Monthly Archives: April 2014

Group process from a diversity lens: The car repair

By Lee Mun Wah April 24, 2014

This vignette and those to follow in the coming months are actual situations that have occurred in my diversity workshops. They will include my thoughts/rationale and the interventions I used, as well as questions for the facilitator, group/dyad exercises and a summary that helps to place the event in a larger societal context. All the vignettes are adapted from my diversity training manual, The Art of Mindful Facilitation. In each article, I will also include an example of the presenting workshop issue related to the vignette — in this month’s case, the issue of shame.

This is an interactive process, so I ask that readers follow the steps below in their suggested order to better serve the purpose of these articles.

1) Watch this short video clip:

 

 

2) Return to this article and read the description of the vignette.

3) Answer the “practice process questions” following the description of the vignette.

4) Before reading further, write your own intervention.

5) After writing your intervention, read the remainder of the article, which includes my thoughts, the intervention I used and a summary.

6) Optional: Read the corresponding workshop issue(s) from The Art of Mindful Facilitation.

For an introduction to this series, read “Group process from a diversity lens” in the April issue of Counseling Today.

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I asked a small group of about eight people if any of them had personal stories about racism that they had kept secret. A young African American woman, Jennifer, raised her hand. She shared how she went to an auto repair shop with one of her female co-workers, Leslie (who was also participating in the diversity workshop), because her car needed repairs. When they got there, the head of the shop talked only to Leslie, who was white, about the car. Jennifer felt very hurt car_repairby the white male mechanic ignoring her, as well as by Leslie not saying anything to object. Jennifer said, “So many times I feel like I don’t count, or as if I’m just the dumb black girl … and I just feel powerless sometimes.”

An older African American woman, Linda, and another older African American man, Thomas, yelled at Jennifer for not being assertive enough. Linda said, “Don’t let white men or any man talk to you like that! Every black woman has to show up for herself. … Is she (referring to Leslie) paying the car note? Why didn’t you ask him that? … Step forward, sister, and you run your own business. … You think she (again referring to Leslie) cares about you?”

Leslie protested under her breath, “I do care about Jennifer! … I was just trying to be nice.”

Looking down and afraid, Jennifer said, “I know, and she was just trying to be helpful. I didn’t think the person (the mechanic) was doing it on purpose. It was just …”

Jennifer faltered, appearing as if she were going to break down. The silence in the room was deafening.

Practice process questions for the facilitator

1) What came up for you in reading this vignette?

2) What are some of the key words or phrases to focus on?

3) Why do you think the mechanic ignored Jennifer?

4) Why do you think Leslie didn’t say anything to the mechanic?

5) What did Jennifer need from Leslie? Why?

6) What is familiar about this scenario?

7) Why do you think Linda and Thomas were so angry with Jennifer?

8) What does Jennifer need in this situation? Why?

9) Who would you work with first? Why?

10) How would you work with the rest of the group?

11) What is not being said here?

12) What is difficult about this scenario? Why?

At this point, I suggest you write your own intervention before reading the remainder of this article.

My thoughts

This was not going to be an easy situation because of all the folks involved and the many emotions being expressed. Yet signs were everywhere that beginning with Linda was the obvious choice, though not the easiest. I often share with my trainers that when we are afraid, we need to go to the “eye of the storm” because that often is where everyone is focused. It is the elephant in the middle of room that can’t be ignored or avoided.

When I looked at Jennifer, I realized that she needed to express her anger and get back her own voice. However, because of the way Jennifer looked down, seemingly in shame, she was not in any shape to go deeper with Linda. I hesitated to work with Jennifer first because her demeanor showed me she was going further and further into herself.

If I worked with Leslie first, I would be duplicating what had happened at the repair shop — choosing the white person over the person of color. I didn’t choose Thomas for a similar reason — it would have represented another man taking over the conversation and possessing the power to choose and define the issue.

Intuitively, I sensed there was a link to be made between Linda and Jennifer. Perhaps a younger Linda was being reflected in the present-day Jennifer. It was the intensity of Linda’s response to Jennifer that told me something was still unfinished in her life. Perhaps Linda was still speaking to that anguish and loss in herself as well.

The task at hand was how to help Linda express that vulnerability in front of the group and with Jennifer. It would require slowly establishing a trusting relationship with both Linda and Jennifer, one that took into account their past histories and pain. I realized that I had a couple of important advantages, however. I am a person of color, and I am familiar with Jennifer’s experience. At the same time, I was close to Linda’s age. It was my hope that these factors might help me in bridging a relationship with Linda.

The intervention I used

I asked Linda what was familiar about what had happened to Jennifer. Linda talked about how she had struggled against racism in college and said that nobody had been there to help her, so she had been forced to learn how to be strong on her own. I then asked her what she thought she needed years ago. She said she wished someone had been there for her.

“What do you think Jennifer needs?” I asked.

Linda smiled. “Perhaps what I needed,” she said.

With that, Jennifer started crying. I told Linda to go over to Jennifer. “I think she needs you right now,” I said. They cried in each other’s arms.

So, you see, Linda wasn’t really yelling at Jennifer. She was yelling at all those folks back in college and the isolation she had felt in her life as a young black student in a mostly white environment. Jennifer’s experience brought Linda back to that place — the point of her departure where she started protecting herself and vowed never to let herself be that vulnerable again with whites.

In working with Jennifer, I encouraged her friend and co-worker Leslie to ask Jennifer what was familiar about what had happened at the repair shop. This empowered Jennifer and gave her a chance to deepen her relationship with Leslie — a relationship in which their ethnic differences and privileges had never been broached. This also provided Jennifer with an opportunity to be heard and understood as a woman of color. I also asked Jennifer to tell Leslie what she had needed from her when the situation with the mechanic occurred.

Group/dyad debrief

1) Who did you identify with in this situation?

2) Why do you think Jennifer didn’t react to Leslie at the car repair?

3) What was familiar about this incident?

4) What did you learn from this exchange?

Summary: The summary provides a way to create closure by identifying a larger societal context to what happened and also to share what is needed. It is also a time to acknowledge those who have shared. The facilitator presents this summary to the whole group.

“Sometimes what we hate in others is a reflection of what we hate in ourselves. We need to avoid shaming that part of ourselves that we see in others, while remembering to acknowledge those hurt and unfinished places within us.

“As you can see today, at any given moment we can get a second chance in life to give to others what we didn’t get. Just as parents get to give their children what they didn’t get, Linda got to go back into that place in her life that was unfinished. Only this time, by helping Jennifer, she was able to help and heal herself too.

“It is so easy here to take sides in situations like these. The real work is to support everyone to be heard and acknowledged.

“It’s also important when someone tells us their story of being hurt and victimized to remember to listen and ask questions in support of them, rather than distancing them with our judgments and blaming.”

Workshop issues

The presenting workshop issues in this vignette are shame and blame (pages 39 and 26, respectively, in The Art of Mindful Facilitation manual). It is very useful to include these issues and their interventions in your sessions. The following description of shame gives an example of the content and format of the workshop issues from the manual.

The definition of shame is a painful emotion caused by a strong sense of embarrassment, guilt, disgrace or unworthiness. The difference between shame and guilt is that often the individual feels like he or she is a shameful person, whereas an individual who feels guilty often feels it is because of a specific act or situation.

People who feel shame often look down or avert their eyes when talking about their experiences. Have them look up, not only to “face” those around them, but also to be seen, accepted and possibly forgiven.

Shame often “freezes” someone to the past and makes the person feel powerless. The work is to have that person relate what happened and how it affects him or her today. This gives the person’s shame a face and present-tense reality.

Suggested interventions 

1) When the person is finished sharing, have the group notice the impact of what happened to her or him. Allow plenty of time for silence and reflection.

2) When the person is finished talking, have the group members repeat back what they have heard.

3) Ask the group members if they have ever felt ashamed and didn’t want anyone to know about it. If they are willing, have them share their personal stories.

4) Have the group share how they feel about what they have heard and how they now feel about this person. In the cycle of shame, a main cause is the feeling of unworthiness. By having group members share how they feel about this person in a positive way, they offer acceptance and healing. By having the participant look up at the group, the cycle of personal shaming and isolation begins to be broken.

Group summary

We all have something of which we are ashamed or not proud. To go on with our lives, we need to take responsibility, forgive ourselves and others, and then try again.

