Tag Archives: Counselors Audience

Counselors Audience

Achieving a better understanding of adult autism

By Kenneth J. Smith September 11, 2017

Autism, Asperger’s and “nerd” personality features (to use a concept from Temple Grandin, a prominent author and speaker on both autism and animal behavior) seem to have something of an air of mystery and intimidation for many mental health professionals. Let’s face it, clients with autism/Asperger’s have very different ways of perceiving and thinking than most counselors do. For instance, talking about feelings in an unstructured way à la Carl Rogers is unlikely to be nearly as productive with these types of clients as with other clients. Barring extreme examples, I prefer to think of individuals with autism, Asperger’s or nerd characteristics as having a set of co-occurring personality features rather than a mental disorder. To that end, I refer to these kinds of clients as PFAANs (personality features of autism, Asperger’s and nerds). I refer to non-PFAANs (sometimes called neurotypical) as NONs.

When I became a licensed professional counselor, I had a decade of experience running pigs through mazes (animal behavior/animal welfare research) for my Master of Science and working as a humane handling consultant/reviewer in more than 350 slaughterhouses (basically, I did work similar to what Grandin does in slaughterhouses). During that time, I read all kinds of books by Grandin and others to see how autism might help me understand animal and human behavior and cognition to further my work and career. Coming from this background, I was rather surprised to learn that I was expert in counseling adults with PFAAN, and now a large part of my practice rotates around this. I provide a therapy group for developing social skills in adults with PFAAN, and I help NONs better understand and engage with spouses or loved ones with PFAAN. At least in my region, there are very few mental health colleagues I can refer to who have much expertise in adult PFAAN approaches and needs.

The lack of services for adults with PFAAN (and their loved ones) is striking. Many resources are available for childhood/adolescent autism, but these approaches do not seem well-suited for adults, and there is almost nothing for people over age 21. Although I have no hard statistics to back this up, I suspect that individuals with PFAAN make up at least 20 percent of the U.S. population. To quote Hans Asperger, “Once one has learned to pay attention to the characteristic manifestations of autism, one realizes that they are not at all rare.”

To illustrate how many clients you might be seeing without realizing that they have PFAAN, consider whether you could apply the ways of thinking presented in this article to many of your clients who work in science, technology, engineering and math careers. You will see clients with PFAAN in your practice, so it is important to have a way of understanding their thinking patterns.

A central issue for clients with PFAAN is their lack of ability to naturally recognize emotions and empathize with others. If you’re confused by how to help, it may be useful to conceptualize the different ways that emotions seem to work in these clients compared with most other clients. A common tool used in mental health therapy is the Feeling Wheel developed by Gloria Willcox. It is the one tool I have found that both PFAANs and NONs seem to comprehend, so it has served as a valuable tool in bridging the understanding gap between these two groups.

The Feeling Wheel is an excellent way of visually conceptualizing how emotions work differently for clients with PFAAN and NONs. Grandin has suggested that a good method for teaching cognitive flexibility to individuals with PFAAN is to describe people and their actions as a mixture of colors.

The Feeling Wheel (see above) is also in line with another of Grandin’s concepts in which she describes a difference between PFAANs and NONs. She says that many individuals with PFAAN tend to think in specific pictures, whereas NONs seem to think in words/emotions. How this pictures versus word concept works can be quite complicated, but the visual concepts in the Feeling Wheel simplify how to explain this difference. I have developed a list of concepts using the Feeling Wheel and its colors to help counselors and clients empathize with one another and to get to the clients’ goals and skill development.

Concepts

Concept A: People with PFAAN will intuitively get/understand only the innermost (core) feelings. If most people in the world had PFAAN, the Feeling Wheel would probably contain just an inner core (see image below).

The recognition of the detailed emotions (represented in the outer rings of the Feeling Wheel above) seem to develop naturally in NONs but not in individuals with PFAAN. The outer rings of the Feeling Wheel can be taught to clients with PFAAN, but this must be done in an inductive way, similar to the way that most NONs learn math. NONs start with 1+1=2; people with PFAAN need to draw a picture of what the more subjective feeling looks like in NONs so that they can relate the outer rings back to the inner core that they more readily understand. I’ll share more about this later.

Concept B: Emotional processing changes how the world is seen and experienced. NONs can have all kinds of emotions at the same time. For example, if a NON sees a cow, he or she might have several different emotions at different intensity levels about that cow at the same time:

a) Peaceful: “That cow chewing cud is so Zen.”

b) Anxious: “That cow might come and attack me.”

c) Sad: “That cow will be killed to be eaten.”

d) Angry: “I get angry about the ways cow are treated in bullfights.”

The NON’s emotions will also tend to make the picture of the cow less distinct when the person turns the cow into words and emotions. (I think this is somewhat similar in idea to Carl Jung’s archetypes. For example, you don’t remember one cow; you shove the individual cow you see into the archetype cow in your mind.) So, often, this will happen in NONs:

Individuals with PFAAN tend to have only one or a few emotions at a time. They seem prone to black-and-white thinking, rigidity to change and litigiousness (for example, they may ask what the hard rules are for social interaction). So, when a person with PFAAN sees a cow, and if he or she finds cows peaceful, conceptually, the emotional experience he or she will likely have is the picture of that cow overlaid with the emotion (see below).

The way that emotions work in people with PFAAN seems to more closely model the way that emotions work in social animals. For example, a dog either likes a person or is scared of a person, but the dog rarely seems to have both emotions at the same time.

Concept C1: Individuals with PFAAN tend to have one emotion at a time (AND versus OR emotions). NONs can often experience several emotions together. I refer to this as AND emotions (see below).

 

Clients with PFAAN may also have different emotions about something, but they can process only one at a time. I refer to this as OR emotions (see below).

Concept C2: NONs mix emotional colors to get completely novel feeling colors, whereas PFAANs flip between colors. Related to Concept C1, NONs use AND emotions to make new emotional colors (think of mixing paint). A NON might feel strongly peaceful yet a little afraid when seeing a cow (mix dark blue and light orange to get a teal emotional archetype cow).

Individuals with PFAAN won’t readily mix colors, although they might flip between emotions rapidly. The flipping is where they are analyzing what to do (“Should I cry or run away?”) if more than one emotion is present (for example, strong peaceful feelings and a little fear of a specific cow). Usually, the emotion expressed in the client with PFAAN is the most “vivid” color emotion.

Concept D: Individuals with PFAAN take more time to process and switch between emotions. OR emotions and emotional flipping appear to lengthen the time it takes to process the emotions. This lack of speed in emotional processing is often interpreted by NONs as not caring, being cold or being anti-social. The speed of emotional processing seems very important to most people, and many of my clients with PFAAN develop deep shame for their inability to rapidly process emotions. (See No. 5 under the “Counseling approach ideas” section below for more illustrations of this concept.)

Concept E: Individuals with PFAAN are prone to emotional and sensory overload, which may lead to a new emotional color that equals shutdown. What do you often get if you mix all the colors of the feelings together in individuals with PFAAN? Black. This is a good conceptualization of what happens in many people with PFAAN when they are confused or overloaded: shutdown.

Shutdown also happens in NONs (think about the shutdown of emotional controls in the animated movie Inside Out, where everything became gray and the emotions no longer worked). However, it usually takes much more time and intensity (think posttraumatic stress disorder) for NONs to get to black.

To extrapolate from the work of John Gottman in couples therapy, men are generally more prone to sensory/emotional shutdown than are women (see Gottman’s concepts of stonewalling and flooding for more information and illustrations). Based on my work with clients with PFAAN, I strongly suspect that men naturally have more features of PFAAN than women do. The Centers for Disease Control and Prevention reported that autism is 4.5 times more likely to be diagnosed in males. This means that many more men than women would have mild features of PFAAN. Grandin suggests that among girls, PFAAN is often labeled as being a “tomboy,” which doesn’t seem to receive the same level of focus or concern as the presence of autism in males. New research also suggests that females with PFAAN may generally be better than males are at social masking of these features. Or to quote Asperger, “The autistic personality is an extreme variant of male intelligence.”

An example from my experience is that giving too many food choices to a client with PFAAN can lead to shutdown. A large menu may be too hard for these individuals to process in a given amount of time because what they “feel” like having can often take much more time to figure out than it would for other individuals.

Concept F: The default emotion of most individuals with PFAAN is anxiety (if not shutdown). Anxiety appears to increase in those with PFAAN from adolescence on. I believe that increased anxiety proneness is a strong feature of being a person with PFAAN, although such a view is controversial. Novelty — good, bad or indifferent — almost always causes more fear in those with PFAAN than it does in NONs. Hence, rigidity in behavior, speech, routine or time management may often be an attempt to control fear.

Individuals with PFAAN and animals share the experience of novelty and sensory overstimulation producing anxiety and fear. An example from livestock science is the observation of flight zones in animals. The flight zone is how far an animal stays away from a person or experience. The less anxiety the animal feels, the smaller the flight zone. Novelty and sensory overload in animals produce fear or anxiety and lead to avoidance behavior. Thus, if this is the animal’s experience, the flight zone increases. Flight zones are reduced through exposure and positive (or at least neutral) experience. Being around strangers often produces great anxiety in animals and in clients with PFAAN. Thus, both will often avoid strangers whenever possible.

Counseling approach ideas

It is important to realize that counselors will likely need to be much more directive and teacherlike with clients who have PFAAN than with their other clients. Unconditional positive regard, reflection and talk therapy probably won’t be particularly useful because these clients are unlikely to get what these Rogerian-based interventions are working on or doing. What is most likely to be helpful to these clients is to remain focused on the skills that they need and then teaching them those skills. What follows are some approaches I have discovered that seem to help clients with PFAAN in the context of therapy.

1) Teach/discuss the Feeling Wheel concepts. I have found that simply teaching the Feeling Wheel concepts discussed in this article provides many clients who have PFAAN with the tools to move toward their goals and something constructive to do in the counseling context. These clients tend to be analytical and often like testing ideas. Interestingly, many clients with PFAAN are shocked when they find out that most people experience more than one emotion at a time. PFAANs and NONs speak a very different emotional language, so it is important to have a “Rosetta stone” to help facilitate emotional communication.

2) Teach the general behaviors that the emotions cause or are related to. For me, these are the main behaviors that go with the Feeling Wheel, and teaching these behaviors gives clients with PFAAN clues of what to look for in others. Behaviors are often easier to measure than are other ways of interpreting emotion. I relate the core emotions to the following broad behaviors (although there are many others):

Emotion Behavior

Powerful Having a choice/creating

Joyful Attraction/pursuit

Scared Avoidance/flight/urgency

Mad Aggression/flight

Sad Slowing down/reflecting

Peaceful Calm/unhurried/content

In my experience, the best emotional states in which to be empathic/thoughtful are sad, peaceful and powerful. Mad, scared and joyful appear to be more action oriented. Make sure that the client with PFAAN is in or near one of the thoughtful emotional states when practicing empathy training.

3a) Teach these clients to label the emotion they see in others so they can relate it back to the core emotions and choose an emotionally appropriate response. Practice what the emotions on the Feeling Wheel’s outer ring look like. For example, ask what the visual and auditory signs are of a person who is discouraged. The person may look down, exhibit less body movement, speak about being discouraged and so on. Once that emotion is labeled, trace it back to the core emotion (discouraged is a kind of “scared”) to help the client understand it better and have empathy.

3b) Teach clients with PFAAN phrases and actions that can be used once they empathize with the person’s emotion. Just because clients with PFAAN learn to empathize does not mean that they know how to respond appropriately. For example, a client with PFAAN might feel great anxiety at a funeral. To break the silence and sense of mourning that is causing his anxiety, he may start talking loudly to those around him about a new model airplane he is working on. This incorrect social response can have serious repercussions.

It can be helpful for these clients if counselors assign them a set response (at least in the beginning) for each core emotion. For example, you might instruct the client, “If you determine that a person is sad, a good response is to tell that person, ‘I am sorry that X happened’ in a calm voice.”

4) Teach one concept from the Feeling Wheel at a time. Remember, the emotional parts of the Feeling Wheel should be taught to clients with PFAAN in much the same way that you would teach children math: Start with the basics and work up. Clients may have no idea what scared looks like in themselves or others, so provide clear, visual, colored examples to illustrate the emotion. For instance, if the emotion is isolation, you might provide the visual of a person trapped in a purple box (because purple is the color for sad on the Feeling Wheel). A mirror might also be useful to show these clients what their facial expressions seem to be communicating to the counselor at any given time.

5) Teach clients to say “whoa.” Emotional processing takes longer in people with PFAAN, so it becomes very important for these clients to be able to communicate this to others. This is especially important in intimate relationships. I have noticed that many individuals with PFAAN are married to or have intimate relationships with NONs who are very emotional. To adapt a Catholic marriage concept, I think there might be great complementary benefit to such matches. He (usually) balances out her (usually) emotionality, whereas she provides him with an emotional vocabulary and a feeling of being needed. Sometimes this arrangement works well for many years, but then the more emotional partner begins to believe that the emotional avoidance and lack of emotionality/spontaneity on the other partner’s part indicate that he no longer loves her. Very often, this is not the case.

To offer a case example, if a wife asks a husband how he feels about her, she usually wants an answer that is specific and immediate. If the husband has PFAAN, it may take him some time to work out exactly what feelings he needs to communicate, no matter how much he loves her. This delay is often interpreted as the husband not caring, which can cause serious relationship issues. Either the client with PFAAN or the counselor needs to explain to the wife that it is hard for the husband to rapidly communicate his feelings but that, given time, he will tell her exactly how he feels.

You might also help clients with PFAAN “schedule” spontaneity into their relationships to improve them. I had a friend who decided that his wife liked being surprised with flowers, but he was not at all given to being spontaneous. So, he sat down, budgeted how many times he could afford to give his wife flowers (yes, he had a flower budget), and then randomly assigned different dates on his schedule for presenting the flowers. As a result, she got spontaneous (thus emotional) demonstrations of affection, and he still got to operate via a schedule and a budget. It worked great for them.

In a work example, a colleague wants to know everyone’s gut feelings about a new project. It may be important to teach the client with PFAAN how to tell this colleague that it will take time to understand what he or she feels about the project. If forced to communicate too quickly, deep anxiety or shutdown may occur. Clients with PFAAN typically have difficulty with “gut” feelings.

6) Use superhero/comic/sci-fi character modeling. Most of my clients with PFAAN like superheroes, fantasy and science fiction. Anime, a kind of film animation that originated in Japan, also seems very popular with these clients. I have noticed that almost every time an anime character has an emotion, the emotion is accompanied by an exaggerated facial expression or sound cue. You almost always know how an anime character feels, which may explain why anime is so popular among individuals with PFAAN. Many researchers seem to suggest that Asian cultures include more PFAAN by nature (e.g., saving face, defaulting to authority) than many other cultures do, which may explain why anime has these features.

