Tag Archives: American Counseling Association

Counseling Today recognized with five awards

August 18, 2021

The Counseling Today staff won a total of five awards in APEX 2021, the 33rd annual awards program recognizing excellence in publishing.

Senior editor Lindsey Phillips received a Grand Award in the writing category for her July 2020 feature “Putting first responders’ mental health on the front lines.” Of nearly 1,200 entries, only 100 Grand Awards total were presented across 13 major categories.

Senior writer Laurie Meyers earned Awards of Excellence in two separate writing categories: one in COVID-19 media newspaper/magazine articles for her December 2020 feature “Facing a winter of discontent” and another in health and medical writing for her May 2020 feature “Life after cancer.”

Senior writer Bethany Bray won an Award of Excellence in the feature writing category for her October 2020 cover story, “Helping clients develop a healthy relationship with social media.”

The August 2020 issue of Counseling Today was recognized with an Award of Excellence in the category of best magazine, journal and tabloid issue over 32 pages. Among the articles featured in that issue was a cover story on racial trauma and Black mental health.

The Counseling Today staff have received a total of 58 awards for writing, design and website excellence over the past 16 years.

Supporting AAPI communities: ‘We still need to do more’

By Bethany Bray August 2, 2021

The United States has seen a significant spike in anti-Asian hate crimes and discrimination in the past year. Since spring of 2020, “there was anti-Asian bigotry and misinformation spreading almost as quickly as the [corona] virus itself,” said Rep. Judy Chu at an online panel discussion hosted by the American Counseling Association last month to address the recent rise in anti-Asian sentiment and the professional counselor’s role in addressing it.

“Conversations about mental health have never been more important,” she noted. “With each new report of an innocent Asian American being attacked, many across the country worry, ‘Will I be next?’” Chu, a Democrat who has represented California’s 27th district since 2009, is a psychologist and the first Chinese American woman to be elected to Congress.

She was one of three legislators on the panel discussion held on July 21. The other speakers included Rep. Sharon Tomiko Santos of Washington and Sen. Chris Lee of Hawaii as well as ACA CEO Richard Yep and ACA President S. Kent Butler.

The panelists noted that stigma and barriers, including being isolated or marginalized because of language barriers, often keep those in the Asian American and Pacific Islander (AAPI) community from seeking mental health services. Lee and Santos also discussed how mental health, trauma and the COVID-19 pandemic intersect.

“The issues that we are seeing have a lot to do with the isolation that we’ve experienced under COVID-19 restrictions and the challenges of race that have never been resolved in our country,” said Santos, who has been a community activist for more than 40 years. “What we are seeing, in my opinion, is the exacerbation of those fault lines that have existed in our communities for many, many years. … These are challenges that will involve all of us working together at the state and national level to address.”

Butler noted that counselors are called to help all disadvantaged groups. Not only is helping people regardless of their background or immigration status an ethical mandate but it is also a part of “who we are” as counselors, Butler stressed.

Although numerous measures have been passed by local and federal legislatures to better track and address anti-Asian violence and hostility in the United States, “we still need to do more,” Chu said. “There is so much that can be done to support our communities, and counselors are on the front lines.”

 

 

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Watch the full video of the July 21 event at ACA’s YouTube page: youtu.be/PYAvqIOWEzo

Related reading from Counseling Today

Take action

Support the following initiatives and others by visiting the ACA Take Action page:

  • Teaching Asian Pacific American History Act
  • Stop Mental Health Stigma in Our Communities Act
  • Increasing Access to Mental Health in Schools Act

More from ACA

 

 

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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.

Cultivating space for inclusivity

By Laurie Meyers July 21, 2021

S. Kent Butler says he’s an elephant in a world built for giraffes. And he is here to shake things up. 

This metaphor comes from R. Roosevelt Thomas Jr. and Marjorie L. Woodruff’s book Building a House for Diversity: How a Fable About a Giraffe & an Elephant Offers New Strategies for Today’s Workforce, explains Butler, who became the American Counseling Association’s 70th president on July 1. The elephant and giraffe are friends, but their relationship falters when the giraffe invites the elephant home. The house is not designed for the elephant. It’s tall and narrow, so the elephant has trouble navigating this space and often smashes into doorways and walls. Rather than accommodating his friend, the giraffe suggests the elephant change itself to fit in the giraffe’s environment by taking up aerobics or ballet.

Like the giraffe, the counseling profession hasn’t always created space for individuals in marginalized communities to hold leadership positions, Butler points out. In the past 70 years, ACA’s leadership has primarily been white, with Butler being only the second African American man to serve as president.

“Leadership can look different and still be good,” Butler stresses. 

As Butler notes, the counseling profession will have to continue to reshape itself to accommodate diverse leaders. “And this change will not be easy or comfortable,” he admits. “It will shake things up. Now we’re making way for other people to come into this counseling space and work together to build a better environment for all.”

Man meets moment

Cyrus Williams, a counseling professor and director of the counselor education and supervision doctoral program at Regent University in Virginia Beach, finds this era — one in which COVID-19 has laid bare this country’s health disparities, Black and brown people continue to lose their lives in acts of police brutality and racist attacks on Asian Americans continue to escalate — a perfect time for Butler to take the helm as ACA’s president. 

Facilitating difficult conversations about racial reconciliation, co-conspiratorship and the effects of racial injustice on communities is his area of expertise, Williams says. “He’s been working at this since we met, this has been his journey,” he says.

Williams was working in student services at the University of Connecticut while Butler was studying for his doctorate in counselor education and counseling psychology. “There weren’t a lot of Black men on campus,” he says. “We found each other and became friends.”

Because they both shared a passion for working with low-income, first-generation college students, they later collaborated on several work projects, including scholarly publications. 

Butler is a professor of counselor education and the former interim chief equity, inclusion and diversity officer at the University of Central Florida as well as a fellow of the National Association of Diversity Offices in Higher Education. 

