Monthly Archives: September 2014

Shifting student demographics shine light on need for greater cultural awareness in schools

By Bethany Bray September 29, 2014

This fall marks the first time that there is a statistical “minority majority” in U.S. public schools, with students of color now surpassing the number of white students.

That shift has been happening gradually for a number of years, according to the U.S. Department of Education, which notes that student demographics still vary considerably from state to state and even school to school.

This change in the student population only reinforces the need for school counselors to fully understand, be familiar with and draw upon the culture of their school’s students and the community at large, says Lynn Linde, who chaired the American Counseling Association’s School Counseling Task Force last year.

“Counselors are often the point of contact with parents and the community. They need to be culturally aware and sensitive to the families with whom they work. Different cultures view education differently,” says Linde, a past president of ACA and the director of clinical experiences in the school counseling program at Loyola University Maryland. “Parents from some cultures view the educators as the experts and leave decisions to them. That does not mean that the parents don’t care, and [it] should not be interpreted as such. Schools have to use multiple approaches to reach out to families and communicate with them. Counselors also need to be sensitive when arranging services for students whose parents may or may not want help. And they may also work with parents who put tremendous pressure on their child to succeed or to engage in activities the parent feels are important but in which the child has little interest.”

The better counselors understand the school’s community and culture, the better they understand what the needs are and how to meet those needs, Linde says.

A minority majority

This fall is projected to be the first time that the overall percentage of white students has dipped below 50 percent in the nation’s public schools. Conversely, enrollment figures for Asian and Hispanic students have greatly increased.

The Pew Research Center, which dissected the Department of Education’s data, explains:

“A steady demographic change over the years has resulted in a decline in the number of whites in classrooms, even as the total number of public school students has increased. In 1997, the U.S. had 46.1 million public school students, of which 63.4 percent were white. While whites will still outnumber any single racial or ethnic group this fall, their overall share of the nation’s 50 million public school students is projected to drop to 49.7 percent.”

Since 1997:

The number of white students has declined by 15 percent, falling from 29.2 million to 24.9 million in 2014
The number of Hispanic students nearly doubled to 12.9 million
The number of Asian students jumped 46 percent to 2.6 million
The number of black students has remained relatively steady

Breaking the mold

“As educators, we need to be adapting,” says Carlos Hipolito-Delgado, president of the Association for Multicultural Counseling and Development, a division of ACA. “We need to understand the kids that are coming in the [school’s] door and provide an experience that is relevant to their life and their culture. Unfortunately, I don’t think there are too many schools that are willing to engage in that work. Unfortunately, we push it off onto the students and force them to adapt.”

The first step in changing that, Hipolito-Delgado believes, is to keep schools from becoming cookie-cutter and generic – in everything from their curriculums to their school mascots.

For example, the posters in school cafeterias and libraries are often the same from school to school and don’t necessarily reflect the culture of the student body, says Hipolito-Delgado, an associate professor at the University of Colorado Denver who has a background in school counseling.

A school needs to be both welcoming and tailored to its students, he says. For counselors, this includes knowing the culture, traditions and values of the student community and using those things to connect with students and their families.

Hipolito-Delgado recommends figuring out what metaphors and counseling tools will “speak” to students of a particular culture. “It’s not about being stereotypical but using [students’] culture as a resource,” he says.

For example, familiarity, or working with people who are known and liked, is important in Latino culture, Hipolito-Delgado says. For this reason, counselors working with Latino students may find success with peer-to-peer initiatives.

“I have seen that youth of color are often more comfortable coming initially to a peer,” he says. “Part of this, I think, is the perception that the peer will better understand where they are coming from and will be less likely than an adult to judge them. Also, peers are not seen as agents of authority as a school counselor might be seen.”

Lead by example

Sharon Sevier, chair of the board of directors of the American School Counselor Association, another division of ACA, encourages counselors to seek professional development opportunities to stay abreast of the needs of diverse populations. Talking with students, parents and community leaders about their culture can be a learning opportunity as well, she says.

“The issues of respect and acceptance are ongoing challenges in our society today. Teachers and staff have the responsibility to validate and welcome all voices and to ensure that everyone is heard. As staff, we are the role models for our students. They watch and listen to how we react and interact. We have to live respect for others in the hope that our students will follow our lead and take those actions out into the community,” says Sevier, a high school counselor in suburban St. Louis. She has been a school counselor at every grade level, both in urban and rural settings, during her 30-year career.

“In classrooms, it’s very important to set the expectation that everyone is valued within these walls,” she emphasizes. “Discussion is open to all, and everyone is to be respected. That doesn’t mean you have to agree with everything that is said, but it’s expected that everyone will listen and reflect upon the viewpoints of others. At holiday and celebration times, we must not assume that everyone celebrates in the same way. That’s a perfect time to open a conversation about diversity and give students an opportunity to talk about their own customs and practices.”

Know the full picture

Understanding the culture of the student body should also include awareness of socioeconomic factors such as mobility (how frequently residents move in and out of town), how many students are eligible for free or reduced lunch programs, and how many students speak a language other than English at home, Linde says.

She encourages educators to “think out of the box” to meet the needs of families. It shouldn’t be assumed that every family has a computer and Internet access, that students will have a quiet place at home to do homework or that a parent can leave work in the middle of the day to attend a meeting at the child’s school, she says. In addition, counselors should ensure that any information sent home with students is translated for non-English-speaking families, and translators should be available at school meetings.

