Monthly Archives: December 2015

Race talk and facilitating difficult racial dialogues

Derald Wing Sue December 22, 2015

Over a five-year period, my colleagues and I have conducted a series of studies to explore the psychology of racial dialogues or “race talk” in the training of counselors and other mental health professionals. As we become an increasingly diverse society, it is impossible for counselors not to encounter clients who differ from them in terms of race, ethnicity and cultural background. The Branding-Images_Rosesinability to honestly dialogue about race and racial issues can serve as a major hindrance to effective multicultural counseling. Although our research has been conducted in an educational and training context, I believe our findings are equally applicable to all racial dialogues, whether they occur in education, employment, health care, public forums, the media or among neighbors.

In our studies, we specifically focused on:

  • The characteristics of race talk
  • Ground rules or guidelines that explicitly and implicitly dictate how and when race is discussed
  • Whether people of color and Whites perceive the rules differently from one another
  • The impact of race talk on participants
  • How educators could create conditions conducive to successful outcomes

Each of these areas has formed topics in my most recent book, Race Talk and the Conspiracy of Silence: Understanding and Facilitating Difficult Dialogues on Race (2015).  

What is race talk?

Race talk is a dialogue or conversation that involves topics of race, racism, “whiteness” and White privilege. Race talk is generally filled with intense and powerful emotions, creates a threatening environment for participants, reveals major differences in worldviews or perspectives and often results in disastrous consequences such as a hardening of biased racial views. Unless instigated in some manner, the majority of people in interracial settings would prefer to avoid such topical discussions or to minimize and dilute their importance and meaning.

Our findings suggest that difficult dialogues on race:

  • Are potentially threatening conversations or interactions between members of different racial and ethnic groups
  • Reveal major differences in worldviews that are challenged publicly
  • Are found to be offensive to participants
  • Arouse intense emotions such as dread and anxiety (for Whites) and anger and frustration (for people of color) that disrupt communication and behaviors
  • Are often instigated by racial microaggressions
  • Involve an unequal status relationship of power and privilege among participants

In 1997, President Bill Clinton’s national dialogue on race concluded that open and honest conversations about race lead to positive race relations. If racial dialogues are an important means to combat racism and discrimination, how can we make people more comfortable and willing to explore racial topics? And if racial topics arise in counseling sessions, how can counselors and clients engage in an honest therapeutic dialogue rather than avoiding it? Answering these questions is especially urgent as difficult dialogues on race become unavoidable and as well-intentioned people of all races find themselves unprepared to deal with the explosive emotions that result in polarization and hard feelings.

Poorly handled, race talk can result in misunderstandings, increased antagonism among trainees and students, and blockages in learning. Skillfully handled, however, race talk can improve communication and learning, enhance racial harmony, increase racial literacy and expand critical consciousness of one’s racial/cultural identity. In this article, I share some of our findings regarding a few of the ineffective and effective strategies in facilitating difficult dialogues on race. Space does not allow discussing the other many strategies I have identified in my book.

Ineffective and successful strategies

Race talk is often not about the substance of an argument but rather a cover for what is actually happening. To facilitate difficult dialogue about race in a productive manner, instructors and trainers need to understand not only the content of the communication but also the process resulting from the interpersonal dynamics. Exploring ineffective and effective race talk strategies will lead to more positive outcomes in workshop and classroom settings.

Five ineffective strategies

1) Do nothing

2) Sidetrack the conversation

3) Appease the participants

4) Terminate the discussion

5) Become defensive

Our studies indicate that instructors and trainers who have not developed a good sense of who they are as racial and cultural beings tend to use ineffective race talk strategies. These behaviors generally lead to negative outcomes in race talk but are of value in demonstrating what not to do and revealing possible solutions.

Do nothing

Many people will commonly opt for silence in the midst of heated race talk. In classrooms or a supervisory situation, for example, they allow students or supervisees to take over the conversation, exhibiting behavioral and emotional passivity in their own actions. Studies suggest that although facilitators are experiencing powerful emotions and anxieties when dialogue on race occurs, they attempt to conceal these feelings for fear of appearing inept. Feeling paralyzed, lacking racial consciousness and experiencing confusion about how to intervene leads instructors and facilitators to a deep sense of personal failure. More problematic is that their actions or inaction suggest to students and trainees that race talk should be avoided.

Sidetrack the conversation 

Consider the following scenario of an unsuccessful racial dialogue.

The context: An educator-training workshop

The topic: Past discrimination and oppression against people of color

White female trainee (stating her thoughts angrily): Why aren’t we also addressing issues like sexism? We women are an oppressed minority group as well! I always feel training like this makes women invisible and that our needs are ignored. Women are paid less than men, we are treated as sex objects … I mean, everything is about race and racism, but what about us? What about our situation?

Instructor: Yes, I … I … I … can understand that, but I can’t cover every single group that has been oppressed, and this training is about the oppression of people of color and the harm they experience from oppression.

Trainee (raising voice): Women are harmed too. Why does it have to be like that anyway? Why use an arbitrary decision in deciding which group to address? I just don’t believe you can relate to my situation as a woman!

Instructor (becoming defensive and attempting to appease the trainee): Well, it’s … it’s … not really arbitrary. There are many reasons why I concentrate on racial oppression … but, let me see … OK, maybe we can … let’s talk about the plight of women as an oppressed group. It’s not my intent to ignore discrimination against women. In fact, many of our studies on discrimination have dealt with gender microaggressions like sexual objectification.

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The preceding difficult dialogue displays a prime example of a trainee, in this case a White female, attempting (most likely unwittingly) to sidetrack the conversation from the topic of race to gender. In classroom settings, race talk is often uncomfortable for trainees and instructors alike. Avoidance takes many forms, and an instructor may unintentionally collude with the participant in avoiding race talk for many reasons, the ultimate result being diversion from discussing the real issues.

Appease the participants

Some trainers and instructors avoid deep discussions of race to maintain what they perceive as group or classroom harmony. They are sensitive to how the school, college or organization perceives the workshop or class and attempt to elicit positive feelings and opinions from participants at the expense of productive discussion.

Appeasement may take many forms:

  • Allowing the conversation to be sidetracked
  • Not confronting the points being made by the participant
  • Stressing commonalities and avoiding differences
  • Discussing superficial issues without exploring deeper personal meanings

Maintaining harmony can negate deeper explorations of biases, stereotypes and deep-seated emotions.

Terminate the discussion

When instructors are concerned that a racial dialogue threatens to get out of control and are unable to determine how best to handle the situation, one of the most common actions is to terminate the dialogue. It may not be intentional, and it may involve the following strategies:

  • Placing conditions on how the dialogue should be discussed, thereby quashing the natural dynamics involved
  • Tabling the discussion and not carrying through on the promise to return to the issue in the future
  • Asking the parties involved to discuss the matter with him or her outside of the workshop or class
  • Stressing that the parties involved should calm down, respect one another and discuss the topic in a rational manner (negating the expression of feelings)

Become defensive

Race talk between instructors and trainees operates on the principle of reciprocity. Whether instructors are White or people of color, defensiveness or having one’s buttons pushed is a common phenomenon. To deflect perceived criticism or uncomfortable feelings, trainees may directly or indirectly attack the content of the communication or the credibility of the communicator. When confronted with a defensive challenge by trainees, instructors of race talk may also

become defensive, especially when they find their message being invalidated or their credibility assailed.

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These ineffective reactions provide us with clues about the facilitative conditions that need to exist and the types of interventions most likely to help trainees move from racial obliviousness to racial consciousness of themselves and one another.

Five successful strategies

1) Understand your racial/cultural identity

2) Acknowledge and be open to admitting your racial biases

3) Validate and facilitate discussion of feelings

4) Control the process, not the content, of race talk

5) Validate, encourage and express admiration and appreciation to participants who speak when it feels unsafe to do so

Dialogues on race commonly exhibit clashes between the racial realities of one group (people of color) and another (generally Whites). The conflicts between racial groups and their hidden meanings tend to emerge in the context of race talk. Having critical racial consciousness formed from a nonracist/anti-racist orientation is key to developing and using successful race talk strategies.

