Monthly Archives: September 2018

Technology Tutor: Making sure your website is seen and complies with the ACA Code of Ethics

By Rob Reinhardt September 11, 2018

Having a website is a building block that is integral to most successful businesses these days. This is no different for counselors running a nonprofit, agency, private practice or other venture. Increasingly, people are connecting with their service providers by first encountering them online through directory listings and websites. Even when referred directly to a counselor by someone else, many prospective clients want to read more about the counselor before making contact.

The expanding importance of websites leads to various topics, including creating quality content that attracts, and connects with, the people for whom you or your organization are best suited to provide services. Before that can happen, however, people need to be able to find your website.

To that end, I want to discuss some important recent developments that affect the visibility of websites. For good measure, I’ll also cover some items you should review to ensure compliance with the 2014 ACA Code of Ethics.

What’s the big deal about SSL?

SSL, or Secure Sockets Layer, is the encryption protocol for websites and browsers. If a site is using SSL, you will see “https” instead of “http” in front of the internet address/URL. Depending on your browser, you may also see a lock, the word “Secure” or both.

In the past, SSL was used primarily on e-commerce sites. The prevailing logic at the time was that the SSL level of security was necessary only when carrying out financial transactions. Later, any site featuring accounts or logins was added to the list of those needing this higher level of security.

Now, however, it is important for every site that collects information to use SSL. This is true even if you have only a simple contact form. Here’s why:

Security: The use of SSL can help prevent malware/viruses on your website. Even if the only way that people submit information through your website is a contact form, you don’t want someone to have the potential of spying on everything submitted via that form.
Search engine optimization (SEO): SEO is the process of improving how your website performs in searches. In short, you want your website at or near the top of the page when people search for specific terms (for example, “counselor your town”). Google “punishes” sites in search results that don’t use SSL. This means that your website may be less likely to be found by potential clients if you aren’t using SSL.
Ethics and professional appearance: This past July, Google Chrome started showing sites as “Not Secure,” along with a red caution triangle, in the Chrome web address bar if they aren’t using SSL. This isn’t likely to make a good first impression on potential clients who are investigating your services. Furthermore, the 2014 ACA Code of Ethics requires that we take reasonable measures to protect people’s privacy and confidentiality.

Standard H.2.d. states: “Counselors use current encryption standards within their websites and/or technology-based communications that meet applicable legal requirements. Counselors take reasonable precautions to ensure the confidentiality of information transmitted through any electronic means.”

Fortunately, SSL has become much easier to implement, and many web hosts offer it for little or no cost. One program that many participate in is called Let’s Encrypt (letsencrypt.org). Be sure to check with your web host or web developer to address this if you haven’t already.

Pro tip: To learn more about SEO, check out the excellent beginner’s tutorial at moz.com/beginners-guide-to-seo.

Pro tip 2: Now is the time to incorporate video. Not only does video provide an opportunity to let clients “meet” you and your organization, but it also tends to help with SEO. Counselors in private practice have reported significant success in having videos of themselves speaking about counseling and their approach or even giving tours of their office. Videos along these lines can help clients connect with us and feel more at ease about contacting us.

On the ethics side

While looking at potential improvements to your website, you have the perfect opportunity to also ensure that you’re taking steps to comply with the 2014 ACA Code of Ethics. Here are a few of the things to have on your checklist:

Post your informed consent, policies and licensure information

Standard H.5.b. of the ACA Code of Ethics says: “Counselors who offer distance counseling services and/or maintain a professional website provide electronic links to relevant licensure and professional certification boards to protect consumer and client rights and address ethical concerns.”

There isn’t necessarily a specific way or format in which these need to be posted, but they should be readily accessible. It may be a good idea to have them somewhere in your menu structure to ensure that you have accessibility covered.

Testimonials and reviews

Do you have testimonials or reviews posted on your site? Although these can be incredibly helpful for most businesses, there are some very important restrictions and caveats that counselors must follow. (For more, see ct.counseling.org/2015/04/ethical-pitfalls-of-online-testimonials-and-reviews/). Now is a great time to add some testimonials from colleagues and referral sources.

Social media policy

You likely have social media such as your Facebook page linked from your website. So, be sure that you also have an updated social media policy available on your site.

Standard H.6.b. states: “Counselors clearly explain to their clients, as part of the informed consent procedure, the benefits, limitations and boundaries of the use of social media.”

Secure contact form

Although SSL will secure data sent from a client’s computer to your web server, the protection ends there. Depending on your web host and package, there may be no encryption on the server or on the delivery of the contact form contents to your email address. This is the one point of data collection almost every counselor and counseling-related organization has on their site that can be considered a point of potential vulnerability. The good news is that there are easy and inexpensive ways to secure contact form submissions. (See tameyourpractice.com/email for more information.)

****

Want to know more about improving your website? Do you have specific questions? Do you have suggestions for what to cover in a future Technology Tutor column? Drop me a line.

****

Rob Reinhardt, a licensed professional counselor supervisor, is a private practice and business consultant who helps counselors create and maintain efficient, successful private practices. Before becoming a professional counselor, he worked as a software developer and director of information technology. Contact him at rob@tameyourpractice.com.

Letters to the editor: ct@counseling.org

****

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.