Counselors may also need to engage in more outreach and hold school meetings out in the community instead of in the school building, Linde says.

In communities with high mobility rates, counselors may find it useful to set up a year-round mentoring program for new students. Schools in towns with low mobility, in which the majority of new students enter school at the beginning of the year, may be better suited to a fall orientation program, she says.

“Schools that are successful don’t draw the line at what is a family responsibility and what is a school responsibility,” Linde says. “They provide whatever they can so students are successful: school supplies, meals, clothes, access to medical and dental care, counseling, helps for parents and families, etc. … Our old model of teaching and homework may have to change to be responsive to the needs of current and future students.”

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Fostering school community with a focus on diversity

Creating a welcoming school environment in which students of all backgrounds feel connected is key as school demographics change. Here are a few ways counselors can help.

Travel the world at lunch

“I was supervising an intern who was placed in a very diverse elementary school,” Lynn Linde says. “The students brought their native foods to school for lunch, and some students were making fun of what other kids were eating. The school, under the leadership of my school counseling intern, instituted a ‘mix it up day,’ where they did a schoolwide program on understanding and accepting diversity and then had to sit at lunch with students they didn’t know. The initiative helped the students understand that what was strange to them might be someone else’s favorite food.”

Seek out community resources

Carlos Hipolito-Delgado suggests that school counselors – especially those starting at a new school – engage in a resource mapping project he learned from counselor Vivian Lee. Work with students to create a map on a large piece of paper. Put the school building in the center of the map, then have students add community resources they know and use, such as local churches, afterschool programs, recreation centers and nonprofit organizations.

Once finished, the school counselor should go and visit each site on the map, introducing themselves to the leaders of the different organizations. Find out what’s important to these community stakeholders, says Hipolito-Delgado, and listen to what they have to say.

“Going into the community and humbly learning about the community is the best way to learn about what [students’ and families’] needs are, what they’re expecting from you and what their students are going to bring into the schoolhouse,” he says.

Get parents involved

Getting parents involved in school activities helps school staff get to know them better and vice versa. Beth Lindsay, an eighth-grade counselor in Fletcher, North Carolina, says parental involvement is a good way to foster community. Her school, Cane Creek Middle School, has initiated a volunteer program in which parents are matched with a particular teacher. A relationship is fostered as parents help with science labs, make copies or do whatever little tasks the teacher needs.

Lindsay and her colleagues, Nicki Neumann and Fran Hensley, led a session titled “Enhance your school climate and nurture a sense of belonging” at the American School Counselor Association conference this past summer.

Read and talk about it

Hensley, a counselor at Glen Arden Elementary School in Fletcher, North Carolina, suggests including the books The Crayon Box That Talked by Shane DeRolf and The Golden Rule by Ilene Cooper in classroom discussions about diversity and tolerance.

Fourth-graders at Hensley’s school also interview students who are new to the school, take their photos and a write a brief biography about them, which then gets posted on a “newcomers” bulletin board.

“The children and staff are always amazed to read from what different countries our new students have come,” Hensley says.

Make it fun

An “international club” for students can be an engaging way for students to learn respect for other cultures. At Lindsay’s school, the club is led by a Spanish teacher.

Hensley’s school organized a “holidays around the world” pancake breakfast last winter. Each student was given a passport that was stamped as they traveled to different stations around the school gym that represented different countries, she says. At the Spain station, students from a Spanish immersion class sang holiday carols in Spanish. Student-made ornaments were sold to fund an emergency account for school families who needed help with gasoline and groceries, Hensley says.

Service learning

Neumann, a seventh-grade counselor at Cane Creek Middle School, says her school’s service club activities often include lessons and discussions about diversity.

“I’ve always felt that because [our school] isn’t more diverse, our students need more information and experiences with other cultures to get them ready for the real world,” says Neumann, who coordinates the service club. “Also, I believe our small percentage of students from other cultures need extra support because of this issue.”

Neumann gave these examples of club activities:

A teacher whose husband was serving in Afghanistan visited the service club, talked with students and showed slides of her husband’s work with the local population. Afterward, club members wrote letters to U.S. servicemen and women and sent care packages.
A different teacher showed photos and spoke about the years she spent working in Guatemala with the Peace Corps. “We discussed what it would be like to grow up in a community without the resources we have,” says Neumann.
Another teacher showed photos from a trip to South Africa, and the club collected funds to send to an impoverished school in that country.
A parent guest speaker (whose adopted daughter attends Neumann’s school) spoke about
Students in Cane Creek Middle School’s service club display the blankets they made to send to orphans in China. (Photo courtesy of Nicki Neumann)

China’s one-child policy and its impact on girls, says Neumann. Afterward, the club made blankets that were sent to China for orphaned baby girls.

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

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From the president: Intentional collaboration at all levels

By Robert L. Smith September 26, 2014

Robert L. Smith, Ph.D., ACA 63rd President

Those of you who have been following the From the President columns lately are probably familiar with the global theme of intentional collaboration that I have been emphasizing. In this column, I’d like to offer a more in-depth review of this concept, while also looking at the importance of infusing intentional collaboration in all aspects of our lives, both within and outside of what we do as professional counselors and educators.

