Monthly Archives: December 2016

Is it OK to have it all?

By Kathleen Smith December 21, 2016

As Lindsey Mitchell approached the end of her doctoral program in counseling at George Washington University, she wasn’t quite sure what was next. After a decade of intense focus on her education, she found her career options in the field both exciting and intimidating. When Mitchell began talking to other women in her program about career choices, she realized that questions about ambition, leadership and family were common among female counselors.

Energized by these discussions with her colleagues, Mitchell decided to take the conversation to the American Counseling Association’s 2016 Conference & Expo in Montréal. Her idea took shape as a panel session called “To Lean In or Not to Lean In: The Diverse Experiences of Women in the Counseling Field.” The title alone was enough to catch the attention of many women at the conference and set the stage for an engaging talk between four ambitious and thoughtful counselors.

The phrase “lean in,” made famous by Facebook Chief Operating Officer Sheryl Sandberg’s 2013 book, Lean In: Women, Work and the Will to Lead, is rife with connotations and criticisms. Sandberg encouraged women to take risks, not make sacrifices based on hypotheticals, and to pursue leadership by taking a seat at the table. A former chief of staff for the U.S. Treasury secretary and a leader in the tech industry, Sandberg draws from her years of experience in male-dominated fields.

But when Mitchell and others considered this philosophy of leaning in, they faced an important question: What does “sitting at the table” mean in the counseling profession when the majority of counselors and ACA members are already female? Weren’t they already at the table?

A colleague of Mitchell’s recommended that she recruit Desa Daniel, a doctoral counseling student at Kansas State University, as a compelling voice for the ACA Conference panel discussion. Daniel thinks that numbers alone aren’t enough to change leadership dynamics. Although ACA and the counseling profession as a whole may be filled with women, she notes that leadership positions within the profession don’t always mirror those numbers. “We still have a long way to go until women hold positions in universities and governance that reflect their presence,” says Daniel, adding that she’d like to serve as president of ACA in the future. She currently serves as the student representative for Counselors for Social Justice, a division of ACA, and as student liaison for Division 45 (the Society for the Psychological Study of Culture, Ethnicity and Race) of the American Psychological Association.

Jessica Jackson, a licensed mental health counselor and a doctoral candidate in counseling psychology at New Mexico State University, also joined the discussion. She points to the male-dominated foundational and theoretical influence in the field as a real challenge. “When you look in the texts, our foundational knowledge is coming from men of European descent, and the structure of the training is based on that,” she says. “No one deviates from the blueprint, so to me, that doesn’t feel like a field dominated by women.”

Jackson also points out that texts such as Sandberg’s, as well as feminist psychology and various waves of the feminist movement, typically failed to include black women in the conversation. Part of her role on the panel, she says, was to help remind counselors that women of color can still be forgotten or excluded in a space that is predominantly female.

Having it all

Comedian Tina Fey wrote that the rudest question someone can ask a woman is, “How do you juggle it all?” Fey suggested the question operates on the assumption that, for women at least, success in one arena of life (e.g., the workplace) implies failure in another (e.g., family life). The question is rarely posed to men. Members of the conference panel set out to consider what “having it all” looks like in the counseling profession and whether balance between multiple arenas of life is possible.

“Can women have it all? I think yes, but we may have to package what that looks like in a different and creative way,” Mitchell says. Currently serving as an Americans with Disabilities Act counselor at Houston Community College, Mitchell points to the male-dominated workplace models that create impediments to women who desire balance between work and family life. For instance, she observes, when their children are ill, some mothers in the workforce will hide that fact and instead claim a sick day for themselves because they don’t want their parenting responsibilities to hurt how they are perceived at work.

“You would think that in a female-dominated field like counseling, it would be better,” Mitchell says. “But we’re still using these male business models instead of thinking about how we can be greater leaders to women that maybe we didn’t have. Sometimes we don’t have a model for what that looks like, so we have to start creating our own.”

These sentiments reflect a common critique of Sandberg’s idea — namely that Lean In ignores systemic obstacles that are present and remain unchanged in the workplace, regardless of whether women make it to the top playing by the current rules. So what rules do counselors need to change to make the workplace and the classroom more flexible and empowering places for women?

Mitchell asked Megan Doughty Shaine, an assistant professor of psychology and counseling at Hood College in Maryland, to bring her voice to the panel as a professor and parent. Shaine shared how her desire to have a multifaceted career and also be a mother affected her path. “It does change the way you move through your education, from the internships you accept, to the jobs you consider, to how you prioritize things,” she says. For example, Shaine limited her search for doctoral programs to the East Coast because she wanted to be close to her family when she started one of her own.

Shaine recommends that women in counseling leadership model how conversations about “having it all” are OK and even encouraged at work. “You’re more likely to have a female supervisor than a male supervisor, at least in the clinical world,” she says. “We have to really evaluate how open we are with these issues of work-life balance.”

Jackson agrees, pointing out that real pressure still exists to choose between focusing primarily on career or family in academia. “People don’t feel comfortable choosing a middle ground because that looks like you don’t know what you want,” she says. “But I don’t think it’s impossible to integrate and have both. My idea of success is being able to acknowledge and appreciate the many roles that I have as a black professional woman without having to sacrifice what means the most to me.”

Finding balance

Members of the panel also considered how to model what good mental health looks like for women trying to balance multiple roles in life. “So many of the conversations that we have about self-care feel fake,” acknowledges Daniel, who does CrossFit every day as a self-care measure. “We have to show tangible examples of what it looks like and how people manage it over the course of their careers. We need to lead by example but also help people set objectives and deadlines for self-care.”

Mitchell suggests that establishing and maintaining boundaries is an important piece of achieving balance. “I feel the pressure to be everything to everyone, and I know that is not a realistic expectation,” she says. “There will be stages in my life where my professional career has to take priority and other times when it will take a step down in importance. I know I entered this profession because I care about people and want to help, so there can be a conflict when I have to put myself first and inadvertently disappoint somebody in another area of my life. So it is a bit of a Catch-22. But this conflict will have to be resolved by continuing to reevaluate my values, my stage of life and what my goals are at the time. It’s an ever-changing process.”

Rather than a detour from success, Jackson sees the pursuit of balance as integral to achieving her goals. “I’m a happier and better person when I can feed the many different parts of who I am,” she says. “By engaging in prayer, checking in and being honest with myself, and being present in the moment, I am better prepared to achieve my idea of success. Potential conflicts may arise due to this expectation that to be successful in your career, you must dedicate your entire life to your career. But I don’t believe in that. I don’t believe that I have to achieve burnout in order to be successful.”

