Tag Archives: school counselors audience

Taking a clinical selfie

By Bethany Bray October 25, 2022

“But first, let me take a selfie.”

This phrase, which was first popularized in The Chainsmokers’ 2014 breakout hit song “#Selfie,” has become a common saying in today’s culture — and one that is sometimes used to satirize younger generations who can’t seem to experience something without documenting it with a self-portrait.

On the surface, the act of taking a selfie can seem shallow or self-promotional. But Amanda Winburn and Amy King, both counselor educators who have a background as a school counselor, say that when used intentionally and in a structured way, selfies can become a therapeutic tool and a way to spark self-reflection, engagement and connection with younger clients.

“We know that children are engaged in” taking selfies, says Winburn, a licensed school counselor, licensed professional counselor and registered play therapist. “So why not take the positive attributes of this practice and expand upon it” in counseling?

Selfies in session

Winburn and King, who have presented on the therapeutic power of selfies at conferences of the American Counseling Association and the American School Counselor Association, have used selfie activities as a therapeutic intervention in individual and group counseling settings.

“This is just one more way we could give children and adolescents an opportunity to express themselves and narrate their story,” says Winburn, an associate professor of counselor education at the University of Mississippi. “We try and incorporate [clients’] worlds in our work, and selfies are an everyday part of our world and everyday part of expression for children, adolescents and adults. It really is the new self-portrait.”

However, Winburn and King stress two important caveats to this work:

  1. Practitioners should take care to ensure that any selfies captured in sessions are not taken with a device that is connected to the internet (i.e., not the client’s personal cellphone) so the images cannot be shared or used in a nontherapeutic context.
  2. Practitioners must obtain consent from a parent or guardian to capture the image of any client under the age of 18.

King, a certified school counselor and provisionally licensed professional counselor in private practice in Mississippi, uses a tablet computer that does not have internet access to allow students and clients to take selfies. She prints the selfie images and keeps them in a client’s file to refer to during sessions and deletes the images from the device. The tablet and client files are kept in a locked cabinet in her office when not in use, she explains.

Tapping into self-expression and boosting empathy

Having young clients take selfies during counseling sessions can serve as a visual and relatable way for them to track their progress in therapy, Winburn and King suggest.

Selfies can document physical aspects of improvement and growth in ways that a client may not notice without a visual record, such as smiling or holding their head up more, sitting tall and appearing more confident, Winburn explains.

When she was a school counselor, King once used selfies to help a student who was struggling with self-confidence. The student kept the printed selfies that she took in counseling sessions in a journal, to which she added notes and drawings. When King and the client talked about her therapeutic progress and looked through the selfies together, the young client was able to recognize that she looked happier and more confident in her progression of photos throughout the year.

She was able to note that she had gotten taller and that her smile was brighter. “She was glowing because she was looking at herself in a really positive way and reflecting about that,” King recalls.

King, a lecturer in counselor education and supervision at Boise State University, finds that students love to look back at their progress in counseling, and by using selfies, young clients can visualize that progression of moving away from having a tough time to having a better outlook on their situation or life.

In addition to strengthening expression and self-confidence, using selfies in this way also provides an opportunity for counselors to explore and process clients’ feelings of self-doubt or self-criticism, Winburn says. In therapy, selfies can be a visual portrait of a client’s narrative and a discussion starter for work that increases self-awareness and emotion recognition.

Winburn advises counselors to ask clients questions to understand the motivations behind their self-expressions and explore if they are trying to portray themselves differently than they really are. For example, she says clinicians can ask, “How does seeing that image make you feel?” or “What makes you feel that way?”

Winburn asks her counseling students at the University of Mississippi to take a selfie at the beginning and end of their day for an entire week. She tells her students, “It’s a way to step out of your comfort zone and process how you were feeling [that week] and how you portray yourself.” Then they reflect together in class on the story their selfies tell, which can be quite eye-opening, Winburn says.

King also used selfies in group counseling with second grade girls during her time as a school counselor. The group’s focus was on building confidence, communication, friend making and social skills. Learning to give and receive positive affirmations — to oneself and others — was an important component of this group work, King notes.

King, assisted by graduate counseling interns, had each group participant take a selfie with a school-issued tablet computer. The student would first look at the selfie themselves and then share it with the group. This activity allowed participants to open up and talk about the feelings their selfie elicited and, in turn, prompt group members to offer positive feedback.

It was a powerful experience that boosted the second graders’ empathy, reflection and listening skills and their ability to consider others’ perspectives, King says. The students would listen, connect and make comments such as “your eyes are really sparkling in that one,” she recalls.

After the group had been meeting for a little while, teachers and recess monitors at King’s school began to report that the students who were in her counseling group started to have more positive interactions during recess, she says.

Using selfies in counseling can help children actively learn and foster positive feelings about themselves as well as learn about individual and cultural differences in group settings, King notes.

“There’s no right or wrong way to make a selfie,” she adds.

Keeping an open mind

King and Winburn acknowledge that counselors can sometimes be skeptical of using technology in sessions, especially mediums such as selfies that can have negative connotations. However, they feel that when used in an ethical and appropriate way, selfies can strengthen trust and the therapeutic alliance with young clients.

It can also be a way to model that technology can be used in a positive way, to build each other up, King adds.

“Make sure you’re using safeguards to keeps clients safe, but try it [using selfies], embrace it and be open to it,” Winburn urges. “Especially with adolescents, counselors need to be playfully engaged and aware of where they are. This is an active way of embracing the world that they live in and meeting them where they are.”

wavebreakmedia/Shutterstock.com

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 Related reading, from Counseling Today:

 

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

Increasing mental health access through school and community partnerships

By Jessica Holt August 5, 2022

In 2014, I shifted from working as a professional counselor in a mental health agency to working as a school counselor in the metro Atlanta area. I had experience working with adults and children who had emotional, behavioral and substance abuse disorders, so I thought that transitioning to the school system would provide a much-needed break and keep me from burning out.

