Tag Archives: International Members Audience

International Members Audience

Lessons from Lilongwe

By Leah K. Clarke July 27, 2016

The author in front of a statue of Hastings Kamuzu Banda, the first president of Malawi.

The author in front of a statue of Hastings Kamuzu Banda, the first president of Malawi.

During my first internship as a master’s student, I provided in-home family counseling and quickly became overwhelmed by the needs I thought I saw in my clients’ lives. Most of my clients had low incomes, and some lived in subsidized housing. With excellent supervision, I did my best to provide counseling, but as a new counselor, I was desperate to see that what I was doing was actually making a difference. My clients’ lives continued to be difficult on many fronts.

Perhaps to make myself feel useful and wanting to help others on a practical level, I began volunteering with a refugee resettlement agency — providing transportation, teaching English and helping with paperwork. I lived in two worlds — one where I tried to impact what was going on externally and one where I tried to impact what was going on internally. At the end of my counselor training, a part of me was not convinced that counseling was an effective way to help people with significant day-to-day needs. Was it a counselor’s job to attend to every level of Maslow’s hierarchy? I questioned what impact, if any, I had made on my counseling clients’ lives.

I went on to write my doctoral dissertation on the experiences of the refugees I had gotten to know. They had joys and very real struggles. Meanwhile, questions still lingered for me: Was counseling what they needed? Was I really helping?

It took a trip across the Atlantic to realize that my cynicism regarding the role of counselors had softened. In 2014, I spent three weeks in Lilongwe, Malawi, in southeastern Africa. Malawi calls
itself “the warm heart of Africa,” and indeed it did provide a warm welcome and a tropical respite from a cold U.S. winter. Malawi is the same size as Pennsylvania, where I now live and work as a counselor educator. But Malawi has 4 million more people than my home state, and it is one of the poorest countries in the world economically.

I traveled to the African nation as part of the Malawi Counseling Institute, organized by Old Dominion University and NBCC International (NBCC-I), a division of the National Board for Certified Counselors. Institute participants from the United States partnered with the Guidance, Counselling and Youth Development Centre for Africa in Lilongwe, Malawi’s capital city. The center is run by counselors and educators from all over Africa and serves as a hub for training counselors and professionalizing counseling.

On our first day at the center, the staff greeted the U.S. participants with jubilant hugs and kisses and lingering handshakes. They wanted to know how we had slept, how our travels were, what we needed. On our second day, we again were greeted with jubilant hugs and kisses and lingering handshakes. The center staff already knew all 11 of us by name. The same warm welcome was repeated each day until we boarded our plane home three weeks later. We spent our time in Malawi putting on a conference for local counselors, collaborating with the center staff on professional advocacy projects and providing consultation and encouragement for counselors/teachers and students in primary and secondary schools.

The young people who attended the schools we visited were not referred to as students but as learners. I like this naming tradition because the role of “learner” captures something that “student” does not. To study something is to know more about it, but to learn something is to make it part of yourself. Learning changes how you operate in the world.

When I reflect on my time in Malawi, I see myself as a learner. Being there changed how I saw counseling. It became clearer to me what a counselor’s role could be when the needs are numerous. In Lilongwe, these moments of clarity came to me as lessons (plus I like titles with alliteration: Lessons from Lilongwe).

Lesson No. 1: The relationship is the task

Toward the end of our time in Malawi, the U.S. participants arrived at the counseling center eager to have a productive day of collaboration with our hosts. Our time was ending, and certain tasks felt unfinished. We were there to share our expertise, and I wanted to feel useful and productive.

But a change of plans was announced; we were going to spend the day sightseeing and getting to know our African colleagues better. Complaining about our thwarted agenda, we loaded into the vans.

It turned out to be a wonderful day of simply being together and learning about Malawi’s history and culture. Our hosts knew better than we did that it would be a productive day because strengthening our relationships was the task. Instead of checking things off of my self-affirming to-do list, I found myself truly having to “be” with my hosts and fellow participants.

Task versus relationship orientation has been used as a leadership theory paradigm, but I think it also applies to counseling. When we lean too heavily on a task orientation in counseling, we end up with clients who feel pressured or defensive and counselors who feel frustrated and ineffective. When counseling is only about the relationship, clients and counselors can feel lost and unsure. Techniques such as motivational interviewing help us focus on goals in a relationship-friendly way so that we can attend to both task and relationship.

But there are times when you prioritize one over the other. This lesson was brought home to me recently when we learned that the person who organized that day in Lilongwe — the director of the center — had died. He was a remarkable person who stopped corruption at the center and literally got it out of the weeds. How thankful I am that we accomplished “nothing” with him that day.