 

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Lee Mun Wah is a Chinese American documentary filmmaker, author, educator, community therapist and diversity trainer. For more information, including a link to his services and trainings, visit the StirFry Seminars & Consulting website at stirfryseminars.com.

 

Letters to the editor: ct@counseling.org

 

And baby makes three

By Stacy Notaras Murphy

babyI remember the first client I told about my pregnancy. I was starting to show and realized I couldn’t put the news off any longer. Dawn (client names have been changed throughout to protect confidentiality) was the one person on my caseload I was nervous about telling because she was going through fertility treatments to become pregnant herself. In my anxious state, I made the impatient decision to start my notifications with her rather than learning from and building on my experiences in telling other clients.

“You might have some feelings about this, but I’m pregnant,” I blurted out at the end of a session. Dawn paused, smiled and said, “Well, thank you,” and then she left. Though we kept working together, we never really discussed her feelings about how I delivered the news of my pregnancy to her. I look back on that with such regret. I wish I had had more of a strategy in that moment.

I was meeting weekly at the time (and still to this day) with a peer supervision group made up of therapists who are mothers. Our experiences of telling clients about our pregnancies are all somewhat similar, and they include both hits and misses. We all recall times when we used the information to good therapeutic effect. We also recall instances in which the news derailed what might have happened under other circumstances.

According to the U.S. Department of Labor, women make up approximately 70 percent of all counselors. In addition, nearly three-quarters of ACA’s membership is female. These numbers suggest that it will not be particularly uncommon for clients to work with a counselor who is pregnant during treatment. Although studies and papers on the topic are not plentiful, the subject comes up in wider discussions of transference, countertransference and ethics. Among the questions to consider are when to reveal the pregnancy to clients, how much detail to offer and how to ensure proper client care both leading up to and during maternity leave.

While many clients have little conscious reaction to their counselor’s pregnancy, others have strong feelings that can be named with the counselor or that show up in other ways. One colleague described a client who threw himself into a crisis just before her maternity leave began. In their work, it became clear that he had done this to give her the opportunity to prove her commitment to him — by attending to his needs despite having an infant at home — or to unmask her as the abandoning mother he recalled from his own childhood.

Not all therapeutic alliances are deeply challenged by the counselor’s pregnancy, but most will experience some impact, if for no other reason than it necessitates a break in the counseling process. Preparation, awareness and collegial support are indispensible tools during this time.

Moment of truth

Patti Anderson is an ACA member and licensed professional counselor (LPC) in private practice in Washington, D.C. She is also the mother of one school-age son and younger twin daughters. During her first pregnancy, Anderson was a full-time counselor at a university. She left that position after her maternity leave ended and launched her own private practice. Her second pregnancy happened five years into building that business. “I noticed I felt more pressure and anxiety with the second pregnancy in regard to finances, clients and the business’s ability to withstand my maternity leave,” she reflects.

Anderson says a vital support was having supervisors who were available for help and quick consultation. “For me, that availability was key to being able to quickly check in to manage countertransference and unique client issues,” she says, adding that her second pregnancy had more emotional components. “It was a real balancing act between what’s best for my family, what’s best for my clients and what’s best for the business. As you can imagine, sometimes those things clash, and sometimes the problems, solutions or truth of the situation were unconscious to me, but my supervisor really helped me tease them out.”

Once, during a session with a long-term client, Anderson was overcome with morning sickness. Because she was only about four weeks along at the time, she had not planned to tell anyone about the pregnancy for several more weeks. “[The client] noticed that I didn’t look well,” Anderson says. “She has good boundaries and didn’t ask what it was, but I could tell she was worried. I was scared to tell anyone yet, so I let her leave the office with the ambiguity of what was wrong hanging out there. Later, I decided to call her and explain the situation. She was really relieved, as she thought I had cancer, and appreciated me following up with her.”

That experience reminded Anderson that clients can be forgiving of our mistakes, and that those times often serve to deepen the work that counselors do. “The best lesson I learned was to treat each client individually, mindfully tell them and talk with them about it when it [was] appropriate for them within reason,” she says. For some clients, simply knowing her due date was enough detail, and Anderson notes that limiting the information about her pregnancy helped demonstrate good boundaries for certain clients. Still, other clients had specific questions about how her work schedule might change after delivery.

Laura Jessup is a counseling resident and ACA member working as a therapeutic day treatment specialist at a middle school in Manassas Park, Va. At the time of our interview, she was pregnant with her first child and had just revealed this news to her caseload of five adolescent clients.

Having recently told teachers and staff at the school, Jessup wanted to tell her clients in person before they heard it elsewhere.

“I thought about the word choice I would use with each of them and particularly about how I would avoid putting too much of the focus on me during this part of the session,” she says. “Even though it was my news and experience, I wanted to keep the focus of the session about them.” She notes that she wanted to be able to talk to each of the adolescents about how her pregnancy would affect them, help process their individual reactions and answer any questions they might have.

Jessup says she didn’t receive any advice from her supervisor about how to announce her pregnancy in the counseling room. “Truthfully,” she says, “I did not think to consult any reading materials or articles. I briefly consulted with a colleague regarding if I should sit down each of my clients and share with them the news or just wait for them to find out eventually from others. She helped confirm my initial instinct that I should tell them directly.”

Traversing transference

The reactions Jessup received were mixed, but one stood out. Jessup had worked for more than a year with Cara, a 14-year-old female. After being told the news, the adolescent’s first statement was, “Well, what’s going to happen to me? Who’s going to be my counselor?”

Jessup knew heading in that she was unlikely to receive the socially appropriate “congratulations” response from such a young person. In fact, Cara’s egocentric, developmentally appropriate reaction confirmed Jessup’s choice to reveal the pregnancy to her clients directly. By being patient and interested in Cara’s own experience of the news, Jessup learned even more about the adolescent’s history and interior world.

Cara “went on to elaborate about how one of her favorite teachers had just recently left for maternity leave, and she was experiencing some conflicts with the substitute teacher who had replaced her,” Jessup says. She tried to alleviate some of Cara’s concerns by explaining that she would be on maternity leave only during the summer break. “She expressed some relief but then reminded me that pregnancies don’t always go as planned and that I might have to be on bed rest or have to leave work earlier than expected,’” Jessup says. The two have continued to process the experience, which has ended up revealing new details about how several of Cara’s family members have experienced miscarriages and complicated pregnancies.

Sometimes transference issues are more hidden, as in Cara’s case, while others are right at the surface. Anderson worked with a woman, Tanya, who had lost a baby at 20 weeks. “As I got more and more pregnant, she starting reexperiencing the trauma, and we used those sessions to really provide her with a safe space to talk about the difficult emotions coming up for her around my pregnancy,” says Anderson, who also worked closely with Tanya’s psychiatrist to ensure she had another outlet for processing her feelings.

Timing is everything (to new clients)

Once the word is out about a counselor’s pregnancy, she also must consider what impact that might have on any new clients she takes on before her due date. W.E. Wang, an LPC and ACA member in Fairfax, Va., is now a stay-at-home mother. Before having her child, Wang worked in a partial hospitalization program where she led groups and counseled individuals for an average of three months at a time.

Wang says conscious consultation with co-workers and supervisors was key to getting her ready to talk about her pregnancy with clients. She prepared for those discussions with clients by thinking through the details she wanted to share — such as the starting date of her maternity leave — and those that she wanted to keep private. “The most important advice that I received from my colleagues was that I needed to be aware of my needs,” Wang says. She notes that her colleagues and supervisors encouraged her to pay attention to her own self-care and to set boundaries about whether she wanted to publicly share the child’s gender.

“My clients were surprisingly accepting of the news,” Wang recalls. “Most reactions were related to anxiety on how the pregnancy might affect their treatment. I did start treating a few clients midpregnancy, where it was obvious to them. One client in particular was very guarded, even skeptical, about my ability to work with her since the presenting problem was related to anger outbursts and difficulty coping with mood swings.”

Wang explained that the client, Mary, a married woman without children, first arrived at a group session and was the only new member present. When Mary recognized that Wang was pregnant, her facial expressions revealed surprise and agitation. “She proceeded to share that she [could not] allow herself to be angry with a pregnant person. Therefore,” Wang says, “she worried that she [could not] be completely open and honest during treatment.” Wang explained that she worked as part of a treatment team made up of several professionals who were available to help Mary.