I always ask my clients with PFAAN about their favorite superheroes or other favorite characters. This gives me insight into the clients and often provides a good picture that I can use to help them develop the emotional attributes exhibited by the characters they admire. I use this superhero therapy in a variety of ways, but one good technique that uses the Feeling Wheel is to make a color feelings diagram based on the client’s favorite superhero so that the client has some visual concept to reference.

For example, a client with PFAAN may really like and want to emulate Spider-Man. Spider-Man is a mix of powerful (he fights evil and has superpowers), joyful (optimism and hope) and scared (social anxiety caused by nerdiness) emotions. Aiming the client toward getting the emotions he or she needs to be more like the superhero provides structure for change. “I have plenty of scared. To be more like Spider-Man, I need to practice being more powerful.”

One warning: Make sure that clients choose characters who will move them toward healthy and effective goals. If a hero (or anti-hero) whom a client has chosen would be unhealthy to emulate emotionally or morally, don’t be afraid to speak up. I say this from personal experience. I had one client who really liked the character Deadpool, but under no account should this character be an emotional or moral model.

Conclusion

The concepts I have illustrated connected to the Feeling Wheel have been a revelation in helping my clients understand the difference between PFAANs and NONs and how to approach skill building and therapeutic effectiveness. It is the only tool I know of that explains and demystifies emotional responses in PFAANs and NONs (the group that most counselors fall into). These concepts and approaches have made a huge impact on my ability to help clients with PFAAN and their loved ones.

Adults with PFAAN will find their way into your practice. It is important to know how their emotions work and what may be effective and rewarding in therapy, both for them and for you.

 

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Kenneth J. Smith practices at Spirit of Peace Clinical Counseling in Ohio. He enjoys working with clients with PFAAN and clients with existential challenges, teaching and speaking. He holds a bachelor’s degree in animal science, a bachelor’s in history, a master’s degree focused on animal welfare/behavioral psychology and a master’s in clinical mental health counseling focused on the treatment of shame and guilt. Contact him at info@kentherapy.com or through his personal professional website at kentherapy.com.

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

 

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

Counselors’ career paths and insights

August 25, 2017

[EDITOR’s NOTE: This is an online-only companion article to the September cover story that appeared in the print edition of Counseling Today.]

Professional counselors find their way into the profession in a multitude of ways. Some individuals know it is their calling even in their undergraduate years. Others enter the counseling profession after first having had a career in another field or returning to the workforce after raising children. Still others are inspired to pursue training as counselors at the suggestion of a mentor or after personally encountering the good work of a professional practitioner, either in their own life or in the lives of friends or family members.

Regardless of how they get here, however, they all have one thing in common: a deeply felt calling to help others.

Counseling Today asked American Counseling Association members from across the country to share — in their own words — their personal stories of how and why they entered the profession and the insights they have gained along the way.

 

 

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The path that lead me to counseling is an interesting one, but I can’t quite see any other way it would have happened for me. I was a psychology major as an undergraduate at New York University when I was hired as a sophomore to work at The Maury Povich Show. I started as the receptionist, but within a year and a half I had been promoted several times and was now a producer, still in my junior year at NYU. I spent the next decade producing Maury, Sally Jesse Raphael and Queen Latifah and was nominated for an Emmy in 1996. Beyond the perceived glitz and glamour of rubbing elbows with celebrities and befriending some of them, was the common thread of dysfunction, pain and grief that all my guests shared.

Having interviewed almost 10,000 people over the course of 10 years, I could hear my calling into the counseling field. These television guests needed help, not just 15 minutes of fame. I often found ways to help the guests by connecting them to therapists in their hometowns, but it never felt like it was enough. Gradually, the episodes I produced became the conduit for my tackling mental health issues in my own way. Granted it was sensationalistic, but I had to try and marry the two fields.

Shortly after retiring from television at age 28, I went back to school to get my graduate degree in social work at NYU. Unfortunately, Sept. 11 happened and I withdrew from classes for personal reasons associated with the attacks. Instead, I decided to become a realtor and open a real estate firm in New York City. Albeit successful, the idea of being a psychotherapist persisted. I eventually closed a lucrative real estate business and pursued [studying] counseling at NYU instead.

Being a professional counselor for me is an extraordinary gift. I have grown personally and professionally in so many ways, and each and every day I continue to learn from both my colleagues and my patients. Originally, my fantasy was to be in private practice working with rich female patients. I had an extreme resistance to working with males in any capacity. My path led me to a social service agency in Brooklyn where I worked with men with severe and persistent mental illness (psychosis) comorbid with substance abuse. I fell in love with all my male clients! It was challenging, but so rewarding. It didn’t take long to figure out the trauma that each of these individuals faced, both in their past and present lives. So I decided to become a trauma specialist.

Today, I run a successful private practice with two colleagues. Together we clinically supervise 10 post-graduate limited-permit counselors, three licensed mental health counselors and four licensed master social workers. Myself, I’m an eye movement desensitization and reprocessing (EMDR) trauma specialist and work with people to heal trauma-related symptoms. I also utilize cognitive behavioral therapy (CBT), neuro-feedback and psychodynamic therapy to help bring about change.

What I have learned, however, is that the best work comes from using my relationship with my patients to identify interpersonal issues and make lasting change. Additionally, I also use my skills as a consultant in group relations work (organizational psych and leadership).

I would advise graduate students to keep their minds open and let the counseling field speak to them. What is it saying to them? Who is it telling them to help? How is it telling them to get there? I think it’s safe to say that we don’t know anything when we graduate, we learn who we are as counselors as we engage with patients and do the work. Don’t pigeon-hole yourself into one particular area right out of school, you may just miss out on something spectacular if you do.

  • Anthony Freire, a licensed mental health counselor (LMHC), EMDR trauma-specialist and clinical supervisor in private practice in the Soho area of Manhattan

 

 

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I think this profession chose me. It seems that since I was a very young girl, God had this path planned out for me, even though I had no idea. And yet what really brought me to counseling was my own suicide attempt in 2005. Here is what I tell people about why I am a counselor:

“Twelve years ago this August, I attempted suicide. By the grace of God (the hospital staff and modern medicine) I survived. I don’t know what scars you carry, what weighs you down, what trips you up. I don’t know what masks you wear or what dreams you’ve lost, but I do know that the greatest of all gifts is this day.

Choose life. Choose this, your messy life. Your purpose may be unknown, your path may be windy and your heart may be heavy but you have meaning. I am proof that we are more than our scars. Today I am more than my shame — for I know rape, alcoholism, mental illness, cancer, death, child abuse, divorce, abortion, infidelity, bankruptcy, violence, guilt and loss. And I could get bogged down by the very weight of all the scars I carry or I can choose to get up and walk again taking each step and each day as a gift.

If you’re lonely or hurting or struggling to find a way to keep going today, please reach out to someone. You may not see us and you may not know who we are but there are many of us who have been where you are. We’ve felt the pain that you are experiencing that makes death look like the best option – the only option. We’ve learned (I’ve learned) that those thoughts and the situation that you’re in, the doubt, shame, guilt and fear will pass. It will be hard and messy, nevertheless, choose life!

You [can] heal and grow and learn and breathe. I’ve learned to love and I’ve learned to live. Choose life.”

I’m not one for quoting the Bible mostly because my memory isn’t that good and my attention-deficit/hyperactivity disorder (ADHD) gets in the way. But recently a friend reminded me of this verse and I think it fits today: Deuteronomy 30:19 “This day I call the heavens and the earth as witnesses against you that I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live …”

I have sat at all sides of the proverbial table, as an adolescent and adult in individual counseling, as a parent (adoptive/foster/biological) in parent-child/family sessions, as an advocate and mental health professional (parent partner and therapeutic foster parent), so being a counselor/therapist seems like a natural fit. Therefore I think I am drawn to this profession because 1) I believe deeply in the impact of good counseling and 2) I want to be a part of change and healing.

I’m a storyteller and a lover of stories. As a little girl I loved books. I read everything I could get my hands on. In my professional life, I listen to people’s stories every day — captivated by their emotions, their history, the personality within their story. I can’t say that I’m a writer or that I’m even good at writing. Yet, as I hear each person’s story, their stories impact me deeply. I hear truth, pain, sorrow and joy in the lives they have led and I feel honored to be a part of their journey.

My advice to others in the profession is to learn about how to run and operate a business and find a mentor or two to help you through the process. Also, do your own work (i.e., engage in your own counseling/therapy with many different therapists). Engage in self-care and don’t let this work take over your own life; protect against compassion fatigue.

  • Lily Maino, a licensed professional counselor (LPC) in private practice in Windsor, Colorado

 

 

 

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I worked as a janitor, repair person, certified welder, office worker and in factory jobs prior to becoming a counselor. I was working in a factory when the boss called me into his office to discuss his concern about coworkers crowding around my work area discussing their issues. At one point he said “I hired you to do shipping and receiving, not be the company shrink.” At that moment it dawned on me that I needed to go to college to become a counselor. I remember saying “You’re right, thank you. Every job that I’ve ever had, the boss talked to me about this. Everyone seems drawn to me to talk about their problems. I quit, I’m going to college.” It dawned on me as I got into my truck that I had no idea how one went to college but I figured it out.

I did seven or so educational programs and have worked in most treatment settings. I’ve been told that I am the “go to” person for the toughest cases but to me, I’m just a guy that was tired of the status quo and decided to design and build his own charity [a nonprofit counseling center]. I like to create things and empower people. I love the toughest situations because when you have conquered those you feel so alive.

What drew me to this profession? People drew me. For some reason they were drawn to me and I had natural gifts for working with people. I decided that they all couldn’t be wrong and that if they were going to come it was my responsibility to get as much training and as broad an experience base as possible. I feel that it is my calling and will do it until I feel I am being called into something else.

The advice I would give to graduate students and new professionals is to never stop learning, never stop expanding your knowledge base, not only professionally but as a person. The broader your knowledge base the more people you can potentially connect with because you will have a better understanding of their frame of reference.

Some folks see weakness in being different. I learned to see [being different as a] strength. Embrace your uniqueness and forget about what society feels someone of your status should be. I have a Ph.D., am certified in two countries [the United States and Canada] as well as a host of other things but I also like to drive farm tractors, frame buildings, do plumbing, restore classic vehicles etc. I can get as dirty as the dirtiest sand hog, clean up and do a doctoral level lecture before delving into something else. Never let anyone dictate what you should do, feel or act. Your power comes from being who you are. Make it matter.

 

 

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As a non-traditional student, I had an intense interest in becoming an effective counselor. I appreciated how spending time with folks and listening to what they have to say was beneficial for them, with noticeable relief on their face replacing the distress. I felt rejuvenated after our time together. There came a time that having an undergraduate degree would have been enough for me however, with the changing times employers were notifying staff that a graduate degree was now required to sustain employment. I quickly without hesitation immersed myself. The graduate program was chock-full of information, experience, camaraderie  and inspiration.

For me, becoming a therapist was a by-chance chain of events. Coming from a single-parent lifestyle I held several jobs to make ends meet including housekeeping, janitorial, receptionist and health information technician. I was involved in a motor vehicle accident that caused severe injuries which altered my employment opportunities.

During recovery I was led to this profession through re-assessment of life, career and the enjoyment of working with others. Even as a young child, I realized that I loved listening to others, mesmerized at age 3 by the conversations of others, enjoying socialization in adolescence and supporting individuals in adulthood as they struggled with life challenges to liberate themselves from sadness, frustration and fear mounted from their personal experiences. The moment in undergrad we began “fishbowls” (internship and practicum) I knew this was a good fit, offering an opportunity to do what I love as a full-time profession!

CBT is the therapeutic approach I have chosen most often, due to the practicality and positive outcomes I have experienced with clients (and it is an evidenced-based therapy). That’s not to say that I haven’t implemented other modes into my practice. I have learned a few lessons along the way – especially that not one mode will fit all individuals so being flexible and meeting the client where they are and having that conscious awareness [is important]. Understand and be in the moment, be present and mindful of the undercurrent and the unspoken. Have an approachable manner with steadfast boundaries.

Feel comfortable asking questions, reach out to other professionals, pay attention to yourself, carve out time for self- reflection often and develop a strong reserve of self-care techniques to postpone burnout. That being said, I think it is important (and wished I had known what I do now) that you don’t just jump into practice knowing how to do it. You will be learning along the way, things that education does not teach and cannot replace experience, allow yourself to make mistakes for retrospective corrections.

Remain humble because just as you believe you are an expert, along comes a client that will challenge you. Remember: cause no harm is treating within your scope of practice. Refer when you feel it would be the right thing for the client and bring vibrancy and fresh approaches into your practice. Be yourself and enjoy the moment – change what you can to move forward and let go of what you need to in order to grow, and please, do not take anything personally!

  • Rhonda J. Cox, LPC, certified addiction counselor and owner/therapist at A New Life Counseling, Inc., Grand Junction, Colorado

 

 

 

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What drew me into the counseling profession was much struggle in my own life with depression and anxiety and striving to feel relief from these symptoms. I also always had a desire to help others with their problems. I’ve always been the friend who was the good listener and willing to help others. I also have been in therapy at various times in my life. I could always relate to being the therapist and found everything about the field fascinating. I have also done work with motivational seminars and alternative therapies which have provided much insight and been the perfect complement to traditional therapy. These various modalities have encouraged my continued growth in every area of my life. It’s been a godsend and I’ve never been more happy.

My path has changed recently since I have an interest in family dynamics and how our family history affects us. As a result of learning more about this subject and receiving my mother’s help with our genealogy I was able to get more information about our family and about my ancestor’s stories. Needless to say I was able to see some patterns in family members. Having this insight has allowed me to explore this further and how it relates to my life as well as heal unresolved issues. Understanding this has allowed me to also help clients gain insight as to how family history affects them and how to feel more peace overall with their situation and in their lives.

I specialize in anxiety, depression and addictions as a result of working in various settings with other therapists and psychiatrists, taking courses and workshops as well as personal experiences. My modalities that I use mainly are CBT and psychodynamic. However, I place a strong emphasis on mindfulness, or helping people to slow down and live more in the present.

One big lesson that I have learned is that I’m not going to be the right counselor for everyone. This is difficult when it comes up but some clients do bring up that they don’t feel we have the right chemistry. This makes all the difference in the world when they are sharing their deepest feelings.

If I had to give advice to graduate students I would encourage them to not only look for internships in the field but to read as much as possible on their particular niche and to network with others to learn as much as they can and connect. It’s a great idea to get involved in school and get affiliated with membership organizations helping counselors to expand their knowledge and connecting with others in the field.

Also, students should be sure that this is the work that they will love doing since the field is not known for making too much money, but the rewards far outweigh the salary.

  • Jennifer Colton, a LMHC and credentialed alcoholism and substance abuse counselor (CASAC) with locations in Brooklyn and Queens, New York

 

 

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I was always into counseling, in a manner of speaking, since I began my career in industrial relations. This really involved a lot of counseling in dealing with unions and workmen. Grievance handling, which was an integral part of the role required being both sensitive and open to ideas, content and suggestions. I also realized with time that it took patience and often both of us had own agendas to fulfil. Getting to a mutually acceptable position was always the challenge. Therefore patience was a rewarding enabler. Along the way I also began to develop deeper insights into behavior.

