 2008 the problems Chinese immigrant youth have with expressing themselves adequately in English. These researchers conducted intense focus groups with immigrant youth and were able to provide reasons why language difficulties made pursuing friendships an additional challenge. These students had pressing family, school and work responsibilities that gave them little time for social interactions that would help them improve their English skills. Furthermore, their decreased opportunities for practice made them particularly uncomfortable in social situations. Although seemingly commonsense information, these types of studies are important to educators and others who advocate for these students. The concrete, scientific reasons behind how language barriers inhibit bright students from doing well shows policy makers why these students need additional services — for example, special social interaction groups during the school day, which they are more likely able to attend versus afterschool programs.

Furthermore, providing scientific research allows advocates to show just how serious the consequences of language difficulties can be. Senel Poyrazli and Kamini Grahame, two researchers at Penn State Capital College who specialize in immigrant and international student experiences, found in 2008 that the lack of opportunity to meet new people left international students of various racial and ethnic backgrounds feeling socially isolated. These students were at particular risk for depression and anxiety. Strong proof for why social isolation was a serious concern for these students allowed these researchers to suggest meaningful solutions to university officials and others who familiarized themselves with the study. Thanks to these researchers, and those like them, we now know that increasing social support for immigrant students with low English proficiency can be the make-or-break factor in salvaging their overall educational experience and healthy development.

For example, I have another friend named “Ines” who emigrated from the Dominican Republic to the United States during her childhood, similar to Javier. However, Ines moved with her entire family to a predominantly Hispanic community. She was supported not only by her family, but also by an abundance of friends, teachers and members of a strong church community who spoke her native language. Ines had a completely positive experience as a Hispanic immigrant youth in the United States. Javier and Ines have nearly the same strong level of English proficiency today, but very different experiences to achieve it.

With the growing globalization of the world, language will become increasingly important in our environments. Group counseling literature with a linguistic focus shows that group interventions can be an important tool in helping immigrant and international students develop a bicultural/linguistic identity. With a broader view of multicultural competence, the human services and education fields will expand to serve populations in great need of their services, along with the help of others who are willing to advocate for them.

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Krystle Dorsey earned her Master of Education in Counseling and Development from George Mason University. She currently works for the university’s college access program. Krystle advocates for the educational success, leadership potential, and career development of at-risk youth. Contact her at kdorsey757@gmail.com.

Why counselors need to pay attention to the perpetrator, too

Heather Rudow August 12, 2013

Many are still reeling over the case of Ariel Castro, the Cleveland man responsible for kidnapping three women and holding them hostage for more than a decade. Castro, a former bus driver, abducted Michelle Knight in 2002 at age 21; Amanda Berry in 2003 at age 16; and Georgina “Gina” DeJesus in 2004 at 14. The women were held in captivity in Castro’s home until May 6, when Berry shouted for help while Castro was out. Castro pleaded guilty to 937 criminal counts of rape, kidnapping and aggravated murder and was sentenced to life in prison without the chance of parole, in addition to 1,000 years. The city demolished the house on Aug. 7.

Lisa Lopez Levers, a professor of counselor education and supervision at Duquesne University and member of the American Counseling Association, says she believes it’s important to look at all sides of the case. Levers spent 15 years working in the community mental health and private practice sectors, focusing on trauma recovery and the impact of violence on child development. Levers edited Trauma Counseling: Theories and Interventions, which was published last year.

Counseling Today asked Levers to share her thoughts on the case and what she felt was most pertinent to counselors.

What are your general thoughts on the case?

Obviously, the Cleveland kidnapping case was a horrific ordeal for the three young women and the child. The responses of the survivors, in the aftermath of this egregious event, have been inspiring, to say the least.

Is there anything unique about this case, as opposed to others you’ve seen/heard of?

I actually was asked by a foreign government to work on a high-profile case in which a government official was abducted. I also have worked on various types of domestic abduction cases. In the Cleveland case, the extent of the perpetrator’s sadistic behavior toward his victims was stunning. Equally astonishing to me, under the worst circumstances imaginable, was the propensity of the victims to bond with and care for one another. It strikes me that one element of this case involved Stockholm syndrome. Clearly, the perpetrator managed to gain a high level of control over his victims — any acquiescence to his demands certainly was linked directly to their survival. Yet, in spite of individual suffering and abject terror, these young women formed a community among themselves that assisted in their survival. Their ability to aid one another, during a decade of horror, was awe-inspiring.

Why do you think the general public was so captivated by this story?

This was such an extreme version of the day-to-day interpersonal violence that some people experience and to which we, as a society, tend not to pay enough attention. Rapes, intimate partner violence, abductions and other types of interpersonal brutality unfortunately occur every day, and they just do not register on our various radar systems. This scenario makes me think of Hannah Arendt’s notion of the banality of evil, when regular citizens come to accept a premise of ordinary acts of violence as somehow becoming normalized and therefore being “okay.” As citizens of the society, I believe that we are complicit when we choose not to pay attention to the “smaller,” everyday incursions against civility. Generally, we choose to ignore this, but when such an extreme atrocity occurs, it reminds us of our humanity, as well as our vulnerability. This is precisely the type of event that should send us into deep levels of self-reflection about this particular scenario and then have us engaging in the broader discourse regarding “how” and “why.” These young women were from lower socio-economic groups, and their parents could not even convince local law enforcement personnel to investigate properly. We need to examine how social marginalization infringes upon human rights and human dignity.

