Monthly Archives: November 2020

Seeing the whole gifted child

By Lindsey Phillips November 30, 2020

Assessing symptoms and determining a treatment plan for clients is never a simple or straightforward task. That can be especially true when it comes to working with gifted and twice-exceptional clients.

Imagine that a second-grader who is highly intelligent comes to your counseling office. The child has some intense interests, which is not uncommon with individuals who are gifted, and they struggle with emotion regulation, which appears to be related to the child’s perfectionism and low frustration tolerance. You might assume that this client’s struggles are just a natural consequence of being gifted.

Emily Kircher-Morris, a licensed professional counselor (LPC) at Unlimited Potential Counseling & Education Center in O’Fallon, Missouri, made this assumption. It wasn’t until her client entered the fourth grade that Kircher-Morris learned that giftedness alone couldn’t “explain away” the student’s emotional struggles. After experiencing a major event, the client’s problems increased to the point that Kircher-Morris referred him to a psychologist for a full differential diagnosis. Upon receiving the results, she was shocked to find out that her client was not only gifted but also autistic.

“I had fallen into the [common] beliefs about giftedness: That the [emotional struggles] were just sensory intensity or perfectionism,” says Kircher-Morris, an American Counseling Association member who specializes in gifted and high-ability individuals. “I missed how intense his meltdowns were and that his intense interests were related to autism, not giftedness.”

It’s true that individuals who are gifted may possess an intense interest, but they can communicate about other topics in addition to that passion, whereas someone with autism spectrum disorder can’t easily talk about other topics, Kircher-Morris explains.

To make an accurate assessment of a gifted client, professional clinical counselors must first know what “giftedness” even means. The problem is that the exact determinants and measurements for giftedness vary from state to state and even school to school. But according to the National Association for Gifted Children (NAGC), individuals deemed to be gifted or talented have the capability to perform at higher levels than their peers, and they require modifications to their educational experience to learn and to realize their potential.

Neither Kircher-Morris nor James Bishop, an LPC at Blank Slate Therapy in Frisco, Texas, distinguish between “gifted” and “high achieving” because they say some individuals need to be cognitively challenged regardless of whether they meet the formal definition of being gifted. And sometimes gifted individuals have learning disabilities or mental health issues that require them to get help — a concept that can be difficult for individuals who are used to having things come easily to them, Kircher-Morris points out.

(Mis)Identifying giftedness

There is also a substantial amount of anecdotal information, as well as misconceptions, about giftedness, and Bishop, executive director of the Passionate Mind Institute, warns that even mental health professionals can fall prey to pseudoscience on the topic. For example, some counselors too easily embrace overexcitability as a common characteristic of gifted individuals even though there isn’t much current research to support the belief, he says.

People may incorrectly assume that someone cannot be gifted if they are not doing well in school or that gifted individuals never need help, Bishop continues. Some also believe that individuals who are gifted are more prone to depression, but research shows they are as well-adjusted, if not more so, than their peers in the general population, he adds.

Such misconceptions, as well as concern about clinical misdiagnoses, led Bishop, a member of ACA, to conduct a study to test the ability of mental health professionals to recognize gifted characteristics in presenting clients using vignettes that illustrated common issues and characteristics related to giftedness. Half of the 330 participants were prompted that giftedness could be a factor, but regardless of that prompting, Bishop found the majority of participants still clung to the diagnosis of a disorder over an assessment of giftedness. (See “The potential of misdiagnosis of high IQ youth by practicing mental health professionals: A mixed methods study” in the journal High Ability Studies.)

Bishop’s study suggests that even mental health professionals, not just educators, have trouble factoring giftedness into their clinical assessments. “Being mindful and educating yourself on the real struggles that gifted [individuals] face can make you a better clinician in terms of assessing a gifted [client] and being able to determine whether their problems are the result of a disorder or are simply part of their gifted nature,” says Bishop, who chairs the NAGC Social and Emotional Development Network.

But finding training in this area can be challenging for counselors. Bishop says he had to get a doctorate in educational psychology to become formally educated in the subject. He isn’t aware of any counseling program that offers a concentration in giftedness.

The lack of adequate training is a problem because, according to Michelle Tolison, a licensed clinical mental health counselor in Charlotte, North Carolina, giftedness should be a specialty just like trauma. In fact, she believes that without being adequately trained, counselors can do extensive damage if they work with clients who are gifted.

Bishop, author of a forthcoming book on anxiety and giftedness for parents, recommends that counselors attend national and state gifted and talented conferences for opportunities “to dive into the subject, meet people in the field and get a sense of how they [as counselors] can play a role.” In addition to the resources provided by Supporting Emotional Needs of the Gifted ( and NAGC (, Bishop and Tolison, owner and lead therapist at Dandelion Family Counseling, recommend reading Giftedness 101 (by Linda Kreger Silverman) and Misdiagnosis and Dual Diagnosis of Gifted Children and Adults (by James T. Webb et al.).

The gifted gap

Most gifted children are identified through testing or teacher referrals in elementary schools. The problem is that there is no one standard test used in schools to determine giftedness. On top of that, many school districts don’t test every student. Instead, they rely on teacher referrals, which, as Renae Mayes, an associate professor in the counseling program in the Department of Disability and Psychoeducational Studies at the University of Arizona, points out, introduces bias.

To highlight this potential bias, Mayes, an ACA member whose research focuses on gifted education and special education for students of color in urban environments, poses several insightful questions: How are teachers trained to recognize giftedness? How are they trained to recognize that giftedness exists in many different kinds of bodies? Will teachers see a Black student who can’t sit still in their seat and has lots of energy as someone who is gifted and excited about learning, or will they perceive the child negatively — as someone who has a behavioral problem or wants to disrupt the learning environment?

The sad reality is that the current method of identifying giftedness has led to an underrepresentation of individuals from marginalized backgrounds in gifted programs. Researchers at the Thomas B. Fordham Institute recently found that in schools that feature gifted programs, only three states enroll more than 10% of their Black and Hispanic students in such programs; in 22 states, that figure stands at less than 5%.

Black and Hispanic students are also overrepresented in special education, Mayes points out. When children are put in special education, it often becomes the only lens through which they are perceived, she says, and the likelihood of them also being identified as gifted dramatically decreases. As Mayes notes, these children tend to be viewed through a deficit perspective, which often incorporates stereotypical understandings of culture and disability rather than allowing children to be seen for their gifts and talents.

According to the article “Myths and research regarding the socio-emotional needs of the gifted,” published in the September issue of The Gifted Education Review (of which Bishop serves as co-editor), individuals from different cultures may not be as readily identified as gifted. Among the reasons highlighted in the article are because these individuals’ cultural norms differ from those of the prevalent culture (e.g., what might be viewed as positive assertiveness in one culture might be perceived as too aggressive in another) or because they are gifted in their first language, which differs from the English language programs in their schools.

“There’s a big push in gifted education to modify how we identify students and make it tied to what kids need academically,” says Kircher-Morris, the president and founder of the Gifted Support Network, a nonprofit dedicated to helping the families of gifted and high-ability learners. “And schools are getting better about identifying kids younger, and they’re doing more universal screening,” which helps remove issues of bias that can arise with teacher and parent referrals.


Gifted individuals may also have a special need or disability. According to NAGC, the term twice-exceptional (also known as “2e”) describes gifted children who have the potential for high achievement but also have one or more disabilities, including learning disabilities, speech and language disorders, emotional/behavioral disorders, physical disabilities, autism spectrum disorder or other impairments such as attention-deficit/hyperactivity disorder (ADHD).

“People don’t often think that individuals who are gifted can also have [a] disability,” Kircher-Morris says. “It’s kind of counterintuitive, so you end up with kids who are exceptionally cognitively able but perhaps they have ADHD or are autistic and they need a 504 plan or perhaps even an individualized education program.”

Kircher-Morris, chair-elect of the NAGC Social and Emotional Development Network, has noticed that sometimes teachers don’t feel as though they have to make accommodations in environments such as advanced placement classes. These teachers just expect that if a student is in such a class, they should be able to do the work. She often reminds educators that not taking a challenging course is not an accommodation. Twice-exceptional students still need to be challenged; they just need some help along the way.

It can be easy for counselors and other mental health professionals to miss a diagnosis of twice-exceptionality, says Kircher-Morris, who hosts the Mind Matters podcast, which focuses on the development of high-ability and twice-exceptional people across the life span. She is also the author of the forthcoming book Teaching Twice-Exceptional Learners in Today’s Classroom.

