Monthly Archives: March 2016

Falling short of perfect

By Laurie Meyers March 28, 2016

This past December, a major pop culture event occurred for which millions of people had been waiting longer than three decades: Star Wars: Episode VII was released. Finally, the story from 1983’s Return of the Jedi was continuing. Many fans reserved tickets two months in advance, while others camped out in line overnight to be part of the audience for the first of the film’s showings. Individuals active on social media reasoned that it was essential to see this latest installment of the Star Wars series as soon as possible to avoid tripping over spoilers.

As with any work of art, people held widely divergent views of the film. In print and online — particularly on social media — passionate discussions were held on virtually every facet of the new movie, but one of the most frequently broached topics involved actress Carrie Fisher. People weren’t usually talking about how Fisher’s character, Princess Leia, was now a general or how great it was to see one of the original characters in the newest film or even the quality of Fisher’s performance though. Instead, the comments most frequently referred to her graying hair and extra weight. The overall sentiment was that Fisher was not aging “well.”

At the same time, no significant accompanying discussion took place about Harrison Ford’s (Han Solo’s) graying hair or Mark Hamill’s (Luke Skywalker’s) prodigiously grizzly beard. Instead, the refrain heard throughout social media was: What happened to the princess in the gold bikini?! (For those who have somehow managed to resist the force of the original Star Wars trilogy, Fisher — as Princess Leia — had two scenes in Return of the Jedi in which she was held prisoner while dressed in a gold-colored leather and metal bikini. The image of Fisher in the costume has become iconic.)

As Fisher herself said in a 2011 blog post discussing her decision to become a spokesperson for the weight loss company Jenny Craig: “You know, I swear when I was shooting those films, I never realized I was signing an invisible contract to stay looking the exact same way for the rest of my existence.”

Fisher’s “invisible contract” is representative of the expectations that women face in American society today: to remain young and beautiful forever, to work harder to be considered equal to men (and yet be paid less) and to be a perfect daughter, mother and wife or partner — all while doing the majority of the housework, child rearing and caregiving. Despite the significant strides women continue to make toward equality, societal expectations still lead many women to think that they can (and should) “have it all.” But that picture is acutely unrealistic, say counselors.

“Having it all means being able to fulfill multiple expectations simultaneously — the perfect appearance, perfect relationships, perfect mother and perfect career,” says Laura Hensley Choate, a licensed professional counselor (LPC) who has written extensively about women’s and girls’ issues. “It means being perfect according to societal standards for each of these roles, but even if this were possible, it also means achieving them all simultaneously.”

The problem, counselors say, is that these standards are perniciously presented to women not just as goals that can be achieved but as expectations that must be met. And when women fall short of these standards, they often view their unsuccessful attempts as personal failures rather than as an understandable inability to meet unreasonable expectations. This perspective can cause feelings of frustration, inadequacy and shame and, in some cases, lead to more serious problems.

“These expectations are so unreasonable and unattainable, and much of it is out of an individual’s control,” comments Vanessa McLean, an LPC from Richmond, Virginia, whose specialties include women’s issues. “It is easy to see how women become plagued with anxiety, self-doubt and negative cognitions that can easily spiral into anxiety disorders or depression.”

By identifying and countering these harmful societal influences, counselors want to help women separate self-image from societal expectations — and perhaps even start changing and setting the expectations themselves.

Chasing eternal youth and beauty 

Throughout much of history, women were valued only for their beauty and fertility, says Choate, a member of the American Counseling Association. Although these qualities are no longer the sole sources of a woman’s worth, youth and beauty are still the most valued, she continues, and once a woman ages and those qualities are diminished, she loses value. In contrast, Choate says, research has shown that the characteristics most prized in men — wealth, power and status — increase with age, meaning that men generally gain value as they age. This disparity is evident in popular culture, particularly in films, which frequently pair young women with much older men, but not vice versa, she notes.

In society at large, this translates into an internalized mandate for women to fight against aging by any means necessary: products, diets, surgery and so on, says Choate, a professor of counseling education at Louisiana State University. Although we live in a youth-obsessed society, the pressure Branding-Images_Falling-Shortis mostly one-sided, she notes. “Men do not feel this same pressure. Certainly not to the same extent that women do,” Choate says.

The youthful ideal that women are supposed to maintain is in itself unrealistic, McLean says. “It isn’t just attractiveness that is the ideal but an obsession with physical perfection,” she explains. “Perfect hair, perfect skin, perfect body, perfect teeth. … And the message is not only geared to young single women but to all women.”

“Women now have equal rights and opportunities to pursue education and careers,” McLean continues, “but if you consider the message that mainstream media send, both overtly and covertly, the message is still that women’s primary value is sex, [which equals] physical attractiveness.”

Working more for less

Women have largely seized the opportunity to pursue advanced education and careers, but on a societal level, their contributions in the workplace are not as highly valued as those of men — not just symbolically but also literally, experts contend.

According to a 2014 study by the U.S. Census Bureau, the median annual salary for women is 79 percent that of the median annual salary for men. That’s 79 cents for every dollar a man makes. A 2015 comparison by the U.S. Department of Labor measuring weekly salaries found that women make 81 cents for every dollar that men make. “Women often feel more pressure in the workplace to perform, simply to get equitable recognition and pay,” McLean says.

Many women’s wages are affected by factors such as maternity leave and child care, as are their career trajectories, which are often linked to making better wages, says Nadine Hartig, an associate professor and chair of the Department of Counselor Education at Radford University in Virginia. Beyond the physical demands of pregnancy, giving birth and raising children, women are often confronted with choices related to balancing their work and life roles. These are choices that men generally do not have to make, Hartig points out. Even if a woman’s husband or partner assumes some of the child-rearing and household responsibilities, the bulk of those responsibilities will typically still fall on the woman, says Hartig, a member of ACA.