Instructors and trainers can conduct positive race talks with the aid of effective facilitation strategies. However, these suggestions and strategies are based on the assumption that instructors are enlightened individuals who have done the necessary personal work to develop nonracist and anti-racist identities.

Understand your racial/cultural identity

Effective facilitators must understand themselves as racial/cultural beings by making the invisible visible. A lack of insight and awareness will only perpetuate ignorance in the trainees they hope to help. Facilitators cannot be effective instructors unless they are aware of their own worldview, including their values, biases, prejudices and assumptions about human behavior.

For example, what does being White, Black/African American, Asian American/Pacific Islander, Latino/Hispanic American or Native American mean to them? How does their racial identity affect the way they view others and the way others view them? Understanding oneself as a racial/cultural being goes hand in hand with how well-grounded and secure one will be in a racial dialogue.

Acknowledge and be open to admitting your racial biases

On a cognitive level, facilitators must be able and willing to acknowledge and accept the fact that they are products of the cultural conditioning in this society, having inherited the biases, fears and stereotypes of the society. When facilitating a difficult dialogue on race, most instructors are wary about communicating their own prejudices and will respond in a cautious fashion that may be less than honest.

Publicly and honestly acknowledging personal biases and weaknesses to self and others may have several positive consequences:

  • Experiencing freedom from the constant vigilance exercised in denying their own racism or other biases
  • Modeling truthfulness, openness and honesty to trainees about race and racism
  • Demonstrating courage in making themselves vulnerable by taking a risk to share with trainees their own biases, limitations and attempts to deal with their own racism
  • Encouraging others in the group to approach the dialogue with honesty, seeing that their own instructors are equally flawed

Validate and facilitate discussion of feelings

Validating and facilitating the discussion of feelings is a primary goal in race talk. The facilitator must create conditions that make the expression and presence of feelings a valid and legitimate focus of experience and discussion.

Studies in classroom settings indicate, almost universally:

  • The importance of allowing space for the strong expression of feelings
  • That allowing participants to talk about their anxieties or anger helped them understand themselves and others better
  • That it was important to create conditions that allowed for openness and receptivity to strong emotions

Trainees in these studies greatly appreciated instructors who were unafraid to recognize and name the racial tension and the feelings emanating from the discussion because it helped them demystify its source and meaning. It can be helpful for the instructor to ask, for example, “How are you feeling right now talking to or being confronted by this Black person?”

Control the process and not the content of race talk

When a heated dialogue on race occurs, the conversation between diverse participants is typically on the content level, but the true dialogue is taking place on a less visible level (White talk versus back talk). Common statements (content level) when White talk occurs include:

“My family didn’t own slaves! I had nothing to do with the incarceration of Japanese Americans.”

“Excuse me, sir, but prejudice and oppression were and are part of every society in the world, not just the U.S.”

“I resent you calling me White. You are equally guilty of stereotyping. We are all human beings.”

The substance of these assertions has validity, but to deal with them strictly on the content level will only result in having race talk sidetracked, diluted, diminished or ignored. Understanding the subtext that generates these statements is critical for both the instructors and trainees to deconstruct.

Consider the earlier vignette. The instructor attempted to control the content of the discussion rather than the process of the dialogue. An important education exercise is to practice analyzing these statements from both the content and process levels.

Validate, encourage and express admiration and appreciation to participants who speak when it feels unsafe to do so

Participants can feel threatened when engaging in race talk. Accordingly, instructors should express appreciation to those who take a risk and demonstrate courage, openness and the willingness to participate in this difficult dialogue. Examples of what an instructor might say:

“Mary, I know this has been a very emotional experience for you, but I value your courage in sharing with the group your personal thoughts and feelings. I hope I can be equally brave when topics of sexism or homophobia are brought up in class.”

“As a group, we have just experienced a difficult dialogue. I admire you all for not ‘running away’ but facing it squarely. I hope you all will continue to feel free to bring up these topics. Real courage is being honest and risking offending others when the situation is not safe. Today, that is what I saw happen with several of you, and for that, the group should be grateful.”

Let’s return to the earlier vignette. As you recall, we opened with a dialogue that was less than successful. Let’s close with an example of a successful racial discussion.

Female trainee (stating her thoughts angrily): Why aren’t we also addressing issues like sexism? We women are an oppressed minority group as well! I always feel training like this makes women invisible and that our needs are ignored. Women are paid less than men, we are treated as sex objects … I mean, everything is about race and racism, but what about us? What about our situation?

Instructor: I’m glad you brought that up. You make excellent points. Yes, women are definitely an oppressed group, and we can talk about that as well. (Instructor acknowledges legitimacy of comment and lowers potential argument on the issue.) Before we do that, however, I’m picking up on lots of strong feelings behind your statement and wonder where they are coming from. (Instructor controls the process by refocusing exploration on the trainee.)

Trainee: What do you mean?

Instructor: You seem angry at something I’ve said or done.

Trainee: No, I’m not … I’m just upset that women get shortchanged.

Instructor: I can understand that, but the intensity with which you expressed yourself made me feel that my points on racism were being dismissed and that issues of racism were unimportant to you. (Instructor indirectly distinguishes between intention and impact.) Being a woman, you clearly understand prejudice and discrimination. Can you use the experience of having been oppressed to better understand the experience of people of color? (Instructor aids trainee in using common experiences of marginalization to bridge, rather than dismiss, another group’s oppression.)

Trainee: I guess so … I … I guess racism is important.

Instructor: You don’t seem very sure to me. You still seem upset. (Instructor makes a process observation.) What is happening now? Can you get into those feelings and share with us what’s going on?

Trainee: Nothing is going on. It’s just that, you know, it’s a hot topic. I guess, talking about racism, it seems like you are blaming me. And I don’t like to feel wrong or at fault or responsible.

Instructor: Tell me about feeling blamed. In what ways do you feel blamed?

Trainee: Well, maybe there are feelings of guilt, although I’m not to blame for slavery or things of the past. (Trainee begins to address real issues related to her defensive reactions.)

Instructor: Good, let’s all (referring to entire workshop group) talk about that. Now we are getting somewhere. (Instructor turns to entire group of trainees, who have been transfixed by the interaction.) I wonder if some of you can tell me what you see happening here. Do any of you feel the same way? What sense do you make of the dialogue we just had here? (Instructor involves the entire group.)

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As educators and counseling professionals involved in racial conversations, whether spontaneous or planned, we will continue to be confronted in our teaching, training and counseling with challenges about how to turn tricky discussions into teachable moments rather than failed exercises. Will we opt for a journey of silence, avoiding honest racial dialogues? Or will we choose to effectuate real change — starting in our classrooms, workshops, supervisory sessions and counseling sessions — by following the path of racial reality and honesty, which may be full of discomfort but guarantees to offer benefits to all groups in our society?

 

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

Derald Wing Sue is professor of psychology and education at Teachers College, Columbia University. He is author of Race Talk and the Conspiracy of Silence: Understanding and Facilitating Difficult Dialogues on Race (2015), Microaggressions in Everyday Life: Race, Gender and Sexual Orientation (2010) and Counseling the Culturally Diverse: Theory and Practice (2013).

Letters to the editor: ct@counseling.org

Worrying for a living

By Laurie Meyers

T his past August, The New York Times published an extended and detailed article on the work culture at Amazon.com (“Inside Amazon: Wrestling Big Ideas in a Bruising Workplace.”) The picture it painted was not pretty. The article, written from interviews with 100 former and current Amazon employees, depicts an atmosphere in which employees are pitted against one another and encouraged to report any co-worker’s perceived deficiencies to that worker’s manager. According to the article, workweeks of at least 80 hours are expected, as is the willingness to work on holidays. Branding-WorryThere is also a yearly culling process in which managers at each level must present detailed cases citing the reasons for keeping (rather than firing) each of their subordinates. Multiple former employees also told the Times they were put on “probation” by Amazon after returning from maternity leave or a leave of absence due to serious illness.

