Addressing and loss

Also inside: • Helping couples through divorce • An interview with Kathleen Sebelius • Emotion-focused relationship enhancement • Students’ perspective on the 20/20 initiative

CounselingTodayJune 2012 Cover Story

26 A loss like no other By Lynne Shallcross Although loss is a universal experience, every person’s grief process is unique, and that reality has encouraged counselors to gradually leave behind one-size-fits-all approaches to grief .

Features 32 When the vows break 26 By Stacy Notaras Murphy A high priority is rightfully placed on counseling’s role in helping to prevent divorce, but the need for counseling doesn’t end even if the does.

38 Bridging the separation between behavioral and general health care Interview by Frank Burtnett Health and Services Secretary Kathleen Sebelius discusses barriers to care for people with behavioral health needs and the changing landscape of 32 U.S. health care.

40 Knowledge Share Improving couples’ attachment security, intimacy, stability and satisfaction By Barry G. Ginsberg The founder of the Center of Relationship Enhancement takes a deeper look at why emotion-focused relationship enhancement therapy often achieves the best 40 outcomes for couples.

46 Opinion A student perspective on 20/20: A Vision for the Future of Counseling By Marte Ostvik-de Wilde, Jordan P. Hammes, Gitima Sharma, ZiYoung Kang & Denise Park Doctoral counseling students identify the aspects of the Principles for Unifying and Strengthening the Profession that are most relevant to them.

Extras

50 Stacey Davidson essay takes first place Contents in Ross Trust Graduate Student Competition

June 2012 | Counseling Today | 3 CounselingTodaJune 2012y Columns ACA 10 Washington Update

The Two-Minute Advocate 11 Celebrating 6060 yearsyears 12 Counselor Career Stories The American Counseling Association is celebrating its 60th anniversary 14 Through a Glass Darkly as an organization in 2012. These are a few of the items concerning ACA (then known as the American Personnel and Guidance Association) that Learning Curve: Notes From a Novice appeared in The Guidepost (the predecessor of Counseling Today) from 18 1970 to 1973: n Richard C. Kelsey is appointed APGA’s first executive assistant for 20 Private Practice Strategies human rights. The APGA Senate created the new position to staff an APGA National Office for Non-White Concerns. Among Kelsey’s 22 Resource Reviews early efforts are two workshops in Washington and Atlanta at which participants agree on two priority needs: assisting counselors in school 24 Spotlight on Journals systems in the process of desegregation and developing a non-White information and human resources bank. (February and September 44 Recent Books by ACA Members 1970 issues) n The first national drug abuse prevention program for guidance counselors begins as the result of a $7,500 grant to APGA from the General Electric Foundation. Stage One of APGA’s Regional Training Institutes in Drug Abuse Prevention kicks off when regional project Need to Know directors meet in Washington. Training includes a trust walk; briefings with experts on the pharmacological, psychological, legal, ethical and 5 From the President social aspects of drug abuse prevention; and visits to Washington and New York drug rehabilitation centers. (February and April 1971 issues) 7 Executive Director’s Message n The Citizens’ Advisory Council on the Status of Women charges that sex discrimination is taking place in the nation’s public schools and that 8 Letters to the Editor counselor attitudes are abetting such discrimination. “Specifically, the report states that many counselors as well as teachers lack information CT Learning Exam and sensitivity to changing life patterns of women and to widening 34 vocational and higher-education opportunities resulting from changing attitudes and equal opportunity legislation.” (Sept. 29, 1972, issue) 49 NBCC Perspective n A headline in Guidepost reads “Counselor Grads: Moratorium Urged.” The accompanying article cites a report that the total number of 54 In Memoriam: Larry Bruce Golden teacher education graduates trained as guidance counselors in 1971- 1972 was 2,324 but that the number of new guidance counselors hired 56 Division, Region & Branch News was only 952. In response to the article, a counselor educator at Ohio University says counselor trainees are increasingly being hired in non- 58 Bulletin Board school settings. “It would seem,” his letter reads in part, “that APGA should acknowledge that, while school counseling has been and should Classifieds remain an integral part of professional counseling, the needs point 60 increasingly toward non-school roles, such as in community-clinical contexts. Therefore, rather than declaring an illogical moratorium, a challenge could be issued to redirect counselor education resources to new contexts.” (Jan. 12 and April 20, 1973, issues)