Hartig notes that she made a career choice herself because of the demands of motherhood. “I chose not to go into a tenure track right away mostly because I thought it would kill me to do that at the same time as raising children,” she says.

Many women wrestle with the challenge of how or if to try balancing motherhood and work, knowing that the decisions they make could mean delaying or even derailing a career. Women are sometimes judged negatively for taking time away from work, even for maternity leave, but they are also susceptible to being judged for returning to work as quickly as possible and continuing to pursue their careers, note Hartig and Choate.

When a woman who is a mother seeks a promotion, her dedication to her children may be questioned, along with her ability to get the work done, says Hartig, an LPC who also maintains a small private practice. “This can be done in really insidious ways, with comments such as, ‘I’m concerned you won’t have enough time for your family [if given the promotion].’ Generally, men do not face this same kind of judgment. No one questions a man’s commitment as a father if he takes a promotion.”

McLean says that when parenting and household duties are factored in, research has shown that women perform 50 percent more daily work than men.

“The reality is that working mothers still tend to serve as ‘managers’ of the home,” agrees Choate. “They are the ones who keep up with the schedules, the tasks that keep the household running, the doctor’s appointments, the school needs. And while research shows that fathers do help out, it is the mothers who tend to assign the tasks to keep everything on schedule.”

“So, the mothers have to manage the home tasks — which of course take a great deal of mental energy for planning and can lead to worrying — while fathers tend not to carry this burden with them,” Choate continues. “And the societal expectation is that a good mother will keep the family’s schedule flowing seamlessly. If things don’t run well in the home, the expectation is that the mother is not doing her part well. And for single mothers, this pressure is even greater because they are not only the managers of the home, but they also have to carry out all of the tasks with very little help or support.”

Sadly, for many women, the harshest critics they face are themselves, Choate says. They try to have it all and then feel like failures when they can’t achieve the impossible. In essence, she says, “having it all” boils down to “figuring out a way to look young, thin and beautiful, be home with the kids as much as possible, be a superstar at work, have lots of successful friendships, have a blissful romantic relationship, have a perfectly decorated, always clean home [and] cook fresh, organic meals daily.”

Breaking free of the mold 

Choate says counselors can help their female clients uncover the unrealistic expectations they are operating under. “What are the actual standards they hold up for themselves in order to feel they are a success? Actually putting these expectations into words is the first step in helping to change them,” she says. “Where did they learn these expectations? How did they come to internalize these expectations? Did they learn them from parents? Teachers? Coaches? Popular media? Whose approval are they seeking?”

Once a client realizes she is responding to outside forces rather than considering options that might be right for her, the counselor can help her identify ways of creating a healthy balance that fits her life, Choate says. The counselor should have the client ask herself what makes sense for her given her personal strengths and resources.

“This will look different for everyone,” Choate says. “What are realistic and meaningful goals that respect self-care and balance versus living up to a never-ending treadmill of others’ expectations? Helping our clients separate the difference between societal ‘shoulds’ versus what each client actually wants for herself will be very freeing for her.”

In Choate’s book Girls’ and Women’s Wellness: Contemporary Counseling Issues and Interventions, published by ACA, she talks about strategies couples can use to strike a balance in household duties. Rather than trying to decide how to divide tasks exactly 50-50, she suggests that couples talk about particular duties that each partner prefers. For instance, one might prefer folding laundry to vacuuming, or washing dishes rather than taking the trash out. Couples should also talk about who will keep track of items such as bill paying, appointments and other deadlines. The most important goal is for both partners to be satisfied with the division of labor, Choate says. It is also important for partners to be flexible enough to temporarily take on more or less responsibility when needed, she adds, such as one partner tackling extra household tasks when the other partner has a project that requires extra hours.

Hartig also helps her clients re-examine the stereotypes they have been taught, particularly as they relate to body image. “I believe the first step is assessing where clients’ narratives about their bodies began,” she explains. “For example, was the client told she was fat by a parent, or did the client gain a significant amount of weight and feel differently about his or her body? Identifying the struggles a client has about his or her body is important to begin working toward self-acceptance. Often, a negative body image is indicative of feelings of inadequacy and shame. Working on these feelings can lead clients to finding peace with their bodies.”

“Some of the ways that we work with clients on self-acceptance is to explore the negative self-talk they experience and where this self-talk originated,” Hartig continues. “Coaches, parents, teachers and friends all can have an immense impact on self-talk. Counteracting this self-talk with CBT [cognitive behavior therapy] can be very helpful. Creating a new narrative about the client’s self and body is also helpful. For example, a client who can say ‘My body is strong and my body helped me escape some pretty hard situations’ is on the road to appreciating her body.”

Hartig also notes the importance of counselors being aware that negative societal messages about appearance and body image are even greater for women who are not white or heterosexual. “Women of color face even greater assaults on a positive body image [because] our culture has an ideal that is rarely inclusive of all women — or people,” she says. “Women who identify as lesbian or bisexual are also often marginalized and misunderstood with regard to body image.”

“Internalized self-loathing is a natural consequence of media and other outlets that do not embrace the beauty of diversity and realness of people,” Hartig says. “Understanding these issues specific to different cultural groups is key to helping clients with body image issues.”

McLean uses brain-based psychoeducation to help women understand why they feel they need to meet society’s unrealistic expectations. For instance, she explains that humans are hard-wired to seek social approval, so it is normal for people to want to conform. McLean then helps clients to understand their own expectations and fears and to recognize and reframe cognitive distortion. She encourages women to explore how to balance their lives around their personal values rather than around social expectations.

Hartig likes to use narrative therapy to examine her clients’ struggles with the expectations they feel they need to meet. As she listens to clients’ stories, she finds it particularly important to note losses — for example, dreams or plans a woman may have had to let go of in one part of her life, such as her career, to attend to an aspect in another domain, such as family.

