Monthly Archives: May 2018

The opioid crisis and a wounded counselor’s heart

By Antoinette D’Angelo (pseudonym) May 14, 2018

[Editor’s note: Because of the personal nature of the narrative, the author is using a pseudonym.]

 

“Welcome to the club!” This greeting, typically extended to new members, often implies certain advantages, discounts and perks. However, the club my husband and I unwittingly have joined is based on an experience I would not wish on my worst enemy.

We received “the phone call” — the one every parent dreads in their wildest nightmares — at 2:30 in the morning in mid-February. It was the police station calling to tell us that our son had overdosed. He was alive, barely, but they had found him just in time.

A tumult of thoughts raced through my mind. Our son lives 2,600 miles away. Could it be a mistake? Were they sure it was our son? He wasn’t supposed to be in that city. What is happening?

As I write this, I know similar words must have been said or written a million times over by so many other heartbroken parents. In truth, there is nothing new to read here. Yet, it is my son I am writing about, my “kid” (now in his 30s). It is my same son whom I desperately worried may not live when I went into labor at six months gestation. It is my child whom the OB-GYN gave only a 10 percent chance to make it. It is my child who did make it, who went on to do great in school, who had tons of friends, who graduated from college, who got married and had a wonderful job. It is my kid who loved cutting down Christmas trees when he was little, swam like a fish and played soccer until his feet ached. It is my child who loved our annual summer trips all across the country to see major attractions and visit dozens of national parks. And it is my son whom the police were now telling us had almost died of an opioid overdose.

I write this story partly for the cathartic release it provides. Our family has cried more tears over the past few months than we could have previously imagined possible. Perhaps more important though is this: The ultimate irony of this situation is that I am a licensed mental health counselor, a licensed addiction counselor and a master addiction counselor. I am an assistant professor of counselor education and teach courses in addiction and treatment. I “know” so very much — maybe even too much on paper — about this disease of addiction, while simultaneously finding that I know so very little.

 

A quest for treatment

A few hours later, we raced to the airport, my husband catching the first available flight to the East Coast. We decided that once my husband got more information, I would fly out. Unfortunately, his plane was delayed, he missed his connecting flight and he ended up arriving after midnight. With no “new” news about our son, the hours ticked by excruciatingly slow.

The next morning, my husband went to see our son in jail — the words still seem incredulously stark written here. They brought our son out in a wheelchair. He was retching violently, trembling uncontrollably and could barely speak. My dear, sweet, gentle husband wept because he thought our son, who was in full-blown detox, was going to die. My husband and son could talk with each other only through a television screen. After 10 minutes, they took our son away.

I called the jail shortly thereafter and pleaded to find out what was happening. The response was that they weren’t allowed to tell me. Many hours later, I was routed to an “angel” sergeant who explained the jail’s “detox protocol” — they give the inmates Tylenol and a pill for nausea, but the inmates throw that up immediately.

Our son was in sheer agony, and we had never felt so utterly helpless in our entire lives. We could not even get a message to him. The whole experience shook us to our cores, and we felt nearly incapacitated by immobilizing grief.

My husband had his “one allotted visit” for the week, which was on Saturday, meaning that the next visit couldn’t be until Monday. We were distraught with worry about our son’s condition but weren’t allowed any additional information. We contacted an attorney in the area whom we had worked with previously years prior. Blessedly, he took on our son’s case but was likewise unable to find out anything over the weekend — and Monday was a holiday. Our agony continued, piercing our souls.

Tuesday was the bond hearing. Our son had been charged with two felonies and two misdemeanors. Our attorney spoke on our behalf. Amazingly, our son was released from jail in our recognizance, as long as he agreed to go directly into treatment.

The next several days were a blur-filled nightmare that involved navigating the quagmire of insurance situations. We found that because our son was “five days sober,” no detox unit would take him, reasoning that he was not in quite desperate enough straits at that point. No residential treatment center would take him; he didn’t qualify for Affordable Care Act insurance because he had lost his job. He couldn’t get on Medicaid because his physical address was listed a state away. We couldn’t get the best insurance money can purchase because he had a pre-existing condition. Our son was still in a very fragile state, with double vision, horrible stomach pains, crawling skin sensations, major sleep deprivation and continuous hot/cold sweats. He needed help — fast.

With no other viable options, our attorney managed to get an emergency stipulation granting my husband permission to drive our son the 2,600 miles across country to where we live. Meanwhile, I had stayed at our home, spending countless hours investigating insurance options and trying to find a residential treatment center for our son. My husband drove as he never had in his life, making the trip in three and a half days. They arrived in the middle of the night, our son a mere shell of the vibrant, funny, creative, loving soul that he once was.

We signed our son up for Medicaid in our state, which featured a 45-day backlog. We could request emergency consideration, with the possibility of them meeting us within 48 hours, but there was no guarantee. Our son would have to be assessed, and then there was the issue of actually finding him a bed at a residential treatment facility.

I must have contacted at least 25 treatment centers; none would take Medicaid. So there our son languished. We watched him slipping away from us as he struggled with his new sobriety and no treatment. If our son had been suffering from any other “acceptable disease,” waiting to obtain treatment would have been deemed unconscionable and cruel. From my view, it is beyond words that we ask those who suffer to simply bear their pain and deal with it.

I emboldened myself to share the situation with some trusted co-workers. The disease of addiction is still fraught with stigma, but I was so beyond that now, knowing that if we didn’t find something soon, the agony our son was experiencing would lead him to the streets. Human beings can withstand only so much pain. He was attending 12-step meetings as best he could but was so weak, it was hard for him to focus. He was more than ready for treatment and begged us to help him find something. He was simply too ill to do this on his own.

Through the grace of a co-worker, I was able to contact a treatment center that a relative of hers had attended with great success. I called, and we made an appointment the next day. The center took only private insurance, but we had already explored every other possibility. There were no other viable alternatives. It caused us to ponder, what does a person do who has no access to health care? (And, thus, all the overdose headlines!) We brought our son in for an intake assessment, and three hours later, he was in detox treatment; the timetable was for 35 days.

 

 

An equal-opportunity disease

Our story is merely a reflection of the countless individuals now suffering from our nation’s opioid crisis. Tragically, a huge percentage of those addicted are not so lucky as our son has been to have survived. Our son has an unfathomable journey ahead of him to maintain his sobriety. The shattering statistics confirm that only about 10 percent of individuals who are addicted find treatment — perhaps half of them will remain sober.

Our son’s addiction to opioids started as many others have. He had a back injury at work a few years ago, and his doctor prescribed OxyContin. Our son found some relief from the back pain but, more insidiously, found that it also helped with his longtime struggle with depression. Alas, he was a sitting duck. When the pills were gone, he tried to get more from the doctor, to no avail. He finally asked a friend, who led him to someone who had a few, and the rest is history.