Identifying colors to create a rainbow of cohesion in the workplace for helping professionals

By Jetaun Bailey and Bryan Gere September 7, 2018

The idea for this piece came about when I (Jetaun Bailey) was pursuing my master’s degree in counseling. I recall my professor stating clearly that burnout occurs often among helping professionals and that the average stay for a counselor employed at a mental health facility is two years.

As one of my assignments, I completed and presented a paper on ways for helping professionals to avoid burnout. However, not once in my presentation did I illustrate ways that the workplace could employ preventive services to combat burnout. At the time, my focus was on using self-care and, ultimately, I received a grade of 100 on that project. However, in reflecting on my counseling career, I realized that workplace training programs overlook helping professionals by not addressing topics related to the complex workplace dynamics that may contribute to burnout, which is likely to increase, because the demands in the counseling profession can be overwhelming.

According to Amanda Stemen’s 2014 article, “Burnout: Who’s taking care of the care takers?” management in the helping professions focuses more on clients than on employees. Many factors are related to burnout. Low salaries are one contributing factor but not the most significant. Many of us who enter the helping professions, counseling in particular, understand that we are not pursuing a lucrative career. However, lack of managerial support is believed to be a significant factor in burnout. This lack of support isn’t necessarily intentional; it is thought that many in management believe that helping professionals have innate abilities to solve their work-related problems. However, in many cases, counselors work in isolation, without support from management and peers, and know its effects.

Thus, management’s support is critical in reducing burnout among helping professionals. In speaking with Terra Griffin, a manager at an acute behavioral hospital unit for children and adolescents, she revealed that the turnover in the unit was among the highest in the hospital. Such high employee turnover costs organizations time and productivity. One of the staff’s chief complaints was management’s failure to provide them with relevant training to meet the demands of the job and promote workplace cohesion, which had led to many problems within the teams.

Stemen’s article suggested the need for professional development in addressing burnout. She reports that providing professional development opportunities customized to employees’ interests encourages growth that benefits both the individual employee and the organization.

Mind-mapping

One professional development approach is to employ mind-mapping concepts. This is accomplished by creating a specific topic or question so that each person in the training session can see other points of view rather than just his or her own. This nonintrusive approach facilitates group cohesion. Researcher Tony Buzan, the author of Use Your Head, developed the mind-mapping concept in the 1970s. It is designed to facilitate the sharing of ideas and concepts to solve problems.

Through observation, Griffin employed this concept in a series of training sessions simply by asking employees in a unit where turnover had been problematic a simple question: “What is your favorite color?” Initially, the employees did not seem eager to participate in the training session. Remarkably, however, when Griffin focused the initial session on that single question, changes in body language occurred among the staff immediately, as if thinking about their favorite colors had some sort of healing effect. Afterward, they were eager to share their favorite colors and the ways they identified with those colors personally.

Interestingly, although employees weren’t given information about the psychological meaning of each color ahead of time, they ended up describing them similarly to how they were presented on Griffin’s color chart. Furthermore, they could identify their similarities and differences in relation to their multiple colors. This helped shed light on some of the difficulties the employees faced in creating a more cohesive work environment.

Three therapeutic teams were present at each training session, each of which was composed of two therapists, one psychiatrist, several nurses and several behavioral specialists. During their self-exploration of the colors, Team 2 realized that many of its members shared the same favorite color, red, while the two therapists identified with blue. Incidentally, of the three groups, Team 2 was confronting the most difficulties. Many of the team members who identified with red were having difficulties sharing leadership responsibilities and were disregarding the leadership authority of the two therapists who identified, unconsciously, with blue. Once members of Team 2 were able to understand their difficulties, they began to discuss ways that their team could work more cohesively. As a result, Team 2 set team goals, with respecting one another identified as the top priority.

Instead of asking employees direct questions about their workplace problems, this exercise of looking at their favorite colors appeared to be a nonintrusive method that encouraged employees to share their differences. Griffin’s simple question elicited many answers with respect to therapeutic problems occurring in this workplace of helping professionals, and thus promoted resolutions to some stressful issues.

The psychology of color

Intrigued with the feedback from the staff during these sessions as they compared their favorite colors to their personalities with respect to their workplace relationships, we set forth to emulate this training. Ultimately, we implemented a similar version in a group of training sessions for graduate students who would be entering the helping profession as practicum and internship students. Their feedback and interactions were outstanding. We learned much about our students that we had not known, and this helped us revamp our practicum and internship training program for students and site supervisors.

As a result, we set out to explore how many nonintrusive, evidence-based training programs of this nature were available. We conducted a content analysis of evidence-based studies on the psychology of color. We also sought to determine the extent to which such training materials are designed to facilitate workplace cohesion among helping professionals.

Using the American Psychological Association (APA) database and electronic resources, we searched APA PsycNET, PsycINFO and PsycARTICLES from their inception through 2018. Furthermore, we used the Google Scholar search engine. The search phrases we used were “evidence-based practices on color psychology” and “training curriculum on color psychology.” The criterion for inclusion for review was that the title contained the search phrase; studies that did not meet the criterion were excluded.

After completing the content analysis, we could not find a single evidence-based study on color psychology or training curriculum related to the topic. We also were unable to determine the extent to which such training curricula facilitated workplace cohesion among helping professionals. There appears to be a significant gap in the literature pertaining to the actual use of color psychology in the facilitation of workplace cohesion in human services or among helping professionals. We did not find any specific evidence-based studies that provided empirical information on training materials on the subject that lead to workplace cohesion. The absence of this information reflects the extent to which the topic is largely unexplored and illustrates what little recognition it is accorded.

