Tag Archives: Counselor Education & Supervision

Counselor Education & Supervision

Document like a clinician: The ins and outs of documenting your training supervision

By Brian Carnahan and Margaret-Ann Adorjan January 17, 2017

Supervision is critical to the career development and advancement of many mental health professionals, including counselors, marriage and family therapists, and social workers. The boards responsible for licensure set standards regarding the number of hours, frequency and nature of the supervision necessary for licensure as an independent professional. Various professional organizations also set standards for other credentials and certifications. For example, the National Board for Certified Counselors requires national certified counselors to earn 100 hours of supervision and work as a counselor a minimum of 3,000 hours.

Given the centrality of supervision to the mental health professions, it is surprising how often it is treated casually. Clinicians who must document client files are often lax in how they treat the supervision they receive. One can understand why. Supervision can feel like a break from work, even though work is discussed. Unfortunately, supervision is not the time to relax.

It helps to understand the supervision requirements in the jurisdiction in which you are receiving supervision. Some jurisdictions have limited requirements for documentation, but most jurisdictions require some tracking of supervision. Although it should go without saying, it bears repeating: It is your responsibility as the professional receiving supervision to know what is required. Too often, the professional in supervision relies on more seasoned professionals for guidance. But rules and requirements can change, making it important for the professional seeking independent licensure to remain up to date, including verifying with the appropriate board what must be done to earn supervision hours.

Think about treating supervision sessions as you might a session with clients. In this situation, you are the person receiving a service — namely, supervision. Take notes, and follow up after the session with additional notes and thoughts. The notes and comments you retain will help to make clear that appropriate training supervision occurred. This can be particularly important if any questions arise regarding the type of supervision provided. Occasionally, the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board has to consider whether supervision should be classified as work supervision or training supervision. The details in the training log, along with the applicant’s explanations, can help answer those questions.

If a supervision form is required, use the form prescribed by the licensing board. If one is not available, create one that covers, at a minimum, the supervision date, the length of the session, name of the supervisor, topics discussed, required follow-up and similar entries. Consult your jurisdiction rules regarding supervision to make sure nothing is missed.

It can help to seek templates from supervisors or colleagues, but beware. Just because someone else is using a template does not mean that it is sufficient. Too many professionals have found themselves in trouble because they relied on the work of others instead of seeking guidance from their respective licensing board. Where supervision is concerned, it pays to confirm with the appropriate board what format, if any, is required.

Consider tracking work hours, particularly client contact hours. Also, be sure to confirm whether there are requirements to log separate direct client contact hours or “relational” hours. This distinction can be important depending on the license type or certification being sought, particularly if the supervision is earned by a marriage and family therapist. Documenting and retaining these hours can make a difference in obtaining a license in another state. Even if your jurisdiction does not have specific requirements for documenting supervision, you may wish to maintain it anyway, because other jurisdictions may require evidence of supervision when you apply for a license.

Some jurisdictions require persons seeking a supervision designation (such as Ohio for its licensed professional clinical counselor with training supervision designation) to complete supervision of supervision. Supervision of supervision is when a professional is supervised while providing training supervision. These sessions should also be carefully documented. Check with your licensing board to determine how (or whether) these hours can be used by each of the professionals involved because some jurisdictions limit who can claim the hours as supervision.

Retain an electronic version of all your supervision documentation. This log could be in a Word or Excel file, or you could regularly scan and save the written log to a file sharing service. A number of free and low-cost cloud storage solutions can help with this task. Your ability to use the supervision hours is only as good as your ability to document the fact that you completed the supervision.

Turn in supervision logs or evaluations as required. In Ohio, we recommend turning in evaluations at the end of the first year of supervision and the end of the second year, when the independent license is sought. We also recommend submitting evaluations whenever supervisors change. This helps to ensure that the supervision is documented fully. Although Ohio does not require submission of the logs, they must be available and up to date in case there are any questions about the supervision and the logs are requested to confirm any details.

Completing supervision requirements does not have to be stressful. By knowing the requirements, retaining good records and completing required documentation in a timely manner, a licensed professional can secure his or her independent license.





Brian Carnahan is executive director of the state of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact him at brian.carnahan@cswb.ohio.gov.


Margaret-Ann Adorjan is the marriage and family therapist licensure coordinator and investigative compliance officer for the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact her at margaretann.adorjan@cswb.ohio.gov.




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 graduate school decision: Four diverse student voices

By Essence Fiddemon, Nayo Tabron, Thomas Latson and Kimberly Cabral April 29, 2016

Choosing the right graduate school for counseling can be both a challenging and exhilarating experience. Applicants have many motivators to weigh when making this decision and often have Group of Graduatesmany choices concerning which school and program will best fit their needs. This article shares the stories of four students who recently chose to enter a master’s program in clinical mental health counseling. Additionally, each student provides tips for other individuals who are contemplating the decision to enter a graduate program in the mental health field.



Before entering graduate school, I found myself caught in a dilemma. I had just finished my bachelor’s in June 2015, and here I was in August 2015 not making enough money with a bachelor’s degree to independently support two children.

I always wanted to complete graduate school, but I was nervous and hesitant about the debt that it might cause. After much consideration, I decided to enter graduate school and view the debt in a different light. Either I was going to put myself in debt by struggling to care for my children, or I could put myself in debt because I invested in my education to get to a better situation financially.

I set my fears aside and began to research schools that interested me. I knew that in my future career, I wanted to have the knowledge, skills and training to counsel all individuals, not just children. I decided to complete a master’s in clinical mental health counseling because I wanted to counsel children, adolescents and adults with developmental trauma.

