Monthly Archives: October 2020

ACA legislative briefing tackles racism, police reform and mental health issues

By Laurie Meyers October 20, 2020

The nation is poised at a historic moment in which the American people’s recognition and understanding of the injustices that happen every day in Black and brown communities is at an all-time high, said Rep. Anthony Brown, D-Md., one of the speakers at the American Counseling Association’s Legislative Briefing on Racism, Police Reform and Mental Health held via Zoom on Wednesday, Oct. 14. He urged legislators, policy makers and advocates to use this awareness to make truly transformational changes to police departments.

Organized by ACA’s Government Affairs and Public Policy department, the briefing consisted of a bipartisan panel of national and local legislators.

ACA CEO Richard Yep opened the session with a statement noting that the association denounces all forms of racism, police brutality, systemic violence and white supremacy. The briefing was offered to ACA’s membership, legislative staff and advocates who are working on bills currently before the 116^th Congress, specifically focusing on racism, police reform and mental health.

MSNBC commentator Aisha C. Mills, a longtime political strategist and social impact advisor moderated the briefing. Before turning the discussion over to the first panelist, Brown, she took a moment to acknowledge the pain that was happening in communities all over the country as a result of interactions with police departments.

“It’s fraught—there’s a lot of tension,” Mills said. “One of the conversations that too often gets lost is that law enforcement responds and reacts in a way that is about safety, is about duty to protect communities and is not always able to be flexible and sensitive to the needs of people who are struggling with mental health issues.

“We’re hopeful that through this conversation, we will learn about a variety of solutions that policy makers are thinking about—legislation that can be moved and … that the counseling community will be able to connect with ways that you all can be in better partnership with law enforcement and legislators as we all try to seek solutions together,” she concluded.

The role of mental health in transforming community policing

Mental health professionals play a vital role in the broader public health of our communities, noted Brown. Their expertise must be a key feature in work to combat racism—particularly in police departments.

“The killing of Black Americans at the hands of the police is an epidemic in this country—one that has existed for decades and has gone largely unaddressed,” he continued. The deaths of George Floyd, Breonna Taylor and countless other Black men and women has highlighted the need to fundamentally transform policing in this country.

“I believe we should start by changing the culture of policing by moving the officers who protect us away from a warrior cop mentality toward their proper goal as community guardians,” Brown emphasized. “We must also recognize and acknowledge that officers are often tasked to respond to certain situations where they don’t necessarily have the proper training.”

Police officers are often unable to properly understand the citizens and communities that they are confronting or engaging with and thus cannot properly de-escalate or manage a situation, he said.

“Since 2016, nearly a quarter of the people killed by police officers have had a known mental illness,” Brown said.

He believes that calling upon the expertise of mental health professionals is a vital part of preventing such tragedies.

“I believe we can save lives by acting more with compassion and understanding rather than force,” he said. “We can save lives and livelihoods when we stop criminalizing mental illness and addiction by instead providing resources and help to those who need it. We must also provide structural reform in police departments.”

This was the intent of H.R 7120, the “George Floyd Justice in Policing Act,” which was passed by the U.S. House of Representatives in June.

The George Floyd Act seeks to transform police departments by reducing their militarization by preventing the transfer of military equipment from the U.S. Department of Defense to local police departments, removing bad officers and banning harmful practices such as choke holds and no-knock warrants. It also proposed training for police departments on diversity and cultural sensitivity, including how to end racial, religious and discriminatory profiling.

“We know that this legislation alone won’t be enough,” he said. To establish a more just country, we need to invest in long neglected policies and programs that meet the social needs of communities and address the structural disparities that harm Black and brown families, Brown said.

This month the House passed the Strength in Diversity Act of 2020 (H.R.2639) to address the persistent racial disparities in the education system. Brown authored an amendment to the act that would provide funds to recruit, hire and train more school counselors.

“School counselors play a vital role in students’ success,” he said.

On the other side of the aisle—and the other body of Congress—Jake Hinch, legislative assistant to Sen. James Inhofe, R-Okla., said that the senator had become interested in the intersection of mental health and policing because statistics show that approximately one in 10 police calls and one in four shootings involve someone with a mental illness.

Inhofe believes that one of the ways to address these issues is with S. 1464, the Law Enforcement Training for Mental Health Crisis Response Act of 2019, which would provide state, local and tribal agencies with federal grant funding for behavioral crisis response training. Inhofe believes that the training would provide knowledge that would assist police officers when responding to calls that include people who are suspected of being under the influence of drugs or alcohol; are possibly suicidal or suffering from mental illness.

A call for counselors to lend their expertise

Charlyn Stanberry, chief of staff for Rep. Yvette Clarke, D-N.Y., began her portion of the panel by noting that Oct. 14, the date of the event, would have been George Floyd’s 47^th birthday.

We are in a period of reckoning when it comes to systemic racism, police reform and mental illness, she said.

