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Counselors Audience

Pride in practice: The journey towards LGBTQ+ counseling competence

By Jonah Friedman and Megan Brophy June 30, 2021

Lesbian, gay, bisexual, transgender and queer+ (LGBTQ+) people are marginalized, often at risk of discrimination due to sexual, gender and affectional minority orientations. While queer people experience heightened prejudice, research from the American Psychiatric Association has indicated a lack of suitable counseling for LGBTQ+ groups that would greatly benefit from increased services.

This need for appropriate queer counseling is amplified by the growing percentage of self-identifying LGBT people. The Washington Post recently published findings from a Gallup Poll revealing a 1.1% increase in LGBT adults from 2017 to 2020 and that 1 in 6 individuals ages 18-23 identify as LGBT. Given a growing queer population and the increased need for counseling, there is a clearly identifiable gap for qualified services.

Queer-competent counselors can help. Unfortunately, there is a lack of queer competence among many practitioners, perhaps because of the small number of available LGBTQ+ courses and training opportunities for counseling graduate students. Even when proactive and eager graduate students seek out dedicated coursework, internships and training experiences in queer settings, viable options are limited. The cycle of limited to nonexistent queer-accessible counseling resources is perpetuated without available training experiences. How can we become LGBTQ-competent counselors when so few opportunities exist for education and practice in this area?

The queer experience

We live in a society that gives preference to white, Christian, male, cisgender, and heterosexual people. To retain power, both intentionally and not, these dominant identities often oppress any divergence. Youth are commonly indoctrinated to believe that departure from societally deemed normative standards, such as same-sex attraction or nonbinary gender, is deviant or wrong. This belief system often intensifies with age and can lead to the discrimination and oppression of queer people throughout the life span. To remain safe in today’s heteronormative and cisnormative society, many queer individuals hide their identities. Doing so is often the only way for them to be treated equally to their straight, cisgender counterparts.

Researchers Laura S. Brown and David Pantalone showed that the nature of constant secrecy, dissonance and struggle to conform adversely affects mental health. The Substance Abuse and Mental Health Services Administration has found that sexual minorities who experience exclusions from society have higher rates of mental health disorders, major depressive episodes and substance abuse. The Trevor Project’s data even indicate that queer youth experience higher rates of suicidal ideation.

Additionally, Darrel Higa et al. from the University of Washington found that when LGBTQ+ people choose to share their identities with parents, guardians, schools and workplaces, they are often met with rejection and discrimination. This is seen through higher rates of homelessness and increased unemployment in comparison with heterosexual individuals. Despite LGBTQ+ people experiencing heightened mental health disparities, queer clients often find unsupportive counseling services. 

Counselor competence 

LGBTQ+ clients benefit from counselors and mental health agencies that provide acceptance and validation through queer counseling competence. The Society for Sexual, Affectional, Intersex and Gender Expansive Identities (formerly known as the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling), established a task force in 2012 that outlined queer-competent counseling behaviors. The competencies touch on queer human growth and development, social and cultural foundations, helping relationships and more. The same group released competencies for counseling transgender clients in 2009. These resources, while important for agencies to utilize, have not been updated in a decade and would benefit from the inclusion of newer relevant queer research.

Having queer-competent counselors in all mental health settings is crucial to fostering open discussion and disclosure of LGBTQ+ client identities. A survey by the Center for American Progress shows that a lack of trust exists within the LGBTQ+ community for health care systems. It is likely that counselors will need to continually gain the trust of queer clients due to their historically negative health care experiences and traumas. To achieve such trust, counselors should provide appropriate services to LGBTQ+ clients as directed by the queer counseling competencies and the American Counseling Association’s ethical obligations of beneficence and nonmaleficence.

Paper guidance on LGBTQ+ competence exists, but the field is obligated by these same values to provide more than the prevailing “self-teach” approach. When queer competence is effectively implemented, the resulting safe spaces, open dialogue and unconditional positive regard will encourage more LGBTQ+ clients to show up authentically. Findings from Edward Alessi et al. revealed that a queer affirmative approach to counseling resulted in a stronger therapeutic alliance and increased well-being for LGBTQ clients. There is a great need for graduate students and current practitioners to better learn queer counseling competencies.

Missing coursework

To gain LGBTQ+ competence, graduate students and practitioners must engage in coursework and continuing education on queer theory. Furthermore, they must partake in related training experiences. Many students and practitioners face obstacles to finding such offerings. The following details our experiences (Jonah Friedman and Megan Brophy) as we struggled to find appropriate training in this area.

Jonah entered a master’s in counselor education graduate program in August 2020. In an early academic advising session with faculty, he expressed interest in LGBTQ+ counseling. When seeking out classes in gay affirmative therapy and related theories, Jonah was informed there were no related course offerings at the college he attends. An institution that so strongly emphasizes its core tenet of multicultural competency had no classes specifically on LGBTQ+ counseling. While regretful, this is the case at a majority of universities offering master’s in counseling and related degrees. The resulting options were to forgo such classes or to transfer in pertinent elective credits from one of the few programs with queer counseling coursework. Eager to obtain such training, Jonah began the search to find other CACREP-accredited graduate programs offering courses in LGBTQ+ theoretical approaches.

In New Jersey, there are 12 CACREP-accredited universities offering graduate counseling degrees on a variety of tracks. A review of these programs and their course directories revealed only four clinical mental health programs regularly offering electives on sexual issues in counseling or gender issues. None of these courses was explicitly dedicated to the study of working with LGBTQ+ clients. The remaining programs did not list relevant electives or did not offer any form of an LGBTQ+ counseling course. This absence may be attributed to CACREP not requiring the integration of LGBTQ+ counseling education to earn accreditation for clinical mental health programs.

To take appropriate courses, Jonah applied to Southern Methodist University (SMU) in Dallas. The school has a counseling program that boasts an affirmative therapy with LGBT clients track. Jonah has since enrolled as a nonmatriculated student in two electives: “Affirmative Therapy with LGBTQ+ Individuals: Advocacy Across the Lifespan” and “Affirmative Therapy with Transgender and Gender Non-Conforming Clients.” Although the experiences have been enlightening, allowing for exploration of sexuality and gender through a deeper and more critical lens, it was a difficult and arduous process to obtain this theoretical training. The time, costs and effort of taking these classes at a second institution only adds to the hardships created by the lack of initial course offerings.

Additionally, Jonah was able to take courses online and remotely at SMU only because of COVID-19 guidelines. During regularly structured semesters, such courses are in person and unavailable to out-of-state students. Furthermore, Jonah enrolled in these courses proactively; students not seeking out queer counseling coursework will be minimally exposed to these crucial theories. When such courses are not offered or required, there is an inherent implication that queer theory is not important to CACREP or our practice as counselors.

Lacking clinical experiences

Even if LGBTQ+ courses are secured, counseling students must then engage in queer-relevant training experiences to build practice competency. This approach follows the logic of formative development within the counseling field: first learning the theories through coursework, followed by application during clinical experiences.

Megan Brophy’s experience finding an LGBTQ+ based internship as a graduate student proved challenging. Throughout the states of New Jersey, New York and Pennsylvania, Megan found only four sites offering exclusively LGBTQ+ oriented counseling. To secure competitive internships at such sites, students often begin applications and interviews up to six months prior to the start of a program. At one site in Philadelphia, the application window was open only for a single month. Many other sites accept only one to three interns annually. This highly selective approach for interns greatly increases the already difficult endeavor of finding a relevant training position. The limited funding and logistical roadblocks for hiring interns and licensed practitioners at these sites hinder counseling students from gaining the clinical experiences necessary to become queer-competent counselors. Students struggle to structure their degrees around obtaining these queer-focused internships while working to stay on track to graduate.