In time, with an improved understanding of my own life position and deeper insights into my own being, drivers, motivations and desires, I began to ask myself how I may add value to those who might need the advantage of my own experience and insights. I consciously moved into learning and experiencing the skills and building the capacity to deal with mental health.

I soon recognized that this space was presently occupied in India only by psychiatrists and there was not much room available nor would they the fraternity allow for influencing such cases. In India counseling for mental health consists more of being a caseworker reporting information to a [medical] doctor. I realized with time that doctor’s orientations were more to do with “healing,” which meant give medication and little emotional support. Therefore I decided that I would like to explore the potential to be able to provide that support rather than being a documentations expert.

I expanded this into getting a professional coaching training and qualification.

I recognized that this was a good input because it helped me to enable my clients to deal with themselves by helping them examine themselves, their strengths and their present constraints. I recognized that empowering the client was the best enabler to help them resolve their own issues.

I have now expanded this role into counseling for adolescents too. I have found that it helps the adolescent recognize that they are not dealing with a parent figure but with a friend and a person open to their own experiences without being judged. This has helped considerably.

My interests still are in mental health. Unfortunately, being a counselor is akin to meeting a “shrink” – something that we Asians do not take to kindly. Even during my training days with genuine patients in a hospital the process was always to not talk about mental health but to say that the patient was “possessed” and therefore this period was to enable that possession to be removed.

The second aspect is costs. Clients want quick fixes. They are not prepared to invest time which they equate to money.

I have never received any career advice anytime. That’s why I believe I would like to help my clients look at themselves their strengths and their capacities and make informed choices.

As to what advice I can give its simple: This is not a profession for crusaders. This is taxing emotionally as you often have to hear events and incidents that can be very disturbing and often conflicting with your own values and morals. As a professional you need to be able to remain objective, unbiased, non-directional and at all times enable the client to make the choices. This is important because then they own the outcomes.

 

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I joined the military so that I could go to college to study psychology so I took advantage of the opportunity to pursue it.

Back in high school I studied psychology 101 and fell in love with it. I then wanted to be a mental health therapist to help others. Self-esteem is a key factor in which I have. I enjoy making people feel better about themselves.

I have worked with adults and adolescents, which has changed my path because of different populations and demographics. I specialize in Gestalt therapy, which focuses on the here and now in the present moment. I ended up with this specialty because it has always been the way that I think. I do not believe in dwelling in the past, although it is a great staring point, the past can be a great or not so great memory. This is why it is so important to confront it right now because it really matters the most.

I also work in the security profession and I teach at a police academy and psychology plays a major part in law enforcement.

I have learned that no one client is alike and so you must have the ability to adjust to different ways of therapy. This is accomplished by constantly staying abreast and in tune with what is new in the field and ensuring that my continuing education is relevant to my particular field of study.

Advice I would give to new professionals and graduate students: Remember foremost the [ACA] Code of Ethics, be mindful that there is a large burnout factor in counseling and ensure that you always take care of yourself so that you can take care of others. Always remain objective, consult with your colleagues, don’t channel negativity, and never take anything personal.

A piece of advice that I received along the way is to always keep in mind that the client’s welfare is the number one priority and documenting is a close second. The advice that I wish I received along the way would have been to remember that this field is very demanding and there are some jobs that will have a higher client case load than others, and so I should always be prepared.

  • Tillie Brown, a licensed clinical professional counselor (LCPC) in Upper Marlboro, Maryland, U.S. Army veteran and security specialist with the federal government

 

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After two years of information technology (IT) consulting after college, I realized that there was no passion in my work. As an undergraduate at the University of Michigan – Ann Arbor, I had thoughts of becoming a therapist but got derailed and went in to business. I quit my job in IT and began applying to graduate schools. I looked at Ph.D. programs, however I wasn’t interested in research and wanted to focus solely on face-to-face clinical work.

I wanted to have deeper conversations. I wanted to collaborate with passionate people to help change their lives in the way that they wanted to change. I find it an honor and privilege that individuals and couples ask me to help them in authentic and vulnerable ways.

I enjoy in-the-moment problem solving, deep human connection and a shared experience in which we don’t know all the answers. In being a therapist, boundaries are essential and it is a good fit for me in that I am engrossed in my work while I am at the office, however I can leave it behind at the end of the day.

At the end of graduate school, I had learned about Intensive Short-Term Dynamic Psychotherapy (ISTDP), a highly active and specialized type of therapy originally formulated by Dr. Habib Davanloo. I now video record my work and have sought advanced training, which has helped to improve effectiveness.

I specialize in ISTDP; however I have much to learn. Becoming an expert is a life-long journey with much effort, such as supervision with a trusted mentor and deliberate practice, such as watching video tapes of your own work and monitoring patient and therapist response.

I have learned that it is important to learn a method. Research has shown that there is effectiveness across many methods, however having a skill set and a framework to work with allows the therapist to go off wandering with a home to come back to. Learning how to use a compass is essential in getting lost, which is a huge part of being a therapist, whether we like to admit it or not.

Some therapists sit with visions of past mentors, parents and/or heroes on their shoulders. If they are being unkind and/and harsh, they either need to be ignored or the therapist needs to understand that their harshness and attack is his or her own inner saboteur. This work is personal, and we cannot go deeply into our patients without going deeply into ourselves. A patient needs a vulnerable and human partner, not a guru.

  • Michelle M. May, LPC in Arlington, Virginia, who specializes in couples therapy and Intensive Short-Term Dynamic Psychotherapy

 

 

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My career path was one which can be described as traditional. I attended undergraduate [university] right after high school. I then proceeded to graduate school, completing both my master’s and doctoral degree.

I did not know what area of study to engage in until my junior and senior year of college. I became engrossed in the field of psychology. I would have liked to have been exposed to psychology earlier in my studies as an undergraduate. Nevertheless, I proceeded on to graduate school, with an emphasis in human development counseling. Upon graduation, I continued my studies to meet the licensure requirements as a psychologist.

I continued to attend conferences, workshops and seminars to the point of establishing my specialty area in neuropsychology. I now hold board certification in neuropsychology.

One piece of advice to students and early career counselors is [to] never stop learning. Continue attending conferences, seminars and workshops. Expand your knowledge and if [you are] faced with a challenging client/patient, consult with your colleagues. I have been in this field for over 35 years and I still am learning. Never stop acquiring knowledge.

  • Jose G. Vega, licensed psychologist, board certified neuropsychologist with added qualifications in forensic neuropsychology in Pueblo, Colorado

 

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I was initially planning on going to law school but an encounter with a LPC created an interest in me that I felt would be a better fit for me, while simultaneously feeling a drawing toward ministry. At the time I felt like my being an LPC could provide an inroad into a community of faith whose members were hesitant about the field of counseling. In the early 1990s counseling was not as accepted in some faith and community circles like it is today. Through perseverance and education many of those walls have been shattered to the betterment of those accessing our services.

The profession is a good fit for me because it allows me the ability to practice independently and be a force for change and empowerment in our community.

I have made deliberate efforts to explore as many areas of counseling as possible and now have experience with counseling in many populations including military, disaster mental health, pastoral counseling and community mental health counseling. Specifically, volunteering with the American Red Cross opened up trauma counseling as a significant part of my practice.

[My advice to others in the profession is] allow yourself the time to explore the many avenues that counselors can. Travel and allow yourself the opportunity to explore the many niches available in our field. I have found that change is absolutely possible and empowerment and hope is real. I have found setting personal boundaries is essential to my own healthiness and helpfulness as a counselor also. I watched a man pass out while handing out bottled water to others after having told them to hydrate and take care of themselves while not taking his own advice. I have found it essential and important to practice what I preach. I have also discovered, over time, that many things I said I would not enjoy or was fearful of became areas of passion and expertise. Learn all you can at every opportunity and get involved as a counselor in every area possible: your job site, your organization, community and state and national levels.

One of my professors said to “push yourself beyond yourself.” Impose boundaries and venture beyond your comfort zone and you may realize there are things you enjoy and are really skilled at that you only discover by trying.

  • Donnie Underwood, LPC and licensed marriage and family therapist (LMFT) in private practice in Arcadia, Louisiana; president of the Louisiana Association of Marriage and Family Counselors; an ordained minister; and Louisiana state liaison for the American Red Cross

 

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As a teenager, my friends called my home phone “Lisa’s hotline” because they would call me for advice and guidance. I always loved helping my friends solve their issues and explore ways to have more confidence. It was only normal for me to go into counseling because I loved talking with my friends and family about self-exploration, personal growth and development.

In college, I took as many psychology classes as possible and asked professors for opportunities to perform research and/or work on psychological projects with them. Immediately after college, I went into graduate school to obtain a master’s in clinical psychology. At that time, I specialized in [treating clients who had experienced] domestic violence and posttraumatic stress disorder (PTSD) in teenagers. After working at several psychiatric facilities, I took a break to raise my family. As I raised my children, I still wanted to work in the counseling field.

Seven years ago I decided to return to the counseling field, but I made a major change to [specializing in] marital and premarital therapy. That area has been my passion for many years because I had seen so many friends and family members struggling in their marriages and relationships. I thought that retraining in this new area could have an impact on couples. I decided to train at the Gottman Institute with John and Julie Gottman because they have performed 40 years of research on what makes a successful relationship. I had confidence that their method of marital therapy was the most efficient and effective.
The best advice I can give a graduate student is to find a good supervisor. A supervisor should be supportive, knowledgeable and encouraging. My supervisor gave me many tools to become the best therapist possible. She helped me focus on my strengths and gently pointed out the areas I needed to improve.

I work in the counseling field, but as a mother, frequently, I wear the “hat” of a counselor, assisting my children in ways to resolve conflicts, learning how to develop self-esteem and teaching them how to trust themselves. My journey has been a fabulous one because on a daily basis I help my clients live healthier, happier and more peaceful lives. In addition, many of my couples have learned how to have a loving and warm relationship, which also positively impacts the future generation. I believe that on this journey I learned to trust myself and listen to my inner wisdom.

  • Lisa Rabinowitz, licensed clinical professional counselor (LCPC) in private practice in the Baltimore, Maryland area, specializing in premarital and marital therapy

 

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After completing an undergraduate degree in fine art and graphic design from Temple University’s Tyler School of Art, I spent 12 years working in the corporate world of advertising and design; first in Houston and then in Princeton, New Jersey. One part of my job entailed sitting around a conference table, meeting with clients and trying to determine what they had in mind. This was a challenge when [they] each had a different point of view regarding a particular campaign. Many of my colleagues avoided the frustration of interacting with clients. They joked that I’d make a good therapist.

When my husband accepted a position in the small town of Easton, Pennsylvania, I worked as a freelance graphic designer for a while, but felt frustrated with my career. I did, however, enjoy talking with clients and getting to know them. That helped me to form friendships and feel connected to my new community.

As an undergraduate, I had taken elective classes in philosophy and psychology, though I never planned to pursue a career in either field. Over time, I embraced a philosophy that synchronistic events and apparent coincidences may lead to one’s true destiny. I was aware that helping others find solutions to problems was a common theme in my life and I felt honored when appointed by friends or family to take on that role.

The day I decided to research counseling programs in my area, I found that Lehigh University, which was 20 minutes from my home, had such a program. They also offered evening classes, which was ideal as we had two small children. The deadline to apply was the very next day! That was another crazy coincidence. I decided to apply, despite having to gather transcripts and letters of recommendation in record time. I was accepted.

I was drawn to this profession in my quest to do something meaningful. As a graphic designer, I loved to create and design, [but] each job was extremely important, there were tight deadlines and the final product had to be perfect. I spent late nights far from home, checking brochures as they rolled off printing presses to ensure quality. Once they were circulated, people would look at them briefly and then throw them into the trash. I wanted to do something with my life that mattered.

Counseling was a good fit for my lifestyle. My children were in elementary school when I started practicing. I worked for a community program that provided one-to-one counseling services to teens in their schools. The hours were ideal. I was able to be home with my children at the end of the school day. Working with high school students was very rewarding, as I could observe change and growth in my clients. I really enjoyed guiding them and helping them overcome whatever difficulties they brought to our sessions.

When my children left for college, I gradually transitioned away from working exclusively in school settings. I opened a small private practice, where I meet with teens, college students, adults and families. After working with teenagers for twelve years, it was refreshing to add older clients to my case load.

I currently work four days per week as a counselor and one day per week as a fine artist. To be happy, I need both the solitude of painting in my studio and the opportunity to interact with people.

My advice is not to be afraid to evolve and make changes to your career. Try working with different age groups, in different settings. Learn new counseling techniques. Challenge yourself to stay fresh. Make time for activities that bring you joy – and pay attention to where your life is leading you.

  • Denise Pollack, LPC with a small private practice in Easton, Pennsylvania and artist (specializing in contemporary realistic oil paintings)

 

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I always knew that I wanted to be in the helping profession and I never questioned my counseling route. I graduated with my undergraduate degree in psychology on a Saturday and started my master’s program on Monday, which I went through very quickly. While still attending college (undergraduate), I took a position at our local mental health agency as a grant writer and an administrator of housing grants. This was a natural fit for me and I have always prided myself on my ability to guide and supervise others. Not only is my role to help be a present and attentive person in my client’s lives, I enjoy working with new professionals in the counseling field. I spent about seven years as the executive director of a children’s residential center, which involved being on call 24/7 before I eventually moved into a smaller practice as an independent consultant.

[At first,] I was adamant that I did not want to work with children! I have a very small family and the youngest member in my family is my sister who is 30 years old! When I took a position as the executive director of a children’s residential center for adolescent females, my entire perspective changed. I now see kiddos as young as 5 years old with a specialty focus in trauma.

I was the oldest of three sisters and my mother instilled a strong sense of dedicating your time to others throughout our childhood. From a very early age, I remember making crafts for a mental health group home down the street from us, volunteering time at a food pantry and running children’s programs at our library. She also had a strong belief in giving back to others. When we would receive Christmas presents, for each new thing [gift] that came in, an equal number would be donated.

Counseling is a great fit for my personality! My husband says that I may be the only person in the planet who actually enjoys going to work every day! I love the diversity and challenges that are presented me every day, and I love the fact that my clients also push me to grow outside of my own comfort zone.

[My advice to others in the profession:] Be able to laugh at yourself. Set some limits, but be a flexible and open person to thoroughly enjoy the profession.

Also, find your balance. A big heart and a desire to help others are an essential aspect to this field, but without taking care of yourself and your own mental health, burn out will be inevitable. Know how to laugh.

Most people set off into this profession thinking that they are going to help so many people. But this biggest tip I ever received is that our most important role of a counselor is to help people to help themselves.