Rep. Clarke is the vice-chair of the House Energy and Commerce Committee, which has jurisdiction over healthcare—including mental health, Stanberry noted. As part of the Congressional Black Caucus (CBC)—which was specifically tasked by Speaker of the House Nancy Pelosi with putting together the George Floyd Policing Act—Clarke was involved with the public health aspects of the bill, which included discussions on how public safety in all communities could ultimately be reimagined so that it is just and equitable. In practice, such an effort would require bringing all stakeholders, such as law enforcement, mental health professionals and constituents to the table. One of the ways the CBC sought to ensure that would happen was by including a provision within the bill for providing public safety innovation grants for community-based programs, Stanberry explained. The grants would go toward creating task forces that would examine how policing would fit into the community and contribute to public safety in an equitable way.

“That’s a big part of what we as individuals and counselors need to think about,” she said. “How can you play a role if these grants are brought into the communities and talk about what this new 21^st century police, community policing or public safety looks like?”

Hinch said that discussions like the ACA briefing are essential for him and other staff to stay aware of crucial issues. Legislative teams cover a lot of different subject areas and rely upon experts to educate them.

“It’s important for counselors to come to their representatives in Congress to explain what the issues are and what they can do better,” he said, adding that Sen. Inhofe wants to hear from everyone, whether they be Democrat, Republican or Independent.

“It’s vital for the senator that we continue to have these kinds of conversations,” Hinch said.

Stanberry added that although they are entering a lame duck session, the 117^th Congress will be in session in January. There will be a lot of hearings that have to do with mental health, and she is officially issuing a call for research and expertise from counselors.

The final speaker was Georgia State Senate Majority Leader Bill Cowsert, the head of the state Republican party and chair of the Senate Law Enforcement Reform Committee, which is looking at police practices and procedures. The committee’s intent is to see if police officers are receiving sufficient training to prepare them to deal with potentially confrontational situations such as crowd control or serving warrants or any incidents in which mental health issues may come into play, Cowsert explained. They’ve only had one meeting, but what the committee found is that throughout the country, police departments seemed to be getting a lot of training in de-escalation. Cowsert said he and the committee believe that the training could be improved upon. They intend to hold a hearing with members of the local mental health community in order to gain insight on how to improve training.

As the briefing ended, Stanberry and Hinch both placed their contact information in the comment boxes and urged the audience to get in contact with them to share ideas, comments and expertise.

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Resources

Related reading, from Counseling Today:

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Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@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.

Pop-top cans: Ensuring services truly support those experiencing homelessness

By Seneka Arrington and Chad Yates October 19, 2020

Community food pantries rely upon the generosity and goodwill of community members. Food pantries are invaluable to those individuals and families who are either homeless or facing food scarcity.

As an education specialist for a large nonprofit, I (Seneka Arrington) oversaw the daily operations of our local food pantry. In the back, from ceiling to floor, nonperishable food items — organized by soups, vegetables, meats, snacks and beverages — lined the walls. On a shelf sat prepared food bags, created by hand and ready to be distributed to those in need.

One afternoon, a man walked through our front doors and requested a bag, stating, “I haven’t eaten in days.”

With delight, I grabbed a food bag and handed it to our guest. Famished, he decided to open the bag in front of me just to “have a few bites.” But to his dismay, he was unable to access any of the food because every can in the bag required a utensil to open.

Discouraged, he mumbled, “It’s so hard to get here. Now it’s hard to get the food out. This always happens.”

I quickly apologized for the inconvenience and asked if I could make the situation right. I took his bag and returned to the fully stocked pantry, scanning for a meal to provide to my guest. On the middle rack, three items in pop-top cans caught my eye. I grabbed all three and created a dinner bag that my patron could enjoy. Upon receiving this new food bag, the man smiled and hugged my shoulders.

This experience highlighted for me contradictions in the ways our society tries to support, care for and aid those who are homeless. Although goodwill is typically present in these initiatives, a lack of intentionality often plagues efforts to reduce suffering in this community. I came to recognize how education could increase the effectiveness of the support offered by society. From that point on, my mantra became that all food bags “need to make sense and include only pop-top cans.”

Homelessness is an ever-present concern in communities. The problem is anything but invisible. More than half a million people in the United States experience homelessness on any given night. The National Coalition for the Homeless highlights three types of homelessness: chronic, transitional and episodic.

Chronic homelessness is used to describe the people who are most vulnerable due to experiencing homelessness for at least a year while also struggling with a substance use disorder, physical disability or serious mental illness.

Individuals experiencing transitional homelessness rely on the shelter system for a short period. These individuals are likely to be younger and to have become homeless because of a calamitous event.

Episodic homelessness includes people who experience mental health, medical or substance abuse issues. These individuals are chronically unemployed, resulting in a frequent shuffle in and out of homelessness.

Homelessness and helping those in need has been a passion of mine since I was in the third grade. In working with this population, I have witnessed a frequent lack of intentionality by those who donate or serve and a subsequent lack of self-worth on the part of those who receive these donations or services. What are we saying to a person when we hand them food that they cannot access? As helpers, what is our attitude around giving to those in need? Do our services reflect our support?

