Monthly Archives: February 2020

Help wanted: Managing work stress

By Bethany Bray February 28, 2020

In 21st century America, the adage that “all work and no play” makes a person dull should probably be amended to say that it makes a person stressed out.

Every job involves a certain amount of stress, and it’s normal for work demands and pressures to ebb and flow. When the tension rises above a normal level for a sustained period of time or becomes an ongoing reality, however, work-related stress can dramatically affect the individual’s personal life and mental, emotional and physical health. Trying to handle friction with a co-worker or supervisor, taking on an unwanted change in role or responsibilities, or being forced to navigate a toxic work environment, possibly including bullying or harassment from co-workers, can all result in stress setting up shop in a person’s life and remaining there, even after the workday (or workweek) is done. Today’s technology tools — wonderful as they can be — are another common contributor to ongoing work stress because they tend to encourage overwork and expectations of around-the-clock connectivity. Work emails don’t typically abide by a 9-to-5 schedule, and neither do smartphones, laptops and WiFi connections.

Professional clinical counselors, no matter their setting or specialty, may notice work stress manifesting in clients’ lives in a variety of ways. Some clients might complain about having trouble sleeping or experiencing physical aches and pains. Others might mention ruminating on work issues when they are off the clock, associating their self-worth with career achievements, feeling guilty when they take time off, fearing losing a job, or even feeling mentally or emotionally exhausted just thinking about their job responsibilities or work environment.

Work-related stress “can take away some of our joy,” says Michele Kielty, a licensed professional counselor (LPC) and licensed school counselor in Virginia. “We can be so overrun with responsibilities that we experience a lack of joy in things we have previously found joy in. … It’s carrying an ever-present, low-grade, oppressive stress with you all the time. It can take over your life more than you’d like for it to.”

Simply put, work stress keeps us from being the person we want to be, says Kielty, a professor of counseling and director of the school counseling program at James Madison University (JMU) in Harrisonburg, Virginia.

Complicating the issue further is that some clients who realize that work is the main cause of their stress feel embarrassed that a job can have that effect and level of control over them.

“The painful thing about this is that there can be a lot of regret, guilt and, occasionally, shame over loss of presence — not being able to be fully present when you’re home or around your children,” says A. Renée Staton, an LPC and professor in JMU’s counseling program. “Parents may report [in counseling] that their work stress might not feel like it’s on the forefront of their mind, but they’re finding they’re more reactive and impatient with their children. It might be harder to keep things in perspective, in context, when they’re responding to their children.”

A major source of stress

A majority of American adults (64%) cited work as a significant source of personal stress last year in the American Psychological Association’s annual Stress in America survey, which collected data from more than 3,000 adults between August and September 2019. Among Gen Xers, money and work were tied as the most frequently cited sources of stress (at 65% apiece). Among millennials, money (72%) barely edged out work (71%) as the most frequently cited stressor. Work was the second-most cited source of stress for baby boomers (preceded by health concerns), whereas Generation Z, or the post-millennial generation, reported work as its third-largest source of stress (behind money and health concerns).

The American Institute of Stress, a Texas-based nonprofit organization, notes that work and career are major sources of stress for Americans and can be linked to hypertension, increased risk of heart attack, and other medical concerns.

“Although the Institute is often asked to construct lists of the ‘most’ and ‘least’ stressful occupations, such rankings have little importance for several reasons,” the organization says on its website (stress.org). “It is not the job but the person-environment fit that matters. … Stress is a highly personalized phenomenon and can vary widely even in identical situations for different reasons. One survey showed that having to complete paperwork was more stressful for many police officers than the dangers associated with pursuing criminals. The severity of job stress depends on the magnitude of the demands that are being made and the individual’s sense of control or decision-making latitude he or she has in dealing with them. Scientific studies based on this model confirm that workers who perceive they are subjected to high demands but have little control are at increased risk for cardiovascular disease.”

Dissatisfied, disconnected, underappreciated

The term “work stress” can mean different things to each individual client, and a counselor’s response should be tailored to each client’s distinct situation. However, Sharon Givens, an LPC in private practice who specializes in career development and mental health, has found some common themes in her work with clients. She says that levels of dissatisfaction and stress can surge for individuals when they:

Are in a job or role that they find unfulfilling or don’t enjoy
Have issues with leadership (e.g., think that they have a bad boss, don’t feel respected or valued, have a personality or values conflict with a supervisor or company leadership)
Believe they are not being compensated properly financially
Are doing work that doesn’t meet their needs, such as personality style, passion or interests

This last bullet point can make all the difference, asserts Givens, president-elect-elect of the National Career Development Association, a division of the American Counseling Association. At the end of the day, a job will be a good fit only if what it offers matches what the individual needs. For example, a person who values teamwork and struggles to work independently will never thrive in a position in which they work alone from home full time, says Givens, whose practice has offices in Columbia, South Carolina, and Charlotte, North Carolina.

Research indicates that many workers leave jobs on the basis of whether they connect with their co-workers. Stress and unhappiness will naturally swell if an employee doesn’t enjoy the work or the people with whom they work — even if the employee is well-compensated, Givens adds.

Jennifer Linnekaste, an LPC with a practice in Oslo, Norway, specializes in career counseling and helping clients with work-related trauma. She says counselor practitioners should probe with further questions when clients, regardless of their presenting issue, spend a majority of sessions discussing or complaining about negative issues at work. Practitioners can get a fuller picture by asking clients when they began feeling overly stressed and whether that coincided with a change in leadership or supervision at work, a new job role or new work responsibilities, a traumatic incident in the workplace, or some other work-related circumstance.

Work stress occurs on a continuum, and “whether or not someone can handle that stress is totally within the perception of the client,” adds Linnekaste, who is writing a book on work trauma to be published by ACA.

Possible indicators

When work stress bubbles over, personal relationships commonly suffer the effects. That’s because work stress often robs individuals of their ability to engage with and be fully available to the people they love, Kielty says.

Givens, an ACA member, has seen work stress put so much strain on clients’ marital relationships that they end up on the verge of divorce. Carrying around constant feelings of stress can make the person become less patient, more irritable, and more likely to be snappy with or lash out at their significant other and other loved ones, generating relationship conflict as a result. Or, a couple can become distant if one person, feeling overwhelmed by work, shuts down and doesn’t want to communicate their needs and stressors to a partner, Givens points out.

