Monthly Archives: September 2022

Disarming anger

By Bethany Bray September 23, 2022

Anger is personified in the animated Disney-Pixar film Inside Out as a stocky, red-faced character who is prone to mistrust and often takes things personally. He is easily upset and when he perceives a situation as unfair, he begins to yell and emit flames from the top of his head like a blowtorch.

Although the 2015 film was made with a younger audience in mind, many adults can easily relate to this character. The “flames” that erupt when Anger escalates may be figurative rather than literal, but it can feel just as real as depicted on screen.

Anger is one of a multitude of emotions that is a normal part of the human experience. Clients, however, sometimes avoid talking about their anger in counseling because it can be uncomfortable and hide emotions that may feel more vulnerable for them to reveal, says Kelly Smith, a licensed professional counselor (LPC) who has extensive experience working in the field of domestic violence, including helping perpetrators with anger issues. 

Counselors can play a key role in removing the barriers and stigma that keep clients from addressing their anger, Smith stresses. This includes making it clear that anger is a normal occurrence and something to address when dysregulated. If a counselor is qualified and open to helping clients who feel angry all the time, they should emphasize that on their professional website and bio information, she adds.

“People can struggle with feeling out of control. And sometimes that is expressed as anger,” says Smith, an assistant professor in the Department of Counseling at Springfield College in Massachusetts. “It’s important to normalize that this is something to get help for.”

Interrelated emotions

Anger can be such a complicated emotion that clients struggle to describe it or identify its nuances and connections. An essential first step toward helping clients understand their anger is guiding them to explore the full range of what they’re feeling, says Smith, a member of the American Counseling Association.

Several of the counselors interviewed for this article say they use an emotions wheel to guide clients toward understanding their anger more fully, including emotions that are interrelated. Smith says she uses it in every session as a discussion starter.

In addition to shame and embarrassment, anger can be connected to feeling threatened, overwhelmed, vulnerable, resentful, overlooked or unrecognized and a range of other experiences that clients may struggle to express or connect the dots, says Reginald W. Holt, an LPC in Connecticut and Missouri and a licensed clinical professional counselor (LCPC) in Illinois. 

Holt created and led an eight-week mindfulness-based relapse mitigation program that focused on emotion regulation, including anger management, with clients at an outpatient addictions treatment facility. Holt, along with Mark Pope, published the findings from this program in a 2022 article in the Journal of Human Services.

Holt says he noticed a common pattern of emotions among the program participants, all of whom were men on probation and parole. Many of the men would become angry — at their situation, at others or at the universe — when they experienced triggers, lapses or cravings for substances, he recalls. These feelings would often be intensified if the client was feeling unsupported because their family or loved ones had established firm boundaries or ostracized the client, which often happens within support networks when addiction and related behaviors cause problems, notes Holt, an ACA member.

When clients had relapses, their anger was often accompanied by feelings of remorse, powerlessness, frustration, defeat or fear that the rest of their life would be an unsuccessful, frustrating struggle to gain control over substance use, says Holt, a master addiction counselor, advanced alcohol and drug counselor and internationally certified advanced addiction counselor. This pattern would reoccur time after time until clients learned to recognize these interrelated concerns and respond, rather than react, to feelings of anger.

“Anger is the surface level, but if you dig down below that, it’s usually a sense of not having control and below that, a sense of fear,” he says. “It boils down, in some respect, to feeling overwhelmed, feeling helpless [and] feeling like it’s all too much.”

Exploring the origins

When a client appears to be struggling with anger, Smith recommends counselors conduct a thorough assessment for mental health issues that sometimes go hand in hand with anger such as substance use, domestic violence or abuse, posttraumatic stress disorder, borderline personality disorder, depression as well as medical issues such as brain injury or chronic pain. Clients who present with anger may need counseling work to address these other related issues first, either within the counseling sessions or in additional work with a specialist or in a group setting, she notes.

Anger can also be a “learned behavior,” says Toni Moran, an LPC and co-owner of a consulting and counseling practice in Denver. This was the case for Moran, who grew up in a household where there was a lot of yelling — and never an apology or repair. As an adult, it has taken a conscious effort to unlearn these patterns she saw as a child, she says.

Clients who, at an early age, witnessed caretakers, adults or even siblings default to anger and lose control of their emotions learn that it’s a way to connect, communicate, be heard and get one’s needs met. “It takes a lot of self-awareness and insight to say, ‘I probably could have handled that in a better way,’” Moran says, “And a lot of the people who are coming to me with anger problems weren’t modeled that in childhood.”

Moran and the other counselors interviewed for this article agree that delving into a client’s childhood and historical narrative can be a key way — for both client and counselor — to understand the context for their angry feelings and behavior.

However, Moran stresses that practitioners should use their “counselor intuition” to gauge how soon a client might be ready to talk about their childhood and the origins of their anger. Building rapport and trust with clients who struggle with anger should take priority, she says.

Alice Edwards, an LPC who specializes in helping clients with anger at her Houston private practice, agrees that questions about a client’s childhood can help shed light on the roots of their anger, as well as make it clear to the client that long-held patterns of anger and/or aggression will continue to plague them until they are processed.

Edwards begins these discussions by asking a client to remember the first time they experienced the type of anger that they struggle with now as an adult. She prompts them to recall how old they were, what was going on in their life at the time, how they felt and if the situation was ever resolved.

The counselor’s role, she says, is to guide the client with gentle questioning that can help uncover connections between past situations and patterns that occur in their adult life.

This was the case for a male client of Edwards’ who was struggling with problematic, angry feelings toward his work supervisor. Conversations about the client’s upbringing revealed that his father, who was in the military, had been absent a lot during his childhood because of work travel. And whenever the father returned home, he was extremely strict and often angry with the client. Exploring this history in counseling helped the client draw connections between his anger at his father and his anger at his boss and helped him move toward healing, Edwards recalls.

Diffusing anger

Humans express and present anger in different ways, which means each client will have unique needs and they may need to work on a variety of issues in tandem with their anger in counseling. These issues can include processing trauma, improving self-compassion, learning communication skills or conflict management, and working on better expressing their needs. And for some clients, it may be all of the above.

The counselors interviewed for this article, however, agree that clients won’t be able to delve into a treatment plan until they learn coping mechanisms to diffuse their anger in real time. They shared the following techniques to help clients learn to calm themselves, reflect and find ways to reroute their emotions to keep anger from escalating into problematic and negative patterns and behavior.

Breathing and mindfulness. Breathing techniques can serve as a useful and easily accessible way for clients to pause whenever they feel themselves becoming angry. Breathwork was the first layer of the mindfulness method that Holt used with clients in the relapse prevention program. Focusing on breathing often calmed the participants to the point where they could be mindful of their other physical sensations, range of emotions and five senses, which further helped them to slow down. The clarity of mind clients gained through this progressive mindfulness technique allowed them to reflect on the “rational and reasonable choices” they could make to replace anger as a response mechanism, notes Holt, an associate professor in the Department of Counselor Education and Family Therapy at Central Connecticut State University.

