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

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

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

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

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

Multiculturalism, social justice and human rights

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

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

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

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

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

The impact of human rights on graduate students

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

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

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

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

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

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

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

Human rights and counselor education programs

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

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

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

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

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

 

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

For graduate students:

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

For counselor education programs and educators:

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

 

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

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

 

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

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

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

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

Remembering Martin Buber and the I–Thou in counseling

By Matthew Martin and Eric W. Cowan May 8, 2019

Counseling research designed to measure therapeutic efficacy has increasingly focused on empirically validated methods and interventions. On the other hand, counselors have long understood the therapeutic relationship to be the most powerful meta-intervention for fostering client change and transformation. Carl Rogers’ No. 1 rule — that the counselor and client must be in psychological contact — is the precondition for all therapeutic movement. As counselors, we must “be someone with” rather than “do something to” the client.

However, the interpersonal process that occurs between counselor and client is difficult to quantify because it possesses intangible qualities that slip through the fingers of measurement and scientific scrutiny. The relationship between counselor and client seems to transcend any particular intervention strategy. The maxim “it is the relationship itself that heals” is an organizing principle to which most counselors subscribe and yet still sometimes forget. In the search for empirically validated methods, are we in danger of losing touch with what matters most in counseling?

Another consideration is the cultural shift that has altered how people communicate, with interpersonal contact becoming increasingly digitized, objectified and packaged in virtual platforms. Will the next generation of counselors still give primacy to the sense of “presence” in the therapeutic relationship that is the heart of counseling? From our perspective, it seems that a counselor’s enhanced capacity for meaningful interpersonal contact is more important than ever.

Philosopher Martin Buber detailed the qualities that characterize a real “encounter,” or I–Thou meeting, between two people. His ideas remain as relevant today as when they helped to shape the humanistic movement in psychology and counseling.

The I-Thou encounter

According to Buber, an interpersonal encounter contains wonderful potential that far exceeds two separate people in conversation. This potential becomes apparent when two people actively and authentically engage each other in the here and now and truly “show up” to one another. In this encounter, a new relational dimension that Buber termed “the between” becomes manifest. When this between dimension exists, the relationship becomes greater than the individual contributions of those involved. This type of meeting is what Buber described as an I–Thou relationship.

The I–Thou relationship is characterized by mutuality, directness, presentness, intensity and ineffability. Buber described the between as a bold leap into the experience of the other while simultaneously being transparent, present and accessible. He used the term “inclusion” to describe this heightened form of empathy. It is a far cry from the now-familiar scene of a group of friends sitting around a table at a restaurant, all gazing into their smartphones.

Buber saw the meeting between I and Thou as the most important aspect of human experience because it is in relationship that we become fully human. When one meets another as Thou, the uniqueness and separateness of the other is acknowledged without obscuring the relatedness or common humanness that is shared. Buber contrasted this I–Thou relationship with an I–It relationship, in which the other person is experienced as an object to be influenced or used — a means to an end. Regrettably, the I–It relationship requires little explanation for anyone living in a cultural frame of absent-mindedness and technological materialism.

The world of I–It can be coherent and ordered — even efficient — but it lacks the essential elements of human connection and wholeness that characterize the I–Thou encounter. The I–It attitude is increasingly depersonalizing and alienating as it becomes structuralized in human institutions. When an extreme I–It attitude becomes embedded in cultural patterns and human interactions, the result is greater objectification of others, exploitation of people and resources, and forms of prejudice that obscure the common humanity that unites us.

Although Buber saw the I–It as an essential pole of human existence, he thought humanity was losing its ability to orient toward the Thou. He emphasized the important balance required between the two poles if humanity was to survive the dangers inherent in the possibility of mutual destruction.

Counselors view the client–counselor relationship as the foundation of all therapeutic growth because it is fundamentally affirming of human connection, validation and participation. In our own small sphere of influence, we are a force for promoting a more compassionate and humanized world. Counselors should keep this in mind even as we strive toward greater technical organization and efficiency within a mental health “service delivery system” that is not entirely compatible with our broader aims.

To exist is to be in relation

Buber rightly understood that human development occurs in a relational context. Human beings are highly social creatures who need love and care from others to survive through infancy and beyond. An absence of these relational needs almost always leads to psychological injury.