Intentionality can have a number of different meanings. In this column and others, I refer to intentionality as involving thoughtfulness, contemplation, planning and purposeful action that can lead to the empowerment of individuals or groups of individuals. Collaboration involves working with other individuals or groups to achieve a desired goal. This can involve two or more organizations internal to the American Counseling Association, such as the Association for Counselor Education and Supervision, Counselors for Social Justice and the International Association of Marriage and Family Counselors, or external organizations such as the American Psychological Association (APA) and the American Association for Marriage and Family Therapy (AAMFT).

Most collaboration requires leadership, which can take place at a number of levels. At the ACA presidential level, a current example involves inviting projects from ACA divisions that will increase their membership and strengthen their relevance. These projects, funded by ACA and reviewed by the ACA Executive Committee and ACA staff, are intended to strengthen the infrastructure of our organization — in this case, our divisions. By the time this column is published, division presidents will have received proposal forms and instructions so that their divisions can take action.

Intentional external collaboration involves ACA working with closely related professional associations such as APA and AAMFT. Because of ACA’s current status and phenomenal growth, we can participate on equal footing and with equal voice with all other associations. Recently, I had successful meetings with APA leadership, particularly those involved in the Society of Counseling Psychology, to discuss current issues and future collaborative efforts. I look forward to continuing this collaboration at the society’s upcoming summit, just as I look forward to continuing the collaboration with AAMFT later this year at its annual conference. These represent only two examples of the many organizations that are significant to ACA’s present and future and with which ACA continues to work.

The cover story in this issue of Counseling Today focuses on our work with families. Cohesion and adaptability, concepts associated with the circumplex model of marital and family systems, are often included when discussing healthy families. Cohesion focuses on the ability of a couple and family system to balance separateness. Adaptability, as it relates to a family system, is the ability of a family to change its structure, roles, rules, behaviors and response patterns when confronted with challenging situations and life stressors. Adaptability is considered a measure of a system’s ability to adjust to change.

These concepts also have relevance for healthy organizations. In the field of organizational management, adaptability can be seen as an ability to change in order to stay relevant and meet existing needs. If ACA and professional counselors are to solve current issues, whether it’s inclusion of our services under Medicare, hiring within the Department of Veterans Affairs or funding for school counseling, it would be wise for our collaborative efforts to be cohesive and for our subsequent actions to be appropriately adaptive. These are tall orders, but the goals are worth striving for as we collaborate to accomplish those things we would like to see changed in our professional and personal lives, whether they relate to organizations, families or individuals.

All the best,

Robert L. Smith, Ph.D., NCC

ACA 63rd President

Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.

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CEO’s Message: Surviving, then welcoming, transition

By Richard Yep

Moving forward. Moving ahead. I was moved. It was a moving experience. Strangely, each of those phrases is apropos to something that will occur to your national headquarters staff next month. After a 30-year run at the office building we have called “home,” ACA will be relocating to a new building that will address the growing concerns we had about our current office.

ACA CEO Richard Yep

Our current space has gone through various “build-outs” and changes over the years to continue allowing staff to do the work that supports our members. We have made due with a number of Band-Aid-style changes for several years. Dealing with an elevator in which a number of us (including me) have been stuck has only added to the challenges (some might say “adventures”) we face each and every workday.

So, when our lease runs out, we will be picking up and moving. The good news is that we found a space about a half a block away from our current location. That means those who have a longing to visit the old place can walk over at lunchtime and still take their chances with a ride on the elevator.

But things weren’t always like this. When I arrived as a newly hired staff member back in 1984, the building was only a year old. It was sleek and modern, and the extra space it provided meant we no longer had to store books in a bathtub. Huh? Our headquarters previously had occupied two connected townhouses in Washington’s Dupont Circle neighborhood. Through the years, however, the number of staff and projects had grown so much that by the time we left, books really were stored wherever space could be found.

For you ACA history buffs, the association moved from Washington to an area of Northern Virginia called Bailey’s Crossroads. These offices provided temporary housing while the ACA Foundation bought the land and ACA built its headquarters in Alexandria, Virginia, at 5999 Stevenson Ave. (The building was sold several years ago, with ACA remaining as the building’s anchor tenant.)

Those of us who have worked at 5999 Stevenson for so long understand that the move to the new office is critical if we are to continue meeting member needs — and doing so in an environment that supports collaboration across all our departments. The gains in energy efficiency will be significant, and the new physical layout will contribute to staff producing the best possible resources for members.

Still, I find the experience similar to going through drawers at home and realizing that it’s time to finally “retire” (a gentler way of saying throw out) that ratty old T-shirt that exudes comfort and familiarity. As such, I have given great thought to understanding the needs, concerns, hesitations and anxieties of our staff as we begin this migration. Some are “way ready” to move on. Others are a bit more philosophical but understand the need to go. And still others have a bit of trepidation about relocating (even if it is only a half a block away).

As professional counselors and counselor educators, you routinely deal with clients and students who experience various dimensions of transition. You are experts at helping them face the associated challenges. I honor each of you for that work and your ability to provide counsel and support for these individuals, couples, families and other groups.

