Tag Archives: research

Racial bias in gifted and talented programs

By Scott Sleek September 26, 2023

Flaws in testing and racial biases among teachers and school counselors are some of the reasons many Black boys are left out of advanced learning programs and misdirected into special education, according to the article “Inequitable representation of Black boys in gifted and talented education, Advanced Placement, and special education” published in the October issue of the Journal of Multicultural Counseling and Development (JMCD). The report is part of a special issue of the journal, “Understanding the Black Male Experience: Recommendations for Clinical, Community, and School Settings,” guest edited by Isaac Burt, Erik M. Hines and James L. Moore III.

Donna Y. Ford

In the article, Donna Y. Ford, a distinguished professor of education and human ecology at Ohio State University (OSU), and her colleagues describe why teachers too rarely refer Black boys to gifted and talented education programs and too often send them to special education. Educators often develop erroneous and harmful perceptions of Black boys as lazy, unruly and apathetic, the authors note. Furthermore, tests often lack cultural context for Black students and favor those who excel at pen-and-paper exams rather than oral expression, they say.

James L. Moore III

The co-authors include Moore, distinguished professor of urban education and inaugural executive director of the Todd Anthony Bell National Resource Center on the African American Male at OSU; Tanya J. Middleton, a clinical assistant professor of counselor education at OSU; and Hines, a professor of counseling at George Mason University.

Counseling Today recently spoke with Ford and Moore about their JMCD article and the issue of racial bias in academic placement. (This interview has been edited for clarity and length.)

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**What motivated you to write this JMCD article?**

Ford: In 2023, racism is still a problem, anti-Blackness is a problem, inequity is pervasive, and underrepresentation of Black boys in gifted and talented programs is a problem. I grew up believing in the United Negro College Fund, whose mantra is: “A mind is a terrible thing to waste.” In the article, we also talk about how a mind is a terrible thing to erase. And that’s why we want more Black boys in gifted and talented education, getting the services they deserve and need.

Moore: It was an opportunity to integrate the gifted education literature with the multicultural counseling literature. These combinations are not very common in the counseling literature.

Generally speaking, Black young men and boys occupy a distinctive space in American society. Too often this group is seen as a part of a group rather than the individual. There are inescapable experiences, regardless of whether your family comes from an affluent community or from humble beginnings. You can look in any school district in America, and Black men will be grossly underrepresented in gifted and talented programs or advanced academic programs. But they will be overrepresented in special education.

a group of young children eating lunch at school, the focus is on a young Black boy

Monkey Business Images/Shutterstock.com

Ford: Black boys make up 9% of our school students, and they make up only 3.5% of students in gifted and talented education. So they are the most underrepresented of any group. We need to keep highlighting this fact, not just to teachers but to school counselors as well. When students are disengaged because they’re not challenged, then they become an underachiever, and it contributes to this overwhelming achievement gap.

What are the most critical points that you would like people to take away from the article?

Ford: We must address test bias and use alternative methods of testing, evaluating and assessing Black boys. In this article, for example, we talk about nonverbal measures and nonverbal subscales.

We must also stop placing our Black boys in special education because when you get services that you don’t need, there’s nothing special about special education. It is imperative that educators be careful and avoid racial bias when placing Black children in special education programs.

And then finally, culture matters and representation matters. We need to be culturally responsive and antiracist, and we need more minoritized professionals in our schools.

Moore: Broadly speaking, we need schools that adapt to students, rather than forcing students to adapt to schools. One of the things that we’ve written extensively about is deficit thinking and how it often becomes self-fulfilling. When a student has perceptions that the teacher doesn’t believe in their academic ability, it tends to have negative effects on their educational outcomes. It’s important that teachers communicate accurately and recognize that some communication styles convey to some students that they’re incapable.

Another issue is representation. When Black students enter gifted programs, they frequently opt out or want to get out of these advanced academic programs because there isn’t representation that is reflective of their experience or of people who look like them. In turn, they are sometimes asked to speak on subject matters that may be viewed as speaking on behalf of the group, and we know that creates anxiety, which then impacts performance.

What role do counselors play in working toward solutions for these issues?

