Monthly Archives: December 2014

Counseling goes to the movies

By Bethany Bray December 5, 2014

Watching a movie — whether at home curled up on the couch or at the theater with a tub of popcorn — is a great way to relax and check out from reality for two hours.

Movies can also be a hit-the-nail-on-the-head portrayal of life, including mental health struggles and Movie Tickets and Popcornrelationship problems that counselors hear about on a daily basis.

We asked counselors to tell us about their favorite movie portrayals of counseling or mental health themes — either movies they simply like to watch themselves or films that they have recommended for clients.

From Silver Linings Playbook to Terms of Endearment, their responses show how art – in this case, film – can truly imitate life.


(* Indicates an American Counseling Association member. Responses have been edited for length.)




Antwone Fisher (2002)

Submitted by Feliesha Shelton-Wheeler*, a mental health staff therapist at Gannon University’s Health and Counseling Services in Erie, Pennsylvania, with a Psy.D. in clinical psychology


Antwone Fisher is one of my favorite films. The 2002 movie is based on the New York Times best-selling book Finding Fish: A Memoir, by and about the author and namesake of the film, Antwone Quenton Fisher.

The movie, directed by Denzel Washington, one of the stars of the film, tells the true story of an African American man’s journey of resilience and movement toward self-awareness. Viewers get a glimpse of Antwone’s (portrayed by actor Derek Luke) struggle to overcome a turbulent life that we learn began the day he was born in prison and placed in foster care. The movie begins with a recurring dream that foreshadows the movie’s ending. We learn that Antwone is in the Navy and, due to several angry outbursts and physical fights, he is mandated to attend therapy with a psychiatrist, Dr. Davenport (Denzel Washington). In the three limited sessions he has with Dr. Davenport, Antwone reveals the painful hardships he has endured in his life.

The content within the counseling sessions between Dr. Davenport and Antwone contain several real-life counseling/mental health themes, including repressed emotions, sexual abuse, posttraumatic stress disorder (PTSD), neglect and abandonment, issues of self-worth and identity, interpersonal relationships and death/grief and loss.

It is not often as therapists that we have the opportunity to witness the transformation of a client. Through the magic of film, the movie allows us to witness Antwone’s transformation in just a few hours.

The movie is definitely a tearjerker, but there are plenty of moments of humor and hope that counter the sadness.



What About Bob? (1991)

Submitted by April R. Crable*, a licensed professional counselor (LPC) in Virginia and Florida, and field experience coordinator and core faculty member at Walden University


I first watched What About Bob? as a teenager. At that time, the thought of becoming a counselor had never crossed my mind, and I enjoyed the movie for what it was: a comedy. I remember thinking that Bill Murray’s role as Bob Wiley was hilarious and annoying, and I felt sorry for Richard Dreyfuss’ character of Dr. Leo Marvin. As a counselor, I can now appreciate the lessons in this movie. What About Bob? contains several helpful teaching moments for both senior and novice clinicians. As a faculty supervisor, I often show clips of this movie to my students to show them the importance of being mindful of our purpose, that we are humans and that there is no such thing as a perfect counselor.

In the movie, we find Dr. Leo Marvin at a point in his career where he seems to be focused on becoming a “renowned therapist” with a slight ego. His ego is the reason he accepted the referral for Bob in the first place, even though it was right before he was going away on a monthlong vacation and he did not do his due diligence in researching the needs of Bob. Dr. Marvin soon abandons Bob and asks him to read his book Baby Steps while he is away.

Throughout the movie, Bob tries various ways to reach Dr. Marvin during his vacation, such as pretending that he is going to kill himself. Dr. Marvin receives a call that Bob completed suicide. Dr. Marvin shares this with his wife — without a second thought about his own feelings of losing a client or about the client. He says, “Oh well, let’s not let it ruin our vacation.”

The lesson learned is that it is easy to become emotionally numb when we are wrapped up in our own lives or after years of practice. If you have seen the movie, you know that Bob continues to infringe on Dr. Marvin’s vacation and family, and while Dr. Marvin continues to try to get rid of Bob before his interview with Good Morning America, Bob eventually wins over Dr. Marvin’s family members and turns his own family against him.

Dr. Marvin eventually loses it to the point where he is hospitalized and tries to kill Bob with a bomb attached to his body. He convinces Bob that this is “death therapy.” At this point, Dr. Marvin does a little kick of joy because he believes he is finally free of Bob.

Haven’t we all experienced this level of frustration with a client? We may not have thought about using death therapy, but we may find ourselves feeling happy if they miss an appointment or take a little vacation from therapy.

Most of my students gain insight midway through the movie. They see that Dr. Marvin spends most of the movie attempting to get rid of Bob without taking time to consider the reason that he needs his help. We may sometimes forget to listen to a client and get wrapped up in our own agenda. We are often the cause of our own frustration and burnout. At the end of the story, Dr. Marvin is shown in a psychiatric facility in a wheelchair, unable to speak.

This is an awesome reminder that we all need a break sometimes. I no longer feel sorry for Dr. Marvin as I once did as a teenager. From a counselor’s perspective, I can honestly say that I identify and empathize with him. At some point, we have all felt a little stressed, frustrated and off our game. After all, there is no such thing as a perfect counselor.



Ordinary People (1980)

Submitted by Andrea Rohr*, a certified rehabilitation counselor (CRC) who works at an opioid treatment facility in Jamaica, Queens, New York


Ordinary People explores the fragmentation a family experiences after the loss of a teenage son. The surviving teenage son, Conrad, has developed survivor’s guilt and posttraumatic stress as a result of the boating accident that killed his older brother. Conrad has recently returned home from a psychiatric hospital following an attempted suicide. Albeit a reticent participant in therapy, Conrad starts seeing Dr. Berger in the hopes of getting better.

In therapy, progress for Conrad is slow and his family tensions continue to escalate. Buck is revealed to have been his mother’s favored son, and he, rather than Conrad, died in the boating mishap. In the hope of offering some insight into the family, Conrad’s father pays Dr. Berger a visit. Forthcoming in expressing his feelings, Conrad’s dad realizes during his session that he’s really there to explore his own feelings. The family unit remains fractured, however, since Conrad’s remote mother abhors therapy, deflects any discussion of feelings and eventually leaves the family.

During one scene in the movie, Conrad seeks out his friend Karen, whom he knew at the psychiatric hospital. Karen assures Conrad she’s all right and is no longer pursuing therapy. She explains she saw a therapist when released from the hospital but quit after her dad said no one could make her better other than herself. The movie crescendos when Conrad later discovers Karen killed herself. That Dr. Berger agrees to see Conrad – after a desperate call late on a cold winter’s night – is a tribute to the commitment of Conrad’s therapist and a discernment of desperation. It is during this heated late-night session that Conrad experiences the epiphany: He held on. Conrad held on to the boat and survived; Buck could not – and died.

Ordinary People is an intense drama with a settled – if not happy – conclusion for its players. The movie implies therapy works. Those who seek treatment make progress and move forward. Those who avoid treatment have less successful – sometimes even suicidal – outcomes.



Canvas (2006)

Submitted by Dominick Carielli*, a licensed mental health counselor (LMHC) who has worked for the Calandra Institute, Queens College, New York, for the past 30 years


A number of films deal with counseling and mental illness, and most people will immediately think of A Beautiful Mind and Good Will Hunting. Less well known, though no less riveting and powerful, is Canvas, a 2006 film that chronicles one woman’s battle with schizophrenia and the impact it has on her husband and young son.

There are many things that I love about Canvas. It is a film about real, ordinary human beings who are struggling with the everyday aspects of life while trying to cope with something profound and potentially devastating and destructive. It is also about family and relationships. In counseling, most of us focus on treating individuals. It can be easy to lose sight of how a mental illness can dramatically impact the lives of those who are close to the client.

Particularly salient is the effect of the mother’s illness on her 10-year-old son. While in the beginning stages of forging his own identity and establishing relationships with peers, he is thrust into a world of chaos. He loves his mother but is at the same time angry with her, ashamed of her and has those frightening moments where he wonders if he might become like her.

The film also closely examines the relationship between father and son as well as the symbolic loss of a person that can occur with diseases like Alzheimer’s or schizophrenia; the individual they once were no longer exists. Canvas stirs us, warms us, challenges us and educates us.



Silver Linings Playbook (2012)

Submitted by Cristina Ciobanu*, who is studying counseling and development/clinical mental health at Texas Woman’s University in Denton, Texas


In the 2012 movie Silver Linings Playbook, a [person with a] mental health condition interacting with another doesn’t always equal disaster. Sometimes, it might just equal healing. Pat (Bradley Cooper) is a recovering bipolar disorder patient who formerly snapped at the sight of his wife cheating on him with a colleague. Tiffany (Oscar-winning actress Jennifer Lawrence) is a widow who engages in a medley of sexual behaviors at work in order to deal with the loss of her husband.