Our move is more than just packing boxes and installing a new phone system. I see the transition as symbolic of what ACA must do if it is to continue meeting the needs of its members and increasing the public’s (and media’s) awareness of professional counseling. As we look toward creating and providing services for those of you who have been loyal members, we also are “moving” forward to think through how we can best help those professional counselors and counselor educators who will be working into the middle of the 21st century.

Still, I will miss the old place, and I reserve the right to occasionally walk over and ride the elevators.

As always, I look forward to your comments, questions and thoughts. Feel free to call me at 800.347.6647 ext. 231 or email me at ryep@counseling.org. You can also follow me on Twitter: @RichYep.

Be well.

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Exploring the impact of war

By Keith Myers

A small town celebrates a homecoming. Parties are given in honor of the combat veteran who has returned home triumphantly. Families and loved ones are reunited, and community leaders show honor to the warrior by offering laud in public ceremonies. All appears to be whole again.

But as the dust settles and the town returns to its normal quiet state, they emerge. Silence seems to activate them. Attempting to sleep exacerbates them. Panic, fear and horror accompany them. They are a reminder of personal losses, and they are joined by a feeling of intense guilt. They are war memories.

These memories are much different from the typical memories one might have about a past life event. For one thing, they are traumatic in nature and carry with them a tidal wave of emotional surge. They overwhelm the body with their intense physiological manifestations. They overwhelm the soul via spiritual and moral injuries. They overwhelm the mind with their unrelenting and intrusive presence. They demand full attention, often invading precisely when their host is trying to avoid them.

War memories are one of the hallmark symptoms of combat trauma and a primary stressor experienced by many combat veterans. Learning about common war stressors provides counselors with a necessary foundation for working with this population. It also helps counselors to better understand the military culture as it relates to the overall clinical context of combat trauma.

In the seminal work on combat trauma, Combat Stress Injury: Theory, Research and Management, William Nash, a U.S. Navy psychiatrist and director of a Marine Corps program to prevent combat stress injuries, speaks of war stressors and the critical role they play in modern warfare. He teaches that war stressors can be divided into five groups: cognitive, emotional, social, physical and spiritual. In this article, I will examine these five categories of combat stress mostly within the context of Operation Iraqi Freedom (OIF, Iraq conflict), Operation Enduring Freedom (OEF, Afghanistan conflict) and Operation New Dawn (OND, Iraq conflict since 2010).

Cognitive stressors

Changing rules of engagement: A primary cognitive stressor that is common in operational conflicts is the ambiguous or changing “rules of engagement” (ROE). ROE include the standards that determine when military personnel are permitted to fire their weapons and at whom. In the OIF, OEF and OND conflicts, U.S. troops are not allowed to use deadly force unless a clearly armed adversary poses a clear and immediate threat to U.S. troops or civilian life.

As Nash explains in Combat Stress Injury (2006), “This is a laudable standard, one that all honorable warriors hope to meet at all times. But in the three years since the U.S. invaded Iraq, for example, a number of ambiguous situations have become almost commonplace for soldiers and Marines. One is the use by Mujahadeen of civilians, including women and children, as human shields. This was encountered in many areas of Iraq, particularly where fighting was the bloodiest and most contested, such as in An Nasiriyah during the initial push toward Baghdad and during the second battle of Al Fallujah in November 2004.”

These types of ambiguous situations were very common in OEF and OIF. Such impossible choices cause increasing cognitive stress burdens within the context of a traumatic combat environment.

Boredom: Another cognitive stressor of combat trauma is monotony or boredom. Military clients speak of this often when recalling their deployment experiences. They talk about how their day-to-day work was mostly boring and consisted of long periods (from several hours to several days) with very little action. Some military personnel may constantly patrol the same areas over and over again with nothing significant to report.

Often, the operational activities of a combat zone include a systematic monotony that provides limited recreational activity. However, it is important to note that during these periods of boredom, warriors are still expected to remain on “high alert” because the enemy could strike at any time. This state of being on guard even during periods of boredom and monotony has a significant effect on cognitive stress.

Emotional stressors

Fear and horror: Combat veterans often report that losing buddies and being killed or seriously injured are common fears that everyone experiences on the battlefield. Many of these veterans have directly experienced firefights and enemy ambushes or witnessed the death and injury of multiple buddies in combat. This fear exists on a continuum, ranging from the anticipation and dread of preparing to deploy into a combat zone to the terror that accompanies the threat of being severely injured. The greatest fear for warriors is not being killed or losing a buddy, however. The greatest fear is losing their honor on the battlefield. This kind of honor is upheld in the values and oaths of the different military branches.

The death of friends: Military personnel who deploy and serve in combat zones together form the most intimate of bonds. Nash explains that the emotional impact of losing a close comrade in war is not unlike the loss a mother experiences when her child dies. The levels of disbelief, shock, guilt, shame and longing may be much the same for both.

However, unlike the grieving parent, the warrior has little opportunity to fully experience the intense feelings that accompany the loss or to do the necessary cognitive work that might help him make sense of things. The warrior cannot allow himself to grieve; he must remain partially numb to the loss so that he can continue to do his job. Therefore, numbness becomes adaptive within the work environment of the combat theater.