Together, Wang and Mary worked to create a plan in case Mary felt her anger escalating, such as removing herself from the situation or asking for support from another team member. Wang also took the opportunity to explain that she worked to keep her treatment process transparent and that there would be plenty of room to discuss the pregnancy if Mary ever had anything to process. “Throughout treatment, we worked on grounding skills and increasing awareness of her emotions,” Wang says. “She did not appear to have any other concerns relating to my pregnancy for the rest of the time I worked with her.”

In contrast to those working in agency settings, many counselors in private practice often set a date when they will stop taking on new clients. I recall thinking it would be fine to do an intake in my sixth month of my first pregnancy, but when time came for my maternity leave, I regretted having to cease working with that client after what felt like a short time together. Rather than set her up with a support network to get through my time away, we decided together to transfer her case to a colleague. During my second pregnancy, I was much more conservative about accepting new clients after the third month and made sure to disclose this information with every new referral that came in.

Anderson also chose the “open book” route and allowed new referrals to assess their own personal comfort levels working with someone about to take a leave of absence. “I had a couple of people who did not return after I had the babies. I attempted to follow up with them to make sure they found someone else. I felt like I did everything I could to provide them a safe space to handle this transition, but at the time,” she acknowledges, “it felt more personal, like I did something wrong.”

“My supervisor helped me really take a look at those pieces and work through them,” she says. “I also had a few who canceled our first appointment upon my return. I felt like I knew what that was about for many. It was good material and helped clients uncover abandonment and anger issues. It also gave me a look at how they operate with others in their lives.”

Anderson advises counselors to consider their own personal style of connecting with their clients and to use that style to help clients process the new information about the pregnancy. “It helped so much when I moved from seeing the process as more of a policy or procedural issue to authentically, openly incorporating it into my therapy,” she says.

Transition planning

ACA member and recent counseling graduate Renee Rivera is working toward licensure in New Jersey. She was engaging in individual therapy when her own counselor got pregnant. One day, Rivera’s counselor sent her a text message canceling an appointment because she was not feeling well.

“I responded that I didn’t know she had been sick and hoped she felt better, at which point she [texted back] that she wasn’t sick, she was pregnant,” Rivera says, adding that they had been working together weekly for about eight months. “I received a phone call the following week from a new therapist informing me that [Rivera’s counselor] was on maternity leave and that she would be taking over my sessions. When I showed up for the session a few weeks later, I was informed that the new therapist was no longer with the group, and I would be seeing someone else [new] again.”

Reflecting on the experience as a client, Rivera found the entire situation odd and somewhat overwhelming. Considering the experience as a trained counselor, she says the circumstances were poorly managed. “I respect not immediately disclosing the pregnancy, especially if you aren’t planning on going on maternity leave immediately and feel you have time to broach the topic later,” she says, “but to be told via text message while canceling an appointment feels like a boundary issue. It was almost like having a conversation with a friend, which is not what I expect when talking to my therapist.”

“Additionally,” she continues, “I felt like the team did not have a proper plan to deal with my therapist’s maternity leave. When the interim solution they adopted did not work out, I was never informed and, as a result, ended up not having an appointment for about a month, at which point the mix-up and other issues related to me having to switch therapists were never addressed. Although I ultimately handled the transition well, I can imagine that other clients may have had a more difficult time with the situation and ultimate adjustment period.”

Having lived through this series of therapeutic missteps, Rivera recommends that counselors have a transition plan and seek to include colleagues and other staff members in that strategy, if appropriate. “Depending on how long you may be on maternity leave, a client could be significantly impacted as a result of the pregnancy,” she says. “Being sure that they are prepared to make the adjustment to either not seeing you for an extended period of time or meeting with a new therapist will make the transition that much easier, especially for clients who may struggle with change and transition.”

Jessup agrees that counselors ought to take the time to create a transition plan for each client and discuss that plan at the time they reveal news of the pregnancy to the client. “Having a plan in place and being able to verbalize it to the client early on also demonstrates to the client that the counselor is considerate of his [or] her needs and is working to ensure that they continue to receive quality treatment,” she says.

Use it or lose the chance

Although it’s a disruption to business as usual, a counselor’s pregnancy can become a conduit for new insights and a deepening of the therapeutic alliance. One of my clients once reflected that seeing me, then at age 33, change physically into a mother actually challenged her long-held, biased expectations about her own mother’s ability to parent her because she had her as a teenager.

Similarly, Heather Tustison, an ACA member in Boise, Idaho, is approaching her first pregnancy as an opportunity to normalize pregnancy as part of the general human experience. Tustison serves as a clinical supervisor at her own private practice and training facility, where she sees an average of 20 clients per week and supervises four interns. At the time of our interview, she noted she had been unable to find many materials about how to deal with client issues and pregnancy. As such, she consulted with colleagues and decided to start disclosing her condition to clients at the four-month mark.

Her clients’ reactions ran the gamut from positive (“Your child is going to be so well-adjusted!”) to fearful (“What will I do without you?”). Tustison says the most transference has come from those clients with abandonment issues. “Their intensity has increased and their symptoms have increased the closer we [get to] my due date,” she notes. She adds that she chose to bring her observations of the clients’ reactions into the counseling process to help them explore the roots of their concerns.

Tustison has worked with her clients to normalize the human experience of attaching to someone who then may not be as available due to pregnancy or some other physical issue. She also urges counselors to consider and possibly disclose any physical reactions to pregnancy that may be preventing them from performing their job in the same way they did before. “I have had to make restroom breaks a part of the ‘hour session,’” she says. “My baby is positioned very high, and I often sigh or yawn just to breathe. Both may be seen as inconsiderate or disrespectful but have been unavoidable.”

 

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Contributing writer Stacy Notaras Murphy is a licensed professional counselor and certified Imago relationship therapist practicing in Washington, D.C. To contact her, visit stacymurphyLPC.com.

 

Letters to the editor: ct@counseling.org

 

 

Advocacy in action

By Laurie Meyers April 23, 2014

ProtestAdvocacy is a concept that can evoke visions of protesters and picket lines, phone banks and information booths, and maybe even knocking on doors and accosting strangers on the street.

But at its most basic level, advocacy means to help or assist, and isn’t that the essence of counseling?

“I feel that the basic principles of advocacy — helping people to be their best — have always been a part of the profession in some ways,” says Courtland Lee, a past president of the American Counseling Association and a pioneer in multiculturalism and social justice work. “But it’s evolved over time. People really started to use the word advocate in the real sense [in the] 1960s as the major social justice movements — the struggle for civil rights, the anti-Vietnam War movement and the call for women’s equality — began to transform society.”

Counselors, like the rest of society, were affected by these movements, Lee says. “It started as more of a philosophy that counselors need to be agents of social change. As it evolved, advocacy became part of the multicultural and social justice movements,” says Lee, a professor of counselling at the University of Malta and editor of the ACA books Multicultural Issues in Counseling and Counseling for Social Justice.

Counselors began realizing that working with the client one on one wasn’t always enough, Lee says. Making lasting differences in clients’ lives often required challenging the prevailing environment and working to change it.

Rita Chi-Ying Chung, an international expert on multicultural and cross-cultural counseling, discovered that truth at the beginning of her career when she began working with refugees, a population forced to navigate many cultural barriers when arriving in a new county.

“I felt that we were creating kind of a revolving door where we would see clients, they would feel better, and then leave and go back in their world and get exposed to whatever issues or injustices that were happening to them, and their pain and difficulties would just come back,” says Chung, an ACA member and professor in the counseling and development program at George Mason University (GMU) in Fairfax, Va. “As counselors, I just think a critical part of our counseling is advocacy — not just on an individual level but on a community as well as a systemic level.”

The need for advocacy isn’t limited to large societal movements or even large groups of people, however. The need is present in every counselor’s office, school or classroom.

“Advocacy is not an adjunct piece; it’s a core, fundamental piece of any counseling we do with anybody,” says Fred Bemak, Chung’s research partner, frequent collaborator and spouse.

Lee offers the example of a famous case in Maryland in which a mother struggling to make it paycheck to paycheck and who couldn’t afford health insurance was unable to take her son to the dentist when he got a toothache. Tragically, the tooth became infected, the infection spread to the boy’s brain and he died.