For instance, Hartig had a client who had decided not to have a second baby because she wanted to pursue tenure. However, after achieving tenure, she didn’t find it particularly satisfying and felt that she had given up the chance to have another child for nothing. It was important for the woman to grieve this loss, Hartig says.

Hartig encourages clients to grieve such losses by helping them develop rituals for letting go. This might involve a client writing a letter to herself and then burning or shredding it, releasing balloons, journaling or even holding a “funeral” for what was lost. The funeral ritual might include gathering pictures or symbols of what the woman lost, putting them in a box and burying them.

Once the client is ready, Hartig helps her to “reimagine and recreate,” building a narrative around what she wants her life to be going forward and how she can make that happen.

“For some, writing this plan down makes sense and is helpful,” Hartig says. “This can take the form of a ‘letter from your future self’ or free writing/journaling about hopes for the future. This process can also be done in the therapy session, as some clients do not respond well to written homework. I think the crucial element is to gently invite the client to envision a life that looks different than what … she originally planned, once the grief has dissipated.”

Until society rejects the picture of perfection that is “having it all,” counselors can play an important role in helping women strike a balance that allows them to have what they need.

 

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To contact the individuals interviewed for this article, email:

 

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Related reading:

See Laurie Meyers’ companion article to this piece, “Girls feeling pressure to be ‘sexy, famous and perfect’,” for more on how counselors can help young girls defy societal stereotypes and pressures.

 

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

Letters to the editorct@counseling.org

 

Coping with college

By Laurie Meyers

Often parentally micromanaged, pressured by high expectations, grappling with depression and anxiety, a bit socially awkward or just a little bit lost in a strange new world, today’s college students are seeking counseling in greater numbers than did previous generations, according to college counselors and other experts.

Those who counsel students point to various factors for this surge in clients, including greater overall awareness of mental health issues, higher rates of depression and stress, and a huge increase in the overall student population at colleges and universities. According to the Institute of Education Branding-Images_CollegeSciences, the research and statistical arm of the U.S. Department of Education, between 1992 and 2012 (the latest year for which statistics are available), the number of students enrolled in degree-granting institutions has grown by 39 percent.

National surveys conducted by the American College Counseling Association (ACCA), a division of the American Counseling Association, indicate that the percentage of students struggling with serious mental health issues has also increased. In addition, 42.4 percent of the almost 75,000 undergraduate students who completed the 2015 annual American College Health Association National College Health Assessment reported experiencing greater than average stress within the past 12 months, and 10.3 percent reported feeling tremendous stress. When asked about depression and anxiety during the previous 12 months, 35.3 percent of survey respondents reported feeling so depressed that it was difficult for them to function; 57.7 percent indicated feeling overwhelming anxiety.

At the same time, staff growth at college and university counseling centers has typically failed to keep pace with this increased burden. As a result, these counseling centers are often scrambling to stay on top of their caseloads, and college counselors are using a variety of campus resources and outreach methods to meet the needs of today’s students.

Welcome to the new world

One of the defining features of the traditional college experience is leaving the nest. But many students in the current generation are having trouble finding their wings, according to college counselors. That’s in part because, generally, today’s young adults are used to their parents managing many aspects of their lives, says Suzanne Degges-White, who supervises student counselors as part of her role as a professor and chair of the Department of Counseling, Adult and Higher Education at Northern Illinois University.

“We’re dealing with helicopter parents,” she says. “They’ve done so much [for their children]. And then when you get to college, your teachers don’t care if you do your homework, and your parents aren’t there to remind you.”

“There’s this idea that kids need protecting, so when they get to college, suddenly if they don’t like a class or their roommate, this may bring them in to the counseling center,” adds Degges-White, the ACA Governing Council representative for the Association for Adult Development and Aging.

ACCA President Amy Lenhart agrees, saying that the students she sees often seem ill equipped to handle many of the demands they face, such as managing their academic workloads, interacting with instructors and other students, and even getting to class on time. Both Lenhart and Degges-White say they regularly encounter students who have trouble making any kind of significant decision on their own. In some cases, parents are still trying to make all the decisions for their college-age children, says Lenhart, who works with students on general counseling issues and career concerns at the counseling center at the Preston Ridge Campus of Collin College in Frisco, Texas.

“I can tell you that even in counseling, parents want to make appointments [for their son or daughter],” she says. She has also encountered parents who want to sit in on their son’s or daughter’s career counseling sessions. In such cases, it is important for counselors to set boundaries and let parents and students know that it is time for these young adults to make certain decisions on their own, Lenhart says.

The consequences for students who struggle to make decisions and manage their lives can be severe, Degges-White says. Not studying, skipping classes and failing tests can quickly lead to academic probation, she points out. Although it is easy to dismiss such behavior as laziness or a lack of interest, Degges-White contends that would be a mistake. Instead, counselors need to ask students about their classes, including why they’re not going or why they think they’re failing a particular subject, she says. The answer may be related to poor time management, and many colleges have workshops to which counselors can refer students.

Of course, there may be other underlying reasons. “Sometimes students don’t go to classes because they are not interested in them,” Degges-White says. “Maybe they aren’t suited to the subject or even need a different major.”

However, if the behavior is due to a lack of accountability, counselors should work with students on making decisions and then accepting the consequences, Degges-White says. She likes to use choice theory to help students explore the options available to them. “How are the choices you are making now going to get you to your goals?” she asks. “If they’re not, what other choices can you make?”

ACA member Nick Patras, a licensed professional counselor and assistant director of the counseling center at Texas A&M University-Commerce, dissects the time management process with his clients. Sometimes students come to the counseling center after their first semester having failed several classes and hoping for an easy and instant answer, he says.

Instead, Patras delivers a dose of reality, but he also tries to provide helpful strategies to get the students back on track. “Do you have goals? Do you have projects? Do you have them broken down into stages, or do you wait until the last minute?” he asks these students. “I educate them on how to plan and manage projects by breaking them down into little bites.”