The article struck a chord. Loudly. As of Dec. 3, the article had received approximately 6,000 comments, the majority of which reflected reader outrage. Some who commented noted that similar workplace atmospheres exist at businesses in Silicon Valley and on Wall Street.

Other publications debated whether the article provided a complete picture of worker satisfaction at Amazon or merely highlighted the experiences of a few disgruntled employees. Some even questioned why anyone cared about the work culture of one particular company.

Perhaps the article become such a hot topic of conversation because many of those who read it recognized certain of the conditions described therein in their own workplaces, even if Amazon’s work culture as a whole may still be an outlier.

Crushing workloads. Hostile supervisors. The expectation to be available at any time, including during “off” hours. Co-workers competing to see who stays at the office the latest. Work-induced stress and depression. These factors are merely a sampling of the work issues that regularly bring clients to counselors’ offices.

“The corporate world to me sounds horrible,” says Barbara Ungashick, a licensed professional counselor (LPC) with a private practice in Denver. “The CEOs get $100 million, while those on the bottom rung get paid $15 an hour.”

Ungashick, an American Counseling Association member, accepts payment through employee assistance programs (EAPs). Although she says people aren’t necessarily seeking her out exclusively because of work-related stress, she calls it a pernicious force that is frequently entwined with the other problems with which clients present.

Workplace pressure has become so prevalent that both the World Health Organization and the National Institute for Occupational Safety and Health consider job stress to be a significant risk to public health.

Workers in overdrive

When pressed to pick the workplace stressor she hears about most often from clients, Ungashick says it is likely workload. She traces this back to the Great Recession when companies cut back their workforces out of necessity, but never replaced the displaced employees as the economy recovered. Instead, Ungashick has observed, the workers who remain are often performing the work of two or three employees.

Research tends to confirm Ungashick’s observation. Numerous studies have found that although the jobs lost during the recession were more likely to be midlevel and high-level positions, the economic recovery has consisted mostly of adding low-paying jobs. What’s more, the “restructuring” doesn’t necessarily seem to be over.

Robin Redman, a former human resources professional turned licensed professional counselor of mental health, says she continues to see frequent reorganizations that result in higher workloads for clients. “I had one woman yesterday who said she felt like she was on a wheel and couldn’t keep up,” says Redman, who has a private practice in Wilmington, Delaware. “She’s working 12 hours [per day] only to come home and attempt to catch up on emails.”

Brenda Ramlo, an LPC with a private practice in Colorado Springs, is hearing similar stories from her clients. “I think the expectations for workers continue to increase, leading to greater stress, on all levels of employment,” she says. “Because many workplaces are focusing more on increased productivity while using less resources, workers at all levels are feeling squeezed to produce more with less.”

“Additionally,” she continues, “because of the change in methods of communication over the past 10 years, employees are often expected to answer calls, emails and texts at all hours of the day and night, regardless of their pay or position. As a result, their time to regenerate and connect with family and friends is diminished.”

Employees increasingly feel the pressure to be reachable by multiple means, including email, cell phone, voice mail and text, confirms Cristi Thielman, a licensed mental health counselor with a private practice in Seattle. In fact, in some organizations, employees feel the need to use constant connectivity as leverage to ensure job survival, says Thielman, who draws half of her client base from EAP referrals.

“Performance evaluations that rank employees against each other are a source of anxiety for many employees,” she explains. “If an employee knows that their co-worker is working late into the evening or is available at all times of the day, they feel they need to compete with that co-worker and be just as available. So it becomes very difficult to unplug. Clients are often working at home even when they’re off the clock.”

As a result, co-workers often sense they are being pitted against one another, regardless of whether that is management’s intention. In addition, examples of positive management seem hard to come by, according to the counselors whom we interviewed. They say their clients generally report micromanagement, unclear goals, poor communication and other ineffective management practices.

“This increased stress seeps into the way people interact with or support one another at work,” Ramlo says. “When an environment becomes competitive, people are taxed, and negative behaviors are more likely to come out.”

Sometimes, she continues, that negativity and competition become the norm. “If someone is working in a toxic environment or has been dealing with criticism, they may start to lose sight of what is reasonable behavior from both themselves and their co-workers,” she explains.

“Many people feel like they have little choice but to keep working at their current position, despite their discontent, due to high debt, a tight budget and a less-than-ideal job market,” she concludes.

According to a 2015 Work-Life Survey by the American Psychological Association, 37 percent of Americans report regularly experiencing significant stress on the job. With the same study showing that 48 percent of Americans report that they regularly respond to work communications after normal office hours, that job stress is increasingly bleeding into personal time. These stressed-out workers may be worried about losing their salaries, but they are often unaware of the price they’re paying for uncontrolled work stress.

“Many individuals with work stress begin using substances or escalate what use was already present, have trouble sleeping, become irritable or experience depression and anxiety,” Ramlo points out. “These symptoms become noticeable and disruptive in the individual’s personal life and relationships.” Employees suffering from excessive work stress may also develop health problems such as fatigue, headaches, elevated blood pressure, weight changes and gastrointestinal distress, she adds.

“Stress in the workplace and increased workload can lead to poor diet [and] exercise and increased irritability, decreased stress tolerance and increased anxiety and depression,” Thielman says. “Clients in these situations then are less likely to socialize, may rely on drugs or alcohol to relax and have low energy during their free time to pursue hobbies and interests.”

It isn’t uncommon for stressed and overtaxed workers to be unaware of how problematic their behavior has become, Ramlo says. “The person is not always pleasant to be around, has difficulty leaving work [at work] or is not interested in previously pleasurable activities,” she notes. “In many cases, it is a spouse or family member who is the primary motivator for the individual to seek help because they have noticed a change [in the person].”

Something’s got to give

Once clients have realized that work is wreaking havoc in every aspect of their lives, the challenge is figuring out what to do about it.

“I will often do the pros and cons with [clients] to assess if remaining in their current position is the best option or if there are changes that can be made in their current position or if seeking other employment will be the best option in the long run,” Ramlo says. “I’ve worked with individuals who are in work environments or jobs that are more what someone else may have wanted for them or do not match their personality. They often feel there is an expectation to push through and that if they are good enough, they could make it work. Accepting that their personality could be better matched or goals could be realized with much less stress in a different setting is tremendously freeing.”

Thielman says that exploring how clients deal with work stress provides her with clues about whether their current job is a bad fit, whether they need to change their approach to work or both.

“To do this, we look at what they enjoy, what they don’t enjoy and which aspects of the job are causing them the most stress,” she explains. “Another goal is to explore with them how their own actions and beliefs contribute to their work stress. For example, do they believe they must do their job perfectly? Is it difficult for them to say no to more work? Is the amount of effort commensurate with their outcome?”

“I encourage clients to try to understand and become more accepting of their work style and approach,” Thielman continues. “In the process of exploring these issues, we then discuss what changes they could make to their approach to the job while keeping within their own work style and priorities.”

Redman encourages her clients to ask themselves what’s keeping them in their current job. “Is it strictly financial? Is it fear? What’s keeping you there?” she asks. “If you love the field, can you get another position?”

But what happens if a client doesn’t want to or simply can’t leave his or her current job? “Once clients become more aware of the impact of their job stress and become more clear on what helps them decrease work stress, they often become more confident in expressing their needs with their co-workers and supervisors,” Thielman says. “Many clients have had success in communicating these needs more clearly to their co-workers and supervisors and in setting clearer boundaries about the amount of work they can accept.”

Thielman also dedicates time to actively working with clients on communication skills. “I stress [speaking] from a place of what they need versus what they want others to do,” she says. “From our work of understanding and accepting work style and approach, the client is able to communicate with others from the perspective of trying to maximize [his or her] working style [and] emphasizing that [he or she wants] to do good work and be productive, which I generally find is true for most people.”