Buber called this deep participation with, and acceptance of, another’s essential being “confirmation.” He believed that one’s innate capacity to confirm others, and to be confirmed in one’s own uniqueness by others, is the source of our humanity. The innate subjectivity that unfolds within every human being can begin to be actualized only when it is accurately mirrored in the eyes of another. Confirmation is at the heart of the I–Thou meeting, of human flourishing and of counseling.

Confirmation is similar to the concept of not imposing “conditions of worth” in the relationship. However, confirmation goes a step further by acknowledging the person’s potentialities — what one may become. For example, a child experiences the tension between growth and fear along each step of the developmental path. The parent can either accept the child’s reluctance in the moment or encourage the child to take the leap. At all ages, human thriving is found in these continual moments of confirmation of potentiality from person to person. As a client struggles with making the “growth choice” or the “fear choice,” the counselor invites the client to greater participation, yet expects to bump into the old fears that make such participation fraught for the client.

Unfortunately, we aren’t always as mindful and present as we’d like to be with others, and we ourselves have not been affirmed in the eyes of others as often as we would like. Even the best of us can fall into an I–It orientation with the world, failing to see the other person at all. Buber believed that these “missed meetings” were the ultimate failure of human relationships and resulted in us losing a part of ourselves.

We all desire to be confirmed in our uniqueness, but when we realize that confirmation is not going to happen, we seem to sacrifice true confirmation for mere approval in hopes of preserving our attachment to others. We cultivate the ability to “seem” a certain way to others to elicit approval, but such approval does nothing to nourish our “being.” A person would rather be confirmed in that which he or she is not than chance the possibility of not being accepted at all.

Unfortunately, this “seeming” mask tends to get stuck, and as one hides one’s being in fear, the possibility of an I–Thou relationship is lost. As Buber cautioned, “To yield to seeming is man’s essential cowardice, to resist it is his essential courage.” When the I of the I–Thou relationship is sacrificed for the It orientation of abstracted relation, authentic human growth and connection are lost, and the I begins to wither away.

Healing through meeting

How can we as counselors foster and model I–Thou relationships with our clients and help them avoid the temptation of “seeming” like someone they are not? Buber thought the answer could be found in a process of active imagination that he termed “inclusion.” In this process, the barriers and constrictions that prevent one from being fully present to an I–Thou encounter indicate where the work is to be done. In what ways must the client stay hidden from others and protect his or her own inner thoughts, feelings and fantasies?

In inclusion, one imagines what another person is feeling, thinking and experiencing while standing in relation to them as a Thou. Rogers’ concept of empathy and Buber’s concept of inclusion are similar (in fact, the two of them debated about it). However, inclusion places greater emphasis on the unique subjectivity of the person attempting to understand the other.

The attempt at understanding the subjective inner world of the person is not a one-way street because the counselor must account for his or her own influence upon the client as both participants come into psychological contact. The I–Thou is a relational event that is co-created; it does not fully reside in one participant or the other. The counselor’s ability to mine the riches of the present encounter and wonder “what is happening between us in the immediate moment” expresses Buber’s notion of inclusion.

We as counselors have the ability to confirm our clients through the process of inclusion, providing them with a relationship that can heal the wounds of their past missed meetings. We must stand in relation to our clients as an I to a Thou to successfully inspire them to move from a “seeming” stance to one of greater authentic participation and “being.”

Although empirical methods and interventions are critical in guiding our understanding of best practices, we must not forget that the single most predictive variable in whether counseling is effective is the client’s experience of the counseling relationship itself. Clients deserve to be seen as a Thou. As Buber once said, “In spite of all similarities, every living situation has, like a newborn child, a new face that has never been before and will never come again. It demands of you a reaction that cannot be prepared beforehand. It demands nothing of what is past. It demands presence, responsibility; it demands you.”

Every moment is an opportunity for “healing through meeting.”

 

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Matthew Martin is a graduate of James Madison University’s clinical mental health counseling master’s program. He is currently completing his residency in counseling at the university’s counseling center. Contact him at matthewmartin.rva@gmail.com.

Eric W. Cowan is a professor in the Department of Counseling and Graduate Psychology at James Madison University. He is the author of Ariadne’s Thread: Case Studies in the Therapeutic Relationship. Contact him at cowanwe@jmu.edu.

 

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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.

Putting PTSD treatment on a faster track

By Bethany Bray August 27, 2018

An exposure-based therapy method has shown to reduce the symptoms of posttraumatic stress disorder (PTSD) in just five sessions, according to researchers.