Knowing your students

Josh Gunn, the director of counseling and psychological services at Kennesaw State University in Georgia, urges college counselors to be aware of their campus culture and who their students are. For instance, Kennesaw State’s student body features a significant percentage of first-generation college students, he notes.

Parents who have been to college generally impart at least a minimal amount of knowledge to their children about how college works, but first-generation students don’t have that advantage, says Gunn, a member of ACCA. Not knowing anything about college life can pile on an additional layer of uncertainty and stress, he points out.

First-generation students are also more likely to be putting themselves through school, which may mean working a job in addition to attending classes, Gunn says. For these students, academic struggles may be at least partially tied to general financial stress or simply not having as much time to focus on their studies, he explains. Counselors should consider how putting students in touch with other resources such as the financial aid office or an academic adviser might relieve certain stressors for students, he says.

It’s also important for counselors to keep in mind that not all college students are young adults fresh out of high school. Some students, especially on today’s campuses, are individuals who are beginning or returning to college later in life, Degges-White points out. These students are confronting many of the same stressors as their younger peers, but they will be juggling those stressors with work and family concerns, she says.

Lenhart’s institution is a community college, which means that its students don’t have to meet the enrollment requirements that applicants at four-year colleges and universities do. Because of this, she explains, some of those who enroll — for example, a 50-year-old student who hasn’t taken classes since high school — might not be ready for the courses he or she is taking. It’s important for counselors to consider factors such as these when students come in with academic problems, Lenhart says. What seems like (or may in part be) a time management problem could actually involve a skills deficit for which counselors should refer students to the tutoring center and their academic advisers, she says.CommunityCollege

When academic performance is a predominant concern for students, it affects every area of their lives, including their mental health, Gunn says. Therefore, when students come to the counseling center and present with depression, anxiety or stress, it is important for counselors to ask how their courses are going, because academic concerns may be exacerbating whatever other issues they are concerned about, he says.

Counselors should also keep in mind that if a student is struggling with academics, that issue doesn’t necessarily go away just because the mental health problem has been addressed. “If you’ve cured someone’s depression but they flunk out, you’ve failed,” Gunn says.

 Making new connections

Joel Lane, who studies the theory of emerging adulthood and is the coordinator of the clinical mental health counseling program at Portland State University in Oregon, says that, traditionally, a person’s late teens and early 20s were when attachment relationships shifted from one’s parents to peers and romantic partners. Possessing the ability to form and maintain these healthy attachments is especially important in times of transition and can affect not just an individual’s personal life but his or her professional life as well, he says.

However, for members of the millennial generation, that process has become more complex for several reasons, according to Lane. One is that young adults (ages 18-25) are “younger” psychosocially than previous generations have been. Millennials’ identity exploration is taking place at a later age when they are no longer adolescents but when they do not consider themselves adults yet either, he says. Also, because their parents often continue to manage their lives, these young adults may be less likely to seek other sources of emotional support, at least in the “real” world, Lane continues. Where today’s young adults tend to turn to seek support and interact with others is social media, he explains. And although social media may be good for those purposes, it does not generally prepare young adults for making connections and conversing in their classes, in social situations or on the job, Lane contends.

Unfortunately, many college counselors report that social anxiety — which negatively influences a person’s ability to form new attachments — appears to be much more prevalent among today’s students than in prior generations and is a factor in a significant number of their clients’ cases. Patras says that about half of his cases involve social anxiety as either the presenting concern or an aggravating factor. Often, he says, the students he sees simply do not understand how to interact with others.

“They don’t know how to talk to people, how to carry on a conversation or how to ask someone out,” Patras says. “It’s partly socioeconomic” — the university where Patras works is located in a rural, impoverished area — “but [it’s] mostly because they are interacting on social media and not in real life.”

Lenhart and Degges-White have observed this as well. Although none of the three counselors believes that social media is inherently bad, they do think it has caused a significant shift in how young adults interact with one another. “They say they are ‘dating,’ but they might just be interacting on Facebook or through texting,” Patras notes.

Although it’s true that adolescents and young adults are establishing social networks online, they typically do this in solitude at their computers or on tablets instead of learning face-to-face communication and interaction skills, Degges-White says. She adds that many of today’s college students spend their social time video chatting with friends from home rather than going out and making new friends.

Technology does provide its own kind of connection and access to a wide array of helpful resources, Lenhart acknowledges, but it is also easy to hide behind, particularly for those with social anxiety. “We want them to actually be out in the world,” she emphasizes.

Which is why some college counselors are gently but firmly pushing students out of their comfort zones.

For instance, Patras holds workshops on social skills. He teaches students how to integrate into an unfamiliar group by first finding one person within the group to talk to. When participants ask how to start a conversation with someone they don’t know, he tells them to ask the other person about himself or herself. “Everyone likes to talk about themselves,” he says. In the workshops and in individual counseling, Patras also teaches students relaxation and emotional regulation skills such as mindfulness meditation and deep breathing to help ease their anxiety.

Lenhart asks students to try attending social events such as campus group meetings or parties. “Just challenge yourself,” she urges students. “Make sure you have a way you can leave if you get uncomfortable, and just stay, even if it’s only for 10 minutes.”

Degges-White believes a combination of cognitive behavior therapy and a bit of desensitization therapy is effective in helping students overcome social anxiety. Her counseling center also refers students to small group sessions in which students can practice talking to one another. Degges-White has also found that giving “homework” assignments to students, such as having them talk to at least one person in one of their classes each week, encourages greater social engagement. Because a lack of social skills is becoming more common in young people, even high schools are beginning to offer groups that focus on these skills, she says.