In addition to staying alert to possible red flags in clients’ personal relationships, counselors should listen for other clues that work stress may be manifesting in clients’ lives, Givens says, including:

Displaying anxious behavior, including feeling paranoid that they are going to be fired
Spending a large amount of time talking about financial worries
Expressing a lack of commitment to their work, desiring to take excessive amounts of time off, or doing the bare minimum to get by
Expressing a lack of fulfillment or using language that indicates they simply tolerate their work
Expressing that they feel stuck, are too old or too entrenched to try something new, or are thinking about premature retirement
Saying that they do not enjoy, engage with or trust their co-workers
Feeling a lack of control or power over their work situation, feeling like a victim or feeling overlooked in company decision-making

Work stress may also be to blame if clients talk about physical symptoms such as headaches, high blood pressure, gaining or losing a significant amount of weight, or having trouble sleeping.

Fatigue can be another indicator that work pressures are overwhelming a client, says Quentin Hunter, an LPC associate in Kentucky who co-authored the September 2019 Journal of Counseling & Development (JCD) article “Assessing Life Balance and Work Addiction in High‐Pressure, High-Demand Careers.” When clients talk about chronic tiredness, feeling totally spent once they get home, not being able to turn off their “work brain,” or ruminating about work tasks when watching television or eating dinner with their family, counselors should probe with questions to learn more. “People often come in knowing that they’re exhausted by their job and that it’s affecting them, but not that it’s inappropriate,” notes Hunter, who works in a group private practice in a rural setting.

Amanda M. Evans, an LPC and co-author of a 2013 JCD article titled “Work-life Balance for Men: Counseling Implications,” notes that work stress can manifest in ways that chip away at clients’ overall wellness, including decreases in marital satisfaction and sexual activity or an inability to fully relax and engage in activities and hobbies that they previously enjoyed.

“For me, it would be concerning if a client says things like, ‘I just need to push through’ or ‘If I put my head down [and work hard], it will get better,’” says Evans, an assistant professor in JMU’s graduate psychology department and director of the university’s clinical mental health counseling program. “A counselor can be a reminder that it’s not a requirement [to be unhappy at work], and that’s not how we have to live our lives.”

Evans, Kielty and Staton have discovered that work stress often emerges as an issue that connects to other mental health topics that they collaborate on as colleagues at JMU, including most recently in their research on bicultural identity, which the trio presented at the Let the Voices Be Heard! conference in Belfast, Northern Ireland, this past October. (The conference, billed as “an international conversation on counselling, psychotherapy and social justice,” was jointly planned by ACA, the British Association for Counselling and Psychotherapy, and the Irish Association for Counselling and Psychotherapy.) Evans and Staton will also discuss work stress as part of a poster session on institutional discrimination at the ACA 2020 Conference & Expo in San Diego in April.

Recognizing counseling’s roots

Counselors may see clients who name work stress as their presenting issue. This is often the case for Givens, who receives many of her clients through referrals from employee assistance programs. But other clients may show up to counseling for help with a troubled marriage or help dealing with depression without realizing that work stress is inextricably linked to their presenting issue, Givens says.

“Work is such a large domain of our life, and it plays such an integral part in impacting our mental health,” Givens explains. “You can’t address one without the other.”

In other situations, Kielty points out, clients may come to counseling for work stress because it feels like a “safer,” less stigmatized or less embarrassing issue than what may be lying underneath, such as marriage trouble or intimate partner violence. In other words, for certain clients, work stress may represent a more acceptable way of entering the counseling relationship.

Givens says career counselors and mental health counselors shouldn’t hesitate to refer clients to one another or to co-treat clients who need to focus on both realms of life.

Many of the counselors interviewed for this article pointed out that the counseling profession’s foundations are in career counseling and say that professional clinical counselors shouldn’t hesitate to lean into the profession’s vocational roots.

“Remember that work and career are a key part of almost everyone’s life, so we need to spend some time exploring them,” says Hunter, an ACA member and assistant professor at Lindsey Wilson College in Columbia, Kentucky. “If you ask, ‘How’s your job?’ and they answer, ‘Great,’ don’t just accept that and move on. … A client might not necessarily say, ‘I know that work is stressing me out’ or ‘I hate my job,’ but it’s still sucking up a lot of their energy, and they’re not feeling effective in the domain they came to you for.”

Spurring self-reflection

Discovering to what degree work stress is affecting a client’s mental health can be eye-opening for both counselor and client. Hunter says he often begins by asking clients to reflect on where a majority of their energy is going. “We only have so much personal energy each day,” he explains to clients. “How much of it is going into your work domain, family domain and individual domain, and where are the deficits? Where have you seen this affect you? … Work can impact all of the domains of wellness, [including] sleep disturbances, spirituality, intimacy with a partner, energy levels. How much of your life is wrapped up in work?”

Hunter often directs clients to think of their day as a pie, with each slice indicating a domain where they invest their energy. He then asks them to consider how this looks and feels. Is work the biggest slice? The entire pie? Are they OK with the way their pie is divvied up? Is it causing them stress?

Another exercise Hunter finds helpful is to have clients create a prioritized list of their values and the things they find important in life. Most clients place family and relationships at or near the top of their list and relegate work to further down. From there, Hunter spends time talking with clients about the priority they assign to different aspects of their life and where things may be out of alignment related to where they spend most of their energy. For instance, if work is No. 5 on their list of things they value, does that correspond with how much energy they are dedicating to it? If their marriage or their relationship with their children is the first thing on their list, is that part of their life truly receiving the most of their attention and energy?

Staton agrees that values exploration can be an important part of counseling with clients who are struggling with work stress. Counselors can help clients realize when their work does not align with their personal values, determine what is essential for them to “feel fulfilled without overdoing,” and learn when to say no and make changes when their situation doesn’t match with “what they truly want in their heart,” Staton says.

Kielty, a past president of the Association for Spiritual, Ethical and Religious Values in Counseling, a division of ACA, suggests that counselors guide clients in making a list of values and creating goals based on the top values they identify. For example, for clients who value autonomy, an appropriate goal might be to uninstall work email apps from their smartphones so that they can’t be contacted — and aren’t tempted to engage with work — when they’re supposed to be off the clock. Clients who value flexibility might consider requesting a change in their work schedule to do four 10-hour shifts per week so that one weekday is left free to go on field trips with their child’s school, grocery shop or focus on self-care, Kielty suggests.

These counseling exercises are all done with an eye toward building self-evaluation and self-reflection skills in clients, Hunter notes. One of the most important things counselors can help clients do when their work stress spikes is to take a step back to assess what they want their life to look like versus what it looks like in reality, he says.

Any type of contemplative practice — such as journaling or mindfulness — can help clients reflect, hone self-awareness and be honest with themselves, Hunter says. These skills are also important to instill in clients so that they can fall back on them outside of counseling sessions, he adds.

“[Creating] that space to listen to yourself and have self-evaluation is a hard habit to build but so powerful,” Hunter says. “Eventually, they will leave therapy and have to self-prescribe their own goals. They need to be able to assess their energy levels and where [in which domains of life] they are placing importance.”

