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Seeing the whole gifted child

By Lindsey Phillips November 30, 2020

Assessing symptoms and determining a treatment plan for clients is never a simple or straightforward task. That can be especially true when it comes to working with gifted and twice-exceptional clients.

Imagine that a second-grader who is highly intelligent comes to your counseling office. The child has some intense interests, which is not uncommon with individuals who are gifted, and they struggle with emotion regulation, which appears to be related to the child’s perfectionism and low frustration tolerance. You might assume that this client’s struggles are just a natural consequence of being gifted.

Emily Kircher-Morris, a licensed professional counselor (LPC) at Unlimited Potential Counseling & Education Center in O’Fallon, Missouri, made this assumption. It wasn’t until her client entered the fourth grade that Kircher-Morris learned that giftedness alone couldn’t “explain away” the student’s emotional struggles. After experiencing a major event, the client’s problems increased to the point that Kircher-Morris referred him to a psychologist for a full differential diagnosis. Upon receiving the results, she was shocked to find out that her client was not only gifted but also autistic.

“I had fallen into the [common] beliefs about giftedness: That the [emotional struggles] were just sensory intensity or perfectionism,” says Kircher-Morris, an American Counseling Association member who specializes in gifted and high-ability individuals. “I missed how intense his meltdowns were and that his intense interests were related to autism, not giftedness.”

It’s true that individuals who are gifted may possess an intense interest, but they can communicate about other topics in addition to that passion, whereas someone with autism spectrum disorder can’t easily talk about other topics, Kircher-Morris explains.

To make an accurate assessment of a gifted client, professional clinical counselors must first know what “giftedness” even means. The problem is that the exact determinants and measurements for giftedness vary from state to state and even school to school. But according to the National Association for Gifted Children (NAGC), individuals deemed to be gifted or talented have the capability to perform at higher levels than their peers, and they require modifications to their educational experience to learn and to realize their potential.

Neither Kircher-Morris nor James Bishop, an LPC at Blank Slate Therapy in Frisco, Texas, distinguish between “gifted” and “high achieving” because they say some individuals need to be cognitively challenged regardless of whether they meet the formal definition of being gifted. And sometimes gifted individuals have learning disabilities or mental health issues that require them to get help — a concept that can be difficult for individuals who are used to having things come easily to them, Kircher-Morris points out.

(Mis)Identifying giftedness

There is also a substantial amount of anecdotal information, as well as misconceptions, about giftedness, and Bishop, executive director of the Passionate Mind Institute, warns that even mental health professionals can fall prey to pseudoscience on the topic. For example, some counselors too easily embrace overexcitability as a common characteristic of gifted individuals even though there isn’t much current research to support the belief, he says.

People may incorrectly assume that someone cannot be gifted if they are not doing well in school or that gifted individuals never need help, Bishop continues. Some also believe that individuals who are gifted are more prone to depression, but research shows they are as well-adjusted, if not more so, than their peers in the general population, he adds.

Such misconceptions, as well as concern about clinical misdiagnoses, led Bishop, a member of ACA, to conduct a study to test the ability of mental health professionals to recognize gifted characteristics in presenting clients using vignettes that illustrated common issues and characteristics related to giftedness. Half of the 330 participants were prompted that giftedness could be a factor, but regardless of that prompting, Bishop found the majority of participants still clung to the diagnosis of a disorder over an assessment of giftedness. (See “The potential of misdiagnosis of high IQ youth by practicing mental health professionals: A mixed methods study” in the journal High Ability Studies.)

Bishop’s study suggests that even mental health professionals, not just educators, have trouble factoring giftedness into their clinical assessments. “Being mindful and educating yourself on the real struggles that gifted [individuals] face can make you a better clinician in terms of assessing a gifted [client] and being able to determine whether their problems are the result of a disorder or are simply part of their gifted nature,” says Bishop, who chairs the NAGC Social and Emotional Development Network.

But finding training in this area can be challenging for counselors. Bishop says he had to get a doctorate in educational psychology to become formally educated in the subject. He isn’t aware of any counseling program that offers a concentration in giftedness.

The lack of adequate training is a problem because, according to Michelle Tolison, a licensed clinical mental health counselor in Charlotte, North Carolina, giftedness should be a specialty just like trauma. In fact, she believes that without being adequately trained, counselors can do extensive damage if they work with clients who are gifted.

Bishop, author of a forthcoming book on anxiety and giftedness for parents, recommends that counselors attend national and state gifted and talented conferences for opportunities “to dive into the subject, meet people in the field and get a sense of how they [as counselors] can play a role.” In addition to the resources provided by Supporting Emotional Needs of the Gifted (sengifted.org) and NAGC (nagc.org), Bishop and Tolison, owner and lead therapist at Dandelion Family Counseling, recommend reading Giftedness 101 (by Linda Kreger Silverman) and Misdiagnosis and Dual Diagnosis of Gifted Children and Adults (by James T. Webb et al.).

The gifted gap

Most gifted children are identified through testing or teacher referrals in elementary schools. The problem is that there is no one standard test used in schools to determine giftedness. On top of that, many school districts don’t test every student. Instead, they rely on teacher referrals, which, as Renae Mayes, an associate professor in the counseling program in the Department of Disability and Psychoeducational Studies at the University of Arizona, points out, introduces bias.

To highlight this potential bias, Mayes, an ACA member whose research focuses on gifted education and special education for students of color in urban environments, poses several insightful questions: How are teachers trained to recognize giftedness? How are they trained to recognize that giftedness exists in many different kinds of bodies? Will teachers see a Black student who can’t sit still in their seat and has lots of energy as someone who is gifted and excited about learning, or will they perceive the child negatively — as someone who has a behavioral problem or wants to disrupt the learning environment?

The sad reality is that the current method of identifying giftedness has led to an underrepresentation of individuals from marginalized backgrounds in gifted programs. Researchers at the Thomas B. Fordham Institute recently found that in schools that feature gifted programs, only three states enroll more than 10% of their Black and Hispanic students in such programs; in 22 states, that figure stands at less than 5%.

Black and Hispanic students are also overrepresented in special education, Mayes points out. When children are put in special education, it often becomes the only lens through which they are perceived, she says, and the likelihood of them also being identified as gifted dramatically decreases. As Mayes notes, these children tend to be viewed through a deficit perspective, which often incorporates stereotypical understandings of culture and disability rather than allowing children to be seen for their gifts and talents.

According to the article “Myths and research regarding the socio-emotional needs of the gifted,” published in the September issue of The Gifted Education Review (of which Bishop serves as co-editor), individuals from different cultures may not be as readily identified as gifted. Among the reasons highlighted in the article are because these individuals’ cultural norms differ from those of the prevalent culture (e.g., what might be viewed as positive assertiveness in one culture might be perceived as too aggressive in another) or because they are gifted in their first language, which differs from the English language programs in their schools.

“There’s a big push in gifted education to modify how we identify students and make it tied to what kids need academically,” says Kircher-Morris, the president and founder of the Gifted Support Network, a nonprofit dedicated to helping the families of gifted and high-ability learners. “And schools are getting better about identifying kids younger, and they’re doing more universal screening,” which helps remove issues of bias that can arise with teacher and parent referrals.

Twice-exceptionality

Gifted individuals may also have a special need or disability. According to NAGC, the term twice-exceptional (also known as “2e”) describes gifted children who have the potential for high achievement but also have one or more disabilities, including learning disabilities, speech and language disorders, emotional/behavioral disorders, physical disabilities, autism spectrum disorder or other impairments such as attention-deficit/hyperactivity disorder (ADHD).

“People don’t often think that individuals who are gifted can also have [a] disability,” Kircher-Morris says. “It’s kind of counterintuitive, so you end up with kids who are exceptionally cognitively able but perhaps they have ADHD or are autistic and they need a 504 plan or perhaps even an individualized education program.”