Managing mental health needs

College counseling centers don’t just deal with students’ issues related to time management, academic adjustment, social skills, being away from home for the first time, getting used to living with other people and, as time goes by, choosing a major and career path. The age range when most people go to college — late teens to early 20s — is also the age at which serious mental illnesses such as depression, bipolar disorder and schizophrenia often appear. College is also a time when many people choose to begin experimenting with drugs and alcohol, which can lead to substance abuse problems.

Unfortunately, the level and length of care that college counselors can provide to students experiencing serious mental health issues varies greatly. Patras says that his counseling center currently has the resources to work with students for as long as they need it and are willing to do the work. According to Patras, the small city of Commerce has only two mental health professionals, and many of the university’s students don’t have private insurance, so the school’s counseling center is a particularly essential resource.

Other institutions are forced to limit the number of sessions that each student is entitled to or else maintain long waiting lists because demand is so high, Lenhart says. Because of these limitations, many college counseling centers focus on triage. This involves getting the most severe cases in or, if necessary, referred out for hospitalization or psychiatric care immediately, and using brief interventions such as solution-focused therapy for less severe cases, she says.

Some colleges are relying more frequently on group therapy, which doesn’t count against students’ allotted center visits and has the added benefit of helping students interact with others, Lenhart says. This is especially important in cases in which students are dealing with depression or social anxiety, she adds. Groups can also be particularly beneficial for students dealing with grief, working through issues related to their sexual or gender identity and a wide range of other challenges.

Gunn says some of the counselors in his center are taking on the role of case managers in the more complex cases. These counselors get students who just got out of the hospital or have special needs set up with a psychiatrist or an on-campus counseling group.

College counselors are also reaching out to students to raise their awareness of the many services that counselors can provide; distributing psychoeducational materials and doing public screenings; and educating faculty and staff on spotting the signs of behavioral problems.

Gunn’s counseling center gives regular workshops on everything from decision-making to general wellness to sexual assault awareness. He believes that college counseling needs to become more proactive; not just to let students know where the center is located and say, “Come see us when you’re ready,” but to actively look for potential problems in hopes of preventing bigger ones. His staff regularly provides information about identifying behavioral problems to the resident life program, department heads and other faculty and staff. In addition to encouraging prevention, he hopes that counselors can help create campus cultures in which the belief becomes that safety is everyone’s responsibility.

Lenhart bemoans the lack of residence halls on the community college campus where she works because she believes that hall staff — due to their more frequent contact with students — serve as a sort of first line of defense for identifying students who may be struggling and in need of counseling. That doesn’t mean the college’s faculty and staff aren’t vigilant. In fact, she says, faculty and staff often bring students to the counseling staff’s attention and even walk those in need of help to the center if need be.

“We train them [faculty and staff] for what to look for,” she says. “Dropping grades; changes in appearance, such as becoming disheveled, not bathing; maybe acting out in class; maybe being angry — any kind of change in behavior that is unusual for that student.”

“We have to work harder at promoting counseling to students because of the come-and-go nature of our [community college] program,” Lenhart says. “I think, sadly, the assumption is that counselors at community college campuses are like guidance counselors.”

So, Lenhart and her counselor colleagues educate, educate, educate, conducting psychoeducational sessions and distributing informational fliers for national events such as Depression Awareness Day. Professors also have the counseling center staff visit classes and give presentations on stress and anxiety, she adds. She believes that classroom sessions not only help demystify what college counselors do but also get students more comfortable with the idea of coming to the counseling center.

Many colleges now have a kind of “college 101” class for incoming freshmen. The counselors interviewed for this article said it is important for college counseling centers to be involved with these efforts, either by providing educational materials or giving presentations.

Patras’ counseling center maintains liaisons within all of the university’s major academic departments and also works closely with campus police, who refer students to counseling if they have had trouble related to alcohol or drug use. The counseling center also educates other faculty and staff about possible indicators that students may need help, such as unusual acting-out behaviors (for example, outbursts in class), slipping grades or a previously responsible student who is now missing classes or not completing assignments.

Behavioral intervention teams are also becoming common on college campuses. The problem-solving teams typically include counselors and representatives from campus departments such as student affairs, campus police or security, student conduct and resident life, explains Brian Van Brunt, a past president of ACCA and author of Harm to Others: The Assessment and Treatment of Dangerousness, published by ACA. These teams meet regularly — typically once a week — to exchange information. The goal is to identify incidents or patterns that might indicate a possible problem — such as increased substance abuse arrests or a rash of suicide attempts — and to formulate a course of action with the goal of preventing larger problems.

Events such as the 2007 mass shooting at Virginia Tech provided the impetus for the creation of behavioral intervention teams, Gunn says. Even so, he cautions college counselors not to focus exclusively on such large-scale events. “Don’t waste all your time preparing for a mass shooting that may never happen,” he says.

Events such as a student’s suicide are more common, he explains, and likely to have a significant effect on campus mental health. To reach as many students as possible, counselors need to encourage an environment of multidepartmental sharing, he adds.

In many ways, counselors interviewed for this article say, college counseling has become a campuswide effort.

 

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Additional resources

For those who would like to learn more about the topics addressed in this article, the American Counseling Association offers the following resources.