Written exposure therapy (WET) consists of one 60-minute and four 40-minute sessions, during which clients are guided to write about a traumatic event they have experienced and the thoughts and feelings they associate with it. Researchers recently tested the method’s effectiveness alongside cognitive processing therapy (CPT), a more traditional talk therapy method that typically involves more than five sessions. Clinical trials were conducted at a U.S. Department of Veterans Affairs (VA) medical facility with adults who had a primary diagnosis of PTSD.

The researchers’ findings, published in JAMA Psychiatry this past spring, suggested that WET was just as effective as CPT in reducing PTSD symptoms.

“WET provides an alternative [treatment] that a trauma survivor might be more likely to consent to, especially if verbalizing the trauma narrative causes a sense of shame or guilt,” says Melinda Paige, an American Counseling Association member and assistant professor at Argosy University in Atlanta whose specialty area is trauma counseling. “The more evidence-based options the trauma counselor has to consider, the more options can be offered to the client. WET provides an option for written expression rather than verbal and a shorter length of treatment, which may be preferable to survivors, including [military] service members.”

“Effective trauma treatment is the antithesis of the traumatic event itself in that survivors experience person-centered core conditions such as congruence/genuineness, nonjudgement and empathic understanding, as well as a sense of control over their recovery experience,” adds Paige, a member of the Military and Government Counseling Association (MGCA), a division of ACA.

MGCA President Thomas Watson agrees that the addition of another method to a trauma counselor’s toolbox will only benefit clients. “Those involved with service delivery to service members and others diagnosed with PTSD are always enthusiastic about how applied, evidence-supported treatment approaches have the potential for effective and ethical positive change,” says Watson, an ACA member and assistant professor at Argosy University in Atlanta. “An obvious goal of the WET approach is to implement effective treatment options that are efficient for both client and clinician.”

The research study involved 126 male and female participants, some of whom were military veterans and others who were nonveterans. The participants were randomly sorted into two groups: those who received five sessions of WET and those who received 12 sessions of CPT.

“Although WET involves fewer sessions, it was noninferior to CPT in reducing symptoms of PTSD,” wrote the researchers. “The findings suggest that WET is an efficacious and efficient PTSD treatment that may reduce attrition and transcend previously observed barriers to PTSD treatment for both patients and providers.”

The researchers reported that the WET group had “significantly fewer” dropouts (four) than did the CPT group (25).

This factor is another reason for counselors to consider using WET, Paige notes. “Maintaining a survivor’s physical and emotional safety and doing no harm by utilizing evidence-based and minimally abreactive trauma reprocessing interventions is essential to trauma competency. Therefore, WET may be a less invasive and more tolerable exposure-based PTSD treatment option,” she explains.

At the same time, Benjamin V. Noah, an ACA member and past president of MGCA, was discouraged to see that the study excluded PTSD clients who were considered high risk. Individuals had to be stabilized by medication to be included in the clinical trials.

“Many of the veterans I have worked with dropped their medications [because] they do not like the side effects. Therefore, I believe the study overlooked veterans that may be higher risk,” Noah says. “Additionally, a high risk of suicide was an exclusion for being in the study. Again, this leaves out those veterans who need help the most and could benefit from a short-term approach.”

Noah, a licensed professional counselor in the Dallas area whose area of research is veteran mental health, has used written therapy methods in his own work with veteran clients and has found the methods helpful. A therapy session provides a safe and supportive environment for clients to write about traumatic experiences – particularly clients who may be trigged by the exercise when alone, he explains.

“I have had veterans triggered doing [writing] as homework; keeping the writing in session acts as a safety measure for the [client]. Helping veterans resolve their event or events — which I call the ‘nightmare’ — that led to PTSD has been a focus of my work since I was able to put my own nightmare to bed,” says Noah, a U.S. Air Force veteran and a part-time faculty member in the School of Counseling and Human Services at Capella University.

WET is one of many methods that should be considered by clinicians working with clients who have PTSD, Noah adds.

“I would like to see more research within the VA and National Institute of Mental Health on the use of Viktor Frankl’s logotherapy, solution-focused brief therapy, sand tray therapy and other approaches that counselors are using in their work with veterans,” Noah says. “There are articles focusing on other approaches, but these tend to be the experiences of a few counselors and do not have the research rigor used by [the WET study researchers]. I do applaud the authors for showing the efficacy of a brief therapy approach for use with veterans, and I do plan to look deeper into written exposure therapy and perhaps use it in my future work with veterans.”

