Monthly Archives: February 2021

Delivering difficult news: From adults to future adults

By Kelsey Mora February 10, 2021

As a dual certified child life specialist and licensed professional counselor, the questions I most often get from parents and caregivers are “What will I tell the children?” and “How will I tell the children?” These questions come up when facing a new diagnosis, a loss of a pregnancy or loved one, a traumatic injury, or a suicide attempt.

Although I work in a setting and with a population where I am prepared to assist families and parents through such life-altering events, many clinicians are not. To support other providers when faced with similar questions from their clients, I have developed three key tips for delivering difficult news to young children. These tips can be applied not only to medical events and loss, but also to divorce, an upcoming move, a local tragedy, and other life-altering events.

1) Honesty really is the best policy.

Being honest with children builds and maintains their trust. By not telling children about an event, we risk the likelihood of them hearing false information from someone else or finding out about it in an uncontrolled way. This may involve an overheard phone call, a read text message or an encounter with a neighbor, friend or relative. As counselors, we can empower our clients by explaining to them that they, as trusted adults, have the ability to control the delivery of this information to their children and create an environment where it is OK for them to talk about the event.

When children are forced to come to their own conclusions about what is happening, their imaginations may create something far worse than the reality. The caregiver should follow the child’s lead by assessing what they already know before providing or correcting the information. It is important for parents/caregivers to use simple, clear and honest language with their children and to understand that this may need to be repeated over and over again.

Avoid euphemisms. Even though terms such as “cancer,” “dying” and “divorce” may seem harsh or scary for children, these terms are less likely to lead to misconceptions later. Adults can always clarify terms along the way, but starting with the real words is recommended. For example: “Dying means he will not come home; his body no longer works” and “Divorce means we couldn’t get along anymore. We have decided to live in different houses, but we both love you very much.”

Find an appropriate setting. Encourage the adult to identify a private, quiet and comfortable setting, preferably outside of the child’s safest place (which, for most children, is their bedroom). Consider the living room or dining table. Practice starting by giving a warning shot. For example: “I have something sad or difficult to tell you.” Help parents/caregivers to think about the best timing of the conversation. Who should be there?

Finally, it’s OK for adults not to know what to say or how to answer their child’s questions. They can say, “I don’t have all of the answers, but as soon as I do, I will tell you.” This builds trust and is still honest. Help the child to at least know what will happen next and what they can expect. Once the discussion has taken place, give the child or adolescent time to adjust. Rehearse by acknowledging, “I know this was not what you expected to hear,” and practice providing empathy and reassurance that they (the adult) will be there if the child or adolescent has more questions, concerns or feelings. Young children may need time to play, whereas older children may prefer being with their peers. Both responses are developmentally appropriate.

 

2) When in doubt, keep things normal.

Children benefit from structure and clear expectations. However, it can be very hard to maintain routine for children when disruption is taking place. When this is the case, encourage your adults clients to prepare their children for anticipated changes. For example, if the children are able to attend their extracurricular activities or playdates but will be picked up by a friend or relative instead of their parent, make sure this is communicated to them. Similarly, if the bedtime routine or school drop-off will look different, parents/caregivers should ensure their children know who and what to expect. Children are resilient, but they do best when prepared for change.

Help your adult clients consider ways to include the child. Children may benefit from having a role or purpose. For example, they could be responsible for packing a bag or making a card. When possible, parents/caregivers should identify choices to offer to give children a sense of control and mastery during a time that feels out of their control. The child should not be forced to do something such as say goodbye to their loved one, but they should be given the option and presented with different ways to do so.

Caregivers may think they know what is best for their child and then be surprised by the child’s decision. I have worked with children who have persistent regret over not participating in their parent’s funeral but were denied the opportunity because the surviving parent was trying to protect their child. Often, parents will ask, “What if they [the child] regret their decision?” I reassure parents that they can remind their child that they were given a choice and that they made the choice that was best for them in that moment.

 

3) Expressing feelings is healthy.

When your adult client says, “I have to be strong for them [the children]” or “I can’t let them see me cry,” ask the parent/caregiver: “What does being strong really mean?”

Children who grow up in a home where they are shielded from feelings may inadvertently learn to internalize their feelings. Parents, caregivers and other adults possess the potential to teach children about the healthy expression of all emotions — the good, the bad and the ugly. It is inevitable that children will experience heartbreak, disappointment and upset throughout their life trajectory. When they are faced with these circumstances, it is imperative that they have learned how to identify their feelings and express them safely and effectively. Being strong can mean demonstrating appropriate reactions to situations.

Help your adult clients name their own feelings. Have them practice “I feel” statements such as “I feel sad because your grandpa is in the hospital” or “I feel worried about everyone’s safety.” Then, encourage them to follow these statements with plans that can be shared with their children, such as “But I am going to do everything I can to help you feel safe and cared for during this difficult time.” This encourages children to express their own feelings safely and effectively and to feel comfortable asking questions when they have them because they know it is OK to talk about the situation. Furthermore, practicing this gives the adult client an opportunity to process their own thoughts and feelings about the event before being in front of their child.

 

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These three tips can be applied to and modified for children of any age facing nearly any difficult event. I have used these principles to provide guidance for parents and caregivers on explaining recent events, including the pandemic and social unrest, to their children.

Developmental reactions to difficult circumstances will vary by age. Infants may demonstrate increased crying, clinginess or fussiness. Toddlers and preschoolers may regress or display a fear of separation. School-age children may exhibit irritability, confusion and distractibility. Adolescents may display anger, take on new roles and express criticism. But when parents and caregivers provide honest information, present clear expectations and encourage healthy discussions, children and adolescents are more likely to experience a positive adjustment both during and beyond the situation.

 

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Kelsey Mora is a dual certified child life specialist and licensed professional counselor who works both in a hospital setting and for a private practice in the Chicagoland area. She specializes in helping children and adolescents cope with illness- and grief-related challenges and is specifically trained to coach caregivers on language and techniques to use when parenting their child through medical conditions, family life transitions and traumatic loss. Contact her at kmora@illnessnavigation.com or through her website at illnessnavigation.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.

Exploring class privilege in counselor education

By Cynthia Miller, Frankie Fachilla and Jennifer Greene-Rooks February 9, 2021

James is a student in the first year of his master’s program in counseling. Typically very conscientious and enthusiastic, he recently started to leave class early without any explanation. Last week, he missed all of his classes and did not contact anyone to explain his absence.

When his adviser calls him to express concern, James says that his car recently broke down and he does not have the money to pay for repairs. He’s been relying on friends to help him get to and from class. He’s been leaving early because that was the only time someone could give him a ride home. Last week, he couldn’t find anyone to give him a ride. He’s been too embarrassed to ask his classmates or his professors for help.

Stephanie is in the final year of her doctoral program and has been applying for teaching positions. Despite good grades, multiple honors within her program, good teaching reviews from students, and strong recommendations, she is having difficulty getting interviews. Stephanie recently received feedback that her curriculum vitae lacks evidence of significant professional involvement. Reviewers have been concerned that she has not shown evidence of attending or presenting at state, regional and national conferences. Although she is a member of the American Counseling Association, she has not joined any divisions or state chapters.

Stephanie is frustrated and discouraged. She has not been able to afford the registration, travel, lodging and meal expenses associated with conferences, nor could she pay for multiple professional memberships. She feels that her financial position during her doctoral studies is being held against her during her job search.

Celia is a single mother of three living in a multigenerational home with her children and her elderly parents. She has worked as a case manager for several years, and her supervisor has been consistently impressed with her work ethic, empathy, creativity and critical thinking. Her supervisor has been encouraging her to pursue her master’s degree for years.

