Tag Archives: Counselors Audience

Counselors Audience

Career counselors: On the front lines of battling student stress

By Neil O’Donnell March 27, 2017

It won’t be news to most readers that undergraduate students everywhere encounter an incredible amount of stress throughout their college years. Colleges and universities offer a considerable range of services and programming to address a variety of stressors, including test anxiety, financial hurdles and personal struggles.

Even with all that focus on helping students to mediate stress and anxiety, I think one source of stress often gets overlooked: career stress. After nearly 15 years serving as a career and academic counselor for undergraduates, I am disheartened that such an oversight remains prevalent, both nationally and internationally, among administrators in higher education.

In a recent survey of 131 undergraduate students, I found that only 12 percent remained undecided regarding what major they wanted to pursue. To assume that only 12 percent of these students remain stressed is misguided, however, especially when learning that 56 percent of respondents to the survey were still uncertain concerning the career path they wanted to pursue. From firsthand experience, I know that this uncertainty causes considerable stress and anxiety for undergraduates.

As for the survey? Of the students who participated, 49 percent indicated that they endured stress over deciding on a major or career path.

Why are so many students battling this stress? We certainly have incredible assets in place to provide undergraduates with career guidance. Most four-year colleges and universities have

career centers staffed with career counselors to help students research majors and career paths. In addition, career centers often offer enrolled students access to free career assessments, including the Strong Interest Inventory, FOCUS, Myers-Briggs Type Indicator or an array of other assessments based on the Holland Career Codes. But even with all these resources available, students rarely utilize career centers for much beyond getting help writing a résumé or cover letter during their senior years (admittedly, I was guilty of this too). Therein lies the problem.

Fellow career counselors and coaches know the following advice all too well, but for other counselors who are working with undergraduate students, I’d like to offer some insight into helping them navigate their career research and mitigate the stress that all too often accompanies that search.

 

1) Get students to visit their campus career center during their first semester at college. I understand students have a lot to contend with as they enter their first semester of college. Between getting comfortable with the layout of the campus, the location of their classes, college-level course work and the campus food, the first two weeks of the semester are not an easy time for students who are seeking to begin their exploration into majors and career paths. By the third week, however, I find that students are ready to invest time into career research, and a visit to the career center is a good first step. Before sending my students to the career center on campus, I provide them with an overview of the center’s resources and the services the staff provides to undergraduates. Additionally, I discuss career assessments with my students and the information they can glean from assessment results.

Counselors familiar with the career assessment used by a student’s campus career center can provide students with background on the assessment, including information on the assessment’s format and how to access the assessment online if that is an option. Additionally, it is a good idea to stress the importance of seeking a full interpretation of the assessment results by one of the career specialists at the campus career center. In some instances, students can receive assessment results without having to speak with a career counselor or career coach whose expertise includes interpreting these assessments. As I tell my students, they will undoubtedly be able to gain insight from the assessment themselves, but I also stress that there are a multitude of intricacies they will likely overlook. These are bits of information that a career specialist would be able to identify and interpret for the student — information that could be crucial in helping a student identify an appropriate major or career path to pursue.

To avoid a lot of the hesitation and accompanying stress that students have with visiting a career office, I find it helpful to provide students with a few questions to ask the career center staff. In particular, I advise students to ask about the center’s career assessment and how to set up an appointment to go over the results. For those students with majors already in mind, advise them to ask if a particular career center counselor has experience helping students in that major.

A final step is to make certain students know where to find the career center. Yes, it is relatively easy in most cases for students to determine where on campus the career center is located. However, I find that providing the contact information to the students increases the likelihood that they will follow through and visit the career center. Take the extra minute or two to show students the career center’s website, and then email students the center’s contact information, including room location, email and phone number.

2) Seek a follow-up with the student. Before I end my initial meeting with students, I ask them to meet me after their meeting(s) with career center staff. I find that doing so encourages students to follow through on the guidance and their career research. These follow-up meetings offer the opportunity to mediate any stress that arises from visiting the career center. Specifically, students are often stressed that one visit to the career center did not help them immediately decide on or discover the best major and career path for them.

During these follow-up meetings, I help students develop (or adjust) their career research plans. Those counselors who are certified and proficient in the career assessments their students have taken can use these meetings to address student misunderstandings about their assessment results and expand on any feedback the students received from career center staff.

3) Seek additional follow-up after the student completes the assessment. In the event the student took an assessment but did not review the results with a career specialist at the college career center, advise the student to return for a review from the career center staff. It is critically important that students receive that feedback from those who are trained to interpret the results. I have found that the majority of students who meet with career center staff for guidance report that these meetings help reduce their stress and anxiety related to career concerns. In my current survey, 78 percent of respondents indicated that their meetings with a career counselor helped them decide on a major or career path. Furthermore, 69 percent of respondents indicated that meetings with a career counselor helped reduce their stress surrounding career and educational planning.

4) Advise students to communicate with professors on campus whose specializations match the students’ career interests. Even the most experienced career counselor has limited knowledge of the diverse job opportunities afforded by every major and degree. For example, from my personal experience, none of the career counselors on my college campus knew the array of specialties within anthropology, a field that leads to careers beyond professorships, museum curators and forensic specialists.

This is where campus professors are so vital to a student’s career research. The professors in each department likely possess a wealth of knowledge regarding job opportunities and career specializations that a given major affords students. Unfortunately, students often fail to seek career guidance from department professors earlier on (i.e., freshman or sophomore year).

As career counselors, it is incumbent upon us to direct our students to department professionals. Again, drawing from my own experience, speaking with department professors helped me to identify and focus on short-term and long-term careers, which ultimately reduced my stress (especially when many individuals asked me what in the world I was going to do with an anthropology degree).

5) Advise students to communicate with professionals in the communities surrounding the college campus. Connecting with campus professors/professional staff is often not enough to provide college students with a full understanding of the potential (career-wise) that each major offers. To that end, it is important to encourage students to reach out to community professionals to gain an extensive understanding of the possibilities that exist. Another benefit to reaching out to community professionals is that students may learn of unadvertised job opportunities during these discussions, all while expanding their professional networks. What’s more, engaging with professionals who have already put the student’s major into practice often helps to put the student’s mind at ease.