Breathing techniques work well as a primary and go-to tool for clients because they can bring the person out of fight-or-flight mode and reactivate their logical, problem-solving ability, Holt explains.

He encourages clients — and students, when teaching mindfulness as a counselor educator — to practice and hone these skills during mundane, everyday activities such as brushing their teeth, washing the dishes or taking a shower. Individuals can learn to focus on the temperature of the water or the taste of the toothpaste instead of letting their mind wander, he explains. And when it inevitably does, they can learn to gently lead themselves back to a mindful focus without self-judgment.

He challenges clients (or students) to gradually increase the amount of time they practice mindfulness, and then they discuss what did and didn’t work and what they learned when they debrief with him in session (or class). 

Safety planning. Creating a safety plan is a common and important practice in domestic violence work, but it can also be helpful for clients who struggle with anger, Smith says. The key is to create safety plans with clients before they need them and to have the client come up with the content. 

Clients can often identify how, where and why their angry behavior usually occurs, Smith notes, which makes them the best experts on ways that behavior can be diffused or curtailed. So the safety plan won’t have the desired effect unless the client, not the counselor, identifies the steps in their plan, she stresses.

For example, a client who has a history of physical expressions of anger might suggest removing the doors from the kitchen cabinets so they cannot be slammed or replacing metal or wooden drink coasters in their living room with cardboard ones so they cannot be thrown as easily, Smith says.

A client can also create a plan to use when they’re with a person or in a situation that usually makes them angry. Perhaps they come up with a signal to let a trusted friend or partner know when they’re starting to feel angry and need to take a break, she says. Then the client could go outside and take a quick walk or use other coping mechanisms to calm themselves.

Safety planning in this way ensures that clients have healthier alternatives at the ready to express themselves or release their anger, Smith adds.

Journaling. Journaling can serve as an outlet to document the strong feelings that clients who struggle with anger sometimes have trouble tolerating or understanding. Moran asks each of her clients to find or purchase a notebook for journaling as they begin counseling work together. Clients can often benefit from documenting their thoughts and tracking their progress in a journal, she says, but it can be a particularly helpful medium for clients who are working on anger issues. Moran sometimes suggests these clients turn to their journal after an angry incident to record the feelings and sensations they experienced and, in turn, reflect on what they learned.

Prompting clients to keep track of the events and interactions that happened before an angry episode, Edwards adds, can help them connect the dots between triggers and patterns that influence and lie underneath their anger.

Writing assignments, however, may not be a good fit for all clients. Edwards says that she sometimes encourages clients to record themselves (using audio or video) on their cellphones, which they can replay later.

Releasing through movement. Anger is an active emotion, so it helps to move one’s body to release it, Moran says. She sometimes teaches clients who struggle with anger a technique she calls “shaking leaf,” where they stand and shake their body to release tension, anger, frustration and related feelings. She says she often stands up and does this with clients to encourage them and illustrate the technique in session. Any movement that feels therapeutic to a client can be helpful in this way, she notes. Moran also finds that tapping and bilateral stimulation techniques can be useful for clients to process anger in the moment. 

Movement in the form of exercise played a key part in helping a client who once sought counseling from Moran after being written up twice at work for angry behavior, including throwing a chair. He had chronic stress that was unaddressed, and it escalated to a boiling point when co-workers were not completing tasks in a certain way, she recalls. He also felt intense shame about his behavior after the fact.

In counseling, Moran and the client found that a three-pronged combination of coping mechanisms —  physical exercise (walking his dog and riding his Peloton bike), journaling, and breathing and mindfulness techniques — provided the outlets he needed to release, process and reflect on the anger he was feeling. The client found it particularly helpful to do breathwork and body scanning in his car when he arrived at work each morning and at the end of his day before driving home, she says.

Moran counseled the client for two years and he was never written up by his employer again. By the end of their sessions together, he continued to journal regularly to process his feelings and thoughts, but the client no longer found work to be a source of frustration, she says.

Interjecting humor. Alison Huang, an LCPC with a private practice in Silver Spring, Maryland, often counsels clients who struggle with anger. When a situation seems unfair, clients who are prone to anger often take it personally, Huang says, so she sometimes takes a creative, humorous approach to help clients who react in this way to reframe the situation.

Huang often suggests that clients picture people who have made them angry as a minion, the yellow creatures who first appeared in the 2010 film Despicable Me. Loyal and loving, the minion’s childlike behavior and attempts to help often result in unintended mayhem.

Picturing the person who cuts you off in traffic, a difficult co-worker or your irritating neighbor as a minion makes it hard to get angry at them because they didn’t mean it and they don’t know any better, Huang explains.

She sometimes plays video clips of the minions for clients in counseling sessions as they talk through scenarios that made them angry. She asks clients: How would you feel and react if you were a bystander in this scene with the minions? How is it different than your reactions in real life?

Introducing the minions as a coping mechanism often makes clients laugh and instantly diffuses their anger, she says.

“Humor and reframing are a good combination for [addressing] anger. Having some laughs shifts their energy suddenly, softens their demeanor and increases their capacity for empathy for others and themselves,” Huang continues. “It’s very easy for those who struggle with anger to take things personally. [In counseling, try and] find ways for them to detach and keep from taking it personally — get out of that loop and find new thought patterns.”

Befriending anger

Anger is often viewed with negative connotations (both by clients and within society), but counselors can guide individuals to see that it is only negative when it’s dysregulated and results in unhealthy behaviors and patterns. When used in a productive way, anger can inform us, alert us and protect us — it can actually be a good thing, Moran says.

In fact, her goal, she says, is not to help clients get rid of anger — which is a normal human emotion and will always be present — but to help them learn to process it in a more constructive way.

Depending on a client’s needs and situation, Huang uses a combination of methods, including relational therapy, mindfulness, and acceptance and commitment therapy, to help individuals process anger and the deeper issues that sometimes underlie it, such as fear of abandonment.

According to Holt, the crux of helping clients overcome dysregulated anger is helping them learn to see it as an emotion to explore and learn from, rather than something to suppress or be overcome by. He aims to help clients rewrite their “automatic pilot” use of anger as a go-to response.

Offering the client psychoeducation on the nervous system and how anger can be connected to humans’ fight-or-flight response is an important first step in this process, Holt says, as well as teaching mindfulness techniques, such as body scanning, to help clients become attuned to how anger feels in their body and the physical cues that indicate it’s beginning to escalate, such as a clenched jaw or upset stomach.

“It can be an empowering experience [for the client] to acknowledge that ‘I felt angry and I sat with it, investigated it and realized that it didn’t have to overtake me,’” Holt notes. 