Kircher-Morris has had several clients get psychological evaluations and come back with a misdiagnosis. She recalls an example in which one of her elementary-age gifted clients was having meltdowns at school, becoming emotionally dysregulated and having trouble understanding nonverbal cues. Kircher-Morris knew the client was gifted, and she strongly suspected he was also autistic. The boy’s parents were reluctant to accept that label because of the stigma surrounding autism. It was easier for them to just say, “He’s quirky because he’s gifted.”

When Kircher-Morris finally convinced the parents to get a psychological assessment for their son, she wrote a letter to the person doing the assessment and told them the child was gifted to ensure that would be factored in. But the person doing the assessment did not specialize in giftedness and ended up diagnosing the child as depressed because sometimes when he had meltdowns, he would say, “I hate myself. I wish I could die.”

Kircher-Morris knew the client wasn’t clinically depressed. Instead, he was having big emotions and wasn’t sure how to talk about them, she says. She adds that one day of testing and questionnaires is not enough to fully understand and diagnosis a person.

Kircher-Morris still works with this student, and now that he is in high school, his autism is more pronounced. When his schedule shifted and he had to start showering in the mornings instead of the evenings, he didn’t handle it well at first. Kircher-Morris worked with him on regulating his emotions around this change. The student also has some issues with friends at school, but other people in his life often view him solely through a lens of giftedness and assume that he shouldn’t have any trouble communicating, Kircher-Morris says. They don’t realize that as a twice-exceptional adolescent, he sometimes does have certain challenges.

Trying to identify a client as twice-exceptional is even more difficult because of the concept of masking. As Tolison notes, gifted individuals with a learning disability can fall into one of three categories:

1) The individual’s advanced intellect compensates for their learning disability.

2) The learning disability or special need overshadows the person’s giftedness.

3) The giftedness and learning disability mask each other to the point that the individual appears to have average intelligence.

Research shows that twice-exceptional children are often diagnosed later than their peers because their struggles aren’t as noticeable initially, Kircher-Morris says. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders states that individuals with autism, for example, may be able to compensate for their comparative lack of social skills until social expectations exceed their abilities, she notes. A gifted child who is also autistic may not have a language delay when they are little, but by the time they get to middle school or high school, their emotional and social struggles and rigid thinking become more problematic.

“And we’ve now lost all of that time to be proactive and to support them and to help them build the skills they need to be successful, confident and happy,” Kircher-Morris adds.

To avoid mislabeling clients, Tolison, a registered play therapist who works with children who are twice-exceptional (particularly those with ADHD), advises counselors to always consider what the client’s behavior is communicating. Are they fidgeting in the classroom because they are understimulated, or is it a symptom of ADHD?

Therapists need to recognize “the blend of symptomology between gifted and diagnosis,” Tolison continues. For example, mental health professionals shouldn’t presume a client is autistic just because the client is smart and struggles to socialize with peers, she says. Instead, she advises digging deeper and considering whether the symptoms decrease or dissipate when the client is in an ideal setting, such as being around others who have interests similar to theirs.

Giftedness and special education are often seen as being opposite ends of the continuum, Mayes says, but she asserts they are separate continuums and can exist simultaneously. “The disability is the how you do something,” she explains. Even though an individual may need to do a task or skill differently or may need help, they can still possess a higher cognitive ability, notes Mayes, who has published several articles on this topic, including “College and career readiness groups for gifted Black high school students with disabilities” in The Journal for Specialists in Group Work.

Mayes recounts a real case example of how these continuums can overlap in a client: A Black student who was in a gifted program in middle school had an accident and suffered a traumatic brain injury. The injury caused the boy to get bad headaches if he sat for long periods of time, and his vision became blurry. But his cognitive ability was unchanged. He just needed some accommodations to help him at school. His teachers didn’t believe he was actually having headaches, however. They assumed he was just trying to get out of doing the work. The boy internalized their disbelief and told his mother the teachers were looking at him as if he were a “lazy Black kid,” a stereotype he knew was prevalent at the school. Soon thereafter, the boy’s grades started to suffer.

His mother became a big advocate for her son and pushed for a special education and gifted label for him. Even so, the school refused. It wasn’t until the boy entered high school and the school counselor joined the mother’s fight that they finally got some accommodations for the student. When the boy translated his talent for STEM (science, technology, engineering and math) into a passion for band, the band director also advocated for him.

This student had to reconfigure his identity as not just a gifted student but as a gifted student with a traumatic brain injury, and he had to learn to self-advocate, Mayes says.

Asynchronous development

Gifted children’s cognitive, emotional and physical development are often asynchronous, meaning that their intellectual development outpaces their maturity or emotional development. Even though their intellectual skills are advanced, their social and emotional skills may lag behind.

“Cognitive giftedness is not necessarily the same as emotional maturity,” Kircher-Morris says. Because gifted children are often highly verbal and speak as if they are mini-adults, people incorrectly assume that their behavioral and emotional regulation skills will also be advanced, she explains. So, counselors should consider clients’ emotional development along with their cognitive development.

According to Tolison, “There can be upward of a 12-year spread between a child’s intellectual age … [and] their social/emotional age.” For example, a twice-exceptional child with ADHD could be 8 biologically, but with the intellectual capabilities of a 12-year-old and the social and emotional development of a 6-year-old. And at times, the child might have emotional outbursts that are on par with a 4-year-old, Tolison adds.

Tolison often helps her clients first understand emotional language. She finds the “anger iceberg” exercise helpful for teaching emotion identification and awareness. Because some clients might be gifted in empathy, this process is less about identifying emotions and more about learning how to express them, she adds. Tolison then helps clients focus on executive functioning skills such as planning ahead, organizing one’s thoughts, flexible thinking and demonstrating self-control — all of which can be challenging for individuals who are twice-exceptional. She may play chess or Othello with clients to help them work on impulse control, for example.

Kircher-Morris engages clients’ higher-level cognitive skills by adjusting her counseling approach. This can be as simple as using a more advanced technique with a younger client (similar to grade skipping in school), or it may involve tailoring a technique to make it more analytical and creative.

The emotion wheel, which describes eight basic emotions and their varying degrees, is a great tool for helping clients identify and name their emotions, Kircher-Morris says. But this tool may not stimulate gifted clients enough to keep them engaged, so she alters it to make it more cognitively challenging. Her emotion wheel is mostly blank. She leaves a few emotion words in different places around the wheel and works with clients to fill in the blank spaces. Sometimes they look up words in the thesaurus or online to find the “just right” word, and then clients evaluate and determine which words should go on the wheel. This activity builds on the higher-level vocabulary that gifted clients often possess, and it provides them with some autonomy in session, she says.

Letting gifted clients direct (but not dictate) sessions

Kircher-Morris finds that gifted children are often unaware that anything is “wrong.” They can be skeptical of counseling at first, especially if their parents are the ones who initiated it. And because these children are gifted, she says, they often want to know the “why” before they completely trust and participate in different counseling approaches.

For that reason, Kircher-Morris encourages these clients to ask questions and takes time to explain the psychology behind the interventions. She also allows clients to explore what works best for them and to develop their own ideas about what would be helpful.

When Kircher-Morris introduces the cognitive triangle exercise (which emphasizes the relationship between one’s thoughts, feelings and behaviors), she moves beyond just drawing the diagram on a dry-erase board. She also poses a hypothetical example to help clients better understand the underlying principle behind the activity.

An example she often uses is a student who has an upcoming math test. She asks, “What uncomfortable emotions might they be experiencing?” After she and the client brainstorm some possible feelings, she asks, “If they’re experiencing those uncomfortable emotions, then what thoughts might they be having?” She draws speech bubbles on the board, and she and the client fill them in together.

Then they discuss how these thoughts might influence the hypothetical student’s behavior, where the student could intervene and how this would change the outcome. Running through this hypothetical allows clients to better understand the way the exercise works before they apply it to their own situations, Kircher-Morris says.

The fact that gifted individuals have higher-level thinking skills also means they are more likely to find fault in others’ logic, Kircher-Morris says. In fact, because these individuals are often brighter than their parents, teachers and others with whom they interact, counselors might find themselves trapped in a logical corner when a gifted client pokes holes in their reasoning. Should this happen, Kircher-Morris advises counselors not to engage in a power struggle.

“Don’t try to assert your intelligence or the information that you have because that’s going to damage the rapport,” Kircher-Morris says. Instead, her approach is to acknowledge the valid point the client has made. For example, she may say, “I hadn’t thought about it that way. I’ve seen this counseling technique work with other clients, but maybe it won’t work with you. Let’s figure out what will work. Do you think any part of that activity might be relevant for you?”