Kircher-Morris, chair-elect of the NAGC Social and Emotional Development Network, has noticed that sometimes teachers don’t feel as though they have to make accommodations in environments such as advanced placement classes. These teachers just expect that if a student is in such a class, they should be able to do the work. She often reminds educators that not taking a challenging course is not an accommodation. Twice-exceptional students still need to be challenged; they just need some help along the way.

It can be easy for counselors and other mental health professionals to miss a diagnosis of twice-exceptionality, says Kircher-Morris, who hosts the Mind Matters podcast, which focuses on the development of high-ability and twice-exceptional people across the life span. She is also the author of the forthcoming book Teaching Twice-Exceptional Learners in Today’s Classroom.

Kircher-Morris has had several clients get psychological evaluations and come back with a misdiagnosis. She recalls an example in which one of her elementary-age gifted clients was having meltdowns at school, becoming emotionally dysregulated and having trouble understanding nonverbal cues. Kircher-Morris knew the client was gifted, and she strongly suspected he was also autistic. The boy’s parents were reluctant to accept that label because of the stigma surrounding autism. It was easier for them to just say, “He’s quirky because he’s gifted.”

When Kircher-Morris finally convinced the parents to get a psychological assessment for their son, she wrote a letter to the person doing the assessment and told them the child was gifted to ensure that would be factored in. But the person doing the assessment did not specialize in giftedness and ended up diagnosing the child as depressed because sometimes when he had meltdowns, he would say, “I hate myself. I wish I could die.”

Kircher-Morris knew the client wasn’t clinically depressed. Instead, he was having big emotions and wasn’t sure how to talk about them, she says. She adds that one day of testing and questionnaires is not enough to fully understand and diagnosis a person.

Kircher-Morris still works with this student, and now that he is in high school, his autism is more pronounced. When his schedule shifted and he had to start showering in the mornings instead of the evenings, he didn’t handle it well at first. Kircher-Morris worked with him on regulating his emotions around this change. The student also has some issues with friends at school, but other people in his life often view him solely through a lens of giftedness and assume that he shouldn’t have any trouble communicating, Kircher-Morris says. They don’t realize that as a twice-exceptional adolescent, he sometimes does have certain challenges.

Trying to identify a client as twice-exceptional is even more difficult because of the concept of masking. As Tolison notes, gifted individuals with a learning disability can fall into one of three categories:

1) The individual’s advanced intellect compensates for their learning disability.

2) The learning disability or special need overshadows the person’s giftedness.

3) The giftedness and learning disability mask each other to the point that the individual appears to have average intelligence.

Research shows that twice-exceptional children are often diagnosed later than their peers because their struggles aren’t as noticeable initially, Kircher-Morris says. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders states that individuals with autism, for example, may be able to compensate for their comparative lack of social skills until social expectations exceed their abilities, she notes. A gifted child who is also autistic may not have a language delay when they are little, but by the time they get to middle school or high school, their emotional and social struggles and rigid thinking become more problematic.

“And we’ve now lost all of that time to be proactive and to support them and to help them build the skills they need to be successful, confident and happy,” Kircher-Morris adds.

To avoid mislabeling clients, Tolison, a registered play therapist who works with children who are twice-exceptional (particularly those with ADHD), advises counselors to always consider what the client’s behavior is communicating. Are they fidgeting in the classroom because they are understimulated, or is it a symptom of ADHD?

Therapists need to recognize “the blend of symptomology between gifted and diagnosis,” Tolison continues. For example, mental health professionals shouldn’t presume a client is autistic just because the client is smart and struggles to socialize with peers, she says. Instead, she advises digging deeper and considering whether the symptoms decrease or dissipate when the client is in an ideal setting, such as being around others who have interests similar to theirs.

Giftedness and special education are often seen as being opposite ends of the continuum, Mayes says, but she asserts they are separate continuums and can exist simultaneously. “The disability is the how you do something,” she explains. Even though an individual may need to do a task or skill differently or may need help, they can still possess a higher cognitive ability, notes Mayes, who has published several articles on this topic, including “College and career readiness groups for gifted Black high school students with disabilities” in The Journal for Specialists in Group Work.

Mayes recounts a real case example of how these continuums can overlap in a client: A Black student who was in a gifted program in middle school had an accident and suffered a traumatic brain injury. The injury caused the boy to get bad headaches if he sat for long periods of time, and his vision became blurry. But his cognitive ability was unchanged. He just needed some accommodations to help him at school. His teachers didn’t believe he was actually having headaches, however. They assumed he was just trying to get out of doing the work. The boy internalized their disbelief and told his mother the teachers were looking at him as if he were a “lazy Black kid,” a stereotype he knew was prevalent at the school. Soon thereafter, the boy’s grades started to suffer.

His mother became a big advocate for her son and pushed for a special education and gifted label for him. Even so, the school refused. It wasn’t until the boy entered high school and the school counselor joined the mother’s fight that they finally got some accommodations for the student. When the boy translated his talent for STEM (science, technology, engineering and math) into a passion for band, the band director also advocated for him.

This student had to reconfigure his identity as not just a gifted student but as a gifted student with a traumatic brain injury, and he had to learn to self-advocate, Mayes says.

Asynchronous development

Gifted children’s cognitive, emotional and physical development are often asynchronous, meaning that their intellectual development outpaces their maturity or emotional development. Even though their intellectual skills are advanced, their social and emotional skills may lag behind.

“Cognitive giftedness is not necessarily the same as emotional maturity,” Kircher-Morris says. Because gifted children are often highly verbal and speak as if they are mini-adults, people incorrectly assume that their behavioral and emotional regulation skills will also be advanced, she explains. So, counselors should consider clients’ emotional development along with their cognitive development.

According to Tolison, “There can be upward of a 12-year spread between a child’s intellectual age … [and] their social/emotional age.” For example, a twice-exceptional child with ADHD could be 8 biologically, but with the intellectual capabilities of a 12-year-old and the social and emotional development of a 6-year-old. And at times, the child might have emotional outbursts that are on par with a 4-year-old, Tolison adds.

Tolison often helps her clients first understand emotional language. She finds the “anger iceberg” exercise helpful for teaching emotion identification and awareness. Because some clients might be gifted in empathy, this process is less about identifying emotions and more about learning how to express them, she adds. Tolison then helps clients focus on executive functioning skills such as planning ahead, organizing one’s thoughts, flexible thinking and demonstrating self-control — all of which can be challenging for individuals who are twice-exceptional. She may play chess or Othello with clients to help them work on impulse control, for example.

Kircher-Morris engages clients’ higher-level cognitive skills by adjusting her counseling approach. This can be as simple as using a more advanced technique with a younger client (similar to grade skipping in school), or it may involve tailoring a technique to make it more analytical and creative.

The emotion wheel, which describes eight basic emotions and their varying degrees, is a great tool for helping clients identify and name their emotions, Kircher-Morris says. But this tool may not stimulate gifted clients enough to keep them engaged, so she alters it to make it more cognitively challenging. Her emotion wheel is mostly blank. She leaves a few emotion words in different places around the wheel and works with clients to fill in the blank spaces. Sometimes they look up words in the thesaurus or online to find the “just right” word, and then clients evaluate and determine which words should go on the wheel. This activity builds on the higher-level vocabulary that gifted clients often possess, and it provides them with some autonomy in session, she says.

Letting gifted clients direct (but not dictate) sessions

Kircher-Morris finds that gifted children are often unaware that anything is “wrong.” They can be skeptical of counseling at first, especially if their parents are the ones who initiated it. And because these children are gifted, she says, they often want to know the “why” before they completely trust and participate in different counseling approaches.

For that reason, Kircher-Morris encourages these clients to ask questions and takes time to explain the psychology behind the interventions. She also allows clients to explore what works best for them and to develop their own ideas about what would be helpful.

When Kircher-Morris introduces the cognitive triangle exercise (which emphasizes the relationship between one’s thoughts, feelings and behaviors), she moves beyond just drawing the diagram on a dry-erase board. She also poses a hypothetical example to help clients better understand the underlying principle behind the activity.