Guilt and shame: Military leadership places a high priority on responsibility in decision-making because one wrong decision in combat can result in the loss of many lives. Even though this level of responsibility is adaptive and needed, it can contribute to the guilt a warrior experiences. It is not uncommon to hear military clients talk about this guilt, commonly referred to as survivor guilt, when describing their buddies who died in combat. Some warriors state, “I should have been the one who took the fall,” or “I shouldn’t be sitting here right now,” or “I should have done something different.” Sometimes the feelings of intense guilt are manifested in nightmares as the combat veterans’ war memories replay during sleep.

Although it is difficult at times for warriors to overcome this guilt, many of them do not have significant trouble acknowledging it. This acknowledgment should be viewed as a strength and can lead to growth and change when receiving counseling.

Other emotions are related to a sense of shame, such as feeling like a failure on the battlefield. These shame emotions are much more difficult for warriors to acknowledge or express.

Killing: In his masterful and insightful book On Killing: The Psychological Cost of Learning to Kill in War and Society, first published in 1995, Lt. Col. Dave Grossman attests that the act of killing another human being is a traumatic stressor for many combat veterans. He writes that all humans may have an intrinsic aversion to killing members of their own species, an aversion that must be overcome on the battlefield to engage in interpersonal violence. Grossman explains the practical ways that the military desensitizes its members to achieve this purpose. Regardless, killing other humans still remains one of the greatest stressors in combat.

Relationship issues at home: It is well documented that families of military members experience significant stress when their loved one is deployed. It is especially stressful when they may not know where their loved one is or what kind of danger he is experiencing on a daily basis.

This situation is stressful for the warrior as well, especially if some sort of conflict is occurring within the family environment at home. Regardless of whether the issue involves a death in the family or a recent argument with a spouse, the warrior must attempt to continue performing his job well, even while knowing that he cannot address the problem when he “gets off work” later that night, like so many other Americans are able to do. It may be weeks or even months before he is able to fully process the loss of a loved one or address the conflict with his spouse.

Social stressors

Lack of privacy or personal space: Deployed warriors are commonly surrounded by a large number of their comrades, both when sleeping and working. Most of the time, this cannot be avoided, and this lack of personal space is often likened to being packed like a “can of sardines.” For the most part, this tightknit environment is a positive aspect because it enhances the cohesion of the group. This cohesion is vital in combat situations, where warriors must trust one another with their very lives.

However, it also means a near total absence of privacy and the need to share almost all equipment and spaces. This lack of privacy can be stressful, especially when the only items considered personal belongings are weapons and uniforms. Most other items are freely shared among the community of warriors.

Media, public opinion and politics: It is easy to see the devastating effects that the national media and public opinion had on returning Vietnam War veterans and their families. Many were mocked, ridiculed and spat upon in public and in private. Fortunately, the media and public opinion are much more supportive of combat veterans who have served in the Iraq and Afghanistan conflicts.

The national media and public opinion wield power to validate or invalidate the sacrifice and service of warriors. Furthermore, every criticism of these more recent wars or the way they were handled inflicts emotional and social wounds on the warriors who faced death each day. On a political level, when wars are not properly funded or when debates rage in Congress, it has a direct impact on the warriors who are fighting to uphold those same political freedoms. However, politicians and media members are rarely held responsible for the influence they have on warriors in theater.

Physical stressors

Harsh conditions: Nash explains that certain regions in the Middle East and Southwest Asia can reach 120 degrees Fahrenheit in the summer, while lows in the winter can go below freezing. Furthermore, the effects of the heat are amplified by the body armor that military personnel wear, including Kevlar (helmet), flak jacket (armored vest) and new ceramic SAPI (small arms protective insert). Wearing this protective gear can raise the temperature underneath the body armor an additional 10-20 degrees. That level of heat makes staying hydrated a significant challenge, while simultaneously making both physical and mental exertion more difficult.

Sleep deprivation: Very few military personnel in a combat zone achieve six to eight hours of sleep every day. On average, combatants are forced to function on four hours of sleep or less. Some veterans in war zones become so sleep deprived that they experience visual and auditory hallucinations. Sleep deprivation affects many levels of functioning, including attention, memory and higher levels of thinking and decision-making. This combat stressor overlaps with many different elements and could also be placed under the cognitive or emotional stressors.

Pain or injury: During the course of a seven- to 14-month deployment, it is almost impossible to avoid occasional experiences of pain, illness or injury. In fact, many military personnel continue to work through pain and injury.

During a period from 2003-2006, the Department of Defense reported that 18,572 troops were wounded during combat in Iraq. More than half (10,064) returned to duty. According to Nash, this means they returned to their units in Iraq soon after their injuries, usually while still recovering. Some of those injuries were considered to be minor, such as lacerations or eardrum injuries from improvised explosive devices. However, some of those injuries were not so minor. I find the level of resilience and determination that combat veterans exhibit while serving their country in a hostile environment amazing.

Spiritual stressors

Crises of faith: One common stressor that is rarely discussed is the crisis of faith that many combat veterans experience. Spiritual stressors sometimes occur when one is faced with life-or-death decisions, and this is particularly true in combat. Belief in God can be threatened or challenged when encountering the chaos and helplessness of combat situations. This is especially evident when the warrior has a belief in a benevolent God.