In “Colors and trust: The influence of user interface design on trust and reciprocity,” Florian Hawlitschek and colleagues indicate that the literature available on the psychology of color suggests that color preferences associated with personality influence interaction patterns in the employment setting. This illustrates that understanding the role that color preferences play in group behaviors and settings is critical to interprofessional collaborations, especially among helping professionals. Furthermore, other literature has suggested that colors have individual meanings based on a person’s cultural background or racial and ethnic group. Therefore, the influences of color should be interpreted with caution.

However, what made this training so unique is that Griffin did not use any assessment tools to determine anyone’s colors. Instead, she asked each person his or her favorite color and thus gave life to their individuality based on their cultural or racial and ethnic backgrounds without probing for any specific details (colors hold a universal meaning of harmony in many cultures). This mind-mapping technique seemed beneficial. Griffin’s leadership played an important role in helping the employees navigate through their favorite colors by connecting to their personalities and the way they fit within the scheme of their work productivity to create or disrupt cohesion.

Conclusion

As the dynamism within health and human service delivery creates more interdependencies, there is a growing need for professionals to collaborate to achieve better client outcomes. However, there is little information on the role that the characteristics of interdisciplinary teams play in promoting synergy that influences such outcomes.

Shared values, mutual respect for colleagues’ expertise, and patient-oriented goals and outcomes are reflections not only of the diverse interests and asymmetry of power of the various partners in care, but also differences in their personalities and preferences. Therefore, fostering workplace cooperation and cohesion is essential for effective, competent, cost-effective, culturally responsive and comprehensive service delivery.

Creating mind-mapping trainings designed to honor individual uniqueness, such as the identification of favorite colors, can help us achieve such cohesion. These trainings draw us into companionship where we can evaluate our similarities and differences through our individual uniqueness, thus creating a meaningful and purposeful work environment for helping professionals and the clients they serve.

****

Jetaun Bailey is an assistant professor at Alabama A&M University, where she serves as director of clinical training. Contact Jetaun at jetaun.bailey@aamu.edu or baileyjetaun@hotmail.com.

Bryan Gere is an assistant professor at Alabama A&M University, where he serves as coordinator of clinical training in rehabilitation counseling. Contact Bryan at bryan.gere@aamu.edu.

Terra Griffin, a licensed professional counselor supervisor with more than 15 years of experience in counseling management, supervision and training, contributed to this article.

****

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.

Group counseling with clients receiving medication-assisted treatment for substance use disorders

By Stephanie Maccombs September 6, 2018

Holistic care, or the integration of primary and behavioral health care along with other health care services, is becoming more common. In my experience as a mental health and chemical dependency counselor in an integrated care site, I have come to value the benefits that such wraparound services offer.

I now have the opportunity to consult with primary care providers, medication-assisted treatment providers, dentists, early childhood behavioral health providers and our county’s Women, Infants and Children team about their perspectives and hopes for clients. Every client has a treatment team, and each team member is only a few feet from my office door. I quickly realized the significant positive impact that close-quarters interdisciplinary collaboration has for many clients, and particularly those receiving medication-assisted treatment (MAT) and counseling services for substance use disorders.

MAT is a treatment model that lends itself to the integrated care setting. As described by the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT is the use of prescribed medications with concurrent counseling and behavioral therapies to treat substance use disorders. MAT is used in the treatment of opioid, alcohol and tobacco use disorders. The medications, which are approved by the Food and Drug Administration, normalize brain chemistry to relieve withdrawal symptoms and reduce cravings. MAT is not the substitution of one drug for another. When medications in MAT are used appropriately, they have no adverse effects on a person’s mental or physical functioning.

Medications used in MAT for alcohol use disorder include disulfiram, acamprosate and naltrexone. Those used for tobacco use disorders include bupropion, varenicline and over-the-counter nicotine replacement therapies. Medications used in MAT for opioid use disorders include methadone, buprenorphine and naltrexone — each of which must be dispensed through a SAMHSA-certified provider. Naltrexone is the only medication of the three that does not have the potential to be abused. Federal law mandates that those receiving MAT for opioid use disorder also receive concurrent counseling.

Embracing the advantages of integrated care

The combination of medication and therapy offers a holistic approach to treatment that is easily implemented in integrated care settings. The hope offered by the integration of services is embodied in an extraordinary case involving one of my clients who relapsed and arrived to counseling intoxicated, holding their chest. I was able to immediately consult with the client’s MAT provider, who ruled out the physical causes of chest pain after performing an electrocardiogram. Within 30 minutes, I was able to proceed with de-escalation of the client’s panic attack. The MAT provider educated the client on the next steps for care and on the dangers of using substances while taking MAT medications.

In a nonintegrated site, my only recourse would have been calling an ambulance for the client and a long wait at the hospital emergency room — and possibly a client who discontinued services. It is heartening when I can instead walk a client with symptoms of withdrawal across the hallway to the MAT provider or primary care provider, who can in turn offer targeted expert medical advice and medications to alleviate the symptoms.

Despite the substantial advantages that integrated care offers, however, most mental health and chemical dependency counselors are not adequately trained to provide effective counseling in integrated care settings for substance use disorders. In my experience, clients have better outcomes when receiving counseling services in conjunction with MAT. MAT alone can be effective, but the underlying thoughts and emotions that perpetuate use are not addressed unless concurrent counseling services are offered.