He also is a past-president of the Association for Multicultural Cultural Development (AMCD), a division of ACA, but as Williams notes, his presence extends far beyond that. Butler has made myriad connections within the association — not just as a leader but through scholarship and professional collaboration, he says. 

It’s not just the many relationships that Butler has established that will make him an asset as president — it’s his commitment to what ACA represents, points out Ann Shillingford, his wife and colleague at the University of Central Florida. “He has a passion and dedication for the counseling profession — there’s no doubt that he takes it to heart,” she says.

Butler is also a people person, who is good at listening to people and getting to the heart of what they really want — “kind of like peeling an onion,” Shillingford adds. 

She says that Butler is an introvert until he gets to know you. Williams agrees, noting that Butler loves gathering with friends and family. During graduate school, Butler hosted a holiday party for graduate students and friends at the clubhouse of Williams’ condo. Butler spent the entire day before the party gathering supplies. At 1 a.m., he was still running errands when he got caught in a snowstorm. He walked toward the clubhouse, holding a large pan of his aunt’s famous macaroni and cheese, and slipped and broke his ankle. The macaroni and cheese went flying in the air, but unlike Butler, it remained unscathed. He then drove himself to the emergency room and still made it back in time for the party. 

“When Kent talks to you, he is fully engaged,” says Tony Crespi, a psychology professor at the University of Hartford and one of Butler’s former instructors. “You think you’re the only person in the room.”

Crespi also speaks of Butler’s sharp intellect and passion for learning. “I’m someone who gives written feedback on papers,” he says. “I want people to really write well, be persuasive.” Crespi says it’s not uncommon for students to groan over his rigorous standards, but not Butler. He would come to Crespi after class and ask him to go over the comments so that he could understand and make his articles better.

Because Butler came from a counseling psychology program, he could have easily chosen to become a psychologist like many of his peers did, Crespi adds. But instead, he was very intent on becoming a counselor. 

“I think my journey has been one in which I was led to counseling,” Butler says. “I was doing the work of counselor in many roles before getting into counselor education.” As an undergraduate, Butler mentored a number of other students, and then as a graduate student, in addition to his work with college students, he worked with Upward Bound, a federally funded program that provides academic support to low-income and first-generation high school students to prepare them for college.

“I was always working with young people and helping them to become their better selves,” Butler says. “It became really important to me in my degree program to strengthen my skill set in a way that fit with what I was already doing.”

Talking about racial justice

If Butler is the man for the moment, the moment almost missed its man. Violent racism nearly erased the possibility of his existence long before he was born. When Butler’s mother was just 10 years old, an unidentified group of white community members set fire to the house where she, her 14 siblings, her father and her mother — who was pregnant with her 16th child — were living. The fire, which started in the basement, was ignited in such a way that the family was unable to access the doors. The oldest siblings broke some windows, jumped out and caught the other family members as they leapt down from the second story of the dwelling. Miraculously, everyone survived. 

The family lived in a firehouse for a while afterward while Butler’s grandparents worked to make the barn on their property habitable. In an incident that was yet more proof of how much the neighbors didn’t want his mother’s family around, the barn was burned down before they could move in.

“Law enforcement didn’t pursue any leads even after my family told them about hearing voices in the basement before the fire started,” Butler says. And like so many other hate crimes, these cases of arson were never solved.

And yet Butler’s mother and father, who also grew up surrounded by signs that blatantly advertised society’s complete rejection of Black people, “still persevered,” he says. They saw the good in the world and made sure that Butler and his sisters knew that — despite the messages they might receive from society — they were in no way less than anyone else.

Butler says that over the years, his mother taught him not to spend his energy on causes that are unwinnable or to argue just to argue. He has used that lesson in his racial justice work as a reminder to meet people where they are. 

“Me going toe to toe with someone to try and solve an issue is not going to change anything if we aren’t listening to each other,” he says. “If I’m only speaking to hear my point and I’m dismissing yours, then I am not going to help change the narrative. If I want to make people understand where I’m coming from, I have to set a tone and create a space where people can hear me, and I have to speak with enough authority about what I know so that people will listen and take it in.” 

At the same time, Butler points out that it’s difficult to get white people to come to these conversations. “The false narrative of fragility gets in the way,” he explains. “To be truthful, racism was not perpetuated from or benefited by fragile people. So, in that vein, we should not legitimize that white people are powerless against dismantling racism.” 

“We need white people to recognize that this is not about them,” he says. “This is about racism and … systems that are in place. All of us have a role in that and so opposed to me having to come and cater to your guilt or fragility, what I want to do is come to the conversation.” 

“We already know what the issue is,” Butler continues. “I’m not here to hassle with you about whether or not you are racist. I’m here to highlight the fact that racism exists, and we need to change the system. So, get out of your own way. It’s not about you at this point, it’s about trying to change the fabric of America so that all people can be accepted and be a part of the American dream [and] the access to equity that I think all individuals should have.”

Butler asks white counselors to become not just allies but co-conspirators. Allies often are the ones who approach Butler after he speaks about social justice and racial issues or after a meeting and say, “I really like what you said,” leaving Butler to wonder why they didn’t speak up during the meeting. Co-conspirators, however, help pave the way for marginalized populations through education and anti-racism work and speak out against racism when people of color can’t be or aren’t in the room. 

In fact, what people say when he’s not in the room is just as important. “Say it in the room,” Butler stresses. “Be there and help move the narrative forward in the room. People who are willing to speak up, stand in the gap [and] help change the narrative, those are the co-conspirators.” 

Michael Brooks, an associate professor of counseling at North Carolina Agricultural and Technical State University, agrees that “it’s time for other [white] people to put action behind their words.” He and Butler met through AMCD and have forged a bond based not only on professional interests but also on the difficulties of being a Black man in counselor education.