In her search for internships, Megan called a variety of LGBTQ+ community centers in New Jersey to assess the availability of internship opportunities. She discovered that among those offering services, most were limited to support groups facilitated by nonlicensed professionals. In part due to a lack of funding and resources, services were more related to social gatherings, legal referrals and Pride celebrations. Resultantly, queer youth have severely limited access to appropriate counseling services. Relatedly, graduate students attending CACREP-accredited programs cannot obtain internships that meet accreditation requirements for supervision without licensed clinicians at such sites.

Even when qualified services are available, they are often niche and unrepresentative of the greater queer community. One such counseling opportunity is offered through a residential living program available to queer, homeless adolescents in Ewing, New Jersey. While homelessness is critical to address, it is an extreme situation for LGBTQ+ youth to find themselves in. We must also consider queer youth not displaced who are still looking for mental health services.

Finally, we must consider how the lack of availability and accessibility to LGBTQ+ sites directly affect our clients. Traveling great distances to the nearest LGBTQ+ counseling center is a privilege that many do not have. We cannot expect or require our queer clients to travel so far to attain mental health services. Queer-identifying youth almost never have this option without the help of a supportive friend or family member. Beyond that, given school and homework obligations and involvement in extracurricular activities, they may not have the time to travel long distances for services.

While the recent influx of online mental health services stemming from the COVID-19 pandemic has made counseling more widely available, online counseling within an unsupportive home environment may be harmful for LGBTQ+ clients. In such situations, queer clients may not be able to safely disclose information regarding their sexual or gender identity. This emphasizes the work that still needs to be done within the counseling field to create more queer-inclusive spaces with queer-competent counselors.

Understanding queer identity

As counselors, we have a duty to be multiculturally competent. The Multicultural and Social Justice Counseling Competencies, developed by the Association for Multicultural Counseling and Development, detail the layers leading to more inclusive counseling: counselor self-awareness, client worldview, the counseling relationship, and advocacy interventions.

While our field has made strides in the integration of diversity, there is more to be done in helping queer clients. To train and sustain queer-competent counselors, we must make a commitment to better understand the multifaceted aspects of queer culture, identity and relevant terminology. Beyond this, counselors can engage in continued research and relevant literature with the community, including resources provided by leading queer organizations (e.g., The Trevor Project, GLSEN). The understanding of queer identity and worldview is foundational in effectively working with LGBTQ+ clients and empathizing with their unique experiences.

Active advocacy

Rainbow Black/Shutterstock.com

ACA has established a nondiscrimination policy banning all forms of harassment, including protections for transgender, gender nonconforming and LGBTQ+ individuals. We as a profession must move past this passive protection and evolve as active advocates. Practitioners can act with and on behalf of their queer clients on the micro-, meso- and macrolevels of advocacy.

On the microlevel, counselors may work with queer clients to continually affirm their identities. On the mesolevel, advocacy might take the form of working alongside local school systems to organize LGBTQ+ support groups or arranging professional development for staff. On the macrolevel, practitioners can become involved with legislation that is supportive of LGBTQ+ individuals and communities. All three levels of advocacy are required to make a difference in our current climate.

Graduate course offerings

Gov. Phil Murphy of New Jersey recently signed into law LGBTQ+ inclusive curriculum legislation, following the states of California, Colorado, Illinois and Oregon. Out of 50 states, only five have recognized the importance of a queer-inclusive approach to education. Across New Jersey, boards of education have begun to integrate the accurate representation of queer individuals and history into curricula.

So many of the accredited institutions of higher education in the same state have yet to adopt similar coursework. These schools, which are training the counselors of the future, need to offer more classes on queer theory. In doing so, all graduate counseling students will be exposed to basic LGBTQ+ terminology and culture. This integration of queer curriculum will take queer counseling skills past the point of specialization.

LGBTQ+ oriented sites

While it would be ideal to open queer-focused counseling sites across every state, a more realistic plan would be for existing agencies to introduce LGBTQ+ services. For example, High Focus Centers in New Jersey, known for their outpatient substance abuse programs, recently added an LGBTQ+ track addressing substance abuse, queer wellness, self-esteem, empowerment and relational skills. Other sites can commit to adding queer tracks within their programs to allow for more internship opportunities and training in queer-competent counseling. In turn, sites will become more welcoming to queer clients.

A better future

By gaining basic queer counseling competence, advocating for all LGBTQ+ people, enhancing counseling curriculum to be queer-inclusive, and integrating queer support services at all agencies, our field can significantly improve the counseling provided to LGBTQ+ people. We must all become queer-competent counselors and the agents of change in our increasingly progressive field.

 

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Related reading: See Counseling Today‘s June cover story, “Listening to voices of color in the LGBTQ+ community

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Jonah Friedman is a Master of Arts in clinical mental health counseling candidate at the College of New Jersey. He completed his undergraduate studies at Tulane University, where he first discovered his passion for helping others and the value of counseling. Inspired by his current work with the Trevor Project, Jonah hopes to eventually work as a practitioner utilizing an LGBTQ+ affirmative approach. Contact him at friedj11@tcnj.edu.

Megan Brophy (she/her/hers) is a recent graduate from the College of New Jersey. Her work is guided by a passion for social justice and advocacy for marginalized communities. Contact her at brophym1@tcnj.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.

White House: Counselors have role to play in fostering trust of COVID-19 vaccine

By Bethany Bray June 24, 2021

At an online event for mental health practitioners earlier this week, U.S. Surgeon General Vivek Murthy emphasized that professional counselors’ role as “trusted healers” in their communities affords them an important opportunity to support clients — and clear up misinformation — as they’re making decisions regarding the COVID-19 vaccine.

“The name of the game right now is trust. This vaccine campaign will move at the speed of trust,” Murthy said. “And it will depend on what people who are trusted in their communities do.”

Roughly two-thirds of eligible Americans who have not yet elected to receive the COVID-19 vaccine believe common myths regarding the vaccine, Murthy said. These myths, including those that claim getting the vaccine alters your DNA, causes infertility or will give you the COVID-19 virus, are false, Murthy stressed.

The vaccines, the first of which the Centers for Disease Control and Prevention (CDC) greenlighted for adults in December 2020, reflect the culmination of years of research on the mRNA vaccine platform, he said. As with any vaccine, there are risks of side effects with the COVID-19 vaccine, but they are rare — and the risk of getting the COVID-19 virus “far exceeds” the risks of side effects from the vaccine, Murthy said.

The June 21 event, organized by the White House, was part of a larger push by federal health officials in recent weeks and months to close the gap between the number of vaccinated and unvaccinated people in the United States. The forum, held over Zoom, was meant to equip mental health practitioners with information to answer clients’ questions surrounding the COVID-19 vaccine.

The American Counseling Association was a partner in Monday’s event, along with the American Association for Marriage and Family Therapy and the American Psychological Association. ACA members Suzzette Garcia, a licensed professional clinical counselor in California, and Rufus Spann, a licensed professional counselor in Maryland, were included on the event’s panel of mental health practitioners.

Garcia and Spann noted that some of the most important tools counselors can wield to support clients are empathic listening and validation of their uncertainties regarding the COVID-19 pandemic, including vaccine-related concerns. They also acknowledged that clients’ mistrust of the vaccine can dovetail with deeper and long held cultural mistrust of the medical system of a whole.

Garcia said she has role-played with clients during sessions to focus on distress tolerance and challenge their cognitive distortions regarding the vaccine. It’s also important for mental health practitioners to familiarize themselves with accurate information about the vaccine and local resources with which they can connect clients, Garcia said.

Navigating COVID-related uncertainties “is a question that a lot of ACA members have had to deal with,” said Spann, a past president of the Maryland Counseling Association. “We are part of the front-line experience. When these conversations come up, we allow [the client to talk through] life pressures, stress and anxiety. … It has been an opportunity [for clients] to talk to counselors who are able to listen to their stresses, fears and hopes, allowing space for clients to talk about what they’ve experienced and what they hope for the future.”

