Tag Archives: Bullying

Five social, emotional and mental health supports that teens need to succeed

By Dakota King-White, Sade Vega and Nicholas Petty September 9, 2019

Many teenagers have been exposed to traumatic events, and most experience regular life stressors. Exposure to violence and other traumatic experiences can have a lifelong effect on learning and may negatively impact academic achievement. Among examples of traumatic events that some teenagers experience are community violence, school shootings, the loss of a loved one due to death, parental incarceration, divorcing parents, a parent or caregiver with mental illness, and substance abuse in the home. Within the school setting, the negative influence of trauma on teens may lead to poor concentration, declining academic performance, school absenteeism, and the decision to drop out. These challenges create barriers for the success of teens in the academic setting.

Schools across the United States have recognized the importance of providing school-based mental health support because these services benefit students academically, socially and emotionally. However, questions regarding the issues facing teens and the types of mental health supports needed to deal with these issues require further examination. Implementing a needs assessment can assist schools in uncovering the answer to these questions. The findings can then help determine what programming should be implemented to improve students’ overall development, such as teaching them social skills to help them become productive members of their communities and school settings.

We wanted to learn more about the social, emotional and mental health needs of teenagers, so we conducted a needs assessment in which we surveyed 198 high school students in a Midwestern city. The teens in our study identified the types of emotionally stressful experiences they have faced since attending high school. They also described what schools could do to make them feel supported and better able to deal with the related challenges.

The following sections present the five top issues identified by the students we surveyed, along with recommendations on ways that schools can support teenagers socially, emotionally and mentally.

 

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1) Social media makes peer pressure a 24/7 problem. Teens today are confronting certain pressures that teens in the past didn’t face. A prime example: Social media has become an indispensable part of teenagers’ lives. According to a 2018 report written for the Pew Research Center by Monica Anderson and Jingjing Jiang, YouTube, Instagram and Snapchat are the most popular online platforms among those ages 13-17, and most teens have access to these apps on their smartphones. Anderson and Jiang note in the report that 95% of teens have access to a smartphone, with 45% of teens acknowledging that they are online “almost constantly.”

This constant mobile connection creates the conditions for teenagers to consistently be exposed to peer pressure even outside of the school environment. Mina Park and colleagues in 2017, in a journal article in Cyberpsychology, Behavior, and Social Networking, noted that hyperconnectivity to social media can also lead to depression, negative body image and eating disorders.

What schools can do to help: Teens must be given an outlet to discuss their frustrations when it comes to dealing with peer pressure. Students should be directed to their school counselors or other trusted adults in the school with whom they can share their feelings and pressures and get supportive, confidential advice in return. It is also helpful to allow for genuine conversations in the classroom about the importance of students being confident in who they are and embracing their differences. Safe spaces in schools allow teens opportunities to feel supported in a neutral environment, to accept who they are, and to embrace differences among their peers.

 

2) Bullying is a significant issue. Peer pressure is not the only problem arising from constant social media access. The other, and even more troubling, issue is bullying. Teens may experience, witness or engage in bullying situations, including cyberbullying, which is more prevalent among teens.

The Bullying Statistics website (bullyingstatistics.org) notes that cyberbullying may consist of teens sending cruel messages, spreading gossip or posting threatening messages on social media platforms, pretending to be someone else on a social media account, or sexting. According to recent statistics from the website, more than 25% of teenagers have been exposed to cyberbullying situations that have had a negative impact on them. Bullying can have a significant effect on teens socially, emotionally and academically. Some of the negative impacts include depression, anxiety, attendance problems, and decrease in academic achievement. However, many teens who experience cyberbullying do not tell their parents or guardians about these painful experiences.

What schools can do to help: October is National Bullying Prevention Month, and many schools across the United States take time to develop effective strategies to raise awareness about bullying and to prevent bullying incidents on their campuses. It is important for schools to create an environment in which victims of bullying/cyberbullying, or teens who witness the bullying of a peer, can talk to trusted adults about bullying situations. Help your students by providing safe places in schools where teens can disclose when they or their peers are being bullied, or even create a hotline for students to report bullying situations.

Additionally, offer professional development to teachers and other staff members on identifying the warning signs of bullying, and provide them with effective strategies to help students who are being bullied. Likewise, many parents are unaware of how to support their teens when they are being bullied, so invite parents to on-campus workshops where they can learn ways to address these issues with their teens. During the parent and family sessions, discuss the various types of bullying that take place, the warning signs of bullying, and school and community resources for victims of bullying and cyberbullying. Workshops for parents and families can add another layer of support for young people who are affected by bullying.

 

3) Students are concerned about their personal safety. In our study, the third top concern that students reported was anxiety about their personal safety. According to the National Institute of Justice, school safety is currently a common concern among educators and administrators across the United States. Teens may not feel safe in their schools because of gun violence on school campuses across the country or even violence in their own communities or neighborhoods. The National Institute of Justice has stated that more schools have increased their security measures to protect students. Many of these schools have instituted locked doors, security cameras, hallway supervision, controlled building access, metal detectors and locker checks.

More than half of the ninth- and 10th-graders and more than 70% of the 11th- and 12th-graders we surveyed reported that they had experienced a traumatic event while attending high school. These various traumatic events can cause students to feel concern about their overall safety in their schools and communities. This type of stressor can in turn affect how teens engage in their educational environments.

What schools can do to help: Trauma-informed methods must be put in place to support students and their overall safety. Trauma-informed approaches focus on ways to ensure that students feel supported, listened to, and safe. Among the trauma-informed approaches that counselors can create in their schools are to build trust and rapport with students and to collaborate with outside community resources to support students who have been exposed to traumatic events. By getting to know your students, you will notice when their behaviors change, and because you have built trust with them, you can approach them in a friendly way to address these changes.

In addition, provide training on trauma-informed methods for teachers, support staff and administrators at your school. This training will help them create resources aimed at the needs of teens. Additionally, educators can seek professional help for their own personal traumas so that they may better interact with students who are dealing with stressors. By ensuring that teachers and staff members have access to community resources and training about personal safety and trauma, schools are developing leaders who can help students socially, emotionally and academically.

 

4) Students need help coping with their emotions. Teens’ emotions run rampant during their high school years. Most experience a range of emotions, including anger, fear, frustration, disappointment and hurt. These emotions may mask some of the broader issues that students face and that ultimately affect their academic performance.

Some of the students in our study participated in a small group that focused on developing social skills. The single-gender support group addressed the students’ academic, social and emotional needs. The sessions offered teens a safe place to identify stressors in their lives and to discuss the emotions attached to those stressors. By talking about their emotions, students were able to identify yet other emotions that were hiding underneath their anger and aggression. Throughout this process, the teens learned how to effectively articulate their emotions and to identify the underlying factors that were fueling them.

What schools can do to help: Encourage a supportive environment and training for students, such as small support groups facilitated by school counselors, clinical counselors, school psychologists or social workers, as well as peer-to-peer support groups. Teach teens the proper social skills related to identifying their emotions, and explain that all emotions are OK to have.

Quite often, teenagers express only the basic emotions when talking to others, especially adults. However, challenging them to look deeper and to identify the true emotion can be effective. Teens need safe places at school where they can learn how to cope with their anger and the other uncomfortable emotions that they often face.

 

5) Dealing with grief is important. A final concern students reported centered on dealing with grief from the loss of a loved one. Those students in our study who had experienced the loss of a loved one or who had witnessed a friend going through such a loss reported needing a supportive outlet to deal with those losses. Students may experience various losses during their teen years, such as the death of a friend or family member, and they are often left to process their emotions about the loss on their own. If schools are unaware that students have experienced a loss, those students may go without the support that is needed to help them process their grief. A lack of support during this time can have a significant impact on teens succeeding within the academic setting.

What schools can do to help: Build rapport early in the year with students so that they will be comfortable sharing should they experience a loss. During times of loss, allow students to grieve. Provide additional assistance by forming support groups for students who have experienced loss. This type of support can be offered through collaboration with local counseling agencies, hospices or other entities that support families experiencing loss. It is also helpful to maintain a list of community resources that address grief and loss. This community resource guide can be shared with teens, parents or caregivers, and other stakeholders.

Transforming school into an emotionally responsive environment

Students who are well-equipped socially, emotionally and mentally at the beginning of their academic careers can better cope when hardships occur. As counselors, we can help our students succeed in school and in life by first learning to identify their social, emotional and mental health needs, and then providing resources such as social skills workshops and support groups for them. Additionally, we can lead by example by improving our own social, emotional and mental health through professional development workshops that emphasize social and emotional learning practices.

Remember, school is not just a place where students gain academic knowledge; it is where they prepare for life. By doing our part to create a safe and emotionally supportive environment, we can increase the odds that students will succeed beyond the walls of the classroom.