 

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Find out more:

 

Read the research in full in JAMA Psychiatry: jamanetwork.com/journals/jamapsychiatry/article-abstract/2669771

 

From the National Institute of Mental Health: “A shorter – but effective – treatment for PTSD

 

Related reading from Counseling Today:

Controversies in the evolving diagnosis of PTSD

Informed by trauma

Exploring the impact of war

 

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

 

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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.

 

Advancing multicultural and social justice competence in counseling research

By Cirecie West-Olatunji and Jeff D. Wolfgang August 7, 2017

Despite several decades of counseling research focusing on culturally diverse populations, limited knowledge still exists about such issues as parenting, achievement, resilience, the intersectionality of identity and the psychological impact of systemic oppression on clients who are members of culturally marginalized groups. Most of the efforts within the counseling profession have focused on developing multicultural and social justice clinical competence (awareness, knowledge, skills and action) that targets students, practitioners and supervisors.

However, very little attention has been paid to cultural competence in counseling research. Multicultural counseling scholars have asserted that the persistence of problems disproportionately affecting certain client populations may be partly due to how we conceptualize, design, conduct and interpret counseling research. Our use of a marginalizing lens in research may stand as an obstacle to unveiling the truths we need to identify to improve the lives of those most in need.

Cracks in our research foundation

At the heart of criticisms about clinical research are historical issues of item bias, validity and reliability. For example, in 1916, a psychological study at Stanford University on IQ testing concluded that Spanish-Indians, Mexicans and blacks were of lower than average intelligence despite the fact that all 1,000 of the participants in the study were white. Another study concluded that a significant positive correlation existed between degree of whiteness and IQ scores. Today we realize that studies such as these promoted white supremacy.

The problem with white supremacy: Although many people focus on the impact of oppression on the marginalized, there are also psychological implications for mainstream individuals who benefit from social and cultural privilege. According to the late Asa Hilliard (1986), dominant group members can fall prey to:

  • Perceptual distortion
  • Denial of reality
  • Delusions of grandeur
  • Blaming the dominated group fortheir problems
  • Phobic reactions

Additionally, Derald Wing Sue suggested in 2011 that there are cognitive, affective, behavioral and spiritual costs for perpetrators (or microaggressors) of oppression. Thus, the impact of our social positioning significantly affects our ability to design, implement, interpret and apply research about socially and culturally marginalized client populations.

Impact on practice and policy: Although practitioners may feel exempt from considerations about research design, analysis and interpretation, we are consumers of research. Therefore, we can:

a) Fail to critically examine existing research

b) Inappropriately apply evidence-based interventions

c) Poorly conceptualize the needs of our clients and overlook available resources

Furthermore, policymakers have been known to create a trajectory of deficit-oriented policies and programs that have enduring effects on our clients. For example, in the 1960s, the Moynihan and Coleman reports were released to advise the federal government on compensatory education programs. Scholars criticized these reports for stereotyping African American families as pathological because the reports blamed families, communities and African American ethno culture for deficits in educational achievement. This stance was taken without recognizing structural biases in the curriculum, instructional delivery, material resources and overall schooling experiences for this population.

In response to hegemony in research, scholars across several disciplines have offered alternative methodologies to advocate for more validity in research on diverse populations.

Multicultural counseling competence in research

To better articulate the specific competencies in counseling research, it would be beneficial for scholars from several divisions within the American Counseling Association, such as the Association for Multicultural Counseling and Development, the Association for Counselor Education and Supervision, and the Association for Assessment and Research in Counseling, to collaboratively expand the existing Multicultural and Social Justice Counseling Competencies to focus on research. These guidelines could be vetted through the participating divisions and then approved by the ACA Governing Council. As such, these competencies could provide both beginning and seasoned researchers with a framework for more effective investigations of diverse individuals, families and communities.

Awareness: Another recommendation is for scholars to raise awareness of our biases as researchers, reflecting on the implicit historical Eurocentrism in research that continues to impact the design, application and interpretation of results. This can be accomplished through professional development trainings that are delivered online, in person and in print media. Similar to our acceptance of the need to reduce counselor bias in the counseling process, we must also minimize our biases in the research process.

