Tag Archives: Students Audience

Students Audience

From Combat to Counseling: Getting started in counseling military clients

By Duane France January 29, 2020

We want to help people. It’s a common reason many choose to become professional counselors. Maybe we’ve been told we’re good listeners. Maybe we have lived experience with overcoming mental health concerns. Whatever led us to counseling, we want to use our skills to help people. At some point, we may decide we want to help people in the military population: service members, veterans and their families. Perhaps we want to help military kids because we have a couple of our own, or we were one. Or, we want to support military spouses in post-military life because they’re an underserved and under-resourced population.

Having a clinical focus on serving the military population is admirable. More importantly, it’s necessary. With critical mental health access shortages in the Department of Veterans Affairs (VA) and Department of Defense (DOD), and studies that show that community providers are not as culturally competent with the military population as VA and DOD clinicians, it’s essential to increase the military population’s access to timely and competent mental health services.

Counselors often ask me: How do I do it? I may want to serve veterans and their families, but how do I get there from here?

Here are some critical points to consider if you’re interested in working with the military-affiliated population.

 

Know why you’re doing it

Understanding your motivation for serving veterans is critical. More importantly, it’s an ethical responsibility for counselors. In order to give the highest quality of service to those we work with, as well as to be true to ourselves, we need to understand what it is that got us into this work and why we want to do it.

What are your personal and professional motivations to serve this population? Like me, are you a veteran yourself, or (also like me) a child of a veteran? Are you a military spouse who has the lived experience of your partner’s service? Or do you have no prior direct affiliation with the military, but happened to work with the population during your clinical training? Regardless of your background, it’s essential to understand why you chose this particular population to serve.

Photo by U.S. Army Master Sgt. Alejandro Licea/defense.gov

Understand your limitations

Along with why you’re doing it, it’s important to understand your limitations. This could mean that you may have some familiarity with one aspect of military culture but recognizing that you’re not an expert in all military culture. Or that you may come up against some things in your clinical work that you’re not prepared for, and you didn’t know would bother you. I remember several years ago when working with a veteran, a session in which they were recounting significant racial discrimination while they were in the military. This discrimination was the source of their depression rather than PTSD as most people (including the client) assumed. As I was listening to the veteran recount their story, I found myself getting angrier and angrier, to the point where I started to lose concentration and therapeutic objectivity. The former senior noncommissioned officer in me was offended at the experience.

What I didn’t realize was that this was a psychological reaction on my part to two different things: the blatant disregard for the military values that I hold dear shown by the veteran’s leadership, as well as my own unresolved emotional response to racial discrimination in my childhood. A classic example of countertransference. Counselors like me, who identify as military-affiliated, must assess for and address potential countertransference. Just because a counselor is a veteran doesn’t make them the best counselor for veterans, and we need to be aware of the limitations of our own personal experience.

Where do you start?

So understanding why we want to serve veterans is essential, and it’s also important to understand the limitations that we may face, but what about the practical aspects of serving this population? As in, specifically, how do you help? I often hear how difficult it is for professional counselors to serve in the VA (although the department is currently putting a lot of effort into creating more licensed professional mental health counselor positions). And if you’re not in the VA or DOD, but want to help veterans, where do you go? How do you find internships, post-graduate placement or positions for a fully licensed counselor?

There are several suggestions that I often give to those counselors who reach out to me, asking about how they find positions in the community that serve veterans. First, do some research in your area. Are there mental health clinics that primarily serve the military population? Organizations like the Cohen Veterans Network may be a useful resource for internships or to get your pre-licensure hours, or clinics like the one I work for, the Family Care Center, in Colorado Springs. Even if they are not currently taking interns, they may have some advice for you.

Another potential source for positions is to see if there are other veteran services in your community that would be willing to add a clinical component to them. For example, the Veterans Village of San Diego, a nationally recognized leader in serving homeless veterans since 1981, has 27 mental health interns as part of their staff. Organizations that provide employment, housing, legal and financial resources to veterans may be willing to include a mental health component to their services.