Moore: School counselors play a critical role in students taking advanced academic courses. If the counselor only sees deficits, it will play out in how they consult and collaborate with teachers in helping students make decisions, or in how they make recommendations for the students to enter certain academic courses. So, it’s important that school counselors interrogate any deficit thinking that they may have about an individual. And sometimes the deficit thinking might be who their parents are or where they live. And we make broad assumptions. Fundamentally, I believe that great minds come from every ZIP code.

The other way counselors can help is with social, personal issues. Often, when students leave their comfort zone — and that might be friends or representation of their racial group or gender — and they enter a domain where there’s no one to draw inference from, it creates anxiety. So school counselors can help provide social emotional support. They may also need to help the student’s parents understand the significance of advanced academic curriculum and what the benefits are.

What are some problems associated with the current way we test for advanced academic programs?

Ford: Tests are biased, and in our article, we discuss two reasons for this. The first issue is the verbal loading of standardized achievement tests. The tests require an extensive vocabulary, and it does not take into consideration how Black individuals speak. We speak mainstream English, but the majority of us also speak Black English, which is a language, not a dialect.

Verbal loading means you have to have a certain vocabulary. You have to phrase things in a certain way or know certain words. And that is problematic.

The second issue is the cultural loading, which means the test items and correct responses are based on the culture of upper-income white people.

These two issues can be seen in the testing question “How are work and play alike?” We have to consider why the person writing this test chose the terms “work” and “play” and how others may interpret them. Some Black children, for example, may say, “Well, they both have four letters.” Although that’s true, they would get zero points. Instead, they may be expected to say something like, “They’re both something that you enjoy.” But this isn’t true for everyone. Do you think that sanitation workers dealing with the smell of your trash go home talking about, “Oh, I just love my job”? No. So tests are linguistically biased against Black populations and the rest of minoritized groups.

The underreferral of Black boys to gifted and talented education and the linguistically and culturally loaded tests are a double whammy that denies our Black boys opportunities to be challenged and reach their full potential.

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Watch the entire interview with Donna Y. Ford and James L. Moore III at Journal of Multicultural Counseling and Development Special Issue – Authors Interview – YouTube.

Scott Sleek is a freelance writer and editor in Silver Spring, Maryland. He specializes in content related to social and behavioral sciences and clinical care.

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.

Helping counselors who serve sexual and gender minority youth

By Theodore “Ted” Carroll November 17, 2021

To best understand how to assist counselors, we need to address the ways that helpers are supported. The field of counselor education and supervision is composed of educators and practitioners who express support for clinical competence for practice and educational programs. The Association for Counselor Education and Supervision (ACES) is the entity that encourages program development for counseling education. ACES aligns with the 2016 Standards established by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP). CACREP promotes equity, diversity and inclusion in ethical practice, advocacy, leadership and academics. Multiculturalism and diversity are broad topics with specific implications that are included in CACREP’s standards.

In a 2019 article, “An interdisciplinary ecological framework: Intervention for LGBTQ interpersonal violence,” published in the International Journal of Bullying Prevention, Sharon Bruner and colleagues suggested that CACREP-accredited CES programs intend to explore ethical considerations for serving diverse groups. Pointedly, CES promotes helping licensed professional counselors (LPCs) better serve minority populations. Bruner and colleagues asserted that one challenge CES encounters in effectively supporting clinicians and counselor educators is that the ethical views of LPCs related to serving sexual and gender minority youth (SGMY) are virtually unknown. This lack of data prevents the development of appropriate counselor and educator supports.

Jared Rose and associates, in their 2019 article “Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling’s best practices in addressing conscience clause legislation in counselor education and supervision,” published in the Journal of LGBT Issues in Counseling, contended that although CES literature speaks to SGMY views of ethical factors, current journal articles that express LPC views are missing. As the authors highlighted, SGMY harms are increasing because of an apparent lack of clinical competence and awareness on the part of LPCs.

Pointedly, discovering what LPCs are thinking about ethical consideration for serving SGMY might help clinicians and educators overcome inadequacies and increase therapeutic progress for SGMY clientele. One might wonder why this specific qualitative data is missing from the current CES literature base.