An example she often uses is a student who has an upcoming math test. She asks, “What uncomfortable emotions might they be experiencing?” After she and the client brainstorm some possible feelings, she asks, “If they’re experiencing those uncomfortable emotions, then what thoughts might they be having?” She draws speech bubbles on the board, and she and the client fill them in together.

Then they discuss how these thoughts might influence the hypothetical student’s behavior, where the student could intervene and how this would change the outcome. Running through this hypothetical allows clients to better understand the way the exercise works before they apply it to their own situations, Kircher-Morris says.

The fact that gifted individuals have higher-level thinking skills also means they are more likely to find fault in others’ logic, Kircher-Morris says. In fact, because these individuals are often brighter than their parents, teachers and others with whom they interact, counselors might find themselves trapped in a logical corner when a gifted client pokes holes in their reasoning. Should this happen, Kircher-Morris advises counselors not to engage in a power struggle.

“Don’t try to assert your intelligence or the information that you have because that’s going to damage the rapport,” Kircher-Morris says. Instead, her approach is to acknowledge the valid point the client has made. For example, she may say, “I hadn’t thought about it that way. I’ve seen this counseling technique work with other clients, but maybe it won’t work with you. Let’s figure out what will work. Do you think any part of that activity might be relevant for you?”

Tolison agrees that gifted clients benefit from being able to have some control over their therapy, but she cautions counselors not to let them dictate the direction of treatment. She says she often has parents who come to her because they previously worked with another therapist who allowed their gifted child to take control to the point that they weren’t making progress. 

Often, gifted clients are excited to engage in a topic they are passionate about, but that can dominate the session. However, as Tolison points out, counselors can turn that passion into a therapeutic intervention. She once had a client who wanted to talk about the dwarf planet Pluto for most of their sessions. She seized on that as an opportunity to teach the client about mindfulness and social awareness.

She used the phrase “I noticed” to stop him from discussing Pluto: “I noticed you’ve talked 20 minutes now on Pluto. I love that you are sharing your passion with me, but can we take a break because I’m a little exhausted from learning that information right now. Let’s talk about something new.” This statement set a limit for the client while also helping them become more mindful of the passage of time and of other people’s feelings, Tolison says.

Tolison also encourages clinicians to be humble when working with gifted clients. “Sometimes the most therapeutic thing you can do for a profoundly gifted kid is be excited about what they can teach you because in that [process], they are also learning,” she says.

Embracing neurodiversity

Kircher-Morris’ goal is to help normalize the fact that different types of brain wiring exist. People with this brain wiring might be divergent from the norm, but that doesn’t mean something is “wrong” with them. Being gifted or twice-exceptional is simply part of the human condition. Normalizing neurodiversity will encourage people to realize that they need help and give them the courage to ask for it, she says.

Counselors are great at understanding the individual needs of clients, she continues, but unless they consider all the factors, including a person’s cognitive ability, then they may misread the situation and the client’s true needs. For example, if a cognitively gifted child is having a hard time making friends, a counselor might focus simply on helping the child build social skills and self-confidence. But then the counselor would be missing the opportunity to consider other possible factors such as bullying, the child’s high stress levels, their feelings of isolation or others’ upward expectations of them — all of which could inhibit the child’s ability to form authentic relationships, Kircher-Morris explains.

So, she advises counselors working with this population to make sure they view their clients’ struggles through a lens of giftedness. How does giftedness or twice-exceptionality influence these clients’ experiences and reality? Clinicians must also figure out how to leverage clients’ strengths with their cognitive abilities to work through any issues they are having, Kircher-Morris says.

Mayes says counselors must be more holistic in understanding clients and see them as more than their struggles or even their giftedness. “We need to take a broader approach in our professional development,” she says, “so we can start understanding more fully individuals’ identities beyond giftedness to include culture, class, gender identity, affectional identities and so much more.”

 

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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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.

School counseling in the time of the coronavirus

By Laurie Meyers September 28, 2020

“School counselor” is a deceptively simple title. In reality, school counselors play many roles, including social and emotional educator, academic adviser, conflict mediator, wellness coach, mental health therapist, student champion, educational collaborator and family liaison.

Now, with the advent of the pandemic caused by the novel coronavirus, many school counselors have become connectors and comforters-in-chief — not just to students but to parents and school staff.

Last spring, schools began closing in response to the pandemic. According to Education Week, 48 states; four U.S. territories; Washington, D.C.; and the Department of Defense Education Activity eventually ordered or recommended school closures affecting at least 50.8 million public school students. Suddenly, students, families, counselors, teachers and administrators all had to find a way to virtually re-create their in-person school routines. This already-challenging shift was complicated by the significant number of students who lacked access to high-speed internet or desktop, laptop or tablet computers.

Even before the pandemic, civil rights and education groups had been decrying what they had dubbed the “homework gap” because many teachers were increasingly assigning work that required internet access. Already at a disadvantage, these disenfranchised students — many of whom were Black, Indigenous or people of color (BIPOC) — now faced being completely locked out of school academic activities for the rest of the year.

According to “Students of Color Caught in the Homework Gap,” a recent report by organizations that include the Alliance for Excellent Education and the National Urban League, when the wave of school closures occurred, 16.9 million children lacked high-speed home internet access (a number that included 1 in 3 BIPOC families), and 7.3 million did not have a computer or tablet. Many schools spent the spring and summer scrambling to provide devices and internet access to students — a task that was still incomplete going into the new school year. Stories of students struggling to keep up with online instruction on cell phones are still not uncommon.

In addition, when the economy took a nosedive as the coronavirus spread, it made it hard to focus on anything but survival for many families. But even financially secure families found it challenging to provide the ideal learning environment as — in many cases — parents working from home with multiple children wrestled with carving out a physical space and a time for each person to be online. Students missed getting to see their friends and participating in extracurricular activities. Sports seasons were canceled. The theater curtains never went up on school plays. Rites of passage such as prom and graduation ceremonies largely fell by the wayside.

And now it is fall, meaning a brand new school year. Even so, in many parts of the country, the football fields and stands will remain empty, the marching band instruments will stay silent and there will be no homecoming dances. Things are decidedly not back to normal. For that matter, there is relatively widespread belief that “normal” will never return. No one knows what the future will hold.

So, it’s not surprising that parents, students and school personnel are all feeling stressed and overwhelmed. Continuing to hold classes online while simultaneously ensuring that students and families have the needed technological resources — or, in some cases, the absolute basics, such as enough food to eat — continues to be a team effort.

Because safeguarding the mental, emotional and physical welfare of students is the essence of what school counselors do, these professionals have typically been at the center of the problem-solving process since the arrival of the coronavirus. They have conducted check-in phone calls to make sure students had the necessary equipment and internet access; helped parents (or grandparents) with technological troubleshooting; arranged for families in need to receive gift cards and community resources; responded to requests from teachers to find out why students weren’t showing up for online class (and then worked to resolve whatever the barrier was); reassured stressed-out parents; coached families on how to set up a structured school day; made mental health referrals for students in crisis; and provided moral support to teachers, administrators and each other. All while finding ways to continue offering academic guidance, focusing on students’ emotional and social learning, and giving specific support to children who were struggling with various personal and school-related issues.

Counseling Today spoke to several school counselors at the end of the 2019-2020 school year and as they prepared for the new 2020 fall semester to learn more about the challenges of performing their jobs in the midst of a pandemic.

 

Linda Colón
Counselor for prekindergarten and kindergarten students, Bancroft Elementary School, Washington, D.C.

Bancroft is a Title I school (i.e., a facility that receives financial assistance due to a high population of students from families with low incomes) with a majority Latinx student body that also includes children of Ethiopian immigrants. Many of the families in the district live in poverty and often share relatively small living quarters with extended family.

Under normal circumstances, American Counseling Association member Linda Colón gives Bancroft’s youngest students their earliest lessons in social and emotional learning. By observing (and joining) students at play, reading aloud to them, incorporating toys, conversing with puppets and showing self-produced videos, Colón teaches prekindergartners and kindergartners basic social skills and how to recognize and regulate their emotions.