What happens next is a hilarious alloy of confusion, unexpected turns and miraculous discoveries. Tiffany’s blunt but humane sincerity pulls Pat out of his obsession to continue a marriage that doesn’t exist anymore, while Pat gives Tiffany back an old dream by being her partner in a dance competition. The two eventually dance their way into a renewed vision of life.

Despite skepticism of the story’s feasibility, the take-home message is that hope, courage and faith in the process of life can be great pillars in promoting mental health recovery. Beyond that, they can bring more authenticity to our lives and show that the human experience is no easy endeavor, therefore removing the stigma still present in the world of mental health today.



Terms of Endearment (1983)

Submitted by Feliesha Shelton-Wheeler*, a mental health staff therapist at Gannon University’s Health and Counseling Services in Erie, Pennsylvania, with a Psy.D. in clinical psychology


Although this movie is extremely sad, Terms of Endearment is one of my favorite films. (I can actually recite some of the lines from the script because I’ve watched it so many times!) The movie focuses on the enmeshed relationship between a mother, Aurora (played by Shirley MacLaine), and daughter, Emma (played by Debra Winger). In the beginning of the movie, viewers get to witness the humorous yet telling signs of Aurora’s anxious and obsessive behaviors as she climbs into Emma’s crib (when Emma is a baby) and shakes her awake to make sure she has not died of sudden infant death syndrome (SIDS). The film takes us on a journey through Emma’s marital struggles and family choices that Aurora observes with great criticism and disapproval. Despite her constant nitpicking and tiring criticism of Emma’s choices, Aurora quickly wins the hearts of viewers as she painfully has to endure watching Emma struggle with a terminal diagnosis of cancer.

Along with parent-child enmeshment, Terms of Endearment contains other real-life counseling/mental health themes such as empty nest syndrome, grief and loss/death, and terminal illness.

There are several funny parts within the movie that help to balance the film’s overwhelmingly sad events. Viewers will likely enjoy Aurora’s date with her next door neighbor, the astronaut Garrett Breedlove (played by Jack Nicholson) or Aurora’s preference of having her oldest grandchild call her “Mrs. Greenway” instead of “grandmother” because she is not ready to be one.




Free Fall (2013)

Submitted by Michael L. Rockel*, an LMHC in Massachusetts who specializes in solution-focused brief therapy; he is also a national certified counselor (NCC) and certified clinical mental health counselor (CCMHC)


Truth as defined by Webster’s is simply “the real facts about something.”

Hearing, understanding or telling the truth can be exhilarating, painful and full of angst as well. Those of us in the GLBT (gay, lesbian, bisexual and transgender) community can attest to the power of truth and the pain that truth often carries with it.

Coming out can bring a wide range of experiences and emotions. Realizing and telling the truth about oneself can be life affirming and profound, but it can, and often does, bring the overwhelming sadness that comes when one dares to tell the “real facts” about one’s self.

As therapists and counselors, we are often called upon to help a patient or client tell their story in a frank and truthful manner. The telling of the story is where the therapy lies; we [the counselor] can only sit on the sidelines and listen to the pain and the juxtaposed happiness that being truthful about one’s sexuality brings.

I recently saw a movie titled Free Fall, produced by Stephan Lacant and staring Hanno Koffler and Max Riemelt. It is a story about two German police officers who fall in love and have an affair. However, unlike many movies in the same genre, it is told simply, dramatically and powerfully. The movie instantly became one of my favorite movies.

I would recommend this movie to any of my clients who might be in the process of telling their own coming out story. The acting in the movie is actually not bad, and the story has been told many times in many different movies. There is sex, but not gratuitous, drama without being pathos, and a developing love story that is mature and to the point.

I would not only recommend this movie to therapists, but I would use it as a discussion base for therapy with a client. It is comprised of the “real facts” — the truth if you will. My clients deserve nothing less.




Hope Springs (2012)

Submitted by Maureen C. Kenny*, a professor of counselor education at Florida International University in Miami


A movie that I believe represents counselors in an ethical and professional manner is Hope Springs. Steve Carell portrays a counselor (Dr. Feld) who works with a couple that has lost intimacy over the years. They have been married for 30 years, sleep in separate rooms and don’t have sex. The wife (played by Meryl Streep) reads a book by Dr. Feld and convinces her reluctant husband (Tommy Lee Jones) to attend a weeklong couples treatment.

An impressive strength of the film is that the difficulties of the couple are realistically portrayed. The husband struggles with talking about sex with the counselor, while the wife is more open but also apprehensive. Watching them open up in sessions is almost painful. There are silences, there are unstated emotions, and all the while, the counselor is present and working. Dr. Feld is thoughtful, attentive and empathic to the couple’s problems.

The film also shows the struggles people often have committing to treatment (e.g., wanting to keep the status quo, complaints of financial cost, difficulty with self-disclosure and embarrassment).

Most remarkable is that while many movies and television shows portray the counselor breaking boundaries (e.g., becoming friends, overly self-disclosing and, most egregious, engaging in sex with the client), Dr. Feld is represented as a competent and empathic counselor. His depiction is of particular importance in this film because the couple is dealing with sexual and intimacy issues, which in another film might lead to counselor boundary crossing. Dr. Feld does not traverse boundaries, break confidentiality [or] make sexual advances to the wife. Instead, he “stays the course” with the couple. He assigns appropriate homework assignments and maintains a fair and nonjudgmental stance in the sessions. He is able to talk about sexual topics with the couple with ease, proving to be a role model for their increased communication. He normalizes the struggles they have and helps them find ways to address their deepest hurts in the relationship.

The film models a few things for counseling students: couples treatment, working with clients with sexual disorders and working with an older client population and the developmental issues that arise with aging. The counseling scenes in particular make for an excellent training tool.




Raising Cain (1992)

Submitted by Sandy Range*, an LMHC in Stoughton, Massachusetts


Raising Cain is one of my all-time favorites! A professor in grad school (in 1997) had my class watch this film directed by Brian De Palma. I ended up purchasing it for my collection. Before entering grad school, I had a client I was a case manager for who had three distinct personalities caused by multiple childhood and adolescent traumas. Once I saw this film in grad school, I knew that trauma would be my specialty.

Raising Cain is a psychological thriller about one man and his four very different personalities (all played by John Lithgow, including the role of his sadistic, psychiatrist father).

Carter is a psychologist, husband and overly caring, helicopter dad. However, he is fearful and unable to take action or take control of his life. Cain is Carter’s twin brother who is psychotic and vicious, yet he gets things done on Carter’s behalf no matter who it hurts or kills. Josh, the little preadolescent boy, is always the victim; Margo, the shero (female hero), only presents herself when absolutely needed to protect Carter and the children from Carter’s father.

I own an outpatient mental health clinic in Stoughton, Massachusetts. Being a trauma specialist, I enjoyed this film (from a clinical perspective) because it shows how Carter’s psychiatrist father experimented on him as a child. Through torture, imprisonment and neglect, he intentionally split Carter’s psyche to see how many personalities would emerge. The others all play a part in doing and undoing the father’s horrific experiments on more children.

This film provided me a visual understanding of how the personalities work together and also against each other toward a goal. The personalities always serve a purpose and have a goal. This film helped me, as a mental health professional, to help my patients understand the goal of each personality and how they can work together, heal and eventually merge.

After viewing this film, I attained a differing insight and perspective into dissociative identities, schizophrenia and psychosis. Makes one wonder about the mind of (the film’s director) Brian De Palma though!




The Squid and the Whale (2005)

Submitted by Daniel Jay Wiggins*, a master’s student (clinical mental health counseling) at Troy University in Alabama who is interested in student affairs counseling


The Squid and the Whale was written and directed by Noah Baumbach in 2005. This high-conflict, low-resolution indie film revolves around a fragile family system and is flavored with and characterized by the continuous shattering of the familial dynamic. The film is a great depiction of familial struggles, showcasing the relation between a parent’s weakened behavioral, emotional and interpersonal spheres of existence and the developmental immobility in children.

The two characters that caught my focus in the film were the sons of Bernard and Joan Berkman: 16-year-old Walt and 12-year-old Frank. The film focuses on the journey through divorce between Bernard and Joan and its effect on the children individually and collectively, as well as the divorce’s effect on the overall family dynamic.