6) Encourage students to seek field experience during summer breaks. Summer vacation is a time for college students to reenergize. That said, there is no reason why students can’t use the summer months to further investigate their major and the career opportunities the major offers. Finding part-time, full-time or volunteer employment opportunities is a great way to gain firsthand experience in the field. Encourage students to speak with their professors and the community professionals with whom they connected to determine what jobs or volunteer opportunities exist that would provide related experience and help students gauge the appropriateness of the major they are currently pursuing.

Such summer experiences are more prevalent than most students and counselors might realize. It comes down to asking the right people what opportunities exist. In addition to giving students related experiences to include on their résumés, such jobs could provide money for college and help students expand their professional networks. Based on my own undergraduate experience, such opportunities reduced student stress by helping them gain a better understanding of the course material from the major, while also revealing hidden career paths not often attributed to the major.

7) Remind students that it’s OK to change their minds regarding their career goals. So what happens when students follow the above advice and determine that they are pursuing a major or career path that is unsuited to their interests, strengths and long-term career goals? Changing a major can be extremely stressful for students because they often feel it is a sign of failure. I remind students that changing a major is a common occurrence. At the same time, I also remind them that it is better to change directions with their newfound knowledge of their major and themselves now than to wait; it is a decision that could save them considerable time and money later on. It is also important in such moments to congratulate students for their efforts. This is encouragement that will help them tackle the stress and worry that often follow a change in major.

 

Collectively, these strategies have aided me in reducing my students’ stress, while simultaneously helping them determine a worthwhile career and gain valuable field experience prior to graduating. It is especially rewarding when one of my advisees follows through on this advice and has a full-time job lined up before graduation because of connections that he or she has made with community professionals. It is even more rewarding when graduates from years past return to say they still love the major and career paths they pursued after completing the aforementioned research. I believe other career counselors might find similar results as they assist students in managing stress related to choosing majors and career fields.

 

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Neil O’Donnell is a senior counselor for SUNY Buffalo State’s Educational Opportunity Program, where he provides personal, academic and career counseling to undergraduates. O’Donnell is also the author of The Career-Minded Student, a book that provides a plan of action that helps undergraduates succeed in class while preparing to compete for jobs immediately after graduation. Contact him at odonnenp@buffalostate.edu.

 

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Related reading

From the Counseling Today archives: “Unprepared, undecided and unfulfilled

Anxiety, confusion and questions of identity greet many college seniors as they consider their impending graduation and the necessity of determining their next steps in the ‘real world.’ wp.me/p2BxKN-3PD

 

 

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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.

What gets in the way? Examining the breakdown between research and practice in counseling

By Samantha McMorrow March 22, 2017

It is frequently noted that counselor practitioners in the field do not contribute nearly enough to research and publications, despite calls for them to do so. It is believed that research should inform counseling practice and practice should inform counseling research, yet there appears to be a breakdown between the two.

The counseling literature has presented several common hypotheses regarding why counselors in practice typically choose not to participate in research and publication efforts. These reasons include a lack of time, a lack of reinforcement, a lack of interest and a lack of experience in research.

Lack of time certainly seems like a valid hypothesis. It is undoubtedly a factor with considerable influence, especially for those counselors who are working in agencies where they must secure a large number of billable hours each week. Still, it is not necessarily the prohibitive factor.

Arguments can definitely be made that there is also a lack of reinforcement or a lack of interest for counselor practitioners to conduct research or to publish. For instance, employers at agencies and schools do not have their systems set up to reinforce this work in the way that universities do. However, this in itself is not inhibitive either.

Inexperience in the area of conducting research also seems like a reasonable factor that could impede practitioners’ contributions to research and publications. However, as a practitioner myself, I contend that a looming factor exists that has not been brought to the forefront. Namely, it is just not very easy to be out in the field and have access to channels to conduct publishable research. There are systems in place that are meant to protect our subjects (and rightfully so), but these systems do not lend themselves well to counselors in the field conducting research.

Furthermore, the path for practitioners to follow to get started in research is not always clear. A counselor in the field has access to clients but not necessarily access to university faculty, and without that, the counselor is stopped before he or she even gets started. The counselor could certainly conduct action research in efforts to inform his or her own practice. However, peer-reviewed, scholarly publications will not accept traditional research for publication without Institutional Review Board (IRB) approval, which comes from universities. Furthermore, universities will not grant IRB approval to research proposals without having a principal investigator (PI), and this PI must be a full-time faculty member of the university.

This is the first and most difficult hurdle to get over in practitioners conducting research. The counselor must find a full-time faculty member at a university that is willing to be the PI on the counselor’s research, which is no small commitment. Then the counselor must hope that the faculty member remains at that particular university throughout the course of the counselor conducting and writing up the research. Otherwise the counselor goes back to the beginning again to locate a new PI and submit an amendment to the IRB board to get approval for this change. The whole process can be confusing and intimidating for counselors in the field to navigate.

Subsequently, the process of getting IRB approval once the counselor practitioner has formed a partnership with a PI is detailed and somewhat lengthy, but not overly complex. Both researchers in this partnership will need to complete certain trainings to ensure that they understand issues surrounding protecting their subjects. They will also complete documents displaying the informed consent process that will be used in their research and submit the detailed and complete plan for the research, which may require cultivating further relationships with other departments if advanced statistical analysis is part of the research plan. This relationship can be the lifeline that keeps practitioners involved in the research effort once the analysis of the data becomes advanced and possibly intimidating for the average counselor in practice.

Furthermore, the university should have comprehensive instructions for how the counselor will submit the research proposal for IRB approval. This will be done once the counselor has a PI and a complete plan for how the research will be conducted. In addition, if counselors plan to conduct their research at their agencies or in their school districts, they will need to secure additional approvals from those specific sites.