Lesson No. 2: Hospitality matters

The cultural value placed on relationships in Malawi means that a significant amount of time and energy is invested in formal hospitality for visitors. This is in stark contrast to American casualness.

Our African hosts dressed formally in our presence, and tea was served every afternoon. Meetings began with elaborate introductions and expressions of gratitude that revolved around hierarchies that were somewhat vague to us. This level of pomp and circumstance sometimes felt embarrassing or superfluous. Then I realized how much Americans eschew ritual and traditions for the sake of efficiency and personal comfort. Formal hospitality sends a message: You are valued and you are important.

Once when I was conducting a family session as a 20-something counselor, a client directed a remark at me to the effect of “why should I listen to this teenager in a hoodie?” The sweater I was wearing did indeed have a hood. Although I am (and was) aware that this client’s reaction was about more than my attire, I now think he was right. I wasn’t dressed in a way that conveyed how important my work was or how important the client was.

There is much we can do as counselors to make our clients or students feel important and valued. How welcoming are the spaces we invite them into? How welcoming are the words we use when we see them? Admittedly, it takes thought, effort and resources to decorate a waiting room or to dress more formally. It doesn’t take much, however, to say, “I’m so glad you are here today.” I see no downside to causing ourselves a little bit of discomfort for the sake of valuing others.

Lesson No. 3: Dependence is dehumanizing

One of the highlights of our trip was a private meeting for our group with Joyce Banda, who was then the president of Malawi. Of course, to say that we met her might be an overstatement; she talked and we listened. Still, I was moved and sobered by what she shared.

Banda was Malawi’s vice president when her predecessor died in office, leaving her in charge of a government that was being accused of corruption. Her opponents claimed she was part of the corruption, whereas she claimed she had helped to eliminate it. The corruption scandal, called Cashgate, triggered an audit that brought international donors, including the U.S. government, to Banda’s door to demand house cleaning and, in some cases, to stop funding. Roughly 40 percent of Malawi’s budget is dependent on foreign aid. One thing Banda said about this reckoning was that she hoped one day she could meet with foreign leaders and “just have tea in the garden.”

What I took away from this encounter was the dehumanization that occurs when a relationship is based solely on dependency. When roles are constrained to “giver” and “taker,” no one feels satisfied. The “giver” feels frustrated if the gifts are not used as intended, whereas the “taker” feels oppressed and belittled.

There are more eloquent speakers on the problems of foreign aid, but I see this dynamic playing out on the micro level. When counselors get into the mindset of “us” helping “them,” we have started on the path to dehumanization. Although there are times when clients and students legitimately need us in healthy ways, as counselors, we should be looking to put ourselves out of business. We work not just to heal wounds but also to equip. Yes, we pass along skills and ideas that are useful for the client’s or community’s goals, but we should also know when to get out of the way. We should be alert to when “helping” is actually making things worse or simply benefiting the helper emotionally or monetarily.

Lesson No. 4:  There is no hierarchy of needs

The idea of a hierarchy of needs, proposed by Abraham Maslow in a paper in 1943, was among the first things I was taught as an undergraduate psychology major. I think it has stuck in my memory because the idea is alluringly intuitive.

Maslow believed that people’s behaviors would drive them to satisfy one need before focusing on the next. In the pyramid-shaped illustration of the concept, physical and survival needs make up the base of the hierarchy, and then at the small top is self-actualization.

Although many scholars agree that the needs themselves exist in people, there is almost no empirical support for the hierarchy. Yet it is referenced frequently. Recently, at a gathering of counselors, someone mentioned working with clients with limited resources and followed it up by saying something like, “It’s Maslow’s hierarchy — you can’t do counseling with someone who doesn’t know where they will sleep tonight or get their next meal.”

So, what is a counselor to do in a country full of people experiencing daily threats to their survival — high rates of HIV and maternal mortality, floods and food shortages? In that context, is counseling irrelevant? Is it only for those who are privileged enough to move toward self-actualization? Or should counselors work only to feed the hungry while ignoring their emotional needs?

Counseling was born out of meeting both practical and emotional needs. The first counselors did vocational development for soldiers returning from World War II. There is still a strong force within the counseling profession that reminds us not to ignore the daily realities of those we are serving. We are called to pay attention to those realities and get involved in them. I certainly advocate for advocacy, but I also know it is tempting to substitute it for good counseling.

As counselors, I think we should be about what we are about. Counseling is what we are good at, and counseling is a tool useful to people with all different kinds of needs. Physical and practical needs are not necessarily unrelated to emotional needs. A mother is better able to provide food for her children if traumatic flashbacks are not stopping her from going to work. Parents can better support their child with a learning disability if they figure out how to value each other’s strengths. A fifth-grader can focus on taking an exam when he is not worried about being bullied.