  • Jessica A. Oates, licensed professional clinical counselorsupervisor (LPCC-S) and clinical director at Comprehensive Behavioral Health Associates in Austintown, Ohio

 

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I think I always knew I wanted to be in a helping profession. As a child I have the distinct memory of wanting my first summer job experience to be at a local crisis center. I ended up pursuing psychology and human resource management for my undergraduate degrees, and my career started out in human resource management, when I worked in the HR department of an electric utility company. I did this for five years. My main responsibilities were recruitment, training and development, and performance management. Even then my favorite parts of my job were helping staff identify their training needs and developing in their own careers.

When I got the opportunity to pursue full-time graduate education I went all in and completed a counseling degree in order to become a licensed professional counselor. I have now been licensed for about two and a half years and have also completed requirements to become an LPC supervisor.

I have never regretted the decision to pursue counseling as a career as it’s the most rewarding and fulfilling work I have ever done. I realized this very early in my counseling career when during my internship with a private therapist I had a particularly long day, from about 7 a.m. to 7 p.m. working with clients. At the end of that day I was surprised that I was not as exhausted as I thought I would be. It made sense to me then [the adage] “If you do what you love you will never work a day in your life.” I was absolutely sure then that I had found the right career fit for me!

I currently work for a community mental health center and have been there for almost five years. Of course there are the usual challenges associated with working for a state agency (bureaucracy, redundant paperwork) however the core work that I do is still absolutely rewarding. I have received specialized training along the way (e.g. EMDR) and I have seen the results in my work with clients.

I would encourage graduate students and new professionals to begin to consider what their passion or specialized area/niche would be and get certified. Most of the clients I see have extensive trauma histories and co-occurring issues and I am still in the process of getting advanced training in those areas to more adequately serve them.

Continued training and self-care never stops in counseling, and this is one of the reasons I love what I do. Thanks for giving me the opportunity to share!

  • Toya Compton, LPC supervisor (LPC-S) and senior triage specialist at the Jim Taliaferro Community Mental Health Center, Lawton, Oklahoma

 

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My first degree is in nursing. Later I graduated as a psychologist in my country which was a full-time career for seven years. I came to the U.S. to complete my master’s degree and my Ph.D. but could not afford the doctoral degree. So my chances were to become a social worker, mental health or family counselor. I choose to become a counselor.

The need of serving people and my curiosity for understanding human behavior drew me to this profession. This career lets me accomplish what I love the most: [working with] the brain and the human behavior.

Pain management and personality disorders are my specialties. I work for a pain management clinic and personality disorders are very attached to pain perception.

One lesson I have you learned along the way: Our mind is so powerful that we can do whatever we want with it.

  • Marly Ayala-Ycaza, LMHC in Bradenton, Florida

 

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I took a long, rather odd route to becoming a counselor. This career was nowhere on my radar when I first graduated from college. I originally went into library work. I love libraries and was happy with the work, but it was a part-time job and after a time, and an attempt to sell handmade crafts in addition to it, it became clear that I needed a larger income.

I enjoyed working with my hands and I had read about a professional trade school in Vermont that taught paperhanging. I enrolled there, attended the program for the requisite 10 weeks and went into business. I enjoyed the work. I enjoyed making my own schedule, and I enjoyed talking to the people in whose homes I worked. Some days I had rather long intimate discussions with the “lady of the house” while I worked. I became a mother and the flexible schedule worked for me. Then, my oldest child was diagnosed with a serious mental illness and life changed drastically. Our home sometimes felt like it was under siege.

In time, I sought the advice of a therapist and an advocate to help find an appropriate school placement [for my child]. The advocate eventually asked me to work with her and help other families through the journey. Twenty-five years after I first began hanging wallpaper I decided to become a counselor and enrolled in graduate school to become an LPC.

I found counseling to be an excellent career choice for an older person. Life experience is invaluable. It makes the work we do as counselors real – not just theoretical.

My advice to those new in the profession is to give up preconceived ideas about what is the right way to live, to think and to be in the world. This is not to say to give up our ethics and morals, but as counselors we must realize that everyone’s experiences are unique and judging has no place in our job. We must start where the client is and allow them to see that perhaps the way they have done things is not working for them and help them find new choices and viewpoints and ways to think of things.

My career path has not been entirely what I expected. I do contract work with courts, working with people who are referred by child protective services, people who have acted out in anger and need to learn to manage their emotions and many other individuals with many other needs.

  • Mary Spradling, LPC and limited license psychologist (LLP) in Kalamazoo, Michigan

 

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I found my way into this profession extremely circuitously. I took modern dance in high school because I could not take [gym class] in the hot California sun. The struggle to be who I was drew me to study dance at UCLA. After teaching, choreographing and dancing in high schools and colleges, I felt dance was limiting.

I moved to Washington, D.C. and worked with special children (autistic, developmentally delayed, behaviorally disturbed). I later worked with patients with severe mental illness at St. Elizabeth’s Federal Mental Hospital. I moved to West Virginia and began working at a mental health clinic. I learned traditional counseling on the job in the line of fire, as is said.

Later I expanded my arts background and traveled in America, Jordan and Canada doing creative arts therapies. Later I trained as a hypnotherapist, trauma specialist (EMDR) and also employed the creative arts therapies in a variety of settings. Then I went into private practice as an LPC in 1989. I often employ a mix of the above modalities.

I specialize in trauma and PTSD. My own birth was traumatic and I had many consequences to overcome and learn from, and later to share the knowledge with others. I was born into a PTSD world (Army brat on military bases) which gave me a deep understanding of how to work with people who have experienced life-threating situations, veterans and children of war.

There are many avenues for this work. I traveled and gave workshops. The breadth of my training and experience gave me “wiggle room” to explore working with people with severe mental illness as well as the “worried well.”

The element of creativity has been a strong thread throughout my practice. Creativity and spirituality are closely connected and my practice has become more spiritual in its approaches. Often people with severe trauma also have a plethora of “the big questions” such as: What is life? What am I supposed to be doing? Why do bad things happen to good people?

Lessons I have learned along the way: Be open. I can support myself doing what I love doing and that is helping others. I don’t give advice [but] I might suggest: Be humble, respect differences and listen better. It does help to know yourself and be an open-minded learner.

I have done traditional counseling but have found that one size does not fit all. It is crucial to be broadly trained and experienced in different settings to support flexibility and open mindedness.

  • Jo Weisbrod, LPC in private practice in Lewisburg, West Virginia

 

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Dreams come true. I was led to the counseling profession when I was in my 40s and burned out as a stay-at-home mom. I was co-facilitating sexual abuse support groups, and it was the counselor co-facilitating the group with me who said, “Dana you’re gifted at this. You need to get your degree.” Three years later, I became an LPC and opened my practice (Child and Family Counseling Center of Columbus, Ohio) in 2012.

Last January I transitioned my practice into a nonprofit and with that added a chemical addictions counselor, two social workers, three equine professionals, an administrative assistant, two horses (Batman and Ellie May) and our therapy dog, Willow to our team. We specialize in treating minor [youth] and adult survivors of sexual abuse. Clients interact with horses at the barn and our therapy dog at the office. The power of animals in the treatment of humans is significant.

Animals offer clients the opportunity to build a healthy relationship. It may sound fundamental, but we know deficits usually exist in most of our populations. Another benefit of horses is that they are always honest. This purity coupled with their heightened sensitivity to our energy and emotions gives a client immediate feedback. The honesty reflects truths hidden below their subconscious. Another relational aspect is that horses live in herds like our human families. Coming to the barn clients are having an experience. It’s not didactic, but experiential.

Research tells us heart rates decrease [as we] pet our dogs. Doing reunification sessions between a child victim and their perpetrator (often a family member), the victim often wants [our therapy dog] Willow next to them during the session(s), acting as a comfort.

People are often uncomfortable coming into our offices. Animals often provide a distraction from their presenting issues. They act as a bridge at the office and barn for people to disclose root issues leading to their psychological pain.

I can often fail to take care of myself much like many of the clients I treat. Implementing routines and rituals assist in my wellbeing, along with good sleep, nutrition and exercise. Feeling safe to share my challenges relaxes me along with the rhythm of brushing the horses. These animals have taught both my clients and me the importance of listening more deeply, being more honest and the healing that takes place when we are heard and feel understood.

  • Dana L. Kasper, LPC, clinical coordinator for Reins of Freedom nonprofit in Ohio, writer, speaker and advocate for survivors of sexual abuse

 

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I was drawn into the counseling profession because of my passion and belief that many of the personal and social needs of our children were not being met in the classroom. I felt that by becoming a community resource, I could better serve the behavioral, mental health and family needs. This would help alleviate many of those issues experienced by both children and staff inside and outside the classroom.

I feel that this has been “good fit” for me because I grew up in the same communities [I now practice in] and am better equipped to understand the needs of clients both young and old.

My path has included working and managing an outpatient facility and later working at an inpatient hospital setting for several years with clients experiencing mental health and substance abuse problems. As a result, I decided to specialize in treating clients with comorbidity behaviors.

The lessons I have learned include the rewarding feeling I get each time a client takes ownership of their lives. They use phrases such as “I know what I should be doing” or “I’ve learned greater acceptance of where I am in my life.” It has been enriching to see my own personal growth as I continuously strive for excellence in the profession and address my personal self-care and desire to live a balanced life.

I would encourage both graduate students and new professionals to pursue their dreams and desires to enter the profession no matter what vehicle or career path they take (business, science and research, education or analytical reasoning). You may be destined to serve in clinical, forensics, community, Christian, marriage, family or rehabilitation counseling. The key involves developing your knowledge, skills and attitude of the profession.

An area that I have had to develop in my work that does not relate to traditional counseling is using counseling skills to manage my business. This includes active listening, rapport building, reframing, redirecting and being supportive, etc. These skills have been instrumental to help promote marketing, schedule appointments and provide flexibility, along with resolving billing issues as I continue to expand in this technological and e-commerce world.

The key advice I was given was the need to get connected to a professional organization. This has helped me maintain my professionalism and gain the knowledge and skills needed to be successful in pursing my professional and personal goals.

The advice I would give is to stay connected to a professional organization and if it is your desire to be a part of the helping profession, I encourage you to follow your passion.

  • Srlestine Davis, LPC and substance abuse counselor at Keys to Wellness and Recovery Services in Houston, Texas

 

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I first considered becoming a counselor while on sabbatical in 2008 at a community college where I worked teaching biological sciences. I interviewed several professors at the university where I worked during the sabbatical in both biology and counseling. Being an introspective and observant person, I needed more information to make an informed decision. I knew I didn’t want to compete [for] a university job in biology. I recognized my restlessness and desire for change – and I had a strong desire to help people be successful in a more personal way.

The reason I took sabbatical was the restlessness that had grown over time. I worked the prior 20 years as an administrator and professor at the community college and had returned to the classroom the semester before I requested and was granted the sabbatical. I volunteered at the university biology department in preparation to enter the Ph.D. program in biology education. But as the time approached to complete the application process, I felt I needed to really consider what I wanted to do in the next 10 years. That’s when I knew I didn’t want to teach large classes of undergraduate general biology or graduate seminar classes. I needed something different.

To honor my restlessness, I sought to answer: “What change was calling me?” “What do I see myself doing in ten years?” “What can I do that is personal, individual and reconciling for that person?”

My answer was found in my delight in hearing people’s stories and being able to accompany them on paths to reconcile issues of identity, in relationships and career choices and accomplish goals. I began to see counseling as a viable career choice. I would need the appropriate credentials but I was willing to return to the university as a part-time student. I made preparations to enter the program the following spring semester. That was in 2009 – and I haven’t looked back.

During my internship at the university counseling center I discovered a passion for suicide prevention that afforded opportunities to teach and counsel. My work provides suicide prevention gatekeeper workshops and evidence-based therapies such as Collaborative Assessment and Management of Suicidality (CAMS), CBT and grief counseling, attachment based-emotionally focused therapies for individuals, families and couples. This is my seventh year as a psychotherapist and I am excited about the opportunities in my new chosen field of study and work.

My career trajectory into counseling began after a full and rich career working in science as a microbiologist, college professor and dean of science and mathematics and continues on a journey of discovery and service of reconciliation that is even more fulfilling and enriching. My career goals include qualifying for a LPC and becoming certified in emotionally focused couples therapy.

  • Brenda Manthei, licensed associate counselor (LAC), trainer and psychotherapist funded by a Garret Lee Smith Suicide Prevention grant in Flagstaff, Arizona

 

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Growing up I always knew that I wanted to spend my life helping people. I’m from a small town in central Louisiana. When I graduated high school, I did what most high school graduates do, I left the town. There were really only three options for me: I could go to college, seek a career in the oil industry or join the military, which I actually did. I joined the U.S. Navy and served four and a half years serving during Operation Desert Storm. While I was in boot camp, I chose to get training as a hospital corpsman, similar to the civilian licensed practical nurse (LPN). After completing that training and my first tour of duty at the naval hospital in Orlando, I was scheduled to transfer to another duty station. Instead, I decided to take on a second academic training tour and study to be a psychiatric technician, partially due to interest I was gaining in psychology while I took night classes at an onsite military-based college. After completing the Navy’s psychiatric technician training school, which took about six months, I was stationed at another military hospital and worked in the psychiatric ward for the remainder of my military service time. While serving in the military full time, I increased my college studies from part-time to full time and studied psychology at the University of Central Florida. I was fortunate to graduate from college approximately one month before my separation from the military.

Immediately after my discharge and because I had obtained a bachelor’s degree in psychology, I was able to work for the Florida Department of Children and Families (DCFS) as a child and family counselor. My primary job was to manage families referred to the department because abuse, neglect or abandonment of children. After working there for one year, I decided to pursue my master’s degree in counseling and was able to complete that degree in three years as I continued my work with the state of Florida in the capacity of psychological specialist for Florida’s state prison system. I was fortunate to be a part of the clinical team which opened the state’s first state of the art psychiatric hospital in the prison system.

Two years later, I was licensed and practicing in three states: Louisiana, Georgia and Florida. Since then I have opened and managed behavioral health companies and provided behavioral health services in through very diverse service systems.

The counseling profession is a good fit for me because it allows for so much flexibility, diversity, practice options and opportunities to help people.

During the early part of my counseling career, I focused on therapy. Now I am primarily focused on training and development of counselors and behavioral health service systems. I have also become increasingly involved with mental health policy by defending and advocating for professional counselors and practice.

The greatest lesson I think I’ve learned is that counseling is not a one size fits all profession. A counselor’s success is primarily depended upon how hard that person is willing to work and how creative that person is in order to maximize the opportunities given within the profession.

My advice to others: This profession is saturated and competitive – it’s sink or swim. The financial rewards (pay) are scaled down and the work is overwhelming. Creativity, hard work and inspirational attitudes with excellent clinical knowledge will give you the cutting edge in the profession.

I got a great (private practice) internship that helped to pave the way toward me understanding the business side of the profession, of which I attribute my success in the profession to.