Celia recently met with the program director of a counseling program at a local university. She was excited to learn about the classes she could take and the career possibilities that would be available to her if she enrolled and completed the degree. However, when Celia learned that she would have to complete an unpaid internship, she became discouraged. As the sole provider for her family, she cannot afford to give up her full-time job to do an unpaid internship, and the counseling program did not have any sites that offered internship hours only in the evenings and on weekends. Celia ultimately decided not to enroll.

Stories such as James’, Stephanie’s and Celia’s are familiar to many counselor educators, but these stories remain rarely discussed despite the counseling profession’s rich history of promoting awareness of, and respect for, issues pertaining to multiculturalism, diversity and social justice. Both the ACA Code of Ethics and the Multicultural and Social Justice Counseling Competencies developed by the Association for Multicultural Counseling and Development highlight the need for counselors to be aware of issues of privilege and oppression based on membership in various groups. Counselors are also called to understand how such issues affect the worldviews and concerns of the people they serve, and to work to reduce disparities that are based on privilege. 

As counselor educators and students in counseling training programs, we have observed that conversations about privilege and oppression are common in training but that they generally occur in two ways. First, the conversations typically use a lens that looks outward into societal structures while neglecting to use a lens that looks inward and focuses on how our own educational and professional structures create disparities. Second, such conversations most frequently center on advantages given to a person on the basis of sex, race, gender identity, ethnicity, sexual orientation, religion or age, while ignoring socioeconomic class. 

The lack of recognition of class privilege is also reflected in our research. Although a large body of research on privilege based on other criteria exists, there is very little research related to privilege based on class. However, our collective experience leads us to believe that class privilege is embedded in our counseling training programs in ways that create real barriers for entry into the counseling profession for all but the most economically privileged. This strikes us as a significant oversight in the conversation on privilege in general and a crucial issue to address if we are to live up to our ideals as a profession.

Understanding class privilege and classism

Class privilege is generally defined as the tangible or intangible unearned advantages enjoyed by someone of higher class status. At an individual level, indicators of class privilege include such things as the ability to own a home, support a household with one job or one salary, afford child care, pay for a vacation, enjoy frequent meals out or amass savings.

Class privilege exists within the larger construct of social class, which categorizes individuals into groups based on similar levels of wealth, power, resources or status. In the United States, discussions of social class are often considered taboo. As such, social class can be difficult to define. It is important to note, however, that social class does not refer merely to economic status — it also refers to other forms of capital available to an individual. In his 1986 essay “The Forms of Capital,” Pierre Bourdieu identified three different types of capital:

  • Economic capital — command of resources such as money, assets or property
  • Social capital — possession of a network of relationships that provide access to power, recognition or economic or cultural capital
  • Cultural capital — possession of education, knowledge or skills that provide an advantage when trying to obtain a higher social status

In the context of higher education, class privilege can present itself not only through differences in the amount and kind of capital available to students, but also through institutional and programmatic policies and expectations that privilege the holders of different types of capital over those who do not possess that capital. When students lack capital in comparison to their peers, or when they encounter institutional and programmatic policies that assume access to capital that they do not possess, they can experience marginalization and oppression. When marginalization or oppression occurs based on social class, it is referred to as classism

In our experience as graduate students and counselor educators, we have observed multiple ways in which class privilege and classism pervade graduate programs in counseling even as they go unacknowledged. We believe that ignoring students’ social class positions in counselor education programs facilitates microaggressions related to social class and perpetuates a system of oppression that must be acknowledged, explored and addressed if we are to truly live up to our ethical ideals.

Class privilege in counselor education systems

In 2019, a small group of counselor educators and counseling students began an informal discussion on the CESNET Listserv (CESNET-L) concerning the ways in which social class was perceived to create additional privileges and barriers for students in counseling programs. Participants in the conversation identified multiple ways in which class privilege is embedded in counseling programs. Their comments reflected experiences with class privilege based primarily on economic capital, although cultural capital and social capital were also mentioned. A review of that discussion follows.

Class privilege based on economic capital

Class privilege within counseling programs takes many forms, and although it may be overlooked by counselor educators, students are very aware of it. With respect to economic capital, participants in the discussion noted that class privilege is present from the very beginning of the training process when prospective students must be able to afford application fees and pay for required entrance exams such as the GRE graduate school entry exam. In addition, discussion participants pointed to the overall cost of counseling programs as a significant barrier and noted that many programs contain hidden fees that are not included in the advertised cost. These fees include such things as student activity fees, mandatory membership in professional organizations with significant dues, technology fees, fees for comprehensive exams such as the National Counselor Examination or the Counselor Preparation Comprehensive Examination, and graduation fees. Doctoral students, in particular, reported embedded expectations that they would attend conferences without any consideration of their ability to pay for travel, lodging, food and registration fees. 

In addition to the costs cited for applying to and attending counseling programs, there were concerns related to costs of living while enrolled. Participants in the discussion noted that students with dependents must find ways to cover child care or elder care and maintain an income that allows them to continue to pay for food, clothing and other household expenses. Because the majority of counselor training programs offer little in the way of grants or scholarships — particularly at the master’s level — the system appears skewed in a way that privileges those with greater economic capital who can afford the added financial burdens that come with enrollment. 

The unique problem of unpaid internships

The practicum/internship experience also exposes class privilege inherent in counseling programs. Practicum and internship experiences typically take about one year to complete and require students to devote between 10 and 20 hours per week to the experience. While the internship experience is an invaluable part of training, the vast majority of internships are unpaid. Some programs may even have internship policies prohibiting any form of payment.

This system inherently privileges those who can afford to give up full-time jobs to devote themselves to internship. Students who cannot afford that option find themselves trying to complete practicum and internship hours on top of working full time and attending classes. This creates a nearly untenable level of chronic stress and exhaustion that students who are more privileged do not have to bear. 

Class privilege based on cultural capital

Participants in the CESNET-L discussion also identified ways in which access to cultural capital creates advantages or disadvantages in graduate school. Among those identified were the quality of prior educational experiences, family members’ educational experiences and attainment, family expectations and support of educational attainment, and other experiences that supported educational attainment.

As much prior research has indicated, educational achievement is highly dependent on the quality of education beginning at the prekindergarten level and lasting through high school. Every year of educational experience sets the stage for the next and begins to build a set of advantages and disadvantages. Access to high-quality, heavily resourced elementary and high school education provides easier access to a college degree that prepares students adequately for graduate-level work in a counseling program. Gaps at any level leave students struggling to catch up. Students who did not attend high schools or colleges where writing was heavily emphasized, for example, may struggle to succeed in counseling programs that place a premium on strong writing skills.   

Another privilege that helps students access resources in graduate school is having family members or mentors who have enrolled in and completed higher education. Their knowledge can be capitalized on to navigate the educational system of graduate school. There seems to be a relationship between familial expectations and the willingness of students to take on the tough task of graduate school and then to stay enrolled. We are personally aware of students whose family members have not been supportive of their educational endeavors, interpreting the student’s pursuit of higher education as a rejection of the family’s culture. As they try to work on their degree, these students face the unenviable challenge of navigating a graduate culture in which they frequently feel they do not belong, while simultaneously receiving messages that they no longer fit in with their family either.

Class privilege based on social capital

Additionally, the CESNET-L conversation touched on aspects of privilege that are related to social capital or the ability to build social networks that support access within graduate programs and to employment. Generally, social capital is related to extracurricular activities and family occupations that result in networking opportunities. In counselor education programs and employment, social capital is built through program and department social events, conferences that allow and create networking opportunities, and other situations that support access to mentoring. 

