Tag Archives: school counselors audience

U.S. student-to-school counselor ratio shows slight improvement

By Bethany Bray October 20, 2017

On average, there is one school counselor for every 482 K-12 public school students in the U.S. This number has decreased slightly from the previous year’s average of 491-to-1.

The American School Counselor Association (ASCA), a division of the American Counseling Association, compiles a report each year on student-to-school counselor ratios, based on data from the U.S. Department of Education’s National Center for Education Statistics. ASCA’s latest report, released this week, included data on public K-12 schools in the 2014-2015 school year, which is the most recent information available.

“The work that school counselors do to support students’ academic, career, emotional and social development is absolutely critical,” says ACA President Gerard Lawson, an associate professor of counselor education at Virginia Tech. “In today’s schools, counselors are also relied on for their expertise in working with broader mental health needs. It is encouraging to see some improvements in the ratio of students to counselors, and we know that counselors can serve their students, schools and communities more effectively, when the ratio of students to counselors is lower and sustainable.”

The report highlights a disparity that exists across America. The highest ratio, with 924 students for every one school counselor, was Arizona, and the lowest, with a 202-to-1 ratio, was Vermont.

ASCA’s recommended student-to-school counselor ratio is 250-to-1.

“These counselor-to-student ratios are headed in the right direction, but they have a long, long way to go. More school counselors need to be hired, especially in states with the most egregious ratios,” says Nancy Carlson, a licensed clinical professional counselor and ACA’s on-staff counseling specialist.

 

Other highlights of the report:

 

  • States with the highest student-to-school counselor ratios were Arizona (924-to-1), California (760-to-1), Michigan (729-to-1), Minnesota (723-to-1), Utah (684-to-1), Illinois (664-to-1) and New York (635-to-1).

 

  • States with the lowest student-to-school counselor ratios were Vermont (202-to-1), Wyoming (219-to-1), Hawaii (293-to-1), North Dakota (307-to-1), Maine (315-to-1), Montana (319-to-1) and Tennessee (339-to-1).

 

  • California showed the most improvement over the previous year; the state’s ratio decreased 9 percent, from 822-to-1 (2013-2014) to 760-to-1 (2014-2015).

 

  • Alabama’s ratio also shifted 9 percent, but in the other direction. The state lost nearly 150 school counselors between 2013-2014 and 2014-2015, increasing its ratio from 417-to-1 to 453-to-1.

 

 

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ASCA’s full report, with a state-by-state breakdown, is available online: schoolcounselor.org/asca/media/asca/home/Ratios14-15.pdf

 

Read ASCA’s press release about this year’s numbers:  schoolcounselor.org/asca/media/asca/Press%20releases/ASCA-Student-to-SC-Ratios-Press-Release-10_2017-Final.pdf

 

The American Counseling Association’s School Counselor Connection page: counseling.org/knowledge-center/school-counselor-connection

 

 

 

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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.

 

 

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’13 Reasons Why’: Strengths, challenges and recommendations

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

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

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

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

 

Strengths

1) Raising awareness that suicide is a real problem.

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

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

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

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

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

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

3) Suicide is complex and individual.

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

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

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

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

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

4) The central message is a positive one.

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

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

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

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

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

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

 

Challenges

1) Graphic nature and contagion

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

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

2) Survivor’s guilt and revenge fantasies

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

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

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

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

 

Recommendations

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

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

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

2) We need more than prevention programming in schools.

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

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

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

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

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

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

4) Use an intervention model backed by research.

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

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

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

 

Summary

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

 

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

 

 

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

 

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

 

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

 

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

Bringing the family counseling perspective into schools

By S. Kent Butler, Tony D. Crespi and Mackenzie McNamara May 8, 2017

Children in schools today come from increasingly diverse and complex families. As illustration, more than 1 million families are impacted annually by divorce. In fact, approximately 13.7 million single parents are raising 21.8 million children, and 1 in 3 Americans are stepparents, stepchildren, stepsiblings or part of a stepfamily. Furthermore, according to a 2009 article published in the journal Family Relations, it is estimated that only 31 percent of fathers who no longer live with their children maintain weekly contact with those children. It is easy to conclude that the issue of divorce alone has a profound impact on many millions of children in the U.S.