And finally, there is a national program that may be of some benefit. Give An Hour is a national network of volunteer clinicians who serve the military population. I often recommend it as a resource for those veterans and family members looking for support outside of my local area. It is also a way to connect with other like-minded professionals serving the military population. If you’re looking to serve veterans in your area, it’s a good idea to reach out to those who are already doing so and network with them. You can find a list of clinicians in your area who are working with the military by searching for providers in your zip code, and reaching out and connecting with them on LinkedIn or through email. It’s likely that you will find one or two who would be willing to sit down and talk and give some professional advice on what serving the military looks like in your location.

Serving those who served

Dedicating your professional career to serving those who served and those who care for them is admirable and not to be taken lightly. Like many other underserved populations, it is necessary to understand the unique culture of the military and how it impacts our clients. Through diligence in our preparation, we can make sure to provide the best care possible for those who sacrificed much on our behalf.

 

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Duane France, LPC

Duane France is a retired U.S. Army noncommissioned officer and combat veteran who practices as a licensed professional counselor in Colorado Springs, Colorado. He is the director of veteran service for the Family Care Center, a private outpatient mental health clinic specializing in service members, veterans and their families. He is also the executive director of the Colorado Veterans Health and Wellness Agency, a 501(c)3 nonprofit that is professionally affiliated with the Family Care Center. In addition to his clinical work, he writes and speaks about veteran mental health on his blog and podcast at veteranmentalhealth.com. Contact him at duane@veteranmentalhealth.com.

 

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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.

Reconciling disability studies with mental health counseling

By Emily Cutler January 21, 2020

Growing up Jewish and queer in a conservative part of Birmingham, Alabama, I faced some pretty severe bullying as a child and teenager. It was a common occurrence for me to be called anti-Semitic slurs and mocked for looking and acting different. I was excluded by almost all of my classmates and had very little social support.

As a result, I struggled a great deal with my mental health. I felt depressed and anxious almost every day, and there were times when I felt sheer panic and terror about the prospect of attending school. Because I never seemed to fit in, I was convinced that I was fundamentally unlikeable and that the only positive quality I possessed was my near-perfect academic track record. So, on top of the anxiety and depression I felt as a result of being bullied, I also put enormous pressure on myself to score perfect grades. Any score less than 100 would send me into a spiral of shame and self-hate.

I cried a lot, and this worried many of the adults around me. I was sent to a number of therapists throughout my childhood. Most of them focused on figuring out ways to get me to stop crying so much. I was prescribed medication, exercise and an array of breathing techniques. Some of the therapists worked on encouraging me to act more “normal” — perhaps if I didn’t talk about my academic interests so much, or if I stopped trying to be the teacher’s pet, or if I were just less sensitive, then more of my classmates would like me.

Although some of the advice was useful, there were many times I walked out of therapy continuing to feel like something was wrong with me — that it was my fault that I was being bullied because I was just too weird and different to understand how to act like everyone else. More than anything else, I was frustrated with myself for not being able to stop crying or feeling depressed.

 

An empowering approach

My experiences with and perspective on therapy changed drastically when I went away to college. After struggling considerably with the transition to a new city and new environment, I reluctantly sought counseling from my university’s mental health center. I can still remember my first session. After answering some questions about my childhood during the intake, I said, “I know I must seem really messed up. Everyone hated me in high school, and now I just started college and I still don’t fit in. There’s something wrong with me. I know it. I just can’t fit in anywhere.” I could feel myself starting to tear up, so I immediately apologized for crying. “And on top of that, I am so overly emotional! I must be your worst client.”

My new counselor raised his eyebrows and looked up from his notes. “I was actually about to say that the way you’re reacting seems normal to me. It sounds like you had a pretty difficult time in school, and that was hard for you — it would be for anyone. And the transition from high school to college is hard too, which is also normal. I don’t know if I’ve met anyone who didn’t struggle to make friends in the first few months of college. I think it shows that you have a lot of resilience to get through all of that and to reach out for help.”

I was shocked. Here was a counselor who was not saying that anything was wrong with me or that I needed to change myself to fit in better. In his opinion, I was having a natural reaction to the circumstances I had been through. I’d never heard anything like it before.

