Tag Archives: interdisciplinary

Adding a counselor’s voice to law enforcement work

By Bethany Bray March 17, 2016

For Gregory Moffatt, counseling and crime solving go hand in hand.

Moffatt, a licensed professional counselor (LPC), runs a private practice in which he specializes in working with children who have experienced physical or sexual abuse. He is also a professor of counseling at Point University in West Point, Georgia.

The other half of his career, however, is a little more unconventional. He’s a risk assessment and psychological consultant for businesses, schools and law enforcement agencies. Moffatt has done everything from assisting with hostage situations and unsolved cold case investigations to teaching at the FBI National Academy in Quantico, Virginia. In addition to providing training and consultation, he evaluates police officers who have been involved in a duty-related shooting to determine if they’re ready to return to active work on the force.

He’s also filming on-camera commentary as a psychological consultant for a new cable television show on hostage situations. The program, titled “Deadly Demands,” premiers March 21 on Investigation Discovery, a network of the Discovery Channel.

After years of working with corporations and law enforcement agencies, Moffatt is often the person they call to evaluate unusual situations, such as when an employee is making co-workers uneasy or

Gregory Moffatt, LPC and professor of counseling at Point University in West Point, Georgia

Gregory Moffatt, LPC and professor of counseling at Point University

a case arises that doesn’t fit the norm. It’s not a niche that he initially set out to carve for himself, but rather one that he entered “through the back door,” he says.

When Moffatt first started teaching at Point University more than three decades ago, he was the only professional counselor on campus. One day, the university’s administration approached him and asked for his help with a situation involving a student who was stalking another student.

“Stalking laws weren’t in place. Back then, even the term [stalking] wasn’t an everyday term,” says Moffatt, an American Counseling Association member. “Back then, hardly anyone did work in violence risk assessment.”

As he got involved in the case, Moffatt started researching risk assessment methods, which grew into a personal area of interest. He eventually established his own consulting business, through which he provides workplace violence assessment and training. The FBI contacted him to provide training at its academy in Quantico after he published an article in an academic journal on violence risk and assessment.

Law enforcement agencies are good at lots of things, but threat assessment isn’t always one of them, Moffatt says. That’s where his skills as a professional counselor can help fill in the “why” of a situation, he says.

Moffatt uses his counselor training to look at a specific situation’s “collection of evidence,” he says. For instance, how does the person tell his or her story? What indicators can be found in the language the person uses? What does his or her past behavior indicate? What coping skills does the person have?

“My job is to tell them [a company or law enforcement], ‘This is what I think; this is what you’re looking for,’” Moffatt says. “The question for us, in mental health, when someone’s sitting in our office is, ‘Is this person a risk?’ Sometimes the answer is yes. … How many coping skills does he [the client] have in his toolbox? If it’s a pretty empty toolbox, then I’m worried.”

For example, Moffatt was contacted by local law enforcement to evaluate the threat level of some letters a judge was receiving in the mail. Officials suspected the letters were being written by a man who had come through the judge’s courtroom for a minor infraction, he says.

Moffatt looked at the man’s behavior history (he had brandished a firearm in the past but never fired at anyone) and the language used in the letters. His counselor training helped him pick up clues — for example, symptoms of delusion and other things that would make a person unpredictable — to determine that the man was a “big talker,” but that the letters were most likely a way of “puffing out his chest” rather than an actual threat.

“I thought there was a very low possibility that he would shoot this judge. Years later, nothing has come of it,” Moffatt says.

Today, he works regularly with the Atlanta Police Department’s cold case squad and writes a regular column on children’s and family issues for The Citizen, a newspaper distributed in Fayette County, Georgia.

Moffatt says he is drawn to the sometimes gritty specialty of crime and violence assessment because he likes being part of the solution and helping to bring some closure to the victims of crimes.

“The world is not made up [solely] of bad guys and good guys,” he says. “If you go to any prison in the country, you will find a small percentage [of the inmates who] are horrible and need to stay locked up for the rest of their lives. The rest are human beings who have made a mistake. The hardest part about our job [as counselors] is to have compassion. We can take people, in any condition, and help them become more functional.”

 

Q+A: Gregory Moffatt

 

You encourage all counselors to learn more about risk assessment, whether through reading, professional development, trainings, etc. Why do you feel this particular topic is important for counselors to know?

Risk assessment is necessary in any clinical context. Violence happens in homes, schools, workplaces, on the bus, on the street and in the synagogue/cathedral. Assessing for violent behavior against others is just as important as assessing for suicide risk, [which is] something we do regularly. You don’t have to specialize in workplace violence or school violence for this to be part of your assessment toolbox.

 

Do law enforcement professionals often think of or turn to psychologists first when looking for help with mental health expertise? From your perspective, what can a professional counselor offer in this area that is different than other helping professions?

Actually, I don’t think most law enforcement people know the difference. Even when they do, they often have limited or no budgets for outside consultation. Professional counselors are cheaper than psychologists, typically. Counselors are just as competent to offer fitness for duty interventions/assessments, post-shooting intervention, violence intervention/anger management and other common needs in law enforcement as any psychologist — assuming, as always, that one is trained to deal with that population. This training is readily available to LPCs.

 

What suggestions would you give to counselors looking to help or make a connection with their local law enforcement or violence prevention agencies?

Law enforcement agencies are notoriously fraternal, and even agency to agency there is little cooperation. A given agency believes it is better than any other agency, and going outside law enforcement is seen as a negative. However, developing relationships and bringing skills to the table — especially if it is cost-effective — is the way in the door over time.

 

What are some of the main takeaways that you’ve gleaned from your work with law enforcement and risk assessment that you want professional counselors to know?

Behavioral/mental health issues are present in all corners of life. Finding a way to apply your interests in mental health in specific climates — e.g., schools, law enforcement, court — is what makes one’s career fascinating and rewarding. I look back on 30 years of work — opening doors, looking for opportunities and taking those opportunities — and I couldn’t be happier. I’ve helped hundreds of children, written hundreds of articles and numerous books, spoken to thousands of audiences and helped put many bad guys in jail — hence, making the world safer and people happier. Who could ask for more?

 

****

 

Read more about Gregory Moffat’s work and find a list of suggested resources on trauma, violence, parenting and other topics at his website, gregmoffatt.com

 

****

 

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

 

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

Who influences today’s counselors?

Compiled by Bethany Bray March 3, 2016

WWYD_1Who are the major influences on today’s counseling professionals? What voices, both within and outside of the profession, are counselors listening to and intently following?

Recently, Counseling Today posed these questions to a random assortment of American Counseling Association members and a few select counseling leaders. The responses were as diverse as the association’s membership. From personal mentors and supervisors to eminent thinkers and authors, from human rights champions to neuroscientists and others on the cutting edge of research, today’s counselors are influenced by a wide variety of voices.

 

Editor’s note: This online exclusive article is an addendum to Counseling Today’s March cover story on influential thinkers. Many thanks to the numerous counselors across ACA who contributed to this project.

 

****

 

 

The counselor who has had the biggest impact on me is my clinical supervisor, Kim Kelley. She taught me the value of truly practicing self-care, rather than just giving lip service to it. She also helped me with patience and self-compassion. She is a shining example of what an ethical, humane practitioner is like.

Brad Reedy, a psychologist whom I have had the pleasure of knowing well, has also had a profound influence on the way I work with clients. He once said to me “the way you hold the client in your mind matters.” Having seen how well he holds clients in his mind, I have tried to emulate this.

James Hollis has written terrific books that compel a deeper examination of the human condition. He taught me that psychotherapy means “listening to the soul,” according to the Greek roots of those words.

Outside the profession, I have been most influenced by my parents, who together taught me the value of equality, generosity and the balance between a worldly life and a spiritual life. They believe that fortunate people have a responsibility to help those less fortunate, and I try to carry this idea from them in my daily life and work.

One of my biggest inspirations in life comes from the founder of Aikido, a man named Morihei Ueshiba. He was a very disciplined, thoughtful man and he developed this martial art to serve humanity. Aikido teaches self-control, patience, poise, relaxation, harmony and care for all beings. I have been profoundly influenced by his teachings and writings.