According to SAMHSA’s Treatment Improvement Protocol (TIP) No. 43, counseling for clients in MAT programs:

Provides support and guidance
Assists with compliance in using medications in MAT appropriately
Offers the opportunity to identify additional areas of need
May assist with retention in MAT programs
Offers motivation to clients

Although individual counseling is valuable, I am focusing on group counseling in this article because it offers similar benefits to individual counseling and is typically more cost-effective. In addition, TIP No. 43 notes that group counseling in MAT programs reduces feelings of isolation, involves feedback and accountability from peers, and enhances social skills training.

Resources for group counseling with MAT clients, or group counseling in integrated care settings, may not be easily accessible to many counselors-in-training or to practicing counselors. My goal is to share tips and resources with mental health and chemical dependency counselors that may be helpful in enhancing group counseling services for clients receiving MAT in integrated care settings. These tips and resources may also be useful to those providing group counseling services to MAT clients in settings that do not offer integrated care.

Tips and resources

1) Holistic education: MAT and integrated care are relatively new concepts for counselors, and we are still adapting. If it is new for us, it is new for our clients too. In the initial sessions of psychoeducational or process groups, the inclusion of education about MAT, the benefits of counseling in conjunction with MAT, and treatment in integrated care settings is essential.

Having access to a range of service providers is a benefit that clients should understand and utilize. Treatment team members can speak to the group about their role in client care and how their role may relate to the counseling group. For example, a dentist might help with appearance and self-esteem issues; an early childhood care provider might help the children of clients process situations arising from parental drug use; a primary care or MAT provider might link the client with hepatitis C treatment in addition to MAT. Such education can answer many questions that the group may have and help clients benefit from quality holistic care.

2) Dual licensure and continuing education: Many chemical dependency counselors refer out to mental health counselors and vice versa. In integrated care, it is ideal for counselors to be dually licensed. Dual licensure and training can assist counselors in identifying and addressing a variety of dynamics that may arise in group counseling with MAT clients.

For example, one client might have major depressive disorder and be using MAT for alcohol recovery, whereas another client might have symptoms of mania and be receiving MAT for opioid recovery. The way that counselors assist these clients may differ based on their knowledge of mental health diagnoses and the substance being used. Furthermore, counselors who are knowledgeable about these differing yet comorbid disorders will be better equipped to provide education to the group about the individualized and shared experiences of each member in recovery.

Some states have a combined mental health and chemical dependency counseling licensure board, whereas others have separate licensing boards. For more information about licensure, contact your state boards. If dual licensure is not plausible or desirable, I strongly recommended seeking continuing education in both mental health and chemical dependency counseling, as well as their relation to MAT.

3) Cognitive behavior therapy (CBT) and solution-focused brief therapy (SFBT) techniques: According to SAMHSA’s webpage about medication and counseling treatment, by definition, MAT includes counseling and behavioral strategies. The combination of MAT with these strategies can successfully treat substance use disorders.

One of SAMHSA’s recommended therapies is CBT, an evidence-based practice that has been shown time and time again to be effective in the treatment of substance use disorders. In an extensive review of the literature about the efficacy of using CBT for substance use disorders, R. Kathryn McHugh, Bridget A. Hearon and Michael W. Otto (2010) outlined a variety of interventions shown to be effective in addressing substance use disorders in both individual and group counseling. Those interventions included motivational interviewing, contingency management, relapse prevention interventions and combined treatment strategies.

Combined treatment refers to the use of CBT alongside pharmacotherapy, which includes MAT. Although some studies the authors reviewed indicated that MAT alone could be effective in treating substance use disorders, others demonstrated that combined treatment was most effective. Given SAMHSA’s recommendation, the literature review and my own personal experience, I believe that CBT may best benefit a group of MAT clients with substance use disorders in an integrated care setting.

Although CBT is suitable, I have learned that integrated care sites are much more fast-paced than the typical behavioral health counseling agency. Primary care and MAT appointments are as short as 15 minutes. In my work with our on-site behavioral health consultant, I noticed her quick and effective use of SFBT with individual clients. Although there is some research discussing the use and efficacy of SFBT in the treatment of substance use disorders, there is little information about using SFBT in groups with MAT clients in integrated care. This is a much-needed area for future research.

4) SAMHSA: SAMHSA has been mentioned various times throughout this article. That is a tribute to the value I place on the agency’s importance and usefulness. SAMHSA, in my opinion, is the best resource for exploring ways to enhance groups for clients receiving MAT. SAMHSA offers educational resources about a variety of substance use disorders; forms of MAT for different substances; comorbidities; and evidence-based behavioral health practices. SAMHSA is up to date, provides a variety of free resources for counselors and other professionals, and also has information about integrated care for professionals and clients.

According to SAMHSA’s TIP No. 43, groups commonly used with MAT clients include psychoeducational, skill development, cognitive behavioral and support groups. Suggested topics for individual counseling with MAT clients, which easily can be translated to group format, include feelings about coping with cravings and a changing lifestyle; how to identify and manage emergencies; creating reasonable goals; reviewing goal progress; processing legal concerns and how to report a problem; and exploring family concerns. Visit SAMHSA’s website (samhsa.gov) to enter a world of helpful information and resources for both personal professional development and client development.