Over the next several months, I went from viewing myself as an unlikeable weirdo to a person who is different (and perhaps weird in a good way!) but still deserving of acceptance and belonging. I started to see my uniqueness as a strength. Instead of encouraging me to change myself to fit in, my counselor empowered me to seek out on-campus groups and spaces where I would be accepted. As a result, I joined my campus Hillel as well as Active Minds, a student mental health organization. My counselor also encouraged me to stand up for myself in instances of bullying. Above all, he never pathologized my emotions or told me it was wrong to feel sad or depressed. I finally felt that I was being given the space to process and react to some of my experiences as a child.

 

Finding my path

Later on, I began to get involved with initiatives and organizations that focus on combatting prejudice and social injustice. I interned at the Anti-Defamation League of Philadelphia during my senior year of college, and I completed an honors thesis on weight-based bullying (bullying due to a child’s weight or size). Eventually, through my coursework and through my involvement in different advocacy communities, I found my way to disability studies, a discipline that centers the voices of people with disabilities and explores philosophical, cultural and sociological perspectives on the experience of disability.

Generally, the field of disability studies challenges the idea that disability is solely or primarily an individual defect in need of medical treatment. Instead, it posits that disability is the result of a multitude of factors, including societal exclusion and inaccessibility. The perspectives encompassed by disability studies greatly resonated with me as someone who cares deeply about challenging social injustices and exclusion rather than primarily changing individuals. Over the past several years, I have become intricately involved with disability studies research and advocacy.

One of my most pivotal moments has been coming to view myself and accept my identity as a person with a psychiatric disability. Embracing that identity has allowed me not only to accept myself and reduce my shame around having experienced mental health struggles, but also to become connected to a community of people with similar experiences and perspectives. I started working with the National Empowerment Center, an organization led by and for mental health consumers. With the center, I develop advocacy initiatives, educational programming and workshops that center the voices of people with lived experiences of mental health challenges and advocate for increased self-determination and acceptance of people with psychiatric disabilities.

The most meaningful and fulfilling part of my work has been spending time with people who have psychiatric disabilities, sitting with them through difficult times and empowering them to advocate for their rights and self-determination. My work has often included responding to people in crisis and providing space for them to experience strong emotions and extreme states.

 

A ‘fit’ for counseling?

My passion for that kind of intensely interpersonal, relational work sparked my interest in becoming a mental health counselor. As I began to explore the possibility of pursuing a graduate degree in counseling, I became increasingly certain that it was the right choice for me. There is little I care about more than supporting people with psychiatric disabilities to gain agency over their lives and experience community, connection and meaning. However, I also wondered how my disability studies background and perspective would fit with my role as a counselor. Whereas the disability studies field seeks increased acceptance and accommodation of disability in society, the counseling field often seeks to treat or prevent psychiatric disability. Would it be possible for me to reconcile both of these goals and perspectives?

I am only in my third semester of graduate school, so I do not yet fully know how I will integrate my disability studies background with my role as a mental health counselor. However, I believe it will be quite possible to do so.

In my own experience with counseling at my university’s mental health center, I felt that my counselor focused much more on encouraging me to accept myself and to find spaces where I would be accepted than on changing me or “fixing” me. I hope to take this same general approach with my clients. I believe that person-centered therapy and other humanistic approaches to counseling provide an excellent framework to accomplish this. These approaches require therapists to work with clients from a position of unconditional positive regard and to support clients in discovering their strengths rather than operating from a deficit-based model.

I also believe it is important to learn from counseling approaches developed by and for other marginalized communities. For example, while homosexuality used to be pathologized as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, many counselors now practice LGBTQ-affirming therapy. This approach supports LGBTQ clients in accepting themselves and decreasing any feelings of shame they may have related to their identities. Similarly, feminist therapy focuses on empowering women and people from other marginalized groups to advocate for themselves and to challenge injustice in their daily lives. Similar approaches could be applied to counseling clients with disabilities, including those with psychiatric disabilities.