It is important to first look at our biases toward those who are homeless and the difficulties that surround asking for help.

Stereotypes about homelessness

Throughout my career, I have heard words such as annoying, needy and lazy applied to those who are experiencing homelessness, often as justification for someone’s lack of desire to serve this population. Such words are often used when describing panhandlers. “If that person can ask for money, they can get a job” is one prevalent line of thinking that negatively influences people’s willingness to help those they deem to be undeserving. There is also the idea that given all of the community and government efforts to assist those who are homeless, individuals who are still asking for help are not taking advantage of these resources.

Homelessness is repeatedly associated with choice. Those burdened by homelessness are often viewed as being individuals whose predicament resulted from their own poor choices and who have full autonomy to get themselves out. Many of these individuals desire stability, but the added stresses of humiliation, worries of where to sleep at night and food insecurity are their reality.

Their losses of employment, housing and family are commonly viewed as resulting from poor decision-making and mismanagement. These negative impressions are so ingrained in our society that even well-meaning citizens have difficulty giving to those in need. Understanding the complexity of homelessness, addressing our personal biases and updating these beliefs are the first steps on the path toward advocating for this population.

Understanding homelessness through the lens of a counselor

Community mental health agencies are supportive of accepting individuals who are experiencing homelessness. These agencies typically accept Medicaid/Medicare or offer sliding feel scales to help these individuals obtain services.

Other organizations in which counselors may work with individuals who are homeless include nonprofit agencies, Department of Veterans Affairs facilities, and child and family services agencies. In addition, school counselors may assist students whose families are transitory or homeless.

As counselors, we are tasked with being influencers of hope and developers of self-worth. We create spaces for growth and facilitate transformations. Even as we help individuals work through the hardships associated with homelessness, coupled with the psychological processes, we must recognize basic needs. Often, it is a lack of basic necessities that serves as a significant barrier or hindrance to an individual’s progress. Counselors are therefore encouraged to affirm the existence of said barriers, as well as the barriers of discrimination, poverty, injustice and hardship.

Counselors can create spaces for individuals to work through feelings of guilt, shame, helplessness, hopelessness and fear associated with simply surviving from day to day. Counselors can also work with clients who are homeless on overall wellness. We recommend addressing the “Six Dimensions of Wellness” created by Bill Hettler, co-founder of the National Wellness Institute. The six dimensions are:

1) Emotional wellness: Reducing stress and improving sleep

2) Environmental wellness: The creation of happy, clean and safe spaces

3) Social wellness: Relating, interacting and communicating

4) Physical wellness: Regular exercise, proper nutrition and good sleeping habits

5) Intellectual wellness: Problem-solving, processing and creativity

6) Spiritual wellness: Meaning, purpose and guidance

In addition to addressing the emotional and psychological needs of individuals experiencing homelessness, counselors rely on community resources and relationships with community stakeholders to meet the needs of this population. Through interdisciplinary partnerships, counselors can create a broad network of support. These duties — e.g., securing food or shelter — are typically divided among helping professionals rooted in various disciplines other than counseling.

Factors counselors should consider

The stigma around asking for help: Even with a strong support system made up of co-workers, friends, family or helping professionals, it can be difficult to ask for help. People experiencing homelessness are often seen as burdensome, which can reduce the willingness of these individuals to request assistance.

In addition to the stigma of asking for assistance, few organizational and individual resources give without first asking or demanding that individuals meet certain criteria. The number of documents required to prove homelessness and obtain housing, food and security impedes the process at times. Advocacy from the counselor and education regarding how to navigate the complex system of aid can assist clients who are homeless in connecting with the necessary support.

Health: Individuals who are homeless can face severe barriers in accessing basic needs related to health and nutrition. The prerequisites to obtaining medical services, coupled with the financial means to sustain such services, hinder access and consistency. Health complications, poor hygiene, lack of adequate or varied nutrients, possible drug and alcohol abuse, and environmental stress directly affect the health and well-being of individuals experiencing homelessness.

Illnesses that most individuals recover from within a couple of days (e.g., the common cold) can become serious problems for those who are homeless due to living in unsanitary conditions. Chronic conditions are vitally important to consider because they require consistent medical treatment and healthy lifestyle habits to control. When not adequately treated, these physical conditions worsen over time and can contribute to mental health issues and a decrease in quality of life.

To assist these clients, counselors can aid in providing seamless transitions to medical offices. Partnering with local transportation networks, churches, food banks, medical professionals, local free medical clinics and shelter systems can create consistent care and build a supportive community to address homelessness collectively. Support is often evidenced by donations and collaborations.

Mental health and emotional well-being: Mental health conditions can be either the cause or the result of homelessness. A study by the National Institute of Mental Health reported that approximately 6% of Americans are severely mentally ill, compared with 20-25% of individuals experiencing homelessness. The predominant mental health disorders seen in those living in impoverished conditions include major depressive disorder, bipolar disorder and schizophrenia. Mild, yet prevalent, mental health issues show up in the form of generalized anxiety and adult attention-deficit disorder.