“So, imagine this mom coming in for grief counseling,” Lee says. “It’s one thing to help her process grief, but at the same time, she is stuck in a dead-end job [and] another son has never been to the dentist, so the same thing could happen to him. Grief counseling on its own is not sufficient.”

But how would a counselor advocate for the client? By addressing the circumstances that led to the tragedy, Lee says. For instance, he suggests, the mother needs a better job, so perhaps the counselor could find a program that would help her upgrade her skills. The counselor could make a simple phone call to the state’s social services department to see what assistance the client might be eligible for, such as help with energy bills, emergency cash that could go toward paying rent or food stamps. The counselor could assist in securing dental care for the other child by checking with the dental community to find a dentist or clinic willing to provide low-cost or pro bono work.

Many of today’s counselors are actively advocating for clients, causes, social change and even the profession itself. In this article, we share a few of their stories.

Stopping traffic

Since 2012, Rita Chi-Ying Chung has received both the Gilbert and Kathleen Wrenn Award for a Humanitarian and Caring Person and the Kitty Cole Human Rights Award from ACA. Much of her work focuses on social justice and human rights. But Chung, who is also a consultant, researcher and faculty member at GMU’s Diversity Research and Action Center, didn’t start her career looking to become an advocate. Instead, advocacy found her.

“I was trained in a more traditional way of counseling, and advocacy wasn’t a real part of it,” says Chung, who was born, raised and educated in New Zealand, where she received her master’s and doctoral degrees in psychology at Victoria University of Wellington. But then the so-called “boat people” — Southeast Asian refugees who fled by sea on makeshift rafts and boats — started arriving in New Zealand in the 1980s. These were the “second wave” of Southeast Asian refugees from Vietnam, Cambodia and Laos who were fleeing the postwar chaos that still lingered nearly a decade after the fall of Saigon and the end of the Vietnam War.

Chung was working in community mental health centers as the refugees poured in. Her superiors thought she was uniquely qualified to work with this emerging client population because she was the only Asian counselor in Queensland and perhaps in all of New Zealand at that time.

“I was bilingual in Chinese — not any other Asian languages, just Chinese — but many of the refugees were Chinese-speaking Vietnamese, so we were able to communicate,” Chung recalls. “Because of that, I think some of the social services staff thought, ‘OK, she’s Asian. She’s talking to some of them, so therefore, she must be able to speak to all of them.’’’

The hugely uninformed assumption that one Asian person could somehow communicate with all other Asian people made Chung consider that the mental health community was likely oblivious to other cultures and their specific psychosocial needs as well. After all, if professionals didn’t even know what language the refugees spoke, how could they begin to understand and help them cope with their trauma?

Chung has published numerous articles and books on advocacy, multiculturalism and social justice. Today, she continues to advocate for and work with refugees, immigrants, minorities and other at-risk groups. An international conference on at-risk children led Chung to her current primary focus: child sex trafficking, particularly of Asian girls. She spent approximately three years traveling to Burma (Myanmar) with the nongovernmental organization (NGO) Save the Children UK to work with trafficked children and study possible ways to stop child trafficking.

The issues surrounding child trafficking are complex, Chung says. Girls are often sold to traffickers by their parents, which most counselors (and most other people in the Western World, for that matter) find extremely difficult to understand. But these are areas that are extremely impoverished, Chung explains, and sometimes the choice boils down to taking money from the traffickers for one child or watching one or more of your children starve to death.

“If it’s a difference between someone in your family’s going to die if you don’t put food on the table or you may be trafficked to another country, what are you going to do?” asks Chung. “You also need to understand Asian culture. In general, there is this concept of filial piety. The obligation for any child is to take care of their parents, which includes not only taking care financially, but to obey and respect and sacrifice anything for the greater good of the family.”

Even when the police raid a brothel and the trafficked girls are “freed,” they may choose not to go home, Chung says. “It’s not because they love what they’re doing. In all my years studying the trafficking industry, I’ve never met anyone who said, ‘Yeah, I volunteered.’ The Asian girls don’t leave because they feel that leaving is letting their family down,” she says.

“At the same time, they can’t leave because there is nowhere to go,” she continues. “In this culture, there is such stigma about rape and abuse. There’s such shame and loss of face, which doesn’t just apply to the girl but to the whole family.”

“It’s difficult,” Chung says. “I suddenly realized that in such an economically depressed situation, we’re not going to stop trafficking. It took me awhile to just accept the fact because I came into it thinking I was going to help prevent it.”

What Chung does do is ease community reentry for girls who have the option of coming back, in part by helping communities develop realistic alternatives for making money.

Easing reentry also involves education, Chung says. Part of that is sitting down as a community and collectively talking about how the group can heal, she says. Sometimes the healing involves listening to the girls’ stories.

“Sometime we’ll do role-play where the girls play out what it is like to be trafficked, telling their stories in an indirect way,” explains Chung. “Survivors will take on different trafficking roles. One person will be a trafficked individual, one person will be the madam in the house, etc. During this kind of simplistic playing out of roles, you can look around the community, and people are just crying. They’ve never truly thought about what the girls’ experiences were like. Once we get those tears out, the healing begins.”

Even so, the process is never simple. In some cases, Chung says, the family won’t take the girl back, especially if she is pregnant. However, others in the community may step forward and offer her a place to stay. Sometimes girls who were trafficked will band together and find a facility where they can live as a group.

Regardless, it remains essential to provide the girls with ways other than sex work to make money. Sometimes, however, the suggestions aren’t practical.

“We’ve got to give girls education and skills, but there are these programs out there that want to teach girls to be hairdressers and then send [them] back to their villages. What’s the point?” Chung exclaims. “Because, quite frankly, if I’m poor and I’m having trouble putting food on the table, I’m not going to pay someone to wash my hair.”

“I say [instead], what are the local resources? In one area, they have all these grasses they can weave with, and people use natural products to make dyes,” she explains. “So we thought, why not make lots of baskets and dye them different colors? Maybe we can find someone to take them once or twice a week to local markets and sell them, and that’s a way of sustainable living.”

For those who are still being trafficked, Chung and others have tried to provide a few safeguards. “We set up toll-free numbers in countries so that if there’s been some coercion, fraud, some threat, there’s someplace they can call,” she says. “Sometimes girls don’t even realize they are being trafficked into the sex industry. They have been told that they are going to be a maid or waitress or nanny somewhere, earning a lot of money, and before [they] know it, they are in a situation where their passports have been taken and they’ve been told that they owe a lot of money.”

Any attempt to stop or reduce trafficking must also address the demand side, emphasizes Chung, who was invited in 2008 to give a presentation on the cultural issues surrounding child trafficking at the United Nations. “White European men will go to different countries in Europe or Asia to have sex with children, but they don’t classify themselves as pedophiles. In the trafficking world, we call them ‘casual pedophiles,’” she says.

Most people are also unaware of how much sex trafficking goes on in the United States, Chung says. People would be shocked to discover that sex trafficking can take place anywhere, in anybody’s neighborhood, she says. The victims are not only women and children brought in from other countries but, in some cases, underage American girls. According to an FBI report from 2011, more than 290,000 U.S. youth were considered to be at risk for becoming trafficking victims. Although most victims of trafficking come from impoverished backgrounds, traffickers also target girls from more affluent families who are vulnerable for a variety of reasons, such as a history of sexual abuse, drug addiction, extreme low-self esteem, a desire to fit in or even promises of a glamorous lifestyle. Chung points out that in Northern Virginia, where she lives, there have been recent cases of high school girls being pulled into the sex industry.

“Human trafficking goes way back in civilization — back to the days of the Roman Empire — and it’s big business,” concludes Chung.

Counseling and advocacy: Two parts of a whole

For Fred Bemak, the academic program coordinator for counseling and development at GMU, advocacy and counseling are fundamentally intertwined. He was an advocate even before he became a counselor, and that experience shaped how he viewed his training and the counseling profession.

While in college, Bemak served as a summer counselor in the Upward Bound program, which works with youth from diverse backgrounds, including those who are economically disadvantaged, to give them a jump start toward college. Bemak continued working with Upward Bound throughout his counseling training, and the juxtaposition created significant cognitive dissonance for him.

