Tag Archives: Professional Issues

Professional Issues

Voice of Experience: One quiet hour

By Gregory K. Moffatt September 24, 2018

Seven-year-old “Adam” (not his real name) concentrates on the project in front of him. He is coloring on a piece of paper on the floor in my therapy room, and I am sitting close beside him. Crayons litter the floor, and I can see him thinking carefully as he selects each color. He leans back against my arm like a baby bird snuggling beneath its mother’s wing. This simple behavior says, “I trust you,” and it is a very good sign.

As he bends forward to color, he exposes his neck beneath the curls of his hair. I can see the fading remnants of bruises in the shape of fingers. Similar bruises are visible on the exposed skin of his arms. I know there are still more bruises in places I can’t see. I also know that he would never lean back against his stepfather like he is doing with me. It wouldn’t be safe for him. The touches he has received at home have not been gentle ones.

Adam’s world is very small. He lives in a small trailer and attends a small elementary school. He doesn’t play sports, take piano lessons or engage in any other activities outside of his home. He has never had a party or been to a sleepover at a friend’s house. Chances are good that he never will.

Adam’s world is small, but it is also very crowded. Siblings, stepsiblings, mother, father, stepparents, teachers, social workers, counselors, doctors, lawyers, judges — these are the people who inhabit Adam’s world.

Adam looks forward to coming to see me each week. When his world and mine overlap, it is just the two of us. We play in the sandbox, draw pictures or play with puppets. I learn a lot about his world from the way he plays, his choices of toys and the emotion he puts into the activities of our sessions together. Sometimes he talks of yelling and hitting. Other times he tells stories of policemen and social services workers. Still other times, he just plays quietly.

There is little I can do to make Adam’s home life easier. The law has done little to protect him and, as well-intentioned as they have been, social agencies have in many ways made his life harder. He is a powerless child at the mercy of a world of adults who like to think they care. But in reality, they care more about their own interests and personal agendas than they do about children like Adam.

To most of the people in his life, Adam is just the troubled kid whom nobody would miss if he disappeared. He is a child who makes teaching harder. He is the disruptive child whom parents don’t want their kids playing with. They can’t understand him, and many of them don’t even try. Even his caseworker is too busy and too jaded to connect emotionally with Adam. I can only help him develop skills to cope in his crowded and noisy world. It breaks my heart, but I’ve seen it many times.

In some ways, Adam is an enigma to me. He giggles as he tells me about something funny his sister did at home. How does he find happiness in this life he lives?

It always surprises me how the things of the world that otherwise would be important to me seem to fade in their significance when I am working with a child such as Adam. No matter what is happening in my life, when I close my office door and I have this quiet hour with a client, I don’t think about politics, war, terrorism, money or even my family. I concentrate fully on Adam. I am his for one hour. He knows he is safe with me and that I will always honor and respect him, his thoughts and his dreams. He knows I will not betray his secrets or laugh at his fears.

When our time is up, Adam rises to leave. He doesn’t look back as he exits my office. One way he copes is by living from moment to moment, investing only in that moment — no future and no past.

People often wonder how I work with children such as Adam. “How can you sleep at night?” they ask, shaking their heads.

I can sleep because I know that even if it is only for one hour, I can make a child’s world a little more tolerable. I know I am helping create a better world for children like Adam because for one hour, they can know they are safe and secure and that I really do care about them. I have no hidden agenda.

I can sleep because working with children like Adam helps me to put life in perspective. It makes me a better father and a better human being. This is my calling, and I wouldn’t have it any other way. This is why I became a counselor.

 

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.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.

Behind the Book: Gatekeeping in the Mental Health Professions

By Bethany Bray September 17, 2018

The academic evaluation of graduate students in counseling education programs is straightforward: Their ability to master the material becomes apparent in grades assigned and credits earned.

“However, evaluating trainee competency in the domains of interpersonal behavior, intrapersonal functioning and professional conduct to determine readiness to practice is much more subjective,” write Alicia M. Homrich and Kathryn L. Henderson in the preface to their book Gatekeeping in the Mental Health Professions, published by the American Counseling Association.

Gatekeeping’s “ethical mandate speaks not only to protecting the clinical professions and the public from harm but also to providing trainees with transparent feedback regarding their competence and their likelihood of success as professional clinicians. During their time of struggle and challenge, effective feedback and remedial support from gatekeepers can offer trainees an opportunity, should they choose to accept it, to achieve success and develop into competent, ethical and professionally effective clinicians.”

An important issue that is sometimes avoided, gatekeeping is of growing interest in the counseling profession and an often-discussed topic at professional conferences, Homrich notes.

Homrich, a professor in the graduate studies in counseling program at Rollins College in Winter Park, Florida, and Henderson, an assistant professor in the Department of Counseling and Applied Behavioral Studies at the University of Saint Joseph in West Hartford, Connecticut, became friends through their mutual interest in the topic. Counseling Today sent the duo some questions to find out more.

 

Q+A: Gatekeeping in the Mental Health Professions

 

You are both counselor educators. How did you become confident and comfortable with the gatekeeping aspect of the job?

Alicia M. Homrich: I don’t think gatekeeping is ever easy or comfortable. Every step of working with a student who is struggling with intrapersonal issues, interpersonal behavior and/or professional conduct concerns needs to be handled delicately and respectfully.