When choosing a graduate school and field, I knew that I had to choose a field that I liked because it would be hard to invest myself in a school or field that I did not care for. As my graduate school experience began, I felt nervous and anxious. I had to remind myself that nothing comes easy and that the rewards would be worth it in the end. I noticed the further I got into the program, the less scary the experience became. I was more scared of the title “master’s degree” than anything else. The moral of this story is to overcome fear, because fear kills so many dreams and aspirations.

Currently I am a full-time worker with two small children. The support system I have is amazing. Graduate school became more stressful toward the end of my first term, but it was still manageable. In the future, I hope to have my own practice, and I would like to be involved in consulting. I would like to counsel adults with developmental issues and children who have experienced sexual trauma and physical abuse.

Graduate school will challenge you and reward you. In graduate school, you will learn how to master your writing and time management skills. My first tip to readers is to stay totally invested in your education despite your doubts. My second tip as you struggle through graduate school is to remember that to whom much is given, much is required.



My first encounter with the counseling world happened when I was 8. My parents took me to see a counselor so that I could work through my confusion about their divorce, among other things. At 8, I was far more aware of the world than most, and I really didn’t care to spend my time in a counselor’s office once a week, especially because I felt belittled by my counselor. He spoke to me like an unaware child who couldn’t comprehend my emotions. The anger I felt toward my counselor turned into a sympathetic compassion for others like me — for others who felt like they weren’t being heard.

I turned this compassion into a career path and have aimed to change the system and those who work in it ever since. In my path, I have encountered terrible testimonials that made me weep for those who turned to the mental health and substance abuse care systems. They expressed to me that they too felt belittled. This has driven my passion even further and motivated me to continue my education beyond my undergraduate degree.

Deciding whether I wanted to go to graduate school was a long process. I had to consider if school was necessary to achieve the goals I wished to accomplish. I had to first make sure that the school I chose had an accredited degree program that would prepare me with the knowledge I need to pursue my goals. Finding a school that was CACREP accredited but also helps students obtain licensure was very important.

Currently I am pursuing my degree in clinical mental health counseling. I wanted a school that would build not only my fundamental knowledge but my professional knowledge as well. Not only is the school providing me with the basic knowledge I need to be a counselor, but it also provides me with opportunities to be experienced in the counseling field, which is a bonus. Having proper knowledge about the legalities of my career choice is very important in my pursuit to change the current systems.

I hope to open up more doors for people not only to get the help they need, but also to feel comfortable enough to do so. My future goals are to motivate counselors to take the time to listen to their clients and figure out what their problems are before diagnosing them for life.

Since being in graduate school, I have learned two things that I believe all those in pursuit of higher education should know. My first tip for those considering or starting the graduate program is to always use your resources. Making connections with the faculty around you and using the educational resources provided on campus are good ways for you to excel academically and to grow your network. Talking to people who have already achieved the professional or educational goals you are pursuing is a great way to learn the customs of pursuing professional and educational goals.

The second tip all potential graduate students should know is to develop time management skills. Depending on your school choice, the pace of the school may be more or less than you are accustomed to. This can cause you to become either overwhelmed or stagnant, either of which can have large effects on your grades. It’s important to schedule time to complete and comprehend your assignments while also providing yourself with downtime to prevent burning out.

So, the next time you consider whether graduate school is worth the effort, it is. Taking the time to advance yourself in life, in any facet, can open doors far beyond what you might imagine.



I was led to counseling in high school after taking an intro to psychology course. Learning about the mind and the way it works piqued my interest because I was coming to accept the fact that I was gay.

Children are very conscious, and as a child I came to the understanding rather quickly that being gay was not acceptable in society. I discovered that I was considered mentally ill until 1987, when the decision was made to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. I felt like a normal, conscious person, but society told me that my thoughts were not normal or conscious. I knew that something was wrong with this idea. When I made it to a bachelor’s program in psychology, I realized that I was not alone, and I wanted to help others like myself.

After graduating with my bachelor’s degree in psychology, I felt that I was equipped with the foundation I needed to start my journey, but I wasn’t qualified to provide help in the context I desired. I quickly realized that I would not be able to fully fulfill my purpose without an advanced degree. My reason for choosing a master’s in the clinical mental health counseling program was because I enjoyed the idea of sitting down and helping people work through their problems as a clinician, as opposed to the assessment and testing angle that a psychology master’s would provide.

I have always been ambitious, and the idea of continuing my education has always been a driving force in my life. I relocated from Florida to Georgia in 2009 for a job opportunity at a residential treatment facility, and I decided to continue my education. Of course, life doesn’t go exactly as we plan it out, and establishing a life for myself via full-time employment prevented me from starting school right away. But I knew the stars would align when it was my time.

It was a difficult decision because I had to continue working full time and needed flexibility. I was determined to make it work, and I was accepted into graduate school for my master’s in clinical mental health counseling in October 2015.

Currently, as a student in my first term, I am surprised at how much I am analyzing myself while learning the material. I realized that counselors must explore their own lives and personal experiences to effectively help others understand their experiences. Realizing things about myself and how I fit into the spectrum of life gave me a sense of purpose and opened my eyes to the importance of helping others realize their purpose. The curriculum in my Foundations of Mental Health Counseling course definitely helped me solidify and understand my professional identity and equipped me with a wealth of knowledge about myself.

My future now gives me a sense of success and fulfillment. I’m looking forward to studying counseling theories because my goals involve implementing strength-based modalities to help gay, lesbian, bisexual, transgender and questioning at-risk youth achieve success.

My tips for those considering or starting a graduate program are to be ready to face yourself and any issues in your personal life, such as your sexuality, that may be barriers to your own success. Students should use the experience as a sense of self-therapy in an attempt to prepare to help others. Also, to ensure success, students should become comfortable with writing. I have always been a writer, and I love to express myself through words. With the help of the available resources for writing in graduate school, students should graduate as better writers than they were when they started.