Getting to know students’ families and getting them invested in their children’s learning has always been an integral part of Colón’s counseling approach. She says that she’s “planting a seed” of awareness about the importance of education and attendance from an early age. Colón meets with parents to answer questions and, if requested, gives them advice on how to reinforce the social and emotional lessons that their children are learning.

Another benefit of establishing a relationship with families — and checking in regularly via phone or in person (during nonpandemic times) — is that Colón can get a better sense of the problems with which the families might be struggling. If they trust the counselors and teachers, she says, they will be more likely to reach out if they need help addressing emotional or mental health problems or accessing vital resources such as food and shelter.

Colón has been finding new ways to stay connected to her students and their families since March, when schools across the metropolitan region shut their doors and transitioned to online learning to finish out the school year because of the coronavirus. Schools in Washington, D.C., opted to begin the new year virtually as well, with an option to reevaluate in November.

“We can’t just say, ‘This isn’t going to work,’” Colón says. “We have to figure it out. We owe it to the kids.”

Before in-person learning ceased completely in March, Colón, knowing that the children were feeling anxious, created a lesson centered on “claiming strategies.” She reminded the children that when they were really afraid, it was helpful to talk about it, and she provided them with some age-appropriate safety information.

But the most important piece was the practical activity: washing hands. “We want to keep the germs away, so we wash our hands for 20 seconds,” Colón told the children, reinforcing the statement with videos and puppet demonstrations of hand-washing.

Colón also made videos so that the children’s social and emotional learning could continue virtually. The videos covered topics such as keeping a positive mindset, practicing breathing techniques and exercising mindfulness.

Colón also spoke to some of her students and their families one-on-one, either on the phone or via Microsoft Meetings, to find out how they were coping, to offer a sympathetic ear to stressed-out parents and to provide a reassuring presence for anxious children. She has given her phone number to parents and encouraged them to call or text her if they need help. As distance learning continues, she has been encouraging teachers to reach out as much as possible too. In addition, Colón has worked directly with parents to help solve technological problems.

This year, one of her initiatives is to help parents find a way to provide a space for children to take a break from their surroundings — a relaxation bubble. Many of her students live in small spaces, so the “bubble” might be something as simple and small as a blanket draped over a chair to make a mini tent.

Even at a young age, children are more aware of what is going on around them than most people realize, Colón says. They know that people are sick and dying, and at this age, children are less able to process the fear, which leaves them at risk of getting stuck in fight-or-flight mode. When they are at school, they can see their friends on the playground and have other opportunities to get away, but at home, exposure to trauma — even if only through the television — may be inescapable.

Activities such as drawing, watching a fun video or escaping to their relaxation bubble can help relieve the agitation, Colón says. The staff at Colón’s school has requested that markers, crayons and paper be sent to all the families.

Research also shows that when people are experiencing trauma, simply making a connection with a sympathetic presence can help, Colón says. So, she believes that keeping in contact with students and families is one of the most important things school staff can do right now.

“It’s finding a way to establish that connectedness,” she says. “When you’re in school, you’re waving to them [students and families], saying ‘Hi, good morning,’ singing a silly song. You’re doing something to make a connection that doesn’t have anything to do with academics.”

“I think our [school counseling] services are needed more than ever,” Colón says. “We’re the ones who are getting the pulse [of the community].”

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Natasha Griffith
Counselor for first through sixth grades and homeless coordinator, Dorothy I. Height Elementary School, Washington, D.C.

Height is also a Title I school, with many of its families living at or below the poverty level. Most of the students are Black — primarily first-generation Ethiopian. Approximately 20 to 30 percent of students are Latinx.

“I think this year, I’ll feel proud and accomplished if I can master Microsoft Teams and have whole class sessions,” says ACA member Natasha Griffith, whose school — like Colón’s — will be all virtual until at least November. She has modest goals for kicking off the school year, including holding a few smaller group sessions with students in fourth through sixth grades. Griffith’s role as the school’s homeless coordinator — which involves helping families in transitional housing find financial and community resources — can make that goal challenging. “I have to focus on the barriers that children and their parents face,” she says.

Griffith says she and her co-workers “hit the ground running” last spring when school buildings closed, distributing gift cards from the city’s public services department and money from a GoFundMe campaign to the neediest families and making sure that students had computers. But there will be an ongoing need for assistance during the current school year. In fact, although Griffith wasn’t officially working over the summer, she heard from families in search of additional gift cards and did some interpreting for the school’s technology contact, who doesn’t speak Spanish. Most of the students received computers or iPads in the spring, but stable internet access was a persistent problem, so the school has been setting families up with mobile hotspot devices (routers connected to a cellular data network that provides Wi-Fi connectivity).

Griffith will also continue to call families to check in on students who aren’t showing up online. If their absence is due to technological problems, she will make sure they get the resources they need. If the absence is because the students and families aren’t adapting well to virtual learning, then Griffith will do her best to help them navigate the unfamiliar territory and highlight how important it is for students to participate so that they don’t fall behind. “So many students weren’t participating [last spring],” she says. Even if families aren’t experiencing technological difficulties, many of them still aren’t sold on virtual learning, Griffith says.

Unfortunately, as is the case in many communities across the country, there will be cases in which Griffith isn’t able to get in touch with families. The counseling staff at Height does work closely with a social worker from Washington’s department of public health who is responsible for connecting families with resources, and Griffith says that she has been able to accomplish a lot. Even so, the reality is that educational continuity is incredibly difficult for schools to provide during the pandemic.

As she did last spring, Griffith will continue to help bridge the gap between parents and teachers. Many parents are feeling overwhelmed, and coping with online learning is yet another source of frustration for them. Griffith provides a listening ear and works toward helping families see that the school staff is there to help, not to judge. She is also concentrating on developing lesson plans that help students navigate the virtual landscape and encouraging them to ask for help when they need it.

Another challenge Griffith is facing is that she has no designated “classroom time” online. To present lessons, she has to be flexible and grab any spare time that teachers have in their class schedules. To supplement, she is planning on developing videos covering the social and emotional learning topics that make up the core part of her counseling curriculum, including managing anger, building self-esteem, learning to identify emotions, developing resilience and using tools for academic success. She has been rearranging her apartment to carve out a space for filming. The videos will be posted on Microsoft Teams for the students to access on demand.

In the spring, Griffith created a few virtual “lunch bunches” for small groups of students. She and the children would play games such as self-care bingo; squares included actions such as taking a shower, eating breakfast, listening to your body, taking a break, meditating, calling a friend and saying something good about yourself. She would also ask students about what they were doing outside of their classroom lessons. “It gave them a place to talk about missing their friends,” she says. “It was also something social that wasn’t related to school.”

Griffith is starting up the virtual lunches again during the current school year. She would also like to find a way to virtually re-create the in-person restorative circles that she used to hold in school. The activity, which usually involved 20-22 students, was focused on building community. Griffith would ask open-ended questions (usually focused on having respect for fellow students) and present students with a talking piece to pass around the circle. Students could choose to keep the piece and speak, or pass it on.

“I think restorative circles work well because they allow students to express their feelings about various social and emotional learning topics,” she says. “It allows students to take ownership and be an involved participant in the classroom community.”

Griffith will continue to connect with students any way she can while her school is held online, but she believes there is no substitute for face-to-face interaction. “Especially for these kids,” she says. “Saying in person, ‘You’ve got this. You can do this.’ That’s what I live for as a school counselor … [to] make a difference and tell them they matter.”

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Judy Trigiani
Counselor for kindergarten through sixth grades, Spring Hill Elementary School, McLean, Virginia.

Spring Hill has a large population of international students, many of them the children of diplomats and business people from around the world. Some of these families temporarily relocated to their home countries to wait out the pandemic and have not yet returned to the U.S.

The plan for ACA member Judy Trigiani’s school district is to operate exclusively online through at least the first quarter of the school year and then to reevaluate. But as Trigiani noted at the end of the prior school year, one of the biggest burdens of the pandemic for people is not knowing when it will end. Or, in the case of schools, when bringing students back in person will not carry the threat of widespread community spread. “We are trying to plan for the unknown. We don’t know when we’ll go back yet,” Trigiani says.