“Kent is a large man with a dark complexion — he gets judged well before you get to know him,” says Brooks, who has a similar problem. Butler and Brooks often discuss how they have to be mindful of what they say and what gestures they use because they are constantly at risk of being misunderstood, misinterpreted and stereotyped. 

Brooks is excited that another Black man has been elected as ACA president, but as he points out, “the fact that Kent is [only] the second Black, African American male to be president should be embarrassing, and the counseling profession should be asking itself why it’s taken so long.”

Brooks is also aware that there is only so much one can do in a year, so he hopes the counseling profession has reasonable expectations of how much Butler can accomplish during his presidency.

Butler in Dubai in June 2016.

Football, family and far-flung places

Although Williams often has to remind Butler about maintaining work-life balance, ACA’s newest president does take time to relax. Shillingford says he’s a huge Dallas Cowboys fan and has assembled so much merchandise that she finally put her foot down about more memorabilia entering the house. She also admits to occasionally diverting Cowboys’ apparel to Goodwill. 

Butler also loves listening to music — particularly jazz, rhythm and blues, and gospel. He declares himself a night owl, which he admits is a problem when you have to get up early. He’s prone to staying up late doing work and occasionally watching shows he previously recorded. 

He and Shillingford love to travel — for work and pleasure. Some of their favorite places include Barcelona, Hawaii, St. Thomas, Dominica and South Africa. Butler says he would like to return to Africa and visit other countries, particularly Liberia because he discovered through DNA testing that he has family roots there. Butler and Shillingford also relish spending time at home with their 9-year-old daughter, Summer Joy, and Shillingford’s son, Justin, who is 21.

Butler with his wife (M. Ann Shillingford), stepson (Justin Ford) and daughter (Summer Joy Butler)

Presidential influence

One could say that Butler is now hoping to use his personal and professional life experiences to help the counseling profession become its best self. 

Because racial injustice and other inequities have imprinted themselves in such stark relief, “we have to pay attention to how systems are affecting different groups,” Shillingford says. Butler is hoping to use his platform to address issues of diversity linked not only to race and ethnicity but also to gender, disability, immigration and other intersections, she says. 

Butler’s overall goals for his presidency include helping the profession realize that people from varied groups and intersections can be leaders. “I think so often we look to a leader to be a certain type of person,” Butler continues. “We need to bring all people to the table. It’s about inclusivity.” He also plans to create leadership initiatives that help to develop future diverse leaders. 

Counselors should bring diversity to their client base as well, he adds. He urges his fellow counselors to consider what the profession is doing to dispel the stigma and distrust held by marginalized communities to help people see counselors as a supportive resource that can help them navigate life’s challenges and improve their mental wellness.

Because the presidency is only for one year, Butler has spoken with Williams about how he hopes to create initiatives that will continue to thrive long after his term ends. Butler “wants to be able to replace himself,” Williams says, with leaders who will continue the work of fighting injustices and eliminating disparities within mental health care systems. 

He also wants to make sure that the counseling profession maintains the current momentum for diversity, equity and inclusion. He hopes to help counselors begin to engage in difficult dialogues and become social justice advocates.

Butler is at a point personally and professionally where he is ready to speak his truth. “This is my story, my narrative,” he says. “I’m coming to expose you to my experiences. I’m going to be truthful about who I am. I’m not here to step on toes, but if your toes are in the way, move.”

S. Kent Butler, ACA’s 70th president

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Read S. Kent Butler’s first presidential column from the July issue of Counseling Today: “Shaking it up and tapping you in

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Laurie Meyers is senior writer at Counseling Today. Contact her at LMeyers@counseling.org

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

Team from Montclair State University wins ACA’s 2021 Doctoral level ethics competition

June 21, 2021

This award recognizes exceptional, demonstrable understanding of the ACA Code of Ethics, the foundation of ethical professional counseling practice. Each year, ACA honors top-ranking teams in both Masters and Doctoral level graduate degree programs.

 

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Culturally Responsive Ethical Decision-Making During COVID-19

By Rebecca Randall, Sunanda Sharma and Matthew Tirrell

Department of Counseling, Montclair State University

ACA Graduate Student Ethics Competition – Doctoral Category

Faculty Advisor: Dr. Dana Heller Levitt

 

Abstract

The COVID-19 pandemic imposes novel conditions on counseling supervisors and extends the boundaries of ethical considerations. Remote supervision of counselors-in-training, as described in the current case, poses unique challenges to the supervisory triad. To evaluate the proposed scenario for potential ethical dilemmas, the authors consulted and applied the Transcultural Integrative Model (TIM) for ethical decision-making (Garcia et al., 2003). The authors identified several concerns that involve the stakeholders in the case, including: client welfare, counselor impairment, the supervisory relationship, the praxis of virtual supervision during COVID-19, and professional gatekeeping. The case content was examined from a multicultural lens and assessed for congruence with the foundational principles and standards of the counseling profession. Proposed courses of action include remediation for the counselor-in training, support for the supervisor-in-training, and collaborative, culturally responsive communication among the stakeholders.

 

Culturally Responsive Ethical Decision-Making During COVID-19

COVID-19 prompted professional counselors to adapt to rapidly changing circumstances with no advanced preparation. Despite this, the counseling profession responded by shifting: how counseling services are delivered, how counselor educators and supervisors are preparing counselors-in-training, and how counselors-in-training are working with clients under these challenging circumstances (Bray, 2020). In this context, Caila, a doctoral level supervisor and student, encounters a number of ethical concerns which impact several stakeholders. We will assess the case and offer recommendations for the most appropriate course of action through use of the Transcultural Integrative Model (TIM) for ethical decision-making (Garcia et al., 2003).