An intersectional approach 

Another critique of the philosophy behind the “lean in” movement and second-wave feminism is the relative lack of examination of women’s intersecting identities. At the ACA Conference, panel members wanted a significant amount of the conversation to focus on the diverse roles and identities of women in the counseling field and the impact this reality has on what it means to lean in.

Jackson points out how traditional advice given in books such as Sandberg’s, including the call to be assertive, may not work for every woman. “As a black woman, being assertive comes across as being the angry black woman. So how do I navigate the need to be assertive without also coming across as angry, even when I’m not angry? Because as soon as I’m assertive, that’s what everyone assumes,” Jackson explains. “When people give you advice, it’s coming from their social identity: their privilege, their background, etc. So you have to figure out what you can take from that and what you can leave.”

Jackson also recommends that female counselors gather both mentors who share their identities and those who do not to help them better navigate the field. When her interest in pursuing a research career led her to apply to the National Research Mentoring Network, she decided to choose a white male as one of her mentors to give her a different perspective. “He gave some insight on how to approach challenges rather than simply focusing on why people don’t understand things the way I do,” Jackson says.

For Jackson, who aspires to improve pipelines for people of color into academia and the mental health field, leaning in also includes starting conversations about the changing landscape of counseling and the reality that counselors don’t provide services to just one population. “We have to expand our ability to provide therapy to people with multiple identities and make room for them at the table as well,” she says. “If the path to leadership was really so linear, there would be a more diverse group of people stepping into those roles.”

Shaine asserts that counseling programs also have to address intersecting identities for their students, particularly those who are considered nontraditional. She points to the young women in her classroom who also work full time and the middle-aged mothers who are returning to school after a long hiatus or a career change. “We have to support them and try to be creative in helping students navigate a program,” she says. “Otherwise, we’re going to lose their voice and we’re going to end up with this monolithic student body, which I don’t think any of us want. That feels very antithetical to the counseling profession, where we want a diversity of perspectives.”

Counseling education programs could also use creativity and a focus on intersectionality to prepare women for a variety of roles in the field. Daniel points out that these programs rarely focus on issues such as licensure, starting a business or management roles. “Counselor ed programs need to step up their game and talk to people about what’s possible on the ground,” she says. “It’s socially unjust to send women out into the field without the full resources of what it really means to have a clinical practice.”

Advice from the panel

When asked what advice they would give to women entering a counseling education program or their first job as a counselor, panel members provided a variety of suggestions.

Mitchell, who aspires to a major leadership role in university student services, says that surrounding herself with the type of women who prompted these conversations in the first place was her best resource. “Sometimes we’re afraid to do that because we don’t want to feel like the least intelligent person in the room,” she says. “But you have to put your insecurities aside and see what you can learn from these women because, someday, you’ll be the person in the room somebody else is looking up to.”

Jackson says that advocating for your interests can go a long way. “If other people have that interest, then maybe you have enough people to request a class on that subject,” she says. “To me, that’s how change starts — being vocal and advocating for yourself.”

Shaine says women in the counseling profession shouldn’t lose sight of the flexibility they possess. “You can make a choice and change your mind later. We have an incredibly flexible field that gives us many different options. Be gentle with yourself,” she advises, “and know that the choices you make now can always be adjusted if they don’t suit you in the future.”

Daniel, who aspires to be a faculty member in a counselor education program, says that supporting other women can be empowering in itself. “We need to be better about supporting all women in their journeys, even if it doesn’t look like [our] own,” she counsels. “At the end of the day, we are creating pipelines for little girls to be what they want to be.”




Kathleen Smith is a licensed professional counselor and writer in Washington, D.C. Her book, The Fangirl Life: A Guide to All the Feels and Learning How to Deal, was published earlier this year.


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Cultivating a practice of mindfulness

By Laurie Meyers

In 1979, Jon Kabat-Zinn, author and professor emeritus of medicine at the University of Massachusetts Medical School, founded the Mindfulness-Based Stress Reduction Clinic, which uses a combination of mindfulness meditation and yoga to promote healing. In the ensuing decades, interest in mindfulness — not just for physical healing but also for emotional healing — has mushroomed. In a reader poll taken at CT Online ( in November, 87 percent of respondents said that they regularly use mindfulness techniques with their clients.

Meditation is perhaps the best-known mindfulness-based practice, but there are actually numerous techniques, says national certified counselor Danielle Richards. Her research, which she has presented at American Counseling Association conferences, focuses on mindfulness and self-compassion.

“There are clients and clinicians who benefit most from guided imagery and contemplative practices, while for others what is most helpful is sitting and walking meditation,” Richards says. “One individual may benefit from brisk walking meditation, while another from slow. Another individual may find that chanting or utilizing a mantra anchors them, while another the breath.”

At root, mindfulness is simply the practice of being present in daily life, explains Richards, an instructor in psychology and mental health/developmental disabilities at the College of Southern Nevada. “It encompasses being present with those around you and with what you are doing,” she says. “Overall, what I have seen as most helpful, across settings and populations, are practices that help individuals bring mindfulness into their daily lives.”

Walking meditation is one of the activities Richards recommends for cultivating awareness. “It can be applied to normal activities one does in a day, such as opening a door or walking between classes or brushing one’s teeth or washing clothing,” she says.

Richards teaches two types of walking meditation. “One involves lifting, moving, placing … where the individual focuses on being mindful of each aspect of the movement as they perform it slowly,” she explains. “The other type involves counting while walking at a comfortable pace, so it can happen as part of daily activity rather than as an isolated formal practice. It involves a sequence such as 1, 1-2, 1-2-3, 1-2-3-4, and goes up to 10. The counting serves as a placeholder for the present moment — just as the breath does in sitting meditation — so that as one’s mind wanders, the counting allows [the person] to come back to the present moment.”

Richards, a former counselor practitioner who presents workshops on mindfulness and mindfulness meditation, recommends that clients try out different walking paces to see which works best for them.

“Notice Five Things” is another simple method that counselors can use with clients to help them tune in to their surroundings, Richards says. The steps are as follows:

1) Pause for a moment.

2) Look around and notice five things that you can see.

3) Listen carefully and notice five things that you can hear.

4) Notice five things that you can feel in contact with your body.

Noting or describing — silently putting words to experience — is a technique that can be incorporated into any mindfulness practice, but it is particularly helpful for those who ruminate or are simply stuck in their own heads, Richards says.

“For instance, when feelings arise, one can silently note those feelings,” she says. “[You] could use a phrase like, ‘It’s a feeling,’ or be much more specific and note each individual feeling by name: anger, boredom, calm. For example, in a tense situation, one might observe a feeling of anxiety and simply note it as ‘I’m feeling anxious’ or ‘I’m noticing a feeling of anxiety.’”

