Tag Archives: Counselor Educators Audience

Counselor Educators Audience

Healthy conversations to have

By Kathleen Smith July 26, 2017

In the United States, 1 in 6 adults has a prescription for a psychiatric drug. That ratio only increases among individuals who walk into counselors’ offices, leaving many counselors feeling that they must perform a special type of tightrope act to talk about medications with their clients. Given that licensed professional counselors don’t possess prescription privileges, some counselors feel that they lack the training to carry on such discussions. Other counselors fear letting their own beliefs and biases show. Regardless of the reason, some counselors are quick to refer clients back to their doctors or psychiatrists rather than engaging clients in a thorough conversation about medication management themselves.

Because primary care physicians write almost 70 percent of antidepressant prescriptions, counselors may find that new counseling clients who are on medication have yet to have an extended conversation about medication management and their overall mental health. These clients may not have given much consideration to how long they want to stay on medication, or they may be uninformed about the possible risk of growing dependent on sedatives, anxiolytics and other medications.

Several counselor educators are taking up the charge of encouraging more informed and comfortable conversations in the counseling room about client medications. American Counseling Association member Dixie Meyer presented with colleagues at the association’s 2016 conference in Montréal on adjunctive antidepressant pharmacotherapy in counseling. Meyer dedicated her dissertation research to the sexual side effects of antidepressants and their effects on romantic couples. As her research expanded, she grew more and more fascinated with exploring the relationship between psychopharmacology and counseling.

Today, as an associate professor in the Department of Family and Community Medicine at St. Louis University, Meyer educates many primary care physician residents, and she notes that counselors sometimes forget that they have a unique ability to conceptualize clients. “Primary care physicians are expected to be able to know pretty much anything, but they do not have the same level of depth in their mental health training,” she says. “Counselors need to really think about what kind of information they can share with a primary care physician, and the answer is, a lot.”

Meyer explains that counselors may have a greater understanding of the impetus for the client’s condition, the specific symptoms the client has experienced, which of a medication’s potential side effects might be more of a challenge for the client and what additional resources the client may need to maintain medication adherence.

Biases and fears

Professional counselors carry their own biases and values related to psychiatric medications, often based on their individual experiences and training. It is easy to see how the counseling profession as a whole might feel threatened by the statistics, however. For example, nearly $5 billion is spent every year on TV ads for prescription drugs. Then there is the fact that more than half of all outpatient mental health visits involve medication only and no psychotherapy.

A physician assistant with a second master’s degree in counseling, ACA member Deanna Bridge Najera is frequently invited to talk to counselors about improving dialogue between medication prescribers and counseling professionals. She gave a presentation at the ACA 2017 Conference in San Francisco titled, “Medicine Is From Mars and Counseling Is From Venus: How to Make It Work for Everyone.”

Najera has heard skeptical counselors make many statements about psychopharmacology, including that such medications turn people into “zombies,” alter their personalities or simply produce placebo responses. As a master’s counseling student, she also heard many comments from fellow students about their negative relationship with medication or their family members’ negative experiences.

“We have to make sure that we have these conversations out loud,” Najera says. “We have to ask counselors what their concerns are. The way I explain it, the medicine is supposed to allow you to be who you’re supposed to be. It doesn’t change who you are; it just makes it more manageable to learn and grow.”

Although there is still no clear winner in the medication versus therapy debate, researchers are learning more about who might respond to one treatment better than the other. For example, a 2013 study in JAMA Psychiatry found that patients with major depression with low activity in a part of the brain known as the anterior insula responded well to cognitive behavior therapy and poorly to Lexapro. Those patients with high activity in the same region did better with medication and poorly with the therapy. Researchers have also concluded that patients who are depressed and have a history of childhood trauma do better with combined therapy and medication than with either treatment alone.

“We chose our profession because we believe in our profession,” Meyer says, “but the research is going to report no differences between counseling and medication. I do see a lot of bias, and one of my concerns is that our No. 1 goal should be to help the client. So whatever the client’s perspective is, whatever the client thinks is going to help them is probably what will help. They are the experts on their own life.”

Erika Cameron, an associate professor of counseling at the University of San Diego and an ACA member, presented with Meyer in Montréal. When they were enrolled in the same doctoral program, Cameron found herself sharing Meyer’s interest in psychopharmacology and considering how she could respond to the general wariness of school counselors around the topic of medication.

“There can be a bias that that’s not part of their role. They are not diagnosing or prescribing, so they don’t need to know about medication,” says Cameron, who once worked as a school counselor. “But by not talking about it, we might be harming the client. Or if you don’t know that a student is on a medication, then you don’t know what behavior sitting in front of you is normal or atypical for that particular student.”

Another common trepidation among counselors is the fear of stepping outside their lane when it comes to talking about psychiatric medication. Clients often ask for advice about certain medications or when starting any type of drug, but there is a temptation among some counselors to avoid the subject or simply to refer all questions in that vein to a psychiatrist or doctor.

Franc Hudspeth, associate dean of the counseling program at Southern New Hampshire University and also a licensed pharmacist, says that counselors should serve as educators and advocates when it comes to client medications. “We should never cross that line of telling a client what to do with that medication,” he says. “We have to refer back to the foundation of our profession. We help individuals overcome problems, and we don’t give them the solutions. It’s saying to the client, ‘If you have concerns, we can present this to your prescribing physician, and I will support you in any way, but I’m not going to tell you how to do it or what to do with the medication.’ I wouldn’t even do that as a pharmacist. We have to help people make the best decisions based on the best information.”

Hudspeth also says that he observes more of a general hesitancy at work than a fear of liability among counselors. “If someone advocates for their client and their voice gets squashed by a physician or a psychiatrist, there may be some hesitancy to get involved. But it never hurts to voice concerns and to be the advocate for your client,” he says. “[Still], I do think that some counselors fear the repercussions of helping a client speak up.”