Counseling services require weekly sessions for effective treatment. Consistency is key to progression, follow-up and accountability. However, lack of adequate sleep and lack of access to immediate needs can continually disrupt the process of counseling for individuals who are homeless.

A recommended strategy that may be helpful to counselors is incorporating a weekly needs assessment to inquire about the client’s basic needs and whether they are being met. It can also be helpful to connect clients to resources that will allow them to attend counseling more consistently, such as free transportation and stable shelter. It is recommended that counselors put a multifaceted approach in place to address the needs of and provide appropriate mental health care to individuals experiencing homelessness.

Impact on helping professionals

Individuals experiencing homelessness are especially vulnerable due to a lack of access to stable shelter, reliable communication, financial means and medical resources. These barriers also restrict access to preventative health care and treatment that could aid in cultivating a more balanced and healthier lifestyle.

Gaps in professional partnerships often hinder consistent and effective care. Continuity of care should flow from the counselor to the medical professional, to the housing caseworker, to the food pantry volunteer. When this flow is inconsistent, so is the individual’s access to these services. Collaborative efforts, or a lack thereof, weigh heavily on the ability of those who are homeless to have their physiological and psychological needs met.

Most housing and homeless assistance organizations are fragmented and enigmatic systems. The difficulty in navigating such systems often leads to a sense of hopelessness and helplessness among individual in need. People are forced to obtain information on available services and programs through peer-to-peer interactions. Crisis response centers are under-resourced. Helping professionals receive incomplete information related to available resources and to the eligibility criteria for existing programs. Unfortunately, this fosters individual disengagement and distrust for public systems.

Consistently having to address crises and concerns such as trauma, addiction and emotional disorders with clients can be an overwhelming task for counselors. This is characteristic of settings in which clinicians are vulnerable to workplace stress, burnout and compassion fatigue. The latter can result in a lack of intentionality and patience when working with individuals experiencing homelessness.

Due to the physiological demands, working with homelessness requires patience and persistence that are not typical of everyday counseling encounters. As a result, counselors can experience a parallel process of hopelessness and subsequent compassion fatigue and burnout. To combat burnout, organizations can provide space for processing groups in which counselors can provide support to one another. These groups can be extended to partners in the community.

Action steps

Appropriately and competently addressing the needs of the homeless population requires intentional exploration and understanding of the multifaceted tenets of homelessness. The figure below depicts the necessary steps for counselors’ work with homeless communities.

Specific training for counselors and counselor trainees is essential in addressing the privation of the homeless community. Training can be offered through community and private mental health agencies and integrated into counseling programs. Practitioners and stakeholders can play an active role in addressing and supporting the identified needs by providing corporate training in the form of panels, lectures and service learning. Helping professionals and organizations can utilize the literature that expounds on care and attention for homeless communities.

Engagement efforts and materialization of the next steps can be demonstrated through interdisciplinary partnerships and collaboration. Immersion, outreach and advocacy can also serve as action steps toward increasing awareness and practical experience.

Action steps for work with homeless communities

Hopes for the future

Highlighting access and engagement is pivotal in effecting change and fostering spaces where homeless populations can receive care. Multiple health and human services agencies, including the Substance Abuse and Mental Health Services Administration (SAMHSA), prioritize connection to programs that help address and prevent homelessness. The core principles of SAMHSA, as noted in its strategic plan, include expanding access to the full continuum for mental and substance use disorders and engaging in outreach to clinicians, grantees, patients and the public.

Health and human services typically include discharge planning in addition to financial support through Housing First programs. The Housing First model was created in New York City by Sam Tsemberis in the 1990s. Tsemberis asserted that housing was the only solution to homelessness. The model highlighted the significance of permanent housing for the chronically homeless with no conditions attached.

Counselors can be at the forefront of advocating for the integration of this model, with modifications that include intentional interaction, purposeful food contributions, advocacy and activism, preparation, partnership and hope. A modified approach could focus on creating opportunities for people experiencing homelessness to adopt a healthy and stable lifestyle through holistic treatment. Specific methods for counselors include:

Training on people-first language
Pursuing partnerships with low-cost grocery stores to provide vouchers to clients
Increasing access to medical and clinical services through remote client monitoring and telehealth mediums
Providing continuity of care by granting computer access in clinical spaces
Offering career counseling
Instituting a commuter benefit program by teaming with an independent transportation network and providing transport vouchers

Neglecting the resources that can contribute to the success of people experiencing homelessness is akin to giving someone a can of food that is inaccessible to them. A pop-top-can-oriented organization or helping professional embodies compassion and wherewithal that fosters change and growth. Counselors can further close the gap by offering substantive interactions with built-in goals for meeting clients’ hierarchy of needs, encouraging comprehensive treatment, and promoting hope by helping homeless individuals discover exceptions.

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Seneka Arrington strives to bridge the gap between research and practice, emphasizing the importance of connection, collaboration, and translating research findings into clinically meaningful information. For the past decade, her practice and research have been in the nonprofit sector, highlighting homelessness, mental health, career counseling and service leadership. She is a licensed professional counselor, as well as a current doctoral student and graduate teaching assistant at Idaho State university. Contact her at arrisene@isu.edu.