  • Leroy ScottLPC-S (Louisiana), LMHC (Florida) in Zachary, Louisiana

 

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While in the U.S. Marine Corps, I enrolled in some college courses to begin preparing for my future after serving my country. One of the officers I served under was a trained psychologist so I took a few courses in psychology and developed an interest to help others. When I attended college after my time in the Marines I completed a bachelor’s degree in criminal justice and decided to pursue a master’s degree in community mental health counseling.

I thought pursuing a counseling degree would be beneficial to help people who struggled with behavioral health challenges who entered the criminal justice system.

I am passionate about delivering quality services to all my clients and consider counseling a part of my mission in life.

I initially worked in a nonprofit agency before transitioning to a community hospital setting, followed by moving into the field of employee assistance programs (EAP). Eventually I returned to a nonprofit agency and worked closely with the Drug Court and Federal Reentry Program before opening my own private practice business. I have close to 30 years of experience working with individuals, couples, families and groups. As an EAP professional I have provided critical incident stress debriefing to local and national events that have impacted employees, families and communities.

Lessons Learned: As a professional, counselors must embrace diversity and accept their clients unconditionally. Also, it is importance to consult and communicate with peers.

Advice to students and others: Be open minded, passionate and nonjudgmental toward your clients and colleagues. Always be eager to learn new skills and remember that you don’t have all the answers. Stay hungry to grow and remain humble. It’s not about you, It’s about your client’s health and wellbeing.

  • David Jennings, LPCC, licensed independent chemical dependency counselor (LICDC-CS), certified employee assistance professional (CEAP) and founder of Premier Counseling and Coaching Services, a private practice with offices in Cincinnati, Dayton and Columbus, Ohio

 

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I have been in private practice for 33 years. Actually, I always wanted to be a teacher [but] my guidance counselor talked me out of it. “No future jobs,” he said. I got my associates [degree] in business administration. I wanted to be successful but didn’t want to enter corporate America so I got my bachelor’s [degree] in criminal justice, my only other interest. Landed a job counseling ex-offenders. Hardest job I ever had. My next job was counseling high school dropouts, still without [having taken] a counseling course.

We used to administer “interest inventories” and I took one and my career path became crystal clear. Every job, full or part-time, as well as every volunteer position [I had done] was in counseling or teaching.

I went back for my master’s degree, opened my practice, became certified and licensed and have been successful ever since. Thirty-three years in the same beautiful, warm office. A few times a year I develop, market and conduct weekend workshops on various topics employing counseling, teaching [and] every other skill I have. I am very happy to say that I love what I do.

I believe that being a psychotherapist is a good fit for me because, humbly, I am good at it. I possess the necessary qualities. I am a good listener, empathetic, respect confidentiality and truly care about helping others.

To those entering the field I would recommend getting their master’s in counseling as I did or getting master’s in social work. Employment opportunities abound. [Do not chose] psychology unless you want to pursue a doctorate.

Invaluable pieces of advice I received were to get personal counseling and supervision. Also I became active in my professional association, ACA. I attended yearly conferences and while my degree taught me counseling techniques, at the conferences I attended specific workshops on issues my clients presented.

  • Ramona Bobe, LMHC in Glen Head, New York

 

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I initially started out as a nursing major [in college]. I took a psychology course as an elective and fell in love with the study of human behavior. I changed my major immediately to psychology after that. After completing my bachelor’s degree in psychology, I begin looking into graduate programs and found counseling to be the best fit for my career goals.

The study of people and seeking a deeper understanding of human behavior drew me to the field and has kept me in the field. Along the way I have learned to trust the process. Also that people are the experts of their experiences and it’s important to keep that in the front of our minds when interacting with people.

The most helpful advice I received was to trust the process and that therapy is a marathon, not a sprint, and it takes time for people to create new processes and experiences.

  • Brittany Johnson, LMHC in New Albany, Indiana

 

 

 

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Add your voice to the conversation in the comments section below; Tell us about your own career journey and the lessons that you have learned along the way.

 

Letters to the editor: CT@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.

A path well chosen

Compiled by Bethany Bray

Professional counselors find their way into the profession in a multitude of ways. Some individuals know it is their calling even in their undergraduate years. Others enter the counseling profession after first having had a career in another field or returning to the workforce after raising children. Still others are inspired to pursue training as counselors at the suggestion of a mentor or after personally encountering the good work of a professional practitioner, either in their own life or in the lives of friends or family members.

Regardless of how they get here, however, they all have one thing in common: a deeply felt calling to help others.

For this month’s cover story, Counseling Today asked American Counseling Association members from across the country to share — in their own words — their personal stories of how and why they entered the profession and the insights they have gained along the way.

 

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Like many of my fellow counselors, I took a rather circuitous route to the field. Prior to becoming a licensed professional counselor (LPC), I spent 21 years as a fighter pilot in the United States Navy and Naval Reserve and 10 years flying for United Airlines. I had a great contract with the airline, enjoyed the lifestyle and loved getting to turn and burn in a Navy jet on the weekends. I never thought I’d want to be anything else but a pilot.

On the morning of Sept. 11, 2001, I took off from Hartford, Connecticut, as the first officer aboard a United 737 [aircraft]. As we flew the departure through beautiful clear skies over Manhattan, I found myself caught in the middle of an event that would change all our lives forever.

I spent most of the next six years on active duty, recalled three times, including one 18-month mobilization in support of Operation Iraqi Freedom. Shortly after coming home from Iraq, my marriage ended, and I found myself a single father caring for three young kids struggling with the legacy of war and divorce. Caught in the grip of a deep depression, I wasn’t much of a father. I definitely wasn’t the strong, stable one they needed.

When it finally became obvious we needed help, I reached out for counseling. I saw a counselor doing traditional talk therapy, and my kids started working with a counselor doing equine therapy. For me, it helped to talk with someone, but I could never get over the fact [that] my counselor had no experience with or knowledge of the military. This hang-up was all mine, but it kept me from fully investing in the process, and I eventually quit going.

I probably would never have gone back to counseling, let alone become a counselor myself, had it not been for the experience my kids had with the horses. This unique therapy became a transformational experience for all of us. The kids developed a more realistic understanding of themselves and the world, rather than one overly based on fear and mistrust. The horses acted as catalysts for learning authenticity, respect, empathy and self-confidence. They showed my kids [that] they didn’t need to fear or avoid uncomfortable feelings. Through the bonds they formed with their horses, my kids learned they were valuable and worthy of love. Perhaps most importantly, they learned to accept that they weren’t to blame for everything that had happened in the preceding few years, but feeling sad because of it was OK. Those few months proved to be a pivot point for the kids. They are now young adults, each embracing life with all its ups and downs and excited for what the future holds.

Having a front-row seat to my children’s amazing transformation transformed me. I became fascinated by how counseling could change lives — and especially how horses seemed the perfect partners in this journey. I left United and never looked back. Over the next few years, I earned my master’s in counseling, reentered personal counseling and overcame my depression. Eventually, I met a wonderful woman (a fellow Navy veteran) and married again.

Today, I’m the clinical director at Equest in Dallas. I work with a team of counselors, social workers and equine specialists to provide equine-facilitated counseling to veterans and military families. Every day I’m reminded of just how much counseling can help — and how, for so many folks, horses are the best counselors of all.

— Jeff Hensley, LPC and clinical director at Equest, a nonprofit equine therapy organization in North Texas

 

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I initially was drawn to education and taught as an assistant middle school teacher. There I developed an emotional intelligence curriculum but felt limited by the bureaucracy and standards. I got a job working as field staff in a wilderness therapy program, where I got incredible exposure and practice working in a clinical realm in a unique setting. The company I was working for at the time (Evoke Therapy Programs) offered to help me go to graduate school and allowed me to train under therapists. I could not refuse this wonderful opportunity to get training and work in such an expansive, powerful “office,” and, hence, my path to become a therapist began. I began working in the wilderness and now have moved to helping young adults transition out of wilderness therapy and teaching graduate students at Oregon State University. 

Most people “know what to do” but struggle to “do what they know.” Telling someone something is not nearly as helpful as creating the space for the client to have new experiences, even if it is as simple as being in contact with emotion and not responding in their old patterns.

My advice to graduate students and new professionals who are entering the profession? There are more and more counselors. Find a passion or interest and try to carve out a specialty or something that will allow you to stand out.

— Sean Roberts, LPC, clinical director at Cascade Crest Transitions in Bend, Oregon, and an adjunct instructor at Oregon State University

 

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As a young mother in my early 30s, my family was plunged into crisis when my two oldest children were victims of a crime. Caring counselors helped every member of our family at the time. Later, in my 40s, when I had the opportunity to return to school, I could think of nothing I wanted to be more than a counselor, like those who had helped my family and me when we were in such distress.

My advice for those entering the profession is to consider a specialty in disabilities. In addition to being a licensed marriage and family therapist (LMFT) and licensed professional clinical counselor (LPCC), I am a certified rehabilitation counselor (CRC), and that has served me well. With the aging of the baby boomers, disabilities are expected to skyrocket. The field needs people who are well-versed in how to provide accommodations, who can advise families struggling with a disabled member or help someone cope with all the changes a newly acquired disability can bring. This can provide a valuable specialization for your career and make you an important resource within your community.

Within disabilities, I subspecialize in brain injury, autoimmune disorders and hearing loss. My interest in brain injury started with a client who had survived a severe traumatic brain injury. The more I learned, [the more] I realized brain injury is a hidden epidemic in our society. It’s thought [that] 50 percent of homeless people have one.

All counselors need training on the difficulties of mild to moderate brain injury. These may be the clients with severe fatigue, concentration problems, a history of homelessness and multiple employment failures. They struggle to get through their day, often not knowing what is wrong with them and why they can’t be “normal” like their peers. A well-educated, thoughtful counselor who is knowledgeable about the challenges of brain injury can make a world of difference.

Longtime career counselor and chair of the San Francisco State University counseling department, Robert Chope, once told me to always have multiple income streams. He advised people to have a variety of ways in which they make money in the field. For example, in addition to a private practice, he suggested teaching, coaching, writing a book, creating webinars or a continuing education series related to your book or a specialization. This could potentially create several different income streams. If something happened to one, it would be possible to focus on the others for a while if needed and not lose everything. Great advice from a well-known giant in our field.

— Laura C. Strom, LMFT, LPCC, CRC, a trauma and disabilities specialist with a practice in Santa Rosa, California

 

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I had a suicide in my family when I was a teenager. Having personal experience dealing with emotional issues at a young age fueled my drive to find a way to help people. I think counseling is a good fit for me because I’m good at helping others break down issues, and [I] find joy when a client feels normalized with their pain.

My path just to getting licensed is a long one. I believe that I’ve changed as a person since I started counseling professionally. Every day is a challenge, and [this] has taught me to be more creative.

The biggest lesson I’ve learned is that all the textbook learning they teach you in graduate school is not at all how it works in real life. Counseling is much more than sitting in a room with a client. It’s about working with people in all walks of life, in everyday settings, and looking outside the box.

My advice to new [practitioners] is to know your boundaries and stick to them. … Also, try everything. We are so often told to stay in parameters of fields or specialties. But I found that having many different types of jobs in different areas has really opened my mind to what I wanted to do and what I never want to do again.

Emelia Thygesen, credentialed alcohol and substance abuse counselor and licensed mental health counselor (LMHC) at the Onondaga County Justice Center for the Syracuse City School District in New York and online therapist at 7cups.com and Betterhelp.com

 

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I first knew I wanted to work in the psychology/counseling field in high school. I felt I had a calling to work in the field, although I didn’t understand the differences in the professions within the field. I took a psychology class in high school, and I was hooked. It came naturally to me, was interesting and I was passionate about it.

I obtained my undergraduate degree in psychology from Florida State University, took a few years off as I had my daughter and then started my master’s program at Florida State.

Shortly after graduation, I transitioned to a position at a forensic facility working with adult males who were [found] not guilty by reason of insanity or incompetent to proceed to trial. I was quickly put into a supervisory position over social workers and social services staff. I remained in the forensic field for four years, then had a premature child who required a lot of special services and needed me to have a flexible schedule. I then started working in community mental health as a therapist. This role was perfect for me to be able to balance the needs of my children and still work full time. It was frustrating, though, because it was fee for service. This meant that if the clients didn’t show up, then I didn’t get paid, and that could be overwhelming at times.

While working at this agency, I did a number of things to help my career. I became licensed (more than six years after graduating) and completed a certificate program for sex therapy. I realized throughout the course of my work that sexual issues were grossly ignored by most mental health and other health professionals. This became an area that I was passionate about within the counseling field. I started a part-time private practice focusing on sex therapy. I was the first sex therapist in my hometown and one of few in the surrounding areas. I was also the first to work in community mental health. I gained a ton of experience during this time as people came to know about me. Clients would call the agency asking to make an appointment with “that sex lady,” a persona that I have now adopted to use for speaking engagements, trainings, etc.

I recently started the Florida Association for Sex Therapy and Education. The goal of this organization is to have an organization specific to sex therapists and educators in Florida, as requirements differ here from the rest of the country. I want to expand awareness of sexual issues and sex education to youth and adults in the community.

I honestly believe my journey was meant to go the way it did. I had opportunities that I passed up (i.e., going to a doctorate program immediately after my bachelor’s). I could have gotten licensed sooner, or I could have worked in different jobs, but I truly believe that every experience I have had has helped   mold me into who I am today.

The best advice I can give someone is to pay attention to what feels right for you. Listen to your gut. Pay attention to the things that you are passionate about. Find ways to incorporate your passion into your work.

— Valerie Richards, LMHC, certified sex therapist, owner of Vivas Counseling Services in St. Lucie and Martin counties and founder of the Florida Association for Sex Therapy and Education

 

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I started undergraduate college with the intent of becoming a commercial pilot, but an elective class on counseling turned my career in a totally new direction. My undergraduate professor introduced me to the field, and even though he retired long ago, he still is a mentor to me. From that point on I knew I wanted to be a counselor, and I’ve never looked back.

I continued directly from undergraduate to graduate school and my Ph.D. program. I learned to channel my love for children into a specialty of working with sexually and physically abused children, where I’ve invested the majority of my clinical time over the past 30 years. I chose children because I learned in my very first internship that many problems in later life have their roots in childhood. If those problems had been addressed early on, my clients’ lives would have taken very different paths.

My graduate internship supervisor helped me learn to get to know myself — a lesson I desperately needed — and how to manage my frailties and personal issues in a professional context. I have not seen her in 25 years, but her voice is often in my head, and I quote her to my own students, interns and supervisees. Therefore, I’m a die-hard advocate that counselors should also be in counseling.

My career has been exciting because I have not been afraid to try new things and to apply my counseling skills in nontraditional arenas (law enforcement, criminal profiling, business consulting). I was able to recognize open doors that led to many exciting and fascinating turns in my career.

In the field, the hardest lesson for me to learn — one that I regularly try to communicate to my interns and supervisees — is that the real world doesn’t always work the way we are taught in sanitized classrooms. Learning to apply ethics and evidence-based theory in a multicultural world that doesn’t always play by [the] rules we assume is a tough part of learning the field.