I do not mean to suggest that psychiatric disabilities should never be treated or prevented. Many people with psychiatric disabilities want treatment such as cognitive behavior therapy, dialectal behavior therapy, and medication. Neither should exercise and breathing techniques be discounted because they are very useful for many people. However, there is no reason why the social and systemic factors affecting a person should not also be explored. In fact, professional counselors have an ethical and moral obligation to encourage people with disabilities to advocate for themselves. If clients are facing prejudice or discrimination on account of their psychiatric or other disability (or other difference), it may be helpful to explore ways of addressing that with them. Counselors can also encourage clients to request disability accommodations and link them to organizations such as peer-run wellness centers and peer support groups through which they might find acceptance and social support.

The 20/20: A Vision for the Future of Counseling initiative, sponsored by the American Counseling Association and the American Association of State Counseling Boards, reached a consensus definition of counseling as “a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.” I believe that the disability studies field complements and enhances this goal rather than taking away from it. As a future counselor with a disability, I look forward to empowering my clients to accomplish their goals and to stand up to any injustice that stands in their way.

 

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Emily Cutler is a graduate student in clinical mental health counseling at Troy University in Tampa, Florida. In addition to pursuing her studies, she provides training and consultancy on the topics of disability rights, trauma-informed care, suicide prevention, peer-run mental health services, and the Health at Every Size paradigm. Contact her through her website at emilyscutler.com.

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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.

Human rights 101, Part 2: Implications for graduate students and counselor education programs

By Clark D. Ausloos and Taylor Nelson December 2, 2019

Part one of our two-part series provided a foundation of the importance of human rights, the relevance to professional counseling, and practical strategies to use when working with clients who have experienced human rights violations. Part two focuses on human rights, social justice and advocacy related to counseling graduate students and counselor education programs.

Many people enter the counseling profession because they have a desire to help people. They have a knack for listening and possess a genuine curiosity for the human condition. Many students have a passion for mending, repairing and supporting others towards self-actualization. In many introductory graduate classes, students explore the foundations of the counseling profession, learning about psychotherapy pioneers such as Sigmund Freud, Carl Jung, Alfred Adler, Frank Parsons, and Carl Rogers, and learn necessary basic skills in order to best help clients.

However, graduate students are not often given clear direction on how to execute one essential ethical mandate dictated in the ACA Code of Ethics: to “advocate at individual, group, institutional, and societal levels to address barriers and obstacles that inhibit access and/or the growth and development of clients” (A.7.a). Advocacy can seem confusing and challenging to graduate students – some might even think: I didn’t become a counselor to engage in advocacy. Many graduate students are unclear as to the multifaceted roles that counselors have, including the component of advocacy as it relates to human rights issues. This lack of clarity is not unfounded  –  professional counselors often lack consensus on how best to advocate for and on behalf of their clients’ human rights.

Multiculturalism, social justice and human rights

Counseling is a young profession and has seen many developments throughout the years. Starting in the late 1980s, professional counselors saw a need for attention to diversity in clinical and educational settings. Increasingly, counselors were diagnosing and treating individuals who differed culturally from themselves. Therefore, the needs of the profession shifted, however slowly, to meet the needs of consumers. At that time, scholarship focused on racial and ethnic identities in counseling, and mainly examined the relationship between a professional counselor’s ethnocultural identity and that of the client. In the 1990s, Garry Walz and colleagues identified significant trends that should inform future counseling, including developing skills in counseling older adults, counseling family systems, a commitment to multiculturalism, and most salient to this article, the development of advocacy skills.

In 1992, ACA’s first Multicultural Counseling Competencies (MCC) were developed for professional counseling. Becoming competent in multicultural counseling would require counselors to not only understand and honor the diverse customs of different cultures but to recognize the additional barriers many client groups faced. Meeting the needs of disadvantaged clients would require not just knowledge, but action. In 1998, the American Counseling Association (ACA) formed a new division — Counselors for Social Justice (CSJ)— to implement social action strategies aimed at the empowerment of clients and oppressed individuals and groups. With the increasing awareness that social justice concerns must take a prominent role in the profession, the need for individual counselors to gain competency became clear. Because social justice and multicultural issues are inherently linked, the competencies were incorporated into an adapted version of the MCC in 2015, creating the Multicultural and Social Justice Counseling Competencies (MSJCC). At the same time awareness of the importance of advocacy—both for the profession itself and for counselors’ work with clients—was growing and became a focus for ACA leaders. A task force was created to develop advocacy competencies. The ACA Advocacy Competencies were completed in 2003 to provide guidance for counselor advocacy at the micro (e.g., clients, students), meso (e.g., communities, organizations), and macro (e.g. to reflect the profession’s growing understanding of the use of advocacy with clients and their communities and were updated in 2018.