Knowledge: We also need to educate researchers, clinicians and students about culture-centered and emancipatory research methodologies. This content can be taught across the curriculum but should be shared particularly in the diversity, research and assessment courses at the master’s level and in the core statistics courses for doctoral students. Graduate counseling students can become knowledgeable of alternative tools for engaging in research, particularly when investigating diverse cultural populations.

Skills: ACA and other professional counseling organizations can intentionally integrate trainings into their conference programs to create a cadre of multiculturally competent counseling researchers. In doing so, counseling leaders can move toward eliminating bias in counseling research to better meet the needs of diverse individuals in society. Despite intent, counseling researchers of all ethnic, cultural and national backgrounds need to immerse themselves in the ethnophilosophies to determine what phenomena can be held constant across cultures. In training practitioners to become multiculturally competent, we hold them accountable for increasing awareness of their biases to better conceptualize and intervene. Researchers need to embrace this same level of accountability.

Action: Ruth Fassinger and Susan L. Morrow (2013) proposed several ways in which counseling researchers can reflect social action competence in their scholarship. First, when designing research, investigators can create a collaborative team that includes scholars, practitioners and laypeople who have both insider and outsider knowledge. This allows for authentic and critical dialogue to challenge any inculcated myths about marginalized groups and to enhance the truthfulness of the study.

Second, researchers can consider that the very topic chosen for investigation is culturally biased. Thus, culturally responsible researchers ground their research in the values and realities of the cultures under investigation. Furthermore, the topic of concern should have practical considerations and outcomes for the community under investigation.

One of the ways I (the first author) have demonstrated social justice competence in my research is in the realm of dissemination. In addition to publishing community-based research in professional journals, I have used a readers theater format to bring the findings to life in performance-based presentations before community members. This promotes dialogue among community stakeholders about the research findings and their implications and what actions they would like to take to resolve the concern. Cultural competence in counseling research requires that we all consider alternatives to business as usual to seek different outcomes for members of marginalized client populations.

Better choices in counseling research

Collaborating with clients: Client empowerment is one of the hallmarks of our discipline. We rely on a belief in the client as the driving force of therapy. This stems from a philosophical thrust away from the behavioral patterns and intrapsychic forces that dominated mental health literature until the 1950s. Although we have done an outstanding job over the past six decades of infusing this core assumption into counselor training for therapeutic application, we need to turn our attention toward counseling research competencies that embody respect for marginalized client populations.

One methodological approach that promotes empowerment and respect focuses on collaborating with participants to enhance credibility and rigor to the research design and interpretation. Such an approach allows participants to give voice to the nuances of their situation to inform research design and to provide clarification during the data interpretation process.

Using problem-based inquiry: Expediency is a core assumption in counseling. Yet persistent problems plague some members of society even as researchers continue to profit from exploration without intervention. Advocating for our clients through research is an imperative. Culturally specific research should not impose majority values onto marginalized client populations. Instead, emphasis should be placed on community ownership and collaboration in defining clinical problems and devising associated interventions. After all, the community is the best source of knowledge about itself.

Furthermore, community members can be the most active agents in addressing the most pressing issues in their neighborhoods and families. Involving community members in solution development empowers the community instead of relegating its members to the role of passive recipients of assistance.

Using a strength-based perspective: Prior to designing a study, confirm your understanding of the issues to determine if the construct holds across cultural frameworks. Check with community representatives to see if your conceptualization of the problem is accurate. Once you have completed data collection and analysis, double back to community members to secure their feedback on the findings of the study for catalytic validity.

Reveal who you are in the study. Are you an insider witness or an outsider witness? Is your vantage point valuable because you are new and bring a fresh perspective, or is it valuable because you have intimate knowledge of the community dynamics and stakeholders? In making recommendations, can you build upon the existing strengths of the participants? Answering these questions will assist in developing research that:

  • Is more grounded in the discipline
  • Increases the truth-telling in the study
  • Aids in the authenticity of the findings
  • Moves toward solutions to problems in the real world

In sum, we have come a long way in advancing multicultural counseling competencies over the past few decades. The inclusion of social justice competencies was significant because they served to integrate social action into our counselor identity. Now it is time to focus on cultural competence and social justice in counseling research to better serve our clients.