This kind of mental noting of emotions helps clients to identify feelings and thoughts that they want to resist and instead learn to accept them through methods such as breathing exercises. “For example,” Richards says, “‘Breathing in, I am feeling worried. Breathing out, I am taking care of my worry.’”

Awareness is central to mindfulness practices. Richards explains that becoming truly aware of what is distressing to an individual and how that stress affects him or her is a key part of stress management.

As part of becoming aware of emotions, and stressful feelings in particular, Richards likes to use journaling with clients. “Individuals can become truly aware of the stress in their life and how they engage with it. This is a first step to choosing a response rather than acting on gut reaction,” she says.

“We all have unique patterns of how we respond when we are distressed and a unique set of stressors,” Richards explains. She encourages counselors to have their clients discuss or journal on the following questions:

  • When you feel stressed out, how does the stress manifest in you? Do you experience it physiologically — tightness in your throat, rapid heartbeat, sweating? Behaviorally — crying, yelling? Emotionally — sadness, depression, anger? Cognitively — negative thinking patterns? Or some combination?
  • Notice how much time out of the day you feel out of control, overwhelmed and stressed. Where have your thoughts taken you? The past, present or future? What are your experiences with past, present and future thinking?

Richards is also a big proponent of mindfulness meditation but notes that it is sometimes a misunderstood practice. “Many people think that mindfulness is a practice that involves emptying one’s mind of thoughts. This misconception can leave people feeling like poor meditators,” she says. “Mindfulness meditation is not about emptying the mind, but rather focusing one’s attention and training one’s mind to be more focused, effective and skillful in everyday life. Mindfulness is not about trying to make anything happen or getting to some special state of relaxation, although relaxation may be a byproduct.”

“When teaching formal sitting meditation,” Richards continues, “I stress that when one’s mind wanders, one gently brings it back to the breath, which is representative of the present moment.” In fact, she adds, noticing that the mind has wandered and then bringing it back to the present moment is itself a sign that the person has accomplished mindfulness.

Mindfulness for college students

Richards has also conducted a series of research studies with undergraduate students to determine whether brief mindfulness interventions affect measures of well-being and have the potential to increase self-compassion and decrease thought suppression. The most recent study, consisting of three stages over a period of roughly two weeks, combined group instruction and individual activities.

In the first stage, 15 students participated in a five-hour group meeting during which mindfulness was defined for them and they received instruction on how to practice sitting mindfulness. The group also engaged in a guided sitting mindfulness exercise together. Participants then learned about and engaged in several types of walking mindfulness exercises, followed by a mindful eating activity. In addition, the students were taught about stress, stress reduction and how mindfulness could help them become more aware of the relationship between thoughts, feelings and behaviors.

The participants also learned about lovingkindness mediation, which works by extending lovingkindness to oneself, to a person one loves and cares about and then to a person who is challenging to love, in that order. The actual meditation involves silently repeating the phrases, “May I be happy, may I be healthy, may I be safe and may I have the ease of well-being.” Individuals then say these phrases again, replacing “I” with the name of the person they love and care about and then with the name of the person who is challenging to love.

In the study’s second stage, participants were tasked with performing different mindfulness activities on their own over the course of two weeks and completing the online diary that kept a daily record of these activities. Every other day, the students received online “booster” activities that assisted them in their independent mindfulness practices. For example, for the lovingkindness meditation, the booster treatment consisted of answering the following questions: What arose in your mind as you practiced lovingkindness for yourself? Describe the images or feelings that came up. What are the easiest and most difficult aspects of this practice? What was your experience in working with a difficult person?

When participants submitted documentation of having completed the booster activity through related homework assignments, they also submitted their online diaries. The instructor provided individualized feedback to each participant through email.

The third stage consisted of another five-hour group session that included conflict-resolution activities and explored incorporating formal mindfulness practices into daily living.

The study showed that the mindfulness program was effective for increasing wellness and self-compassion and decreasing thought suppression, according to Richards. This is particularly significant, she says, because college counseling centers are typically short on both time and money, making brief treatment methods particularly attractive.

ACA member Tamara Knapp-Grosz, director of the counseling and testing center at the University of North Texas, has also found mindfulness practices useful for helping college students. “Students transitioning to college are inundated with so many changes that they may feel a true sensory overload at times, which can translate to a ‘freeze’ stress reaction where they shut down,” she says. “Mindfulness practices teach students how to slow down and give time to pause and observe rather than feeling the pressure to react immediately. I typically will do lots of psychoeducation on how strategies can be utilized and have homework between sessions where students can try out or practice what we have discussed in session.”

Knapp-Grosz, president of the American College Counseling Association, a division of ACA, uses a variety of mindfulness strategies with students. Among her favorite activities:

  • Mindful hand exercise. Hold your hands together tightly for 10 seconds and release. Pay attention to the sensations of tension and release.
  • Mindful writing. Find a favorite place and focus on the sounds, smells and tactile experiences around you. Write these down in as much detail as you can. This helps you to be fully present in the moment rather than racing to the past (depression) or to the future (anxiety).
  • Mindful awareness. This is similar to mindful writing, but instead of writing about the things around you, simply slow down and take in every detail in your surrounding area. Look at things as if you are seeing them for the first time.
  • Stop and breathe. As your mind wanders, bring yourself back to focusing on your breath.
  • Mindful balloon. “When something challenging is bombarding us, using [our] breath can also get us unstuck and [help us] move on rather than ruminating,” Knapp-Grosz says. “I teach students to visualize letting go of whatever challenge they are struggling with and cannot move on from as they exhale each breath. Sometimes even seeing a balloon floating away, with each breath going higher and higher.”

Mindfully managing addiction

ACA member Mark Schwarze finds mindfulness practices a helpful addition to the traditional group format used in addictions counseling. The group format is typically based on techniques rooted in cognitive behavior therapy (CBT) and motivational interviewing.

“From a biopsychosocial model, those with innate vulnerabilities to addiction have high levels of anticipatory thinking and reactivity,” explains Schwarze, an assistant professor and director of the clinical mental health program at Appalachian State University in North Carolina. “Mindfulness can be a way of ‘being’ in the world that, at first, feels difficult. Over time and with practice, the mindful client can develop a passive response to triggers and leave more time to make choices that will lead away from impulsive behavior. In traditional CBT-based relapse prevention, clients are required to dispute an illogical/irrational or impulsive thought and replace it with a more logical/rational one. Mindfulness-based relapse prevention only asks for acknowledgment and [a] return to the present.”