The luxury of time is a frequently overlooked form of social capital. Students who do not have outside jobs, caretaking obligations or other responsibilities are able to attend extracurricular events, participate in honor society meetings and attend presentations at agencies in their communities. The same is true for students who have strong support systems that can be called on to help with their other responsibilities and obligations so that they can participate in professional events. Students without the luxury of time to participate in outside events and develop their networks can find themselves at a disadvantage relative to their more privileged peers once they begin searching for jobs.   

Getting to know our students and addressing class privilege

The CESNET-L discussion provided anecdotal evidence for the idea that class privilege is embedded in the structure of counselor education in multiple ways. But how extensive is the problem? In considering that question, we realized that we did not have any good data on who our counseling students really are with respect to class and class struggles. 

In an attempt to answer the question, research teams have formed to gather quantitative and qualitative data about who our counseling students are with respect to their social class and what their experiences have been with class privilege and classism. We hope that data culled from this research will provide the foundation for a more critical and comprehensive examination of our current training system and result in structural changes that make it easier for students from less privileged backgrounds to obtain a counseling degree.

In the meantime, we believe counselor educators can take some steps now to begin addressing class privilege in a more conscious way: 

  • Consider broaching the issue of class privilege with all students. Individual advising should include a discussion of barriers for students related to class. Group conversations during coursework about privilege and oppression can also incorporate class, alongside other forms of privilege due to gender, race or sexual identity. These conversations will help bring class privilege out of the shadows.
  • Implement a more formal process to survey students at different stages in the program to assess their levels of economic, cultural and social capital. These survey results can be incorporated into the program’s evaluation plan. For example, how many students would struggle to complete internship hours during the typical 9-to-5 workday? How many internship sites offer hours outside of that time frame that students can access? Should programs seek relationships with additional alternative sites that offer weekend and evening hours?
  • Develop aggressive fundraising strategies that emphasize the critical role counselors play in addressing the mental health needs of the community. For programs in universities with strong development offices, this may require advocating for greater visibility of the needs of counseling students among the university’s donors. For programs without strong development offices, it could mean advocating for the creation of a development position. Even if more funding for assistantships is not available, strategies can be developed to help students raise funds to attend conferences or other professional development activities. Any degree of financial help will decrease barriers related to economic privilege.
  • Reduce barriers to paid internships. If sites have the ability to pay students for internships, they should be allowed to do so. However, many sites simply lack the funding necessary to pay interns because they cannot bill for services provided by interns. This requires advocacy with managed care organizations at the state and national levels to allow agencies to bill for services provided by students under the supervision of licensed staff.   
  • Create a formal mentorship program in which students who desire mentorship are paired with faculty, graduates or, potentially, more advanced students in the program. Informal mentorship will, by default, favor students with more class privilege (those who have time to attend departmental events or informally attend office hours for faculty). A formal mentorship process decreases these barriers. Formal mentorship programs also create opportunities for the mentors (more advanced students, doctoral students or alumni) to add experience to their résumés.

Final thoughts

Graduate programs in counseling emerged in the mid-20th century, at a time when higher education was less expensive, costs of living were not as high, and families were easier to support on a single wage. Privilege in graduate education on the basis of sex, race, gender identity, age and other characteristics certainly existed at the time these programs were created and still exists today, but much progress has been made in the past few decades in terms of recognizing and actively addressing those barriers. Class privilege, however, has gone largely unaddressed, even as economic disparities widen. 

We acknowledge that the steps outlined above are not representative of an exhaustive list of all possible steps that could be taken to address class privilege in counseling training programs. However, we believe the steps provide a starting point for counselor educators to more fully enact the ethical call to work to reduce disparities by intentionally addressing class privilege in their program structures. We also hope that our ongoing research will lead to a greater understanding of who our counseling students are with respect to their social class positions so that we can create a training system that better meets the needs of students in the 21st century.

 

For additional information about class privilege and our research, visit our website at https://classprivilegeinces.wixsite.com/mysite.

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Related reading, from the Counseling Today archives: “Cultivating social class awareness in the counseling profession

 

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Cynthia Miller is a licensed professional counselor and counselor educator with a private practice in Charlottesville, Virginia. She has been a practicing counselor for almost 20 years, working with adults in university, community and correctional settings. Contact her at cynthiamillerlpc@gmail.com.

Frankie Fachilla is a licensed professional counselor with 12 years of full-time counseling experience in community mental health and correctional settings. She now provides trainings on evidence-based practices, supervision and coaching to clinicians in community mental health settings. Contact her at frankiefachilla@gmail.com.

Jennifer Greene-Rooks is a counselor educator with a research background in areas such as multicultural counseling competence, counselor preparation and supervision, school counseling, and leadership. Her background is in school counseling, although she now focuses on the preparation of multiculturally competent, social justice-focused counselors. Contact her at jgreene@txstate.edu.

 

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

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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.

Addressing the invisibility of Arab American issues in higher education

By Souzan Naser February 5, 2021

COVID-19 has wreaked havoc in just about everyone’s life, and it is not lost on me that individuals are deeply feeling the cost of this pandemic. Too many people are grieving the loss of loved ones, recovering from their own illnesses, suffering from food and housing insecurity, and coping with depression, anxiety and isolation. As we begin to settle in with a new presidential administration, we can begin to have a glimmer of hope that our country will take a more aggressive approach to managing the spread and treatment of COVID-19.

For me, the impact of the pandemic has been less severe, and I feel especially fortunate. I was reaching the midpoint of my sabbatical when the virus took hold and shelter-in-place orders were issued. Like many of those reading this article, I was scheduled to attend the April 2020 American Counseling Association Conference in San Diego, and I was thrilled to have been given the opportunity to present and facilitate a workshop. My presentation, adapted from my doctoral research, was to examine the paucity of Arab American cultural competency training available for college counseling professionals. I also planned to unpack the contemporary needs of Arab American students, their expectations when meeting with a counselor, and the factors that increase their likelihood of engaging with a mental health provider. I am passionate about this research, especially given the lack of adequate mental health services for Arab American students and how this affects their success.

In this piece, my aim is to amplify the micro-level personal concerns of Arab American students who participated in focus group sessions that I led, those whom I counsel and teach, and those more broadly who live in the Arab American community of Chicagoland (Chicago proper and its adjoining suburbs). I will also provide recommendations, based on feedback from students, so that we can keep pace with the contemporary challenges of this population and confidently assist them when they call on us for support while experiencing psychological distress.

Study background

Since 2015, I have been studying the preparedness of community college counselors to effectively engage with Arab American college students. Pre- and post-tests were used to assess counselors’ levels of cultural competency with Arab students. The post-tests were administered after counselors participated in a 90-minute professional development program called Understanding the Arab American College Student.

My study also included Arab American college students, who through a series of focus group sessions offered a rich critique of how the political landscape shapes their experiences and identities. The information they shared also captured the essence of who they are culturally, socially and religiously, and how they navigate their identities at home and school. They also shared the importance of having mental health practitioners who understand their worldview and can be turned to for support.

Background on Arab Americans

Arab American identities are vast and complex, and the Arab American students with whom counselors interact in their offices are just as diverse as the 22 countries these students emigrated from or have ancestral ties to: Algeria, Bahrain, Comoros Islands, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen. Members of this community have been immigrating to the United States since the late 1800s and have long been a part of the fabric of American society, making significant economic, educational and political contributions. According to the Arab American Institute, which is one of the longest-standing Arab civic engagement organizations in the U.S., it is estimated that nearly 3.7 million Americans trace their roots to an Arab country. Although Arab Americans live in almost every part of the U.S., more than two-thirds of them reside in just 10 states: California, Michigan, New York, Florida, Texas, New Jersey, Illinois, Ohio, Pennsylvania and Virginia.