There are criteria that have made the difference in the graduate program where I work: All faculty are in agreement about our ethical and legal obligation to gatekeep to protect future clients and the reputation of our profession. The second is the intentional formulation of strategies that include very clear standards for student behavior and published policies and procedures [which] students are informed of when they enter the program and throughout their enrollment. This ensures that remediation efforts are not a surprise, if they occur, and are intended to help get the student on the right track.

Other than these two important tactics, we work as a team to make decisions on how to go forward. Group consensus and support for each other increase our comfort level so no one faculty member or supervisor is acting alone. We do the same by educating our site supervisors.

Kathryn L. Henderson: Yes, never easy or comfortable. I find it so important and vital that it is a duty and not a choice. That’s what draws me to this topic. Especially when harm to a client is possible or there’s the concern a student might not be successful in the field after graduation. To me, that’s tantamount to lying by omission or false representation if we ignore serious concerns. It also does a great disservice to our students.

Consulting with colleagues and mentors has been central to the development of my gatekeeping abilities. I find not being alone and having support to be essential.

 

Do you believe that the counseling profession, as a whole, does a good job with gatekeeping?

AMH: I believe the counseling profession does more than our allied professions to educate and inform gatekeepers of their roles, remediation strategies, and ethical and legal mandates. However, in terms of actual implementation of gatekeeping strategies, a lot of variation exists across counseling education programs nationwide.

Some programs are diligent about their obligation to gatekeep — implementing policies, engaging in procedures and remediating or dismissing students or supervisees with personal or professional conduct [that is] inconsistent with profession standards. Other programs avoid the gatekeeping process altogether in order to retain students, avoid potential legal action or sidestep the uncomfortable emotional and time-consuming nature of the gatekeeping process.

Despite this range of engagement, the counseling profession is one of two clinical training tracts that consistently takes gatekeeping seriously. Psychologists have paid the most attention to the responsibility of gatekeeping, as evidenced by task force work and literature. Social work comes third in the lineup, and marriage and family therapy appears to be the least attentive of the clinical professions in examining this issue and providing strategies as measured by their professional literature.

Despite this variation, each profession acknowledges the need for a gatekeeping process in their ethics and standards. A continuum exists across professions that includes very conscientious educators and supervisors versus programs that don’t prioritize or are avoidant of the gatekeeping mandate described by their ethical codes.

 

What resources would you recommend for counselor educators or supervisors who aren’t comfortable with gatekeeping and having tough conversations with counselors-in-training?

AMH: Work with your colleagues to design and implement policies and procedures, and don’t go it alone, especially for serious conversations with trainees. Obtain support for decision-making and action-taking from your professional colleagues, including department chairs, deans and administrators, as well as human resources, some of whom you may have to educate about our ethics and licensure obligations. I have also increased my comfort level by going to workshops hosted by ACA and the Association for Counselor Education and Supervision (ACES), as well as reading every professional article I can find on the topic.

The goal of this book [Gatekeeping in the Mental Health Professions] has been to bring all of the knowledge and wisdom generated by the four allied mental health professions, along with strategies that work, together in one resource.

KLH: One thing that helps me when I’m struggling with gatekeeping is to reflect on my own personal process and try to hunt for the source of the discomfort. Is it fear of hurting the student or supervisee? Second-guessing myself? Fear of confrontation or conflict? I find that dealing with my own discomfort head-on helps me to process through it more effectively.

As for those tough conversations, I find empathy goes a long way. It does not mean agreeing with a trainee’s choices or actions, but it helps create a connection at times.

 

Are there any misconceptions on this topic — particularly, ones held by counselors — that you want to clear up?

KLH: One misconception, or perhaps a common fear, is that gatekeeping is always a negative experience — and it can be. However, I’ve had many constructive and positive outcomes from gatekeeping. Students sometimes will express gratitude in that no one has ever been that honest with them or they have not felt as if they mattered in the program but do now.

AMH: I agree with Kathryn. The assumption that engaging in gatekeeping is overwhelming and conflictual is inconsistent with my experience. There are plenty of supervisees and students, whether they are the individuals engaged in remediation or not, who are appreciative that there are standards that protect future clients and the reputation of the profession. They also witness experienced members of the profession engaging in the process of protecting current students and supervisees, vulnerable clients and the reputation of the profession for which they are training. They appreciate the action of supervisors and faculty in gatekeeping efforts and go on to value and fulfill this ethical mandate after graduation.

 

In the book’s preface, you write that evaluating a counselor trainee’s personal and professional conduct is subjective, not clearly defined, and “lacks common agreement within and across the mental health professions.” How can this be remedied, in your opinion? Or is it a concept that can’t be standardized?

AMH: I believe it is a concept that can be standardized, at least in the counseling profession. I would love to see ACES initiate a task force that identifies standards for interpersonal, intrapersonal and professional qualities critical for professional counselors and [then] publish a set of best practice standards or a procedural list for the gatekeeping process that is supported by the division and ACA. This would provide a steppingstone or source of support for counselor educators and supervisors.

I have conducted and published a few research projects on this topic in an effort to get the ball rolling. These studies and resulting lists of suggested standards and procedures are covered in the book.

KLH: Yes, I agree totally. The field of psychology has done much more work through the American Psychological Association and its official task forces than [has] the counseling field, which we discuss in the book. Research is emerging that is promising and could inform any potential professional association task forces.

I would love to see ACES or ACA initiate an effort as well to create best practice norms. A set of official best practice standards could also be a tool to advocate to university or agency administrators who may be wary of provoking unhappy students, similar to how the American School Counselor Association (ASCA) standards serve an important advocacy tool for school counselors.

