Monthly Archives: March 2022

Counseling From a Survivor’s Perspective: Understanding the cycle of abuse

By Leontyne Evans March 18, 2022

Recently, I was facilitating a conversation around supporting survivors of intimate partner violence (IPV) in the workplace, and a clinician approached me afterward and said, “Hey, this was a great presentation. I now know how to better support survivors in the workplace and signs to pay attention to, but I’m not sure I understand intimate partner violence as a whole.” This was an eye-opening moment for me. I consistently go out and speak on this topic, but I never start at the beginning.

We first have to understand the cycle of abuse, a concept that originated with psychologist Lenore Walker in the 1970s, to better support survivors of IPV. It’s not enough to be aware of the cycle or have a diagram printed out; there has to be an understanding of what it is and how someone may find themselves in the cycle. When we seek to understand, it creates an opportunity for empathy to grow and biases to shrink. So, let’s break this down so we can be more impactful when serving survivors.

The cycle of abuse, also known as the cycle of violence, refers to common patterns of abusive behaviors, which are often associated with high emotions and periods of reckoning or revenge. The pattern, or cycle, repeats itself and can occur multiple times during a relationship.

This cycle is broken up into different stages (discussed more in the next section). But these stages don’t all happen at once, and the cycle will look different for every person. In some instances, the complete cycle can happen within a couple of hours, while other times, it may take up to a year to complete.

In short, the cycle of abuse is unpredictable and follows no rules.

The best way to conceptualize it is to think about the first time you went on a roller coaster ride: You feel the rush of excitement while waiting in line, but, as you get closer, a little anxiety creeps in. Then suddenly, it’s your turn! Your excitement, anxiety and fear all come together creating a beautiful storm of emotions.

The person operating the ride locks the safety bar in place, signaling your last chance to change your mind. You could back out now, but you’ve been waiting for this moment for so long you have to see it through. As the ride starts, your anxiety lessens. Everything feels good as the roller coaster ascends to the peak position. Even though you’re nervous, it still feels safe.

Then, all of a sudden, it drops! It all happens so fast. The ride descends rapidly, along with your stomach. Your heart rate speeds up as you are jerked side to side and up and down, and no matter how scared you are, you can’t get off. You’re stuck. No one can see you crying; no matter how loud you scream, there isn’t anything you can do except wait until it’s over.

The next thing you know, you’re on the straightaway: The ride slows down and you think you’ve survived the worst part. You start to feel safe; you can breathe again. But as soon as you take a breath and get comfortable, the ride takes another dive and the cycle starts all over again.

Survivors of intimate partner violence also experience periods of happiness, thrill and excitement in their relationships, so it’s not as easy as one may think to “get off the ride.”

The five stages

In an abusive relationship, the abuse starts way before it ever becomes physical. It is well-known that the cycle of abuse includes four stages (tension, incident, reconciliation and calm), but from my experience, I argue there are actually five stages:

1) Trust building. This stage, similar to any other relationship, is where someone establishes an emotional connection, and may even fall in love. In unhealthy relationships, this typically happens extremely fast. Two people meet, create a trauma bond and become the center of one another’s lives within days or weeks. Like the first time someone rides a roller coaster, it’s new and exciting. Even though they may be nervous, the anticipation of seeing where things will go outweighs the concern. (The initial excitement of the ride.)

2) Tension building. This is when the impending victim begins to notice a change in their partner. Some abusers may become clingier, whereas others may be more distant. They may become angered or irritated with small things that typically wouldn’t upset them. This change isn’t connected to any particular life event. This is what causes the victim to feel confused. One minute things are going so well, causing the victim to wonder what they could have done to cause someone to go from being the nicest/sweetest person to being mean, cold or dismissive. (The ride ascends as tension builds.)

3) Incident of abuse. The abuser releases the tension and engages in abusive behaviors. These behaviors may not be physical; they can be emotional, mental, financial or even spiritual. This may show up as insults or irresponsible behaviors such as spending money that was designated for the household bills. Maybe the abuser stays out all night or hides the car keys. The victim may believe they are responsible for the abuser’s actions and that this abusive behavior stems from something they did to cause the tension or change. (The ride descends rapidly.)

4) Reconciliation. During this stage, the abuser expresses remorse and what appears to be genuine regret for their behavior. They may even make the victim feel guilty for “causing the behavior.” The victim, who is still questioning their emotions and processing what happened, may feel a sense of relief that things are going back to “normal.” (The straightaway.)

5) Calm. After reconciliation, there is usually a sense of calm after the storm. This period of time could last for several weeks or months, depending on the abuser. The extra love and kindness from the abusive partner trigger a reaction in the victim’s brain that releases feel-good and love hormones known as dopamine and oxytocin. This release of hormones makes them feel closer to their partner and as if things are back to normal. (The ride slows down.)

However, right when the victim starts to heal and believes it won’t happen again, the ride starts to ascend, tension begins to build, and the cycle starts again.

What counselors must understand

When I host workshops on IPV, I often say, “Put yourself in their shoes; meet the survivor where they are.” And without fail, there is always a professional in the room who responds, “I couldn’t even imagine.” But the truth is we have all been abused and misused by individuals to some degree — maybe not to the same extent as IPV — but the emotional dilemma that weighs on you is similar. We’ve all been on our own emotional roller coaster.

Maybe you had a friend whose behavior made you question whether you were really friends. Some days they were really nice, but other days they made you wonder if they liked you at all. Maybe there was a family member that you just wanted to feel loved by, but no matter how hard you tried, you never got the love you desired. What about that person you wanted to make proud, but they always made you feel like your efforts weren’t good enough? Maybe you have experienced the heartbreak of having a family member or friend only want you around when it benefited them.