On the streets today, one pill of OxyContin can cost as much as $60; a bag of heroin costs $5. There is no mystery why so many turn to heroin — not to get high but rather to relieve the impossible, all-consuming withdrawal. My son told us he tried countless times to overcome “the beast” on his own. The longest he made it was two and a half days — two and a half days of wretched, skin-crawling, vomiting, horrible agony. And we wonder why so many people are addicted. We treat people like criminals just for self-medicating their pain. We seldom think of them as even being human anymore, deserving of immense care.

As I tell my counseling students all the time, addiction is an equal-opportunity disease. I’m not a person in recovery, but I have attended dozens of 12-step, self-help meetings through the years. I worked as the program director of an outpatient substance abuse clinic for 10 years, often accompanying colleagues to open meetings so that I could honestly recommend them to my clients, know what they were all about and for the knowledge of “keeping it real” (that last one is crucial to me as a counselor and an educator.)

When I teach addiction courses, I ask my students to attend at least two open 12-step meetings if they are not seeking their own recovery but are there to learn, or two closed meetings if they are there to help themselves. They come back to class and share their experiences, which are often incredibly humbling to hear. They include tales of feeling embarrassed, finding it hard to enter the buildings, driving around several times looking for the courage to go in and acquiring sincere admiration and respect for those in recovery who have survived and share their journeys with others. The textbooks we have are tremendous, but nothing replaces the personal epiphany one can attain by witnessing these 12-step meetings. Many students have shared the sentiment, “There but for the grace of God …”

 

Holding on to hope

My irrational side tells me to beat myself up. I have been blessed with all this incredible knowledge and insight as a counselor and still did not know what my son was going through? I have refused to do so, however, not only because I realize that now is not the time for recriminations, but because I fully comprehend that addiction is a baffling and cunning disease.

It all makes sense now, of course — the endless need for money to pay for mysterious car breakdowns and vet bills for the dog, the many trips to see doctors for a once very healthy and fit young man, the horrible pain he was experiencing when his marriage fell apart. We wondered, of course, but were too far away to verify. We spoke frequently with our son but saw him briefly only three times over the past three years. Meanwhile, his addiction truly began to escalate.

It does no good to wallow in self-pity. It is just as futile to assign blame and fault. Pain, hurt, anger, frustration, desperation, sorrow, fear — all of these, and so much more, are ongoing and understandable. However, the one thing this disease cannot take from us is hope. The rational side of my being knows about evidence-based treatments, what has the best outcomes for success and what needs to happen.

In that sense, it has made things much easier for our family to endure because all of what is unraveling is in the range of “normal,” and that brings great solace. Our family is attending family counseling, going to Al-Anon meetings, reaching out to trusted friends and relatives, and realizing that we are so incredibly not alone. Still, it amazes me that if we were to tell a friend that our son has cancer, heart disease or even HIV, the response would be more understanding, more forgiving, more helpful. We have come light years in the field of addictions during the past two decades (I know — I teach this stuff!), yet we remain in the Stone Age as far as acceptance, understanding, scorn, victimization, blame and judgment go.

My hope is that readers will find some comfort in this writing (counselors are human beings first, with real-life crises of their own). I have found that addiction is an immensely alienating and isolating disease. So many people believe it will not happen to them or their loved ones because, after all, the person does decide on their own to pick up that first drink or drug, right? However, no one ever sets out in life to become an addict of any kind.

As human beings, our physiological needs are the most basic and supersede all others (refer to Abraham Maslow’s hierarchy of needs). We want relief from our physical/psychological/spiritual pain now and resort to self-medicating on a regular basis. I often ask my students, “What is your drug of choice? Is it caffeine, tobacco products, shopping, gambling, exercise, relationships, etc., etc., etc.?”

The point is, we are all slaves to our prefrontal cortexes, and once we find something that works for us, we make those lovely endorphins, the “intermittent positive reward” phenomenon takes hold, and we get positively rewarded for repeating that behavior. We are masters at conning ourselves into believing that the consequences of whatever we rely on continue to be far less than the rewards. And slowly, insidiously, the disease of addiction takes on a life of its own for far too many.

 

A time to take action

We know the physiology behind addiction. Those of us in the field screamed our warnings regarding OxyContin when it was first introduced in the late nineties. It didn’t require a huge knowledge of biochemistry to recognize the effects; its victims were immediately seen and affected so devastatingly.

Addiction professionals continue to scream from the highest pinnacles about the high potentiation for addiction from these drugs; we portended this epidemic well over a decade ago. And yet, here we are, still screaming of the dangers even as countless individuals are prescribed these drugs daily.

In 2017, the Centers for Disease Control and Prevention estimated that more than 115 people die every day due to opioid overdoses. I am not blaming the pharmaceutical companies (though perhaps I should?) or the physicians. Their ultimate goal (one hopes) is to adhere to the Hippocratic oath, to do no harm and to relieve human suffering. However, I believe that we have reached a tipping point, as Malcom Gladwell described in his book of the same name. Our nation is realizing that this crisis affects our mothers, our fathers, our sisters, our brothers, our daughters, our sons, our relatives, our friends, our co-workers, our ministers, our doctors … and ourselves.

The #MeToo movement has shown us the time for action is now. The #TimesUp movement is doing the same. The #NeverAgain movement is gaining immense momentum. It is time for our passions, our sensibilities and our combined courage to demand more research and increased access to treatment. It is time to get over our fear, ignorance and blame regarding addiction. And we need, once and for all, to acknowledge that the disease of addiction is happening at lightning speed all around us, with no letup in sight.

There is no time to waste on blame or recriminations; we need to act. Addiction can take hold of any of us, regardless of our training, our background, our socioeconomic status or our rationale. It happened to my son, despite all of the knowledge I possess as a counselor.

My fervent belief is that with understanding and proper intervention and treatment, we can more readily help those who are afflicted. More importantly, I believe we need to get at the real root of why people need to self-medicate in such powerful ways. We knew our son had problems with depression. He attended a few counseling sessions over the years, but there was no incentive to stay, and even taking the step of seeing a counselor came with perceived stigma. We all have the power to change the paradigms around this.

As of this writing, our son is more than 60 days clean and counting. He has completed his residential treatment and is living with us, taking it one day at a time and trying to deal with life on life’s terms. The neglect of his overall health has taken a huge toll, but together, we are trying to slowly repair its ill effects. This will definitely take time, but the joy is that now we do have that precious commodity.

My message to all my dear counselor colleagues is this: This disease affects all of us. The palpable pain of our nation is excruciating, and we are all awash in its collective anguish. As a nation, we must reach out, not suffer alone. We need to find hope, discover solace and all begin to heal. We also must find the profound courage to act and change our national discourse and paradigms on how we view and treat people who are self-medicating in hopes of finding relief from traumatic pain.

As counselor change agents, we can do this! There can be no higher calling. #EndOpiods.

 

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Antoinette D’Angelo is the pseudonym for an assistant professor of counselor education teaching in a university in the western U.S. She is a licensed mental health counselor, national certified counselor, master addiction counselor and licensed addiction counselor. She has worked in the human services/counseling profession for over 44 years. Her research interests include substance abuse and trauma treatment; crisis and disaster counseling; counselor wellness and alternative holistic treatment methods; and immigration, DACA, and refugee assimilation and reform.