 

What inspired you to collaborate and create this book?

KLH: Our main goal was to create a sort of one-stop shop for tools and resources on gatekeeping and remediation, which Alicia mentioned earlier. Instead of needing to do extensive research on the many aspects of gatekeeping, which can be overwhelming, the book serves as a thorough resource on how to implement gatekeeping.

We hope, in particular, that it serves as a catalyst for new supervisors and doctoral students to undertake this important ethical task. The opportunity for us to collaborate happened at first by chance: We only know each other through meeting at professional conferences. We both would present on the topic and then attend other presentations on the topic, so we got to know one another over the years. And then we became friends.

AMH: The development of our professional collaboration and resulting friendship has been based on our shared passion to improve our profession, demystify the gatekeeping process and encourage counselor educators and supervisors to engage in this vital professional responsibility. We wanted to provide information, strategies and skills that support the implementation of gatekeeping in training. Our friendship developed as we worked together to achieve these goals and came to know each other better.

 

Why do you feel the book is relevant and needed now?

KLH: The literature in the field has developed to a level where compiling the findings in the form of a book to encourage application of the information was logical. This is something that clinical educators and supervisors are actively trying to understand and implement.

For instance, the topic of gatekeeping is growing in popularity. It was scarcely on the map about a decade ago, and then it exploded and continues to be a common topic at conferences. Because of the many ethical and legal issues attached to gatekeeping, it is important that counselor educators and supervisors practice in an informed and progressive way, for the protection of the field and to strive in the best interests of our students and supervisees.

 

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Gatekeeping in the Mental Health Professions is available both in print and as an e-book from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-347-6647 ext. 222.

 

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Related reading from Counseling Today

 

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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.

 

 

Identifying colors to create a rainbow of cohesion in the workplace for helping professionals

By Jetaun Bailey and Bryan Gere September 7, 2018

The idea for this piece came about when I (Jetaun Bailey) was pursuing my master’s degree in counseling. I recall my professor stating clearly that burnout occurs often among helping professionals and that the average stay for a counselor employed at a mental health facility is two years.

As one of my assignments, I completed and presented a paper on ways for helping professionals to avoid burnout. However, not once in my presentation did I illustrate ways that the workplace could employ preventive services to combat burnout. At the time, my focus was on using self-care and, ultimately, I received a grade of 100 on that project. However, in reflecting on my counseling career, I realized that workplace training programs overlook helping professionals by not addressing topics related to the complex workplace dynamics that may contribute to burnout, which is likely to increase, because the demands in the counseling profession can be overwhelming.

According to Amanda Stemen’s 2014 article, “Burnout: Who’s taking care of the care takers?” management in the helping professions focuses more on clients than on employees. Many factors are related to burnout. Low salaries are one contributing factor but not the most significant. Many of us who enter the helping professions, counseling in particular, understand that we are not pursuing a lucrative career. However, lack of managerial support is believed to be a significant factor in burnout. This lack of support isn’t necessarily intentional; it is thought that many in management believe that helping professionals have innate abilities to solve their work-related problems. However, in many cases, counselors work in isolation, without support from management and peers, and know its effects.

Thus, management’s support is critical in reducing burnout among helping professionals. In speaking with Terra Griffin, a manager at an acute behavioral hospital unit for children and adolescents, she revealed that the turnover in the unit was among the highest in the hospital. Such high employee turnover costs organizations time and productivity. One of the staff’s chief complaints was management’s failure to provide them with relevant training to meet the demands of the job and promote workplace cohesion, which had led to many problems within the teams.

Stemen’s article suggested the need for professional development in addressing burnout. She reports that providing professional development opportunities customized to employees’ interests encourages growth that benefits both the individual employee and the organization.

 

Mind-mapping

One professional development approach is to employ mind-mapping concepts. This is accomplished by creating a specific topic or question so that each person in the training session can see other points of view rather than just his or her own. This nonintrusive approach facilitates group cohesion. Researcher Tony Buzan, the author of Use Your Head, developed the mind-mapping concept in the 1970s. It is designed to facilitate the sharing of ideas and concepts to solve problems.

Through observation, Griffin employed this concept in a series of training sessions simply by asking employees in a unit where turnover had been problematic a simple question: “What is your favorite color?” Initially, the employees did not seem eager to participate in the training session. Remarkably, however, when Griffin focused the initial session on that single question, changes in body language occurred among the staff immediately, as if thinking about their favorite colors had some sort of healing effect. Afterward, they were eager to share their favorite colors and the ways they identified with those colors personally.

Interestingly, although employees weren’t given information about the psychological meaning of each color ahead of time, they ended up describing them similarly to how they were presented on Griffin’s color chart. Furthermore, they could identify their similarities and differences in relation to their multiple colors. This helped shed light on some of the difficulties the employees faced in creating a more cohesive work environment.

Three therapeutic teams were present at each training session, each of which was composed of two therapists, one psychiatrist, several nurses and several behavioral specialists. During their self-exploration of the colors, Team 2 realized that many of its members shared the same favorite color, red, while the two therapists identified with blue. Incidentally, of the three groups, Team 2 was confronting the most difficulties. Many of the team members who identified with red were having difficulties sharing leadership responsibilities and were disregarding the leadership authority of the two therapists who identified, unconsciously, with blue. Once members of Team 2 were able to understand their difficulties, they began to discuss ways that their team could work more cohesively. As a result, Team 2 set team goals, with respecting one another identified as the top priority.