Supporting clients if and when they decide to leave a job and transition to a new role is important, but a counselor’s guidance shouldn’t end there, Givens says. “In many cases, work stress can be the symptom of something greater, and it’s our responsibility to research and make sure we understand the root cause to help the person holistically, instead of just from a career or mental health perspective,” she explains.

Givens recalls a client who initially came to her for career guidance. He expressed feeling unhappy and “maxed out” in his role as an executive vice president. As Givens’ work with the client progressed, he also disclosed that he had become distant from his wife. The couple wasn’t communicating well, and their sex life was “nonexistent,” according to the client.

Further assessment and exploration revealed that the client wasn’t clicking with a new boss who had recently started working at the client’s company, leaving the client feeling undervalued. On top of everything else, Givens found that the client had never processed his parents’ deaths (his mother had been dead for eight years and his father for 26) and was beginning to show signs of depression.

At that point, “the work stuff became secondary,” Givens remembers. She introduced grief work and self-esteem techniques into their sessions, as well as cognitive behavior therapy. She worked with the client for roughly a year and a half, and during that time his self-esteem and marital relationship began to strengthen and rebound.

Roughly a year into their therapy relationship, the client made the decision to leave his company and find a new position. He received three desirable offers and ultimately accepted a position as a CEO — a life goal he had always wanted to achieve, Givens recalls.

Guiding influences

When considering changes to a work situation or pursuing work-life balance, it is often clients who have the answers themselves, Givens says. A counselor’s role is to guide and support clients as they take a step back, tap into the answers they already have within, and make decisions.

Givens had a client who came to her for career counseling. The client was well-paid, but she was also responsible for three different roles at her company: payroll, accounting and human resources. “When we talked it through, she realized it wasn’t fair to get one salary for three jobs,” Givens says. “She didn’t see it until she took a step back [in counseling] and realized, ‘I could get paid the same amount for doing just one of these jobs!’ Eventually, she made the choice to leave.”

Givens has a number of worksheets, questionnaires and other tools she uses in sessions with clients who are struggling with work stress to spark self-reflection and engage in goal setting. One of these tools is a puzzle with blank pieces that can be written on with a special marker and wiped clean for reuse. Clients label the puzzle pieces with various aspects of their lives, including work, and then fit the pieces together in two different ways: as their “ideal” life puzzle and as what their life looks like in actuality. After talking things through with her clients, Givens asks them what they would need to change — which puzzle pieces they would need to shift or remove altogether — to make the two puzzles be in better alignment.

In a similar vein, Givens uses a “life wheel” illustration (below) with clients so they can rate different areas of their lives (finances, career, relationships, relaxation, etc.) on a scale from 1 to 10. This exercise provides both the counselor and clients a better understanding of how clients see themselves and where they are — and aren’t — finding fulfillment.

Image courtesy of Sharon Givens

Givens also created and uses a flowchart-type document that she refers to as a “gap analysis.” The chart has two boxes with a gap in the middle. She asks clients to write a description of what their life looks like now in the first box and ideas about the life they would like to have in the second box. Clients’ challenges and missing pieces are written in the gap between the two boxes. These challenges and missing pieces might include getting a professional certification, partaking in additional training, or pursuing additional education to get into a desired career, she notes. In each session, Givens works with the client to set goals, address the challenges listed in the gap on the flowchart, and check in about progress.

“It could be that [a client] wants to be a plumber, but they need the proper training. I would help them connect to that,” Givens says. “Ultimately, that’s what we’re trying to do: get the client to where they want to be and get over what’s getting in the way.”

When clients are feeling overwhelmed by work stress, counselors can help them break up what seems like an insurmountable challenge into smaller pieces, says Evans, a member of ACA. She suggests that practitioners equip clients with coping mechanisms, including psychoeducation on self-care, boundary setting and thought-stopping techniques, to navigate the here and now before tackling bigger decisions such as whether to leave a job or change career paths entirely.

Kielty notes that lessons on mindfulness and body scanning can provide clients with helpful tools for managing their emotions at work when stress begins to overwhelm them. “Identify what sets you off and how you can create healthy spaces for yourself. Create some healthy space between you and your work,” she advises.

Kielty, a member of ACA, often introduces the concept of “mindfulness moments” when she does workplace trainings. Taking time to reset, even if it’s just for a minute or two, can be a tremendous coping mechanism for handling work stress, she says. Resetting might include closing the door to one’s office and taking deep breaths, going for a brisk walk, doing a quick body scan or taking inventory of one’s senses of sight, smell, hearing, taste and touch. Mindfulness helps regulate stress hormones and heart rate, improves concentration and increases self-compassion, says Kielty, who adds that mindfulness is an evidence-based way to “help build inner resources.”

Being able to pause, even for just a moment, gives a person choice, agency and some options for dealing with stress rather than allowing it to control them, adds Staton, an ACA member.

Hunter sometimes equips individuals who are having trouble separating their work and home lives with a mantra they can repeat to themselves each day as they’re leaving work: “I’m finished with work today. I’m leaving work here in the parking lot. Anything that needs to be done at work can be done tomorrow (or the next time I return).” This simple exercise can help clients reinforce the idea that they are not their jobs and that work is only part of who they are, he says.

Counselors should be aware that some clients who struggle with work stress may also have a work addiction, Hunter points out. As is the case with any process or behavioral addiction (e.g., gambling, gaming, shopping), work can become an activity that provides a person with a temporary “high” and serves as an escape to avoid other issues. Professional clinical counselors should listen closely for hints that clients are practicing avoidance behaviors — such as throwing themselves into work to avoid dealing with relationship problems or mental health issues — or using language that may indicate work addiction, such as “I only feel good when I’m at work,” Hunter advises.

Although goal setting can be a helpful part of supporting clients through work stress, Hunter cautions that counselors must be sensitive to the individual client’s needs and personality before using the approach because it may not be a good fit for everyone. Setting benchmarks — such as leaving work by 5:30 each day, having dinner with the family every evening and making time to read a book for pleasure — can be helpful for clients who are interested in order and objective tasks, he says, but it can feed into anxiety for other clients.

“Goal setting can be a good place to start, until [finding work-life balance] becomes more natural,” Hunter says. “But when we set expectations, we have to realize that they can be anxiety-provoking. A client can throw themselves more into work because they don’t feel like they’ll meet their goals or have anxiety over meeting goals. The bigger goal should be knowing when work-life balance is off-kilter and needs to be shifted.”

Flipping perspective

One major factor that can contribute to clients’ hesitancy to push back against unrealistic workloads or to experience guilt over taking time off is cultural messaging, Hunter says. Clients may struggle to equate work stress with its harmful effects (physical and mental) because American culture emphasizes that working and supporting yourself is a highly valued quality.