(Left to right, top to bottom) Bechara Choucair, White House vaccinations coordinator; Suzzette Garcia, a licensed professional clinical counselor in California; Robin McLeod, a licensed psychologist in Minnesota; Kelly Roberts, a licensed marriage and family therapist in Oklahoma; Rufus Spann, a licensed professional counselor in Maryland; Neetu Abad, a behavioral scientist at the CDC; and U.S. Surgeon General Vivek Murthy speak at at June 21 event titled “White House Virtual Conversation: Mental Health Professionals and the COVID-19 Vaccinations Effort.”

Murthy noted that the COVID-19 death rate in the United States is now the lowest it has been in a year. However, thousands of cases are still diagnosed each day, and variants have emerged that pose particular danger to the unvaccinated.

“We have a lot more work to do, and this is where we need your help,” Murthy told the mental health professionals participating in and watching the online event (dubbed “White House Virtual Conversation: Mental Health Professionals and the COVID-19 Vaccinations Effort”).

The key to increasing vaccination rates is for people who are uncertain about the COVID-19 vaccine to hear from people they trust, including professional counselors. No amount of advertising can match that power, Murthy said.

Bechara Choucair, the White House vaccinations coordinator, acknowledged that it is not within mental health professionals’ scope of practice to encourage their clients to get vaccinated. However, the White House wants to ensure that practitioners are well-equipped to answer clients’ questions surrounding the vaccine and talk through any potential fears they may have, Choucair said.

Those fears and hesitancies might include a phobia of needles or medical offices, a lack of trust in the vaccine and its development (or in the medical establishment as a whole), and resistance to government influence.

Murthy noted that mental health is a priority of President Joe Biden’s administration and that mental health-related topics come up often in Murthy’s regular COVID-19 briefings with the president.

The COVID-19 vaccine is “our most reliable pathway out” of the pandemic, Murthy asserted. It’s “one giant step toward getting back to normal” so that people can once again gather in person and find social connection — “which we know [is] so important to mental health,” Murthy said.

 

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Watch the full video of the event on the White House YouTube channel: youtu.be/tzFS63G5sP8

 

Visit the CDC’s COVID-19 page at cdc.gov/coronavirus and ACA’s page of COVID-19 resources for counselors at counseling.org

 

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

 

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

Celebrating Man’s Search for Meaning

By Rodney B. Dieser and Cynthia Wimberly June 7, 2021

Viktor Frankl was born in Vienna, Austria, on March 26, 1905, and died in that same city on Sept. 2, 1997. Frankl wrote the celebrated Holocaust testimony Man’s Search for Meaning and is widely known as the founder of logotherapy/existential analysis, which is a form of existential counseling. 

Logotherapy, sometimes referred to as Franklian psychology, has been called the “third Viennese school,” after Sigmund Freud’s school of psychoanalysis and Alfred Adler’s school of individual psychology (Freud, Adler and Frankl were Jewish, all three lived in Vienna, and for a time Adler lived across the street from Frankl’s birth home). Just as Adler left Freud’s school of psychoanalysis over conflict related to differing theoretical perspectives, so too did Frankl leave Adler’s school of individual psychology. Frankl rejected Adler’s doctrine of “will to power” and Freud’s “will to pleasure” as the main motivation for living and instead argued that a “will to meaning” was humans’ main motivation. 

The American Medical Society, the American Psychiatric Association and the American Psychological Association officially recognized Frankl’s logotherapy as a scientifically based school of psychotherapy. The Association for Humanistic Counseling, a division of the American Counseling Association, explicitly identifies Frankl (along with Adler, Carl Jung and Karen Horney) as a pioneer who was influential in the development of humanistic counseling. 

This year marks the celebration of the 75th anniversary of Frankl’s Man’s Search for Meaning. This acclaimed book recounts Frankl’s experiences as a prisoner in Nazi concentration camps during World War II. It also describes the concepts of logotherapy/existential analysis (as do the other 38 books that Frankl wrote). In a 1991 Library of Congress survey, American readers voted Man’s Search for Meaning as one of the 10 most influential books in their lives. It currently appears on the “100 Books to Read in a Lifetime” list curated by the editors at Amazon Books. In 1997, when Frankl died, Man’s Search for Meaning had sold over 10 million copies and been translated into 24 languages. 

Still, few counselors, and few other people for that matter, understand the story of this best-selling book. As such, the purpose of this article is to tell the history of this influential treatise and to highlight the mental health counseling contributions of Frankl and logotherapy in the contemporary period as we celebrate the 75th anniversary of Man’s Search for Meaning. 

The history of Man’s Search for Meaning

Because Man’s Search for Meaning was Frankl’s first book to receive national attention in the United States, many assume it was his first book. Likewise, many readers believe that Frankl developed the underlying principles of logotherapy during his 2.5 years (1942-1945) as a prisoner in four concentration camps, including Auschwitz. (Frankl’s father, mother and brother were all killed in concentration camps.) 

In reality, the major concepts of logotherapy/existential analysis were developed before World War II began. Between 1928 and 1930, while still a medical student in Vienna, Frankl helped create youth counseling centers because he wanted to serve adolescents. He was specifically focused on preventing suicide among teenagers. After Frankl completed a doctorate in psychiatric medicine in 1930, he worked at Steinhof Psychiatric Hospital (in Vienna), where he became director of the department for female patients who were suicidal. 

In 1940, Frankl joined the Vienna Rothschild Hospital as head of the neurology department and was working on his first book that outlined his thoughts and theories on logotherapy, titled at the time (in German) Medical Ministry. When Frankl entered his first concentration camp in 1942, he attempted to smuggle a copy of his manuscript in the lining of his coat, but it was confiscated and destroyed. While sick with typhoid fever, and with only a pencil and some stolen scraps of paper, Frankl focused his mind on the future goal of publishing his book. During this time, he began to reconstruct the main ideas of Medical Ministry in shorthand and was able to hide these notes until he was freed. This book, Frankl’s first, was published in 1946 in German, and in 1955 it was published in English with the title The Doctor and the Soul.  

The first version of Man’s Search for Meaning, the book for which Frankl is most widely known, was also published in 1946, after Medical Ministry/The Doctor and the Soul. Frankl later explained that the book detailing his experiences in the concentration camps seemed to pour out of him. Originally, it was meant to be published anonymously. Only after much urging from his friends did he allow his name to be associated with it, and then he added an explanation of logotherapy. 

Logotherapy is based on the idea of identifying meaning in life and then imagining and working toward that purpose-outcome or future goal. Frankl self-discloses in Man’s Search for Meaning a time when he was depressed and in physical pain in a concentration camp and “forced” his thoughts to a future purpose where he saw himself standing on the platform of a well-lit and pleasant university lecture room. In front of him, Frankl saw (in his imagination) an attentive audience listening to him give a lecture on the psychology of concentration camps. Just as he found a future purpose in writing Medical Ministry/The Doctor and the Soul while enduring great suffering, Frankl also found a future purpose in writing Man’s Search for Meaning while enduring great suffering. The book’s original title, written in German, was A Psychologist Experiences the Concentration Camp. The title of the first English-language version, translated by Ilse Lasch in 1959, was From Death-Camp to Existentialism: A Psychiatrist’s Path to a New Therapy. 

The major antecedent to the publication of Man’s Search for Meaning took place in 1957, when the Religion in Education (RIE) Foundation sponsored Frankl to visit American universities as part of a lecture tour. RIE director Randolph Sasnett and his wife, Martena, scheduled a meeting in which Frankl met Harvard University’s Gordon Allport, a prominent psychologist who is today considered a founding figure of personality psychology. Sasnett persuaded Beacon Press to publish Frankl’s book, but it was Allport’s endorsement that provided a major push for the book to be printed. When Frankl revised his book for Beacon Press in 1962, its titled was changed to Man’s Search for Meaning: An Introduction to Logotherapy. 