A common question is, “How can God allow this evil to exist when He is supposed to be good?” Some warriors find it impossible to continue believing in this view of God and experience a crisis of faith that affects them on many levels (cognitive, emotional and so on). On the other hand, some veterans’ faith and religious convictions are deepened by their experiences. But no matter whether their faith is ultimately strengthened or weakened, most veterans face spiritual stressors.

Struggle with forgiveness: Nash explains this concept, stating, “Awful things happen in war; they are often unavoidable. And even the bravest and strongest can be pushed to the point of acting in ways that later may be deeply regretted. Finding a way to forgive oneself … can be a significant challenge.”

I have also discovered this to be true in my work with military veterans. It is common for warriors to have an easier time forgiving others than forgiving themselves. Part of this may be attributed to warriors holding themselves to such high personal and professional standards or the level of responsibility that the military instills in them. However, further research is needed in this area before definite conclusions are drawn. An important part of treatment with this population should include a focus around self-forgiveness by the warrior.

Evidence-based treatments for combat trauma

What evidence-based treatments can counselors utilize for posttraumatic stress disorder (PTSD) related to combat? While various types of treatments can be helpful with this population (biofeedback and stress inoculation training, for example), there is not enough space to discuss all of them. Therefore, I will focus on the three empirically based treatments given an A-plus rating by the Army surgeon general in 2012 for reducing combat-related PTSD symptoms among veterans.

EMDR: Eye movement desensitization and reprocessing (EMDR) is an evidence-based psychotherapy treatment that was originally designed to alleviate the disturbance associated with traumatic memories. The Adaptive Information Processing Model posits that EMDR facilitates the reprocessing of traumatic memories to an adaptive resolution. After successful treatment with EMDR, affective distress is relieved, negative beliefs are reformulated and physiological arousal is reduced.

During EMDR, the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. Therapist-directed lateral eye movements are the most commonly used external stimulus, but a variety of other stimuli include hand-tapping and audio stimulation (see emdr.com). A treatment course of 12 sessions is common. I utilize EMDR in my clinical work with combat veterans and have achieved some significant clinical outcomes over the past three years. For information on receiving intensive training in EMDR, see emdrhap.org.

CPT: Cognitive processing therapy (CPT) is derived from cognitive behavior therapy (CBT). According to the National Center for PTSD (ptsd.va.gov), CPT includes four main parts of treatment:

1) Having clients learn about PTSD symptoms and how treatment can help

2) Getting clients to become aware of their thoughts and feelings

3) Having clients learn skills to challenge those thoughts and feelings (cognitive restructuring)

4) Helping clients understand the common changes in beliefs that occur after going through the trauma

CPT puts less focus on the traumatic event itself and more focus on the beliefs resulting from the trauma and the impact those beliefs have had on the person’s life. From there, it is about the client deciding whether those beliefs are accurate or inaccurate. For a helpful and free web-based learning course, visit cpt.musc.edu/. For additional training, check the Center for Deployment Psychology at deploymentpsych.org/workshops.

Prolonged exposure: Prolonged exposure also has its roots in CBT. It focuses on repeated exposure to the traumatic event(s) and the accompanying thoughts, feelings and situations to reduce feelings of anxiety and disturbance.

The National Center for PTSD highlights the four primary elements of prolonged exposure:

1) Education: Having clients learn about their symptoms and how treatment can help

2) Breathing training: To help clients relax and manage distress

3) Real-world practice (in vivo exposure): Reducing clients’ distress in safe situations that they have been avoiding

4) Talking through the trauma (imaginal exposure): Helping clients get control of their thoughts and feelings about the trauma

Prolonged exposure typically involves eight to 15 sessions, with several homework assignments given in between sessions. For more information on trainings, refer again to the Center for Deployment Psychology.

Final thoughts

Perhaps you are a professional counselor who has always wanted to serve veterans in your private practice, or perhaps you are a counselor who is already working with this population. Either way, given that it is estimated that up to 20 percent of combat veterans will develop PTSD, it is important that counselors acknowledge and understand the common stressors of war combat. In gaining this knowledge, you can better connect with the military client who is (or who will be) sitting in your office or agency. And by being familiar with the effective treatments and where to obtain training, you will be better equipped to effectively help this client deal with the effects of combat trauma and PTSD.

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Keith Myers is a doctoral student in counselor education and supervision at Mercer University in Atlanta, Ga. A licensed professional counselor and intensively trained eye movement desensitization and reprocessing therapist, he is also a member of the American Counseling Association’s Traumatology Interest Network. Visit his website at keithmyerslpc.com and contact him at keithm355@gmail.com.

Letters to the editor: ct@counseling.org

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Related reading: See Myers’ piece from August 2013, “Effective treatment of military clients”: ct.counseling.org/2013/08/effective-treatment-of-military-clients/

Addressing learners’ emotional reactions to race-based trainings

By Tina R. Paone and Krista M. Malott September 25, 2014

When addressing race-based topics in counselor trainings, have you noticed times when learners’ emotional reactions inhibited their abilities to absorb training material or your ability to instruct? If the answer is yes, know that you are not alone. Race-based trainings are not for the faint of heart — at least not if done well.

As noted by activist Paul Gorski, effective anti-oppression efforts are those that pose a true threat to racism and injustice. They seek to prepare learners for transforming (eradicating) oppression or inequity rather than merely increasing clients’ comfort with oppression. Such efforts propose major changes in both people and systems. These changes can be particularly anxiety-provoking for whites who, largely growing up in racially segregated schools and communities, may be unaware of the presence of racism in self, others and the system.