Drawing from psychologist Tara Brach’s RAIN method, Holt used mindfulness to teach the participants in the relapse prevention program to explore and learn from their anger. Brach’s acronym can be a helpful way to introduce clients to the idea of pausing to consider why they’re becoming angry and finding other ways to channel that energy, Holt notes. RAIN prompts users to:

Recognize what is happening

Allow and acknowledge that the experience is happening

Investigate it with curiosity

Nurture with self-compassion

Holt says the clarity that comes with this measured, calm response also helps clients to learn to take in the full context of an anger-provoking situation and assess whether it is a source of true harm or simply perceived harm.

It can be a hard thing to learn for those who have used anger to express themselves or react to uncomfortable feelings for a long time, Holt admits, and it will need to be repeated and practiced. It also requires them to be able to identify the full range of emotions that they’re feeling and deploy self-compassion.

This focus on exploring anger creates “an opportunity to slow down; become more intimate and familiar with your emotions as they rise, crest and fall; and be able to tolerate the discomfort of that in the moment,” Holt continues. And it introduces skills for “checking where the anger is residing in your body and befriending it, rather than being afraid of it and avoiding the impulse to discharge it immediately because it’s uncomfortable.”

Moran takes a similar approach with clients by using techniques to help them detach and separate themselves from their anger. For example, she says counselors can encourage clients to view situations that provoke anger with curiosity. It can be helpful for clients to consider why their anger is showing up now, she adds, and think through the events that led to these feelings by asking what activities they were doing, who they talked to and what happened earlier.

Slowing down to consider the potential reasons for and the context of their anger in this way can also help them identify needs that aren’t being met, and in turn, prompt them to communicate their needs instead of responding in anger, Moran says.

She also teaches clients who struggle with anger to rephrase their “I” statements. Instead of thinking or saying, “I am angry,” they can learn to describe it with language such as “I feel anger” or “Anger is showing up right now.”

It can be helpful to teach clients to view anger as a person who is coming to visit, Moran notes. “Have the client address it, [saying] ‘I see you and I feel you. What are you trying to tell me?’ It’s often trying to warn us that something’s not right. And when we ignore [its message], it gets to a boiling point.”

Anger’s aftermath

A final — and important — step for clients to overcome problematic anger is learning the skills to acknowledge when they have responded in anger or hurt others and apologize, when appropriate, Moran says.

She uses the repair techniques outlined in the Gottman method of couples therapy with clients — both individuals and couples — who struggle with anger. Depending on a client’s needs and situation, a person can work on repair individually by writing in a journal or recording their thoughts or collaboratively by speaking with others who were affected by their angry behavior.

Repair is helpful because it prompts the client to acknowledge what happened as well as its context, Moran says. “They can come back to the person or people who were involved and say, ‘I was feeling angry and this is why, and it wasn’t OK for me to do or say XYZ,’” she explains.

For clients, the process of making amends by verbalizing or writing how they felt and behaved during an angry episode can also help strengthen their skills of distancing themselves from their anger, separating facts from feelings and communicating their needs, Moran adds.

“When I see shame [in clients who struggle with anger], it’s often because their angry behavior resulted in hurting someone else or made them look bad,” she says. “I try and help clients separate themselves so they don’t see themselves as the emotion.”

Benjavisa Ruangvaree Art/Shutterstock.com

 

Clients who don’t see anger as a problem

Practitioners may encounter clients who describe angry feelings and behaviors in counseling sessions but don’t see them as inappropriate or problematic.

In some cases, anger has become such a go-to or automatic response for a client and a way to get their needs met that they don’t even recognize it as anger, says Kelly Smith, a licensed professional counselor (LPC). It can also be a learned and internalized behavior, especially when a person has not had examples in their life of people who deal with anger in a healthy way.

Smith, who has extensive experience working in the field of domestic violence, says this is not uncommon among clients who are perpetrators of abuse. She once worked with a perpetrator of domestic violence who mentioned in session that every time they were upset with their partner, they went into the kitchen and tightened all the lids on the jars so their partner would have trouble opening them.

This client described this behavior as playing “a joke” on their partner, recalls Smith, an assistant professor in the Department of Counseling at Springfield College in Massachusetts. They didn’t see it as an act of aggression or anger; they thought it was funny. 

“When working with perpetrators, they might not see themselves as angry, but it’s a part of their situation,” Smith explains. “They often minimize [anger], deny it or justify it to make it something other than what it is. They might say ‘I only did X …’ to make [behaviors associated with anger] sound smaller than what it was or deny that it was aggression or abuse in the first place.”

For example, one of Smith’s clients shared that in an attempt to leave an argument with their partner, they simply “picked their partner up to move them out of the way.” But the police report shared another perspective: This act of “moving” their partner resulted in a broken door. 

It may go without saying that clients who struggle with anger can benefit from learning coping skills to be able to calm themselves and respond in a less aggressive way. But, as Smith notes, individuals who minimize or ignore their anger may not be ready to learn these skills — let alone address the heavy issues that can dovetail with anger, such as substance use or trauma.

She recommends counselors find and focus on motivation to connect and prompt growth with these clients. For clients who minimize anger, this often takes the form of finding a reason to change besides wanting to avoid getting in trouble for their angry behavior (e.g., wanting to change because they love their spouse), Smith says. And, most importantly, these reasons for motivation to change must be concepts (or people) that the client, not the counselor, identifies, she emphasizes.

Clients may need to revisit these conversations and remind themselves of their motivation throughout counseling work for anger or aggression. Smith suggests that counselors prompt the client to talk about where they want to see themselves in 10 years: How will they behave? What will be different in their life? How will they handle things that have made them angry in the past? Then, have the client identify things they need to do one week, one month and one year from now to reach that 10-year goal, Smith says.

 

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

Voice of Experience: Diversity and third-culture kids

By Gregory K. Moffatt September 21, 2022

Pita Design/Shutterstock.com

My client was a 19-year-old female presenting with anxiety. She had just started college, and her anxieties had led to trouble concentrating and making friends, and they sometimes kept her awake at night. She was also troubled by the fact that until recently, she had been easygoing and didn’t get ruffled quickly.

The client was a child of a missionary family, and for over a decade, she had lived in South America. But she was born in the United States and had spent nearly all her grade school years in a rural community on the east coast where she now attended college. She and her family also made regular visits back to the United States during those ten years when she was living abroad.

One would have thought that returning to the United States for college after spending the last 10 years in South America would have been an easy transition for her. After all, she was already an easygoing individual, she functioned well in her adoptive culture, and she never had any issues on her sabbaticals home to the United States. But it wasn’t easy, and she couldn’t understand why.

But I had an idea.

When she left the United States, she was only nine years old. The world she knew was long gone because of the passage of time and her own development from child to adult. On top of that, in her visits back to the United States, she spent most of her time looking up old friends or enjoying the company of relatives until her trip was up and she had to go “home” in South America.

As a white girl with blond hair, she was an anomaly in Ecuador. She lived in a community where English wasn’t spoken. Although she spoke Spanish without much of an accent, it was still not her first language. She was not a true Ecuadorian.

But when she returned to the United States, she also discovered that she was not a true American either. Being gone most of her adolescence, she had missed 10 years of acculturation. TV shows, movies, music and cultural events were just some of the things she couldn’t relate to. It was like she walked into a very long movie just at the end; she didn’t know what was going on around her.

