Monthly Archives: August 2015

Creativity: A central component of counseling

By Thelma Duffey August 25, 2015

Resourcefulness. Innovation. Activity. Action. These are just some of the words that come to mind when I think about creativity and how to apply it to my life as a counselor. What do you think of when you hear the word creativity, and in what ways could you see the presence (or lack) of creativity

Thelma Duffey, ACA's 64th president

Thelma Duffey, ACA’s 64th president

having an impact on your life? Do you feel energized, hopeful and invested in life, in your profession and in the people around you? Moreover, do you feel the life energy that propels you to create, connect and make a difference? I hope so!

How wonderful it is — in all stages of life — to feel the kind of energy that inspires gratitude, a sense of accomplishment and kinship. It is the kind of connection that helps us know that what we do matters and that the people around us are better for the experience. This is truly one of the most wonderful benefits of being a counselor. We have opportunities to make an impact, and our shared creativity helps us to do just that.

I was delighted to learn that this month’s Counseling Today cover story would highlight the role of creativity in counseling. Like many of you, I know the value that creativity provides us as counselors. And when I think about some of the challenges within our profession and our society — as well as the opportunities before us — I feel confident that our collective creativity will help us reach our goals.

In July, nearly 140 counseling leaders met on Capitol Hill to advocate on behalf of our profession as part of the American Counseling Association’s annual Institute for Leadership Training. I was inspired by the great energy, deep commitment and much appreciated camaraderie that we shared as we worked together. Furthermore, I was excited to see the various ways that our collective creativity stimulated new ideas and motivated new collaborations for moving forward.

As we closed out the week, I shared two initiatives that inspire my own creativity and passion. One initiative relates to professional advocacy, and the second involves a social action project that addresses an anti-bullying/interpersonal violence campaign. Both initiatives create opportunities for counselors to come together and collectively make a real difference.

We can make a significant contribution to our communities and to the profession of counseling at this critical point in its development. By working together productively and cohesively, we can:

  • Educate the public, legislators and other mental health professionals about who counselors are and what we do
  • Serve our communities and widely address interpersonal violence and bullying issues

I believe creativity is central to the work of counseling. We help clients create new possibilities, reconsider unproductive messages and capitalize on our shared resourcefulness every day. We use our creativity when we conduct research and explore interventions grounded in the principles of professional counseling. Our creativity helps us discover innovative ways of providing counseling in all the settings in which we work. Innovation is at the heart of change, and because we are in the business of transformational change, we can make the world a better place by inspiring and supporting constructive change within our communities.

We can use this same creative spirit and sense of community to strengthen the counseling profession by advocating for ourselves, appreciating our good work and sharing our tremendous value with the public. This is wonderful work! It is ours to do. This is the work I invite you to invest in this year.

 

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Going beyond ‘no means no’

By Laurie Meyers

Survivors and activists have sought for decades to shine a light on the issue of sexual assault on college campuses with everything from Take Back the Night events to No Means No education campaigns. A Columbia University student who graduated in May made national headlines when she spent her senior year carrying a mattress with her everywhere she went on campus to represent the dorm room bed where she alleges she was raped as a sophomore. The alleged perpetrator was NOallowed to remain on campus.

And yet the debate about how best to address sexual violence on campus rages on. For that matter, researchers can’t even seem to agree on how often sexual assault occurs on campus. On the one hand, the 2006 federally funded Campus Sexual Assault Study of more than 5,000 women and 1,000 men at two large (unnamed) universities found that 1 in 5 female college students had been sexually assaulted. However, a 2014 Department of Justice report based on the answers of 160,000 respondents in the National Crime Victimization Survey found that an estimated 0.6 percent of female college students had been sexually assaulted.

Experts have pointed out significant shortcomings in both surveys, but some recent data, gathered in the first quarter of the year and released in June, aligns with the 2006 study. These findings come from a joint Washington Post-Kaiser Family Foundation poll of more than 1,000 randomly selected recent college graduates. The poll defined sexual assault as five types of unwanted contact: forced touching of a sexual nature, oral sex, vaginal sexual intercourse, anal sex and sexual penetration with a finger or object. One in 5 of the female respondents reported having been sexually assaulted in college. Five percent of the poll’s male respondents also reported being sexually assaulted while in college.

Regardless of the numbers, few would argue that any sexual assault is one too many. Counselors who are on the front lines of prevention efforts on college campuses say that decreasing the number of sexual assaults can’t be accomplished simply by raising awareness but must also be accompanied by widespread behavioral and cultural change. That is a complex and daunting task, but the counselors we spoke to — who are engaged in research or are working with campus programs — believe that current campaigns to reduce sexual violence through education sessions, campuswide activities and, in some cases, even the theater, can bring about lasting change.

A holistic approach to prevention

For decades, prevention efforts failed to address all of the factors that contribute to sexual assault, instead placing the onus on individual women and what they should do to prevent being assaulted, says Laura Hensley Choate, an American Counseling Association member who researches and writes about women’s and girls’ issues. Until relatively recently, she adds, little thought was given to also addressing perpetrators or potential perpetrators in prevention efforts.

As researchers began focusing on college men’s attitudes and behaviors, it quickly became apparent that most of these men didn’t have a clear understanding of consent. In fact, many still believed that, in certain cases, women “were asking for it,” Choate says. Another significant finding also emerged. Although prevention efforts consisting of short-term education programs sometimes temporarily changed men’s attitudes, they did not change behavior. Any lasting change would need to involve long-term education.

ACA member Brittany Talley, coordinator of the Campus Violence Prevention Program (CVPP) at Southeast Missouri State University in Cape Girardeau, Missouri, agrees with that assessment. She has found that although many students — women included — have learned that “no means no,” they don’t really understand that a woman’s decision to consent to sex is completely independent of what she is wearing or whether she has slept with the person in the past.

In the presentations that Talley gives, she also emphasizes that a literal “no” isn’t the only way of communicating that a person doesn’t want to have sex. “We talk about what ‘no’ might [sometimes] sound like — ‘I don’t really feel like it’ or ‘I don’t really want to,’” she says.