I told myself, “This is going to be so much better because I’m going to have a regular schedule and lots of breaks. No more managing crises, being on call, treatment planning or dealing with severe problems.” But I was wrong. Although my role and job title changed, I was still seeing a lot of the same issues, especially self-harm, anxiety and depression.

In addition, working with middle school students requires a lot of energy, flexibility, patience and compassion. You are helping young people at a pivotal time in their personal, social and academic development. They are beginning to learn what is most important to them and create their identity. Combine that with peer pressure, hormones and more rigorous classes and your job as a school counselor seems never-ending.

The current challenges in schools

School counselors, much like teachers, were already suffering from high levels of burnout, fatigue and stress before the COVID-19 pandemic. And the last three years have only made the situation worse. At my school, more students are struggling with depression and anxiety and have less resiliency or grit. Many of our students’ families are also dealing with unemployment, homelessness and financial issues.

All these factors have the potential to affect students’ behavior, mental health and interactions with others. I have noticed an increase in the number of students who engage in self-harm as well as students presenting with suicidal ideations. My school district has a specific protocol for school counselors to follow if a student presents with suicidal ideation. This includes using the Columbia-Suicide Severity Rating Scale, communicating with parents and guardians, referring to crisis services and creating safety plans when students return to school. But this protocol only addresses part of the problem: the suicidal ideation and the need for a safety plan. It doesn’t address the presenting problems of depression or anxiety, nor does it help students develop coping skills to prevent future crises.

Kenny Eliason/Unsplash.com

My school also administers a survey to students in the fall and spring each year to assess school climate, student resiliency, social-emotional learning and other topics. The survey results from the previous school year help guide social-emotional learning curriculum the following year. The survey data from 2020-2021 revealed that many students at my school lacked coping skills and grit, so the school system has taken several steps to help students with these issues, including weekly social-emotional learning lessons, wellness campaigns and an anonymous reporting system that allows parents and students to report students who are at risk (e.g., engaging in self-harm, experiencing child abuse, being bullied). 

The Georgia Apex program

My school district was chosen to participate in the Georgia Apex Program during the 2021-2022 school year. This state-wide program, which is funded by the Georgia Department of Behavioral Health and Developmental Disabilities, promotes collaboration between community mental health providers and schools to make mental health services accessible to students and their families.

The program’s goals include early detection of adolescent behavioral health needs, increased access to mental health services for children and youth, and coordination between mental health providers and local school districts. This is a wraparound (comprehensive) program that includes behavioral health assessments, psychiatric/nursing services, individual and family therapy (school-based and community), and community support services (e.g., case management).

My school district partnered with two local mental health agencies so that three schools, including mine, could have a school-based professional counselor onsite to help students who present with a variety of issues, including anxiety, depression, self-harm and suicidal ideation. Kasey Ross, a licensed professional counselor (LPC) who is employed by a mental health agency in north Georgia, is one of the two school-based therapists my school district hired. She works two days at the middle school, two days at the high school and one day at her mental health agency (with the option to come to the school that day if needed).

“When we can detect behavioral health needs early, we can help reduce admission to higher levels of care, reduce unexcused absences and reduce disciplinary actions as well,” Ross says. “Additionally, the program is available at schools, homes and other community places, which makes it flexible and convenient for many families.”

The Apex referral process

School counselors often have large caseloads and limited time to work with each student. This can make it difficult to help students with more severe issues. In addition, school counselors are seeing an increase in students who need mental health services.

This is where the Apex program comes in. The school counselor can gather more information about the student’s personal needs and can give the student and their parents/guardians information about the Apex program. With the parent’s/guardian’s permission, the school counselor can then refer a student to the Apex therapist who has partnered with the school. The referral includes student demographics, presenting problem(s), insurance information (if they have any) and contact information for the parent/guardian.

The program is primarily for students who have PeachCare (Georgia’s version of Medicaid); however, students who do not have insurance are also able to receive services for up to 60 days, and the Apex therapist helps to connect them with local resources to obtain insurance. The school counselor can also refer students who have private insurance, and the Apex therapist can also help connect them with providers who accept their insurance.

Having a school-based therapist in our building, who is accessible four days out of the week, has been a game changer. This program allows school counselors such as myself to help students who might not otherwise receive the care they need because of our high caseloads. Even if we were allowed to provide therapy to students, we simply don’t have the time because our work is solution-focused and brief. Now, after meeting with a student who is in crisis, I can refer them to the school-based therapist, which is often a huge relief for the student’s parents.

And the process is quick and easy. I can give the student the information packet for Apex and do the online referral while they are in my office. The school-based therapist typically reaches out within 24 hours to set up an intake appointment, where they will do a behavioral health assessment and then develop a treatment plan. The therapist discusses with the student and parent/guardian when they will provide therapy and how often, and because the therapist is connected to the school, they can access the student’s school schedule and arrange counseling sessions so they do not affect students’ academic performance. For example, I have several students who meet with our Apex therapist during their electives. In addition, the Apex therapist can also meet with students and families in the community, including at the library, at the therapist’s clinic or in the students’ homes.

The benefits of the program

The Apex program appealed to several parents of my middle school students because it made counseling accessible, convenient and affordable. The community-based mental health provider, Ross, was able to help these students in some way.

One student, for example, reported feelings of depression and anxiety because her parents were going through a divorce and her mother had been diagnosed with breast cancer. As her school counselor, I was able to meet with her and gather more information about how this had been affecting her at school and home. After meeting with the student, I called her parents to tell them about the Apex program and how it could benefit their daughter. They agreed and asked me to send the information home with her and to also go ahead and do the online referral.