 

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Dakota King-White is an assistant professor in counselor education at Cleveland State University. Prior to that, she worked in K-12 education as a school counselor, mental health therapist and administrator. Contact her at d.l.king19@csuohio.edu.

Sade Vega is a student in health science at Cleveland State University. In 2018, she received the university’s undergraduate student research award for her research on assessing the social, emotional and mental health needs of high school students. Contact her at s.m.vega@vikes.csuohio.edu.

Nicholas Petty is the director of undergraduate inclusive excellence at Cleveland State University. Prior to working at the university, he was an administrator in the Cleveland Metropolitan School District, where he earned national attention for his innovative approaches to behavioral intervention and student motivation. Contact him at n.petty@csuohio.edu.

 

Letters to the editor: ct@counseling.org

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

 

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

Leading an anti-bullying intervention for students with disabilities

By Katherine A. Feather and Tiffany M. Bordonada January 10, 2019

For more than 40 years, bullying in schools has remained relatively stable and today is recognized as a serious social problem. In 2014, the Centers for Disease Control and Prevention (CDC) and the Department of Education released the first federal standardized definition of bullying, which includes unwanted aggressive behavior, observed or perceived power imbalance, and repetition of behaviors or high likelihood of repetition. In addition, the CDC and Department of Education acknowledged direct and indirect modes of bullying and four types of bullying that school-age children can experience: physical, verbal, relational and damage to property.

According to the National Center for Education Statistics (2015), approximately 1 in 4 students in the United States reported having been bullied at school. However, evidence suggests that school-age children with disabilities are two to three times more likely to be bullied than are their peers without disabilities (for more, see the three-volume set Disabilities: Insights From Across Fields and Around the World). It is absolutely critical for professional counselors to assist those who are targeted and support proactive interventions that decrease bullying for students with disabilities.

Intervention strategies that are grounded in social learning theory and established on client-centered, community-based and experiential methods have been shown to be successful with children who have disabilities. Such interventions have a positive effect on children’s self-efficacy, self-determination and social skills. Furthermore, counselors can adapt experiential-based activities to provide these students with opportunities to learn new skills, make decisions, experience successes and take calculated risks. Finally, counselors need to recognize the strengths of students with disabilities, teach them to feel comfortable with who they are and empower them to implement bullying prevention skills.

This article will outline proactive prevention in terms of experiential group activities that focus on self-efficacy, self-determination and social skills training when working with school-age children with disabilities. The experiential group activity we will be describing was originally developed by Able SC, an empowerment and advocacy organization in Columbia, South Carolina, for people with disabilities. We collaborated with Able SC and tailored the activity to meet the needs of middle school and high school students with disabilities.

Aims

The experiential activity includes four primary objectives that positively affect self-efficacy, self-determination and social skills. The objectives are to help students:

1) Identify and understand various bullying behaviors

2) Recognize the warning signs when a person is being bullied

3) Learn strategies to manage bullying

4) Learn steps to take in the here and now to address bullying

Preconditions

Prior to engaging group members in the experiential activity, several preconditions should be met. First, counselors must have a strong therapeutic alliance with the participants before engaging them in the group activity. Second, counselors should provide proper accommodations to address the unique needs of the group members. Third, counselors must be willing to be creative and flexible to adapt the experiential activity to the individual strengths of the group members. Fostering a strengths-based approach is imperative when helping school-age children with disabilities to explore their self-efficacy. Finally, counselors must display competence with multicultural social justice counseling before working with children with disabilities.

The process

The first part of the group facilitation process involves assisting group members with understanding the various types of bullying (i.e., physical, verbal, relational and damage to property). The role of the group leader is to facilitate a discussion about these various bullying types, which may prompt group members to recognize specific examples. Additionally, the group facilitator should discuss the importance of recognizing real or perceived power imbalance and determining how often the power differential occurs. In other words, was this a one-time incident, or was it done repeatedly to hurt the individual? The group facilitator must guide students in understanding these two concepts that help to define bullying: observed or perceived power imbalance and repetition of behaviors. The group facilitator should also assist students in understanding the confusing distinction between when someone is joking versus when someone is actually engaging in bullying behavior.

To foster another mode of understanding, the group facilitator can also engage group members in a role-play demonstration to act out the different types of bullying. If the participants find it difficult to participate in the role-play, group facilitators can provide examples of the types of bullying to ensure support for students during the demonstration. In addition, it is important to identify the individuals involved with the bullying episode (i.e., bully, target and bystander) to provide clarity during the role-play. For instance, the group facilitator should discuss with group members how the bystander can be the most influential person in the situation either by acting as a solution to the problem or by instigating the bullying. Finally, the group leader encourages group members to identify characteristics of being a bully.

This will help students to recognize these traits so they can avoid engaging with those who display such behaviors.

The second part of the experiential group activity consists of identifying warning signs that an individual might be being bullied. These signs include:

  • Physical signs (e.g., cuts, bruises, scratches, headaches or stomachaches, damaged possessions, missing possessions)
  • Emotional signs (e.g., withdrawal or shyness, anxiety, depression, aggression, suicidal ideation)
  • Behavioral signs (e.g., changes in eating or sleeping habits, nightmares, no longer wanting to participate in school or activities that he or she once enjoyed, bullying siblings)
  • Academic signs (e.g., changing the manner in which he or she gets to school, being driven to school instead of riding the bus, having a noticeable drop in grades)

After determining the group’s understanding of the warning signs, the group facilitator can propose an experiential group activity in which the group members identify strategies to manage bullying. The group facilitator can engage the students in a role-play scenario in which the target initially fights back. The facilitator should then prompt a dialogue on the positive and negative consequences of engaging in this approach. Next, the group facilitator encourages the group to identify nonviolent strategies that the target can use in the same scenario. This will prompt group members to recognize how implementing a nonviolent approach to bullying can be an effective option.

Next, the group facilitator needs to co-construct with the group members prevention strategies to manage bullying behavior. A few general prevention tactics include:

  • Telling an adult
  • Walking away
  • Ignoring the bully
  • Avoiding the bully by interacting with friends or avoiding places the bully is known to be

Group members should be taught to understand the differences between the roles of bully, target and bystander and recognize appropriate prevention strategies that they can use if they find themselves in any of these categories. For example, the group facilitator could encourage the group members to identify effective prevention strategies specifically for the bystander role. These strategies include telling the bully to stop, helping the target to walk away, recruiting friends to intervene and getting an adult.

To reiterate, it is important to provide group members with specific scenarios to ensure that they understand the differences between the three roles and know which prevention strategies are appropriate for each scenario. Furthermore, have group members share times when they have fallen into the specific category of bully, bystander or target to guarantee that they are addressing their personal experiences with bullying.

Additionally, the group facilitator can engage the group in a role-play exercise to review the three categories and to collaboratively identify:

1) The bullying behavior

2) How the target reacted to the bullying

3) How the bystander(s) reacted

4) How the bully responded to the situation

5) Whether the bullying was managed in an effective way

6) How the bullying scenario could have been handled differently

7) How the group members would feel as the target in the scenario

This role-play provides group members with a greater sense of self-awareness as it relates to self-determination, self-efficacy and social skills. In addition, the role-play increases empathy toward others because group members vicariously experience the thoughts, feelings and behaviors of the target.

Finally, the group facilitator can engage the group members in personal action plans to reinforce what was previously reviewed and to address steps to manage bullying (for a detailed figure outlining the personal action plan, see Katherine A. Feather’s 2016 article “Antibullying interventions to enhance self-efficacy in children with disabilities,” published in the Journal of Creativity in Mental Health). The facilitator asks the group members to independently acknowledge personal situations in which they have been bullied; their thoughts, feelings and reactions to the experience; how they handled it; and what they could have done differently. Once they have completed the chart, group members are prompted to share their stories if they feel comfortable. The personal action plan is an important part of the experiential activity because it gives group members something tangible they can take with them to remind them of what they have learned and that they can reference in the future.

Finally, at the discretion of the group facilitator, group members are encouraged to discuss assertive communication and the various communication styles, such as the difference between “I” and “You” statements. This particular discussion can transition into recognizing the importance of self-advocacy and one’s ability to make informed choices. The group facilitator can end the session by reinforcing individual empowerment and emphasizing the group members’ potential to manage bullying. The tools used to combat bullying speak to the group members’ self-efficacy, showing them that they have the ability to exert control over their own behavior, motivation and social environment (as explained by Albert Bandura in his 1977 article “Self-efficacy: Toward a unifying theory of behavioral change”).

Modifications to the process

Counselors who use this experiential activity may wish to adapt the group in the following ways:

1) Assess whether a particular student would be a better candidate for individual counseling and modify the activity for individual, rather than group, counseling.