Transcultural Integrative Model of Ethical Decision-Making

The TIM is an ethical decision-making model that accounts for personal, professional, and collaborative perspectives on ethical dilemmas (Garcia et al., 2003). The TIM is the most conducive model to explore the various dimensions of this case, due to its focus on cultural context and its utilization of social constructivist strategies to collaboratively formulate an ethical response. Caila’s intersecting identities (e.g., race, gender, ability status) and the issues of power and privilege between all the stakeholders inform a number of concerns within this case. We will use the Multicultural and Social Justice Counseling Competencies (MSJCC) to examine each stakeholder’s positionality with respect to their marginalized and privileged identities (Ratts et al., 2016). We will analyze this case through a multicultural lens, informed by the MSJCC, which will permeate our use of the TIM: interpreting the situation, formulating an ethical decision, weighing competing nonmoral values, and planning and executing the selected course of action (Garcia et al., 2003; Ratts et al., 2016).

Interpreting the Situation Through Sensitivity, Awareness, and Fact-Finding

The first step in the TIM (Garcia et al., 2003) is to seek a deep understanding of the potential ethical dilemmas posed in the case. Identification begins with a close examination, informed by the cultural perspectives of each stakeholder, attention to the foundational ethical principles of the profession, and commitment to accurate interpretation (Garcia et al., 2003). There are several ethical considerations in this case: client welfare, counselor impairment, the supervisory relationship, virtual supervision during COVID-19, and professional gatekeeping. The stakeholders in this case are Kyle, Caila, Dr. Smith, Kyle’s clients, and the site supervisor.

Client Welfare

Kyle reported to Caila that his site is not following recommended COVID-19 safety guidelines, which puts his clients at risk. Although Caila attempted to contact the site, her inability to conduct a live site visit precludes her from effectively evaluating client well-being. Caila did not inform Dr. Smith of Kyle’s safety concerns, which exacerbates the clients’ vulnerability. Dr. Smith’s lack of awareness exposes problematic relational patterns in the supervisory triad that may further threaten client well-being.

Counselor Self-Awareness and Self-Advocacy

Counselors are called to grow in self-awareness and to self-monitor for potential impairment (ACA, 2014). Caila has not been fully transparent in her supervisory relationships about her compromised self-efficacy amid the stress of quarantine. Similarly, as counselors and supervisors are charged with advocating for client welfare, they are also called to self-advocate for their wellness. Caila’s difficulty with self-monitoring and self-advocacy is a significant concern with implications for her supervisory relationships and client welfare.

Supervisory Relationships

Transparency and cultural awareness in the supervisory relationship, which appear to be challenges for these stakeholders, are essential to competent supervision and counseling (ACES, 2011). Kyle and Dr. Smith met for supervision without informing Caila, and Caila withheld critical information from Dr. Smith regarding her tenuous mental and physical states. Additionally, ​Kyle draws on commonly used microaggressions against Black women (Moody & Lewis, 2019), which warrants an exploration of his intent and meaning.​ ​Culturally-informed ethical concerns extend to Caila and Dr. Smith’s relationship as well, given its cross-cultural and hierarchical nature. Attention to sociocultural positionality and power differentials appears to be of concern in the supervisory relationship dynamics.

Informed Consent in Virtual Supervision

Supervisors must provide comprehensive informed consent to supervisees prior to engaging in virtual supervision. It is unknown to what extent Caila has met this responsibility. It is unclear if Caila communicated her decision to conduct virtual supervision exclusively in her professional disclosure statement, as suggested by Kyle’s reported dissatisfaction with the absence of in-person supervision.

Gatekeeping

Caila and Dr. Smith are responsible for monitoring Kyle’s patterns of behavior to ensure adherence to professional and ethical counseling standards (ACA, 2014). Dr. Smith is also obligated to continually assess Caila’s competence as a supervisor. Caila’s and Dr. Smith’s struggle to communicate transparently about their respective responses to Kyle’s resistance (e.g., his hesitance to address safety concerns at his site and his response to Caila’s feedback) raises concerns about their efficacy as gatekeepers. Ultimately, Dr. Smith is responsible for ensuring both Caila and Kyle act in ways that safeguard their clients’ well-being.

Formulating an Ethical Decision

Once counselors have fully engaged in a thorough process of exploration, reflection, and fact-finding, they review the ethical dilemma, guided by the ACA ​Code of Ethics​ (2014) and other pertinent guidelines, and seek collegial consultation (Garcia et al., 2003). A review of all of these resources inform possible courses of action.

Relevant Ethical Standards

A.1.a. Primary Responsibility.​ ​Congruent with the fundamental principles of beneficence and nonmaleficence, the primary responsibility of counselors is to “respect the dignity and promote the welfare of clients” (ACA, 2014). Perhaps the most significant concern in this case is client welfare at Kyle’s site. All of the stakeholders in this case have a responsibility to act in the best interest of their clients and ensure their safety.

A.7.a. Advocacy.​ ​Counselors and supervisors are responsible to act as advocates when they identify barriers to clients’ and supervisees’ well-being. Kyle identifies safety concerns at his site and is called to advocate on his clients’ behalf, yet he is hesitant to do so. Likewise, Dr. Smith is responsible for inquiring into the well-being of and advocating for his students and supervisees.

F.5.b. Impairment. Supervisors hold the dual responsibility of ensuring client welfare and fostering supervisee growth. Caila must engage in ongoing self-reflection and self-monitoring to recognize how COVID-related challenges have compromised her ability to carry out her supervisory responsibilities.

F.2.b. Multicultural Issues/Diversity in Supervision.​ ​Supervisors are responsible for broaching issues related to multiculturalism and diversity in their work with supervisees. Given the differences in their racial identities, as well as the hierarchical nature of the supervisory relationship, Caila must broach cultural differences with Kyle, as well as issues pertaining to power and privilege, in order to model effective broaching in the counseling relationship.

F.4.a. Informed Consent for Supervision.​ ​In their use of virtual platforms, counselors and supervisors maintain the responsibility to adhere to established standards of care. As Caila decided to utilize online supervision, it is imperative that she discuss this choice, as well as its implications, in the ongoing process of informed consent with Kyle.