Now imagine that a young student and her mother walk into the professional school counselor’s office on a Monday morning. Mom explains that she and her husband are pursuing a divorce — he recently told her that he’s been having an affair and has decided to move in with his girlfriend. The daughter acknowledges feelings of depression and admits to having angry outbursts at home. Mom says she is concerned because her daughter’s grades have been dropping.

Considering the large number of children and adolescents coping with parental divorce, it’s not surprising that this fragmented family came to the school counselor’s office. In fact, it’s a good thing. Both daughter and mother need someone to talk to, and schools are a natural access point for services. However, many professional school counselors are not trained in family dynamics and are not familiar with key tenets that impact family counseling, so they may not know how to proceed.

A sample case

Susie is 15. A high school freshman, she knows only that her father left the house two months ago to move in with his girlfriend. Susie’s parents had been together for 16 years, getting married shortly after college.

Susie’s father hasn’t called since leaving. Susie is unaware that her father told her mother that although he loves Susie and her younger sister, who is in seventh grade, he hasn’t missed seeing them in the least. Mom decided not to share this comment with the children, but she does confide this secret to you, the professional school counselor.

Sitting in your office, Susie suddenly looks up and exclaims that she is scared she will have to move and change schools. She also says that she’s having a really tough time paying attention in class and explains that her grades are slipping. “I hate my dad for doing this!” she yells.

Suddenly, Susie starts shaking and breaks down in tears. After a few minutes, Susie tells you that she is spending a lot of time with her boyfriend, partly to stay out of her house. She acknowledges feeling depressed. After pausing for a moment, she looks at her mom and states, “I really hate Dad. His girlfriend is so young. She’s in her 20s. She’s not much older than me!”

Academically, Susie has been an A and B student, but her grades have fallen since her father left. Her mother acknowledges that things are tough at home and reveals that she didn’t learn about her husband’s affair until the day he moved out. “I really don’t know what’s going to happen,” she tells you. “I know we’re getting a divorce, but beyond that I just don’t know.”

Your school doesn’t have a social worker. However, you have a colleague who has been studying family counseling, so you knock on her door to ask for a consultation. After sitting down, you share a few thoughts.

You note that, fundamentally, Susie needs someone to talk to about these issues. Acknowledging that you are speculating, you openly wonder what type of impact the obviously poor communication in Susie’s family is having on her. After all, her father has not called in two months, her mother was completely unaware of the affair and her mother is keeping the father’s confession of not missing his kids a secret. These facets alone highlight poor family communication. In addition, Susie is scared that she might have to move and change schools. Clearly the issues are widespread.

Risk points

Here are some risk points to consider as you work with Susie:

  • Parenting after a divorce differs significantly from parenting prior to
    a divorce.
  • Single-parent families in the United States are increasing.
  • Children of divorce have more mental health problems in comparison with their peers.
  • Suicide is the third-leading cause of death among U.S. youth.
  • Brain regions responsible for decision-making are not fully developed in youth.
  • Changes in family structure can have an affect on school grades.
  • Anxiety, depression and behavior problems are elevated after divorce.
  • Children of divorce often feel a sense of instability.

An understanding of these risk points is essential for moving forward with children and families because the risk points can provide direction for the work that needs to be done. For example, knowing that mental health symptoms are elevated following divorce and impulsive decision-making is greater among youth, you should assess Susie’s level of safety. In this case, Susie also makes many “red flag” statements.

These are things that counselors know how to address but might not always consider without an awareness of the data. In addition, parents can become defensive, or they might blame themselves for their children’s difficulties. For this reason, it is imperative to educate parents on these risk points. It is also important to realize that family issues may require clinical supervision.

Supervision around work with families 

Susie is not alone. As your colleague notes, Susie is one of many children and adolescents who are coping with family stressors. With the prevalence of so many family issues, a growing number of states have enabled licensed marriage and family therapists (LMFTs) to work in the schools. Connecticut, New Mexico, Maine, Texas and Illinois have passed specific laws to allow LMFTs to work in schools, whereas Massachusetts allows LMFTs to work under a general mental health designation.