The author Hermann Hesse has deeply affected my thinking through his books, most notably Siddhartha and Steppenwolf. He writes with such heart, and he captures the beauty and struggle of humanity so well. — Peter Allen, program director for College Excel in Bend, Oregon

 

 

****

 

 

Aaron and Judith Beck’s version of cognitive behavioral therapy is by far the most influential to my practice. This model can be applied to a wide variety of problems and offers a strong framework for me, as a counselor, to conceptualize my clients’ problems. It also provides a multifaceted framework for client improvement. Behavioral techniques (e.g., relaxation) can be used to bring about rapid improvement in symptoms. This allows for more long-term cognitive change to occur as clients are able to gain relief from overwhelming emotional states. The model just makes sense to me.

Richard Ryan and Edward Deci are also currently large influences for me. They are in the world of psychology as a whole, but not heard about much in what we do as counselors. Their self-determination theory is important to my practice. This theory informs a great deal of my work with criminal justice clients, but I would encourage any counselor to investigate this approach to understanding human behavior and motivation. I believe self-determination theory can help us wrap our heads around client problems and, most importantly, solutions. — Jason E. Newsome, licensed professional counselor (LPC), approved licensed professional supervisor (ALPS) and president of Dayspring Counseling Center in Dunbar, West Virginia

 

 

****

 

 

 

I am a psychologist who has been a school teacher and principal. The people who influence me most and allow me to grow as a professional and as a person are my patients. Each of the people I meet with has a unique story and have chosen to include me in one of their chapters. I view that as a great honor to accompany them in those pages and listen to them as the writers. I listen to what motivates them and their style of writing. I listen for how they choose to express themselves and the pictures they paint with their words. I try to imagine their characters in their lives and how they have contributed to their growth. I help them recreate timelines, settings and plots. I listen and help them process what they believe to be the climax of their story and I guide them to use different points of view. They are the writers and I learn from their life stories and sometimes, if we are lucky, there are happy endings but I always know there is suspense and adventure in every one of my patient’ s stories. — Robyn Glickman, school and clinical psychologist in Michigan 

 

****

 

I rely on the works of brilliant psychiatrists who are neuroscientists such as Bruce Perry, Daniel Siegel and Bessel van der Kolk. Without understanding the brain, it is difficult to be effective as a counselor. The brain and mind impact each other which means at a minimum, the two are intertwined with thoughts, emotions, chemicals, genetic predisposition, previous experiences and misfiring neurons — which means that focusing on the psychology of the client alone is not enough. I am a licensed professional counselor in Macomb County, Michigan and most of my experience has been with children and adolescents; predominantly those with an array of anxiety and mood disorders and (who) often come with a history of abuse, neglect or trauma. In addition to an eclectic approach to counseling based on the popular theorists of our field, I use modalities such as neurofeedback and animal assisted therapy in my work. — Amy Johnson, LPC, unit marketing manager and director of the animal assisted therapy certificate at Oakland University School of Nursing, Rochester, Michigan

 

****

 

 

Paulo Freire has tremendously influenced my work as a counselor educator. Freire was a Brazilian educator who focused on the educational experiences of the most marginalized members of Brazilian society. His book Pedagogy of the Oppressed transformed how I view education and inspired my work with marginalized communities to foster critical consciousness. In my courses I avoid lecturing, reduce power differentials, encourage dialogue and questioning and promote critical consciousness in my students. Inspired by Freire, my research focuses on the oppression of marginalized groups; I study the negative impacts of racism and internalized racism. Freire’s teachings also inspired my research on strategies that promote critical consciousness and sociopolitical development in counseling students and K-16 (kindergarten through college) students. Freire’s notion of praxis (a circular marriage of theory and practice) is also a major influence. I am co-founder of a charter school that uses my work on sociopolitical development to foster the empowerment of marginalized students. — Carlos P. Hipolito-Delgado, associate professor and program leader in the counseling program at the University of Colorado Denver and chairman of the ACA Foundation

 

****

 

 

Within the counseling profession, my work has been most influenced by three specific theorists who have informed how I practice, how I believe mental health issues develop and how they are best resolved: Carl Rogers, William Glasser and Albert Ellis. I use one or a combination of the three approaches when treating clients. Rogers taught me how to treat clients that simply need a safe space to process and express. Glasser taught me how to help clients who make poor decisions. Finally, Ellis taught me how to resolve depression, anxiety and other mental health diagnoses and symptoms. Together, the three approaches can be used to treat almost any client that I would see.

Outside of the counseling field, the Dalai Lama has most influenced my views and my work. There are many things I appreciate about his views. Obviously, he has lived a life focused on helping others. He presents with very clear themes in his life: non-violence, appreciating the moment and spiritual harmony. He instilled in me the idea of living a principled life, one where we focus on ourselves as people and being harmonious with nature, instead of being focused on the past, the present or material gains. He has also modeled activism, a key facet of being human and being a counselor who advocates for my clients. — Patrick Powell, licensed mental health counselor (LMHC) in Florida, Licensed Professional Counselor-Mental Health Service Provider (LPC-MHSP) in Tennessee and assistant professor and director of the Counselor Education and Supervision Program in the College of Counseling, Psychology and Social Sciences at Argosy University in Sarasota, Florida as well as president of the Florida Association of Counselor Education and Supervision

 

****

 

 

Oprah Winfrey is the preeminent voice that influences my counseling practice with athletes. Her personal and professional life stories provide both an example and game plan for how to become your best in your own life. The athletes that I encounter at all levels are expected to perform at their physical peak before they have fully completed their development as a person. I view my role in performance enhancement as helping athletes develop other strengths to help improve their sports performance. Oprah has created a world through her interaction with other leaders where being who you are, right where you are, is okay. But she stresses to start the work of personal growth from there! — Vonetta Kalieta, LPC, instructor in the Graduate Department of Psychological Counseling at Monmouth University in West Long Branch, New Jersey and practitioner at Learned Excellence for Athletes in Tinton Fall, New Jersey

 

****

 

 

The caregivers and children (that I work with) have shown me the immense potential for global change held within attachment relationships. They have taught me to trust the process, especially the parallel process. In genuine, therapeutic relationships support of the primary caregiver (and) the caregiver’s attachment relationship with that child can heal and grow. The growth often spills over into positive behaviors, self-esteem and healthier relationships with others. It is remarkable. — Anna Van Wyck, LPC and infant and family specialist in Mears, Michigan

 

****

 

 

I, like many counselors, use different approaches to my counseling. I work with college students, and find that Cognitive Behavioral Therapy (CBT), positive psychology and the solution-focused [approach] work well. For traditional aged college students this is often the age when depression and anxiety are first showing up, so I feel it’s helpful to use methods that will give them tools to learn how to cope and help themselves. CBT is also one of the most widely studied therapies for depression and anxiety and it also works well with various cultures.

As a college counselor I also do career counseling. I use some of the work by Mark Savickas, which is more narrative in approach. For students, it is often helpful to work with them in career counseling to help them connect with prior life experiences and interests to help assist in the career decision-making process. — Amy Lenhart, LPC, a counselor at Collin College in Frisco, Texas and president of the American College Counseling Association, a division of ACA

 

****

 

 

Rarely does a client come to us without some type of crisis in process. As counselors, we thrive on helping people make meaning of the challenging events that may overtake their lives or rewrite dysfunctional beliefs that may improve their life stories. Yet, these efforts take a remarkable toll if the “givers” do not replenish their minds, bodies and souls. Robert Wicks, psychologist, prolific author, speaker and sage has spent his career exploring how resilience is nurtured and sustained to promote growth post-trauma. Of particular note is his concentration on how caregivers can help themselves by finding crumbs of alone time, conducting daily debriefings, jettisoning false personal beliefs and practicing mindfulness. My personal favorite is his theme of “being faithful in the moment” with clients, family, friends and self. Crises will come, but it is how we handle them personally and with our clients that will be remembered. — Tina Buck, a licensed graduate professional counselor at Carroll County Youth Service Bureau in Westminster, Maryland

 

****

 

 

Resilience theory has been influential to my counseling practice, including the ideas of Steven M. Southwick, George A. Bonanno, Ann S. Masten, Catherine Panter-Brick and Rachel Yehuda (co-authors of the 2014 journal article Resilience definitions, theory, and challenges: interdisciplinary perspectives). As I work with children and adults who experienced trauma, a key factor is guiding the development of resilience. Masten noted “positive assets” in the individual provide strong potential for resilience, and recognized spirituality and religious beliefs as important. With great amount of effort to counsel and help those who are experiencing negative effects following a trauma event, Bonanno suggests the need to focus on “what goes right in people who negotiate potentially traumatic events with equanimity.” Resilience theory changes perspectives noting, “the experience of trauma does not only yield pathology.” In counseling, I want to provide clients with support and clinical perspective integrated with elements that spawn and develop resilience.