I would encourage new counselors to do three things. First, never stop learning. Continue supervision, participate in professional organizations, read the journals and go beyond basic CEU requirements.

Second, never do anything just for the money. No license, title or position will bring you satisfaction by itself. No one owns me, and I could quit my job today if I wanted. Even when I made very little money, I lived by this principle, and the freedom it brought me is indescribable.

Third, don’t be afraid to think outside the box and pursue an area of the field you love. Burnout won’t ever happen to me because I am not really working; I’m doing the things I love every day. All of us start with general practice and pay our dues early on, but learn what gives you energy and focus your practice in that direction when the opportunities present themselves.

— Gregory K. Moffatt, professor of psychology at Point University in Georgia, an LPC and certified counselor supervisor in private practice with offices in the Atlanta area, author, clinical supervisor, public speaker and consultant to businesses, law enforcement and foster care agencies

 

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I spent more than 20 years in business, real estate and finance. I had become increasingly disinterested in my work and decided to brainstorm ideas for an alternative path. My husband recommended a career counselor who had given a presentation at his employer’s [office]. I made the appointment, and in the course of discussions with her around my possible interest in some type of teaching, she asked if I had ever thought about counseling. Our meeting was on a Friday. By the time the weekend was done, I had begun the process of applying for my master’s in counselor education, and I have never regretted my decision. I loved each step of the academic journey as much as the destination of becoming a licensed counselor.

Professional counseling allows me to be authentically me and do what I love: listen, support, collaborate and empower. My specialties are adults in transition and grief/bereavement. Adult life transitions is an area for which I have the greatest affinity. It has been extremely rewarding working with clients to reframe struggles into opportunities and journey with people reclaiming their lives, especially in the second half. Grief and bereavement influence every aspect of life. Nothing prepares you more for living than death. Contemplating terminal illness, death and their anticipatory effects was an emotional thing for me. Through learning and experience, I took it by the hand to walk with it to dispel some of the fear. It is a privilege to share that journey with others.

The career advice I would give others is that peer support and collaboration are invaluable. Private practice can be somewhat isolative. Align yourself with colleagues, and be selective in consultation groups. Meet with people you trust who model professionalism and integrity and understand the client concerns you present.

Also, self-care, self-care, self-care. You don’t want to burn out doing what you love.

— Katherine Perry, LCPC in private practice in Saco, Maine

 

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I started out thinking that I wanted to be a wilderness therapist. I love camping and hiking, and the impact of nature on treatment outcomes was compelling. I shifted to doing sailing-based therapy through local nonprofits and colleges.

Throughout this journey, I launched a small private practice to pay off student loan debt. Then I started blogging and podcasting about the things I was learning. Over time, I found that as counselors, we aren’t really taught how to grow a practice through business basics and marketing. So, counselors struggle when, in reality, a lot of the principles are really easy.

I was drawn to counseling because I wanted to help angry kids. I was beat up a few times in middle school and really wanted to help hurting families. But then I started looking more at systems and how counselors weren’t thriving. I shifted from focusing on the clients to focusing on helping more practices to thrive.

It’s interesting how my professional path has changed, but many of the themes of wanting to make an impact stay the same. As a professional counselor, it is important to see how I can expand the ideas of counseling beyond just the typical therapy walls.

I’m really excited about this coming generation of counselors. They are digital natives, so the idea of creating a podcast, blog or e-course to expand what they are doing in therapy is not foreign. My best advice to graduate students and new professionals is to start blogging, talking about their experiences and [giving] advice. That’s what we try to do every day at [my blog] Practice of the Practice.

When I think back on my early career, I wish someone would have said, “Counseling theory applies everywhere. You don’t have to take the traditional path.” For a long time, I felt like a “bad” counselor because I was doing more business consulting with therapists, but in reality, it was strengthening the field and the overall fabric of our society.

— Joseph R. Sanok, LPC, owner of Mental Wellness Counseling in Traverse City, Michigan, and creator of the Practice of the Practice podcast, which was named one of the top 100 podcasts to listen to by The Huffington Post

 

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As long as I can remember, I wanted to help people, and I was intrigued by the human mind and how people heal and grow. I’ve seen and read about so many people who have experienced so much trauma, struggle and pain and made it through those experiences stronger, happier and successful. I wanted to be a part of that experience, the journey and the will of the human spirit.

What drew me to study counseling specifically (over social work and psychology) was a certification program in complementary medicine and wellness. During my first year in college, I struggled with anxiety and panic attacks. I discovered breathing techniques and meditation, which really saved me. I wanted to teach others the tools that can also save them from stressful situations. This experience led me to become a registered yoga teacher, allowing me to teach meditation and breathing practices to my clients.

Interestingly, I started out in a holistic counseling center as an intern. I moved on to work with children after that, then I worked with inmates in the county jail with a focus on substance abuse. And now, 17 years into my career, I am in a private practice using my yoga teacher training and coaching skills to provide a holistic growth and wellness approach to counseling. I am now exactly where I want to be.

My advice to new professionals would be to go for your dreams, do what you love and keep that passion alive. Service to our community is so important. And self-care is above all. This is definitely a career where you can lose your sense of self if you’re not mindful. The better you can care for yourself, the better you can serve others.

— Dawn Gaden, yoga teacher, life coach and LPC at a counseling practice in Beverly Hills, Michigan

 

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Before deciding to become a counselor, I worked 15 years in corporate America. Because I enjoyed working in business, I decided to open my own counseling practice after returning to school and graduating with a counseling degree. As the founder and owner of Grace Liberty Counseling, I’m able to pursue my passion of serving others as a counselor while continuing to stay involved with the business aspect of owning my own company. I provide counseling services to children, adolescents, individuals and families. Each individual and family has unique strengths to draw out and build upon, and I am passionate about helping my clients build healthier, [more] meaningful and happier lives.

The piece of advice I would give to graduate students and new professionals who are entering the profession today is to have faith and to stay focused. I’ve learned that building my counseling practice takes time, finances, planning and execution. I find that self-care, being mindful and having the support of your friends and family are important. I also find it helpful to collaborate and consult with other professionals. Life is a journey, and you are the answer to somebody’s prayer. If you do your part to add to the health and well-being of others and your community, you will find counseling to be a fulfilling career.

— Abigail Castel, LMHC and clinical supervisor with a counseling practice in Bellevue, Washington

 

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My journey to professional counseling began in my undergraduate program, working toward a bachelor’s degree in psychology. I received two field placements, one as an assistant to a school social worker, working with pregnant teenage students, and the other working with at-risk teenagers and their families in a local nonprofit agency. Both placements were challenging and rewarding experiences that led me to continue to follow my passion in counseling children, youth and their families.

During my journey as an LPC intern, I was very fortunate to have been matched with an encouraging, honest and helpful supervisor. She helped me navigate the seemingly scary road to private practice and encouraged my professional growth and connection with other amazing therapists.

My best piece of advice for new graduates and professionals is [to] connect with mentors and other professionals in your field and explore various counseling avenues. Throughout my journey to private practice and owning my own practice, I have found invaluable connections that nurtured my professional and personal growth. On my path to becoming a counselor, I have made connections through my employment at nonprofit agencies, schools, advocacy programs and volunteerism within the mental health community. Instead of finding myself in competition with other therapists, I have learned to embrace an attitude of learning, sharing knowledge and celebrating the successes of others, as they have celebrated my successes.

Without the mentorship of my supervisor and other experienced therapists, I would not have been as confident or prepared to take the leap of faith into owning my own private practice. [Working in an office as] a private practitioner can be lonely and isolating work. However, I make it a priority to continue to seek out and connect with other therapists as a mentor, consultant and friend. I have learned to share about my own professional journey, challenges, trials and successes to encourage other therapists on their professional path to nurture ethical, professional and beneficial relationships with their clients. Creating a network of accountability and encouragement to other counselors and therapists helps to create able therapists to best meet the needs of their clients.

I have heard numerous horror stories from clients who have experienced unethical, maleficent and unprofessional therapy from other practitioners. I hope to be one link in building a stronger and [more] able network of therapists to meet client needs. [Involvement] with professional networks and organizations is another avenue to be connected with and stay updated on counseling, theoretical and ethical standards.

— Courtney Guhl, licensed professional counselor supervisor and registered play therapist in private practice in Fort Worth, Texas

 

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I was an anxious child, and I grew up to be an anxious adult. I suffered with panic attacks and anxiety for more than 20 years. My undergraduate degree is in communications, and after working in the public relations/advertising field for a while, I left to start a family. I then ran a small business with my husband. While raising our two children, I really felt the limits that panic disorder had placed on my life. It became increasingly difficult for me to do the most basic of things, such as go to the supermarket, and I was quickly running out of excuses for why I could not attend events. I thought that this was the way I would have to live my life.

I finally sought help and got relief from a very talented therapist, and I realized how powerful therapy can be. I was able to get my life back and do things without all of the “what if” thinking. It became clear to me that a career helping others to get relief from anxiety is what the universe had planned for me.

[Choosing my specialty as a counselor] was an easy decision for me. I know anxiety from the inside. I believe that unless you have suffered with panic and anxiety, it is really hard to fully understand what it is like to live a life filled with terror and dread and constantly be on guard. My clients appreciate that I get it and also realize that there is hope.

I would advise new professionals to find a modality that they believe in and then train with experts and learn as much as they can. I would also suggest having a mentor or someone with experience in the same modality with whom they can consult.

I’m not sure if this is career advice. However, one of my professors once told me to enjoy the journey, and I am!

— Tish Schuman, LPC, national board certified clinical hypnotherapist, certified master hypnotherapist and owner of Calm Pathways Counseling in Mount Laurel, New Jersey

 

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I was interested in psychology while in high school in the seventies in south Louisiana. The thought of eight years of college [for psychology degrees] was a huge deterrent, so I majored in English literature and journalism and began a career as a print reporter in the early eighties. I really got into my assignments digging for the roots, the solutions and the personal in each story.

After getting married and having a child, I miscarried a second child five months into term and then had three subsequent miscarriages. I sought out the help of a psychologist to reroute my life.

My therapist was a widow, a mother of two young sons when her husband was tragically killed. Her story was one of slow and steady coursework in psychology to support her family and define herself in the wake of her new existence. She told me it actually didn’t matter if she — or now myself — didn’t graduate; it was the getting out and being part of something we enjoy that was important.

At age 35, I enrolled in an adult program at the University of Delaware and took classes on the days my son was in KinderCare. Then my husband’s work transferred us to Mexico City. I finished my undergraduate degree in psychology at the United States International University located there and began a prep course for a master’s program exam. I was going all the way!

[When we were] transferred back to the United States, I started my master’s in counseling psychology at the age of 40 at Immaculata University in Pennsylvania and graduated at age 43. I became an LPC three years later and, now, at age 58, I enjoy a private practice in two locations that completes me.

Everyone has a story at some level of development. As a therapist, I help my clients write and rewrite their own stories.

Graduate students and new professionals will achieve maximum satisfaction if they are truly interested in their clients’ narratives and help them edit out the superficial and flesh out the deeper meanings of their lives.

As a specialty, I chose treating eating disorders because they embody the definition of a true mystery illness. Unraveling that mystery and seeing a healthy young person emerge is a life’s work well spent. I also found through the years that I have a great love for and connection with these young women for an inexplicable reason. Perhaps it is a motherly instinct not fully tapped.

— Diane R. Girardot, LPC with offices in Philadelphia and Chadds Ford, Pennsylvania

 

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I spent 23 years in the special education field as a teacher, supervisor and director of student services. The one service I saw [that] we were missing the most was tending to the mental health of the students and, most especially, their parents, who were struggling with raising a child with mild to severe special needs. I used a lot of federal funds to begin an elementary counseling program and developed some parenting programs. That led me to the interest in another degree, and I went back to school for counseling. I eventually left education and went into counseling practice. My degrees also led me to work part time in a private foster care program as an educational and career counselor/consultant. I’ve been in private practice for 23 years, and [I am] getting ready to retire pretty soon.

I was drawn to the profession even before my educational experience by a counselor who helped me through a serious depression. She may have saved my life, and I wanted to help others.

One way my path has changed is finding out what I like and don’t like. About six years ago, I stopped working with children, very discouraged that most of it was divorce cases wanting the counselor to be on each parent’s side. I admire those who are really good at that.

My advice, especially in private practice, is learn how to do your business as well as counseling. Most programs do not prepare us for the business end, and we are naive. I was shocked in the beginning that [clients] don’t pay their bills, they blow off appointments and they expect the utmost from you but nothing from themselves in terms of communication. It would be so much easier just to know [this] and accept the realities in the beginning. I’ve talked to many others who have felt the same way. This is what I wish I had received along the way.

One of the best pieces of advice I received was from a counseling professor who said, “You have to care passionately and not care all at the same time.”
Also, that sometimes we’re the teacher and sometimes the learner. Learn to do both well.

— Dianne Kruse, LCPC in Nampa, Idaho

 

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I’ve enjoyed my winding path from Peace Corps volunteer to computer trainer/tester to counselor. When I considered becoming a counselor prior to college, I couldn’t fathom how I’d listen to people’s problems all day and still feel OK in the evening. Not knowing what career to choose, I enrolled in computer science, thinking I’d be good at it. When I graduated with a bachelor’s in 1986, the job offers I received sounded boring, and the jobs didn’t feel meaningful. So I joined the Peace Corps — something that had been on my mind for years. I served in Mali, West Africa, teaching high school math and maternal and child health. Living abroad expanded my mind. An extra bonus was meeting my husband.

Once back in the United States, I found a job teaching a software product to insurance companies. Although I loved teaching and traveling all over the country, I wished I was teaching something more meaningful to people’s lives. Once we had children, I became a software tester because it allowed me a flexible schedule.

Even as a kid I enjoyed having deep conversations. I still do. As a teen, I was the friend people talked to. As the go-to hair stylist for my fellow Peace Corps volunteers, the conversations went deep. One friend accused me of having a
“truth serum.”

Although the computer field was good to me, ultimately it wasn’t fulfilling. I realized I wanted to have those conversations and help people as a profession. At the age of 40, I enrolled in a master’s in counseling program and loved it. After graduating, I worked in a children’s program for two years, then joined some friends in their private practice. That was eight years ago.

I know counseling is a good fit for me because it matches who I have always been. Not only do I get to have meaningful conversations and help people, I also continually learn and grow on a personal level. What a bonus! Currently my growth is focused on tuning into and trusting my intuition. I am noticing some positive effects.

Some of the lessons I’ve learned thus far are: Our brains are dangerous places, and we generally believe the negative stuff going on in there. Growth and healing are possible. Mindfulness is the pathway to growth. Address childhood wounds. Energy psychology (e.g., tapping) is cool, and it works.

My advice to those entering this field: Get therapy. Be compassionate and caring with yourself and your clients, of course, but turn that good healing inward.

My current career goal is to expand into teaching and training of the concepts that I find so meaningful. In addition, I’ve set a goal of having a TED Talk on a counseling topic by the time I’m 60. Wish me luck!