F.6.a. Evaluation and F.6.b. Gatekeeping and Remediation.​ ​As a supervisor-in-training, Caila has the responsibility to give Kyle concrete feedback about his performance and to keep her faculty supervisor apprised of challenges she experiences. As a counselor educator and faculty supervisor, Dr. Smith is responsible for supporting and empowering Caila in her work with supervisees. He will further attend to his supervisees’ developmental needs and tailor his interventions accordingly.

Possible Courses of Action

Once counselors have identified and explored the implications of professional standards, they generate potential courses of action, attending to the positive and negative consequences of each, and engage in consultation (Garcia et al., 2003). Caila is the catalyst for an ethical course of action because, as the case stands, Dr. Smith and Kyle have decided to work together without consulting her. Possible courses of action either include Caila not taking action or addressing Kyle or Dr. Smith separately. ​Caila’s inaction maintains the status quo, leaves Kyle’s clients at risk, and misses an important opportunity for her and Kyle to grow as culturally responsive advocates and counselors.​ Another consequence of Caila’s inaction might be that Kyle would not receive remediation necessary for his development, and he will be at risk of “gateslipping”, a phenomenon in which counseling students who require additional support and education continue through their program without remediation (Gaubatz & Vera, 2006). If Caila chooses to address Dr. Smith or Kyle individually, there would be limited accountability for ethical action and remediation. It is possible Caila will encounter resistance by enacting an ethical course of action; however, there is overwhelming positive value if she chooses to address the identified concerns.

Planning and Executing the Selected Course of Action

Caila, Dr. Smith, Kyle, and Kyle’s site supervisor have contributed to the issues in this case in different ways, and each party will have varied ethical responsibilities. There are common factors to each party’s action: transparent communication, consultation, critical reflection, broaching race and culture, safeguarding client welfare, and documentation. The concrete actions outlined for each stakeholder are based on considerations from the TIM (Garcia et al., 2003).

Caila

COVID-19 pandemic conditions necessitate that counselors “practice what they preach” by engaging in self-care and protecting their health, just as they would recommend to their clients (Bray, 2020, p. 21). As an individual at higher risk, Caila is conducting her work remotely in order to remain safe; however, she is not impervious to the psychological toll of the pandemic. It is imperative for Caila to reflect upon how her marginalized intersecting identities as a Black woman with compromised health inform her worldview, value system, and actions (Chan et al., 2018; Fickling et al., 2018) through the pandemic. ​The contrast between Caila’s sociocultural status and her positional authority in her evaluative role as a supervisor-in-training (Rapp et al., 2018) may have led to a tentative approach to her gatekeeping responsibilities.​ C​ aila must reflect upon why she is reticent to disclose her emotional struggles and recognize that her silence jeopardizes her standing in her doctoral program, her supervisory relationships, and the welfare of her supervisees’ clients.

Caila will benefit from consultation with a departmental advisor or mentor to receive support as she navigates this process and so she may receive guidance about how to engage Dr. Smith and Kyle in a productive dialogue. Caila should schedule a virtual meeting with Dr. Smith to disclose how COVID-related challenges have impacted her supervisory practice. Caila must also address Dr. Smith’s decision to supervise Kyle without consulting her, suggest a meeting between the three of them to address concerns in their supervisory relationship, and work collaboratively with the field placement coordinator to investigate COVID-related concerns at Kyle’s site.

Dr. Smith and the remediation committee at the university will determine specific interventions for Caila; however, crucial components to be infused throughout are: increasing her personal awareness (Roach & Young, 2007), implementing strategies to aid in her development as a supervisor and gatekeeper, (Henderson & Dufrene, 2017; Rapp et al., 2018), and learning how to broach race and culture (Day-Vines & Holcomb-McCoy, 2013). In order to become a culturally responsive counselor educator and supervisor, Caila must acknowledge that effective counseling begins with her self-awareness (Day-Vines & Holcomb-McCoy, 2013). She must recognize how cultural context impacts clients’ concerns and how important it is to model broaching race and culture with her supervisees (Day-Vines & Holcomb-McCoy, 2013). Through her critical reflection and professional development process, Caila will take steps to protect client welfare at Kyle’s site, strengthen her self-monitoring skills, and further develop her identity as a supervisor (Fickling et al., 2018).

Dr. Smith

Dr. Smith can engage in critical reflection using the MSJCC (Ratts et al., 2016) to increase his self-awareness about his power and privilege in his roles as a male counselor educator, supervisor, gatekeeper, and faculty member (Chan et al., 2018). It is crucial for him to respond to his diverse students’ needs and leverage his privilege to support the stakeholders in this case (Chan et al., 2018; Fickling, et al., 2019). Dr. Smith must also reflect on what contributed to his decision to circumvent Caila by offering Kyle supervision, rather than empowering them to address their working alliance directly (Rapp et al., 2018). After this reflection process, Dr. Smith must meet with Caila to follow-up about her experience in quarantine, how she is balancing her responsibilities, and how he can support her. Dr. Smith and Caila should also schedule a meeting with Kyle to: address the challenges in Kyle and Caila’s working alliance, collaboratively create an action plan with the field placement coordinator to address the challenges at Kyle’s site, and integrate the MSJCC into the counseling and supervisory relationships (Fickling et al, 2018).

Dr. Smith should inform Caila and Kyle that he will approach the remediation committee to create plans that are grounded in guidelines such as the ACA​ Code of Ethics​ (2014), the CACREP (2016) standards, and the university’s gatekeeping policies in the student handbook (Shuermann et al., 2018). Dr. Smith must ensure that the plans address Caila’s and Kyle’s specific needs in a way that fosters their professional development (Henderson & Dufrene, 2017). Finally, as a counselor educator and faculty member, Dr. Smith has an ethical duty to advocate for his diverse students. As he engages in critical reflection, recommends remediation, and documents this process from his perspective, it is incumbent upon Dr. Smith to share his experience with his colleagues, department chair, and university officials to implement more inclusive policies that support Black and minoritized counselor education doctoral students like Caila (Henfield et al., 2013).