Chad Yates is an associate professor of counseling at Idaho State University. His counseling experience includes working with individuals with substance abuse disorders, batterers and survivors of domestic violence, families, and as a generalist treating many diverse client issues. His research interests include evidence-based practice in counseling, client-focused outcome evaluation, and the treatment of individuals with substance abuse and co-occurring disorders. Contact him at yatechad@isu.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.

Social media and active listening skills don’t seem to mix

By Grace Hipona October 13, 2020

Since the onset of COVID-19, I have observed through my work with clients via telehealth that people’s reliance on social media as a vehicle for connecting with others has intensified. While this engagement may be beneficial and necessary during the pandemic, it does not afford us the opportunity to connect on a more meaningful level. Even more concerning is how this contributes to individuals not directly learning active listening skills.

Simply put, COVID-19 and our over-reliance on social media as a means to connect has impacted the process of ACTIVE communication. Think about a typical post, whether it consists of a picture, a funny quote or the sharing of a political news article. The main benefit of social media is to put information out into the universe as a means of sharing with others. However, this process is usually one-sided and does not typically result in active conversation. Individuals may use social media to stay “up to date” with others, but this might involve simply scrolling through posts without providing any comment or engaging in any conversation.

Think about the typical responses to a post. Individuals can choose to “like” a post, comment or scroll on. These responses lack much opportunity for active exchange. I emphasize “active” because even with a high-engagement social media post in which there is an exchange of comments, there is a passive reactiveness that ensues. Sometimes, the thread may become lengthy and escalate, leading to some inflammatory or not-so productive statements. Regardless, the active listening process is not present.

When we are talking with others in person, common courtesy is to ask, “How are you?” or “How are you doing?” The other individual responds with a reflexive, “Good” or “Fine,” and then also asks, “How are you?” But on social media, this quick and simple process is completely bypassed. Typically, there is no exchange of questions. There is a responsiveness, but people are responding to statements, NOT questions.

For example, I recently posted a picture of a family outing. One of my friends wrote, “Beautiful,” and several others “liked” my picture. But people did not typically ask, “How was it?” or “How did it go?” Nor did I expect them to. There is not “room” for an active exchange. I am unidirectionally telling you about my life, not asking you to engage with me. Social media is no substitute for an actual conversation because there is no depth.

What happened to asking questions?

More and more, my clients verbalize challenges related to developing meaningful relationships. In many cases, I believe their reliance on social media in place of more interactive engagement is a primary reason for that.

Some people are not being taught how to have a simple conversation — not just an exchange of ideas but questions that can enrich a conversation. The clients I work with who fall into this category, many of whom are younger, are developing without an understanding of the importance of asking questions.

We ask questions to demonstrate that we care about the other person. We also ask questions to obtain more information, more details. We ask each other questions so that we can have a conversation. We ask open-ended and follow-up questions to learn the depths of a person.

Asking questions allows us a window into someone’s inner world, and this glimpse is key in building relationships. Without creating this opportunity, our connection with someone will remain surface level and superficial. I can recall interactions with people in which I shared about myself, but the listener didn’t ask any follow-up questions.

Those experiences feel odd and confusing. It can even come across that the other person is self-involved or selfish. Having such an experience can be deflating and potentially cause a barrier to further interactions.

Unfortunately, when people use social media as a substitute for connection, these feelings of isolation can be exacerbated, with users not always consciously realizing that they are missing critical aspects of engaging.

Actions to take

As counselors, we are constantly searching for opportunities to help others. So, what can we do in this instance?

1) Educate: One of the many hats counselors can wear is that of the educator. We can talk about the process of active engagement and share strategies to maintain active engagement even during these challenging times. We can directly teach our clients, students and supervisees about the significance of active listening. We can point out why social media does not easily allow for this. Because the process of active listening is typically a strength of counselors and because we are trained in it, we may sometimes forget that it is a developed skill and that it takes education and practice.

2) Role model: We can role model in our everyday lives by taking the time to ask others, “How are you feeling?” Typically, we might ask, “How are you doing?” However, if we want to demonstrate how to have a more meaningful exchange, asking how a person feels gets below the surface and provides an opportunity to show that we care and want to have a more significant interaction. We can also ask, “How can I better help support you?”

In other words, the active engagement process begins by asking a simple question. But once that has been mastered, we can more thoughtfully ask specific questions. In our sessions with clients, we can help them practice this art of asking questions, and they can experience the benefits.

3) Advocate: Students need to be taught these skills directly. Sometimes we assume that people will learn active listening skills somewhere along their journey in life. However, the only way to really know whether someone has learned a concept is to teach them that concept.

To piggyback on my first point, we need to advocate in our communities and education systems for classes, groups or other learning formats that can be geared toward active listening and interpersonal skills. This is especially important for a younger generation that is much more reliant on social media for communicating. From my perspective, it seems that students are given the opportunity to directly learn these subjects only if they have a formal diagnosis and undergo the process of obtaining an individualized education program.