— Penny Mechley-Porter, LPC in private practice in Erie, Pennsylvania

 

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I knew at the age of 17 that I wanted to be a school counselor. At that time in my state, it was required for you to get a degree and certification as a teacher (K-12) in order to be a school counselor. I pursued the path to school counseling by obtaining my bachelor’s degree in secondary social studies education, which allowed me to take some broad field psychology courses that related to my interest in counseling.

When I was 17, my stepfather was in a rehabilitation center, and I visited him with my mom every weekend. I met a person [another patient/resident] in the center who just needed to talk and process his feelings. I would listen to him every weekend. He told my mother that I was a great listener and really helped him to express his feelings. It was the moment that I knew I wanted to be in a helping profession.

School counseling is not a job for me, it is a passion. I love the everyday experience of helping students grow in the areas of personal, academic and career development. Each day is a different journey, which keeps the art of counseling interesting.

I have had the opportunity to work as a school counselor in all grades from prekindergarten to 12th grade. It has been a rewarding experience to work and learn about each developmental level. I have become interested in teaching future school counselors and have become an adjunct professor in school counseling.

Every day of school counseling is different. You must be flexible. I have learned to be data driven and produce data that show results of my work. Relationships become the most important part of counseling in the schools. You have to be connected to the faculty, staff, students, parents and community to earn the rapport and respect to be able to do a good job.

The one piece of advice that I received that was most helpful to me as a school counselor was to not get caught up in a single counseling theory. As you practice, you will use many theories and develop your own way of serving clients. That helped me to find what works and what style fits my personality and ability to help others.

— Brian Law, school counselor at Valdosta High School in Georgia and adjunct professor in the Department of Psychology, Counseling and Family Therapy at Valdosta State University

 

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In high school, my career goal was to become a counselor. After a lengthy detour, I have. At the age of 21, having completed my bachelor’s degree, I took my first counseling course. It was required that we work with a student intern. The intern I was paired with was not a good fit for me. At the end of that term, I decided to take a break from school and planned to go back later.

Coincidentally, I heard that the phone company (in 1972 there was only one!) was offering paid training in computer programming. I passed the aptitude test and was hired. Thirty-five years later, I had been a vice president at two international financial institutions and an independent project management consultant. Technology was an interesting and challenging career and I enjoyed it. I noticed, however, that I was losing enthusiasm for the work. I didn’t hate it. I just wanted something new.

I thought about giving counseling a try, but it was a big risk for me to leave the high-tech arena. A quote I read from Tennessee Williams helped clarify my direction: “There is a time for departure even when there is no certain place to go.” I entered a counseling program at Portland State University and received my master’s in counseling in marriage and family therapy and mental health counseling.

Counseling has been extremely rewarding for me. It is also interesting and challenging in an entirely different way. One of my areas of focus is working with business professionals because I share a frame of reference for the problems business folks deal with — relationship problems and issues related to Type A behavior patterns such as chronic stress, workaholism and perfectionism. I also help people deal with anxiety, depression, life transitions, grief, past trauma and a desire for personal growth. I am honored on a daily basis to be allowed into my clients’ lives and trusted to help them.

My suggestion for prospective counselors is to get information about the health care industry to make an informed career choice. Consider aspects of the counseling profession that are ancillary to the therapeutic methods used with clients. These include private practice versus organizational work [and] financial, regulatory, legal, ethical, licensing, marketing, technological and insurance requirements.

My excitement for counseling continues to grow. Looking back, I owe my interest in this work to counselors who helped me along the way — my wonderful high school counselor and a brilliant psychologist who helped me discover the strength within myself. I offer my clients my presence and the skills I’ve learned to help them find a deeper awareness of their own competence, value and humanity. I hope when they look back, they also feel enriched by the experience.

— Ramona Roberts, LPC and counselor supervisor in private practice in Portland, Oregon, and clinic director of the Community Counseling Clinic at Portland State University

 

 

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Nearly 50 counselors answered Counseling Today’s call to share career stories for this article — too many to print here. Read more responses from these practitioners at CT Online at wp.me/p2BxKN-4P.

Add your voice to the conversation in the comments section below — tell us about your own career journey and the lessons that you have learned along the way.

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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

 

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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.

Keeping the focus

By Traci Pulliam Collins August 7, 2017

During the counseling process, most clients will describe some form of interpersonal or relational trouble. This trouble might be identified as relationship dissatisfaction, conflict in a marriage or partnership, or even the absence of relationship (loneliness).

One theoretical approach — emotionally focused therapy (EFT) — works well in individual, family or couple counseling. EFT for couples is a well-researched, evidence-based treatment with a systematic approach of steps and stages. Although the theory and working model are easy to understand, application of the model can be quite challenging. This steep learning curve may discourage counselors from implementing the model to its full potential.

Experience lends a few recommendations that may help counselors persevere through the learning curve on their way to becoming effective EFT counselors.

Back in the July 2012 issue of Counseling Today, Stacy Notaras Murphy addressed the question, “What’s on the radar of today’s counselor?” The American Counseling Association members surveyed for this article provided a wide range of responses, but a few topics were repeated across the group, including EFT for couples.

New professionals may hope to add EFT to their tool belts and develop a range of competencies. Midcareer professionals and seasoned counselors may desire to diversify their tools for couple therapy or to jump on board with this innovative approach. No matter the reason for the interest, counselors want an approach that is grounded in theory and is supported by empirical evidence. In addition, professional development can be costly and time precious; therefore, it is important to seek training that will pay off in effectiveness and ease of application.

EFT has solid empirical support for effectiveness, but the application may troublesome. Counselors may become impatient when learning new skills or techniques that do not fit neatly into or integrate with their current style of practice. EFT requires a paradigm shift for most counselors who learn the model.

 

EFT overview

EFT is a brief model rooted in attachment theory with humanistic and systemic influences. Counselors assist couples by using EFT to create a more secure attachment style between partners while also using experiential techniques. Les Greenberg and Sue Johnson formulated EFT in the early 1980s, and Johnson developed a systematic outline of steps and stages for clinicians to follow when helping couples move toward secure attachment and greater connection.

In 2004, Johnson published the second edition of The Practice of Emotionally Focused Couple Therapy: Creating Connection, which is the go-to source for understanding the theoretical and practical application of the EFT framework. Johnson has studied the dynamic attachment dance between partners, providing a road map for creating a secure bond that is divided into three stages:

1) De-escalation

2) Restructuring interactions

3) Consolidation

De-escalation, consists of a series of steps aimed at identifying the negative cycle the couple find themselves in — ultimately leading to disconnection. Identifying their attachment needs and discovering their distressing interactions reframed in the attachment language and cycle moves couples toward de-escalation.

Normalizing their interactions as a distressing dance that many couples find themselves engaged in helps the couple try to connect. This also provides an opportunity to briefly educate clients on the EFT model, its treatment protocol and the implications of research findings. Taking this action can provide couples with reasons to more deeply engage in the therapeutic process.

Restructuring interactions is the working stage in which interpersonal interactions shift from the original cycle to a new pattern of emotional attunement and secure connection. This is the place where the withdrawers re-engage and the blamers soften if the partners explore and share their attachment vulnerabilities and relationship needs.

Finally, in consolidation, couples apply the improved relationship functioning and more secure attachment bond to the problems that arise in day-to-day life.

 

Development of an EFT counselor

The EFT model reframes the counselor’s conceptualization perspective toward looking at couples through an attachment lens. This lens shapes the counselor’s understanding of human experience and strengthens the empathic attunement abilities, preparing the EFT counselor to frame even the most hurtful behaviors of a partner into the need for attachment and connection.

This process can be challenging for a counselor, requiring intentionality and constant emotional engagement (a leaning in if you will) with clients. The counselor’s leaning in creates moments of vulnerability and welcomes clients out into the open. Proper application of EFT is counseling at its best; it is draining and invigorating at the same time.

After spending years learning this model and interacting with folks across the developmental spectrum of EFT counselors, several important themes come to mind for me:

  1. a) Experiencing tough moments of feeling lost
  2. b) Being confused
  3. c) Having memorable and highly purposeful moments
  4. d) Realizing I am in a constant state of learning

It seems likely that I will never arrive at perfection, and the learning curve is continuous.

Perhaps the EFT counselor continues this difficult learning curve because of the successful moments. Witnessing couples creating connections and more secure attachments is a deeply moving, powerful and, at times, sacred experience.

Although those moments may cause some EFT counselors to desire more, it seems that counselors can benefit from acknowledging and preparing for the learning curve and managing the developmental process. The following section contains suggestions that may enhance mastery of the learning curve

 

Anchor yourself with the empirical evidence

The EFT clinician–researcher partnership is an important component of the following the model principle. Clinicians can glean confidence by utilizing the EFT research evidence to enhance their learning curve. This involves familiarizing oneself with the professional literature sources and staying current with EFT research findings.

The EFT model has grown in popularity, and a body of research has evolved. In 2016, Stephanie Wiebe and Sue Johnson published a review of EFT research, building on a previous meta-analysis in which a large effect size of 1.3 and a 70-73 percent recovery rate were found. The more recent review presented an examination of applying the EFT model to specific issues facing couples (e.g., depression, trauma, attachment injuries such as an infidelity), pointing out how EFT research findings have surpassed the standards for being perceived as an evidence-based approach for couples.

The strength of empirical evidence places EFT for couples on the radar for counselors as an approach that clinicians can feel good about using. Couples can benefit from learning that the EFT approach is organized and well-researched, and that the research findings indicate effectiveness for couple therapy.

 

Trust the model

When beginning a session, remember what the EFT counselors and researchers before you have experienced and contributed. The research evidence provides a secure base. Much like the theoretical roots in attachment theory, counselors must stay grounded and rooted in the evidence of sound research and design.

Integrating other techniques or frameworks is a deviation from the model and may bring more confusion than comfort. Remember, this model works, and it works powerfully. Trust the model and stay the course, even when things get tough.

 

Avoid getting caught up in the details

The presenting issues that couples will voice may seem endless. Before realizing it, you can begin wondering whether one partner should just help more with the dishes and things might be all better.

In that moment, you have moved away from the influence of empirical evidence and training — the steadfast counseling seat — and shifted to the couch with the couple. At this point, the room can quickly be filled with shared frustration and hopelessness.

The details are so important to the clients, because these details represent something much greater (i.e., loneliness, abandonment, feeling inadequate). On one hand, the details do not hold the solution, but they do provide hints toward the couple’s particular pattern, or the dance.

 

Refresh and reflect

The EFT model is organized and simplified into steps and stages. Yet application of the theory is not so simple. It is important to revisit your materials and ground yourself in the steps and stages, skills and interventions. Consider a refresher course or spend time reviewing your training materials to bring you back to the model in the purest sense.

Observe another EFT counselor in action, such as the “EFT in Action” live couples counseling observation by Lorrie Brubacher, certified EFT therapist and supervisor, at the Carolina Center for EFT. This live demonstration offers a reminder of the core interventions that can help regenerate your work.

Even better, watch your couples counseling taped sessions to observe your process, finding moments of strength and instability to inform your practice. All of these steps will support a deeper understanding of EFT in action.

 

Seek a learning community

EFT counselors guide couples to greater awareness, vulnerability, connection and effective dependency in their relationships. In 2003, Johnson described the significance of dependency in relationships in a chapter of Attachment Processes in Couple and Family Therapy. She provides a powerful paradigm shift from partners being overly dependent or independent to effectively or ineffectively dependent.

Correspondingly, EFT therapists should embrace the effective dependency of the EFT learning community. Beyond the referral networks, EFT communities can provide feedback, encouragement and connectivity. An EFT support system makes the EFT learning curve journey more meaningful and enjoyable.

 

Final thoughts

The EFT model indicates several parallel lessons for EFT counselors in training. Remembering the successes provides a touching motivation to help more couples find connection by using the powerful EFT model.

The developmental process for EFT counselors can be very demanding, and the learning curve can be tough for even seasoned couples counselors. Yet, somehow, having a hand in or orchestrating the dance between partners is so rewarding that it provides motivation to keep going.

In the EFT process, you may observe one partner painfully waiting on the edge of his or her seat, session after session, for the other partner to show up and be emotionally responsive. Then when it happens, the emotional relief is so overwhelmingly wonderful that the couple leap across the room to embrace in a tearful hug.

 

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Traci Pulliam Collins is a licensed professional counselor and national certified counselor. She works as a professional counselor in Greensboro, North Carolina. Currently, she is pursuing her doctoral degree at North Carolina State University. Contact her at tpcolli2@ncsu.edu.

 

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

Counseling transgender persons and their families

By Al Carlozzi August 1, 2017

For the past several years, I have provided and supervised counseling services for transgender persons and their family members and conducted workshops for mental health professionals, school counselors and educators on optimal ways for responding to the needs of transgender youth and adults. The purpose of this article is to share information for understanding transgender persons and describe current practices for treating transgender persons and their families.

A person’s gender typically is assigned at birth and is determined primarily by external genitalia but also can be confirmed by gonads, chromosomes, hormones and internal organs. Newborns are usually designated male or female and, on rare occasions, intersex. Gender identity refers to the subjective sense of who one is as far as male, female or other. Gender identity is determined more by the brain than by sexual anatomy. It is not something that any of us choose. Most people have a sense of their gender identity by age 4, although this sometimes happens earlier and sometimes later in life.

Cisgender persons are those whose gender identity and expression are aligned with the cultural and social expectations of the gender they were assigned at birth. The majority of persons are cisgender. Gender-nonconforming persons are those whose gender identity or expression are inconsistent with societal expectations typically associated with males and females. Some gender-nonconforming persons do not fit into the gender binary (male or female) as others do and may consider themselves to be gender fluid, gender queer or gender nonbinary. Transgender persons (about 0.6 percent or more of the U.S. population) have a strong inner sense that their bodies and the gender assigned to them at birth are incongruent with their gender identity. They may be assigned-at-birth males who identify as female (male to female or MTF) or assigned-at-birth females who identify as male (female to male or FTM).

It is important for counselors to understand how their transgender and gender-nonconforming clients identify, especially given that gender identity is now considered to be more a spectrum between male and female and may indeed be a galaxy of possibilities. Some gender-nonbinary persons do not seek hormone or surgical treatment and are comfortable with a more nonbinary gender expression, whereas others do seek medical interventions. With some exceptions, transgender persons desire and, if at all possible, pursue hormone and surgical treatment to experience congruity between their bodies and their minds. In other words, most transgender persons desire and pursue transition to the gender with which they identify. Transgender persons are the focus of this article.

Counselors and the general public need to understand that there is a difference between gender identity and sexual orientation. Some people make the erroneous assumption that transgender and gender-nonconforming persons are gay. The truth is that they, just like cisgender persons, may be gay, straight, bisexual, pansexual or asexual. Stated simply, sexual orientation refers to who one wants to sleep with, whereas gender identity refers to who one wants to sleep as, meaning as male, female or some other gender identity in that galaxy of possibilities.