Tolison agrees that gifted clients benefit from being able to have some control over their therapy, but she cautions counselors not to let them dictate the direction of treatment. She says she often has parents who come to her because they previously worked with another therapist who allowed their gifted child to take control to the point that they weren’t making progress. 

Often, gifted clients are excited to engage in a topic they are passionate about, but that can dominate the session. However, as Tolison points out, counselors can turn that passion into a therapeutic intervention. She once had a client who wanted to talk about the dwarf planet Pluto for most of their sessions. She seized on that as an opportunity to teach the client about mindfulness and social awareness.

She used the phrase “I noticed” to stop him from discussing Pluto: “I noticed you’ve talked 20 minutes now on Pluto. I love that you are sharing your passion with me, but can we take a break because I’m a little exhausted from learning that information right now. Let’s talk about something new.” This statement set a limit for the client while also helping them become more mindful of the passage of time and of other people’s feelings, Tolison says.

Tolison also encourages clinicians to be humble when working with gifted clients. “Sometimes the most therapeutic thing you can do for a profoundly gifted kid is be excited about what they can teach you because in that [process], they are also learning,” she says.

Embracing neurodiversity

Kircher-Morris’ goal is to help normalize the fact that different types of brain wiring exist. People with this brain wiring might be divergent from the norm, but that doesn’t mean something is “wrong” with them. Being gifted or twice-exceptional is simply part of the human condition. Normalizing neurodiversity will encourage people to realize that they need help and give them the courage to ask for it, she says.

Counselors are great at understanding the individual needs of clients, she continues, but unless they consider all the factors, including a person’s cognitive ability, then they may misread the situation and the client’s true needs. For example, if a cognitively gifted child is having a hard time making friends, a counselor might focus simply on helping the child build social skills and self-confidence. But then the counselor would be missing the opportunity to consider other possible factors such as bullying, the child’s high stress levels, their feelings of isolation or others’ upward expectations of them — all of which could inhibit the child’s ability to form authentic relationships, Kircher-Morris explains.

So, she advises counselors working with this population to make sure they view their clients’ struggles through a lens of giftedness. How does giftedness or twice-exceptionality influence these clients’ experiences and reality? Clinicians must also figure out how to leverage clients’ strengths with their cognitive abilities to work through any issues they are having, Kircher-Morris says.

Mayes says counselors must be more holistic in understanding clients and see them as more than their struggles or even their giftedness. “We need to take a broader approach in our professional development,” she says, “so we can start understanding more fully individuals’ identities beyond giftedness to include culture, class, gender identity, affectional identities and so much more.”



Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at or through her website at


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.

Wellness: Getting beyond the buzzword

By Bethany Bray November 20, 2020

When Amazon’s Prime Day arrived in mid-October, media outlets from NBC News to reported on the “wellness deals” — on everything from sneakers and wristband fitness trackers to yoga pants and weighted blankets — not to be missed during the online behemoth’s annual spate of sales.

The term wellness is frequently tossed around (some would say a little too frequently) in the popular lexicon. But it’s no wonder that the aura of wellness is so often touted to attract consumer attention. After all, who doesn’t want to be well?

Of course, in the realm of counseling, wellness encompasses way more than yoga pants and running shoes. But what does wellness mean exactly? When counselors say they are practicing through a lens of wellness, what sets that apart from any other therapy framework? Most importantly, how does wellness counseling help clients?

Defining wellness

The ACA Encyclopedia of Counseling refers to wellness as “a state of positive well-being … in which body, mind and spirit are integrated.”

While often used as a buzzword in modern culture, wellness is nothing new. The ancient Greeks, including the philosopher Aristotle, wrote of the importance of a prevention-focused approach to health.

As Jane Myers, perhaps the individual most associated with wellness in the counseling profession, wrote in the Encyclopedia’s wellness entry, “The main qualities defined by the ancient Greeks remain the hallmarks of wellness today. To live long and live well, individuals need to attend to their physical, cognitive, emotional and spiritual selves.”

As Myers went on to describe, wellness counseling incorporates a strengths-based approach. Because each area of wellness affects the others, counselors can assess a client to find one area of wellness in which they are strong and use that as a tool to boost other realms of wellness in the client’s life.

Myers and her husband, Thomas J. Sweeney, are known for their development of the Indivisible Self, an evidence-based model of wellness.

A helpful approach to wellness leverages a client’s existing strengths, values and resources, says Michael Desposito, a licensed professional counselor (LPC) who pulls from several wellness models, including Myers and Sweeney’s, in his work with clients at his Canton, Ohio, private practice. What wellness counseling is not, he stresses, is adding things to a client’s regimen that could ultimately subtract from their wellness. Simply recommending physical activity or other wellness-focused activities for wellness’ sake — “additive subtractions,” as Desposito calls them — is not wellness counseling, nor is it helpful, he asserts. Adding something that isn’t already part of a client’s daily life may not be maintainable for them, he notes. In addition, counselors must remember that some clients might not be able to afford gym memberships, massages or other services frequently promoted under the wellness umbrella.

Additionally, viewing wellness as an either-or concept — such as either going to or skipping yoga class — does a disservice to clients, Desposito says. Wellness is not something to be added or subtracted, but rather honoring the client and improving their functioning in the now, he explains.

A wellness framework works best “when you can bring in the client’s own unique strengths and resources that they have,” says Desposito, a member of the American Counseling Association. “They know themselves the best. Have them show you that.”

Beyond diagnosis

Wellness counseling is a framework that clinicians use alongside and in addition to their preferred theoretical orientation. At its root, wellness counseling views clients holistically, focusing not only on an individual’s mental and physical health but also on their spirituality, social connections, work life, home environment and numerous other factors that vary slightly depending on the wellness model used.

In essence, wellness counseling looks beyond just the client’s diagnosis or presenting concern. However, as Desposito points out, to function as practitioners — and, particularly, to be reimbursed by insurance companies — professional counselors often follow the medical model, which is driven by diagnosis.

“Over time, that culture starts to inundate how we [counselors] look at people,” he says. “It can cut people down to a symptom instead of a whole person.”

Wellness is integral to the person, says Desposito, who co-presented the session “Factoring Wellness Into Treatment Planning” at ACA’s 2019 Conference & Expo in New Orleans. He often tells his clients: “At the end of the day, just because I decrease a symptom, it doesn’t increase your health.”

Desposito offers some examples to further illustrate a wellness framework. Perhaps a college-age client struggles with social anxiety and is uncomfortable presenting or speaking in class. A practitioner without a wellness focus might equip the client with adaptive coping tools or challenge the client to push themselves and speak to three peers or classmates in between counseling sessions. As a wellness-focused practitioner, Desposito would instead find ways to leverage a strength that is already present in the client’s life. For instance, if the client enjoyed playing video games, Desposito might “assign” social exposure challenges outside of sessions that involved playing video games online and chatting with other players.

Similarly, if a client was drawn to making to-do lists at home and work, Desposito would leverage that in session to have the client make lists of therapeutic goals. Checking items off their list would provide the client a sense of achievement and build momentum toward growth, he says.

“Simply decreasing anxiety [or other presenting concerns] will help them feel better, but is it holistically helping the client? … Just because you reduce their symptoms doesn’t [necessarily] make the client’s life any better, and it makes them open to going back into old patterns if life doesn’t get any better,” explains Desposito, who is active in the Association for Humanistic Counseling and is a past president of the Ohio branch of the Association for Spiritual, Ethical and Religious Values in Counseling.

Desposito recently worked with a transgender client in his 20s who was taking a semester off from college. After moving home, he found himself apart from his friends and social supports. The client’s family did not support his transgender identity, so he spent much of his time alone in his bedroom playing the video game Animal Crossing. (Note: Identifying details have been changed to preserve confidentiality.)

Desposito began seeing the client after he had been hospitalized for suicidal intent and multiple suicide attempts. His presenting issues were self-injury, gender dysphoria, suicidal ideation and major depression. In their work together, Desposito listened for and pulled out the client’s existing strengths. This led to the client rekindling his love for drawing and painting. As their work progressed, the client would show Desposito some of his drawings in session, and they would discuss them together. “The wellness model helped him look at what he was getting out of life versus everything that was going wrong,” Desposito says.