My interest in the world of counseling embarked when I decided to leave a life and career in the music industry that was full of glitz and glamour. However, I strongly believed that I was choosing a path that felt much more rewarding. A path filled with light. A path that has purpose and endless possibilities to make a difference in the lives of other individuals who are in need of some guidance and encouragement.

My decision to enroll in the clinical mental health counseling program derived from the passion I have to help at-risk youth gain skills to overcome their struggles and obstacles. This passion came from the struggles I personally faced as an at-risk child. Fortunately, I was lucky to have two individuals who helped me learn the skills I needed to be able to succeed in life, and I was inspired to do the same for other at-risk youth.

My decision to enroll in the clinical mental health counseling program came close to three years after I had received my bachelor’s degree in psychology. My passion to succeed in life and help those individuals who need that extra push or guidance was far stronger than the doubt and obstacles I had about enrolling in graduate school. Additionally, I realized that with a bachelor’s degree in psychology, I was limited from being able to achieve my future goals. Furthering my education became almost impossible to ignore.

After doing extensive research on graduate schools, I came across one school that really stood out to me. The flexibility of the program’s schedule, the scholarly faculty and the fact that the program was CACREP accredited was very influential in my decision.

My current experience in my first class has come to an end and has proved to be very informative and motivational. This class is called Foundations of Mental Health Counseling and truly embodies the foundation of everything the clinical mental health counseling program consists of. In all honesty, I was extremely nervous when I first started this class because I had no idea what to expect. I also had reservations about how it was going to affect my personal and work life. Fortunately, now that I am at the end of the course, I can say that this class has helped calm my nerves and given me some insight on what to expect in future classes and in the counseling field in general.

My future goals consist of running my own practice; playing a major role in implementing a program inside school systems to either replace suspension or work hand in hand with suspension; and starting a nonprofit organization that empowers at-risk youth and troubled families while positively influencing school systems and communities worldwide. To some, it may seem as if I am biting off more than I can chew. However, in my eyes, if you truly want something in life, it is up to you and only you to make that dream turn into a reality.

My tips for those considering or starting a graduate program are to make sure you engage in self-care and to study smarter, not harder. Engaging in self-care can help you avoid burnout and keep a healthy balance between work, life and school. Some examples of self-care are working out, meditating and practicing mindfulness.

Learning how to study smarter and not harder is also very important to your success. Staying organized, using good time management, taking good notes and reviewing them consistently are all ways that you can study smarter and not harder. In the end, remembering why you entered the graduate program should be your biggest motivator.



The backgrounds, personal stories and inspirations behind counseling students’ decisions to attend graduate school are unique to each individual. Whether those experiences are as a mother, a former patient, someone accepting his sexual identity or just someone with natural talent, we all share a passion to learn about what it takes to help bring about the best in all of us.

Counseling students share a set of values that all people in helping careers possess, including empathy, passion and a nature of selflessness that ensures we are helping our clients reach their full potential. Future counseling students should know that this career is about more than personal gain or financial stability; it is about changing the world one client at a time.




The authors of this article were students in a Foundations of Clinical Mental Health Counseling course at Argosy University, Atlanta, taught by associate professor Allison L. Spargo. Tanisha Johnson, a doctoral student, served as a teaching assistant. Both Spargo and Johnson are members of the American Counseling Association.




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.

Singalong with Richard Watts: Teaching REBT through song

By Bethany Bray February 16, 2016

When Richard Watts’ counseling graduate students arrive to class for a unit on Albert Ellis and rational emotive behavior therapy (REBT), they’re in for something a little different.

Watts, a professor at Sam Houston State University in Huntsville, Texas, pulls out his guitar and sings songs he’s written to illustrate the irrational beliefs that Ellis in part developed REBT to combat.

Set to familiar tunes such as “Mary Had a Little Lamb” and “Oh Suzanna,” Watts’ song lyrics paint a picture of some of the self-sabotaging feelings and behaviors that REBT addresses, such as perfectionism, obsessive relationships, defeatism, victimhood and so on.

Ellis referred to such beliefs as “stinking thinking,” Watts says. REBT works to reverse negative, often paralyzing thoughts into rational beliefs, such as an acceptance that we are not perfect and that life won’t always go our way, but that is OK.

Through the years, Watts has written a slate of songs to highlight the self-defeating beliefs with which many people struggle. In most causes, the songs feature a good dose of humor. For example, the “Rejected Lover’s Refrain,” sung to the tune of “On Top of Old Smokey,” ends with the lines: “Oh

Richard Watts with his guitar.

Richard Watts with his guitar.

why did you leave me? What’s that all about? I guess that I’m worthless and you figured it out. I really deserve this, I know that it’s true. If I only could dear, why, I’d leave me too!”

Watts distributes the lyrics in class and encourages his students to sing along. He’s been singing about REBT in his classroom — as well as in group therapy settings and, occasionally, at professional conferences and events — for two decades.

“We sing the songs and they make us laugh, but many times humor also makes us think,” says Watts, a professor of counseling and director of Sam Houston State University’s Ph.D. program in counselor education. “[As] I’m teaching students, I’m trying to get them to think about their own irrational beliefs as well as their clients’.”

Watts is following in the tradition of Ellis, who wrote songs to illustrate irrational beliefs decades ago. Ellis led workshops every Friday night at his New York City institute for many years. Known for his big personality, wit and sometimes-irreverent style, Ellis would pull members of the audience on stage for live therapy sessions. He used the songs as a therapy tool, often encouraging the audience to sing along. In 1987, Ellis penned a chapter “The use of rational humorous songs in psychotherapy” in ‪William Fry and Waleed Salameh’s book ‪Handbook of Humor and Psychotherapy: Advances in the Clinical Use of Humor.