Having the conversation

How exactly should counselors respond when clients want to talk about psychiatric medications? In an effort to provide effective psychoeducation, Meyer says, counselors shouldn’t be shy about asking thorough questions upfront concerning clients’ beliefs and ideas related to medication. She suggests asking questions such as, “How do you know that you want to be on a medication?” and “Are you likely to have another depressive episode?” Questions such as these can provide valuable insight into the client’s knowledge (and knowledge deficits) about medication. For example, a client who wants to take an antidepressant might not realize that half of all individuals with depression will not experience another episode.Most frequently prescribed psychiatric medications in the U.S.

Najera also encourages counselors to ask clients where they obtained their knowledge about particular medications. “Many people have the idea that newer is always better, which study after study has shown is not true,” she says. “A client might see a commercial for a new medication and ask if it will work. I’d rather them not break the bank for a new medication when there’s a $4 medication at the local pharmacy that’s just as effective.”

Hudspeth suggests that counselors do a medication check-in with clients at every session. He says the best question counselors can ask clients who are already on medication is, “How is your medication treating you?” This kind of general question can help counselors gather information without overeducating clients in a way that predisposes them to having side effects, Hudspeth explains.

Cameron agrees that the simplest approach is often the most empowering for clients. “Sometimes [it’s simply] asking, ‘Did you read the really long paper that came in the bag with your pills? What is the medication really treating? What are its side effects? What would be considered not normal for you?’ [It’s] educating clients to be critical consumers of their medication,” she says.

Cameron also encourages counselors to role-play conversations that clients could have with their prescribing doctors. Counselors can assist their clients with compiling a list of questions to ask and also encourage them to track their symptoms, thoughts and feelings while on a particular medication. Data can be a powerful tool for holding doctors accountable for connecting clients with the best medication options, but sometimes clients need to learn what to observe while on their medications, Cameron says.

Counselors may also need to have conversations with clients about the impact that their physical health can have on their mental status. Meyer encourages counselors to take time to consider how nutrition, physical illnesses, medications and other substances could potentially influence the mental health of their clients. Anything from high blood pressure medication to birth control pills to low iron could be a culprit, and Meyer worries that individuals who don’t provide their doctors with detailed information about their health are at risk of being prescribed medications that don’t fit their particular symptoms.

“If a client has not had a physical in a long time, then you do not know if there are cardiovascular concerns, hormonal concerns, cancer symptoms or one of the many other disorders that can have depressive side effects or present as depression,” Meyer points out.

Counselors are also charged to have open and honest conversations with parents who are worried about putting their children on psychiatric medications. When Hudspeth worked as a pharmacist in the early 1990s, he began noticing that many children were being medicated without solid reasoning to back it up. Thinking there might be a better approach, he went back to school to become a counselor and later a counselor educator. In his counseling work with children, he has fielded many questions from parents about whether their child should be evaluated for the need to take psychiatric medication.

“My perspective is that the evaluation isn’t going to hurt anything,” Hudspeth says. “I tell parents that they don’t have to make the decision to choose medication, but if the child is medicated, he or she will also do better if they’re in therapy. The two treatments are synergistic, and our goal as a team is to find the [right] balance of different components.”

Cameron adds that school counselors are presented with the complex task of advocating for developing kids who are on medication. “Because there’s so much hormonal change and physical growth, medication may need to be adjusted more frequently,” she says. “School counselors have the ability to see these students on a daily basis, and if we’re not paying attention to these changes, there could be a downward spiral before something
is corrected.”

Psychopharmacology in counseling classrooms

Counselor educators are tasked with preparing their students for the increased use of psychiatric medication among their clients. The 2016 CACREP Standards require clinical mental health counseling students to be educated about the “classifications, indications and contraindications of commonly prescribed psychopharmacological medications for appropriate medical referral and consultation.” Similarly, the CACREP Standards say that counselor education programs with a specialty area in school counseling should cover “common medications that affect learning, behavior and mood in children and adolescents.”

Hudspeth is of the belief that every master’s program in counseling should require a psychopharmacology course. “When 50 percent of our clients are on medication, we should have a basic foundation for understanding psychopharmacology,” he says. “New practitioners need to be better prepared for what they’re going to face in internship or post-master’s work, so they should be familiar with what medications are used for what disorders and what kind of side effects pop up.”

A 2015 article in the Journal of Creativity in Mental Health by Cassandra A. Storlie and others explored the practice of infusing ethical considerations into a psychopharmacology course for future counselors. The authors argue that counselor educators should engage students in talking about how their own values and perceptions about medication use could potentially affect the quality of counseling service they provide. The authors tracked the success of one psychopharmacology course that asked students to complete a variety of creative assignments, including reporting on a legal or ethical issue in the field of psychopharmacology, interviewing an individual who takes a psychotropic medication and discussing fictional client scenarios. At the end of the course, students reported greater confidence in how they understood their role related to discussing medication with clients.

Cameron agrees with the benefits of offering a psychopharmacology course to counseling students. She also sees value in inserting medication conversations into her supervision work with students. When her students bring in case conceptualizations during their internship work, she asks them to list what medications the client is taking. She then asks them to educate their peers about what each medication is treating, what the dosage is and any typical side effects.

“I have to model being comfortable bringing up the topic of medication so that my students get more comfortable,” Cameron says. “Often they don’t talk about medication because they feel that they don’t know it all. They don’t want to give bad information. But they can learn to take a proactive role by sitting with a client and saying, ‘Hey, let’s look this up. Let me get this resource guide or a consult on this.’ There’s this fear, especially with student counselors, that you have to know everything to be able to be helpful.”

Areas for growth

Of course the work of medication education doesn’t end with graduate school. New medications are steadily being introduced, and over time researchers will learn more about the long-term effects of popular ones. Cameron recommends that counselors keep a copy of the Physicians’ Desk Reference, a compilation of information on prescription drugs, in their office. “They update it pretty regularly, so when you have clients come in, you can open the book and figure out what’s going on,” she says.