I have come to fully value counseling and have made peace with its limits. It might feel good at times to try, but I cannot be all things to all people, nor can the profession of counseling. When it comes to other cultures, I want to be a learner who takes in how other groups of people care for and help one another. I hope this will allow me to be a really good counselor for those who cross my path as I pass along the tools I have learned.

I hope that in southern Africa or anywhere else, counselors who know the needs of their communities can draw on what counseling has to offer. And if you are ever in central Pennsylvania, I hope you will stop in for tea.




Leah K. Clarke, a licensed professional counselor and national certified counselor, is assistant director of the graduate counseling program at Messiah College in Grantham, Pennsylvania. Contact her at lclarke@messiah.edu.

Letters to the editor: ct@counseling.org

Professional trip to India opens eyes, fills hearts

By Bethany Bray June 20, 2016

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

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

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

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

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

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

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

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

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

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

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

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



In their own words

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


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

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

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

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

— Eliina Belenkiy, George Mason University


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

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

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

— Alexander Hilert, George Mason University

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

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

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

— Tosha Pearson, UMSL


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

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

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

— Meaghan Lakes, UMSL







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


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Counseling and Russian culture

By Anton Ivanov and Clifton Mitchell April 27, 2016

In Russia, counseling is often not considered a substantial profession. Unfortunately, the same is true for any country that used to be a part of the USSR. A very limited number of nonmedical-model counseling centers exist, particularly in rural parts of the country. The sad truth, however, is that most Branding-Images_Russiaof the Russian population doesn’t even know about such services.

Anton Ivanov (this article’s first author) grew up in Russia. After five years in the United States, and as a second-year student in a counseling program, he has become acutely aware of the substantial contrasts between the two countries when it comes to their perspective and practice of counseling. He has a desire to educate American counselors about his country and people.

Historical context: Residue of the Soviet regime

To grasp fully the mentality of the Russian people regarding counseling, one needs to look deep into the country’s history. In the Soviet era (1922–1991), counseling and psychological services were either not available or were rejected by the government and people. Thus, such services were extremely rare. Lacking counseling services, Russians with mental health problems or drug and alcohol addictions were historically treated by medical doctors through the use of medications.

Sigmund Freud’s works were translated into Russian during the Soviet era and were one of the few sources of learning about psychotherapy for Soviet therapists. However, his works were soon forbidden, as were many works of other Western practitioners. For those seeking a more thorough review of the history and current development of counseling in Russia, we suggest reading Christine L. Currie, Marina V. Kuzmina and Ruslan I. Nadyuk’s article, “The Counseling Profession in Russia: Historical Roots, Current Trends and Future Perspectives,” in the October 2012 Journal of Counseling & Development.

Historically, people diagnosed with severe mental health issues in Russia were often sent to medically oriented psychiatric hospitals where confidentiality rights were not generally considered. When records were disclosed, citizens were often stigmatized and disgraced, which limited their opportunities for employment and minimized their chances of living a life without scrutiny. In many Russian communities, simply mentioning that parents were seeking mental health services for their children or themselves could have negative consequences. When such information became public knowledge, families’ reputations were jeopardized, and they were often stigmatized as “dysfunctional.” Unfortunately, these attitudes remain prevalent today.

Further compounding the stigma, the government used psychiatry as a tool to suppress ideas that were different from the accepted ideology by labeling rebels as “mentally unstable.” Because the specter of mental health problems were used to dissuade dissent, terms such as psychology, psychiatry and psychotherapy came to arouse fear among the population.

To complicate matters further, the idea that social or environmental factors could cause certain mental health issues was strictly rejected; the only allowed stance was that all psychiatric disorders had a biological cause. As a result, people suffering from psychological issues often minimized their symptoms in an effort not to see a doctor. When Russian people are sick, they often quip that “the issue will disappear by itself” or “it is already too late to treat the issue; it is incurable.”

Throughout Russian history, its people have commonly sought counseling and psychological help from “healers” who are believed to possess “good” energy, holy powers, skills to fix people’s issues and the ability to foresee events. Healers often prescribe herbs that are believed to be helpful. Russians also practice balneotherapy, take mud baths and schedule spa visits to reduce their stress levels and treat physiological issues. Most Russians rarely see a doctor about their mental health issues. Instead, many Russians prefer to talk about their problems with their friends in the kitchen while sharing a bottle of vodka.