Allport wrote in the preface that one of Frankl’s great contributions to mental health counseling was to ask clients, “Why do you not commit suicide?” From their answer, Frankl assisted clients in finding their logos (a Greek word for “meaning”) and built therapy around it. Allport also noted that unlike many European existentialists, Frankl was not pessimistic. Allport remarked that Frankl, a person who had experienced so much suffering, took a remarkably hopeful view of people’s capacity to transcend their predicaments and quandaries.   

Frankl’s experiences in the Nazi concentration camps that he described in Man’s Search for Meaning were a validation of the concepts of logotherapy that he wrote about in Medical Ministry/The Doctor and the Soul. In essence, the camps were qualitative research and fieldwork observations for the three basic tenets of logotherapy. First, that meaning exists and is discoverable, even under the most overwhelming and distressing life events. Second, the will to meaning is a human’s main motivation for living and a sturdier and healthier motivator than the will to pleasure and the will to power, as suggested by Freud and Adler, respectively. Third, no one and no thing can take away the human freedom to find meaning. Regardless of circumstances, people can change their attitudes (reframe) toward an unchangeable fate (e.g., choosing how to die, and modeling it, when a person has a terminal illness). 

After World War II ended, Frankl was hired at Poliklinik Hospital in Vienna as head of the neurological department. During this time, he earned a (second) doctoral degree in philosophy from the University of Vienna. His dissertation was an examination of the relationship between psychology and religion. In it, Frankl encouraged the use of Socratic dialogue (self-discovery discourse) with clients to help them interact with their noetic (spiritual) unconscious. This dissertation eventually became a book published in German in 1948, with the English-language version published in 1975 as The Unconscious God: Psychotherapy and Theology.

Frankl continued his professional and academic labor in logotherapy throughout his life. He was rooted in a scholar/researcher-practitioner model, with one foot squarely set on scholarship and research and another foot firmly planted as a psychiatrist and counselor working with clients. Frankl wrote close to 40 books and became the first non-American to receive the American Psychiatric Association’s prestigious Oskar Pfister Award for important contributions to religion and psychiatry. He was a visiting professor at Harvard, Stanford and many other American universities. 

Contributions to the modern era of mental health

Frankl’s paramount contribution to the field of mental health is the development of logotherapy, which postulates that people are motivated by a will to meaning, or an inner pull to find and discover a meaning in life.

 Three basic principles of logotherapy are:

1) Life has meaning under all circumstances, even the most miserable ones.

2) The main motivation for living is our will to find meaning in life.

3) People have freedom to find meaning in what they do and what they experience, or at least in the stance they take when faced with a situation of unchangeable suffering. 

As Frankl stated in many of his writings, lectures and presentations, people can discover meaning in life in three ways: 

1) Through creativity — by creating a work or doing a deed

2) By experiencing something or encountering someone

3) By the attitude they take toward life and unavoidable suffering

As Frankl outlined in Man’s Search for Meaning, and as based in his concentration camp horrors, everything can be taken from a person but one thing — the ability to choose one’s attitude in any given set of circumstances. Frankl referred to this as the last of the human freedoms. 

Although Frankl warned against “prescribing” meaning to clients, and was criticized by both Rollo May and Irvin Yalom for being too authoritarian with clients (possibly a cross-cultural misinterpretation between American and European culture made by May and Yalom), his work has continued to provide insight for those searching for meaning. Throughout his writings, Frankl stressed that counselors could help clients imagine three future areas where meaning can be discovered. 

The first area is creative activities, which can occur in work, leisure and volunteer spaces. Frankl listed hobbies and centripetal leisure — leisure values that move a client toward core values and meaning — as untapped resources to engage in meaning. Second, experiences in life, such as encounters with art, nature and other people (especially people whom you love and who love you back) can reveal meaning. Throughout his life, Frankl wrote often about his love of nature, both his quiet time in nature and his serious leisure endeavor of mountain climbing. Third, the attitudes taken toward an unchangeable fate, often referred to as “attitudinal change intervention” by logotherapists, can provide meaning. In essence, this is a type of attitudinal reframing based on finding meaning in the moment and finding meaning in future actions. 

This is what Frankl demonstrated when he “forced” his thoughts to a future purpose when abused in the Nazi concentration camps (e.g., imagining himself giving a future lecture on the psychology of concentration camps at a university setting) and when he was deeply ill with typhoid fever (e.g., working on, and imagining, his future book Medical Ministry/The Doctor and the Soul). It is why Frankl wrote, in Man’s Search for Meaning, that logotherapy focuses on the future or the meanings still left to be fulfilled by the client. It is also why he would ask his clients the specific question “Why do you not commit suicide?” and from their answer locate their meaning and then build therapy around future endeavors related to that meaning. It is why Frankl would have clients write their eulogy or view themselves from their death bed so they could, in an imagined state, look over their life to discover meaning or future purposes.  

Connected to the development of logotherapy, Frankl also pioneered theoretical frameworks and interventions that contributed to the broader professions of counseling and psychotherapy. For example, Frankl’s academic focus on self-transcendence, explained in his book Will to Meaning, aids in helping clients surpass or go beyond the self. Frankl defined self-transcendence as the human capacity to reach out beyond oneself toward a meaning to fulfill, people to love and causes to service. Today, the idea of serving something larger than the self, which can result in an abundance of positive emotion, is a core axiom of positive psychology. Frankl suggested this more than 50 years ago, before positive psychology existed. 

Connected to self-transcendence, Frankl also wrote about self-distancing, which is the capacity to step away from ourselves and look at ourselves from the outside, such as using humor and laughing at ourselves instead of being too serious about ourselves. Frankl is also a pioneer in creating the intervention of paradoxical intention, which he described as a self-distancing technique. During a paradoxical intention, a counselor intensifies the client’s emotional state and dysfunctional behavior to help the client understand the irrationality of the behavior or emotional reaction. This can include, for example, suggesting that a client who has insomnia stay up all night long or asking a client who has a pleasing personality to exaggerate pleasing other people (sometimes in a humorous manner) in a role play with the counselor or as a homework assignment. 

In the 1980 book Existential Psychotherapy, considered a classic for students studying existential counseling, and his recent memoir, Becoming Myself, Irvin Yalom outlines Frankl’s fundamental and groundbreaking contributions to existentialism linked to therapy. More recently, logotherapeutic concepts, sometimes referred to as “meaning-centered counseling,” have been integrated into cognitive behavior therapy and positive psychology (see the academic work of Paul T.P. Wong, president of the Meaning-Centered Counselling Institute in Canada and editor of the International Journal of Existential Positive Psychology).  

Seventy-five years after Frankl wrote Man’s Search for Meaning, his influence is still felt worldwide, with logotherapy training centers in Canada, Israel, Great Britain and Vienna. In the United States, the Viktor Frankl Institute of Logotherapy (headquartered in Texas) offers continuing education hours and training that can result in the academic associate, diplomate clinician or diplomate in logo-philosophy (outside of the health care profession) credential (see viktorfranklinstitute.org/education).

Conclusion

At the end of the preface of Man’s Search for Meaning, Gordon Allport called the book a “gem” and wrote that it provided a compelling introduction to the most significant psychological movement of that era. As mentioned earlier, Allport commented that Frankl, a person who experienced so much suffering, took a remarkably hopeful view of people’s capacity to transcend suffering and pain. To this end, and not to trivialize the suffering and death that occurred, we end this article by sharing a hopeful thought that Frankl wrote about in Man’s Search for Meaning:

“One evening, when we were already resting on the floor of our hut, dead tired, soup bowls in hand, a fellow prisoner rushed in and asked us to run out to the assembly ground and see the wonderful sunset. … After minutes of moving silence, one prisoner said to another, “How beautiful the world could be!”