Books (counseling.org/bookstore)

  • Group Work and Outreach Plans for College Counselors edited by Trey Fitch and Jennifer L. Marshall
  • Harm to Others: The Assessment and Treatment of Dangerousness by Brian Van Brunt
  • Eating Disorders and Obesity by Laura H. Choate
  • A Contemporary Approach to Substance Use Disorders and Addiction Counseling, second edition, by Ford Brooks and Bill McHenry
  • Treatment Strategies for Substance and Process Addictions by Robert L. Smith

Webinars (counseling.org/continuing-education/webinars)

VISTAS Online articles  (counseling.org/knowledge-center/vistas)

  • “Counseling International Students” by Julia F. Kronholz
  • “Distressed College Students Following Traumatic Events” by Simone F. Lambert, Joyce C. Lambert and Samuel J. Lambert III
  • “Helping College Students Develop Mental Wellness Skills Through Journaling Techniques” by Julia Y. Porter
  • “Needs Assessment for Counseling GLBT Clients” by Rebecca Gardner, Joshua Adkins, Whitney Gillespie and Cristen Wathen
  • “Passport to Wholeness: The Effects of a Campus Mental Health Fair on Help-Seeking Attitudes” by Lucinda C. West and Anita Knight
  • “Recovering College Students: Practical Considerations for College Counselors” by Mark S. Woodford
  • “The Effects of a Brief Mindfulness Intervention on Self-Compassion Among Undergraduate College Students” by Danielle Richards and William E. Martin Jr.

 

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The American College Counseling Association, a division of ACA, focuses on fostering student development in colleges, universities and community colleges. Visit collegecounseling.org to learn more about the division and to access its array of resources.

 

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To contact the people 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

Using “Inside Out” to discuss emotions with children in therapy

By Mercedes Fernández Oromendia March 25, 2016

When Inside Out, the latest Pixar movie, was announced this past summer, I was excited to see how the writers would represent complex human inner experiences in a fun and child-friendly way. As a counseling psychology graduate student, I often find myself trying to explain concepts about emotions to children or their parents and searching for creative ways to make our inner experiences more concrete.

Pixar did not take this task lightly. The computer animation film studio consulted with two of the leading scholars on emotion, Paul Ekman and Dacher Keltner, to ensure that the movie portrayed emotions accurately while also capturing the attention of its young audience.

Ekman and Keltner propose that there are seven distinct emotions experienced by everyone across cultures and ages: anger, joy, disgust, fear, sadness, surprise and contempt. The first five of these were the basis for the main characters of Inside Out. The collaboration between the movie’s writers and these two leading experts on emotions created a wonderful tool that clinicians can use to explain emotions to children and adolescents and their parents. It distills complex concepts from neuroanatomy and personality psychology into accessible and fun characters.

Audience members have the opportunity to imagine what it would be like if each of the five main emotions — joy, anger, disgust, fear and sadness — had their own feelings and how they might interact with each other.

The personified emotions take us on a roller coaster ride as they each do their best to help 11-year-old Riley adjust to moving from Minnesota to San Francisco. At the beginning of the movie, Joy tries to find the silver lining in everything, even when the movers lose the family’s things and Riley’s parents start fighting. Sadness seems to be inexplicably sad at all times, but Joy works hard to prevent Sadness from touching the control panel and making Riley experience sadness. As the story unfolds, several key points arise that can be useful to discuss with clients or with our own children:

1) All emotions are important and helpful at times.

2) We can have more than one feeling about an event.

3) Sadness is important and can foster connection with other people.

4) Feelings about past events can change over time. (So true!)

5) Expecting someone to be happy all the time is impossible. (Amen!)

6) Emotions may look a little different for each person.

These six messages can be communicated differently depending on the age of the child. With younger children or children who have difficulty identifying emotions, Inside Out can be a great tool to talk about what each emotion looks like and feels like. When the child is feeling sad, does he or she feel like Sadness: tired, droopy and wanting to cry? When the child feels angry, does he or she resemble Anger: making fists, yelling and wanting to run or hit? Having these types of conversations InsideOut2can be a crucial first step in teaching emotion regulation.

The film’s message that one event can bring up more than one emotion can be introduced into the therapy room by asking a child to write down or draw how Anger, Sadness, Fear and Joy feel about an event, such as an impending divorce. This activity might help children to recognize and accept that they are afraid of not seeing their father and sad about all the fighting but also excited by the idea of getting two sets of Christmas presents next year.

I used the same activity with an adolescent client who was considering ending a difficult romantic relationship. I had tried several other approaches to help her explore her thoughts and feelings around the relationship but hadn’t made much progress.

One session, she mentioned that she had seen Inside Out that past weekend, so I asked her to draw what each of the five characters from the film was feeling about her partner. Next, I asked her why she thought each character was feeling the way she had described. This activity made room for a wider range of emotions and helped the client increase her self-compassion and begin to accept that it was OK to be sad about ending a relationship, regardless of how problematic it had been.

InsideOutAnother helpful activity is to ask children and adolescents (and parents too) to imagine what the five characters are feeling in another person’s head. Doing so can build empathy and understanding and increase connection.

For instance, a girl may be angry at her father because he does not let her go to the movies alone with her friends. The therapist can ask her to describe or draw what is going on with each of the five emotions in her father’s head.

Through this exercise, the girl may slowly realize that her father might be afraid that something will happen to her, sad that she is growing up and soon will be missing family game nights on Fridays, yet joyful that she has friends. As a way to build parents’ communication and compassion with their children, I have also asked them to describe what they believe the five characters might be feeling in their children’s head.

These are just some of the ways that Inside Out can be incorporated into our daily interactions with children and adolescents to help foster emotional awareness, empathy and compassion. The applications are endless.

Now we just have to wait to see what happens to all those emotions when Riley reaches puberty …

 

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Mercedes Fernández Oromendia is a counseling psychology doctoral candidate at the University of California, Santa Barbara. Contact her at mfernandezoromendia@umail.ucsb.edu.

 

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Related reading

 

Nonprofit News: Transforming from general clinician to nonprofit manager

By “Doc Warren” Corson III March 21, 2016

Most of us started our clinical careers not as managers but as line staff at local mental health programs, eventually working our way up to positions of more authority and responsibility. Some of us have worked very hard to learn the craft of nonprofit management, while others have simply transferred into these new positions as they became available without receiving any additional training or education beyond learning on the job.