Instead of asking employees direct questions about their workplace problems, this exercise of looking at their favorite colors appeared to be a nonintrusive method that encouraged employees to share their differences. Griffin’s simple question elicited many answers with respect to therapeutic problems occurring in this workplace of helping professionals, and thus promoted resolutions to some stressful issues.

 

The psychology of color

Intrigued with the feedback from the staff during these sessions as they compared their favorite colors to their personalities with respect to their workplace relationships, we set forth to emulate this training. Ultimately, we implemented a similar version in a group of training sessions for graduate students who would be entering the helping profession as practicum and internship students. Their feedback and interactions were outstanding. We learned much about our students that we had not known, and this helped us revamp our practicum and internship training program for students and site supervisors.

As a result, we set out to explore how many nonintrusive, evidence-based training programs of this nature were available. We conducted a content analysis of evidence-based studies on the psychology of color. We also sought to determine the extent to which such training materials are designed to facilitate workplace cohesion among helping professionals.

Using the American Psychological Association (APA) database and electronic resources, we searched APA PsycNET, PsycINFO and PsycARTICLES from their inception through 2018. Furthermore, we used the Google Scholar search engine. The search phrases we used were “evidence-based practices on color psychology” and “training curriculum on color psychology.” The criterion for inclusion for review was that the title contained the search phrase; studies that did not meet the criterion were excluded.

After completing the content analysis, we could not find a single evidence-based study on color psychology or training curriculum related to the topic. We also were unable to determine the extent to which such training curricula facilitated workplace cohesion among helping professionals. There appears to be a significant gap in the literature pertaining to the actual use of color psychology in the facilitation of workplace cohesion in human services or among helping professionals. We did not find any specific evidence-based studies that provided empirical information on training materials on the subject that lead to workplace cohesion. The absence of this information reflects the extent to which the topic is largely unexplored and illustrates what little recognition it is accorded.

In “Colors and trust: The influence of user interface design on trust and reciprocity,” Florian Hawlitschek and colleagues indicate that the literature available on the psychology of color suggests that color preferences associated with personality influence interaction patterns in the employment setting. This illustrates that understanding the role that color preferences play in group behaviors and settings is critical to interprofessional collaborations, especially among helping professionals. Furthermore, other literature has suggested that colors have individual meanings based on a person’s cultural background or racial and ethnic group. Therefore, the influences of color should be interpreted with caution.

However, what made this training so unique is that Griffin did not use any assessment tools to determine anyone’s colors. Instead, she asked each person his or her favorite color and thus gave life to their individuality based on their cultural or racial and ethnic backgrounds without probing for any specific details (colors hold a universal meaning of harmony in many cultures). This mind-mapping technique seemed beneficial. Griffin’s leadership played an important role in helping the employees navigate through their favorite colors by connecting to their personalities and the way they fit within the scheme of their work productivity to create or disrupt cohesion.

 

Conclusion

As the dynamism within health and human service delivery creates more interdependencies, there is a growing need for professionals to collaborate to achieve better client outcomes. However, there is little information on the role that the characteristics of interdisciplinary teams play in promoting synergy that influences such outcomes.

Shared values, mutual respect for colleagues’ expertise, and patient-oriented goals and outcomes are reflections not only of the diverse interests and asymmetry of power of the various partners in care, but also differences in their personalities and preferences. Therefore, fostering workplace cooperation and cohesion is essential for effective, competent, cost-effective, culturally responsive and comprehensive service delivery.

Creating mind-mapping trainings designed to honor individual uniqueness, such as the identification of favorite colors, can help us achieve such cohesion. These trainings draw us into companionship where we can evaluate our similarities and differences through our individual uniqueness, thus creating a meaningful and purposeful work environment for helping professionals and the clients they serve.

 

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Jetaun Bailey is an assistant professor at Alabama A&M University, where she serves as director of clinical training. Contact Jetaun at jetaun.bailey@aamu.edu or baileyjetaun@hotmail.com.

 

Bryan Gere is an assistant professor at Alabama A&M University, where he serves as coordinator of clinical training in rehabilitation counseling. Contact Bryan at bryan.gere@aamu.edu.

 

Terra Griffin, a licensed professional counselor supervisor with more than 15 years of experience in counseling management, supervision and training, contributed to this article.

 

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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.

Graduate counseling students: What makes you different?

By Sarah Fichtner September 3, 2018

As a counselor master’s student approaching graduation in December, a few lessons have become ingrained in my mind: “Always advocate on behalf of your clients”; “engaging in self-care is essential”; and “practice in accordance with the ACA Code of Ethics.” At times, when I am lying in bed after a long day, I find myself reflecting on these tasks and whether I did my best to adhere to them.

Although these lessons are crucial for counselors-in-training, I wish one other lesson had been emphasized earlier in my graduate studies: the importance, essentiality and ultimate difference of putting yourself out there in the counseling world and making a name for yourself.

According to CACREP, there are more than 800 accredited counseling programs across the United States, which means that thousands of counselors will be graduating at the same time and applying for many of the same positions. As a novice counselor, I was naïve to this concept. When I entered my graduate program, I quickly began mirroring my peer’s habits. I focused on earning top grades, copying down important concepts in class, establishing my counseling skills through role-plays and researching internship sites. It was not until I attended the New Jersey Counseling Association conference at the end of my first year of graduate school that I realized just how important a young counselor’s identity is. From that moment on, my graduate mindset changed.