Etiology of transgender

Family members and the general public often want to know how this happens or why some people are transgender. The etiology of transgender may be understood as a complex interaction of social/cultural, cognitive and primarily biological factors, consistent with explanations of gender identity in general.

A growing body of evidence suggests that being transgender is a congenital condition caused by varying degrees of testosterone exposure in utero. Research also suggests that transgender persons possess brain characteristics more like the gender with which they identify than the gender they were assigned at birth. Furthermore, some genetic studies show a high concordance rate among identical twins, thereby adding further credence to a primarily biological explanation.

So, there is growing evidence that transgender persons are, as Lady Gaga says, “born this way.” Being transgender is not a function of socialization, improper parenting or exposure to traumatic events. Rather than playing a role in the etiology of being transgender, socialization tends to squelch transgender and gender-nonconforming identities. Besides, most transgender persons are less concerned with why they are and much more focused on being who they are. Contrary to prejudicial views held by some in the general public that transgender persons are mentally ill or merely pretending to be the opposite sex, being transgender is best considered a medical condition that can be treated successfully with hormonal and surgical treatments and psychosocial support.

Gender dysphoria

Although being transgender is not a mental illness, most transgender persons experience dysphoria at various times in their lives. The dysphoria experienced by transgender persons is likely attributable to having to live in a body (and social role) that does not feel congruent with their sense of self in a society that misunderstands and discriminates against them.

The gender dysphoria diagnosis (302.85) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) indicates that it may include symptoms of depression, anxiety, fear, guilt, low self-esteem, shame and self-hatred. For some transgender persons, these negative emotional experiences may lead to self-harm, substance abuse and eating disorders. A more detailed description of the criteria that must be met to assign this diagnosis is provided in the DSM-5.

It is our job as mental health professionals to treat the dysphoria and associated symptoms, not the person’s gender identity. The inclusion of any diagnosis in the DSM-5 specifically for transgender persons is controversial. Many view the diagnosis as stigmatizing, even if it was included in the DSM-5 to support access to and insurance coverage for mental health and medical services.

The effects of dysphoria are concerning. One statistic that is particularly startling is that 41 percent of transgender persons attempt suicide, compared with less than 2 percent of the general population. Other statistics derived from the 2011 National Transgender Discrimination Study of 6,456 transgender and gender-nonconforming adults:

  • 57 percent have experienced rejection by their families
  • 53 percent have been verbally harassed in public settings
  • 97 percent have been harassed or discriminated against in work settings
  • 28 percent have experienced harassment in medical settings
  • As many as 27 percent have been refused medical care in the past

One encouraging statistic from this study is that 78 percent of those who completed their transition felt more comfortable at work and improved their job performance, despite mistreatment at work. This suggests that completing transition engenders greater confidence and comfort with self and may strengthen the transgender person’s ability to cope with stressful environments.

The World Professional Association for Transgender Health (WPATH) Standards of Care (currently SOC-7) provide state-of-the-art guidelines for the proper treatment of transgender adults and children. Treatment involves an integration of medical interventions, social support and community building, and mental health care. Treatment is integrative and collaborative with other professionals and is most effective when it includes advocacy and education within family, school, work and community contexts.

Medical interventions

Medical interventions may include any or all of the following, depending on the age and gender identity of the transgender person:

  • Puberty blockers that suppress the physical signs of puberty, which transgender adolescents often experience as distressing
  • Hormone replacement therapy (testosterone for FTM and androgen blockers and estrogen for MTF transgender persons)
  • Gender confirmation surgeries, including top surgeries (mastectomy and male chest contouring for FTM and breast augmentation for MTF transgender persons) and bottom surgeries (phalloplasty, scrotoplasty, metoidioplasty with or without urethroplasty, and hysterectomy for FTM, and orchiectomy, vaginoplasty and labiaplasty for MTF transgender persons)

Cosmetic surgeries may also be performed, such as tracheal shave and facial feminization surgery to help feminize facial features in MTF persons. Electrolysis or other hair-removal methods may also be considered by MTF transgender persons to feel and appear more feminine.

Androgen blockers and estrogen help to feminize the body in a variety of ways but do not feminize the voice, so MTF transgender persons may seek voice training to feminize their voices. Testosterone will deepen the voice and promote growth of hair on the face and body, so there is typically little need for FTM transgender persons to seek voice training or cosmetic treatments.

Social support and community building

Social support is very important for reducing the sense of isolation that many transgender persons experience. Many report that they first sought information and support for themselves on the internet, describing how comforting it was to find out there were other people like them.

Such support can be enhanced by actual support groups like those provided at the Dennis R. Neill Equality Center in Tulsa, Oklahoma. The Equality Center offers several groups in support of transgender and gender-nonconforming persons, along with many other services for LGBTQQIA (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual) people. There are support groups for transgender men, women, children and teens, and for parents of transgender children and teens. I have served as a co-facilitator of the support group for parents of transgender children and teens for the past six years and have placed three to six graduate students at the Equality Center each year to provide counseling services and help facilitate support groups.

Open Arms Youth Project is another agency in Tulsa that provides social support for LGBTQQIA youth, and my graduate students have co-facilitated a weekly support group there. Other community organizations such as PFLAG (Parents and Friends of Lesbians and Gays) provide social support for family members. Gay-Straight Alliance groups in schools, and support groups and student organizations on college campuses, can serve as safe zones for adolescents and young adults.

Such groups for transgender persons and their family members provide useful information about medical, cosmetic and legal steps in the transition process. These groups are also central to the community building that provides hope and support for dealing with unaccepting environments and other challenges that transgender persons may encounter. Fostering the development of support services and participating in community-building efforts are among the ways that professional counselors can make a positive difference in the lives of transgender persons and their families.

Community building can also be helpful in organizing or participating in efforts to challenge legislation that would be harmful to transgender persons. Under President Obama, the U.S. departments of Justice and Education established guidance and took steps to protect the rights of transgender persons in the workplace and the rights of transgender students in the schools to use restrooms consistent with their gender identity. However, some state legislators, attorneys general and governors resisted these actions. Several state attorneys general filed suit against the Justice Department in 2016, and some state legislators have succeeded in enacting state laws that restrict the restroom usage rights of transgender persons.

In the early weeks of the Trump administration, the Justice Department and the Education Department rescinded the guidance that served to protect the rights of transgender persons and students. However, this past May, the 7th U.S. Circuit Court of Appeals ruled that a school district in Wisconsin violated the rights of a transgender student and upheld a lower court injunction requiring that the district allow him to use a restroom that aligns with his gender identity. This federal court ruling has far-reaching implications and adds to the growing number of judicial decisions that protect transgender persons from discrimination.

Nevertheless, the rights of transgender persons to use restrooms consistent with their gender identity remains both a national- and state-level issue, when all transgender persons want is to feel safe and comfortable using a restroom for the same reason that anyone wants to use a restroom. Counselors can be helpful to transgender persons by advocating for their rights. Considering that many transgender students report being bullied in schools, counselors can support anti-bullying state legislation and intervene, as appropriate and with their clients’ consent, in school systems where transgender youth experience harassment. The importance of the counselor’s role as an advocate for social justice is strikingly evident in our efforts to help transgender and gender-nonconforming persons.

Mental health care

Professional counselors can be helpful to transgender persons by providing informed, competent and compassionate mental health care. According to WPATH SOC-7, minimum qualifications to provide mental health care to transgender persons include a master’s degree in a clinical behavioral science field; training and competence in the DSM-5; documented supervised training and competence in counseling/psychotherapy; and continuing education in the treatment of gender identity issues and WPATH SOC. The Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling (a division of the American Counseling Association) and the American Psychological Association have also published guidelines for treating transgender and gender-nonconforming clients.

Transgender persons present several common concerns to counselors and other mental health professionals. They may present with symptoms associated with gender dysphoria, such as depression, anxiety and suicidal ideation. Some may need help with substance abuse or other harmful means of coping with distress. It is also important to attend to any co-occurring mental health issues that may require a referral to a psychiatrist for medication. Be aware that some transgender youth develop eating disorders, and others may be on the autism spectrum, so collaboration with providers with specialized expertise in these areas may be necessary. Counselors also may need to attend to traumatic experiences and symptoms of minority stress associated with discrimination, stigmatization and harassment.

Other commonly expressed concerns involve:

  • Disclosure to others (coming out)
  • The timing and extent of transition
  • The impact of transition on relationships with current partners/spouses/children (in adult transgender persons)
  • Support or nonsupport of parents and extended family
  • Concerns about passing as the gender with which they identify
  • Reactions from employers, school personnel, leaders and members of their religious groups, and their peers at work or school

It is important to recognize that our clients’ age, stage of life and stage in the transition process will likely influence the concerns and issues presented. A Tanner Stage 1 child (birth to onset of puberty) may have issues with family, school and peers, whereas a Tanner Stage 2 child (onset of puberty) may present with family, school and peer group concerns, as well as worries associated with the changes that accompany puberty that can be very distressing for transgender adolescents. Young transgender adults may have concerns about reactions and treatment by employers and fellow workers. Older adults may share these same concerns and have compounding issues with spouses and children (whether young children or adult children), depending on the person’s age of coming out and transitioning. Transgender persons at any age or stage of life may have issues with their parents, siblings, extended family members, friends, church or faith, and the larger political/social climate for transgender persons.

Regarding ethical responsibilities, it is crucial that counselors are aware of, confront and alter their own biases, fears (transphobia), discomfort, gender-normative assumptions and lack of information about transgender persons. One of the best ways to do this, as with overcoming any discomfort with people we perceive to be different from us, is to get to know persons who are transgender. This requires openness to learning about their experiences, listening with empathy to their life stories and demonstrating respect. One of the major ways we show respect when working with transgender and gender-nonconforming clients is by asking them about and consistently using their preferred pronoun (she, he, them, etc.), the name by which they prefer to be called and their self-defined gender identity (transgender, gender queer, gender nonbinary, etc.).

It is also important that we are respectful of our transgender clients’ sense of timing for coming out to others, and the pace and timing for steps they wish to take in their transition. Some transgender persons seek multiple surgeries (top, bottom, cosmetic), whereas others choose not to take all of these steps in their transition or simply cannot afford every surgical intervention that they might desire.

Furthermore, passing as the gender with which they identify may be more important to some transgender persons than it is to others. Passing should never be more important to the counselor than it is to the transgender client. A counselor should never say to a transgender client (as one counselor did), “If you are ever going to pass as female, you need to do something about your face and your voice.” That remark by a counselor left one client feeling degraded.

Instead, it is counselors’ responsibility to reduce the shame associated with self-stigmatization and internalized transphobia that transgender clients may experience and to help them replace that shame with pride. Knowing that the antidote to shame is self-esteem and pride, counselors must help these clients identify positive resources and strengths. It is our responsibility as counselors to cultivate a safe therapeutic environment for transgender clients — a safe zone where they feel supported, affirmed, respected and appreciated for their courage and resolve.

It is helpful for counselors to know that transgender clients are likely to want to take steps to change their names and gender markers on legal documents such as driver’s licenses, birth certificates, passports, academic/school records, medical records, Social Security cards, bank accounts, credit cards and other financial records such as trusts and wills. The ease or difficulty in making such changes depends on the jurisdiction and particular offices involved (and, if the transgender person is a minor, the support of parents or legal guardians). Ideally, counselors will know or learn enough about making changes to legal documents to be able to direct their clients to people and resources that will be helpful.

When mental health professionals work with transgender clients, they can expect that these clients will ask them to provide a support letter for medical treatment at some point. Such letters should include results of an assessment to determine if the diagnosis of gender dysphoria is warranted and if any co-occurring conditions are present (such as substance use or abuse, smoking, eating disorder, etc.) that could affect medical treatment. For more detailed information about letters to physicians and surgeons, counselors should consult WPATH SOC-7 and obtain continuing education to enhance their knowledge of the “gatekeeping” role of mental health professionals. SOC-7 makes clear that the role of mental health professionals involves much more than assessment and letter writing; it includes support, collaborative care, education, systems intervention and advocacy.

Families of transgender persons

Although family members vary in their degree and pace of acceptance, most struggle adjusting to the change in their identity as a family. When individuals come out as transgender in mid or late adulthood, cisgender spouses or children may be affected. Couples or family counseling may assist cisgender spouses and children in making accommodating adjustments to the changing gender identity of a spouse or parent.

Some couples work through the issues associated with such a change and maintain their love and commitments to stay together, whereas for others, such adjustments are too difficult. Some couples part amicably and the individuals remain friends, whereas others feel betrayed, and if minor children are in the home, custody battles sometimes transpire. Counselors can help spouses and children (whether younger or older) by providing information about being transgender, enlisting their empathy and caring for their transgender loved one, and empathizing with their feelings, which may include grief, shame, anger and worries about their family.

When a child, teenager or young adult comes out as transgender, parents and siblings also make accommodating adjustments in their identity as a family. Counselors can assist parents by supporting them in their grief and worry about the well-being of their transgender child. Counselors can also serve as a resource for information about gender identity and the coming out process, and they can assist parents and their transgender children in determining when and how to inform grandparents, extended family members, friends, school personnel and church personnel. Advising parents about books and articles to read and websites to educate themselves about their transgender child or teen can also prove beneficial. Two books I recommend as helpful resources for parents and professionals are The Transgender Child by Stephanie A. Brill and Rachel Pepper (2008) and The Transgender Teen by Brill and Lisa Kenney (2016).

Parents and other family members often struggle, at least temporarily, with the names and pronouns by which their transgender loved ones want to be referred. Counselors can encourage family members to be intentional about using these names and pronouns, while also recognizing that mistakes happen and that it will take practice to get everything right consistently.

Whether working with parents in counseling or in support groups, counselors can address parental concerns about medical and cosmetic interventions and procedures for changing legal documents. It is important for counselors to support and affirm appropriate action when parents of transgender youth express concerns about bullying or harsh treatment by peers or school personnel, their child’s depression or suicidal ideation, and negative reactions by extended family or others. I have witnessed parents and family members of transgender youth change from being grief-stricken to becoming empowered advocates for their transgender child. In our parent support group, it is common for parents to share their concerns, challenges and triumphs.

The more I work with transgender persons, the more impressed I am with their courage and resolve to be genuinely who they are in a world that can be hateful. The more I work with their parents and family members — and with mental health professionals, educators and others who support transgender persons and stand up for their rights — the more I am encouraged that understanding and compassion will ultimately triumph over ignorance and hate.

 

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

Al Carlozzi is a professor of counseling and counseling psychology at Oklahoma State University (OSU) and serves as director of the OSU-Tulsa Counseling Center. He has provided counseling services and supervised the provision of services to transgender and gender-nonconforming clients, conducted numerous continuing education workshops on treating transgender persons and their families, and collaborated with the Dennis R. Neill Equality Center in Tulsa, placing graduate students there as counselors and co-leading a support group for parents of transgender children and teenagers. Contact him at al.carlozzi@okstate.edu.

Letters to the editor: ct@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.