The first wave of multicultural counseling informed us that there were critical differences among our clients and between clients and counselors. This required self-awareness of bias, knowledge of diverse groups and specialized clinical skills. In the next wave, we were able to further distill differences within cultural groups and expand our understanding of diverse client populations to focus on sexual orientation, gender and issues beyond U.S. borders.

This current wave of multicultural counseling encourages us to take action. Advancing multicultural counseling competence in research is a giant step toward minimizing bias and promoting wellness for the underserved. So, we ask, whether you are a counselor educator, professional counselor or counselor trainee, what can you do to advance your multicultural competence in research?

 

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Cirecie West-Olatunji is an associate professor at Xavier University of Louisiana and a past president of the American Counseling Association. Her research projects focus on the relationship between traumatic stress and systemic oppression. Contact her at colatunj@xula.edu.

Jeff D. Wolfgang is a researcher and practitioner in Jacksonville, Florida. His research interests include international adoption, culture-centered counseling interventions, pediatric counseling and traumatic stress among young children. Contact him at conference.wolfgang@gmail.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.

Behind the Book: Counseling Research: A Practitioner-Scholar Approach

By Bethany Bray April 17, 2017

The first paragraph of the preface in Richard Balkin and David Kleist’s book Counseling Research: A Practitioner-Scholar Approach acknowledges that research is probably not something that most counselors get excited about.

However, it’s a much-needed endeavor and something that counselors are particularly suited for, they write.

“Counselors make great qualitative researchers because of the natural fit of hearing our clients’ narratives and to establishing meaning from them. These same skills can be used in developing meaningful research,” they write.

Counseling Research: A Practitioner-Scholar Approach was published by the American Counseling Association this year. Balkin, a professor and doctoral program coordinator at the University of Louisville and Kleist, a professor and chairman of the Department of Counseling at Idaho State University, know each other through their work in the Association for Counselor Education and Supervision (ACES), a division of ACA.

 

Counseling Today sent the co-authors some questions, via email, to learn more.

 

Your book emphasizes the “practitioner-scholar model” for research. Can you elaborate on that?

Rick Balkin: As a journal editor [Balkin is editor of ACA’s Journal of Counseling & Development], one of the topics discussed often is the gap between practice and research. Does one reflect the other? It should, and we see this in the ACA Code of Ethics, “Counselors have a responsibility to the public to engage in counseling practices that are based on rigorous research methodologies” (p. 8).

Many future counselors might think they will never do research, but they will definitely use research in their practice, and so we hope this text serves as a nice bridge. Furthermore, we provided sections on research design [to] help emerging researchers, such as a beginning doctoral student, begin to conceptualize how they can design and conduct research.

David Kleist: For myself, I was strongly motivated to clarify the “practitioner-scholar” role and relevance for master’s students identity as developing professional counselors. For years the profession of counseling has only viewed master’s students as passive consumers of research, not active knowledge-producers. However, with the counseling profession’s distinct training structure (with the terminal clinical degree being the masters), and the doctoral degree focused on counselor education and supervision, we need licensed professional counselors who see their role as researchers — that is practitioner-scholars — to inform the practice of counseling as they comprise the majority of front line counseling practitioners. A past doctoral advisee of mine, Megan Michalak (2013), conducted a grounded theory study of how counselor educators promote scholarship with counselors-in-training. Her research communicates that this role as knowledge-producer can be integrated into counselor training beyond merely training master’s students to be passive consumers of research.

 

In your words, why are counselors a good fit for research work? What particular skills do they bring to the endeavor?

Rick: Our skills in listening, attending to a narrative and trying to get deeper into the issues affecting our clients make us a natural fit for qualitative research. To be good stewards of the profession and strong advocates for professional counseling, we need to know that what we are doing is effective and helpful – and be able to explain that to consumers and stakeholders. We need to be knowledgeable about research and how to access and evaluate data in this era of accountability where counselors may be called in to court or have to justify our services and funding.

David: Rick is dead on accurate, particularly as to the readiness for counselors to conduct qualitative research. The foundational counseling skills are also the foundational skills of skilled qualitative researchers. The counseling profession is situated to be at the forefront of mental health qualitative research.

 

What was your inspiration to collaborate and create this book?