Not surprisingly, alcohol is another huge component in many campus sexual assaults. “There is huge misunderstanding about alcohol use and consent. Some students don’t realize that if you are too drunk to drive, you are too drunk to consent [to sex],” says Talley, a provisionally licensed professional counselor.

Talley addresses these myths and misunderstandings in a talk that all freshmen and transfer students are required to attend when they arrive on campus. The 35-minute education session focuses on dating and sexual violence, including how prevalent it is, what constitutes violence, how to get help and how outsiders can help. Talley also hands out cards with a help number and information on what to do after a sexual assault.

In addition to giving presentations and workshops to classes and student groups, Talley has coordinated a number of highly visible awareness events on campus. Part of the goal in these campaigns is to help engage bystanders because she believes that they play a crucial role in preventing sexual assault and violence. For instance, she says, if students at a party or bar notice that someone is being plied with drink after drink, they should step in or get help.

This past fall, the CVPP participated in RAINN (Rape, Abuse and Incest National Network) Day, an annual event devoted to sexual assault education. Most vividly, umbrellas are designed and displayed by participants to draw attention to the issue of sexual assault. The umbrellas can be decorated in any manner the participants wish but must include at least one mention of RAINN somewhere in the design. In addition to making its own umbrella, the CVPP invited various student organizations to submit umbrellas. This was done not only to raise awareness but also in hopes of getting more student organization members involved in prevention efforts, Talley says. On RAINN Day, 20 student organizations displayed umbrellas. Some organizations used serious themes, while others designed their umbrellas as emblems of support. For instance, the group made up of criminal justice students designed an inside-out umbrella because sexual assault turns a person’s life inside out, Talley notes.

The CVPP has coordinated other efforts as well, including the clothesline project, in which T-shirts bearing the stories of survivors of sexual assault were hung up on a clothesline on campus, and “Sexy Time Talk,” in which students lead discussions that focus on the characteristics of healthy and unhealthy relationships.

Only time will tell whether activities such as these will have a significant effect on the sexual assault rate on campus, Talley says. In the meantime, students and staff are reaching out to assist survivors who want help but haven’t been able to take that step, she says.

“One of the most common ways I hear of a case is through other students or a staff member,” she says. “They may ask me to reach out to a particular student, or professors might walk students over or have me come to their offices.” CVPP is part of the university’s counseling and disability services, and in addition to her prevention efforts, Talley counsels survivors of sexual assault.

ACA member Jennifer Sharp oversaw a sexual violence peer education program known as PHREE (Peers Helping Reaffirm, Educate and Empower) at Penn State from 2009 to 2012. “PHREE members worked with the [university’s] Center for Women Students to develop a variety of events designed to support survivors of sexual and relationship violence, provide accurate information about violence and raise awareness,” says Sharp, a national certified counselor (NCC).

PHREE coordinates educational presentations at residence halls and sororities on topics such as dating violence, healthy relationships, sexual assault and consent. It also uses creative, often performance-based events to raise awareness. During Sharp’s time, PHREE members engaged in the university’s participatory theater project, Cultural Conversations, which focuses on social justice issues. PHREE’s performance was on body language. Various participants acted out representative scenarios, and then audience members and performers engaged in a discussion of the issues.

During Sharp’s tenure, PHREE also planned and assisted with activities for sexual assault awareness months that included “survivor speakouts” and poetry/spoken word events that emphasized themes of sexual assault and survival.

Sharp is now an assistant professor of counseling at Northern Kentucky University, where she helped secure a grant to fund the Norse Violence Prevention Project. “The grant essentially provides funding to coordinate and strengthen existing resources for survivors of sexual assault, relationship violence and stalking,” she says.

Sharp is also implementing the Norse Violence Prevention Peer Educator program, which is based in part on the knowledge she gained while working with PHREE. Peer educators are currently being trained to advocate and offer support for survivors of trauma.

Providing services, support and a sense of safety to survivors

Even if the number of sexual assaults on college campuses is reduced significantly, there will always be survivors. Some of those who have experienced sexual violence will seek counseling to help them process and move beyond these devastating events.

Survivors who seek help immediately or shortly after the assault and those who seek help later face many of the same issues, but there are differences in their presenting issues and primary needs, says Sue Swift, a licensed professional counselor (LPC) at the Collins Center, a community center in Harrisonburg, Virginia, that provides mental health, crisis, medical, support and legal services to survivors of sexual assault and violence. The center also uses advocacy and education in its efforts to help end sexual violence in the community.

“When we work with survivors immediately after an assault, we have the primary goal of stabilization and re-establishing at least a basic sense of safety,” Swift says. Establishing safety is especially important in cases of campus sexual assault because the survivor may attend classes, socialize or even live with the person who committed the assault, note counselors who work at on-campus facilities.

When a survivor comes into the Maxine Platzer Lynn Women’s Center at the University of Virginia right after an assault, counselors first determine whether the student’s living situation and general physical environment are safe, says ACA member Charlotte Chapman, an LPC who serves as the director of counseling services at the center. It is also important to start establishing a sense of emotional safety by ensuring that the survivor has a support group or safety net in place.

“A lot of people will say, ‘I don’t want my parents to know,’” Chapman says. “We’d prefer that they use family as a source of support, but that’s not always what they want. … We talk to them about tapping into [support] resources on and off campus.”

Sometimes their best friends aren’t on campus with them, especially if the survivor is a first-year student and hasn’t yet formed strong social bonds, Chapman notes. In such cases, counselors at the women’s center will talk to the student about how to access her or his network of friends through methods such as Skype.

Survivors of sexual assault need help to feel safe because of the range of frightening emotions they are experiencing, Swift points out. “Often, survivors at this stage [immediately or shortly after an assault] are feeling overwhelmed, vulnerable and fearful,” she says. “Counseling can help [survivors] sort through and reduce anxieties [and] develop plans for getting support and taking tiny steps forward.”