There are many assumptions about Arab Americans that can interfere with the therapeutic process and alliance. For instance, Arab and Muslim are not synonymous; in fact, over 60% of Arabs residing in the U.S. are Christian, not Muslim. Arab Americans may be first, second or third generation. Some are fluent in Arabic and English, whereas others may speak only one. Another commonly held misconception revolves around the citizenry status of Arabs. Of Arabs in the U.S., 82% are citizens, the majority of whom are native-born.

Misguided beliefs, stereotypes and popular assumptions may lead us to view members of this community as one-dimensional, but in fact, Arab American students are distinct, so each student should be regarded as an individual with unique experiences.

Political stress

Although we lack data on students who have an Arab background because they are expected to identify as white/Caucasian on most college and university admission forms, a few campuses such as the University of Illinois at Chicago have some data illustrating that Arab Americans make up a significant portion of the student body. Additionally, the college for which I work sits in a congressional district that has one of the largest concentrations of Palestinians in the U.S. It is clear that we also enroll a sizable number of other Arab American students. Because Arab American students constitute a significant percentage of the college population — while simultaneously facing targeting and various forms of racial/ethnic exclusion — it is imperative that our field incorporates a mental health framework that honors this population’s sociopolitical experiences and cultural and religious background.

In addition to facing many of the same challenges that college students generally encounter, such as navigating academic stress, negotiating relationships with friends, and deciding on a major, Arab students are subject to an ongoing and unrelentingly hostile political climate. These students, their families and their communities at large are dealing with the impact of anti-Arab and Islamophobic foreign and domestic policies such as the global war on terror, the Muslim travel ban, mass surveillance, and racial profiling programs promoted under the “countering violent extremism” framework. These policies and programs trickle down into Arab Americans’ everyday lives in the form of hate crimes, discrimination and a generalized sense of fear.

All of this can contribute to the development of mental health issues or exacerbate already-existing psychological disorders. Focus group participants shared how repressive policies shaped by the Trump administration (especially the Muslim travel ban executive order) translated into their everyday experiences of feeling anxious, alienated, intimidated and untrusting of institutions that are meant to be supportive. Several students at the time disclosed their feelings of uncertainty with comments such as, “Personally, I was scared during the election and when Trump became president,” “There’s still some fear that I have about what he can and cannot do to us as Arabs or Muslims,” and “The Muslim ban was very traumatizing, not just to me, but to people who could not come back to the States when they left for vacation.”

In failing to understand the political stress our Arab students are enduring, and by neglecting to engage in meaningful and elevated conversations about political issues that concern them, we run the risk of these students prematurely terminating sessions. Students in the focus group spent a considerable amount of time discussing the factors that would discourage them from returning to see a counselor. The following quotes highlight some of the factors mentioned:

  • “It has to be a judgment-free zone, and if it isn’t, then I wouldn’t return to counseling.”
  • “I don’t want to be judged or misunderstood based on what they’re hearing about Arab Americans in the media.”
  • “There has to be a connection. The counselor has to understand me as an Arab American.”

Culturally competent practitioners must be able to monitor their biases and examine how their own racial/ethnic backgrounds may play a role in forging an authentic relationship with Arab American students. One of the biases mental health professionals may hold that could influence their attitudes toward this population is associating all Arabs or all Muslims with a potentiality for criminality or terrorism. These associations are not held exclusively by professionals in our field. Rather, they are common misconceptions that are the product of government discourse, domestic policies and campaigns such as the global war on terror.

In my research, nearly 70% of the counselors surveyed agreed that many people may hold negative attitudes, stereotypes, preconceived notions and biases about Arab Americans. Other biases, steeped in corporate media, include the portrayal of Arab and Muslim women as docile and submissive — victims of a backward culture and religion from which they need to be rescued. A student who participated in the focus group sessions indicated that they “worry about how counselors get their information about us. Are they getting [it] from media outlets, and how does this impact the way counselors work with us?”

Despite our every attempt as professional counselors to be supportive of Arab and Muslim college students, applying a one-size-fits-all approach without critically examining our understanding of how anti-Arab racism and Islamophobia operate may not serve their best interests. While many counselors who are committed to diversity may have backgrounds in some social justice/racial issues, they usually lack training in the area of Arab American exclusion and discrimination.   

Cultural considerations

While social injustice is a factor to consider when working with Arab American students, they, like any other students, also need to sort through a wide range of micro-level challenges. Family issues, intergenerational dissonance, acculturative stress and identity confusion are just a few of the personal stressors that may compromise this population’s emotional well-being.

In Arab society, family is central. Family is the conduit through which cultural continuity is promoted and through which the rich traditions and values of the homeland are invoked. Both the immediate and extended family are heavily involved in the enculturation, upbringing and decision-making processes of the Arab American students you counsel. Counselors may find that even through adulthood, Arab American students will not make decisions in isolation. Rather, the expectation is that they will consult with members of their family before deciding on a course of action. Because they come from a collectivist society, in which the needs and wants of the group supersede those of the individual, these students may hesitate to act if a course of action or decision does not mirror the values of the family, does not benefit the collective or is considered shameful.

Whereas the dominant white middle-class U.S. values emphasize autonomy and freedom to make decisions without having to defer to others, cultural norms in Arab families dictate the opposite. As clinicians, we should consider how the practice of encouraging students to differentiate their individual identity from that of their family is antithetical to most Arab Americans. When our Arab American students are feeling obligated by their family to make a decision that does not necessarily satisfy their own desires, we should explore how we can assist them in negotiating an outcome that meets their need without being seen as a betrayal to their family.

Rather than viewing these distinct cultural forms as dysfunctional or expecting our Arab American students to align with Euro-North American-centric ideals in order to be healthy and feel supported, I propose that we use the inherent strengths of their own heritage, culture and values. By doing so, we are demonstrating an appreciation for their background and worldviews. Focus group participants shared the importance of integrating their cultural heritage when implementing therapeutic techniques. One participant stated, “Non-Arab counselors need a better understanding of who their Arab students are and the mechanisms our parents use to raise us.” Another suggested, “Counselors shouldn’t assume things about us; they should ask us about our values, beliefs and customs.”

Although it cannot be emphasized enough that family represents a core aspect of Arab culture, we also come to learn that honor, respect, morality, hospitality and generosity are other dominant features of this group. When working alongside Arab American students, it is useful to keep these cultural norms in mind so that these students will feel heard, understood and appreciated.

Intergenerational dissonance — another common source of stress for Arab American students — can arise when students are feeling pressured to hold steadfastly onto traditions of cultural heritage or religious values with which they no longer identify. Students shared the stress of negotiating relationships with their parents, and the acculturation differences between them, with these types of responses:

  • “Our parents worry about us becoming ‘Americanized’ and disregarding our traditions and religious practices.”
  • “I think there are a lot of struggles that Arab Americans face, especially if they were born in America but their families were not.”
  • “We feel obligated to do what our families expect of us.”

Students also candidly shared how intergenerational dissonance leads to other points of contention, including students wanting more freedom than the parents are willing to give, and the negotiation of romantic relationships, marriage and career choice.