2) When implementing the experiential training, augment the activity to meet the needs of the group participants. For example, for the personal action plan, participants can use numerous mediums to complete the activity (e.g., act out the steps, cut out pictures from a magazine, draw, write, use note cards with words, use assistive technology, discuss steps verbally).

3) Delivery of the experiential group activity must be based on students’ presenting characteristics to ensure full understanding of the material. For example, counselors need to address a comprehensive range of needs among students with disabilities. Therefore, counselors can provide additional scenarios of the components for the activity. This will encourage repetition and opportunities for practice. Counselors are also encouraged to collaborate with school personnel to ensure that they are meeting the needs of the student and integrating all necessary interventions to promote student success.

4) This experiential group activity may not be applicable for all students with disabilities. We suggest that counselors consult and collaborate with school staff to gauge the appropriateness of the intervention for individual students.   

Considerations

Counselors must intervene in a timely manner by recognizing, assessing and engaging students in activities that will combat bullying and provide them with the skills to be successful in the school environment. However, counselors must be sensitive to group membership. Therefore, counselors may want to consider making the group available to peers without disabilities. Inclusive practices may buffer against bullying by providing peer models to students with disabilities, as well as by promoting social competence among all students. Isolating students with disabilities does not provide them with the practice and validation they need to develop appropriate social skills. Thus, combining students with disabilities and their peers without disabilities fosters an inclusive approach and ultimately enhances a community of knowledge and understanding.

Finally, prior to implementing this experiential activity, we encourage counselors to become familiar with the social model of disability and the capabilities framework versus the medical model of disability. The social model of disability is a different way of viewing the world and challenges the typical attitudes toward disability. Fostering a capabilities approach validates the ideologies of inclusion that stress equality, acceptance and valued participation. The capabilities approach is a holistic social justice initiative that assesses disability on the basis of one’s abilities and functioning within society. Counselors need to recognize the impact that society has on the individual and the barriers that students with disabilities face on a daily basis.

 

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Helpful resources for counselors

  1. PACER’s National Bullying Prevention Center (pacer.org/bullying/resources/students-with-disabilities)
  2. StopBullying.gov page on bullying and youth with disabilities and special health needs (stopbullying.gov/at-risk/groups/special-needs)
  3. “Bullying and Disability: An Overview of the Research Literature” (tinyurl.com/BullyingAndDisability)

 

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

Katherine A. Feather is a licensed professional counselor in Arizona and an assistant clinical professor in the Department of Educational Psychology at Northern Arizona University. Contact her at Katherine.Feather@nau.edu.

Tiffany M. Bordonada is an assistant professor in the Department of Counseling and Human Services at the University of Scranton. Contact her at Tiffany.Bordonada@scranton.edu.

 

Letters to the editor: ct@counseling.org

 

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

When bias turns into bullying

By Lindsey Phillips June 29, 2018

We all have our biases — but just because bias is a universal part of the human experience doesn’t mean it is something we should ever dismiss offhandedly, either in ourselves or others. That’s because bias has serious consequences, and when left unchecked, it can turn into bullying. A 2012 study of California middle and high school students published in the American Journal of Public Health found that 75 percent of all bullying originated from some type of bias against a person’s race, sexual orientation, religion, disability or other personal characteristic.

People often talk about bullying in general terms. But as Anneliese Singh, a professor of counseling and associate dean for the Office of Diversity, Equity and Inclusion at the University of Georgia, points out, “If you look more closely at ‘general bullying,’ what you’ll see is a lot of bias-based bullying.”

SeriaShia Chatters-Smith, an assistant professor of counselor education and coordinator of the clinical mental health counseling in schools and communities program at the Pennsylvania State University, defines bias-based bullying as bullying that is specifically based on an individual’s identifying characteristics, such as race/ethnicity, gender, sexual orientation or weight. For example, adolescents might create Snapchat stories that attack someone on the basis of their race, weight or sexual orientation, and parents or teachers might treat children differently on the basis of their skin color, notes Chatters-Smith, an ACA member who presented on “Bullying Among Diverse Populations” at the ACA 2017 Conference & Expo in San Francisco. Research indicates that individuals of color, particularly black and Hispanic men, are more likely to be identified as being aggressive, she adds.

In her research on transgender people, Singh, who co-founded the Georgia Safe Schools Coalition and founded the Trans Resilience Project, has found that bias-based bullying can be based on appearance, gender expression or gender identity, and it can range from name-calling to physical and sexual harassment and assault.

A four-letter word

When people start talking about someone having a bias, those four letters typically trigger a negative reaction and shut down conversation, which isn’t productive. Thus, Chatters-Smith argues that helping people understand that everyone has biases is crucial to addressing bias-based bullying.

However, this task can be difficult because people often resist closely exploring their own prejudices. Counselors should help clients realize that just because everyone has biases doesn’t mean they are excused from recognizing and addressing their own, Chatters-Smith argues.

Because bias is often an emotionally charged topic, Chatters-Smith finds it helpful to start with a nonthreatening example. After pointing out bias, she asks clients when they first identified something as their favorite color. Most people can’t remember when this color preference started because they were young, Chatters-Smith says. She explains how after someone establishes a color preference, the brain starts to sort things by that color.

“When you see something that is your favorite color, you are more likely to gravitate toward it. You have more positive feelings toward cars that are your favorite color. … And sometimes a car may not be the best-looking car, but because it’s our favorite color, we gravitate toward it. That is bias,” Chatters-Smith explains.

Bias is a kind of sorting process that our brain goes through, she continues. “The experiences that we have with individuals can then cause us to have specific attitudes toward someone, and when we see them, we prejudge that they are going to act or be a certain way because of those experiences. … We do an automatic sort.”

Counselors are not immune to bias either. For example, a counselor might assume that a black male client who is unemployed did something to cause his unemployment, Chatters-Smith says. If this happens, the counselor needs to take a step back and ask why he or she is entertaining that assumption, she continues.

These internalized biases can also have a direct effect on students. For example, Singh says, LGBTQ students will not feel safe reporting bias-based bullying by their peers when they hear educators or school counselors expressing anti-queer or anti-trans views. Educators can also hold bias against students in special education, which may limit the opportunities those students have to learn, she adds.

Singh, an American Counseling Association member and licensed professional clinical counselor in Georgia, finds cognitive behavior therapy (CBT) helpful because challenging irrational thoughts is at the heart of addressing bias-based bullying. Thus, counselors need to ask clients and themselves some CBT-related questions: Where did you learn this thought? What research supports this idea?

Counselors “have to become strong advocates in order to interrupt those beliefs systems because the person enacting them — whether or not they’re conscious [of it] — isn’t going to stop until there’s an advocacy intervention,” Singh says.

After making clients (or educators) aware of bias, counselors can work with them to figure out times that they might have sorted a person into a category before getting to know that person and then brainstorm ways to manage that differently in the future.

Counselors can also benefit from bias-based bullying training. In working with Stand for State, a bystander intervention program at Penn State, Chatters-Smith found that certain questions or situations related to bias would cause the counselors participating in the bias-based education to pause or stumble. “A person who is not educated to know [how to respond] can get really thrown off guard,” she says.

Chatters-Smith knows from experience. Once in a workshop, she mentioned how saying that all Jewish people are good with money is an example of a racially charged joke. One of the participants responded, “But all Jewish people are good with money.”

Chatters-Smith questioned this statement by asking, “Really? All Jewish people? Where does this stereotype come from? Is this a racially based stereotype that is meant in a negative way?”

“One of the most damaging things that can happen in [a] workshop is if a bias educator is perpetuating bias,” Chatters-Smith contends. This experience helped her realize that the trainers themselves needed training to be effective at bias and discrimination education. She is currently developing workshops and a workbook that will allow counselors to practice answering questions and go through specific scenarios related to bias-based bullying to help them gain confidence and knowledge in handling these challenging situations.

Uncovering bias

A counselor’s role is to interrupt the systems of bias-based bullying, Singh argues. This process starts with the intake assessment, which should clearly define what bias-based bullying is and provide examples, she continues.

Counselors need to ask upfront questions about bias and harassment in counseling to let clients know that these issues exist and that they affect mental health, Chatters-Smith says. The best way to know if it is happening is to ask, she adds.

Of course, when assessing clients, counselors can also be alert to signs that bias-based bullying may be occurring. Anxiety or fear of being bullied may cause younger children to wet their beds at certain times of the year (right before school starts, for example) or to avoid public bathrooms, Chatters-Smith notes. She advises school counselors to pay close attention to the dynamics between students in the cafeteria. “A child can be sitting at a table full of kids because they don’t want to sit alone, but no one is interacting with them. No one is talking to them. They’re purposely being excluded,” she says.