 

In addition to the books mentioned throughout this article, information was drawn from the following sources: 

  • Stephen Kalmar’s “A Brief History of Logotherapy,” from Analecta Frankliana: Proceedings of the First World Congress of Logotherapy, 1982
  • Robert Leslie’s “The Story of a Bestseller,” published in The International Forum for Logotherapy, 1990
  • The Viktor Frankl Institute of Logotherapy in America website (viktorfranklinstitute.org/about-viktor-frankl)

Jorm S/Shutterstock.com

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Rodney B. Dieser is a licensed mental health counselor and certified therapeutic recreation specialist. He is a professor in the Department of Health, Recreation and Community Services and affiliated faculty in the Department of Counseling at the University of Northern Iowa. Contact him at rodney.dieser@uni.edu.

Cynthia Wimberly is vice president and teaching faculty in the Viktor Frankl Institute of Logotherapy. She is a licensed professional counselor supervisor in Texas, a national certified counselor and a national certified school counselor. Contact her at cynthia.wimberlyphd@gmail.com.

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

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

Responding to the increase of hate crimes against Asians and Asian Americans

By Yumiko Ogawa, Yi-Ju Cheng, Yung-Wei Dennis Lin and Terence Yee June 2, 2021

Violent attacks on Asians and Asian Americans (A/AA) have increased exponentially since the start of the COVID-19 pandemic. According to data from the Center for the Study of Hate and Extremism, although the number of overall hate crimes in the United States’ largest cities decreased by 6% in 2020 compared with 2019, anti-Asian hate crimes soared by nearly 150%. Cities with the largest increases in anti-Asian hate crimes included New York City (833% increase), Philadelphia (200% increase), Cleveland (200% increase) and San Jose, California (150% increase). 

According to data from Stop AAPI Hate, 3,795 cases of anti-Asian hate incidents were received by its reporting center between March 19, 2020, and Feb. 28, 2021. Verbal harassment made up the majority of the reported hate incidents (68.1%), followed by avoidance or shunning (20.5%), physical assault (11.1%), civil rights violations such as refusal of service (8.5%) and online harassment (6.8%). Media coverage of hate crimes against A/AA reached a fever pitch after the horrific killings of six Asian women in the Atlanta metropolitan area and the physical assaults in New York City of a Chinese woman who was slapped and set on fire, a Filipino American man who was slashed across his face with a box cutter, a Thai immigrant who died after being shoved to the ground, and a Filipino American woman who was suddenly kicked in her stomach and head repeatedly in broad daylight. 

Like those in other ethnic groups, A/AA experiencing racial discrimination may develop mental health concerns such as generalized anxiety, panic disorder, depressive disorder, a low level of life satisfaction, low self-esteem, sleep problems, low appetite and even suicidal ideation. On top of these potential mental health concerns, the recent violent attacks may have caused many A/AA individuals to become hypervigilant or even fearful in public more frequently and to constantly worry about the safety of their families and friends. 

These attacks and harassments immediately drew heightened attention in many professional fields, including counseling. Professional counseling organizations such as the American Counseling Association, the Association for Multicultural Counseling and Development, and the Association for Assessment and Research in Counseling have responded to anti-Asian hate crimes through official statements, specific research grant releases and other supportive actions. At the same time, individual counselors should also recognize our ethical obligation to nondiscrimination and social justice. According to the 2014 ACA Code of Ethics, professional counselors are responsible for providing nondiscriminatory counseling services (Standard C.5.), advocating for individuals who are underserved or experience barriers to services (A.7.a.), and contributing to the public good (C.6.e.). 

So, what should and can professional counselors do to respond to anti-Asian hate crimes? Perhaps, the very first step is to gain a deeper understanding, especially about the hidden factors and prejudices that might have historically contributed to the discrimination behind anti-Asian hatred.

Lev Radin/Shutterstock.com

Contributing factors

Various factors contribute to the increase in anti-Asian hate crimes. One of the most visible and widely debated factors is the use of racist language (especially by influential public figures) such as “China virus,” “Wuhan virus” and “kung flu.” The use of such language provides permission or license for others to express their deeply held prejudices. Researchers have coined this phenomenon the “emboldening effect.” There are many other myths, however, that have fostered the prejudices that we, as a nation, have toward A/AA.

One hidden prejudice could be that A/AA are viewed as perpetual foreigners. Seemingly innocuous questions such as “Where are you from?”; “Where are you really from?”; and “What’s your real name?” perpetuate this belief, with the underlying assumption being that they cannot be from the U.S. and their English-sounding name is not their real name. This belief that A/AA are foreigners extends to the entertainment industry. Take the movies Minari and The Farewell, for example. Despite being American-made films, both movies were ineligible for the Golden Globes’ best picture category. Instead, they were relegated to the best foreign language film category because much of the movies’ dialogue was not in English. The implicit message here is that A/AA experiences are not American enough or, even worse, that these populations are always viewed as being foreigners/outsiders. Such perspective relegates A/AA populations to some kind of marginalized status and also fosters disdain or hostility among many Americans toward them.

Another hidden prejudice is the model minority myth. This myth perpetuates the belief that A/AA are the most successful minority due to their hard work, focus on education and community support. There are three problems with this myth. 

First, the myth paints a monolithic picture of the Asian community when there can be huge disparity within the different Asian diasporas. For example, Bhutanese Americans experience a higher poverty rate than do other Asian groups, such as Japanese Americans. Second, the internalization of this myth puts enormous pressure on A/AA to succeed, which can negatively affect their mental health. 

Third, and perhaps most damaging, is that this myth perpetuates another myth: the myth of meritocracy. The underlying message is that the Asian community has transcended decades of racism because of their hard work; therefore, if an individual (or a particular group) is not as successful, it is assumed to be due to their lack of effort rather than systemic injustice. This line of thought effectively creates a wedge between different minority communities in the U.S. and
maintains the status quo of white privilege and supremacy.

Collectivism may be another significant but often neglected factor. The majority of A/AA populations share a belief that their identity lies within a group, such as their family, a specific community or even collective society (see Derald Wing Sue and David Sue’s Counseling the Culturally Diverse: Theory and Practice). Growing up and living in such collectivistic culture, A/AA individuals are typically educated to honor harmony and avoid conflict, and gradually they develop a tendency to be compliant and quiet or to keep away from standing out, even in a positive manner. 

Coupled with this sense of collectivism, many historical policies, such as the Chinese Exclusion Act, have silenced the A/AA community. To survive, A/AA populations learned to be self-reliant and not bring attention to issues surrounding the A/AA community. Sayings such as “keep your head down” and “the nail that sticks out gets hammered down” are common mantras that A/AA individuals typically hear from their parents and grandparents. Thus, when they experience unfair treatment, bullying, discrimination or even violence, they tend to tolerate it and choose not to report. Although the collectivistic way of being in no way causes hate crimes against A/AA individuals, perpetrators of hate crimes may perceive members of the A/AA community to be easy targets because of their lack of self-advocacy. 

Many A/AA people have internalized the model minority myth and developed a condition of worth around it. They believe they should be exemplars for others and succeed in various aspects of their lives — socially, academically and financially. Otherwise, they “fail.” In fact, one study reported that Asian American college students were more susceptible than other ethnic minority college students to experiencing feelings of being impostors. Failure to tolerate the discrimination and preserve the collective honor of becoming a model minority may result in a sense of guilt, bringing shame to the family, community or society. 

The perception of A/AA as foreigners has also become an inhibitor to self-advocacy. There are legal and political histories that have contributed to this perception, but a lack of English proficiency, the presence of prominent accents and the use of nonalphabetic characters are also believed to promote their “foreigner” status, discouraging them from voicing their experiences of racism and discrimination. 