“With these acute clients, we might spend a good amount of time normalizing their reactions and feelings but also helping them with grounding techniques and coping skills to deal with the anxiety and stress they are probably feeling,” Swift continues.

Counselors at the Collins Center may also help survivors of sexual assault access resources such as law enforcement, medical assistance and campus services (when appropriate) if they haven’t already done so, she says.

On the other hand, Swift says, survivors who come in for counseling years after an assault are in various stages of distress or healing. Some survivors may seek counseling after a triggering event, while others arrive ready to talk after years of burying their feelings, she says. Regardless of the circumstances that bring them in, these survivors have all had time to tell themselves a “story” about their assault — a story that may include distortions and inaccuracies, Swift says.

“Survivors often blame themselves in some way for what happened or feel badly about themselves,” she explains. “They may feel the assault defines them. Their self-esteem and relationships may suffer.”

It is important for counselors to understand that survivors often have a deep sense of shame. They feel as if the assault was their fault or that they could have prevented it, even when they know intellectually that this isn’t true, say Swift and her colleagues at the Collins Center.

Counselors can be effective at helping survivors of sexual assault work through these feelings, Swift says. She and her colleagues at the Collins Center have found that a supportive approach that allows survivors to set the pace works best. Typically, Swift and her fellow counselors begin by helping these clients to develop coping skills and providing them with psychoeducation about trauma. Most survivors will need help correcting cognitive distortions about themselves and their assault, such as blaming themselves, Swift says. These clients may also benefit from grief work to help them mourn the losses they’ve experienced as a result of the assault, she continues.

“Support groups can also be very healing,” Swift asserts. “Being together in a group, even informally, with others who understand your pain is transformative for many.”

If a client cannot find a support group that offers a good fit, bibliotherapy involving the stories of other survivors can be an extremely helpful alternative, she says. “Many survivors think they are ‘crazy’ until they hear their thoughts and feelings expressed by another survivor,” she adds.

Caution! On campus, confidentiality may not apply

This past January, a University of Oregon student who alleged that several members of the basketball team had raped her sued the university for mishandling her case. Although the players were eventually dismissed from the team and suspended from the school, the survivor alleged that the university had delayed its investigation to ensure the players could remain on the team for the remainder of the season.

As part of a counterclaim — which has since been dropped — the university requested that the campus counseling center release the student’s treatment records.

The incident served as a glaring reminder that counselors who work in campus mental health centers need to ensure that their clients understand that, in certain cases, their records and confidentiality may not be protected. The state of Oregon claimed that it had a right to the student’s records under the federal Family Educational Rights and Privacy Act (FERPA), which allows an educational institution to access student records to defend itself against lawsuits.

“FERPA covers educational records and only educational records. Treatment records for mental and physical health are specifically excluded,” says Perry Francis, who served as the chair of ACA’s Ethics Revision Task Force. However, he explains, the student’s lawsuit in this case specifically mentioned emotional distress, and in Oregon, the law says that if mental health is included as part of a lawsuit, defendants have the right to defend themselves with access to the records. This is an area in which counseling ethics and law collide, notes Francis, a professor of counseling and coordinator of the counseling clinic at Eastern Michigan University.

“Legally, short of a court order, we [the counseling clinic] are not going to release a student’s records,” he says. Counselors do have to follow the law, but before releasing anything, the counselor should discuss it with the student to make sure he or she understands, adds Francis, a past president of the American College Counseling Association (ACCA), a division of ACA. The counselor should also talk to the student’s attorney to discuss what the order specifies and how the counselor or counseling center might limit the information they release. It may be that not all of the records are germane, notes Francis, an LPC and NCC.

M.J. Raleigh, a past ACCA president and the director of counseling and psychological services at the University of North Carolina at Pembroke, confirms there are times when she and her staff have had to release information, but they take actions to limit it.

Anne Marie “Nancy” Wheeler, the risk management consultant for ACA’s Ethics Department, says a counselor who has been asked for a client’s file might be able to provide only a summary of the file rather than the entire file.

“If a counselor receives a subpoena, in many states, the counselor can see if a summary will suffice,” she says. “This is sometimes addressed by state statute, or sometimes the client or counselor can file a motion to quash or a motion for a protective order, which would lead to a court order from the judge. If there is an actual order from the judge, the scope of that order will determine whether a summary or the entire record can or must be released.”

So where does this leave survivors who come to college counseling centers? Raleigh and Francis emphasize the necessity of informed consent for all clients who seek services at a college or university counseling center at every stage of the counseling process, beginning with the intake form. Counselors need to make sure clients understand that there may be circumstances under which the center won’t be able to keep records confidential, they say.

Michelle Wade, an ethics specialist with the ACA Ethics Department, says that counselors who are compelled to release client information should work through an ethical decision-making model. This will help them look at all possible options and outcomes of releasing client information to determine the best course of action that causes the least amount of harm to the client.

“Professional counselors should be aware that they may be called upon to disclose confidential client information under a variety of circumstances, and legal requirements may dictate compliance with such requests,” says Erin Shifflett, director of the ACA Ethics Department. “However, it is imperative that counselors consider their ethical obligations as well. Prior to disclosing any information, counselors should develop a rationale for the disclosure which explores the ways in which the client may be impacted by the release of confidential information and ways to mitigate any potential risks.”

 

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To contact the individuals interviewed for this article, email:

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

 

Taking steps toward dignity

By Bethany Bray August 24, 2015

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What do we want? Dignity!

When do we want it? Now!

This chant echoed across the National Mall on Monday, Aug. 24, as a large group of people stepped off for the inaugural Destination Dignity march.

The event, organized by a coalition of mental health organizations, agencies and nonprofits, was planned to rally against the stigma and discrimination people with mental illness face, from trouble finding housing to increased rates of incarceration and homelessness.

Marchers, many wearing green T-shirts and ribbons and carrying signs, processed along the National Mall in Washington, D.C., finishing in front of the U.S. Capitol. Participants were from the local area, as well as Maryland, New York, New Jersey and other states.