When I tell people this, they say, “But I wasn’t in an intimate relationship with the person who mistreated me.” I would like to challenge that as well. Intimacy is defined as a feeling of closeness. Because intimacy is involved in all relationships (even work relationships), we have all had an experience of being mistreated — to some degree — by someone we have been intimate with or felt close to. When working with survivors, remember what it felt like for you to have this experience with someone you loved.

I am sure you are wondering, “As professionals working with this population, how do we help clients get off this roller coaster ride?” I am so glad you asked! As mentioned earlier in this article, the first step is understanding the cycle. If someone is on this roller coaster ride, they can’t just get off. It’s too dangerous.

But we can help them prepare for the ride until they are ready to get off. Safety planning is essential. We can help the client to identify signs of each phase and ways they can remain as safe as possible. Introducing the client to the cycle, helping them understand the current stage they are in and identifying strategies to stay safe during every phase lessens the shock and helps the client feel more prepared. Similar to how counselor help clients manage their anxiety triggers, we can help the client prepare for what’s coming, so it doesn’t pose as much of a threat. The more they know, the more prepared they will be to exit the cycle when it is safe for them to do so.

How to be a supportive ally

Become knowledgeable about the cycle of abuse so you can identify which stage the client is in. Then you are in a better position to help them to become more aware of this cycle so they can learn to identify the stages on their own.

And continue to educate yourself. Remember the more you seek to understand, the more helpful you can be.

Stephen Hateley/Unsplash.com

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Leontyne Evans works as the survivor engagement specialist for Survivors Rising, where she helps to empower and uplift survivors by providing education and resources that encourage survivor voice and self-sufficiency. Her monthly Counseling From a Survivor’s Perspective column for CT Online aims to help clinicians better understand and serve people who have experienced interpersonal violence. She is also a published author of two books, Princeton Pike Road and Relationships, Friendships and Situationships: 90 Days of Inspiration to Keep Your Ships From Sinking, both of which support her mission of ending the cycle of unhealthy relationships. Contact her at leontynesurvivorsrising@gmail.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.

Behind the Book: Counseling Leaders and Advocates: Strengthening the Future of the Profession

Compiled by Lindsey Phillips March 14, 2022

The future of the counseling profession depends on the leadership and advocacy of its current and future members. But what makes a good leader or advocate and what can clinicians learn from current counseling leaders?

Counseling Leaders & Advocates: Strengthening the Future of the Profession, an ACA-published book co-edited by Cassandra Storlie and Barbara Herlihy, explores these questions by examining the personal and professional experiences of prominent leaders and advocates in the field.

The profiled leaders in this book do not name a single leadership theory that guides their work, but as Storlie and Herlihy point out in the introduction, they all “speak of leadership as a process of empowering others and as an opportunity to advocate.” They don’t “espouse a traditional view of leadership as a power-over position,” they note, “rather, they speak of ‘leading from behind,’ working ‘behind the scenes,’ and ‘leading by doing,’ not for their own aggrandizement but to move our profession forward and improve services to our clients.”

The COVID-19 pandemic and systemic racism and injustices will continue to challenge leadership and advocacy. Storlie and Herlihy hope this book will encourage the next generation of leaders and advocates who, they argue, “must embrace the complex issues facing our clients, the profession as a whole, and our national and global societies if we are to advance and continue to distinguish excellence in professional counseling.”

Q+A: Counseling Leaders and Advocates: Strengthening the Future of the Profession

Responses are written by editors Storlie and Herlihy. Storlie is a licensed professional clinical counselor supervisor and an associate professor and doctoral program coordinator in the counselor education and supervision program at Kent State University. Herlihy is a professor in practice and doctoral program director in the counselor education program at the University of Texas at San Antonio as well as professor emeritus in the College of Education and Human Development at the University of New Orleans.

How are leadership and advocacy similar and how are they different?

As counselors, it is natural for us to consider ourselves advocates. We advocate for clients, groups, families and communities and on behalf of our profession. Advocates are driven by a passion to make positive change in the lives of their clients, in the systems that contribute to marginalization and oppression of clients and client populations, and in the profession for the purpose of increasing our capacity to reach and help those in need. Yet, many of us do not consider ourselves leaders.

Leadership and advocacy are inherently related, and advocacy initiatives taken on by counseling leaders affect our world today. Most importantly, leadership in counseling has been emphasized from the servant leader perspective (a phrase coined by Robert K. Greenleaf in 1970). The leaders profiled in our book did not view leadership as a power-over position. Instead, they saw it as leading by doing and working behind the scenes for the sake of moving the profession forward and improving client services. As such, one can deduce that leadership in counseling is ineffective when leadership practices move away from our core values as professional counselors. That said, if you are a leader in counseling, you are most likely an advocate. If you are an advocate in counseling, you are most likely a leader!

What qualities or personal characteristics are essential to being a good leader or advocate?

Taking information from the areas of servant leadership (Greenleaf, The Servant as Leader, 1970), authentic leadership (Bill George, Authentic Leadership: Rediscovering the Secrets to Creating Lasting Value, 2003) and transformational leadership (Ronald Piccolo and Jason Colquitt, “Transformational leadership and job behaviors: The mediating role of core job characteristics,” 2006) literature, good leaders and advocates share power and allow for space to include all voices. They are genuine, relational, ethical, motivating and inspirational. In addition, given the challenging times in which we are living, it is essential for leaders to be adaptive and to help others understand the complexities of their environment to better help people deal with change.

How does being culturally responsive change the way a counselor approaches leadership?

We don’t know where we are going if we don’t know where we have been. By striving for culturally responsive counseling leadership, we embark on a journey in which we voluntarily accept both the privilege and responsibility of intervening. Culturally responsive leaders will help our profession become stronger and more inclusive, representing more diverse voices and combatting systemic injustices. These leaders also examine how their intersectionality (a term coined by Kimberlé Crenshaw) affects others. They focus on challenging their worldviews to uncover unconscious bias and move forward reflectively to ameliorate barriers to inclusion.