This is the less understood and more complicated side of research for many practitioners, but it can be sorted through. Cultivating relationships with faculty members in counseling and other needed departments at universities can ease this process.

In a 2005 article, “Collaborative Action Research and School Counselors,” Lonnie Rowell looked at these collaborative relationships, noting that research-oriented facilities were being developed to bridge this gap between university faculty and practicing counselors. In addition, they serve as a model to link counselors-in-training with counselor practitioners for action-based research.

But despite attempts to build stronger connections between researchers and clinicians, another important factor often impedes counselors from engaging in research. A 2010 study by Darcy Haag Granello published in the Journal of Counseling & Development looked at cognitive complexity among practicing counselors over the course of their careers. The study found that counselors do grow and develop over their careers, especially with 10 or more years of experience. However, seasoned counselors may “forget” that they did not always know a particular technique or approach or did not possess their current conceptual understanding of issues or relationships when starting out in practice. This lack of reflection on their own growth could lead them to erroneously believe that they have nothing to research or write about that other counselors do not already know.

Taking some of our own advice as counselors in this situation could prove to be the solution. If counselors are mindful about their practices and really reflect on what they are doing, how they are doing it and why they are doing it, plenty of ideas will follow. Alyson Pompeo and Dana Heller Levitt proposed in their 2014 article, “A Path of Counselor Self-Awareness,” that practicing counselors have an ethical responsibility to self-reflect on their practices. Being a curious observer of your own work as a counselor can lead not only to professional growth but also inspiration regarding needed research and possible publications.

The literature has identified several factors to explain the existing disconnect between counselor practitioners and research efforts. If we are to truly use research to guide practice and use practice to inform research, then a bridge needs to be built that will bring counselor practitioners into the world of research. If we acknowledge the need for developing connections between university faculty and counselor practitioners, plus the need for increased self-reflection in the field, perhaps the gap that must be bridged will end up being not quite so large.

 

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Samantha McMorrow is a practicing school counselor with K-12 endorsement and a licensed professional counselor. She is also a national certified counselor and is certified as a chemical dependency counselor in Alaska. McMorrow currently serves as an adjunct instructor for the University of Alaska Fairbanks in its Counseling Department. Contact her at sgmcmorrow@alaska.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.

Yalom urges ACA attendees to hold fast to self-care and the therapeutic alliance

By Laurie Meyers March 17, 2017

At Friday’s opening keynote session of the American Counseling Association 2017 Conference & Expo in San Francisco, psychotherapy sage Dr. Irvin Yalom shared his insights on everything from self-care and vulnerability as a therapist to counseling by text, his love of literature and the essential nature of the therapeutic bond.

Yalom, one of the most influential mental health professionals of our time, began the session by answering a question about the importance of self-care for counselors from moderator Adele Cehrs, the CEO of Epic PR Group and a former journalist. Yalom credited strong personal relationships, including his marriage of 60-plus years and consistent peer support, as keys to his

Dr. Irvin Yalom gives the opening keynote address at ACA’s annual conference & Expo March 17. (Photo by Paul Sakuma Photography)

own personal self-care. For many years, he has been an active participant in a “leaderless” therapy group for psychotherapists (among other groups) that meets for 90 minutes every two weeks. Within the confines of these confidential group sessions, members share their day-to-day struggles and client interactions that have evoked personal problems or concerns.

“I urge you to get into a group like that,” he told the more than 3,000 counselors assembled for the keynote. “It’s a key part of my week. I never miss a meeting if I can avoid it. That is my major source of self-care. That and getting therapy.”

Likewise, Yalom encouraged counselors in the audience to secure their own personal therapy, not just once, but many times throughout their careers.

In response to a question from Cehrs, Yalom also spoke about how and why he often chooses to “reveal” some aspect of himself in interactions with his clients. He said that his upcoming memoir — which he believes will be the last book that he will write — touches on this topic in some depth.

Yalom said he always tries to be “real” with clients and bring something of himself to the session. When Cehrs asked if he thought that he’d ever crossed a line and revealed too much, he thought for a moment before replying no.

“I can be quite revealing … but always in service of therapy,” he said.

Part of being revealing is choosing to be vulnerable as a therapist and admitting to his clients that he doesn’t have all the answers — a practice he started early in his career. Offering an example, Yalom recalled the first session he had as a young therapist with a female client in her 30s. He asked her what brought her to therapy.

“She said, ‘Well, I’m a lesbian,’” he recounts. This was in 1955, Yalom notes, and he genuinely had no frame of reference for this client at that time. “I don’t know what that is,” he told the client. “Could you please educate me?”

Yalom also recalled another valuable lesson he learned early on that cemented his belief that it could be valuable to put himself into his interactions with clients. While working in a long-term care facility, he was charged with treating a woman with catatonia. He met with her every day, but she never spoke. In fact, she was completely unresponsive, much like a living statue. Unsure of how to connect with a client who couldn’t respond, Yalom decided he would simply talk to her. He began sharing with her what he’d read that morning in the newspaper or talking about how he was doing.

Several months later, the patient was prescribed a new drug that had an amazing therapeutic effect, dispelling the catatonia and allowing the woman to speak again. Yalom was curious about her perception of the “therapy” he had tried during her period of catatonia and asked her what it was like.

“Dr. Yalom,” the woman said, “you were my bread and butter.”

This also demonstrated to Yalom the power of the therapeutic bond. He saw that simply by interacting with the woman and showing her that she still had value, even when she was catatonic, he had brought her comfort.

Yalom, an emeritus professor of psychiatry at the Stanford University School of Medicine, is also known as a prolific writer of both nonfiction and fiction, including his widely praised “teaching stories” and “teaching novels.” He described these works to the audience as having “one leg in literature and one leg in psychotherapy.”

“When I was a teenager, I had this strong idea that the best thing one could do was to write a novel,” Yalom told the audience. However, he revealed, as the child of Russian immigrants, he essentially had two options when it came to career choice: “We could become doctors, or we could become failures.” Although, in truth, there was a third option. “We could go into business with our father,” he added.