Schwarze, who presented at the ACA 2016 Conference & Expo in Montréal on mindfulness in addictions counseling, describes three specific exercises counselors can use with these clients: basic breathing meditation, a SOBER breathing space exercise and the practice of urge surfing.

“[Breathing] meditation typically focuses the client on their breath with instruction to acknowledge distractions without judgment, and then to return focus to the breath,” Schwarze says. “It is the ability to be aware of your mindlessness and return focus to the present that is really the skill to be developed.” He adds that counselors can find many examples of breathing meditation scripts or prerecorded guided meditations to help clients learn this type of meditation.

Schwarze says the other two techniques he favors are borrowed from mindfulness-based relapse prevention therapy. “The SOBER breathing space is designed to be a short exercise to break stimulus-response patterns that can happen in high-risk times for recovering clients,” he explains. During these times, clients are taught to take a three- to five-minute timeout and follow the prompts in the acronym SOBER:

S: Stop what you are doing and focus.

O: Observe the sensations in your body.

B: Breathe and focus on your breath.

E: Expand your awareness.

R: Respond mindfully.

The other technique, urge surfing, teaches clients struggling with addiction to see their cravings in a different way, Schwarze says. “Often we think of cravings as increasing in intensity over time when, actually, cravings crest and trough like a wave. At the crest of the urge, clients are asked to observe without judgment. The client observes what is happening at that point and time and doesn’t place values on those thoughts as good or bad. Alternately,” he says, “the bottom of the craving holds equally important information that may help clients root themselves in this less-anxiety-inducing space.”

Schwarze points out that clients can download recordings to guide them through both the SOBER breathing space and urge surfing exercises. “Having recordings can be a great way to encourage clients to engage in mindfulness practice on a daily basis,” he says.

Schwarze is a firm believer in the benefits that learning to live mindfully can have for clients struggling with addiction and substance abuse problems. “I suggest that counselors work with their clients to develop a realistic plan for mindfulness practice. Daily practice is ideal, but counselors should see what clients are willing to do,” he says. “Technology has made practice much easier. There are multiple apps, websites, recordings and videos that provide clients with guided meditations and other mindfulness-based exercises. Some techniques might be helpful during a craving or other difficult time but, really, developing an orientation to the experience of mindfulness provides a wider benefit.”

A source of counselor clarity

Of course, mindfulness isn’t reserved solely for clients. Counselors can benefit too, both personally and professionally.

In his pursuit of a greater overall sense of wellness, counselor Jeffery Cochran began seeing an acupuncturist in his late 30s. After doing a holistic evaluation of Cochran, the acupuncturist told him, “You need to spend some time just sitting and staring.”

“I realized that I was never still, or at least never inactive, internally or externally,” says Cochran, a professor of counseling at the University of Tennessee. “I had been highly successful being goal directed, but maybe that driven approach to life was beginning to have its limits, and [I] was not fully who I wanted to be. So, I embraced meditation to learn to be still, to learn to quiet my mind, to learn to react to fewer impulses.”

“I look at my meditation time as a counterbalance to my fairly driven, goal-oriented personality,” says Cochran, who presented on meditation and counselor self-awareness and well-being at the 2016 ACA Conference. “It is time set aside each day in which my intent is to be without tasks to check off. Time to simply ‘sit and stare’ while bringing my focus only on a meditation that I have selected [such as] breath counting or watching thoughts. I try to have the mindset that if there is some positive outcome, that’s nice, but whether there is any positive outcome or not, my purpose is served in taking some time to focus the mind away from my work tasks, away from my impulses and racing thoughts — time to just sit with myself.”

Cochran emphasizes that he does not consider himself an expert on mindfulness, but he believes that his personal practice has given him a better sense of balance in his life and also made him a better counselor. He wrote about meditation exercises in the second edition of The Heart of Counseling: Counseling Skills Through Therapeutic Relationships, a book that he co-authored with his wife, Nancy.

“Sitting with one’s own emotions [and] listening to one’s own thoughts without judgment is great training for attending to the emotions and thoughts of another without judgment,” Cochran explains. “Meditation is also about acceptance — learning to accept experience, learning to accept self. I think that sometimes our lack of acceptance of aspects of others stems from areas of the self that are
not accepted.”

Since beginning a regular practice of mindful meditation about 15 years ago, Cochran has noticed other differences in his counseling too. He says he is more at ease with the silences that are a natural part of counseling and better able to sit with the most painful and intense emotions.

“Meditation can help the counselor share the client’s experience as needed without defenses or hesitation, but with a steady awareness of one’s self as separate,” Cochran explains. “Any negative influence from the counselor’s unspoken or unrealized agenda or bias is decreased as the counselor comes to the session with a greater awareness of self, making clearer [those] choices of how best to help and what responses to provide.”

Knapp-Grosz also believes that mindful practices can be a boon to counselors. “We are all super busy as counselors and are managing multiple stressors. Learning simple mindfulness techniques that we can use between sessions or following a stressful meeting helps us with rebounding and, in turn, being more fully present for our next [client].”

In addition to using the exercises that she teaches to college students at her counseling center, Knapp-Grosz has another favorite mindfulness technique that she has dubbed “smelly travel.”

“[It’s] one of my all-time favorites that I try to do whenever I travel,” she says. “I really stop and breathe in the smells around me while looking at the beauty before me. Focusing on the smell helps me to imprint the feelings of relaxation and joy of that moment, and I can recall it by using that smell again in the future to stimulate that relaxation and feeling of peace when I need it. For example, I can return to my favorite Hawaiian beach very vividly by smelling Kona coffee. This is the opposite of what happens in PTSD [posttraumatic stress disorder], where a smell elicits the past traumatic memory. Mindful smelling can be used in powerful ways as a stress reliever and is wonderful for anxiety and depression.”

Knapp-Grosz also touts the benefits of mindfulness practices for stimulating creativity. “Sometimes we need to unplug and take a timeout to get our creative juices going again,” she says. “Mindfulness helps us notice things around us that we have shut out. It brings perspective and a new way of viewing all that is around you. Have you ever noticed that some of your best ideas seem to come at that time just before you fall asleep or when you wake up? This is similar in that mindfulness practices quiet all of that day-to-day chatter that keeps us from being aware of all of the innovations around us.”

Counselor, heal thyself

Working with first responders in his Philadelphia-area practice inspired licensed professional counselor Charles Jacob to begin studying vicarious trauma. “For a lot of folks who see terrible things during their 9-to-5 [jobs], it can be incredibly difficult to leave work and go about daily life as if the world is a normal place,” he says. “So many [clients who were first responders] seemed to have a belief in the world that was, well, pretty jaded and hopeless.”