Singh and Chatters-Smith also urge counselors to watch for signs of depression or anxiety, client withdrawal, client complaints that are not tied to anything specific, chronic tardiness, or changes in client behavior such as nervousness, avoiding school or sessions, or missing certain classes.

Counselors should exercise the same level of vigilance with young adult and adult clients. Chatters-Smith finds that counselors often fail to factor in the isolation, feeling of being ostracized and lack of belonging that some minority college students experience at predominantly white institutions. Counselors “know all of [these factors] impact mental health from [the] K-12 research of bullying but seem to forget about it when people graduate from high school,” she argues.

In addition, counselors often “do not factor in the cultural pieces of experiencing bias-based bullying at work. It manifests itself differently,” Chatters-Smith says. For example, individuals may go on short-term or long-term disability, or bullying may result in harassment claims or absenteeism from work. In certain instances, clients may not be able to put a finger on the core issue causing them not to enjoy the workplace, or they find that for some unknown reason, they can’t please a co-worker or employer, she says.

Sometimes, clients don’t even recognize that bias-based bullying could be an issue until the counselor brings it up, Chatters-Smith adds. Thus, she advises counselors to ask questions such as “Have you experienced any prejudice or discrimination at work?” or “Do you have increased anxiety around yearly evaluations for work?”

“In any organization that has built-in hierarchies, bullying [is likely] to occur,” Chatters-Smith says. For example, in the military, transgender individuals still face discrimination, and often discrimination is based on race or socioeconomic status, such as enlisted individuals versus officers who require a college education and receive more money and leadership positions, she explains.

Avoiding assumptions

When people are introduced to the concept of bias-based bullying, they often assume that it involves someone from a dominant group bullying someone from an oppressed group. “When you think about bias-based bullying, typically people are going to gravitate toward majority [versus] minority … but at the same time, it can happen within group,” points out Cassandra Storlie, an assistant professor of counselor education and supervision at Kent State University. She cautions counselors not to overlook the possibility of intracultural bullying because it does happen. For example, a Latino child may bully another Latino child because that child doesn’t speak Spanish, or an individual may bully someone else of the same ethnicity because that person’s skin color is judged to be “too dark” or “too light.”

Just because someone is oppressed does not mean that they can’t be oppressing others, Chatters-Smith emphasizes. “For centuries … African Americans have bullied each other based on darker complexion versus lighter complexion, and the same thing happens in Latino and Hispanic groups as well,” she says. “What makes it identity based and bias based is because there are biases that come along with the perspectives of individuals who are of darker skin. Even though it’s within a specific racial category, the bias is still there, and then the individual still has the psychological impact because they’re being bullied just for who they are.”

In addition, although people of color have a higher likelihood of being bullied in predominantly white settings, bias-based bullying can still occur when they are in settings with higher diversity, Chatters-Smith notes. The bias may just take another form and be based on characteristics other than race, such as sexual orientation, she explains.

Within transgender communities, someone who is more binary identified and operates with certain gender stereotypes may discriminate against another transgender person for not looking enough like a woman or a man, says Singh, a past president of both the Southern Association for Counselor Education and Supervision and the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling. Within-group bullying is particularly painful to the individuals who experience it because the group is supposed to be their source of support and belonging, she says. 

Singh also points out that bias-based bullying can be targeted at anyone based on how he or she is perceived. “If they’re perceived to step out of a gender or sexual orientation box, even if they don’t have that identity, they may experience [bias-based bullying].” In fact, Singh says, a substantial amount of anti-queer and anti-trans bullying is actually experienced by cisgender and straight people.

Creating a positive, safe environment

“Ethnic identities are strong protective factors,” says Storlie, president-elect of the North Central Association for Counselor Education and Supervision. She encourages counselors to find ways to celebrate cultures and differences. If counselors are practicing in a school district or community that isn’t taking preventative measures against bias-based bullying and being inclusive and advocating for all students, then they need to take initiative and educate those communities, Storlie says.

One approach that Storlie, an ACA member and a licensed professional counselor with supervisory designation in Ohio, suggests is to mention how diverse populations are increasing. In fact, according to the National Center for Education Statistics, the percentage of white students enrolled in public elementary and secondary schools decreased to less than 50 percent in 2014, while minority students (black, Hispanic, Asian, Pacific Islander, American Indian/Alaska Native and those of two or more races) made up at least 75 percent of the total enrollment in approximately 30 percent of these schools.

Storlie works with a school district that has Ohio’s second-highest number of students who speak English as a second language. Roughly 50 percent of the student body is Latino — up from approximately 2 percent only two decades ago.

When Storlie first walked into the school district, she couldn’t find any Spanish on the walls of the schools or in school materials, but since she started working with the educators and teachers, all of the school district’s documents are translated. “If you’re handing this information out to students … you’ve got to make sure it’s in the right language,” she argues.

Schools are in transition now because of increased diversity, Storlie notes. “It’s happening across the country where teachers don’t look like the kids that they’re teaching anymore, and they have stereotypes that can be pervasive,” she observes. Thus, counselors need to work with educators and communities to ensure that they are being inclusive.

Storlie advises counselors to facilitate events such as English classes for parents whose first language is not English to improve communication between teachers and parents, and workshops to educate parents, school personnel and the community on bias-based bullying. Counselors might also provide workshops for school personnel on multicultural competency, she says.

The Human Rights Campaign Foundation’s Welcoming Schools program is one helpful resource, Chatters-Smith says. The program provides training and resources such as recommended books, lesson plans and videos to school educators to help them create inclusive, supportive school environments and aid them in preventing bias-based bullying.

Building strong relationships

Storlie has found that teachers and school personnel who instill hope in their students — regardless of any identifying characteristic — have the best outcomes. These students often have higher levels of school engagement, demonstrate greater resilience and enjoy more academic success.

The therapeutic relationship can play a central role in instilling hope and achieving these positive outcomes, Storlie argues. For that reason, she adds, counselors shouldn’t become so focused on theories and techniques that they forget what it means to foster a good relationship with their clients. Among individuals who have been oppressed or marginalized, there is often an “us versus them” attitude, so the challenge for counselors is finding a way to reconnect and develop the relationship, Storlie says.

Trust is one key component of building a strong relationship with clients. However, Chatters-Smith has found that adults don’t always trust children’s reports of bias and discrimination. In her private practice, Chatters-Smith often works with children of color who report that no one believes them when they complain about bias-based bullying. Over time, this disbelief can result in their silence. Thus, she emphasizes, it is crucial that counselors believe children when they report having experienced bias-based bullying and discrimination.

In addition, Storlie stresses the importance of taking a team approach to bias-based bullying. “You can’t do it solo. … You really have to have the team approach because that’s how change happens,” she says. This is especially true for school counselors confronted with high student-to-counselor ratios, she adds.

When school counselors notice bias-based bullying in their schools, they should connect with other leaders in the school district and position themselves as a part of the leadership team, Storlie advises. Then, in this leadership position, counselors can educate school personnel on warning signs and interventions for bias-based bullying, thereby creating a team approach to intervening, she explains.

School counselors should also strive to work with families to address bias-based bullying. Because family members’ work schedules may not coincide with school system hours, counselors might have to get creative to find ways to reach families, Storlie continues. “School counselors who stay in their offices are not going to be able to reach families the same way that … [counselors] doing outreach with families would,” she adds.

In Storlie’s work with undocumented Latino youth, she found that the school counselors who were present, who made a point of getting out of their offices and who were visible to parents — for example, showing up at basketball games after school hours — enjoyed the most effective relationships with families and students. Their students were also more receptive to looking ahead and thinking about their future careers, she adds.

Bystander intervention

“What hurts [children] typically is not specifically the bullying itself. What hurts them is the other children around who stand and watch it happen,” Chatters-Smith asserts. The inaction and silence of bystanders causes people who are bullied to feel depressed and isolated, and it feeds into dysfunctional thinking that they are not good enough and no one cares about them, she adds.

In workshops, Chatters-Smith uses an active witnessing program to train people how to respond to discrimination and bias. Because bias-based bullying is often verbal, onlookers can state that they disagree with what is being said and question the validity of the biased comment, she elaborates. Bystanders can also support the person being bullied by telling them they are not alone or calling for help, she says.

Bystanders can also help people who commit the offense to self-reflect by asking them to repeat what they said and letting them know that it was hurtful, Chatters-Smith continues. If a bystander doesn’t feel safe to intervene at the time of the incident, they can later call a manager (if the bullying incident happened in an establishment or organization) or notify someone about what they witnessed, she advises.

Chatters-Smith has also used ABC’s What Would You Do? — a hidden-camera TV program that acts out scenes of conflict to see if bystanders intervene — in her workshops. She plays the scenarios from the show but not the bystanders’ reactions. Instead, she has workshop participants use the skills they have learned in the workshop to see how they would respond.