Still, with all of this information, graduate students may be left wondering, “what exactly does this mean for me?”

As mentioned in part one of our series, human rights are civil, political and/or cultural rights that are afforded to humans regardless of our intersecting identities. When these rights of our clients are violated, there are tremendous mental health repercussions. Counselors-in-training need to understand the complexities of human rights issues, when and how these rights are violated, and the ways they can engage in advocacy around these issues.

There is a clear connection between social justice, advocacy and human rights. At times, social justice can be combined with advocacy, creating social justice advocacy, which can be described as organized efforts aimed at influencing sociopolitical outcomes, often with or on behalf of vulnerable, marginalized populations. Whether direct system intervention or collaborative advocacy with clients or client groups, counselors-in-training and practicing counselors need to be able to conceptualize and execute advocacy and social justice strategies to mitigate health disparities caused by human rights violations.

The impact of human rights on graduate students

Beginning counseling students are asked to reflect upon their own worldviews and to begin to form a framework from which they will work with clients – a theoretical orientation. It is likely that human rights issues have, in some way, affected students’ lives prior to entering graduate school.

Tracy, for example, is a graduate student who has encountered societal barriers due to their non-binary gender identity (non-binary denotes a gender identity that is not defined in terms of the traditional binary of male or female). Tracy has faced discrimination in schools, was forced to use a bathroom that was not congruent with their identity and has encountered challenges with changing their gender marker on legal documents. This pattern of harassment and obstruction has not only impeded Tracy’s pursuit of their right to a quality education—it has threatened their personal safety. As a counselor in training, Tracy’s worldview and the way they approach counseling will be directly affected by these violations of their human rights.

In contrast, Anthony is a counseling graduate student with numerous identities. As a White, heterosexual, cisgender male, Anthony has experienced very few human rights violations. Yet human rights issues have already had an effect on Anthony’s worldview and theoretical orientation. Because Anthony has not experienced discrimination due to gender identity or sexual orientation, has not experienced poverty, harsh criminal sentencing and does not face obstacles related to legal documents or using public restrooms, his understanding of the relationship between human rights and counseling will be markedly different than Tracy’s.

These two examples demonstrate that when students begin their counselor training, their views on human rights issues have already been shaped by their experiences. A student who has not experienced violations has potentially started to develop a worldview that may not include an understanding of human rights issues. In contrast, a student who has experienced violations not only has an understanding of human rights issues but has been shaped by the difficulties they faced. These divergent experiences will affect the students’ training and may have a significant influence on their work as professional counselors. Thus, it is essential to intentionally address these issues in graduate school.

Learning the effectiveness of clinical interventions in counseling sessions is an established and vital part of graduate students’ training. However, it is equally imperative that counselors-in-training learn how effective—and necessary—it is to work with clients in varying groups and levels, such as families, groups, and at the community or other systemic level. Using a social justice and advocacy approach allows counselors to empower marginalized clients while also working to change the existing external environments for the clients.

For example, as a counselor-in-training, Anthony may work with a 14-year old bisexual, transgender person of color who has experienced time in the criminal justice system. To provide effective counseling, Anthony not only needs to know information about the current justice system, youth under the law, gender, sexuality and racial and ethnic identities and how this impacts his clients health, but also ways to systemically advocate with and on behalf of this client, as an essential part of ethical treatment and attention to social justice.

Anthony can get this critical information by using resources such as Human Rights Watch, an international organization which investigates and reports on human rights-related violations around the world lists several current human rights concerns on their website: Harsh criminal sentencing, racial disparities, drug policy and policing, children in the criminal justice systems, hate crimes, rights of non-citizens, sexual orientation and gender identity, women’ and girls’ rights, and national security, among others.