Jacob, an assistant professor in the counseling and family therapy program at La Salle University in Philadelphia, was particularly interested in how working with trauma affects counselors. “Vicarious trauma isn’t unique to counselors, but counselors who work with traumatized populations are certainly more susceptible,” he observes.

The effects of vicarious trauma can cause changes to counselors’ core beliefs about their work, says Jacob, a member of ACA and president of the Pennsylvania Counseling Association. “For example, if I spend the majority of my time working with victims of sexual assault, I may begin to believe that the world is a cruel and unfair place,” he explains. “I may become fixated on the idea that bad things happen to good people so often that the world is a dangerous place, and safety for myself and the people I love is wishful thinking at best. This cynical worldview can lead to depression, anxiety or a general decreased belief in the goodness of humanity. For these folks, the standard self-care prescription doesn’t seem to work as well. In short, a yoga class will not cause me to change my core belief that people are inherently terrible.”

Curious about whether mindfulness might be a useful intervention, Jacob and Rebecca Holczer, a colleague from La Salle, conducted a research study with a group of counselors who worked primarily with trauma survivors. The participants completed two questionnaires, the Trauma Attachment and Belief Scale, which assesses the presence of vicarious traumatization, and the Cognitive and Affective Mindfulness Scale–Revised, which assesses mindfulness qualities. The results, published in the Journal of the Pennsylvania Counseling Association this past spring, indicate that counselors who are naturally more mindful — meaning inherently better at being more present and aware — are less likely to experience vicarious trauma.

“As best we can figure, the combination of awareness and nonjudgment allows [mindful counselors] to empathize with the client without losing their sense of self,” Jacob says. “They care about the problem when they’re in session, but they let it go and move on afterward. They see the problems the client is experiencing more objectively, but no less compassionately.”

Although being mindful is linked with less vicarious trauma, there is no research on particular practices, says Jacob, who is also a licensed psychologist and licensed marriage and family therapist. “We know that mindful people are less susceptible to vicarious trauma, but we’re still trying to make sense of interventions that directly affect the process,” he says.

Research does, however, link meditation and breathing exercises to stress reduction. With that in mind, Jacob and colleagues gave a presentation at the ACA 2016 Conference & Expo that featured mindfulness exercises that counselor practitioners can use to help guard against vicarious trauma.

“In our presentation, we talked about the use of meditation before sessions. The idea here is to reduce the experience of anxiety during the traumatic event [hearing a client’s story that the counselor finds traumatizing] to alter the emotional aspect of the memory of trauma so that it causes less stress later on — similar to the use of beta blockers in the treatment of PTSD.”

“For example,” he explains, “a counselor who meditates for 10 minutes before what they perceive to be a stressful session would hopefully go into the meeting with a reduced heart rate, blood pressure, etc. When presented with a troubling client narrative, there’s a better chance [the counselor] might feel less stress and distress, and have a reduced chance of vicarious trauma, [because] they will remember the event later on as being less stressful.”

The meditation practice requires just 10 minutes at the beginning of the day, Jacob says. He recommends that counselors use a mat on the floor or sit in a chair comfortably, set a timer for 10 minutes and then sit silently and motionless while mentally repeating a personal mantra that syncs with slow, controlled breathing. “Focus only on remaining still, breathing, repeating your mantra and staying focused and present,” Jacob emphasizes.

Jacob and his colleagues also presented a breathing exercise that counselors can use themselves in session. “The basic idea here is that exposure to trauma causes the sympathetic nervous system to kick in,” Jacob explains. “Your heart rate and blood pressure go up and your breathing becomes rapid and shallow. … You can’t control your heart rate, blood pressure or any of those other pesky automatic responses … but you can control your breathing.”

Jacob describes the exercise as a fairly uncomplicated method of slowing down the breathing and holding enough oxygen in the lungs long enough to do good things in the body. “The other plus to this exercise: It’s simple enough for you to do it in front of someone and not look insane,” he says with a laugh.

“In the event that a client begins recounting a trauma that is particularly troublesome for you, first continue focusing on what the client is saying,” Jacob directs. “Then use a slow, controlled breath to inhale through your nostrils until your lungs reach their full capacity — a process that takes about 10 seconds. Hold this breath for approximately one second, and then begin the process of slowly exhaling through a small parting of the lips — no bigger than the diameter of a coffee straw — for the duration of about 20 to 30 seconds. You should notice nothing amazing really … just a slight decrease in heart rate and blood pressure such that the physiological response of anxiety is less and the ability to be aware and present is easier to access.”

Jacob says an additional impetus for his research was his concern that the phrase “self-care” has been getting a little too nebulous in the counseling profession. “We talk about it very generally and very often, but I find that this doesn’t usually provide much direct guidance for struggling clinicians. I really think that making efforts to think and practice differently is our best bet at keeping clinicians safe, healthy and happy.”




Additional resources

To learn more about the topics addressed in this article, take advantage of the following select resources offered by the American Counseling Association:

Journal articles (

  • “Mind The Gaps: Are Conclusions About Mindfulness Entirely Conclusive?” by Adam W. Hanley, Neil Abell, Debra S. Osborn, Alysia D. Roehrig & Angela I. Canto, Journal of Counseling & Development, January 2016
  • “Effect of a Mindfulness-Based Intervention on Counselor-Client Attunement” by Stefani A. Schomaker & Richard J. Ricard, Journal of Counseling & Development, October 2015
  • “Mindfulness-Based Awareness and Compassion: Predictors of Counselor Empathy and Anxiety” by Cheryl L. Fulton & Craig S. Cashwell, Counselor Education and Supervision, June 2015
  • “Mindfulness-Based Interventions in Counseling” by Amanda P. Brown, Andre Marquis & Douglas A. Guiffrida, Journal of Counseling & Development, January 2013

Book (

  • Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice, second edition, edited by Craig S. Cashwell & J. Scott Young




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

Letters to the editor:




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The Counseling Connoisseur: Enjoying the holidays by letting go of expectations

By Cheryl Fisher

“Peace begins when expectation ends.” — Sri Chinmoy


My family recently celebrated several milestones of honor. Turning 16 and now boasting a driver’s license, my nephew has intensified his campaign to own that ever-elusive Mustang. Meanwhile, his parents celebrated their 50th birthdays. The grandest of celebrations, however, honored my parents, who both turned 80 this year.

This special event warranted all the hoopla we could muster. We reserved my parents’ favorite restaurant, which has played host to their Saturday date nights for more than 30 years. We ordered a three-tiered cake that was glazed in teal and decorated in white-and-black lattice and beads. Cherries jubilee, my father’s favorite dessert, was assembled to accompany the cake.