Watts decided to write songs of his own after discovering that today’s college students aren’t as familiar with many of the older tunes that Ellis’ songs are set to. At first, Watts says, his students are a little startled by seeing their professor in a new context — similar to seeing your teacher in the grocery store as a kid. But they soon warm up, he says, even laughing and singing along.

“I’m not [Eric] Clapton, but I can play pretty well,” Watts says with a chuckle. “I thought it’d be a clever way of introducing the material.”

When used in group therapy, especially in groups with men, the songs often get clients to open up, he says.

“Many times [in group settings], clients are reticent to share ideas that might be inhibiting their progress,” says Watts, a licensed professional counselor supervisor, American Counseling Association fellow and immediate past president of the North American Society for Adlerian Psychology. “But we’ll sing these songs, and I’ll see them laugh and whisper to their neighbor, ‘This is so me!’ … After they’ve sung and laughed together using those songs, they feel more at liberty to talk about and unpack the meaning that they saw in those songs for themselves.”

Similarly, the songs serve as an icebreaker in the classroom. They are also an effective, if nontraditional, way of helping students learn and remember Ellis’ points. The lessons stick with students much more so than if they were to simply read about the concepts in a textbook, Watts says.

In one case, a student who struggled with perfectionism printed out Watts’ song about the issue (the “Perfectionist’s Refrain”) and attached it to the visor of her car as a reminder. Other students have asked for recordings of the songs to use in sessions with their own clients.

“They sing about it, they laugh about it and then we talk about it,” he says. “It’s an application exercise. They’re not merely reading about the different [cognitive] distortions. In a sense, the songs are fun case studies. They learn to listen for the irrational belief theme underpinning [each] song. It sets them up for having an ear and an eye for the mistaken beliefs.”

After singing his songs, Watts urges students to start looking for irrational beliefs elsewhere, including in popular culture. Students are often surprised to discover how often irrational beliefs – from love lost to feelings of worthlessness – are embedded in their favorite music, he says.

Given Watts’ penchant for using clever lyrics as both a teaching and therapy tool, it perhaps comes as no surprise that he has a musical background. He came to the counseling profession after earning an undergraduate degree in music (choral conducting) and working as a church choir director. As an undergrad, he put himself through college by singing in piano bars.

Watts’ irrational belief songs proved so popular that some of his colleagues encouraged him to submit the songs for publication in the Texas Counseling Association’s academic journal. They were published in academic journals several times in the 1990s, including in the Journal of Humanistic Counseling.

Watts sent a copy of his song lyrics to Ellis prior to the influential psychotherapist’s death in 2007. Ellis responded with a letter, written on the letterhead of his Institute for Rational-Emotive Therapy, and said that Watts’ songs were “right on the ball and can be very useful.”





Richard Watts’ REBT song lyrics and recordings are available online at bit.ly/1PwpziW.

Contact Watts at rew003@shsu.edu





Albert Ellis

Albert Ellis

Interested in learning more about Albert Ellis and REBT? See “Getting to know (and love) Albert Ellis and his theory,” Allen Ivey’s recent Q+A with Ellis’ widow, Debbie Joffe Ellis, that appeared in Counseling Today.








Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org


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

Can you relate?

By Kevin Glenn October 22, 2015

I was given an assignment in a theories class during the last semester of my undergraduate studies. The assignment was to choose a counseling approach on the basis of agreeing with its theories and assumptions and then defend my rationale for using that approach in counseling. At the time, I was torn between Alfred Adler’s individual psychology and Aaron Beck’s cognitive therapy, ultimately choosing the latter.

I have remained in touch with the teacher who gave me that assignment and recently asked him which theorist or therapy his students write about most frequently. He told me that more students turn in papers on Adlerian psychotherapy “by far” than any other therapy. He went on to explain that Two-docs_brandingmost of his students can relate to Adler more than any other of the theorists to whom they are exposed (which is a limited number in most bachelor’s programs).

We both speculated about why so many students might write about Adler and then later become primarily cognitive behavior therapists once they get into practice. For example, I have seen this occurrence among interns at my current place of employment. My former teacher and I concluded that the high demand for evidence-based practice was likely the primary reason for this theoretical “migration,” with limited exposure to alternative therapeutic approaches being a secondary reason.

Evidence-based practices, eclecticism and integration

The rise of evidence-based practices has shifted demand in their favor, while parity laws have turned demand into requirement. Most evidence-based practices come from cognitive- and behavior-based therapies.

Jonathan Shedler’s 2010 article, “The Efficacy of Psychodynamic Psychotherapy,” published in American Psychologist, offered techniques from psychodynamics that are evidence-based. In his 2005 article, “Positive Psychology Progress: Empirical Validation of Interventions,” also published in American Psychologist, Martin Seligman and colleagues reported on the effectiveness of relationships in psychotherapy through his humanistic approach, positive psychology.

But many other approaches favorable to counselors still lack this evidence-based foundation. So what are counselors to do when the theoretical assumptions with which they agree from a specific therapeutic approach cannot meet the demands of evidence-based practice?

The most common solution is eclecticism and integration. These words are sometimes used to describe different approaches, but they are also used interchangeably in many circles, scholarly or otherwise, to describe essentially the same process: combining bits and pieces of various theories and techniques based on the risks and needs of each client. Although this approach has shown promise, authors such as Brent Slife, Frank Richardson, Robert Fancher, John Norcross, Larry Beutler and Arnold Lazarus, to name only a few, have pinpointed a series of difficulties yet to be overcome in the eclectic/integrative movement. There are several obstacles, but the two most common are the lack of a guiding theory to direct and inform interventions and, on the other end, too much theory to be practical.