The next day, Ross contacted the parents and scheduled a first session with the parents and the student for later in the week. I continued to check in with this student throughout the year, and she said that the counseling sessions had helped her to feel less depressed and anxious.

There are many advantages to the Apex program. According to Ross, “the benefits of school-based mental health services include increased access to mental health services, improved attendance and academic performance, increased engagement at school and a reduction in mental health stigma. In addition, there are typically fewer classroom disruptions, less disciplinary referrals, less course failures and a decrease in inpatient hospitalizations.”

Three schools in our district currently have an Apex therapist. Ross, the therapist working with my middle school and the connected high school, has a caseload of 32 students. Our district also plans to expand this to two elementary schools next year. Ross notes that her agency also provides Apex services to six other counties and has helped 294 students so far. “We are growing and will be able to help even more students and their families next year,” Ross says.

I hope that the funding for this program (and others like it) will continue because it has made a positive impact on the climate at my school and the lives of my students.

 

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Related reading: See Counseling Today‘s August cover story (in which Holt is quoted), “Responding to the youth mental health crisis in schools.”

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Jessica Holt is a licensed professional counselor and has been working as a counselor since 2010. She is starting her ninth year as a school counselor. She primarily works with middle and high school students to help them meet their academic, social and emotional needs.

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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.

Responding to the youth mental health crisis in schools

By Bethany Bray July 25, 2022

Late last year, U.S. Surgeon General Vivek Murthy issued an advisory to call attention to what he described as a “youth mental health crisis.” Depression, suicidality and other mental health challenges have been on the rise among American youth in the past decade, but Murthy believes the stressors and isolation of the COVID-19 pandemic exacerbated an already alarming situation.

In a June interview with ABC News, Murthy acknowledged that the crisis is ongoing, saying, “Ultimately, we will know when we’ve reached the finish line when they’re [American youth] doing well and they tell us they’re doing well and when data tells us that as well.”

Murthy’s advisory called attention to a concerning situation that school-based counselors continue to witness firsthand. American students are experiencing an increasing severity and prevalence of mental health challenges that range from self-harm and disordered eating to underdeveloped social and emotional regulation skills.

Students are trying to learn among a multitude of storms. America continues to struggle with the ongoing dual crises of racial injustice and the lingering COVID-19 pandemic. And on top of that, divisive issues related to schools have been making news headlines lately, including laws created to target transgender youth, arguments about critical race theory and school curriculum, and despair and finger-pointing after the deadly school shooting in Uvalde, Texas, which claimed the lives of 19 elementary school students and two teachers. 

It all adds up and is affecting the day-to-day lives of children and families. 

With a problem so large, it’s going to take more than school-based counselors to reverse the concerning trends in youth mental health. School counselors are on the front lines of this storm, but they also need buy-in, support and collaboration from school administration and staff, parents, community mental health professionals and the community at large.

Distress in students

Jennifer Akins, a licensed professional counselor (LPC) and president of the Texas School Counselor Association, noted that schools across her state are seeing both increased prevalence and severity of depression, anxiety, self-harm, suicidality and eating disorders among students. This has prompted statewide agencies to collect and track data on student mental health, including self-harm, to inform interventions and programs to be deployed in the public schools, Akins says.

“These are not new issues for us, but the thing is the numbers are so much greater,” says Akins, the senior director of guidance and counseling for the McKinney, Texas, public schools. “A huge area of need right now is emotional regulation. They [students] are just not as skilled right now at managing strong feelings. … Students who are experiencing thoughts about self-harm are more often advancing those thoughts into action. They now have thoughts, plus a plan, plus action.”

Texas school counselors are also reporting an increase in self-harm in young students at the elementary level, Akins adds.

Akins is far from alone in what she is seeing. The school-based counselors interviewed for this article report similar rises in self-harm, depression and other mental health challenges among their student populations. Many of these issues were present before the pandemic, but the isolation and lack of social interaction the students experienced while learning remotely during the first years of the pandemic weakened students’ social skills and their ability to regulate their emotions and cope with distress. According to several of the school counselors interviewed for this article, students’ social media use is also a factor that often makes these issues worse.

Jessica Henry has been a high school counselor for 15 years in the Akron, Ohio, area, and she says she’s never seen so many students struggling with suicidal ideation, self-harm, depression, anxiety and panic attacks.

Students are experiencing a lack of resilience and continue to struggle to adjust to in-person school, and for some, this includes developing unhealthy coping mechanisms such as self-harm, Henry says. Small problems that could otherwise be overcome often spiral into “the end of the world” for students, adds Henry, a licensed school counselor in a seventh through 12th grade school in Ashland, Ohio.

For some students, home can be a tumultuous atmosphere and a source of stress, so school functions as a safe place, which they lost when schools switched to at-home learning during the pandemic, notes Henry, a licensed professional clinical counselor and supervisor.

Jessica Holt, an LPC and counselor at a middle school in metro Atlanta, has noticed that in addition to self-harm, depression and anxiety, interpersonal problems, such as bullying and conflict with peers, have become more prevalent recently. Her school has seen an increase in the number of students requesting one-on-one counseling on their own, as well as referrals from teachers and school staff for students who need someone to talk to. There has also been an increase of students who are struggling with sexuality or gender identity issues or who feel like they don’t fit in, she says.

Even though most schools have returned to in-person instruction, the effects of being out of the school environment continue to affect students’ mental health, particularly their self-esteem, social skills and anxiety, says Holt, a member of the American Counseling Association. They are still out of practice with navigating classroom dynamics and making friends.