In the meantime, Trigiani and the rest of the staff at Spring Hill continue to try to keep things as “normal” as possible. Traditionally, the school’s year starts with an open house and a new family and student orientation. This year is no exception; however, the events will all be virtual. Families and students will connect via Blackboard Collaborate, where staff will introduce themselves and talk about the school community, scheduling and resources available to parents. A question-and-answer session will follow. The school is also hosting town hall meetings and a kindergarten orientation to present new resources and answer questions.

This year, there will also be a technology orientation to demonstrate Blackboard features such as the icons for accessing the microphone and video and “raising” your hand; how to magnify the screen; agreeing, disagreeing and reacting to the teacher and fellow students with emojis; and where to find the chat box, Trigiani says. The technology orientation will also cover some of the other programs the school will be using. Blackboard Collaborate enables staff to post videos and PowerPoints and share their screens. The tech session will also demonstrate how to access the website and the asynchronous learning area (video sessions that students can watch on their own schedule). Trigiani has also been preparing PowerPoint presentations for parents on topics such as setting up their children’s workspaces and how to talk to children about COVID-19.

Trigiani and the rest of the counseling staff will continue to visit the virtual classrooms every morning to check in and say, “We’re here if you need anything.” There are 18 classrooms per counselor, and counselors go into one classroom each day, she explains. Sometimes, they conduct a lesson. Other times, Trigiani will show up early just to chat with the kids, asking them to use the emojis to let her know how they are doing. If a student expresses distress or Trigiani hears or sees something that causes her concern, she meets with the student individually online and works to address the issue.

Individual counseling, social skills instruction, school counseling programs, parent meetings, the identification and sharing of resources — all of the normal work of school counselors also continues virtually. In addition, Trigiani works with parents who are struggling to cope with their children’s behavioral, social and emotional issues. If necessary, the counseling staff makes referrals to outside mental health resources.

The key, Trigiani says, is something that one of her former bosses used to say: “Keep your community and people informed, and stay as positive and flexible as you can.”

Trigiani believes that technology will continue to become more and more critical to school counseling, even after schools decide to return to the in-person model. Not only will retaining a virtual element allow medically fragile students better access to education, but it will also help counselors prepare students for 21st-century jobs by enabling them to give students training in online social skills, Trigiani asserts.

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Randi Vogel
Counselor for sixth grade, Thomas Pyle Middle School, Bethesda, Maryland.

Pyle also has a significant number of international students, which means that the student population is somewhat transitory.

“This pandemic has really brought to light the social-emotional needs of our students,” ACA member Randi Vogel says. “Even students who we considered very solid are having difficulties.”

In the spring, several students who were already struggling with mental health issues deteriorated further with the loss of a structured school environment and ended up needing to be hospitalized, she says. But even students who had no history of mental health issues were experiencing anxiety and stress.

After school moved online, Vogel and her team put out an announcement on the school portal that they were available via email and Zoom. They also sent out regular surveys asking students how they were feeling, if they needed anything or whether they just wanted to share.

One girl replied that she needed a Chromebook laptop to keep up with her school assignments. Another student said, “I miss you — and I fell and broke my arm.” Some students expressed that they just really wanted to talk, so Vogel and her team connected with them individually via video chats.

The surveys also asked students what they were doing to take care of themselves and to whom they had reached out. Every time that Vogel spoke to a student, she would ask them what they were doing for themselves.

Vogel’s district is starting the new school year with virtual-only instruction and will reassess in November. Although many students may have initially enjoyed the novelty of learning from home, that sentiment generally seems to have worn off, Vogel says. “I have heard from several parents and students that they truly miss the school experience — chatting in the halls with their friends, switching classes, the cafeteria, after-school activities, the bus rides to and from school.”

Although her school can’t re-create those experiences, the days will be more structured and organized for students this year, she says. There will be more live and interactive instruction, in contrast to this past spring, when teachers primarily gave lessons via “asynchronous learning,” which involved using previously recorded videos that students would watch on their own. Teachers then offered online “office hours” to field follow-up questions.

“Parents definitely want more ‘live’ instruction and for more of the day to mimic what occurs in the building,” Vogel says. Although this may help virtual lessons to feel more like regular class, she anticipates that students will have difficulty being on their screens for so many hours, despite the breaks that have been built into the schedule.

“We, as counselors, will continue to reach out to our students to see how we can help them virtually,” she says. “This might look like lunch bunches or initiating one-on-one Zoom calls as check-ins.”

Vogel says her counseling department really prided itself on always being available to students during the day. In fact, they had several students who were issued “flash passes” so they could come to the counseling office anytime they needed a break. “Once we are back in the building, I expect that to resume,” she says. “However, it is much more challenging to establish relationships with middle schoolers via Zoom.”

Because so many students are struggling or just need a little extra help coping, Vogel and her colleagues will be incorporating more mindfulness and stress-reduction activities and class meetings into the virtual day for students. “I think it will be very beneficial to have the students hear from one another how they are managing and that they are not alone with their feelings,” she says.

 

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Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

ACA School Counselor Connection (counseling.org/membership/aca-and-you/school-counselors/school-counselor)

ACA Mental Health Resources (counseling.org/knowledge-center/mental-health-resources/)

Books & DVDs (imis.counseling.org/store)

Books

  • A School Counselor’s Guide to Small Groups: Coordination, Leadership, and Assessment edited by Sarah I . Springer, Lauren J. Moss, Nader Manavizadeh and Ashley Pugliese
  • Critical Incidents in School Counseling, Third Edition, by Tarrell Awe Agahe Portman, Chris Wood and Heather J. Fye
  • Developing and Managing Your School Guidance and Counseling Program, Fifth Edition, by Norman C. Gysbers and Patricia Henderson
  • Solution-Focused Counseling in Schools, Third Edition, by John J. Murphy

DVDs

  • Acute and Severe Behavior Problems presented by Dave Scott
  • Bullying in Schools: Six Methods of Intervention presented by Ken Rigby
  • Managing Conflict in Schools: A New Approach to Disciplinary Offense presented by John Winslade
  • Quality Circle Time in the Secondary School presented by Jenny Mosley

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Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

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

Solution-focused tools to help school counselors in a pandemic

By Mark M. Jones September 14, 2020

Counselors in schools are facing unprecedented challenges during the COVID-19 pandemic. School buildings across the country were closed this past spring, and as we transition to the new school year this fall, some students will attend school only remotely through online learning. Others will be in school part time with reduced capacity, whereas still others may return to a full-capacity school but urged to keep physically distant and with their faces covered throughout the long days.

In addition, because of pandemic management measures, students have been spending an unusual amount of time with their families, some of whom are under new and severe emotional, health and financial stress. The pervasive spread of COVID-19 is associated with higher unemployment and poverty, greater use of illegal drugs, and new and sustained trauma experiences. On top of all this are the ongoing string of horrific news stories reporting White on Black violence and ethnic hatred, which are compounding societal stresses.

School counselors must be prepared to support a wide array of student concerns associated with COVID-19 and the accompanying social isolation. Counselors who can assist many students with significant needs in a brief, flexible way in both remote and in-person venues will be particularly valued.

Fortunately, the solution-focused model of counseling is highly adaptable to a wide range of problems, including grief, trauma and anxiety. It is appropriate for suicide prevention efforts, classroom lessons and even brief check-ins with students who are not demonstrating any outward sign of struggle. Instead of a deep dive into problem origination and causation, this form of counseling targets clients’ hopes, resources, exceptions to problems and descriptions of a preferred future. It also fosters vicarious resilience, which will help counselors who may have their own diminished stamina arising from personal struggles related to the pandemic.

Solution-focused counseling was pioneered by Insoo Kim Berg and Steve de Shazer from their work at the Brief Family Therapy Center in Milwaukee in the 1980s. It has evolved and become widespread over the ensuing decades through the work of many advocates in counseling, therapy and coaching. It is sometimes called “brief counseling” because it can be highly effective in a few 20- to 50-minute sessions, or even during a short hallway or classroom conversation.