Viewing this film through a developmental lens allows the viewer to fully see its multifaceted nature. The beauty of this film is [the portrayal of] the deep psychological and developmental aspects of each character, as well as the use of nontraditional familial conflicts between the protagonists. The characters each have severely damaged interpersonal relationship skills rather than simple, traditional character roles with expected or anticipated familial conflicts.

Through a more in-depth analysis of the film, clinicians should strive to a) identify the characters in struggle; b) understand the comparison/contrast between where each of them should be developmentally according to [Erik] Erikson’s stages of psychosocial development and where they actually are; and c) understand which technique(s) would best be used to help the clients from a wellness perspective.

The Squid and the Whale makes for a great beacon of reassurance for doubtful mothers and fathers everywhere. From an analytical clinician’s perspective, Frank is identifiably stuck in the fourth stage of Erikson’s psychosocial development (industry vs. inferiority), which will undoubtedly create problems for his movement through the fifth stage of development (identity vs. role confusion). Walt has adopted his father’s personality as his own, which is observably incongruent with his authentic self. In Eriksonian terms, he is stuck in the fifth stage of psychosocial development. Both boys have several abnormal behaviors that reinforce the hypothesis of their mental and/or cognitive instability. Frank and Walt show great potential for improvement and developmental resolution. However, the developmental crises must be resolved or else they will continue to negatively affect each boy’s personality and identity until resolution occurs.

I think The Squid and the Whale did a great job of representing modern familial struggles through an overall fragile familial system without going over the top.



Batman Begins (2005)

Submitted by Michael Brant*, a graduate student in the professional counseling program at Liberty University. He lives in Pennsylvania, near the border of Maryland and plans to practice in Maryland.


I especially like Batman Begins because of its origin story. The character of Bruce Wayne/Batman has been around for over 75 years. I believe a lot of the character’s success is that unlike most superhero characters, such as Superman or Spiderman, Batman is a mere human. His humanness makes him easy to identify with.

There are many mental health concepts within Batman Begins. Grief is a key element to the young Bruce Wayne that he carries with him after the death of his parents. Bruce holds on to the past and will not let go of it. It seems as though he has a major depressive disorder that was triggered by his parents’ death. This comes out in how he has an alter ego, Batman, yet still passes himself off as the rich Bruce Wayne. This is how some [people] who have milder conditions take great strides to hide their condition. Additionally, due to his alter ego, the idea of a personality disorder is also an issue.

One of the other areas that deal with mental illness is the Arkham Asylum. Dr. Crane (the film’s villain, also known as the Scarecrow) says, “Yes, but this is a mental asylum for the criminally insane. The unusual is usual here.” One of the questions raised by the film is what causes criminals to be criminals — is it an area within or without their control? Later on in the conversation, Dr. Crane continues, “We’re not talking about a few easily manufactured eccentricities.” This is referencing the idea of how someone might fake a mental illness as a defense for committing a crime. Dr. Crane also leads in a discussion about his advocacy for psychopharmacology and the belief in the mind’s ability to effect change in the body.

There are many areas in which questions are brought up that deal with ethics when it comes to Dr. Crane and the Arkham Asylum. I work with adults with developmental and intellectual disabilities, and often when I see depictions of places like Arkham Asylum on film, I think of places like Willowbrook State School (in New York City) where those with various conditions were sent and abused.

There are many more areas that I could continue to discuss. However, I think that this is a good taste without spoiling the whole movie. Think on these things while watching it either for the first time or the next time.



Call Me Crazy (2013)

Submitted by Catherine Mukes*, an LPC in Texas who works at a mental health agency and plans to move to private practice


The movie I am recommending is titled Call Me Crazy. I ran across this film on Netflix and later realized that it was a Lifetime (channel) movie. The movie is a compilation of five interconnected stories about people with mental illness as well as those with family members who are mentally ill. The film addresses life with schizophrenia, bipolar disorder, major depression and PTSD.

What I love about this movie is that it brings an honest and real look at how mental illness can impact lives — and also be overcome. It takes into account the real struggles that the individual and those around them deal with while trying to cope with the illness, including shame, denial and guilt. The film does not berate or belittle those with mental illness but depicts them as simply human.

It a warm, inspiring and well-crafted film that I think professionals, professionals-in-training, the community at large and clients could really glean from.



Life as a House (2001)

Submitted by Everett Painter*, a counselor at Walters State Community College in Tennessee and a doctoral student in the counselor education and supervision program at the University of Tennessee–Knoxville; he is also an adjunct instructor in the psychology department at Tusculum College in Tennessee


Life as a House offers several scenarios from which to evaluate crises. This is a story of a family in turmoil. The main character, George, is divorced, unhappy and lives in a dilapidated house that is the blight of the neighborhood. His ex-wife, Robin, is remarried but also remains unhappy. Significant friction and conflict exists between them. They have a rebellious 16 year-old son, Sam, who is tormented and angry. Sam actively tries to avoid them and experiments with a variety of drugs.

George is unexpectedly let go from a job he has held for 20 years. Soon after, he learns he has terminal cancer and only four months to live.

Over the course of the film, George is forced to consider issues related to intimacy, work, parenting, substance abuse, communication and mortality. While we never see him seek formal treatment, the process of therapeutic change is depicted in a natural way as people rally around and reconnect with him. The power of social support and unexpected pathways to resilience is revealed.

Life as a House progresses at a rapid pace and is inconsistent with more realistic timelines and the crooked pathways typical of crises or personal transformations of this nature. Nonetheless it is a dramatic illustration of the opportunities embedded in traumatic experiences. This story represents a specialized case featuring compounded losses. It reminds us that in such instances, counselors must have a broad set of skills in order to manage the complex range of emotions and psychoeducation necessary for client care and ethical practice.

In the end, the renovation of George’s house that takes place throughout the film is a metaphor for rebuilding a shattered life. The process that unfolds is analogous to crisis counseling, as elements of empowerment, support, resiliency, growth and meaning are all addressed. George, as well as the rest of his family, is transformed by the experience that embodies the ultimate goal of moving a client from a maladaptive, lowered level of functioning to that of survivor, where strength and growth replace distress.

As George says in the film, “Sometimes things happen for a reason … something bad to force something good.”



Iron Man 3 (2013)

Submitted by Daniil Marchenko, a recent master’s graduate in counseling psychology and a lover of all things “nerd” who is currently pursuing his counseling licensure in Texas


Even superheroes have mental health problems.

I liked two things about Iron Man 3. The first is that Tony Stark’s (Iron Man’s) mental health issues were not central to the plot. Unlike more typical mental health movies, Iron Man 3 was not about his mental health issues. It was about Iron Man doing his Iron Man stuff and dealing with his mental issues as they showed up. It presents a truer picture of a typical mental illness than some other movies that are centered specifically on the issue.

The second thing I liked is the popularity of the movie. Identifying with Tony Stark is more socially acceptable than identifying with characters from Good Will Hunting (the 1997 film that also deals with mental illness). Imagine a teen presenting with anxiety in your office. You show him or her a clip of Tony Stark having a panic attack. Panic attacks suddenly become more manageable and less stigmatized. Because now your client can be like Iron Man. And we all want to be a little like the superheroes that we love.



A Beautiful Mind (2001)

Submitted by Amy Valentine, an NCC in Los Angeles who works in workforce development and uses her counseling background for team-building exercises and training for businesses


I love the movie A Beautiful Mind, as it demonstrates what it is like to experience schizophrenia from a first-person perspective. The audience gains a wider perspective and appreciation for this mental illness.

The film is based on the life of John Nash, a brilliant mathematician who suffered from schizophrenia. It makes you really think about what it is like to experience this illness on a daily basis. From a personal standpoint, I found myself empathizing with the wife of the main character.

From a family systems perspective, this gives the clinician and counselor great insights to utilize as a framework for diagnosis and treatment. The director did a great job from a perception point of view. The emotions one experiences while watching this movie will transport you into another’s point of view, allowing you to experience schizophrenia firsthand. I enjoy movies like this.



What Dreams May Come (1998)

Submitted by Harland C. Wable*, a co-occurring specialist in the field of chemical dependency and licensed mental health counselor associate in Spokane, Washington


Within What Dreams May Come there are the all-important factors of relationship building, raising a family and parent-child dynamics. It seems like parents are [too] busy to raise their children and choosing their careers over children.

It raises questions about the different aspects of children wanting the approval and affection of their parents and children becoming distant. The film also deals with the loss of children, depression, suicide and suicide attempts, frustrations, anxiety, loss and despair.

And not lost in all of this is the all-important aspect of love. There is a love that runs deeper than anyone can imagine. During the first part of the movie, one has to look for it, as it is hidden in different aspects of life. During the later parts of the movie, it is not difficult to see the love that is so strong that one would do anything to find [his or her] soul mate.