The more aware counselors become of bias, prejudice and discrimination in their day-to-day lives, the more it will affect them in their work with clients, Chatters-Smith says. “Practice is what helps us move forward as individuals,” she explains. “When you are at the store, when you are eating in a restaurant, when you are in the mall, when you see these things happening, if you feel [like you] know what to do, you’ll become more aware of what it is and you’ll feel more confident at not only being able to intervene and be empowered in your everyday life but also being able to talk to your clients about their experiences.”

Storlie and Singh both tout training student leaders as an effective approach to preventing bias-based bullying. Often, students — not counselors — are the ones who hear about or witness these instances of bullying. So, counselors can work with these student leader groups to teach them how to intervene, Storlie says.

Another way to create a team approach to bias-based bullying intervention is through the use of popular opinion leaders, Singh says. With this approach, school counselors and teachers nominate student leaders who represent different groups in the school (à la The Breakfast Club). With the counselor’s guidance, these students discuss bias-based bullying, what they’ve noticed and how they might be able to change it. Then, after learning bias-based bullying interventions, the popular opinion leaders try them out and report on which ones worked and which ones didn’t, Singh explains.

An ongoing issue 

Singh warns of the danger of minimalizing bias-based bullying — such as saying that people “don’t mean it” — because it sends a message that it is OK to have bias. Comments that dismiss bias-based bullying “can really add up over time in the form of microaggressions for transgender people,” she argues. “But, more importantly, [these comments create] a hostile environment in society, and that hostile environment in society can set transgender people up for experiencing violence.”

“When children grow up in an environment where they are taught implicit and explicit messages about whose identities matter and whose don’t, and then there’s power attached to that, then you’re going to see those negative health outcomes,” Singh argues. “And they’re not just negative health outcomes and disparities. They’re verbal, physical and sexual harassment that play out across people’s bodies and communities. Those microaggressions add up to macroaggressions on a larger scale.”

Apologizing isn’t the answer either. Often, people who bully, commit a microaggression or say something prejudiced will apologize by saying that they didn’t intend it that way, Chatters-Smith says. “It’s not intent that matters. It’s impact. … Whether or not you intended it, it doesn’t matter. It hurt the person.”

One possible solution is to start bias education at a young age so that over the life span, people are more aware of bias-based bullying and discrimination, Singh says. Counselors can challenge the internalized stereotypes that people learn in society about themselves and others and counter those biased messages with real-life experiences and compassion, she adds.

Education and awareness are key because bias-based bullying is an ongoing issue. “[Bias] is not going to go away. … People are going to find a way to treat each other differently. I think that what will change is more and more people not accepting it,” Chatters-Smith says.

This past spring, social media revealed another case of discrimination when two black men who were waiting for a friend were arrested at a Starbucks in Philadelphia on suspicion of trespassing. The incident might have received little notice except that a white woman posted a video of the arrest on Twitter and challenged the injustice, which prompted protests. Starbucks responded by apologizing and announcing that it would close thousands of stores for an afternoon to conduct racial bias training in May.

Even though this injustice never should have occurred, the public outcry sent a message that these two men were not alone and that bias is not acceptable, Chatters-Smith says. “The intervention is what’s going to change [things],” she says. “If we have more eyes on it, hopefully we can reduce the impact and reduce the duration and the longevity of the impact of these instances.”

Chatters-Smith, Singh and Storlie all agree that counselors have an important role to play in educating people about bias and building strong partnerships between educators, parents, students and communities. “[Counselors] are in the business of helping people challenge inaccurate, internalized thoughts,” Singh points out. “Counselors have to challenge those thoughts and help rebuild beliefs systems that include the value of a wide variety of social identities.”

 

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist living in Northern Virginia. Contact her at consulting@lindseynphillips.com or through her website at lindseynphillips.com.

Letters to the editor:ct@counseling.org

 

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

’13 Reasons Why’: Strengths, challenges and recommendations

By Laura Shannonhouse, Julia L. Whisenhunt, Dennis Lin and Michael Porter September 4, 2017

The Netflix series 13 Reasons Why has launched a national discussion regarding teen suicide, motivating a webinar response from professional organizations about how to shape the dialogue, dozens of editorials and millions of cautionary letters home from schools to parents across the country.

The series, based on a novel, is narrated by high school student Hannah Baker, who made a series of cassette tapes to be passed to 13 individuals she argues contributed to her reasons for dying. Her story is seen through the eyes of a peer, Clay, who listens to the tapes. He comes to understand Hannah’s perspectives about those people and events she claims motivated her suicide, which include Clay’s own (in)actions.

The series has been critically acclaimed for the acting and commended for addressing challenging topics, such as bullying/cyberbullying, sexual assault and teen suicide. However, school administrations, school counseling associations, suicide prevention organizations and counseling/psychology associations such as the American Foundation for Suicide Prevention (AFSP), the Suicide Prevention Resource Center (SPRC), the American School Counselor Association (ASCA) and the National Association of School Psychologists (NASP) have advised caution because of the graphic nature, revenge fantasies and potential contagion effect. This article highlights strengths and major challenges of the series. It also provides recommendations that have been underrepresented, though not absent, in the discussion.

 

Strengths

1) Raising awareness that suicide is a real problem.

According to the Centers for Disease Control and Prevention (CDC), suicide is a major public health issue. The most recent  statistics available note that among high school students, 17 percent have seriously considered suicide, while 8 percent have attempted suicide within the past 12 months. We know that for every suicide, there are many survivors, including the family and friends of the person and those who have experienced psychological, physical and social distress after exposure to a suicide.” The most commonly cited statistic is that each suicide directly affects six people; however, more recent research argues there are between 45 and 80 survivors per suicide.

In 2015, there were more than 44,000 reported suicide deaths, including 5,191 deaths by suicide among those ages 15 to 24. However, this statistic includes only those that were reported. Although there is no consensus on the rate of under-reporting due to stigma or ambiguous cause of death, the best analysis suggests that for each completed youth suicide, there are 100-200 times as many nonfatal suicide actions.

Combining CDC data with our current understanding of rates of suicidal ideation in youth, in this moment there are close to 15 million people in the U.S. who think of suicide in any given year. Suicide is a very real public health issue; when it is ignored, stigmatized or minimized, we as a community are missing the chance to prevent it.

2) Even professional counselors may not be ready to respond to a suicidal situation.

Because counselors often receive referrals of clients who are suicidal, counselors’ competency in identifying and intervening with those at risk is crucially important. However, the overtaxed counselor in 13 Reasons Why, Mr. Porter, is underprepared to face a suicidal student coping with complex trauma. Although he did not act in the scope of best practice, his failings are unfortunately not unusual among counselors, despite decades of advocacy for increased suicide assessment trainings in counselor education.

Mr. Porter missed several suicidal statements (e.g., “I need everything to stop”), made assumptions about contributing events and was uncomfortable talking about suicide (and other issues). We may easily judge Mr. Porter’s mistakes, but as counselors, we should take this opportunity to reflect and ask ourselves if we are ready to respond to a student at risk of suicide. The research is equivocal.

3) Suicide is complex and individual.

Although 13 Reasons Why portrays some known “red flags” that can indicate suicidal intent, the factors that contribute to individual suicides vary. Stressors that may influence one person’s decision to die by suicide may not have the same effect on others. For instance, we know that not all people who are depressed die by suicide (research shows the rate is from 2-15 percent) and that not all people who complete suicide are depressed. There is a variety of prevention programming regarding common warning signs. However, there is no perfect amalgam of warning signs or demographics (e.g., risk for transgender persons) that helps us differentiate who will decide to die by suicide. We need to go beyond just learning warning signs in order to help.

Livingworks, a suicide intervention training organization, focuses on three elements when assessing warning signs and risk factors. First, we must look for the meaning behind stressful events. For instance, in 13 Reasons Why, being listed “Best Ass” was highly distressing to Hannah because she felt objectified and was concerned people would misperceive her to be easy. However, another student, Angela “Best Lips” Romero, was flattered by such attention. The meaning behind the stressful event is more important than the stressful event itself.

Second, we need to know that warning signs can be, and often are, expressions of pain. When Hannah pushed Clay away, he recognized that something was wrong but did not see that her rejection was an indication of emotional pain. Third, we must trust our intuition. One peer recognizes Hannah’s poem as a cry for help but does not offer assistance. We need to pay attention to our gut feelings and act on them to take care of each other.

13 Reasons Why provides an opportunity to see Hannah’s experience of several traumatic events (cyberbullying, being stalked, public objectification, losing money, feeling responsible for a person’s death, witnessing rape and being raped) and does a good job of depicting the pain, shame and isolation she experiences as a result. The viewer has an opportunity to consider Hannah’s subjective experience and understand how the cumulative effect of these “reasons why” motivates her to suicide.