Furthermore, some A/AA populations may have inherited the feeling of “indebtedness” to America from the first generation of Asian immigrants. Many Asians immigrated to the U.S. for better educational, economic and employment opportunities, especially for their children. Some Asian immigrants also fled to the U.S. to avoid human rights abuses and nondemocratic rule in their own countries. Early Asian immigrants may thus rationalize the racism they experience in America as the price of admission they need to pay to this country.

Emerging voice and hope

However, since the surge of xenophobia toward A/AA resulting from the COVID-19 pandemic, A/AA have been taking more active and vocal roles to advocate for the realization of their rights. Stop AAPI Hate, sponsored by multiple organizations, was established in March 2020 to stand united against racism and hate that targets Asian American and Pacific Islander (AAPI) communities. In addition, the news media has been highlighting the escalation of hate crimes against A/AA. In March, Democrats in the House of Representatives held the first congressional hearing on anti-Asian discrimination in three decades.

Several factors, such as the utilization of social media and the increased representation of A/AA in entertainment, politics, sports and executive roles, are conducive for this somewhat unusual movement among A/AA to make new cracks in the “bamboo ceiling.” We want to highlight two other plausible factors: a demographic change within the U.S. and a generational change among A/AA. 

Many A/AA grow up in a collectivistic cultural background that encourages the pursuit of harmony with others (in particular, others in the majority) and values showing respect toward others who are higher in the social hierarchy. The fact is that minority populations are becoming a majority in the U.S. Activism against racial injustice, for civil and human rights, and for equity for themselves is becoming a part of the discourse of this new majority. A/AA are drawing inspiration from activist movements, such as Black Lives Matter, that have emerged out of other underrepresented communities. Even as we recognize the divisions between minority communities and their different histories of suffering, there is a chance to continue the history of solidarity for those who have been kept in subordinate positions.

Generational change is another significant factor. Second, third and even younger generations of immigrants are often substantially better off on several socioeconomic attainments such as income, education and homeownership than their parents who migrated to the United States, according to Pew Research Center analysis. These individuals are more assimilated to the U.S. culture and more astute to the issues of inequality and social justice than their parents or grandparents are or were. Thus, thoughts about racial identity and racism may be quite different between younger generations of A/AA and early Asian immigrants. 

For example, younger A/AA individuals may naturally claim their identity as Americans and thus may not possess the deep indebtedness that was part of their parents’ or grandparents’ experience. In addition, whereas early Asian immigrants typically embraced collectivism and harmony, younger A/AA generations may prioritize equality and social justice. Even the use of technology makes a difference between A/AA generations. Younger A/AA individuals are much more familiar and comfortable with using social media to communicate their thoughts and advocate. All of these generational changes have contributed to raising a stronger voice against anti-Asian hatred.  

Suggestions for counselors

Highlighting issues surrounding the A/AA community is a step in the right direction because it combats the invisibility of A/AA experiences. Efforts to include the A/AA community in the discourse should be consistent rather than a one-time event. We offer a few suggestions for counselors on starting and maintaining the conversation. 

1) Practice self-reflection: If you are a counselor educator or supervisor, have you talked or facilitated discussion in your class or with your students/supervisees about the escalation of hate crimes and discrimination against A/AA? If so, why? If not, why? If you pause and examine your thoughts, feelings and physical reactions, what do they tell you about your perceptions or hidden beliefs regarding A/AA populations?

2) Broach the conversation: After the mass shooting in the Atlanta area in March, each of the authors of this article were reached out to by friends, colleagues, former professors and even their students. We all appreciated and felt touched by even short messages such as “How are you doing?”; “I am just thinking about you”; and “I am grateful you are in my life.” There might be hesitation to bring national news to an individual level, but we encourage counselors to reach out if they think about doing it. These gestures can make many A/AA individuals feel cared for and assured that they are part of the larger community in the U.S. 

3) Voice concern about exclusion of A/AA: We noticed that some organizations were offering multicultural training on racial minority groups that did not include A/AA or having diversity committees without an A/AA representative. Reaching out to organizations to address the need for the inclusion of topics related to the A/AA community or individuals from an A/AA background is advocacy work that we all can engage in. 

4) Reach out to your elected officials: Email or call your local elected officials and ask them about specific bills and votes that affect A/AA communities. Express your concern and support for A/AA in your community. The National Asian Pacific American Women’s Forum (napawf.org) has a petition page that suggests elected officials focus on fighting systemic racism and address the needs of survivors and the affected community.  

5) Reach out and enhance counseling accessibility to A/AA populations: We encourage counselor educators and professional counselors to consider providing support groups for A/AA individuals on campus and in the community. Professional counselors could collaborate with local elementary, middle and high schools to provide individual counseling, support groups or psychoeducation sessions not only for A/AA students but also for their parents and families. Professional counselors may also consider posting mental health service information specifically related to A/AA populations and anti-Asian hate crimes on their professional websites. Asian mental health communities such as the Asian Mental Health Collective (asianmhc.org) provide lists of Asian counselors. 

6) Provide education in the community to foster mutual understanding and promote equality: Share your knowledge on mental health and multiculturalism with people in your community. For example, local public libraries often hold workshops and presentations. Professional counselors can use such channels to help people in the community gain a better understanding of the impact of racism and discrimination on their daily functioning.  

Conclusion

As we were working on this article, continual occurrences of hate crimes (as of April 24, the latest being the mass shooting at an Indianapolis FedEx facility that killed four Sikhs, among others) prompted us to revise the manuscript multiple times. The addition of each hate crime example added heaviness and fear to our hearts. This feeling of heaviness and fear is a glimpse into the world of racism. 

Hate crimes/violent crimes against A/AA are not a new phenomenon, and racist acts are occurring on a daily basis. However, these acts often receive attention only when they result in mass shootings, viral videos or sensationalized coverage in the media. Then, gradually, the attention fades away. 

One of our co-authors, Terence Yee, remembers a comic strip in which everyone wants change, but fewer people want to change, and even fewer want to lead the change. The fact that anti-Asian hate/violent crimes have captured national attention and people are talking about them is progress. This progress is giving us something to ponder: Now that we know it, what will we do with it?

 

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Yumiko Ogawa is an associate professor in the Department of Counselor Education at New Jersey City University. She has more than 25 years of clinical experience in various settings. In addition, she has been providing play therapy training in the U.S., Japan and the Philippines. She is a co-founder of the Play Therapy in Asia Summit. Contact her at yogawa@njcu.edu.

Yi-Ju Cheng is an assistant professor in the counseling program at Rider University. She is a licensed professional counselor and registered play therapist whose clinical and research interests center on children and their families from diverse cultural backgrounds.

Yung-Wei Dennis Lin is an associate professor in the Counselor Education Department at New Jersey City University. He came from Taiwan and has resided in the U.S. for 17 years.

Terence Yee is an assistant professor in the Department of Education and Counseling at Villanova University. Being an immigrant from Malaysia and identifying as Malaysian-Chinese, his research interest includes the experiences of international counselor educators and international students. He has a private practice that serves predominantly Asian and Black men.

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

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

Money on the mind

By Laurie Meyers April 7, 2021

Money is the dirty little secret of American society. The unspoken social contract is that, like Voldemort, it shall not be named. We may joke about winning the lottery, but we don’t reveal the strained financial circumstances that underlie that pipe dream. Modern life is not cheap. Unfortunately, many workplaces and professions do not reflect this reality. Could we be making more money? Who knows? Many companies forbid their employees to discuss salaries with co-workers.

Meanwhile, our consumerist culture makes it easy for money to fly out of our wallets and onto our credit cards. Financial experts (some of whom sound a bit like scolds) urge us to maximize our contributions to our retirement plans and have savings sufficient to sustain us for six months or more of unemployment. These are worthy goals, but most Americans find them challenging to achieve.