Leadership does not always mean serving in formal positions (e.g., president of a counseling organization). What other ways can counselors be leaders and advocates within and outside the profession?

Formal leadership is just one of the ways you can be a leader and advocate in our profession. In Chapter 3 of the book, Michael Brubaker and Andrew Wood highlight previous scholars who have shown us the importance of developing advocacy dispositions, relationships and knowledge to set up and best execute and evaluate advocacy plans. These efforts can be conducted within the counseling profession or outside the profession. We also think it’s important to carefully select counseling sites or populations you work with and partnerships that allow you to best formulate your leadership and advocacy plans. Perhaps it’s partnering with a school district or joining a local National Alliance on Mental Illness (NAMI) group to better support the mental health needs of your community. There are myriad ways in which counselors can be leaders and advocates — and as we mentioned earlier, you probably already are!

What are some key takeaways from the stories of counseling leaders and advocates in the book?

Ahhh … key takeaways! Well, one thing that stood out for us is how many leaders have served as role models and mentors to others within the profession, and how deeply they appreciated their own mentors. Additional principles that were woven throughout their stories were having a vision for the future, encouraging and empowering others, recognizing the contributions of others, and engaging in self-reflection. We think it is also important to point out that each leader shared their own experiences of adversity that they overcame — showing us that these individuals, who have passion and purpose, also had to dig deep to gain resilience as leaders and advocates.

How do counselors overcome challenges and setbacks in their career and how does this shape the leader or advocate they become?

Of the leaders and advocates we profiled, each had their own unique challenges and setbacks. As Devon Romero, Madelyn Duffey and myself (Cassie) synthesized in Chapter 17, these leaders were “People who encountered doubt and persevered in the face of grief, loss, and adversity … [and] who made mistakes and desired to learn from them. …[This] adversity shaped who they are, how they lead, and what they value.”

One of the ways counselors can overcome challenges and setbacks in their career is to use their skill sets to be reflective about what they are experiencing. Both of us have reflected on setbacks in our own careers and found it helpful to explore what we have learned from the challenging experiences. If we can use a professional challenge to bring added value to our lives, then we are navigating our professional journey with perseverance.

What role do mentors and supervisors play in shaping new leaders and advocates in the profession?

Mentoring is crucial for the development of new leaders and advocates. Good mentors are those who make time to be available to their mentees (often throughout several decades), who convey a belief in these mentees when they don’t yet believe in themselves, and who open doors to provide opportunities to gain leadership and advocacy experience. Mentors can also be sponsors in that they are looking out for possibilities for their mentees when those mentees are not present.

We believe that being a good role model and truly modeling culturally responsive leadership can be a valued lesson for mentees. My (Cassie’s) mentors have been and still are culturally responsive leaders and open to growth in their own development as professionals and individuals.

The counselors profiled in the book spoke with gratitude of their own mentors, and they took pride in the mentoring they have provided to others over the years. Our current leaders and advocates have a strong commitment to “pay it forward,” which seems to make it inevitable that this commitment will transfer to the next generation and to generations to come.

What practical advice do you have for counselors as they move into leadership and advocacy positions in the counseling profession?

In the book, we offered five suggestions for aspiring leaders and advocates. First, find a mentor. Mentors can help you navigate your way toward gaining leadership experience and learning to advocate in ways that fit with your passions. Second, start small. Most of us have difficulty even imagining ourselves ever becoming as accomplished as the leaders and advocates profiled in the book. Rather than immobilize yourself with comparisons, realize that opportunities for leadership and advocacy are all around you, and volunteer for a small opportunity to serve a cause about which you care deeply. Third, keep your balance. This suggestion serves as a reminder of the importance of self-care and life-work balance. Fourth, lead to serve rather than acting out of a need to fill a line on one’s vita or to feel important. Servant leaders are absolutely the most effective leaders we have in our profession. Last, trust yourself. If someone sees something in you, it’s because it’s already there.

What is the most important or surprising lesson you have learned about leadership throughout your own counseling career?

For Barbara, it was the realization that leadership is composed of a set of behaviors rather than holding a formal title or position. Many, if not most, of our leaders and advocates are working behind the scenes, fostering change and furthering social justice initiatives without a need for recognition.

I (Cassie) second all that Barbara outlined above, and I also want to point out the important need to intentionally “pay it forward” and help to mentor others’ leadership development.

What does being a leader mean in today’s social climate, especially considering the ongoing COVID-19 pandemic and social unrest?

That is an excellent question! In the current political and social climate, a starting point for bringing people together in peace is for us to use our basic counseling skills such as listening — really listening — in an attempt to understand beliefs and values that clash with our own. We counselors have the skills to build bridges!

We also need to ensure we can have the crucial conversations necessary to help make sustainable change. We recognize this change does not happen overnight, but we also realize that change will never happen if we don’t talk about uncomfortable topics and honor the human dignity of everyone.

What practical actions can leaders take to combat systemic injustices and racism in the counseling profession and society at large?

We believe that silence in the face of injustice and racism is collusion. Leaders who are in the privileged position of being respected and admired have an obligation to speak up and confront injustice and prejudice, both within our profession and in the larger world. Although practical actions may look different at the microsystem level versus the macrosystem level, counselors can tailor their actions to advocate with and on behalf of those most marginalized. Additional actions can be further developed when integrating the Multicultural and Social Justice Counseling Competencies into one’s work.

In the book, you call on the counseling profession “to nurture, mentor, and increase diversity among future leaders.” How can the counseling profession address the lack of diversity within counseling leaders moving forward?