 

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For more, see a follow-up article from this author: “Healing the healers: Counselors recovering from familial addiction

 

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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.

Nonprofit News: Goodbye, farewell and amen

By “Doc Warren” Corson III May 11, 2018

Change is a large part of what we do. Nothing stays the same no matter how hard we try, and that, my friends, can often be a good thing. A few years ago, I contacted the editor of Counseling Today and shared my thoughts on the need for a column that spoke to the masses of folks in the counseling profession who dedicate their lives to serving others through nonprofit work. I provided some story ideas and hoped to see some of them end up in print.

To my surprise, the editor not only liked the idea but offered the column to me; he even helped me flesh out the name. Since that time, I have written every column and answered every email on a pro bono basis as a way to give back to a profession that has given so very much to me. I have been amazed at the volume of emails I have received related to my online column and the number of countries those emails have originated from. I’ve done my best to answer each and every query, although I’m sure my spam filter may have hidden a few.

As a teenager, I was part of a team that educated folks of all ages about safer sex practices, teen pregnancy and related issues. The first time I met the other team members, I was simply a student at school, watching the team’s presentation in the auditorium. I disagreed with some of the team’s points and had some insights of my own to share. I had never raised my hand in a large group before and had no plans heading into the presentation to raise my hand this time, but something the group said caused me to launch my hand high into the air.

I shared my concerns and saw that I had unintentionally made the presenters uncomfortable. I noticed their boss and my principal looking at each other, their faces turning a bit red. I sat down after saying my part and, after the presentation was done, I went back to class as normal.

Suddenly, I heard my name called and I was directed to the office, where I saw my principal and the whole team waiting for me. I thought I was in trouble, but, instead, the team members told me they were aware of their shortfalls — although they had never been called out on them before. To my surprise, they offered me a slot on their team, saying I could focus on the issues I had identified. Initially, I declined, but over the succeeding weeks, the team’s director called me again and again until I finally agreed to try the team out. That’s the thing about life: If we refuse to go beyond our normal comfort level, we rarely grow.

I started with small presentations, but within weeks, I had been moved up to state- and national-level presentations. Eventually, I was reaching international organizations, all at a time before the internet, YouTube and the like. I enjoyed the process a great deal and learned so much. A small-town boy, I twice went to Washington, D.C., to present in front of an international audience, rally on Capitol Hill and meet with high-powered politicians. It was not an experience this former high school dropout and single father (with custody) had ever expected. The tour lasted a few years and included interviews on the radio and television, in newspapers and magazines, and by the Associated Press.

I remember talking with the team’s director one day about how I would know when it was time to move on. I asked if there were guidelines in place or a time limit for the position. She replied simply, “When it’s time, you will just know.”

A year or so later, I found myself reflecting on what I had done. I had become a headliner for two presentation teams for programs focused on young parents, helped raise funding for programming for young fathers in both programs and done much to raise general awareness of the topics. I was nearing the end of high school and was ready to head out into the workforce full time. Someone who had seen me speak at the state capital helped me get a job, and with that, I felt I was ready to fade away from the public light. Things had changed, and with those changes, I found my passion waning. It was time.

The only job I have had for many, many years is as director of the charity I founded. I have been here since 2005 but started to develop the charity much earlier. During that time, we have grown from tiny and poor with a small office to having a corporate office at our original location and a therapeutic farm at another location. At our farm, we help train and mold the incoming generation of clinicians while also doing everything we can to make a real and lasting difference in the lives of those with whom we work.

I can’t imagine ever moving on from this place. I have even turned down offers that would have doubled my salary, halved my workweek and provided me with benefits that I never would have imagined. As good as those offers have been, none of them possessed the magic that this place has for me.

I believe I am answering a calling from above to serve, and serve I do to the best of my ability. Money is not my driving passion, nor will it ever be. I live in the same humble place I lived when I turned 6 and likely will remain their till I am called home. The only difference is that I own the place now.

My passion for “Nonprofit News” has not waned. I enjoy writing about and encouraging others to “do good,” and I cannot see that changing anytime soon. Still, for reasons not worth exploring in this column, I find that now is the time for me to depart. I am thankful for having had a brilliant editor on this column and for having a person who always seemed able to find the very best images to go with everything I submitted. I am thankful for the American Counseling Association for embracing me as a member so many years ago and for the always available David Kaplan (ACA’s chief professional officer), who has listened to various ideas over the years and who has been there to provide information for columns when needed.

I am humbled by the sheer number of emails I have received about this column and that this small-town “doc” has been able to consult with folks from all around the globe without ever having to leave the farm. You all have made this adventure one that I will never forget.

Beyond my normal work, I find myself suddenly exploring options that I had declined in the past. There is a possibility that you may see a Doc Warren YouTube channel very soon. I may contact the TV channel that once offered me my own show titled “Real Issues With Doc Warren.” There is the possibility of a podcast or radio show as well, although I have even money on the likelihood that I may just give myself extra tractor therapy time. Turning wrenches has been ever so appealing to me as of late …

If there has been one main theme that I have tried to convey to you all, it is that good ideas should never be silenced due to a lack of funding, a lack of space or a lack of experience. If you have a passion, an idea and the drive, you can make almost any nonprofit dream take flight. Start small and keep the spending low, but think big. Think long term while also focusing on each day. When I lacked a fax machine, I was thinking about when I would have acres of land for my clients. Never accept failure as an option.

 

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Nonprofit News looks at issues that are of interest to counselor clinicians, with a focus on those who are working in nonprofit settings.

 

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. Additional resources related to nonprofit design, documentation and related information can be found at docwarren.org/supervisionservices/resourcesforclinicians.html.

 

 

 

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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.

 

Applying the MCC in a divisive sociopolitical climate

By Patricia Arredondo and Rebecca L. Toporek May 9, 2018

We are living through a historic era that many people describe as divisive, polarizing and disheartening. The world of social media never sleeps, and we are bombarded with images of pain and strife. The visible presence of neo-Nazi groups marching, the increase in arrests and deportations of immigrants from sanctuary sites, the killing of unarmed Black boys and men, the senseless deaths from domestic terrorism in Las Vegas and Orlando, the increased incidence of school shootings and the devastation of natural disasters in Houston, Florida and Puerto Rico have led many of our students and clients to wonder aloud: What is going on? Will access to guns continue to bring violence into our schools? Will North Korea bomb the United States? Will we have a new civil war in our country? Will our access to health care be compromised because of tax breaks to wealthy corporations? No counselor is immune to this sociopolitical climate of tension and uncertainty.

Though not always verbalized, these questions are on the minds of many individuals, creating both cognitive and emotional dissonance, much as similar events did 25-30 years ago. In 1991, we witnessed the brutal beating of Rodney King, a Black man, by Los Angeles police officers. In 1989, the Berlin Wall was opened and eventually taken down. Also during this time period, following the CIA’s involvement in Central America, refugees who had been forced to flee from El Salvador, Nicaragua and Honduras were denied asylum in the United States. Today we witness the disruption of families through deportation and the incarceration of children, separated from their parents and often left to languish indefinitely.