My client was what is referred to as a third-culture kid — people whose identity is influenced by their parents’ culture and the culture(s) in which they are raised. Third-culture kids are often the children of missionaries, nongovernmental organization workers or military families. My client obviously didn’t totally belong to the guest culture (Ecuador), but she didn’t belong to her home culture anymore either. Not every third-culture kid’s experience, of course, is as stressful as my client’s. Most of her stress stemmed from the fact that she was not prepared for feeling like an outsider in her home culture.

Transitions from one culture to the next are easiest when the cultures are similar, when the visit is short, and — as is often true for Americans — when they take U.S. culture with them. When I hear about someone from the United States traveling abroad and I learn that they stayed in American hotels, ate American food and spoke nothing but English, then I know they took America with them.

But for missionaries and NGO families, living on the economy almost necessitates diversity of culture, longer stays, and an inability or lack of desire to take America with them. The “American” stands out and may take years to be thought of as an insider.

At the same time, attempting to gain acceptance in the chosen culture by default also means leaving one’s home culture behind. Third-culture individuals are like ships without a flag.

In our never-ending attempts to improve our understanding of diversity, it would be easy to overlook third-culture kids. Based simply on appearance, people may not realize someone is a third-culture kid. I could have easily missed the significance of my client’s third-culture status and focused only on her anxiety. That would have, at best, slowed down her healing.

Recognizing that she was really neither American nor Ecuadorian helped her understand why she didn’t seem to fit in a culture where she looked like everyone else. This realization was the beginning of her developing coping strategies that worked quickly and helped her symptoms of anxiety abate.

Large international agencies often employ mental health workers to assist their personnel when they transition to a new culture as well as when they are ready to transition back to the United States. But smaller agencies such as the one my client was associated with may leave navigating this transition up to the individual, which is what happened to my client.

When I was a graduate student in the 1980s, “diversity” generally focused on issues of race. Fortunately, our thoughts on diversity have evolved since the 1980s, but we still have a long way to go. And we can start by recognizing overlooked areas of diversity, such as third-culture kids, and developing strategies to help them.

 

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Read more on the nuances of counseling third-culture kids in a recent article from Counseling Today: “Growing up between cultures

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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

Working with perpetrators of child sexual abuse

By Lisa R. Rhodes September 16, 2022

Perpetrators of child sexual abuse are a clientele that some counselors may find challenging to treat. According to the Department of Justice Office of Justice Programs, the term “sex offender” refers to a person who is convicted of a sex offense, which is defined as “a criminal offense that has an element involving a sexual act or sexual contact with another” as well as one that is an offense against a minor.

As of April, 767,023 people were listed in the sex offender registries in the United States, according to SafeHome.org. This number, however, may not reflect the total number of people who have sexually abused children. The Rape, Abuse and Incest National Network (RAINN) reports that the majority of sexual assaults are never reported to law enforcement.

Courtney T. Evans, a licensed clinical mental health counselor with a private practice, Purpose in Grace Counseling, in Eden, North Carolina, says mental health treatment, specifically sex offender therapy, is a recommended form of counseling to reduce recidivism rates among perpetrators of sexual assault.

“While traditional therapy seeks to reduce feelings of anxiety and inadequacy, sex offender therapy seeks to confront the offender with thinking errors, promoting accountability and acceptance for actions,” notes Evans, a member of the American Counseling Association who specializes in treating people with trauma-related disorders, specifically children who have been sexually abused. “Sex offenders are given tools in counseling, but just like someone who attends Alcoholics Anonymous meetings long term, sexual offenders should engage in lifelong support.”

Risk factors

Community safety is the first goal of sex offender therapy, says Pablo Serna, a licensed professional counselor and independent contractor at Henger Enterprises, a therapeutic practice specializing in sexual offender risk assessment and evaluation and sex offender programming in Wisconsin.

Serna has counseled adult male sex offenders, including those who have abused children, for eight years. Most of his clients are mandated by the court to undergo sexual offense treatment or their probation officer may refer them to the practice where he works.

Serna treats perpetrators using group therapy, and he says group members can range from those who fully admit to an offense to those who admit they’ve done something wrong but are not willing to accept full responsibility for their actions.

“As a facilitator, I will introduce concepts in a general way prior to moving to [the topic of] offenses so members will grasp the idea before applying it to their offense,” Serna explains.

If a group member is reluctant to participate, Serna says he applies ideas from motivational interviewing. For example, he may empathize with the member about how group therapy can be uncomfortable or how the member does not want to be in the group. “I will admit I cannot make him participate and ultimately, he has the choice to participate,” Serna says. “Yet I point out discrepancies like ‘If you want your probation agent off your back, is not participating [going] to help with that?’”

The end goal for clients, Serna says, is to “prevent further victimizations by demonstrating an understanding of their [clients’] thinking and the risk factors that contributed to their offense and [having them] assist in developing interventions.”

Serna and his colleagues use a sex offender treatment curriculum that was developed by Joseph Henger, the president and clinical director of Henger Enterprises. The curriculum involves the perpetrator understanding the cycle of sexual abuse and relapse prevention to help them develop positive lifestyle changes. The curriculum’s main focus is to diminish deviant arousal and overcome pro-offending beliefs and behaviors, Serna says.

Serna and his colleagues also use Static 99R, an actuarial risk assessment tool developed by Karl Hanson and David Thorton. The Static 99R has 10 risk factors for assessing people who have been convicted of a sexual offense. The score of the risk factors characterizes a person’s relative recidivism as below average, average, above average and well above average.

The risk factors are divided into three categories: static, dynamic and acute. The static category refers to risk factors that do not change; the dynamic category notes personality traits or learning deficits that can change with an outside intervention, such as counseling; and the acute category refers to factors that are temporary or that can easily change because of the person’s environment or relationship with others.

According to Serna, static risk factors can include a person’s age, their prior criminal record, their gender and the relationship of the perpetrator to the victim. Dynamic risk factors are ones that can change over time, such as whether the person has any positive life influences, displays impulsivity, has problem solving skills, has an increased sex drive or any deviant sexual interests (such as voyeurism or exhibitionism) or if the person has cooperated with the probation, parole or correctional authorities involved in the assessment and management of their sexual offending behavior.

Dynamic factors, Serna says, can shed light on the person’s motivations to commit a sexual offense. He’s noticed that several of his clients who have perpetrated a childhood sexual offense have a few risk factors in common: a deviant sexual interest or attraction to children, an emotional connection to children or a hypersexual nature.

Clients often tell Serna that they feel they don’t fit in with their peers and that they feel more comfortable doing things that children do, such as playing video games. And a deviant sexual interest in children, he says, is often what allows perpetrators of sexual abuse to give themselves permission to cross social boundaries in order to have sexual contact with someone they know is a minor.