Furthermore, decorations, flowers and unique trinkets were crafted and arranged to create a special tribute to family members. We compiled a soundtrack, with a conglomerate of music specially selected to appeal to each of the honorees. We hired a photographer to document this precious event. The drinks were poured. The food was delectable. Everything was perfect.

Except … the music wouldn’t play because there was no access to Wi-Fi … and the cake leaned like the Tower of Pisa as it settled on the stand … and the toast I had spent hours preparing didn’t come out quite as eloquently as rehearsed. Even the cherries jubilee failed to ignite, requiring the dousing — OK, the dumping — of more brandy than should ever be used in any dessert.

It was a circus of mishaps. Nothing turned out as planned. But once we were able to lean into the moment and dispel our illusions of control and perfection, we engaged in merry-making and memory-making that will last a lifetime.


Five tips for enjoying the holidays

‘Tis the season for gatherings filled with song, culinary bliss, gifts and expectations. Invariably, it is the stress generated from these expectations that diminishes the magic that can be found among family, friends and festivities. Rather than succumb to the tyranny of expectations, here are five liberating suggestions for the holidays:

1) Focus on the moment. Often we impose expectations around time. We either have the perception of too much or, more commonly, too little time. However, time is, according to Einstein, an illusion.

Therefore, spending precious time in the past or the future can be futile. Focus on the moment at hand. What is it that you want to remember about this moment? Is it the perfectly crafted table setting and trimmed tree … or is it the communion of family? Finally, find ways to simplify your schedule. Prioritize activities and give attention only to those that are meaningful to you.

2) Set boundaries, and don’t take it personally. Setting boundaries is probably the most powerful tool you have for protecting against the stress that is sometime generated by family and friends. Be clear and assertive. If you are unable to host an event, then (practice with me) just say, “NO.”

No is a complete sentence and really does not require an explanation. If you feel compelled to provide an explanation, then do so … but do not personalize any response you may receive. Everyone is entitled to her or his reaction; however, we do not need to take that reaction on. If Aunt Susan always criticizes your sweet potato casserole (regardless of how much you modify it to her specifications), then let it go. This is not about your casserole. Aunt Susan simply benefits from the illusion of control she exerts when she criticizes. It is her baggage — you don’t need to carry it.

3) Think in possibilities rather than expectations. Unlike expectations, which often hold assumptions from past experience and promote rigid thinking, possibilities are based in the mystery of the moment. All things are possible in any given moment. It is possible Uncle Tommy won’t have too much eggnog and need a ride home. It is possible that the cousins won’t engage in a passionate dispute over political views this year. Possibilities allow room for change.

4) Embrace the mishaps. If we must carry expectations at all, then expect that mishaps will occur. Stuff happens. Presents don’t arrive on time. Dinners don’t look like their airbrushed pictures in the magazines. People … well, people can be temperamental. Yet it is often the mishaps that generate the charming memories that we hold so dear.

5) Remember that it is temporary. In the midst of the hustle and bustle and family dynamics, remember that it is all temporary. All of it. The holiday. The time together. The busyness that we impose on ourselves and each other. It is simply a flash, and then it is over. All that remains are the memories we have chosen to create. Therefore, craft wisely.



The pictures from my parents’ celebration arrived recently — 335 snapshots that captured moments from this monumental family event. Each print portrayed a perfect interaction of smiles and hugs. Beautifully set tables, the cake perfectly straight and tall, the cherries jubilee aflame.

Yet behind each perfect pose and print resided another story … a narrative flawed by imperfections. A narrative that fades into our family history of “mostly happily ever after.”

From my family to yours … Peace and Happy Holidays!




Cheryl Fisher


Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland, and a visiting full-time faculty member in the pastoral counseling program at Loyola University Maryland. Her current research is titled “Sex, Spirituality and Stage III Breast Cancer.” She is also writing a book, Homegrown Psychotherapy: Scientifically Based Organic Practices, that speaks to nature-informed wisdom. Contact her at








Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.



The culture of smoking in substance abuse recovery

By Bethany Bray December 12, 2016


Editor’s note: This online exclusive is a companion article to Counseling Today’s December feature “What counselors can do to help clients stop smoking,”


Less than half of substance abuse treatment centers in the United States have tobacco cessation programs, according to the U.S. Centers for Disease Control and Prevention. At the same time, the rate of smoking is much higher for those with mental illness or behavioral health problems than it is in the general population.

Despite all of the known health risks associated with smoking, many inpatient or rehabilitation facilities still give smoking breaks as a reward or as part of behavior modification programs, says Greg Harms, a licensed clinical professional counselor (LCPC), certified addictions specialist, and alcohol and drug counselor with a private practice in Chicago.

“There’s such a culture of smoking in mental illness treatment and substance abuse recovery. Historically, it was thought as helpful – an outlet that wasn’t their main addiction (alcohol, illegal zxqdghr2kiw-stas-svechnikovdrugs, etc.). This persists even to this day,” says Harms. “Doctors will still ignore the smoking issue. It just doesn’t get addressed. It’s really part of the culture at day programs, treatment programs and nursing homes.”

There’s a longstanding myth among helping professions – particularly those in the addiction and rehabilitation specialties – that smoking is “not as bad” as other addictions, says Ford Brooks, a licensed professional counselor (LPC) and professor at Shippensburg University of Pennsylvania.

This school of thought is exemplified in the fact that the co-founders of Alcoholics Anonymous, Bill Wilson and Bob Smith, both died of smoking-related illnesses (cancer and pneumonia), says Brooks.

“They were sober, but they were chronic smokers,” he says.

Practitioners often overlook a client’s smoking to focus on seemingly “bigger” problems, such as alcohol dependence, severe mental illness or illegal drug use, says Brooks. But smoking poses its own significant health risks, from lung disease to cancer, he notes.


Smoking quitlines: A lifeline for practitioners and clients

In the U.S., each of the 50 states, the District of Columbia, Puerto Rico and Guam have telephone “quitlines” that offer information and live support to callers who are looking to stop smoking.

American Counseling Association member Gary Tedeschi, clinical director of the California Smokers’ Helpline, urges counselors to call their state’s quitline themselves if they have questions or are looking for guidance to help a client through the quitting process.

Tedeschi, a national certified counselor and licensed psychologist, also encourages counselors to connect their clients with a local quitline. The service can offer more frequent and targeted contact for clients outside of counseling appointments. It also may help those who are less likely to open up in face-to-face meetings in a counselor’s office, Tedeschi adds.

