This award recognizes graduate counseling students with exceptional insight and understanding about the counseling profession and the work of professional counselors in mental health, private practice, community agency, agency, organization or related counseling settings.
Winner: Adriana Walsh
Adriana Walsh is a master’s student in the clinical mental health counseling program at Wake Forest University. Before moving to North Carolina for graduate school, Adriana worked in her home state of Maine as a full-time crisis and support line advocate for the statewide sexual assault helpline. Although she is just beginning to explore her clinical populations of interest, she hopes to support people around issues of anxiety, grief and loss, trauma, chronic pain and illness, identity concerns, and life transitions. Adriana is drawn to existential, narrative, and relational-cultural approaches and hopes to incorporate elements of the expressive arts and ecotherapy into her work with clients. She holds a bachelor’s degree in music from Grinnell College. In her free time, Adriana enjoys cooking, traveling, long walks in nature, playing and writing music, and spending time with family.
To engage fully in the profession of counseling means to understand counseling as both an art and a science. While the “art” of counseling comes intuitively to many, its scientific quality can appear more elusive. Yet, as stated in the 2014 ACA Code of Ethics, measuring therapeutic effectiveness is necessary to ensure that clients’ time, energy, and money are not wasted on treatment that is at best ineffective and at worst harmful. As a first-year counseling student, I find myself facing a delicate conundrum: how can counselors engage in the crucial science of measuring therapeutic outcomes without forgetting the fundamental humanness upon which effective therapy is contingent?
Fortunately, outcome measurement does not necessitate abandoning therapy’s human quality, but in fact depends upon it entirely. Take, for example, María, a recent immigrant from Mexico. She is in an abusive relationship and presents with debilitating social anxiety. What might effective counseling look like to María? Does it mean gaining the courage to leave her partner? Does it mean addressing her anxiety enough to leave her house and buy groceries? Or does it mean something else entirely?
In truth, the answers to these questions must come largely from María herself. While clinicians depend upon their own professional expertise grounded in empirical research, the cornerstone of effective counseling is the integration of client feedback. Still, traditional means of soliciting feedback (e.g., a post-session conversation or survey) may not always yield accurate evaluations of client outcomes, and the feedback process should be tailored to each client. For instance, María’s social anxiety may render honest face-to-face feedback difficult. She may also hold back critiques because she is not be accustomed to having her voice privileged in relationships. Language and cultural differences must be considered as they, too, may inhibit open and clear communication of feedback.
Counselors can minimize such barriers by cultivating a “culture of feedback,” in which regular client input is normalized and encouraged. To this end, counselors should provide options regarding how clients provide feedback (e.g., verbal vs. written), use language that resonates with and empowers clients (e.g., avoiding psychological jargon), and present opportunities for feedback early and often.
Additionally, counselors must be willing to grapple with potential blind spots, balancing our clinical expertise with an attitude of humility and proactively seeking peer and supervisory input. We must remain critically aware of structural forces that threaten our capacity to objectively assess counseling outcomes, such as insurance policies that prize specific approaches. It is essential that we recognize and resist pressures to fit our evaluations of outcomes into certain molds when other approaches may better suit a given client.
Counselors must strive for long-term effectiveness by advocating against oppressive conditions that pose barriers to seeking or continuing therapy, including discrimination, poverty, insurance costs, and stigma. Finally, adopting an attitude of “scientist practitioner” (e.g., by engaging in action research) can empower clinicians to view the analysis of outcomes not as the sole responsibility of ivory-tower academics, but instead as an integral component of all effective counseling.
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.