Today, three essential living documents continue to call the counseling profession to action. The Multicultural Counseling Competencies (MCC, 1992), the operationalization of those competencies (1996) and the Multicultural and Social Justice Counseling Competencies (MSJCC, 2015) help counselors, educators and supervisors navigate our tumultuous times and provide guidance for ethical and effective practice — clinical, educational and advocacy. These guides prove useful and applicable for contemporary challenges.

The MCC, developed by Derald Wing Sue, Patricia Arredondo (one of the authors of this article) and Roderick J. McDavis, were the impetus for change in the counseling profession and continue to hold relevance in today’s national discourse. Then and now, we see:

a) Increasing racial and ethnic diversification of the country, with the U.S. becoming a majority/ethnic minority country

b) Legislation being promoted to oppress persons of color, people with disabilities, Indigenous peoples, immigrants, LGBTQ individuals and other underrepresented groups

c) The pervasiveness of White supremacy and White privilege

d) Eurocentric models in counselor training that ignore intersecting identities and the sociopolitical context that introduces barriers and oppression

e) Ethical issues resulting from the failure to consider cultural differences and variabilities, particularly in practice and supervision

In this article, our intention is to call attention to stressors in U.S. society and to discuss how the MCC can continue to be catalysts for inclusion and social justice advocacy.

The MCC framework

During the past 25 years, the needle has not moved with respect to the composition of counselors-in-training and counseling faculty. We are still a predominantly White profession, although our clients are increasingly diverse and with intersecting identities.

Now more than ever, the MCC and the Dimensions of Personal Identity (DPI) model provide guidance for understanding ourselves and our clients through an examination of cultural worldviews in a sociopolitical environment. They invite us to examine privileges and unconscious biases that may be detrimental to teaching and counseling. They also point out the harm of neglecting the environmental conditions that benefit or adversely affect individuals.

The DPI model presents an intersectional approach to identity and includes numerous dimensions, such as predetermined characteristics that serve as a profile (e.g., age, ethnicity); our experiences and opportunities (e.g., educational background, income); and a contextual dimension that shapes our experience (e.g., historical and sociopolitical events). This model communicates several premises:

a) We are all multicultural individuals.

b) We all possess a personal, political and historical culture and biases.

c) We are affected by sociocultural, political, environmental and historical events.

d) Multiculturalism also intersects with multiple factors of individual diversity.

The MCC and subsequent MSJCC are about change, requiring counseling professionals and graduate students alike to reflect on their own lenses and those of their clients/students, the role of power and privilege, and how the MCC can support respectful responses and engagement in times of political divisiveness. National incidents during the past few years remind us of the need to know facts, engage in perspective-taking and examine our personal beliefs and feelings to engage in ethical and effective counseling.

Current realities

When former President Barack Obama was elected, many people and organizations stated that we were moving into a post-racial era. However, even following his election, assertions about the president’s birthplace persisted (including allegations perpetuated by our current president, Donald Trump). This action propagated doubts about Obama’s legitimacy and arguably subjected him to more scrutiny than previous presidents faced.

Following Obama’s 2008 election, there was an astounding increase in hate groups in the country, accompanied by a rise in hate crimes. For example, hate crimes against Muslim Americans rose 67 percent in 2015. During the national election campaign season and subsequent election of Donald Trump in 2016, the number of hate crimes increased again dramatically. In October 2017, 25.9 percent more hate crimes were reported than in October 2015. According to the Southern Poverty Law Center, there are now 954 hate groups operating in the United States. In addition, 623 “patriot” organizations were classified as active, extreme anti-government groups in 2016.

The White nationalist march that sparked violent conflict and led to the death of one counterprotester this past August in Charlottesville, Virginia, provides a high-profile example of the increased visibility of hate groups. This event is a vivid reminder that hate thrives in many sectors of our society, including among neighbors, friends and family. Trump’s comment that there was fault on both sides minimized the killing of Heather Heyer, a peaceful demonstrator.

Another example of great divisiveness and misunderstanding from 2016 involved the controversy surrounding athletes “taking a knee” during the playing of the national anthem before NFL games. Colin Kaepernick, then a quarterback for the San Francisco 49ers, initiated this action to call attention to racial biases among police forces, the killing of young Black men and the subsequent acquittal of White police officers. As the movement grew, so did the hostility verbalized by the current presidential administration and a segment of the public. A failure to dialogue, inflammatory assertions and the blaming of athletes only exacerbated a national divide. We wonder why these peaceful protests could not be tolerated. Framing this as a “patriotism” issue and a Black-White divide rather than a human-rights and freedom-of-speech issue further polarized the public. As counselors, we may see clients with a range of opinions and perspectives on this and other issues, and we too have to examine our beliefs on these divisive issues.

The #MeToo movement cannot be overlooked in this discourse. Thankfully, the voices of privileged women brought this center stage, yet it was Tarana Burke, an African American woman, who coined the term and brought issues of oppression among working-class women in the South to light. Women across the life span, but particularly girls, women of color, older adult women and economically disadvantaged women, continue to be victimized in a heteropatriarchal society. Although the majority of counseling professionals and counselors-in-training are women, we must be intentional about addressing sexism in the classroom, therapy room and institutions in which we work. We are privileged, but many of our students and clients may not know how to negotiate spaces of harassment and sexual assault.

There is no time for complacency if we, as counselors, consider ourselves to be ethical and multicultural and social justice advocates. The impact of a dissonant national climate and visible expressions of hate on clients and communities must inform our work.

Counselors possess critical competencies to facilitate and support clients, peers and family members who require advocacy. To this end, we must use critical thinking, seek accurate information and develop understanding of sociopolitical contexts. Collective responses and calls to action for justice have been framed politically within the context of a racialized history. For example, assertions that the Black Lives Matter movement is parallel to White supremacy groups misconstrue the purpose of the organization. Black Lives Matter is a collective response of peaceful marches that began in response to the killings of Trayvon Martin and other young Black men, whereas, White supremacy is a movement based on the belief that the White “race” is superior. These are very different premises and have very different purposes.

The “March for Our Lives” and “March Across America” were spearheaded by high school students in response to deadly school shootings. These young people raised their voices to challenge legislators and school officials to make schools safe. These marches were visible nationally and brought the issue of gun control to the forefront. School counselors and educators nationally supported the power of these voices. Within the framework of the MCC, we can critically understand the racialized context in which these voices are heard. In the process, many have recognized that youth of color have been raising the issue for some time.

Legislation and policy affecting human rights

There are a number of examples of policy and legislation that endanger human rights and, thus, the well-being of clients and communities.

The website I Am an Immigrant (iamanimmigrant.com) posts empowering messages detailing personal stories of perseverance and success from immigrants from various countries. Contrast this with scenes of individuals being taken from their homes by U.S. Immigration and Customs Enforcement — families torn apart, children witnessing their parents being handcuffed, individuals and communities living with new fears and trauma. Hate-based trauma is a critical clinical issue and one that is directly connected to current sociopolitical events and policies.