I started to go above and beyond to create my own unique “brand.” I found myself researching current trends in the counseling field, editing and re-editing my resume and cover letter, reading the most up-to-date articles and journals, and consulting with my professors about counseling-related opportunities that I could participate in outside of the classroom. I constantly asked myself, “What can I do to separate myself from every other counseling master’s student graduating from an accredited university? What makes my resume special? What makes me different?”

This pursuit to create my own personal brand eventually led me to the American Counseling Association (ACA) 2018 Conference & Exposition in Atlanta this past April. One of my professors at Kean University in New Jersey spoke to my multicultural counseling class about the ACA graduate student essay contest. She passed around a handout encouraging my class to submit a proposal. Immediately, I knew that this was the perfect opportunity to define my identity and get my name out into the counseling world. After writing and rewriting my proposal, I finally submitted my essay in December. Because the winners would receive complementary registration to the ACA Conference, I could hardly wait for the winning essays to be announced. Finally, on Feb. 28, I received an email asking for my attendance at the ACA National Awards Ceremony; my essay had been chosen as one of the top entries. I was one step closer to becoming a known face in the counseling world.

Upon arriving at the ACA Conference, I prepared myself to get the most out of my experience. I printed out my resume, picked out my best business attire, scheduled an appointment with the ACA Career Center and promised myself that I would speak to as many people as I could. I was a novice counselor who planned to leave the conference educated on the licensure process, the benefits of a doctorate in counselor education, employment trends, who to contact post-graduation regarding approved supervisors and any other helpful information I could soak up.

Having this goal-oriented mindset opened my eyes to the true kindness and genuineness of the counseling community. Within minutes of entering the conference center in Atlanta, my wildest dreams were exceeded. I was engaging in impromptu, inspirational meetings with fellow master’s students, doctoral candidates, counselor educators and authors. I soon learned that the counseling community is a tightknit group of exceptionally talented and personable individuals. During my four days in Atlanta, the connections I made completely changed my personal and professional life.

There are so many people that made my experience worthwhile, but for the sake of time and space, I will mention just a few. Dedicated representatives from Magnolia Ranch, a rehab facility in Tennessee, engaged in personal conversation with me on multiple occasions. I must have stopped by their expo table at least twice per day, and each time they were just as eager to ask about my professional journey, share their insights on the counseling profession, talk about their contributions to mental health and, of course, answer all my questions about their therapy horses. (I, as a horse owner, could talk about equine-therapy for days.)

Gerald Corey, Michelle Muratori, Jude Austin and Julius Austin, co-authors of the book Counselor Self-Care (published by ACA), each connected with me on a personal level. After attending their presentation on self-care, I was determined to purchase a copy of their new book and get it signed. However, with more than 100 people in attendance at their presentation, I overestimated my chances of purchasing a book. It had quickly sold out. As a Type-A individual, self-care was something I had consistently failed at, and I knew this book would assist me in my quest to accomplish a better self-care plan. Thus, I made it my mission to find a copy of their book.

After stopping by the ACA Bookstore at the conference on multiple occasions, speaking with the authors directly and bargaining with the conference staff to sell me the copy in the display window, I started to feel defeated. It was in that moment that I decided to approach the authors one last time and express my appreciation and gratitude for their work (book or not, the information I had gained from their presentation was priceless). Surprisingly, they thanked me for my kind words, interest in their self-care book, and perseverance and commitment as a counselor-in-training. Then Michelle Muratori dug into her purse and handed me her own personal copy of Counselor Self-Care while all the authors smiled.

I spent the next few minutes chatting with her. We discussed her career as a counselor educator and clinician at Johns Hopkins University. She provided me with such valuable insight, motivation and hope for my future as a professional counselor. Additionally, prior to the book signing, I had the privilege of speaking with Julius Austin. We connected on our similar experiences of being Division I college soccer players and the transition into the counseling profession. He empathized with and understood the many emotions I went through as I left the collegiate world behind.

Finally, during one of the keynote speaker presentations, I sat next to Ed Jacobs. I introduced myself and expressed interest in his role as a program director (at the moment, I didn’t know he was a renowned author and educator in the field of counseling and that he had written the group counseling book used in my graduate program). Our conversation flowed as we talked about his position at West Virginia University, my current clinical work with children and my hopes and dreams for the future. Before we parted ways, he encouraged me to attend his group counseling session, where he would be presenting on group counseling techniques to use with children and adolescents. I made it a point to attend his workshop, and I am so happy that I did.

After the session, I went up to him to thank him for taking the time to speak with me earlier in the day. He smiled and said, “You came.” Then he reached into his bag and pulled out a copy of the book he wrote on individual counseling techniques. He handed it to me and said, “I’m really happy you came and hope we stay in touch.” I was so humbled and touched by his kindness and generosity. I, too, hope our paths will cross again.

When I returned home to New Jersey, I was filled with gratitude, warmth and excitement for my future profession. The conference was more than I could have ever imagined. However, I know that my pursuit to establish a unique identity is an evolving journey. I need to build on the connections I have made. I have reached out to Drs. Muratori, Austin and Jacobs and have been overwhelmed with the thoughtful and efficient responses I have received.

For example, Dr. Jacobs stated that one of his greatest joys is mentoring students and that he would be more than willing to guide me in my journey as a novice counselor. Within days, he had connected me with a counselor educator here in New Jersey; my name was quickly spreading throughout the counseling world. My resume was being reviewed by many professionals, my email inbox was filling up with new messages, and my identity as a counselor-in-training was far greater than that of a master’s student graduating from a CACREP-accredited program. There was a face to my name.