4) Research: My insights into the impact of social media and technology in general on active listening are not heavily researched. I have found some anecdotal information on blogs and in newsletters, but there do not appear to be many evidenced-based articles available. Given that reality, another important opportunity we have as counselors is to collect data, both formally and informally. We can then share our findings to help inform others.

It is challenging just to survive in these times, let alone do any one of the things I describe above. But when I feel overwhelmed by our collective experience, I focus on what I can control. I can purposefully choose and feel empowered by these choices. I can choose to directly communicate with people rather than relying on social media.

Sometimes when I think about macro-level change, I feel like I am not doing enough. I do believe that our individual efforts have an impact on the larger community, however. Therefore, I remind myself that even the simplest of exchanges can be significant. It starts with asking a question.

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Related reading: See Counseling Today‘s October cover story, “Helping clients develop a healthy relationship with social media”

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Grace Hipona is a licensed professional counselor for NeuroPsych Wellness Center P.C. and holds a doctorate in counselor education and supervision. Her dissertation focus was on disaster mental health (specifically sheltering in place). She is also a certified substance abuse counselor and approved clinical supervisor. Her experiences over the past 15 years includes working in private practice, managing behavioral health programs, teaching graduate students, and providing supervision for master’s-level counseling students and counselors-in-residence. Contact her at ghipona@hotmail.com.

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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: The hurting counselor (an update)

By Gregory K. Moffatt October 7, 2020

In 2018, I published a Member Insights article in Counseling Today titled “The hurting counselor.” I received more feedback on that article than anything else I’ve ever written, and it went on to become the most-viewed article posted to CT Online at any point in 2018. Nearly all the responses I received were comments about how counselors had (just like me) neglected self-care until crisis slapped them in the face and they realized they didn’t have the tools to deal with it.

In that article, I described a time when my marriage was failing and how, at the same time, my self-care had been sorely neglected. Even though my own story was a part of that article, my real point was to petition readers to take self-care seriously. Fortunately for me, at the end of the article, I gratefully noted that my marriage had been salvaged. Healing was slow and setbacks continued, but things improved.

Sadly, I’m here to tell you that a very painful tragedy has found me once again, and I’m devastated. I’ll leave the specifics of my painful situation unspoken because if I told you what it involves, then some readers might think to themselves, “That doesn’t apply to me.” The specifics of my situation are not why I am writing this follow-up article, any more than my original article was just about the sadness of my failing marriage. Let’s just say that I’m hurting as much as one can hurt and still survive.

But just like before, my purpose is to address the importance of self-care. I religiously practice what I told readers about in “The hurting counselor” two-plus years ago. My separation that I wrote about at the time had happened almost a decade prior, and it nearly crippled me. I couldn’t eat or sleep, and I scarcely could get through each day. My compromised self-care nearly did me in.

But since that time, I’ve been practicing everything I wrote about in “The hurting counselor,” and now that I’m yet again facing a very painful experience, I’m so glad I did. The follow-up is that self-care is not only helpful but crucial.

Don’t get me wrong. The tragedies of life are always hard: the loss of a child, the humiliation of arrest and jail, failed relationships, crippling physical illnesses, etc. The timing of my current situation, coming as it does in the midst of the coronavirus, the beginning of a very challenging school year at my university, and a generally hard time of life, makes it worse.

My days are difficult and my nights are even harder, but I’m managing reasonably well — unlike the time I wrote about previously — because I’ve practiced our ethic of self-care. The unavoidable pain of personal crisis won’t defeat me as it nearly did years ago. I have a therapist, I play, I eat right, and I rest as well as I can. All the keys to reasonable self-care.

As noted above, self-care is not an option. It is an ethical obligation. The excuse that “I don’t have time” to exercise, go to therapy, eat well or take a day off is not only untrue, it is irresponsible.

Unlike the situation I found myself in all those years ago, today I’m making better decisions because I’m in better condition and I have the strength to do it. I will weather this storm with clarity of thought and resilience of heart. Neither of those things is possible without regular self-care. Fortunately, I’ll also be in reasonable condition to continue working with my clients, my interns and my supervisees. They will never know that I’m in the midst of a crisis unless I tell them.

If we are not taking care of ourselves, we will make poor decisions in all sorts of areas. We will stay in toxic relationships and dead-end jobs or work too many hours. Our lack of clarity will make it hard to see the damage we are doing to ourselves. I know that in my prior life of poor self-care, I could not have weathered this current hurricane. Today I’m so strong, even though daily I’m feeling vulnerable and battered.

I often tell stories about my life, my clients and my practice in my column, but this particular article is as personal as it gets. I’m not just processing my current pains with you, however. Because of the outpouring of responses I received from my original article on self-care, I know that self-care is a problem and a challenge for many therapists. It is imperative that we tend to it so that we are adequately prepared when we are facing deep hurts — as we all inevitably will in one way or another.