One thing we can do is to monitor our own implicit biases as we identify up-and-coming leaders who might benefit from opportunities to join with us in the work we are doing. We can also remember that diversity involves the intersection of multiple identities, not just those that are visible. Many of the leaders profiled in the book were aware of their privilege and were committed to ensuring they were inclusive as they were “paying it forward.”

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Counseling Leaders & Advocates: Strengthening the Future of the Profession was published by the American Counseling Association in 2021. It is available both in print and as an e-book at counseling.org/store or by calling 800-298-2276.

Watch ACA President S. Kent Butler’s conversation with Cassandra Storlie in a recent episode of the “Voice of Counseling” video podcast: https://youtu.be/157o_3QrHwk

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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.

Other people’s monsters: A personal account of vicarious traumatization

By James M. Smith March 9, 2022

Last year, I was fortunate to have a piece published in Counseling Today with my co-author, Adrian Warren. The article, which appeared in the June 2021 issue, encapsulated our research on adult male survivors’ lived experiences of disclosing child sexual abuse.

Necessary to this research was the interview process in which I listened to the stories of men who had experienced horrific child sexual abuse, some by multiple perpetrators. These interviews took place over the course of about six weeks. I was bombarded with horror stories of emotional betrayal and sexual violence.

Then the nightmares started.

I can’t recall the exact date of my first nightmare, but I remember waking up angry and in a cold sweat after having dreamed that my youngest, 8 years old at the time, had been molested by a friend’s father. A few nights later, I dreamed I was beside my oldest son’s hospital bed after he was found beaten on a playground at school. In my dream, he was too ashamed to tell us who the perpetrator was or what exactly had happened. I woke up again in a cold sweat with a deep feeling of guilt that my son had been victimized. It took a minute for me to realize it was just a dream.

A few weeks after the nightmares started, my daughter, our middle child, announced she was planning to go to a sleepover at a friend’s house that weekend. “No, you’re not,” I blurted out without thinking.

My wife gave me an inquisitive look and asked, “Why not? We don’t have anything planned this weekend, do we?”

I couldn’t respond. I honestly didn’t know why I had suddenly become defensive, maybe even a little angry, about the thought of my daughter spending the night at a friend’s house. She had done it before many times, and we knew the family she would be staying with. My wife and I had been friends with this family since before our children were born. Why did I suddenly feel sick to my stomach at the thought of our daughter going to their home?

My wife made the arrangements. My daughter would go straight from school on Friday to her friend’s house with her friend’s parents, and we would pick her up around lunchtime on Saturday.

Friday loomed. The knot in the pit of my stomach grew heavier. Friday morning, I woke up in a cold sweat. Before getting in the car to take our daughter to school, I made sure she had her cell phone, a portable charger and her charging cable. I went over with her what numbers to call “if anything happened” and she needed us. I harped on it.

“Dad, chill out,” she said that morning. “You’re freaking me out a little.”

I was freaking myself out a lot. I checked my phone about every two minutes to see if she had called. When 9:30 p.m. rolled around, I called her. She didn’t answer. I was over the edge. I texted her and asked what she was doing. “Hanging out,” came the reply. She had just finished watching a movie, and they were getting ready to play some games. I spent that night in a state of near panic. I slept for maybe an hour and made sure my phone was on full volume and by my side the whole time.

Saturday morning came, and I couldn’t wait to go get our daughter. I was crawling out of my skin waiting. I almost called her at 6:30 a.m. to make sure she was OK. I sat that morning in a state of uncontrolled fear until we picked her up and she was safe with me again.

Mindfulness in action

The next day, as I nursed my cup of coffee, I realized I had not spent time in my mindfulness exercises all week. I have practiced mindfulness for more than 20 years. It was first introduced to me by Benedictine monks at a college I attended. Mindfulness exercises helped me manage depression and anxiety. When I became a counselor, I started integrating mindfulness into my own work with clients.

I put my coffee aside and went to my meditation chair. I have a specific place where I practice mindfulness exercises. The chair is comfortable but not so much that I fall asleep. It helps me sit up straight. I can put my feet on the floor or cross them underneath me depending on what is most comfortable on any given day. I went to my chair and began a mindfulness body scan.

I could feel how my feet rested on the floor with my ankles crossed. I could feel the bend of my knees and how my legs felt as I focused on each part of them. I could feel the pressure of my forearms resting on my thighs as my hands were placed in my lap, cupped in each other.

Yupa Watchanakit/Shutterstock.com

My attention moved up my hips and to my abdomen. Fear. There it was. Intense fear. The fear filled my stomach and rose up my chest like I was gagging on it. As I got in touch with that fear, I could feel my heart pounding and the tension in my shoulders, arms and neck. I noticed for the first time the stutter of my breath as I exhaled. I sat with this fear, recognizing the emotion of it. I accepted that I was afraid of something. I noted the physical sensations of fear and moved on with my body scan.

I spent the rest of the day paying attention to those physical cues of fear. I noticed how they intensified as my children talked about their activities. Every time my children mentioned their experiences of spending the night at a friend’s house or participating in some extracurricular activity, my stomach would knot up and my breath would quicken.

As I reflected on that fear in the coming days, I kept coming back to the same question: “What am I afraid of?”

“They’re going to hurt your children.” The voice was clear inside of me, although it felt a little alien.

“Who’s going to hurt my children?”

“Your friends. Your family. The abusers and manipulators. And you won’t know who they are until it’s too late.”

I had heard of vicarious traumatization in my academic studies, and it had always been an academic exercise: Identify the symptoms, prescribe intervention, promote prevention. I thought my academic understanding would be enough to insulate me from the threat.