4 | Counseling Today | June 2012 From The President CounselingToday inventory of what has been accomplished during the past several months. As I start Counseling Today Staff this review, I realize that I am privileged Publisher to “carry the baton” for but a single lap in Richard Yep this venture. It is apparent that the passing Associate Publisher Carol Neiman of the baton to the next runner/leader is Editor-in-Chief Don W. LockeDon W. highly critical. Jonathan Rollins I had the good fortune to receive an 800.347.6647 ext. 339 excellent handoff from Marcheta Evans to [email protected] start my tenure. Marcheta is one of those Senior Writer rare colleagues who can inspire you and Lynne Shallcross Passing the baton force you to think beyond boundaries. 800.347.6647 ext. 320 I also have come to realize that part of [email protected] enjoy watching track and field Marcheta’s success was due to the manner Staff Writer competitions. I recognize the level of Heather Rudow in which she received the baton from Lynn 800.347.6647 ext. 307 Iskill required for each of the events, Linde. Lynn is thoughtful and experienced [email protected] but I am particularly impressed with what and has provided mentorship for both Advertising Representative it takes to field a winning relay team. Each Marcheta and me as we focused on the Kathy Maguire member of the team must possess certain needs of our association. It is now my 607.662.4451 skills and perform certain assignments responsibility to ensure that the transition [email protected] to enable the team to be successful. The to Brad Erford goes smoothly, thus Graphic Designer critical component for success, however, enabling the association to maintain its Carlos J. Soto II is the preparation for and the actual 800.347.6647 ext. 377 current pace and continue making positive [email protected] passing and receiving of the baton between strides. members of the team. This year has marked our 60th as an CT Column Editors This activity must be completed association. We have had the opportunity Washington Update multiple times during the course of to reflect on the remarkable progress Scott Barstow the race. Three team members must be the profession and the association have 800.347.6647 ext. 234 prepared to receive the baton, two must made over that span. We have reached [email protected] both receive and pass the baton, and the 50,000-plus mark in membership, Counselor Career Stories one has the task of making the initial reflecting a 10.4 percent gain for the year. Rebecca Daniel-Burke 800.347.6647 ext. 230 baton pass. A single misstep or lapse of We have focused on membership services [email protected] concentration can cause the baton to and increased the use of technology Resource Reviews be dropped or bobbled, and the results and social media to keep each member Kelly Duncan are usually disastrous, no matter how informed. We have made an effort to [email protected] large a lead the team has built. All the enable branches to develop leadership and Private Practice Strategies preparation and effort quickly evaporates encouraged membership participation Anthony Centore into “what might have been.” Thoughts at all levels in our association. We have [email protected] abound among the teammates concerning begun work on revising our ethics Spotlight on Journals what each could have done to optimize code and have taken a stand relative Sheri Bauman [email protected] the performance of the team as a whole. to the revision of the Diagnostic and Could each runner have applied greater Statistical Manual of Mental Disorders. New Perspectives Donjanea L. Fletcher concentration to his or her responsibilities? We are working to secure employment [email protected] How could each have better prepared to for professional counselors in a variety The Digital Psyway pass or receive the baton? of venues. We have advocated for Marty Jencius It is hard for me to conceive that my professional unity and taken opportunities [email protected] tenure as president of the American to sit at the table with our fellow mental Inside the DSM-5 Counseling Association will close at the health professionals. K. Dayle Jones end of this month. I am just learning how I am going to stop writing now and [email protected] to accept my assignment to “lead from focus on passing the baton to Brad. Learning Curve: Notes From a Novice the middle,” which I discussed in my very Thanks for allowing me to serve as your Suze Hirsh [email protected] first president’s message to you. What president, and be assured that I am Through a Glass Darkly currently preparing for whatever will be once seemed like plenty of time to “take Shannon Hodges care of the business of the association” is required by the next team with which I [email protected] now fading, and I face the task of taking have the opportunity to serve. u