Hudspeth says counselors should stay informed but also avoid the subtle ways in which they might give advice about any medication, including over-the-counter ones. “A client may come in and say, ‘I’m having difficulty sleeping,’ and a counselor says, ‘Have you tried melatonin?’ They just stepped over that line,” Hudspeth says. “Just because you can buy it at Target or Walmart doesn’t mean you should be asking those questions.”

Meyer suggests that counselors who feel overwhelmed with the breadth of information on medications begin with the client population they serve most frequently. “What information can help your particular clients?” she asks. “Start there and seek out information, depending on who’s coming in and how you can treat them to the best of your ability.”

Above all, Meyer recommends that counselors never forget to take the topic of medication seriously in their work and training. “When you are choosing to take a medication, you may be choosing to have potential side effects. You are choosing that you will alter your neurochemistry. That is not a decision that should be taken lightly. It is not an easy decision,” she says. “When a client makes a choice about whether to take a medication, they need to make it from a place where they are well-informed.”

 

****

 

Kathleen Smith is a licensed professional counselor and writer in Washington, D.C. She is the author of The Fangirl Life: A Guide to All the Feels and Learning How to Deal. Contact her at kathleensmithwrites@gmail.com.

Letters to the editor: ct@counseling.org

 

****

 

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.

Teaching counselor education curriculum in a ‘new reality’

By Suzanne A. Whitehead May 19, 2017

I love my job, my calling, as a counselor educator, and I take my role and passion as a graduate student advocate, public innovator and social justice change agent to heart every single day. As Mahatma Gandhi once said, “Be the change you wish to see in the world.”

His words are my mantra in life. Each one of us touches the hearts of so many others and, thus, the very future.

But teaching in these uncertain, turbulent times has been challenging to say the least. A powerful, yet almost silent and unspoken subtle change has occurred in my classrooms. It almost feels like a gray mist or cloud that is not seen but clearly felt.

I have never tried to be political with my students or to discuss politics in the classes that I teach. I don’t believe in it. Just because a professor has a “captive audience” in a class and CAN speak his or her mind doesn’t mean that one should. I don’t shy away from state, national or global issues because they are often pertinent to the material we discuss. Still, I don’t offer my own political opinion on these issues, mostly out of respect, but also because I feel it’s the right thing to do.

I care a great deal about my students. I can see the concern and worry in their eyes. They are more unsettled than normal, and the mood is palpable. Approximately 80 percent of my students are Hispanic and bilingual. They share an immense pride in their heritage, culture and family systems. I honor their commitment to their communities, their livelihoods and this country that they dearly love.

My students bring in reports of their own counselees in schools and agencies who share stories of intense fear, anxiety and pain at the idea that they, or their parents, could be deported. We have a lot of “Dreamer” students (children of undocumented immigrants) at my university and many of these children and families in our surrounding communities. Their understandable angst is powerful, heart-wrenching and compelling.

 

Teaching in these challenging times

And now we are asked to continue to teach our students as though nothing has changed in our world. No matter how one voted (or chose not to vote) in our nation’s most recent election, one thing is for certain: It has been an incredibly acrimonious, divisive and challenging time for our entire country. I have my opinions, but they are not for me to share them with my students. Yet they share theirs, every day. They have to because it affects their lives, their families and the clients they serve.

Other counselor educators who are struggling with these same issues may be wondering: How do we respond in a caring, empathic, yet ambiguous, way and not take sides?

The danger in “taking sides” is that even if I find great personal solace in doing so, I may also inadvertently destroy a student’s belief that each person has a right to free speech and to believe as he or she sees fit. In my bully pulpit ramblings, I could possibly (even if unintentionally) insult or even scar a student who may hold vastly different opinions from my own. That would be inexcusable. That serves no one except for my own selfish gain.

 

What we can do

It tugs at my heartstrings, but the only conclusion I can see is to treat this situation as a counselor would with any client. We must be confident, genuine, caring and willing to listen. We need to share that we understand students’ (and their clients’) fears and concerns. We express great empathy for what they are experiencing and model, summarize and validate their honest emotions, using an overall person-centered approach from Carl Rogers.

This isn’t always easy with a large number of students on one’s caseload. I never want to appear disingenuous. I just keep telling them, and myself, that their feelings, and those of their clients, are real, significant and truly matter. I will not judge; that is not my purpose as an educator. And I will not just gloss over everything with the proverbial, “It will all be just fine” message, to assuage their fears and my own discomfort.

All we can do is let them know how much we care and then use our own therapeutic orientations that we hold dear to help them and their clients. For example, in using a brief solution-focused therapeutic approach (Steve de Shazer), they can explore their options and what they believe IS within their power to influence, and develop effective ways to cope and move forward. These are all productive ways of handling and making sense of difficult times. The basic tenets of Viktor Frankl’s logotherapy seem useful here as well — finding purpose and meaning, even within one’s suffering and turmoil, and a reason to keep going.

 

Wellness for counselor educators

It is also more evident than ever that we as counselor educators need to take the time for wellness and coping strategies for our own mental well-being. It is one thing to conduct site visits and observations to see each of my students working with children, adolescents and adults. I too hear their stories firsthand and feel great empathy for their situations. But now, we also hear the same concerns from our students in our classes, and it is hard not to feel their pain intensely.

I reach out to my professional colleagues for feedback and interaction. I value the unwavering support of my family and friends and cherish their input now more than ever. And I have become intensely aware of where my own “head” is at — and my emotions — and utilize my coping strategies to the fullest. I consciously try to “check my ego and attitude” at the door before I step into the classroom and hold fast to the belief that I am here to instruct, teach, lead and inspire. The American Counseling Association’s values and code of ethical conduct are bedrocks of sanity to hold dear.

I am guessing that things will continue to be tricky for many of us in the coming months and years. As educators, we need to help each other through these very different times and circumstances. Knowing that the counseling profession is strong, and that our colleagues are always there for us, brings great comfort and resoluteness. My fervent hope is that it brings the same to each of you.

“Carpe diem,” dear colleagues.

 

 

****

 

Suzanne A. Whitehead is a licensed mental health counselor and assistant professor of counselor education at California State University, Stanislaus. Contact her at sawhitehead7@gmail.com or swhitehead1@csustan.edu.