Due to the coronavirus pandemic, all of Desposito’s sessions with this client occurred virtually, and a major turning point happened in real time during a video session. The client opened a drawer in his bedroom to look for something and came across a box cutter. His anxiety spiked as he realized he had overlooked this one implement when ridding his bedroom of all of his self-injury tools.

Desposito helped the client process the feelings he was experiencing, and the client came to a realization: The box cutter had been in his drawer the entire time, and he had forgotten about it because he never felt the need to use it.

Desposito says it was an incredible feeling to hear the client, while still in session on his phone, walk down the hallway, give the box cutter to his father and state, “I don’t need this anymore.”

“That was a first major turning point for this client,” Desposito says. “What was being utilized by this client [instead of cutting] was other skills he had been taught [in counseling]. He recognized that he didn’t feel trapped in his bedroom anymore. … He opened the drawer and, boom, ‘Oh, my gosh!’ he saw the knife and realized that he had been doing a host of other things and didn’t need it.”

Leveraging strengths

Cristal Clark, an LPC, counselor supervisor and founder of a private practice in Fort Worth, Texas, describes her approach to wellness as working with clients to “fix the why, not the what.”

Wellness, Clark says, is “peace — but not contentment. It’s being joyful and thriving in the circumstances where you are.”

The approach’s focus on leveraging client strengths can include reconnecting them to interests they once enjoyed, such as hobbies they previously engaged in before having children or encountering other life changes, explains Clark, an ACA member and a practitioner of eye movement desensitization and reprocessing.

Ann Church, a licensed clinical mental health counselor and co-founder of a wellness-focused therapy practice in Charlotte, North Carolina, notes that leveraging client strengths can also involve helping clients identify things that are already part of their life that they haven’t previously recognized as a strength. For instance, counselors may need to encourage clients to reach out to a friend in their church or spiritual community or reconnect with former classmates through an alumni group. Counselors can also ask, “Who is your favorite person in your family?” Most clients have a ready answer to that question, Church says, and counselors can follow up by suggesting that they call this family member to reconnect and find support.

A focus on client strengths also requires forging a strong therapeutic bond to discover what their strengths truly are, Clark says. “What appears to be someone’s strengths at the outset really could [just] be something that they’re good at,” she notes.

Clark once worked with a female client who had a doctorate and a successful job at a local university. The client was very logical, calculated and organized — a type eight on the Enneagram — but she was also very sad and wrestled with suicidal ideation.

Clark’s counseling work with this client focused on emotion regulation, managing her anxiety triggers and drawing on her spirituality. As they formed a therapeutic bond, Clark began to understand — and, in turn, helped the client understand — that the client’s organization skills weren’t actually her strength.

“She had to have things exactly the way she wanted to manage her fear,” Clark recalls. “Her organization was a coping skill to keep anxiety at bay. Her true strengths were listening and helping her students identify goals and creating plans to get there. When she is in that helping mode and giving control to other people, she is able to find peace.”

At intake, the client had exhibited strong suicidal ideation. Six months later, she came into a session with Clark in tears and exclaimed, “This is the first time in 30 years I haven’t felt suicidal.” Those feelings had ebbed because the client had learned to regulate her emotions and, in turn, her self-esteem had grown stronger, Clark says.

The client’s history included abuse and neglect, and she had “spent her whole life proving that she’s worthy,” Clark says. “Now, she believes that she’s worthy. That’s the shift in the paradigm, from an external to an internal confidence.”

The client has gone on to complete a second master’s degree and has adopted a habit of walking every day.

“To be able to use a client’s strengths [in counseling], you have to build a rapport with them to hear their story and hear what their strengths truly are,” Clark says. “We looked at her overall picture of wellness to find what she wanted [to improve about her life]. The root of it was that she wanted to stop feeling these painful feelings and didn’t want to die [by suicide].”

Counseling a client without considering all of the facets of their wellness is like buying a car based on color instead of its gas mileage and other factors, Clark says. “It’s not just the person in your office; it’s their job, their family [and] entire system. If you don’t ask the questions to get to know the whole person, if you don’t look at outside factors and provide tangible opportunities to reach what they need and want … it [counseling] won’t break the cycle.”

The whole picture

Research continues to confirm what wellness practitioners have long acknowledged: “Physical health, spirituality, social supports, mental and emotional health, and all of these systems are interrelated and they impact one another,” Church says.

“If we’re talking just about a client’s feelings or, for example, anxiety … it’s really important to understand what the root of that anxiety is, but also what are the contributing factors around that that can help them manage that? [Ask clients,] ‘What are your social supports? How much caffeine are you drinking? What is your sleep like?’ We know that all has an impact on how you feel. … If you [the counselor] are not taking all of that in, you’re missing a key factor in helping people feel well,” Church says.

Hailey Shaughnessy, a licensed mental health counselor in Florida, sees the benefits of a holistic focus all the time in her work as a therapist in the cardiology unit at Sarasota Memorial Hospital. The hospital uses Dr. Dean Ornish’s program for treating heart disease, enrolling patients not only in medical treatments but also in a multidisciplinary regimen that includes exercise instruction, nutrition counseling, and therapy sessions focused on reducing stress, regulating emotions and boosting mental health.

Shaughnessy, who also has a private counseling practice in Sarasota, says many of the cardiac patients she sees for therapy at the hospital are dealing with emotion management issues (especially around anger) and stress. Patients are also screened for anxiety, depression and other mental health conditions. Prior to treatment, Shaughnessy says, patients often don’t realize that emotions have a direct impact on their physical health, most notably on the heart.

In sessions with cardiac patients, Shaughnessy sometimes reads sections of Deb Shapiro’s book Your Body Speaks Your Mind: Decoding the Emotional, Psychological, and Spiritual Messages That Underlie Illness. In response, Shaughnessy often sees these patients nodding or hears them say, “That is me.”

Patients often see vast improvements, not only in their physical health but in their overall life quality as well, and in a shorter time than if they didn’t receive multidisciplinary treatment, according to Shaughnessy.

“The brain is not separate from the body. Your emotions affect your brain and then, in turn, your body,” says Shaughnessy, an ACA member whose first career was as a personal trainer and fitness instructor. “[Wellness] is something that I deeply believe in, and I practice it myself. I know how much better I feel when I work out. I know how much more confidence I have when I’m [physically] strong,” she says.

Shaughnessy grew up in a family in which girls weren’t encouraged to play sports. When she began exercising in college, she noticed a corresponding boost in her mood. “I’ve seen myself how these different things affected me personally, and I truly believe if they can help me, they can help others,” she says.

Asking the right questions

In addition to drawing upon client strengths, many of the counselors interviewed for this article associate a wellness focus with a thorough intake process. That involves asking targeted questions to understand and monitor all domains of a client’s wellness, from whether they have a primary care physician and take vitamins regularly to their social supports, home environment and family of origin.

Jen Monika McCurdy is an LPC who works within a wellness framework at her St. Louis private practice that specializes in maternal mental health. Her intake form includes entire sections with detailed questions asking about clients’ medical health and histories (including any prescribed or nonprescribed medicines they are taking), exercise habits and other areas of wellness. In the section about sleep, she asks clients how easily they fall asleep, whether they dream and if they feel refreshed when they wake up. McCurdy mostly counsels female clients, so she also asks targeted questions about their menstrual cycle and how it affects their mood and functioning.

All of this information helps her treat clients holistically, beyond their diagnoses or presenting issues, McCurdy says. When working with peripartum clients, the wellness framework is a natural fit, she explains, because social supports, sleep patterns, prenatal vitamins, water intake, nutrition, exercise and other wellness indicators are all integral for breastfeeding mothers, clients undergoing fertility treatments and those struggling with postpartum stress.

“With a wellness approach, you’re not just working with anxiety [or another presenting issue], but the whole person,” says McCurdy, a member of ACA. “It’s empowering them that their illness does not define them, empowering them to tell their story.”

Church also uses a thorough intake questionnaire with clients and notes that open-ended questions help clients tell their story. Beyond simply asking about a client’s sleep, she’ll ask them to walk her through their evening and bedtime routines. Do they log on to Facebook or have a glass of wine after putting the kids to bed? How much caffeine do they normally consume, and at what time of day?

From there, Church will transition to providing psychoeducation to clients, talking about what a normal sleep cycle looks like (and confirming that it’s normal to have periods of wakefulness in the night), alcohol’s effect on metabolism, and how both alcohol and the blue light emitted from electronic devices can disrupt sleep.