The MCC guide us to examine our attitudes about immigrants, documented and undocumented alike. If we subscribe to, or neglect to refute, statements that all Latino men are “rapists and drug dealers,” as stated by the president, or that immigrants in low-paying jobs are taking opportunities away from American citizens, then counseling and teaching relationships will be harmed. We must become knowledgeable about the facts concerning immigrants’ historical and current contributions to U.S. society and recognize the shadow of illegitimacy that is cast with harmful rhetoric.

Legislation proposing to ban transgender individuals from the military, limit the access of transgender persons to school bathrooms and remove protections for LGBTQ individuals in the workplace have also reemerged as contentious human-rights issues. These issues should encourage us as counselors to take a moment for self-examination to ensure that we understand our responsibilities. The MCC acknowledge that we all have biases and assumptions based on personal values, but in our professional role, we are expected to uphold the ACA Code of Ethics, including the requirement to pursue nondiscrimination.

With the spate of 2017 hurricanes — including Harvey, Irma and Maria — we witnessed people’s resilience despite the extensive loss of homes, lives and livelihood. What was equally striking was the differential response of federal agencies to the victims of Hurricane Maria on the island of Puerto Rico. The damages were anticipated, but the slow engagement by the U.S. government was inadequate on many accounts. Many months later, a lack of safe drinking water, electricity to fuel hospital generators and internet access to check on loved ones are among the persistent examples of neglect. There were also many blame-the-victim taunts by the U.S. president. These were noted by many Puerto Ricans, human-rights advocates and others as indications of double standards, raising questions about the role of biases in federal response to disasters.

As counselors informed by the MCC, we must ask ourselves about this differential treatment of U.S. citizens and the lack of basic historical knowledge concerning Puerto Ricans as U.S. citizens. This example of marginalization cannot be overlooked.

Awareness and guidance from the MCC, MSJCC

In addition to providing guidance regarding multicultural counseling interactions, the MCC, its operationalizing document and the MSJCC give guidance that is useful in contextualizing and responding to the impact of these traumatic and life-ending events — for clients, for communities and for counselors themselves. We will provide just a few examples but encourage readers to invest in a more thorough examination.

One overarching dimension, implicit in the MCC and explicit in the MSJCC, is that of privilege and marginalization. This dimension calls on counselors to examine their position and power within institutions and society in relation to clients. For example, the current U.S. presidential administration and economic power structures reflect White, Christian, male, heterosexual norms, and numerous legislative and judicial decisions are reinforcing values associated with beliefs about the superiority of those identities. The position of the counselor in relation to those decisions and identities is relevant in terms of beliefs and socialization, as well as what the counselor might represent to the client. Are we seen as trustworthy or “handmaidens of the status quo” (Sue et al, 1992).

In any constellation of the counseling relationship (i.e., whether the counselor is of a similar background to the power brokers and the client is similar to communities being targeted for oppression, whether those roles are switched or whether the counselor and the client are of similar identities), the DPI model highlights the ways in which these identities may be relevant. The dimension of privilege and marginalization should be considered in each of the three arenas of MCC: counselor awareness of own values and biases, client worldview, and culturally appropriate interventions and advocacy.

Counselor awareness of own cultural values and biases: As a critical component of multicultural counseling, current political, social and global events present opportunities for examining counselors’ perspectives and how those perspectives contribute to the counseling environment. These beliefs may support clients experiencing marginalization or they may interfere with best practices and the amelioration of systemic oppression.

Differences based on political or economic views, unexamined racial bias, beliefs about immigration or other stimuli may promote assumptions about clients, their choices and the epistemology of their concerns. Furthermore, divisiveness in communities, the media and families can contribute to conflict that is not easily resolved. There are some who see student advocacy for school safety as opposite to Second Amendment rights. These are intrinsically related issues.

One example of an observable indicator of cultural self-awareness (as quoted from the 1996 MCC operationalization document): “Can identify specific social and cultural factors and events in their history that influence their view and use of social belonging, interpretations of behavior, motivation, problem-solving and decision methods, thoughts and behaviors (including subconscious) in relation to authority and other institutions and can contrast these with the perspectives of others.” In the current political climate, in which legislation limits the rights of entire segments of the population (e.g., members of the LGBTQ community, women, Muslims, immigrants, refugees), this statement suggests the importance of counselors examining their own history in relationship to authority, institutions and beliefs.

Counselor awareness of client worldview: Many current events require us to reflect in terms of the sociopolitical climate and biases. Power differentials between clients and counselors are always present. Differences in the counseling dyad based on a client’s underrepresented identity status require the counselor to attend even more intently.

For example, in counseling, college students who were protected under the Deferred Action for Childhood Arrivals (DACA) program may now be preoccupied with concerns about remaining in the U.S., the possible deportation of loved ones and harassment by others who consider them to be undocumented immigrants. Trust issues may also inhibit these clients from fully disclosing out of fear that the counselor might break confidentiality because of the student’s status.

Understanding clients’ worldviews includes understanding the sociopolitical reality in which they live, their fears, the reality of the bias they may face and the impact of immigration policies and practices on their families and communities. Regardless of immigration status, or beliefs about immigration, when the current presidential administration makes broad statements disparaging immigrants and connecting that to cultural identity markers such as ethnicity, it affects entire communities. In the example involving DACA, it is important to understand the policies, rights and resources available to students and to understand the climate of their peers and institutions.

Moving beyond DACA, since the 2016 presidential election, expressions of hate against immigrants, Muslims, Black students and others have increased. Multicultural practice requires an understanding of that climate and how it affects clients. As counselor educators, it is our responsibility to check in with our students to support and hear them out. This is a small gesture of advocacy.

Culturally appropriate intervention strategies: Culturally appropriate counseling interventions include work with clients and on behalf of clients. The MCC advise counselors to consider the cultural contexts of clients and counseling approaches that are congruent for clients’ developmental level, familial and cultural beliefs, and acculturation. Understanding the client’s cultural and sociopolitical context should help determine culturally appropriate interventions and support systems. In the MSJCC, the Advocacy Competencies are also integrated as interventions. The ACA Advocacy Competencies provide valuable guidance for advocating with clients and on behalf of clients to address many of the difficult issues affecting their well-being.

In the DACA example, counselors could advocate through individual interventions, organizational interventions and policy or legislative actions. Individually, counselors could provide students with campus resources to assist with documents that need to be submitted and with identifying DACA-informed immigration attorneys.
DACA clients may also be facing hostility either from fellow students or, in some cases, from staff or faculty. Counselors, as charged by the ACA Code of Ethics, are responsible for bringing discrimination to the attention of their employers and for acting in the best interests of clients. This is an example of an intersection between advocacy and ethical imperatives and would represent organization-level advocacy.

 

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Patricia Arredondo is president of the Arredondo Advisory Group and faculty fellow at Fielding Graduate University. She has published extensively on multicultural competencies and guidelines, Latinx mental health and immigrant identity challenges. She is a past president of the American Counseling Association. Contact her at parredondo@arredondoadvisorygroup.com.