Yalom also responded to queries about advice for new counselors and his views on the role of technology in counseling. He expressed regret that so many new counselors work in environments that focus solely on cognitive behavior therapy (CBT) because it is labeled an evidence-based model. “CBT omits the essence of psychotherapy — the interpersonal nature of the therapeutic relationship,” Yalom asserted.

When asked about telecounseling, Yalom talked about being invited to work for a company that facilitates counseling via text. He initially thought it was a horrible idea, but the organization convinced him to supervise some novice psychotherapists. Yalom was surprised by what he learned.

“They [the psychotherapists] weren’t doing what I would have done, but it was working,” he said. “Clients felt very connected.”

But when the company expanded to telephone and video counseling, clients weren’t as enthusiastic.

“There is a whole new generation that wants to talk that way [by text],” Yalom says. “They’re not comfortable on the phone or on video.”

Innovations such as these have the power to help many people, Yalom noted. Still, he reminded his supervisees — and the audience at his keynote — not to lose sight of the therapeutic alliance, even when using new technologies.

“You can still ask [the client], ‘How are things going between us?’”

 

 

Dr. Irvin Yalom (left) shared insights from his storied career and answered questions from the audience at ACA’s annual conference & Expo March 17. At right is moderator Adele Cehrs, CEO of Epic PR Group and a former journalist. (Photo by Paul Sakuma Photography)

 

Dr. Irvin Yalom signs books and meets attendees after his keynote address at ACA’s annual Conference & Expo March 17. (Photo by Paul Sakuma Photography)

 

For more photos from the conference and Yalom’s keynote, see bit.ly/1MOAysM

 

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

 

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

The healing language of appropriate touch

By Gregory K. Moffatt March 7, 2017

I learned a lesson about the power of touch totally by accident. I didn’t learn this lesson in graduate school, from a book or journal article, or from any professional training. Instead, it happened in the front yard with my son.

He was 8 years old at the time and already displaying the burgeoning need for the independence of adolescence. We were wrestling in the grass, and I intended to tease him by holding him like a baby, thus challenging his independence. I expected him to immediately resist my grasp, but when I looked into his face and talked to him like a baby, he became surprisingly still. He stared straight into my eyes as one might expect an infant to do. I talked to him about when he was little and how I used to snuggle him in our rocking chair in the middle of the night.

“I can stop if you want,” I told him.

“No, that’s OK,” he answered calmly. Almost mesmerized, he stayed in my arms until I was too tired to hold him any longer.

This incident fascinated me so much that, in the tradition of theorists such as Jean Piaget, I used my child as a miniresearch subject, adding this type of snuggling to my son’s bedtime ritual. Several times over the next couple of weeks, just before sleep, I would snuggle him close, caress his hair or rub his back and talk to him about when he was a baby and what it was like bringing him home from the hospital. Each time I got the same response I had witnessed in the yard. It appeared that my son gained peace by letting me touch him tenderly as he lay in bed at the end of the day. If I didn’t snuggle him, he requested it.

After awhile, I decided to see if there was a use for this type of energy in therapy.

Why we touch

If you take a moment to observe people in the public square, you will be astonished at how often they touch — couples holding hands, a friendly back slap between friends, a couple sitting side by side on a park bench leaning into one another, a friend who touches another’s upper arm while listening intently.

Why do we do this? After all, most of the ways we touch are unnecessary for conveying the basic message. We could easily restrict ourselves only to words. Touch augments our conversations, adding garnish and accent to what we want to communicate, but it is also something much deeper.

Without touch, relationships are less than satisfying. Ask any married military couple when one partner is deployed, people who have loved ones in prison or couples whose relationships are dying. The absence of touch leaves us yearning and empty, even if we still hear statements such as “I love you.”

Conversely, watch the reunions of military families, loved ones outside of prison on the day of release or the power of gentle touches between couples who are trying to repair their broken marriages. These touches communicate that “You are safe” and “You are not alone.” These messages are at the very core of healthy human attachments.

There is great precision in touch, and social rules for touch are highly refined. We can touch only certain people in certain ways. At times touch must be invited, but there are other instances when it is expected; to ask for it would be uncomfortable. In my college classroom, it may be acceptable for me to briefly put my hand on a student’s shoulder as I lean over the desk and provide assistance on a test question, but I can’t leave it there very long. And if I move my hand in any direction at all from that shoulder, the touch immediately becomes awkward at the very least, but more likely unwelcome and inappropriate.

Appropriate touch depends on who is touching whom, the genders and ages of each person involved and the relationship between these individuals. Who we touch, what body part touches what body part, how long and with how much pressure — these are the unwritten rules of touch that, under normal conditions, we develop over time in our home cultures. Similar to the way that we manage personal space, we manage touch using unwritten rules that most of us know, yet we would have a very hard time articulating them.

The importance of touch  

We don’t have to look far to discover the importance of touch from the research. Studies going back to the 1800s demonstrated that babies who were not cuddled beyond their basic needs were more likely to die of fetal failure to thrive. They just didn’t grow.

Attachment theory is built on the importance of touch and has demonstrated that extensive face-to-face and skin-to-skin contact between caregiver and child is important for the bonding process. This is the foundation on which all relationships are built throughout life. Infant massage and the soothing effects of therapy animals are just two more recent areas of touch that are well-documented.

Interestingly, many mammals rely heavily on touch to communicate many things. For example, when an elephant mother delivers a calf, every adult female in the herd touches it. They bump up against it with their legs or trunk or in some other way make contact. This communicates acceptance into the herd. If they do not do this, the mother and calf are shunned. For the first several months of the calf’s life, it stays within touching range of its mother. Dogs, cats, lions, otters and chimps all touch with great frequency.

Early in the past century, John B. Watson advised parents to touch their children “as little as possible.” He couldn’t have been more wrong. Humans are social creatures. We have an innate need to interact with others, and touch is essential to our existence. The difference between good touch and bad touch is timing, place of touch, context and purpose. Touch that communicates giving is healthy. Hugging a crying child who has hurt his or her knee is a giving touch. Physical and sexual abuse are selfish, taking touches.