Staff members who speak to quitline callers are well-trained and able to coach people through the quitting process, says Tedeschi. They also contact each caller again after the initial conversation to provide follow-up support.

Tedeschi says the phone counselors at his quitline call people several times – even if it’s just a brief check-in – during a person’s first week of quitting to reduce the chance of relapse.

“It’s a free service, it’s convenient and [it] helps people deal with the ambivalence they may feel about behavior change,” Tedeschi says of telephone quitlines. “Once they make initial contact, we will proactively follow up. We don’t have to wait for them to return [to a counseling office] or call back. They might be ambivalent about quitting or changing, but we’re not.”


Find out more at or call 1-800-QUITNOW






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


Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at






Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Raising public awareness of the counseling profession

By Bailey P. MacLeod and James W. McMullen December 8, 2016

Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.”
— Consensus definition of counseling developed and approved through
20/20: A Vision for the Future of Counseling


Renaldo sits at home dreading when the next panic attack will hit him. It has happened twice this month already since his wife abandoned him and their young son. Renaldo now makes it a point to leave work earlier than normal each day to avoid the stress of traffic.

Even though Renaldo feels like he is losing control, he makes an effort to seek help for himself and his child. But while researching online, speaking to family members and his physician, and having parent-teacher conferences, he is bombarded with an avalanche of confusing and often conflicting information.

Renaldo’s family doctor recommends that he seek a psychiatrist for medication for extreme anxiety. His sister offers the phone number of a social worker Renaldo can speak to on a daily basis for a reduced fee. Online, Renaldo finds a listing for a licensed professional counselor in a december-authorsneighboring city who specializes in working with panic attacks, but another website states that he should see a clinical psychologist if he is prescribed any medication. During a recent parent-teacher conference, the second-grade teacher suggested that his son meet daily with the school counselor to address his withdrawn behavior that is steadily getting worse.

Renaldo is presented with many different options, but he desires more support because he is overwhelmed and confused about which direction to follow. Should he seek medication to feel less worried? What is the difference between a clinical psychologist and a licensed professional counselor? Which one is covered by his insurance? Can he receive the help he needs through a social worker? In what ways can a school counselor support his child? Will Renaldo need to seek outside help if his son continues to struggle at school?

These are just some of the questions that Renaldo faces as he begins the seemingly daunting task of seeking mental health services. Professional counselors and counselors-in-training have found themselves facing similar questions while debating the future of our profession.

Over the past couple of decades, we have heard numerous calls for professional advocacy and a desire for unity among counseling specialties. Delegates to the 20/20 initiative, co-sponsored by the American Counseling Association and the American Association of State Licensing Boards, began meeting in 2006 as a means to position the counseling profession for the future by the year 2020.  Through this initiative, delegates representing 31 major counseling organizations identified the Principles for Unifying and Strengthening the Profession, developed a consensus definition for counseling and most recently finalized a licensure title and scope of practice for counselors to lay the groundwork for licensure portability.

Although the profession has advanced the process to understand what it means to be a professional counselor, roadblocks still remain. Fragmentation continues to drive some specialties to advocate for individual areas rather than counseling as a greater whole. A lack of consensus on licensure education requirements still remains an obstacle to training.

There is also a lack of knowledge regarding public perception of our field. A consensus definition of counseling was created for use with the public, but how do we begin to explore its potential? How do we bolster our identity with the people we serve? If it can be difficult to explain to the public where our profession fits in with other mental health professionals, then how do we let the pubic know that we are available to serve their needs? How can clients such as Renaldo make better “informed decisions” about where (and from whom) to seek services?

To address these issues, the 20/20 initiative states that one of the strategies to support a unified vision of counseling includes conducting ongoing outreach to the public. By looking at the public’s perceptions of counselors and other mental health professionals, the authors of this article hoped to gain a better understanding of:

  • How the public makes decisions regarding seeking mental health services
  • How counselors are viewed differently from other helping professionals
  • To what level the public agrees with the consensus definition of professional counseling

What is professional advocacy? 

Much of the counseling literature on advocacy focuses on advocating for our clients to promote their needs and find them resources. Professional advocacy, on the other hand, has received less discussion, even though it is equally important in meeting the needs of clients and society.

Professional advocacy means promoting counseling — and counselors — as a legitimate profession that is worthy of serving the public based on specific training and credentials. Without this advocacy and recognition from the public, counselors would not be allowed to bill for insurance, gain licensure or work in a variety of settings and with a broad range of clients and issues.

Many barriers to professional advocacy exist for individual counselors attempting to balance the multiple roles of being a counselor in the community. Specific obstacles include a lack of funding or support from their agencies, a lack of time, opposition by other providers and a lack of knowledge about professional advocacy. Despite these barriers, most counselors would agree that professional advocacy is necessary to promote our services and help a greater number of clients in the community.

Counselors do not necessarily need to devote countless hours to volunteering for larger organizations or lobbying for the profession (although these efforts are still needed and helpful). Advocacy can be done at a microlevel by adjusting how you promote the counseling profession in common interactions with clients, agencies, community stakeholders and other mental health providers. But to understand how better to advocate, we must first be aware of what the public knows about professional counseling.

Public perception

What does the public know about professional counseling? It turns out not a lot, at least in comparison with their knowledge of psychiatry, psychology and social work.

In 2014, we conducted an online survey of 300 individuals from the general public about their perceptions of professional counseling and other mental health professions. The participants came from 43 different states, and more than half of them had received mental health services in the past. Compared with their knowledge and perceptions of psychiatry, psychology and social work, these participants’ responses indicated less knowledge and information about the educational requirements, licensure standards, experience and scope of practice of counselors.

Their answers shed light on ways that counselors can advocate for the profession with clients and the community. What follows are important findings from our survey and suggestions for how counselors can use this information to promote their work.


Many counselors have had the experience of trying to explain what being a “counselor” really means to others outside of the profession. Often, people will follow that explanation up with a question: “So, is that like a psychologist (life coach/guidance counselor/social worker)?”

The reality is that the meaning of professional counselor is not as widely known as other mental health professions with longer histories. Given that professional counseling is relatively new compared with psychology, psychiatry and social work, the general public is not as well informed about who counselors are and what we do. In addition, the term counseling is not a protected term, meaning it is used to describe a variety of other services and professionals outside of professional counseling.

Licensure terms (e.g., licensed professional counselor, licensed mental health counselor) also vary between states, which can further confuse public understanding. Likewise, roles among professional counselors can also vary. For instance, clinical mental health counselors, university counselors and school counselors can be expected to perform different tasks for the populations they serve.