“I realized pretty quickly that helping people accommodate to those social conditions was not a good way to do counseling,” explains Bemak, the founder and director of GMU’s Diversity Research and Action Center. “The traditional counseling field said, ‘Let me help somebody feel better about themselves even though they’re poor and they’re hungry and they don’t have a job and people are discriminating against them, and let me help them adapt to all that so that they can manage their lives.’ … From my Upward Bound experiences, I learned that’s not quite enough. Because we’re helping people to adapt to oppressive situations and the conditions of their lives don’t change, we’re just trying to change their mental status to say [in essence], ‘I’m poor and I’m happy,’ and that’s ridiculous.”

Bemak trained in what was considered to be one of the more progressive programs of its time, but as he describes it, it was still based on European-American concepts that didn’t fit the circumstances he was seeing at all.

“In the morning, I’d have been in the African American community with parents who were frustrated and angry and upset about life, trying to figure out how to manage without food. And then,” he says, “I’d go to these counseling classes, and it would be like two different planets.

“There was my training, and then there was working with vulnerable people in difficult circumstances. I had to craft together … how do I take this training and capitalize on it for the purpose of meeting the needs of people who are in marginalized circumstances?”

Those dual, clashing experiences spurred Bemak to get his doctorate so he could qualify for positions through which he could influence policy and bring social justice, multiculturalism and advocacy to organizations across the United States and then abroad.

His international work began when one of Bemak’s friends, a Yale University psychiatrist, received a general call for assistance from community service providers to assist with the needs of incoming Southeast Asian refugees. “He said, ‘Call Fred. He knows about working with children,’” Bemak recounts. “I said, ‘But I haven’t even been to Vietnam or Cambodia!’ They said, ‘You’ve been to Asia, and that’s as close as we can get.’”

Bemak learned by doing. “I didn’t know much about that population and what was going on,” he says. “But very quickly, because there were very few people in the United States doing this work, I became an ‘expert.’ I didn’t know enough to deserve the title, but there was basically no one else, so I was getting calls from all over the country to do training and consulting, and everywhere I went, I learned more.”

Bemak’s work has since expanded to include refugee populations from around the world. He has helped provide services in 55 different countries. He says his experiences continually remind him of the importance of advocacy and how much more he still needs to learn and do.

“One of the things I’ve been doing recently that has been very, very intense is working with postwar/conflict youth. Working with child soldiers, working with abductees, working with orphans, working with people infected with HIV/AIDS as a result of war. I’ve been doing that in Uganda most recently and looking at some other projects in Liberia,” says Bemak, who consults for the NGO Invisible Children.

“It’s incredibly intense and painful work,” he continues. “Many times in these counseling sessions, I’ll have been the first person to hear these stories because people have not been able to tell them because they have not found the conditions in which they feel they can.”

All of Bemak’s advocacy counseling work revolves around helping diverse people and communities in need, but after Hurricane Katrina, he felt compelled to create a kind of urgent care counseling unit that would respond in the wake of disasters. Bemak was at a national counselor educators’ meeting when, roughly six weeks after the devastating storm, someone asked who among the attendees had been to the Gulf Coast and seen the horrible devastation. Only a few hands went up. Worse yet, in Bemak’s opinion, the counselors who had visited the region had assisted primarily by helping to clean up, not by putting their desperately needed counseling skills to good use with the affected population. Worst of all, he says, when he looked into relief efforts, he found that small, diverse communities in Mississippi were not getting the services they needed. He notes that most of the focus was on New Orleans, but even there, the need was so great that there weren’t enough mental health providers to go around. Bemak was afraid that smaller affected communities in Mississippi were getting lost in the shuffle.

“So, I created Counselors Without Borders in my head, right there,” he says. In addition to its work in Mississippi after Hurricane Katrina, Counselors Without Borders has also provided culturally sensitive services to migrant communities and on American Indian reservations when wildfires scorched Southern California in 2007, as well as in Haiti in the wake of the 2010 earthquake.

The organization only deploys where it is needed. “I only want to go to places where needs are not being already met,” Bemak says. “Counselors Without Borders is a backup organization to come in and do culturally responsive work where it’s not being done.”

The thread that runs throughout all of Bemak’s work is social justice — how to address human rights and help achieve equity in counseling. The answer, for him, is advocacy.

“In the work we’re doing [as counselors], I think we’re really contributing to problems by not addressing advocacy and by not incorporating that as a core part of our jobs,” he asserts. “I think we’re contributing to the social problems and the inequities and the social conditions that oppress and hurt people.”

The battle for mental health

Keith Myers, a licensed professional counselor in Atlanta, has always been interested in the military. It’s a bit of a family tradition. His father was in the Navy during World War II, and both of his brothers have also served.

Myers chose to take a different route. The ACA member has been a practicing counselor for approximately 11 years and has worked in a variety of clinical settings. One of those settings turned his interest in the military into a focus for advocacy.

Myers has been a private practitioner for almost a year now, but before that he spent about two and a half years working with and advocating for veterans and active-duty service members at the Shepherd Center in Atlanta, a private rehabilitation center that specializes in brain and spinal cord injuries. As he would learn, working with this population required an approach based on an understanding of the military’s unique culture.

Specifically, Myers worked in the SHARE (Shaping Hope and Recovery Excellence) Military Initiative, an intensive outpatient program for veterans and active-duty members who had sustained a traumatic brain injury (TBI). Although SHARE received referrals from the military, it was a privately funded initiative that provided something military services did not offer — a chance to receive physical rehabilitation and mental health treatment simultaneously, Myers says.

“Patients could receive treatment for both their TBI and PTSD [posttraumatic stress disorder], which is a great advantage because it can sometimes be difficult to tease out what is [caused by] TBI and what is PTSD since their symptoms often overlap,” says Myers, a member of both the ACA Veterans Interest Network and the ACA Traumatology Interest Network.

The treatment was comprehensive. Patients had access to physical therapists, occupational therapists, speech therapists, physiatrists and mental health treatment, including individual, group and, in some cases, family therapy, Myers explains.

To even begin the process, however, Myers had to earn the clients’ trust — to advocate through understanding. “Military clients can be a difficult population to establish trust with just because they have a general mistrust of anyone outside the military. … There are exceptions, but they are pretty distrustful of civilians in general,” he says.

That distrust extends particularly to mental health practitioners of any kind. In the military, a strong stigma is attached to mental health problems and treatment, Myers explains. And if a service member does get help within the military system, there is virtually no confidentiality, unlike in the private or public mental health sectors. Military mental health practitioners report to higher-ranking officers and must disclose any potential problems that come up in sessions, he says.

“In fact, among military personnel, the mental health professionals are known as ‘wizards’ because they can make you disappear from your unit,” Myers says ruefully.

So, with each of his clients, Myers began by explaining that confidentiality worked differently at the Shepherd Center. He would not be revealing their conversations to anyone. Although he was required to give general reports on progress, the details of what was said in the therapy room would stay in the therapy room.

Myers also used his background to start to connect. “I was a little looser with my professional and personal disclosures. I could see there was clinical value in disclosing that I came from a military family and sharing some of my experience,” he says.

Just having knowledge of military culture and knowing the differences between branches was a big help. “Always know your branches,” he advises. “Never call a Marine a soldier — that’s an Army designation. Don’t call someone a sailor unless they are in the Navy.”

It may sound like a small thing, he says, but the military and its branches have their own unique culture, and taking a multicultural approach and getting to know and understand this population’s customs is essential to establishing trust and counseling effectively.

“It’s a slow process in the beginning,” Myers says, “but once rapport is established, the sense of trust becomes an almost unbreakable bond.”

Now back in private practice while earning his doctoral degree, Myers’ desire to help military members has led to significant advocacy work, both at the individual and community levels. Myers currently sees several military clients and advocates for them by helping them fill out disability paperwork with the Department of Veterans Affairs. He also accompanies certain clients on visits to their physicians. The visits started when several clients confided to Myers that they didn’t really know what they wanted or needed from their doctors.

“We would sit down before the physician’s appointment, and the client and I would talk about the visit and what their needs were,” Myers explains. “Then we would kind of do a role-play of what I [as the client] might say to the physician, and sometimes the client would say, ‘What you said is better than how I would say it, so would you mind coming to my appointment?’”