 

****

 

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

Behind the Book: Counseling Research: A Practitioner-Scholar Approach

By Bethany Bray April 17, 2017

The first paragraph of the preface in Richard Balkin and David Kleist’s book Counseling Research: A Practitioner-Scholar Approach acknowledges that research is probably not something that most counselors get excited about.

However, it’s a much-needed endeavor and something that counselors are particularly suited for, they write.

“Counselors make great qualitative researchers because of the natural fit of hearing our clients’ narratives and to establishing meaning from them. These same skills can be used in developing meaningful research,” they write.

Counseling Research: A Practitioner-Scholar Approach was published by the American Counseling Association this year. Balkin, a professor and doctoral program coordinator at the University of Louisville and Kleist, a professor and chairman of the Department of Counseling at Idaho State University, know each other through their work in the Association for Counselor Education and Supervision (ACES), a division of ACA.

 

Counseling Today sent the co-authors some questions, via email, to learn more.

 

Your book emphasizes the “practitioner-scholar model” for research. Can you elaborate on that?

Rick Balkin: As a journal editor [Balkin is editor of ACA’s Journal of Counseling & Development], one of the topics discussed often is the gap between practice and research. Does one reflect the other? It should, and we see this in the ACA Code of Ethics, “Counselors have a responsibility to the public to engage in counseling practices that are based on rigorous research methodologies” (p. 8).

Many future counselors might think they will never do research, but they will definitely use research in their practice, and so we hope this text serves as a nice bridge. Furthermore, we provided sections on research design [to] help emerging researchers, such as a beginning doctoral student, begin to conceptualize how they can design and conduct research.

David Kleist: For myself, I was strongly motivated to clarify the “practitioner-scholar” role and relevance for master’s students identity as developing professional counselors. For years the profession of counseling has only viewed master’s students as passive consumers of research, not active knowledge-producers. However, with the counseling profession’s distinct training structure (with the terminal clinical degree being the masters), and the doctoral degree focused on counselor education and supervision, we need licensed professional counselors who see their role as researchers — that is practitioner-scholars — to inform the practice of counseling as they comprise the majority of front line counseling practitioners. A past doctoral advisee of mine, Megan Michalak (2013), conducted a grounded theory study of how counselor educators promote scholarship with counselors-in-training. Her research communicates that this role as knowledge-producer can be integrated into counselor training beyond merely training master’s students to be passive consumers of research.

 

In your words, why are counselors a good fit for research work? What particular skills do they bring to the endeavor?

Rick: Our skills in listening, attending to a narrative and trying to get deeper into the issues affecting our clients make us a natural fit for qualitative research. To be good stewards of the profession and strong advocates for professional counseling, we need to know that what we are doing is effective and helpful – and be able to explain that to consumers and stakeholders. We need to be knowledgeable about research and how to access and evaluate data in this era of accountability where counselors may be called in to court or have to justify our services and funding.

David: Rick is dead on accurate, particularly as to the readiness for counselors to conduct qualitative research. The foundational counseling skills are also the foundational skills of skilled qualitative researchers. The counseling profession is situated to be at the forefront of mental health qualitative research.

 

What was your inspiration to collaborate and create this book?

Rick: Often research courses for counseling students are farmed out to another departments or taught across the college of education. In other words, counseling programs often lack ownership of their research classes. That is unfortunate, because we end up learning about, and ultimately trying to adopt, the strategies used in educational research. But educational research is often related to student performance in classrooms, schools, school districts and statewide performance. These are large systems with a lot of people and data. But whom do counselors see? Predominately we see an individual, small groups, couples and families. So I view counseling research as quite different from educational research, and I wanted to highlight that as well as provide an opportunity for counseling departments and counselor educators to take more ownership of their research classes. ACA did not have a research book, so I saw an opportunity to lend a counselor voice to this area.

I truly enjoy teaching research and helping students understand and relate to concepts that quite often are found intimidating. David Kleist and I knew each other for many years and have co-chaired the ACES INFORM program together. I knew his passion for qualitative research, and I wanted that passion and voice reflected in the book. I think that is something that this text delivers that is different from other books.

David: Hearing that ACA reached out to Rick to write a research book made total sense. When Rick approached me I was touched by his generosity, and his understanding that he could write the qualitative chapters but maybe not with the same passion as he would the quantitative chapters. For myself, I felt overwhelmed, and initially quite hesitant. I knew that I had clear ideas and passion toward qualitative research but wondered what collaboration with Rick would look like. I trusted our past — and ongoing — relationship through ACES and thought we could create an accessible text that clearly communicates the role of scholar for both doctoral and master’s students in the counseling profession.

 

Do you feel the counseling profession, as a whole, produces enough research? Is there an unmet need (if so, what particular areas of research)?

Rick: I think we need to do more client-centered research. We see a lot of research come out on the role of counselors, counselor training and training/practicing within various competencies. But I think we need more research on what we [are] doing with our clients and how our interventions affect clients. I think this type of research can elevate our profession even further.

David: I agree with Rick and would refer back to my comments above to extend the conversation. The counseling profession’s training structure is distinct from the profession of psychology. Psychology has the doctoral degree as the terminal clinical degree, which clearly includes training to conduct research. Thus, psychology conceptualized the “scientist-practitioner model” more than 70 years ago to frame the purpose of the doctoral degree in psychology. The counseling profession would benefit from framing the training of professional counselors as “practitioner-scholars” [and] client-centered research would be the focus. For the doctoral degree, which focuses on producing counselor educators and supervisors, we need to conduct research on the education and supervision of counselors, too, stretching our time thin for also conducting client-centered research. Our profession is still young and developing, and framing our master’s level counselors as “practitioner-scholars” will go a long way to meeting Rick’s goal — our goal — of conducting more client-centered research.

 

What would you want counselor practitioners who aren’t in university settings to know about this topic?