Kyle

Kyle’s contribution to his personal and professional growth will depend on his personal “reflective stance,” defined as the counselor’s willingness to seek self-reflection opportunities and openness to change (Pompeo & Levitt, 2014, p.85). Accordingly, Kyle will agree to meet with Caila and Dr. Smith to discuss their concerns. Through a balance of challenge and support, Caila and Dr. Smith will guide Kyle’s process of critical reflection to promote his self-awareness. Kyle must reflect on his reluctance to advocate for his clients. Caila and Dr. Smith can validate his fear of negative evaluation but firmly remind him of his primary ethical responsibility and commitment to the foundational principles of the profession.

Cultural responsiveness is an ethical mandate for counselors, and therefore Kyle must reflect more on his cultural identities and how his assumptions, values, and biases inform his decision-making as a counselor and supervisee. For example, Dr. Smith and Caila can challenge Kyle to reflect more on his resistance to Caila’s feedback, as well as his inappropriate response to it (e.g., enlisting Dr. Smith for supervision without Caila’s knowledge). Some resistance to supervisors’ critical feedback is normative (Bernard & Goodyear, 2019), but it is curious that Kyle initially was unable to provide concrete examples of what he reports as “aggressive and too critical.” Such terms are examples of gendered racial microaggressions often applied to Black women in work and school settings (Moody & Lewis, 2019), and Kyle must reflect upon his statements to determine if they accurately represent his work with Caila. The depth of Kyle’s critical reflection, as well as his responsiveness to the specific actions recommended by the remediation committee, will encourage his ethical development.

Site Supervisor

Finally, the proposed action plan must include consideration of Kyle’s internship site. Dr. Smith, Caila, and the department’s field placement coordinator should collaborate on the creation of a plan for addressing the COVID-related safety concerns at Kyle’s site. At minimum, this plan should designate a field coordinator or faculty supervisor who can conduct an in-person investigation. Based on these findings, additional measures can be discerned. Dr. Smith or Caila will further communicate to the site supervisor the importance of open and timely communication. Optimally, faculty, students, and site supervisors will commit to “collaborative gatekeeping” (Dean et al., 2019), which helps to prevent “gateslipping” (Gaubatz & Vera, 2006), in addition to meeting counselors’ fundamental responsibility: to respect client dignity and promote client welfare.

Conclusion

Caila, Dr. Smith, and Kyle are involved in a case with myriad issues, and there are serious ramifications if proper ethical action is not taken. Although COVID-19 has posed several challenges, counselors, supervisors, and counselor educators must still promote ethical practice through transparent communication and collaborative supervision in service of client welfare. We have identified the ethical concerns and the relevant standards from the ACA ​Code of Ethics (2014), and we have proposed an ethical course of action using the TIM (Garcia et al., 2003). The course of action was rooted in foundational counseling principles, racial and cultural awareness, and the counseling literature. Caila, Dr. Smith, and Kyle may all learn from this situation and grow in their professional development which will serve them and their future students, clients, and supervisees well.

 

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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.

Team from New Jersey City University wins ACA’s 2021 Masters level ethics competition

June 15, 2021

This award recognizes exceptional, demonstrable understanding of the ACA Code of Ethics, the foundation of ethical professional counseling practice. Each year, ACA honors top-ranking teams in both Masters and Doctoral level graduate degree programs.

 

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ACA Graduate Student Ethics Award for Master’s Degree Students

By Mercedez Ruiz, Felipe Alexandre, Jay Sontag and Carl Bain of New Jersey City University

 

Madigan, Racine, Cooke, and Korczak (2020) stated that COVID-19 required an urgent change to the implementation of mental healthcare. With stay-at-home mandates and business lockdowns occurring in the interest of public safety, clinicians needed to adapt in order to provide much-needed services to their clientele while ensuring medical safety for all parties. Telemental health services allowed for a continuation of care while adhering to the safety protocols put in place. Benefits to telemental health include a reduction in certain barriers to treatment (transportation, access in rural & urban settings, reduced cost; Madigan, Racine, Cooke, & Korcak, 2020). However, there are also significant limitations to telemental health such as magnifying social inequalities (lack of adequate or no internet connection, lack of devices that can connect to the internet, lack of internet literacy; Madigan, Racine, Cooke, & Korcak, 2020). There is also the question of a clinician’s comfort and competence level to provide telemental health services. All of these benefits and limitations combined create a very unique situation that many clinicians and students may be facing when navigating telemental health services. This brings us to Shannon’s dilemma as a practicum student whose clinical field experience changed drastically due to the pandemic.

 

Decision Making Model: Identification of Problem, Application of Code of Ethics, and Nature of Dilemma

Shannon’s site has allowed for distance counseling but has not ensured that supervisees are able to offer knowledgeable or competent client care. In addition to lacking telehealth training, Shannon does not possess the right technological resources and cannot offer an appropriate setting to deliver confidential, ethical, or effective counseling remotely. Because supervision is overseen virtually, Shannon is finding it difficult to maintain a healthy working relationship with her supervisor (B.3.c. Confidential Settings; American Counseling Association, 2014). Shannon’s lack of training and resources, and the current management style of her supervisor, may be contributing to her feelings of discomfort towards distance counseling. Shannon is certainly faced with unique challenges caused by a global pandemic but attempting to overcome these issues would be consistent with the foundations that the counseling profession is built on.

While their recent attempts to meet have been unsuccessful, Shannon must work quickly to improve the relationship with her supervisor and address her personal concerns (F.8.d. Addressing Personal Concerns; American Counseling Association, 2014). By working closely with her supervisor, Shannon will have the best chance of achieving her main objectives — delivering confidential, knowledgeable and competent client care during practicum.