A manageable alternative

A viable alternative for bridging the gaps between various theories and evidence-based practices comes from a phenomenological theory known as ontological hermeneutics, which is an interpretive approach that seeks to understand what it means to be a human and to have experiences. It emerged as a viable theory long before Sigmund Freud conducted his first psychoanalytic session. As context, ontological hermeneutics was in its germinal stages before the first shots on Fort Sumter were fired to open up the Civil War. Since then, many psychotherapists, as far back as the revered philosopher and psychologist William James, have utilized elements of this theory in their practice.

But what does a 160-plus-year-old theory have to offer counselors operating under the banner of evidence-based practice in the 21st century? In a single statement: a comprehensive yet manageable theory of human nature that is advantageous to therapist conceptualization and intervention.

Unlike many mainstream psychotherapeutic approaches that maintain an individual perspective when working with clients, ontological hermeneutics conceptualizes from a relational perspective. Relationships present endless possibilities for relating to others (e.g., nonchalantly, compassionately, sarcastically) and being in the world (e.g., happy, depressed, engaged, aloof). This informs therapists that clients’ psychological ills are not occurring solely within, or because of, the individual. Rather, they emerge from clients’ relationships with, and patterns of relating to, others. In other words, a client may not be depressed because of faulty information processing and distorted thinking, but rather because the client has developed various patterns of relating to others that are not conducive to healthy relationships, therefore affecting the client in adverse ways.

The difference here, according to ontological hermeneutics, is that the client did not develop these maladaptive patterns of relating on his or her own, or as the sole result of internal cognitive or affective processes. These patterns were cocreated simultaneously by the client and the other people with whom the client is in relationship. There are endless possibilities for relating to others, however, and choosing to relate to others differently can improve well-being. And because all parties equally coconstitute a relationship, its very nature begins to change as soon as one participant (i.e., the client) chooses a different possible pattern of relating. It follows, then, that the crux of what hermeneutic theory is saying is that relationships heal, especially ones characterized by compassion.

Although there is no research supporting the efficacy of ontological hermeneutics, there are anecdotal experiences from counselors who have seen therapeutic gains through its application with clients. I am one of those counselors. Additionally, Seligman’s famous study from 1995, “The Effectiveness of Psychotherapy,” determined that psychotherapy in general, regardless of modality, is very effective. With that said, counselors attracted to theories such as existentialism, Adlerian, Gordon Allport’s trait theory or ontological hermeneutics can still maintain an overall evidence-based therapeutic practice because of eclecticism/integration.

A theory by another name

The greatest strength of ontological hermeneutic theory is its conceptualization prowess without being too theoretically laden. Much of what draws counselors to Adlerian, existential, logotherapy, humanistic and client-centered approaches, and even to a certain degree cognitive- and behavior-based therapies, can be found within ontological hermeneutics. Its theoretically sound tenets of what causes and ameliorates human suffering make it ideally situated to serve as a grounding theory in an eclectic/integrative approach.

Using ontological hermeneutics as a guiding theory that informs counselors how to incorporate and utilize evidence-based interventions can become a very specific eclectic approach. Some of us hermeneuts have started referring to this kind of approach as relational and compassionate psychotherapy (RCP).

If someone asked me what RCP is, I would respond by saying: “It is an eclectic approach that uses a well-accepted, comprehensive theory of human nature to inform how I intervene with evidence-based interventions. It greatly resembles relational and dialogical counseling and is characterized by compassion and empathy. Additionally, it is a continuation of previous efforts to utilize hermeneutic theory in psychotherapy.”

Knowing that healing takes place within relationships characterized by compassion is what guides the counselor’s selection of interventions. For example, it is common for the clients I work with to believe that other people do not like them. Instead of challenging their cognitive distortion from an individual perspective, I probe for more information about the nature of their relationships. Typically, these clients and I discover together that they spend a far-too-significant amount of time talking about themselves in their conversations. This opens me up to challenge their cognitive distortion from a relational perspective.

In cases such as these, I challenge the clients to stop personalizing their conversations with others too much. I then encourage them to utilize the GIVE skill, an interpersonal skill from dialectical behavior therapy that helps clients improve relationships by showing interest in and validating others (GIVE stands for gentle, interested, validate and easy manner). The assumption is that by devoting some attention and interest to others, clients learn to be more compassionate, leading to improved relationships and, in turn, a healthy support system. This ultimately creates new possibilities for being in the world, which is what ameliorates symptoms.

A three-step intervention

Hermeneutic counseling, or what some of us are referring to as RCP, is a very simple process that many seasoned counselors will find familiar. In its most basic form, the process has three steps.

1) Focus on the interrelatedness between the counselor and the client.

2) Maintain an attitude of openness.

3) Find ways to offer suggestions and new possibilities for the client to heal.

Although extremely similar to our basic core counseling skills, there are some subtle differences that enhance RCP. When counselors focus on their interrelatedness with clients, they are focusing on their relationship and rapport. However, there are some variations. Mainstream approaches therapeutically utilize rapport as a foot in the door, or a hook, with the client when intervening. With RCP, that rapport is not a means to an end; it is the end in and of itself. It is meant to be meaningful to both the client and the counselor.

The rationale for this is that relationships characterized by compassion are the healing factor (what we refer to in the clinical literature as the curative factor) for human suffering. As the counselor models compassion, the client emulates that model in his or her own life. In turn, this will improve the client’s relationships with family members and friends, enhancing the client’s support system.

All counselors already maintain an attitude of openness to their clients. RCP tenets attempt to develop this notion further by taking it from a level of understanding and empathy to a level of meaning and mattering. In other words, a counselor following this three-step model allows what the client says to matter and even change what the counselor thinks and believes when it is appropriate.