Rick: Often research courses for counseling students are farmed out to another departments or taught across the college of education. In other words, counseling programs often lack ownership of their research classes. That is unfortunate, because we end up learning about, and ultimately trying to adopt, the strategies used in educational research. But educational research is often related to student performance in classrooms, schools, school districts and statewide performance. These are large systems with a lot of people and data. But whom do counselors see? Predominately we see an individual, small groups, couples and families. So I view counseling research as quite different from educational research, and I wanted to highlight that as well as provide an opportunity for counseling departments and counselor educators to take more ownership of their research classes. ACA did not have a research book, so I saw an opportunity to lend a counselor voice to this area.

I truly enjoy teaching research and helping students understand and relate to concepts that quite often are found intimidating. David Kleist and I knew each other for many years and have co-chaired the ACES INFORM program together. I knew his passion for qualitative research, and I wanted that passion and voice reflected in the book. I think that is something that this text delivers that is different from other books.

David: Hearing that ACA reached out to Rick to write a research book made total sense. When Rick approached me I was touched by his generosity, and his understanding that he could write the qualitative chapters but maybe not with the same passion as he would the quantitative chapters. For myself, I felt overwhelmed, and initially quite hesitant. I knew that I had clear ideas and passion toward qualitative research but wondered what collaboration with Rick would look like. I trusted our past — and ongoing — relationship through ACES and thought we could create an accessible text that clearly communicates the role of scholar for both doctoral and master’s students in the counseling profession.

 

Do you feel the counseling profession, as a whole, produces enough research? Is there an unmet need (if so, what particular areas of research)?

Rick: I think we need to do more client-centered research. We see a lot of research come out on the role of counselors, counselor training and training/practicing within various competencies. But I think we need more research on what we [are] doing with our clients and how our interventions affect clients. I think this type of research can elevate our profession even further.

David: I agree with Rick and would refer back to my comments above to extend the conversation. The counseling profession’s training structure is distinct from the profession of psychology. Psychology has the doctoral degree as the terminal clinical degree, which clearly includes training to conduct research. Thus, psychology conceptualized the “scientist-practitioner model” more than 70 years ago to frame the purpose of the doctoral degree in psychology. The counseling profession would benefit from framing the training of professional counselors as “practitioner-scholars” [and] client-centered research would be the focus. For the doctoral degree, which focuses on producing counselor educators and supervisors, we need to conduct research on the education and supervision of counselors, too, stretching our time thin for also conducting client-centered research. Our profession is still young and developing, and framing our master’s level counselors as “practitioner-scholars” will go a long way to meeting Rick’s goal — our goal — of conducting more client-centered research.

 

What would you want counselor practitioners who aren’t in university settings to know about this topic?

Rick: Research is similar to our counseling skills; if you are not using your skills you tend to get rusty. So, for counselors who have not thought about research in a while, this text provides a very readable overview. We tried to use a voice in this text that is more engaging, fun and practical. Like any research text there are technical terms, but I believe we explain them well and we only use counseling examples. All of the research cited in the book is from counseling research. In essence, this is a book written by counselors for counselors.

David: Research is becoming more and more a collaborative endeavor. I would want counselors to have access to counselor educators in academic settings to consult on developing group research projects targeting the frontline provision of counseling services.

 

What makes research an area of interest for you, personally?

Rick: The formative experiences of my counseling career including working with adolescents admitted to inpatient psychiatric hospitalization. I worked during the period [when] managed care really started to take over — in Arkansas that was 1993 to 2000. So, I saw a lot of change in terms of length of [hospital] stay and how we had to justify our treatment interventions for working with adolescents. I constantly had to answer questions related to why the adolescent required hospitalization and what were we doing to address the issues. I had to verbalize an understanding of what [we] were doing and why it was effective — and yet the system was changing so rapidly I do not think there was sufficient data to justify what the insurance industry was executing. So, when I entered my doctoral program, I saw an opportunity to use research to advocate for clients and to push back against changes that were not helpful to our clients. I see research as a way to not only enhance the care we provide our clients but to advocate for them.

David: I became a counselor to better understand how I could “help people,” the cliché response for most beginning counselors in training. The core of this interest is a curiosity of people [and] of people in relationships. I see curiosity as core to the research process. For me, this book emphasizes to master’s students, in particular, that they have the essential quality of curiosity to not only to provide counseling services, but also to engage in research.

 

 

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Counseling Research: A Practitioner-Scholar Approach is available both in print and as an e-book from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-422-2648 x 222

 

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Related reading: See Counseling Today‘s recent online exclusive: “What gets in the way? Examining the breakdown between research and practice in counseling

 

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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.

 

 

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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.