What do you think counselors need to know?

Counselors need to understand the core experiences of persons who have been exposed to traumatic events and to be sensitive to the emotional and cognitive states that are engendered by acts of neglect, cruelty and violence. It is wonderful that our accrediting body, the Council for Accreditation of Counseling & Related Educational Programs, has acknowledged the importance and mandated the inclusion of trauma, crisis and disaster in the curricula of counselor education programs. But counselor educators still have a long way to go in terms of embedding these issues across the curriculum, as well as developing content-specific courses. As a professional counselor of 37 years, I can guarantee that any licensed counselor is going to encounter clients in crisis as well as clients who have been seriously traumatized. An unfortunate aspect of humanity is that these issues always have been and remain ubiquitous.

What do you recommend for counselors who may be counseling victims or families of victims who have gone through this kind of ordeal?

Unfortunately, many practicing mental health professionals, across disciplines, have not had any pre-service preparation for dealing with survivors of trauma or for assisting clients in the management of crisis situations. Given the extreme nature of this particular ordeal, any counselor needs to recognize the seriousness of such a case and, in the absence of appropriate training, needs to refer the victims/families of the victims to appropriately trained professionals.

In the meantime, every practicing counselor who has not had pre-service training in trauma, crisis and disaster services needs to acquire in-service or ongoing training and to stay current with the relevant literature. For counselors who work regularly with trauma, self-care is of paramount importance, and I cannot emphasize this last point enough.

What are your thoughts on Ariel Castro?

Let me begin by emphasizing my concern for the survivors and how remarkable I think their responses have been. I believe that these young women embody the construct of resilience. Even during the televised sentencing, they maintained dignity and hinted at an extraordinary determination that they will not be defined by this atrocity and that their survival includes moving well beyond this horrendous event. The women have been horribly victimized, and their transformation to survivors is beyond admirable — this is a given and should go without saying.

I am in Africa right now, and I stopped my work to watch the Castro sentencing on CNN. It made me sick all over again. But I cannot help agreeing with Castro on one issue, the claim that he is not a “monster.” Now, my resonation with his claim differs greatly from what I believe is his likely motivation for asserting such. I have a lot of diagnostic impressions, but without interviewing him personally, it would not be fair to comment. However, I think that there is some danger in simply “dismissing” him as a monster. We use terms like “The Cleveland Monster” and “House of Horrors” to distance ourselves from the abject depravity of the situation. But to follow this metaphor, Mary Shelly’s Dr. Frankenstein createdthe monster; the “monster-ness” of the creature was not innate.

It is evident from everything that I have seen on TV and read in newspapers that Castro’s behavior was sadistic and narcissistic. For example, I was stunned during the sentencing when he asserted, in spite of the evidence — chains, ropes and boarded windows and doors — that the women were there of their own accord. I equally was stunned that he clung to the excuse of being a “sex addict,” and I was glad that the judge dismissed this. However, I believed Castro when he said that he was sexually abused as a child, and I think that this is a crucial issue. Clearly, this is no excuse for the evil that he has committed. But we need to understand the dynamics of severe early childhood abuse and how, left unattended and in concert with other potentially negative environmental factors, as a society, we run the risk of newly emerging perpetrators. This leads me back to Hannah Arendt’s banality of evil. It is easy to construct Castro as a monster — this lets all of us off the proverbial hook. If I construe Castro as a monster, over there, I can situate myself over here, with all of the other non-monsters. But Castro is not a monster — he is the construction of what we can come to expect as a society when we ignore child sexual abuse — indeed, extreme child maltreatment of any kind. It is not about him; it is about us.

Do you have any additional thoughts you’d like to share?

In this type of horrendous criminal activity, we pay attention to the victims, as well we should. In fact, the way that local, national and even international communities have come together in support of the Cleveland survivors has had to be healing for the women. So when interpersonal violence is this extreme, it almost seems counter-intuitive to suggest that we need to pay attention to the perpetrator, other than to lock him up — in this case, for well over 1,000 years. However, if we ever are to have a positive influence on the cycle of violence, it will be, in part, because we develop early and effective interventions for those who become the perpetrators of violence.

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

VA to host mental health summits

August 6, 2013

(Photo: Wikimedia Commons)

The Department of Veterans Affairs (VA) will be hosting mental health summits at each of the 152 VA medical centers across the country over the next several weeks. The announcement was made during the Military Family Mental Health Conference at the White House. The mental health summits will provide an opportunity for VA facilities to establish and enhance positive working relationships with their community partners. Furthermore, these summits will help encourage community engagement in order to better address and understand the broad mental healthcare needs of veterans and their families. More information and dates can be found at http://www.mentalhealth.va.gov/summits.asp

Human trafficking — and resilience — in Cambodia and Thailand

Heather Rudow

Brittany Catania, an American Counseling Association new professional member who recently graduated with a master’s in counseling from Indiana State University (ISU), spent three weeks this past May in Southeast Asia learning about the topic of human trafficking on a deeper level.