The American Counseling Association was one of the event’s supporting partners; several ACA staffers and local members participated. ACA donated water bottles for the event that featured the ACA logo and the phrase “Step by step, day by day, stand up for mental health!”

Eduardo Vega, director of the Mental Health Association of San Francisco and one of the main organizers of the Destination Dignity march, was among the many people who said they hope the march will become an annual event.

Although Monday’s march was less than a mile, advocates still have many miles left to go before successfully destigmatizing mental illness, said Vega.

 

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Destination Dignity marchers process along the National Mall towards the U.S. Capitol. (All photos by Bethany Bray/Counseling Today)

 

 

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Destination Dignity: March for Dignity and Change in Mental Health

Aug. 24, Washington, D.C.

 

We call for:

  • An end to a society in which people with mental health conditions die up to 25 years younger than the rest of the population
  • An end to unconscionable levels of unemployment, incarceration, homelessness and suicide
  • An end to negative portrayals and scapegoating in the news and media
  • An end to underfunding of services, harsh practices and fragmented “fail-first” systems that require a person to be in crisis in order to access help
  • An end to the criminalization of mental illness and substance use conditions

Source: destinationdignity.org

 

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For more information, see destinationdignity.org

 

Search for the hashtag #MHDignityMarch on social media for photos and posts from the day’s events

 

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Eduardo Vega, director of the Mental Health Association of San Francisco, rallies the crowd. The back of Vega’s t-shirt reads “People recover. Stigma hurts. You can make a difference. Demand dignity now.”

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A march participant is interviewed by the local media (Telesur).

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

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

 

Taking a creative approach to client change

By Laurie Meyers August 20, 2015

Fan culture has gone mainstream. Whereas once the celebration of popular media was confined mostly to small, under-the-radar TV show and comic book conventions, today myriad fan gatherings take place — both on the Internet and off. Shows and characters that not so long ago would have been considered “niche” — think superheroes, science fiction, the supernatural — today embed themselves in the public consciousness and serve as springboards for the creativity of passionate fan bases.

The granddaddy of all fan conventions, the San Diego Comic-Con, has grown from a small gathering creative-approachof 300 comic book fans in 1970 to 130,000 attendees in 2015. These fans — many dressed in full costume as their favorite characters — gather to attend panels and events that revolve around movies, TV shows, comic books and graphic novels. There is even a multiday mini-conference that explores the psychology of comic books. Beyond the fan conventions, a plethora of blogs, online groups and sites for writers of fan fiction extend these expressions of creativity even further.

Counselors typically embrace creative expression because they say it can contribute to a person’s overall wellness. Likewise, many counselors believe that creativity is an essential part of the counseling process itself. The counseling professionals interviewed for this article use pop culture mechanisms such as books, movies, music, graphic novels and TV shows, among other creative methods, as a strategic part of their practice, teaching and supervision techniques.

Defining creativity in counseling

Some counselors automatically assume that the phrase creativity in counseling is limited to art therapy, drama therapy and certain other experiential techniques. They may even think that they need special training to incorporate creativity into their practices, but that is definitely not the case, says American Counseling Association President Thelma Duffey, who was also the founding president of the Association for Creativity in Counseling (ACC), a division of ACA.

“One of the wonderful things about creativity is that it belongs to everyone, and we can find it almost everywhere,” Duffey says. Creativity in counseling refers to the creative human capacity to effect change, she notes, and it includes a process that involves shifts in thoughts, feelings, behaviors and perspectives.

Recently, Duffey and fellow counselors Stella Kerl-McClain, Shane Haberstroh and Heather Trepal were asked to write about creativity in counseling as a theoretical framework for an upcoming theories text. They defined creativity in counseling as a shared counseling process involving growth-promoting shifts that occur from an intentional focus on the therapeutic relationship and the inherent human creative capacity to effect change.

In practice, this can take various forms, according to Duffey. “Although it is not necessary to use activities or interventions in CIC [creativity in counseling] practice, counselors may use creative resources such as music, books, journaling, film, etc., or any number of other resources to support their work,” she says. “Our creativity gives us the flexibility to look at things differently and move in a new direction. Our creativity also inspires hope. And hope is a good thing in counseling and in life.”

Telling the client’s story

Stories, whether presented through legends, poetry, prose, music or movies, offer a powerful way of connecting to clients and then encouraging them to share their own stories, says Elizabeth Hall, an ACA member who is a practicing psychotherapist in the Denver area. “For every human experience, there is a mythological story somewhere out there that examines it through a hypothetical lens,” she says.

Hall first became interested in the power of mythology and stories as an undergraduate at the University of Colorado. In addition to taking several psychology classes, she took a religious studies class with a professor who used mythology to teach. The idea of examining the mythology of various cultures for a window into the human psyche stayed with Hall as she became a licensed clinical social worker. She went on to get a doctoral degree in mythological studies with an emphasis in depth psychology. Stories have since become an integral part of her work with clients.

Hall says that incorporating stories and images from current culture is particularly effective when working with adolescents because these clients often have trouble expressing their inner experiences. Hall has found that expressing themselves through a discussion about a book, movie, song, TV show or comic book makes it easier for adolescents to share their feelings.

Hall often starts a therapeutic conversation by asking clients what music they listen to, what movies they like or what they are currently reading. “It’s an alternative to a face-to-face interview,” she says. “They can speak through the story. They may tell me that they just watched a film like Harry Potter, and I’ll say, ‘Oh, tell me about it.’”

As a client tells the story from his or her point of view, Hall takes note of what aspects of the story the individual focuses on. Bullying is a common theme among adolescent clients, she notes. Many of her clients gravitate toward comic books and superheroes, which frequently feature the hero overcoming instances of bullying.

“I’ll ask them, ‘How did Spiderman — or whomever — overcome bullying?’” Hall says. In that way, she explains, she is “interviewing the story,” which is less threatening to the adolescent than being questioned directly. Through this process, clients sometimes grow comfortable enough to talk about their own problems with Hall. But even when that isn’t the case, Hall says that mythological tales and bibliotherapy can be healing on their own, much like play therapy.