Shannon must ensure that she is skilled enough to provide distance counseling, so she must ask her supervisor to direct her towards the best telehealth training module. When discussing options, Shannon should be ready to suggest some of the online courses that she has found, especially if her supervisor is unfamiliar with telehealth training. By working with her supervisor to identify optimal telehealth training resources, Shannon may be able to obtain the right levels of knowledge and competency (H.1.a. Knowledge and Competency; American Counseling Association, 2014).

Next, Shannon must identify the best way of delivering private and confidential care to clients. Because she lives with two roommates, it may be unrealistic for Shannon to expect privacy for herself or her clients. Furthermore, internet providers in her area do not offer reliable service, which will likely lead to continued frustration for Shannon and her clients. While Shannon can inform clients of the benefits and limitations of digital counseling, the level of care that she can offer under current conditions could potentially do more client harm than good.

Shannon’s community mental health agency is limiting in-person activities; however, mental health providers do qualify as essential under current guidelines. Once she is knowledgeable in digital counseling, it may be prudent of Shannon to explore the possibility of offering distance counseling to clients from the mental health agency rather than her apartment. The agency site will presumably have the technological resources that Shannon needs for distance counseling. It is also very likely that the site can offer a private setting for Shannon to conduct digital counseling alone and undisturbed. Shannon is uncomfortable offering counseling under her current circumstances; however, it is possible that her feelings may change once she is able to offer counseling under better conditions.

Despite the global pandemic, in-person mental health services are still the only way that some individuals can obtain treatment. Fortunately, the Community Mental Health Centers Act of 1963 mandates that these community centers provide a wide range of federally and state- funded outpatient services to the underprivileged and low-income community (National Council for Behavioral Health, 2021). As such, it is possible that Shannon’s site will continue offering in- person counseling to some capacity. During conversations with her supervisor, Shannon should also explore the possibility of offering in-person counseling services at the agency. By doing so, she may be able to serve the disadvantaged members of her community, while at the same time, provide therapy in a way that is more consistent with her previous training. While providing in- person therapy may be a good option, Shannon must carefully discuss the various safeguards and protocols that are in place at the agency in order to make the best decision for herself and her clients.

Potential Course of Action

We have determined the following as possible courses of action for Shannon to take. We concede that each option has some undesirable consequences and/or risks associated with them. They are: A) to continue working from home by problem-solving individual issues; B) to explore the option of returning to the site or her university; or C) to discontinue practicum. Problem-solve current work-from-home situation (Option A)

Step 1. Consider getting supplemental training in telemental health. Telehealth training courses can be found online and are usually completed in under eleven hours (Center for Credentialing & Education, 2021). Shannon should seek out other professional development resources such as the ACA to receive additional training (there are digital resources available on the counseling.org website).

Step 2. Documenting site supervisor. We are not of the opinion that this supervisor needs to be reported, given the current unusual circumstances regarding COVID-19. We do, however, believe that Shannon’s supervisor may be behaving unethically and in a way that is unjust both to Shannon and, more importantly, to the clients she is serving. Shannon should keep a regular and accurate record of the number of meetings missed by the supervisor as well as detailed notes regarding anything that has led her to believe that the supervisor is “distant.” This way Shannon has a log of the things that have been done outside of her control that may be affecting her current growth and practice as a counselor, as well as her mental health as a pupil.

Step 3. Work out a strict schedule with roommates. The efficacy of this plan is seriously limited by what kind of space Shannon has, but the reality is that she cannot continue to work in her current environment if there is any risk to the clients’ privacy.

Step 4. Work closely with her graduate program supervisor. One step which needs to be taken before any other action or plan is put in place is that she must get in contact with a program supervisor regarding the difficulties experienced with the site supervisor. While her weekly group meeting might not be the optimal time for her to voice her concerns, she still must make the time and space to reach out if she is to proceed ethically.

Desirable Outcomes

Shannon will be able to continue practicum. Naturally, Shannon is eager to complete her hours and graduate in a timely manner. Trying her best to adapt to and persevere in the current global situation would be important for Shannon’s livelihood and may even be necessary depending on her current economic standing. Additionally, clients will be able to continue service with the same counselor they are used to and with whom they have formed a rapport. It is important to remember that especially during times of national and worldwide crisis, clients who have underlying emotional challenges are made more susceptible to negative thoughts and feelings. Shannon should try very hard to continue seeing her usual clients, but only if she can provide care competently and with integrity.

Undesirable Outcomes

Shannon still has difficulty with her internet. Since this is a problem with her region as a whole, this is not a resolvable issue, and Shannon would have to continue seeing clients with the understanding that calls or sessions may be dropped. A significant risk of this ethically is that if Shannon is seeing a client who is contemplating hurting himself or others, she is at even more of a disadvantage than the normal (suboptimal) remote session would allow, since she may not be able to get back into contact with the client. Likewise, a client may forget her circumstances and misinterpret a dropped call, triggering feelings of rejection or abandonment.

Even with a schedule resolved and use of headphones, it may be unavoidable that the roommate could overhear information regarding a client. For the roommates to even know the name of Shannon’s clients is a breach of the clients’ privacy, and so the specifics and nuances of the living situation really could provide an insurmountable block for Shannon’s practice. In addition, during quarantine the roommates may not have another location to go and may be uncomfortable with leaving home or even susceptible to the COVID-19 virus. Given these circumstances, it would be important for Shannon to consider how much space she and her roommates have and if there is a way to ensure maximum possible privacy.

Return-To-Site or Find Secure Alternative Location (Option B)

Step 1. Consider getting supplemental training in telemental health.