Here I was though — nightmares, hypervigilance, intrusive thoughts, all underneath an anger that I didn’t understand. The worst part was the constant suspicion of everyone, even family members. As a counselor, I knew what these symptoms indicated. As a person, I wasn’t ready for the emotional toll they would take.

Support and self-care

I have always made it a point in my professional career to maintain a close-knit support group with other clinicians. Sometimes, I’ve been able to do this with co-workers in the same treatment organization. Other times, I’ve worked diligently to create my own professional support network. The iteration of my professional support network during this season of my life was a small group of three other counselors who met about every other week to talk and drink coffee. They were mindfulness practitioners too.

We visited with each other, and I let them know what was going on with me. Their response was more of a “Well, duh!” support than the kind of empathy that Brené Brown has spoken elegantly about, but that’s the kind of relationship we have. I told them I was kind of at a loss, and they helped me put together a plan and a series of exercises. They reminded me of the fundamental mindfulness concepts: radical acceptance, nonjudgment, compassion, patience, here-and-now focus. They reminded me to remain attuned to what I was paying attention to in my thoughts, to my emotions and to my body. They reminded me that the time to practice mindfulness is not when I’m in the grip of a vicarious trauma reaction or panic episode and most need to be mindful, but rather when I’m more relaxed.

Together, my support network and I worked out a plan of practice to address the experiences I was having. The first step was acceptance. I worked on accepting that the fears I was experiencing were not from my own lived experiences.

I found an image once of a woman walking down a darkened street. Her shadow was visible from a nearby street lamp, but behind her were the shadows of monsters clearly coming from a different source. This image summed up my understanding of vicarious trauma. Those of us in the helping professions can be haunted by the monsters that other people have faced.

We as counselors have many protective factors, including our knowledge, a developed self-awareness and strong support networks. While these protective factors may help us gain insight, they do not insulate us entirely from the vulnerabilities of our profession. Sometimes, we must accept the truth that we are not doing very well ourselves. The fear, nightmares, hypervigilance, suspicion and anger followed me but did not originate from my own experiences. Accepting that I was having these experiences was key to dismantling them.

The second step was to make sure I was engaging in my daily mindfulness practices. It has always been very easy for me to get busy and forget about the things that keep me well. I mentioned that I had not engaged in mindfulness practices the week prior to my daughter’s sleepover. That wasn’t because I deliberately chose to put these things on the back burner or to ignore my own needs. I just got busy.

Our practices for self-care are training for a marathon — training that needs to happen before the day of the race. We learn coping skills, just as our clients do, to make sure that we can manage our experiences as helpers. So many of the clients I have worked with through the years believe that they need to use the coping skills we review only when they are in the midst of dysregulation, be it panic, anger or addiction. We as counselors know that if a coping skill is not practiced before it is needed, it is not as effective as it could be when the time comes to use it.

The same is true of our own self-care. If the only time we engage in self-care is when we are on the edge of burnout, compassion fatigue or vicarious trauma, our self-care might stave off a crisis, but it won’t be very effective at keeping us well. So, I pledged to my support group that I would return to the daily practices that had helped me in the past. I made a commitment to them to practice mindfulness skills in meditation at least 30 minutes every morning, to exercise several times a week and to spend more time with my spouse and children. I committed to being mindful.

Finally, I used my support network. I have been to counseling in the past. It helped me immeasurably and put me on the path of becoming one myself. I am not opposed to seeing a counselor for my own individual therapy. Just as I encourage my clients, however, I decided to use my natural support network first.

These are friends in the profession with whom I have bonded. We meet regularly and speak openly to one another about our personal challenges. Sometimes we complain about our employers. Sometimes we complain about our employees. Most of the time we challenge one another to make sure we are taking care of ourselves, our families and our clients. I knew that I could sit down with them and say, “I think I’m having a vicarious trauma reaction.” I knew that they would hear me and help me recenter and get through it. Each time that we met afterward, I shared with them how I was doing on my plan to address these experiences.

Having this professional support is invaluable to me. We gather often to challenge, support and educate one another. This small group of clinicians is an important element of my self-care and ongoing professional competence.

Along with this professional network of support, I have natural supports in my life. I belong to a group of men that meets every Saturday morning for breakfast to share our stories of personal faith and to hold one another accountable as spouses and fathers. I shared with this group what was happening. They expressed understanding.

I also told my wife what was going on. She asked me if I wanted to stop letting our kids spend the night with friends for a while. I said just the opposite. I felt we needed to proceed as normal with our children’s activities, and I needed her to remind me that it would be OK.

This sharing of my experiences with my natural supports helped in the acceptance process. Talking about it with them and having to explain it at times helped me accept that it was happening.

Working through

I wish I could say that the nightmares, discomfort and anxiety stopped after a period of time. Word spread through my professional network that I had expertise in working with men who were survivors of child sexual abuse. This led to me getting more referrals of this particular client population than I had before. I have heard many more stories of abuse and betrayal since then. So, I continue with the regimen I established:

Regular meetings with my professional support network
Daily training in mindfulness practices that prepare me for the moments of panic I sometimes feel
Honesty with my natural supports in life, which helps with the acceptance that I have this vulnerability

The symptoms of vicarious trauma have not gone away, but I am managing better. I still wake up occasionally from a nightmare, but the nightmares are less intense. I still experience bouts of anxiety when my children attend sleepovers and other activities. I was out of my mind this past summer when my kids went to a swim party at a friend’s house. I practice deliberately shifting my attention to other things until they are home and remind myself constantly that my wife and I have done our due diligence regarding who our children are spending time with.

I caution counselors-in-training against acting as their own counselors. In this spirit, I continue contact with my support network of other counselors. I am radically honest with them about my self-care. These supportive colleagues helped me create a list of things I need to watch for as indicators that I should seek individual counseling myself.