Of course there is a lot more to this movie than meets the eye.

As a chemical dependency counselor, there are no major chemical dependency issues [in the film]. But from a mental health viewpoint, [there are many such issues].

Love this movie.



Another Year (2010)

Submitted by Heather Zeng*, an LPC in San Francisco and core faculty member at Capella University


Another Year is a portrayal of a well-adjusted British family over the course of a year and their constellation of friends who have challenges coping with life. It’s a favorite to share with counseling students because it’s a distinct portrayal of individuals who forge healthy relationships and those who don’t, with the ensuing aftermath and implication of these impasses to themselves and others around them. The language of the lead character, Gerri, a therapist, is helpful to observe as she models many positive counseling skills, from listening to gentle confrontation in her work and life relationships.

Gerri and her husband, Tom, are gardeners, and you might say they cultivate empathy and compassion in their lives. In one part of the movie when explaining his work to his family and friends at dinner, Tom states in so many words, “I dig holes in the ground to see if things can be held up under our feet.” Essentially, another way of describing his wife’s role as a therapist — digging deep into individual’s selves to find structure in their lives to rebuild.

Tom and Gerri’s life is contented. They tend to their garden of life, and this is how it grows.

However, their friends are another story. Gerri’s friend Mary from work is fragile and frazzled, gliding into everyone’s life with restlessness. Nothing has stuck for her except her work. All problems are perceivably solved by the next great relationship. She’s assured a car will be the answer to her frustrations in life, [but] it only makes things worse. In one scene, she doesn’t want to drop off Joe, Tom and Gerri’s son, as she feels she will get lost and not find her way home. It’s analogous to how lost she is in life. Mary assuredly states several times in the film, “If you have the need to share anything, I’m here for you,” assuming others have the weighty trials she has.

Gerri is compassionate to Mary as a friend, forgiving of all her failings and foibles, until she turns jealous and overtly adversarial to her son Joe upon his good fortune of finding love and happiness in a new relationship.

Equally, Tom’s friend Ken is in the midst of his own struggles, overeating, overdrinking, overworking. At a mutual party, Mary comments about Ken negatively, to which Gerri affirms, “Life isn’t always kind, is it?” The compassion Gerri shows for Ken, Mary cannot offer in turn to him. She is too enmeshed in her own limited view to see that, indeed, in many ways they (she and Ken) are on mutual life tracks. That is, lonely and grieving of nonevents in their lives.

So for your next movie assignment, consider Another Year! Try to have students take a character and transcribe their comments. It can be insightful [concerning] how what is said and what is done can be miles apart. In contrast, it also affirms that perception can be a powerful tool for valuing what is and not what might be. It can also be a great qualitative question for students: How does your garden grow (a metaphor for life and relationships)?





Don’t see your favorite movie listed here? Add it in the comments section at the end of this article. Be sure to include why you think it’s a good portrayal of counseling or mental health themes.




Related reading

Check out St. Louis LPC Ryan Thomas Neace’s piece on Good Will Hunting:


Also, see Counseling Today’s 2011 feature article on cinematherapy:




Bethany Bray is a staff writer for Counseling Today. Contact her at


Follow Counseling Today on Twitter @ACA_CTonline and on Facebook:


CEO’s message: In your own words

By Richard Yep

Richard Yep, ACA CEO

Richard Yep, ACA CEO

Last month, I asked ACA members to enter a drawing by sharing their thoughts on the following question: What do you find most meaningful as a professional counselor or counselor educator? I thank all of you who chose to respond.

The answers I received were from a cross section of our members, including those who are just starting out in their careers, some who have been practicing for quite some time and others who chose professional counseling as a second career. I was overwhelmed by the number of counselors who participated. In addition, your answers were poignant, touching, meaningful and inspirational.

I have to believe that the motivation for participating went beyond simply entering a drawing. Rather, I think that those who provided answers wanted to share their thoughts with you, their colleagues.

As we close out the calendar year, I thought it would be nice to reflect on the ways many of you have worked so hard to make an impact in the lives of your clients, students and communities. Here are some select snippets I received in response to the question I posed in last month’s column.

“Most meaningful to me is giving those who come to me for counseling the opportunity to tell their story. I believe in the power of words as medicine, and I am proud and humbled to have the opportunity to share in this healing.”

“I also am still amazed sometimes at that moment when the light comes on in a client’s head. I think I live for those moments. It does not happen every time of course. For some it is not so dramatic. But I love it when someone looks up and you can see the transformation. It is humbling as well to realize people are trusting us with their most vulnerable feelings and experiences.”

“I have found that the most meaningful thing that you can have in your life as a trained counselor is your own locus of control. … It is important as a counselor to know how to build your energy. I see a lot of people who are depleting their energy and not taking the time to rest and rebuild their reserves. My locus of control allows me to know my limits and when to say ‘no’ when I need to.”

“What I find most meaningful as a professional counselor is —

  • When the client makes the choice not to cut or consider suicide as an option and learns how to use his or her anger and pain constructively.
  • When the parents finally see the results of their commitment to consistent, positive discipline and healthy communication and start to enjoy being a family again.
  • When that boy in the group who is usually sarcastic or detached shares his story and makes a connection between past trauma and present dysfunctional beliefs.
  • When the client is comfortable sharing his or her true thoughts because they know I don’t judge.

There are many more meaningful moments like these, but in the end, the most meaningful part of being a professional counselor is when clients finally reach the point where they can truly say, ‘Thanks for your help, but I don’t need you anymore.’”

“I find it most meaningful to continue to educate and train future counselors. Each student who graduates goes forth to advocate, mentor, counsel and assist individuals, couples and families in the community we live in. I also find it especially timely to train students not just in advocacy and social justice, but in disaster response.”

I hope you will all enjoy this winter season and take the time as we close out another year to reflect on your good work and the impact you have made. I also hope that you take some time for self-care and personal enjoyment.

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 You can also follow me on Twitter: @Richyep.

Be well.


Emerging leaders: ACA’s future

By Robert L. Smith

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

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

Meeting with emerging leaders of the American Counseling Association is one of the most rewarding experiences for any ACA president. I have had the opportunity on several occasions to meet with emerging leaders, including at the Southern Association for Counselor Education and Supervision Conference in Birmingham, Alabama, in October.

The energy and enthusiasm of our emerging leaders is always amazing. Meeting with future and current leaders in the counseling profession at these events provides numerous opportunities to share how one can successfully move into a leadership role. In addition, there is always plenty of time to recognize mentors and discuss leadership styles.

During several of these meetings, I’ve had the opportunity to discuss the importance of intentional collaboration and how it works with individuals, groups of individuals and organizations. When thinking about collaboration, intentionality is important. Intentionality means acting with purpose, thoughtfulness, respect and openness.

When individuals and organizations are challenged, it is important to collaborate. Collaboration involves looking at the “why,” “how” and “what” factors of any situation. The “why” factor provides a historical picture of the challenge that is in front of us, including significant events that led to the problem. The “how” factor helps us identify and understand what it is that keeps a problematic situation alive. This factor can include individuals, events and circumstances that give life to a problematic situation. The “what” factor involves a search for solutions. That process can be time consuming and frustrating. However, by using intentional collaboration while examining the “what” factor, there are many opportunities for creativity and solutions to surface.

I observed emerging leaders using the approach of solution-focused thinking. When emerging leaders, ACA members, professional officers and staff at ACA, and elected leaders of ACA work together to find solutions, it is exciting. Emphasizing a solution-focused approach during intentional collaboration will move the counseling profession forward. By focusing on solutions, I am sure we will solve current issues such as:

  • Licensure specifics and portability of licensure
  • Recognition of all counselors to gainfully practice in areas in which they have demonstrated expertise and training
  • Counseling veterans
  • Opportunities with TRICARE and Medicare
  • Inclusion of new counseling interest groups within the ACA structure
  • Nationwide recognition of professional counselors as the major provider of mental health services
  • Resources for addressing social justice issues and demonstrating efficacy of treatment for a wide range of mental health problems
  • Worldwide recognition of ACA as the “center for research dissemination” of evidence-based mental health treatment approaches
  • Recognition of ACA and its divisions, branches and regions as examples of effective collaboration

I am optimistic about our future. So, many thanks to our emerging leaders — because you are our future.

All the best,

Robert L. Smith, Ph.D.

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


To whom shall I refer?