Outside of the counseling profession, the greatest influence on my work comes from strong religious leaders. Speakers such as Ravi Zacharias (Ravi Zacharias International Ministries), John Ortberg (Menlo Park Presbyterian Church) and Josh McDowell (Josh McDowell Ministry) emphasize the importance of maintaining faith, hope and prayerfulness. They encourage compassion and forgiveness as important to healing and healthy living, which are attributes supported by research (Baskin and Enright, 2004). Many individuals who seek counseling note that faith-based practices are desirable and soothing. Faith-based characteristics reflect counseling ethical practice such as genuine caring, non-judgmental acceptance and kindness. Ideas from a faith-based perspective strengthen counseling focus, empathy and compassion as well as serve to provide a means of self-care for the counselor and healing properties to clients. For these reasons, gleaning from religious leaders inspires counseling work that is wholesome, passionate, fully engaging, client centered and self-supportive.

Susan Luck, a licensed clinical social worker (LCSW) in New York and Virginia and instructor of graduate counseling and human services courses at Liberty University Online

 

 

****

 

 

There are many influential individuals within the counseling realm that have influenced my work. One such individual is Brené Brown (research professor at the University of Houston Graduate College of Social Work) who has helped shape me into a better counselor but as an individual as well. Her research on imperfection, shame, courage, living whole-heartedly, self-compassion and living authentically have started to become the bedrock of my approach. These principles, when applied with Dialectical and Cognitive Behavioral Therapies, have made a strong impact on my clients. These principles are important because if we can pull out our thoughts, behaviors, secrets and whatever we don’t talk about, the fear of shame and guilt can be put out there with people that we trust and know that trust wouldn’t be violated. Brown explores the importance of talking about these things in our lives, which allows us to be vulnerable and really connect with each other on a whole-heartedness level. — Noor Pinna, LMHC and owner of a private practice in Fishkill, New York

 

****

 

 

Over the 50+ years of my connection to counseling, there have been significant changes. In the beginning, we studied core philosophies of theorists such as Carl Rogers and Albert Ellis. There was a tendency, even then, to skip study of the core philosophies and jump to use of the responses (e.g., techniques) emerging from those theorists — a flawed practice since attempting to emulate another without being that person is inevitably faulty.

The contemporary influence of Bill Gates and Steve Jobs has made that “practice-sans-theory” approach become even more extensive. I can even download an app that will send a daily note of encouragement to a client — and I don’t even have to know what it says. I’ll be interested to listen to ACA conference discussions to see if practice emerges from philosophy. I suppose I could just Google my question — or ask Cortana. — Brooke B. Collison, professor emeritus of counselor education at Oregon State University and ACA past president (1987-1988)

 

****

 

 

I have been drawn to the social equality philosophy and individual psychology of Alfred Adler as represented principally in the works of Rudolph Dreikurs, whom I had the pleasure of knowing for a brief time before his death. Child and classroom guidance, parent education and the influence of one’s early life experiences as revealed in early memories first got my attention as “common sense” and teachable.

As a practitioner, Dreikurs’ empathy was based upon insight into the human condition. He had little time for contributing to anyone staying in a state of emotional upheaval. Both Dreikurs and Adler were strategists who gently invited clients to enter into a dialogue. Then they used their unique skills to uncover and challenge mistakes in one’s private logic and guide clients to new approaches in their life tasks at work, in their families and friendships, identity and spirituality. Their practical methods based upon a sound philosophy won me over. — Thomas Sweeney, professor emeritus of counselor education at Ohio University, executive director emeritus of Chi Sigma Iota International and ACA past president (1980-1981) who lives in Lexington, North Carolina

 

****

 

 

Richard James has worked for more than 30 years developing training, prevention and intervention programs for law enforcement, military and community agencies to address the timely issue involving the intersection of mental illness with law enforcement/corrections/military veterans in crisis situations. I’ve had the honor of studying under Richard James as a student and currently work as a junior faculty under his mentorship co-leading the Crisis Research Team (at the University of Memphis) in engaged research projects. His thorough text on crisis intervention strategies outlines the (crisis intervention) training he pioneered 30 years ago to train law enforcement to identify and de-escalate people with mental illness in the field, which is used in thousands of jurisdictions on three continents. Although he is at the end of his career, he exhibits incredible passion for mentoring junior faculty and masters and doctoral students in engaged research towards helping discover viable solutions for improving the treatment of mentally ill offenders.

As a play therapist and someone who works with offenders and addictions, I am also influenced by several clinicians/researchers who together help me practice neurobiologically-informed counseling. Paul Wachtel articulates relational psychoanalysis as it is practiced in contemporary settings. He describes a therapeutic approach that is flexible, technically eclectic (including behavioral therapy) and connects with the emerging evidence of interpersonal neurobiology that helps me conceptualize client-therapist dynamics. Bruce Perry’s work in interpersonal neurobiology as it relates to trauma and the concept of neurosequential interventions has influenced my continuous assessment and choice of intervention strategies with addiction and offender clients from a developmental perspective. I have found this to be most effective in engaging challenging clients to really work in treatment. Finally, the creators of Theraplay, Phylilis Booth and Ann Jernberg, provide a framework for an object-relations/attachment approach to working with interpersonal trauma that has helped me improve outcomes with challenging populations. — Leigh Falls Holman, licensed professional counselor-mental health service provider (LPC-MHSP), registered play therapy supervisor (RPTS), clinical mental health counselor (CMHC, assistant professor in the Counseling, Educational Psychology and Research program at the University of Memphis, associate editor of the Journal of Mental Health Counseling and president of the International Association of Addictions and Offender Counselors (IAAOC), an ACA division

 

****

 

 

For me, the most influential figure for establishing and developing a positive counseling relationship by the use of empathy and unconditional positive regard is Carl Rogers, augmented by the work of Gerald Gladstein, a pioneer of non-verbal communication and Howard Kirschenbaum, who tirelessly advanced knowledge of Carl Rogers as a person, philosopher, practitioner and giant in the counseling field. He kept Roger’s work fresh and more relevant to newer generations of counselors. The most influential person for providing assessment tools and strategies for helping clients know who they are, and how vocational personality informs decisions related to choosing a college major or program of study and occupation is John Holland, as augmented and advanced by Janet Lenz and Robert Reardon (co-authors of Handbook for using the Self-Directed Search: Integrating RIASEC and CIP theories in practice). Reardon and Lenz integrated these two theories of vocational choice with the self-directed search, and nestled it into college career and counseling centers where it can maximize Holland’s influence. — Peter A. Manzi, national certified career counselor (NCCC) and master career counselor (MCC) who lives in Rochester, New York. He is also contributing faculty in the School of Counseling, College of Social and Behavioral Sciences at Walden University

 

****

 

 

Wow. This is a tough question! I would have to say (my influence) is Jon Carlson. There are two specific reasons for this. First, as a clinician—specifically an Adlerian, Jon’s scholarship in the work of Alfred Adler and his approach is seminal. He has been an ambassador of Adlerian therapy to the counseling field, and has influenced the wider recognition and acceptance of Adler’s ideas and practice in schools and in mental health settings. As a counselor educator, Jon Carlson has been influential to me through his vast library of video recordings that he has produced with the acknowledged masters in the field for over 20 years. These videos have a simple, yet overwhelmingly effective formula that I feel is invaluable to educators and trainees: Use real clients in live settings, and watch the entire interaction without interruption. And while it might be easier to use actors and more efficient to use scripts, I have found no better tool to help illustrate the processes of effective counseling. Truly, this is his gift to the field, and we are the beneficiaries.