In the final analysis, my experience of vicarious trauma did not affect my work with clients. Based on the feedback I receive from them, they continue to feel that I am present and empathic, compassionate and helpful.

No, this experience primarily affected my life at home and my relationship with my children. It wasn’t just that I wanted to crawl into a hole but rather that I also wanted to put my kids in a hole where I thought they would be safe. My fear was closing in around my children, making me want to shrink their world and experiences. It threatened their well-being as they continue developing into their outstanding selves.

Through this experience, I have learned that self-care for me means that I wrestle with other people’s monsters so that my children, wife and friends don’t have to wrestle with mine.

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James M. Smith is a licensed professional counselor, national certified counselor, approved clinical supervisor and board certified telemental health provider. In addition, he is a contributing faculty member with Walden University, a husband, a father, and a friend to a golden retriever. To contact him, email james.smith@mail.waldenu.edu.

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

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

Counselor burnout during COVID-19

By Carrie L. Elder, Elizabeth K. Norris and Leann M. Morgan March 8, 2022

As professors of counselor education at three separate universities, we share a vested and common interest in counselor wellness. When COVID-19 hit, we began researching burnout in counselors. There is a consensus in the profession that burnout is the gradual onset of emotional, cognitive and physical exhaustion related to work. Often there is a sense of dread and avoidance with completing work-related tasks.

Our thinking was that due to the demands on counselors and the heightened health scare during COVID-19, counselors would begin to burn out. We wanted to understand the relationship between the new pandemic and counselors’ levels of stress, burnout, resilience and self-compassion during this time. We asked ourselves how we could better understand this unprecedented phenomenon so that we could better support our students, our supervisees, our colleagues and ourselves.

After conducting three independent research studies over the past year, we discovered some surprising results that could help us define — and rule out — what issues counselors may be facing and what can help keep us well during our parallel experiences with clients during the continued evolution of COVID-19.

Surprising Evidence of low burnout rates

In the past year, we have been inundated with anecdotal information from online sources and peer-reviewed manuscripts that communicate how counselors are experiencing high rates of burnout while seeing clients during the pandemic. This is a fair and seemingly clinically sound assumption, except that our current research isn’t supporting this claim. Three independent research studies that gathered data from counselors across the country in 2020 and 2021 indicate that burnout rates in counselors remain low, which is consistent with reports prior to the pandemic.

Three months into the pandemic, we sampled 211 counselors and found an average burnout rate of 20.85, which fits in the “low” category. According to Henry E. Stamm, developer of the Professional Quality of Life Scale, a score of 22 or less indicates low levels of burnout; a “moderate” score ranges from 23 to 41. Most participants in our first study scored low on burnout (67%), with the remainder displaying moderate levels (33%). No participants reported high levels of burnout. In this first study, we found self-compassion and resilience predictive of lower levels of burnout.

Eight months into the pandemic, we conducted two additional independent studies looking at other predictors of burnout. In the second study, 252 counselors reported an average burnout level of 20.99, again in the “low” category. This study found compassion for self and others predictive of resilience, whereas empathy was predictive of burnout.

The third study surveyed a national sample of 125 counselors who reported an average burnout level of 22.09, which again is consistent with that of the “low” burnout category. This study found that counselors’ negative perceptions of their working conditions, maladaptive coping styles, decreased levels of compassion satisfaction, higher caseload volumes of clients with trauma-related concerns, and lower levels of resilience were predictive of burnout.

Low burnout rates are surprising and, again, seem counterintuitive, even when we take our own experiences into consideration. This isn’t to say that counselors aren’t experiencing burnout, however, because they are. They just don’t seem to be experiencing it any more than they did before the COVID-19 pandemic.

Admittedly, it is hard to define an experience when it is one the current generation of counselors has yet to practice and live through completely. The trajectory of COVID-19 variants is still unknown, so further defining the struggle that counselors may be facing can be beneficial in increasing our ability to maintain personal wellness.

So, what is preventing counselors from experiencing higher burnout rates given the added stressors we have all faced this past year-plus, both at home and at work? Our research indicates that counselor resilience during the pandemic is moderately high. These findings suggest that counselors may be uniquely suited to cope with the additional pressures of a pandemic. By utilizing skills taught in counselor training programs and supervision — including maintaining adequate self-care, maintaining healthy boundaries, practicing ethical decision-making and responding to crises — counselors seem to be able to maintain enough resilience to keep burnout levels low.

Pandemic fatigue

If we aren’t experiencing burnout, then what are we experiencing? Here’s what we think: The phenomenon of providing counseling during a pandemic has produced an outcome unique to COVID-19 — pandemic fatigue. It is time that we talk about what this means for counselors.

The World Health Organization defines pandemic fatigue as “a reaction to sustained and unresolved adversity which may lead to complacency, alienation and hopelessness, emerging gradually over time and affected by a number of emotions, experiences and perceptions.” Pandemic fatigue is dissimilar to burnout in that the exhaustion being experienced isn’t related only to our work as counselors but is woven throughout the tapestry of our lives as a whole.

To us, this makes good sense. Counseling during a pandemic means that we cannot leave all of our clients’ material at the office. Because we are all experiencing the pandemic — clients and counselors alike — we, as counselors, carry our own experiences of the pandemic home with us. Often, we are transitioning from holding space for our clients’ concerns related to the pandemic to going home and doing the same for ourselves and our families. In this context, we can start to see that it’s not necessarily the tasks related to counseling that are increasing burnout but rather the increasing demands on our personal lives that are leading to pandemic fatigue.

Fortunately, counselors are trained to respond in crisis situations. When the pandemic hit, we continued to provide care to the growing numbers and needs of clients, most likely by shifting to a new telehealth business model to safeguard our health and the health of our clients. We prepared for a sprint instead of pacing ourselves for a marathon. Although access to vaccinations has provided some health care workers an increase in psychological resilience, counselors are still in the race with no known finish line in sight for themselves or their clients.