One model to help contextualize suicidality is the interpersonal-psychological theory of suicidal behavior developed by psychologist Thomas Joiner. Joiner states that the highest risk occurs when one feels like a burden to others, feels alienated or lacks belongingness and, crucially, has overcome the natural human inclination toward self-preservation. This model posits that suicide is a process — one gradually builds tolerance to the idea through self-injurious thoughts or behaviors (although each person’s path is unique). There are multiple points on that path at which others can intervene. The 13 Reasons Why series emphasizes those missed opportunities. As in Hannah’s case, every day there are suicides that happen as a result of those missed opportunities.

4) The central message is a positive one.

In the last episode, Clay says to Mr. Porter, “It has to get better, the way we treat each other and look out for each other.” Instead of feeling guilty or turning away, we can task ourselves with being more supportive community members.

All too often, we operate from a place of fear, which is understandable considering that schools have a legal duty to protect students from self-harm, and lawsuits are a potential reality (as shown in 13 Reasons Why). However, when systems or individual responders act out of fear, it focuses the interaction away from the needs of the person at risk. Even well-intentioned modern practices of “suicide gatekeeping” have substituted swift (and protocol-driven) identification and referral for the direct supportive intervention by community members proposed by John Snyder in 1971. Clay’s words echo those from Snyder half a century ago, when he said that most “who attempt suicide are victims of breakdowns in community channels for help.”

Although Mr. Porter clearly failed to proper identify Hannah’s suicidal ideation, perhaps even more troubling was his failure to hear her story and understand the factors behind her decision to die by suicide. Listening and demonstrating empathy to someone who is struggling was demonstrated to reduce suicidal ideation on calls to the National Suicide Prevention Hotline. Talking about suicide can help the person at risk to no longer focus on the past or feel alone and, instead, shift to the present moment, where the person can feel understood and cared for. If those in Hannah’s community who were witness to her emotional pain had actively engaged her and listened, it may have reduced her isolation and lessened her self-perception as a burden. This may even have prevented Hannah’s death.

Research indicates that our personal beliefs about suicide influence our responder behaviors. Therefore, gaining awareness of our beliefs and how our ability to intervene is affected by them is vital. Regardless of whether we can stop a suicide, we can control how prepared we are to try. We can make sure that our systems (in schools and elsewhere) are places where it is easy for someone to receive help.

After working through Hannah’s tapes, Clay now believes that we are, in a way, our brother’s keepers. Community-level response by direct intervention is a central theme in my (Laura Shannonhouse) research. It involves equipping “natural helpers” (e.g., teachers, bus drivers, resources officers, school counselors/psychologists) with the skills needed to perform a life-assisting suicide intervention at the moment it is needed most.

The producers and cast of 13 Reasons Why have underscored their desire for this series to start a conversation. Although that has certainly been accomplished, we hope the dialogue focuses more on how we can “look out for one another” and foster communities less at risk for suicide.

 

Challenges

1) Graphic nature and contagion

Viewers of 13 Reasons Why watch two rape scenes and Hannah’s suicide, which is shown in detail. Nic Sheff, one of the writers of the series, stated that the scene of Hannah’s suicide was intended “to dispel the myth of the quiet drifting off.” Some crisis texts suggest that we “deromanticize” suicide by helping our clients understand the unintended effects of trying to die by suicide, such as surviving but becoming disabled or alienating friends and family. Therefore, an argument could be made that a graphic, painful portrayal of suicide is warranted.

However, research does suggest that suicide portrayals can contribute to contagion by triggering suicidal behaviors in people — particularly youth — who are experiencing high levels of emotional distress. In fact, SPRC and AFSP have made recommendations for best practices in prevention of suicide contagion. A discussion of post-suicide intervention to prevent contagion is beyond the scope of this article, but as an example, the locker memorial portrayed throughout the series is against standard guidance (it should not last for weeks, as shown). Furthermore, when considering how media reaction to the series has often included sensational headlines, it is helpful to review these recommendations for reporting on suicide.

2) Survivor’s guilt and revenge fantasies

By assigning “reasons why,” the series sends a message that Hannah’s death is caused by other people’s actions. When Clay openly questions, “Did I kill Hannah Baker?” his friend Tony answers dramatically, “Yes, we all killed Hannah Baker.”

Although we suggested earlier that we all have a responsibility to create communities that help prevent suicide, Tony’s level of direct attribution can be counterproductive. Hannah experienced multiple losses, traumas and stressors caused by others, both intentionally and unintentionally. Placing responsibility for her death on those individuals instead of on Hannah’s action can exacerbate survivors’ guilt. Those viewers who have lost a friend, loved one or acquaintance to suicide may feel even more strongly after viewing the series that “It is my fault.”

These feelings are associated with lower functioning in comparison with survivors of accidents. Although undeserved, survivor’s guilt is a real phenomenon, and considerable research shows that even counselors who experience the death of a client by suicide can experience shame/embarrassment and emotional distress.

Whereas Clay may feel guilt for his part in Hannah’s story, the tapes could implicate others in criminal or negligent behavior, perhaps giving Hannah posthumous revenge. Some viewers who may have struggled with suicidal ideation themselves could get the message that if they take their lives, they can get revenge on those who have hurt them. This is an additional reason that schools across the nation and professional helping organizations have felt the need to do damage control for 13 Reasons Why.

 

Recommendations

1) Parents need to not just talk but watch, listen and connect.

Some school counselors argue that it’s harmful for children and teens to watch the series on their own without the support of a parent or trusted adult because the series depicts a graphic and romanticized portrayal of a teenager in crisis and does not identify competent resources capable of helping her. Accordingly, many experts encourage parents to talk to their children about the series. In addition to using talking points, we recommend that parents listen deeply and without judgment to what their children say. When people feel genuinely heard, they are more likely to talk about their true thoughts and feelings.

To accomplish this goal, parents can use active listening skills, such as open-ended questions, reflections of feeling, paraphrasing and encouragement. Also, we recommend that parents watch the series and risk being human — risk being impacted by the series and empathizing with their child. The construct of empathy is powerful, particularly if it is sincere. For a three-minute visual summary, consider watching Brene Brown on empathy. In our counseling skills courses, we often talk about “getting in the well of despair” and genuinely connecting with others. We know that talking about suicide paradoxically provides a significant buffer to suicidal action.

2) We need more than prevention programming in schools.

We know from a well-regarded U.S. Air Force study that we need suicide programing at all three levels: prevention, intervention and post-intervention. Many suicide prevention programs have been implemented in the school context, but there is mixed evidence of their effectiveness. From our clinical experience in crisis response, our scholarship and our history with training a specific model of suicide intervention, we need to acknowledge that we are biased about what types of programming should be implemented and when is the right time to implement. We feel that an appropriate first step for a school system is to implement basic screeners and gatekeeper trainings such as Signs of Suicide or Sources of Strength.

However, suicide prevention should not end with identification for referral. Optimally, the process continues by assessing level of risk, identifying reasons for dying and reasons for living, discussing alternatives to dying, enlisting the support of trusted loved ones and limiting access to lethal means or securing the person’s environment. Because youth who struggle with thoughts of suicide often seek out the support of those they trust rather than professional mental health providers, those teachers, coaches and others with open hearts and doors are the most effective gatekeepers for a system. Their nondirection and empathy are useful pedagogical qualities and vital to effective suicide intervention.

We endorse models that empower those “natural helpers” to provide a potentially life-saving intervention for students who are in suicidal distress. Although this may be augmented with the support and follow-up of a trained mental health provider, gatekeepers can implement the steps listed above.

3) Be intentional about identifying caregivers and shifting school culture.

My (Shannonhouse) research involves partnering with school districts and superintendents (in Maine and Georgia) to identify “natural helpers” and equip them with the skills to perform a life-assisting intervention in the moment (i.e., Applied Suicide Intervention Skills Training, or ASIST). These natural helpers are often teachers, resource officers, coaches, administrative staff, bus drivers and other people who are likely to be confidants to students who experience distress. Measuring suicide intervention skills and responder attitudes is easy for an academic. Identifying those school personnel in the trenches who would be first responders is more difficult — it requires the total involvement of administrators. Furthermore, such an approach requires schools to commit to a student-centered response model.

ASIST is relationship-driven and aligned with the values of the helping professions. It meets the needs of students who are at risk by focusing on responding to those immediate needs rather than referring the student (which can lead to further isolation and an increased sense of burdensomeness). Although the student is often referred for more long-term counseling, ASIST provides the student with a six-step intervention at the moment it is most needed and can be performed by anyone over age 18. Having natural helpers trained in ASIST or a similar protocol can dramatically increase a school’s responsiveness and effectiveness to help students in distress.