Also, I would have to say I am influenced by the work of John Gottman (and his wife, Julie Schwartz Gottman). As one of the foremost researchers in couples and couples counseling, John Gottman’s approach has utilized observational methods to painstakingly study the relationships of well-functioning and poorly functioning couples. He has observed the key sequences in ordinary, everyday interactions that have allowed for old myths to be shattered. In addition, Gottman employs cutting-edge mathematical modeling to derive some of the essential dynamics of the couple relationship that I have modified in my own research on the therapeutic relationship. I am using his affective coding schemes and mathematical modeling equations to look at novice and master clinicians to decode the key sequences in the therapeutic relationship, and hope to uncover the key elements to successful counseling endeavors. In addition, as clinicians, the Gottmans have put their research efforts into a training program that is impacting thousands of therapists and even more couples to work through complex issues and lead better lives. — Paul R. Peluso, LMHC, LMFT, professor and chairman of the Department of Counselor Education at Florida Atlantic University in Boca Raton and president of the International Association of Marriage and Family Counselors (IAMFC), an ACA division

 

****

 

 

The late, great Viktor Frankl Holocaust survivor, psychiatrist, neurologist and author of the prolific Man’s Search for Meaning is my go-to source for inspiration and guidance when it comes to troubleshooting irrational thinking and behaviors. Frankl believed that dysfunction is driven by the lack of an individual to perceive the meaning and purpose they have in life. Rather than enhancing the self through an internal locus of control, people focus more on their external locus of control to make themselves feel valued. In the 1960’s, Frankl stated that the U.S. population was far more materialistic than the German population. This can be the result of the onslaught of commercialism that emerged in the mid 20th century that conditioned people to move their beliefs to wanting material things rather than procuring items they actually needed. It is not things that nurture a true sense of belonging, but the procurement of non-material cognitions. — Vanessa L. Dahn, LPC and adjunct professor of sociology and psychology at Colorado State University-Pueblo, Pikes Peak Community College and Southern New Hampshire University as well as executive director of Safe Landing Group Center, a facility for at-risk youth in Calhan, Colorado

 

 

****

 

 

Like many counselors, I apply an eclectic approach to therapy and it seems that regardless of the presenting problems, way in which information is gathered, treatment goals are established and interventions are implemented, the theories that tend to drive these processes for me almost always come back to Fritz Perls, Carl Rogers and Albert Ellis. The importance of self-awareness emphasized by Perls, as well as the humanistic perspective on self-actualization influenced by Rogers and Ellis’s practice of cognitive restructuring in an effort to challenge self-defeating irrational thoughts are all foundational concepts to my practice that weave their way in and out of sessions throughout the entire therapeutic process. — Alyson Carr, LMHC, qualified supervisor and doctoral candidate at the University of South Florida in Tampa

 

****

 

 

Because I specialize in neurological cases, I like the work of Daniel Siegel. He gives beneficial information about counseling and the brain. I like psychiatrist John Ratey for bringing our attention to exercise and mental health. Norman Doidge and Jeffrey Schwartz are impressive with their work on neuroplasticity, which explains how change is attained biologically through therapy. I also like the work of M. Scott Peck, who was one of the most brilliant minds in psychiatry and psychotherapy in the 20th century, in my mind. Every counseling professional and student should read (Peck’s book) The Road Less Traveled. Cardiologist Herbert Benson discovered the relaxation response in the 1970’s and really changed the way medicine views the person. Instead of viewing the human being as dichotomous, we found out the human being is really integrated system. — Kevin Wreghitt, a mental health clinician counseling people with disabilities in day habilitation and college settings in Massachusetts

 

 

****

 

 

From within the profession two men have influenced my thinking greatly, and I cannot say one more than another because both have been creative visionaries: Gilbert Wrenn and David Tiedeman. Each was each was ahead of his time in foreseeing the usefulness of the computer and the advances technology would bring to the counseling professional. Yet both were holists, humanists and poets. I was fortunate enough to meet each of them before I was president of ACA and both communicated with me in poetry and prose throughout my presidency, sending encouragement and inspiration.

Two women also have influenced me professionally. The first, Katherine “Kitty” Cole, and I met at a conference. She was president of the National Career Development Association (NCDA) at the time. I was barely involved. She said that she thought I had talent. Whether I did or not is moot. She put me on a committee. I was hooked. Thelma Daily (ACA president 1975-1976) is the other woman. Never had I met someone so encouraging. Model par excellence, as she did for so many, she mentored me. — Lee Richmond, professor of education at Loyola University in Baltimore and ACA past president (1992-1993)

 

****

 

My clinical work is informed by the legendary Irvin Yalom. Author to a plethora of fiction and nonfiction writing, Yalom has been instrumental in promoting therapeutic transparency and embracing the humanity of self and relationship. He suggests that when we dare to confront (what he calls) the four “givens” of existence (inevitable death, aloneness, free will and the need for meaning construction), it is possible to experience personal growth and change. All of Yalom’s work centers around the authenticity of relationship and to this, I am indebted.

Last year when my article “What Would Yalom Do” (a tribute to his work When Nietzsche Wept) was published, Irvin Yalom emailed me his gratitude in observing his work. He is not a man who needs my endorsement. Yet, he took the time to thank me. This is a man who exceeds his scholar, he is an artist. — Cheryl Fisher, a Licensed Clinical Professional Counselor (LCPC) in private practice in Annapolis, Maryland and visiting full-time faculty member in the Pastoral Counseling Program for Loyola University Maryland

 

****

 

We invite you, in turn, to consider who influences your work as a counselor. The exercise may spur some self-reflection on what methods and philosophies you place value on and how you have learned and evolved over the course of your career. We encourage you to share your responses in the comments section below.

 

****

 

 

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

 

Letters to the editor: ct@counseling.org

 

Handle with care: Addressing child trauma in West Virginia

By Bethany Bray May 5, 2015

“Their normal is chaos, and we have to bring calm.”

For public school students in West Virginia, the calm therapist Felicia Bush is referring to comes in the form of an innovative, multidisciplinary program that aims to identify and treat trauma in real time.

Bush, a provisionally licensed social worker with a master’s degree in counseling, provides trauma-focused therapy for youth in the public schools through the Defending Childhood Initiative (DCI). The program brings together law enforcement, public school staff and mental health professionals to create a HandleWithCaresafety net for youngsters, bridging the gap between what happens at home and the hours they spend at school.

For example, a child might witness police responding to a domestic violence incident that occurs in the home in the wee hours of the morning. Through DCI, police officers are trained to note whether a child was present during such incidents. Officers then find out what school the child attends and file a “handle with care” notice with the school. The one-page form doesn’t provide details about what happened but simply lets the school know that the student may need extra attention.

“The child sometimes discloses what happened but not always,” Bush says. “You don’t have to know what happened. You just have to know that something happened that potentially can affect the child’s ability to learn.”

In other cases, a parent or caregiver might alert the school that something is going on at home, such as a parent’s impending military deployment or the death of an extended family member.

After being alerted, DCI’s network clicks into place to provide whatever extra care the child may need at school — from a space to shower, nap and change clothes to a chance to retake a test to recurring sessions with a trauma-focused therapist.

Law enforcement personnel and entire school staffs — from principals to the cooks in the cafeteria — complete DCI training to help them identify and be sensitive to child trauma. The initiative is designed to stem both the short-term and long-term effects of trauma, especially its impact on children’s ability to learn.