Hall, who is a professor and assistant dean at the Rueckert-Hartman College for Health Professions at Regis University in Denver, also supervises interns working in an adolescent treatment center. Some of her interns use art and storytelling to create groups centered on the hero’s journey. One group even used The Hunger Games book trilogy and movie series.

“The basic hero’s journey is that they have to leave home to go off on their own,” Hall explains. “Eventually they find allies and battle mysterious forces.”

Hall believes that the hero’s journey is symbolic of the struggle that many adolescents — particularly those in treatment centers — face. The stories surrounding this journey help adolescents to become aware of their own strengths and recognize the internal “monsters” that get in their way, she explains.

“I think we, as adults, forget how horrifically challenging adolescence is,” Hall says. “It’s a very confusing time, a time of a lot of uncertainty. … They are trying to establish who they are — separate from family and culture — and they feel the pull toward adulthood but also back toward childhood.”

Entering the client’s world is sometimes the only way for a counselor to get a response from that person, Hall says. She mentions one of her interns who was working with a 14-year-old boy who wasn’t interested in anything but one particular book that he read over and over again. The boy was also on the autism spectrum and wasn’t very good at communicating. The intern and other therapists complained that they couldn’t tear his attention away from the book. Hall advised them to use his fascination with the book to their advantage and enter his world by asking him about it. Once they did that, the boy came out of isolation and actually started putting the book down to focus on other things.

Hall also uses stories with her adult clients, although the process is not typically as elaborate as it is with adolescents. Instead, she simply likes to ask these clients if they have seen a movie recently or heard a song that has stuck with them. If so, Hall and the client talk about it.

“When you engage the imagination through story or image,” she explains, “it gets clients into a different part of the brain — [the emotional], not just the intellectual.”

Creativity and technology

Emily Dennis, an ACA member and counseling doctoral candidate at Kent State University in Ohio, became convinced of the healing power of creativity while she was an undergraduate. During her freshman year, Dennis’ father was diagnosed with cancer and she temporarily withdrew from school. She suddenly had a lot of time on her hands and had always enjoyed painting.

“I found that art was fulfilling and something I needed in my life,” she says. “That’s kind of why I chose to study art therapy — I found it to be a really powerful healing tool.”

Although Dennis went on to earn dual master’s degrees in counseling and art therapy, she identifies herself not as an art therapist but as a creative counselor. She doesn’t think counselors should need specialized training to incorporate creative methods into their practices.

“I strongly believe that creativity is for everyone,” she says emphatically. “Counselors need creative interventions.”

Dennis, who is on the board of trustees for ACC and is also chair of its graduate student committee, has discovered that technology can make it easier for counselors to use creative interventions. During her time as a doctoral intern counseling children at a community clinic in Akron, she used basic drawing and publishing apps such as Drawing Pad and iBooks to provide narrative therapy.

For instance, when children presented with anxiety, Dennis would ask them to draw a picture of anxiety with a stylus, a stylus brush or their fingers, depending on the app. She would tell them that their anxiety picture could take any form they wanted, such as a monster. Then Dennis and the client would talk about the drawing and how it felt to give anxiety a face.

After drawing the picture, certain children wanted simply to throw their anxiety out, which on the iPad was as easy as clicking on the virtual trash can. But others wanted to explore their anxiety further, so Dennis would work with them to create a story.

“We might put the monster in different scenarios,” she explains. “Was there a time when the monster wasn’t there? What was that like? What will you do if the monster comes back?”

These stories would include ways to “defeat” the monster, Dennis says, and because the stories were created with an app, they were easy to email or print out in a form that resembled a real book.

Children were typically excited to use the technology, Dennis says, and the process was faster than using a pen or crayons and paper. In addition, she didn’t have to stock a multitude of supplies.

“Sometimes using an iPad is just easier,” she says. “I think that the ‘undo’ button is a really big advantage because, for a lot of people, it takes away some of the fear of facing a blank piece of paper.”

Dennis also teaches family therapy courses at Indiana University of Pennsylvania and recently used a slightly more old-fashioned type of technology — television — to put a creative spin on her lessons. After showing episodes of the sitcom Everybody Loves Raymond, she would ask the class to diagnose the show’s family members and come up with a treatment plan. It was a fun way for the students to practice what they were learning and helped hold their attention during the five-hour classes, Dennis says.

Both in the counseling room and the classroom, Dennis experiments with technology and popular culture to tailor her creative approach to clients and students. “Creativity can augment theories and approaches,” she says. “It keeps me interested as a counselor, and it keeps the clients invested as well.”

The science of creativity

Courtney Armstrong is a licensed professional counselor with a private practice in Chattanooga, Tennessee. During her 20 years in practice, she found that experiential techniques produced better results for her clients than did cognitive therapy alone, particularly in cases involving trauma, so she set out to learn why.

“I wanted to understand the neuroscience [behind it],” says Armstrong, whose recently published book, The Therapeutic “Aha!”: 10 Strategies for Getting Your Clients Unstuck, describes creative counseling techniques and the science behind this approach.

Armstrong, an ACA member, also presents workshops for counselors on creative experiential techniques. “The main thing I teach is that when we are doing experiential counseling using art, role-play, drama and imagery, we are influencing the emotional part of the brain,” she explains.

The emotional part of the brain is separate from the verbal parts, so talk therapy doesn’t affect the emotional source of the problem, she continues. Particularly in cases of trauma, emotional reactions lay down neuropathways, she says, and these emotional memories need to be “rewritten.”

Neuroscientists believe this process requires memory reconsolidation, or reopening the memory “file” and laying down a new memory to replace the old one, Armstrong explains. Therapies that incorporate physical elements, such as eye movement desensitization and reprocessing, cultivate the rewriting and reconsolidation of memory, she notes. The research indicates that experiential counseling methods work the same way, she adds.