For example, I recently worked with a client who believed that her peers at our day-school program were making fun of her. However, her teacher was not observing any bullying, and the client wouldn’t give me any specific examples. She simply alluded to the way her peers were looking at her while laughing.

Instead of resorting to reframing her cognitive distortions, I allowed what she was saying to matter to me and took it to be true. Although this may sound like distorted logic, RCP posits that the client’s perspective, and the meaning that the client draws from that perspective, is equally important to my own. By demonstrating that degree of humility and providing this client’s perspective equal say in her therapy, I sent the message that I trusted and validated her. In doing so, I also reinforced for her that therapy offered a safe environment to be who she truly is and to continue exploring her experiences so that the possibility for transformation would increase. About three weeks later, staff uncovered some notes my client had been passing over the course of a month and a half, the contents of which contained ample bullying from her classmates.

The step of uncovering ways to intervene and offering suggestions that might lead the client to heal also carries similarities to basic counseling skills. However, RCP has its own variations.

The biggest difference is that RCP counselors offer suggestions and interventions from a place of deeper humility. RCP counselors accept that the suggestions and interventions we offer may not work for particular clients. We also accept that our understanding of what is going on with the client may not be complete (unlike what mainstream conceptualizations may suggest).

When counselors following this three-step model offer suggestions, they understand that they are merely providing counsel, and they respect that the client may opt to disregard that counsel of legitimate accord, not necessarily because the client is resistant. In such cases, the RCP counselor reverts back to Steps 1 and 2 to continue dialoguing with the client until greater understanding of the issues can be achieved and a more applicable intervention realized.

Relationships heal

Counseling does not have to be a complicated, mechanized process that risks confusing clients and building the kind of resistance that shuts clients down. Instead, counseling can be very concrete, simple and compassionate. It is not necessary for counselors to subscribe to ontological hermeneutics and RCP to implement the three steps discussed above or the tenets that accompany them. Clients will appreciate any counselor, utilizing any therapy, who adheres to this model.

In a 2007 article, “Taking Relationships Seriously in Psychotherapy: Radical Relationality,” Brent Slife and Bradford Wiggins reminded us that there is “nothing radical about the notion that ‘relationships heal.’” Terms such as rapport and therapeutic alliance have been bedrock principles of the field for decades now. It only makes sense that a relational theory whose interventions are based on ideals such as relationships, compassion and healing would come to the forefront of the minds of counselors who agree with these notions of how to relate
to clients.




Kevin Glenn is a licensed clinical mental health counselor and a theoretical counselor. Contact him at klg65@gmx.com.

Letters to the editorct@counseling.org

Going beyond ‘no means no’

By Laurie Meyers August 25, 2015

Survivors and activists have sought for decades to shine a light on the issue of sexual assault on college campuses with everything from Take Back the Night events to No Means No education campaigns. A Columbia University student who graduated in May made national headlines when she spent her senior year carrying a mattress with her everywhere she went on campus to represent the dorm room bed where she alleges she was raped as a sophomore. The alleged perpetrator was NOallowed to remain on campus.

And yet the debate about how best to address sexual violence on campus rages on. For that matter, researchers can’t even seem to agree on how often sexual assault occurs on campus. On the one hand, the 2006 federally funded Campus Sexual Assault Study of more than 5,000 women and 1,000 men at two large (unnamed) universities found that 1 in 5 female college students had been sexually assaulted. However, a 2014 Department of Justice report based on the answers of 160,000 respondents in the National Crime Victimization Survey found that an estimated 0.6 percent of female college students had been sexually assaulted.

Experts have pointed out significant shortcomings in both surveys, but some recent data, gathered in the first quarter of the year and released in June, aligns with the 2006 study. These findings come from a joint Washington Post-Kaiser Family Foundation poll of more than 1,000 randomly selected recent college graduates. The poll defined sexual assault as five types of unwanted contact: forced touching of a sexual nature, oral sex, vaginal sexual intercourse, anal sex and sexual penetration with a finger or object. One in 5 of the female respondents reported having been sexually assaulted in college. Five percent of the poll’s male respondents also reported being sexually assaulted while in college.

Regardless of the numbers, few would argue that any sexual assault is one too many. Counselors who are on the front lines of prevention efforts on college campuses say that decreasing the number of sexual assaults can’t be accomplished simply by raising awareness but must also be accompanied by widespread behavioral and cultural change. That is a complex and daunting task, but the counselors we spoke to — who are engaged in research or are working with campus programs — believe that current campaigns to reduce sexual violence through education sessions, campuswide activities and, in some cases, even the theater, can bring about lasting change.

A holistic approach to prevention

For decades, prevention efforts failed to address all of the factors that contribute to sexual assault, instead placing the onus on individual women and what they should do to prevent being assaulted, says Laura Hensley Choate, an American Counseling Association member who researches and writes about women’s and girls’ issues. Until relatively recently, she adds, little thought was given to also addressing perpetrators or potential perpetrators in prevention efforts.

As researchers began focusing on college men’s attitudes and behaviors, it quickly became apparent that most of these men didn’t have a clear understanding of consent. In fact, many still believed that, in certain cases, women “were asking for it,” Choate says. Another significant finding also emerged. Although prevention efforts consisting of short-term education programs sometimes temporarily changed men’s attitudes, they did not change behavior. Any lasting change would need to involve long-term education.

ACA member Brittany Talley, coordinator of the Campus Violence Prevention Program (CVPP) at Southeast Missouri State University in Cape Girardeau, Missouri, agrees with that assessment. She has found that although many students — women included — have learned that “no means no,” they don’t really understand that a woman’s decision to consent to sex is completely independent of what she is wearing or whether she has slept with the person in the past.