Consequently, although emotional reactions to race-based topics are quite normal and to be expected, as an instructor, it is difficult to know how to respond in a way that maximizes learning. Indeed, Derald Sue, a scholar and educator on race, has noted that fear of learners’ negative reactions has compelled educators to omit race-based topics from multicultural trainings altogether. Yet an abundance of literature exists to provide guidance in working with such reactions. This article offers a brief summary of some of those suggestions, along with additional tactics that we have applied in various university and community-based trainings.

Emotional reactions

Scholars have cited a range of reactions by white learners to race-based topics. Some examples include shock or hopelessness upon realizing the existence and magnitude of racism and its impacts; anger and frustration at hearing perspectives that contradict personal assumptions of meritocracy; guilt in realizing one’s own racism or racial privileges; fear of revealing racism to peers during trainings; and fear of having to assume responsibility for ending racism, including fear of the repercussions of such actions. Overt actions such as shouting (with expletives), crying, changing subjects repeatedly and direct confrontations are easy to identify as emotional responses to race-based topics. However, we have found that the majority of reactions tend to be subtler. Examples include:

Leaving the room repeatedly (to use the restroom, get a drink, etc.)
Being continually distracted/preoccupied with non-course elements (food, written materials, personal appearance, various electronics)
Being physically disconnected (sitting sideways, sitting outside the learning group, sitting with one’s back toward the instructor)
Remaining passive or refusing to speak
Having ongoing side conversations with others
Regularly being absent or tardy

At times, it can be difficult to know if such reactions stem from the instructional topic or are related to other issues (for example, some students are just naturally preoccupied all the time, need to use the restroom frequently or have personal life stressors fueling such behaviors). When these reactions happen repeatedly, however, particularly during difficult junctures (for example, during potentially “hot” moments in conversations or content), the behavior warrants exploration and a possible intervention. A 2009 study by Nancy Chick, Terri Karis and Cyndi Kernahan identified the importance of addressing such emotional reactions to establish a greater sense of learner safety and remove impediments to learning. Following are several suggestions for both addressing and reducing the likelihood of negative learner reactions.

Instructor self-reflection

When observing that a person’s reaction is impeding his or her learning or is negatively affecting others, instructors may want to first consider their own role in the perceived problem before taking action. Self-reflective questions include:

Why do I think the learner is reacting this way? Does the issue rest with the learner, or have I contributed to his or her reaction? For example, have I presented the materials clearly? Have I offended the learner in some way, such as shutting the person down or using a demeaning tone?
Am I having my own reactions that need attending to (for example, transference/countertransference)?
What has impeded me from acting on any of the above issues, and do I need to attend to that impediment?

Instructors’ negative responses to learners’ reactions can result in the ineffective management of learner emotions and ultimately create a hostile learning environment. Such responses can be diminished by reminding ourselves that emotional reactions to race-based topics are extremely common and do not necessarily indicate resistance, conscious efforts to sabotage the training or an attack on the instructor as an individual. It also helps to remind ourselves that people are trying to do the best that they know how. Learners may logically be attempting to protect themselves from what feels like psychological harm. Indeed, the realization of white persons of the reality and impact of racism in society can be a dramatic turning point in their lives. Scholars have used language such as trauma, dilemma and crisis to correspond with the magnitude of this growth process.

There are myriad ways to attend to learners’ reactions to race-based topics. Regular incorporation of one or more of the following types of interventions may reduce the frequency or impact of emotions as they emerge, as opposed to waiting to respond until a larger crisis presents itself.

Sharing verbally

Researchers have noted that students in race-based courses can alleviate negative affect and increase learning through the identification of similar emotions with others. What follows are various approaches to accomplish this.

Instructor modeling: Instructor modeling can normalize students’ experiences and reduce the immobilizing shame that can impede learning about race-based topics. Modeling includes self-disclosure of one’s own feelings and possible techniques for attending to them. One example of this: “Feelings of shame or frustration come up for me when I catch myself in a microaggression, but I’ve gotten better about just noticing those feelings, letting them pass and then stepping up to make reparations for the mistake made.” (On a side note, this example models a mindful-based response in which the emotion was brought into awareness but explicitly not assigned a judgment. Rather, it was allowed to dissipate and then was replaced with anti-racist action.)

Pair and share: Ask students to turn to a peer and share for three minutes their reactions to a provocative event, assignment or reading. Individuals can be paired in various ways. For example, pair students with someone who is racially similar to them (or someone who seems closest to them in their racial identity development level), pair them with a different individual each time to allow for connection with many members, or pair them with the same person all semester to allow for greater familiarity and comfort in sharing. Ensure that both individuals in each pairing get the chance to share.

Scaling emotion: One way to allow the expression of emotion and to identify similarities across learners’ reactions is through use of solution-focused scaling. In this technique, learners stand and physically scale emotional reactions to instructional content. One end of the continuum could be defined as “feeling overwhelmed with a certain emotion, question or response,” while the other could be “feeling underwhelmed, have few questions or am comfortable with the topic.” Instructors can ask learners to define and explore reactions with the people standing closest to them. Afterward, instructors can ask learners to place themselves along the scale according to where they would like to be and to identify what kind of personal action or peer/group support they need to get there. With groups that find standing difficult due to disabilities, or if the size of the room prohibits such activity, instructors can draw a scale on a board and ask learners to indicate where they fall on that scale. They can then sit with others who indicate similar placement.