For others, a hypersexual nature plays a part in their motivations. “Some people are pretty indiscriminate” when it comes to sex, Serna notes. They want to have sex with whomever says yes or whomever is available. These clients define themselves by their sexual acts, he says, because it gives their ego a boost and helps them to feel better about themselves.

Although the assessment tool does not consider if the person was sexually abused in childhood or if it is even a risk factor for their behavior, Serna has found that the client’s own childhood sexual abuse can play a role. He has worked with clients who have abused children and tried to justify their actions by saying, “I was abused as a child. I learned to live with it, so I figured my victim would” or “The person is too young; they won’t remember it.”

Serna says other examples of distorted thinking include:

  • “She’s attracted to me; she’s older than her age.”
  • “I needed my sexual needs met. The person was there at the time.”
  • “I’m not going to take the time to find out how old this person is.”
  • “If a girl is able to have her period, she’s good for sex.”

Serna establishes some ground rules with his clients, including having mutual respect, not using objectified language (e.g., sexist or racist slurs), displaying respectful behavior (e.g., not falling asleep during group sessions), respecting the privacy of other group members and completing assigned therapeutic work.

Taking responsibility

Evans, an assistant professor of counseling at Liberty University, says the current treatment for perpetrators of sexual abuse focuses on the management of the offender. “Most programs are victim-centered approaches,” she explains. “The goal of counseling sex offenders is to prevent recidivism, while different acts and regulations pave the way for enhancing public safety and protecting victims through supervision, re-entry, registration and community notification.”

Evans says that sexual deviance (e.g., sexual interests for children over adults, abnormal preoccupation with sex) among people who sexually abuse children is often associated with an increased likelihood of sexual reoffending. “Child sexual offending may be part of a broader pattern of criminal behavior, underpinned by antisocial, impulsive and aggressive tendencies and a lack of empathy,” she notes. “This is why sexual offender counseling focuses on building empathy and taking responsibility.”

A cognitive behavioral technique that Serna uses in counseling is covert conditioning, a therapeutic approach created by John Morin and Jill Levenson. In their book Road to Freedom: A Comprehensive Competency-Based Workbook for Sexual Offenders in Treatment, Morin and Levenson note that covert conditioning helps perpetrators of sexual abuse control their arousal by linking “deviant sexual thoughts with images (pictures in your mind) of some of the terrible consequences of sex offending.”

Serna often asks clients to write a script about the distorted thinking or triggers that might occur before they decide to engage in a risky situation. Then, they write a second script that includes the negative consequences they will experience if they move forward with their desires.

The purpose of this exercise, Serna says, is for clients to attach the triggers for their behavior in risky situations to a realistic consequence, such as being incarcerated or dealing with feelings of shame or embarrassment.

When clients review the scripts repeatedly in group therapy, the recognition of their unhealthy thought patterns and the negative consequences “becomes automatic,” Serna notes. The scripts also include a part that allows clients to create a way to escape risky situations or distorted thinking patterns so they can apply and reinforce interventions with alternative thinking and behaviors, he adds.

People who sexually abuse children need to be aware of triggers, Serna stresses, but it is even more important for them to understand the problematic thinking and choices of their behavior and identify appropriate interventions.

“If they stick with me, they’re going to have a level of responsibility,” he says.

The importance of self-care

Although sexual offense therapy is an important tool in helping to reduce crimes of a sexual nature, it can also take a toll on the counselors themselves. In fact, research has found that mental health professionals who treat perpetrators of sexual assault often need psychological support themselves.

In an article on counseling sex offenders and self-care, which was published in Cogent Social Services in 2019, Evans, along with Courtney Ward, explored the impact of burnout and secondary/vicarious trauma on counselors who work with people who commit sexual abuse, and they found that mental health professionals who do this kind of work often “have a high rate of burnout and stress.”

Thus, “understanding self-care factors that influence well-being is essential,” Evans says.

In the study, Evans and Ward acknowledged that this kind of work can be difficult for some counselors because they are required “to engage in traumatic material in graphic detail while maintaining an empathic relationship with the client.” In addition, they noted that “perpetrators/offenders of sexual abuse are [often] in denial or demonstrate little or no remorse for their abusive behavior, which may exacerbate the impact on the counselor.”

Evans says the detrimental effects on counselors who work with this population can include changes in their self-perception, changes in their thoughts about other people and their environment, problems in personal and romantic relationships, changes in their sexual performance, and depression.

“Personal factors can make a counselor more prone to countertransference,” Evans adds. For example, a counselor who works with this clientele could become more protective of their own children because of the material they deal with in session. If this happens, Evans recommends clinicians seek supervision and feedback on ways to distance their own lives from their clients’ lives, which can also help counselors become more sensitive to the ways countertransference can occur.

Serna says he has managed to remain largely unaffected by the content of his therapeutic sessions with clients who have sexually abused others. He currently leads about 14 to 15 two-hour group therapy sessions per week with clients who have sexually abused children, enticed children, have downloaded/distributed materials online in which children are sexually exploited or have sexually abused adults. Some group members have also abused adults.

Yurta/Shutterstock.com

“If it came to that point [being emotionally affected], then I would know that I can’t do this anymore,” he admits.

Serna says he remains objective and requires clients to reflect on their distorted thinking and feelings because they impact their own lives — not his. “It’s up to the offender to evaluate their own thoughts, rather than me making a judgment about it,” he explains.

With a career that spans 15 to 20 years in the field, Serna has counseled a diverse clientele from the chronically mentally ill to families and adolescents. And he says these experiences have helped him to recognize his own biases and the necessity to lean on his training to maintain a professional distance from difficult clients.

“I’ve learned how to take a step back and be objective,” he says. “I feel like, as a therapist, my role is to be objective.  So, when I hear these things, the only way to help them [clients] is to be objective.”

Serna says he maintains boundaries with his clients by not disclosing any personal information, such as his relationship status or if he has children. And he practices self-care by running three miles a day, playing piano and guitar, drawing and taking art classes in his spare time.

“I think keeping these boundaries permits me to separate my personal and professional life,” Serna explains. “When I am frustrated at work, I know it’s a professional issue and will look [to] the resources I have.”

Serna says if he ever gets emotional because he’s feeling frustrated, he’s trained himself to say, “OK, Pablo, this is becoming your issue now.”

Evans suggests that counselors who want to work with this population be “self-reflective regarding signs and symptoms of burnout and engage in self-care activities for prevention and alleviation.” Some self-care strategies include meditation, mindfulness, journaling and personal counseling — anything that promotes emotional well-being.

Overcoming barriers

Most of Evans’ students have not expressed an interest in treating perpetrators of child sexual abuse, largely due to preconceived notions that most people who commit sexual abuse are predators and highly resistant to treatment, she says. Personal morals and beliefs may also prevent students from choosing to work with this population, Evans adds.

But for counselors who are interested in working with this clientele, Evans recommends they seek training and certifications (such as the National Association of Forensic Counselors’ Certified Sex Offender Treatment Specialists and the Certified Juvenile Sex Offender Treatment Specialists certificates) so they can better help this population. It is also important for counselor educators to prepare students to work with difficult clients, particularly those who abuse children, Evans says.