Rebecca L. Toporek is a professor in the Department of Counseling at San Francisco State University. She has written extensively on multicultural counseling, social justice, engaged empowerment of communities and advocacy. Her counseling specialties are focused
on career and college counseling.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go
to ct.counseling.org/feedback.

 

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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.

Behind closed doors

By Zachary David Bloom May 7, 2018

Few topics are more controversial or downright uncomfortable to talk about than sex and sexuality. It seems we could examine any period of time in human history and find a number of social values and ideas related to sexual behavior, all of which might be discussed with some nuanced language or slang of the time. More often than not, we would find some positive messages about sex but also a fair share of messages that promote — intentionally or not — feelings of guilt and shame. Even with the timeless double binds that accompany messages around sex and sexuality, it is important to recognize that sex remains an important part of our storied history. After all, without sex, we wouldn’t even be here to have this conversation.

When we talk about sex, we are talking about something loaded with assumptions and values. Sex does not exist in a vacuum; rather, it is woven into our personal identities. It is with that idea that I want to encourage sensitivity and tolerance for a topic that has been dressed up and dressed down: pornography.

Sex and pornography in the 21st century

When considering key markers of sex and sexuality that exemplify the zeitgeist of today’s technological era, one might think of pornography, an industry that pulls in billions of dollars each year. Access to pornography has only increased with widespread use of the internet and the diverse number of gadgets available to connect to it. As such, it makes sense that counselors report working with more and more clients who have issues related to their pornography use.

Researchers have attempted to establish correlations between pornography use and a number of other issues of clinical concern (e.g., depression, anxiety), but it has been difficult to draw any definitive conclusions. However, we do know that clients are presenting to counseling for issues in their romantic relationships related to pornography use (e.g., fighting about how much or how often it should be viewed, if at all), for issues that mirror symptoms of addiction related to their pornography use and for a variety of other issues that can be traced back to their pornography use.

Some of the more nuanced issues related to pornography use include clients reporting decreased sexual satisfaction in their primary relationship or even an inability to perform sexually because of a desensitization to sexual stimuli. Some clients report experiencing anxiety and distress about expectations — either self-imposed or solicited by a partner — to replicate acts depicted in pornography that contrast with the client’s value system. Similarly, some clients report experiencing distress connected to feelings of inadequacy that result from comparing themselves with the actors and actresses in the pornography industry.

This is not an exhaustive list, but I believe it speaks to what has been identified in the counseling literature and what counselors have anecdotally reported seeing in their practices, which parallels what I have seen in my own clinical practice. It is also worth noting that clients are more likely to come to counseling with presenting issues that appear not to connect to their pornography use. Most often, this is because the presenting issue simply has no connection to their pornography use. Other times, it is because clients have not yet gained awareness of how their presenting issue relates to their pornography use or, commonly, do not yet feel safe enough in the therapeutic relationship to talk about their pornography use. Yet the question remains: Why are clients now coming to counseling for issues related to pornography?

Accessing pornography

Imagine a child on a school playground in Anywhere, America, playing with their friends when they hear a sexual word or phrase that they’ve never heard before. Maybe they don’t even know that the word has anything to do with sex or sexuality. Now imagine that the child is too embarrassed to ask their friends about it, so the child either types the word into an internet browser on their smartphone or waits until they get home to Google it. In a matter of seconds, the child is confronted with definitions that might go beyond their scope of understanding or is seeing a sexual act, either via high-definition images or video.

Although this example doesn’t fit as well for older age groups, it is representative of how the cultural narrative around pornography has changed from previous decades. You can imagine that the same child in the 1970s or 1980s would not have had easy access to that kind of content. Instead, the child would have needed to ask a friend or relative to explain the concept or term. Even if this person felt uncomfortable with the question or was not the ideal person to ask, there still would have been a connection between the two people. In other words, the child would not have been left to wrestle with this concept in isolation.

In previous decades, if minors wanted to access pornography, they had to find it, borrow it or steal it. Adults needed to show an ID to purchase it. Today, the only thing required to access pornography is a technological device. Even devices with software blocking services work inconsistently at best. Consequently, we are simultaneously more connected and more isolated than we have ever been in human history.

When we think about the dynamic and contrasting messages that society promotes about sex and sexuality and place that in conjunction with sexuality being tied into a person’s identity and valuation of themselves and others, it makes sense that we are seeing an increase in problems related to client pornography use.

Discomfort with sexuality

One could make the argument that most clinical issues might increase or decrease along with the availability of and accessibility to: fill in the blank. For example, a couple might argue more when they reach retirement and spend more time together (i.e., an increase of minutes together). The issue of pornography, however, is more dynamic than its presence or absence because it is a piece of the larger puzzle of sexuality. As readers are likely aware, there is often a significant amount of shame and guilt tied to issues of sexuality — for clients and counselors alike.

Sexuality is described as being part of the human experience, and the helping professions’ various accrediting bodies recognize it as such. However, human sexuality is not a standard and mandated part of counselors’ training. In fact, the general sex education that a counselor receives as a child and adolescent in elementary, middle and high school varies in depth and breadth — if it’s covered at all. Consequently, counselors experience a wide spectrum of comfort levels when it comes to discussing issues of sexuality in general. In addition, counselors’ comfort with sexuality influences their propensity to assess and treat clients for sexual issues.

Perhaps because of their lack of formal or meaningful sex education, some people — including counselors — have reported turning to pornography to learn about sexuality. The concern about this is that pornography is not considered to be a realistic portrayal of sex or intimate relationships. Thus, it might lead individuals to form unrealistic expectations about what happens in a sexual encounter and to pursue sexual activities that could interfere with fostering a successful or satisfying sexual experience. At the same time, counselors might be impaired to provide helpful or accurate psychoeducation to their clients related to sexuality if they do not have a more reliable source of information than pornography.

Taking down barriers

The best way to position yourself to meet your clients’ needs when it comes to working with issues of sexuality or pornography is to know yourself. These are controversial topics, and the first step in being available to your clients is to take ownership of your own beliefs, values and attitudes about sex, sexuality and sexual behaviors. As a starting point, ask yourself how comfortable you feel when thinking about working with a client who reports wanting to reduce their pornography use or who says their pornography use is interfering with their romantic relationship. If you notice discomfort or an aversion to working with a client on those issues, it might be a good time to seek consultation or supervision concerning the source of your discomfort.

In my experience with counselors-in-training and counselors I have met at various conferences, the discomfort tends to stem from one of three things:

1) Religious or spiritual values that make it difficult to maintain a stance of unconditional positive regard

2) Previous experiences of trauma that make it difficult to stay present when delving into discussions of sexuality

3) Feelings of incompetence when it comes to forming or maintaining healthy sexual relationships

For issues of personal values and beliefs — whether stemming from religious/spiritual foundations or not — I think it can be beneficial to pursue counseling services to explore those feelings of discomfort. Counseling can be an effective way to question and deconstruct beliefs that might be interfering with the formation or maintenance of a therapeutic relationship with a client who is wrestling with any of these issues. I find it helpful to allow myself to maintain my belief system and simultaneously place brackets on that belief system so that I can join a client or couple without my lens impeding on their experience. Sometimes I find that working with a client or a couple might remind me of an old belief or value that I once held. I can recognize that the belief is no longer serving me and that I am ready to discard it.