The clients felt better having someone to help articulate all of their needs, and Myers liked being there to make sure his clients felt their needs were being addressed.

Myers is also advocating by educating other mental health and health professionals about the unique needs of the military population. He has presented at multiple health facilities in the Atlanta area, including an audience of 80 at an area psychiatric center. Myers also presents on the topic to faculty and students at Mercer University, where he is earning his doctorate.

Myers’ presentations educate audiences about the extreme physical and mental stressors that military clients experience. “The heat is extreme — often well over 100 degrees — and military members have to endure it, often while dressed in body armor,” he points out. “Missions require a high degree of vigilance and are sometimes ambiguous. They may be peacekeeping or diplomatic [missions], but there is always the threat of IEDs [improvised explosive devices] and the possibility of ambush or military fire.”

Those in combat also have to face things such as conflict within the unit, the loss of fellow unit members, general fear and horror, and the possibility of death or being maimed. And even when they return home, Myers says, they still must deal with the memories and the myriad emotions those memories engender.

Myers has been pleased with the feedback he receives, particularly from audience members who come up after his presentations to tell him they have always been interested in treating military members but haven’t known how or where to begin. He helps interested counselors and other mental health professionals to get started, whether it is through professional connections or simply working with nonprofit advocacy organizations such as the Wounded Warrior Project.

Myers says he will continue to present, and once he has finished his doctorate, he hopes to teach counselor trainees not just about military culture, but also combat and trauma.

“One of the most rewarding aspects of working with this population is being able to serve those who served,” he says.

The accidental advocate

When ACA member Kevin Feisthamel began his job at the Cleveland Clinic Foundation’s Melon Center for multiple sclerosis (MS), he knew little about the disease. He had just finished a counseling internship that focused on health psychology and had developed a strong interest in neuropsychology. So when a neuropsychological technician position opened up in the MS clinic, he jumped at the chance, despite not knowing anything about the symptoms, prognosis or treatment options for MS. At first, he simply focused on administering the personality and intelligence tests. After all, he reasoned, that was what he was there for.

But it didn’t take long for Feisthamel to recognize the devastation that MS can cause and to realize that the clinic patients needed more than just test administration — they needed empathy and knowledge.

After their initial baseline tests, patients would return about three months later to be retested. Feisthamel would score the tests, and the clinic neurologist and psychiatrist would evaluate the results, looking for decline or changes in cognition.

“Suddenly,” Feisthamel says, “I was seeing these highly intelligent people whose mental function was markedly decreasing over time. I would also see people — kids, really — who were 18 or 19 and in wheelchairs, and I was amazed at how debilitating this disease could be. I just couldn’t imagine what they were going through, and I tried to put myself in their shoes but realized that I didn’t even know enough to do that. That’s what got me started. I felt educating myself was crucial not only for myself but for the clients I was seeing.”

Although Feisthamel wasn’t addressing the decline and associated symptoms directly with the patients, he felt he needed to know more to better understand the bad news he sometimes had to deliver. He also wanted to help on a systemic level by participating in research that could uncover more about the effects of MS — in particular depression and fatigue, which were symptoms he witnessed so often.

Eventually, Feisthamel began sitting in with the neurologist and taking part in the discussions with patients. He also was invited to start taking part in presentations on the research the Cleveland Clinic was doing related to MS. He was involved in several studies, including one that focused on depression in MS patients. For that study, Feisthamel looked at the personality assessment data the clinic had collected and tried to identify specific personality characteristics that might help individuals cope with their depression.

Feisthamel eventually left the Cleveland Clinic to pursue his doctorate, but he retained his passion for research and advocacy. He no longer devoted so much time to MS, although he did write a meta-analysis of research on pharmacological and counseling interventions for MS patients with depression for his psychopharmacology class. The article was later published in a peer-reviewed journal in 2009.

Today, Feisthamel teaches at Walden University and is also director of the health center at Hiram College. He is still an enthusiastic advocate, but his current focus is on the science of happiness and positive psychology. He established a Hiram chapter of Active Minds, an organization that empowers students to speak openly about mental health to encourage help-seeking behaviors, and recently completed a week of education on suicide prevention. Feisthamel sees clients daily but says about 80 percent of his job at Hiram revolves around getting out and educating people about where and how to get help and what kinds of things they can do for themselves.

“I don’t worry a lot about the people I do see,” he says. “I worry about the ones I don’t. That’s why I have to get out of my office to talk about counseling services and to give presentations on campus to students and faculty.”

Feisthamel is also encouraging advocacy among future counselors. Walden’s counseling program is focused on social change, he says, and he regularly asks his students to think about what social change is and how they can use it to advocate for their clients.

“We can have a huge impact, not just at the national level, but at the community level,” he emphasizes.

Defending counselors everywhere

John Yasenchak, an ACA member from the Bangor, Maine, area, never really considered himself much of an advocate. He’d participated in a few things to help raise awareness around counselor identity, but mostly he was focused on his practice and the classes he taught at Husson University.

Then came the fight around MaineCare, the state’s Medicaid program. The state Legislature has been trying to cut the program’s funding for years, according to Yasenchak, and in 2013, lawmakers decided MaineCare should stop reimbursing licensed clinical professional counselors (LCPCs) for patients who had “dual eligibility,” meaning they were eligible for both MaineCare and Medicare.

“The justification was based on Medicare’s refusal to include counselors as legitimate mental health providers who deserve to be reimbursed,” he explains. “The state pointed to this regulation and asked why it should reimburse counselors if the national Medicare system wasn’t.”

The prospect of being locked out of MaineCare sent shock waves through the state’s counseling community, Yasenchak says, because it would put counselors’ income or positions in jeopardy and many clients wouldn’t be able to continue receiving care from their chosen LCPC providers. “I had students coming in asking me if they should continue in the counselor education program. Was there an actual future in counseling? Would they even be able to find jobs, or should they switch to another helping profession?” Yasenchak recounts.

The situation served as a real wake-up call about the need for Maine counselors to start lobbying for recognition as legitimate mental health providers, not just at the state level but at the national level too, Yasenchak says. They did lobby the state Legislature, but the Maine Counseling Association (MeCA), a branch of ACA, and the Maine Mental Health Counselors Association realized that counselors could never be secure professionally until the Medicare problem was addressed.

Yasenchak, then serving as president of MeCA, and others started reaching out to contacts who had connections to Susan Collins, one of Maine’s U.S. senators. In the meantime, the state lobbying effort was gathering support from consumers and the CEOs of federally backed medical centers and furiously raising awareness. This activity and the many written testimonials it garnered were part of the background information presented to Collins. Her office responded positively but wanted more information, even asking Yasenchak and others to do research in the Federal Register.

The legwork paid off. By the time Yasenchak and several of his colleagues met with Collins, she had agreed to help sponsor the Seniors Mental Health Access Improvement Act of 2013 in the U.S. Senate. The bill is currently being reviewed by the Senate Finance Committee. A companion bill that includes Medicare reimbursement for LPCs has also been introduced in the House of Representatives.

Yasenchak and colleagues Deb Drew and Jeri Stevens are sticking with the process. Despite the dedicated lobbying at the state level, the Maine Legislature passed legislation denying reimbursement to LCPCs for dually eligibl clients. This is a targeted exclusion that does not apply to any other mental health professionals, Yasenchak points outs. Clients who had previously seen an LCPC had to transfer care to other providers unless they pursued a special waver.

Yasenchak knows that counselors’ livelihoods and clients’ treatment will continue to be threatened — and, in some cases, eliminated — until the fight for Medicare reimbursement is won.

Looking back, moving forward

As the counseling profession moves forward, all counselors need to learn how to advocate for their clients, Lee says. Advocating for all clients means that counselors will help not just by talking about their clients’ presenting issues, but by ensuring that they have access to the resources necessary to meet their needs, he explains. This shift toward advocacy is reflected in the increasing number of counseling programs that train students in working for social change.

As calls for counselor advocacy grow, so does the need for strategies to carry out advocacy work. Rebecca Toporek helped provide counselors with practical steps for implementing advocacy efforts when she, Judy Lewis, Mary Smith Arnold and Reese House developed the ACA Advocacy Competencies as part of a task force. The ACA Governing Council endorsed the Advocacy Competencies in 2003.