Continuing education, politics and religion

First, CES programs lack awareness and training opportunities that might better equip LPCs for serving SGMY. The abundant choices for continuing education (CE) allow precedence of preference and exclusions of convenience. In other words, as health policy specialist Sari Reisner indicated in a 2015 volume of The Milbank Quarterly, clinicians often seek out enriching CE based on their historical interests. Therefore, sometimes established therapists decline new CE options because the information is perceived as extremely unfamiliar. Paradoxical to CE purposes, new ideas for CE are ignored for decades before becoming widely embraced, despite being based on cutting-edge research findings.

Second, Reisner suggested that some clinicians are closed-minded concerning nontraditional sexual and gender identifiers. Reisner implied that some LPCs are completely refusing services to SGMY based on political and religious beliefs. Although LPCs have a right to refuse service based on scope of practice considerations and conflicting personal beliefs, the 2014 ACA Code of Ethics sets clear referral standards. Reisner purported that the problem exists because some LPCs are not referring out at all, denying SGMY counseling access and violating professional ethics guidelines. Reisner continued pointing out that some of these same clinicians are not returning phone calls, emails or similar communications from SGMY inquiring about services.

Manivong Ratts and colleagues, in their 2016 article for the Journal of Multicultural Counseling and Development, “Multicultural and Social Justice Counseling Competencies: Guidelines for the counseling profession,” discussed CES pedagogical development that would more effectively support educators, counselors and counseling students. Intriguingly, they suggested appropriate communications and referral practices as part of the need for specific counselor training and curricula topics. Notably, CACREP-accredited CES programs would benefit from hearing what a thorough cross-section of the LPC population thinks about ethics for providing services to SGMY and the implications for practice and accessibility standards.

Why and how

Ratts and team suggested that clinicians and educators would benefit from knowing more about LPCs’ views concerning ethics implications for serving SGMY. In turn, SGMY clientele might benefit too. After all, as Reisner indicated, increased counselor effectiveness often leads to individuals’ substantial therapeutic progress.

Reisner and Ratts and colleagues encouraged future studies to focus on LPCs’ views regarding ethically serving SGMY. Furthermore, Reisner and Ratts and colleagues explained that the lack of LPC data incidentally helps maintain the status quo, highlighting that some SGMY clients are underserved, neglected or ultimately denied access to counseling services. In addition, these authors implied that poor access conditions enable less than adequate clinical services and increase SGMY harms such as homelessness, substance use, severe mental health symptoms and suicides.

However, based on information from existing CES research, the above indications are primarily derived from SGMY’s perspectives, not the perspectives of counselors. Although this synopsis includes some related professionals’ views on ethics considerations for serving SGMY, it excludes LPCs’ views. Reisner and Ratts and colleagues suggested that including LPCs’ ideas about ethics and counseling SGMY might expand ethical practices for clinicians, advance CES program development, and reduce serious SGMY harms. Arguably, knowing more about what LPCs think might save lives. At the very least, counselors and educators would be assisted, thereby more effectively supporting LPCs and CES.

It is likely that the majority of ethical dilemmas and the lack of adherence to ethics standards have more to do with LPCs not being equipped with the necessary awareness and training than it is a total lack of regard for SGMYs’ needs based on extreme political or religious beliefs. For the most part, counselors become professional helpers because they really want to help others. In fact, most counselors, educators and counseling students seek to better understand people and topics with which they aren’t initially familiar.

Outliers exist, however, and it is questionable whether LPCs would admit to feeling ill-equipped regarding awareness, training, referral standards or anything else. Perhaps simply asking LPCs questions about their experience serving SGMYs would produce more qualitative data that might help colleagues and inform CES program development. Direct ethics inquiries can be avoided while still gathering valuable information from LPCs. Of course, as mentioned previously, some clinicians might benefit from a thorough review of referral standards regardless of whether they are equipped or willing to counsel SGMY.