Use of group format: The use of small groups, in which learners are seated in a more intimate circle formation, offers an alternative to traditional row seating and can facilitate a greater comfort level for members to share. Trust and cohesion, the cornerstones of group work, are more easily achieved in these smaller settings, thus allowing for greater vulnerability. Learners can be asked to express personal reactions to instructional content in the group on a regular basis or in relation to specific events, topics or heated exchanges.

Write it out

Many articles have discussed the merits of allowing students to process learning and affective reactions through writing. Following are several ways to do this.

When it’s really hot, stop and journal: When emotions are extremely high after a hot moment (for example, someone says something highly offensive or controversial and no one seems to be able to respond coherently), stop and ask learners to journal their thoughts. This also gives the instructor time to consider his or her next step.

The minute paper: Don Locke and Mark Kiselica wrote about this technique in a 1999 article on teaching about race. In calmer moments, perhaps at the end of a session period, ask learners to write for one minute about their reactions regarding what transpired that day in the training.

Weekly journaling: Ongoing journaling is a great way to gauge learning or affective responses for those students who are especially quiet. Journals could be handed in electronically to increase confidentiality, with entries being written from locations that are free of peer influence. Instructors can respond more personally in these journals to normalize learners’ reactions and to offer individualized words of support. In addition, private sharing of learners’ feelings absolves learners of color from feeling responsible for comforting or reassuring their white peers, which is a troubling phenomenon that can happen in racially mixed trainings.

Get creative

Nontraditional, creative means of eliciting and processing learners’ affective responses can offer a safer venue for bringing both conscious and unconscious feelings that may be impeding learning to the surface. Instructors could use films, crafts or movement. The following examples cover techniques that we have used.

Sand tray: Based on sand tray therapy, this process involves learners using miniatures to create a representation in a small tray of sand. When using this in conjunction with a race-based training, the instructor might give directions such as, “Create a sand tray to represent what you are experiencing right now in this training.” Learners can then be asked to interpret their trays with peers while identifying similarities and differences in their experiences. The instructor can also offer additional interpretations of certain unconscious reactions represented in the trays. Used several times across a semester, and optionally captured with photos, the sand trays can be compared over time so that learners can visualize their own growth and the growth of the group.

Photojournaling: Photojournaling combines photography with journaling to express one’s emotions. An instructor might use specific prompts for the assignment, such as, “Photojournal how you felt after learning about racial microaggressions today.” The prompt can also be nondirective or open-ended, such as asking learners to create a photojournal of their overall reaction to the day or training.

Sculptures: Using human sculpturing, as taken from family therapy practice, an instructor would place learners in a physical arrangement in the room to represent emotional reactions that she or he is observing. Conversely, learners could be asked to sculpt themselves or the group as a whole. We have used this activity to sculpt a room of students whose negative reactions brought learning to a complete halt. After placing the students in their sculpture (in this case, learners were placed with their backs to the instructor, and as far across the room from the instructor as possible), the sculpture’s meaning is described, and learners are asked to process and make meaning of the sculpture. They can then place themselves in a new sculpture according to where they would like to be and discuss what will help them get there.

Snowball activity: In this activity, learners write down their emotions on one or several pieces of paper. They then ball up those emotions and have a “snowball fight” (they throw those pieces of paper at one another). To ensure that the written comments will remain anonymous, ask learners to pick up and throw the snowballs several times. Then ask them to select one or several snowballs near them and read them out loud. The group can then discuss the written reactions, noting similar and dissimilar comments, and brainstorm solutions for managing particularly difficult emotions.

When all else fails

If a learner continues to exhibit strong and negatively impactful reactions after the previous suggestions have been applied regularly, the instructor will want to be more direct. You could address the learner separately, pulling the individual aside to note your observations, but this should always be done with a tone of care. For example, “I can tell that this topic is really affecting you, and I’m wondering how I can help.” If using a group format, this direct inquiry could be done in the group setting. Member feedback could be elicited concerning how the behavior is affecting the individual’s learning as well as the group process.

Don’t go it alone

Finally, because this is hard work and emotional reactions are to be expected, race-based trainings call for community support. We know instructors who have given up teaching multicultural trainings altogether because of burnout associated with attempting to respond to learners’ reactions.

When struggling to respond effectively to one learner (or to an entire group), consult with a colleague who is engaged in this type of work. Remember that some of the best allies can be found across work settings and disciplines. They can be university or community professionals engaged in any form of anti-oppression work (for example, anti-sexism or anti-poverty) because such endeavors are interrelated. Regular participation in such supportive groups would be ideal. This work cannot, and should not, be done alone.

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Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Tina R. Paone is an associate professor and chair of the Department of Speech Pathology, Educational Counseling and Leadership at Monmouth University at West Long Branch. Contact her at tpaone@monmouth.edu.

Krista M. Malott is an associate professor in the Department of Education and Counseling at Villanova University.

Letters to the editor: ct@counseling.org