In Holt’s experience, many parents overcompensated and became more involved in their children’s lessons while they were at home for virtual learning. Parents would log in during virtual learning and check their child’s grades, monitor their work and send messages to teachers. As a result, Holt has noticed that students are struggling with autonomy and self-esteem now that they have returned to in-person classes. Parents are more likely to be the one to message the school when a student is failing, she notes, rather than the student being proactive and asking to make up missed assignments or for extra help.

“Kids don’t have problem-solving skills because things have been done for them. They don’t know how to cope when they are in distress,” Holt says. “One thing that has come out of the pandemic is [problems with] accountability. Students are not taking responsibility because their parents have taken everything on. … That self-advocacy piece is not there for a lot of students.”

Early intervention

Derek Francis, manager of counseling services for the Minneapolis Public Schools, says that his district will be doubling the number of elementary school counselors this fall. Counseling staff at the elementary, middle and high school levels in Minneapolis have also been leading more small groups for students to focus on social-emotional learning, managing stress, anxiety and other mental health challenges.

Minneapolis students are struggling not only with self-esteem, peer conflict, anxiety and other mental health issues but also with discrimination and bias based on racial, sexual and other identities, including negative interactions on social media, says Francis, who co-authored a chapter on proactively addressing racial incidents in schools in the ACA-published book Antiracist Counseling in Schools and Communities. In response, Francis’ school district has enhanced counseling services (including small groups) and weaved mental health discussions with a cross-cultural focus into classroom lessons across grade levels. It’s powerful when students hear that their peers are feeling some of the same anxiety and distress they are experiencing and are able to talk about it openly, says Francis, who works in the Minneapolis Public Schools’ Department of College and Career Readiness.

The Minneapolis schools are also taking an early intervention approach to mental health. Recent years have shown that elementary students can benefit from learning coping skills that help them regulate and calm themselves and deal with strong emotions, Francis says. So the district has been teaching young students how to identify when they’re becoming overwhelmed, name their feelings and use skills to calm themselves, such as breathing techniques, as well as letting them know whom they should contact within the school for additional help.

Self-regulation in a young student can mean the difference between moving on from a negative interaction with a peer on the playground or remaining upset the entire day, says Francis, an ACA member. Teaching young students these skills during elementary school may keep them from carrying over or forming difficult or unhealthy behaviors, such as skipping class, into middle or high school.

“The younger we can help kids know how to regulate their emotions and talk about their feelings, the better,” he stresses.

As manager of all the school counselors in the Minneapolis Public Schools, Francis often goes into classrooms to speak with students. During a recent session on “the power of words” with third, fourth and fifth graders, he sparked discussion by asking students for examples of incidents when they’d heard an “ouch” (hurtful) word and ways to respond when they are the recipient of or witness to an ouch word. The students had plenty of experiences with ouch words, including one kid who had been ridiculed for his lisp.

Francis then focused the conversation on social skills, empathy and ways to connect with people who come from different backgrounds. His overarching message to the students was that school should be an inclusive place, says Francis, a professional development specialist with Hatching Results, a company that provides training and continuing education for school counselors, administrators and school districts.

Francis says his district intentionally approaches hate and bias incidents in the same way they treat fire drills: It’s something for staff, students and parents to prepare for. That way, when something does happen, everyone knows how to talk about it, respond and connect with resources. 

The Minneapolis schools have also focused on the negative implications that social media use can have on student mental health. It’s become clear that students are saying hurtful things to each other online, not only on social media platforms such as TikTok and Snapchat but also via the chat feature on video games, group text messages and other avenues, Francis notes.

Adults don’t often realize how much of students’ lives are spent in the digital world, he says, and parents and students alike are not often aware of the connection between social media use and how a person feels about themselves. Many students do not have a parent or adult who monitors their dialogue on social media or helps them know when to log off or disregard negative comments, he adds.

“[Students’] brains are not developed yet to know how their words impact other people. It’s an area that needs a lot more development after the pandemic,” Francis continues. “The [effects of the] isolation of the pandemic, when paired with the negativity of social media, can really distract them from seeing positive things about themselves. We have to be mindful of the impact of screen time on students’ mental health. … It really impacts the school environment when it’s unaddressed.”

Forging connection

Holt and the other school counselors at her Atlanta-area middle school coordinate their schedules so they can visit and speak to the classrooms each fall. These visits serve as an opportunity to survey students on their mental health needs, and they also allow students to meet the counselors and learn more about the schools’ counseling programming.

The survey data they collect during these classroom visits informs the counselors’ focus for the year (e.g., the need for small groups to help students with anger, parental separation, grief or other issues) and also helps them identify and connect with individual students who are at risk, Holt explains.

Tracking student concerns and tailoring an appropriate counseling response are even more vital as mental health difficulties are on the rise.

Three students at Holt’s middle school have taken their own lives in the past five years. Part of the district’s response to the suicides, as well as to the overall increase of mental health needs, has been to establish a program that installs school-based therapists to provide long-term therapy for students. This year, Holt’s district has increased the number of school-based therapists to meet  the demand.

Holt’s school has also adopted several peer-based programs, including one that pairs established students with peers who are new to the district and another that trains students in suicide prevention and how to respond and connect a peer to appropriate help when they notice suicidal ideation (e.g., observing evidence of cutting in a peer as they change clothes for physical education classes).

The peer programming, counselor classroom visits and other recent initiatives are aimed at preventing students from falling through the cracks and help the counselors keep their finger on the pulse of the school, Holt explains. And it’s had a positive impact on school culture.

Like Holt, Henry feels that counseling staff need to be more visible and involved in their schools to respond to the recent rise in mental health needs. Now more than ever, school counselors need to get creative and set an example for other school staff by taking the first steps to forge connection with students, Henry says.