“I think that most counselors have so much empathy for children, as we all should, and this influences feelings and thoughts related to harm to children,” she says. “This is a positive attribute in counseling, [but] it also greatly impacts services to sexual offenders.”

Perpetrators of sexual assault are often victims of sexual offenses themselves, Evans continues, so she advises counselors to take preventative action by “working with those who have experienced trauma and doing trauma screenings and, if warranted, assessments on each client.” Evans says understanding the client’s lifestyle and private logic is essential in understanding their current behavior and preventing future maladaptive behavior.

“I hope that counselor education can instill [an] understanding of sexual abuse, … not only for the victims [but also for] the motives and proper treatment for offenders,” she says. “This is … the best way to treat the problem [and] to work preventatively.”

 

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Lisa R. Rhodes is a senior writer for Counseling Today. Contact her at lrhodes@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.

Preventing veteran suicide

By Justina Wong September 9, 2022

In February, Russia invaded Ukraine and started a war that is still going on today. When President Zelensky asked foreign fighters to join Ukraine’s resistance against Russia, many American veterans answered the call. Although it’s a devastating war that has taken many innocent lives, it has given some veterans, especially those who are still struggling with the aftermath of the U.S. military’s withdrawal from Afghanistan, a renewed sense of purpose.

Having a sense of purpose and belonging and working toward a common goal can help veterans who are struggling with suicidal thoughts or ideations. According to the Centers for Disease Control and Prevention, in 2019 an average of 17.2 veterans died by suicide daily, and from 2001 to 2019, the suicide rate among veterans increased by almost 36%. In certain battalions, there have been more deaths from suicide than those killed in action during the wars in Iraq and Afghanistan.

With September being Suicide Prevention Awareness Month, it is important to remember that suicide affects the military and veteran communities year-round. 

What to know about veterans and suicide

Suicide in the veteran community is different from suicide in the civilian community. Veterans have a higher suicide rate compared to civilians, and in my personal experience working with different nonprofit veteran organizations and being friends with veterans, I noticed that veteran suicides can sometimes be more impulsive than civilian suicides.

Photo by Sgt. Agustín Montañez/defense.gov

I also noticed that one of the biggest triggers for veteran suicides are other veteran suicides/deaths. In talking with veterans, I learned that some are more likely to think about and follow through with taking their own life when they hear about a close friend who died by suicide or died from a variety of reasons.

In my attempt to destigmatize suicide among veterans, I encourage all the veterans I speak with to be transparent and honest about their experiences. I have heard some harrowing stories.

One veteran told me about how his team leader in Iraq attempted to end his own life in front of his family members, and when he survived, he crawled into his bedroom and died in a second, fatal suicide attempt. The veteran who shared this with me could not fathom why the family did nothing to stop him, and he felt hopeless and helpless.

Another veteran told me about how a happy battalion reunion with his fellow veterans ended in tragedy when one of his friends who had been struggling with survivor’s guilt for many years died by suicide. After the reunion was over and they all went home, three more of his fellow veterans killed themselves and another died in a car accident. He said he felt hopeless because it didn’t seem as if anyone or anything could help stop veteran suicides.

The two most common statements I hear from veterans about suicide in the veteran community are that it never ends and that it’s not about if but when it will happen to them. Stories and statements such as these happen too often among veterans, but it doesn’t have to be that way.

Screening for triggers

One of the biggest lessons I learned through my nonprofit work with veterans is that clinicians need to understand what triggers veterans to attempt to take their own life and how to continuously screen for these triggers.

Potential triggers could include the following:

  • Being reminded of a similar place through smell, sound or sight
  • Having a history of mental health illness
  • Losing fellow veterans to suicides or other deaths such as drowning, car accidents or fires
  • Experiencing the death of family members who were pillars of support
  • Ending a romantic relationship through breakup, separation or divorce
  • Feeling hopeless, helpless and like nothing will ever take their pain away
  • Continuously seeking and being denied help
  • Facing financial, food or housing insecurities
  • Being exposed to continuous world tragedies such as pandemics, natural disasters and school shootings
  • Being in toxic environments where they are emotionally, mentally, physically or sexually abused

Veterans are special people because they signed up to do a job that most people are unwilling to do. Every human being has a breaking point, and it’s up to counselors to ensure that veterans don’t reach their breaking point or to help veterans navigate their lives if they do reach that point.

Nontraditional ways to help veterans

When veterans leave the military community, they often lose their sense of purpose. As I mentioned previously, some veterans found their sense of purpose again by helping Ukrainian refugees or helping train Ukraine’s military to fight Russia.

In my CT Online article “Addressing the Afghanistan humanitarian crisis,” published earlier this year, I referenced Ben (a pseudonym), a former Marine and a personal friend of mine. He worked as a military contractor for 15 years until the United States withdrew from Afghanistan, a withdrawal that caused Ben to struggle with moral injury.

When Russia invaded Ukraine, Ben decided to end his military contracting career to join a group of veterans who served in special operations units prior to leaving the military. Together they deployed to Poland and Ukraine to train individuals in Ukraine’s military and help evacuate Ukrainians who had difficulty leaving.

This new mission gave Ben a renewed sense of purpose, and his feelings of anger, hopelessness and worthlessness over the United States withdrawal from Afghanistan subsided. He also had the opportunity to go into Ukraine at the beginning of the invasion to help evacuate Ukrainians who had physical disabilities. He told me about how he and another veteran helped carry an older woman who was in a wheelchair to safety across the border to Poland. The woman’s son had died recently, and she was the sole caretaker for his four children, all of whom were under the age of 15.

Although carrying an older woman across the border may seem like a small act, her gratitude toward Ben ignited his passion for continued selfless service. It reminded him that he can still utilize what he learned in the military to help people. It was the moment that Ben realized he wasn’t hopeless or worthless. He had skills and a purpose. He went from helping Ukrainians evacuate to training Ukrainian women in hand-to-hand combat and combat triaging. I heard a great sense of pride in his voice as he described these events to me.

Ben’s decision to deal with his anger, hopelessness, worthlessness and suicidal thoughts by helping evacuate and train Ukrainians might not be a traditional form of therapy, but it worked for him just as much as traditional forms of therapy work with civilians.