When humans are confronted with a crisis, they draw on short-term survival instincts and systems. When circumstances drag on, new coping strategies need to be implemented to prevent or reduce behaviors that cause fatigue and demotivation.

Pacing ourselves

So, what can counselors do to pace themselves for the marathon we find ourselves in? Here are three suggestions:

1) Utilize parallel processes in supervision. Counselors shouldn’t be afraid to discuss fatigue, lack of motivation or other symptoms of pandemic fatigue with a clinical supervisor or colleague. Regardless of years of experience, talking about the exhaustion of providing care during the ongoing pandemic can have a dual benefit.

First, counselors can work with their supervisors to identify and discuss any guilt, demotivation, and lack of energy with clients, and ways of improving resilience in these areas. In doing so, the counselor participates in a parallel process that may trickle down to how the counselor identifies and treats pandemic fatigue in clients. Using the parallel process may increase new coping strategies and resilience in both counselor and client.

2) Practice compassion more and empathy less. According to neuroscientists Olga Klimecki and Tania Singer, empathy activates the pain network within the brain. In contrast, compassion activates nonoverlapping brain regions. In a subsequent study of counselors, increases in compassion (compared to increases in empathy) were associated with increases in counselor resilience. This means that counselors may benefit from practicing compassion to self and others. It also means identifying causes of suffering and working to alleviate them.

This contrasts with our practice of empathy. Empathy requires the counselor to take the perspective of the client by “trying on” their pain. When we practice empathy by putting ourselves in our clients’ shoes, our brains have difficulty distinguishing what is “ours” and what is “theirs.” Taking the client perspective requires an additional process of emotional regulation to distinguish others’ suffering from our own, which may add to counselor fatigue.

fizkes/Shutterstock.com

Practicing self-compassion may also aid in identifying and decreasing guilt associated with the counselor’s inability to treat as many people in need as possible throughout the pandemic. Recent literature has captured the moral challenges of counselors when they are unable to provide more services to the increasing numbers (and overwhelming needs) of clients. When we practice self-compassion, we address our desire to help others and the guilt that arises when we cannot do so, while offering lovingkindness toward ourselves in the midst of that guilt.

By engaging in this self-compassionate process, counselors are better able to extend the same care and consideration to their clients. After all, we cannot effectively lead our clients to a place we have yet to discover or experience ourselves.

3) Define personal space and time. Remember, slow and steady wins the race. It looks like we are in a fluctuating pandemic that has the potential to affect us and our clients for some time to come. Intentionally carving out time and space to come back to center so that we can choose what we do with our time (instead of ceaselessly dedicating it to work) can provide balance.

No, this doesn’t necessarily mean taking a spa day, getting our nails done or binge-watching reruns. Those coping strategies are good only in the short term to distract from stress. They might have been effective coping strategies during the first months of COVID-19, but they can quickly turn into maladaptive behaviors that prevent us from being in our feelings and really assessing what we truly need. Instead, we are asking counselors to pay attention to their thoughts, bodies and feelings and prescribe leisure time (and purposeful aloneness) accordingly. Healthier coping strategies may enable us to remain resilient for the long haul.

Summary

Why is this important? Yes, we have available vaccinations and boosters, businesses are back up and running for the most part, many children and adolescents have returned to school for in-person learning, and more counselors are seeing clients face-to-face. Even so, we have such little information about how professional counselors remained well during pandemics and crises prior to COVID-19. Because little can be gleaned from the past, we hope to provide additional context centered on counselors’ experiences during global crises. Based on our research, we have a better understanding of what is keeping us well and what we may need to do to maintain that level of wellness.

As a profession, it is easy to focus on the needs of clients and not to focus on our own needs. The truth is that by keeping ourselves well, we are better positioned to help our clients reach and maintain their own wellness. Additionally, when we are well, we are more likely to make ethical decisions.

Our mental health is not separate from that of our clients. When they are suffering more, we are more likely to feel its effects, much like a shared experience. Conversely, when we are suffering more, our clients too are more likely to feel it. During the pandemic, when both counselors and clients are experiencing the same challenging phenomena, our symbiotic relationship needs to be addressed.

Given the ongoing nature of COVID-19, the unpredictability of its variants and an undetermined end point for the pandemic, understanding counselor wellness during this time is imperative. Counselors have described feeling burned out, and this is mirrored in current literature. When tested, however, we did not find counselors to have higher rates of burnout than before the pandemic. Instead, counselors may be experiencing pandemic fatigue marked by chronic stress that impacts perceptions of events, increased exhaustion and decreased motivation.

To mitigate these symptoms, counselors can use parallel processes in supervision to reinvigorate both the counselor and the client, practice compassion toward self and others, and carve out time for intentionally addressing needs. Using new coping strategies may help counselors to pace themselves during the COVID-19 marathon and mitigate pandemic fatigue.

Considering the gradual onset of burnout, it is plausible that counselor burnout rates will climb as the pandemic continues. However, many of the coping strategies we recommend using to reduce pandemic fatigue should also help prevent increases in burnout.

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Carrie L. Elder is a visiting assistant professor and clinical coordinator at Mercer University in Atlanta. She is a licensed professional counselor (LPC), national certified counselor (NCC), certified professional counselor supervisor and registered art therapist. Contact her at elder_cl@mercer.edu.

Elizabeth K. Norris is an assistant professor of counseling at Denver Seminary in Littleton, Colorado. She is an LPC, NCC and board certified telemental health provider (BC-TMH). Contact her at elizabeth.norris@denverseminary.edu.

Leann M. Morgan is core faculty in the School of Counseling at Walden University. She is an LPC, BC-TMH and certified career counselor educator. Contact her at leann.morgan@mail.waldenu.edu.