Schools clearly represent an important access point for mental health professionals. But with only six states utilizing LMFTs in schools, it is extremely important for professional school counselors and their supervisors to know how to manage these situations with families.

As you ponder your next meeting with Susie, you need information. Direct supervisors are often part of the structure of many agencies, but professional school counselors might need to seek support from a colleague with training in family counseling. Such supervision might come from a guidance director, a school psychologist, a consulting psychologist, a marriage and family counselor, or a local family agency.

Two popular family therapy models that might help Susie are presented below.

Symbolic-experiential family therapy 

This model, derived from the work of Carl Whitaker, addresses both individual and relational patterns. It is focused on both personal growth and family relations.

Fundamentally, the therapist helps dislodge rigid patterns and stimulates flexibility using a family’s natural pull toward growth. Focusing on the present, the therapist helps people recognize their real feelings, express those feelings and move forward, individually and as a family. Key points follow.

  • The “battle for structure” involves clients (a family) “sizing up” a therapist. There is no “identified patient”; rather, the family is the therapy unit. In this model, the therapist must win the battle and control therapy. For instance, if the therapist invites the entire family and one member does not show up to the session, the therapist may refuse to meet until everyone attends. In the case with Susie, you might note that you, Susie, her mother and Susie’s sister must all attend.
  • The family must win the “battle for initiative”; this involves their decision to take charge of their lives and decisions. Is Susie committed to resolving her feelings? Will she commit to six counseling sessions? Is she willing to confront her father about calling his children? Is she motivated to initiate change?

Therapy progresses through stages:

1) Engagement: This is the “meet and greet” phase. You have already started this stage with Susie and her mom.

2) Middle phase: Families are encouraged to change through confrontations, encouragement and interventions. Can Susie’s family meet to start this process?

3) Late phase: Increased flexibility is a focus for the family. Can Susie’s family talk through how the divorce will change their life?

4) Separation: As the therapist separates, the family takes responsibility.

Symbolic-experiential family therapy often advocates the use of co-therapy, making it a great model to use with a more “senior” therapist. In this fashion, supervision can be active and ongoing as you acquire firsthand skills in family counseling.

Structural family therapy

The structural approach, typically associated with Salvador Minuchin, views problems as being rooted in family interactions. Fundamentally, if we can help change the family’s organization (structure), its members typically find that they feel better and their symptoms are often relieved. Key points follow.

  • Enmeshment or disengagement: Family members may range from those who are overly connected to those who are disengaged. Enmeshment tends to prevent growing maturity, whereas disengagement may lead a child to feel abandoned. Most families are not one or the other but have subsystems that reflect their tendencies. For example, a disengaged father who is overly involved at work may neglect the family. In response, the mother may compensate by becoming overly involved. Is Dad really connected? What is the structure
  • Boundaries: Are parental boundaries rigid or flexible? Are grandparents a resource? Can a child visit Dad at work, or does the family maintain a rigid rule against it? Can Susie ask Dad questions? What are the boundaries? What is spoken? What is unspoken?
  • Alignments: Who joins together? Are children aligned against the parents? Did a parent resent and refuse to attend a child’s sporting activities? Did a parent require everyone to attend? What are the alignments?
  • Triangulation: The permutations of triangulation in families can be abundant. A child and parent may triangulate against another parent. A parent having an affair can create a triangle with the other spouse. Will Susie triangulate with Mom against Dad? What triangles exit?

The structural model also features several stages:

1) Joining and accommodating

2) Assessing family interactions

3) Monitoring dysfunction

4) Restructuring patterns

Summary and considerations

When a student walks into a professional school counselor’s office, we are presented with a rare opportunity. When a student and parent walk in together, we are handed an even rarer opportunity.

Family counseling offers unique and engaging ways of reframing problems. Rather than blaming an individual for a particular problem, family counselors look at the family system. Perhaps a child’s acting-out behaviors allow parents to avoid looking at their relational problems. Perhaps a child’s failing grades reflect more on family anxiety and stress than on individual issues. Fundamentally, family counseling takes a larger, more systemic perspective of presenting issues.