Counseling veterans often requires a certain level of creativity, especially if traditional therapy is not working. Here are some nontraditional forms of therapy that may help veterans:

  • Engaging in activities that utilize a veteran’s military occupational specialty
  • Using adventure/outdoor forms of therapy, such as hiking, cycling, hunting, fishing, whitewater rafting, skiing, snowboarding or surfing
  • Volunteering with organizations that are built and led by veterans (e.g., Team Rubicon, The Mission Continues, Team RWB, Operation White Stork)
  • Attending unit/battalion reunions on a regular basis
  • Using cinematherapy
  • Incorporating creative arts, including drawing, painting, sculpting, glassblowing, coloring, music and writing
  • Utilizing an organized battle buddy system
  • Doing good deeds for others
  • Attending veteran retreats that are specifically built for veterans struggling with suicidal ideation
  • Engaging in religious or spiritual activities and rituals 

Counselors must take action

The veteran population has always been a population that is underserved. During my fieldwork internship, I worked with veterans who waited months to get appointments with mental health professionals at their local Veteran Affairs clinics. Even veterans who expressed experiencing suicidal ideations were denied services and forced to wait. Most veterans will give up after being denied many times. Some veterans will assess their situation and decide that it is not as severe as other veterans’ problems and will not seek help so that their fellow veterans are serviced first.

As counselors, we must do better. As a community and world, we are better than this. It is up to counselors to uphold veterans’ human rights and advocate for them. This population will always be underserved unless we as a community of mental health professionals come together to serve those who have served us.

Counselors must take action. Veterans deserve to know that they are not alone.

 

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Related reading, from the Counseling Today archives:

Suicide prevention strategies with the military-affiliated population

Advice for counselors who want to work with military clients

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Justina Wong

Justina Wong is a second-year new professional currently earning hours toward licensure at a group private practice in California. She serves on the Military and Government Counseling Association’s board of directors and has worked with veterans in the nonprofit community for over 10 years. Justina is also a member of the American Counseling Association’s Human Rights Committee.

 

 

 

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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.

Rewriting the client’s narrative through colors

By Jetaun Bailey, Heather Hodge, Beverly Andes, Bryan Gere and CharMayne Jackson September 8, 2022

In our work as counselors and educators, we find that others are increasingly receptive to conversations about color preferences and interpretations during our interactions. It is as if talking about colors creates an entryway for open dialogue, mutual respect and connectivity and encourages all who are present to express authentic and insightful thoughts and opinions. Moreover, we have noticed that there is a connective alliance between these conversations and the continued, open discussions about understanding personality and issues related to mental health.

This process begins by asking  a  simple question: “What color or colors do you feel reflect your personality?” The individual or participants almost always pause, smile and then say, “Good question.” This practice of starting the discussion with a nonintrusive question creates a calm, safe space for everyone to become curious and explorative and engage in meaningful dialogue before delving deep into a topic about their mental health concerns.

And the answers to this seemingly simple question can be rather complex. The numerous color mixtures and hues we see — and the myriad ways in which we view colors — invokes meaning in our lives. Regardless of cultural background, influential sport teams, seasons of the year or clothing trends, colors have a way of speaking to the individual as well as the collective. 

The power of colors 

After witnessing the power of color in a staff training, Bryan Gere and I (Jetaun Bailey) first wrote about the psychology of colors in the 2018 Counseling Today online exclusive, “Identifying colors to create a rainbow of cohesion in the workplace for helping professionals.” Since then, we have incorporated colors into our teaching and counseling activities, including classroom discussions, group presentations and individual client sessions, as a unique way to get to know the student or client in a nonintrusive yet welcoming manner.

Recently, the authors of this article used color psychology to help the participants in a process group rewrite their own narratives by using their favorite color. We asked the participants to reconsider their past experiences through the lens of this color. The goal of this exercise was to help them discover what was preventing them from acting as their true selves in the present and to help them learn to move ahead effectively into the future. According to a 2019 article by Benjamin Hardy in Psychology Today, rewriting one’s present and future narratives requires an investigation of one’s past. A person’s outlook on their past narrative affects their present and future narratives, and in turn, their new outlook on the present and future also changes the significance they place on their past experiences. 

During this group presentation, one person described her favorite color as pink. After stating this, she seemed uncomfortable and almost apologetic for her answer. And she downplayed her color by saying, “It is a color that symbolizes weakness.” When we asked her to elaborate on why she felt uncomfortable sharing that this was her favorite color, we learned that she also considered herself “weak.” 

This discovery led to a deeper conversation on how she defined weakness and its relationship to the color pink. She said that pink is a “girly” color and is associated with being kind and pleasant and not speaking up for oneself. She then told us that she had been unable to advocate for herself and had remained in a broken marriage for years. She had allowed herself to be dominated during her marriage, and as a result, she had low self-esteem. By processing with the other group members, this participant began to understand not only the negative cultural and societal norms associated with the color pink (e.g., frail, timid, overly emotional disposition) but also positive traits such as compassion. This discussion and reframing allowed her to look at pink in a new way, and then she used this new perspective to reframe her thoughts about herself. What she once mistook as a representation of her personal weaknesses, she now realized represented her internal strength of compassion. Thus, her story was rewritten. 

Although this color activity was part of a one-session process group, it can be modified and used in regular group therapy as well as in individual sessions. Counselors can also use this activity as a training tool for various organizations. Within a work environment, for example, the color activity would allow employees to learn more about themselves and others within the organization. This insight can be revealed in a nonintrusive fashion that others may not be aware of. I (Jetaun Bailey) once used this activity in a training with a group of university faculty members. One of the faculty members identified with the color gray and associated it with neutrality. She went on to explain how her family life was chaotic, and she found solace in remaining as neutral as possible, which is a trait she had carried over into her work life. This trait led several of her co-workers in the group to express how they had noticed she had perfected the skill of remaining neutral, and although this trait is often considered a positive quality, it sometimes meant she would avoid addressing situations to remain neutral. Asking a nonintrusive question about color allowed the faculty to gain a greater understanding about their co-worker. 

Steps for implementing the color activity 

The group activity of rewriting one’s narrative through colors involves four sequential steps. During these steps, participants analyze their past using their favorite color, and in doing so, they are able to determine what prevents them from being their authentic self. In turn, this helps them to function more productively in the present and move forward into their future. 

Step 1: Connect colors to the client’s personality. Counselors can ask questions to help clients connect the color(s) with what it means about their personality. They can start by asking, “What color or colors do you feel reflect your personality?” While each participant answers the question, counselors should notice their body language or any spoken or unspoken explanations about the color(s), such as the previous example about the participant who closely identified with the color pink. Clinicians can then ask a gentle yet appropriate question about what they observed while the participant was identifying their favorite color. Some participants are forthcoming. For example, a Chinese American who participated in our process group easily connected the color red, which is symbolic in both Chinese and American cultures, to her own struggle with identity. She explained that she had been embracing and respecting one culture while feeling embarrassed by the other. 

Step 2: Investigate negative associations with the colors. Counselors should ask group members to identify one or two negative associations with the color(s) they chose and how it relates to past experiences in their lives. In addition, clinicians can ask the other participants in the group to share the negative connotations they may have heard about the color(s). This allows every participant to stay in a neutral zone so that no one feels attacked personally, and it also offers a broader understanding of the various meanings ascribed to colors on the part of different individuals, cultures and ethnicities. As noted by Iris Bakker and colleagues in their 2015 article published in Color Research and Application, a person’s gender, age, education and personality (e.g., being technical, emotional or a team player) affect their color preferences.