Counseling in a modern, virtual world now means counseling through video calls without guarantees of confidentiality because students may be in only semiprivate or even public environments. Solution-focused counseling is not problem-phobic, but because of its embedded focus on goals, preferred futures, assets, resources and exceptions to problems, it poses less risk of revealing private, sensitive information that might be overheard by a family member at home.

Three-minute check-ins

Given the long absence from school and the limited amount of time students can be with school counselors, short three- to five-minute check-ins offer one practical way of providing support to students and gauging their emotional state. School personnel are key reporters of child abuse, and there are serious concerns about whether students could be enduring abuse because of having limited access to these trusted adult advocates.

Consider the following eight check-in questions:

  • What is your best hope for this year?
  • On a point scale of 1 to 10, where are you if 10 means that things are going as well as you could hope and 1 is the opposite?
  • What are you most proud of in how you handled being at home for so long?
  • If this turns out to be a really good year, what is something you will have done to make it that way?
  • Who will notice?
  • Do you feel safe at school and home?
  • Who is a trusted adult you can talk with if you are upset?
  • Is there anything else you would like me to know?

These types of questions allow students to express their preferred future, their resources to help them get there and a description of what that future will be like, including who will notice. Humans are social animals, and having students describe what others will see in them when they are successful helps make the path visible to them.

Even if there is not time to ask all of these questions, getting students to describe their preferred future, their resources and their social supports will help them move in small steps toward something hopeful. It will also allow the counselor to gauge students’ emotional states and resources.

Grieving students

Helping students cope with grief does not have to focus only on challenges and sadness. It can also effectively include conversations about joys and happiness. Students first need a counselor who will actively listen to their story of pain in losing a loved one (or a different loss), but a solution-focused counselor will also ask questions that seek descriptions of what the loved one liked to do and the positive aspects of the relationship.

Questions about what the decedent did for the student, enjoyed about the student and how the student knows these things can draw out memories of the relationship and help the student see their own assets and strengths through that relationship. Asking what students sees in themselves that the decedent saw can create rich descriptions of the strength of that connection.

Grief involves coping, so a solution-focused approach may include questions of how the student has managed to get out of bed and arrive at school, and what the decedent would be most pleased to see regarding how the student is getting along. For those students who are less verbal, allowing them to draw their coping skills or positive aspects of their relationship can supplant, or support, the dialogue.

Suicide prevention

All school counselors must be prepared to assess suicide risk in students. Unfortunately, given the diverse demands of school counseling, sometimes single meetings with students in the near term are all that are possible.

Fortunately, solution-focused counseling offers a framework to go beyond just assessing suicide risk; it paves the way toward fostering hope and engaging in critical prevention work. In addition to the classic questions surrounding scaling (e.g., “What keeps you from being one number lower? What will you be doing when one number higher?”) and questions about best hopes and a preferred future, more nuanced questions may elicit additional solution-oriented thinking. Some examples include:

  • If we asked the version of you that has been happier, what would that version tell you to do?
  • What would that version remind you that works for you?
  • How have you made it this far?
  • When in the last week were things a little better?
  • Who is on your support team?
  • Who could we bring into this conversation?
  • What job should we give that person?
  • What would that person advise right now with how you are feeling?

According to John Henden in Preventing Suicide: The Solution Focused Approach, one of the most powerful interventions is having the student imagine being a witness at their own funeral and describing who would be most upset, what advice that person would wish they had given, and what options other than suicide would the student wish they had tried.

Group counseling

Group counseling in schools is often based on themes such as anxiety regulation, social skill development or anger management. In the midst of a pandemic, school counselors may want to expand groups beyond narrow themes to include more students.

Taking a solution-focused approach allows a single group to include individuals with a variety of social and emotional needs. In the first group session, ask students about their best hope for how the group could help them. They can address their preferred future by describing what life would be like if things were better. Describing instances when this has happened and exceptions to the problem allows them to envision the change that is possible. Group members can then scale their current position, followed by questions of what idea they would be willing to try between now and the next session to move one step closer.

Subsequent sessions would start with each member reporting what is better since the last meeting, scaling their status and whether there were setbacks, describing how they coped and detailing what signs they will see when there is progress. To take advantage of the group dynamic, some of these questions could come from fellow members, or members could offer suggestions for what has worked for them. Ensuring that the group includes compliments from the leader and fellow members will help ensure that it is a positive and rewarding experience.

In addition, incorporating activities into groups helps children express themselves in a variety of ways. Fortunately, there are abundant solution-oriented activities to employ. An excellent resource for solution-focused activities with children is Pamela King’s Tools for Effective Therapy With Children and Families: A Solution-Focused Approach.

The following activities may be particularly useful:

  • Cartoon panel: Ask students to draw their miracle day using a six-panel cartoon or, alternatively, six resources/strengths they possess or six challenges they overcame with the names of the people who supported them and the skills they learned.
  • Mock interview: Prompt students to record a video interview of another student, or have them interview one another in a live video group stream. Prompts might include: What strengths did you use to overcome your challenge? How did you keep going and not give up? What advice do you have for others struggling with what you struggled with? Today, when you are being your best self, what are you doing well?
  • Rainbow questions: Have students pick three different Lego pieces that you supply (if meeting in person), or just ask them to name their top three specific color choices. Then, based on the colors selected, have them answer color-coded questions. For example:

Green: Imagine you are talking to your 5-year-old self. What is the wisest advice you would give yourself on how to handle being quarantined?

Orange: What did you do to help yourself get along with your family during quarantine?

Yellow: What is the nicest compliment you have received since the COVID-19 outbreak?

Dark Blue: Who supported you best during the quarantine? what did they do?

Black: What will your friends notice when you are your best self?

  • List it: Ask students to take a piece of paper and draw a line down the middle. On one side write challenges, and on the other side list strengths, resources and trusted advisers who help them with those challenges.
  • Face mask: Have students draw an outline of their face (or body) on each side of a page. On one side, ask them to draw or list what others see in them. On the opposite side, have them draw or list the strengths and resources they possess that others don’t know about.
  • News reporter: Have students interview key people in their lives and learn what those individuals see as their strengths, skills and resources. Ask students to elicit examples and stories, then write up the information as a newspaper piece.

Morning meetings

According to the Responsive Classroom approach, the goal of a class morning meeting is to “set the tone for respectful learning, establish a climate of trust, motivate students to feel significant, create empathy and encourage collaboration, and support social, emotional and academic learning.” Morning meetings are an easy opportunity to incorporate dialogue about the crisis in a way that can make evident to individual students their best hopes, personal resources, and instances of the preferred future being present.

Best hopes for the school year can be asked individually or as part of a group, such as, “What do we need as a group to end this school year well?”

Questions about resources and strengths could include, “When things were difficult, what was most helpful? What is something you tried that helped you to cope that you had never done before? Imagine you get in a time machine, go one year in the future and COVID-19 is finished. Look back to right now and describe something you are proud of in how you handled all of this Who was helpful to you? What would that person say if they were here describing something you did well? Whom do you admire and why? How are you like that person?”

Lessons

Solution-focused lessons can incorporate scaling as well as movement. Best hopes or goal setting can include floor spots that are numbered 1 to 10 (or write numbers on separate pages). Students can take turns standing by their number and then taking a step forward and describing what they will be doing when they are one number higher. Alternatively, a number line from 1 to 10 can be drawn and hung on the wall in class, and students can put a Post-it sticker on the line where they are. For a video chat, they can simply say their current number.

Picturing their preferred future and their resources can be done through letter writing. Students can be asked to think about what they would like to be doing in their career and life in 20 years. Have them imagine they are living that life and they find out that they can get messages back to the past. Ask this successful adult who is living their hoped-for life to describe to their younger self the challenges they faced, the internal assets that helped most and the people who were supportive. Then have them give their best advice on how to navigate the next 20 years.