Long hours and heavy workloads leave teachers and counselors prone to burnout, but students also suffer when teachers and school staff focus on just getting through the school day and lose sight of the emotions and issues that students are dealing with beyond academics, stresses Henry, who is co-author of the 2019 book Mental Health in Our Schools: An Applied Collaborative Approach to Working With Students and Families. School staff who don’t take the time to connect with students, she says, risk not being able to recognize when a student is having an “off” day or exhibiting uncharacteristic behavior that indicates they need extra support.

School counselors can take steps to prevent this by encouraging teachers to spend time bonding with students at the start of the year, rather than diving into rigid topics such as classroom rules and expectations, Henry says. She notes that icebreaker activities, such playing bingo or prompting discussions about students’ favorite television shows or rides at a local amusement park, can make a big difference in fostering connection.

“And with that [activity] comes so much more dialogue,” she adds.

Henry also encourages counselors to be proactive and make their services known during team meetings and trainings among school staff. By emphasizing that their “door is always open” for collaboration when a student is struggling behaviorally or academically, counselors can help remind teachers that they are an important resource that can help address the underlying reasons for disruptive behavior or failing grades, such as anxiety, self-esteem issues or food insecurity at home. 

Henry says that improving student mental health and school culture is about school counselors “being present, being around [the] teachers and being around students as much as possible,” including in the hallways and at lunch. “And invite teachers to collaborate with you when a student seems ‘off,’” she adds. “When an adult reaches out, little things like that can change a kid’s life and make them feel like someone does care.”

Henry often offers to serve as a mediator between a teacher and a student when behavioral issues or conflict arises in the classroom. “I sometimes meet with a teacher behind the scenes to say, ‘Have you tried this?’ or ‘When I worked with this student, here’s what worked, here’s what he responded to,’” she explains. “It’s just like a [counseling] treatment plan; if something is not working, we move on and try something else.”

It’s easy for school staff to focus on what a student is doing wrong, she notes, but it’s more helpful to focus on what they’re doing right and emphasize their strengths. Offering students creative options beyond discipline and exploring the reasons why they’re struggling is key.

“We need to meet kids where they are,” says Henry, who counsels individual clients part-time at a private practice in addition to working as a school counselor. “Some of these kids just want to be heard. Just listening to what they have to say and not judging them makes a big difference. They need to feel like people [school staff] care.”

Barriers to behavioral health care 

School counselors are often the first mental health professional a student who is struggling with mental illness comes in contact with, notes Stephen Sharp, a school counselor at a middle school and coordinator for K-12 school counseling services in the Hempfield School District in the suburbs of Lancaster, Pennsylvania.

However, many students need long-term outpatient therapy that would not be appropriate or feasible for school counselors to offer. When students and families face barriers to access behavioral health care, it only adds to the increasing student mental health needs that schools are facing, notes Sharp, a member of the American School Counselor Association (ASCA) board of directors. 

The issue that Sharp says he finds most challenging is that for many of his students, all of their mental health support “begins and ends at the school walls.”

Sharp says he’s seen students go months without needed treatment because they were put on a waiting list for an appointment with a local mental health provider or they lack insurance or the ability to pay for treatment not covered by insurance. In some cases, undertreatment or lack of preventive treatment has led to student hospitalizations, he adds.

The biggest need for my students is access to ongoing behavioral health services,” he says. “The reality is that it [the gap in services] creates a disproportionate burden on the schools. Not just on school counselors but teaching staff as well.”

Sharp’s school district has a strong partnership with a local behavioral health provider who provides school-based services for students. However, he says that many students are not able to take advantage of the service. Both lack of insurance and limited coverage are barriers to treatment for students, he notes, but the latter is more pervasive. Students may have health insurance, but their plan may not cover certain services such as school-based therapy or virtual therapy, he explains.

There is also a shortage of behavioral health care providers just at a time when there is an increased demand for services. Sharp says that his school struggled this year to find a qualified school-based therapist to hire in addition to school counseling staff.

Sharp’s district is not alone in this phenomenon. Francis says that community mental health agencies in Minneapolis are also full and have waiting lists. In Texas, community resources that would otherwise provide support for families outside of schools, such as social service organizations, civic centers and nonprofit programs, are declining — and in some areas are nonexistent, Akins notes.

The pandemic revealed the cracks and flaws not only of our education system but also the health care and mental health care systems, Sharp notes.

“We are in a behavioral health care crisis, not just in the state of Pennsylvania but nationally as well, and it leads to a lack of access to care. Certain areas (e.g., rural) have always had a lack of care, but it’s gotten so much worse,” Sharp says. “All of this is really disheartening and challenging, but it’s also something that we absolutely as a profession and a society need to be talking about. What level of advocacy and coordination are we going to do to address these concerns?”

Sharp says the past year has been the hardest year yet for him professionally. But at the same time, he sees opportunity ahead.

One of the lessons gleaned from Hurricane Katrina, Sharp notes, is that a coordinated response works best in times of crisis, especially when there are financial strains and staffing limitations. There is an opportunity for national-level organizations such as ACA and ASCA to offer guidelines, training and other programming to address the rise inyouth mental health concerns, he says. And there is also opportunity for multidisciplinary collaboration. For example, the Pennsylvania School Counselors Association (PSCA) is working with the Pennsylvania chapter of the American Academy of Pediatrics to address the barriers to care in their state, he notes.

Support from professional organizations as well as collaboration among and across helping professionals at the local, state and national levels “makes things better but also makes us [individual counselors] feel like we’re not the only ones pushing against a brick wall,” says Sharp, a past president of PSCA. “The more innovative that we can get and share stories of success, those are the types of things that will lead to something better after this.”

All hands on deck

As a school counselor, Holt says that she sometimes thinks of her role as a “connector” between students and families and wraparound resources that can help meet their needs outside of school, including mental health services. However, she advises school counselors to only share resources that they are familiar with and have vetted to ensure that they offer quality services.