“If I were talking to a beginning practitioner [about wellness], I would say, ‘Mind, body, spirit — bringing those things into intake and sessions is really important,’” says Church, an ACA member. “Because we can teach all the skills and coping mechanisms and all sorts of models to people, but if we’re not helping them use [and draw from] other aspects of their life, we’re really seeing them through a narrow, narrow lens. We’re seeing them as a diagnosis rather than as a whole human being.”

Several of the counselors interviewed for this article noted that a wellness perspective also involves working closely with other helping professionals to refer or co-treat clients. This can include a range of practitioners, from chiropractors and medical doctors to massage therapists, acupuncturists and physical trainers. Shaughnessy often works with a nutritionist who can advise her private practice clients about their diet and map their gut microbiome, as well as a specialist who conducts sleep studies. McCurdy, as a maternal mental health specialist, has forged connections with infertility clinics and OB-GYN practitioners in her area.

“It’s so helpful to look at a client as a team,” McCurdy says. “I can’t be their sleep specialist, but I can talk [in counseling] about the importance of sleep. But if they have a potential sleep issue, then I’ve got to get them support [from a specialist]. It’s my value and my duty to get them that support.”

For McCurdy, one of the most important parts of the wellness framework is for counselors to be willing to practice what they preach, encompassing everything from self-compassion and working to maintain social relationships to having a meditation practice and getting consistent physical exercise.

Counselors also need to show empathy regarding how difficult it can be to talk about, and monitor, aspects of one’s lifestyle that are very personal. “If you’re going to preach wellness to someone, you have to believe it’s important and share that value with them,” McCurdy says. “When you have a wellness perspective, you’re always thinking of how things are going to work systemically — how an intervention will work in [a client’s] life, their family, their community. We have to hold that truth to ourselves as well … acknowledging that it’s not easy to go for a run, not drink beer, and eat healthy when you’re mentally struggling. Honor the concept of where the client is, where they want to be, and hold hope for them [that they can get there].”

Desposito acknowledges the importance of asking questions about diet and other domains of wellness, but he warns that too many questions can cause clients to become discouraged. He uses wellness models, including the eight dimensions of wellness (social, environmental, physical, emotional, spiritual, occupational, intellectual and financial) referenced in the Substance Abuse and Mental Health Services Administration wellness initiative, to assess which areas of a client’s wellness are strong and which may need extra attention.

Wellness goes far beyond exercise and other physical indicators, says Desposito, who recently co-authored an article on promoting identity wellness in LGBTQ+ adolescents in the Journal of LGBT Issues in Counseling. “If I am only looking at physical factors, I am only making a composite of my client,” he says. “We can’t say, ‘This is the best answer.’ We have to value what the client values. We have to help the client find their values and adapt [our counseling] to their values, but temper that with a multicultural lens. Yes, it’s great to take vitamins, but what if you can’t afford them?”

“A wellness framework doesn’t say, ‘That’s wrong,’” Desposito continues. “It says, ‘What can we do to use that [aspect of a client’s life] to help?’”

Counselors must also remember the parameters of their role and refrain from making medical or other recommendations that are outside their scope of practice.

From questions to psychoeducation

For Church, a powerful first step with clients is often normalizing the feelings they are experiencing and explaining their biological connections. For example, she says, a client who overexercises may not realize that the nervous system interprets that physical stress the same way it does the stress a person experiences at work or when going through a divorce.

“Normalize those feelings and don’t pathologize them. Explain [to the client], ‘This is your body motivating you to make a change,’” Church says. “Then, explore the changes they can make. Maybe it’s creating a support network, or whatever it takes for that person.”

Wellness counselors look not only at what brought a client into therapy but also at the connection that issue has to the client’s spiritual life, emotional health and other domains of wellness, Church emphasizes. “We are very intentional about bringing those aspects into the session, raising awareness with clients around those issues that may or may not be impacting why we’re here, and then following their lead.”

Church once worked with an adult client who sought counseling after the breakup of a long-term relationship. He was experiencing intense feelings of shame, vulnerability, anxiety and grief. He was also confronting a loss of identity, having trouble “figuring out who he was” outside of the relationship, she says. All of this resulted in frequent bouts of weepiness.

As a wellness counselor, Church helped the client understand the biological and physical connections to the emotions he was feeling and how they could be harnessed to move him toward healing. Part of this, Church says, was offering psychoeducation about how the nervous system and our fight-or-flight response work, and how that was leaving him on edge and “emotionally all over the place.”

The client was also having trouble sleeping and was turning to alcohol to cope. In sessions, Church explained that a lack of sleep inhibits the body’s ability to deal with stress and discussed how alcohol further exacerbates that cycle. She also worked with the client’s physician when a psychiatric medication was prescribed to help the client.

In counseling, Church and the client worked on identifying and managing his anxiety triggers and finding connections beyond his ex-partner. The relationship had represented his entire immediate social circle, so they worked on rebuilding that based on ties he already had through work, family and old friends.

This also included the client getting back into bike riding, an activity he had once enjoyed but had largely stopped engaging in while in a relationship. Getting back on his bike not only lifted the client’s mood and alleviated his stress but also helped him forge an identity outside of his relationship with his ex-partner. It also led him to find social connection when he started riding with a local biking group.

Over time, the client progressed to being able to make decisions based on a thoughtful response instead of emotional reactions, Church says. “This is a person who [previously] didn’t share a lot about how he felt. Now he’s able to manage big feelings and not get overwhelmed,” she says. “He’s able to start incorporating his physical and emotional sensations and thoughts in a way that is helpful and utilize some of his physical wellness things, such as bike riding and moderating his alcohol intake, to bring that all together. Also, it has really opened him up [to see] what is a meaningful life for him.”

For McCurdy, psychoeducation with clients often involves the power of journaling. She asks clients to track their eating, exercise and other day-to-day indicators in a journal, along with their emotions and mental state. This helps clients connect the dots, she says. For example, clients might notice that their mood worsened the day after they drank alcohol.

Shaughnessy also recommends journaling to her clients, along with tracking their sleep, exercise, food and vitamin intake, and moods. Counselors typically check in with clients about how they are reacting to any psychiatric medications they may be taking. Similarly, Shaughnessy says, counselors should check in about the holistic aspects of their clients’ daily routines.

In keeping their journals, McCurdy tells her clients, “All of your thoughts matter — the hopeful ones and the scary ones.” In sessions, she asks clients to talk about something that’s going well, “even if it’s the tiniest of things.”

She also prompts clients to make lists of things for which they’re grateful in their journals. This is all with an eye toward empowering clients and focusing on their strengths, especially when circumstances such as a miscarriage or infertility make them feel like so much is out of their control. McCurdy’s work with peripartum clients often includes regulating their self-talk and equipping them with positive affirmations, such as “I will survive this” or “I can get through this.” For clients going through infertility treatments, she works to plan ahead with them so they will have a toolkit of coping mechanisms — especially social supports — for the two anxiety-provoking weeks between when the fertility treatment occurs and when it’s time to take a pregnancy test.

With all clients in session, McCurdy says, “I listen to what’s working for them and hone in on that. I often ask clients, ‘What is going well for you today? What is your happy? What went well, and what can we do more of?’ … And [I] celebrate their wins too. I tell clients that I’m proud of them, in awe of them. The fact that you were able to put your hair up, put on your shoes and get outside is a win. Just walking to the mailbox is a win. Honor the courage that it took for them to do that.”

More than massages

The word wellness is in the very definition of counseling used by ACA and developed more than a decade ago during the 20/20: A Vision for the Future of Counseling initiative: “Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.”

Wellness is sometimes viewed in simplistic terms, but in reality, it is tied to the profession’s call to social justice, Desposito says, “because you’re meeting [clients] where they’re at and honoring their experience.”

“Wellness can be very abstract, [but] that holistic piece, how the whole person is working together, social justice is paired with that,” he says. “Wellness is often assumed to be self-care or taking a vacation. Wellness is often viewed as this thing that you do on the side. … Wellness can’t just be, ‘Oh, just go get a massage.’ You [the counselor] have to honor the multicultural aspects of a client and discover how you can find wellness [for them] right here in this moment.”



Action steps for more information:


Contact the counselors quoted in this article:


Related reading

Book titles recommended by the counselors quoted in this article:

  • Your Body Speaks Your Mind: Decoding the Emotional, Psychological, and Spiritual Messages That Underlie Illness by Deb Shapiro
  • Spark: The Revolutionary New Science of Exercise and the Brain by John J. Ratey
  • Why We Sleep: Unlocking the Power of Sleep and Dreams by Matthew Walker
  • Intuitive Eating by Evelyn Tribole and Elyse Resch
  • The Body Keeps the Score by Bessell Van der Kolk
  • Start Where You Are: A guide to compassionate living by Pema Chodron
  • Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment by Brendon Stubbs and Simon Rosenbaum


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


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.