I saw the important role of touch in assessing relationships in the days when I did marriage therapy. Couples in my practice often didn’t touch at all. They sat on opposite ends of the couch or in different chairs. I could often spot the most troubled marriages by the way the couples touched or the way they completely avoided touching. Couples who were deeply committed to salvaging their marriages would touch one another gently, with compassion and healthy emotion, even in the midst of their hurts, resentments and anger. I remained on the lookout for things such as a pat on the arm, an empathetic hug or a natural snuggle against each other on the sofa.

John Gottman has noted that in healthy marriages, touching is one of the vital signs of positive interaction. According to Gottman, people in very troubled marriages may touch, but they grip, cling or touch with force or desperation. At home they withhold touch or touch too hard (abusively), both of which are deeply damaging.

The physiology of touch 

Touch affects us in the right side of our brains. We don’t think it through logically. In both positive and negative ways, we respond to touch instinctively.

In infancy, even before the cerebral hemispheres are fully developed enough to manage language, the brain stem, through the vagus nerve, connects the brain, the heart and the visceral organs of the abdomen. Interesting research known as polyvagal theory proposes that it is this 10th cranial nerve that gives us our “gut feeling” in some situations.

Touch stimulates this nerve, which is wired to the amygdala, the central switchboard of our emotions. When touch is “good,” it can stop the release of the hormones that cause stress. Good touch promotes the development of attachment. Bad touch does the opposite. In either direction, these routes are classically conditioned and become our default emotional responses; they can be changed only with counterconditioning. Consequently, right-brained emotional regulation may be part of the source of many dysfunctions. These dysfunctions serve as facsimiles for the things we really want.

Children touch freely and naturally. It isn’t until they are socially conditioned to do otherwise that they change. Unfortunately, that is when children join the ranks of even relatively healthy adults who desire to be touched but don’t know the most effective way to ask for it. In short, we don’t know how to say, “Hold me.”

Could it be that simple?

The ethics of touch in therapy

We don’t have to look far to find a reason to avoid touch in therapy. Some people don’t like to be touched; touch can be self-serving for the therapist; touch can be misinterpreted and blur boundaries; touch is especially risky with some client populations such as sexually abused children.

But I believe there is a place for touch in therapy. About 10 years ago while I was attending an ethics seminar for child therapists, someone brought up the issue of touching one’s clients. “I never EVER touch any client,” one therapist adamantly averred. Nods and mumbling agreements from others followed.

After several similar comments, I couldn’t keep quiet any longer. I said, “If you choose never to touch your clients, you probably will be relatively safe from accusations of impropriety, but you may also cheat your clients of one of the most powerful tools you have at your disposal.”

I expected scowls and sneers from the 200 or so professionals in the room, but, strangely, my comment seemed to change the direction of the conversation. One after another, people noted how they had carefully used appropriate touch to bring healing and comfort to their clients. In the end, the general conclusion was that touch is a tool, like any therapeutic tool. To ignore it completely may be unnecessarily limiting to one’s practice. A proper touch in an appropriate way at the appropriate time can be comforting and healing.

The ACA Code of Ethics does not prohibit or, for that matter, even directly address touch. With the obvious exception of Standard A.5.a., which prohibits sexual or romantic relationships with clients, one must think through the various ethical implications of the ACA Code of Ethics regarding touch. Avoiding harm to the client (termed nonmaleficence and addressed in Standard A.4.a.) is probably as close as one can come to the issue at hand.

The question we must pose as counselors is whether touch would be helpful or harmful to the client in any given situation. A recent paper from the Association for Play Therapy proposes that touch should be used cautiously, but the key ethical issues are to avoid exploitation, to touch only in ways that are consistent with the therapeutic goals and needs of the client, and to take developmental considerations into account. The paper suggests that the likely interpretation of the touch by the child is also critical. This conceptual approach to touch is consistent with ethical codes from nearly all professional associations.

Therapeutic applications

I decided to work with children early in my career because, while I was an intern, I saw many people still carrying the pain of childhood abuse with them into their 50s and 60s. If bad touch can be so powerful that its effects can be felt for a lifetime, then maybe good touch can be so powerful that it can help heal these hurts.

At the time of the experiment with my son, I thought I was on to something new. Little did I know that this idea wasn’t novel. Donald Winnicott proposed this idea almost 70 years ago when he taught us that touch could be useful in psychotherapy. It is interesting that Winnicott’s research demonstrated that parents don’t actually have to be “great” parents. They simply have to be “just good enough,” to use his words, to meet the child’s needs. In other words, even marginal parents by social standards can be just good enough if they coo, snuggle and lovingly touch their children.

With a parent’s help, I’ve used touch as I did with my son with some of my clients. For example, one of my 5-year-old clients was exceedingly impulsive and hyperactive. I described what I wanted the mother to do and asked her if she would be interested in sitting in with her son during therapy and trying this behavior with him in session.

“He won’t let me hold him,” she said. “He is just too hyper.” But she agreed to try.

After asking his permission (I always respect a person’s right to not be touched — adult or child), we proceeded, and the results were fantastic. As I expected, his response was exactly like my son’s. He relaxed in his mother’s arms for almost 15 minutes without exhibiting a single hyperactive symptom. For this reason, I have given “touching homework” to parents for years. I am amazed at the number of issues that can be addressed with this simple behavior.

Another of my clients was a 15-year-old girl. She was defiant at home and at school, obstinate and bordered on incorrigible. The relationship between this teenager and her mother was tense to say the least. I suggested to the mother that her daughter really needed a physical connection with her. “Try just holding her and see what happens,” I suggested. Like the mother of the 5-year-old I just described, this mother told me that her daughter wouldn’t allow herself to be held, but she agreed to try.

The next week, the mother called to tell me about her experience. “My daughter came home from school and came in the kitchen. I asked her about her day and got the normal disinterested grunt from her. I said, ‘Come hug your mother.’ My daughter said she didn’t want to, but I said, ‘I’m not asking. Mother needs a hug.’”