For instance, Armstrong had a client who was referred to her by a psychologist. The woman had come to the psychologist because she felt like her throat was closing up anytime she ate, but there was nothing physically wrong with her.

“He [the psychologist] had her do positive self-talk and exposure techniques, forcing herself to eat, and it just made her so frustrated,” Armstrong says. “He finally sent her to me because he thought there might be trauma in her background.”

Armstrong had the client close her eyes, focusing on the sensation of her throat closing and when she first remembered feeling it. Together, they traced the sensation back to her childhood. The woman’s parents often fought at the dinner table, and she remembered constantly thinking that she would do anything not to have to eat at the table.

Armstrong talked to the client about her ultimate goal — to be able to swallow and eat without difficulty. She first worked with the client to come up with an image that would replace the thought of the dinner table. Armstrong asked her to picture something that flowed, and the client came up with a waterfall. Armstrong then had the woman envision stepping back into the dinner table scene but instructed her to think of the waterfall instead of how she would do anything to not have to eat there. According to Armstrong, this method quickly led to resolution of the woman’s problem.

Armstrong also likes to use music in her counseling practice, particularly with clients who are dealing with grief. She first asks clients to come up with a playlist of songs that remind them of the loved one who is no longer there. “You have to guide them so that the list isn’t just a bunch of sad songs,” Armstrong advises, adding that these first few songs are a tangible way for clients to retain a connection to their loved one.

Next Armstrong talks with clients about how their loved one wouldn’t want them to suffer or continue to be in pain, so she directs them to pick additional songs for their playlist that represent how their loved one would want them to feel. Armstrong doesn’t recommend specific songs; she asks clients to simply pick what speaks to them.

Sometimes the healing benefit of the playlist extends beyond the client. Armstrong recalls one client who developed a playlist in counseling after his child died. “He didn’t want to share it with his wife [at first] because he thought it would be too painful,” Armstrong recounts. “But then he decided to do it, and his wife had her own songs that she wanted to add. It really helped them to reconnect” in the aftermath of the tragedy.

Armstrong traces the advent of her use of creativity in counseling to her time as an intern and young counselor working with inner-city youth in New Orleans. As part of a grant-sponsored school counseling program, she went to schools in impoverished neighborhoods to help students. Armstrong came prepared with conflict management manuals and had training in cognitive behavior therapy, but she quickly realized the students weren’t at all interested in engaging with her.

Armstrong needed to understand their world, so she started small and offered a bribe of sorts. “I said to them, ‘If you will share something about yourself, I will get up and do an awkward white girl dance,’” she remembers. “They loved that.”

As Armstrong learned more about the adolescents, it became obvious that their biggest concern was getting to and from school and in and out of their neighborhoods without getting shot. They didn’t have many goals or expectations beyond that.

“They didn’t believe that they had any options or that they would ever leave the projects,” she recounts. “[They said,] ‘We can either work at McDonald’s, sell drugs or by some miracle get recruited by the NBA.’ I needed to have them believe they could have a life outside of the projects.”

Over time, and in addition to her “awkward dance,” Armstrong used more humor, music and other creative techniques to cement her relationship with the group. “They were really creative, so we used a lot of art,” she says, “not just to express how they felt but to depict how they wanted to feel.”

The youth used their art to explore lives and careers outside of the projects. Armstrong also gave them practical challenges by having them create a mock design business, and she appointed the students to various roles — designer, CEO and so on. She thinks this creative approach taught them more about how to work together than any of the traditional conflict resolution techniques she was originally prepared to apply.

“We had some good successes in the group,” Armstrong says. “Some of the kids left the gangs.”

In fact, a decade later, Armstrong was in the airport in New Orleans, and one of the girls she had counseled — now a young woman — was working there. She recognized Armstrong and stopped to thank her, telling her that Armstrong had genuinely helped her believe that she could change her life trajectory.

Approaching controversial topics

Counselor educators and co-researchers Tina Paone and Krista Malott, members of ACA, believe that using creative methods to teach can make it easier for counseling students to learn about and discuss controversial topics. Paone, an associate professor at Monmouth University in West Long Branch, New Jersey, and Malott, an associate professor at Villanova University outside of Philadelphia, are both longtime proponents of creativity and experiential learning. They have recently been studying the effects of using sand trays, journaling, photojournaling and other creative techniques in their classes on racism and white privilege.

“The reason we became so interested in this topic is that we found students would have strong emotional reactions [to classes on racism and privilege] and sort of shut down emotionally,” Malott recalls. “I thought, ‘What can we do?’” She notes that issues such as racism and privilege are essential parts of a counselor’s diversity training.

The counselor educators say that it can feel confrontational to students to be lectured on these topics and uncomfortable to be forced to sit and have open discussions on the subject matter. Sometimes, Malott notes, students get defensive about the concept of white privilege or, conversely, discouraged at how thoroughly entrenched racism is in society. When learning about microaggressions, students may also feel guilty or upset upon realizing how often they have participated in those small acts of racism.

Malott and Paone have their students write journal entries about what they are thinking and what they have learned after each lecture. Although they hold group discussions, they also like to add a physical element to the students’ learning. For example, Paone positions students in poses that she thinks reflect how they have reacted verbally. She also acts out how she feels the students are reacting to her — for instance, by posing with her back to the class if she thinks they are not really listening. Paone uses experiential and physical techniques in part because she believes they can be more engaging. In addition, she thinks it is important to use multiple teaching styles because students learn in different ways — some are predominantly verbal learners, whereas others are more visual.

Malott agrees. “Kinesthetic learning is another way to experience information,” she says. “When I teach, moving and talking while [the students also] move seems to work best.”

For instance, Malott has her students engage in various physical or almost gamelike activities. “I have a microaggressions activity where I will post common microaggressions on the wall,” she offers as an example. “The students have several cards with them, and they go around and look at each post and put down a card if they feel the behavior really is a microaggression. … The students are excited to move because it’s not just me talking at them.”

