Decades ago, you might have gotten some funny looks or raised eyebrows if you used the word “neurocounseling” in a professional setting. In recent years, however, counselors have become increasingly interested in using concepts from neuroscience to inform and support their work with clients.
What makes professional counseling compatible with neuroscience? How can it help counselors gain insights into human behavior and the challenges that clients bring into counseling sessions?
Counseling Today asked three practitioners for whom neurocounseling is an area of expertise, Thomas A. Field, Laura K. Jones and Lori A. Russell-Chapin, what draws them to this topic.
The trio are co-editors of the ACA-published book Neurocounseling: Brain-Based Clinical Approaches. Field is an associate professor in the master’s counseling program at the City University of Seattle; Jones is an assistant professor at the University of North Carolina at Asheville; and Russell-Chapin is professor of counselor education at Bradley University in Illinois.
Q+A: Why neurocounseling?
Laura Jones: Coming into the field with graduate degree in cognitive neuroscience, I have always playfully said that I do not know how to be a counselor without considering what is happening in the brains and bodies of my clients — both the physiological factors that have led to their struggles and resilience as well as the neurophysiological corollaries of their growth. As a counselor-in-training and later a student in counselor education, I could find very little work discussing this connection and became passionate about trying to bridge the two fields.
One of my foremost professional endeavors is to facilitate the intentional and informed integration of neuroscience into our field in a way that honors our professional identity (as I am also quite passionate about professional advocacy as well) and in doing so enrich and increase accessibility to training in this area. I am endlessly excited by the emerging science that can, has and will continue to influence the mental health field. For example, how can we ignore research that suggests that levels of certain gonadal hormones (steroids) have the potential to influence an individual’s susceptibility to suicidal ideation and attempts, drug relapse, responses to traumatic stress, etc., or the burgeoning research that implicates dysbiosis (imbalance) of our gut microorganisms (e.g., bacteria) in our mental health, or the fact that our body’s immune response has implications on mental and emotional wellbeing.
Although Descartes’ mind-body dualism has long been disproved, we (mental health and medical practitioners alike) often still function, largely implicitly, from this paradigm. Each and every day, researchers are substantiating just how complex this connection truly is, thereby underscoring how we can no longer work in health silos. This integrative perspective is the future of mental health.
Counselors have the opportunity to learn from other fields and use this information to strengthen our work with clients and our field as a whole. I firmly believe that counselors are well positioned to provide valuable and unique contributions to broader deliberations, research initiatives and policy efforts in the national mental health sector, and in doing so, secure our position as a leader among the mental health professions.
Another reason that I have become so passionate about this work stems directly from clinical experiences, much of which has centered around work with trauma survivors and individuals struggling with substance use disorders. I cannot express how powerful and empowering it has been for clients with whom I have worked to understand how processes in brain and body may be contributing to their struggles. The phrases, “So, you mean I’m not crazy?” “It makes so much sense!” and “Can you please explain that to my family?” have been used more than once. As counselors, we also are well aware of the pervasive and damaging stigma shrouding mental health challenges and those who are struggling. Most individuals with clinically diagnosable disorders never get the help they need, owing largely to this stigma.
Providing a physiological rationale for mental health challenges can significantly reduce mental health stigma; make mental health, often considered an enigmatic concept, more tangible; and alleviate the blame and shame that those who are struggling frequently experience.
Thom Field: Neuroscience attracts me for several different reasons. First, I think neuroscience provides a scientific basis for understanding important foundational concepts about human development, the impacts of oppression and marginality and the centrality of the counseling relationship. It has already provided us with significant insights into why certain problems develop at different stages (e.g., why the emerging adulthood years make a person susceptible to develop bipolar disorder or schizophrenia; see Seth Grant’s genetic lifespan calendar). Second, certain clinical issues are better understood and addressed through the lens of neuroscience, such as traumatic brain injury, posttraumatic stress, substance use, autism, attention-deficit/hyperactivity and even depression. One of my close family members has a diagnosis of schizophrenia and another autism, so understanding how to prevent and treat these conditions is important to me personally. Third, neuroscience helps to explain why we respond to certain events, such as why our physiological systems become activated in response to threats in the environment, leading to quick and often automatic decision-making and action such as aggression. I am part of a team that has developed a therapy model around this concept (neuroscience-informed cognitive behavioral therapy (CBT); see the website http://www.n-cbt.com/ for more information). Fourth, many of my fellow counselors and students continue to underprioritize Maslow’s basic needs like sleep, and sometimes do not ask about this during the first meeting with a client/student. Fifth, and perhaps most important, neuroscience offers promise for the discovery of new information about the brain and body that can make us more effective professionals.
Most psychotherapy research is limited by self-reported data (which is largely unreliable) and has largely failed thus far to distinguish specific behaviors and interventions on the part of the counselor that lead to more effective client outcomes. For example, meta-analyses have found that most counseling theoretical approaches are equivalently effective, and component studies have found that specific components of a model (e.g., the trauma narrative in trauma-focused CBT) are relatively unimportant to overall effectiveness. Thus, while psychotherapy generally appears to be effective, we still have little clue as to what factors make counseling more/less effective.
I believe that the objectivity of brain imaging and measures of neurological activity may help us to better measure what makes counseling more/less effective in the future.
Lori Russell-Chapin: I have been teaching and practicing counseling for at least three decades. It seems that many clients are searching for methods to help them feel better. So many of my clients have been to several counselors who have been helpful, but the clients are needing, wanting and searching for “one more thing” to help with their psychological and physiological concerns. Neurocounseling, or bridging our brain to behaviors, is the missing piece or “thing” of the puzzle.
As I teach students, clients and other helping professionals about neurocounseling, an all-encompassing phenomenon seems to occur. Without exception when people begin to learn more about the brain and body connections, they often comment, “If I can control my breathing or heart rate or skin temperature, then perhaps I can control so much more in my life!” Offering people self-regulation skills teaches intrinsic locus of control and personal accountability. Neurocounseling strategies demonstrate on an individual basis quantitative measures to show counseling efficacy measures. An example of this is a client who enters the counseling office with a skin temperature of 75 degrees. With one skin temperature imagery exercise, the client may be able to raise the skin temperature 5 to 10 degrees. I have had clients literally skipping out my office because they have learned this simple but essential biofeedback tool. This is an outcome measure at every counseling session.
Another fun example of neurocounseling: I wear biofeedback/temperature control nail polish. I am constantly getting feedback about what is going on in my day. This is a constant reminder for me to diaphragmatically breathe, slow down and self-regulate!
Teaching others about neurocounseling doesn’t just help them with situational symptom reduction, but it teaches a unique approach to wellness, life and a method for adapting and regulating through life’s difficulties.
Related reading, from the Counseling Today archives:
Want to connect with other counselors who are interested in neuroscience? Join ACA’s Neurocounseling Interest Network. Contact Lori Russell-Chapin at firstname.lastname@example.org or visit neurocounselinginterestnetwork.com.
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