5) Professional counseling organizations: Whereas SAMHSA offers information about substance use disorders, comorbidities, MAT, and individual and group counseling, the counseling profession’s codes of ethics and practice documents are crucial to the ethical provision of group counseling in this challenging field. Among the resources to consider are the 2014 ACA Code of Ethics, the Association for Specialists in Group Work (ASGW) Best Practice Guidelines (which clarify application of the ACA Code of Ethics to the field of group work) and the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling’s (ALGBTIC’s) competencies for providing group counseling to LGBT clients. ASGW also has practical resources to augment your group counseling skills through its Group Work Experts Share Their Favorite Activities series. Combining these resources with information acquired from SAMHSA and the tips in this article should prove helpful in designing and running effective groups for clients in MAT in integrated care settings.

Conclusion

As integrated care becomes more widespread, counselors must adapt their practice of counseling to the environment and to the full range of client needs. It is a counselor’s duty to utilize the benefits that integrated care has to offer, such as immediate and continual collaboration with treatment team members.

For clients in MAT, group counseling in integrated care can provide a multitude of benefits, including the opportunity to learn from each treatment team member, the opportunity to build community in the journey to recovery and accountability. To enhance group counseling in these settings, counselors might consider:

Including education from each service provider in the early stages of the group
Seeking dual licensure or relevant continuing education opportunities
Implementing theories that are suitable for the client issue and the setting
Using resources made available by SAMHSA and professional counseling organization such as ACA, ASGW and ALGBTIC

Implementing these tips and resources will result in a fresh and efficient group counseling experience for clients in MAT in integrated care settings.

****

Stephanie Maccombs is a second-year doctoral student in the counselor education and supervision program at Ohio University. She is a licensed professional counselor and chemical dependency counselor assistant in Ohio. She has worked as a home-based addiction counselor and currently works in a federally qualified health center providing mental health and chemical dependency counseling services to adults participating in medication-assisted treatment. Contact her at sm846811@ohio.edu.

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.

****

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.

Addressing ethnic self-hatred in Latinx undergraduates

By Carlos P. Hipolito-Delgado September 3, 2018

When Europeans first made contact with the indigenous peoples of the Americas, a path toward Eurocentrism was set in the Western Hemisphere. In the years since the conquest and colonization of North America and the establishment of the United States, the cultural values and social policies of this country have favored people of Western European heritage.

Although the sociopolitical and cultural superiority of Europeans validates the experience of white Americans, these edicts render Latinx communities marginalized or invisible. What is worse, people of Latinx descent might come to accept the superiority of the white population. When this occurs, a person is said to have internalized racism.

In the 2006 article “Naming racism: A conceptual look at internalized racism in U.S. schools,” Lindsay Pérez Huber, Robin N. Johnson and Rita Kohli defined internalized racism as “the conscious and unconscious acceptance of a racial hierarchy in which whites are consistently ranked above People of Color. … It is the internalization of the beliefs, values and worldviews inherent in white supremacy.”

Internalized racism is thought to have negative physical and psychological consequences for people of color. Even so, the bulk of the research on internalized racism has focused on communities of African descent. Most of this research can be credited to Jerome Taylor, as either he conducted these studies or other researchers used his survey instrument, the Nadanolitization scale, to assess internalized racism.

Research studies have linked internalized racism in communities of African descent with increased abdominal fat, higher glucose levels and larger waist circumference, which are indicators of more serious health concerns. Additionally, internalized racism has been linked to marital dissatisfaction, increased depressive symptoms, increased stress, decreased self-esteem and decreased life satisfaction. In one of the few studies examining internalized racism in Latinx communities, I found that internalized racism was negatively related to ethnic identity development among Latinx undergraduates.

Although it appears that internalized racism has a negative impact on communities of color, we do not know why racism gets internalized. Two prominent theories are that 1) exposure to racism leads to its internalization and 2) acculturation to a racist society leads to the internalization of racist values. The exposure to racism hypothesis is largely grounded in social conditioning, in which repeated exposure to racism ultimately leads an individual to accept racist notions as truth. The acculturation hypothesis argues that by adopting the values of a racist society, the individual must accept racist notions in conjunction.

The research

Given the limited research on internalized racism in Latinx communities and the desire to better understand why racism is internalized, I undertook a study guided by two research questions:

1) Does exposure to racism predict the internalization of racism in Latinx undergraduates?

2) Does acculturation to U.S. society predict the internalization of racism in Latinx undergraduates?

(A quick note on usage of the word Latinx. Spanish is a gendered language with masculine and feminine pronouns; some readers might be more familiar with the usage of Latina and Latino, for example. To break from these gendered conventions and to be more inclusive of folks who do not identify strictly with one gender, scholars and activists have called for the usage of Latinx.)

Participants in this study were recruited from college Latinx student organizations. Using a variety of group email lists, I reached out to faculty and student advisers at two- and four-year colleges and universities and solicited their aid in recruiting potential participants. In total, 350 first-generation Latinx students participated in this study. These participants represented 93 universities from 29 states. All of the participants self-identified as Latinx. Furthermore, 75.7 percent of the participants identified as female, 20.6 percent identified as male, 0.3 percent identified as transgender and 1.1 percent identified as other (2.3 percent of participants declined to identify). The average age of participants was 21.81.