“I also encourage clients to communicate a willingness to collaborate with the other person,” Thielman says. “For example, I might coach a client to say, ‘I am realizing that with my extra workload, I feel I am having trouble dedicating the amount of time necessary to this project. I want to make sure my work is getting done well, so I am wondering if we could talk about what the possibilities might be for managing my workload.’”

Ramlo also emphasizes communication skills with her clients. “Role-playing can be an effective strategy in helping clients communicate what they want or need,” she says. “Clarifying problems and goals is also instrumental in making sure clients effectively communicate what they want or need. When people get overly emotional, it is often hard to adequately see and articulate what they want to say, thereby increasing the chances they will not get their needs met.”

Communication skills are helpful, of course, but stressed-out workers also need coping mechanisms. Thielman emphasizes the importance of her clients taking simple steps such as eating lunch away from their desks, seeking out co-workers to take brief walks with during break times and engaging in meditation or other mindfulness practices to help with relaxation and focus.

“I work with clients to find little ways all day long to interject some relaxation into their work routine such as taking time out to meditate or do some deep breathing or even go for a walk,” adds Ramlo. “I encourage them to decorate their cubicles with pictures of family or their favorite vacation spot. I encourage them to take breaks, ask for help when needed and go to the nearest park to have lunch and enjoy nature. Above all, I think it’s important to laugh throughout the day to avoid getting too mired down in the details of the job.”

Ramlo also believes it is crucial to help clients identify sources of healthy support in their lives — both at work and outside of work — and reconnect.

“I would help [clients] determine what kind of support they need and who in their life can provide it,” she says. “For instance, instead of commiserating with other disgruntled employees at happy hour, [I might suggest] joining with people who can provide timely feedback if they notice you slipping into negative patterns or help cheerlead you through a tough time. Or, if they need ongoing support that they don’t have or [if they] work from home, maybe joining a local group to help enrich their life outside of work.”

Speaking of which, there is a world outside of work, and these experts emphasize that counselors need to help clients recognize when they aren’t spending enough time there.

Work to live or live to work?

What makes you happy? That’s a question Redman says overworked and stressed employees — and the rest of us for that matter — don’t spend enough time thinking about.

All of the counselors interviewed for this article mentioned the pace of our 24-hour, on-demand society as a complicating factor when it comes to all kinds of stress, including stress connected to work. “People aren’t allowing themselves to have downtime,” Redman asserts. “They’re not taking care of themselves emotionally.”

Redman highly recommends that her clients start taking time to journal, go to the gym, practice yoga or do whatever else they enjoy. Even if it’s “just a couple of hours a weekend — go out,” she says. “Get a babysitter and go to dinner.” She believes these breaks provide people a necessary chance to regroup and review what is important in life and what isn’t.

Ramlo agrees that work-life balance is important. The needed balance is different for each person, she acknowledges, but she often joins with clients to assess whether they’re happy with their current work-life ratio. Ramlo helps clients step back and look at the big picture to prioritize and be realistic about what they can accomplish. For instance, a plan to spend less time at work would involve analyzing what skills the client is currently using, identifying what is and isn’t working, and determining how the client might use his or her time more efficiently.

“Work identity is important for many people, but I encourage them to look at other aspects of their identity that help define them,” Thielman says. “Is family time important? Time with friends? Travel? Spiritual practice? Artistic expression? Whatever it might be, are they satisfied with how much energy and time they are spending in those pursuits?”

“Looking at these issues can help [clients] see how they want to spend their time and balance their life,” she continues. “Recently, a client and I worked on managing her workplace stress and workload issues. The client began to spend more time on self-care and the personal aspects of her life and ultimately decided to leave her current job for a new one. In the new job, which she finds less stressful, she is making a conscious effort to incorporate self-care into her daily routine. Her levels of stress and depression have decreased significantly as a result of finding more balance between work and personal life. And because she has more energy, she is devoting more time to the relationships in her life that matter to her.”

 

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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

Scaling client walls

By Laurie Meyers

Every practitioner has been confronted by them — clients who show up for counseling (at least physically) but demonstrate little interest in actually being there, or clients who come in week after week but seemingly fail to make any progress. In some scenarios, these clients rarely speak. Or they talk about making changes but don’t take action. Or they talk about everything under the sun except what’s actually bothering them. You try to gently guide them; they drag their heels. What’s a Branding-Images_Client-Wallscounselor to do when faced with a client who is resistant?

Start by realizing that it isn’t useful to label a client as resistant, says W. Bryce Hagedorn, an addictions counselor in Orlando, Florida. The resistance, he says, comes from the client-counselor relationship — in particular, how a counselor approaches change.

“A big assumption that counselors make — particularly the longer they are in the field — is that they know what is best for clients,” says Hagedorn, a member of the American Counseling Association. “I don’t know that they would admit it, but the longer you are in the profession, the better you get, so you think you know how to achieve change. And we start to impose on clients.”

“We are trying to be agents for change, and we assume that [clients] are ready, willing and able,” he adds. “We design action-oriented change when they are
not ready.”

Hagedorn says it can be especially easy to fall into the trap of trying to impose change when working with clients who have substance abuse issues. Counselors often assume that people with substance abuse issues are in denial and thus need a “push,” Hagedorn says. On top of that, practitioners may feel the pressure of having a limited amount of time that insurance will pay for the client to complete treatment, he says.

“We need to get people [in treatment] from point A to point B, but when we push people toward B, people push back,” he explains. “It’s only natural. People don’t like change.”

Change is a process

Hagedorn, the former editor of the Journal of Addictions & Offender Counseling, says that earlier in his career, he was unquestionably guilty of pushing clients, often without quite realizing it. He was working with people struggling with substance and process addictions, both of which are often comorbid with other mental health issues.

“Just because clients are agreeing with you doesn’t mean they are going there with you,” he says. “There were plenty of times in the beginning [of his career] where, although the clients would agree with my ideas, they never tried them. I would design all of these activities and homework, but they just wouldn’t do them.”

Hagedorn eventually realized that although he was employing a more subtle form of pushing, he was still trying to move clients faster than they wanted to go. He reframed his approach by using the stages of change model developed by James Prochaska and Carlo DiClemente. The model focuses on specific strategies that are helpful to clients at each particular stage of change: precontemplation, contemplation, preparation, action, maintenance and termination.

“I was always using CBT [cognitive behavior therapy], and it’s really designed for people who are in the preparation or action stage [of change],” Hagedorn reflects. He eventually realized his activities weren’t working because the clients he was seeing were still contemplating change rather than preparing to take action or engaged in action toward change.

Hagedorn describes the thought process of clients who are in the contemplation stage as follows: “Since I am thinking about change, change is happening.” And that is valid to a certain degree, he says.

“For them just to come in [to counseling] each week, that can be a huge change for them,” he says. “We [counselors] tend not to honor that. If we can help them recognize what the next step would be, whether or not they are going to take it, that is significant.” Counselors must realize that ambivalence about change and relapse to past behaviors are normal and expected parts of all change processes, not just those related to addiction, Hagedorn says.

To encourage clients in their efforts at change without imposing his own ideas on them, Hagedorn started using motivational interviewing, a technique that incorporates principles from the stages of change model. Motivational interviewing also uses reflective listening, which demonstrates empathy and helps diffuse resistance, Hagedorn says.

As an example, with a female client considering leaving an abusive husband, Hagedorn says he might start with a statement such as “Tell me about what happened during the last altercation.” He then listens for specific details to reflect back and summarize so that the client will know he is listening.

“I’m listening both for words that use explicit feelings and for underlying meaning,” he elaborates. “She may say, ‘I just don’t know if I can do this anymore.’ So I can either say, ‘You don’t know if you can stay, or you don’t know what’s going to happen?’”