Facing a winter of discontent

By Laurie Meyers November 19, 2020

In 2005, a Welsh psychologist announced that he had created a formula combining factors such as weather, holiday debt, the amount of time elapsed since Christmas and the likelihood of already-abandoned New Year’s resolutions to determine the most depressing day of the year: the third Monday in January, aka “Blue Monday.”

To many people — particularly those in the upper latitudes of the Northern Hemisphere — this sounded logical. After all, January can seem a little grim, with its feeble sunlight and frequently unpleasant weather, the end of holiday festivities, and endless commercials for diets and exercise equipment. As we rise in the dark to trudge to work and are again greeted by darkness on the commute home, spring does seem particularly far away.

But the vaunted “discovery” was, in truth, a public relations stunt masquerading as science. Blue Monday and its phony formula were commissioned by a savvy travel agency in the United Kingdom as a faux-scientific excuse for people to stop sitting in their cubicles complaining about dreary weather and book a vacation to someplace warm and sunny.

In 2020, winter arrives toward the end of a calamitous year and with additional challenges beyond the usual seasonal funk. Americans are already reeling from a spring and summer spent isolating and physically distancing to avoid the novel coronavirus that causes COVID-19. It was difficult or unsafe to participate in many of the sun-soaked rituals that normally help buoy people against the coming of winter.

As fall arrived, more than 200,000 Americans were dead, and the country began experiencing another nationwide surge of COVID-19 cases. Many people have lost loved ones. Isolation, lack of contact with friends and family members, and the difficulties of home schooling and working from home have taken a significant toll.

Winter promises more of the same, and what spring might hold is entirely uncertain at this time. The holiday season — which can be difficult for many people under the best of circumstances — is especially fraught this year. Public health experts have discouraged indoor gatherings that include people who do not live in the same household. This directive has left many wondering how — or if — they can celebrate with loved ones.

Unhappy holidays?

In a year when virtually nothing has been normal — “new” or otherwise — the longing for traditional celebrations may be especially intense. But it’s essential for clients to realize that the holidays, like the preceding seasons, will most likely be atypical, says licensed professional counselor (LPC) Stacy Blassingame.

“Most of us are feeling an increasing loss of connectedness to relationships and traditions we’ve come to rely on to give life meaning and purpose,” she says. But clients need not give up on the idea of sharing the holidays with loved ones; their celebrations simply need reimagining, says Blassingame, a member of the American Counseling Association whose specialties include anxiety and family issues.

She helps clients explore what aspects of the holidays have traditionally felt the most meaningful to them — such as baking and cooking, gift-giving, taking pictures or sharing stories — and then identify different ways of incorporating those things into celebrations. Blassingame and her clients have looked into ways of using the entire holiday season, rather than just a day or two, to connect with friends and family via Zoom or even through small, physically distanced gatherings.

One advantage of the increasing incorporation of technology into celebrations is that clients are more likely to include family members who aren’t usually able to travel to in-person gatherings, she points out. “In fact, this summer, I had the opportunity to participate in a Zoom bridal shower that connected me with family members I haven’t seen in years,” says Blassingame, a counselor and managing director at the St. Louis counseling practice Change Inc.

Lauren Ostrowski, an LPC in a Pottstown, Pennsylvania, group practice whose counseling specialties include depression, anxiety and relationship issues, suggests that clients get creative with technology. Instead of gathering in person as they normally would, family members could mail or drop off their gifts and then open them at the same time on Zoom, or use the platform for cooking and eating a holiday meal together, suggests Ostrowski, a member of ACA.

Not everyone views the holidays as a time when all is merry and bright, however. “The holidays are complicated for many people in the best of times,” notes John Ballew, an LPC practicing in the Atlanta area. “For many people, not being able to spend time with those we love has been painful. For others with complicated family relationships, the idea of not being able to visit during the holidays may be more distressing than the actual loss of time with family.” Some clients might tell themselves how awful it is that the pandemic is keeping them from spending the holidays with extended family, when the reality is that the prior year at Thanksgiving, they ate and drank too much and got into a big fight with their relatives, he says.

“Counselors never want to minimize their clients’ experiences,” cautions Ballew, an ACA member. “But helping clients explore what’s really important to them, what’s meaningful, may help alternatives emerge.”

Perhaps a holiday away from family conflict will provide a much-needed break, he says. And if clients end up spending the holidays mostly alone — by choice or not — can they find a way to make the season meaningful in a new way?

“Holiday time is often an overwhelming whirl of shopping, consuming and busyness,” observes Ballew, whose counseling specialties include depression, anxiety, relationship problems and couples counseling. “Yet this time of year also lends itself to reflection and thinking about what is important. Counselors have an opportunity to help clients understand the potential for something good beneath the layers of loss.”

Laura Brackett, an LPC and the director of community engagement at Change Inc. in St. Louis, notes that her clients have been bringing up the holiday season and how different it will be for months in advance. She says that before discussing how to mark the holidays, it was essential for her to understand whether the holidays had historically been a time of celebration or pain for each of her clients and if something — besides the pandemic — was contributing to making this year different from past holiday seasons.

For example, marking the holidays during a year in which a parent died and the pandemic prevented a client’s family members from gathering to mourn is drastically different from welcoming this year’s social distancing as a break from having to travel to four separate places in a 24-hour period, Brackett emphasizes.

“In general, I ask my clients what they need to grieve, to celebrate, to remember and to let go of,” she says. “We also discuss what power they have in deciding what this holiday season will be to them, including if they want to acknowledge it at all.”

Some clients this holiday season may have mixed emotions, including guilt and grief, Ostrowski says. “There are a lot more people who have an empty chair at the table this holiday,” she observes.

Ostrowski helps clients find ways of honoring their absent loved ones, such as decorating a certain way or even just sharing memories with a friend or family member. She also reminds clients that it is OK to experience a moment or time of joy amidst the grief as a kind of gift to themselves. Ostrowski asks clients to notice those feelings — how one part of them may be sad, while another part is enjoying the moment. “You can have two different emotions at once,” she confirms to clients.

A new kind of family conflict

Even among the most even-tempered families, it wouldn’t be the holidays without at least a little conflict. This year, some of the dissent is likely to be about public health experts’ advice against gathering — at least indoors — for the holidays. Family members may have divergent views of what a “safe” gathering looks like.

“Anxiety about these situations is very real,” Ballew says. “It has been called insinuation anxiety: a worry that not agreeing with someone’s choices implies criticism of how they are managing pandemic life. It is important to affirm clients who are rigorous in social distancing if that’s what they’ve decided is the best course of action.”

Ballew also probes for signs that the conflict is an indication of problematic family dynamics. “It isn’t unusual for clients to report that they feel disrespected in long-standing patterns with parents and other family members,” he explains. “Social distancing decisions may be merely the most recent manifestation of this. Coaching them through this involves several steps: identifying the problem and the desired outcome, clarifying their boundaries and choices, then using behavioral rehearsal or role-play to gain some skill in navigating these challenging interactions.

“Many people want family members to validate their choices as a way to ease their own anxiety in the face of uncertainty. I find it helpful to point out how this gives the client’s power away, leaving them at the mercy of people who may have values significantly different from their own.”

Blassingame says many of her clients feel as if the pandemic has ruined large parts of their lives. She says that allowing clients to give voice to all their disappointments often helps them realize that in some ways, they agree with those who are against a socially distanced celebration because they believe it won’t feel like the holidays without gathering in person. Recognizing this allows clients to empathize with family members and approach the conflict feeling more empathetic and centered.

Blassingame adds that some clients also find it helpful to rehearse how to respond to family members who are hurt or disappointed. They can use statements such as, “I’m really sad that it’s not safe for us to get together too. I can’t wait until we’re all together again.”

However, some clients face weightier decisions, she says. “I have also had clients who had to seriously weigh the pros and cons of spending a holiday without aging loved ones, recognizing that this may be their last holiday together,” Blassingame explains. “One client of mine had an open and difficult conversation with her aging parents weighing the pros and cons of not seeing them this year.”

In the end, the client and her parents decided that they would always regret it if they ended up missing a potential last chance to celebrate together. They have decided to spend the holiday together while taking all possible safety precautions, Blassingame says.