Rick: Research is similar to our counseling skills; if you are not using your skills you tend to get rusty. So, for counselors who have not thought about research in a while, this text provides a very readable overview. We tried to use a voice in this text that is more engaging, fun and practical. Like any research text there are technical terms, but I believe we explain them well and we only use counseling examples. All of the research cited in the book is from counseling research. In essence, this is a book written by counselors for counselors.

David: Research is becoming more and more a collaborative endeavor. I would want counselors to have access to counselor educators in academic settings to consult on developing group research projects targeting the frontline provision of counseling services.

 

What makes research an area of interest for you, personally?

Rick: The formative experiences of my counseling career including working with adolescents admitted to inpatient psychiatric hospitalization. I worked during the period [when] managed care really started to take over — in Arkansas that was 1993 to 2000. So, I saw a lot of change in terms of length of [hospital] stay and how we had to justify our treatment interventions for working with adolescents. I constantly had to answer questions related to why the adolescent required hospitalization and what were we doing to address the issues. I had to verbalize an understanding of what [we] were doing and why it was effective — and yet the system was changing so rapidly I do not think there was sufficient data to justify what the insurance industry was executing. So, when I entered my doctoral program, I saw an opportunity to use research to advocate for clients and to push back against changes that were not helpful to our clients. I see research as a way to not only enhance the care we provide our clients but to advocate for them.

David: I became a counselor to better understand how I could “help people,” the cliché response for most beginning counselors in training. The core of this interest is a curiosity of people [and] of people in relationships. I see curiosity as core to the research process. For me, this book emphasizes to master’s students, in particular, that they have the essential quality of curiosity to not only to provide counseling services, but also to engage in research.

 

 

****

 

Counseling Research: A Practitioner-Scholar Approach is available both in print and as an e-book from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-422-2648 x 222

 

****

 

Related reading: See Counseling Today‘s recent online exclusive: “What gets in the way? Examining the breakdown between research and practice in counseling

 

****

 

Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.

 

 

****

 

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

 

Counseling’s connector-in-chief

By Bethany Bray June 30, 2016

When you see Catherine Roland at a professional event, the number of lives she has touched throughout her career soon becomes clear.

“You can go to any American Counseling Association conference, and when [Roland] walks down the hall, people are constantly stopping her, running up to her, hugging her. She’s left behind quite a trail of very accomplished people,” says Vincent Viglione, clinical assistant professor at Fairleigh Dickinson University in New Jersey. “Without her, I would not be where I am today. And it’s not just me. She gives constant, very intentional support, good advice and goodwill through it all. She’s very interested in the betterment of the profession.”

Roland, chair of the counseling program at the Washington, D.C., campus of the Chicago School of Professional Psychology, becomes the American Counseling Association’s 65th president on July 1.

“I think of her as the pied piper of counselor educators. She has a gift for it,” says Larry Burlew, a retired counselor educator and licensed professional counselor (LPC) who worked with Roland at the University of New Orleans and Montclair State University. “She draws people in and knows how to connect well with people. She’s extremely friendly, very loyal and high energy. She’s the glue. She glues people together.”

Many of Roland’s former students have gone on to educator or leadership roles within the counseling profession. Some now pass on her example of mentorship to students of their own. A case in point: Monica Osburn, a past president of the American College Counseling Association, says she was one of five students from her Ph.D. cohort with Roland at the University of Arkansas who went on to become ACA division presidents.

Richard Balkin, another member of that Ph.D. cohort and a past president of the Association for Assessment and Research in Counseling, says Roland’s legacy extends to the students he graduates as a professor at the University of Louisville. “They all know who Catherine Roland is. They see her as part of their lineage,” Balkin says. “It really is an ACA family that she has created. … She’s very good at making connections. She’s very relational in her leadership approach. That’s one of the real treats of knowing Catherine and working with her.”

Although Roland has held many titles throughout her career, she says her role of mentor is one of the most important to her. “I was mentored well, and I’ve always thought that was important. You pay it back,” Roland says. “It’s something that you give to someone, and they give it to other people. … My book of students past is very long, and that is such a gift.”

Career journey

Roland brings a diverse skill set to the ACA presidency. She has worked in private practice; in student affairs as a college dean, residence life director and director of a college counseling

Catherine Roland, chair of the counseling program at the Washington, D.C., campus of the Chicago School of Professional Psychology

Catherine Roland, chair of the counseling program at the Washington, D.C., campus of the Chicago School of Professional Psychology

center; and as an educator, both in public school classrooms and as a counseling professor.

As a counselor, Roland’s areas of focus and expertise include LGBT issues, trauma and aging. She is a past president of the Association for Adult Development and Aging, a division of ACA, and has more than three decades of experience in private practice counseling couples, families and individuals. She has also been employed both at small private colleges and large state universities. A native of Long Island, Roland has worked and studied in eight different U.S. states, plus the District of Columbia.

Roland began her career as a high school English teacher at an inner-city school in Cincinnati, where she became good friends with a co-worker who was a school counselor. Through that friendship, Roland became more interested in the ways that counselors could support students and meet their needs.

“I took a couple of master’s classes in counseling, and I knew that was it,” Roland says. “When I was in doctorate work, I just fell in love with the clinical piece of [counseling]. I have always dealt with people of all ages. Counseling, in general, fits my personality very well. I really like working with families, couples … and some of the more difficult stuff — trauma, death and dying, and grief.”

After earning her master’s degree and doctorate from the University of Cincinnati, Roland transitioned from classroom teaching to student affairs, working at universities in Philadelphia, just outside New York City and New Orleans. She spent a decade in full-time private counseling practice in New Orleans before becoming a college professor.

While living in New Orleans, Roland was very involved in providing support services, both as a volunteer and as a professional counselor, to those in the community affected by AIDS. This was in the 1980s, when little was known about the disease and a crushing amount of stigma was attached. People would often lose their jobs because of the diagnosis, Roland says.

“There were no medications. … We didn’t know back then. We thought it was a death sentence,” she says. “I devoted most of my practice and personal time to HIV/AIDS work, and that’s what shaped me. It changed my life, and it changed my practice as well. I started doing a lot of pro bono work. … It was a very difficult time in the city, very tragic.”