She continued: “I stood there holding her for a minute or so, initially expecting her to pull away, but she didn’t. I felt her relax, and weakly she put her arms around me too. We stood there for 20 minutes. Neither of us said anything. You never told me how long to do it, so I just kept standing there!”

The mother finally told her daughter that she could go if she wanted, but — as my son did with me — the daughter declined and continued standing there soaking up the human-to-human contact. Her real need was for contact — especially from her mother — but she didn’t know how to ask for it. This teenager had substituted promiscuity, chemicals and other facsimiles because she didn’t know how to say “touch me” in a healthy way. After this interaction, her dysfunctional behaviors began to abate.

I believe that counselors can also garner great benefits by carefully using therapist-client touch. For instance, I have used hand massage with children who have been physically abused. Their body memory has taught them that touch is a painful thing. At first, some of them have trouble interpreting touch. Others, sadly, but consistent with the research, feel very little at all. This is their bodies’ subconscious defense against repeated painful touch.

My goal is to use hand massage as counterconditioning to retrain the body memory of these children to recognize good touch, pleasant connection with another human being and how touch can be a giving behavior rather than a taking behavior.

During these sessions, the child stands in front of me while a parent watches from a nearby chair. I gently massage the child’s hands with lotion as I talk about his or her value as a human being and what a great gift it is to feel another person in a nonthreatening way. The first time or two that I do this, these children often stare at me and remain motionless, having absolutely no idea how to process a touch that feels so pleasant. Over time, they begin to long for it and, as parents practice this technique at home, the children need me less and less.

Conclusion

The number of reported cases of abuse today is far beyond what it was 20 years ago, in part because people know what to look for. People who routinely work with children are trained to look for signs of abuse in children and also in behaviors that they observe between adults and children. Even laypeople have become acutely aware of various forms of abuse.

For the most part, this has been a very good change. However, it has been accompanied by an increased possibility of being sued for abuse or, even worse, charged with a crime and jailed because of abuse allegations. This has led many professionals who work with children (teachers, counselors, psychologists and others) to completely back away and, like some of my colleagues in the seminar, never to touch children in any way. This is a tragic shift. Children long to be touched — as do most of the rest of us.

A friend recently told me that he and his wife had gone to couples therapy. At the conclusion, the therapist asked if she could hug them both. It offended my friend greatly, and he told me he would never go back to counseling. I suspect this therapist either significantly misread cues or, more likely, was seeking to fulfill her own needs. As we all learn very early in our training, it isn’t about us.

But as is the case with any tool in therapy, appropriate touch can be a powerful tool for healing. Just as we have learned over the decades about the use of personal space, we can find differences in the meaning of touch based on who is touching whom, in what way, with what frequency and in what context. So, I propose that counselors consider using touch as one of the many tools in their therapeutic toolboxes.

By the way, my son is an adult now. Recently he came home for a visit. One of his boyhood friends was with him when he came through the backdoor. Even though his friend was watching, my son hugged me long and hard. It was a deep and meaningful hug and, just as when he was little, I was surprised that he held on so long. But I didn’t mind at all.

 

 

For some good reading in this area, I recommend Touch: The Science of Hand, Heart and Mind by David J. Linden, and Touch in Psychotherapy: Theory, Research and Practice, edited by Edward W. L. Smith, Pauline Rose Clance and Suzanne Imes.

 

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Gregory K. Moffatt is a licensed professional counselor, a certified professional counselor supervisor and a professor of counseling and human services at Point University in Georgia. He has been in private clinical practice for nearly 30 years. For the past 18 years, he has specialized with children ages 3-10, and he has worked with infants and babies, providing developmental analyses and consultation with parents and organizations that deal with children. Contact him at greg.moffatt@point.edu.

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Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having your 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.

Conversion therapy: Learning to love myself again

By Luke Romesberg February 27, 2017

When I was 14, I came out as gay to my parents. I was confident in my decision and felt ready for the world to meet the real me. Many argue that I was too young, but I had recognized and understood my feelings for a very long time. I just needed everyone else to catch up.

I was raised Catholic — not strict Catholic, but Catholic nonetheless. I attended church with my mother every Sunday, and also catechism class before or after Mass. My father always stayed home. He is Lutheran but quit practicing many years ago. Regarding politics, my parents were, and are, Republican. As with religion, my mother took an active role in this area. I grew up in a small town in Pennsylvania, made up mostly of middle-class Caucasians, and always had dreams of leaving for a large city.

Athletics were a large part of my childhood and adolescence. Ice hockey, football, baseball, soccer — if it was available, my father had me involved. As it turns out, I was not bad at athletics, but not fantastic either. My academics were much more important to me. This seemed to be a source of disappointment for my father, which I believe fractured our relationship at that time. Technology also fascinated me. I spent much of my time playing video games and surfing the internet. The internet would become one of my only outlets during some of the most painful times in my life.

 

Coming out

Despite aspects of my upbringing that many would regard as combative to the LGBTQ community, my hopes for coming out remained positive. I devised a plan. Being a millennial, my instinct was to scour the internet for thoughtful ways to reveal my identity to my parents.

After much research, I decided a letter and CD would suffice. I wrote a long, detailed composition explaining many aspects of my identity that I had kept hidden. I expressed my feelings that I was a Democrat, was done playing sports in high school and identified as part of the LGBT community. By the time my parents were reading it, I would already be at a friend’s home, where I planned to stay for a few days (also noted in my letter).

Feelings of pride and happiness surrounded me. At the same time, anxiety consumed me. I was nervous yet ready. I assumed that revealing my identity would be the most awkward aspect of coming out. Little did I know then that those feelings of awkwardness would only increase for many years.

My perfect coming-out plan crashed and burned one fateful night. During a shopping trip, I purchased a baby pink, size-small T-shirt. I loved that shirt. I would likely still be wearing that shirt if my mother had not thrown it away — and if I could still fit into a size small — but that is another story for another day.