“When I grew up, being a workaholic was a compliment,” Hunter says. “Counselors can be advocates [for the idea] that work is not the be-all, end-all, and there can be rewards in other domains of life. We can be the ones to push and question that as a culture. … While it’s good for people to have direction in a career and feel valued, it’s important to balance that with family and life outside of work.”

Counselors can be agents of change in this regard, Hunter insists, and help clients make a cognitive shift: Work is not intrinsically bad, but it can become a problem when it negatively affects an individual’s mental health and spills over into their personal life. This is especially true, Hunter says, when working with clients who struggle with work addiction, who express feeling like everything rests on their shoulders, or who voice sentiments such as “If I don’t do this work, who will?”

“When it comes to work-life balance, it’s such a challenge in 2020 America to think of work as a problem. It’s hard to argue that working hard and supporting your family is wrong,” Hunter observes. “A client may say, ‘I’m doing everything right. I’m doing what I should to build a career and support myself and my family.’ When in actuality, overwork is the issue, and feeling obligated to a career and sacrificing other aspects of life.”

“Oftentimes, a career will take as much as you will give,” Hunter continues. “We live in a capitalist society, and even a well-meaning organization will accept all the work you will put into it, and it’s up to the individual to say when it’s enough. The organization never will.”

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Contact the counselors interviewed for this article:

Amanda M. Evans: evans3am@jmu.edu
Sharon Givens: visionscounselingandcareer@gmail.com
Quentin Hunter: hunterq@lindsey.edu
Michele Kielty: kieltyml@jmu.edu
Jennifer Linnekaste: jennlinnekaste@lifedesignonlinecounseling.com
A. Renée Staton: statonar@jmu.edu

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Want to learn more?

Sharon Givens will present the session “Career development and mental health strategies” at the ACA 2020 Conference & Expo in San Diego in April. Find out more about Givens’ presentation and numerous other sessions on career-related topics at counseling.org/conference.

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Additional resources

Take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

“Worrying for a living” by Laurie Meyers
“Could toxic workplaces be killing your clients?” by Laurie Meyers
“Generational divisions in the workplace: Where counselors come in” by Bethany Bray
“When the caring is too much” (on work stress in the veterinarian profession) by Christine Sacco-Bene and Fay Roseman
“Fertile grounds for bullying” (on workplace bullying) by Laurie Meyers

Books (counseling.org/publications/bookstore)

Coping Skills for a Stressful World by Michelle Muratori and Robert Haynes
Postmodern Career Counseling: A Handbook of Culture, Context and Cases, edited by Louis A. Busacca and Mark C. Rehfuss
Career Counseling: Holism, Diversity and Strengths, fourth edition, by Norman C. Gysbers, Mary J. Heppner and Joseph A. Johnston

ACA divisions

National Career Development Association (ncda.org)
National Employment Counseling Association (employmentcounseling.org)
American Rehabilitation Counseling Association (arcaweb.org)

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Should I stay or should I go now?

What should a counselor’s role be when a client who is overwhelmed by work stress wants to throw in the towel and leave a job? Explore this issue in an online exclusive article at CT Online: https://wp.me/p2BxKN-5SZ

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@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.

Should I stay or should I go now?

By Bethany Bray February 26, 2020

When work stress becomes overwhelming, a knee-jerk reaction may be to dust off your resume and search for a new job. You may even fantasize about walking out and throwing in the towel to rid yourself of a micromanaging boss, an abrasive co-worker or an unrealistic workload.

But will leaving a stressful work situation solve the problem?

Not always. Professional counselors say that leaving a job without considering the full picture of what is stressing you out – both at work and in your personal life – may not eliminate all of your discomfort.

Stress can quickly resurface if a person switches jobs to a position that isn’t a good fit for them or doesn’t address underlying issues that are affecting their mental health, such as unprocessed grief or past trauma, says Sharon Givens, a licensed professional counselor (LPC) who specializes in career development and mental health.

“We need to make sure we understand the root of a client’s stress. Look at the long term and not just the transition of leaving a toxic situation,” says Givens, whose private practice has offices in Columbia, South Carolina, and Charlotte, North Carolina. “They need to transition to somewhere they can sustain and not just make a move.”

A counselor’s role should never be to suggest that a client leave or stay at a particular job. However, a counselor can be a guide and support as a client steps back to assess what is out of balance in their life and creates goals to move toward the life they want to live, says Givens, president-elect-elect of the National Career Development Association, a division of the American Counseling Association.

“We can evaluate what this job means for this person [the client] and evaluate what this job is to this person,” agrees Quentin Hunter, a licensed professional counselor associate who counsels clients in a rural area of Kentucky. “What is the job like, and what does it demand? Is their stress unusual, constant or changing – and can they make changes?”

Hunter acknowledges that some clients may not have the option to leave a position if job options are scarce in their area, especially if their financial situation wouldn’t be able to sustain the transition until paychecks begin to come from a new employer. Counselors can help these clients make healthier choices about staying, Hunter says. “They can stay because they have reasons and not just stay without intention.”

For some clients who come to counseling for help dealing with work-related stress, “work may simply be non-negotiable,” adds A. Renée Staton, an LPC and professor in the counseling program at James Madison University in Harrisonburg, Virginia. “There may be no way out because it’s the only opportunity, the only game in town. It’s important to acknowledge that it’s a reality for many of our clients.”

Counselors can give clients “the space to acknowledge that this [work situation] is difficult … and normalize that [stressful] feelings come and go, and we deserve our own self-care and respect as we encounter these challenges,” Staton says.

In sessions with clients, Givens relies on an array of counseling tools to help clients identify the ways their job is affecting them and to arrive at the best decision for them based on facts rather than emotion.

“We take a step back and look at the variables of what they can change and can’t change. After mapping it out, I will ask, ‘What do you think is the best for you?’” she says. “I put the question back on them so they can ultimately make the decision. It needs to be based on symptoms and facts versus ‘I feel like.’ [We look at] what is actually happening, what are the symptoms and, then, what are your options?”

Finding solutions

Jennifer Linnekaste, an LPC who specializes in career counseling and helping clients with work-related trauma at her practice in Oslo, Norway, recalls one client who worked in an engineering firm and came to her because he felt he was stagnant in the position he had held for 15 years. “Tom” (not his real name) felt like he had no energy. He had come to dread the thought of being assigned new projects at work and “a never-ending string of meetings that felt pointless in nature to him,” says Linnekaste, an adjunct professor (teaching online) for Regent University in Virginia Beach and Old Dominion University in Norfolk, Virginia.