Participants completed an online survey consisting of the Everyday Discrimination Scale (EDS), the Abbreviated Multidimensional Acculturation Scale (AMAS) and the Mochihua Tepehuani scale. Furthermore, I used hierarchical linear regression in an attempt to answer my research questions regarding the cause of internalized racism. The Mochihua Tepehuani, a revised version of the Nadanolitization scale adapted to assess internalized racism in Latinx communities, acted as the criterion variable in the analysis. The EDS assessed exposure to racial discrimination. The AMAS was used to assess participants’ degree of acculturation to U.S. culture and values. Both exposure to racism and acculturation acted as predictor variables in this study.

Through hierarchical linear regression, I was able to assess the strength of the overall model with both exposure to racism and acculturation acting as predictors of internalized racism and the individual impact of the two predictor variables. Although the overall model was statistically significant, the amount of variance accounted for by this model was slight (R² = .06, p < .001). This means that the relationship between the predictor and criterion variables is not likely due to chance, but that the predictive power of combined variables is small. Individually, exposure to racism (β = .14, p < .05) and acculturation (β = .20, p < .001) were significant predictors. In this case, a one standardized point change in exposure to racism or acculturation produced a .14 or .20 standardized point change, respectively, in the internalized racism scores of participants.

Based on these results, it appears that both research questions can be answered in the affirmative: Both exposure to racism and acculturation to U.S. society predict internalized racism in Latinx undergraduate students.

Interrupting racism’s impacts

Although most counselors might intuitively know that racism negatively affects Latinx undergraduates, the findings of this study provide empirical evidence of racism’s impacts. Furthermore, the impacts of racism — hurt feelings, a sense of exclusion and the like — are not fleeting. Rather, the impacts linger in the minds of Latinx undergraduates. Over time, the cumulative impacts of racist encounters can lead to the internalization of racism, ultimately steering Latinx undergraduates to conscious or unconscious acceptance of the cultural and intellectual superiority of whites.

To intervene in the internalization of racism, counselors are encouraged to help Latinx undergraduates talk through instances of discrimination. This begins with validating students’ perceptions that they have experienced racism. The challenge with processing incidences of discrimination is that racism can be subtle and subjective — as in the case of microaggressions. This inability to objectively say that a racist incident has occurred might lead some individuals to dismiss or downplay the incident.

Recently, I was working with a university student who shared a story of experiencing discrimination on campus. The student, uncertain of how to make sense of the event, shared her experience with a good friend, who immediately told her she was making a big deal out of nothing. After talking through these events with me, the student came to the realization that her friend’s reaction was more hurtful than the original discriminatory event had been. When processing an incidence of racism, it is important to remember that the perception of the event can be more important than the facts of the event. Therefore, a microaggression might not be a big deal for me as a Chicano counselor who has dealt with racism all of my life, but it could be a huge deal for a student who is experiencing racism for the first time. As such, we should take time to validate the perceptions of the student.

Another strategy I have found useful in helping Latinx undergraduates process incidences of discrimination is to examine the source of racist notions. Beverly Tatum (in her classic text Why Are All the Black Kids Sitting Together in the Cafeteria?) explained that biased thoughts are a product of limited information. From this perspective, bias is a product of the perpetrator’s ignorance; the person possesses limited information about the Latinx community and has made a gross generalization.

After talking through a student’s emotions surrounding an incident of discrimination, I will introduce Tatum’s perception of bias. My hope is for the student to realize that racism is not the student’s fault. It is not a reflection of the student’s culture or heritage, but instead is the product of a biased perpetrator and a racist society. This typically alleviates some of the student’s stress and allows the student to see the interaction in a new light.

Avoiding assimilation

The melting pot and other assimilationist notions can be viewed as an American ideal. Assimilation tends to gain popularity in communities of color during periods of heightened racism. Since the presidential election of 2016, Latinx communities have faced an onslaught of racist depictions by politicians and media outlets. This is especially true of the Mexican community, whose members have been described as drug dealers, rapists and murderers by President Donald Trump.

In an attempt to avoid racism and discrimination, Latinx parents might try to expedite assimilation in their children by promoting the adoption of traditional American cultural values and the abandonment of Latinx values. The belief is that Americanization will enable Latinx youth to pass as Americans and avoid racism. Alas, the promotion of assimilation leads to the portrayal of American culture as being superior to Latinx culture — the very definition of internalized racism described earlier.

Unfortunately, some Latinx individuals are overdetermined by their physical features; dark-skinned folks such as myself can never pass as Euro American. Regardless of attempts to assimilate, we will always be recognized for our cultural heritage. As such, an assimilationist upbringing can backfire if Latinx students experience rejection from their white peers for being too brown. These same students can then also be excluded by their Latinx peers for not being Latinx enough. In part for this reason, I encourage counselors to help Latinx families take a strength-based perspective on their cultural heritage and to look to biculturalism over assimilation.

Assimilationist notions also have a history in higher education. Respected higher education scholar Vincent Tinto described the need for students to assimilate to the college campus and leave the home culture behind to be successful and persist to graduation. Alas, campus climates are a reflection of Euro-American values. Higher education personnel who promote an assimilationist agenda of higher education success also promote notions of American cultural superiority, thus increasing the Americanization of Latinx undergraduates and, potentially, increasing the internalization of racism.

Fortunately, higher education scholars such as Sylvia Hurtado have recognized the flaws in Tinto’s early work and promoted models of student engagement that recognize the positive influence of cultural heritage, family and community. Furthermore, Hurtado and her colleagues have argued that assimilationist models do not accurately account for the success and persistence of students of color in higher education.