Often in immigrant families, the children adopt dominant white middle-class U.S. values at a much faster pace than their parents do. This can cause disharmony and disruption in family functioning. According to psychologist and scholar John Berry, a number of factors, including age at immigration, language fluency and the reason for leaving the home country, determine the ease and comfort with which individuals adjust upon immigrating to the U.S.

During the course of my research and my years spent counseling Arab American students, I have learned that some of these students have assimilated with ease into mainstream U.S. life but have determined that it is equally important to them to maintain the richness and beauty of who they are as Arabs. They view themselves as members of a collectivist people with a strong extended family network, a rich heritage and culture that informs their way of living, and (for some) a religious framework from which they draw strength and guidance. These students have learned how to effectively and strategically weave in and out of the American and Arab in them; they have found a way to manage the conflicts associated with intergenerational dissonance.

Students who are struggling with identity confusion, and pushing back against familial pressures, want to explore the facets of their identity on their own terms. Focus group participants explained the challenges of trying to live “on the hyphen” (as in Arab-American) and navigating the contradictory worlds in which they live:

  • “I feel like Arab students are lost and don’t know how to act. They’re like in between and unsure if they are more Arab or more American.”
  • “Our families struggle with understanding what it’s like for their child to be an Arab living in America. We struggle with being American at school, and we struggle with being Arab at home.”
  • “I live both the Arab and American life, but I feel like non-Arabs see me as the other.”

Arab American students face ongoing angst caused by trying to live out their hyphen, which involves modifying and massaging the parts of their heritage that they want to maintain and embrace and discarding those that are no longer meaningful to them. Negotiating the complexities of their identity is further complicated by living in a hostile political landscape in which they are generally made to feel unwelcome and marginalized.

During the time of my study, Arab American students were in the thick of grappling with the realities of a newly elected president who was targeting members of their community with a travel ban and threats of deportation. Students spent considerable time processing how the election cycle and rhetoric from Donald Trump left them feeling vulnerable and affected their sense of belonging on campus. One student stated that Trump’s jingoistic sentiments during the election period “[bred] all kinds of hostility and hate, not just toward Arabs, but all other minorities, and the results have been disastrous.” According to a 2017 report by the Southern Poverty Law Center, hate crimes against Muslims grew by 67% in 2015, the year that Trump launched his campaign for president.

Arab American students’ sense of security has been punctured by a hostile climate that criminalizes and scrutinizes them. Students are telling us that it is a complicated time to be Arab or Muslim, and they need counseling professionals to have an understanding of how their identities are being shaped by the political landscape. Considering these conditions, how do we establish safety in the therapeutic encounter? How do we affirm these students’ humanity and obviate their concerns?

Counseling considerations

To establish culturally responsive care to Arab American students, we need to consider both the macro-level political stress that is causing these students harm and the micro-level challenges that affect their psychological well-being. As counselors, we have a unique opportunity to strengthen understanding of the contemporary challenges Arab American students face and the therapeutic measures we use to address them.

These students are informing us that they will benefit from counselors who are familiar with family dynamics, intergenerational dissonance and identity confusion. As counselors trained in Euro-North American counseling theory and technique, we need to critically examine the applicability of these models to the Arab American student and modify the strategies we use so that they complement the worldview of this population. If we fail to do so, we may mischaracterize cultural norms, beliefs, values and traditions as oppressive or primitive, which could inadvertently shame the students with whom we are working. We may also construe or unfairly judge these students’ family interactions as unhealthy with blurred boundaries, or consider them enmeshed and fused, interfering with individuation and differentiation of self.

These terms, inherent in Western models of family therapy, are incongruent with the Arab American family system. Applying these concepts may unknowingly leave these students feeling judged, misunderstood or misheard and could lead to premature termination of therapy. Instead, we should consider reframing our understanding of Arab American family dynamics by viewing these interactions as loving, caring and uplifting, and meant to provide unconditional support.

In addition to the factors previously mentioned, students shared other elements that would discourage them from returning to see a counselor:

  • “I had a counselor who would advise me or come up with solutions that were more appropriate for non-Arabs.”
  • “I was given solutions from counselors that do not match what I am looking for or who I am.”

Those who participated in the focus group also explicitly let us know that it is a trying time to be an Arab American student. They are traversing a hostile political climate that is causing them psychological distress. Being well-meaning and using the compassion that called us to this field may not suffice. As counselors, it is our duty to intentionally address any gaps in our knowledge base concerning the roles that culture, racism and oppression play in impeding these students’ abilities to function academically and personally. If we neglect to do so — and if misguided beliefs, popular assumptions or personal biases go unchecked — we may unintentionally revictimize these students. To eliminate the potential for harm, we can monitor our sensitivity to the historical and current oppressions that Arab American students experience. This can be accomplished in part by attending professional development opportunities that increase our understanding of this population’s sociopolitical, cultural and religious needs.

Finally, we can help these students re-create and reimagine the world they live in by acting as agents of change who advocate for and work alongside them to eliminate institutional discrimination. This includes having conversations with administrators to critically examine our campus communities to determine whether we are taking the necessary steps to promote a sense of belonging for this population.

Institutional responsibility includes counting Arab American students on admission forms and monitoring any inequities that could leave these students feeling vulnerable and paralyzed. Our institutions of higher education should also take intentional steps to diversify the recruitment and hiring of faculty and staff to complement the demographics of their respective student body populations. Ultimately, the question that counselors and institutions of higher education should be asking is, “How do we help Arab American students feel safe, understood and integrated?”

 

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Souzan Naser is an associate professor and counselor at Moraine Valley Community College in Palos Hills, Illinois, where she has won awards for her work on increasing diversity on campus. Her doctoral dissertation addressed the paucity of Arab American cultural competency training available for counseling professionals. She was born in Palestine and raised on the southwest side of Chicago, in the heart of one of the largest concentrated Arab American communities in the U.S. Contact her at nasers2@morainevalley.edu.

 

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

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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.

Wanted: Bilingual and bicultural counselors

By Lindsey Phillips February 3, 2021

Successful therapeutic relationships are built on trust and understanding, so counselors can ill afford to have words and phrases become “lost in translation.” Cultural competency on the part of counselors is also crucial, especially as clients are becoming more linguistically and culturally diverse.

According to the 2019 American Community Survey conducted by the U.S. Census Bureau, 22% of U.S. households speak a language other than English at home, with 13.5% speaking Spanish. And this number will only increase in the years ahead. The Instituto Cervantes, in its Yearbook of Spanish in the World 2019, estimates that nearly 1 in every 3 Americans will be Hispanic by 2060, making the United States the second-largest Spanish-speaking country in the world after Mexico. The Pew Research Center projects that 19% of Americans will be foreign born by 2050, up from 12% in 2005. It also estimates that 82% of U.S. population growth will come from immigrants and their descendants.

The counseling profession emphasizes cultural competency, but evidence suggests that the mental health field as a whole isn’t keeping up with the rising demand for bilingual and bicultural services. According to survey results released by the American Psychological Association in 2016, approximately 10.8% of U.S. psychologists reported being able to provide services in a language other than English, with only 5.5% able to provide services in Spanish.

This lack of culturally competent services can take a toll on people’s mental health. “When clients can’t find a bilingual counselor, they become more isolated. Often, they don’t talk about their emotional issues because they don’t feel that they can be seen or understood on a linguistic or cultural level,” says Ingrid Ramos, a licensed professional counselor (LPC) and the director of the Bienestar (wellness) and Resilience programs at The Women’s Initiative in Charlottesville, Virginia. “Then, you see a worsening of symptoms.”