4) Use an intervention model backed by research.

ASIST is a 14-hour, two-day, internationally recognized and evidence-based model that has been adopted by multiple states and the U.S. Army. It has also been recognized by the CDC and used in crisis centers nationwide. Caregivers trained in ASIST consistently report feeling more ready, willing and able to intervene with a person at risk of suicide.

The program has been evaluated in a variety of settings (click to download), with pretest to post-test improvement noted in trainees’ comfort level at intervention and in their demonstrated intervention skills in response to simulated scenarios. Although outcome research is rare, research compared ASIST-trained counselors with those trained in other models through a double-blind, randomly controlled study of more than 1,500 calls to the National Suicide Prevention Lifeline. Those trained in ASIST more often demonstrated particular behaviors such as exploring invitations, exploring reasons for living, recognizing ambivalence about dying and identifying informal support contacts. Those trained in ASIST also elicited longer calls.

We found that ASIST can be applied to both university and K-12 settings. Our work measured increased suicide intervention skills and beneficial responder attitudes, which have been maintained over time. We have trained more than 500 people in ASIST and have received multiple reports of teachers disarming fully formed suicide plans with their new skills. More recently, we have conducted behavioral observations of ASIST responder behavior and have begun evaluating outcomes of students who have received ASIST intervention. Initial results have been promising, including better coping and commitment to follow-up and decreased lethality.

 

Summary

Although 13 Reasons Why gives us pause for its poor portrayal of effective suicide intervention, we feel that the series raises awareness and, at its core, advocates a community-level response to suicide prevention. This message to “look out for each other” is aligned with more intervention-oriented gatekeeping. We have explored the impact of one such model, ASIST, in several educational settings and found that it improves responder behavior. Furthermore, this approach comes with a mindset that systems can harness their strengths (i.e., natural helpers) to focus on responding to and intervening with the student rather than simply identifying and referring the student to the system.

 

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Please contact me (Laura Shannonhouse) should you have any questions about our research.

 

 

Laura Shannonhouse is an assistant professor in the Counseling and Psychological Services Department at Georgia State University. Her research interests focus on crisis intervention and disaster response, particularly involving social justice issues in this context. Currently, she is conducting community-based research in K-12 schools (suicide first aid) to prevent youth suicide and with disaster-impacted populations in fostering meaning-making through one’s faith tradition (spiritual first aid).

 

Julia L. Whisenhunt is an associate professor of counselor education and college student affairs at the University of West Georgia. She specializes in the areas of self-injury, suicide prevention and creative counseling. She is particularly interested in the relationship between self-injury and suicide and ways that mental health professionals can apply this knowledge to clinical intervention.

 

Dennis Lin is an assistant professor at New Jersey City University, with areas of expertise in play therapy, child/adolescent counseling and assessment, suicide prevention/intervention, quantitative research and meta-analysis. He is also a certified master trainer of Applied Suicide Intervention Skills Training (ASIST).

 

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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.

Addressing religion and spirituality in counseling with bullying survivors

By Elizabeth R. O’Brien and Amanda L. Giordano June 5, 2017

The alarming prevalence of bullying in the United States warrants continued education and dialogue among counselors regarding effective ways to serve clients who are survivors of bullying. One aspect in need of more inquiry is the ethical and effective integration of religion/spirituality in clinical work with clients who have experienced bullying.

Bullying, defined as unprovoked abuse in the form of physical, verbal, relational or cyber acts of aggression, can intersect with religion/spirituality in several ways:

a) The experience of bullying can affect clients’ own religion/spirituality.

b) Clients can experience bullying by religious groups or group members.

c) Clients can experience bullying as a result of their membership in marginalized religious/spiritual groups.

In this article, we briefly discuss counseling considerations for each scenario.

 

 

Bullying’s impact on survivors’ religious/spiritual beliefs 

Consider the case of “Sara,” a 16-year-old Caucasian high school student. Sara does not fit within the thin ideal that is so prevalent among American high school females. Because of her insecurity regarding her physical appearance, Sara wears dark, loose clothing and tries to hide behind her long hair. Sara’s appearance, coupled with her low socioeconomic status, makes her the target of bullying from her classmates. Her classmates call her degrading names (verbal bullying), and many of her female peers refuse to engage with her at all (relational bullying). The cumulative effect of these daily taunts and exclusion leads Sara to counseling.

Sara’s experience of verbal and relational bullying constitutes a traumatic event. Peer groups are extremely valued and influential during adolescence. Through exclusion by her peers and being a target of their verbal assaults, Sara has cultivated a sense of hypervigilance and feelings of perpetual danger. Additionally, Sara has internalized shame regarding her body image and low socioeconomic status.

During the initial counseling intake, Sara reveals that these experiences of trauma and shame have caused her to question aspects of her religious/spiritual beliefs. Sara identifies as a Christian and reports that she has prayed for relief from bullying. She feels as though her prayers have gone unanswered. She also is questioning her worth to God and ruminating on the thought that perhaps he does not love her.

Sara’s case highlights several counseling considerations. It is clear that her experience with traumatic bullying at school intersects with her religious/spiritual identity. Specifically, Sara has attempted to respond to the bullying by using a religious coping skill (prayer), but she continues to struggle with painful emotions and negative thoughts. Furthermore, she is pondering existential questions concerning the nature of God and her inherent worth but has been unable to find adequate answers.

Therefore, it is important for the counselor to fully assess Sara’s religious/spiritual identity. A thorough assessment in the form of unstructured dialogue regarding Sara’s religious/spiritual history, or the use of standardized spiritual assessment instruments, can help the counselor understand Sara’s Christian identity and worldview.

Through the exploration of Sara’s religious/spiritual identity, the counselor discovers that Sara is uncertain about the concept of prayer and how it applies to her current situation. Sara expresses a desire to learn more about various types of prayer and gain insight into the purpose of the practice. The counselor and Sara agree that she specifically is searching for spiritual direction within the Christian faith tradition regarding the practice of prayer. The counselor provides a menu of options for how Sara might meet this goal. These options include self-study (i.e., reading Christian books and listening to sermons/messages on prayer), meeting with a Christian religious leader or engaging in experiential learning through the practice of various types of prayer (ritual, conversational, centering, contemplative, etc.).

After exploring each option, Sara decides that she would most like to meet with a Christian pastor for an interactive conversation about prayer. The counselor is able to refer Sara to a Christian pastor in the community and helps her set up a meeting. Along with prayer, Sara and
her counselor explore other ways in which Sara can use religious/spiritual coping strategies — such as finding support in her faith community — in response to bullying.

Sara’s experience of bullying has also affected her religious/spiritual worldview by calling into question her perceived value to God. The counselor enters into Sara’s frame of reference to unpack the meaning of her victimization as it relates to her relationship with God. The counselor is careful to utilize the skill of bracketing to avoid imposing her own beliefs onto Sara. Bracketing consists of intentionally compartmentalizing the counselor’s personal values to impartially enter into the client’s worldview.

Through their dialogue, the counselor reflects one of Sara’s core beliefs — that inaction is evidence of dislike. Continued exploration reveals that this belief emerged from Sara’s childhood experiences with her mother. Living below the poverty line, Sara often did not have the same possessions and opportunities as other children her age. She concluded that her mother’s lack of material provision reflected a lack of love and care. Sara then generalized this core belief to her relationship with God: His perceived inaction to stop the bullying constituted evidence of his dislike toward her.

The counselor and Sara examine evidence for and against this belief until Sara develops insight into the limitations of such a dichotomous view. Over time, Sara adopts a more adaptive and nuanced perspective of the meaning of others’ perceived inaction, which helps resolve her spiritual struggle. Throughout this discussion, the counselor is careful to keep in mind models of spiritual development, such as James Fowler’s stages of faith development, to work within Sara’s appropriate developmental level.

These represent only a few examples of how the experience of bullying can affect a survivor’s personal religious/spiritual belief system. Counselors should be skilled and competent in assessing client religion/spirituality, referring or consulting with religious/spiritual leaders, bracketing personal beliefs and considering models of religious/spiritual development in their conceptualization of the bullying survivor.

Bullying by religious/spiritual groups or group members

Next consider “Jacob,” a 31-year-old Black male who identifies as gay. He is employed as an accountant for a trucking and transport company that is characterized by strong Christian values. Working for this company for the past three years, Jacob has continuously dodged questions about his personal life because he fears his co-workers’ reactions to finding out he is a gay man.