Based on the work of Hurtado, a multidimensional approach might be better for promoting the success of Latinx undergraduates and avoiding the internalization of racism. In a multidimensional approach, Latinx students are encouraged to retain their ethnic culture, remain engaged with cultural support systems and view culture as a resource in promoting their academic success. Similarly, undergraduates learn about the culture of their institution and the skills necessary for them to successfully navigate higher education. A significant body of research supports this multidimensional approach, but for this perspective to be successful, higher education personnel must recognize the value of traditional support systems.

A first step toward this is helping Latinx students recognize the value of their culture and heritage. This can include promotion of Latinx ethnic identity, such as exploring what it personally means to be Latinx and building connections with other Latinx students, for example. Positive Latinx ethnic identity is linked to increased persistence in higher education and higher GPA and might also block the internalization of racism.

Second, institutions of higher education can also work to affirm Latinx culture on campus. This includes holding cultural celebrations; recognizing the achievements of Latinx students, staff, faculty and community members; and providing space for Latinx students to study and socialize.

Finally, higher education personnel can find ways to collaborate with Latinx families and communities.

These combined interventions signal to Latinx students that their culture and community are of value, reducing the perceived superiority of whiteness and, subsequently, blocking the internalization of racism.

Conclusion

Although counselors might intuitively know that racism and internalized racism negatively affect Latinx undergraduates, the full impact of internalized racism will remain unknown until additional research is conducted. Within the context of higher education, it would be helpful to know how internalized racism influences academic performance and persistence. In addition, it would be helpful to know how internalized racism affects self-esteem, academic self-efficacy and depression. Finally, knowing how and why racism is internalized might lead to better strategies to interrupt this process.

Although additional research is needed on the topic of internalized racism in Latinx undergraduates, this study represents an important step in empirically documenting factors that lead to the internalization of racism. It is my hope that this article inspires counselors to consider the impacts of internalized racism and strategies that they might take to help Latinx undergraduates avoid internalized racism.

****

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

Carlos P. Hipolito-Delgado is associate professor in counseling at the University of Colorado Denver. He researches the ethnic identity development of Chicanas/os and Latinas/os, the effects of internalized racism on students of color, the sociopolitical development of students of color and how to improve the cultural competence of counselors. He currently serves as the Association for Multicultural Counseling and Development representative on the ACA Governing Council and is the past chair of the ACA Foundation. Contact him at carlos.hipolito@ucdenver.edu or on Twitter @DrCarlosHD.

Letters to the editor: ct@counseling.org

****

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.

Graduate counseling students: What makes you different?

By Sarah Fichtner

As a counselor master’s student approaching graduation in December, a few lessons have become ingrained in my mind: “Always advocate on behalf of your clients”; “engaging in self-care is essential”; and “practice in accordance with the ACA Code of Ethics.” At times, when I am lying in bed after a long day, I find myself reflecting on these tasks and whether I did my best to adhere to them.

Although these lessons are crucial for counselors-in-training, I wish one other lesson had been emphasized earlier in my graduate studies: the importance, essentiality and ultimate difference of putting yourself out there in the counseling world and making a name for yourself.

According to CACREP, there are more than 800 accredited counseling programs across the United States, which means that thousands of counselors will be graduating at the same time and applying for many of the same positions. As a novice counselor, I was naïve to this concept. When I entered my graduate program, I quickly began mirroring my peer’s habits. I focused on earning top grades, copying down important concepts in class, establishing my counseling skills through role-plays and researching internship sites. It was not until I attended the New Jersey Counseling Association conference at the end of my first year of graduate school that I realized just how important a young counselor’s identity is. From that moment on, my graduate mindset changed.

I started to go above and beyond to create my own unique “brand.” I found myself researching current trends in the counseling field, editing and re-editing my resume and cover letter, reading the most up-to-date articles and journals, and consulting with my professors about counseling-related opportunities that I could participate in outside of the classroom. I constantly asked myself, “What can I do to separate myself from every other counseling master’s student graduating from an accredited university? What makes my resume special? What makes me different?”

This pursuit to create my own personal brand eventually led me to the American Counseling Association (ACA) 2018 Conference & Exposition in Atlanta this past April. One of my professors at Kean University in New Jersey spoke to my multicultural counseling class about the ACA graduate student essay contest. She passed around a handout encouraging my class to submit a proposal. Immediately, I knew that this was the perfect opportunity to define my identity and get my name out into the counseling world. After writing and rewriting my proposal, I finally submitted my essay in December. Because the winners would receive complementary registration to the ACA Conference, I could hardly wait for the winning essays to be announced. Finally, on Feb. 28, I received an email asking for my attendance at the ACA National Awards Ceremony; my essay had been chosen as one of the top entries. I was one step closer to becoming a known face in the counseling world.

Upon arriving at the ACA Conference, I prepared myself to get the most out of my experience. I printed out my resume, picked out my best business attire, scheduled an appointment with the ACA Career Center and promised myself that I would speak to as many people as I could. I was a novice counselor who planned to leave the conference educated on the licensure process, the benefits of a doctorate in counselor education, employment trends, who to contact post-graduation regarding approved supervisors and any other helpful information I could soak up.