Professional school counselors possess wonderful skill sets. They understand rapport building. They understand relational dynamics. They understand problem assessment and the utility of interventions. The connection between families and school adjustment is undeniable. At the same time, school counselors will likely find continuing education and supervision indispensable in helping families.

In our experience, students and families can often benefit from a family counseling perspective. With so many students in the schools coping with changing family structures, it is vital that we expand our skill sets. Fortunately, there are multiple platforms through which we can provide help. Some of these options include:

  • Individual counseling from a family perspective
  • Co-therapy with single families
  • School-based divorce groups with multiple children
  • Single-parent support groups

This article is intended to stimulate thinking and provide a preliminary glimpse into two prominent family counseling theories. Our advice? Be available. Be sensitive. Consider finding a supervisor who is capable of expanding your knowledge and skills in this invaluable area. Truly, children, families and the community stand only to benefit.

 

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S. Kent Butler is an associate professor at the University of Central Florida. He is a licensed professional counselor, national certified counselor and national certified school counselor. He is particularly interested in mentoring, supervision and multicultural issues in counseling. Contact him at skbutler@ucf.edu.

Tony D. Crespi is a professor at the University of Hartford. He is a certified school counselor, licensed marriage and family therapist, and licensed psychologist. He is particularly interested in family counseling and legal issues that affect supervision.

Mackenzie McNamara is a doctoral student in the counseling psychology program at the University at Albany, State University of New York. She most recently worked for New London Public Schools in Connecticut.

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 your 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.

The Social Adventures and Experiments of  Tommy Joe Peterson

By Brandon S. Ballantyne February 7, 2017

The idea of this therapeutic short story is to creatively illustrate the various dilemmas that occur from the perspective of a socially awkward young man, Tommy Joe Peterson. Through the story, the reader is able to gain perspective on the thought process and problem-solving skills of this uniquely talented 11-year-old boy.

Whether this fictional story is read by a child or read to a child by a teacher or counselor, the discussion questions included at the end are aimed at facilitating reflection and interpersonal growth. I believe that discussing the responses to the discussion questions will allow for improved awareness and insight into real-life dilemmas and help children to improve their problem-solving skills in a creative, narrative manner.

The target population for my therapeutic short story consists of teachers, parents, therapists and children of elementary through middle school age, particularly those with a mental health diagnosis similar to or consistent with autism spectrum disorder or social anxiety.

Friendship

Hello, my name is Tommy Joe. I am 11 years old. And in my mind, I am not just a boy. I am the world’s most coolest teenage superhero in my school. Well, at least I pretend to be.

Let me tell you about the time I almost saved my friend William from a flying plate of steaming hot lasagna in the cafeteria. Oh, and just so you know, William is only a few months younger than me. This is what happened …

The day started out just like any other day. I woke up at 6:37 a.m. I always wake up at that time to ensure that I get as many cartoons in as I can before I leave for school at exactly 8:02 a.m. I like the superhero cartoons. Batman is obviously the best, and I think I am like him in some ways. Although most adults say I am socially awkward, whatever that means. Clearly, they do not understand my abilities.

Anyway, after my cartoon time, my mother prompted me to participate in what she calls “activities of daily living.” She is a nurse, and I hear those types of phrases all the time. I have gotten used to it. This is the part of my morning routine during which I brush my teeth and comb through my brown wavy hair. I usually place some deodorant under each armpit, but not a lot. I typically do not like the texture, but I tolerate it enough to get at least a little bit of scent on me. Every good superhero needs a scent — at least that is what my mother tells me.

It was almost time to leave for school, so I slipped on my Velcro shoes and placed my bright red turtleneck on so it fit nice and snug, just the way I like it. I refuse to wear anything else but that red turtleneck. I feel most like a superhero in that shirt. Some people tease me for this. They clearly do not understand my abilities.

The bus ride to school is short. I live only four blocks from the school. And as a fifth-grader, riding the bus is the cool thing to do. On that day, the older kids were making fun of the way I was dressed. They always do. They also make fun of the way I only spray certain sections of my hair. You see, only some sections of my hair get messy, so there is no need to hairspray it all down. Only certain sections need a touch-up.