A few weeks ago, one of Jacob’s co-workers found a picture on social media, posted without Jacob’s knowledge, that showed Jacob and his partner kissing at a friend’s cookout. Jacob was quickly outed, and his co-workers’ attitudes have become difficult for him to manage. Although some co-workers’ attitudes toward him have not changed, others have become hostile (verbal bullying/aggression). And still other co-workers with whom Jacob had no prior relationship have since approached him to discuss their perceptions of the deviance of his behavior (emotional bullying). Because of recent comments from his boss, Jacob also has learned that his advancement potential in the company has been compromised. These instances are very disturbing to Jacob and trigger his own struggle with how his sexual orientation intersects with his religious faith — a topic he has been avoiding since adolescence.

Jacob’s experiences illustrate how clients might feel that they need to deny or hide aspects of their cultural identity in order to belong to the larger group. This experience becomes even more complicated when individuals are struggling with strongly held values that they perceive to be in direct opposition to each other. To elucidate Jacob’s situation, he grew up in a very religious, Christian household. He learned at an early age that members of his family and faith community believe homosexuality to be in opposition to biblical principles. Jacob continues to value religion and spirituality, but he has struggled to reconcile his affectual orientation and the principles of his religion. These seemingly opposing identities (religious and gay) create internal conflict for Jacob.

Jacob’s counseling journey begins by exploring his experiences with his family of origin and the messages he received regarding religion and sexual identity. His experiences of bullying at work have reignited Jacob’s long-held fears that he will be rejected by those he loves. Specifically, he fears that both his biological family and church family will disown him if he is truthful and open about his life as a gay man. In addition, Jacob’s multiple minority statuses (Black and gay) compound his fear regarding potential discrimination.

Through dialogue and reflection, Jacob and his counselor uncover Jacob’s core beliefs about himself, the world and others, including the notion that God’s love, like his family’s, is conditional and must be earned through correct behavior. Jacob’s counselor is trained in Bowenian family systems theory and works with him to create a genogram to begin assessing the nature of relationships between Jacob and those he identifies as family.

In addition, the counselor prompts Jacob to identify the messages he received from individuals in his faith community, family members and religious texts regarding sexual orientation. This begins Jacob’s process of critically examining the relationship between his religious identity and his sexual orientation. The counselor takes a nonevaluative, neutral stance to allow Jacob to wrestle with his prioritization of multiple aspects of his identity and how he can experience more personal integration. Additionally, the counselor helps Jacob consider how he would navigate situations in which his personal beliefs regarding religion and sexual orientation differ from the beliefs of those in his family of origin.

Through counseling, Jacob gains insight into how his current work situation is triggering emotional experiences of rejection from his adolescence, a time when he was not equipped to deal with those experiences. Jacob’s counselor empowers him to see that he has built the resources and skills over time to negotiate his current situation both at work and in his family. Through this collaborative effort, Jacob is emboldened to contact the human resources department at his work. His experiences of bullying are met with concern, and an intervention plan is created to help manage the situation.

Despite the action taken by the human resources department, Jacob discloses to his counselor that he is in a place of unforgiveness toward the individuals who bullied him at work. He describes feeling withdrawn and cold toward these co-workers, where he once felt they had a collegial relationship. His counselor is careful in addressing these emotions because they likely are the coping mechanisms that helped Jacob feel emotionally safe in the past.

Jacob’s counselor explains that experiencing unforgiveness is a natural part of the forgiveness process. His counselor also is very clear with Jacob that the process of forgiveness is about releasing the hold that negative emotions have on him; it does not mean that Jacob is denying that what happened to him was wrong. As Jacob works on his journey toward forgiveness, he relies heavily on prayer and Scripture. These have always been reliable sources of religious coping for Jacob and help him feel connected to both his religious past and his spiritual present.

Bullying related to one’s religious/spiritual identity

A final way in which bullying can intersect with religious/spiritual issues is being bullied because of one’s membership in a religious/spiritual group. Consider the case of “Malik,” a 22-year old Middle Eastern college student. Malik is a practicing Muslim who is a member of his university’s Muslim Students Association and regularly attends worship at a community mosque. Recently, as a result of growing suspicion of Muslims in America, Malik has experienced both physical bullying and cyberbullying. In one instance, while walking home from campus, he was physically assaulted by a group of male students. They called him a “terrorist” while punching and kicking him. Additionally, he has received threatening messages on social media telling him to leave the country. These experiences led Malik to seek services from his college counseling center.

Malik’s religious/spiritual identity is an important part of his cultural makeup. His worldview is shaped by his understanding of Islam and his desire to adhere to the tenets of the faith. As a member of a marginalized religious group in America, Malik experiences oppression in both covert and overt ways, including the overwhelmingly negative portrayal of Muslims as antagonists on TV and in film, poor customer service at stores and restaurants, and being perceived as suspicious or dangerous by others. Additionally, he now is a survivor of various forms of bullying.

Malik reports to his counselor that he feels conflicted regarding his faith. On one hand, he is devoted to Islam, but on the other, he is ashamed of his religion because of the oppression he experiences. He reports feeling guilty for having negative thoughts about his faith and is struggling with feelings of hopelessness.

The counselor listens to Malik’s account with empathy and sensitivity. As a non-Muslim, the counselor also broaches the subject of this cultural difference. He asks Malik what it is like working with a counselor who does not practice Islam. Malik seems to appreciate this question. He acknowledges being nervous that the counselor will secretly be afraid of him as others have been. Broaching the differences between their religious/spiritual cultural identities and the potential impact of those differences on the counseling process helps provide a corrective emotional experience for Malik, who encounters acceptance and understanding from his counselor.

Within the context of this strong therapeutic alliance, the counselor enters into Malik’s worldview and validates his experience of feeling conflicted about his faith. By exploring his thoughts and feelings associated with his religious identity, Malik discovers that he is not ashamed of being Muslim (individual issue). Rather, he longs to be treated with respect and dignity by those who are not Muslim (systemic issue). This insight leads Malik and his counselor into a conversation about systemic oppression and advocacy.

The counselor describes Malik’s experiences with physical bullying and cyberbullying as barriers to his welfare and personal development on campus. As an advocate, the counselor discloses his responsibility to help remove these types of barriers and challenge injustice against oppressed groups. The counselor presents a variety of advocacy options, and Malik decides that he would like the counselor to act with him as he advocates for himself and other Muslims on campus. Malik and his counselor develop an advocacy plan that includes raising awareness regarding Islamophobia on campus, joining with other religious groups to develop a system of support (such as a buddy system to avoid walking alone at night) and alerting campus police to potential threats against Muslim students. The counselor works to empower Malik to develop the skills necessary to complete his advocacy plan.

As evidenced in this scenario, when addressing religion/spirituality among bullying survivors, counselors need a solid understanding of major world religions and the experiences of marginalized religious/spiritual group members in America. Additionally, counselors should have proficiency in the skill of broaching, defined as ongoing, genuine invitations for clients to explore their cultural identities in session. Furthermore, counselors should be able to recognize advocacy needs and be familiar with advocacy competencies and domains at the micro, meso and macro levels.

Resources for continued growth  

Given the many ways in which bullying and religion/spirituality can intersect, it is clear that counselors must be equipped to integrate these important values into the helping process. Although attention to clients’ culture is mandated by the ACA Code of Ethics and various counseling competencies, many counselors struggle to appropriately address aspects of clients’ religion and spirituality. The reasons for this struggle vary but can include counselors’ belief that they lack appropriate training, difficulty bracketing personal beliefs, countertransference issues regarding religion/spirituality and perceived setting constraints. Regardless of the reason, it is up to the clinician to engage in reflective practices and seek additional training as needed in this area.

Resources that are readily available to aid professionals in this task include the ACA Code of Ethics; the Association for Spiritual, Ethical and Religious Values in Counseling’s Competencies for Addressing Spiritual and Religious Issues in Counseling; and the Association for Multicultural Counseling and Development’s Multicultural and Social Justice Counseling Competencies. By increasing their knowledge and skills, counselors can feel competent to
address religion and spirituality with bullying survivors.

 

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

Elizabeth R. O’Brien is a licensed professional counselor and the immediate past president of the Association for Spiritual, Ethical and Religious Values in Counseling, a division of the American Counseling Association. She currently serves as the counselor education program director at the University of Tennessee at Chattanooga and is a UC Foundation associate professor. She has presented both internationally and nationally on issues related to wellness and beginning counselors, marriage and couples counseling, and spirituality and supervision. She recently completed a co-edited textbook titled Supervision and Agency Management for Counselors. Contact her at Elizabeth-O’Brien@utc.edu.

Amanda L. Giordano is a licensed professional counselor and an assistant professor at the University of North Texas. She specializes in addictions counseling, multiculturalism and religious/spiritual issues in counseling. She serves on the board of the Association for Spiritual, Ethical and Religious Values in Counseling and on the editorial review board for the Journal of Addictions & Offender Counseling. Contact her at Amanda.Giordano@unt.edu.

Letters to the editor: ct@counseling.org

 

 

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