Human rights and counselor education programs

In many counselor education programs, human rights issues are often introduced in multicultural and diversity courses, as well as in courses that teach about ethical and legal issues within counseling. However, this is not enough. Additional training is needed but is unlikely to be available to students because most education programs do not offer elective courses in human rights issues. It is often the responsibility of course instructors to take the lead by incorporating human rights issues throughout coursework.

Sufficiently educating students on human rights issues will require curricula and systemic change and will also require counselor educators to self-reflect and understand how human rights issues shaped their own worldview, which will, in turn, affect their work with students. If instructors model silence surrounding these issues, students may graduate from counselor education programs lacking the human rights knowledge that is critical to their work as professional counselors. Counselor educators need to teach students that any reflection on the factors that have shaped their worldview is incomplete without examining human rights issues. The extent of the effect of human rights issues on individuals is evident by examining the significant difference in the lived experiences of Anthony and Tracy.

Although scholarly research plays a part in any graduate program, the expectations for master’s level counseling students are different than those in doctoral programs. Some master’s programs may not assign regular research projects to students. In contrast, doctoral students undertake rigorous research into clinical counseling practices and improvement in counselor education and training. Because human rights issues play an important role in these topics, students are likely to encounter clear examples of violations. For example, research examining the counseling experiences of single mothers of color in poverty might explore systemic barriers and oppression these people face, which are direct violations of human rights.

By not giving students significant exposure to research, counselor education programs are missing an opportunity for counselor trainees to be exposed to human rights issues. The old adage “meet clients where they are at” provides a helpful framework for understanding the need to integrate human rights issues into counseling programs. As part of their training, counseling students provide services to a client base that includes members of society who regularly experience human rights violations. Without an understanding of the myriad forms human rights violations can take (see part one of this series for examples) and an awareness of which populations regularly experience issues—and the physical and mental health damage caused—counselors-in-training will be ill-equipped to meet the needs of their clients.

When counselor education programs minimize or outright ignore human rights concepts in students’ training, they could potentially be causing potential harm to future clients. Nonmaleficence — avoiding actions that cause harm — is one of the fundamental ethical principles of counseling set out in the ACA Code of Ethics preamble. Intentionally infusing social justice advocacy and human rights components into the array of coursework will benefit graduate students’ self-efficacy, their clients, and, ultimately, society at large.

 

In the following section, we provide several strategies for graduate students, counselor educators, and counselor education programs to attend to human rights issues and incorporate advocacy and social justice strategies into the classroom:

For graduate students:

  • Mitigate imposter syndrome related to advocacy by managing self-talk, reflecting on accomplishments, normalizing with other graduate students, and practicing self-grace and compassion.
  • Call, text, email, or write to local, state and national legislative representatives on issues that directly impact human rights issues.
  • Engage in continuous self-assessment related to your own advocacy and social justice competency, by using advocacy competency self-assessment tools and surveys.
  • Conduct research that relates to human rights issues and propose/present it at local, regional, and national counseling conferences.
  • Develop and update a list of local, regional, state, and national resources for clients who experience human rights violations.

For counselor education programs and educators:

  • Foster intentional discussions about current human rights issues throughout all areas of counselor training, in addition to diversity, lifespan, and legal/ethical courses.
  • Integrate human rights issues into case studies and clinical examples so graduate students can experience “real world” examples of clients in training programs, prior to practicum and internship experiences.
  • Co-construct specific advocacy and social justice plans as part of coursework that allows graduate students an opportunity to actively participate in these strategies outside of their practicum or internship counseling sessions.
  • Structure clinical experiences that allow students to work with diverse clients and settings. One way to do this might be to work with the program’s clinical coordinator to ensure practicum and internship sites are varied and, if possible, host a variety of clients with a variety of presenting issues.
  • Teach human rights violation assessment as part of a comprehensive biopsychosocial diagnostic evaluation.
  • Allow guest speakers who have experienced human rights violations in the classroom. The personal stories of people who have lived through human rights violations provide a more vivid and compelling understanding than a lecture containing abstract examples. Mentor and model students in research that relates to human rights issues and empower them to propose/present it at local, regional and national counseling conferences.