I do not think that the other kids understand my perspective. I don’t mind though. Life can be hard for a superhero like me. Clearly the other kids on the bus do not understand my abilities. And anything is better than riding to school with your parents, although my mother does listen to good music. But that is beside the point, and I do not want to ramble on, so let’s get back to the story of how I almost saved my friend William from an extremely steaming hot plate of lasagna.

I meet my friend William at the same spot every day before going into school. Every superhero needs a sidekick, and William is mine. William is shorter than me, and he refuses to be called Billy. He thinks that William is more formal, and he likes that. He has red curly hair and orange glasses. I do not really know where he got those glasses, but I like them. His glasses usually slip down to the end of his nose, and he has to spend most of the day adjusting and readjusting them. We have every class together. Every superhero needs a sidekick, and at least William understands my abilities.

The day was pretty boring until art class. It is like that every day. William and I count down the minutes leading up to our fourth-period art class. For us, it is more than just art class. It is a time for us to create new supercool superhero ideas. And on this day, the topic of class was “favorite transportation.” This was a perfect topic for superheroes like us.

William and I decided to create a spaceship. This was no ordinary spaceship. This was a supercool spaceship that William and I had imagined ourselves using to explore the outermost limits of our galaxy — beyond the black holes, red dwarfs, supernovas and solar flares.

By the way, space is my other supercool area of interest. William is mostly indifferent to the idea of space travel, but every superhero needs a sidekick, and because of that, I think he would come with me anyway. I guess the only problem would be if William gets motion sickness. I wonder if he gets sick in the car? To tell you the truth, I do not really know how William gets to school each day. I have never been in a car with him. Quite frankly, I only see him at school. Oh well, I do not want to ramble. Let’s get back to the story of how I almost saved William from an extremely overwhelming, steaming hot plate of lasagna in the school cafeteria.

Before describing the scene that would be about to take place in the cafeteria, it is important for me to be able to tell you how our art project turned out. William and I made a spaceship using cardboard, paint and a whole lot of glue. The spaceship was red, just like my turtleneck.

William is exceptionally good at folding cardboard, so I gave him the job of working on the wings. William attached long, narrow wings that seemed as if they would touch the ceiling. We carefully added glue to all the areas that needed to be held together, and then we added more glue, and then more glue, and then one last coating of glue to ensure that this spaceship could tolerate the astronomical elements that space travel would bring to the table. Every good astronaut needs a sidekick.

Our hands were sticky from the glue. It was hard for us to pull our fingers apart. But our spaceship was complete. William and I carefully placed the spaceship in our art closet to dry.

The bell rang for lunch. We hurried out of the classroom without cleaning up the rest of our materials. This was necessary because we need to get to lunch early so that we can sit at the table in the left corner — the one by the ice cream cooler. I like ice cream sandwiches, and it is important to be next to the cooler so that I can get two of them before they sell out. Every superhero needs his energy, and I just happen to get mine from ice cream sandwiches.

William prefers pizza, but they do not always have that. I once had the idea of putting my ice cream sandwiches on my pizza, but I have not been able to convince William to try it with me. And as a superhero, you need your sidekick to be on board before trying anything new. But that is for another story. Let’s get back to this one. I don’t want to ramble.

William and I entered the cafeteria and at a casual but fast pace assumed positions at our table by the ice cream cooler. The cafeteria was loud and chaotic as various students attempted to jockey for position in the lunch line. The teacher on duty was obviously struggling to keep order. I could tell by the look on her face. I did not have this teacher for class, but any good superhero can tell when another person is in obvious distress. I wish I could have helped her, but I needed to remain in position at my table.

This was partly due to the fact that the ice cream cooler is positioned just outside the kitchen, and as kids pass through the lunch line, they typically select their favorite ice cream product to complete their tray. William and I do it backward — we wait for a break in the line, and then we purchase our desserts first. Most kids do not think of going to the ice cream cooler first because it is positioned at the end of the line. Being the most supercool superhero that I am, I had developed this approach early last year. William agreed with me, although he typically does. William is a great sidekick.