To better meet the needs of bilingual and bicultural clients, mental health professionals must become more culturally competent themselves. That goes beyond simply speaking another language or being aware of cultural difference. Clinicians need to be prepared to offer bilingual services and practice cultural humility, which requires better bicultural/bilingual training opportunities and supervision.

Finding the right words

Language is central to counseling because it allows clinicians to build rapport and better understand clients’ life experiences, thoughts and behaviors. But fluency in the client’s native language is often not enough to make a counselor linguistically competent in session. Olga Mejía, an associate professor of counseling at California State University, Fullerton (CSUF), acknowledges that mental health terminology doesn’t always translate. She often tells her counseling students, “There’s Spanish, and then there’s therapeutic Spanish.”

Although Spanish is Mejía’s first language, she admits she felt lost during her first clinical position after completing her doctoral program. Her clients and colleagues alike assumed that she could easily offer mental health sessions in Spanish, but she struggled to translate certain technical terms commonly used in the field such as confidentiality and the cycle of violence.

That’s because the process isn’t as straightforward as translating the words and phrases directly, Mejía explains. A direct translation often doesn’t take into account the cultural context and nuance between languages. Therefore, she advises her counseling students to translate the idea behind the terms rather than searching for the perfect word. For example, even if there isn’t a word-for-word match for boundaries in the client’s language, a counselor can explain that people often set rules or limits in relationships.

According to Ye (Agnes) Luo, an assistant professor of counseling at the University of North Texas, even explaining what a counselor is and how that differs from a psychologist can be challenging because some languages, such as Mandarin, use the same word to describe both professions. And certain countries may not distinguish between these roles the way that the United States does, she adds.

Luo, an American Counseling Association member and LPC in Texas who speaks both Mandarin and English, has learned that she can’t simply ask clients if they understand what counseling is because the client’s understanding of counseling may differ from her own. For example, she has worked with clients from Asian countries who expect counselors to prescribe something to “fix” their presenting issues. These clients viewed her as an authority figure rather than perceiving therapy as a collaborative process, she notes.

Interpreters must also be aware of the nuances involved in the way mental health professionals speak. Ramos advises counselors who use interpreters to discuss the therapeutic process with them before going into session. “Our communication is our tool,” Ramos says. “How we say things, how we ask questions, how we reflect back to the client — that’s the counseling intervention.” Therefore, it is important that interpreters also understand how to communicate in this way when translating for clients, she points out. For example, an interpreter could accidentally misrepresent a counselor’s reflective statement by telling the client, “The counselor is repeating what you just said,” rather than translating the reflective statement.

Medical interpretation can feel more transactional, but because counseling involves emotional disclosure and vulnerability, it requires a certain tone and set of communication skills, continues Ramos, who serves on the board of Creciendo Juntos, an organization that provides support and resources for Latinx families and Latinx-serving organizations in the city of Charlottesville and Albemarle County. For this reason, the Virginia Department of Behavioral Health and Developmental Services distinguishes between medical and mental health interpreting, she says. For example, the agency underscores the importance of mental health counselors and interpreters meeting before a session, while acknowledging this is not always necessary in medical settings.

Counselors also have to be upfront with clients about their bilingual language proficiency, advises Luo, a counselor at C2 Counseling in Corpus Christi, Texas. When searching for her own personal counselor, she found a clinician who advertised herself as bilingual in Mandarin and English. But in their first session together, the counselor asked Luo if it was OK if she spoke in English, not Mandarin, because she had never used Mandarin in a clinical setting. Luo acquiesced, but it was not the experience she had desired or expected.

Cultural competency and humility

Counselors must consider the client’s country of origin, not just the client’s language. “Language is essential,” notes Mejía, a bilingual and bicultural licensed psychologist. “But [clinicians] have to have the language with the cultural competency or cultural sensitivity, along with the cultural humility.” For example, in Spanish, knowing when and how to use tu and usted (both words for you) changes depending on age, gender, seniority and familiarity. If counselors don’t have the cultural understanding of that distinction, then they could hurt their relationship with the client, and the client will not feel seen or heard, she says. 

As Alaina Hanks, a licensed professional counselor-in-training at the Gerald L. Ignace Indian Health Center in Milwaukee, points out, a lack of cultural competency can also have serious repercussions, including potential misdiagnoses. Some of Hanks’ Native American clients have told her that other mental health professionals previously misdiagnosed them as having schizophrenia or depression with psychotic features because they mentioned seeing spirits or receiving guidance from ancestors during a traditional ceremony. Counselors must listen to the client and learn about their culture to accurately determine what is connected to culture and what is clinically significant, she stresses.

“A huge part of [cultural humility] is understanding the history of where you are and what that means,” says Hanks, an ACA member who helped co-author the article “A collective voice: Indigenous resilience and a call for advocacy,” published on CT Online in February 2020. She advises counselors to start by learning the histories of the places where they live and work because these histories, in combination with current policies, affect clients.

Because Ramos, who is from the Dominican Republic, often works with clients from Mexico and Central America, she brings a sense of cultural humility and curiosity into session with her. Sometimes, her clients assume that she understands everything they say just because she speaks Spanish. She knows not to make that assumption. Instead, she routinely asks, “What does that phrase mean in your country?” If she still doesn’t fully grasp what the client is trying to convey, she will dig deeper and ask what the phrase means in their community or family.

“As a bicultural counselor, it’s important to remember that every culture has its own way of speaking about symptoms, illness and treatment,” Ramos says. To gain a better understanding of the presenting issue, she asks clients how they understand or see the problem and how their culture views their symptoms or behaviors. She also asks how people in their culture typically cope with these symptoms or behaviors.

Because Native American approaches to wellness are often about gaining balance, Hanks, who is Anishinaabeg and enrolled in the White Earth Nation in Minnesota, sometimes incorporates the medicine wheel when working with Native American clients. The medicine wheel is a sacred symbol used by many Indigenous tribes to represent all knowledge of the universe. It consists of a circle, divided by a horizontal and vertical line, with four colors (black, white, yellow and red). Each tribe interprets the medicine wheel differently.

In Hanks’ traditional teachings from her Ojibwe tribe, the medicine wheel operates as a way for Indigenous people to understand the world and their roles within it. “I have used it similar to a wellness wheel in helping clients identify where they need balance in their lives or finding ways to reconnect counseling concepts in a cultural framework,” she says. She also uses it to initiate conversations about grief and the cycles of life.

Although the medicine wheel is widely recognized among Native American populations, its use varies from tribe to tribe, Hanks says. For that reason, she cautions counselors to practice cultural humility and get training before incorporating the medicine wheel in their clinical practice. The same can be said about the use of any intervention that might speak more fully to a client’s culture but with which the counselor is largely unfamiliar.

Mejía urges counselors to be curious and culturally humble to ensure that they don’t fall prey to assumptions or black-and-white thinking about a culture. For example, in working with a teenage Latinx client, counselors shouldn’t automatically assume that the client is going to leave home to attend college. Instead, Mejía advises clinicians to slow down and consider: Why wouldn’t the client go away to college? What cultural factors might encourage the client to choose a college closer to home? What would it be like if the client did attend school away from home?

Striving to cultivate cross-cultural relationships

Ramos often uses narrative therapy to incorporate a client’s culture, family context and worldview — including their sense of spirituality — into treatment. She frequently uses Latinx cultural references, such as dichos y refranes (i.e., Spanish proverbs and sayings), to engage clients and make their culture and stories central to the session. For example, in a group format, Ramos may ask clients to share popular sayings used in their family, community or culture that relate to the dynamic the group is discussing. In the past, clients have mentioned dichos such as “El tiempo lo cura todo” (which is similar to “Time heals all wounds”) and “Dios aprieta, pero no ahorca” (which is similar to “When God shuts a door, he always opens a window”). This technique can help clients reconsider how they view themselves and their personal journeys, Ramos says.