It’s helpful, Holt says, when a professional counselor contacts her school to let them know they offer group or individual services that are well-matched to their student population. She also recommends counselors have a list of local providers that they can offer to teachers and school staff who, like counselors, sometimes find themselves overwhelmed and in need professional support.

Holt encourages community counselors to connect with their local school counselors, and vice versa. “Having that connection from community mental health to the schools is very important,” Holt says. “The more resources that we [school counselors] know about, the more referrals we can do for our parents and students. If we don’t have connections in the community, it makes it harder. Being able to know that we have partners in the community and knowing what’s available is helpful.”

Akins agrees that partnerships between school and community resources will be key in addressing the recent increase in youth mental health needs. However, community counselors need to recognize that establishing helpful collaboration takes time and patience.

There are a lot of practical components that have to fall into place before a school can adopt a new program or resource, Akins notes. “Instructional minutes are very precious,” she says, so school officials cannot always justify using class time for mental health programming.

Akins suggests that community counselors get to know the unique needs of their local school district, as well as what has and hasn’t worked for other schools, before contacting their school to offer help.

In times of crisis, “sometimes people who are coming from the [nonschool] mental health community think ‘we don’t have time to waste.’ That’s true, but processes are in place for a reason (i.e., student safety),” Akins says. “Taking the time to really connect with your district and plan and develop a formal partnership will be a lot more successful than emailing a principal to ask, ‘Can I come in and do XYZ?’”

Sandi Logan-McKibben, a clinical assistant professor and school counseling program director at Sacred Heart University in Connecticut, asserts that counselors have an ethical responsibility to know what mental health and other wraparound resources are available in their area for clients and students.

She believes in this idea so strongly that she assigns her school counseling students a community mapping project each year. The students are charged with finding resources within the school district where they are working as a counseling intern and then overlaying those resources on a Google Maps image of the area. Students’ maps include not only mental health services but also after-school, tutoring and mentorship programs; organizations that help with food insecurity, homelessness or immigration services; nonprofit or faith-based organizations; and other institutions. 

This mapping project can be helpful for community and school-based counselors, whether they are students or not, adds Logan-McKibben, an ACA member.

She also recommends counselors find and help fill gaps in needed services. This can include anything from advocating for funding at a school board meeting or partnering with an existing nonprofit to expand services to contracting with a local university to offer pro bono counseling services for school students.

“It only takes one person to enact something and prompt change,” says Logan-McKibben, a former school counselor who lives in Florida and teaches virtually at Sacred Heart. “Find out what the actual needs of your community are. Don’t make assumptions. You don’t know unless you reach out.”

Counselors in all settings have a common skill — resourcefulness — and they need to draw on that skill to meet students’ needs in this time of crisis, Logan-McKibben says. This calls for counselors to work with a preventive, proactive and collaborative focus.

“The most important thing for all professional counselors to know is that we’re all in this together. Any kind of school crisis is really a community crisis,” she says.

Sharp agrees that counselors have a role to play in advocating for support for mental health care “both in and beyond the walls of the school.” This is a time to be concerned, he admits, but it’s also a time for meaningful work to be done.

“We also need to acknowledge the work that is being done and was done before [the situation became a crisis]. That work mattered before, and it matters now,” Sharp says. “Whether it’s school counseling or clinical counseling work we’re doing, it’s a sensitive time for the profession, … but [it’s] also a time to be mindful and reflective of victories and lessons learned. Also, [counselors should] take the time to celebrate. Celebrate the work our clients and students have done and use that to make the profession better.”

wavebreakmedia/Shutterstock.com

The influence of social and political issues on youth mental health 

Adults have been making a lot of decisions lately that not only create news headlines but also affect youth mental health, including a law aimed at making it easier for teachers to carry firearms in Ohio schools and the controversial Florida law — dubbed “Don’t Say Gay” by its opponents — that banned classroom instruction about sexual orientation or gender identity.

For school counselors, these issues are more than soundbites on news programs. They affect their students and families and add to the already complicated work school counselors are doing to combat a rise in suicidality and other mental health concerns in American youth.

Jessica Henry, a high school counselor in the Akron, Ohio, area, says she’s had coworkers who have refused to use a student’s preferred pronouns. “Not only is that unethical and has legal ramifications, it’s [also] very difficult to hear when a teacher says, ‘I’m not doing that,’” she says.

Henry, a licensed professional clinical counselor, feels that schools (and school counselors) should take a proactive role to address controversial issues rather than avoiding them. Students, parents and educators need to hear about topics such as racial injustice and LGBTQ+ inclusion, she says.

“We have to address the bigger picture of what is going on in our world. It’s about getting your administrators and superintendent to understand that inclusivity is vital — and in turn, will affect academics,” Henry explains. “It goes back to [asking], ‘Does every kid feel safe in their school?’ ‘Does every kid feel like themselves in their school?’ If even one student says ‘no,’ we’ve got work to do.”

Part of this work also involves the need for counselors to have the humility to recognize their biases, says Derek Francis, manager of counseling services for the Minneapolis Public Schools’ Department of College and Career Readiness. The majority of the counseling profession is white, yet the majority of many school populations are not, he notes.

“We need to be mindful of our biases. … It takes laying down your privilege and learning, open listening and connecting,” says Francis. “Ultimately, we’re trying to build trust when we’re doing counseling. We want all people to know that we have positive regard for them, and we need to come in [with] the right [unbiased] mindset to help the person in front of us.”

The growing polarization of political and social issues in America has also led to distrust of public institutions such as schools, says Jennifer Akins, a licensed professional counselor and president of the Texas School Counselor Association. She’s seen this mistrust spiral into parents equating terms such as “social-emotional learning” with critical race theory.