Both historically and today, Russians respect and trust the army, the church and the national leader. In times of crisis, the Russian people have been inspired and united through the hope that they place in their leaders and the church. People still rely on the Russian Orthodox Church to “solve” their issues. People go to the church to have all their questions answered by priests and in hopes of magically ridding themselves of their mental health issues by either drinking holy water or attending public worship. Russians view priests as authority figures and trust them much more so than they do mental health therapists. Unfortunately, priests have little or no training in counseling and rely on their own knowledge to assist people who are dealing with mental health issues.

Counseling challenges and concerns

Russians’ mental health problems are similar to those found in other countries, but these problems are exacerbated by deeply ingrained political policies and social attitudes that are coupled with severe socioeconomic hardship. High rates of depression, anxiety, drug and alcohol use, eating disorders, divorce, suicide and unemployment are all present. Other lifestyle factors contribute to high rates of cancer and AIDS, leading to a decline in the average life expectancy. Racism, local and international wars, and religious discrimination further add to the stress. In a country where much of the population lives below the poverty level, it appears little might be done to thwart the high levels of depression and apathy. Recent economic sanctions have intensified these problems.

In Russian culture, many men view marriage as a loss of freedom, whereas women generally see marriage as a significant step toward a happy life. Women are often viewed as an inferior gender that prefers dependency and dreams only of having a family, whereas men conduct themselves assertively and prefer independence. Many male children are raised in Spartan conditions under which displays of emotion and the questioning of parents are rarely allowed. Unfortunately, acting in an aggressive manner is too often reinforced. These factors, in combination, have resulted in high rates of domestic violence and an overall hostile culture throughout Russia, making family counseling an urgent need.

Although sexuality is widely discussed among Russians, parents, teachers and priests are skeptical about sex education and hesitate to utilize it. Unplanned pregnancies have resulted in high abortion rates. In a 2001 article in the Canadian Medical Association Journal, Barbara Sibbald noted that Russian women had six abortions on average during their lifetimes. The prevalence of unplanned pregnancies has also resulted in overflowing orphanages that house abandoned children and those taken away from their parents because of drug and alcohol addiction. Understandably, a substantial need exists for access to birth control, sex education, family counseling services and drug and alcohol treatment.

Current status and foundational needs

Generally speaking, counseling in Russia is decades behind the United States in terms of acceptance, education and theoretical development. Yet, as Currie, Kuzmina and Nadyuk noted, counseling has been recognized as a branch of social work and is starting to gain a presence in Russia. Still, counselor education programs such as those commonly found in U.S. colleges are extremely rare in Russia. Counseling is still several steps away from becoming a viable profession in Russia, and various issues need to be addressed before it is viewed as a legitimate, functioning entity.

For instance, the requirements for training and certification vary across the country and are not established or consistently regulated by any governing body. Unfortunately, this has resulted in numerous charlatans and unqualified practitioners claiming to provide “counseling.” Currently, very few facilities consider offering practicums or internships to students. This leaves many beginning counselors poorly prepared for real-life practice. In addition, outstanding students with college degrees are offered no assurance of employment unless they have the aid of social and administrative connections. In addition, the low income of counselors does not attract many students to the field.

After an American Counseling Association delegation visited Russia in 2006, a Counseling Today article reported that Russian counselors were prone to learning one theory and using it exclusively. There appears to be a limited amount of training across theories. Thus, the idea of counselors adapting approaches to the client’s individual personality and problems is not commonly practiced. It is apparent that expanded training in a wider array of approaches is strongly needed.

In a country where corruption is too often the norm and where ethical codes are not viewed as essential, adherence to the strict ethical standards present in the United States is not emphasized. In her article, Sibbald noted that sexual relationships between medical practitioners and clients are common, and ethical standards regarding such relationships are not enforced. In particular because of Russians’ historical distrust of mental health services, it is essential that formal ethical guidelines be established, taught and monitored. Until the Russian public learns to trust that its counselors will protect confidentiality, mental health services will not gain a foothold in Russia.

Potential counseling needs of Russian immigrants 

Many Russian immigrants would benefit from the counseling services offered in the United States, but counselors who underestimate the significance of cultural differences could inhibit the process. In a chapter in the 2004 book Culturally Competent Practice With Immigrant and Refugee Children and Families, Tamar Green described some of the primary psychological challenges that Russians encounter when coming to the United States. These challenges include cultural shock, which involves transitioning from a socialistic to a capitalistic society and from a nonreligious or Russian Orthodox atmosphere to the American spiritual environment. In addition, immigrants must manage language barriers, unemployment, basic shopping knowledge, navigation of the medical system, loneliness and isolation.