Conversations in counseling sessions revealed that Tom went into engineering as a career because he was drawn to the field’s focus on design and creativity. However, his job role had evolved away from the more creative, collaborative aspects that he enjoyed when he first began working for the firm. Roughly five years prior, new management had taken over and introduced new technology that allowed employees to work online and connect remotely.

“At first, Tom said he was checking email occasionally in the evening after [his] kids were settled or in bed. Then, the expectations began to increase,” Linnekaste recalls. “There was far more documentation, and he was moved into a task that involved more quality control – checking to make sure the people under him had done their jobs. He said he hated that. Soon, he found himself in middle management and was responsible for making sure others were meeting their deadlines. As someone who self-professed to be a perfectionist, Tom felt anxious about whether his team members would deliver. It began to consume him, worrying about whether the project would get done because he was the one who was responsible. His supervisor was a positive yet hands-off type of leader. As a result, Tom didn’t feel that he had the tools to manage things well. He also struggled with trying to communicate with those below and above him.”

After one particularly stressful meeting with his supervisor, Tom reported feeling completely overwhelmed and inept in his job. After the meeting, he told Linnekaste, he had “just wanted to walk out the door and never work there again. When I asked how he has persevered to this point, he said sheer willpower and a fear of not having a job. It was clear to me that he was surviving rather than thriving.”

“He came to me because he was wondering whether he should just leave and start somewhere new, but he had several concerns: 1) He actually liked the company and the people he worked with for the most part; 2) He was paid well; 3) He was unsure whether the ‘grass was greener on the other side’; and 4) He was uncertain whether he would be happy if he made a change,” Linnekaste says. “In order to help him make a decision, I felt he needed to have a good conceptualization of the problem and more information to move forward. We agreed on one thing: keeping the status quo was not sustainable [for] his mental health.”

From there, Linnekaste dove into a full assessment with Tom in counseling sessions, asking about his personal and family life, values and role models. The more they talked, the more it became clear that Tom was unhappy because he had lost the ability to be creative – one of his most valued attributes – at work.

Using this as a guide, Linnekaste helped Tom come up with a plan to seek creative work. The first step was to approach his supervisor and explain that his talents were best suited for creative work, not managing others. He planned to ask if there were different roles or tasks he could transition to within the company that would allow for creativity and design work. If his company wouldn’t allow him to change his role, then Tom would begin to search and apply for new jobs that offered creativity.

When Tom returned to counseling after approaching his supervisor, Linnekaste remembers that he smiled as he talked about how well the conversation had gone. His supervisor had been understanding and mentioned a new contract that was coming in that involved designing a new product.

“Tom told his supervisor that he was struggling with the management piece but didn’t want to be demoted. So, the supervisor stated that he was going to enroll him in a management course, as well as assign him a deputy manager that would handle the tasks related to quality assurance and benchmarks. Tom appeared energized and excited,” Linnekaste recalls. “He said, ‘You know, I had forgotten how much cooking was a passion for me. This past week, feeling better about the job front, I enrolled in a cooking class. I also told my wife I would like to have friends over once a month for dinner. We could have themed dinners where I try out different main dishes and they can provide the side dishes.’ When I asked about emails after work, etc., he said that they [didn’t] feel as overwhelming now to answer. He said he [was] going to put a hard boundary on not doing work on weekends, but he [felt] energized about being able to take on his new project.”

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Related reading

For more on helping clients with work stress, see Counseling Today’s March cover article “Help wanted: Managing work stress.”

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

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.

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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.

Can you hear me now? Ways to reduce sound transfer between rooms

By “Doc Warren” Corson III February 24, 2020

Many of us who own or work in a counseling office have been there: We do everything we can to make sure that our client’s personal information is safe and secure. We train staff on confidentiality, buy expensive cabinets to house client charts and related documentation, and may even have an electronic medical records system so that we are compliant with all privacy laws. But then, sitting in our office, we notice that we can practically hear the heartbeat of the clinician in the office next door. How can we maintain privacy for our clients if the sound transfer is so bad?

If you are building or remodeling, there are many things that you can do, and we will explore some of those ideas in a bit. But what if you already have an office and cannot afford or are not allowed a full remodel? Fear not, there are a few things you can do to reduce sound transfer without breaking the bank. The best part is that most of them are easily undone should you leave your current digs.

Ideas to reduce sound transfer in offices that can’t be remodeled

White noise machine or a radio: Placing a white noise machine or a radio in waiting areas will help reduce the ability of others to hear what is being said in your office. These items can be placed in the counseling office themselves if needed, depending on the level of sound transfer.
Rugs: If you cannot do wall-to-wall carpeting, then throw rugs can help absorb noise. A thick rug is best, but be sure to consider tripping hazards and client mobility. Wheel chairs, canes and walkers do well on flat surfaces, whereas shag or fuzzy rugs can impact mobility, so give it some thought prior to purchasing.
Seating layout: Do not face seating directly toward the door because this will direct sound to the door opening, which is the most vulnerable spot in most offices. Instead, have the seating face a wall so that the sound carries toward the walls rather than toward door openings. This will help reduce the amount of sound transfer from vulnerable door area gaps. This is especially key should you have a hollow core door.
Fabric placements: Drapes or wall hangings can help absorb sound and reduce transfer. Also add pillows to furniture — the more the better, so long as they do not get in the way.
Drop ceilings: If your office has drop ceilings, you can put insulation above the ceiling tiles to help reduce sound transfer.
Wait times: One way to reduce the chances of people hearing what is happening in the clinical office is simple and free: Stagger the times of sessions so that one session is likely to be over before the next client arrives. This works regardless of the number of offices and requires just a bit of coordination.

Building or redesigning offices with sound in mind

You might rent or lease a building that allows you to build an office to suit your needs. In certain cases, the building owner may even assume some or all of the costs. In other cases, you will own the building and have the ability to remodel as you desire, so long as you follow building codes and secure the proper permits. Whether you are doing the work yourself or will simply supervise the project, here are some things to keep in mind to reduce sound transfer and increase overall privacy.