Roland says she got involved because more and more of her clients were getting sick with HIV/AIDS. As a private practitioner with a background in student affairs, she frequently received referrals to work with young men and college students. When clients couldn’t pay, she counseled them pro bono.

“I can’t even begin to say how many personal friends I lost, one after the other after the other,” she says. “Of course, if you had the [counseling] license and the degree, you wanted to help. … [This experience] is part of who I am. These are the things that shape us. I learned a lot about adversity. It’s what you did. It’s not something to be congratulated [for]; it’s just what had to happen.”

Roland was involved in numerous agencies and nonprofits that supported those affected by HIV/AIDS in New Orleans in the 1980s and early 1990s, including serving as chairwoman of New Orleans Women Against AIDS. She also helped cowrite a training manual for HIV/AIDS counseling that is still used in New Orleans today.

Roland spent many hours counseling clients in a clinic that was housed in a New Orleans church basement. The operation was kept very hush-hush because of the stigma that was prevalent at that time surrounding AIDS. Part of the work involved opening a sealed envelope with the client that contained the person’s test results. Roland would then counsel the client about the diagnosis, which was most often HIV-positive.

“The indignity those guys must have felt, sitting in a cold room in the basement of a church,” Roland recalls. “You [the counselor] are on one side of the table, and the guy comes in, and he’s never seen you, you’ve never seen him. You’ve got an envelope in your hands which hasn’t been opened yet, so I’m also surprised when I see [the test results]. It never occurred to me that that was hard to do. In retrospect, it was horrendous. It was just what you did. Someone had to do that. … I think back, and I’m so happy to have been a part of that, so proud to have been a part of that.”

A mover and a shaker

Many of Roland’s former students say that she possesses the ability to see qualities and potential in people that they may not recognize in themselves. She is described as the type of mentor who applies pressure when needed but also gives students enough room to grow and learn on their own.

“There were times with me when [Roland] needed to sit back and let me go, and times when she needed to provide more mentorship or challenge me,” says Balkin, an LPC and ACA fellow who is the editor of the Journal of Counseling & Development. “I think she struck that balance very well.”

“She truly is one of the most intuitive people that I’ve ever met. As a student, that was kind of scary. You felt like she was peering into your soul,” says Balkin with a chuckle. “But that allows her to form deeper connections. … It’s not just what you do, but how you get there. That’s important to her.”

Osburn, director of the counseling center at North Carolina State University, describes her former professor and dissertation chair as a “seed planter.”

“She’s so unassuming. It’s just a series of small, building-block snippets that help turn you into this person you’d never thought you’d be. No one moment defines it. It just solidifies over time,” says Osburn, an LPC supervisor. “She is a quiet leader, intentional and thoughtful. She really has a knack for making you feel [that] you are the most capable and worthwhile person, which gives you the confidence to take a leap of faith that you maybe didn’t think you were ready for. And she’ll always be there to catch you if you fall too.”

“She sees things in people that they don’t even see themselves,” Viglione adds. “She sees their strengths, what they need, and she orchestrates it for them.”

In addition to being an intuitive and relational mentor, Roland is a visionary leader who is very driven, according to several people who know her well. “She’s extremely kind and giving of herself, her heart and her time,” Osburn says. “She is this unassuming, always-smiling person, but don’t let that fool you for a second. She is sharp — and fiery if she needs to be.”

Viglione, an LPC and clinical supervisor who has a private practice in Denville, New Jersey, studied under Roland at Montclair State and later worked with her in private practice, sharing an office. He expects that Roland, as ACA president, “will be a driving force — an absolute driving force. I’ve never seen her back down from anything or take shortcuts. She’s pretty straightforward. She knows what she wants, what she needs, and she pursues it single-mindedly. She’s a mover and a shaker, without a doubt.”

Viglione and Burlew saw these attributes come out in Roland as she worked to build a doctoral program at Montclair State a few years ago. When Roland joined the faculty at Montclair State, the university’s counselor education program offered only a master’s degree track. She soon crafted a proposal to introduce a Ph.D. program for counselor education and presented it to the university administration.

A Montclair State dean initially said no to the proposal, Burlew remembers, because the university was considering the creation of several other programs at the time. But that didn’t stop Roland. She worked diligently to rework, edit and finalize her proposal, and the school’s president bumped it to the head of the queue, according to Burlew.

Montclair State’s Ph.D. counseling program, of which Roland was the inaugural director, came to fruition in less than two years. At the time, it was the only counselor Ph.D. program in the tri-state area of New Jersey, New York and Connecticut, Viglione says.

“She hand-picked the professors, designed [the program] and made it happen,” Viglione says. “Everything she puts her hands on, she makes it the best possible thing it can be.”

Burlew also credits the program’s existence and growth to Roland’s effort, vision and initiative. “She just kept at it  [even] after people said, ‘This is never going to happen.’ … It was just like a whirlwind. It was like lightning. That’s how she works. She does things 200 percent. If it’s really important, she’ll figure out a way to work through barriers.”

Catherine Roland, surrounded by students from the first counselor Ph.D. cohort at Montclair State University, at a farewell dinner held for her as she was leaving the university in 2013. Roland was instrumental in creating the university’s counselor Ph.D. program. The students gave her this photo in a frame inscribed with the words “Thank you for believing in us!”

Catherine Roland, surrounded by students from the first counselor Ph.D. cohort at Montclair State University, at a farewell dinner held for her as she was leaving the university in 2013. Roland was instrumental in creating the university’s counselor Ph.D. program. The students gave her this photo in a frame inscribed with the words “Thank you for believing in us!”

The year ahead

Roland is taking the reins at ACA during what may appear to be a turbulent time. In May, the association announced its decision to move its 2017 annual conference out of Nashville after Tennessee passed a law allowing counselors to deny services to prospective clients based on “sincerely held principles.” Denying services based solely on a counselor’s personally held values is a violation of the ACA Code of Ethics (see cover story for more details).