Step 3: Investigate the negative associations with specific colors as potential barriers to personal growth. Next counselors can ask clients to consider how the negative connotations associated with the color could be connected to negative feelings they have about themselves as well as how it might have hindered their growth in the past. It can be helpful during this step to self-disclose. Experts say that in small doses, self-disclosure can be a very effective technique. And when used judiciously, particularly in a group environment, it can help build trust, promote empathy and improve therapeutic relationships.

To break the ice during a group session on one occasion, I (Jetaun Bailey) disclosed that red, my identified color, is associated with aggression and impulsivity and that I am a risk-taker. I noted that I often get into trouble because of my impulsivity and risk-taking nature, and that my association with risk-taking being an ill-advised trait, which I learned from my experiences as a youth, often caused me to remain silent around others. Group processing teaches people how to voice their difficulties, and I believe my self-disclosure in this case increased the bond between the group members and myself. 

Self-disclosing also works well with clients who appear to be introverted. The participant who identified with the color pink in the previously mentioned example was somewhat apprehensive about sharing this color, which could imply that she may have introverted tendencies. But with the counselor’s and group’s own disclosure and encouragement, she began to express herself more freely.

Step 4: Help the client reframe the narrative. After exploring the negative connotations associated with the colors, counselors can ask each group member to think about positive qualities associated with the same color. For example, they could ask, “Now that you are aware of the negativity linked with the color(s) with which each of you have identified, how might you look at that negativity differently?” This technique, which is a form of cognitive restructuring, helps the participants reframe what they find to be negative and reflect a more positive view of the color. 

Clinicians could also have the client replace the negative word associated with the color with its antonym. It may be helpful to provide an example such as how sadness, which is often associated with the color blue, can be reframed by thinking of words that mean the opposite such as hopeful and optimistic. Counselors can then ask each participant to use that antonym or positive word to reconsider how they view their professional or personal lives now as well as how they hope to view it in the future. 

The person who identified with pink, for example, used the word “compassion” to reframe how she viewed herself and her marriage experience. This allowed her to see her strength amid the seeming dysfunction of her marriage, build self-awareness and help her understand that her strength lies in her compassion. In turn, the participant indicated that she would use this strength of compassion to regulate her emotions during difficult moments by using soothing, kind and supportive words or messages rather than self-criticism. She noted that decreasing self-criticism would improve her self-esteem as well as her relationships and communication skills with others. 

During this step, counselors can use a variety of techniques and modalities in addition to the cognitive behavior therapy technique of reframing. In fact, this step is an excellent time to use the “miracle question” technique from solution-focused therapy. For example, the counselor could say, “The rainbow symbolizes many things in Western society and art such as a sign of hope and better days to come. If that were the case, what miracle would your specific color bring you and why? How would that miracle alter the negative connotations associated with your chosen color(s)?” This approach achieves the solution-focused goal of helping clients rewrite their narratives, which makes it a good substitute for the cognitive behavior therapy technique of reframing.

A mindful approach 

This creative approach to rewriting one’s narrative offers inspiration and excitement because it can trigger a child-like curiosity and exploration and disarm tension and the expectation of a stereotypical psychoanalysis. The simple question of “what color(s) best reflects your personality” invites clients to express feeling, emotion and vision, which helps clients break down and deconstruct information into smaller, more manageable categories. Thus, counselors can easily incorporate the mindfulness method throughout this group process.

This question also causes many people to pause and reflect before answering, as though they are engaged entirely in their own mental imagery. The reliance on mental imagery is similar to guided therapeutic imagery, a relaxation technique closely associated with mindfulness. Asking what colors reflect their personality rather than simply asking what their favorite color is requires participants to use an inner sense or senses to elicit sensations associated with the color(s) and consider which color is most closely linked to their personality. 

The participants in our process group transitioned into a state of peace and tranquility the instant the question was posed, coinciding with the mindfulness approach of being fully present. In expressing their colors, they contributed to a sense of belonging created by the shared warmth, friendliness and evident understanding of the issue. The participants continued to work with this prompt in the present moment, completely involved in their own and each other’s experiences of the way their colors were manifesting.

Throughout the four steps of this approach, the counselor holds space for mindful listening. They must listen deeply and ask open-ended questions to allow everyone to express their authenticity through their colors, while gaining clarity and knowledge. And they also need to pay attention to verbal and nonverbal communication, especially to each individual’s breathing and physiological expressions. Clinicians should document clients’ comments and suppress clients’ negative self-talk. 

Effective mindful listening eventually creates an atmosphere of collective communication, resulting in each participant rewriting their narrative from self-reflection and collective sharing by way of mindful listening. The participant who identified with pink provides a great example of this. She communicated through both verbal and nonverbal expressions that the color pink caused her some uncomfortable feelings, and the other participants were able to help her see the beauty in her color and connect it to her own compassion. The participant was then able to self-reflect and reshape  her narrative. 

Because each group member brings their own cultural understanding of colors as well as their own color norms and practices with them, the group also gains a comprehensive richness that infuses components of cultural awareness in this activity of rewriting their narratives through colors. Each participant demonstrates cultural understanding by attentively listening to each other’s relationship with a color(s) and indicating how the connections are similar and different from their own. This cultural awareness creates a collective cohesive and appreciation for one another. As a result of this collective communication, a shared sense of culture emerges; the shared experience of discussing their own colors helps them form a community while still embracing each other’s individual identities and unique cultures.

Conclusion 

Choosing one’s identifying color and the accurate attributes it holds, as well as the feelings and emotions associated with the thoughts, becomes rich material to work with in the therapeutic setting. Having clients consider the basic question — “Which color(s) do you feel reflect your personality?” — prompts a diverse range of responses and often results in enlightenment. It’s as if sharing colors has some magical or unexplainable way of shifting the discourse or topic in the group’s or individual’s favor. We are often oblivious of the way colors influence our moods, sensations and perceptions. Rewriting our narratives by looking at our interactions with colors from a cultural, personal and biological perspective can teach us something about ourselves, of which we are often unaware.

Africa Studio/Shutterstock.com

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Jetaun Bailey holds a doctorate in professional counseling and supervision and is a licensed professional counselor with supervision status. She is also a college professor and a certified school counselor. Contact her at BaileyJetaun@hotmail.com.

Heather Hodge is a graduate student in the mindfulness-based transpersonal counseling program at Naropa University. Contact her at heather.hodge@naropa.edu. 

Beverly Andes is a graduate student in the mindfulness-based transpersonal counseling program at Naropa University. Contact her at beverly.andes@naropa.edu. 

Bryan Gere holds a doctorate in rehabilitation counseling and is an associate professor in the Department of Rehabilitation at the University of Maryland Eastern Shore. He is also a certified rehabilitation counselor. Contact him at bryangere23@gmail.com. 

CharMayne Jackson is a registered mental health counselor intern in Florida and holds a master’s in counseling psychology with a concentration in clinical psychology and a bachelor’s in psychology. Contact her at charmayne.jack@gmail.com. 

 

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.