Given enough natural ability and time, many things can be learned on the job, but being in a position of leadership without possessing the requisite knowledge can result in making many avoidable flat design for team work conceptmistakes. The key in nonprofit management then is not just natural ability and time but a concerted effort to learn the job prior to starting your first day.

Many of us have experienced a boss who pretended to know everything but was often found to be clueless instead. I have consulted with companies having issues with retention and staff morale. These companies have asked me to investigate and come up with possible solutions to the problems plaguing them. At times these issues are systemic or otherwise deeply embedded; other times, it takes only a matter of moments to identify the source of the problem. Examples of this include bosses who have no idea of the many tasks and jobs being performed by the folks they supervise. Other bosses are unaware of even the basic methods applied in successful management.

Simply put, being good at one job is no guarantee that you will be good at another. Almost every counselor clinician is a good listener and communicator, and these qualities provide a good foundation in management. But these qualities alone do not guarantee a successful transition into nonprofit management.

Years ago as part of my dissertation, I interviewed several clinical managers about the approved clinical supervisor (ACS) credential offered by the Center for Credentialing & Education. I was shocked by the results. Although the credential was only six years old at the time, not a single person I interviewed had or was actively pursuing the credential (many became interested in it during the course of our interviews, however). The majority of the clinical managers thought that because they were already supervisors, they were obviously successful and should be grandfathered into the credential. They believed, however, that others entering the realm of supervision could benefit from training; therefore, they supported credentialing in the future. It was beyond the scope of my work, but it would have been fascinating to have been able to ask these supervisors’ subordinates to rate the supervisors’ styles, abilities and overall leadership skills and compare these ratings to how the supervisors perceived themselves. Most possessed little more than on-the-job training.

One of the keys to leadership is knowing when to react (and with how much energy) and when not to react. When leaders show fear, anger, anxiety, etc., it tends to greatly affect those who are looking to them for guidance. Staying calm, not overreacting and maintaining focus can be the difference between a program operating in panic mode and one that quickly rebounds.

Although natural ability can take you far, is it fair to expect clinicians with no formal training to successfully make the transition to management? Is it fair to those they supervise or to those who are in treatment?

Success is within reach for those making the transition, however, and it need not cost a ton of money or take years to achieve. Self-study can take you far, and today is perhaps the best time in history to access information on just about any topic with the help of interlibrary loans, low-cost books from various Internet companies and a plethora of online resources.

If your knowledge level is low in this area, however, self-study may not be the best way to start. Instead, consider formal course work (you don’t necessarily need to gain another degree in this area, but it wouldn’t hurt). A certificate of advanced graduate studies might be a great option because it offers the comprehensive studies found in doctoral programs without requiring the dissertation. Most of these programs will cover the core areas for the ACS credential while giving you a more than solid base of knowledge about clinical supervision and education.

Some employers may also offer formal training, supervision and experiential learning in the area of supervision. Participating in these programs could allow you to advance within your current company. Above all, when entering into nonprofit management, make sure that you go in with a wealth of knowledge, just as you did when you entered the clinical field.

Carl (not his real name) was a tough but fair clinician. He did well in his work, but as he got older, he wanted to move up the ranks a bit to make a little more money and to have the chance to make some changes in the company for which he had worked for years. The transition was a bit strained at first. He lacked any formal training as a manager and supervisor, and his co-workers considered him to be just another clinician instead of the new boss. As was his style, Carl met this head-on and found that he was often butting heads with his workers.

Carl started writing his subordinates up in order to “show them who’s in charge,” but things only got worse. Soon enough, some of his key clinicians were leaving, and the overall morale was declining. Carl also found himself getting angry because some of the changes he had promised himself he would make once he had the authority were not coming to pass due to funding restraints and other contractual obligations. He began to hate his job because of what he perceived to be a setup for failure.

Carl actually was quite talented. Having known him for years, I grew very concerned over the tone his ever more infrequent emails to me were taking. I called him at work one day, which surprised him to no end (I am not known for telephonic communication if I can help it). Still, he shared his frustrations and concerns. It became very apparent that he had underestimated this transition, but with some tweaking, training and time, he would be able to do very well.

We started by reviewing some of the literature in the field and the basic techniques of leadership. He learned that a Rogerian approach to training staff and basic management is often most effective because it allows for a nurturing environment while also providing guidance. He also learned ways to better review funding and other contractual requirements so that he could start implementing his ideas for the program.red boss mug

Whenever new leadership comes into a nonprofit program, some changes in staffing are likely to take place. In fact, it is not uncommon for up to half of the staff to turn over within the first year or so of new leadership, depending on the size of the company and many other factors, including the normal turnover rate (which might be at 30-40 percent anyway). Learning that some staff turnover in the face of change is to be expected took some of the pressure off Carl. He had previously viewed the loss of each staff person as a personal failure on his part.

In time, our mentorship-type relationship, coupled with Carl’s self-study and experience, made a real difference in his leadership style and ability. He became more confident and better able to make decisions. As his confidence grew, he also found that he felt less threatened by his staff when they disagreed with him. Thus, he rarely if ever found the need to write up staff. (Coincidentally, I’ve found that the supervisors and managers who do the most write-ups tend to be the ones who are struggling the most in their positions.)

When you decided to become a clinician, you worked very hard to learn the literature, techniques and related issues of your craft. Becoming an effective manager will require that same dedication. Discover your personal style, but do so in tandem with the knowledge required to do the work. In time and with study, there is no telling how far you can go.

 

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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.

 

 

Adding a counselor’s voice to law enforcement work

By Bethany Bray March 17, 2016

For Gregory Moffatt, counseling and crime solving go hand in hand.

Moffatt, a licensed professional counselor (LPC), runs a private practice in which he specializes in working with children who have experienced physical or sexual abuse. He is also a professor of counseling at Point University in West Point, Georgia.