“Trauma is a public health issue, not just a counseling issue,” says Carol Smith, a licensed professional counselor (LPC) and member of the DCI advisory board in West Virginia. “[Addressing this] is a huge paradigm shift, and it’s going to take all of us.” That includes medical and mental health professionals, educators, law enforcement personnel, religious leaders and others in the community, she says.

 

Getting started

The DCI in West Virginia is a localized version of a program first introduced by U.S. Attorney General Eric Holder. He launched DCI in 2010, prompted by the plentiful research showing that trauma affects a child’s ability to learn and is associated with long-term physical and mental harm.

In West Virginia, U.S. Attorney Booth Goodwin has overseen the launch of a DCI program tailored to local needs, including creation of the “handle with care” form used by law enforcement.

A group from the Child Witness to Violence Project, a successful multidisciplinary trauma-focused program in Brockton, Massachusetts, came to West Virginia in 2011 to train DCI participants before the program launched in pilot schools, according to Tracy Chapman, the victim witness coordinator in the U.S. Attorney’s Office for the Southern District of West Virginia.

“We looked at what works, and we looked at the needs of West Virginia — the needs that are impacting our children, our classrooms,” she says.

The first pilot schools in West Virginia adopted the program in 2013. In less than two years, law enforcement personnel have recorded 414 incidents involving 768 children through DCI, according to Charleston Police Lt. Chad Napier, a coordinator for the program.

Now, after its success in five different pilot schools at the elementary, middle and high schools levels, the stage is being set to roll the DCI program out statewide.

This spring, it was announced that the DCI program will now be headquartered in the newly created West Virginia Center for Children’s Justice, located at a state police facility in Dunbar. This change will allow DCI to be more easily implemented statewide while adhering to a consistent model, Chapman says.

“We can no longer work in our silos focused on one piece of a child’s life puzzle. We must work together to make systemic improvements that can truly change the trajectory of a child’s path,” Goodwin said at the center’s unveiling. “… This [Center for Children’s Justice] will improve communication and collaboration between law enforcement, prosecutors, schools, advocates and mental health providers, and help connect families, schools and communities to mental health services.”

Goodwin has been the driving force between DCI in West Virginia, making it a personal priority, Chapman says. “As a federal prosecutor, we can’t arrest our way out of crime and the types of problems that are affecting our communities,” she says. “We have to provide the resources to children and to communities and to schools to actually change and break the cycle. We have to intervene early, and we have to intervene effectively with kids to help keep them on the right track. That’s his [Goodman’s] message.”

 

Creating a safety net

Through DCI, school staffs work to provide as much specialized care as possible for trauma-affected children, such as partnering them with a mentor or ensuring that they can make up missed homework. The school counselor plays an integral role in these efforts, from readying a schoolwide traumatic crisis response plan to identifying children and families who could benefit from extra mental health support, says Smith, a member of the American Counseling Association and president of the West Virginia Counseling Association.

When children affected by trauma need extra help beyond what the school can provide, they are referred to mental health practitioners who provide in-school therapy as part of DCI. All of these practitioners are specially trained to treat trauma. One of DCI’s pilot schools, an elementary school in Charleston, has established a permanent mental health clinic in the school.

“[DCI] gives services to the child immediately upon the experience of a potentially traumatic event. If it’s needed, the service is there, and there’s no stigma to it,” says Bush, executive director of Harmony Mental Health, a nonprofit mental health and social services agency based in Parkersburg.

Prior to the launch of DCI, Bush says, school staff members had to guess when something had happened in a child’s life outside of school, clued in by sudden behavior changes or when Child Protective Services personnel came to the school — often weeks later — to ask the child questions. Now the initiative is allowing professionals to help students deal with trauma in its immediate aftermath.

Professionals involved in DCI agree that the program is helping to reach students who might have previously fallen through the cracks and not been identified as needing help. “A lot of these kids were never on anyone’s radar unless they were a direct victim,” Chapman says.

 

A culture of safety

In addition to providing extra help for individual children, the DCI program trains educators to introduce schoolwide initiatives that focus on mental health.

In one example, the school principal and other staff members greet students coming off the bus each morning. The students are asked to give a thumbs up or thumbs down, depending on how they are feeling that day. The principal uses this to gauge the school population’s overall climate for the day and tailors the school day accordingly. On “thumbs down” days, this could include having a therapy dog visit the school, postponing testing or introducing extra small group counseling sessions with a school counselor.

A similar initiative is introduced for classrooms. Upon arriving, students are asked to take a marble and place it in a bowl. They select a green marble if they are feeling OK and a red marble if they are feeling bad. The teacher can gauge the classroom’s needs by checking the bowl, adding extra wellness initiatives to the day such as breathing exercises or playing soothing music in the classroom (see sidebar, below).

The program also requires a provider of trauma-focused cognitive behavior therapy to be available at each school, Chapman says.

Individual children who are referred to mental health practitioners through DCI are given an initial screening to see whether they need general counseling or trauma-focused counseling, Bush says. If the case does involve trauma, the therapist will go over a treatment plan with the child’s parent or caretaker.

In addition to trauma-focused cognitive behavior therapy, the mental health practitioners provide lots of psychoeducation, Bush explains. DCI therapists work to help the children understand what trauma is and guide them in learning coping mechanisms, including the management of behavior, anger and emotions.

“Some of [these children] have no ability to identify or control their emotions,” says Bush, who has worked with victims of domestic violence and trauma for more than a decade. “The goal is to help them identify the trauma they’ve experienced, put it into a narrative and begin to express it so it doesn’t affect them for their whole lives.”

Because the therapy is conducted in the schools, mental health practitioners are able to collaborate with school staff, check in often with the children’s teachers and see the students “in context,” Bush says. The mental health practitioners often visit a child’s classroom, the lunchroom or a gym class just to observe the child in a group setting. “We do a lot of listening,” Bush says.

By being so ingrained in the schools, the therapists are also able to schedule therapy around field trips and other events the child would not want to miss, Bush says. Teachers have been very willing to work with Bush and her therapist colleagues, she says, even participating in department and individualized education plan (IEP) meetings when asked.

One of the most helpful aspects of the DCI program is that the children “realize they’re important to us [the adults], to the school and to all the people who have put in extra effort to make this available for them,” Bush says.

 

It takes a village

The DCI program brings together professions that were not always good about communicating with one another, Chapman notes. “Unfortunately, for far too long we’ve all worked in our individual silos. Children do not live in silos. They live in all of our worlds,” Chapman says. “… For far too long we haven’t communicated and collaborated and broken out of our silos to make sure that we’re comprehensively addressing the needs of the child. For far too long these kids have fallen through the cracks.”

Chapman and Bush both use the metaphor of putting pieces of a puzzle together to describe the program’s multidisciplinary approach.

“We all have a little piece of the puzzle, a little piece of a child’s life,” says Bush, adding that anytime those puzzle pieces are connected, it benefits the child. “We’re blurring the lines for the benefit of the child. Not the lines of confidentiality or procedure, but making the community safer by providing a safety net for children so they’re not the next generation of perpetrators or the next generation of adult victims.”

Treating the effects of trauma in young children “is the only place we can truly change the cycle of violence in our community,” she says.

DCI stakeholders — including law enforcement personnel, public school representatives, mental health providers and community partners such as social service agencies — meet often to review and evaluate the work being done.

In some ways, the program’s training has also ushered in a cultural shift, Chapman says, in part by introducing a level of care and follow-up that didn’t often exist previously in the state’s law enforcement. New protocols guide police to avoid making arrests or interviewing witnesses in the

Blackwater Falls State Park, West Virginia

Blackwater Falls State Park, West Virginia

presence of children whenever possible and to make regular, noncrisis visits to local schools.

“There’s a whole new culture and mindset in the police department that they need to recognize when kids are present [during an incident] and the potential impact that could have on the child,” Chapman says.

 

In your neighborhood

DCI was launched in some of the neediest schools in West Virginia. At the program’s first pilot school, an elementary school in Charleston, 93 percent of the students are from low-income families. But those involved in the initiative agree that DCI’s multidisciplinary approach is needed everywhere as well.