A 2019 survey by the personal finance company Bankrate found that approximately 28% of Americans had no emergency savings and only 18% had enough to live on for six months. And a 2019 report by the U.S. Federal Reserve revealed that 25% of nonretired workers possessed no retirement savings at all. Surveys show that a large share of Americans — including those who earn higher salaries — live paycheck to paycheck. Many people get by with the help of a credit card — or three or four. A recent poll by CreditCards.com showed that almost half of Americans (47%) currently carry credit card debt. And even though being in hock to credit card companies is so common, carrying that kind of debt is still associated with a lack of financial responsibility. 

Just set a budget! Track your spending! Stop buying that daily Starbucks latte!

It’s not the latte. And the one-size-fits-all financial advice on offer by cable talking heads and in best-selling books doesn’t typically work. Not just because people’s financial obligations are different, but because managing money isn’t only about the numbers. The way we spend — and save — is tightly entwined with emotion and driven by learned behaviors and beliefs whose existence we are frequently unaware of, according to experts who study neuroeconomics. These factors can prevent us from effectively managing our money.

The mental health consequences of financial difficulties can be significant. Even before the recession caused by the COVID-19 pandemic, Americans frequently rated financial worries as one of their top sources of stress. This past October, the fourth in a special pandemic-oriented series of “Stress in America” surveys from the American Psychological Association revealed that nearly 2 in 3 adults (64%) said money was a significant source of stress in their lives.

Financial difficulties can cause stress and depression. Stress and depression make it harder to tackle money problems. It becomes a vicious cycle — particularly for those who are already living with mental health problems.

Enter financial therapy, which the Financial Therapy Association (FTA) defines as “a process informed by both therapeutic and financial competencies that helps people think, feel, communicate and behave differently with money to improve overall well-being through evidence-based practice and interventions.”

Financial therapists primarily come from the mental health, coaching and financial fields. Some of them are mental health professionals who realized that money plays an important role in overall well-being and decided to become trained to offer financial therapy in addition to their regular practice. Others are financial professionals who realized that they needed to be able to handle the emotional aspects of money and received additional behavioral training or, in some cases, became licensed mental health practitioners.

All of the sources Counseling Today spoke to for this article are licensed counselors who offer financial therapy to existing clients who express interest or as a stand-alone service. They use a variety of tools to help clients understand their internal money narratives, identify behavioral patterns, and process the emotions that are getting in the way of setting and working toward their financial goals.

The field developed out of a body of research on neuroeconomics. Psychologists Ted Klontz and Brad Klontz and financial planner Rick Kahler are widely considered the “grandfathers” of financial therapy.

Early lessons learned

Research by Klontz, Kahler and Klontz suggests that people begin developing money beliefs — and potential future problems — in childhood. These attitudes are often developed through experience and observation rather than parental instruction.

That’s because many families don’t talk about money, notes American Counseling Association member Elaine Korngold, a licensed professional counselor in Portland, Oregon. Children grow up in families not knowing how much money their parents make, how much (or how little) different jobs pay, and what level of income is necessary to cover basics such as rent/mortgage, utilities and food — let alone how to set up and follow a budget, she says.

Although parents usually talk about and teach their children essential life skills such as driving, anything to do with money is often kept secret, says Korngold, who worked in the financial sector before she became a counselor. This not only leaves children uninformed and unprepared but also reinforces the societal perception of money as a taboo topic. As a result, many adults who struggle to manage their finances simply don’t know how to seek help or are too ashamed to ask for it, she says.

But even when parents don’t explicitly teach their children about money, they are still imparting lessons, says Kathy Haines, an LPC in Marietta, Georgia, who is training to become a certified financial therapist through FTA.

An integral part of Haines’ financial therapy process is exploring the financial beliefs held by a client’s family of origin. Haines, an ACA member, asks questions regarding whether money was ever discussed, who managed finances in the family and how. “Were there fights about money?” Haines asks. “Spoken or unspoken messages such as don’t have credit debt? Work hard so that you can take care of yourself?”

Similarly, Korngold asks clients about the spending behaviors they observed growing up. Did it seem like the family was always just making it until payday, or was there any financial cushion? If the family found itself with more money than usual, what did they do with it? Put it in the bank? Take a vacation? Buy a TV?

Jennifer Dunkle, an LPC in Fort Collins, Colorado, whose specialties include financial therapy, asks her clients to write their “money story” by answering a variety of questions: What are your earliest memories concerning money? What did you learn from your family about money? Specifically, what did you learn from your father? From your mother? What experiences did you have with money as a young adult?

These messages and experiences contribute to what Klontz, Kahler and Klontz call “money scripts” — unconscious beliefs that shape our financial behavior.

Money narratives

Dunkle, like many financial therapists, also gives clients the Klontz Money Script Inventory (KMSI) assessment.

“Most adult money scripts are based on earlier life experiences,” she says. “In order to make lasting changes to budgeting, spending, savings and investing plans, it is very helpful to learn more about our underlying beliefs and values in regard to money.”

The most common money scripts include beliefs such as:

  • More money will make things better.
  • Money is bad.
  • I don’t deserve money.
  • I deserve to spend money.
  • There will never be enough money.
  • There will always be enough money.
  • Money is unimportant.
  • Money will give my life meaning.
  • It’s not nice or necessary to talk about money.
  • If you are good, the universe will supply all your needs.

Dunkle explains that Klontz, Kahler and Klontz group money scripts into the following types:

  • Money avoidance: Avoiding dealing with money and rejecting personal responsibility for one’s financial health.
  • Money worship: Believing that a financial windfall or increased income will be the solution to all of one’s problems; being focused on the inward value of the accumulation of money.
  • Money status: Being overly concerned with the idea that self-worth equals net worth; believing that money conveys status; wanting to always have the next new, big-ticket item; and being interested in the outward display of one’s wealth to others.
  • Money vigilance: Being watchful, alert and concerned about one’s finances. Those who are money vigilant are much less likely to avoid their financial matters, overspend, gamble and engage in financial enabling.

Klontz, Kahler and Klontz say that the scripts themselves are not “good” or “bad.” Rather, they are simply indicators of behavioral influences.

“For example, someone who has the belief that ‘I deserve to spend money’ might run up a lot of credit card debt despite not being able to actually afford their purchases,” Dunkle explains. “The script, ‘It is not nice or necessary to talk about money’ could lead to money secrets between spouses. Believing that ‘If you are good, the universe will supply all of your needs” may result in not doing adequate planning and saving for retirement.’”

Working toward change

Dunkle uses motivational interviewing to help clients recognize the adverse effects their financial habits are having on their lives.

“The goal of motivational interviewing in financial therapy is to elicit ‘change talk’ by using the skills of open-ended questions, affirming, reflective listening and summarizing,” she explains. “When clients hear themselves talk about potential changes, they start to believe that change is indeed possible. For example: ‘Getting my finances under control would help me sleep so much better at night.’”

To facilitate the process, Dunkle might ask someone who is money avoidant an open-ended question such as, “What is that like for you, seeing those unopened credit card statements pile up on your desk?”

For someone whose script is money worship, she might make an affirming observation such as, “It sounds as though working 70 hours a week in order to earn more income is really starting to get to you. It’s no wonder that you feel worn out.”

With a money status case, Dunkle says she could listen and reflect back by stating, “What I hear you saying is that you believe that your value in the family comes from showing your relatives how much you earn and how much you own, not from who you are as a person.”

For a client whose script is money vigilance, she might observe and summarize with a statement such as, “Wow, it sounds as though you feel exhausted, thinking that you need to check your accounts every night before you can relax and go to sleep.”

Haines also uses the KMSI as one of her tools for uncovering the narratives that drive clients’ financial behaviors. She breaks down narratives into thoughts about skills or situations and core beliefs about worth.