Although children adapt to the American environment faster, they still experience issues such as feeling neglected by parents, getting help with schoolwork and not feeling protected in a new environment. When going through the adjustment process, these youth can be psychologically traumatized. Green noted that they are searching for their new selves in an environment in which they have distinctly different names and accents. In addition, they are struggling to find new friends, striving to match American clothing styles and trying to develop new hobbies and interests, all of which are quite different from what they knew back home in Russia. At the same time, Russian parents adapting to this new environment are equally overwhelmed and cannot attend to children as much as they might wish. Yet, by virtue of possessing strong and persistent survival skills, Russians have learned to preserve their culture and identity while managing change and settling in other countries.

Russians usually view doctors as authority figures and readily hand their problems over to them. Similarly, if Russian clients decide to try counseling, they may expect the counselor to take responsibility for their problems and are likely to follow the counselor’s advice without question. Because of these characteristics, person-centered approaches to counseling are not likely to be suitable for these clients.

In addition, because of the harsh nature of Russian culture, empathy is not readily understood by most Russians. Olga Bondarenko, an associate professor of psychology at Nizhni Novgorod State University in Russia, points out in an article that Russians frequently mistake empathy in therapy for sympathy or pity, which is less acceptable to them (see bit.ly/23eZEZj). For this reason, directive techniques are much more suitable.

It might also be noted that Russian culture tends to be very philosophical, and Russians like to approach problems from philosophical perspectives. Existential approaches in counseling might best accommodate this cultural feature.

Another feature of Russian culture is a reluctance to wait. Hence, pacing in counseling can become a challenge because Russians expect immediate results. In addition, many immigrants simply cannot afford long-term treatment because of financial constraints. Likewise, the mindset of many Russians is that money should be invested in something tangible, such as electronics, clothes, cars or houses. Investing in counseling will likely seem foreign and even useless to them because of their inability to grasp its benefits and see the results immediately. Counselors will need to explain to Russian immigrants that counseling in the United States is a slower, more deliberate process.

Russian culture is communistic and collectivistic, and because a large percentage of the population lives in extended households, family is likely to be an integral part of these clients’ lives. In Russian schools and institutions, children are called by their last names, thus further promoting the ideology
that family comes first. In stark contrast to American culture, the familial emphasis of Russian culture strongly limits the idea of individuality, if not eliminating it altogether. Counselors should remain cognizant of this when attempting to construct problem solutions for Russian clients.

To better understand these clients, practitioners should bear in mind that Russians may appear to be grumpy, closed, secretive, suspicious, quiet, anxious and rather shy because they have often lived in a state of uncertainty. Many elders were traumatized by the division of the Soviet Union, which resulted in a loss of country, land, currency, political leaders and, most important, identity. It is not uncommon to encounter Russian elders who still hope and dream of one day again living in a socialistic society similar to the former USSR.

Because of a lack of experience with and understanding about counseling, counseling interventions remain novel to most Russian immigrants. If they were court ordered to attend counseling, they would likely find the process strange and present as exceptionally skeptical about its helpfulness. In addition, historical cultural attitudes toward mental health services may be ingrained in these clients, which might make them seem resistant to the process. Counselors should be aware of and prepared to manage this aspect of counseling Russians.

Similar to other cultures, Russians like to criticize and complain about the opposing mindsets and attitudes they encounter in other Russians and the Russian government. Incongruously, counselors may discover that some Russian immigrants are not close to or do not speak positively of other Russian immigrants. If such sentiments arise in counseling sessions, however, counselors should be careful in aligning with these perspectives in an effort to join with the client. Ironically, Russian immigrants might feel offended and disrespected by an American counselor who aligns with a negative attitude toward Russians and their motherland.

Overwhelming contrasts

To comprehend the essence of Russian culture and meet Russians’ counseling needs, one must understand the country’s history and the unique features of its people. This article was written to provide a glimpse into this often misunderstood world.

Being in the United States for five years has given me (Anton) an increased understanding of the usefulness of counseling and its eventual benefits for Russians. Being in a counseling program has intensified my desire to see the counseling field grow in Russia and be used by Russian immigrants. I believe that some information described in this article may also be applicable when working with immigrants from the countries of the former USSR or other Russian-speaking immigrants.

Yet counselors in the United States need to understand that counseling is foreign to most Russians. It is not something that meets the needs of those who come from or exist in a society in which the primary focus is survival, not personal growth. It is our hope that counseling services will progress in Russia and that through an understanding of Russian culture, counselors in this country will be better prepared to educate and counsel Russians.




Anton Ivanov is from Orel, Russia, and is a second-year student in the clinical mental health counseling program at East Tennessee State University (ETSU). He hopes to seek residence in the United States, promote awareness of Russian culture among Americans and help Russian immigrants acclimate to American culture. Contact him at ivanova@goldmail.etsu.edu.