“The Advocacy Competencies were created to provide counselors with definitions, strategies and guidance to facilitate the process of working with clients and client communities to identify the most appropriate action and strategize appropriate actions,” Toporek says.

The competencies define six domains of appropriate advocacy for counselors:

  • Client/student empowerment
  • Client/student advocacy
  • Community collaboration
  • Systems advocacy
  • Public information
  • Social/political advocacy

For more information on the Advocacy Competencies, go to counseling.org/docs/competencies/advocacy_competencies.pdf?sfvrsn=3.

For Bemak, the issue is fairly simple. “If we’re not advocating for our clients,” he says, “we’re not doing our jobs.”

 

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KCA advocates for its next generation

At the Kentucky Counseling Association (KCA), advocacy has taken the form of nurturing and supporting the next generation of counselors.

KCAOver the past few years, KCA, a branch of the American Counseling Association, has launched a series of initiatives focused on counselors entering the profession. Those initiatives range from creating a special tab with graduate student resources on its website to increasing its educational offerings for entry-level counselors at its annual conference.

The effort has been “a win-win,” says KCA Associate Director Bill Braden. The entry-level counselors have brought fresh ideas and a new voice to KCA, while the association’s more experienced counselors have been able to mentor and network with the profession’s next generation.

Attendance at KCA’s annual conference has doubled, which KCA Executive Director Karen Cook attributes to the association’s recent focus on graduate students. KCA has expanded conference offerings for graduate students and new professionals, such as Q&A sessions on licensure, mock job interviews and the creation of a special lounge at the conference venue where graduate students can meet up and network.

The new programs and initiatives were created to focus on a challenging and critical time that can exist postgraduation for new counselors. Upon finishing graduate school, many budding counselors confront the pressures of finding a job and establishing themselves in the profession, all while burdened with student loan debt, Braden points out.

Cook and Braden say that KCA’s leadership team came to the realization that the association needed some type of outreach or mentorship initiative to connect new graduates with the state’s experienced counselors. A small task force, formed in 2012, developed a survey to identify graduate student needs and how KCA could help meet those needs. The survey was circulated at the annual conference and throughout the state. The task force then evolved into a student leadership team that includes representatives from universities throughout Kentucky.

“When we talked with our peers, [we] felt like students were missing out on how they fit into the bigger picture,” says Shana Goggins, a member of the original KCA task force who graduated from the master’s program at Eastern Kentucky University (EKU) in May 2013. “We felt like [we could do] more … to show students how much easier it is to get involved with a professional organization as a student, rather than waiting until you’ve graduated, you’re in the field and you’re trying to navigate work and just getting yourself oriented. We wanted to do something to show students that they were a viable part of the association.”

Goggins and her colleagues helped create a graduate student academy at KCA’s 2013 conference with a lineup of offerings tailored to new counselors, including the Q&A on licensure and sessions on self-care, public speaking, professional networking and other helpful topics.

“We want [new counselors] to understand how important it is to be proud of their profession and the importance of what we do,” Cook says. “We want to continue to listen to their voice and connect them with counselors in the field. We don’t want them to feel like they have to go it alone. … We love to see the interaction that goes on now between the grad students and the [experienced] counselors.”

KCA has also expanded its long-standing graduate school scholarship program. Each university in Kentucky now receives one scholarship for a counseling student to attend a summer class. The scholarship recipient, in turn, is invited to be involved with KCA’s annual conference in the fall, Cook says.

Panagiotis “Panos” Markopoulos, a classmate of Goggins’ at EKU who is now a doctoral student at the University of New Orleans, said KCA supports its members like a family. “It’s not just a one-way street, most definitely,” he says.

Markopoulos and Goggins were both involved in the 2012 task force and were instrumental in launching KCA’s focus on entry-level counselors, Braden says.

“As much as we’ve helped KCA, KCA has helped us,” says Goggins, a prelicensed counselor who is still involved with KCA. “I like to think that they’ve definitely helped us a lot more than we’ve helped them. But they would probably say the opposite. It’s a win-win, on everybody’s end.”

 

— Bethany Bray

 

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To contact individuals interviewed for this article, email:

Courtland Lee at courtland.c.lee@um.edu.mt

Rita Chi-Ying Chung at rchung@gmu.edu

Keith Myers at doc355@yahoo.com

Kevin Feisthamel at FeisthamelKP@hiram.edu

John Yasenchak at yasenchakj@husson.edu

Rebecca Toporek at rtoporek@sfsu.edu

 

 

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Social justice advocate and visionary Judy Lewis passed away as this article on counselor advocacy was being written. See page 48 of Counseling Today‘s May issue for an “In Memoriam” article on her life and legacy.

 

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Laurie Meyers is a staff writer for Counseling Today. Contact her at LMeyers@counseling.org

Letters to the editor: ct@counseling.org

Crossing the finish line: Boston returns to the scene of last year’s trauma

By Bethany Bray April 21, 2014

MarathonMemorial

A temporary memorial, where people hung running shoes, flowers, notes and other mementos, went up at the Boston Marathon finish line within hours of last year’s bombing. Photo courtesy of Michael Kocet

The Boston Marathon’s 26.2 mile course can be a metaphor for what the city has been through over the past year: a long, winding stretch of ups and downs, heartbreak and triumph.

Today, April 21, thousands of runners return to finish the race that was halted unexpectedly and tragically one year ago, when two bombs went off at the finish line, killing three people and injuring more than 260.

Returning to the scene of last year’s trauma will have many mental health implications, not only for the runners but the spectators, local residents and those watching on television, far and wide.

Boston’s Public Health Commission has organized a series of free, drop-in counseling sessions this month for anyone feeling anxious about the one-year anniversary.

While hundreds were injured at last years marathon, the invisible injuries go far beyond those who were physically at the race, says Anthony Centore, a licensed mental health counselor (LMHC) and licensed professional counselor (LPC) with a practice in Boston.

“It’s a difficult week, but the people of Boston are tough. They were tough right after the bombing, and they’re tough now,” says Centore, an American Counseling Association (ACA) member. “This week, some people are angry, many are mourning and others are reflecting on the challenges they’ve overcome over the last year. There is a sense of unity here, and also a desire to show the world that Bostonians won’t be defeated by a terrorist act.”

Several days after last year’s marathon, a large portion of Boston (an area that is home to nearly one million people) was put into a “shelter in place” lockdown as the authorities conducted a massive manhunt for the bombing suspects. Neighborhoods were jolted awake as the suspects threw explosives and fired at police from their vehicle.

In the wake of this extended trauma, Centore’s practice offered free counseling “to anyone who needed it” after last year’s marathon, he says.

“Three persons were killed and an estimated 264 others were physically injured during the bombing. However, the ripple effect, of course, goes much farther,” says Centore. “The physical and psychological recovery of some of the injured may take years. Also, some persons near the finish line were physically unharmed but traumatized by what occurred. Families have been working to find a new normal, and put their lives back together. And there are others who have experienced a secondary trauma, or for whom the bombing triggered a past trauma.”

Boston-area LMHC Michael Kocet uses the words resilience, solidarity and hopeful to describe the city’s emotions through the past year.

Kocet, an ACA member and associate professor in the department of counselor education at Bridgewater State University, says he’s seen “a lot of selflessness” and “boundless compassion” in the wake of last years trauma.

A temporary memorial, where people hung running shoes, flowers, notes and other mementos, went up at the finish line within hours of the bombing. There are still signs with the “Boston Strong” motto in shop windows everywhere you look, Kocet says.

“It’s not something, collectively, you get over,” says Kocet. “… Boston has a reputation for having a tough exterior, [and] we’re an incredibly resilient city.”

Kocet and Centore both said Boston’s ongoing recovery – both physical and psychological — is a testament to the strength of the human spirit.

“I think [the recovery] is a testament to how resilient the human spirit can be, and to how strong the people of Boston are,” says Centore.

MKocet_BAA5K

ACA Member Michael Kocet ran the BAA 5K this month. Photo courtesy of Michael Kocet

Kocet, who recently started running, ran the Boston Athletic Association’s 5K on April 19, which is the same organization that manages the marathon.

Through running, Kocet says he’s come to realize the emotional and psychological connections people make through running – from the cause they’re running for (often fundraising for a charity) to the competition against themselves, to run a faster time.