The class then discusses which items should or should not be defined as microaggressions and why. Placing the most cards correctly becomes almost like a competition, further engaging the students in learning.

Malott also directs students to form groups for some of the activities so they can problem-solve together. Talking about what they see helps reinforce what they are learning, she says. For example, Malott might put up statistics related to racism and quotes from counselors about best practices to support diversity. Students then walk around, read the information and decide which topics they want to dig into at a deeper level. The activity offers students an almost museumlike experience, but enhanced, she says.

“I find that when I wander and look at things in a museum, I still sometimes miss things,” she says. “I think it’s useful to talk with people.”

Malott says that creativity also makes her a better, more engaged teacher. “I’ve always been a creative person, so it appeals to me,” she says. “I also get bored [just] standing up in front of a classroom and giving a traditional lecture.”

Malott points out that some research indicates that students learn more when they are actively engaged. Paone adds that when students learn more, they make better counselors.

Although their study of the efficacy of using experiential techniques to teach students about racism and privilege has covered various methods, Paone and Malott are particularly excited by the prospect of photojournaling. Paone used the technique this past school year in a group experience class, and Malott is considering incorporating it into her classes.

Photojournaling is similar to written journaling, but instead of writing a long entry, students select or take a photo that represents what they have learned from the past week’s class. Students then submit the photo with a short paragraph about why they picked that particular image.

Paone and Malott thought that working with images might provoke a deeper understanding and exploration among counseling students than just reading or writing about racially related topics. Not all of the students were comfortable with the exercise, Paone notes, but many of them indicated that they thought they had learned more by selecting the images.

Students selected some truly powerful and insightful images, according to Paone. For instance, one student submitted a picture of her young nephew screaming while sitting on Santa’s lap. The student called it “raw irrational fear,” explaining that the image of Santa is powerful and magical to some children, yet scary to young children who don’t know quite what to believe or believe only what they have been told. The student said she felt like the image was analogous to her own racial awareness. Up until that point, she said, she had believed only what she was told and had never truly realized that white privilege existed.

Overall, the feedback from students was positive, Paone says. “Students said that they started to pay more attention to what was in the media and would compare it to what they learned in class,” she says. Students also said that photojournaling helped them express how they were feeling and made what they were trying to say more meaningful.

Paone, a licensed professional counselor and national certified counselor, also owns her own counseling practice, the Counseling Center at Heritage, in Montgomeryville, Pennsylvania. She has encouraged her staff to learn about photojournaling, and they often use it in sessions with clients.

Photojournaling can be particularly useful with children, she says, because they typically have trouble fully expressing themselves verbally. It can also be useful with adolescents and adults who have trouble expressing themselves or prefer not to verbalize their feelings.

“It [photojournaling] allows a safety barrier,” Paone says. “They can be as surface or as deep as they want to be [with the images they select].”

If counselors want to dig deeper into an issue that is presented through photojournaling, they can ask questions about the photo itself. This is typically less threatening to clients than if the counselor asks questions directly about them, she points out.

Getting unstuck

“People come to counseling because they want to effect some change in their lives,” Duffey says. “Perhaps they want to see a situation differently or they want to move past some hurt. People hurt over injuries, challenges and lost dreams every day. And, unfortunately, they can sometimes feel stuck in these experiences.”

“The reality is that it can take a lot of work to get past [these negative experiences],” she says, “but the good news is that connecting to our creativity can help us do this.”

 

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Additional guidance and resources

  • The Association for Creativity in Counseling (ACC), a division of the American Counseling Association, was founded in 2004. ACC’s mission is to create a forum for counselors and counselor educators to celebrate the therapeutic power of music, art, theater, storytelling and other creative processes. In addition, it promotes greater awareness and understanding of diverse and creative approaches to counseling. For more information, visit its website at creativecounselor.org.
  • The American Counseling Association and ACC collaborated to develop the ACA-ACC Creative Interventions and Activities Clearinghouse. The database showcases innovative activities and interventions developed for counselors by counselors. The clearinghouse also serves as an idea and information exchange focused on creative and relational interventions for counselors working with diverse populations. Access the clearinghouse at counseling.org/knowledge-center/clearinghouses/activities-clearinghouse.
  • Other resources include the ACA on-demand webinar “Creative Counseling When You Don’t Have Time to Be Creative,” presented by Samuel Gladding, and ACA podcast “Counseling Using Creativity: Facing the Fear,” presented by Krylyn Peter. To access these resources, go to the Knowledge Center section of ACA’s website (counseling.org) and click on “Podcasts” and “Webinars.”
  • Check out Counseling Today‘s online exclusive, “Geek therapy: Connecting with clients through comics, video games and other ‘geeky’ pursuits.

 

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To contact the individuals interviewed for this article, email:

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

Nonprofit News: What’s your passion? Developing a solid plan for your nonprofit

By “Doc Warren” Corson III August 18, 2015

Starting a nonprofit is far from sexy. Many folks start out with a dream that often has them playing the role of a metaphorical knight in shining armor slaying the dragons of oppression, but the reality is Knight and Dragonoften far from exciting. Though painful at times, unsexy issues such as defining your mission, setting goals, exploring funding, registering with the secretary of state, getting a federal tax ID, writing bylaws and related tasks are essential if you want to make a go of it.

You can click on this link to read an expanded version of the chapter I wrote for “Counseling With Confidence,” which explores those issues (and others) in greater depth. However, for this column, I want to focus on the more human element of the plan for your nonprofit.

What is your passion? What is it that got you into the counseling profession in the first place? What makes you want to get up in the morning, and what are you often thinking about when you go to bed at night? Starting a nonprofit is tough. It requires countless hours and many sacrifices, so if you hope to be successful, you need to have something that you are passionate about. Otherwise, you may find yourself running out of steam even before you find yourself opening your doors. Don’t be afraid to be creative and to color outside the lines.

Who do you know that can help? Try as you might, you can’t do everything alone. I tend to work 70-90 hours per week and am very inventive, yet I reach out to others as often as I possibly can. Many times, the doors will remain closed to you, but you only need a handful to open to make a real and lasting change.