Cowritten by Jill L. Snodgrass, Devlyn McCreight and Michael R. McFee December 3, 2014

After three sessions with “Alicia,” a 45-year-old African American woman who was the victim of acquaintance rape, the treatment goals centered on addressing her symptoms of post-traumatic stress disorder (PTSD). The perpetrator of the rape had been a member of Alicia’s church. Although Alicia had subsequently stopped attending worship, the counselor viewed this strictly as a symptom Authors_Decof Alicia’s PTSD. The counselor didn’t consider that Alicia might also be experiencing serious struggles with her faith until Alicia fervently stated, “I will never forgive God. I was a woman of deep faith, always doing the ‘right’ thing. I led Bible study, served on the church council. But I hate God. I really, really do. God let me be raped. God was there.”

Attending to clients’ spiritual and religious concerns as they relate to mental health is a cultural competency. What if the spiritual and religious issues presented surpass the counselor’s competence or level of comfort, however? To whom shall you refer? According to the Competencies for Addressing Spiritual and Religious Issues in Counseling, espoused by the Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC) and supported by the American Counseling Association, an ethical counselor “can identify the limits of his or her understanding of the client’s spiritual and/or religious perspective and is acquainted with religious and spiritual resources, including leaders, who can be avenues for consultation and to whom the counselor can refer.” 


It can be difficult for a counselor to make an appropriate referral, however, if he or she does not possess a basic understanding of the types of spiritually integrated services available. This article presents overviews of Christian counseling, pastoral counseling and spiritual direction to help counselors make informed decisions regarding referral.

Christian counseling

Professional Christian counseling is performed by a diverse community of individuals, including licensed professional counselors, psychologists, social workers, clinical nurse specialists, marriage and family therapists, and psychiatrists. In most instances, the practice of Christian counseling reflects dual training. Individuals who practice Christian counseling obtain their graduate degree from an accredited graduate school and then go on to receive additional theological training. There are religiously affiliated graduate programs and seminaries in every state that offer training in counseling. 

The primary difference between secular and Christian counseling from the client’s experience may best be described as an issue of trust and ease in developing the therapeutic alliance. The first question many religiously oriented clients ask is “Can my therapist accept or understand my Christian spirituality?” This potential hurdle heightens their anxiety about starting counseling and prevents many Christians from seeking treatment altogether. For many of these clients, discovering a counselor who understands and shares their worldview makes developing the therapeutic alliance more fluid and facilitates therapeutic work.

The epistemological foundation (how knowledge is known) of Christian counseling includes spiritual and theological knowledge dating back to St. Augustine and even beyond to ancient Hebrew and Judaic views of knowledge. There is a rejection of the predominant secular worldview. For many Christians, secularism is understandable in the marketplace but becomes offensive and fails to explain concerns of family and spiritual life. Theoretically speaking, Christian counseling replaces a secular anthropology with a spiritual religious anthropology and, specifically, a biblical anthropology. At the same time, Christian counseling holds a deep respect for the contributions of social and natural sciences, while also recognizing the limits of the sciences in addressing psychological and especially spiritual struggles. In fact, there is a long historical tradition of Christian writers and thinkers addressing issues that today we view as psychological. The historical practice of counseling within the Western Christian church was most often referred to as “soul care.”

The rich history of soul care offers more than a thousand years of practices that predate the modern psychology movement inaugurated by Sigmund Freud. Stephen Greggo and Timothy Sisemore provide an excellent history of soul care in their edited book Counseling and Christianity: Five Approaches, published in 2012. They describe how The Confessions of St. Augustine (still a great read for many clients) and Summa Theologica by Thomas Aquinas reflect deep Christian thought while interacting with the secular thinking of Plato and Aristotle. In the 1600s, Richard Baxter and several other Puritan writers eloquently described the nature of melancholy and depression. Reading certain passages from sermons by Baxter or Thomas Brooks is similar to reading the clear descriptions of the vegetative signs of melancholic depression in the Diagnostic and Statistical Manual of Mental Disorders

For modern counselors, one of the most interesting aspects of this lost literature is that Christian writers clarified aspects of obsessive-compulsive disorder (OCD) in the 1600s. In 1660, Jeremy Taylor, an English bishop, used the word scruples in The Rule of Conscience and clearly illustrated the nature and course of obsessive-compulsive phenomena. Taylor’s writings helped illustrate the diagnosis as well as the treatment for what is now called OCD. Scrupulosity is an often-misunderstood form of OCD involving religious and moral obsessions developed in the effort to pursue faithfulness and integrity in one’s spiritual beliefs. A good overview of scrupulosity by the International OCD Foundation can be found at

Scrupulosity is said to be a hazard of any type of spirituality or religion and is viewed as an “equal opportunity offender” across all religious systems. The ideal treatment is a modified exposure and response prevention model that includes consultation with a spiritual leader. Christian counselors trained in the treatment of anxiety disorders may utilize these methods and augment treatment with historical pastoral practices that make the interventions both more accessible and tolerable to the client.

Well-trained Christian counselors not only work from a perspective of using evidence-based practices but also draw on lasting historical pastoral practices such as the use of prayer from the client’s faith tradition. This may take the form of homework or happen as an experiential exercise in the counseling session. Exploration and discussion of the client’s understanding of biblical texts may be part of a key intervention for some individuals. A Christian counselor may redirect a client to practices of thankfulness and away from judgmental and moralistic thinking. This redirection serves as a reminder that God’s greatest commandment was to love. The use of metaphors and allegories from Scripture can help clients find meaning and develop motivation and strength to face life circumstances.  

Recent and continued polling by the Gallup Foundation, the Pew Research Center and the Center for the Study of Religion at Princeton University indicates that the majority of Americans believe in God in some way. The number of religiously oriented clients is far greater than the number of secularly oriented therapists. For this reason, it is a good career move for counselors to increase their cultural competency by including some training in Christian counseling or to network and develop a referral source with a local Christian counselor. Some strategies include attending a continuing education training event offered at a regional Christian graduate school, attending a continuing education workshop provided by one of the various Christian professional organizations (for example, see, and and participating in an ASERVIC division event at the next ACA Conference. You can also use a listing database (such as or to obtain contact information and reach out to local Christian counselors. 

Finally, local networking with pastors and colleagues of religious convictions may be most profitable. Most local clergy develop and keep their own referral lists and are careful in the referral process. This means that if you do not have a direct relationship with them, they will not refer to you. The best way to develop these relationships is to involve the clergy of your practicing clients in the same way you might involve a primary care physician. Obtain a release from your client and reach out to local clergy. Work in a phone call and set up a face-to-face meeting. When you are effective with one of your clients, you will have the gratitude of your local clergy — and likely another resource.

Pastoral counseling

Like Christian counseling, pastoral counseling is also performed by a community of diverse individuals with graduate training in marriage and family therapy, counseling, social work, psychology and clinical pastoral counseling. These individuals most often embrace a bicultural identity, moving fluidly between the cultures of secular mental health practice and religious community. They are less prey-Smalllikely than Christian counselors to reject a secular anthropology and worldview and more likely to explore how God or the transcendent manifests in both secular and religious milieus.

Pastoral counselors are bound by the same state licensing laws that apply to any licensed mental health professional. At present, only six states license the title pastoral counselor. Therefore, depending on their training, pastoral counselors are more often licensed as clinical professional counselors, marriage and family therapists, professional counselors and psychologists. Many pastoral counselors also receive endorsement from their religious communities (for example, receiving the designation of “ordained pastoral counselor” from the American Baptist Church), but this is considered a validation of an individual’s calling to do clinical work, not a license to do so. Religious endorsement is a requirement for certification in the American Association of Pastoral Counselors (AAPC). This certifying organization convened for the first time in 1964 with the aim of holding pastoral counselors accountable to the ethical practice of religiously integrated mental health care. At the time, most pastoral counselors were clergy with psychological training but not licensed mental health professionals.

The foundation of pastoral counseling is synonymous with that of Christian counseling, with both being grounded in the same tradition of Judeo-Christian soul care outlined earlier. According to Charles Gerkin, the historical tradition of soul care was threefold: worship organized by priests, the continuity of tradition guided by prophets and practical guidance in everyday life provided by wise leaders. This threefold tradition was evidenced in the ministry of Jesus and served as the foundation for the helping acts of healing, sustaining, guiding and reconciling that remain central to pastoral care and counseling today.   

The history of pastoral counseling diverged from that of Christian counseling in the early 1960s around the time AAPC was formed. Bruce Narramore wrote an inaugural essay for the Journal of Psychology & Theology in which he advocated for the distinctiveness of Christian counseling as grounded in the authority of Scripture, rigorous academic study and commitment to Christ. Narramore viewed pastoral counselors as being overly influenced by the liberal church and not advancing a biblically sound perspective. Moreover, Christian counseling was populated largely by psychologists and psychiatrists, whereas pastoral counseling was dominated by clergy and religious leaders with psychological and mental health training. The distinction between the two disciplines became clearer in the 1990s when pastoral counselors largely embraced a postmodern, communal contextual model of counseling that privileged the integration of theology and spirituality and generally moved further from dependence on the authority of Scripture.