Students can also interview each other to learn about one another’s recent challenges and resources, including who has helped them, what was most helpful and advice they have for others.

The ongoing pandemic requires that school staff members adjust how learning occurs. Solution-focused techniques allow school counselors to be brief, flexible and powerful in their support of students facing an array of social, emotional and learning challenges.

 

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Mark M. Jones has been an elementary school counselor in Arlington, Virginia, for four years. Before that, he was a trial lawyer for 30 years. Contact him at mark.jones2@apsva.us.

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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 costs of COVID-19: Parental anxiety syndrome

By Rebekah Lemmons September 8, 2020

As counselors in the age of COVID-19, we have seen a lot. We have been on the front lines of treating a new wave of counseling crises, from broad-reaching trauma symptoms to an increase in panic attacks.

One such example is related to parental anxiety. This is a term that stems from an increase in parental stress and accompanying anxiety related to the reopening of states, businesses and schools.

COVID-19 has changed the day-to-day lives of many parents and caregivers. These individuals have been forced to make adjustments in major areas of life, including child care, schooling for children, work dynamics and social supports. These changes create deeper concerns and uncertainties for many adults.

To best help clients effectively manage parental anxiety, we need to understand this phenomenon, who is at risk, what contributes to higher risks, how to effectively cope with these issues, and how to maintain overall health as the pandemic continues.

What is parental anxiety?

Clinically, parental anxiety is comparable to separation anxiety. It includes a high level of anxiety around opening up schools, day cares and related activities in which parents leave their children in the care of others. It has added components of stress and worry that derive from our ongoing transition to a new normal.

For some parents, this leads to increased panic attacks, decreased stress tolerance, sleeplessness, irritability, head and body aches, and exhaustion. It can also lead to increases in family conflict or parental conflict, largely based on disagreements about parenting in a pandemic. Conflicts about transitioning back into school, work or social situations can create tension and magnify existing areas of disagreement.

Who is at risk?

Any parent or caregiver is at risk for parental anxiety. From full-time working parents to stay-at-home parents, any caregiver can develop symptoms of this condition.

Parents who have been keeping their children at home and are preparing to transition children back into child care or school settings outside of the home are at higher risk. Parents and caregivers are also at risk for parental anxiety if they are preparing to return to the office themselves and transition children out of the home.

Any additional stressors or traumatic events can further complicate this condition. For example, if clients have lost a loved one during the pandemic or known someone with COIVD-19, their symptoms of parental anxiety may become stronger. In addition, Black, Indigenous and people of color (BIPOC) may be at increased risk for parental anxiety because civil rights violations and racial trauma from current events have a layered impact on the effects of the pandemic.

What creates these risks?

Collectively, we have all experienced a crisis. This has been described using many terms, including “collective grief” and “collective traumatization.” As we look at how individualized coping is in general, it is no surprise that during major societal shifts and global-scale issues, there is no one way to manage all that is being thrown at us. Even those with higher supports and increased levels of stress tolerance can struggle with parental anxiety.

For this reason, counselors need to be attentive to clients who appear to be doing well despite the circumstances as we transition to normalcy. As with other types of trauma and toxic stress, it is common for people to release feelings when they are in a safe space. With the transition back to routines and schedules, some parents and caregivers may feel increased stability and become able to release deeply suppressed feelings related to the collective grief and traumatization from recent events.

Clients may have been put in positions in which they had to push through difficulties to continue working, parenting and performing in the various roles they played. Even parents and caregivers who report being ready to return to work or to have children return to school can experience this unexpected flood of traumatic symptoms.

How can we help parents manage these symptoms?

In one sentence, healing from collective trauma requires collective compassion. It is important to promote connection and healthy attachments to recover from the negative impacts of compounded events and societal issues.

We can provide a safe space for clients to unload difficult emotions and worries by being empathic, demonstrating patience and providing psychoeducation about trauma. Counselors can also assist clients with increasing their awareness of feelings related to these issues and provide them with stress-reduction interventions.

Additionally, empowering clients to talk to their employers, child care providers and children’s schools about transition plans can help to alleviate fear of the unknown. This also assists parents and caregivers in making informed choices that will best work for meeting their needs and the needs of their families. With education on transition plans and safety precautions in place, parents and caregivers can focus on areas that they can control.

In response to the array of physical, psychological and sensory impacts from this symptomology, integrated psycho-sensory therapy may be beneficial. This therapeutic model includes using aspects of physical wellness such as recommending and referring clients to engage in yoga, exercise classes and related supportive services (e.g., physical therapy/occupational therapy, chiropractic care, massage therapy). It includes aspects of psychological wellness (the theoretical model of choice). Then it adds sensory considerations based on the client’s needs. These considerations may be related to lighting and colors (low lights, wearing and having a background with calming colors or nature), gentle music, and the presence of calming smells (lavender, lemongrass, etc.). See the visual (below) for model components. The diversity of each component added to the next assists clients in minimizing the impacts of how trauma is felt in the body and how it affects our functioning.

Even with telehealth sessions, counselors should consider creative ways to engage clients by giving them options to move around throughout sessions.

Click on the image to see it full size

Other considerations

For many clients, feeling prepared and having a plan can help to eliminate some of their added stress and anxiety. However, it is crucial that counselors continue to help clients maintain flexible thinking and increase adaptability because much about life today is unpredictable.

On a final note, counselors have experienced this pandemic too. We have also taken on the brunt of addressing mental health needs in a time unlike any other. Furthermore, many counselors are also parents or caregivers. It is vital that we take care of ourselves and commit to our own overall wellness. We must embody the level of integrative and holistic self-care that we communicate to our clients.

One thing I have encouraged others to do in these times is to give grace — to themselves and to others. We must have grace as we navigate these challenges so that we can rise above our circumstances and emerge resilient.

 

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Rebekah Lemmons strives to improve outcomes for children, emerging adults and families. For the past decade, her practice and research primarily has been based in the nonprofit sector, with an emphasis on program evaluation, teaching, service leadership, consulting and providing supervision to clinicians. Contact her at rebekahlemmons@yahoo.com.

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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.

School vaping cultures: Acknowledging the impact of COVID-19

By Zachary Short and Nicole Baliszewski June 4, 2020

This past January, global tobacco conglomerate Altria saw a major drop in its stock value on the New York Stock Exchange, depreciating at a value of almost 40% versus its record-breaking highs in 2017. What caused this sudden dip in one of the biggest-rebounding industries of the 21st century? It would be fair to suggest that the COVID-19 pandemic has caused some major complications for both the traditional and electronic cigarette corporations located across the United States.

As a respiratory-based infectious disease, COVID-19 poses an unparalleled threat to the health and safety of individuals across the age spectrum with significant histories of vaping or smoking. In fact, a recent study in the New England Journal of Medicine found that Chinese patients with a history of smoking were twice as likely to suffer from severe infections associated with diseases such as COVID-19 in comparison with those without any smoking history.

Having always opposed the youth vaping/smoking culture, counselors and community advocates across the nation are currently working to answer a significant question: What actions can we be taking to protect our communities from the combined threat of COVID-19 and recent vaping trends?

The truth is, now is the prime time for considering how we can influence our communities to create better post-quarantine schools for our students.

The loss and revitalization of the smoking industry

Only five years ago, health specialists with the Truth Initiative anti-smoking campaign speculated that the tobacco industry and most of the nation’s smoking addictions would expire with the Generation Z demographic. But vaping, the process of inhaling prepackaged aerosols (also known as vapor), has led to the resurgence of nicotine products within school systems.

Through a combination of peer pressure and social media campaigns, students from all backgrounds have found themselves under the influence of Altria’s newest partner, Juul Labs, maker of the Juul electronic cigarette. Largely as the result of the popularization of this flavored electronic smoking device, the number of high school students who use nicotine products has increased from 3.6 million to 5.4 million in the span of only one year, according to the Centers for Disease Control and Prevention (CDC).