Do you know anyone who shares at least part of your passion? Do you know folks who may not get the whole “nonprofit thing” but who have a passion that somehow overlaps with yours? In my experience, I enlisted folks who did not necessarily care about mental health but who were passionate about creating new spaces, gardening or woodworking. By matching their passions to our needs, it has worked well for all.

To get and keep these folks involved, you’ll need to do what you can to make sure they are getting their needs met as well. Let them engage in their passion while you engage in yours. A balanced relationship is typically a healthy one, and nonprofits depend greatly on volunteers to meet their goals. To keep these volunteers, do what you can to make them feel appreciated, valued and stimulated. Match passions with tasks instead of trying to force volunteers into positions that they do not care about.

Where do you want to do it? Are you an office dweller? A country stroller? Someplace in between? Are you looking for a homey place, a sterile place, a place that matches a specific theme or one that will grow with you? When writing your plan, you need to do more than consider your target audience; you also need to consider the proper type of space to conduct the activities of your nonprofit. Be creative! An old warehouse might offer a clean canvas that can be painted and changed with minimal cost. It can be trendy, yet timeless, and often much cheaper than formal office parks. Likewise, an old home can be remodeled and serve you well. Just be sure to check your local zoning laws.

As a way to save costs, we remodeled what essentially was a two-family home (we built a second floor on an existing home) into an office. The first floor has a dedicated office with a waiting area, several offices, a bathroom, storage etc. The second floor has a dedicated home for my family and me. This arrangement allowed for one mortgage payment instead of two. This price savings helped us to do well in the lean years and eventually grow into a much larger program.

Don’t be afraid to start small. Funding is often hard to find. A realist recognizes this and is not afraid to open in a humble office instead of a massive castle. Do what you do well, and you have the potential to grow steadily. It took us seven years after opening to buy our farm. In those years, we remodeled the original office and expanded it as much as we could. Now we have two very workable offices that serve a great number of folks, although each office (Community Counseling of Central Connecticut and Pillwillop Therapeutic Farm) has its own flavor and feel.

Is there a genuine need? Passion is great, but is it realistic? Do folks in your area really need you? If not, are you willing to relocate? Is your area saturated with similar programming already? Is there a sufficient population within driving distance that will utilize your services? Our farm is in a town of about 17,000 people, but neighboring towns offer the potential of a few hundred thousand folks collectively.

If the need for your nonprofit does not appear to exist as originally developed, tweak as needed and do so without fear. This is a natural development. It is also a good thing to consider as the program continues to develop over its life span. Great ideas sometimes have expiration dates, so adjust your course as needed. Although you will rarely abandon your original focus, you will often find that some roads are closed, some roads lead you to other destinations and still other roads will be built as your clientele changes.

Our program added animal-assisted programming as a direct result of client requests. We also changed our website name from www.cccofcentralct.org to www.docwarren.org after clients complained that our website was too complicated. They said, “You’re Doc Warren. Why can’t I type that and get your site?” Until that time, I didn’t even realize that that was what people tended to call me. Clients often have the best insights into what you can do as a program to improve services. Listen to them and do what you can to implement the best ideas.

What potential funding sources are available? Search for grants, search for potential donors, search for programming and search for folks with whom to potentially partner. Even a few dollars can help you meet your goals. Just be sure to check the fine print. You don’t want to accidently trade your ability to be creative and free for any amount of money, let alone a few thousand bucks.

Is anyone else doing what you want to do? If so, how will you be different? Why should folks use you? Differentiating yourself, even when doing what might be very similar to what others are doing, can mean the difference between success and failure. What sets you apart? In what ways are you not a cookie-cutter program?

If you have a tiny budget, it isn’t wise to go head to head with a large program. Instead, use those programs as a guide for how to change the game. See what they may be missing, and then focus your nonprofit on providing that.

For us, it was using names not numbers; it was being homey instead of sterile; it was being a “real” person instead of a “corporate” one. Our biggest competition, which has often been referred to as the Walmart of mental health, helped us define who we are. We are the noncorporate alternative for mental health. While our competition spends more money, month after month, to advertise all its programming, we’ve never spent anything to speak of on advertising — unless you count pens and cards — yet we continue to build. Folks love our alternative programming and love to tell others. This has been very good for us and great for those we serve.

What are the weaknesses of your plan, and how can they be improved upon? As touched on above, it is important to do what you can to turn a weakness into a strength. When reviewing our plans, we saw that we could never compete head to head with the Walmart of counseling, so we decided not to. But instead of looking at our size as a weakness, we viewed it as an opportunity to be dynamic and homey. Instead of bemoaning our lack of money for equipment and supplies, we honed in on building a program that could truly focus on the individual without the need for gimmicks or distractions. Instead of seeing our lack of employees as a bad thing, we designed a program that would be client centered and allow clinicians to make their own calls and do their own scheduling, prescreenings, intakes and assessments. This personalized service resonated with our clientele, many of whom had been used to seeing two to three people before finally reaching their clinician, NonprofitNewsonly to have to teach that clinician what they had already explained to several other folks at the big box programs. We have retained this style even after hiring dedicated people (one exception is having interns return some initial calls so they can gain experience).

When developing a plan for your nonprofit, it is important to take care of the nuts and bolts (which can be found at the link above). It is equally important to remember to be creative, passionate and pragmatic. Everyone can have a dynamic program if they remember that there is more to service than making money — just as you cannot serve freely without the ability to meet your financial obligations. Be creative. Be passionate. Be smart.

 

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Dr. Warren Corson III

Dr. Warren Corson III

 

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, and clinical and executive director of Community Counseling of Central Connecticut Inc. (docwarren.org) and Pillwillop Therapeutic Farm (pillwillop.org). Contact him at docwarren@docwarren.org, particularly to let him know which topics you’d like him to cover in future columns.

 

 

 

 

 

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Previous columns:

A place for nonprofit counselors

Is a 501(c)(3) not-for-profit right for you?