Acoustical substitutes for wallboard: In some areas, it may be beneficial to not use traditional wallboard (Sheetrock) and instead to use one of the specialty acoustical boards on the market. Each offers superior sound deadening, but they can be expensive (five to 10 times the material cost of traditional wallboard). In all of the offices that I have transformed, we opted to use these products once, on one very sensitive wall.
Acoustical putties, sealers, etc.: Often used with the substitute board, acoustical putty is used to seal around any cutouts in the board such as outlets, light fixtures, etc. The sealer goes on all wall studs and any surface with which the wallboard will come into contact. It cuts down on sound transfer. I have used this only in the most problematic areas where I used acoustical wallboard.
Solid core doors: Although they are more expensive than hollow core doors, solid core doors offer more sound deadening/sound deflection. Some solid core doors are made of solid wood, whereas others offer a composite interior that is designed to block more sound. The choice is yours because both have much to offer. Should your office be very problematic, doors designed to block sound are the way to go. In recent remodels, we have chosen to install prehung exterior doors that come with weatherstripping for our offices. While they are designed to keep air out, they also offer superior sound deadening compared with general interior doors that are on the market, and yet they cost about the same as a good quality interior door.
Wall-to-wall carpeting: Hard wood or other hard surface floors are beautiful and can last a lifetime compared with wall-to-wall carpeting, but carpeting does more to absorb sound than hard surfaces can.
Sound-deadening insulation: If the walls have not yet been built or are going to be opened up, sound-deadening insulation is a must. Materials for an average-size office will cost hundreds of dollars but will also offer some of the most effective sound deadening. When framing new walls, building codes may allow for 24-inch spacing of the wall studs. However, it is often far more cost-effective to stick with 16-inch-on-center setup, meaning that every wall stud is installed 16 inches apart from the one next to it if measured from the center of the stud. This is the most commonly used spacing for walls that are being insulated. As such, the cost of the insulation for 16 inch is far cheaper.

It is important to remember to do all walls, including the interior walls, to have effective sound deadening in the office. Whenever possible, also ad sound-deadening insulation in the ceilings and floors.

Doorway placement: Doorways can be one of the biggest sources of sound transfer. If you have the option, avoid having office doors open directly into waiting areas. Instead, try to have a hallway between so that any sound that may escape does not go directly into the waiting area. If this is not possible, see the earlier suggestions for seating layout and white noise machines.
Avoid trendy: More and more old buildings are being converted from factories into office spaces. These areas are often beautifully urban and ultra-trendy. One of the biggest drawbacks to these spaces, however, is the trend to build the walls only 8 feet tall even though the ceilings may be 14 to 20 feet.

Our current office was once designed to look like a barn, so some of the space once had two-and-a-half-story-tall walls. Instead of open air at 8 feet, we added a ceiling. It helped prevent sound transfer and also added 1,600 square feet of additional office space on the new floor above.

Failing to close the overhead area tends to give you a glorified cubicle because the gap between the walls and the ceiling allows for sound to move freely. In a sense, these spaces are even worse than cubicles sound wise because cubicles often have soft materials on their walls to help absorb sound. Some even come with doors and ceilings for added privacy. No sound machine, carpet or other items can overcome several feet of open space (unless the noise machine is set very loud, and that would also affect the session space).

Should your space have very tall ceilings, spend the money to bring the walls up to meet them, or have a lower ceiling built on top of the walls.

Supervise the build: Some of us will tackle all or most of these jobs ourselves and do well. Many of us, however, lack the time or ability to take on some of these tasks. Should you hire all or some of the work out to contractors, do not be shy about making your requirements and desires known. Go out to the job site and supervise every aspect of the build. Make sure that sound-deadening insulation is used in every area (there are many brands with various levels of deadening, so be sure that the right one is used for your project).

Sometimes, a busy crew might neglect some of the cavities that require custom cuts to the insulation. Other times, they may honestly forget to install something that you ordered. Whatever the case, having you there with the plans can help ensure that the build goes as desired. Remember that in most cases, a mistake is just that — so present it to the contractors in a polite manner, without accusation. Whenever possible, find a contractor with experience in sound abatement because that should increase the likelihood of the process going smoothly.

Sound transfer remains a large issue for many offices, whether for-profit or nonprofit. With a bit of research and planning, much can be done. A little elbow grease and some creativity can take you far.

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“Doc Warren” Corson III is a counselor, educator and writer, and the founder, developer, and clinical and executive director of Community Counseling of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). He is certified as a counselor and counsellor supervisor in the United States and Canada. Contact him at docwarren@docwarren.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.

Voice of Experience: Billing guilt

By Gregory K. Moffatt February 18, 2020

I am a very poor bookkeeper. I will admit that up front. I am capable, but I just don’t enjoy managing the finances of my clinical setting. Perhaps more importantly, for many years I felt guilty about charging my private practice clients.

Therefore, I was hesitant to mention overdue balances or to expect payment from my clients at the time of service. It just felt awkward. If clients didn’t pay their bills, I often would let their accounts slide into history and eventually ended up closing their files with an amount due in the ledger.

Then one day, many years into my practice, I got some new accounting software and decided to clean up my old books. For no reason other than curiosity, I went back through all my overdue accounts and was stunned. The total owed by overdue clients was in the thousands of dollars.

Granted, this was over a long period of time — more than 10 years — but those individual accounts that I let slide had added up. I could have bought a new car with that money. Fortunately, my private practice was not my primary source of income. Otherwise, I very likely would have been operating in the red.

It is uncomfortable asking for payment, but this seems to be true only for counselors. Can you think of any other service in which the vendor is hesitant about asking for payment? I can’t. Whether they are plumbers, mechanics, dentists, morticians or babysitters, people get paid for providing a service.

Nearly all of my new counselors, interns and supervisees express some hesitation about charging clients. One experienced counselor, in fact, asked me to look over her revamped informed consent. Her fees were clearly listed.

“You aren’t charging enough,” I told her.

“Really?” she said sheepishly. “I don’t want to be greedy.”

I asked her what her time, education and experience were worth. She had two degrees, was fully licensed both as a professional counselor and as a marriage and family therapist, and had several years of practice under her belt. Yet her fees were the same as when she was still in supervision.

I asked, “Are you providing a service that has value to your clients?” Of course, she said yes.

“Then there is nothing wrong with being paid what you are worth, at least within the market standards.”

She decided to raise her rate — and she deserved the higher fees. She also saw no change in her client base. In other words, none of her clients questioned paying a rate consistent with the standard in the field. As it should be.

One of my colleagues who has run a successful private practice for many years taught me something on this topic. She had a basket in her waiting area with a sign: “Check goes in the basket before you come back” (to the therapy room).

These days, her sign probably says something like, “Payment on my cash app must come through before therapy starts.” I don’t know. But the point is that she set an expectation for payment that was reasonable and clear, and people lived up to her expectations.

Even though my informed consent said payment was due at the time of service, I wasn’t clear about what my expectations for my clients were. My practice demonstrated vague expectations, so my clients back then lived down to them.

I completely understand why we feel guilty about charging as professional counselors. After all, we are helpers, not mercenaries. But few things in life are free.

If a client balks at my fee, I’m happy to provide referrals. I’m also very generous with pro bono hours — as are most therapists. But I no longer feel any guilt about charging my clients or my supervisees. I’ve invested in my career, it costs me money to run my practice, and I’m good at what I do.