In the presentations that Talley gives, she also emphasizes that a literal “no” isn’t the only way of communicating that a person doesn’t want to have sex. “We talk about what ‘no’ might [sometimes] sound like — ‘I don’t really feel like it’ or ‘I don’t really want to,’” she says.

Not surprisingly, alcohol is another huge component in many campus sexual assaults. “There is huge misunderstanding about alcohol use and consent. Some students don’t realize that if you are too drunk to drive, you are too drunk to consent [to sex],” says Talley, a provisionally licensed professional counselor.

Talley addresses these myths and misunderstandings in a talk that all freshmen and transfer students are required to attend when they arrive on campus. The 35-minute education session focuses on dating and sexual violence, including how prevalent it is, what constitutes violence, how to get help and how outsiders can help. Talley also hands out cards with a help number and information on what to do after a sexual assault.

In addition to giving presentations and workshops to classes and student groups, Talley has coordinated a number of highly visible awareness events on campus. Part of the goal in these campaigns is to help engage bystanders because she believes that they play a crucial role in preventing sexual assault and violence. For instance, she says, if students at a party or bar notice that someone is being plied with drink after drink, they should step in or get help.

This past fall, the CVPP participated in RAINN (Rape, Abuse and Incest National Network) Day, an annual event devoted to sexual assault education. Most vividly, umbrellas are designed and displayed by participants to draw attention to the issue of sexual assault. The umbrellas can be decorated in any manner the participants wish but must include at least one mention of RAINN somewhere in the design. In addition to making its own umbrella, the CVPP invited various student organizations to submit umbrellas. This was done not only to raise awareness but also in hopes of getting more student organization members involved in prevention efforts, Talley says. On RAINN Day, 20 student organizations displayed umbrellas. Some organizations used serious themes, while others designed their umbrellas as emblems of support. For instance, the group made up of criminal justice students designed an inside-out umbrella because sexual assault turns a person’s life inside out, Talley notes.

The CVPP has coordinated other efforts as well, including the clothesline project, in which T-shirts bearing the stories of survivors of sexual assault were hung up on a clothesline on campus, and “Sexy Time Talk,” in which students lead discussions that focus on the characteristics of healthy and unhealthy relationships.

Only time will tell whether activities such as these will have a significant effect on the sexual assault rate on campus, Talley says. In the meantime, students and staff are reaching out to assist survivors who want help but haven’t been able to take that step, she says.

“One of the most common ways I hear of a case is through other students or a staff member,” she says. “They may ask me to reach out to a particular student, or professors might walk students over or have me come to their offices.” CVPP is part of the university’s counseling and disability services, and in addition to her prevention efforts, Talley counsels survivors of sexual assault.

ACA member Jennifer Sharp oversaw a sexual violence peer education program known as PHREE (Peers Helping Reaffirm, Educate and Empower) at Penn State from 2009 to 2012. “PHREE members worked with the [university’s] Center for Women Students to develop a variety of events designed to support survivors of sexual and relationship violence, provide accurate information about violence and raise awareness,” says Sharp, a national certified counselor (NCC).

PHREE coordinates educational presentations at residence halls and sororities on topics such as dating violence, healthy relationships, sexual assault and consent. It also uses creative, often performance-based events to raise awareness. During Sharp’s time, PHREE members engaged in the university’s participatory theater project, Cultural Conversations, which focuses on social justice issues. PHREE’s performance was on body language. Various participants acted out representative scenarios, and then audience members and performers engaged in a discussion of the issues.

During Sharp’s tenure, PHREE also planned and assisted with activities for sexual assault awareness months that included “survivor speakouts” and poetry/spoken word events that emphasized themes of sexual assault and survival.

Sharp is now an assistant professor of counseling at Northern Kentucky University, where she helped secure a grant to fund the Norse Violence Prevention Project. “The grant essentially provides funding to coordinate and strengthen existing resources for survivors of sexual assault, relationship violence and stalking,” she says.

Sharp is also implementing the Norse Violence Prevention Peer Educator program, which is based in part on the knowledge she gained while working with PHREE. Peer educators are currently being trained to advocate and offer support for survivors of trauma.

Providing services, support and a sense of safety to survivors

Even if the number of sexual assaults on college campuses is reduced significantly, there will always be survivors. Some of those who have experienced sexual violence will seek counseling to help them process and move beyond these devastating events.

Survivors who seek help immediately or shortly after the assault and those who seek help later face many of the same issues, but there are differences in their presenting issues and primary needs, says Sue Swift, a licensed professional counselor (LPC) at the Collins Center, a community center in Harrisonburg, Virginia, that provides mental health, crisis, medical, support and legal services to survivors of sexual assault and violence. The center also uses advocacy and education in its efforts to help end sexual violence in the community.

“When we work with survivors immediately after an assault, we have the primary goal of stabilization and re-establishing at least a basic sense of safety,” Swift says. Establishing safety is especially important in cases of campus sexual assault because the survivor may attend classes, socialize or even live with the person who committed the assault, note counselors who work at on-campus facilities.

When a survivor comes into the Maxine Platzer Lynn Women’s Center at the University of Virginia right after an assault, counselors first determine whether the student’s living situation and general physical environment are safe, says ACA member Charlotte Chapman, an LPC who serves as the director of counseling services at the center. It is also important to start establishing a sense of emotional safety by ensuring that the survivor has a support group or safety net in place.

“A lot of people will say, ‘I don’t want my parents to know,’” Chapman says. “We’d prefer that they use family as a source of support, but that’s not always what they want. … We talk to them about tapping into [support] resources on and off campus.”

Sometimes their best friends aren’t on campus with them, especially if the survivor is a first-year student and hasn’t yet formed strong social bonds, Chapman notes. In such cases, counselors at the women’s center will talk to the student about how to access her or his network of friends through methods such as Skype.