Ramos doesn’t believe that counselors have to be proficient in Spanish to incorporate Spanish sayings into their practice. “The main point is always to use invitational language in the counseling setting to elicit the dichos and reflections from the client as a way to honor the cultural meaning the dichos might have for them,” she explains.

Ramos also focuses on cultivating the relationship from the second the client enters her office. In the United States, people have grown accustomed to filling out forms as soon as they enter a health facility, but that isn’t true for all cultures. Ramos points out that many Latinx cultures value personalism (i.e., person-to-person contact). So, she first gets to know her clients and discusses the forms with them rather than simply handing them the forms without any explanation.

Ramos has noticed that if she clearly explains the intake process to her clients who are immigrants or refugees, they are more willing to engage with the steps needed to get services. On the other hand, if she just hands these clients a form, they may hesitate to answer questions because they don’t fully know or trust her yet. Simply saying, “Welcome to the office. How did you find us?” or “How can we serve you today?” can be a nonthreatening way to start the conversation, Ramos suggests. “It doesn’t have to be a 30-minute intervention. It can be five to 10 minutes of explaining why they are here and what the process is,” she adds. 

Counselors also need to be sensitive to literacy levels. Asking clients to fill out forms may cause anxiety or shame if they don’t know how to read or write in their native language, Ramos points out. Cultivating that relationship for the first 10 minutes before having them fill out forms can help put clients at ease. Ramos then asks clients whether they feel comfortable filling out the forms themselves or might prefer her support in doing that. This is a simple way to dismantle the shame around any literacy issues so that focus can be put on clients’ needs, she explains.

Recognizing the need for bilingual/bicultural training

Given the increased demand for counselors who are bilingual/bicultural, there is a corresponding need for counselor education to include more programs aimed at preparing counselors to be linguistically and culturally competent. Unfortunately, says Mejía, an ACA member whose research focuses on immigration and the training of bilingual/bicultural therapists, there are not many programs like this currently in the United States, and for the ones that do exist, there are no standards for this type of training.

Mejía noticed that many of the bilingual counseling students at CSUF lacked the support they needed during their practicum training. They rarely had bilingual/bicultural supervisors, and they often had to translate documents, forms and counseling terms on their own without any guidance, she recalls. “They’ve been learning all the [counseling] skills in English, and all of a sudden, they are expected to do it in a different language,” which was intimidating and challenging, she says.

In response, Mejía started and serves as the director of the Ánimo Latinx Counseling Emphasis program at CSUF. The program consists of five master’s-level courses focused on helping students become self-aware as bilingual and bicultural counselors, knowledgeable of Latinx cultures and therapeutic Spanish, and familiar with interventions appropriate to Latinx and Spanish-speaking clients. It also teaches counseling students about social justice advocacy for issues relevant to the Latinx community and allows students, depending on their proficiency, to practice speaking Spanish in a clinical setting. 

Ánimo, which loosely translates to encouragement or spirit, is in its third year, and Mejía can already see the positive impact the program is having on the counseling students at CSUF. She frequently gets inquiries from students about the program, which speaks to the need for such training. But behind the program’s success is a harsh reality: It took 10 years of determination and dedication on the part of Mejía and her colleagues to receive the institutional support needed to bring the program to fruition.

Bilingual/bicultural training programs such as Ánimo also allow counseling students to support and learn from each other. The students in the program recently decided that they want to establish an Ánimo student group to build a supportive community for bilingual/bicultural counselors, which Mejía thinks is a wonderful idea.

Challenges faced by bilingual/bicultural counselors

Often, there is a cultural “tax” associated with being a bilingual or bicultural counselor. Mejía started the Ánimo program to help counseling students, but she doesn’t get consistent faculty release time (i.e., reduced teaching responsibilities to work on other projects) to fulfill duties related to the program, including training faculty, promoting the program, interviewing prospective students, attending meetings, and conducting exit interviews with graduating students. In addition, prospective and current students often seek her out — as director of the program — for advising and mentoring. Still, she finds a way to balance it all because as a first-generation college graduate herself, she knows how important these connections are and how valuable the program is to other bilingual/bicultural counselors. 

Sometimes, colleagues and agencies may expect bilingual counselors to take on additional roles — including ones that might be outside their scope of knowledge or training. When Ramos was an in-home counselor, she would support clients by attending school or social services meetings with them. Those agencies didn’t always schedule an interpreter because they assumed she would operate as both the client’s interpreter and therapist. “That put me in a situation where my mind that I wanted to use for the emotional support of this family now had to be used for interpreting,” Ramos recalls. Interpreting itself can be taxing, she adds, so she had to set boundaries and assert that she needed an interpreter in certain situations so that she could successfully perform her true job as a counselor.

Luo says some of her bicultural counseling students find it difficult to establish boundaries in session. If a counselor feels personally connected to a client because they share a language or similar culture, a danger exists that the counselor could overidentify and self-disclose too much, she cautions.

Isolation can also be an issue for counselors who find themselves in a region or clinical practice in which they are the only ones who are bicultural or bilingual. All counselors can benefit from participating in support groups with other helping professionals, but bilingual/bicultural counselors have unique challenges that may require them to find support groups with clinicians who also share these struggles, Ramos says. For example, a bicultural counselor may have high caseloads of people whose immigration or socioeconomic status affects their ability to access the resources they need, which in turn may affect their well-being.

Of course, it may not be easy to find this support if counselors live in an area without much diversity. Ramos offers the following suggestions for connecting with other bilingual/bicultural professionals:

  • Reach out to agencies within the community that provide mental health services to see if they have bilingual counselors on staff.
  • Find organizations that provide services to immigrants and refugees and that focus on education and advocacy. Although these organizations may not concentrate solely on mental health, they do work to identify the needs and gaps in services for these populations, Ramos says. And counselors could collaborate with these organizations to build a resource network.
  • Check with the counseling or social work departments at local universities and colleges to find alliances of refugees, immigrants or other minority groups.
  • Attend online webinars and trainings, which are more widely available now because of the COVID-19 pandemic. These events will help counselors connect with other bilingual and bicultural providers.

Improving supervision for bilingual/bicultural trainees

One of Mejía’s motivations for starting the Ánimo program was the lack of available supervisors who are culturally and linguistically competent. A supervisor’s lack of cultural competency is a barrier for counselors-in-training, Mejía asserts. Students often tell her they feel unheard or overlooked when their supervisor doesn’t understand an issue they have as a bicultural counselor or as a counselor working with a client from a different culture.

Mejía also gets frustrated when supervisors ask their trainees to translate another colleague’s session or the clinic’s forms or to answer the phones because they are bilingual. Trainees are not compensated for this work, and these tasks don’t count toward their clinical hours, she points out. Mejía often asks supervisors, “Would an English-speaking trainee be required to do this?”

Ramos has noticed that bilingual/bicultural counselors-in-training tend to dismiss their own feelings and challenges when they don’t have a supervisor who is culturally competent. They may think that they are the only ones dealing with an issue and hesitate to bring up their concerns with their supervisor. “Having a supervisor who can relate culturally with the population you are serving can fill the gap needed in support for the counselor,” she says.

As Hanks observes, it can be challenging for supervisors and counseling professionals who have been in the field for a long time to admit that they don’t know something. But taking a reflective and humble approach to supervision helps bicultural counselors to feel seen and heard, she says.