Julie Cavese, an LPC with a private practice in Portland, Oregon, proposes some middle ground. She suggests investing in a space heater, decorating the garage or carport and having a few family members over for a physically distanced gathering. Or, clients could suggest that family members take a holiday walk/hike or gather outside with some hot chocolate.

For clients who don’t feel comfortable getting together with extended family, even outside, “I think just being honest goes a long way,” Cavese says. Clients could tell family members that of course they’d love to see them, but they just don’t feel safe doing so. Then they can add that they’re really looking forward to seeing them next year.

Family members may not be happy with that decision, but Cavese asks clients what their priority is. Is it their personal safety and public health? “Or is it keeping the peace at all costs, even if that means Grandma gets sick?” Cavese says.

Welcoming winter

Blue Monday may be a myth, but there’s a reason that it still pops up in news articles every January. Even people who do not experience seasonal affective disorder (SAD) sometimes feel more sluggish and unmotivated during the winter. Winter weather can make it difficult or undesirable to go out. Many areas of the country routinely deal with heavy snow, biting winds, sleet and freezing rain or, at minimum, uncomfortably cold rain. Even on sunny days, the light frequently feels a bit anemic.

“I’m finding that as the days get shorter, those whose moods are affected by the changing seasons have started struggling with low mood much earlier than in years past,” Blassingame says. “I can’t help but attribute this to the fact that most of us have spent a lot of time alone and in our homes already this year.”

As Ballew notes, this winter we are facing all the usual challenges without the social stimulation of parties and little pleasures such as concerts and plays. 

Blassingame has been urging all of her clients — with or without SAD — to prepare for the increased isolation of the upcoming winter. Take advantage of the time that can be spent outdoors right now, she advises.

“In many areas of the country, individuals can bundle up and go for walks or even consider fall camping or hiking to take advantage of the outdoors during even the coldest months of the year,” Blassingame says. “I [also] encourage clients to think about the things they love to do during the slower, ‘hibernating’ months of the year and begin preparing for them now by planning winter projects and activities such as home projects, crafts [and] cooking new recipes. Some are stocking up on books to read and movies to watch in anticipation of having more free time. Having something to look forward to can be a beneficial tool to cope with longer periods of isolation.”

“This year, self-care is going to be particularly important,” Ballew adds. “Don’t overindulge in self-soothing by overeating and over-drinking, though don’t completely avoid those pleasures either. Exercise is key. Look for something new to add to routines, or change things up if you get bored.”

Blassingame agrees. “During these long months, I’m urging clients to be mindful of their intake of alcohol … as many are more prone to drinking to cope with loneliness and feelings of sadness. Clients also often need help identifying friends they can ask for support to set them up for greater success as the winter drags on.”

One of Blassingame’s clients is assembling a group of friends to do regular check-ins with each other and to drop off or mail random small gifts, such as a candy bar or a package of tea or coffee, so that no one feels forgotten.

Ballew is encouraging clients to renew contacts with old friends and to stay in closer touch with existing friends. He also urges clients to explore online offerings such as meetups, 12-step groups (if appropriate) and other options.

“With single clients, I often talk about how to use online dating apps effectively during a time when dating looks very different from the way it looked last year,” Ballew says.

“It is also helpful for people to cultivate an appreciation for their relationship with themselves,” he continues. “Encouraging new hobbies or reinvesting in old ones may help them reexperience time alone as something to be valued, not just endured.”

Although clients need to find ways to make winter more enjoyable, they shouldn’t feel an obligation to be “productive,” say Blassingame and Ballew.

“For example, I have one client who, at the beginning of the pandemic, was feeling a sense of guilt over not baking bread, learning a new hobby or expanding her mind through reading a new book,” Blassingame says. “We spent time talking about the messages she received growing up about productivity and laziness.”

The client’s father had taught her that it wasn’t OK to spend time relaxing and recharging, Blassingame notes. “When we explored how she wanted to spend her time of isolation, she shared that she has a list of her top 50 favorite movies that she has always wanted to get around to rewatching,” Blassingame says.

The client realized that she didn’t even want to learn how to bake bread. “During her time at home, she watched quite a few of her favorite movies and is saving the rest for this winter when she anticipates spending more time indoors,” Blassingame says. “Sometimes, we just have to help clients give themselves permission to spend their time the way they truly want to spend it.”

It’s great that some people are spending this time learning or doing new things, Ballew says. “But for most of the people I work with, the pandemic and the changes in work and relationships it has wrought have used up much of their bandwidth,” he adds. “Telling a parent balancing working from home with sketchy child care that they should also be learning to speak another language or learn to play the flute is cruel. Yet that’s what some of my clients have been expecting of themselves.

“Counselors are in a great position to help clients recognize the demands that life is placing on them. In my experience, clients’ No. 1 need is to learn greater self-compassion.”

Everyone has their own optimal level of stimulation, Ballew explains. Some people are stretched thin by the demands of the pandemic, while others are understimulated and bored.

“Counselors need to help clients understand their own situation and how to care for themselves,” he says. “Does a client need more structure to calm some of the chaos around them? Or do they need to add a challenge that they will find meaningful?”

“One recommendation I make for most clients is to take time every day to walk with a partner or by themselves,” Ballew continues. “If they are walking by themselves, listening to audiobooks or podcasts can satisfy the urge to learn or do something meaningful. At the same time, the exercise helps them better regulate their mood.”

It’s OK to take winter as a time for self-nurturance, Cavese tells clients. She urges them to embrace its coziness and let themselves enjoy the wrapping up, hot drinks and movie nights.

Holding on to hope

During the long nights of winter to come, it might be easy to feel as if the coronavirus era is endless.

“I don’t think it’s evident to most [people] that what they’re experiencing during the pandemic is a form of grief,” Blassingame says, adding that just naming and normalizing the grief can be therapeutic. Counselors and clients should also explore what has been lost, both personally and as a society, she emphasizes.

“When some clients are struggling, I’ve found it helpful to just say, ‘This really sucks, doesn’t it?’” Ballew says. “Just acknowledging what is right in front of us can be freeing. Give clients space to talk about frustrations, fears and losses, even if they said pretty much the same thing last week. Many clients are struggling to support others, and the counseling session may be their only opportunity to acknowledge the depth of their loss. The goal is to help clients move to a place of acceptance if they can.”

“It’s crucial for helpers to acknowledge how these times have been tough for them as well,” Blassingame urges. “As paradoxical as it may seem, we can often be more helpful when we resist the urge to fix or remove the grief and pain that clients are experiencing. Be a fellow struggling human being who is walking beside them in the same struggles.”

Brackett also believes that counselors may want to consider self-disclosure. “As counselors, we often appear to our clients like we have it all figured out, even if we don’t intend to present that way,” she says. “Would normalizing an experience with your own life help? For example, a client recently discussed worry about the dropping temperature and how it will limit their ability to see people. While we considered ways to keep connection when outdoor activities aren’t as easy, the part of the conversation that steadied them the most was my own disclosure about that concern: ‘I don’t know how to maintain connection during a global pandemic during holiday season in the Midwest in the winter either, and it’s intimidating! Maybe we can figure it out together.’

“It’s that last word — together — that reminds them that even if they don’t know what to do, someone is with them.”


Contact the counselors interviewed for this article:


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


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.

Counseling Connoisseur: Counselors, pets and COVID-19

By Cheryl Fisher November 17, 2020

Isolation is the worst possible counselor.”

– Miguel de Unamuno


COVID-19 has provided a unique opportunity to return previously external occupations such as education and employment to the home. This is often doubly true for counselor educators and students as both classroom and clinical practice are being offered via virtual formats.

This transition has not been without challenges. Whether it is a wardrobe failure caught on camera or a feline sprawled across the keyboard, the virtual classroom and telehealth have blurred the boundaries of our privacy. Classmates, faculty and clients now have access to aspects of our home life. Virtual backgrounds may provide the appearance of an office-like environment veiling the reality of the basement, spare bedroom or even closet. However, household sounds are not as easily silenced when unmuted and meetings now often include the bark or purr of the canine or feline household member.

Additionally, the virtual world is a reminder of the distance required during this pandemic. Water cooler talk and happy hours are now hosted through chats, emails and Zoom meetings. Physical connection is relegated to those deemed safe enough to be in one’s “bubble” such as immediate family members and close friends.