The time was right. William and I stood up to go make our selection. I always purchase two ice cream sandwiches. William typically purchases the Italian ice. At least I think he does. Anyway, it was at that moment when we stood up that I began to notice an increase in chaos in the far right-hand side of the cafeteria. I quickly glanced over, and before picking out my ice cream, I noticed a food fight taking place. It was on the other side of the cafeteria, but it appeared as though it was escalating rapidly.

I needed to get my ice cream. I reached down and realized that I could not pull my fingers apart to grab it. Oh no, it was my worst nightmare. My fingers had been glued together from working on our spaceship in art class. It seemed that the harder I tried to pull them apart, the more they seemed to be glued together.

I had one dilemma with not being able to literally pick up my ice cream sandwich, and another dilemma with the rapidly growing food fight that was moving across the cafeteria like a tidal wave. I had to make a decision. I either needed to take cover and sacrifice my ice cream sandwich, or I needed to take the chance of being hit by food and attempt to grab my ice cream with my glued-together fingers. I had to think quickly.

At that moment, I noticed a red substance flying through the air toward William. I saw it out of the corner of my eye, so it was hard for me to tell what it was. But as it flew through the air, I realized that it was a piece of lasagna. It was hot. I could see the steam coming off of it as it whizzed past the heads of various students.

At this point, even the teachers were taking cover. Mr. Jones was under the table, and Ms. Sprockett was hiding behind the soda machine. The flying lasagna was coming our way, and based on my superhero calculations, it was heading directly toward William.

Everything was moving in slow motion. William was frozen in fear. He needed me. I quickly lunged in his direction and raised my hands in an attempt to take most of the blow from the flying lasagna. Every good superhero occasionally makes sacrifices for his sidekick — at least Batman did.

The only problem was that my fingers were still glued together. The lasagna not only hit my arms, covering me in sauce, but it also smothered William. He had sauce and cheese all over him. And the worst part of it was, I didn’t even get my ice cream sandwiches. The last thing I remember was William tasting the lasagna that was dripping off of his cheeks. William is always good at embracing chaos.

I guess even the best superheroes sometimes have trouble rescuing others. But William and I are still friends. He has forgiven me, and there are no hard feelings between us. I guess what I have learned from this situation is that every superhero needs a sidekick. I do not know what I would do without William. He is my best friend. But maybe next time, I won’t use so much glue.

 

Therapeutic discussion questions 

  • According to Tommy Joe, every superhero needs a sidekick. Who is the sidekick in your life? Who do you feel supported by? Who listens to you when you talk?
  • What makes someone a friend? What makes you a friend? What types of things do friends do for one another?
  • Discuss a difficult situation that a friend helped you with. What did they do to support you?
  • Discuss a difficult situation that you helped a friend with. What did you do to support them?
  • The glue on Tommy Joe’s fingers makes it difficult for him to rescue William and pick up his ice cream sandwiches. What should Tommy Joe have done prior to going into the cafeteria that would have made it easier for him to help William?
  • What is a goal you have in your life? What is an obstacle you face in your life? How can you plan ahead to make accomplishing your goal easier?
  • What can your sidekick do to help you reach your goal?
  • If you were Tommy Joe, what would you have done differently in the story? How would making different decisions have affected the outcome of the story?
  • Is there another way the story could have ended? If so, I would love to hear your version.

 

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Brandon S. Ballantyne, a licensed professional counselor and national certified counselor, has been practicing clinical counseling since 2007. He currently practices at Reading Health System in Reading, Pennsylvania, and Advanced Counseling and Research Services in Lancaster. He has experience working with both adolescent and adult clients struggling with moderate to severe depression and anxiety. He has facilitated many unique interventions and group modalities in the area of addressing relationship conflict and negative thought patterns. Contact him at ballantynebrandon@yahoo.com.

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 your 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.

Reach Higher: Bridging the gaps through cultural competency

By Bethany Bray November 4, 2016

U.S. Secretary of Education John B. King Jr. was preaching to the choir at last week’s Reach Higher Convening when he said school counselors could make a powerful and long-term impact on the lives of students.

“I am here because of the difference educators made for me. I know you make that difference. … You [school counselors] are everyday heroes in our schools,” said King, whose mother was a school counselor.