Clifton Mitchell is professor emeritus at ETSU and author of Effective Techniques for Dealing With Highly Resistant Clients. He travels the country giving seminars on the management of resistance in therapy and providing legal and ethical training in a game-show format. Contact him at cliftmitch@comcast.net, and visit his website at cliftonmitchell.com.


Letters to the editor: ct@counseling.org


AMHCA plans educational trip to Cuba

By Bethany Bray October 5, 2015

Nine professionals from the American Mental Health Counselors Association (AMHCA), a division of the American Counseling Association, will depart for an educational trip to Cuba later this month.

The group, a mix of counselor practitioners, doctoral students and one counselor educator, will spend six days on the island, meeting with medical and mental health practitioners.

“I’ve heard wonderful things about the Cuban people, and I want to engage and learn from them,” says AMHCA President A. Keith Mobley, who is leading the trip. “Cultural competence is an ever-Depositphotos_10094697_l-2015transitioning brass ring to achieve. The more I and others are able to engage with those who are culturally different [from] us, the more we are able to expand our own cultural identity. I’m looking forward to enhancing and continuing my own cultural competence.”

This marks the association’s second trip to Cuba in recent years. AMHCA also sent a delegation to Cuba in 2010.

The current group will depart for Havana Oct. 18 and return Oct. 23.

While there, the counselors will visit numerous medical and mental health centers to meet and speak with practitioners. The group’s schedule will also include a visit to a psychopedagogical center and an HIV prevention center, where they will meet with a mental health team that was dispatched to Haiti to help with relief work after that country’s devastating earthquake in 2010.

“Achieving cultural competence happens best when we are able to get out of our own comfort zone and encounter cultural dilemmas,” says Mobley, a licensed professional counselor supervisor (LPCS).

Mobley explains that cultural dilemmas serve to challenge an individual’s or group’s cultural assumptions by allowing people to compare and contrast a system, belief or value that is different from their own — in this case, the Cuban health care delivery model. In the process, Mobley says, perspectives are expanded; people become more inquisitive and are less likely to take things for granted.

“[We hope to] engage with our own cultural identity and understanding in order to make us, as practitioners, more culturally competent,” he says.

The trip is purely educational. The group was granted visas to visit strictly for professional research purposes, explains Mobley, a clinical professor in the University of North Carolina at Greensboro Department of Counseling and Educational Development.

The AMHCA group will be going to Cuba at a special time, Mobley says. Although relations have begun to thaw between the United States and Cuba — with the U.S. embassy, closed for 54 years, reopening in Havana this past summer — the island nation is not yet open to American tourists.

“It’s a unique opportunity in that the [Cuba-U.S.] relationship is evolving, but it’s not yet possible to hop on a flight and get there on your own [for Americans],” he says.

AMHCA has planned the trip through Academic Travel Abroad, a company that specializes in professional work/study trips. The company will be providing a local guide who will help with logistics and serve as a translator during the group’s time in Cuba, Mobley says.

Academic Travel Abroad also planned AMHCA’s 2010 trip to Cuba. That trip was such a success that AMHCA didn’t hesitate when the company approached it and proposed a second trip to the island, Mobley says.





Find out more about AMHCA’s trip to Cuba here.


Read AMHCA’s announcement about the trip here.





For more on Cuba, see “Forging counseling connections in Cuba,” Counseling Today‘s interview with Eddie Moody, a counselor who has been making professional trips to Cuba for more than a decade.




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


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



Forging counseling connections in Cuba

By Bethany Bray June 1, 2015

There has been a good measure of animosity mixed into the complicated relationship between the United States and Cuba over the past half-century.

Yet Eddie Moody, a counselor who has been making trips to Cuba for more than a decade, says one of the first things he saw on his first trip there in 2004 was a man walking down the street wearing a

Eddie Moody with a taxi driver and his classic car, one of the pre-1960's vehicles the island is known for.

Eddie Moody with a taxi driver and his classic car, one of the pre-1960’s vehicles the island is known for. (Click on photos to see full size.)

9/11 “We Remember” T-shirt.

The Cuban people are warm, inviting and “eternally optimistic,” says Moody, a licensed professional counselor supervisor (LPCS) and professor of counselor education at North Carolina Central University. “You can’t go to Cuba and not notice how jovial and happy people seem to be,” he says. “Part of it is taking difficulty in stride.”

Moody, an American Counseling Association member, travels to Cuba roughly once per year to teach, give talks on counseling topics and meet with mental health practitioners. Over the years, he has forged connections with the psychology department at the University of Havana and with Alexis Lorenzo Ruiz, president of the Cuban Society of Psychology.