Included in that bubble are the family pets. According to researcher and professor of anthropology, Brian Fagan in his book titled The Intimate Bond: How Animals Shaped Human History, “More than fifteen thousand years ago, relationships of familiarity and respect led to cooperation and companionship between people and wolves, the ancestors of the first animals to become members of human families.”

The human-animal connection has led to an interdependent relationship that has provided physical and emotional satisfaction and support for both human and other-than-human companions.

Pets motivate movement

Sitting for hours in front of the computer is contributing to Zoom fatigue and an unhealthy, sedentary lifestyle. Animals motivate movement, encourage play and promote venturing outdoors for walks. For example, my own standard poodle will indicate when it is time for my work break by staring me down. Should I not respond, she resorts to a gentle (but firm and repeated) tap on my shoulder. If I am still remiss in acquiescing her request to go outside, she will break into a barrage of vocalizations that begin as soft whines of malcontent and escalate to barks of infuriation.

One of my counselors-in training described how her pets have navigated the pandemic and motivated family walks and mutual support.

“We have two dogs, a whoodle (wheaton terrier/poodle cross) named Buffy and Coyote, a rescue, who is a terrier mix of some kind.  Buffy looks like a teddy bear and when she isn’t cuddled up with my two boys she is hunting rodents and rattlesnakes. She really lives up to the name Buffy. What can I say about Coyote? Well, he’s a chicken. He’s afraid of his own shadow. The best thing that ever happened to him is this darn pandemic because we are all at home where he can keep tabs on us.  The pandemic has forced us to spend way more time together as a family (for better or worse!) and that includes our dogs. The one thing that we started to do as a family is taking the dogs for a walk. I’m not sure why it took a pandemic to make this a family event but I’m not going to complain, and I know the dogs won’t either.”

Pets decrease symptoms of stress, anxiety and depression

The stressors that have accompanied the pandemic are numerous. Animals are also sensitive to the stress experienced by their human and strive to mediate the challenges. According to Stephanie Borns-Weil, the head of behavior service at Cummings Veterinary Medical Center, animals are also adjusting to everyone being home and trying to navigate the increase in activity. However, routine engagement with pets appears to decrease the stress hormone cortisol and decrease symptoms of anxiety and depression for both human and animal. For example, one client shared this story about her German shepherd:

“After the lockdown, I was feeling sad and isolated. He [the dog] started to see I was in bed a lot. After some time, he would pull me out of bed. Then moved me away from the couch and showing me he was getting fat as well as myself. So, the next morning, he pulled me out of bed and away from the couch. I changed my clothes and started walking. We just walked for 40 minutes, just to be outside and get some fresh air. It started for me to change my habits, diet, routine and even conversation.”

Pets provide companionship without baggage

Pets help decrease loneliness by giving and seeking companionship without the complex emotional conditions of many human relationships. This is not simply an emotional connection but a neurological bond set by increased levels of the neurotransmitter oxytocin in both humans and animals. During the pandemic, people’s increased need for companionship has resulted in an increase in the fostering and adoption of rescue animals. People are searching for that uncomplicated and fulfilling connection. For one client family the pit bull mix they rescued during the lockdown has been a calming presence and a constant companion for their children.

“She [the dog] has given the children unconditional love, a calming presence, and provided us purpose during these eight months of being at home. During the children’s ‘recess’ time from distance learning, we take her on walks around the park and play ball. She forces us to get outside to play and laugh! She keeps us in the present moment. She snuggles them, kisses them and is truly a light during darker days! We are so grateful for her companionship during these challenging times.”

For many people, pets aren’t just companions. As this story shared by a colleague demonstrates, the connection and concern we feel marks them as part of our families.

“My dog has also been my pandemic buddy, sitting next to me through Zoom calls and virtual therapy sessions. We have gone on daily walks and snuggle times on the couch as I did my notes. Sadly, during the last four months he experienced a spinal injury that got progressively worse. We’ve been working with our vet and he’s getting stronger and I can’t imagine what the long days working from home would be like without him.”

Domesticated animals and humans have a long history together. From predator and prey to companions, the relationship is both complex and primal. The pandemic has also invited a greater awareness of our coexistence with many species. Coyotes were sighted in San Francisco, bears in the streets of Los Angeles, and a peacock even adopted a London primary school and the surrounding neighborhood. Many attributed the pandemic-induced reduction in human activity to these increased sightings of wild animals in urban settings.

The human-animal connection is an interdependent relationship and one that can be especially healing during difficult times. When the time comes (and it will) when we begin to return to our classrooms and office spaces, it is important to remember that our pets will also need time to adjust to the changes. While some may be relieved by the quiet, others may be saddened to lose their daytime buddies.

However, never fear. Our pets are faithful and will let us know that deep down they will always forgive us and are ever ready for a luxurious rub behind the ears or a brisk walk in the park. Perhaps it is just as Elizabeth Marshall Thomas, one of the first Westerners to live with the Bushmen of the Kalahari desert and chronicle their relationships with animals and the author of The Hidden Life of Dogs, noted, “No person is too old or ugly or poor or disabled to win the love of a pet — they love us uncritically and without reserve.”


This is dedicated to my co-therapist, 12-year-old golden doodle, Max who died suddenly in July. Your friendship and guidance is sorely missed.


Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy. She may be contacted at




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: Caution for second-language speakers

By Gregory K. Moffatt November 12, 2020

In the summer of 2010, I was teaching a seminar in Tacna, a small desert town in Peru. Even though I am a Spanish speaker, it is more efficient for me to teach with a translator, and I have done so many times in my classes in countries all over the world, including Central and South America. I had been to this particular venue more than once, and my translators had always been English speakers who were fluent in Spanish. I’d never had any significant difficulties with their translations. On this occasion, however, I had a novice translator who was also indigenous to Tacna.

He was very nice, but also very frustrating. Several times during lectures, I had to provide words for him in Spanish or had to clarify his translations. I was frustrated with him, but I attributed his long pauses and confused word choices to his not yet having learned the art of translating, which is, indeed, an art. On the plane heading for home, however, I had an epiphany.

Staring out of the airplane window, I rehearsed several specific instances in my lectures where my translator had trouble. As I thought through those situations, I realized he had been looking for a translation that best conveyed my thoughts into the culture he knew so well. As any speaker of a second language knows, literal translations can often be problematic. My native Peruvian translator knew of subtle nuances of which I could not possibly have been aware. That was the main reason for his pauses and delays in translation. His lack of experience as a translator was a secondary factor.

On the other hand, my American translators in past years had known what I meant, and they had chosen words to communicate to my audience that I heard with my American ears. Therefore, it sounded fine to me. The words matched my expectations. But on my long plane ride home, I realized my prior translators could easily have been making mistakes that I didn’t — or couldn’t — recognize. What I had perceived as correct translations were potentially errant. Ironically, I had been more comfortable with translators who were actually more likely to translate incorrectly than with the one who was most likely to do it accurately.

After working for several years in Central and South America, limping along in my very weak Spanish, I decided to go back to school. I wanted to be able to teach and to do counseling with Spanish-speaking clients in their language. So, I enrolled in a local community college and took two years of Spanish.

My fluency improved to the point that I was able many times to counsel with my Mexican, Peruvian, Argentinean or Chilean clients in their native language. I have spoken on television and in public forums in Spanish and have lectured in Spanish. I know what I’m doing.

But, if given the choice, I will almost always use a translator these days for anything other than casual conversations in Spanish. My fluency can be my enemy. Native Spanish speakers often overestimate my understanding and, if I’m not careful, I’ll do the same thing. They speak faster and assume much. I might hear a term or phrase and misunderstand it (just like we might do in English) but never even know I did it. Remember the days when “bad” meant “good”? Language changes regularly.

Even more critically, as counselors we know that every word, every inflection and every subtle nuance of language can help us better understand our clients. There is no way, even after living my summers in Chile for nearly 15 years, that I can master those nuances even in that one context — let alone generalize it to 20 or 30 different Spanish-speaking countries. Casual conversation? No problem. Counseling, though, requires great precision.

There are ethical and logistical problems with using a translator in counseling. Confidentiality is, of course, one of many. But I’d rather have a translator who is a native speaker and well-versed in the ethics of counseling than to try to go it alone and perhaps miss something critical.

If you serve populations that speak languages other than English, finding a local translator and training that translator for the counseling room is critical.

One last caution: Spanish doesn’t sound the same way in various countries. Whether you are in Spain, Argentina, Puerto Rico, Mexico, Columbia, Peru or Chile, each region has varied cadence and nuances. The same is true with many other languages. So, don’t just call for the “Spanish” speaker.


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


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.