Roland served as president-elect during the past fiscal year under outgoing ACA President Thelma Duffey. As president-elect and a member of the ACA Governing Council, Roland was involved in the discussions and decision to pull the conference out of Nashville. Roland says she is aware of and prepared for the extra demands that will be placed on her and the association in the year ahead.

“I never thought it would be an easy or a simple thing to be president, but this year more than ever, it will be more complicated and intricate,” Roland says. “It’s going to be a challenge, and I’m up for the challenge. … I think I can approach it with a good heart, ready to learn as much as I can, in addition to what I’ve learned [already].”

“Catherine is very approachable,” Burlew says. “If you feel things should be going in a different direction, you can talk to her and she’ll listen. She has an open-door policy. You can walk right up to her as an ACA member, and if she thinks action needs to be taken, she’ll take action.”

Balkin believes that thanks in part to Roland’s previous experience and professional focus on issues affecting the lesbian, gay, bisexual and transgender community, she is the right president at the right time for ACA. “She’s very in tune to the issues that are at the forefront of ACA today,” he says. “I think she’s going to have a very well-timed presidency. … She is a capable person who will, I think, articulate very clearly, compassionately and very empathically the direction that ACA is moving the profession.”

While serving as president, Roland says she will have two focuses: life span development of minority populations and bringing ACA’s branches, divisions and regions together for mentorship and leadership.

“I think we have a lot of things in common among us as far as ACA’s regions, divisions and branches [go]. I want to tap into that. We’re more alike than we are different,” Roland says. “I believe we have more common ground than we understand, and I want to harness that common ground. From that stems the best kind of leadership and leaders.”

 

****

 

Meet Catherine Roland

Degrees: Ed.D. in counselor education and M.Ed. in guidance and counseling from the University of Cincinnati; B.A. in English literature and education from Marshall University in Huntington, West Virginia

Licensure: Licensed professional counselor, national certified counselor and licensed clinical supervisor

Has taught or worked at: The Chicago School of Professional Psychology, Washington, D.C., campus (current position); Georgia Regents University (now Augusta University), Augusta, Georgia; Montclair State University, Montclair, New Jersey; University of Arkansas, Fayetteville, Arkansas; University of New Orleans; Delgado Community College, New Orleans; St. Mary’s Dominican College, New Orleans; Manhattanville College, Purchase, New York; Temple University, Philadelphia; and University of Cincinnati (as a graduate assistant)

What ACA members may not know about her: She currently works a block and a half from the White House. She’s an only child from an Italian American family. She’s an animal lover and a self-described “cat lady.” She loves to travel (Cape Cod, New Orleans, New York City and the Maine coast are her favorite destinations). She also enjoys being outside and taking walks, photography, needlepoint, knitting and going to plays, musicals and museums. Her taste in music is wide-ranging; her favorite genres are opera, country music and rock ‘n’ roll.

 

****

 

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

Letters to the editor: ct@counseling.org

Professional trip to India opens eyes, fills hearts

By Bethany Bray June 20, 2016

Counselors around the world have more in common than you might think.

Angela Coker, an associate professor at the University of Missouri – St. Louis (UMSL), found herself talking about some very familiar issues with international colleagues recently at a conference in Bangalore, India. Challenges that American counselors face – workload, pay rate and questions of counselor identity – are the same for colleagues around the world.

“In interacting with many of the counselors I met at the conference, [I found that] the issue of professional identity of counselors is a worldwide issue. I met a counselor from the U.K. who talked about how most people don’t know what a counselor is, or what we do,” says Coker, a licensed professional counselor (LPC). “It really just hit home again that most people don’t know … We have a lot of work to do, in terms of educating people who we are.”

Coker and Sachin Jain, an LPC and associate director of Counselors Without Borders, led a group of six masters-level graduate students from UMSL and George Mason University to India in January. The group attended and presented at the International Counselling, Psychotherapy and Wellness Conference at Christ University in Bangalore.

Many of the students who went on the 10-day trip said the experience spurred both personal and professional growth; for one student, it also allowed her to overcome past trauma she associated with Indian culture (see sidebar, below).

The conference, jointly organized by Christ University and the University of Toronto, was a gathering of university educators and professionals from around the world. While on the Christ University campus, the group was able to interact and share meals with Indian counseling students.

George Mason student Alexander Hilert remembers this experience as a highlight of the trip.

“I found a great deal of similarity between myself and the (Indian) students, sharing their motivations and aspirations for making a difference and helping others,” says Hilert.

Jain has been leading groups of counselor educators and students on professional work/study trips to his native India for years, including a meeting with the Dalai Lama in 2013. This time, the trek was a chance for students to present at an academic conference, as well as be exposed to culture and perspectives they might be missing in an American graduate program, he says. In India, there is a shortage of mental and physical healthcare, while the needs are great – due to stressors such as poverty, class struggles, rampant corruption and high rates of suicide, says Jain.

“Students are the future leaders for the field. But their [American] training explicitly does not identify the most vulnerable populations living in developing countries, [which] severely limits advocacy and social justice efforts,” says Jain. “My hope is that some of these students return back to India or other developing countries to serve.”

Coker agreed, saying the trip was a chance to “expose some of our students to international thinking.”

“The whole purpose of this trip was international immersion and to increase multicultural consciousness,” Coker says. “A person can get a whole PhD (in the U.S.) without reading a text by anyone who isn’t an American, which I think is crazy.”

 

 

In their own words

Here are some thoughts from the counseling graduate students who traveled to India this winter:

 

“Deciding to make the trip to India was a very challenging decision for me to make personally. Not just because of logistics or the fact I had never been out of the country before but because I had a traumatic experience when I was 14 years old when a man who was from India sexually assaulted me. In court he used his cultural background as a defense. At a young age I became fearful of Indian culture, believing his words that his actions were considered normal in his country. From that point forward I generalized and shied away from the culture; India was one country I told myself I would never visit in my lifetime.