The other half of his career, however, is a little more unconventional. He’s a risk assessment and psychological consultant for businesses, schools and law enforcement agencies. Moffatt has done everything from assisting with hostage situations and unsolved cold case investigations to teaching at the FBI National Academy in Quantico, Virginia. In addition to providing training and consultation, he evaluates police officers who have been involved in a duty-related shooting to determine if they’re ready to return to active work on the force.

He’s also filming on-camera commentary as a psychological consultant for a new cable television show on hostage situations. The program, titled “Deadly Demands,” premiers March 21 on Investigation Discovery, a network of the Discovery Channel.

After years of working with corporations and law enforcement agencies, Moffatt is often the person they call to evaluate unusual situations, such as when an employee is making co-workers uneasy or

Gregory Moffatt, LPC and professor of counseling at Point University in West Point, Georgia

Gregory Moffatt, LPC and professor of counseling at Point University

a case arises that doesn’t fit the norm. It’s not a niche that he initially set out to carve for himself, but rather one that he entered “through the back door,” he says.

When Moffatt first started teaching at Point University more than three decades ago, he was the only professional counselor on campus. One day, the university’s administration approached him and asked for his help with a situation involving a student who was stalking another student.

“Stalking laws weren’t in place. Back then, even the term [stalking] wasn’t an everyday term,” says Moffatt, an American Counseling Association member. “Back then, hardly anyone did work in violence risk assessment.”

As he got involved in the case, Moffatt started researching risk assessment methods, which grew into a personal area of interest. He eventually established his own consulting business, through which he provides workplace violence assessment and training. The FBI contacted him to provide training at its academy in Quantico after he published an article in an academic journal on violence risk and assessment.

Law enforcement agencies are good at lots of things, but threat assessment isn’t always one of them, Moffatt says. That’s where his skills as a professional counselor can help fill in the “why” of a situation, he says.

Moffatt uses his counselor training to look at a specific situation’s “collection of evidence,” he says. For instance, how does the person tell his or her story? What indicators can be found in the language the person uses? What does his or her past behavior indicate? What coping skills does the person have?

“My job is to tell them [a company or law enforcement], ‘This is what I think; this is what you’re looking for,’” Moffatt says. “The question for us, in mental health, when someone’s sitting in our office is, ‘Is this person a risk?’ Sometimes the answer is yes. … How many coping skills does he [the client] have in his toolbox? If it’s a pretty empty toolbox, then I’m worried.”

For example, Moffatt was contacted by local law enforcement to evaluate the threat level of some letters a judge was receiving in the mail. Officials suspected the letters were being written by a man who had come through the judge’s courtroom for a minor infraction, he says.

Moffatt looked at the man’s behavior history (he had brandished a firearm in the past but never fired at anyone) and the language used in the letters. His counselor training helped him pick up clues — for example, symptoms of delusion and other things that would make a person unpredictable — to determine that the man was a “big talker,” but that the letters were most likely a way of “puffing out his chest” rather than an actual threat.

“I thought there was a very low possibility that he would shoot this judge. Years later, nothing has come of it,” Moffatt says.

Today, he works regularly with the Atlanta Police Department’s cold case squad and writes a regular column on children’s and family issues for The Citizen, a newspaper distributed in Fayette County, Georgia.

Moffatt says he is drawn to the sometimes gritty specialty of crime and violence assessment because he likes being part of the solution and helping to bring some closure to the victims of crimes.

“The world is not made up [solely] of bad guys and good guys,” he says. “If you go to any prison in the country, you will find a small percentage [of the inmates who] are horrible and need to stay locked up for the rest of their lives. The rest are human beings who have made a mistake. The hardest part about our job [as counselors] is to have compassion. We can take people, in any condition, and help them become more functional.”

 

Q+A: Gregory Moffatt

 

You encourage all counselors to learn more about risk assessment, whether through reading, professional development, trainings, etc. Why do you feel this particular topic is important for counselors to know?

Risk assessment is necessary in any clinical context. Violence happens in homes, schools, workplaces, on the bus, on the street and in the synagogue/cathedral. Assessing for violent behavior against others is just as important as assessing for suicide risk, [which is] something we do regularly. You don’t have to specialize in workplace violence or school violence for this to be part of your assessment toolbox.

 

Do law enforcement professionals often think of or turn to psychologists first when looking for help with mental health expertise? From your perspective, what can a professional counselor offer in this area that is different than other helping professions?

Actually, I don’t think most law enforcement people know the difference. Even when they do, they often have limited or no budgets for outside consultation. Professional counselors are cheaper than psychologists, typically. Counselors are just as competent to offer fitness for duty interventions/assessments, post-shooting intervention, violence intervention/anger management and other common needs in law enforcement as any psychologist — assuming, as always, that one is trained to deal with that population. This training is readily available to LPCs.

 

What suggestions would you give to counselors looking to help or make a connection with their local law enforcement or violence prevention agencies?

Law enforcement agencies are notoriously fraternal, and even agency to agency there is little cooperation. A given agency believes it is better than any other agency, and going outside law enforcement is seen as a negative. However, developing relationships and bringing skills to the table — especially if it is cost-effective — is the way in the door over time.

 

What are some of the main takeaways that you’ve gleaned from your work with law enforcement and risk assessment that you want professional counselors to know?

Behavioral/mental health issues are present in all corners of life. Finding a way to apply your interests in mental health in specific climates — e.g., schools, law enforcement, court — is what makes one’s career fascinating and rewarding. I look back on 30 years of work — opening doors, looking for opportunities and taking those opportunities — and I couldn’t be happier. I’ve helped hundreds of children, written hundreds of articles and numerous books, spoken to thousands of audiences and helped put many bad guys in jail — hence, making the world safer and people happier. Who could ask for more?

 

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Read more about Gregory Moffat’s work and find a list of suggested resources on trauma, violence, parenting and other topics at his website, gregmoffatt.com

 

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

 

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