“We [school counselors] have been working on mental health issues and school safety for a long time, and many districts have integrated mental health and social-emotional learning [into the curriculum]. There is a segment of the public that has developed a mistrust even of those words, ‘social-emotional.’ They feel that things like mental health don’t really have a place in public education or are inappropriate. That stigma adds to some of the [mental health] needs we’re seeing in students. It’s disheartening,” says Akins, the senior director of guidance and counseling for the McKinney, Texas, public schools. “There’s very little disagreement that parents want to send their child somewhere where they’re cared about and where they’re safe. But the initiatives and programs that help enhance those things are the very things that they are scared into thinking are harmful and terrible.”

One way to reduce these patterns, Akins says, is for school counselors to make transparency and communication with parents about programming a priority, as well as involving parents in the creation of programs as much as possible.

She suggests that school counselors focus on messaging that emphasizes common ground: We all want children to feel connected, to belong and to feel safe, she notes, so open communication about what a school is doing for student mental health — and why you’re doing it — can be helpful. “It’s just a matter of peeling back some of the layers of misinformation,” Akins says.

 

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

School counseling and COVID-19: ‘We can’t go back to normal’

By Bethany Bray December 22, 2021

Meeting students’ mental health needs in the midst of the COVID-19 pandemic has been and remains a moving target for school counselors, says Dodie Limberg, an associate professor of counselor education at the University of South Carolina. However, one thing has become clear: School counseling will never be the same.

“We can’t go back to normal. We shouldn’t go back to the way things were. We need to have our hand on the pulse of what’s needed and how our role addresses that,” says Limberg, an associate editor of the Professional School Counseling journal. “We started the [2021-22] school year in hopes that it would be better or ‘normal,’ but COVID is still occurring and school counselors are trying to adjust as it’s happening. … We are not in a place where we have clear solutions, and that’s a hard thing to come to terms with because we’re helpers.”

Although most school districts have returned to in-person instruction, the environment is not the same as before the pandemic. School counselors are still navigating the unknown in many ways, Limberg notes, such as the challenge of making students feel included when they are quarantined or taken out of class because they may have been exposed to the virus through travel or contact with a family member who has it. School routines and structure have returned in fits and starts for students this year; uncertainty remains an ongoing theme.

“We need to have some grace with ourselves and our students and meet them where they’re at,” says Limberg, an associate editor of Counseling and Values. “We’re still working with students — we have to be — and at the same time, figuring out ‘What does that look like now?’ I really admire how our field as a whole, all counselors, is coping with this. We’re trying what we can, doing what we can in our ability to help people. It’s a lot, and it’s not over.”

School counseling is one of Limberg’s areas of expertise. She, along with teams of researchers, recently conducted three different studies on COVID-19’s impact on school counselors and their work with students throughout the pandemic. The research — two national studies and one involving school counselors in South Carolina — also focused on school counselor burnout and the ways COVID-19 has heightened disparities among students and schools.

Limberg and her co-researchers heard many examples of how school counselors have gotten creative and proactive to support the mental health needs of students, particularly during the 2020-21 school year when many students were learning from home. In cases where families didn’t have internet access, school counselors contacted parents via text message, personally checked on students in the community or helped transform school buses into mobile Wi-Fi hotspots.

School counselors also wielded technology to support students, such as creating a “quiet room” in Google Classroom that students could visit virtually when they needed a break or a moment of calm.

Now, in year two of the pandemic, school counselors continue to meet challenge after challenge, says Limberg, a past president of the Southern Association for Counselor Education and Supervision.

“A school counselor’s role is ideally more preventative. But it’s shifted to become more reactive [during the pandemic],” Limberg says. “We’re functioning in a state of crisis and doing triage work, while still trying to do classroom guidance, running small groups and other school counseling tasks. We are helping [students’] needs on an individual level and struggling to do so [on a] comprehensive [level].”

The pandemic revealed just how much students get out of school besides academics, including social-emotional learning, regular meals and physical activity. It also highlighted the disparities among students, Limberg adds. For example, some parents found ways to augment remote learning  and non-academic aspects of school, whereas others couldn’t because they were working and maxed out themselves or because they couldn’t afford it.

The pandemic also illustrated the importance of mental health. Teachers and school administration turned to school counselors to draw on their much-needed expertise in fostering wellness and mental health, and they realized the pivotal and skilled role school counselors play in a school community. The downside, however, is that many school counselors are now constantly “on demand” by both school colleagues and parents, which has led to them being overworked and, in some cases, burned out.

“We’re just beginning to understand COVID’s impact and how it changes our roles,” Limberg says. “We’re still experiencing COVID-19 and haven’t even scratched the surface of what this will all lead to. How do we prepare and adjust our services while we’re still in the process of understanding what this is? But at same time, it’s hopeful that school counselors are being recognized as an important role for mental health in schools.”

The key to maintaining student mental health and wellness in school settings in the wake of COVID-19, Limberg stresses, is for school counselors and mental health counselors in the community to work together. Viewing all mental health professionals (including school counselors, mental health therapists, rehabilitation counselors, and marriage and family therapists) as all on the same team is an important part of this collaborative approach.

“We need to collaborate, community-wide. We need to not operate in silos. There’s so much need and not enough services,” she says. “Recognizing each other’s identities while working together is the way forward. … We’re all counselors, [so] how can we work together to help?”

 

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Contact Dodie Limberg at DLIMBERG@sc.edu

Find resources for school counselors at the American Counseling Association’s School Counselor Connection page: counseling.org/knowledge-center/school-counselor-connection

FamVeld/Shutterstock.com

 

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Bethany Bray is a senior writer for Counseling Today. Contact her at bbray@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.