“How much is your marriage worth to you?” I asked one potential client who hesitated at starting marriage counseling. (Sometimes I asked, “How much does a divorce cost?” That usually put things in perspective.)

“I guess it is worth $150 an hour,” he said, referring to the fee his therapist was charging. And it was worth it for the therapist too. She used her expertise to help heal a damaged relationship just as a physician might use medication or surgery to help the body heal.

Regardless of whether you have a sliding scale or a fixed rate, accept third-party payments or are cash only, you are providing a service. You spent time, money and energy developing and maintaining your expertise. You deserve to be compensated.

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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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.

A collective voice: Indigenous resilience and a call for advocacy

By Roni K. White, Alaina Hanks, Susan Branco, Nicola Meade and Isaac Burt February 11, 2020

Resilience is one of the characteristics hallmarking the experience of North America’s indigenous tribes. These tribes predate the European exploration and colonization that led to the renaming of these inhabited lands to the United States of America. These acts of occupying launched the dominant discourse and fallacious narrative that Original People no longer exist and began long before the Occupy movement. This ability not just to endure but to remain resilient, despite more than a quincentenary of atrocious acts, government policies, and intentional genocide, speaks to the strengths that exist within Native communities.

With modern technologies expanding platforms for Native people to share history and current events, professional counselors have the opportunity to further their understanding, increase competencies, and expand efficacy. Perhaps the perceived silence of Native voices is not because they are not speaking, but because few are listening.

Too often, professionals who interact with or provide services to a Native tribe record a narrow view. This limited representation misinforms others about the realities that exist and undermines the plurality that is alive. As counselors committed to improving social justice, promoting growth, supporting healing, and championing thriving, we offer a pathway to consider a more informed perspective and tools for advocacy.

Historical relevance

When truth is hidden or unheard, it leads to false teachings and misinformation. Historical accounts are complex, and tribal nations carry their own histories. Explorers, traders and colonizers disrupted the way of life for millions of human beings across North America from the 15th through the 20th centuries. By some accounts, as many as 112 million people — a number that can never be resolved or agreed upon — lived in North America in tribal nations prior to the arrival of European explorers and colonies. The people, constituting self-sufficient nations deeply connected to the lands of North America, have endured immense psychological pain, physical abuse, genocide, and torture at the minds and hands of European colonizers and their descendants.

Despite the intentional disregard and destruction of human life and communities, Native nations continued to promulgate their existence through advocacy and engaging with the U.S. government. In 1824, the U.S. government established the Bureau of Indian Affairs (BIA). In 1830, then-President Andrew Jackson signed the Indian Removal Act, forcing a massive and involuntary migration that resulted in immeasurable fatalities, internment, and the disruption and loss of customs and culture. Persistent broken treaties, ill treatment and racism did not deter Native nations from standing up to the U.S. government or against injustice, discriminatory laws, and other methods to prevent prosperity, equity and health.

From a space of incredible resistance and intelligence, Native nations have effectively changed U.S. laws and practices and transformed the BIA over the years, including the governance and collaboration of sovereign nations. The BIA led the implementation of the Indian Self-Determination and Education Assistance Act of 1975 and the Tribal Self-Governance Act of 1994, which changed how the federal government and sovereign tribal nations interact and conduct business with one another.

Impact of trauma

The great Oglala Sioux chief Red Cloud understood change and the implication of actions. Red Cloud shared that one’s actions impact seven generations. Change is slow, and the impact of change continues over numerous decades. When we look at the undesirable conditions and circumstances various tribes have faced, it is imperative to comprehend the ways in which the ripple effects of history and laws can impose complex trauma on these individuals and communities.

Science reiterates Red Cloud’s sentiments by demonstrating how prolonged stress, inequality and trauma change neurobiological responses. These changes, also known as epigenetics and psychoneuroimmunology (PNI), support understanding of the increased levels of stress hormones found in Holocaust survivors and their children, resulting in high levels of anxiety and depression, ineffective coping abilities, and decreased social functioning. People from Native nations live under perpetual inequality and discrimination and endure many social injustices. It is reasonable to apply scientific understanding to appreciate the epigenetic and PNI changes experienced within Native nations.

Honoring the privilege to serve Native populations includes incorporating a neuroscience-informed traumatology framework. Having this competency promotes a multifaceted lens to conceptualize the presenting problem and address the underlying root causes that might be outside of the client’s awareness. Neuroscience-informed traumatology provides a pathway of healing, growth, advocacy and improved agency.

Present snapshot

The U.S. government consistently uses “less than 1%” to describe the population of Native people, but that number represents millions of human beings. Today, there are 573 federally recognized tribes and an unknown number of unrecognized tribes, which at some counts may be around 196. The number of unrecognized tribes fluctuates due to determination of petition to the U.S. government.

Despite the federal government having recognized tribes, a person may be of Native ancestry and not have tribal membership. Not every person with an identity that acknowledges Native ancestry or who has tribal membership lives on land known as an Indian reservation. Tribal governments have the sovereignty to govern tribal land, and these structures vary from tribe to tribe. When working with these clients, understanding their individual experience and relationship to ancestry and identity is essential in establishing and maintaining a healthy therapeutic alliance. One size does not fit all; history teaches us a fraction of one’s experience.

SEATTLE: Indigenous activists march in solidarity with the people of the Standing Rock Sioux in their fight against the Dakota Access Pipeline, September 2016. John Duffy image/Wikimedia Commons https://bit.ly/31NrgqQ

Cultural revitalization efforts

Even with a long history of oppression, violence and genocide, many tribal communities today are reclaiming their histories through cultural revitalization efforts. In areas with high Native populations, you will often see efforts to bring back cultural knowledge in many ways. These efforts expand beyond the occasional localized community event; instead, they intertwine in the very fabric of daily living in these communities.

Although most cultural programs and initiatives are located within tribal territories, you can often find similar efforts in cities with larger Native populations. Look to the American Indian corridor on Franklin Avenue in Minneapolis as an example of the efforts of urban Indians to stay connected through culture. This neighborhood houses an American Indian Center, urban tribal offices, culturally centered schools, Native housing projects, art galleries and more.

The Indian Pueblo Cultural Center is another example of restoring connection. The Pueblos constructed this center on reclaimed land in the city of Albuquerque, New Mexico. It supports cultural, social, educational and economic needs for the 19 Pueblo communities and other Nations of the Southwest. In many major cities, you can often find at least one entity that supports Native people with culturally specific services and programs.

Reclaiming cultural connections is also a global focus. The United Nations declared 2019 as the year of Indigenous languages, and you can see language revitalization efforts everywhere within heavily populated Native communities. These efforts include immersion programs in day care facilities and schools, language camps, community classes, language bowls and the reproduction of media with Indigenous languages. The fact that children are now able to watch the Berenstain Bears in Lakota is evidence of language immersion and acknowledgement. For many tribes, various cultural values are embedded within their respective language. Thus, language efforts closely interconnect to ways of being.