Catania and eight other graduate students from ISU traveled to Thailand and Cambodia with Destiny Rescue, an organization dedicated to rescuing girls from the human trafficking business. Experiencing the impact of human trafficking firsthand left a lasting impression on Catania and solidified for her that nothing is better for a counselor’s cultural competence than leaving the classroom and directly immersing oneself in the world.

How did you get interested in this topic? What prompted you to get involved with this study abroad opportunity?

Catherine Tucker, a professor in my program at ISU, offered an elective opportunity to study human trafficking and spend three weeks in Thailand and Cambodia. I have had international experience prior to this trip and find that firsthand experience is one of the best teachers. I have found that human trafficking tends to be overlooked, and in an effort to be a multiculturally competent clinician, I felt this was a wonderful opportunity to gain some firsthand experience.

Describe your experience.

We partnered with Destiny Rescue, whose mission is to rescue girls from the human trafficking business. Destiny Rescue has several rescue houses throughout Thailand and Cambodia. They have a rescue team that goes to the karaoke bars to talk to the girls about a better opportunity. The girls are allowed to make their own decision whether to leave the industry they are in. They choose to go to the rescue houses, and once there they are, they are taught a trade of their choice and they make money working at the rescue houses. The girls can make jewelry, jeans, work in the café or a beauty salon. The trades the girls learn can be taken back to their villages, so they aren’t confined to the [geographic] area they are in. Destiny Rescue also has several prevention houses located in more rural, high-risk areas that are designed to educate and keep children out of the trafficking industry. We spent time at three different rescue houses. We were able to implement art therapy activities as well as Theraplay games with the girls. Our goal was not to do therapy but to merely provide them with activities that would be fun and build group cohesion with an opportunity for processing if that was something that was meaningful for them. As we traveled between Destiny Rescue houses, we were able to experience other cultural activities such as visiting Ankor Wat [and] the Golden Triangle.

What stood out most during the trip for you?

We visited Walking Street in Pattaya, Thailand, which is the sex tourism capital of the world. The street is devoted to sex shows and karaoke bars. Many of the women are over the age of 18; however, as the night goes on, the younger girls are brought out. Women and girls are bought and sold on Walking Street in a very public and blatant fashion. The women and girls stand out in front of the bars and clubs, inviting people to go inside. As our group walked up and down the street observing, I was shocked to see the number of families with children walking up and down the street. In one instance, a mother was posing her child with one of the prostitutes to take a photo. To our group, this street was much more than a tourist attraction, however it appeared as though there was a lack of understanding of what goes on in Pattaya. It was shocking and disturbing to see so many children with their parents walking up and down the street, taking in the sights as if it were an attraction.

What did you learn from this experience?

Through this experience, I have been able to see the impact of my Western upbringing in the way I think and conceptualize the world. Prior to the trip, I had taken a multicultural class and had done an extensive amount of reading and discussion about human trafficking, and I felt confident that I was well versed in the nuts and bolts of Thai/Cambodian culture. I knew all the basic things: eye contact, collectivism vs. individualism, male/female gender roles, etc., and I thought I was ready.

We had the opportunity to spend time with several groups of girls, and after the second group, I was baffled, angry and confused. The girls were happy — this was not something I expected or understood. I was angry about what had happened to them, their innocence had been stolen, and the way they had been treated wasn’t fair or right. Taking all of these things into consideration, it seemed like a natural reaction to be angry, sad and upset, but the girls were not. I have come to understand just how important labels are to a Western conceptualization of mental health. When an event happens, good or bad, we gain an understanding and acceptance of it by labeling it, dissecting it and eventually accepting it. This process, whether universal or not, does not appear to happen in the same way across cultures. The staff at Destiny Rescue discussed the girls’ desire to move forward with their lives and to not be defined by their past. This demonstration of resilience and positivity was humbling and taught me more than anything else during the trip.

What do you think counselors can learn from this type of experience?

I think it is important for counselors to know and understand the role of family in the lives of survivors of human trafficking. There is a devotion to one’s family that simply cannot go unacknowledged when working with this population. It is important to recognize that the survivors with Destiny Rescue, as well as across Thailand and Cambodia, sacrificed their youth and innocence in completely selfless ways in order to provide or help their families. As clinicians, we have a responsibility to honor that sacrifice, even though culturally it might not be seen as a sacrifice.

Now that you are back from the trip, what do you believe is the next step?

I believe education and awareness are very important next steps. From a clinical standpoint, it is important to have an understanding of this population so as to better provide for their needs when they come into our offices. From a professional standpoint, it is important to advocate for those who cannot advocate for themselves. I think this can best be done through spreading awareness.

How have you been impacted by your experience?

This trip has impressed upon me the strength of children. I feel privileged to have been able to share a small amount of time with the girls at Destiny Rescue. Their strength and resilience is inspiring and truly remarkable.

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