All communities have children and households that are affected by trauma, Chapman notes. “We all have to think differently. … If we continue to do the same things we’ve always been doing, we’ll continue to get the same results. That goes for schools, mental health [practitioners] and law enforcement,” Chapman says. “Counselors play a vital role in this process as well. … I would encourage mental health providers to think outside of the box [and] understand the limitations that some families have with coming to their offices [outside of the school day].”

“People don’t exist in a vacuum of 50 minutes” — the length of a typical in-office counseling session, agrees Bush. “You want to send them out into as much support as you can possibly garner on their behalf. If you want [clients] to be successful, it’s a no-brainer. Make yourself familiar with all the [support] systems that are available.”

The collaborative work being done in programs such as DCI involves going the extra mile, but it’s well worth it, Bush says. “Step out of your comfort zone and you will have a richness of experience that you can’t imagine,” she says, her voice breaking with emotion. “Open up your world to experiences, people and situations that you wouldn’t normally experience. It’s just such a growth experience for everyone.”

DCI also models what adults regularly try to teach children: to be cooperative. “[Students] see adults working together not in a negative way, but in a healing way,” Bush says.

Both Chapman and Bush stress that communities interested in DCI should adopt the program as a whole. It doesn’t do any good to have law enforcement record and refer children involved in traumatic incidents unless a trauma-sensitive network is set up in the community’s schools, Chapman asserts.

“It takes all these components working together to get this initiative to succeed,” Bush agrees. “It’s important that [communities] don’t piecemeal it.”

 

Meeting a need

Through her involvement in DCI, Smith has decided to devote the remainder of her career to focusing on trauma. At Marshall University, where she is an associate professor of counseling, Smith is involved in the launch of a graduate certificate program in violence, loss and trauma counseling. In addition, several Marshall University counseling interns have been involved in DCI under Bush, Smith says.

“When your eyes are opened to trauma, you realize it’s everywhere. Everyone who walks through your door has it, and if you don’t handle it correctly, you can restigmatize or cause harm,” Smith says. “Counselors can become change agents in the community. … The field is waking up and becoming savvy to the issues that are swirling around us. Yes, it’s exhausting, but it’s worth it.”

 

****

 

Learn more about DCI in West Virginia: handlewithcarewv.org

 

Much of DCI’s schoolwide trauma training is adapted from the book Helping Traumatized Children Learn, a publication of the Massachusetts-based Trauma and Learning Policy Initiative. Find out more, and download the book for free, at traumasensitiveschools.org.

 

 

****

 

Classroom initiatives for “thumbs down” days

What should happen on days when the majority of students indicate that they’re not OK? The possibilities are limitless, says Carol Smith, a licensed professional counselor, member of West Virginia’s Defending Childhood Initiative advisory board and president of the West Virginia Counseling Association.

Examples of activities to calm and refocus students include:

  • Doodle-quilts: Each child is asked to take out a 4-by-4-inch piece of paper (already cut and available for such a time as this) and to spend five minutes quietly doodling on it in whatever colors the child chooses. Students then pass the pieces of paper to the front of the room. The teacher tapes the pieces together and posts the “quilt” of doodles on a bulletin board, observing that the doodles show the students’ “processing” of whatever caused the heated (unhappy/stressed) temperature.
  • Round robins: Children sit or stand in a circle, facing each other. With the process explained and structured by the teacher, each child, in order, identifies one thing that is on his or her mind. The teacher summarizes, validates, encourages and then redirects the children to the work at hand.
  • Stand up and stretch: The teacher validates the students’ collective temperature and provides structure: “We are going to breathe a few breaths and do a few stretches to process our feelings, and then we’ll get to today’s lesson.” The teacher takes students through a couple of deep breaths and a short series of stretches to allow students to “reboot.” The verbal validation, structuring and limited activity work to restore equilibrium and allow students to get back to business.
  • An agreed-to, brief regrounding ritual that has been previously co-constructed by the teacher with the children, typically at the beginning of the school year.

Source: Carol Smith, associate professor of counseling, Marshall University

 

****

 

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

 

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

Working through the hurt

By Bethany Bray March 25, 2014

abusedMore than one-third of U.S. women (35.6 percent) and more than one-quarter of U.S. men (28.5 percent) have experienced rape, physical violence or stalking by an intimate partner during their lifetime, according to a recent survey by the National Center for Injury Prevention and Control.

Those statistics suggest that counselors of all specialties, from school counselors to addictions counselors, are likely to encounter clients who are familiar with the impact of domestic violence. Counselors with expertise in this area stress that the specter of domestic violence is a complicated issue that helping professionals must address with grace and competency.

Working past domestic violence in counseling sessions will almost assuredly involve other issues, says Christine Murray, a domestic violence researcher and associate professor in the University of North Carolina at Greensboro (UNCG) Department of Counseling and Educational Development. Those issues might range from self-esteem, anxiety and relationship challenges to financial problems and finding employment. As one example, Murray says, an abusive spouse may not have allowed your client to hold a job outside of the home or even leave the house unsupervised.

“Domestic violence is something that impacts someone’s mental health, but there are all these other pieces to it,” says Murray, an American Counseling Association member who teaches a class on family violence to her counseling students. “There’s no easy way to say, ‘This type of abuse has this specific answer.’ It’s different with each person. Any form of abuse can be really hurtful to somebody.”

A counselor’s approach might be different with each client involved in domestic violence and should be tailored to his or her experiences and symptoms. Clients may be victims of domestic violence, perpetrators of domestic violence or witnesses — for instance, a child or someone else in the home who saw the abuse occur.

Murray, who prefers the term intimate partner violence to domestic violence, adds a fourth category: survivors. Survivors may be out of their abusive relationship but still experiencing lingering effects of trauma, such as nightmares or flashbacks. According to Murray, counselors are more likely to encounter clients at the “survivor” stage than clients who are still in the thick of an abusive relationship.

Murray, a licensed professional counselor (LPC) and licensed marriage and family therapist, has good reason for applying the term survivor to clients who have withstood abusive relationships. “We don’t want to view people who have been abused as damaged. They may feel that way, but we need to help them and promote that view [that they are not damaged] in society,” she says. “They can have a happy life. They can have happy relationships. There is recovery [and] there is hope that people can experience even after having a horrific experience.”

“Just the fact that they’ve survived and lived to tell the story shows how strong they are, how resourceful,” Murray continues. “There is a lot of strength that comes through that process. They can be encouraged, and they don’t need to be ruined, [even though] that’s often how
they feel.”

Introducing the topic in session

Nancymarie Bride, an LPC, certified clinical mental health counselor and adjunct faculty member at Kean University in New Jersey, says individuals who have experienced domestic violence are often marginalized by the general public and even by mental health professionals. For that reason, these individuals often “do not expect to be believed,” says Bride, an ACA member and past president of the New Jersey Counseling Association who has worked with people affected by domestic violence — both victims and perpetrators — since the 1980s in private practice and group work. “Even sometimes when domestic violence is recognized, it’s not taken seriously enough,” she says.

Counselors shouldn’t expect that clients will bring up their abuse histories on their own, and there are several reasons for that, Murray says. For instance, some clients may not even recognize they are in an abusive, controlling relationship because that type of relationship may be “normal” for them, she says. Other clients assume that the term abuse should be applied only if a spouse or intimate partner has hurt them physically. These clients do not necessarily recognize psychological, verbal or other nonphysical forms of abuse as abuse.

But a lack of recognition is not the only thing that keeps clients from bringing up a history of abuse with counselors, Murray says. Many victims and survivors feel a sense of shame or embarrassment about these experiences. Some even feel they are somehow to blame for being the target of abuse. Others fear being judged or are otherwise unsure of how a counselor might react to their revelation. And some clients try to keep the truth hidden for safety reasons, Murray says, having been threatened with further harm by their perpetrators should they ever tell anyone.