The Reach Higher Convening, a gathering of close to 200 school counselors, administrators and other education professionals from around the U.S., was held Oct. 28-30 at American University in Washington, D.C. The American Counseling Association was a co-sponsor of the event, the

U.S. Secretary of Education John B. King, Jr. speaks at the Reach Higher Convening on Oct. 28. Photo by Bethany Bray/Counseling Today

U.S. Secretary of Education John B. King, Jr. speaks at the Reach Higher Convening on Oct. 28. Photo by Bethany Bray/Counseling Today

fifth gathering held as part of First Lady Michelle Obama’s Reach Higher initiative focused on the bridge between K-12 education and college and career readiness.

While at the convening, King announced that the U.S. Department of Education would expand its School Ambassador Fellows program to include school counselors (starting with the 2017-18 school year). Previously, the program was open only to teachers and school principals. Educators in the ambassador program lend their perspective to discussions about federal programs and are positioned to inform nationwide policy.

The theme of this year’s convening was cultural competence. Workshops and sessions focused on addressing the equity gaps that exist for students from underserved backgrounds.

For example, King posed a question: When you walk into an advanced placement (AP) class in a public high school, does the class makeup reflect the school community as a whole? What about the robotics club or the in-school suspension room?

Only 18 percent of teachers are persons of color, which does not match the overall cultural makeup of America’s student body, King noted.

“We still have not delivered, as a society, on Brown [v. the Board of Education],” King said. “We want students to have role models that look like them. That’s important to how we knit our diverse society together.”

For educators, cultural competence includes knowing – and appreciating – the context in which a student lives, said King. For example, a student who serves as a translator for his or her family may be apprehensive about leaving home for college.

“They [families and students from underserved backgrounds] don’t have the same range of knowledge of what’s possible. … We can affect that through school,” King said.

A school counselor’s role as an advocate, particularly for students who are first-generation Americans, “can change a student’s life trajectory,” said King.

Vivian Lee, an American Counseling Association member and associate professor in the School of Education at Johns Hopkins University, spoke about how each person’s own cultural

ACA member Vivian Lee speaks at the Reach Higher Convening on Oct. 28. Photo by Bethany Bray/Counseling Today

ACA member Vivian Lee speaks at the Reach Higher Convening on Oct. 28. Photo by Bethany Bray/Counseling Today

competence is a lens through which he or she views data such as student achievement statistics.

“Cultural competence is a lifelong journey,” Lee said. “It’s a journey we are all on. It enables us to see that the road is more challenging for some. … We need to be able to see, hear and validate the lives of people in groups other than our own. … The time is now for us to begin these dialogues.”

Lee and another member of ACA, Cheryl Holcomb-McCoy, dean of American University’s School of Education, were instrumental in organizing the Reach Higher Convening at AU. ACA President Catherine Roland also attending the convening.

“It doesn’t get any better than having the White House, the First Lady and the Department of Education recognize and support the integral role of counselors in helping students ‘reach higher,’” said Lynn Linde, senior director of ACA’s Center for Counseling Practice, Policy and Research. She has attended all five convening events.

“This convening focused on equity and access issues for all students and the counselor’s integral role in helping all students maximize their potential,” Linde said. “… [School counselors] see the potential in students who don’t always see it in themselves.”

 

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(From Left to right) Jasmine McLeod, school counseling specialist at the U.S. Department of Defense; Laura Owen, researcher in residence at American University; John B. King Jr., U.S. Secretary of Education; Vivian Lee, associate professor at Johns Hopkins University; and Cheryl Holcomb-McCoy, Dean of American University’s School of Education, at the Reach Higher Convening in Washington D.C. on Oct. 28. [Photo credit: Steven Owen]

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Find out more about the Reach Higher initiative at whitehouse.gov/reach-higher

 

Press release from the U.S. Department of Education on the inclusion of school counselors in the ambassador program: bit.ly/2dZFCPs

 

ACA President Catherine Roland will share some thoughts about the convening in her “From the president” column in the upcoming December issue of Counseling Today.

 

ACA’s Q+A with Secretary King from this summer: bit.ly/1YBlQZu

 

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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.