 

Counselor education programs can also expand outside awareness of human rights issues in a variety of ways:

  • Create statements (with university permission) of support or resolutions that can increase the visibility of and address barriers to human rights issues.
  • Host “days of awareness,” with various human rights topics addressed on different days through flyers, posters or with guest speakers via workshops or panels.
  • Partner with other departments, when possible, in order to cast a wider net of influence and awareness of human rights issues.

 

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Clark D. Ausloos is a doctoral candidate at the University of Toledo. He is a licensed school counselor and currently practices as a licensed professional counselor in a private practice setting in Northwest Ohio. Contact him at clark.ausloos@utoledo.edu.

Ausloos was a member of the American Counseling Association’s Human Rights Committee, as were the authors of the first article in this series.

Taylor M. Nelson is a second-year doctoral student at the University of Toledo. She is a licensed professional counselor in Ohio, working in an inpatient psychiatric hospital setting. Contact her at Taylor.Nelson2@rockets.utoledo.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.

From the President: Sustaining the lifeblood of our profession

Heather Trepal

Heather Trepal, the 68th president of the American Counseling Association

December is here, a time of year (along with the months of May and August) when many colleges and universities hold commencement. The prospect of completing a hard-earned master’s or doctoral degree in counseling is both awesome and daunting. Rightly, graduates are proud of the time and personal and financial investments they have put into earning their degrees. We know that counselors spend roughly four years on their undergraduate degrees and then an average of three years on their master’s degrees.

Even after this robust educational preparation, counselors who wish to become licensed spend another two to three years working under supervision. In addition, counselors sometimes work to obtain certifications in their specialty areas or to become eligible for employment in various settings. We are a well-prepared group of professionals!

We are also in high demand, with severe shortages of behavioral health providers in some states (see “Maldistribution: Mental health care in America,” an online exclusive at CT Online). Although we all know that our profession is robust and that we need to continue to educate our growing behavioral health workforce, there is an important gap. To illustrate my point, I want to share an email that I received:

“I’ve noticed something happening with people graduating from the counseling program, not only at my school but all over the state. I’ve noticed many people graduate and are unable to pursue licensure because they can’t afford supervision or they need a full-time job so they can have medical insurance. I’ve noticed people using the school’s insurance and then panicking when they graduate because they can’t go without insurance and they can’t get a full-time position as a counselor intern until they secure a supervisor and get their license, which can take weeks/months. I would love to do advocacy work for this issue, but I don’t know where to begin. I was wondering if you could point me in the right direction? I don’t know if I need to speak to legislators or the school or the board or the ACA.”

Unfortunately, emails like this one are not uncommon. We have many graduate students and new professionals who are concerned about the prospect of launching their careers. In addition to the practical barriers related to employment, finances and medical insurance, there are the complexities of pursuing licensure or certification, including obtaining supervision.

As a counselor educator and supervisor, I am keenly aware of this pressing issue. In fact, this year, Thelma Duffey is chairing a task force to examine ways ACA can support new professionals and early career counselors. The creation of this task force was partly inspired by a project in Thelma’s career class on advocacy for graduate students and new professionals. The task force is collecting data on such issues as new professional compensation across settings (both geographically and among professions); expanding opportunities for counselors in nontraditional settings; and highlighting transferable skills to corporations, health care organizations, industry, and higher education. Recognizing the great needs of counselors before they are licensed to practice independently, I have asked the task force to also explore the post-graduation licensure internship and supervision experiences of our counselors and recommend advocacy directions. I have also asked our Professional Standards Committee to examine the licensure, certification and practice trends for this group of professional counselors.

I am inspired by the advocacy work of one of our ACA members, Summer Allen, who founded the Texas LPC Intern Association. In Texas, pre-independently licensed counselors, or those who have graduated from a master’s program and are working on supervised licensure hours, are called “interns.” The mission of this organization is to “support the professional development of current and future LPC Interns through free resources, support, community, and advocacy.” In fact, one of its first advocacy efforts was aimed at petitioning the state and licensure board to change the title from LPC intern to LPC associate. Please visit txlpcinterns.com to learn more about the organization’s efforts.