The shirt was flamboyant. That was my goal. I felt comfortable in my identity and was ready not just to come out, but to burst out. I had been stifled in a world of sports and overt masculinity for years. This pink shirt gave me hope. It would be the catapult to my coming out.

The shirt forced people to make assumptions about me, and I welcomed them. What I had not considered, however, were the assumptions my parents were making. The sight of me wearing this vibrant shirt triggered something in them. They became more inquisitive and increasingly watchful. They asked questions: What are you doing? Where are you going? Why do you spend so much time on the computer? Who are you talking to? Who are you texting? So. Many. Questions.

Something changed. We all knew something was different, but nobody vocalized it.

Everything came to a head one night when my father walked into my bedroom holding my pink shirt. With some colorful and hurtful language, he told me the shirt made me “look” gay. His anger seemed to grow with every passing statement.

My anger also grew. I walked to my bookshelf, snatched the letter hidden within a book, and threw it at him. My parents would never receive the CD.

I watched as my father’s anger turned to sadness. He read the letter, and tears formed in his eyes. To this day, I have seen him cry only twice — at his father’s funeral and on this night.

This is when my mother entered the room. “What’s going on?” she asked, concerned. My father handed her the letter. She cried. She screamed. She shouted, “Oh, my God!” Repeatedly. She paced around the house. My father was practically frozen.

I remember feeling upset, but nowhere near their level. What had just happened? Was this really that terrible? To my parents, it was.

My mother rushed to my grandparents’ home, only three houses away. She informed them of the situation. I wasn’t present, so I can only imagine the state of panic that immediately filled the home. My grandparents on my mother’s side held even more intense religious and political views. This was not looking good for me.

I went to sleep that night, tears in my eyes and nervous to attend school the next day. What I had thought would be an awkward, yet happy, moment with my parents turned out to be anything but.

 

Conversion therapy

I revealed my sexual orientation on a Tuesday. By Friday my parents had arranged a meeting with a therapist. They told me he was a religious counselor. This seemed frightening already. He was going to “fix” me. He would make everything “better.”

I didn’t understand exactly what this meant. I didn’t need fixing. I was fine with my identity. I thought maybe my parents needed fixing.

Given that my town was so small, meeting with a conversion therapist was going to be an ordeal in and of itself. My mother’s sister, who had been informed of the situation, located a counselor. They told me he was “the best.” His office was in Philadelphia, nearly six hours’ distance from my hometown. My parents demanded that I miss school on Friday. Despite my protests, we would make the trip to Philadelphia together to meet him.

My memories of this initial session are blurry, although I remember being hounded with questions. Was I ever sexually assaulted? No. Had I ever experimented with same-sex partners? No. Was I happy with my body? No. I was 14 years old and going through puberty. Of course I wasn’t happy with my body.

The questions continued. Did I want to be straight? “Yes,” I answered, even though my brain was saying, “No. Hell no.” I wondered, “Who is this man? What do these questions have to do with my sexual orientation? What is he going to do to me? How is this stranger going to help me change something that I do not want to change?”

Over the course of the next year, I would be a participant of conversion therapy. My sessions were weekly phone conversations that cost my parents a small fortune. The sessions began as an hour in length and then decreased to 30 minutes. As I “improved,” my sessions decreased further to an hour every two weeks and, eventually, to 30 minutes every two weeks. The sessions would occur until I was healed of all of my sexual orientation issues. I was going to emerge a heterosexual young man.

My body was a frequent topic in our sessions. My therapist seemed obsessed with it. I was ordered to take off my shirt and look in the mirror. He would then say, “Please describe what you see. Tell me what parts of your body make you insecure.”

I told him that my stomach was a source of insecurity. He encouraged me to describe it. Allow me to repeat: I was a teenager. My body was changing daily. Many teenagers are insecure about their bodies. The last thing they want to do is discuss the details of these changes with a strange man on the phone.

Nevertheless, my therapist told me that my insecurities were likely negatively impacting my feelings of masculinity. My low levels of masculinity were a reason that same-sex attractions were occurring.

“Same-sex attractions.” He always said that. It was a way to pathologize my feelings. This term was used to separate me from my identity. I was not to refer to myself as “gay.” I was not gay. I was suffering from same-sex attractions.

This is where he first began to break me down. He created some cracks, which would only grow in time.

During the course of therapy, my life at home was changing rapidly. I was now being watched. I was forced to defend all of my actions. I was no longer allowed to watch certain TV shows. If anything surrounding the LGBTQ community was mentioned, I was never allowed to watch that show again. My parents began searching my phone records and forced me to call every number they did not recognize while they listened. They found and called a suspicious number only once but, thankfully, he immediately hung up and blocked my number.

My text messages were read. All of my contacts were questioned. My instant messaging account was reviewed. My computer was moved to the living room. When I used it, my mother would attempt to catch me doing something wrong. She caught me talking to a guy once, but I cut the computer’s power before she could read the conversation. My parents seemed to blame technology for making me gay. My mother once accused me of looking at a stranger the wrong way and swore that I secretly knew him.

I also had to clarify to my mother that I was not a pedophile and had no interest in children. I was no longer allowed to hang out with girls. My former best friend became less than an acquaintance. My parents condemned me for going shopping. I was allowed to wear only certain clothes.

Everything about my life that had once been comforting was stripped away. I was being forced back into the closet. My love for myself was disappearing.

As therapy continued, the therapist informed me that the combination of a “sports dad” and an “overbearing mother” were additional reasons that I was suffering from same-sex attractions. On a related note, he told me that my volatile relationship with my father and my noninterest in sports also contributed to my same-sex attractions. My father and I were instructed to spend more time with each other. Father and son bonding time would surely change my sexual orientation.

My father and I awkwardly began attempting to hang out. We would go out to eat, go to the mall, go see a movie. You know, a stereotypical girls’ night out.

My therapist even suggested that we try more “masculine activities,” such as visiting the batting cages (something I still despise) or throwing a football. One night, my father and I went to see King Kong together as a supposedly masculine activity. At the end of the movie, I left in tears, crying at King Kong’s tragic death. I doubt that is what either my father or the therapist had in mind.