My testimony here will hopefully convince you that there is a good reason to take care of yourself. And I want you to know that I not only practice what I preach to you, but that it works.

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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.

The return of psychedelics to counseling: Are we ready?

By Benjamin Hearn October 6, 2020

Those of us who are professional counselors are perhaps most likely to recognize psychedelic drugs by their recreational or street names — acid, magic mushrooms, ecstasy — and to consider them to be drugs of abuse that may be dangerous to our clients. This is indeed the narrative that has been forwarded since the Controlled Substances Act (CSA) of 1970 classified all psychedelic drugs as Schedule I, indicating that they have a high potential for abuse, have no purposeful medical use and are highly dangerous.

It is sometimes surprising how public perceptions shift and how quickly knowledge can be forgotten. Prior to the CSA, psychedelics were of keen interest to many psychiatrists and psychologists. These professionals were curious about the ability of psychedelics to help patients with substance abuse and to elicit spiritual experiences. Dozens of research studies with thousands of patients were completed using LSD and psilocybin prior to 1970 with promising results, providing evidence in direct opposition to their Schedule I designation.

Considering these research studies, it is more likely that psychedelics’ scheduling status was related to their use outside of medical contexts, especially given their association with the counterculture and anti-war movements that the sociopolitical powers of that time perceived to be threatening. As the decades passed, public perceptions also changed and discussion of psychedelic research within academia became taboo, although researchers familiar with their potential retained interest.

Potential and use in treatment

Eventually, psychedelic research began again in the early 2000s to investigate the safety and uses of psychedelic drugs in substance use and mental health treatment. Psychedelic drugs that are currently being researched or used as treatments include MDMA (also known as molly), LSD, psilocybin (the active compound in magic mushrooms), ibogaine (a compound found in the iboga root) and ayahuasca (a brew of numerous psychoactive plants containing DMT). Results have indicated promise for all of these drugs in the treatment of a wide range of disorders, including posttraumatic stress disorder (PTSD); end-of-life anxiety; social anxiety in adults with autism; depression; obsessive-compulsive disorder; and alcohol, opiate, nicotine and polysubstance use disorders. Psychedelic drugs are also being evaluated as treatments for Alzheimer’s disease and other neurodegenerative diseases due to their apparent neuroprotective factors and ability to enhance neuroplasticity. Outside of their use as treatments in clinical populations, psychedelics have been found to enhance self-acceptance, increase openness and improve social relationships. Their recreational use has even been correlated with reduced reincarceration and past-year suicidality.

Psychedelic-assisted counseling in treatment-oriented settings typically consists of a few preparation sessions with a pair of counselors (most often a male and a female). These sessions are more similar to traditional counseling sessions. During preparation sessions, rapport is built, skills are taught, and intentions and expectations for the psychedelic session are reviewed.

The counselor pair then support the client throughout the entire drug administration session, which lasts between six and eight hours. The client is provided with eyeshades, headphones and specially selected music by the counselors, who offer support through their presence and instruct the client to follow their own internal experience as the drug takes its course. These counselors later meet with the client for shorter integration sessions beginning the day after drug administration and then occurring weekly for a few weeks before treatment is complete.

Time and time again, research has demonstrated these drugs to be safe and viable treatment options that are worthy of significant attention from mental health practitioners. In fact, psychedelics’ potential as treatments for mental health and substance use disorders has led to two drugs, psilocybin and MDMA, being designated as “breakthrough” treatments by the Food and Drug Administration for treatment-resistant depression and PTSD, with full approval estimated to occur sometime during the next two years.

Implications and challenges for the profession

These research findings have been garnering public attention and have been featured in shows such as 60 Minutes and in the 2018 New York Times bestseller How to Change Your Mind by Michael Pollan. Pollan has since led a featured session discussing his book and the future of psychedelics at the American Psychological Association Convention in 2019. The counseling profession has been gravely silent on this topic, however, with no research utilizing psychedelics occurring within any university counseling program. Instead, psychedelic research is taking place primarily through the fields of psychiatry and pharmacology, despite the fact that counselors and other master’s-level mental health practitioners actually help prepare for, facilitate and integrate the psychedelic experience in treatment-oriented settings.

As research continues within these fields, psilocybin mushrooms have been decriminalized or legalized already to varying degrees in the California cities of Santa Cruz and Oakland, in the city of Denver and in the state of New Mexico. In addition, they may be integrated into the state mental health care infrastructure in Oregon through a 2020 ballot initiative (see voteyeson109.org). It is readily apparent that what has come to be known as the “psychedelic renaissance” is occurring at breakneck speeds without the counseling profession’s voice or values being heard and integrated. This poses challenges because the counseling profession is implicated and affected by these developments regardless of whether we choose to participate.

First and foremost, outcome-driven research has neglected to consider the characteristics and competencies of counselors who will administer psychedelic-assisted counseling. This poses serious risks for clients, given that harm is far more likely to occur from practitioners inappropriately using psychedelic-assisted counseling than from the drug itself, due to the extremely vulnerable states elicited while clients are under the influence.