Survivors of sexual assault need help to feel safe because of the range of frightening emotions they are experiencing, Swift points out. “Often, survivors at this stage [immediately or shortly after an assault] are feeling overwhelmed, vulnerable and fearful,” she says. “Counseling can help [survivors] sort through and reduce anxieties [and] develop plans for getting support and taking tiny steps forward.”

“With these acute clients, we might spend a good amount of time normalizing their reactions and feelings but also helping them with grounding techniques and coping skills to deal with the anxiety and stress they are probably feeling,” Swift continues.

Counselors at the Collins Center may also help survivors of sexual assault access resources such as law enforcement, medical assistance and campus services (when appropriate) if they haven’t already done so, she says.

On the other hand, Swift says, survivors who come in for counseling years after an assault are in various stages of distress or healing. Some survivors may seek counseling after a triggering event, while others arrive ready to talk after years of burying their feelings, she says. Regardless of the circumstances that bring them in, these survivors have all had time to tell themselves a “story” about their assault — a story that may include distortions and inaccuracies, Swift says.

“Survivors often blame themselves in some way for what happened or feel badly about themselves,” she explains. “They may feel the assault defines them. Their self-esteem and relationships may suffer.”

It is important for counselors to understand that survivors often have a deep sense of shame. They feel as if the assault was their fault or that they could have prevented it, even when they know intellectually that this isn’t true, say Swift and her colleagues at the Collins Center.

Counselors can be effective at helping survivors of sexual assault work through these feelings, Swift says. She and her colleagues at the Collins Center have found that a supportive approach that allows survivors to set the pace works best. Typically, Swift and her fellow counselors begin by helping these clients to develop coping skills and providing them with psychoeducation about trauma. Most survivors will need help correcting cognitive distortions about themselves and their assault, such as blaming themselves, Swift says. These clients may also benefit from grief work to help them mourn the losses they’ve experienced as a result of the assault, she continues.

“Support groups can also be very healing,” Swift asserts. “Being together in a group, even informally, with others who understand your pain is transformative for many.”

If a client cannot find a support group that offers a good fit, bibliotherapy involving the stories of other survivors can be an extremely helpful alternative, she says. “Many survivors think they are ‘crazy’ until they hear their thoughts and feelings expressed by another survivor,” she adds.

Caution! On campus, confidentiality may not apply

This past January, a University of Oregon student who alleged that several members of the basketball team had raped her sued the university for mishandling her case. Although the players were eventually dismissed from the team and suspended from the school, the survivor alleged that the university had delayed its investigation to ensure the players could remain on the team for the remainder of the season.

As part of a counterclaim — which has since been dropped — the university requested that the campus counseling center release the student’s treatment records.

The incident served as a glaring reminder that counselors who work in campus mental health centers need to ensure that their clients understand that, in certain cases, their records and confidentiality may not be protected. The state of Oregon claimed that it had a right to the student’s records under the federal Family Educational Rights and Privacy Act (FERPA), which allows an educational institution to access student records to defend itself against lawsuits.

“FERPA covers educational records and only educational records. Treatment records for mental and physical health are specifically excluded,” says Perry Francis, who served as the chair of ACA’s Ethics Revision Task Force. However, he explains, the student’s lawsuit in this case specifically mentioned emotional distress, and in Oregon, the law says that if mental health is included as part of a lawsuit, defendants have the right to defend themselves with access to the records. This is an area in which counseling ethics and law collide, notes Francis, a professor of counseling and coordinator of the counseling clinic at Eastern Michigan University.

“Legally, short of a court order, we [the counseling clinic] are not going to release a student’s records,” he says. Counselors do have to follow the law, but before releasing anything, the counselor should discuss it with the student to make sure he or she understands, adds Francis, a past president of the American College Counseling Association (ACCA), a division of ACA. The counselor should also talk to the student’s attorney to discuss what the order specifies and how the counselor or counseling center might limit the information they release. It may be that not all of the records are germane, notes Francis, an LPC and NCC.

M.J. Raleigh, a past ACCA president and the director of counseling and psychological services at the University of North Carolina at Pembroke, confirms there are times when she and her staff have had to release information, but they take actions to limit it.

Anne Marie “Nancy” Wheeler, the risk management consultant for ACA’s Ethics Department, says a counselor who has been asked for a client’s file might be able to provide only a summary of the file rather than the entire file.

“If a counselor receives a subpoena, in many states, the counselor can see if a summary will suffice,” she says. “This is sometimes addressed by state statute, or sometimes the client or counselor can file a motion to quash or a motion for a protective order, which would lead to a court order from the judge. If there is an actual order from the judge, the scope of that order will determine whether a summary or the entire record can or must be released.”

So where does this leave survivors who come to college counseling centers? Raleigh and Francis emphasize the necessity of informed consent for all clients who seek services at a college or university counseling center at every stage of the counseling process, beginning with the intake form. Counselors need to make sure clients understand that there may be circumstances under which the center won’t be able to keep records confidential, they say.

Michelle Wade, an ethics specialist with the ACA Ethics Department, says that counselors who are compelled to release client information should work through an ethical decision-making model. This will help them look at all possible options and outcomes of releasing client information to determine the best course of action that causes the least amount of harm to the client.

“Professional counselors should be aware that they may be called upon to disclose confidential client information under a variety of circumstances, and legal requirements may dictate compliance with such requests,” says Erin Shifflett, director of the ACA Ethics Department. “However, it is imperative that counselors consider their ethical obligations as well. Prior to disclosing any information, counselors should develop a rationale for the disclosure which explores the ways in which the client may be impacted by the release of confidential information and ways to mitigate any potential risks.”




To contact the individuals interviewed for this article, email:



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

Letters to the editor: ct@counseling.org