“I can appreciate how races play a special role in people’s lives,” he says. “The races people chose to run can carry a deep meaning, an emotional connection.”

The marathon can be a metaphor for life, says Kocet. Not only does is it require personal determination, resilience and goal setting, but the need for encouragement and support from spectators on the sidelines.

“Everybody has a journey that they’re running (and) striving toward goals,” he says.

“Watching people cross the (Boston Marathon) finish line, it’s emotional, even as a spectator. I equate it as kind of a spiritual experience, a personal accomplishment,” he says. “… Crossing that finish line (this year) will be even more sweet because of everything that has happened.”

 

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Related links

 

WBUR interview with the Boston Public Health Commission’s executive director on the city’s residual trauma and free counseling sessions

wbur.org/2014/04/07/boston-marathon-counseling-sessions

 

Counseling Today article from one year ago, “The mental health effects of sheltering in place”

ct.counseling.org/2013/06/the-mental-health-effects-of-sheltering-in-place/

 

Q+A with two Boston University professors: What impact did the Boston Marathon bombing have on children?

bu.edu/professorvoices/2014/03/31/what-impact-did-the-boston-marathon-bombing-have-on-children/

 

The Substance Abuse & Mental Health Services Administration (SAMHSA) offers a free downloadable emergency mental health and trauma kit

store.samhsa.gov/product/SAMHSA-Disaster-Kit/SMA11-DISASTER?WT.ac=EB_20130416_SMA11-DISASTER

 

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

 

Follow Counseling Today on Twitter @ACA_CTonline

Virtual school counseling brings unique rewards and challenges

By Bethany Bray April 17, 2014

As a school counselor in Florida, Kristina Knight helps students decide which classes to sign up for and organizes programs on goal setting, drug abuse and bullying. Nothing unusual there.

But something sets Knight apart from the large majority of her school counseling colleagues: She is never in the same room as the thousands of students and parents she counsels.

Knight is a school counselor for Florida Virtual School, one of a growing number of  primary and secondary level online schools  across the United States. According to the 2013 Keeping Pace survey (kpk12.com), 30 states now have at least one full-time online school.

VirtualSchool2As the name suggests, everything is done online at a virtual school, from teaching class lessons to turning in assignments and taking tests. Students take classes and interact with their teachers and classmates via video chat programs, podcasts, online message boards, email and other electronic mediums.

Depending on the school and situation, counselors for virtual or online schools interact with students and parents via email, online instant messaging, telephone, text message or video chat.

In addition to one-on-one interaction, Knight creates webinars for students twice a month on social-emotional and academic topics such as bullying, suicide prevention, finding college financial aid, cybersafety and preparing for the SATs.

Knight says her job at Florida Virtual School is a welcome chance to “get back to the basics” of counseling and really focus on what she’s trained to do: support students and families. Counseling at a virtual school frees Knight from the extraneous responsibilities, such as doing bus duty or being a cafeteria monitor, that she often was assigned when she worked as a high school and elementary school counselor in traditional brick-and-mortar schools.

Virtual school counseling features its own unique challenges, but there are rewards as well.

Tinisha Parker worked as a counselor for four years at Gwinnett County Online Campus, an online public charter school in Gwinnett County, Ga. She advised her students via phone, video and online messaging, but she would also travel to meet them in person on occasion. It might surprise some people to hear Parker say that in some cases, the online format allowed her to make deeper connections with students than a traditional school setting would foster.

“Our relationship didn’t start at 7 a.m. and end at 3 p.m. We weren’t bound by the same constraints – by a physical day or a physical building — like I was in a traditional school setting.” explains Parker, a licensed professional counselor (LPC) and American Counseling Association member who is now the coordinator of advisement and counseling for the Gwinnett Public School district.

The “anonymity” afforded by not sitting face-to-face with a counselor in the same room also made some students more comfortable and expressive, Parker says. For instance, a student who wouldn’t open up to a counselor in person sometimes would feel more comfortable sending a text message, she says.

“It gave me a window to see other parts of their lives that I wouldn’t have been privy to otherwise,” she says.

For example, when Knight called to talk to one of her students about an academic issue, she found out the student was a teenage parent. They chatted as the student was on her way to pick up her child from day care.

VirtualSchool1Counseling a student via video chat or instant messaging also removes the stigma of being seen walking into the school counseling office, notes Tracy Steele, director of counseling at Stanford University’s Online High School, a California-based independent private school. Students are often more comfortable talking with a counselor from their own turf, such as their bedroom, via video chat, she adds.

At the same time, counseling in a virtual school environment has its challenges. For instance, schoolteachers at virtual schools can still refer students to a counselor if they see some of the red flags all teachers look out for, such as a sudden streak of absences or slipping grades. But school counselors at virtual schools do not have the same opportunities that traditional school counselors have to pick up on visual cues, such as student behavior in the hallway or on the playground.

“You’re not around the kids all the time, so your door is not open for a student to come in and physically be upset,” Steele says. “That is a challenge in terms of finding safety nets and opportunities to check in with students.”

Steele says her program makes up for this by being very intentional about engaging students and making sure they are taking advantage of social supports. The counseling staff makes a point of planning programs such as sessions on career counseling, goal setting and other topics to interact with students, she says. They also organize in-person “meet ups” for groups of students around the country and host a summer session on the Stanford campus that features both academic and social programming.

“Some people think [a virtual school] is all about the technology,” Steele says. “For us, it’s all about the connection” — teachers to students, and students to each other, says Steele.

Parker says her school also planned social get-togethers, such as a group outing to a professional baseball game, and even a prom. Students also came to a central campus to take final exams and to have one-on-one study sessions with teachers if needed.

“It’s so easy to go into a shell and clamp down in a virtual environment,” Parker says. “We don’t want it to be a place for kids to ‘retreat from the world’.”

Students enroll in virtual schools for a variety of reasons, from medical problems that prohibit them from attending traditional schools to travel commitments because of acting gigs or competitive sports. Parker says one of their students enrolled so she could take classes while traveling to China to be with an ailing grandparent. Others take single or part-time online classes to supplement the instruction they are getting from their local public schools or homeschools.

In Florida, all students are required to take at least one online class as a public school graduation requirement, Knight says.

A common problem virtual school counselors see among students is time management, because online learning is self-initiated, Steele says. Her school organizes programs to help students focus on organization and study skills, stress and time management.

Another common issue, Parker says, is a misguided assumption among students that online school will be easier than traditional school. In fact, it’s usually the opposite, she says, because the online model demands self-discipline.

Many of the students at Stanford University’s Online High School are “academically talented,” Steele says. However, successful students don’t always reach out for help when they first run into trouble because they’ve always aced things in the past, she says — and “failure” to them may be receiving a B or a C.

Steele says she works with students to talk through what they could do differently next time. She also encourages them to view a challenge as an opportunity to learn and improve.

The American School Counselor Association estimates that less than 1 percent of its members are counselors at online or virtual schools. Still, school counselors play an important role in student growth and learning, no matter the educational format, says Steele.

Students and families will always need the support of school counselors, she says.

Parker encourages counselors not to be afraid of using technology as a tool. Electronic communications cannot replace face-to-face counseling, she says, but they can complement the work that counselors do.

“Quite honestly, this is what this next generation is used to. This is how they communicate,” she says. “This may be your window to communicating with a kid.”

 

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Though based in California on the Stanford University campus, Stanford University Online High School has a student body of roughly 550 from all over the world. Tracy Steele is one of two full-time counselors who focus on the social-emotional issues of students, including outreach on drug abuse, eating disorders, depression and other issues. Other counselors on staff focus on academic issues, such as signing up for classes and college preparation.

ohs.stanford.edu

 

Kristina Knight is part of a team of seven counselors at Florida Virtual School, a statewide online public school with more than 200,000 students. She is responsible for a caseload of roughly 5,000 students, who contact her via phone or email with questions about everything from signing up for classes to applying for college financial aid.

FLVS.net

 

Tinisha Parker worked at Gwinnett County Online Campus from 2008 to 2011. Gwinnett is a full-time public charter school offering instruction for fourth through 12th grades in Gwinnett County, Ga.

gwinnettonlinecampus.com

 

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

 

Follow Counseling Today on Twitter @ACA_CTonline