Moody was one of a handful of Americans at the society’s most recent conference in 2013, where he gave a talk on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

What started for Moody as an intended single trip to teach basic counseling classes at a Cuban seminary has blossomed into a decade of return trips and friendships. Through the years, Moody has learned to navigate the complicated process of gaining permission to travel to the island that sits 90 miles south of Florida. He has had to seek travel licenses from both the Cuban and U.S. governments, he says. It’s a process that will hopefully get easier as relations between the two countries warm, Moody says.

Not surprisingly, in some ways mental health care in Cuba is very different from mental health care in the United States, says Moody. For starters, the terms “counselor” and “counseling” aren’t used or known in Cuba. All mental health counseling is known as psychology, says Moody.

However, many similarities exist between what Cubans refer to as “psychology” and counseling as it is practiced in the United States, according to Moody. For instance, Cuban psychologists rely more on therapy than testing or medication to treat clients. Moody says these professionals’ training and

Moody with Alexis Lorenzo Ruiz, president of the Cuban Society of Psychology.

Moody with Alexis Lorenzo Ruiz, president of the Cuban Society of Psychology.

work are more closely aligned with American counseling than with psychology.

“It’s like counseling because it’s very practical,” he says. “They’re more open to using counseling methods and interventions. … It ranges from psychoanalytic all the way up to cognitive behavioral therapy. To me, it looks more like a counseling setting.”

Most Cuban psychology practitioners hold master’s-level degrees, just like American counselor practitioners, Moody says. Students who attend university for psychology in Cuba get both a bachelor’s and master’s degree together in the span of roughly five years. After graduating, they complete a one- or two-year practicum internship to determine their specialty.

Moody uses the term “rigorous” to describe the psychology degree programs in Cuba. “Once they [psychology students] graduate, they are equipped to work in any specialty,” he says.


In the mainstream

There are also a few things that the United States could stand to emulate from the way that mental health care is embraced and practiced in Cuba, Moody says. For example, psychologists and therapy are part of mainstream culture in Cuba — much more so than is the case in the United States, says Moody.

All psychologists are employed through Cuba’s national health system; there are no individual therapy offices or private practices. Every hospital and clinic has psychologists on staff. Often, Cuban patients are seen by both a psychologist and a medical doctor in the same visit, Moody says.

For example, a patient might come in with a physical ailment, such as stomach pain. If the doctor thinks the pain might be connected to a mental health issue, such as stress or depression, he or she may have the person meet with an on-staff psychologist during the appointment.

This holistic approach to care is a good thing, says Moody, and something from which the United States could learn.

Cuba’s national health system also ensures that every school and large business has an on-staff psychologist for students and employees.

Because these practitioners are so visible, available and part of everyday life in Cuba, meeting with a psychologist there carries much less stigma than does seeing a similar mental health practitioner in the United States, Moody explains.

Psychologists are valued — even looked up to — in Cuba, he says. The profession is truly accessible and integrated into the community, he adds.

The profession has been made even more mainstream thanks to a very popular TV show that features Manuel Calviño Valdés-Fauley, president of the Latin American Union of Organizations of Psychology (ULAPSI). Cubans tune in weekly to hear Valdés-Fauley answer questions and talk about psychology’s application to everyday life, such as dealing with anger or workplace stress, Moody says.


Moody (top right) participates in a presentation on the DSM-5 to faculty and students in the School of Psychology at the University of Havana in May 2013.

Moody (top right) participates in a presentation on the DSM-5 for faculty and students in the School of Psychology at the University of Havana in May 2013.

A two-way street

Through his travels to Cuba, Moody says he has gained an entirely new perspective and appreciation for his chosen profession of counseling. Although he travels to Cuba to give talks and teach, he acknowledges that he has learned a significant amount from the Cubans in the process.

Moody (third from left), with faculty from the University of Havana School of Psychology: M.Sc. Reynaldo Rojas, the vice-dean of foreign relations and research; Professor Marta Martínez, an industrial organizational psychologist (who often serves as a translator for Moody); Dean M.Sc. Karelin López Sanchez, Dr. Eduardo Cairo, professor of neuropsychology and clinical psychology; M.Sc. Greter Saura, a vice-dean of distance education and professor of developmental psychology.

Moody (third from left), with faculty from the University of Havana School of Psychology (left to right): M.Sc. Reynaldo Rojas, the vice-dean of foreign relations and research; Professor Marta Martínez, an industrial organizational psychologist (who often serves as a translator for Moody); Dean M.Sc. Karelin López Sanchez, Dr. Eduardo Cairo, professor of neuropsychology and clinical psychology; M.Sc. Greter Saura, a vice-dean of distance education and professor of developmental psychology.