Despite some setbacks, I was making “progress.” I informed my therapist that I was going through a gray area regarding my sexual orientation. This was all nonsense of course. I was still just as gay as ever; I was just telling him otherwise.

I told the therapist my gray area consisted of a lack of sexual attraction to either sex. He informed me this was normal and represented the lessening of my same-sex attractions.

Little did he know that most of my responses could now be credited to Google. That is the power of technology and the internet. I had researched and became an expert on conversion therapy. I now told him everything he wanted to hear. As a result, I was able to trick him into believing that I was changing.

Therapy continued. I was making strides, leaps and bounds even. I was moving quickly. I was turning into a proud heterosexual. In reality, nothing about my sexual orientation was actually changing. But my previous feelings of comfort and confidence were gone. I felt trapped. My parents and therapist analyzed everything I did. Being the authentic me was no longer an option. I was a stranger in my own body. My insecurities grew. My feelings of self-doubt and depression increased. I was forced back into the closet. The love I had for my identity vanished.

Therapy ended roughly a year after it began. I was “cured.” I finally felt a taste of freedom.

However, despite no longer having to deal with my therapist, my parents now believed I was “fixed.” I feel as though they were in denial, just as I was pretending to be straight. We were all lying to one another, and we secretly knew it.

Everything was not fine. I was still gay. My parents knew it. I knew it too, but we were now back to square one. The next four years proved to be draining. Coming out once was difficult enough, but now I had to find the courage to come out again.

 

Life after conversion therapy

When I was 17, my parents seemed either in complete denial about my sexual orientation or had silently accepted that I was likely going to remain my gay self. Either way, we had not engaged in an actual conversation regarding my sexuality.

Eventually, I began working for a major political campaign in the Democratic primary race in 2008. Here I would meet many like-minded individuals and fellow members of the LGBTQ community. I even met a guy with whom I would have a short-term relationship while he stayed in town for the primary. After many years of feeling trapped and questioned for my every move, I had finally found what I considered a safe zone, an oasis.

My parents weren’t supportive of the Democratic Party and didn’t approve of my volunteerism, but at least they couldn’t accuse me of things when they knew where I was. I began heading to the campaign office almost every day. The office officials quickly promoted me from volunteer to intern, which ultimately helped in my college searches and even landed me a scholarship. This was an extremely positive experience for me. I enjoyed my time spent there and met amazing people who provided me with feelings of inspiration, confidence, courage and, above all else, hope. The love I once had for myself began growing again.

Armed with my newfound positivity and support system, I was ready to once and for all set the record “straight” on my same-sex attractions. I arrived home from a particularly good night at the campaign office. My father was watching television but eventually began making his way to bed.

I stopped him as he headed up the stairs. I told him that “it” was out. I no longer cared. There was nothing they could do to upset me or tell me who I was. I was probably smirking when I told him.

My father’s face twisted. He didn’t say much but did mention being nervous and embarrassed about what everyone else would think. I didn’t care what anybody else thought. I had just come out — again.

This time it was different. I was older. I was more mature. There would be no argument. I loved myself again.

Over the course of the next few months, I began coming out to others, including my close friend. In midsummer, I put my “status” on Facebook. I received messages from concerned classmates and family members: “Your Facebook has been hacked!” I told them, no, it was true. I was gay. I was no longer afraid to reveal it.

I received unwavering support. People sent me positive messages. I entered my senior year of high school with the support of so many. My love for myself blossomed. I was back to my old self. My parents began adjusting too.

I would go on to college in Pittsburgh to study journalism. However, I would quickly change my major to psychology. My time in conversion therapy provided only one positive quality: It lit a flame in my heart and created a burning passion for caring and providing for the LGBTQ community.

I knew I wanted to make a difference. I wanted to be on the other side of this battle. I wanted to do the complete opposite of what my therapist had done for me.

Over time, my parents grew and changed as well. They found love too. Now they accept and support me in all of my decisions. It is truly amazing how things can change.

 

Today

In 2013, I moved to Chicago, where I would eventually receive my master’s degree in counseling and become a licensed professional therapist. Immediately after, at the age of 24, I entered a doctoral program in counseling education and supervision. This leads me to where I am today — and to the ultimate point of this story.

It is essential that the effects of conversion therapy are made widely known. I believe this subject is still in need of increased awareness. Many do not understand how harmful conversion therapy is, and others are entirely unfamiliar with it. Even though my experience with this “therapy type” was not nearly as severe as what others have gone through, it still caused issues that I had to battle.

I was ultimately able to make it through the difficult times these events caused, but many others in my situation do not. As reported by an American Psychological Association task force, people who have gone through conversion therapy face 8.9 times the rates of suicidal ideation, 5.9 times higher rates of depression and are three times as likely as their peers to engage in the use illegal substances and risky sexual behaviors. These statistics simply cannot be ignored. The issues listed are all too familiar for me, even with my somewhat minimal exposure to conversion therapy. It took years of personal reflection and growth, finding forgiveness toward my family, and learning to love myself again to overcome the damages caused by this so-called “therapy.”

As counselors, it is imperative that we do not impose our own value system on our clients. We must always work to ensure that we do not commit any acts of maleficence. Conversion therapy is, without doubt, an act of maleficence. If we find ourselves disagreeing with someone’s sexual orientation, it may be time to take a step back and evaluate our own principles, morals and why we chose to enter this field.

It is our job to know and understand the facts behind conversion therapy. It is not our job to tell people how to live or to attempt to change a client. Rather, we must always work with our clients to support them in their true identities.

 

 

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Luke Romesberg is a doctoral student in the counselor education and supervision program at the Chicago School of Professional Psychology. He is a licensed professional therapist and certified alcohol and other drug abuse counselor. His areas of specialization are LGBTQ issues, addictive behaviors and behavior issues in youth. Contact him at lwr4409@ego.thechicagoschool.edu or on Twitter @LukeRomesberg.

 

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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.