As this discussion relates to previous experiences of trauma, we understand that healing is an ongoing process. Sometimes we might believe that we are healed until we are confronted by our own limitations. We then recognize that it is time to delve further into healing from the past so that we can stay in the present. This, of course, extends beyond issues related to sexuality; it applies anywhere in the counseling relationship in which we find ourselves bumping up against our own walls.

As it concerns feelings of incompetence, counselors’ training in treating issues of human sexuality and their general exposure to sex education vary. I suggest that counselors ask themselves three things: What do I know? What do I want to know? Do I feel confident to relay this information?

To address any deficit in knowledge or any identified room to grow or learn more, I recommend that counselors prepare themselves to work with clients by finding educational resources on sex and sexuality. I also encourage counselors to pursue additional training or workshops through their professional memberships and state and regional conferences. Through identifying our areas of discomfort and our learning curve for the future, we prepare ourselves to best meet the needs of our clients. Of course, we need to be aware throughout the entire process of what our limitations are and when it is time to refer out to another helping professional and possibly even to a certified sex therapist.

In addition to preparing ourselves for working with clients through their sexual issues or regarding their pornography use, we need to provide a space for clients to address these issues. Counselors who report working with clients for issues related to their sexuality or pornography use also often report that they did not ask their clients about these issues. I believe that by soliciting that information early in the counseling relationship — through an intake questionnaire or intake interview — we implicitly state to our clients, “I am willing to discuss this issue, and this is something you can talk about here.” Again, because of the amount of guilt and shame our clients can feel around issues of sexuality, it becomes that much more important to ensure that we are maintaining a safe, supportive and confidential professional relationship.

In my clinical practice, my intake questionnaire includes a space for clients to report on areas in which they have concerns (or in which a family member or friend has raised concerns about them). These areas include gaming, eating, gambling, shopping, sexual activity and pornography use. Only rarely do clients circle “yes” to sexual activity or pornography use. More fruitfully, however, when reviewing the intake packet with clients in session, I ask, “Would this be a place where you might feel comfortable enough to talk about any issues related to sexual activity or pornography use if it came up?” Even if clients state that they do not have a problem in those areas, by having that conversation early on, the implicit message I send is that they can address any concerns related to sexuality or pornography should they ever want or need to.

The work

Beyond knowing ourselves and our own limitations — including when to seek counseling ourselves and when to refer out — there are a handful of recommendations for working with clients regarding sexual issues or pornography use. First, it is necessary to co-create a working definition with the client regarding the presenting issue and any important terms being discussed. In the case of pornography, I recommend asking clients how they define what pornography is. Across the counseling literature, definitions of pornography vary, but what is most important is that you and your client are speaking the same language. So, from the client’s perspective, does something qualify as pornography only if explicit sexual acts are involved, or is it anything that includes nudity? Does sexually provocative material count, even if it does not include nudity?

It is necessary to create this shared definition so that you don’t accidentally dismiss a client’s use of “pornography” as not warranting attention when it is something that is causing the client distress. For example, if a client experiences feelings of guilt for viewing images of clothed people in sexually provocative positions, we want to validate the client’s experience of guilt, even if it might not intuitively resonate with the way that we personally define pornography.

In the same vein, we want to ensure we have a shared definition so that we do not miss opportunities to assist our clients in meeting their clinical goals. For example, I once worked with a man who wished to abstain from pornography use and masturbation for religious and spiritual reasons, and he seemed to be making progress. However, I came to realize that although he was abstaining from traditional pornography use and masturbation, he had begun to engage in more frequent promiscuous sexual behavior. After finding out more about his promiscuous behavior, we were better able to define the “spirit” of his counseling goal, which was to gain greater control over his sexual activity — including abstaining from anonymous sex.

Both in co-creating definitions of pornography with our clients and in the clinical work we do with them, it is also necessary that we model appropriate language. There are compelling reasons to believe that pornography use might promote sexist or harmful beliefs about women resulting from how they are portrayed in pornography. As social justice advocates, it is our job as counselors to balance the deconstruction of sexist or misogynistic ideas without alienating our clients by using overly clinical language or shaming them.

In practice, this means finding a way to ask clients to clarify what they mean when they use a certain term. Similarly, when we use a sexual term, we want to make sure we are using language that the client understands that is also as free of negative associations as possible. In my experience working with clients, depending on the length and strength of our therapeutic relationship, I will typically begin by using the client’s language — asking for clarification when I hear a new term with which I am unfamiliar — and gradually introducing more neutral language to replace the previously value-laden language. As I do this, sometimes the client will follow my lead and it becomes a trend that continues until we are using more value-neutral language throughout all of our sessions.

Other times, I might find a way to introduce a moment of psychoeducation in which I clarify my change in language with the client. I then ask the client to try changing their language too as an experiment to see if they notice any differences in the way they are thinking or feeling. Usually, I can find a way to do this that supports the presenting clinical concern. For example, with a client who presents for counseling for symptoms of depression resulting from the termination of a romantic relationship, I might be able to make a connection between “power” in a relationship and the importance of “respect” in a relationship. We can then discuss how altering our language is a concrete step we can take toward facilitating the change of finding more respect and more even distributions of power in a relationship.

Beyond taking general steps to prepare yourself for working with issues related to sexuality and pornography use, it is also important to be able to provide specific psychoeducation to clients regarding their presenting issue. This is not something that is achieved and completed but rather an ongoing component of being a counselor. Sexuality is diverse, and we need to have sound sources of information not only for ourselves but also for our clients.

Typically, I find in my work that a client’s presenting issue includes myths or deficits in knowledge about sex and sexuality. With younger clients, I find that the deficit in knowledge is often related to safe sex practices. Therefore, I recommend familiarizing yourself with books that you can feel comfortable promoting and sharing with your clients, and internet videos or links that are not pornographic in nature that can serve as educational resources.

Individuals and couples I have seen in counseling for issues related to sexuality or pornography use tend to have one thing in common: They want to have a fulfilling sex life. Consistent with findings in the counseling literature, I emphasize to my clients that a fulfilling sex life comes from a sexual relationship that is founded on trust and vulnerability. In line with that, for some individuals and for some couples, pornography use can be a barrier toward open, honest and vulnerable sexual expression, especially when their sexuality is framed by messages of expectation. Instead, I promote mindfulness practices, sensate focus activities and building on previous experiences of success. Overall, I find that clients make the most progress when they understand that the sexual fulfillment they are seeking is with their actual partner and not with an imagined conceptualization of their partner or a different and more ideal partner.