According to Carrie Doehring, associate professor of pastoral care and counseling at Iliff School of Theology in Denver, pastoral counselors are distinct from those who practice spiritually integrated counseling and psychotherapy because pastoral counselors are theologically educated and thus theologically accountable to the religious organizations that endorse them. Those trained as pastoral counselors in today’s postmodern milieu are taught to counsel clients from any and all religious traditions and to recognize covert religious experiences characterized by Christian theological, phenomenological or universal approaches.

Clients who present with problems they conceptualize through a religious or spiritual framework, or who hold their particular religious, spiritual and theological beliefs as primary and at the foreground of life, may benefit from counseling with a pastoral counselor. In addition, clients who have experienced spiritual or religious abuse, including victims of sexual misconduct by clergy or laypeople within a religious community, may find pastoral counseling especially helpful. Finally, referrals include all clients — from all religious traditions and practices, as well as atheists and agnostics — who wish to explicitly engage religious coping in their treatment. 

Several resources are available if you are interested in making a referral to a pastoral counselor in your area. AAPC provides the names of pastoral counselors throughout the United States who have received advanced-standing credentialing within the organization (see Many colleges and universities offer graduate programs in pastoral counseling, and the associated faculty and administrators would likely assist local clinicians in locating appropriate referral resources. For a list of pastoral counseling programs in your area, visit As previously noted in reference to Christian counseling, local religious leaders often refer congregants for mental health services and can therefore be excellent resources in identifying local pastoral counselors.

Spiritual direction

Pastoral counseling, Christian counseling and spiritual direction are all practices in soul care. However, whereas the first two are clinically focused approaches aimed primarily at reducing psychopathology and solving problems in the life of the client, the goal of spiritual direction is the enhancement of one’s spiritual life through attunement to God’s presence and action. Spiritual direction, sometimes referred to as spiritual guidance, spiritual friendship or holy listening, is grounded in an ancient ascetical practice. It is a process of discernment in which two or more individuals gather to understand God’s will. The focus is on the directee’s relationship with God and the cultivation of his or her spiritual gifts.

In its broadest definition, spiritual direction is not limited to Christianity. Adherents of various faiths participate in these sacred relationships: gurus and disciples, shamans and initiates, roshis and students, among others. Manifestations of spiritual direction are found in a variety of historical and contemporary traditions — just think of Socrates, the Sufis of Islam and the bodhisattvas of Buddhism. Although this article is limited to discussing spiritual direction in the Christian context, it should be noted that clients of various faith traditions may benefit from engaging in spiritual guidance.

Within a Christian framework, spiritual direction is founded on the belief that the Holy Spirit dwells within us. New Testament Scriptures, including passages found in Romans, 1 Corinthians and
2 Timothy, recount the promise Jesus made of the indwelling of the Holy Spirit. “Do you not know that you are a temple of God and that the Spirit of God dwells in you?” (1 Corinthians 3:16). 

Just as Jesus guided the disciples, by the early fourth century Egyptian monastics had created elder-neophyte relationships in which the elders, who had already struggled to align their hearts with God’s will and ways by grappling with the hardships of desert living, offered nurturance, support and correction to others. Over time, an oral tradition emerged that produced the wisdom and sayings of the desert fathers and (although largely omitted from the history) desert mothers as well.

In the sixth century, Benedict and his Rule furthered the practice of spiritual direction by enhancing communal life and the formation of new members. The head of the monastery was viewed as a “spiritual father” who guided the novices, together with the practices expounded in the Rule, to greater intimacy with God. Spiritual direction was an evolving form of soul care. According to Martin Thornton, in the Scholastic period (beginning in the 11th century), spirituality was more “formally studied and analyzed — direction became more of a science than an art.”

The tumult of the Reformation informed three voices that transformed the practice of spiritual direction: John of the Cross, Teresa of Avila and St. Ignatius of Loyola. Their writings combine astute psychological wisdom with a nonpaternalistic approach to direction. The director was considered a witness of God, not in a position to judge directees’ decisions or behaviors, but with the goal of mediating divine action. The post-Reformation period produced many sage spiritual directors, among them laywomen and laymen who wrote prolifically on how to practice the pastoral skill of direction.

Spiritual direction experienced a renaissance in 1970s’ and 1980s’ America due in large part to the influences of the Second Vatican Council and the women’s movement. In the spring of 1973, a small group of spiritual seekers from a variety of denominations came together at the request of Episcopal priest Tilden Edwards for a retreat. That group evolved into a community of “pilgrims,” calling itself Shalem, the Hebrew word for wholeness. The group formed a spirituality center at Washington National Cathedral and began offering classes in contemplative prayer and spiritual direction. The Mercy Center in Burlingame, California, emerged in the late 1980s from a similar collective interest and commitment. And by 1991, Spiritual Directors International had been born as a nonprofit organization for networking and support of spiritual directors in the United States and abroad.

Today, spiritual directors and spiritual direction centers are prevalent throughout the nation and the world. Although the Holy Spirit is the true “director,” numerous men and women, lay and ordained, are trained in the art of spiritual direction. More than 300 training centers are located throughout the country, and many more directors are educated through informal apprentice-style preparation. While many priests, pastors and vowed religious individuals offer spiritual direction, it is a charism or gift, not a skill endowed simply by ordination. Unlike counseling, spiritual direction is not governed by an accrediting body; therefore, although many training programs offer certification, there are no formal qualifications or education requisite for practice. 

In Seeking Spiritual Direction, Fr. Thomas Dubay advises seeking a director with the following qualities:

1) A person of true prayer — liturgical and personal

2) Adequate theological education

3) Sound judgment and experience of life

4) Sufficient understanding of psychology, with the ability to recognize human woundedness and when to make referrals

5) One with whom you feel at ease

Directors should be engaged in their own spiritual direction, participating in regular peer supervision and group study, and seeking their own path to sainthood. Many individuals prefer to seek direction with someone of their own denomination or faith tradition. But as Janet Ruffing contends in The New Westminster Dictionary of Christian Spirituality, “The director does not impose his or her theology, opinions or spiritual path upon the one seeking direction, but rather tries to discover and support the ‘spiritual direction’ the Holy Spirit is already initiating in the directee’s life.”

Spiritual direction is offered individually as well as in small groups, and isolated or ongoing retreats are also common. Regardless of the mode, and unlike counseling, it is not common practice to engage in weekly spiritual direction. Rather, meeting for an hour once a month allows the directee time to engage in his or her own spiritual practice and to reflect upon the Spirit’s movement in everyday life.

The atmosphere fostered in spiritual direction is prayerful and reverent. The director and directee participate in a conversational process to collaboratively discern the work of the Spirit in the directee’s life. This discernment is grounded in a hermeneutic of Scripture and doctrine of the Christian tradition but does not ignore psychological processes. Directors ask facilitating questions, such as “What does it seem God is inviting you to in this situation or in your life? What does it seem God is asking of you?” Directors also draw upon prayer and the movement of the Spirit to guide the process and conversation. 

Spiritual direction can be a transformative practice at all stages of faith formation. Although spiritual directors often possess more theological or spiritual training, their goal is not to impose belief or dictate practice. Rather, they serve as co-witnesses to God’s work in the world, friends and co-journeyers in life. As in many forms of counseling and psychotherapy, the directees are responsible for their own growth, and the motivation for such resides in them rather than in the director. Many spiritual directors request a fee, while some accept a freewill donation. Still others offer their time with no expectation of anything in return.

Although the overall aim of both spiritual direction and counseling is to facilitate greater holistic well-being, their goals are distinct. Therefore, it is not uncommon for individuals to engage concurrently in counseling or psychotherapy and spiritual direction. Counselors may then engage in transferal rather than referral and continue to work with the client toward his or her psychosocial goals. As Ruffing contends in The New Westminster Dictionary of Christian Spirituality, transferal enables “both spiritual directors and therapists … to recognize their specific competencies and work carefully within their own disciplines.” In situations of transferal, the counselor can assist in finding a spiritual director to join the client in his or her faith journey.