This approach communicates empathy while also eliciting information, Hagedorn says. He adds that the mistake many well-meaning counselors make is to instead listen to their “righting reflex” — the reflexive need to make everything “right” for clients.

“When someone comes in and talks about hurt, my righting reflex goes off — ‘I need to make this stop,’” he says. “That is not good because I am going to make a plan, and I start firing off questions: ‘What have you tried? Have you tried this? Why don’t you try that?’ I’m drilling her, and I freak her out. So she starts saying, ‘Well, it’s not always so bad …’”

Instead, Hagedorn likes to use the OARS method, which stands for open questions, affirmation, reflective listening and summary reflections. He says this technique often helps him implement change talk in clients.

“As they’re talking about what’s going on, I’m listening for them to say something that reflects that things aren’t all that they’re cracked up to be,” he explains. “Like [with the client in an abusive marriage], ‘Although I can predict the cycles [of violence], I realize my kids are seeing things that I don’t want them to see.’”

Hagedorn can then pick up on that observation and continue to strategically reflect. “I’m really hearing that there are two sides,” he might say. “On the one hand, you say there is predictability and stability, but on the other hand, you don’t want the kids to see what’s happening. Tell me more about that.”

Hagedorn also emphasizes the importance of counselors not taking any perceived resistance from clients personally. “When they push back, for me it’s a sign that I’m moving too quickly, not that I am doing something wrong,” he says. “I appreciate that as a sign of where we are in the therapy.”

To move past the point of taking resistance personally, Hagedorn said, he had to redefine what successful therapy looks like, and that often requires a great deal of patience. “People can get in a holding pattern. We all have things that we’ve been thinking about for years and haven’t done,” he points out.

Practitioners naturally prefer the action stage, and that can lead to frustration when clients are seemingly “stuck” in the contemplation stage. But as Hagedorn, an associate professor and coordinator in the Department of Child, Family and Community Sciences at the University of Central Florida, reminds his students, the stages of change model teaches that 80 percent of clients are in either the precontemplation or contemplation stage.

Hagedorn considers it a win if he can help clients move forward a stage or move them toward putting together a plan. If a client isn’t yet ready to transition to the next stage but has a good enough experience in counseling with Hagedorn that he or she is willing to come back when there is impetus to make a change, he also considers that a success.

Having said that, Hagedorn acknowledges that he doesn’t simply allow clients to circle around and around a problem with little apparent motivation to move forward. “I set treatment and session goals,” Hagedorn says. “I want to be moving toward something. If there have been a few weeks of no movement, maybe we need to reevaluate goals. Or maybe this stage of counseling is over.”

In such cases, Hagedorn might ask clients if they want to reduce the number of sessions or work on something else. If it becomes evident that certain clients really just want to complain, Hagedorn lets them know that he will still be there when they decide that it’s time to move past what is impeding them.

Solutions for students

ACA member John J. Murphy is an expert at working with a client population that is frequently perceived as resistant: high school students. Like Hagedorn, however, he doesn’t believe such labeling is useful.

“It blames the client for the impasse,” says Murphy, the author of Solution-Focused Counseling in Schools, published by ACA. “It kind of sets up an adversarial environment that I don’t think is really compatible with the way we know good counseling works.”

Calling clients resistant “kind of takes us [counselors] off the hook,” he continues. “It takes away our responsibility for finding a way to connect. They [clients] come to us in all sizes and shapes. Our talent is to tailor our approach to the person sitting across from us.”

Although he rejects the word resistant, Murphy, a former school psychologist who continues to work with students, teachers, parents and administrators, does think that school-age clients pose a unique challenge. “Students and young people rarely refer themselves for services, and that has major implications for how we approach them from the very start,” he explains. “We can’t approach them the same way [we would] someone who enters counseling in a voluntary way.”

Counselors working with young people should be aware that these clients are often in counseling at someone else’s request, Murphy says, and he advises acknowledging this with clients from the start. When applicable, Murphy tells clients that he knows it wasn’t necessarily their idea to be in counseling and understands that it’s not always pleasant to be a part of something when it’s not their choice. “No wonder you don’t like being here,” he might say to the client. “I don’t like doing things that someone who has control over me tells me to do when I don’t want to do them.”

Once Murphy validates school-age clients, he asks about their issues indirectly by inviting them to tell him why they think they were referred for counseling. “I will ask, ‘Do you know why you were asked to see me? Whose idea was it for you to come here? What do you think needs to change to get these people off your back?’” he says.

Murphy firmly believes such queries are helpful. He says the questions serve not only to put him squarely in the student’s corner but also allow him to learn more about the student’s perception of the situation and what he or she wants to get out of the sessions — even if it is just to get out of counseling altogether.

A student is generally referred to the school counselor’s office for behavioral or mental health counseling for one of two reasons: a specific event or ongoing, cumulative problems, says Murphy, a professor of psychology and counseling at the University of Central Arkansas. The event or crisis may take the form of a suicide attempt, a school suspension or getting into trouble with the law. Ongoing problems might include persistent conflict between the student and his or her parents, chronic lateness at school, refusal to do assigned work, disruptive behavior in class or harassment of other students. Other times, the problem may be more subtle, such as a formerly solid student whose academic performance starts to decline in one subject, then another and another, seemingly without explanation.

When faced with a student who seems disinterested in school or at home, it can be tempting to label him or her as apathetic, Murphy says. “That’s just a totalizing description,” he cautions. “It makes it seem like apathy runs from the tips of their toes to their head, and that’s not the way it works. Everyone is motivated by something. Our job [as counselors] is to find something that gives this person a heartbeat and energy.”

Murphy recounts working with a 17-year-old who was referred for counseling because of behavior issues that included not completing assignments. His grades put him at risk of not finishing high school. The school authorities and teachers said the student didn’t care about anything, but when Murphy asked him what he enjoyed doing in his spare time, he quickly learned that the young man had a passion for writing rap songs.

“I learn that this guy spends most of his evenings writing,” Murphy exclaims. “If you said that [a student spends all of his time writing] and they [the teachers] didn’t know anything else, they’d probably think that was great.” Many counselors or teachers might dismiss the student’s passion and talent after learning that the writing primarily involved rap songs, Murphy says, but that would demonstrate a lack of resourcefulness in connecting with a young person.

Murphy went on to ask the student if he had ever spoken with someone who recorded rap music. The young man said he knew someone who occasionally recorded for himself, but not professionally. Murphy then asked the student whether he would be interested in having his rap music recorded if he were to meet someone in the industry.

“He said, ‘Yes! Definitely!’ So now he’s energized,” Murphy continues. “[But] how does this become school related?”

Murphy asked the student if having a high school diploma might help him achieve his dream of getting his rap music recorded. The young man said he thought it would because people automatically assume that individuals who have graduated from high school are smarter. “Now, all of a sudden, school becomes a means to an end [for the young man],” Murphy says.

Murphy kept the focus narrow: You want to get your high school degree. What is one small step that you could take in school tomorrow that would move you toward your goal?

The techniques Murphy used are representative of solution-focused counseling, which he describes as a method of helping people change by building on their strengths and resources. These strengths and resources include elements such as special talents, interests, values, social and family support, heroes and influential people, and even a client’s own ideas about his or her problem and possible solutions. “I want to find out what they think might help turn things around,” Murphy emphasizes.

He also likes to focus on resiliency. “Everyone has overcome lots of things in their lives, [but] when we have a problem, it’s easy to forget that,” he asserts. “One of the core techniques [for developing resiliency] is building on the exceptions — a time when a problem could have occurred but did not.”

For example, with a student having problems with tardiness, Murphy would ask about a time when he or she wasn’t late. “What did you do differently? Who was around? What will it take for that to happen again?” he says.

The student might provide an answer as simple as her mother waking her up instead of her father. Often, Murphy says, he has no way of knowing if the answer the student identified truly made the difference in the outcome, but he’ll suggest that the student try it again to see if it resolves the problem.