Responses to our survey regarding public perception of the educational and licensure requirements of professional counselors varied widely. Two examples: “Someone who went to advocacycollege and obtained at least a bachelor’s in social work or counseling”; “A trained professional in the field of mental health and/or social services.”

Counselors can engage in professional advocacy by informing clients, students, colleagues and the public of their educational backgrounds, credentials and licenses, as well as what these things mean. Participants in our survey endorsed licensure, experience and graduate degree as the three qualities they would most value in mental health professionals.

Counselors might consider displaying their degrees, licenses and professional organization memberships in their office settings and also including this information in their professional disclosure statements. This may seem like a small step, but by taking the time to explain your training and experience, you are educating clients (and potential clients) such as Renaldo about the profession of counseling as separate from other “helping” professions and promoting your own professional competence.

Scope of practice

In general, survey participants assumed that counselors work more with individuals experiencing transient issues or problems in living, whereas they perceived psychologists and psychiatrists as working with more serious issues and social workers engaging more frequently with families. For example, one participant said, “A psychologist would be trying to understand why a person is doing something. A counselor would probably just be giving advice on how to change behavior.”

In reality, counselors work with a large range of issues, populations and techniques. However, states often regulate counselors’ scope of practice, such as diagnosing, which can cause further confusion among the general public. Providing clients, students, referral sources and colleagues outside of counseling with information about your scope of practice, areas of specialization and professional experiences could result in more accurate understanding of what you do as a professional counselor.

Returning to Renaldo’s dilemma, for example, knowing how we stand out among other helping professionals can empower us to better understand our strengths and limitations. This would allow Renaldo to get a glimpse of our professional capacity and how we might collaborate with other stakeholders to provide adequate care for him and his son.

 Promoting our focus

What makes the counseling profession unique among other mental health professions is our wellness-based, developmental approach to mental health. Of all the different areas of focus for counseling, survey participants endorsed prevention as the most valued. In addition, 86 percent of survey participants agreed that the 20/20 consensus definition of counseling fit their idea of professional counseling. Counselors could promote this definition and discuss how their practices align with these beliefs as a means of providing clients with a more accurate understanding of counseling and fighting the stigma associated with seeking counseling.

For instance, Renaldo could be worried about any stigma that might result from his son seeking help from a school counselor. Reaching out to Renaldo could provide a clearer picture of the academic, career and personal focuses of school counseling services. This in turn may
help alleviate some of the anxiety he might be experiencing.

In reaction to the definition of professional counseling, one survey participant wrote, “Honestly, I didn’t realize that professional counseling was an option. I thought it was psychology or something that sounds desperate, like a life coach. It sounds useful, and like something I could recommend for friends.”

Informing the public and potential clients about the focus of professional counselors could open doors for people who would not normally seek services because of their preconceived notions of the field and mental health in general.

Referral networks

The two places survey participants said they were most likely to seek information about mental health services were primary care physicians and the internet. Counselors can advocate for the profession by collaborating with and educating important stakeholders and referral sources about professional counseling services.

Primary care physicians are often clients’ first stop in addressing mental health concerns, and these individuals may be more likely to follow up with a mental health referral if it comes from a trusted professional. Counselors could gain a valuable referral source by making this connection and also educate other health professionals about the research that supports the benefits of counseling for overall mental and physical health (for example, research has shown that a combination of medication and counseling can increase treatment outcomes).

The impact of this referral was evident when Renaldo’s family doctor recommended that he connect with a psychiatrist to receive medication to reduce his anxiety and address the panic attacks he was experiencing. If this doctor had been made aware of the potential benefit of professional counseling in conjunction with seeking medication, we might have been able to centralize the information Renaldo was seeking at a familiar and trusted location.


When discussing the quality and availability of counseling, survey participants frequently mentioned the relationship between counselor and client. For example, one participant stated, “I feel counseling is helpful if one finds the right counselor, and that’s not always easy. If a person finds the right counselor, therapy can literally change their life.”

Participants seemed to agree that the counseling relationship was central to the quality of their experiences with counselors. This parallels what most counselors believe and what the research shows is most important. Professional counselors could advocate for themselves and the profession by making the relationship a high priority in professional statements and behaviors.

For example, counselors in private practice settings could allow potential clients a no-obligation consultation before beginning counseling to see if the relationships might be a good “fit.” This type of approach might empower Renaldo to decide what would work best for his family and show him that he is in control of his treatment. Counselors in other settings could discuss the importance of the client-counselor relationship upfront with new clients or students and allow them to switch to a new counselor within the same setting if the client so chooses.

For many people, the decision to seek help can be difficult. Promoting the importance of relationship within counseling can help create an environment of respect, collaboration and autonomy.

Community engagement 

Finally, counselors could advocate for the profession by reaching out to their communities outside of the counseling setting. For example, counselors could volunteer at nonprofit organizations in their local areas. This allows counselors to be a part of missions that are important to them while also helping counselors with networking and exposure. Giving the public opportunities to meet and engage with counselors outside of the traditional counseling setting and informing them about what counselors do might open doors for people such as Renaldo who have never considered counseling before.

Providing outreach in places that may need additional education or resources could also be a way to combat stigma and stereotypes of mental health issues, teach people about wellness and inform others about the benefits of counseling. For example, a counselor who specializes in children and adolescents could teach a parenting workshop for new foster parents, or a counselor who specializes in addiction could educate staff at a homeless coalition about substance abuse. Outreach and volunteer work allows counselors to use their skills in new and helpful ways, while providing the public with an experience of what counselors do and what they value.


The counseling profession and professional organizations have worked hard to advocate for counseling’s place among the other mental health professions. These efforts have resulted in advances in counselor licensure, insurance recognition and a broader scope of practice. And more advances are currently in progress.

For our profession to address obstacles such as fragmentation of counseling specialties and the general lack of public knowledge regarding our professional capacity, it is important that we develop meaningful strategies like the ones mentioned in this article to continue our efforts in professional advocacy. This can begin at the individual level by exploring our professional identity and creating individual initiatives to help people such as Renaldo better understand our profession and make more informed decisions about mental health services.




Note: Those interested in more information about this topic can refer to the article “What Does the Public Know About Professional Counseling? A Study of Public Knowledge and Perception of Professional Counselors” in the Journal of Counselor Leadership and Advocacy, Volume 3, Issue 2.




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

Bailey P. MacLeod is a licensed professional counselor associate and counselor educator in Charlotte, North Carolina, where she specializes in clinical mental health and addiction. Contact her at

James W. McMullen is an assistant professor of school counseling at the University of Wisconsin-Stout. He is a licensed professional counselor associate, national certified counselor and licensed school counselor. Contact him at

Letters to the editor:




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.