It is often said that graduate students are the lifeblood of our profession. The joy of working with them and supporting them on their journey is one of the main reasons that I became a counselor educator. I implore our ACA branches, divisions, regions, and sister organizations to pay attention to this group of professional counselors. If you know of other organizations and grassroots efforts aimed at supporting new professionals and early career counselors, please reach out and let me know.

 

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Follow Heather on Twitter @HeatherTrepal

Voice of Experience: Looking for honesty in the supervisory relationship

By Gregory K. Moffatt October 24, 2019

Sitting in a workshop for supervisors at the American Counseling Association’s annual conference in 2018, I listened to the presenter discuss cases of ethical violations by licensed counselors around the country. All of us in the room were stunned at some of the flagrant violations that had occurred. Among the examples presented were counselors sleeping with their clients, marrying past clients, and seeing clients regularly in social settings. Some of these counselors were disciplined by their state licensing boards, while others voluntarily surrendered their licenses and left the profession.

It’s a good thing that none of them lived in Georgia, the state where I practice, or they could have gone to jail. In Georgia, it is a felony to sleep with your client or to terminate with a client for the explicit purpose of engaging in a sexual relationship.

The 25 or so supervisors in the room were surprised at the risks these counselors had taken. The obvious question was: “How did it get that far?” We were stunned that any professional would throw all of their education and training away so casually, not to mention the damage they might have done to their clients.

Around the same time, I was managing a situation in which one of my supervisees had committed an unintentional ethical violation right before being fully licensed. This counselor, whom I’ll call Pat, had made a mistake and realized the error within a few days. Without hesitating, Pat called me to ask how to correct it.

We worked through the scenario and came up with a plan. Then came the question I had anticipated from Pat: “What does this mean in regard to you signing my paperwork next month for licensing?”

The harsh answer was that I would not be able to sign off on the paperwork at the time. This particular ethical violation served as clear evidence that Pat wasn’t ready yet for a license, or else the lapse wouldn’t have occurred. Such a scenario is exactly why we undergo supervision as counselors. Supervision isn’t a formality.

My decision wasn’t the end of the line for Pat though. Pat accepted the consequences of the breach and the remediation that I required. As a result, just a few months later, I was happy to sign off. Pat is now fully licensed and in a successful private practice, and I haven’t an iota of concern that Pat will make such a blunder again.

Sitting in that ACA workshop, I realized how fortunate I was that Pat had trusted me enough to risk a delayed license by telling me what had happened. I realized that I must have done something right as a supervisor, although it wasn’t deliberate in regard to Pat’s particular issue.

After that incident, I started speaking more overtly with all of my interns and supervisees about what they would do should they commit an ethical violation that might delay them getting their license. I told them I was wondering whether I had created an appropriate environment (as I must have done with Pat) so that they would be willing to tell me about any violations. This opened up a discussion that continued for several weeks.

My story here isn’t meant only for supervisors. If you are currently a graduate student or counselor in supervision, I hope that you have a trusting relationship with your supervisor. If you don’t — if you couldn’t go to her or him and say, “I messed up,” even when knowing that your licensing process may slow down — you need to either adjust that relationship or find another supervisor.

If you are a supervisor, you must make this an overt part of your discussions with supervisees. Since that 2018 ACA Conference, I have had conversations about this issue on a regular basis with all of my new supervisees and interns, and I believe it has strengthened their trust in me. My situation with Pat was one of only a very few serious ethical issues I have had to manage as a supervisor. Even so, we must be prepared for them, and we must prepare our future counselors for them.

Perhaps most importantly, if you are licensed, you must have a confidant or mentor in the field whom you trust enough to confide in when you make mistakes. This person can guide you through sticky ethical situations and must also be willing to tell you when you have messed up. This brings the risk of being reported to a licensing board, but taking that risk is crucial to our professionalism as counselors. The greater risk in an ethical breach is to the client. What it costs us is secondary.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.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.