Furthering this position is the fact that the use of certain psychedelics, such as ayahuasca and mescaline, is legal under the context of religious practices. Some individuals have capitalized on this reality by advertising these psychedelics as treatments or spiritual sacraments, leading to underground networks of neo-shamans or guides whose qualifications to treat mental health and substance use disorders may be questionable or nonexistent. For example, consider Steve Hupp’s Aya Quest retreat center, as seen on the VICE TV show Kentucky Ayahuasca, where Hupp uses ayahuasca to treat opiate use, eating disorders, depression and other issues.

As psilocybin, MDMA and other psychedelics gain wider approval, it will be necessary to develop competencies, regulations and a professional infrastructure to distinguish and delineate their use as treatments from their use as spiritual sacraments. As necessary as these steps may be, such a process is inherently difficult because of the apparent relationship between psychedelic use and spirituality. Participants in studies that use psychedelics have reported enhanced spirituality, morality and mindfulness. They often describe the experience as being profoundly influential in their lives and on par with other formative experiences such as witnessing the birth of their children.

Clearly, counselors involved with psychedelic-assisted counseling must be able to work with clients to process such intense experiences. This requires a distinct skill set and outlook that may be wildly different from our traditional toolbox of approaches such as cognitive behavior therapy or solution-focused brief therapy. Determining whether that skill set is best developed through having had personal experience using psychedelics will also pose a challenge, although many current and past researchers have suggested that experience is beneficial.

The role and historical stigma of ‘mystical’ experiences

In clinical research, the degree to which participants have a “full” mystical experience has been positively correlated with treatment outcomes. Mystical experiences often involve “nondual” states, in which people may experience a sense of unity between their outer and inner worlds and feel that they have experienced “the infinite” or “ultimate reality.” Individuals may believe their experience to have transcended time and space, and they may feel a deep sense of peace, ecstasy or awe. Perhaps the most unifying feature of mystical experiences is that language cannot adequately capture them; to describe the experience is to exert a form of “violence” upon it.

It is important to note that while psychedelics have been used in Indigenous cultures the world over for millennia to access such states of consciousness, similar experiences have also been prominently described in many major religions, including Christianity, Judaism, Islam, Hinduism, Taoism and Buddhism. Within these religions, such experiences are accessed through the development of spiritual practices, increased devotion or, at times, spontaneously.

Although the subjective experience of spontaneous, practiced or psychedelic-occasioned mystical experiences may appear similar, many may argue that the latter are not valid, that they are “just” drug experiences. These claims lie in stark contrast to user reports of mystical experiences and the lasting effects attributed to them. One recent study found psychedelic-occasioned mystical experiences to be more intense and beneficial than those occurring through other means.

Such dismissal of psychedelic-occasioned mystical experiences may stem from centuries-old stigma, which began when the conquistadors forced Indigenous practices using psilocybin mushrooms (known to the Mazatec people as “the flesh of God”) underground, considering the practice to be blasphemous to Christianity. After the conquistadors’ suppression of psilocybin mushroom use, psychedelics remained forgotten to Western culture until their rediscovery in the 1940s and 1950s, with the synthesis of LSD and publication of an article titled “Seeking the Magic Mushroom” in Life magazine. Psychedelics then enjoyed a brief spotlight in medicine and the counterculture before once again being suppressed by the authorities due to concern over their effects on society. Groups such as the Native American Church and Santo Daime, which used these plants for religious purposes, were subsequently forced to argue with the Supreme Court that prohibition of specific plants and drugs inhibited their religious freedom. These groups were granted exceptions to allow for their use in religious contexts.

Closing thoughts

Given the apparent relationship between psychedelics and spirituality, we must take stock of how we intend to use these tools and what skills are needed to do so. We must also critically consider who these tools are for or belong to. As a profession, we operate from a wellness model and have a duty to promote both client safety and social justice. Psychedelic-assisted counseling presents a tremendously complex issue with respect to these three aspects of our profession, given that psychedelics may be beneficial to nonclinical populations, are closely tied to certain religious practices that have historically been oppressed, and present a risk to client safety from both a medical and practical standpoint.

Analyzing each of these issues as they relate to psychedelics and the counseling profession must be done intentionally and preemptively to develop psychedelic-assisted counseling in a manner that is safe, ethical and just. Such an endeavor takes time, expertise, care and critical thought — which we have yet to begin. Regardless, psychedelics are returning to counseling in the very near future, and we must ask “Are we ready?” If we are not, the profession may be forced to react rather than plan and to follow rather than lead in the exciting but high-stakes “psychedelic renaissance.”

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Benjamin Hearn is a doctoral student at the University of Cincinnati, where he is developing approaches for the counseling profession to use psychedelic-assisted therapies for mental health and substance use disorders. He is also interested in the integration of spirituality to counseling and is an active member of the Association for Spiritual, Ethical and Religious Values in Counseling. He has practiced in a variety of settings, including school-based mental health, private practice and wilderness therapy. Contact him at hearnbg@mail.uc.edu.

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

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.