Although this idea of networking may seem like common sense, I cannot tell you how many master’s students leave their graduate programs unsure of what to do next. It is not that they failed to study hard, earn good grades and succeed in their clinical settings, but rather that their identity as novice counselors mirrors that of every other newly graduated student.

So, to all my fellow counseling graduate students, if there is one thing I hope you take away from this article, it is this: Go the extra mile; get involved in as many activities and events as you can; submit journal proposals; do not be afraid to introduce yourself and network with as many professionals as you can; and, lastly, create your own unique brand. Be bold. Be brave.

Understanding this concept early on will only help you in the long run. With the complex social challenges faced by the nation and the world, becoming the best counselor one can be is imperative. By celebrating our uniqueness and crafting our professional brand, we will be best positioned to solve the mental health problems and other social ills that we all face.

 

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Sarah Fichtner is a former Division 1 women’s soccer player for the University of Maryland. She is completing her master’s degree in clinical mental health counseling at Kean University in New Jersey and currently works at Hackensack Meridian Behavioral Health as a counselor intern, where she practices from a strengths-based model. Contact her at fichtnes@kean.edu.

 

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  • American Counseling Association members: Advance your career with the resources you need in where you can find hundreds of job listings, complimentary career consultations and other helpful career information and services created specifically for counselors.
  • Find out more about ACA’s 2019 Conference & Expo in New Orleans at counseling.org/conference

 

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

 

The hurting counselor

By Gregory K. Moffatt August 13, 2018

It was like someone was sitting on my chest. From the moment I awoke each day, I could barely breathe, and throughout the day, I teetered on the verge of tears. My wife and I had separated, and I thought my 20-year marriage was about to end. My heart was in shreds and, especially because I am a counselor, I was humiliated that I was failing in my marriage. I felt like a fraud in front of my students, and as I struggled through lectures, the words and ideas that left my lips — the ones that normally were energizing to me — now seemed hollow and pointless.

I also struggled to get through my clinical appointments. As one married couple talked about their own pains, resentments and disappointments, I felt so incompetent that it was all I could do not to send them out the door. My worldview — everything I thought I believed in — had been shattered.

And, of course, I also had to face my children, explain things to my extended family and tell my close friends about my troubles. One of the most painful things ever said to me was delivered by one of those people at the time, like a spear thrust into my chest: “You might be a good counselor, but you sure don’t know how to practice it at home.”

It was an impulsive statement not intended to wound me, but those words sealed my burgeoning perception that not only had my marriage failed, but the successful person I thought I had become was merely an illusion. Many times I had talked to others about how failing didn’t make them a failure, but I couldn’t apply those words to myself. I believed I was indeed a failure. Nothing had prepared me for the crippling effects of such a personal crisis on my professional sense of competence, my worldview and my sense of self.

Those days are long behind me now, but the devastating feeling of that painful period was brought back to me recently as I worked with a colleague in the midst of a similar experience. Even now, after many years of healing, that wound is still tender in my heart, and as my colleague talked to me, tears pooling in his eyes, I knew there was little I could say to ease his pain. I recognized that fractured sense of competence in his face. It was the same one that looked back at me from the mirror all those years ago.

Children or no children, short marriage or long, amicable divorce or contentious, splitting up is always painful. I loved my family, and I was willing to do anything to salvage my marriage. In retrospect, that difficult time was one of the best things that could have happened to me. It helped me become a better person, and it helped my wife and me to heal some very deep hurts and disappointments and to begin nurturing a much healthier and happier relationship — one that thrives like wildflowers today. But that experience also taught me that the pain of personal crisis, whatever the cause, can be debilitating to a counselor.

A hard fall

As a professor, writer and clinician, I had always prided myself on practicing the things I taught. Looking back on those years, maybe I succeeded much of the time, but I failed more than I realized. I suppose counselors require a sense of competence, maybe even bordering on arrogance, to take the risks we take each day. After all, we are diagnosing and treating based on a professional judgment call, and if we didn’t have confidence in our abilities, we probably wouldn’t be very good at what we do. We might otherwise stand on the riverbank, foundering in indecision, never daring to venture across.

But that confidence and self-assurance may also blind us and make our fall much harder. As is also true for politicians and religious leaders, people expect more of counselors than perhaps they should. We are, after all, human. But a personal crisis, regardless of whether it is one of our own making, is not just our own. Our pain, embarrassment and shame are inevitably known to many and reflect, however unfairly, on our professionalism. That adds to the weight of our sorrows.

The self-care paradox

There is no shortage of books and articles on self-care for therapists. A quick search in an academic database yielded almost 1,000 articles on the topic. We talk a lot about self-care in our field, but I know that I didn’t practice it well. I suspect I am not alone — and this isn’t a new problem.

My professors and internship supervisors talked about the importance of self-care when I was a graduate student in the 1980s. In 2000, Theresa O’Halloran and Jeremy Linton noted that “wellness is a concept that we as counselors often focus on more readily for our clients than ourselves.” Then, almost 20 years after that, Denis’ A. Thomas and Melanie H. Morris (2017) wrote, “Although most counselors have knowledge about self-care and convey the importance to others, the same knowledge may not translate into self-care action — often when it is needed most.” Apparently, as a group, we practitioners haven’t learned much about the application of self-care in our own lives over the past few decades.