Oftentimes, a client’s history of abuse emerges gradually — and only after the therapeutic alliance between the counselor and client has grown strong, says Allison Crowe, an assistant professor of counseling at East Carolina University who conducts research on domestic violence. “Chances are, [the client] is trying to determine whether or not I’m trustworthy, especially if they’ve been to professionals in the past,” says Crowe, an ACA member who is an LPC and approved clinical supervisor. “Many folks who have gone to seek help have not had a good experience and are very nervous about bringing this up with the next person.”

What if a counselor comes to suspect abuse or intimate partner violence, but the client doesn’t recognize the problem? The way that counselors word their questions is very important, says Brandon Ballantyne, an LPC in Reading, Pa., who facilitates domestic violence evaluations and makes treatment recommendations for families referred to counseling by the county’s department of children and youth services.

He suggests that counselors talk to clients about what it would look like if there were a problem. “You’re not trying to change their mind or indicate there is a problem but [rather] get them to talk about what would signal or indicate there is a problem,” says Ballantyne, a member of ACA. “It helps if it comes from their mouth. You know what direction you want to take the session, but you don’t want to plant any ideas.”

Murray and Bride recommend using the Duluth Model’s Power and Control Wheel (theduluthmodel.org), which categorizes specific abuse behaviors counselors can talk through with clients, including using coercion and threats, using intimidation, using isolation, using economic abuse, using emotional abuse and minimizing, denying and blaming.

Once the counselor establishes what the client views as abuse, the counselor can begin to challenge those beliefs, Ballantyne says. He adds that open-ended questions are most useful. For example, he says, ask the client how his or her personal definition of a healthy relationship is working out. What has it led to? Has it led the person to counseling?

“You never have to feel pressured to convince the client that they should think the way you’re thinking,” he says. “It’s OK to disagree. When you disagree, there’s more opportunity for growth. [Say], ‘It’s OK for us to think differently about this, but let’s talk a little bit more about it.’ Anytime you can [give] the control back to the client, I think that’s when changes tend to stick a little more.”

Self-perception and society’s perception

Clients who have a history with domestic violence can present with myriad related issues, Crowe says. For instance, they may have symptoms of posttraumatic stress disorder (PTSD), including feeling unsafe, experiencing flashbacks or being jumpy, she says. The counselors interviewed for this article also mentioned helping these clients with issues such as anxiety, depression, panic attacks, emotional withdrawal, feelings of helplessness and low self-esteem.

The self-blame and guilt associated with not leaving an abusive relationship sooner, especially if that relationship also involved children, is another major issue that counselors and clients must commonly work through together, Crowe says.

Providing psychoeducation and teaching clients what a healthy relationship looks like are basic but useful techniques that counselors can use, she says. Clients may need to learn that the manipulation and power struggles they have experienced in their intimate relationships — such as a spouse not allowing them to carry a checkbook or go grocery shopping — aren’t normal or healthy, Crowe says. The process involves clients “learning all that abuse entails and forgiving [themselves],” she adds.

Crowe and Murray recently surveyed and interviewed more than 230 domestic violence survivors (male and female) for a research project. The duo is preparing to publish its findings in an educational journal, as well as through a website (seethetriumph.org) and social media campaign.

Through their research, Murray and Crowe heard from domestic violence survivors who felt stigmatized not just in general society but also by the professionals they had turned to for help. In one case, a woman was fired because her employer didn’t want her abusive spouse showing up at the workplace to stalk her. In another case, a police officer asked a victim of domestic violence out on a date when she came to the station to file a report. Another interviewee said her doctor told her she was “stupid” for not leaving an abusive husband.

“The stories that we heard were overwhelming,” Crowe says. “I was taken aback by the poignancy of what these [people] experienced. When someone sees you as ‘she lets her husband beat her,’ people start forming ideas about you. … An incredible takeaway [from the research project] is how much survivors want to help each other” by sharing their stories of survival.

Helping clients recover

Safety first: A counselor working with someone who is experiencing domestic violence must make the client’s safety and well-being of the utmost importance.

Understand that simply giving your business card to an abuse victim can put that person in danger should an overcontrolling spouse or partner see the card and lash out in anger, Bride warns.

Safety should also be a counselor’s first and foremost consideration when choosing interventions to use with a client, says Murray. For example, counselors should use caution when working on assertiveness with a client who is still in a relationship with his or her abuser. If a client were to go home and try being more assertive with his or her partner, that action might spark more abuse, she points out.

Counselors should create and talk through a safety plan with their clients. This intervention can be done with children and adults, victims and perpetrators. For victims of intimate partner abuse, a safety plan might include keeping an extra house key and change of clothes in the car in case their spouse or partner throws them out during an argument. For perpetrators, safety planning might include learning to recognize the need to cool off or “take a time out” during an argument — and understanding that doesn’t mean going to a bar or driving down the highway at 90 mph, Bride says.

Murray recommends the Safety Strategies website (DVsafetyplanning.org), created by the Family Violence Research Group in the UNCG Department of Counseling and Educational Development, as a resource for counselors looking to create safety plans with clients.

Treading gently: A client who has been involved in abuse has been traumatized, and discussions about the abusive situation can trigger PTSD-like symptoms, Murray says. Counselors should talk through the client’s emotions, use trauma-informed care and allow the client to control the pace of therapy.

In addition, counselors must guard against judging these clients or even coming across as judgmental, Murray says. “Make sure as a counselor [that] you’re not restigmatizing your client. You never want them to get the impression that it’s their fault,” she says.

Victims or survivors of intimate partner abuse will talk about that abuse only when they are ready, Bride adds. Because they have navigated within a climate of abuse, they know when it is “safe” for them to talk about that abuse and when it is not, she says.

Assessment: Counselors shouldn’t just ask, ‘Have you ever been abused?’ because clients may have different perceptions of abuse, Murray says. Instead, she recommends asking more behavior-specific questions: Has your partner ever called you names? Who makes the decisions in the relationship? Does your partner check up on you? Have you ever been injured in a fight with your partner?

A holistic approach: Be aware that all aspects of the client’s life — from physical and mental health to parenting, finances and housing — can be affected by abuse. Look at all these areas of the person’s life that have been influenced and talk about what the client’s goals are, Murray says. Help them work toward recreating their life to “build back a sense of self-worth,” she says.

Counselors can also help clients learn coping mechanisms to deal with co-parenting children with an abusive ex-spouse or returning to the dating scene after an abusive relationship.

An interdisciplinary approach: Step out of the “counseling box” to work with other agencies in your community, Murray advises. The individuals interviewed for this article agreed that counselors should become knowledgeable about the domestic violence services in their areas, including abuse hotlines, shelters, school resource officers, women’s clinics, victim advocate organizations, support groups and so on. Also touch base and network with other professionals in your community, such as law enforcement personnel and social workers, who have frequent contact with victims of abuse.

Counselors should also learn the basics regarding how a client would file a police report or restraining order. Counselors — especially child and family counselors — should also know how and when to file a report of child endangerment with their state’s department of child services.

Storytelling and self-care: In talking with abuse survivors for their “See the Triumph” project (seethetriumph.org), Crowe and Murray found that many of these individuals craved the chance to tell their story. Likewise, talking through a client’s story in counseling can help the person to heal and feel validated, Murray says. “Understand that time alone may not determine how salient [a client’s] experience of being abused is,” whether that experience took place one year ago or 20 years ago, she says.

Journaling can be another useful therapy tool, she says, as can trauma-focused approaches such as developing coping resources, dealing with stress, goal-setting, relaxation, self-reflection and self-care. Each of these approaches is about “helping them recreate their own identity on their own terms,” explains Murray.

Social support is another key, especially as it relates to rebuilding relationships with friends or family members who may have been cut off from the client’s life during the period when the abuse was taking place.

Cognitive behavior therapy: Ballantyne recommends talking through these clients’ belief systems, particularly their beliefs about interpersonal issues and relationships. Ask them to describe what they think a healthy relationship looks like. He points out that some clients may have witnessed abuse between their parents and grown up regarding this as “normal,” with aggression or abuse representing the only way to work out problems or resolve issues.

“[Ask], ‘How can we work together to change the way you see relationships?’” Ballantyne says. “You’re encouraging them and planting the seed that they can look at relationships differently. They don’t have to continue the pattern of what they’ve seen [in the past].”