“Solution-focused counseling changes a young person’s focus from, ‘How can I be more like other people’ to ‘How can I be more like myself during my better times?’” Murphy says. “I think it’s really important … when a young person realizes, ‘I already know what I need to do to be better. I just need to figure out how to do it more often or in different circumstances.’”

For instance, a student might recognize that he or she is a very good listener with friends but not with his or her parents, Murphy says. Based on the parents’ experience, they think their child isn’t a good listener at all, and that can become part of the young person’s self-perceived identity. But if the student can realize that he or she already possesses the skills needed to solve the problem, that is a huge step, Murphy says.

“It’s not going to be easy [to make that change],” he says, “but that is completely different than [thinking], ‘There is something missing in me. I am deficient.’”

Making a difference with mandated clients

Kerin Groves, a licensed professional counselor (LPC) with a private practice in Denton, Texas, counsels individuals who are typically very reluctant participants — mandated clients.

Most of her clients are referred through the court system for charges related to substance abuse or at the behest of child protective services. Groves evaluates these clients and, when needed, provides substance abuse or mental health treatment. But with many of the people she sees, her primary challenge is getting them to embrace counseling as a place where they can set and meet goals, which range from avoiding additional entanglements with the law to getting a child or spouse back to simply fulfilling their probation requirements.

Groves’ clients are often angry and defensive, and she has found that the best way to start is by acknowledging that fact and simply listening to what they have to say. These clients typically believe that no one is interested in their side of the story, Groves says, because they claim that all authority figures — from the police and judges to their lawyers, probation officers and child protective services — refuse to hear them out.

“So if they come into my office and I just say, ‘Tell me your version of what’s going on,’ they may talk for an hour and a half to tell me their perspective,” she says. “Even if it’s not based in reality, it’s something that’s almost magical. They will say, ‘You are the first person who has listened to me.’”

“That doesn’t mean I approve,” Groves continues, “but I’ve built up credit with them, let them know, ‘I understand the position you are in.’”

She says this is something that is important with all of her clients, but particularly with those who tend to be the most defensive and ashamed — mothers who have been referred to counseling by child protective services.

“In our culture, we see parenting as a very private matter,” observes Groves, a member of ACA. “Clients take it very personally. There is typically a lot of anger and denial — ‘The caseworker is picking on me.’ … [Being neglectful of or abusing your children is] hard to admit personally, and socially, it’s also taboo.”

It’s not unusual for parents mandated to counseling to claim that it’s no one’s business how they raise their children, she says. “I help them to recognize that they do have certain rights and privileges as parents and that authority figures only get involved when basic standards have been violated, such as the child has not been coming to school, is poorly groomed or can’t sleep because of all the chaos [from fighting or other disturbances] in the house,” Groves says. “There are standards as a society that we have set: We want [our children] to be clean, we want them to be well-fed. When you come up against those standards, then and only then will authority figures step in.”

However, in addition to helping parents understand the reality of their situation, Groves strives to build cooperation. The shame and embarrassment attached to child protection cases tend to work well as motivating factors because, generally, she says, the clients authentically want to change the situations they are in.

“I’ll say, ‘What I hear is that you really want to get your kids back because if you didn’t care, you wouldn’t have shown up for counseling. So let’s talk about what you need to do. What do you think you need to do?’ It’s different than me saying, ‘You need to do this, you need to do that,’” Groves emphasizes. “Most people, if they’re given a chance to relax and see that I’m not technically a part of the system — I’m not the judge or caseworker but someone who has been brought in to help them [the client] — they will come up with, ‘Well, I guess I need to get my boyfriend straightened out’ or ‘I need to stop drinking.’

“[I’ll say], ‘That’s great. I hope your boyfriend gets straightened out, but he’s not here right now. Let’s talk about what you can do.’”

Groves’ goal is to help her clients understand that they are the ones who need to take specific steps to change their circumstances. “If there is drug or alcohol abuse, they need to get treatment,” she says. “If there is a guy who is being abusive to the kids or abusive to the mom in front of the kids, the mom has to make some tough choices.”

Although her clients are often reluctant to come to counseling, it is typically fairly easy to get them to set goals, Groves says. “Most people will agree with, ‘I want to get authority figures out of my life’ [or] ‘I want to get caseworkers off my back.’ Those goals are not incompatible with counseling,” says Groves, who uses a combination of reality therapy, narrative therapy and motivational interviewing with her clients.

In addition, setting even basic goals can sometimes lead to big changes, Groves points out. “I have a client right now who was a very successful drug dealer who made a lot of money at a young age,” she says. “That worked out well for a while, but then he got caught distributing and is on probation.”

“When he [first] came in [to mandated counseling], he was pretty ticked off about it. He had been making $30K a month, and now he was just making minimum wage,” Groves recounts. “I had to spend a lot of time letting him vent about how unfair it was and just had to help him get to the point that this is where he is now. He has now come to the point that he says it’s nice to not have to look over his shoulder all the time. Because if you’re successful [at dealing drugs], someone else wants to take over or the police are looking for you.”

The man had already been on probation for three years before coming to Groves, so he had spent a good deal of time under scrutiny, getting clean and learning to toe the line, she says. During that time, he had started thinking about what was next in his life and was considering going to college.

“I think he had already been in preparation mode and had already decided that [going to school was] what he would choose because he didn’t want someone else to choose for him,” she says. “So we talked about ‘What are your skills? What are your strengths?’ He went back to college to study business because he recognized he was good at business. We turned that toward legal pursuits, and I think he’s going to be a great businessman.”

Groves also asked the client where he envisioned himself in 10-20 years. In thinking about his answer, the client said he had come to realize that if he hadn’t been caught selling drugs when he was, he likely wouldn’t be around because he would either be dead or in prison.

Groves acknowledges that some mandated clients never embrace the need for change. But she has worked with many others who upon being given tools to help them solve their problems were amazed at the difference it could make.

“I can’t tell you how many people have told me, ‘When I got into trouble, it was the worst day and the best day of my life, because I would never have changed if it weren’t for that,’” Groves says.

She doesn’t attribute those changes entirely to counseling, but she firmly believes that the mere act of giving a person a place to be heard and to regain some agency is powerful.

Creative cooperation

Clients have many reasons to be hesitant in therapy, particularly in the beginning, says private practitioner Suzanne Degges-White, an LPC. Feelings of anxiety, a lack of rapport with the counselor and a sense of shame for even needing counseling can all inhibit clients from opening up, she explains.

Because the therapeutic relationship is so crucial to the counseling process, a counselor cannot go forward without gaining the trust of the client, says Degges-White, a past president of the Association for Adult Development and Aging, a division of ACA. “Being asked to disclose and address topics that may be considered private can be anxiety provoking — scary, unsettling, too intimate for many of us,” she notes.

“Clients who choose to begin counseling are seldom intentionally resistant in such a way that they won’t work on an issue, [but] sometimes they need to know the support is in place if the topic gets too scary or shaky or anxiety provoking,” she says. “By finding a way to open up the relationship, you are going to be able to grow the comfort of the client and help the client feel that you and the process are trustworthy.”

“In straight talk therapy, there is so much ‘quiet’ in the room sometimes, with so much weight felt by the client to say what they ‘should’ be saying or to discuss issues they might not be ready to discuss or even that they don’t have the words to discuss,” Degges-White notes. “Sometimes providing a new method of communication and emotional expression can be exactly what is needed to get over the hurdle that has appeared in a session or a course of treatment.”

From her experience, injecting a dose of creativity into counseling often provides a mode of communication that feels less threatening to clients. For instance, asking clients to recreate their world in a sand tray may help them to more accurately evoke and articulate feelings than they could do with words, she says. Hiding a tiny figure under the sand with a larger figure standing on the mound can represent those things that the client is afraid to or not yet willing to say, she adds.

For example, Degges-White once had a female client in her 40s, and in the first sand tray world she created, she picked a tiny rabbit to represent herself, while her husband was represented by a tiger on a mountain. The client was dealing with being abused and feeling trapped.