In addition to the multitude of cultural initiatives and programs that exist, Native people are becoming more actively involved in mental health. In October 2010, Dirk Lammers wrote about the outstanding work conducted by the Urban Indian Health Center throughout the cities of South Dakota to improve both the physical and mental health of Native people living off reservations (see https://sduih.org to learn more).

In June 2011, White Swan reported on a program called Dream Makers in Washington state that youth started to assist other students who were struggling with suicide. The youth made small cards with supportive contact information that the students received. This effort, along with training from a specialist from Indian Health Services, led to zero loss of life due to suicide and an unprecedented referral to the school counselor for mental health needs.

In April 2017, Dan Beaton, from the Iroquois Nation, wrote about his work to assist in culture and ceremonies in Canada, and particularly his encounter with the Attawapiskat Nation. He described the beauty of sharing stories and prayers between different tribes and the healing that such events bring through a common reconnecting to a tribal heritage. Mental health continues to be a priority among Native nations.

Promoting wellness

A plethora of organizations and professional communities are dedicated to promoting wellness among Native nations. The American Indian Health Service (AIHS) serves the urban Native American community in Chicago. It works to address health holistically and has developed innovative medical and behavioral health programs to address the unique needs of indigenous communities. Among these include a Youth Development Program that aims to address emotional health and cultural resiliencies and offers Youth Mental Health First Aid training (visit http://aihschgo.org to learn more about AIHS).

The National Indian Health Board strives to promote successful strategies, identity challenges, support prevention and increase awareness for the behavioral health needs of all American Indian and Alaskan Native people. To acquire valuable resources, visit https://www.nihb.org/behavioral_health/resources.php. Intentional efforts to address prevention and evidence-based treatment for Native people are ongoing. For example, One Sky Center upholds and advocates for culturally appropriate treatment and training to provide mental health and substance abuse services for Native people.

The resilience of Native people encompasses surviving, advocating, healing and thriving. Native Nations and American Indians continue efforts to this day, working on policy issues and engaging in policymaking. The National Congress of American Indians organizes efforts into five policy areas:

Community and culture
Economic development and commerce
Education, health and human Services
Land and natural resources
Tribal governance

Each year, multiple bills are introduced on the floor of the House of Representatives, and multiple cases are heard in the Supreme Court concerning policies in the aforementioned areas. Today, Vice President of Special Projects for the Cherokee Nation Kimberly Teehee is advocating along with Cherokee Nation Principal Chief Chuck Hoski Jr. to enact the 1835 Treaty of Echota, which would seat a delegate in the House of Representatives.

Ethics in advocacy

Distinguished endeavors and strides to achieve equity and fairness for Native people have support from collaborative and cooperative organizations, individuals and agencies. Codes of ethics call on professional counselors on multiple levels to advocate with and on behalf of the communities in which they serve. Specifically, the 2014 ACA Code of Ethics includes promoting social justice in its preamble. Furthermore, Standard A.7.a. charges counselors to engage in advocacy efforts to remove barriers to access and equity for their clients. Ratts, Singh, Nassar-McMillan, Butler and McCullough provide professional counselors with guidelines to include advocacy efforts in their work with clients in the 2015 Multicultural and Social Justice Counseling Competencies (MSJCC). Counselors can use these tools in considering how to best collaborate with Native American clients.

Corresponding with the MSJCC, the idea of humility is of utmost importance when an outsider (non-Native) wishes to serve Native American clients. In certain tribes (such as the Navajo), the act of being humble is a primary concern. Although counselors receive education in empathy, techniques and self-awareness, the ability to be humble is not normally taught.

Non-Native counselors looking to work in Native American communities need to acknowledge that they are outsiders. Even though counselors may have good intentions, they will nevertheless need to prove themselves. Having to go through this vetting process is difficult and something that many counselors find arduous and time-consuming. The mindset of the non-Native counselor can mirror the following: I want to help and cannot quite understand the rationale for the resistance I am encountering. However, the belief of the Native American community can mirror the following: People have come and gone and did not have our best interests at heart. It is clear to see the disconnect between these two mindsets.

One way to resolve this issue is to utilize a combination of humility and the MSJCC. For example, consistent with the MSJCC, non-Native counselors need to have self-awareness and critically comprehend their clients’ worldview. This multicultural outlook includes understanding historical privileges and marginalization.

Counselors who operate within this culturally competent framework understand that it is not entirely about their self-identification but also about how one’s identity may be perceived by others. For non-Native counselors whose self-concept is one of overcoming poverty, stress and discrimination, they may see themselves as having a connection to the communities they wish to serve. Conversely, for those in the Native American community, instead of the personal image the counselor wishes to display, they could potentially see an individual who represents past brutalities and halfhearted efforts to help. It takes movement (e.g., courage, patience, openness) on both parties (primarily the counselor) to understand this mindset and have the humility to accept it and be able to move forward positively.

To gain more in-depth understanding of advocacy efforts, it is beneficial to begin learning about a particular Nation or topic area. Attend meetings or sessions on a Nation or topic, learn about the existing efforts and challenges, and use your skills and time with the permission of the appropriate Native leader. Given Native histories, it is important for non-Native counselors to be aware that there might be times when they need to wait for a leader to invite them into a group they are looking to serve. It will also take time for them to be valued as an ally; interest does not equal automatic acceptance.

Sometimes the best gift one can offer is to be the student. History is ever being amended and recorded; remaining open to learning, increasing awareness of one’s relational existence to others, and identifying noninjurious ways to contribute to the change you imagine will allow you to share in amplifying voices and dismantling inequalities.

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Roni K. White is the founder of Apricity Wellness Counseling and designer of the “Women in the Workplace: Leadership, Barriers, & Struggles” series. She is a national certified counselor and licensed graduate professional counselor. She aspires for equity in a decolonized world. Contact her at rkwcounseling@gmail.com.

Alaina Hanks is Anishinaabeg and enrolled in the White Earth Nation in Minnesota. She is a licensed professional counselor-in-training and a community advocate with HIR Wellness Center in Milwaukee. Contact her at alaina.hanks@gmail.com.

Susan Branco is a clinical assistant professor with Counseling@Northwestern’s clinical mental health counseling program. Contact her at Susan.Branco@northwestern.edu.

Nicola Meade is an adjunct professor with Old Dominion University. Contact her at nicolaameade@gmail.com.

Isaac Burt is an associate professor at Florida International University. His research interests entail working with historically disenfranchised and marginalized populations. Contact him at iburt@fiu.edu.

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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.