When I first learned about the opportunity to travel to India I knew it was a wonderful opportunity, but it was just something I told myself I could not do. Over the next several months I did a lot of self-reflection. When the day came that I got the email announcing the trip I decided in that moment, YES, I was going. It was the perfect time for me in my personal journey towards healing and growth and I just knew it was something I had to do and I would forever regret passing on this opportunity. I sought out supervision from my supervisors and professors; they were all very encouraging and gave me some tools and coping skills to help me on my journey.

One moment in particular was monumental for my personal growth. There was a cultural (dance) performance I was able to witness and I was in complete awe as the group started to perform. It was breathtakingly beautiful and I found myself tearing up. This was a culture I feared for so long, a culture I shied away from, and in that moment I felt genuine appreciation and admiration as I watched this performance and I felt myself take a huge step towards my recovery.

Being immersed into a culture is completely different than reading about it in a textbook or watching a movie. Being able to experience the sights, sounds, tastes and feel of a culture brings my understanding of cultural awareness to a completely different level. By personally overcoming my fears and biases held from a traumatic experience in my youth and by witnessing firsthand the struggles of poverty, racism and cultural norms I know I will be better equipped personally and professionally as a multicultural and social justice [focused] counselor.”

— Eliina Belenkiy, George Mason University

 

“The highlight of the trip for me was attending class and meeting the counseling graduate students at Christ University. This gave me the opportunity [to] see how counseling theory was taught there. For example, mindfulness-based therapy was being taught from a broader cultural and historical perspective. We discussed parallels between our training and perspectives as counselors (there was a great deal of overlap) and learned about the challenges counselors face in promoting the mental health profession in India. I found a great deal of similarity between myself and the students, sharing their motivations and aspirations for making a difference and helping others.

Something critical I learned about myself was how I react to being in an unfamiliar environment culturally. Thankfully I was supported by Dr. Sachin Jain and the students and faculty at Christ. But I think it will help me moving forward, having more empathy for clients navigating culturally unfamiliar environments. I also realize the difference race, gender, ethnicity, religion, disability, sexuality and socioeconomic status play in terms of this experience and the treatment you receive. I would say I’m learning to keep these factors in mind in how I relate to others and the stand I take for social justice.

I think my struggle and ‘aha moment’ was learning to be more present and open-minded. In my mind this is what makes cross-cultural dialogue possible and where the learning occurs.”

— Alexander Hilert, George Mason University

(Left to right) Tosha Pearson-Royston, Eliina Belenkiy, Dr. Angela Coker, Dr. Sachin Jain, Ngozi Williams, Deborah McGhee, Alex Hilert and Meaghan Lakes pictured at the Mysuru Palace in Southern India.

(Left to right) Tosha Pearson-Royston, Eliina Belenkiy, Dr. Angela Coker, Dr. Sachin Jain, Ngozi Williams, Deborah McGhee, Alex Hilert and Meaghan Lakes pictured at the Mysuru Palace in Southern India.

“My trip to India was nothing short of miraculous. I met so many wonderful people during my visit. I was first struck by the noise, dirt, trash and amount of people on the streets at any given time. However, I became so entranced by [the] life I saw on a daily basis. The people were so colorful, energetic and full of life. I was shocked to notice how prevalent colorism was in the country. I noticed most, if not all of the skincare products had bleaching cream, and I felt sad. I felt sad because I began making direct parallels between the people of India and Black/African-Americans and how colorism has affected us. I became very close with a young Indian woman; she explained it this way: ‘families want their daughters to marry men of European decent to have fairer children and grandchildren.’ I’m so thankful for this opportunity, and have used it to help me grow while working with international people during my internship. When working with [clients] I will be aware of similarities that different cultures share and use what I have learned to be the best professional counselor I can be. My [Indian] friend and I have kept in touch since my return to the U.S., and our friendship is growing. I’ve been invited to her wedding and we speak weekly. I wouldn’t trade my time in India for the world, and I can’t wait to return!”

— Tosha Pearson, UMSL

 

“While I had no clear or definite expectations for our trip to India, admittedly, some of my experiences surprised me. My most significant personal reflection is the feeling of Otherness I had while there. That is to say, I felt a different type of ‘other’ than I feel when I am at home in the U.S. As an African-American woman, I am very experienced with being a minority or being viewed as atypical to my surroundings, however, my India experience gave it a different flavor. Not only was I, and a few of my peers, atypical, we broached on the verge of being novelty. Public response to our presence varied from discreet stares and pointing to requests for pictures and being followed by groups of schoolchildren on a field trip. While it did not feel rude, it definitely felt strange, as if I were suddenly under the scrutiny of standards I did not know or understand. As a result, I had a sense of vulnerability throughout my trip, though not feeling unsafe, just uncertainty about where I stood in the grand scheme.

Understanding social justice, multiculturalism and the multiple forms of oppression is essential for every counselor and counseling student because these issues are relevant all over the world. Bangalore, as one of the fastest growing cities in India, must handle issues with pollution, construction and other logistical and socioeconomic problems. For example, the city had some of the busiest and congested traffic I had ever witnessed, but I did not observe many pedestrian crosswalks, despite seeing numerous construction projects in progress. How do these things affect the disabled? The ill? The elderly? As counselors, we must be aware of the wants, needs and obstacles of the minority as well as the majority.

Another area of interest that I observed in India was the standards of beauty promoted by the media. My first observation was that the individuals featured did not match [or] reflect the features of general populace. While somewhat expected, the extent of these differences were sometimes surprising with some models even appearing to have significant European heritage vs. Indian/Asian heritage. Most of the ad models had light eyes, narrow noses and lighter or olive tone skin, while most of the residents in the city did not. Furthermore, many beauty products were promoted as a means of obtaining these features. All throughout the city, we saw billboards for plastic surgery, cosmetic procedures and products, including numerous ads for skin whitening cream. As counselors, we should ask the following questions: How do standards like these affect a culture? How can we understand –isms (such as racism, colorism, sexism, etc.) in a different cultural context than our own?”

— Meaghan Lakes, UMSL

 

 

 

****

 

 

Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.