Counselors should also encourage these clients to veer away from thought patterns that are “all or nothing,” he says. Explore the middle ground with them and teach them that they don’t have to operate out of extremes. Ballantyne advises developing strategies to help these clients regulate their feelings, such as learning coping skills that will aid them in calming down and working through their sadness, anger or anxiety in a positive way.

Don’t make assumptions: A common assumption is that it is always the male who is abusing the female in a relationship. “That’s the majority, but … [abuse] happens in all types of situations,” Crowe says. There is added stigma in abusive situations that involve people with disabilities, same-sex couples and members of minority cultures, she adds. When it comes to abuse, it is important that counselors step outside of their typical frame of reference and drop all assumptions, she says.

Factor in trauma: It is unethical and inaccurate to diagnose clients without factoring in their abuse histories, Crowe asserts. Counselors should not label clients as having certain problems without first working through their experiences with abuse, she says.

Treating the family as a whole

In cases of abuse, Ballantyne advocates for treating the family as a whole when possible. He says this allows counselors and other helping professionals to focus on relationship patterns and behaviors and to begin addressing these problem areas more effectively.

Although he says the parents and children should also have individual counseling sessions, he believes that family therapy can be a major source of healing and insight. “[Clients can] learn that they can still be connected and care about mom and dad without following through with some of the negative decisions that the parents made,” he says. “They can be healthy individuals and be different from mom and dad, while still caring about mom and dad.”

Ballantyne begins by assessing the full history of each parent, from legal problems to addiction and mental health histories, to fully understand what they have struggled with and been treated for. “A lot of the time, mom or dad has a history of trauma themselves,” he says. “In a lot of cases, I’m discovering that when they’ve experienced that abuse and never been treated for it [and] never learned healthy ways to find intimacy with others, intimacy has always been something that’s scary and threatening.”

He works to return the couple and, ultimately, the family, to a place of stability. Ballantyne recommends that his clients take classes on parenting, conflict resolution, anger management, communication skills, setting boundaries and recognizing abusive behaviors. “The idea of being able to walk away from each other and cool off, and then come back and talk about what the problem is, is sometimes easier said than done. That can take a lot of practice,” he says.

After working with the entire family, a child that has been in a foster care situation can sometimes return home, Ballantyne says. “Not always,” he says, “but you need to go through the [therapy] process for everyone to figure out what’s in the best interest of the child.”

Working with perpetrators

Working with perpetrators of intimate partner violence can be controversial territory, and it brings its own set of challenges.

“I definitely don’t think this is a population that counselors should really work with unless they understand the dynamics of family violence,” Murray says. Crowe and Murray recommend that counselors who are not trained specifically to work with domestic violence perpetrators refer those clients to a specialized treatment program.

Bride ran a program for male batterers that was the first of its kind in her area of New Jersey. The group contained both self-referred members and court-referred participants. She used a process-oriented model that carried an expectation of change in the group’s participants.

Getting the men to take full responsibility for the abuse they had inflicted was paramount. “Getting him to admit his behavior, how bad it was and how hurtful it was, that’s where we had to move him,” Bride says.

Each week, the group leaders, who were specially trained counselors, would ask each participant why he was there. At first, Bride says, the answer was often, “The judge sent me.” Eventually, however, the group leaders weren’t the only ones saying that answer wasn’t sufficient; fellow group members wouldn’t stand for it either. “That was the cohesion, the power of the group,” Bride says.

Even so, she says it took six months — the full length of the program — before some participants could acknowledge the worst of their behavior. “Behavior was the first thing that would change. It takes a lot longer to change attitudes,” she says. “Our hope was that we could actually move the men to a place of empathy. And some of them made it.”

Another technique Bride used was to have group members write letters to the person they had abused, acknowledging their behavior and that it was hurtful. The letters were never sent but rather read aloud in group as an exercise, with members giving each other input.

Safety planning and self-care are also important to work on with perpetrators of abuse, Bride says. They need to learn the warning signs of anger and how to cool down, deal with their anger effectively and have a healthy conversation with their spouse, she says.

In her batterers group, Bride had members work to figure out what triggered their anger so they could learn to control it better. Group leaders had members talk about one of the more recent times their anger had gotten out of control. The group would then “hit the rewind button,” Bride says, and talk through the incident to figure out when and why the perpetrator had gotten so angry.

“How do you know you’re angry? Do you only know when you’re screaming? The minute you know that the discussion has escalated, you have to take a time-out and walk away,” Bride counseled her group members. Part of each group member’s safety plan involved a protocol for taking a time-out, such as ducking into the garage to tinker or going to the gym for a workout.

Being able to talk through what stresses them and then work through those stresses are essential skills for men who are prone to violence, Bride says. “It’s very easy to get men to talk the talk, but you have to get underneath to the pain … and move past being the blamer,” she says. “A lot of men talk about how they stuff [internalize] their anger until it’s an explosion.”

Do no harm

Exposure to domestic violence is more prevalent among their clients than many counselors realize, and Murray says many counselors are ill-equipped and undertrained to deal with the issue properly. “Personally, I would like to see a lot more training on this topic within the profession,” says Murray.

Crowe encourages counselors to look for workshops on domestic or family violence to continue their professional development, especially if they didn’t take a class on the topic in their master’s programs.

Counselors who are undertrained may not know how to talk about abuse with a client or may fail to recognize it altogether, which can be very dangerous, Murray says.

“You can do a lot of damage if you don’t understand [domestic violence],” she says, “and you can do a lot of good if you do.”

 

****

 

Myths of abuse

Counselors need to advocate for victims and survivors of domestic violence and expose some of the myths that are prevalent in society at large, says Nancymarie Bride, a New Jersey-based licensed professional counselor and certified clinical mental health counselor who specializes in working in domestic violence.

 

Myth: Domestic abuse is caused by alcohol or drug abuse or addiction, and going through Alcoholics Anonymous or another rehabilitation program will fix the problem.

Reality: Domestic abuse is an issue separate from addiction. In some cases, domestic abuse may even increase when the perpetrator gets sober, Bride says.

 

Myth: Psychopathology, or mental illness, is to blame for domestic violence. The abuser is “not in his right mind,” under extreme stress or mentally ill.

Reality: This is not always the case, Bride says. “When you look at the pattern of domestic violence, [the perpetrator] believes he has the right to control his partner,” she says.

 

Myth: Battering and abuse do not occur in upper-middle-class families.

Reality: “That’s simply not true,” Bride says. Abuse occurs across all demographics.

 

Myth: The abuse was provoked or the victim “brought it upon herself.”

Reality: A victim does not enjoy the abuse and would not provoke it, Bride says.

 

Myth: Abuse is temporary, occurring only during an abuser’s lapse of control.

Reality: In fact, batterers are often very deliberate, Bride says, carefully inflicting physical or mental wounds on their victims in ways that won’t be seen or noticed by others. “The abuser often has an unbelievable ability to choose the time and place of his attack,” Bride says. “It’s sometimes planned.”

 

Myth: The victim is staying in an abusive relationship because she or he wants to. The person could leave at any time if she or he chose to.

Reality: Leaving an abusive relationship is the most dangerous time for the victim, Bride says. It is important for counselors to understand that victims of domestic violence will leave only when they feel it is safe to do so.

 

Myth: What happens behind closed doors is private. Society shouldn’t interfere with family dynamics and problems.

Reality: This myth only makes it harder for victims to realize they are not responsible for what is happening. Bride draws the following parallel: There is no difference between getting angry and shoving someone you just got in a fender bender with and doing the same thing to your spouse at home. Both are assault, Bride says.

 

****

 

See the Triumph

Learn more about Christine Murray and Allison Crowe’s “See the Triumph” research project and social media campaign created to address intimate partner violence in a related article posted on CT Online: wp.me/p2BxKN-3qo

 

****

Bethany Bray is a staff writer for Counseling Today. She can be reached at bbray@counseling.org

Letters to the editor: CT@counseling.org