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

Incorporating creativity into outreach on a college campus

By Melanie Broadwater March 7, 2022

So, you may ask, “What can a small college counseling center with a limited budget do to provide outreach to students during a worldwide pandemic that has dramatically impacted all aspects of campus life?”

Well, the answer to that question is “get creative”!

As the director of the Counseling Center at Thiel College, a private liberal arts college in western Pennsylvania with a combined undergraduate and graduate enrollment of a little over 800 students, I have had an up-close and personal glimpse into the ways that campus life has been directly affected by the COVID-19 pandemic.

The normal, everyday social lives of our college students became strikingly different at the onset of the pandemic. In March 2020, our students returned home to complete the spring semester virtually. Our campus was fortunate to be able to provide in-person learning throughout the 2020-2021 academic year through strict adherence to safety protocols, and for this we were grateful. However, life outside of the classroom was abnormal.

A once bustling campus, filled with the chatter of students in hallways and cafeterias, became unnaturally quiet. Our director of student activities did an outstanding job of engaging and connecting students through virtual events, which helped ease the disconnection that many students were experiencing.

Despite these achievements, I was very aware that there were students struggling under the strain of anxiety, depression and loneliness wrought by the pandemic. I also knew that some of these students were not connected to the campus Counseling Center. Our typical means of providing outreach and connecting with students were no longer feasible.

This led to brainstorming with my colleague and fellow counselor Jodie Witherite, a licensed clinical social worker, about how we could creatively reach students during a time in which in-person contact was limited.

Outreach efforts

The first thing we did was complete a project that was begun pre-pandemic but seemed to fit perfectly with our need to reach students while remaining socially distanced. Our project entailed developing three public service announcements (PSAs) that focused on suicide prevention and marketed the campus Counseling Center along with crisis resources. We worked diligently with our local suicide prevention committee and our college radio station to complete this project. These PSAs continue to be aired multiple times each day.

Next, we considered a way to bring unexpected cheer to our students and created “Boxes of Sunshine.” These small boxes contained a variety of items that were yellow, such as laptop stickers, banana Laffy Taffy candy, a bag of Lay’s potato chips and other small items that were inexpensive. The front of the box had a sticker of a smiling sun with contact information for the Counseling Center. The boxes were distributed as students entered the cafeteria to pick up their to-go lunches. Students were excited to receive their “Box of Sunshine,” with many expressing gratitude for this small gesture.

Several weeks later, I received a phone call from our vice president of student life asking if the Counseling Center would be willing to host this event again, with additional funds being provided to cover the expense. So, we followed this event with “Out of the Blue Boxes,” which were filled with blue items and distributed on a dreary winter day. “Irish Luck Boxes,” filled with green items, were provided on Saint Patrick’s Day. The students began looking forward to these events and were excited to see what surprises awaited them in their tiny boxes.

The Counseling Center typically hosts an annual “Stress Less Day,” when students gather to engage in stress-reducing activities such as receiving massages by a licensed massage therapist and spending time with a certified therapy dog. With the continued goal of making safety a priority, this event needed to be altered to ensure that students were not gathering in large groups. The result was an event termed “Donut Stress Day.”

Students could stop by at any time during a two-hour time frame. They chose a doughnut of their choice, served by a gloved and masked counselor, took a doughnut-themed craft with them to complete in their dorm room and entered to win a large doughnut-themed basket. This event allowed us to market the Counseling Center in a fun and lively atmosphere but without having students congregate.

We are planning additional events throughout the spring 2022 semester. The first involves distributing sealed bags of popcorn with the phrase “Just poppin’ in to remind you we are here,” along with contact information for the Counseling Center. These bags will be distributed by the counselors as students enter or exit the cafeteria for lunch.

We are also planning a workshop series titled “Coping Through Creativity,” which will use artistic and creative means to emphasize healthy ways of managing emotions and stress. These events will be held in a large room to provide opportunity for adequate distancing. The first session of the workshop series will focus on the benefits of journaling. Students will be given a composition book with a plain front and back cover. They will have the opportunity to decorate their journals as they desire with craft supplies that will be provided. They will be encouraged to make their journals a reflection of their own individuality. They will also be given a handout outlining tips on journaling.

Relying on others

Finally, with the Counseling Center seeing an increase in requests for treatment, along with more faculty members requesting that Counseling Center staff visit their classrooms, we are creating a video to promote positive stress management. It will also serve as a marketing tool for the Counseling Center. This video can then be played in classrooms, during athletic team practices, or at any function in which students may benefit from this information. Ultimately, this should reduce the amount of time that Counseling Center staff must spend away from the office and allot more time for clinical care of students.

Along with our outreach efforts, we also rely upon the good-faith efforts of our dedicated staff and faculty to steer students toward the Counseling Center when a need is recognized. In addition, trainings are provided to our Residence Life staff and to mental health-related student organizations to guide them in how to compassionately approach students who may be struggling with mental health concerns. They are taught how to make a referral to the Counseling Center and the process for seeking help in emergency situations.

The unique challenges of conducting outreach to students on a college campus during an ongoing pandemic has led to the stretching of both our imaginations and resources, which I have actually found quite fulfilling. Although there is no way to say with certainty that our outreach efforts have led directly to our growing caseloads, I’m of the belief that outreach has brought some students through our office doors who may not have entered previously. As we all look forward to life post-pandemic, I hope that through continued creativity, our small college Counseling Center will continue to reach students who may not have sought our services otherwise.

Monkey Business Images/Shutterstock.com

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Melanie Broadwater is a licensed professional counselor and a national certified counselor. She is employed by Thiel College as the director of its Counseling Center. Contact her at mbroadwater@thiel.edu.

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