Finding a spiritual director is not unlike finding a counselor in that it is a matter of “fit.” Trained and qualified spiritual directors can be located through retreat or direction centers, parish staff and religious communities. A wealth of resources are available online, including the “Seek and Find” function on the Spiritual Directors International website ( Through this site, you can search for a director based on geographic location and filter results according to religious/spiritual affiliation, institution and more. It is important to note, however, that membership in Spiritual Directors International is open to everyone. Furthermore, because practice is not restricted through licensure, locating an appropriately trained and credentialed director requires its own level of discernment and trust in the Holy Spirit.   


In recognizing that a client’s spiritual or religious beliefs are beyond one’s understanding or expertise, counselors need to perform their due diligence, carefully screening and selecting the appropriate professionals to whom they should refer. Being aware of the broader resources in your area not only helps the individuals, couples and families who come to you seeking help, but also increases interdisciplinary dialogue that can strengthen our communities in ways that would not otherwise be possible.


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

Jill L. Snodgrass is an assistant professor in the Department of Pastoral Counseling at Loyola University Maryland. She is a pastoral counselor and ordained minister in the United Church of Christ. Contact her at

Devlyn McCreight is a licensed clinical professional counselor who is currently pursuing his doctorate in pastoral counseling at Loyola University Maryland.

Michael R. McFee is an associate professor in the Counseling Psychology Department at Eastern University.

Letters to the editor:


The lingering crisis of the Great Recession

By Laurie Meyers December 1, 2014

Anyone who has ever lost a job knows that it takes time to find another one, particularly in times of high unemployment. Since the start of the Great Recession in December 2007, millions of Americans have experienced long periods of unemployment. These extended stretches of joblessness are not only financially devastating but also detrimental to the job search itself because in the current job market, the longer a person is unemployed, the less likely he or she is to find a new job. Once job seekers have been unemployed for six months or more, they become part of the population of “long-term unemployed,” and thus much less desirable to employers.

Even as the general unemployment rate has dropped during the past few years, prospects for the Recession-Smalllong-term unemployed have remained slim, causing this population to suffer significant financial, emotional, mental and physical distress. Counselors — particularly career counselors — are working to help the long-term unemployed find jobs and heal the scars of joblessness.

“Policymakers have not fully recognized or adequately addressed the crisis of the Great Recession,” says Dave Gallison, a licensed professional counselor from Portland, Oregon, who specializes in career counseling. He notes that long-term unemployment rates are still higher today than at any point since the Great Depression. “Everyone sees the unemployment rate and assumes that things are improving,” he says, “but the numbers that are not seen and barely counted are the millions of long-term unemployed, people who can only find part-time work and discouraged workers who are not currently looking for work because they believe no jobs are available for them.”

Part of the problem is that there still aren’t enough full-time jobs for everyone who wants one, according to a September study out of Rutgers University, “Left Behind: The Long-term Unemployed Struggle in an Improving Economy.” The study reports that as of August, there were nearly 9.6 million unemployed workers in the United States, including 3 million people who had been unemployed for longer than six months and more than 2 million who had been unemployed for over a year. In addition, the population of involuntary part-time workers (those who want to work full time but can find only part-time positions) grew from 4.4 million people in 2007 to 7.5 million people in June 2014. The study also notes that although the majority of jobs lost during the recession were mid- to high-paying positions, most of the jobs added during the subsequent recovery have been low-wage positions.

In addition to competing in a market with an insufficient number of jobs, those who have been looking for work for more than six months face another significant barrier to employment. A study conducted by Princeton University professor Alan Krueger and using data from the U.S. Census Bureau found that from 2008 to 2013, only 11 percent of people who had experienced long spells of unemployment had found steady full-time work within 16 months’ time.

In a 2012 study published by the Federal Reserve Bank of Boston, two researchers sent out almost 5,000 fictitious, computer-generated résumés with identical credentials but varying lengths of unemployment in response to job offerings. They found that the “workers” with six or more months of unemployment almost never received a response to their applications, even when they possessed the required experience.

Unemployed, unhealthy and unhappy

As unemployment drags on, many job seekers also increasingly experience physical and psychological difficulties that may make it even harder to find a job. A Gallup survey conducted in 2013 found that 1 in 5 people who had been unemployed for more than a year reported currently having or being treated for depression — a rate double that of the general population.

Numerous studies, not just in the United States but in England, Wales, Sweden, Denmark and Finland, among others, have found that those who are unemployed experience higher mortality rates. The specific mechanisms of the mortality risk have not been identified, but results taken from the 2013 Gallup-Healthways Well-Being Index indicate that obesity levels rise with the length of unemployment. In addition, the long-term unemployed are twice as likely to report having high blood pressure or high cholesterol as those who have been unemployed for a shorter length of time.

Experts note that the mental and physical health problems experienced by individuals who are unemployed don’t just make it more challenging to find work but may also make it harder for them to hold onto a job once they secure new employment. Krueger’s research suggests that many people who have gone through long periods of unemployment return to the ranks of the unemployed within one year of finding a new job. Clearly, job loss is a multifaceted problem, requiring career counselors to assist not only in the job search but also with the fallout of becoming unemployed in the first place.

“For counselors, few client life events rival the emotional strain of job loss,” says Gallison, a member of the National Career Development Association (NCDA), a division of the American Counseling Association. He explains that for many people, what they do is synonymous with who they are. So, when they lose their jobs, they question not only their judgment but also their priorities and ideals.

A 2010 Pew Research Center survey found that long-term unemployment had profound effects on a person’s social life, career and confidence level. Approximately 38 percent of those who had experienced long-term unemployment said their degree of self-respect had decreased (compared with 29 percent of those who were unemployed over the short term). Strikingly, roughly 7 in 10 people who were currently unemployed or had been unemployed said they had changed careers or thought seriously about doing so.

Gallison says people faced with job loss and long-term unemployment often deal with a level of grief akin to what someone might experience when going through a divorce. “I help people work through the stages of grief,” he says, explaining that this process aids people in accepting the reality of the loss and working through their pain.

In addition to navigating that sense of loss, clients need help cognitively reframing the self-blame that often accompanies joblessness, says Rich Feller, an ACA member and former president of NCDA. “Self-blame … deflates energy and strips dignity,” he says. “Clients need support knowing what is and is not under their control. Without that, they misdirect psychological energy, blaming and defeating themselves rather than performing job search and networking efforts.”

Counselors can start to counteract clients’ self-doubt and self-blame by helping them recognize that long-term unemployment is a widespread problem caused by a damaged economy, not because they are “damaged” themselves, explains Feller, a professor of counseling and career development at Colorado State University.

But even if clients have worked through the grief and self-blame associated with job loss, they may need help addressing other disruptive elements.

“They have to adjust to an environment in which [much of] their former social fabric is gone,” says Gallison, offering an example. Most people in full-time jobs in the United States spend more than 40 hours per week at work. In the process, they typically form important friendships in the workplace and engage in activities that become an important part of their social life. Once a job is gone, it can leave behind a big hole in the client’s social fabric. During times of unemployment, staying in touch with friends and family is especially important to retain a sense of connectedness and stave off loneliness, Gallison says.

He also suggests that clients who are unemployed get involved with a group that appeals to them, whether that group is religious, community-based, sports-oriented or interest-based. Becoming part of a group can reduce the sense of isolation that those who are unemployed often feel, while also providing missing structure. Both Gallison and Feller point out that without someplace to be every day, it can be challenging for people to organize their efforts.

Strategies for hope

Lack of support and structure can also contribute to a feeling of being stuck. Clients need to know that “where” they are — a period of long-term unemployment — isn’t a permanent place but rather part of a process, some of which they can work to control, notes Feller.

Gallison agrees. “Unemployed clients must commit to a process — perhaps six to 12 sessions over several months — of self-understanding, internal change and change of work search habits and behaviors,” he says. His process involves helping clients determine their career needs and goals, showing them how to effectively pursue positions in their areas of expertise and teaching them strategies for interviewing.

Gallison is mindful of the need to move quickly. After all, for the long-term unemployed, time really is money. He begins with a general assessment to gauge the client’s job search efforts — how has the client been searching for work, how successful have these efforts been and how could the search be more effective? Gallison is also a big proponent of bibliotherapy to help job seekers clarify what they are looking for in a job search. He regularly recommends that clients read such books as What Color Is Your Parachute?, I Didn’t See It Coming, Transitions and Do What You Are.

Gallison also likes to do a values and motivation assessment because rather than learning simply what the client is good at, he gains insights into what motivates the client. Understanding individual motivation can help Gallison and the client determine the type of workplaces (nonprofit, corporate, large company, small company and so on) best suited to the client.

Developing a focused list of companies and potential positions to target is one of the first steps Gallison encourages clients to take in the active phase of job searching. He first has clients draw up lists of business sectors that interest them, such as health care or finance. Next, Gallison instructs clients to search a list of businesses in their city, town or state (typically available online or at a local library) and select companies for which they might like to work and potential job titles for which they might be qualified.