“We did five different trays [over the course of the woman’s counseling]. In the end tray, she was an elephant — someone who moved slowly but was powerful and could pull trees down. Her husband was still a tiger, but not on a mountain, and she could handle him,” Degges-White recounts.

The woman was searching for the strength to know that she could live on her own if she wanted to, and she started to take steps toward independence, such as getting her own bank account. Although she was still not ready to leave the marriage because of her children, she had a need to feel like an individual. Once that happened, the client felt stronger and more assured. She and Degges-White went over the process of establishing a safety plan if needed, and the client was even able to have some needed discussions with her husband. The sand tray process had helped the woman overcome her lack of belief that she could, and should, express herself, and it also provided her with a different way of seeing herself, Degges-White says.

Other approaches can also be effective in overcoming clients’ hesitancy and unlocking their concerns, says Degges-White, who has found bibliotherapy to be particularly helpful. “It can be a wonderful way for clients to see their story in action without having to own it quite so personally,” she says. “Counselors can assign readings and movies for a client to read or watch and then ask them to journal afterward in order to process difficult feelings.”

Degges-White gives clients questions to answer when journaling or asks them to react to specific characters or events. For example, “What did it feel like for you when character X did that? Have you ever had a time when you wanted to do what character Y did? What did you think about the scene where the big event happened? What are some times in your life when you’ve had those same feelings?”

Degges-White, also a professor and chair of the Department of Counseling, Adult and Higher Education at Northern Illinois University, cautions that not all clients will be open to creative expression and suggests motivational interviewing as an alternative. But whatever approach a counselor takes, she thinks that normalizing the anxiety and reluctance a client may feel is extremely important.

Degges-White also believes it is useful for counselors to own their therapeutic limitations in the face of missing information. For example, she might tell a client, “It may be more challenging and it might take more time to reach the goals you’ve shared with me if we aren’t able to address all the aspects of the issue that have you stuck.”

At the same time, she says, it is important to let clients know that the counselor will accept them wherever they are in the process. She suggests saying something like, “However, I’m definitely glad you’re here, and I know that it took courage to show up today. So let’s begin where you feel comfortable beginning.”

 

 

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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: Ways to avoid quick clinician turnover

By “Doc Warren” Corson III December 21, 2015

As a consultant, I am contacted frequently by programs concerned about high turnover rates and also by clinicians who jump from one program to another without finding a good fit.

There is no one way to ensure that a program will have low turnover or that you will find THE job that is a perfect fit for you, but there are many things that can be considered and tweaked as needed to improve the chances of success. It helps to not be defensive and to maintain an open mind.

Years ago, I interviewed for a supervisory position at a larger program in my home state. They asked me the typical questions such as where I saw myself in five years (finishing my doctorate, getting published and working in a program I felt was making an impact on our clients), what my supervisory style was (aligned with the current data suggesting that a Rogerian approach to supervision often leads to happier, more efficient and more productive workers) and so on.

Toward the end of the interview, after telling me about the program and what it would entail, they asked if I had any questions for them. I avoided some of the more common questions and instead delved into ones that would help me best determine if this program might be a good fit for me. I asked what the average turnover rate was (it was 40-60 percent, although some employees had been there for more than a decade). I asked what, if anything, they were doing to try to lower that rate because it appeared we would be in a constant state of training and looking for new employees (they thought they were giving too much to employees after their first year of service, so they were Handshakegoing to start making employees wait two to five years to receive the full range of employee benefits). I then asked how giving less to employees when they were hired and making them wait as long as five years for full benefits would be an effective policy for addressing turnover given that new employees typically weren’t making it past the first year (their answer: We feel it will work).

At that moment, I knew this wasn’t a place that I needed to be because it appeared that our philosophies and their math did not align. It’s better to not join a program when you sense that the relationship will end in failure than it is to ignore the red flags and hope for the best.

What follows are some potential red flags to explore further, whether you are an employer or a potential employee.

Pay well but respect little: We all know of programs that resemble Walmart in that they are huge and seem to have a presence all over the area. As giant programs, they have many state and federal contracts and thus have the ability to pay salaries that beat smaller programs. New clinicians flock to these places, typically amazed at the starting pay, yet they tend to last a matter of months or, at best, maybe a year or two before running out the door to work “anywhere but here.”

When I conduct exit interviews or consult with these “running employees,” I often find that they didn’t feel respected or heard by their employer. They often mention feeling as if they “sold their soul” or “were treated like a slave.” They sometimes talk about being trained to do their notes and related paperwork during groups and sessions because there was no other time to do it. They discuss how this prevented them from offering high-quality care and how they felt forced to leave to regain a sense of self and integrity.

It is important to remember that clinical professionals chose this field for a reason, and that reason is typically not money or prestige. Allowing them to do their work to the best of their abilities in an atmosphere of respect increases the likelihood of retention and satisfaction.

Have huge employee turnover: If your company has a high turnover rate, there is no question that you have a problem. Before panic sets in and you go to extremes, there are things to consider: Are there some positions that have more turnover than others? If so, what are the likely causes? If these are mostly entry-level positions that folks typically leave for higher positions, that’s shouldn’t necessarily be a surprise. But if the high turnover positions are midlevel or higher, it would serve you well to explore the possible reasons behind it. It wouldn’t hurt to ask outgoing employees why they felt the need to leave and what, if anything, could have changed their minds.

As a potential employee, you would do well to learn about the turnover rates of the programs you are considering and the possible causes to determine if this is a place you can feel comfortable working. Unless you are desperate for a job, you may want to reconsider joining a program that has a high turnover rate, especially if you are looking for a long-term situation.

Fail to work well with others: How well does the program work with other programs? Is it friendly and willing to cooperate, or does it have a reputation for only referring within itself? If the program has a reputation for being closed off or unfriendly, this often is a sign of much bigger systemic issues. These issues may lead to higher turnover rates or less people applying for employment.

Just another number\no room to grow professionally: Does the program take pride in knowing each worker’s strengths and weaknesses? Does the program help to address and shore up those weaknesses while providing assignments that focus on the worker’s strengths? Does the program attempt to promote from within, or does it have a tendency to ignore internal resources and focus on outside sources to fill its openings? How you answer these questions can make a lot of difference as you consider job opportunities.

A cookie-cutter approach to counseling: One of the biggest criticisms I hear, both from clinicians and from clients, is that many programs expect the client to fit the programming instead of having the programming fit the client. Sometimes this approach is unavoidable, such as in cases where the government or another outside agency is funding the therapy and dictates that it must follow a particular approach or design. This may be because the program design is part of a large study measuring the overall effectiveness of the design, so there is no way to alter it and maintain the funding.

If this is the case, however, both clients and clinicians should be advised prior to becoming part of the programming so they can make an educated decision about whether to participate. Sadly, many programs skip this very important step.

Interviewing the potential employer\is this program right for you? As an employer, be cautious of hiring someone who fails to “interview the interviewer” to some extent. You want to see that potential employees are interested in the program, are curious about how it works and what it does, and desire to know how they can make a positive impact if they become part of it.

I make it a practice to ask potential employers how I’ll be empowered to do my job to the best of my ability, whether they will allow me to make changes or if I will be expected to maintain the status quo, and what my target goals and objectives might be. How they answer these questions often tells me enough to know whether I want to work for them. If I don’t, it’s far easier to end the relationship here than it is to leave after a short period of employment.

As a potential employee, remember to be polite but also assertive enough to ensure that you leave the interview with as clear a picture as possible of what your job would be and what the employer’s expectations are. Although it is true that the employer is interviewing you, you are interviewing the employer as well — or at least you should be. After all, you potentially will spend a great deal of your time and your life with this company or organization, so you owe it to yourself to do the best job you can ensuring that this program is the right fit for you.

Many other factors can make an impact in this area, so be sure to do your homework. This article is meant simply as a quick introduction. But with a little work and some forethought, it is well within your reach to reduce turnover, whether you are an employer or an employee.