This is such a bizarre paradox. Counselors, of all people, should know better. We are trained to take care of ourselves, and we emphasize the importance of self-care to our clients. Yet my self-confidence in those days caused me to naively believe that crisis wouldn’t knock on my door. I think in some ways, when counselors talk about self-care, it is more of an academic conversation than a real one. It may be something like the fact that we all know we are going to die someday, but it isn’t real to us until we stare it square in the face.

Divorce, death of a loved one, loss of a job and chronic mental health issues strike counselors’ homes and lives just as they do the rest of the population, and these issues are potentially just as damaging to us as they are to those who are not in the field of mental health.

I couldn’t have prevented the pain of my own crisis, but there are many things I could have done differently to prepare myself for it. My self-care habits back then were weak at best. I’d like to offer some suggestions that can help counselors navigate the sweeping effects of personal tragedy.

Find a counselor before you need one

Unfortunately for me, when the reality of my fractured marriage came calling, I didn’t already have a personal therapist. I had seen one in the past, but I hadn’t had an appointment with him in years, so long that I couldn’t even remember his name.

I should have known better. All of us learn in graduate school that we need to manage our own issues if we want to be effective therapists, and I had been through both individual and group counseling as a part of my graduate work. I thought I had done enough. I reasoned that I had worked through past issues and found a place for my own life’s traumas. Maybe I thought I had “arrived,” but I was kidding myself. Managing the past helped to some degree but not with maintaining my ongoing mental health. Consequently, I wasn’t growing either.

It is easy to rationalize that the cost of regular therapy — both in time and money — doesn’t make sense. We work hard as counselors, and for every hour we spend in our own therapy, we are also losing money because we aren’t seeing clients. But that is false economy. Even if we are managing life fairly well, it still helps to get a checkup. I get a physical every year even though I’m fine; I go to the dentist twice a year even though I don’t have cavities; and I go to the eye doctor each year even though my eyesight is OK. I should have applied the same philosophy to my mental health, getting a mental health checkup every few months at minimum.

So, there I was, in crisis and in need of a therapist, and I had absolutely no idea who to turn to. Plus, I had another serious dilemma that is common among counselors. Almost everyone I knew and trusted in the field couldn’t ethically see me as a client. They were friends, colleagues, former students or former supervisees. I’d consulted with them, taught them or socialized with them. Now I had to find a therapist in the midst of my crisis, and I was left with the phone book — something I always tell people to avoid.

If I had been maintaining an ongoing relationship with a therapist already, this part of my crisis management would have been simple. For that matter, it’s very likely that at least some of the crisis itself might have been avoided. I’ll never find myself in that place again.

Exercise, eat right and rest

Good mental health requires us to eat right, sleep right and get reasonable exercise. I call it “Moffatt’s Mantra,” something my students, interns, supervisees and clients undoubtedly get tired of hearing.

Even before my crisis, I slept poorly, sometimes getting only an hour or two of sleep a night. This went on for years, and just as I apparently had been doing with my personal life issues, I chose to ignore my sleep issues. Oddly, my sleep problems allowed me to be exceptionally productive. Getting to my office sometimes at 1:30 or 2 a.m., I wrote prolifically, publishing many books and articles as a result. But then, in the midst of crisis when I desperately needed rest, even the little sleep I ordinarily might have gotten evaporated. I was preoccupied with shame, regrets and hopes, and sleep was nearly impossible. I made an appointment with my prescriber and began taking regular sleep aids, which was critical to my healing. Almost immediately, a reasonable night’s rest helped my mood improve.

Likewise, in those days, I rarely ate breakfast and often skipped lunch, only to overeat at the meals I did have. Fortunately, I have never been one to eat junk food, but my Southern diet was full of fried foods, fats and carbs. When crisis hit, I couldn’t eat at all. My stomach was upset, and I had a hard time downing even a few bites. Over just a few weeks, I lost more than 20 pounds. Just as was true with my sleep patterns, crisis magnified my poor eating habits. A good friend forced me to eat, often sitting with me during meals — including some that he made himself — to ensure I was getting at least some nutrition.

Of the three areas that constitute Moffatt’s Mantra, exercise was the only one that came easy to me. I have always been good about getting some type of daily exercise — running, biking, swimming or even all three in one day. This is the only thing that helped me offset the fatty, fried-food diet that was my routine and prevented me from gaining unhealthy weight.

Exercise has myriad benefits. Aside from building endurance, muscle tone and a stronger heart, it also improves quality of sleep and mood in general. Research has demonstrated that attention to healthy, reasonable exercise can either lessen the demand for medication or remove its necessity altogether, even with serious issues such as chronic depression. Exercise produces morphine-like endorphins that help to balance our moods. Even moderate exercise just two or three days a week can help manage weight and increase metabolism. Seeing a thinner self in the mirror can also improve mood.

“I’m too busy to exercise” is a very weak excuse. I was very glad that I didn’t have to add exercise to my life during the crisis because I doubt I would have possessed the motivation to work out and try to get in shape.

Supervision

Most counselors engage in supervision until a license or related credential is achieved, but after that, they rarely pursue any form of formal supervision. I think that is a mistake. As a supervisor myself, I have to recognize when a supervisee’s personal life issues, whatever they may be, are interfering with clinical practice without crossing the line and functioning as my supervisee’s therapist.

It would have been wise to have a second set of eyes during my crisis to evaluate my competence and ability to work with the clients I continued to see. An ongoing relationship with a trusted mentor or supervisor not only helps make us better counselors, but our supervisors may also be able to recognize when we are off our game. We lack objectivity when it comes to our own lives — both professional and personal.