Ethical considerations and future research

Regarding the future research and need for focused studies, Myra Parker and team in their article, “Beyond the Belmont principles: A community‐based approach to developing an indigenous ethics model and curriculum for training health researchers working with American Indian and Alaska Native communities,” in the journal American Journal of Community Psychology, underscore that clarity of rationale for conducting research is paramount for research ethics. Furthermore, Parker suggests that a sufficient need for research precludes approval by institutional review boards. Indicatively, the need for knowing more about LPCs’ views is established: Educators, clinicians and clients are likely to benefit from simply knowing LPCs’ views about ethics factors for counseling SGMY.

Basically, the lack of information — a condition of the status quo that prevents best clinical practices — can be solved by ethically and responsibly gathering that data. LPCs’ views can be acquired without any significant risks to people, especially considering that qualitative interviews can be conducted via online videoconferencing platforms. These facts are essential for research protocol, as established by a 1978 National Commission’s publication, the Belmont Report, similarly discussed by Parker.

Identifying the research need and rationale for gathering new information, one might consider the immediacy of the need. LPCs lack training and awareness, which are incidentally enabling poor counseling conditions for SGMY. Who will step up to the plate and perform the needed studies? Delaying the suggested research would perhaps be the most unethical option.

Sharon McCutcheon/Unsplash.com

Practical considerations

Above all, knowing LPCs’ views about ethics for counseling SGMY would help people. Notably, the importance of assisting helpers should not be underestimated. As Lorelli Nowell related in 2017 in The International Journal of Qualitative Methods, the nature of helping others is draining and often leads to burnout. Similarly stated, if research is left undone, then the indicated problem continues. Consequently, the established need also would persist. Ultimately, the result would be that people suffer.

Pointedly, if the need persists, then LPCs would continue to be ill-equipped for best practices for counseling SGMY, and the indicated harms would continue. Incidentally, progress for LPCs and CES would be thwarted. On the other hand, as Ratts and colleagues indicated, if future studies address LPCs’ views of ethics for counseling SGMY, then the stated harms would be likely to decrease, and clinicians and educators would be better supported than they are now.

Intervention factors

New information from LPCs regarding ethical implications for counseling SGMY would likely present new theoretical considerations. Plus, new factors for theory might produce new ways for using interventions. For example, from a social constructivist view, collaborating with peers leads to solutions for interpersonal problems and personal growth.

Additionally, mindfulness interventions such as meditation practice might prove helpful in clinical sessions with individuals experiencing social rejection or low self-esteem due to sexual or gender identity challenges. In his 2019 article in The Counseling Psychologist, Ezra Morris supported this idea, suggesting that opportunities like these might be prime opportunities for theory and intervention advancements. For example, because mindfulness-based practices originate from constructivist tenets, Morris suggested that new applications inform educators of novel program developments. Furthermore, new application opportunities would potentially help the broad human services field, affecting change throughout various helping professions and grassroots humanitarian centers.

Forward momentum

Because CES supports counselors’ competence for practice and educational programs, drawing parallels from ethics and counseling SGMY to practice standards for serving other minority groups is appropriate for the field’s growth. For example, future studies could address LPCs’ views concerning marginalized groups such as those convicted of violent crimes or those who do not have health insurance. The subjects for consideration for future research focuses are nearly unlimited.

Of course, existing CES research should continue to guide future studies. Perhaps articles such as this one will trigger renewed interest in significant research gaps. First things first: helping LPCs to help SGMY helps CES and the broad human services field. The first step is finding out counselors’ views of ethics and serving SGMY.

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Theodore “Ted” Carroll and spouse, Tanya Carroll, operate a private practice in Spokane, Washington, that serves individuals, couples/families and children. Ted is a CES doctoral candidate with Capella University. His research specialization is counseling sexual and gender minority youth. Contact him through the Actualize Psylutions website.

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

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

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

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

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

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

Multiculturalism, social justice and human rights

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

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

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

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

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

The impact of human rights on graduate students

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

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

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

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

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

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

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

Human rights and counselor education programs

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

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

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

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

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

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

For graduate students:

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

For counselor education programs and educators:

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

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

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

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

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

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

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

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.

Letters to the editor: ct@counseling.org

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

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

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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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.