Most of all, he has learned from their example of taking hardship in stride and “doing a lot with a little,” he says. For example, Moody brought one copy of an English-language version of the DSM-5 to the University of Havana during his most recent visit. The entire psychology department will share it – and devour it, he says.

“[The students] are going to get everything they can out of it [the single copy of the DSM-5], much more so than a student in the U.S. who is carrying one around in their backpack,” Moody says. “We complain about a school counselor having 700 students. That’s their [Cuban psychologists’] world too, but they have even less resources. Their love for learning, hunger for study and research – they have a desire to learn that we just don’t have, to be frank.”

With each visit, Moody says he can plainly see that the Cubans with whom he works are making use of the knowledge he shares and find it important. That, along with the warmth of the Cuban people, keeps him coming back, he says. It has also made him more appreciative of the resources he has as a counselor educator in the United States, including “the little things,” such as conversations with colleagues.

“A book means so much more [in Cuba], a lecture means so much more. … That’s part of why I keep going back,” he says. “I may be there, and someone pulls out a handout I gave them 10 years ago. That gets me every time.”


Introduction to Cuba

Moody has also worked as a pastor in the Free Will Baptist church denomination in the United States. It was this connection that first brought him to Cuba.

A member of Moody’s church, a missionary who had worked in Cuba, piqued his interest and helped him to get the numerous governmental approvals needed to travel to Cuba.

Moody initially traveled to teach basic counseling classes at a Free Will Baptist seminary, the Cedars of Lebanon in Pinar del Rio, Cuba. The connections Moody made with people on that first trip, and every trip thereafter, have led to additional opportunities to teach, meet people and plan return trips.

“Once I got there, I really fell in love with the place,” he says. “Truly, you’re always working [while there].”

In addition to teaching, Moody meets with mental health practitioners and local people who approach him with questions. Any counseling he provides during the trips is more like consulting, not in-depth therapy, he explains. He administers psychological first aid and tries to connect people with local resources.

On average, there is a hurricane in Cuba every two years, so there is a significant amount of lingering trauma and an associated need for psychological first aid, Moody explains. He often gives talks and basic training on these topics at churches associated with the Cedars of Lebanon seminary.

Moody (second from right) with students at the Cedars of Lebanon Seminary in Pinar del Rio.

Moody (second from right) with students at the Cedars of Lebanon Seminary in Pinar del Rio.

Moody was introduced to Alexis Lorenzo Ruiz, a professor of clinical psychology at the University of Havana and president of the Cuban Society of Psychology, through another professor he met during one of his church visits.

With each subsequent trip, Moody has worked more and more with Ruiz, including speaking at the university and at the society’s conference, Hominis. He plans to return for the next Hominis conference in May 2016.

Moody does not speak Spanish, although he has picked up some words and cultural cues, such as body language, during his decade of travel to the island. But he mainly relies on translators, which he says is something that is second nature to Cubans. In addition, many Cubans are learning English in anticipation of increased relations with the United States.

Hominis conference sessions are translated into myriad languages. Moody compares it to a United Nations meeting, with attendees from all over the globe listening to translations via headphones.

Hominis 2013 featured presenters, panelists and participants from 23 different countries, including Italy, Argentina, Brazil, Chile, Ecuador, Colombia, Spain, France, Germany, Canada, Russia and Australia, says Moody. Kenneth J. Gergen, president of the Taos Institute in Chagrin Falls, Ohio, delivered a keynote address on the relationship between social constructionism and psychology.


Future opportunity

Moody hopes the number of opportunities for American counselors to travel to Cuba, and vice versa, will only grow and get easier as relations warm between the two countries. This spring, President Barack Obama removed the U.S. designation of Cuba as a state sponsor of terrorism.

“There is interest there. They [Cubans] want us [American counselors] to come and study,” Moody says. “They want to collaborate.”

For counselors who want to get involved and travel to Cuba, Moody suggests attending the Hominis conference as a first step. “It will be eye-opening,” he says, describing it as a natural forum to forge friendships and make connections.

Above all, Moody emphasizes that American counselors and mental health professionals should keep an open mind if they travel to Cuba and go with “an attitude of learning.”

“Don’t impose our way on them. Look at their situation, learn from it and listen. If you do that, they’ll open up, and it will be a two-way street,” Moody says. “Don’t think of them as poor folks in need of rescuing. They’ve got some pretty good stuff going on, and we can learn from it.”





The Cuban Society of Psychology’s next Hominis conference will be May 9-13, 2016, at the Havana International Conference Center.

For more information, visit hominiscuba.com





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


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