Hanks recalls a positive experience she had with a supervisor who was curious and didn’t make assumptions. While working in a youth shelter, Hanks was approached by a Native American child because she assumed that Hanks, who is also Native American, would better understand her. Hanks’ supervisor didn’t address the situation by telling her to set better boundaries. Instead, the supervisor said, “I noticed this one child is really close to you. Tell me more about it. Tell me what you think is going on. What do you think about it clinically?” Those questions led to a productive conversation about Hanks’ therapeutic relationship with the client.

Luo has always had supervisors who were culturally different from her, and none of them asked about how their cultural difference affected the dynamics of supervision. Luo encourages supervisors to be the ones to initiate these conversations rather than waiting for trainees to bring up the topic. Now as a supervisor herself, Luo makes a point to always address culture with her supervisees. For example, she might say, “As you have probably noticed, we come from different cultural backgrounds. Do you want to talk about how these cultural factors affect our relationship?”

Bridging cultural differences

In Milwaukee, Mark Denning of the Oneida Nation created the program Unity Fire to address challenges related to the COVID-19 pandemic and social justice struggles. The program is open to the public and uses Native American customs to help unite communities during a time when many people feel isolated, unheard and unsafe.

Hanks attended a unity fire held during the protest over the killing of George Floyd and remembers it being heavy with emotion. The firekeepers taught those attending how to offer a prayer into the fire using traditional sacred medicines. “There’s space at these fires for [cross-cultural] connection,” Hanks says. “That’s why they call it the ‘unity fire.’ It’s all about people uniting again.” 

Ramos’ agency — The Women’s Initiative — aims to create community partnerships. Its Bienestar program provides counseling in Spanish to Latinas and connects Latinx children and men with bilingual providers in the community. It also offers workshops and presentations centered on Latinx cultural values and resiliency, mental health issues, and cultural barriers that this population often faces.

Staff members at The Women’s Initiative also offer support groups for immigrant and refugee women. For example, Ramos led a basket weaving group, which for many clients was a way to connect a culturally significant craft with emotionally relevant concepts such as change, disappointment and resilience.

The Women’s Initiative also partnered with the International Rescue Committee and Hyojin Im, an associate professor in the School of Social Work at Virginia Commonwealth University and an expert on mental health services and refugee communities, to host trauma-informed cross-cultural psychoeducation (TICCP) leadership training for immigrant and refugee communities in Charlottesville. The TICCP program offers a series of workshops that teach bilingual leaders in these communities about the mental health impact of refugee and immigrant trauma and cultural adjustments to a new country.

TICCP has been a way to bring immigrant and refugee communities together and to create leaders within those communities from which others can learn about mental health, Ramos notes. These leaders “can help to make referrals and to deal with the stigma around mental health,” she adds.

Ramos loves connecting bilingual/bicultural therapists with immigrant and refugee communities and empowering these communities to be active participants in their own mental health. “Whenever I can bridge that gap [between cultures], I like to do it,” she says, “because I know it means a client or family will receive a better service.”

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

No rest for the bullied

By Laurie Meyers February 1, 2021

The climate of intolerance, anger and, to put it plainly, hate, that was encouraged to bloom during the past four years have kept Jessi Eden Brown busy as the professional coach for the Workplace Bullying Institute (WBI) and in her private psychotherapy practice in Seattle. According to the WBI, targets of workplace bullying consistently reported more frequent and more brazen attacks, crippling sabotage, and mobbing based on known or assumed opposition to the Trump administration. Brown has seen this trend playout in her private practice and in her coaching work at the WBI. In the weeks surrounding the insurgent attack at the U.S. Capitol, two of Brown’s clients reported that workplace harassment had escalated to personal property damage.

“One had, ‘Trump 2020,’ scratched into the hood of his car in the employee parking garage,” says Brown, a licensed professional counselor. “And the other told me his locker was broken into [and] the contents [were] soaked in red paint, one day after the U.S. Capitol riot.”

The division between mask-wearers and anti-maskers during the pandemic has also created a pernicious type of bullying, Brown says. “For example, one client told me that three workplace bullies have ‘fake coughed’ in her direction for months, often followed by snickering and occasional obscene gestures. She said she considered reporting the problem to HR or management, but her last grievance resulted in retaliation, so she has opted to try to ignore it and keep wearing a mask.”

The pandemic has also contributed to an uptick in bullying in other ways, Brown says. “At the beginning of the pandemic, many of my clients reported an overwhelming sense of relief as they transitioned to remote work [and were] no longer required to face their bullies in person,” she explains. “Bullying tactics such as micromanaging, nonverbal intimidation and public humiliation were dampened by distance. However, for some clients, that period of calm was short-lived, as bullies began to weaponize the very technology we rely on to work from home. Clients told me their invitations to essential Zoom meetings were ‘somehow overlooked.’ They talked about the relative ease with which bullies manipulate reports and documents, craftily overinflating their contributions and minimizing the target’s value.”

Brown’s clients have also reported feelings of mounting isolation as they face increasing levels of resource gatekeeping.

The economic collapse brought on by the pandemic is also being wielded as a weapon, according to Brown. One client’s boss regularly makes threats such as “This is not the time to be jobless, so you really don’t want to screw up next week’s presentation.”

Brown says that, understandably, most of her bullied clients fear leaving their jobs during the pandemic, despite the abuse they are subjected to.

“Sometimes there are ways to push back and advocate for yourself; other times that may only make things worse,” she says, noting that the outcome is highly situationally dependent. “I work with my clients to explore their options and refocus whenever possible on addressing their health. Setting boundaries, boosting self-care and seeking outlets for processing pain and frustration — all might help the client survive in the job until the outlook is more positive.”

“A couple of my clients have reached their absolute limits in dealing with workplace aggressors and have opted to resign, transfer or prematurely retire despite the extraordinary uncertainty of a global pandemic,” Brown continues. “One client is taking advantage of the opportunity to return to school and recast her career in a different direction. The other is taking a bit of time off, living on savings and repairing his health — knowing he has a financial cushion of exactly six months. As that deadline draws near, we will plan out the next steps and, ideally, he will reenter the workforce feeling a bit recharged and focused on creating a fresh start.”

These are difficult situations to face in counseling, Brown acknowledges, and she sometimes becomes concerned for the safety of her clients. “First, I listen to their account of the incident, allowing the client to process the fear, anger, confusion and vulnerability that comes with being persecuted,” she says. “From there, we talk about any steps — minor as they may be — to help the client feel safer.”

For example, because his house keys and wallet were in the locker when someone broke into it, Brown’s client decided to change all of his locks at home and add two more security cameras to his home system.

In cases that involve bullying that is potentially criminal, Brown and her clients discuss whether to file a police report or take any other formal action, weighing the costs and benefits of these decisions.

“I also research and pass along any specific resources that might offer additional support for my client, such as hate crime victim support groups, PTSD [posttraumatic stress disorder] groups … Unfortunately,” she says, “as things continue to deteriorate in our society, it is challenging to help these individuals fully regain a sense of safety, which is something we often recognize and address openly.”

“I have witnessed the combined effects of a divisive Trump administration, a deadly global pandemic and an intense racial reckoning precipitate enduring traumatic injuries on some of my clients. Often,” Brown concludes, “I think the repair and healing work we do in therapy is only just beginning, and even more challenging times lie ahead.”

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COVID-19 has largely redefined where people work, how people work and the workplace challenges that confront employees as they try to make ends meet. Read more in the article “Working our way through the pandemic,” in the March 2021 issue of 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.