Having this goal-oriented mindset opened my eyes to the true kindness and genuineness of the counseling community. Within minutes of entering the conference center in Atlanta, my wildest dreams were exceeded. I was engaging in impromptu, inspirational meetings with fellow master’s students, doctoral candidates, counselor educators and authors. I soon learned that the counseling community is a tightknit group of exceptionally talented and personable individuals. During my four days in Atlanta, the connections I made completely changed my personal and professional life.

There are so many people that made my experience worthwhile, but for the sake of time and space, I will mention just a few. Dedicated representatives from Magnolia Ranch, a rehab facility in Tennessee, engaged in personal conversation with me on multiple occasions. I must have stopped by their expo table at least twice per day, and each time they were just as eager to ask about my professional journey, share their insights on the counseling profession, talk about their contributions to mental health and, of course, answer all my questions about their therapy horses. (I, as a horse owner, could talk about equine-therapy for days.)

Gerald Corey, Michelle Muratori, Jude Austin and Julius Austin, co-authors of the book Counselor Self-Care (published by ACA), each connected with me on a personal level. After attending their presentation on self-care, I was determined to purchase a copy of their new book and get it signed. However, with more than 100 people in attendance at their presentation, I overestimated my chances of purchasing a book. It had quickly sold out. As a Type-A individual, self-care was something I had consistently failed at, and I knew this book would assist me in my quest to accomplish a better self-care plan. Thus, I made it my mission to find a copy of their book.

After stopping by the ACA Bookstore at the conference on multiple occasions, speaking with the authors directly and bargaining with the conference staff to sell me the copy in the display window, I started to feel defeated. It was in that moment that I decided to approach the authors one last time and express my appreciation and gratitude for their work (book or not, the information I had gained from their presentation was priceless). Surprisingly, they thanked me for my kind words, interest in their self-care book, and perseverance and commitment as a counselor-in-training. Then Michelle Muratori dug into her purse and handed me her own personal copy of Counselor Self-Care while all the authors smiled.

I spent the next few minutes chatting with her. We discussed her career as a counselor educator and clinician at Johns Hopkins University. She provided me with such valuable insight, motivation and hope for my future as a professional counselor. Additionally, prior to the book signing, I had the privilege of speaking with Julius Austin. We connected on our similar experiences of being Division I college soccer players and the transition into the counseling profession. He empathized with and understood the many emotions I went through as I left the collegiate world behind.

Finally, during one of the keynote speaker presentations, I sat next to Ed Jacobs. I introduced myself and expressed interest in his role as a program director (at the moment, I didn’t know he was a renowned author and educator in the field of counseling and that he had written the group counseling book used in my graduate program). Our conversation flowed as we talked about his position at West Virginia University, my current clinical work with children and my hopes and dreams for the future. Before we parted ways, he encouraged me to attend his group counseling session, where he would be presenting on group counseling techniques to use with children and adolescents. I made it a point to attend his workshop, and I am so happy that I did.

After the session, I went up to him to thank him for taking the time to speak with me earlier in the day. He smiled and said, “You came.” Then he reached into his bag and pulled out a copy of the book he wrote on individual counseling techniques. He handed it to me and said, “I’m really happy you came and hope we stay in touch.” I was so humbled and touched by his kindness and generosity. I, too, hope our paths will cross again.

When I returned home to New Jersey, I was filled with gratitude, warmth and excitement for my future profession. The conference was more than I could have ever imagined. However, I know that my pursuit to establish a unique identity is an evolving journey. I need to build on the connections I have made. I have reached out to Drs. Muratori, Austin and Jacobs and have been overwhelmed with the thoughtful and efficient responses I have received.

For example, Dr. Jacobs stated that one of his greatest joys is mentoring students and that he would be more than willing to guide me in my journey as a novice counselor. Within days, he had connected me with a counselor educator here in New Jersey; my name was quickly spreading throughout the counseling world. My resume was being reviewed by many professionals, my email inbox was filling up with new messages, and my identity as a counselor-in-training was far greater than that of a master’s student graduating from a CACREP-accredited program. There was a face to my name.

Although this idea of networking may seem like common sense, I cannot tell you how many master’s students leave their graduate programs unsure of what to do next. It is not that they failed to study hard, earn good grades and succeed in their clinical settings, but rather that their identity as novice counselors mirrors that of every other newly graduated student.

So, to all my fellow counseling graduate students, if there is one thing I hope you take away from this article, it is this: Go the extra mile; get involved in as many activities and events as you can; submit journal proposals; do not be afraid to introduce yourself and network with as many professionals as you can; and, lastly, create your own unique brand. Be bold. Be brave.

Understanding this concept early on will only help you in the long run. With the complex social challenges faced by the nation and the world, becoming the best counselor one can be is imperative. By celebrating our uniqueness and crafting our professional brand, we will be best positioned to solve the mental health problems and other social ills that we all face.

****

Sarah Fichtner is a former Division 1 women’s soccer player for the University of Maryland. She is completing her master’s degree in clinical mental health counseling at Kean University in New Jersey and currently works at Hackensack Meridian Behavioral Health as a counselor intern, where she practices from a strengths-based model. Contact her at fichtnes@kean.edu.

****

American Counseling Association members: Advance your career with the resources you need in ACA’s Career Central, where you can find hundreds of job listings, complimentary career consultations and other helpful career information and services created specifically for counselors.
Find out more about ACA’s upcoming Conference & Expo at counseling.org/conference

****

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.