Step 2. Seek more and better support from the site supervisor. This may require Shannon to go to her program’s faculty with her documentation or she could simply go to the supervisor and be direct about her discomfort. We would advocate the latter as a show of professionalism and respect, but if Shannon is struggling emotionally and mentally then having additional support may be necessary.

Step 3. Inquire about the potential for Shannon to be counseling clients remotely, from the site. This option has the highest potential for positive outcomes out of our three solutions.

Desirable Outcomes

As stated above, we believe that the clients should whenever possible have continuous service from the same individual to whom they have grown accustomed. Rather than seeing clients face-to-face, the risks of catching or transmitting COVID-19 are made lower by continuing to have remote therapy. Shannon’s internet service will be better at the site than in her home. Client privacy is guaranteed if Shannon is able to practice in a space similar to her previous onsite area of practice. The security and integrity of Shannon’s practice will be improved significantly if she is able to be onsite and interact with her direct site supervisor or other mental health practitioners at the community health center. Shannon can still attempt to gain feedback and consult with other professionals, rather than being isolated in her home during her practicum. Finally, Shannon can still gain her hours and experience, graduating from her program on time.

Undesirable Outcomes

It is still possible that the site may not allow for Shannon to return by herself or may not view her services as “essential.” Shannon may still have unresolved issues with telemental health even if she receives supplemental training and has a more efficient environment. Shannon may also be uncomfortable with elements related to COVID-19, particularly if she relies on public transportation for her commute or if she is in an especially vulnerable group for contraction of the virus. If Shannon is able to drive directly or walk to her site, and if the center is open and has regular sanitation maintenance, then her risk is reasonably low.

Discontinue Practicum (Option C)

Step 1. Admit Incompetency. If Shannon cannot remedy her current situation greatly using options A or B, then it is not ethical for her to continue practicing and seeing clients in this way. If she is not able to guarantee safety, privacy, and quality care to her clients, then unfortunately Shannon should show respect to the profession and her clients by stepping down temporarily and resuming her program when circumstances are better for her.

Desirable Outcomes

While we sympathize with Shannon and think that this option is to be pursued only if no other alternatives remain, it is the better option ethically. In her current state, Shannon is doing a great deal of unintentional harm. She is damaging her clients, and herself, emotionally. Shannon is not comfortable with her current level of care, which indicates that she is not in the correct place emotionally or mentally to be taking on the difficulties of others. During an unprecedented time when many people are undergoing loss, trauma, financial difficulty and instability on such a wide scale, mental health practitioners are needed and needed at their best. She is also violating her clients’ right to privacy. Shannon cannot currently guarantee their privacy by continuing to practice in an open space where her roommates may hear information or recognize faces. Currently, Shannon is also not receiving sufficient supervision to learn from or grow from her experience, meaning that even if she completes the hours necessary that does not mean her education will have been of sufficient quality to begin practicing or obtain a license.

Undesirable Outcomes

Shannon’s clients will face the difficulty of transferring counselors, and given the pandemic, it is possible that there is a shortage of working mental health practitioners to fill her spot. As stated above, we are of the opinion that it is very undesirable for clients to be taken from the counselors they have relationships with, especially during this time of general upheaval and instability. This will also have unfortunate consequences for Shannon. She may have to put her career on pause, may face financial instability, and may even experience a worsening of her currently suboptimal mental state. Our advice to Shannon if she absolutely had to follow this option would be to prioritize her own mental health and try to decompress from the stressful situation and painful decision.

Review of Options and Conclusion of Best Course

Our conclusion on reviewing these options and the positive and negative consequences of each, is that Shannon should first attempt to implement option B. If she is able to go to the site with her laptop and mask and can deliver care safely (and perhaps even receive improved site supervision and further training in telemental health) then we believe this imposes the fewest ethical violations and risks. If this option is made impossible by the site or another factor relating to Shannon’s health and comfort, we would urge her to follow the steps outlined in option A and to seek guidance on how to proceed ethically from her program’s faculty. We are unanimous that Shannon should not pursue option C unless absolutely all other factors are unimprovable. Just as a counselor would encourage their clients not to give up and to problem-solve their issues, we would hope Shannon does not cave under pressure but rather gathers herself and tries again.

Evaluation of Selected Course of Action

After reaching a conclusion regarding the best choice of action, we administered three self-tests to evaluate our choice. The first was the test of justice, asking ourselves if we would treat others in a similar situation the same (Remley & Herlihy, 2016). The second test was the test of universality, asking ourselves if we would recommend our course of action to others in a similar situation (Remley & Herlihy, 2016). If other counseling students or clinicians found themselves in a similar situation, we felt confident and comfortable that we would provide them with similar recommendations. Offering a menu of options such as receiving additional training, problem-solving privacy/internet issues at home, and seeking support from supervisors/colleagues provide the individual with an array of options that are culturally sensitive. In regard to Shannon’s situation, and those who are in similar situations, it is difficult to provide a one-size-fits-all solution to this. While for some working out a schedule with a roommate is an easy fix, others may find this very difficult. Keeping in mind that every counseling student does not have identical home environments, access to high-speed internet, and access to private office space, we feel that the course of action listed in option B is culturally considerate and promotes justice and universality. The final test was the test of publicity, asking ourselves if we were willing to have our actions be known to others (Remley & Herlihy, 2016). We felt willing to have our course of action be known and felt hopeful that having others know of our actions could provide guidance to those in similar situations.

 

Conclusion

In summary, we understand that as a graduate student and aspiring mental health counselor maintaining the competence of a consummate professional is not just an ideal but is paramount and attainable. We believe in order for Shannon to proceed ethically and with the most professional standard of care, these are the optimal options to ensure that both the clients receive adequate counseling and Shannon eschews continuing to do her clients a disservice, which could lead to irreparable harm. We also believe that these are the requisite steps to ensure her clients receive counseling that is conducive to a healthy and appropriate environment while also giving Shannon the space where she feels comfortable, competent, and supported by a present and active supervisor.

 

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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.