How significant it would be to know that schools were free of the harmful aftereffects of adolescent smoking, leaving school counselors and clinicians available to attend to the important mental health developments that are so essential in our school systems right now. Instead, we find ourselves dealing with another truly concerning issue: According to the Truth Initiative, 1 in every 4 high school students now uses e-cigarettes.

These concerning statistics represent a call for preventative action in middle schools across the nation. A number of schools and organizations have taken such counteractions to trends in vaping by launching interventions such as confiscation, disciplinary action, and even educational programming. But the culture of vaping continues to persist as a significant concern for parents and educators.

The most terrifying thing about the Juul product so far is that it appears to come off as being innocuous to many people. Most students and parents recognize it as the small USB-shaped device that produces fruit-flavored smoke. Very few seem to grasp the long-term consequences of vaping habits. That being said, those consequences might already be here.

The individuals at risk

Based on data collected by the CDC in early March, evidence suggests that COVID-19 poses a serious threat to all individuals ages 65 and older. Fortunately for students under the age of 18, the percentage of those infected and harmed has been relatively low by comparison.

While most parents find some comfort in hearing that the student demographic is the least impacted by the pandemic, the statistics can change drastically if students are part of the vaping culture that is rampant among youth. According to data provided by the CDC for China’s mainland population facing COVID-19, individuals with respiratory issues predominantly associated with even a small history of smoking or vaping have a 6.3% case fatality rate, in contrast to 2.3% overall. Recognizing how exposure to vaping increases a person’s health concerns, imagine the increased risks that our students could face should their still-developing physiques come in contact with both nicotine products and a respiratory infection.

“What they say is about 80% of people feel the flu, but they will be OK. Where we are getting into trouble is that it can lead to severe pulmonary distress,” says Anna Song, an associate professor of health psychology and leader of the Health Behaviors Research Lab at the University of California Merced. “Smoking is a risk factor for having this disease progress, be incredibly severe, and lead to mortality.”

As we know, COVID-19 has posed widespread challenges to the health and lifestyles of the global population. Societal and educational norms have begun to deteriorate, and everyday tasks and responsibilities now come with an unprecedented health risk to individuals and their families. Of great concern to us is that the unattended trends and cultures of our school systems could be having a negative impact on our students right now. To allow these trends to persist beyond this pandemic is to continue putting our students at risk unnecessarily.

A unique opportunity for change

What makes now such an ideal time to invest in removing the harmful vape cultures that continue to linger in our school systems? Students are largely being required to undertake remote learning during this time, and that may continue for many students even as a new school year begins. The changes and circumstances that come with students’ remote learning actually promote our greatest opportunity for the development of an anti-smoking culture.

Society is recognizing that our plans, policies and preparation were inadequate to succeed in the face of an unanticipated global pandemic. Thus, things are beginning to change. Legislation is developing to create preventative actions around practices deemed unhealthy by medical specialists, and educational policy is constantly being reformed to reflect the needs and issues present in our impromptu teaching conditions. If there was ever a time to acknowledge the statistics that point to the harm that nicotine products pose to our adolescents and to advocate for the safety of our children, it is now.

Large systemic changes are challenging and often are out of our hands, but educators and parents currently have the opportunity to make a notable difference in students’ environments. During this time of partial quarantine, most families are now all in one location — the home. Our students currently find themselves in a setting where they are under the watchful eyes of their families and where smoking purchases and practices are essentially impossible.

In addition to that, they are also in a potential learning atmosphere. Through the joint efforts of educators and parents, our youth can be exposed to real educational and intimate conversations regarding the dangerous practices of smoking. These conversations can mean the world to students who currently feel that their futures and health might be dictated by vaping culture.

COVID-19 has had a harsh and unpredictable influence on our way of life, but it also presents us with a rare opportunity to support our students through one of the greatest health issues of their generation. So, making use of the present, it is time that we as a supportive community of counselors consider what we should be doing to help facilitate and emphasize this process of growth for students’ mental and physical health.

Our responsibility to intervene

As of early April, individuals within Rowan University’s Department of Psychology have been conducting their own research to confront the vaping culture that remains prevalent during the COVID-19 pandemic. Their research takes an interesting approach to behavioral analysis with younger age groups, including the development of interesting activities such as mobile- and video game-based interventions that promote smoking abstinence.

Fortunately, this is just the tip of the iceberg when it comes to the collective efforts of universities to combat vaping trends in student populations. Even educational institutions outside of higher education are recognizing the statistically supported danger that vaping is putting our students in when facing the current health pandemic. As a community, it is our collaborative responsibility to provide education and to take the necessary precautions to protect our students’ health. We are just beginning to understand the proper steps to take when working from a remote distance.

Educating the community: Providing knowledge of the increased risks and hazards of smoking behaviors is the first step to reducing nicotine consumption within our school systems. Given the myriad resources available on the consequences of vaping from the CDC, the National Institute on Drug Abuse and even university websites such as Johns Hopkins Medicine, it is the obligation of school counselors and other school personnel to appropriately share this information with our local communities. It is important to remember that this information needs to be given not only to the students we support, but also to our educational partners and to the families who are acting as our immediate support systems in homes at this time.

Promoting real conversations: With the knowledge and statistics being supplied to our students’ homes, it is more important now than ever that school systems promote real conversations with students regarding the present vaping cultures. Whether it is school counselor-to-student or parent-to-student conversations, we need to understand what the student perspectives are when they see products such as Juul in the media while also witnessing terrifying statistics regarding the spread of a global virus.

With those who are currently smoking, it is vital that we understand their concerns and interests so that we can provide them the appropriate support they need. These conversations are the optimal opportunity to promote and communicate resiliency, empathy and community support to our students. And with those who have never touched a vaping device, communicating this information and the associated risks is the best possible preventative action at this time.

Advocating for policies: To reiterate, now is a turbulent time when leaders are reflecting on educational preparations and policy and how they might be applied for future incidents. In addition to redesigning our school’s remote learning policies, we need to be working as a professional community to advocate for anti-vaping policies within our schools. It is essential that school counselors reflect on school policies regarding smoking tolerance, as well as preventative actions to take, so that they can create real opportunities to support student health.

Fortunately, states and health institutions are rallying to create a number of anti-vaping models that can be implemented or referenced by school counselors looking to better their schools. One such model is the Make Smoking History campaign, conducted by the Massachusetts Department of Public Health, to reduce the percentage of vaping disciplinary actions taken in middle school settings. This is the time to ask for and support the voices of the education community to find out what should be done for the development of our educational systems — not just on a school-by-school basis, but from a legislative perspective.

Forming support groups: Finally, acknowledging that this is a difficult time for individuals who have a dependency on smoking tools to which they no longer have easy access, we need to prepare and create remote counseling groups to support them through potential issues such as withdrawal or rehabilitation. A number of counselors may struggle with the concept of remote group counseling, but these students still need emotional and mental health support to cope with their new distancing from vaping. Counselors should utilize the medical resources and personnel within their school districts to support students in their transition to healthier living. Ultimately, it is groups such as these that we should be planning to implement more frequently in our later return to school.

The truth is that in the midst of a global health crisis, most individuals view the issue of vaping in school systems as relatively small. But the fact is that vaping is a real health issue for our youth, and in combination with the threat of COVID-19, it puts our newest generation of students at exceptional risk for loss. In a moment in history when many counselors are at home and wondering what they should be doing to support their students, imagine what significant change could occur if we all directed a portion of our efforts to acknowledging and countering the present vaping culture.

 

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Related reading, from the Counseling Today archives: “Pushing through the vape cloud

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Zachary Short is a master’s counseling in educational settings student at Rowan University. He currently works as a clinical research intern in a high school setting, where his research in student behavioral outcomes is being supported through the Mental Health Grant Demonstration Program. Contact him through LinkedIn: linkedin.com/in/shortzachary/.

Nicole Baliszewski is a master’s counseling in educational settings student at Rowan University. She currently works as a clinical intern in a middle school setting, where she seeks to provide trauma and mental health support to the special education student population. Contact her through LinkedIn: linkedin.com/in/nbaliszewski/.

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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.