“Step one for both is to become aware of those narratives,” Haines says. “This can be difficult because they run so quickly in the background that we often don’t even know they are informing our behavior. Slowing down and becoming curious about our own thoughts and beliefs can be difficult, but [it] is a necessary first step.”

Haines asks clients to write down their thoughts — which she reminds them are not facts. When reviewing their collection of thoughts and beliefs with them, she asks clients to consider the following questions:

  • “What leads me to believe this is true? Is it from my own personal experience or maybe from some other influential person in my life who has told me this?”
  • “Is it always true? Is there evidence to the contrary?”
  • “If I can’t see evidence of it being true, can I hold the possibility that it’s not true?”
  • “If there is evidence of it not being true, how are those instances different, and how can I intentionally bring more of that?”

For example, many clients believe that they will never be able to manage money, Haines says. “I would ask, ‘What leads you to believe this is true? Are there instances where you have made good financial decisions that align with your values and what you want? What was different about those times? What prevents you from doing more of that? Are there skills that you need to learn? Do you need to ask for help? Is there fear involved?’”

“Once we go deep into the genesis and meaning of the narrative, it can go in any direction,” Haines says.

When a client’s narrative is about worthiness or “deserving” something (such as money or a higher paying job), Haines uses a similar, but less structured, process. “I usually ask those clients to slow down, take a few breaths, close their eyes and ask internally, ‘Whose voice is this?’ Is it yours, or is it someone else’s?” Haines notes that it is almost always someone else’s voice, such as a parent or caregiver or another figure who holds meaning for the client into adulthood.

“We then will unpack whatever comes up,” she says. “I might suggest that those who gave [the client] the message of unworthiness around something — either directly or indirectly — were struggling with their own sense of self and meaning in the world and [it] has absolutely nothing to do with my client.”

“I often will use the visual of newborns in a hospital nursery,” Haines continues. “Are some of those newborns born worthy and others unworthy? This helps them to see that feeling unworthy of something is just an internal narrative, not an absolute truth. I might ask, ‘What will it take for you to feel worthy? How will you know when you are worthy? Think of someone you care deeply about. Now decide when and what they are worthy of.’ That usually feels really uncomfortable for them [the client]. Then I reflect back that’s exactly what they are doing to themselves.”

Haines adds another common belief about money and success is that people who are rich are greedy and achieved that higher position because they didn’t care what they had to do to get there. “In essence, not having integrity,” she continues. “I have seen this a lot. An individual feels strongly about honesty, integrity and not being greedy. They want to succeed, but the people in the positions they want don’t seem to personify integrity. So, the position is out of alignment with their values, and their behavior will not support moving up. We then work on how they can create their own visual of how to be in that position from a place that aligns with their own values.”

Where does the money go?

Overspending is a problem that financial therapists see frequently. Clients show up at Haines’ office wondering why they are always in debt despite making an adequate salary. She helps clients identify what kinds of things they are purchasing and why.

“I’ve had clients who wanted to participate in getting together with friends, perhaps for dinner and drinks, concerts, plays, etc.,” Haines says. “They couldn’t really afford to do these things, but as humans, our need for belonging is so strong that we will do almost anything to fit in. I try to help my clients identify what they get out of these activities. It may be good conversation, advice, laughing together, intellectual stimulation or just not feeling lonely. We then brainstorm other ways to get these needs met, but without having to spend money they don’t have.”

“For instance,” she continues, “instead of expensive dinners, they could meet for coffee and have the same connection and conversation without the cost. If it’s intellectual conversation, maybe starting a book club. One idea that came up was to meet at a park and bring a lunch. The atmosphere is better than a restaurant, and it doesn’t cost anything.”

A possible downside is if the clients’ friends don’t want to make those changes. Then comes the difficult decision of whether the client will commit to living within their means and risk losing the relationship(s) or continue to overspend and remain in the safety of the relationship. This adds another layer of exploration about whether those relationships are, in fact, healthy and reciprocal, Haines says, but the overarching theme remains identifying what those dinners or other expensive activities are providing to clients and how some of those needs might be met in other ways.

“I will add that knowing and having a visual of the ‘why’ [the necessity] of changing financial behavior is always present,” Haines says. “Coming back to that assists with getting over the hurdles of change.”

“Keeping up with the Joneses” is another common spending impetus. Society encourages competition, such as having a nice car just because “everyone else” drives a nice car. But Haines asks clients if that really fits their core values.

“If you value a nice car and if you have one, that’s great, but if you buy a nice car because everyone in the neighborhood has a nice car, that’s going to create turmoil,” she says. For Haines, financial therapy is all about helping clients achieve what they want, not what other people think they should want.

ACA member Edward Kizer, an LPC whose specialties include financial therapy, says many of his clients are aware that they are engaging in compulsive shopping as a method of self-soothing or self-care. He teaches them simple techniques such as belly breathing to reduce their anxiety and also asks clients to think about what shopping gives them.

“If I’m expressing a need through retail therapy, what is that, and how can I feed that?” he asks. “What feeds you? Is it being creative? Is it the outdoors? How do [you] get back to nurturing yourself?”

Impulsivity is a significant driving factor in compulsive spending, says licensed professional clinical counselor Denise Kautzer, who is also a certified public accountant and specializes in financial therapy. She has clients track their spending and encourages them to follow the “24-hour rule,” which involves waiting for 24 hours after seeing something that they want to buy. In the end, they may still end up purchasing the item after giving it more consideration, but adopting this approach cuts down on impulse buys, she says. In addition, because spending often makes people feel good, at least temporarily, Kautzer helps clients identify other things that bring them joy.

Seeing the whole picture

Clients can’t manage their money if they don’t know where it’s going — or where it’s needed. Part of the financial therapy process is identifying expenses and assets: money in and money out.

Brian Farr, an LPC in Portland, Oregon, whose specialties include financial therapy, introduces what he calls a “snapshot” in the first session. “It’s a simple expenses and income and debt worksheet, not a budget or spending plan. Just a snapshot of what a typical month looks like,” he says. “It’s to help introduce them to the reality of their household finances.” Farr’s clients tell him this exercise helps give them clarity and motivation.

Like the other financial therapists Counseling Today spoke to for this article, Farr does not see himself or offer himself to clients as a financial planner. Instead, he helps clients understand their finances and develop a system to help them meet their goals.

“The freedom around money is coming up with some method that makes it visible,” Farr says. Once clients have that picture, he helps them be realistic about what they can and cannot do. That involves identifying how much money comes in and then giving each dollar a “job.”

He finds the youneedabudget.com website useful because it offers helpful videos and allows people to categorize not just their everyday expenses, but also infrequent but large expenses such as holiday gifts, a pet’s yearly checkup at the vet or car maintenance. Clients can then look at the money coming in and evaluate where it needs to go.

“If 60% already has a job to do, stop thinking that it’s yours to do with what you want,” Farr tells clients. He advises them that when they know how much of their money is discretionary, then they can make more realistic choices.

Asking clients about financial health

Many counselors don’t like asking about money. In fact, several of the professionals interviewed for this article noted that counselors often fall under the “avoidant” category when it comes to money scripts. But financial therapists say that it’s essential for counselors to be aware of money stress.

“We all have money stress,” Haines says. “I don’t know a person who doesn’t have money stress at some point in their lives. … It affects everybody.”

Counselors need not create an elaborate process to uncover a client’s money worries, Haines says. “It could be as simple as putting a question on your intake form such as: Are there financial concerns that are impacting you?”

Haines also urges counselors to listen for nuggets of information, such as clients mentioning that they hate opening their mailbox because it’s always full of bills. “You can just ask the question, ‘What impact does that have on you?’” she says. Money troubles are something that most people don’t talk about, even with their friends, so counselors can serve as that trusted person clients share those fears with, Haines emphasizes.

Haines and Kautzer both say that one of the most critical parts of their work as financial therapists is giving people hope.

 

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Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

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