Fostering healing and community through an art and wellness magazine

By Russ Curtis, Lisen Roberts and Merry Leigh Dameron September 29, 2021

As a nation, we have faced several grim statistics in the past few years. Suicide rates have increased more than 30% in half of the states in the U.S. since 1999, and the opioid crisis has become an epidemic. In addition, adverse childhood experiences will likely rise because of the increased isolation and lack of school support services during the COVID-19 pandemic. These statistics are further troubling considering that mental health and addiction issues often begin in adolescence and lead to long-term disability, failure to achieve one’s highest potential and premature death.

Thus, it’s paramount to reach young people using multivariate, systemic and effective outreach methods. Using social media and other online venues can be more effective in reaching larger audiences than using simple public awareness messages, and this method is particularly salient during times requiring social distancing. With grant funding from the Jackson County and North Carolina Arts Councils, the Western Carolina University (WCU) counseling program collaborated with local public schools throughout western North Carolina to create an online art and wellness magazine called Masterpeace. We invited K-12 students to submit art for consideration in this publication, which was designed to do the following:

  • Create an engaging online (and print) magazine that celebrates local student art
  • Build university-school partnerships
  • Collaborate with counseling graduate students to provide mental health and wellness education to children, adolescents, parents, teachers and counselors
  • Destigmatize mental health issues
  • Increase conversation among parents, students, faculty and community members about the importance of seeking help for mental health needs

Healing through art

Coupling art with wellness information is particularly advantageous because research indicates that creating and appreciating art is therapeutic. Creating art elicits similar brainwave activity to what is observed in people while meditating. Art therapy is effective in helping clients who have experienced domestic violence, trauma, depression, personality disorders and schizophrenia.

Artists are visionaries who follow their hearts, not crowds, and are regularly at the forefront of societal change. Often it is music, paintings, graffiti or murals that bring much-needed awareness of inequality and oppression to the public. The aim of this art and wellness magazine is to encourage and nurture students’ creative genius to inspire others to instill a more collaborative and just society.

Expanding the reach

An online magazine can be an effective tool because 95% of teens have access to a smartphone, 89% of them are online multiple times every day and 40% say they prefer to receive health information online versus face-to-face medical visits. In addition, accurate online health information decreases anxiety and depression and increases stress management, healthy relationships and academic achievement. Evidence suggests that online health education is particularly salient for stigmatized topics that adolescents would typically avoid in face-to-face settings.

The WCU counseling program tested the efficacy of including art with mental health information on the university’s social media platform. First, we placed suicide prevention information on the counseling program’s Facebook page. Then, the next day we included student art with the same suicide information post. Adding art to the post increased the reach of the suicide prevention message: 46 more views (168 total), 152 more engagement (165) and 11 more likes (17).

Strengthening university, school and agency relationships

Masterpeace magazine enhances our university, agency and school partnerships by providing an engaging way for students, parents, counselors and teachers to interact during a period of social isolation. The teachers have told us how much they appreciate having the online magazine to discuss with their students and inspire them to create art. For instance, a middle school counselor was working with a student who was new to the school and struggling to fit in. He suggested she join the art club, so she did. And one of her artworks was published in Masterpeace. The counselor said it significantly improved her attitude and school engagement. Another art teacher told us that one of her talented high school student’s intermittent depression was visibly improved after their art was published in the magazine, and the teacher also believed that this publication would increase the student’s chances of receiving college scholarships. It may sound cliché but helping even one student thrive is well worth this publication.

Excitement for the magazine was evident from the number of students and schools that participated. There was a 100% increase in the number of students and a 27% increase in the number of schools that contributed art between the 2020 and 2021 editions. To date, the first two issues of Masterpeace have been viewed over 4,700 times, a reach that is significantly more than faculty could have accomplished by speaking to schools and community groups.

We hope that collaborating with community schools and agencies will also increase their involvement in counseling student field placements, service-learning opportunities, internships, practicums and other partnerships.

Another benefit of this project is that it involves counseling graduate students using what they learn in classes about mental health wellness and prevention to provide salient information throughout the magazine. In turn, this project benefits both graduate and K-12 students because it encourages counseling graduate students, who will become future counselors, to apply course material so that K-12 students will understand and use it in their lives.

Honoring the foundation of the counseling profession

We believe this magazine has a broader and more nuanced purpose. The counseling profession was founded on prevention and wellness principles, and it has increasingly been a leader in the behavioral health field on diversity, social justice and equality issues. The beauty and originality of art are emblematic of the counseling profession’s desire to honor the truth and uniqueness of everyone and allow them to express themselves in their own way. Much like the vision and imagination it takes to generate art, we believe this magazine speaks to the ethos of the counseling profession by honoring the varied and meaningful ways we all contribute to the world, creating an ever-evolving and highly complex beautiful tapestry of humanity.

 

Enjoy flipping through the 2020 issue and the 2021 issue of Masterpeace, and follow us on Instagram @masterpeace.artmag.

“The New King of the Jungle” by Marina Mace, the cover art for the 2021 issue of Masterpeace magazine (published by Western Carolina University in collaboration with the Jackson County and North Carolina Arts Councils)

 

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Russ Curtis is a licensed clinical mental health counselor and a professor of counseling at Western Carolina University. Contact him at curtis@wcu.edu.

Lisen Roberts is the department head of human services and an associate professor of counseling at Western Carolina University, where she oversees 10 academic programs. She continues to be involved in school counseling, counseling ethics and social justice issues. Contact her at lroberts@wcu.edu.

Merry Leigh Dameron is a licensed school counselor and assistant professor of counseling at Western Carolina University. Her research interests include social justice in education, alternative education and school counselor cultural competence. Contact her at mdameron@wcu.edu.

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