With their lists in hand, Gallison prompts clients to reach out to friends, family members, former co-workers and other acquaintances to find potential contacts in the clients’ areas of interest. He also teaches clients to mine their alumni associations for job leads and links to industry leaders. In addition, Gallison likes to send his clients to job search groups because he believes participants — particularly in subgroups such as people holding doctorates or moms returning to work — can learn from one another. Gallison also searches his own professional network for possible leads for clients. He believes teaching clients to develop contacts and set up informational interviews is the best way to help them access what he calls the “hidden job market.”

The workplace social media site LinkedIn is also crucial for networking and finding leads, Gallison says. However, most people don’t pay enough attention to their LinkedIn profiles, he says. “A good LinkedIn profile shares things with a good résumé, but people tend to dump their whole history of past jobs [on their profile],” he says. Instead, he teaches clients to focus on setting up a summary that’s short and convincing — much like the proverbial elevator pitch — accompanied by a few bullet points from recent jobs.

Learning how to set up a good LinkedIn profile is only one part of the self-marketing that Gallison teaches clients. “They need to stand out with really great cover letters and résumés that target the specific employer and position they are applying for,” he says.

And when that résumé draws the attention of prospective employers, Gallison makes sure that his clients are ready with mock interviews. “We talk about what their strengths and weakness are, [which] could be anything from taking too long to answer a question to not making eye contact to not knowing how to dress,” he says.

He also teaches clients how to research the company, understand who the company’s competitors are and be familiar with the company’s mission so they will be prepared to answer questions and ask questions of their own that demonstrate their knowledge of the field.

Unfortunately, some long-term job seekers have an even more difficult time than others, Gallison says. He sees a disproportionate number of men over age 50 in his practice and says that older workers, as well as recent high school and college graduates, are most likely to be among the long-term unemployed.

A common problem with recent graduates and older workers is their lack of relevant experience. Because of the economic downturn, older workers may also have gaps in their résumés. To compensate, Gallison gives his clients strategies to camouflage these gaps or their relative lack of experience. “I coach them to use their résumés selectively and, if at all possible, not use the résumés until further along in the process,” he says. When trying to secure informational interviews, clients can draw up a statement summarizing experience rather than providing a full résumé, Gallison explains. In addition, long gaps in employment can be minimized by listing only years — rather than the month and year — with their employment history.

Volunteering is another effective way for anyone who has been unemployed long term to compensate for employment gaps, Gallison says. But beyond that, volunteering is an effective avenue for acquiring relevant experience, making contacts and just getting out of the house and meeting people, he says.

“Helping others [by volunteering] can help job seekers feel more connected [to the world],” adds Feller.

Recent graduates should look to their alma mater for help during a job search, says Rebecca Michel, a licensed clinical professional counselor and assistant professor of counseling at Governors State University in Chicago. “Establish a strong connection with your university career center,” she advises. “Also look to former faculty for possible mentors.”

At the same time, individuals who are unemployed shouldn’t rely on their colleges or universities as the only avenue for making contacts and finding opportunity, says Michel, an ACA member who studies employment across the life span. She advises those who have been unemployed long term to join professional organizations in their areas of employment interest. In some instances, they may be able to volunteer or even seek leadership positions within the organization, she says.

Individuals who are unemployed should also consider looking to local colleges for certificates or courses that can help them regain job skills or acquire new ones, Gallison says.

The road less taken (for now)

Sometimes, the traditional full-time job might not be the best or even an attainable option, says Ron Elsdon, author of the book How to Build a Nontraditional Career Path: Embracing Economic Disruption.

Elsdon, an ACA member, believes the future of employment for many workers will involve putting together different consulting or part-time jobs based on professional skills and personal interests. For instance, someone who works in finance could become a freelance financial writer or teach finance at a local community college or as a tutor, he explains. That person could add to this freelance or part-time work with a completely different job based on personal interests, such as woodworking or massage therapy.

The change in how workers view employment has already started, according to Elsdon, who is a private practice career consultant and coach in Danville, California. “About 40 percent of the workforce has [already] been engaged in some form of nontraditional work,” he says.

Elsdon works with clients to identify their interests and skills and how these might come together for employment opportunities. He claims that people who pursue this kind of part-time, nontraditional path report much higher levels of satisfaction than do people in full-time traditional jobs. [After this article went to print, Elsdon provided links to data he references in his book: here, here and here.]

Gallison thinks it is beneficial for people to reconsider how and why they work, in part because they are more likely to realize that work doesn’t define them, while also being less willing to let their jobs consume them. However, he still thinks the lack of job openings for those who need them is unacceptable.

“Now that unemployment has slipped below 6 [percent] — 5.9 [percent] for September 2014 — for the first time since mid-2008, this issue is in even further danger of seeming passé or irrelevant in the public consciousness and [to] policymakers, and perhaps even [to] mental health professionals,” he says.

The counseling profession should refuse to let the long-term unemployed get left behind, Gallison declares. “We need to and can advocate successfully for change [in employment practices], just like we achieved mental health parity,” he emphasizes.

Gallison urges counselors to contact their legislators to lobby for help for the long-term unemployed. If counselors and other helping professionals don’t stand up to encourage assistance for the long-term unemployed, Gallison is afraid no one else will.

“It’s out of sight, out of mind,” he says. “This should be treated as a national emergency. There should be a sense of outrage.”


Helping workers with disabilities overcome career barriers

People with disabilities often have the least promising prospects among all job seekers. Discrimination certainly plays a role in that circumstance, but it can also be because disabilities may have prevented individuals from developing the social and professional skills needed for long-term work success, says Deirdre O’Sullivan, an American Counseling Association member and assistant professor of counseling education at Pennsylvania State University in State College.

Sullivan has a background in and still teaches courses in rehabilitation counseling. She is currently researching whether counselors could use the Developmental Work Personality Scale (DWPS) as a tool to help gauge the professional strengths and weaknesses of people with disabilities. The DWPS consists of 27 items that assess behaviors, role models and tasks that individuals encounter during middle childhood.

The scale, designed for adults (either with or without a disability), asks participants to self-assess school behaviors that researchers believe correspond to developing a healthy work personality. Using a scale that goes from 0 (not at all like me) to 5 (very much like me), participants agree or disagree with statements such as “In school I completed my work on time” and “I felt good when I completed my homework.” The DWPS has three subscales or areas of concentration: work tasks, social skills and role models.

Most people develop their abilities to perform tasks in the DWPS’s three areas of concentration, or domains, in school because that is where children learn to interact with peers, listen to authority and meet deadlines, O’Sullivan says. “Most people who are underemployed or chronically unemployed are missing one of these domains,” she explains.

O’Sullivan thinks counselors might be able to use the DWPS and the concepts behind it to go beyond the typical reasons that people may be unemployed. A person’s school and homework habits and whether that person now gets along with bosses and meets deadlines at work may be sensitive areas, but what a counselor discovers can ultimately help the client, she asserts.

“Help people identify if they have any areas they need to improve in order to be the best worker they can be,” O’Sullivan urges. “[Help them ask] ‘How do I improve my ability to resolve conflict? How can I connect with mentors?’”

Thoughtfully considering the answers to these questions could benefit any job seeker, but they are particularly important for people with disabilities, who may be more likely to face problems and, in many cases, discrimination at work, O’Sullivan says.

If a client has experienced disability-related work problems in a former job, a counselor can help the client discover what accommodations he or she needs and how those accommodations can be addressed under provisions in the Americans with Disabilities Act, O’Sullivan says.

“[People with disabilities wonder], ‘How do I get my accommodations filled and still seem like I’m really working full time?’” O’Sullivan says, adding that counselors can help with that process.

In today’s market, the unemployed need all the help they can get. And as O’Sullivan points out, “People with different types of disabilities — visible or not — experience a lot of barriers [at work].”


Additional resources

The American Counseling Association has two divisions that specialize in employment and career development: the National Career Development Association and the National Employment Counseling Association. To learn more about these divisions and their professional journals, visit on the ACA website.


Earlier this year, ACA published the fourth edition of Career Counseling: Holism, Diversity and Strengths by Norman C. Gysbers, Mary J. Heppner and Joseph A. Johnston. The career counseling process outlined in this best-seller is both practitioner-friendly and effective with clients of all ages and circumstances. For more information, visit ACA’s online bookstore at

Also, see Counseling Today’s “behind the book” Q+A with coauthor Norman C. Gysbers:


To contact the individuals interviewed for this article, email:



Laurie Meyers is the senior writer for Counseling Today. Contact her at

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