That well-known line, “Physician, heal thyself,” sounds good, but it is an unattainable goal. Looking back at my own history, I was totally blinded by limitations of maturity and knowledge as well as by my good intentions. It is only through the lens of time that I am able to see that now. There is no way I could have been fully aware back then. Retaining a mentor who could have helped identify when it was time for me to take a step back would have been advisable.

Don’t forget to play

Building a private practice takes time, and many counselors burn the candle at both ends, working late hours and weekends, and seeing 35 to 40 clients per week. Such a schedule is unsustainable without life balance.

There is a huge body of research cataloging the benefits of play. It used to be thought that play was a kid thing. That is absolutely false. Human beings — in fact, most mammals — are prewired to play. The need to play doesn’t end at some arbitrary age that we call adulthood.

In general, research demonstrates the health benefits of play when it offers enjoyment and when the participant suspends time and place in exchange for focusing on an entertaining goal, such as winning a board game, playing tag or shooting basketball. Adults who play are happier and manage stress better. Play boosts morale, improves our “marketability” with the opposite sex and reduces heart rate. A 2016 study in the American Journal of Play even demonstrated the need for play among astronauts and proposed that NASA formally develop a “playscape” for those in microgravity.

Golfing, biking, hiking, playing games with your children or putting together a jigsaw puzzle are only some of the varied activities that constitute play. My favorite play activity these days is camping, and I am in the woods at least one or two days a month throughout the year — rain or shine, hot or cold. The isolation and recreation of the mountains energizes me and recharges my batteries.

Know your limits

One of my strengths in life is that I have never once done anything simply for money. Money doesn’t own me, so nobody else does either. But it is an easy mistake to make, especially as an American, to keep striving for more — a bigger house, a larger counseling practice, more staff, one more speaking engagement, more clients and so on.

Even when your practice energizes you, there has to be something more in life than appointments. It seems so logical, however, to keep taking on new obligations, mistakenly believing that you are “building a practice” when, in fact, you are burning the bridge from both banks. Long-term goals require some sacrifice, of course, but the decision of what to do and what to cut should be based on something other than the bottom line of your bank account or an arbitrary conceptualization of success.

Another reality is that in the midst of crisis, you can’t expect yourself to perform at the same level you would when your life is more normal. When I plunged into crisis, I cut back on as much as I could. I still had to teach my classes, and I continued to see the clients on my caseload I felt I could ethically handle. But I took no new clients, accepted no new speaking engagements, put all of my writing projects on hold and cleared my calendar, canceling a number of events I just didn’t feel strong enough to manage.

You will assume that this article doesn’t apply to you

There are varied perspectives on self-care, but I particularly like O’Halloran and Linton (2000), who propose focusing on wellness in six domains: social, emotional, cognitive, physical, spiritual and professional. Prior to my crisis, I had focused only on one or two of these, even though self-care is mandated by the ACA Code of Ethics. The suggestions I have offered about self-care are a start, but if history has taught me anything, I predict that most readers will say to themselves, “That was an important article. Glad it doesn’t apply to me.” And then 10 or 20 years from now, somebody else will be writing an article for counselors addressing the need for self-care. I would love to be proved wrong.

Just because we are counselors doesn’t make us immune to the ills of life any more than an oncologist is immune to the risks of cancer. In the 1990s, when Elisabeth Kübler-Ross experienced a series of serious health issues, she recanted her “stage theory” completely. A full-page article in my local paper described her health woes and her disparaging comments regarding her theory. I thought at the time her recanting of the theory was, ironically, demonstrative of the anger stage of that very theory. Before her death some years later, she said as much and reaffirmed her personal belief in her theory and life’s work. Despite our knowledge and experience, a crisis blinds us. Affect always trumps logic.

Taking good care of yourself is not only healthy for you, it will help you better serve your clients. Even chronic mental health issues such as depression do not preclude our competence. One of the most influential people in my professional life endured a lifelong battle with depression. I had known her a very long time before she confided that information to me. But she was an amazing mentor whose words and example influence me to this day. Likewise, one of the most naturally gifted interns I have ever had was a woman who suffered major depressive disorder, marriage issues and significant self-esteem issues throughout most of her life. But when she closed her door to begin therapy with her clients, she was amazing.

Both of these women were surprisingly strong, despite their personal life frailties. I am confident that they had learned to manage their challenges — not avoid them — and had developed self-care processes that allowed them to flourish in the counseling room.

It is with some embarrassment that I share my personal failures with you, but as always, this isn’t about me. Instead, I am hopeful that sharing my struggles can help you to avoid the mistakes I made. Pain will eventually find us all. I hope that, with better preparations than I made for myself, you can be prepared to weather the inevitable storms on your own horizons.

My friend has a very long road ahead of him. Recovering when your world lies in tatters around your feet is overwhelming. But he has me — a friend and a confidant. He has his therapist. And he has the physical and spiritual health to face this daily challenge. That is a great start.

 

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Gregory K. Moffatt is a professor of counseling and human services at Point University in Georgia. He is a licensed professional counselor and a certified professional counselor supervisor. Contact him at greg.moffatt@point.edu.

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

 

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Related reading, from the Counseling Today archives:

The battle against burnout

A counselor’s journey back from burnout

Wellness matters

Doing our own work: A parallel process

Behind the Book: Counselor Self-Care

 

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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.