 

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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 Centers of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). Contact him at docwarren@docwarren.org.

From counselor of clients to midwife of hope

By Christine M. Browning December 17, 2015

In preparation for teaching a graduate introductory theories course, I read back through some applicable articles. Arthur J. Clark published an article in the Journal of Counseling & Development in 2010 that described a counseling model based on Carl Rogers’ phenomenological framework.

Clark’s model is composed of three interpersonal ways of knowing:

1) Subjective empathy

2) Interpersonal empathy

3) Objective empathy

As I read through the article, I was reminded of the wealth of application that Rogers’ three tenets — genuineness, empathy and unconditional positive regard — unconsciously contribute to my profession and how effortlessly they align with my personal and spiritual worldviews. Clark’s article also reminded me of a recent counseling session in which a seemingly typical client’s response to a standard interview question solidified my propensity for Rogers’ theory, gave figure to Clark’s form of three separately distinguishable “ways of knowing” and brought a new awareness to the very real and meaningful spiritual moments in a counselor’s profession.

The interview process for a state agency is fairly standardized, but the details are as varied as the people who need to be heard. The process isn’t at all like an initial interview session conducted for the purpose of developing counselor-client rapport in which a treatment plan is proposed, discussed SunnyPathand adopted. Rather, it is a one-time meeting after which a report is written and sent to the state. The counselor’s “job” is to clearly and concisely provide a narrative picture of the client for review.

The information-gathering aspect of the client evaluation is always interesting but typically uneventful. The counseling scenario recorded herein serves as a case study for the application of Clark’s model. The counseling session served to bring my individual inclinations for person-centered therapy, my fund of professional training and my spiritual sensitivity into a keen, insightful focus. Permission has been granted for reproduction of the session particulars reported here.

 

Sympathetic empathy

It was only 10:30 a.m., but it had already been a very long day. As I lumbered to the waiting room to retrieve my third client of the morning, the visible depth of her sadness struck me and shook me out of my self-engrossed Monday stupor.

The two friends who accompanied the disheveled woman rose anxiously in concert with her. I introduced myself and informed the friends that it was not necessary for them to join the woman during the interview session; they would be consulted if and when necessary. The pair reluctantly and simultaneously sat in perched-on-the-edge-of-their-seats fashion. Their concern for their friend was clear.

During this brief exchange, my client never raised her gaze from the spot on the floor directly in front of her feet. Once in my office, she didn’t look up but sat where instructed and answered what was asked with bulleted spurts of information.

I quickly jotted down these words on my notepad: “Low voice tone and rate, poor eye contact, flat affect, despondent, hopeless.” I silently breathed a prayer that God would grant me a sense of His presence and help me identify the onset of the spiral of defeat into which this client seemed to have fallen.

Clark refers to this interchange between counselor and client as subjective empathy, or what Rogers referred to as unconditional positive regard. It is the moment of imagined identification with a client’s plight that consists not of pity or an inclination to “fix” but rather the genuine heartfelt, unspoken tug of humanity between counselor and client.

 

Interpersonal empathy

A few moments into the session, I asked, “Have you ever been married?”

“No,” the client sighed, her gaze still fixed downward.

“Do you have any children?” This is a standard question in the necessary interview process, but the woman’s response was gripping. She looked up briefly and locked her eyes with mine as tears streamed down her cheeks and onto her shirt. Then she lowered her head as her body began to heave with muffled sobs.

I waited for the wave of emotion to pass and felt the atmosphere of the room change. The question I had posed had inserted a key into my client’s private hell. Why did that simple question evoke a torrential response?

With a hushed, respectful tone, I asked if the client could tell me about her tears. As I moved the tissue box closer to her groping hand, she stated in a pointed and harsh tone, “I am not a mother. I had a stillborn baby…” Her carefully worded statement trailed off into a second torrent of tears.

I sat in awe of her bravery and her ability to communicate the depth of her pain with such simply stated words. Words brimming with brokenness and love — a mother’s love.

“I am so sorry for your loss,” I whispered. “How long ago?” I asked.

“Two … years,” was her broken, tearful response.

Her sobbing quieted as we sat together in the palpable sorrow. Somewhere in our brief exchange we had stepped away from the counselor-client relationship and into the territory of two women together shouldering the burden of life and loss.

“I know you told me you do not have any children, that you are not a mother,” I offered, “but you do have a child. You are a mother!”

Her eyes flashed with a spark of light as she settled them onto mine.

“You are a mother,” I repeated. “You birthed a child.”

Clark refers to this second way of knowing between counselor and client as interpersonal empathy — empathy experienced with the client in the here and now from an “extended empathic perspective.” This concept represents Rogers’ genuineness, although less in the sense of counselor identification with the client.

 

Objective empathy

I wrote down the name of a group for women just like her — mothers whose babies drifted into eternal sleep before drawing their first earth-bound breath. These stillborn sons and daughters are beloved children.

My client had never heard of such an oasis. A room full of women with similar experience and understanding — empathy. She readjusted her position in the chair as her bowed shoulders widened and her poorly postured spine straightened. She was incredulous and full of questions about the group.

Clark refers to this tapping into referential data as objective empathy. It is the reflexive skill that develops as a counselor steps away from the classroom and into the lives of real people. Objective empathy brings a synthesis to the broad scope of information obtained during a counselor’s education, practical training and professional credentialing. It is the empathy component of Rogers’ ways of knowing.

“What did you name your child?” I probed, extending the realm of interpersonal empathy we had ventured into together.

As she answered, her tears slowly ebbed and her voice grew confident with the sound of her child’s name in the air. She repeated it. I repeated it. Her countenance brightened. Her eyes cleared. She reached for another tissue with decisive intention, and the interview concluded with the fragrance of hope surrounding us.

About 15 minutes after the she left my office, the woman called to talk to me. I was already with another client, but my secretary took this message: “I got into the group! I start this week!” Her voice was reportedly bright with excitement.

 

Conclusion

Psalm 56:13, written long before my interaction with this client, aptly describes the experience from my perspective: “For you have delivered me from death and my feet from stumbling, that I may walk before God in the light of life.”

The interaction also appropriately answered Gordon Paul’s (1967) quintessential question of best practices in counseling (paraphrased): “What will work best for this particular client with this particular concern at this particular time with this particular counselor?”

In the brief measure of a 55-minute session, I witnessed the beauty of renewal as God’s Spirit hovered and birthed the mother of a stillborn child into life again. In the process, my profession was also altered — from mere counselor of clients to midwife of hope. It was more than theoretical positioning, clinical skill or the demonstration of a new design. It was an amalgam of individuality, knowledge, professional posture and an intentional spiritual sensitivity.

What Clark’s work demonstrates for the counseling community, as viewed through the lens of an actual counseling session, is a framework born of Rogers’ time-honored theory upon which three clearly identifiable elements of empathy are constructed. As demonstrated in the counseling scenario recounted, these three elements can be utilized to facilitate a person-centered approach to therapy.

It is my goal as I train future counselors to introduce them to the expanding wealth of clinical intervention and teach them to assimilate new knowledge into the rich pool of training, closely observe for keys to unlock clients’ stories and remain spiritually sensitive to the potential of client encounters.

As these encounters transpire, we will experience increasing opportunities to function as midwives of hope in this ever-varied, extremely challenging and uniquely rewarding field.

 

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Christine M. Browning is an associate professor and director of the master’s in counseling program at Milligan College in Tennessee. She is a licensed professional counselor, a nationally certified counselor and a senior psychological examiner. In addition to her teaching and administrative duties at Milligan, she maintains a small private practice. Contact her at CMBrowning@milligan.edu.

 

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Related reading

For more on working with clients who are going through a miscarriage loss or infertility, see Counseling Today‘s October cover story, “Empty crib, broken heart

For more on strengthening the counselor-client therapeutic alliance, see our 2014 article “Connecting with clients