As part of counselors’ work of addressing issues of sexuality and pornography use, we need to be prepared for clients to ask us about our own sexual experiences and whether we use pornography. I don’t know how often clients actually raise questions along those lines, but I think that we need to be prepared for such instances. As with most topics, I encourage counselors to explore their own levels of comfort with disclosure and to assess whether their disclosure is for their clients or for themselves. Some disclosures are more or less appropriate with certain clients but not others. However, the entire topic of disclosure becomes especially complicated and potentially harmful when discussing sexuality and pornography. Because of the sensitive nature of the topic, I would encourage you to err on the side of caution when making any disclosures with clients about your own experiences, and I would also encourage you to be prepared with a statement so that you are not caught off guard by a client’s questions.

In the classroom, in session and at various counseling conferences, I have been asked about my personal stance on pornography use. The response that resonates most for me is to remind my clients that what might be right or wrong for me might not be right or wrong for them. In addition, I would not want to influence their choice or decision beyond assisting them in identifying their beliefs about sexuality and helping them to live congruently within their value system.

 

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

Zachary David Bloom is an assistant professor at Northeastern Illinois University. He is also a licensed clinical professional counselor and a licensed marriage and family therapist. He specializes in working with couples and with individual clients with trauma. His research interests include the influence of technology on romantic relationships. Contact him at zacharydbloom@gmail.com.

Letters to the editorct@counseling.org

 

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Related reading, from the Counseling Today archives: “Entering the danger zone

The absence of formal and accurate sexual education is a particularly American problem that may find its way into the offices of professional counselors. wp.me/p2BxKN-3JE

 

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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.

Canine companions

By Laurie Meyers May 4, 2018

Having kids and young adults train rescue dogs isn’t technically animal assisted therapy, but for the kids—and dogs—involved in the Teacher’s Pet program, the result has definitely been therapeutic.

The youth —with the help of professional animal trainers— use positive reward-based training to increase local rescue dogs’ chances of being adopted. In return, working with the dogs helps the students develop patience, empathy, perseverance and hope, says Amy Johnson, the creator and executive director of Teacher’s Pet, a Detroit-area non-profit program.

The idea for the program was born when Johnson, a former public school teacher, was working as a dog training instructor at the Michigan Humane Society. Johnson, an American Counseling Association member, wasn’t sure what the training would look like at first — she simply knew

Images courtesy of Teacher’s Pet. Identifying features of (human) participants have been blurred for confidentiality.

she wanted an intervention that would help both kids and dogs. Johnson contacted every group she could find in the United States and Canada that worked with both youth and dogs to learn more about how their programs worked. Her intent was to work with kids who — like their canine counterparts — were behaviorally challenged and often unwanted. So, not only did Johnson contact school counselors and psychologists for their input, she decided to become a professional counselor herself.

The end result was a program that is 10 weeks long and meets twice a week for two hours. Teacher’s Pet currently works with teens from an alternative high school and three detention facilities and young adults, aged 18-24 at a homeless shelter, says Johnson, a licensed professional counselor. At each facility (except for the homeless shelter), the training takes place on site. Participants from the homeless shelter are brought to an animal shelter to complete the program.

The program’s group facilitators are all professional trainers and they choose only dogs with good temperaments to participate, says Johnson, who is also the special projects coordinator and director of the online animal assisted therapy certificate program at Oakland University in southeast Michigan. Before the participants begin working with the dogs, the facilitators give them some safety training.

“We spend the first day going over body language and stress signals,” Johnson says. “They meet the dogs on day two, after one more hour of dog body language education.”

Other safety measures include limiting the number of dogs — five or six per class of 10 students — and keeping the dogs on long tethers placed 10 feet apart so that they can’t interact with each other, she says. There are also always at least four trainers in the room and the dogs are closely monitored. If a dog gets overexcited, is struggling to get off the tether or barking at another dog, a trainer will remove it from the room, Johnson says.

At the beginning of each session, the lead facilitator goes over the goals for the session, such as teaching the commands “sit,” “stay” or “down,” learning to walk on a leash or not jump for the food bowl. The individual trainers explain how to teach the commands and let the teens or young adults do the actual training as they supervise. The dogs are never forced to participate—if an individual dog is nervous or reluctant, the goal for the day is to establish trust and confidence, she says.

Johnson says that sometimes dogs that come off the streets have specific problems like trembling when people walk by. In that case, the students will sit with the dog until it becomes more comfortable and then start with small steps like going for a brief walk outside.

As participants are teaching the dogs new behavior, often their own behavior changes, she says.

In particular, a lot of the teens and young adults who participate have poor communication skills, Johnson says. For instance, some are so shy that they don’t project their voices and the dogs don’t respond to their commands. The participants have to learn to speak firmly and assertively, and to demonstrate a sense of command by standing up straight. One boy told Johnson that he decided to test the tone of voice and body language he used with the dogs on his peers to see what would happen. Imitating the behavior he used with the dogs gave the boy more confidence and he found it easier to interact with his peers, she says.

Johnson describes another boy who was very angry, had little patience and low impulse control. He had a soft heart and would choose dogs that were struggling, which told Johnson that he was projecting his anger.

“Inside he was like the dogs [scared],” she says. So the trainers paired the boy with a dog that was afraid of men. His job was to make the dog like him, Johnson explains. The boy had to be patient and sit with the dog. As the dog got calmer and more confident, the boy would gently encourage it to move closer and closer. By the end of the program, the dog was joyfully playing with boy.

Johnson says that the program facilitators coordinate with the participants’ counselors when possible, so that if they are struggling with particular problems — such as patience or impulse control — training sessions can include activities that help address those difficulties.

The teens and young adults also learn from each other. The first hour of each session is devoted to training and the second to journaling and “debriefing” — talking as a group about what worked and what didn’t.

Johnson believes that even just the oxytocin release that comes from spending time with the dogs is highly beneficial. The program participants are often deprived of loving human touch and the dogs will lick and hug and make them laugh — reducing their anger and anxiety.

As the program draws to end, saying goodbye isn’t easy, but that in itself can be a lesson learned, Johnson says. The students start to detach from the dogs a little bit, and they’ll talk about how that is a normal part of processing grief and loss, she says. The kids also write letters to potential adopters  touting the dogs’ accomplishments.

When the program is over, the teens and young adults say goodbye to the dogs and learn that they can say goodbye and not have it be the end of the world, says Johnson. The participants also get lots of pictures of themselves with the dogs and a certificate for the wall. Many former students have told Johnson that they keep a picture of themselves and the dog they trained on their dressers.

“I had a youth email me seven years later and ask me for another copy of his certificate because his was in a storage unit that was auctioned off,” she says.

Many graduates want to volunteer with Teacher’s Pet for adoption and other events, Johnson says. The organization also remains a resource for the students — they can get letters of recommendation or basic things like clothes for school or school supplies if needed.

Johnson says that Teacher’s Pet is also currently working with the American Society for the Prevention of Cruelty to Animals (ASPCA) on a longitudinal study to determine if the program produces behavioral changes in the kids, and if so, for how long.

 

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For more information about Teacher’s Pet, visit the website at teacherspetmi.org or email Amy Johnson at amy.johnson@teacherspetmi.org.

Related reading, on therapeutic power of the human-animal bond, from the Counseling Today archives: “The people whisperers

 

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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

 

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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.