June 2012 | Counseling Today | 5 Refresh Your Curriculum With These New Textbooks From ACA! The Counselor and the Law: A Guide to Statistical Methods for Validation of Legal and Ethical Practice Assessment Scale Data in Counseling and Sixth Edition Related Fields Anne Marie “Nancy” Wheeler and Burt Bertram Dimiter M. Dimitrov In this bestselling book, the authors discuss This instructive book presents statistical the legal and ethical dilemmas that can methods and procedures for the validation arise in practice. This edition contains a of assessment scale data used in counseling, new chapter on the use of social media psychology, education, and related fields. and other Internet-related issues, updates In Part I, measurement scales, reliability, to HIPAA through the HITECH Act and and the unified construct-based model regulations, a new legal/ethical decision- of validity are discussed along with key making model, and discussion of the steps in instrument development. Part specific legal risks for counselor educators. II describes factor analyses in construct The issues surrounding civil malpractice validation, including exploratory factor liability, licensure board complaints, analysis, confirmatory factor analysis, and models of multitrait- confidentiality, duty to warn, and threats of harm to multimethod data analysis. Traditional and Rasch-based analyses self, professional boundaries, records and documentation, and of binary and rating scales are examined in Part III. Numerous managing a counseling practice are also addressed in detail. examples, tables, and figures provided throughout the text 2012 | 288 pgs Order #72919 illustrate the underlying principles of measurement in a clear ISBN 978-1-55620-315-2 and concise manner for practical application. 2012 | 272 pgs List Price: $52.95 | ACA Member Price: $39.95 Order #72914 | ISBN 978-1-55620-295-7 List Price: $69.95 | ACA Member Price: $49.95 Developing & Managing Your School Guidance & Counseling Program Counseling and : Fifth Edition Theories and Interventions Norman C. Gysbers and Patricia Henderson Fifth Edition This fifth edition expands and extends edited by David Capuzzi and Douglas R. Gross Gysbers and Henderson’s acclaimed This student-friendly text provides a five-phase model of planning, designing, thorough overview of 14 widely used implementing, evaluating, and enhancing theories. Experts examine each theory from Pre-K–12 guidance and counseling the perspective of its historical background, programs. New to this edition are increased major constructs, goals, cross-cultural attention to the range of issues that considerations, and limitations. Traditional students present, counselor accountability, and brief interventions integrate theory and the roles and responsibilities of district- with specific counseling strategies, giving and building-level guidance and counseling leaders. An array of students further insight into the counseling sample forms, job descriptions, evaluation surveys, flyers, letters, process and guidance in developing and procedures used by various states and school districts clearly their personal counseling style. A consistent case study across illustrate each step of program development. In each chapter, chapters reinforces the differences between theories and a new feature called “Your Progress Check” functions as a illustrates assessment of client concerns and treatment planning. tracking tool for growth at each stage of the change process. A complimentary test manual and PowerPoints for instructors’ use 2012 | 544 pgs | Order #72915 | ISBN 978-1-55620-312-1 are available by request on university letterhead. 2011 | 408 pgs List Price: $69.95 | ACA Member Price: $49.95 Order #72902 | ISBN 978-1-55620-271-1 List Price: $69.95 | ACA Member Price: $49.95 Please include $8.75 for shipping of the first book Visit counseling.org/publications for and $1.00 for each additional book. information on examination copies. Order Online: counseling.org By Phone: 800-422-2648 x222 (M-F 8am – 6pm)

6 | Counseling Today | June 2012 Executive Director's message CounselingToday American Counseling Current leadership Association President lays groundwork Don W. Locke 800.347.6647 ext. 232 [email protected]

Richard Yep for 2012-2013 President-Elect Bradley T. Erford of thanks to you, the members of ACA, 800.347.6647 for meeting one key goal — namely, our [email protected] reaching the 50,000-member mark by the Executive Director ince the late 1990s, I’ve had the end of the fiscal year in June. Actually, the Richard Yep good fortune to serve as your 800.347.6647 ext. 231 goal was accomplished in March! The world executive director. I am sometimes [email protected] S still grapples with an uncertain economic asked if it’s difficult serving under a new picture, but reaching our goal three months Counseling Today (ISSN 1078-8719) is the president each year. My response: Not monthly magazine of the American Counseling early is an indicator that members value the really. Perhaps that’s because I am flexible Association, 5999 Stevenson Ave., Alexandria, services, resources and professional advocacy VA 22304-3300; Telephone: 703.823.9800; and have already worked with the president that ACA provides. Internet: counseling.org. Opinions expressed during his or her president-elect year, as In the coming year, ACA will do its in this magazine do not necessarily represent well as potentially when that person served opinions of the editors or policies of the best to save you time — whether you are American Counseling Association. on an ACA committee or was active in a a seasoned counselor or a new graduate Subscriptions are available for $150 for 12 issues. particular division, region or branch. looking for that first job — by making Whatever the reason, I routinely look Email: [email protected] a concerted effort to help you find those Americas: 1-800 835 6770 forward to building a leadership partnership resources that enhance your work. You have Europe, Middle East & Africa: with the ACA president. Tackling the +44 (0)1865 778315 told us what you expect for the limited Asia: +65 6511 8000 varied challenges and working in a strategic membership dollars you will spend in the Single copies are available for $12.50 each way is rewarding. However, it can also coming year. by calling ACA in-house fulfillment at 800.422.2648 ext. 222. be bittersweet as we head toward the In early 2013, we will launch a totally conclusion of the president’s term on June new ACA website with many features, Periodicals postage paid at Alexandria, Va., and 30. This year will be no different as Don including improved search capabilities and additional mailing offices. Postmaster: Send W. Locke completes his term as ACA’s address changes to ACA Member Services, a better way to connect with like-minded 5999 Stevenson Ave., Alexandria, VA 22304. 60th president. colleagues by creating community around All rights reserved, 2012 by the American I first met Don when he served as a leader various issues. You can also expect even Counseling Association. in the mid-1980s. Don has been active in more ways to earn continuing education Editorial Policies ACA through five different decades, and I credits from us without having to leave your Counseling Today reviews unsolicited articles have come to appreciate his ability to recall office or home. In addition, ACA will better written by ACA members for publication. Not an issue from our past — because he was all articles will be accepted for publication. target what you want in hopes that we can Send articles or request a copy of the writing actually around when that history was being reduce the number of emails, text messages guidelines by emailing [email protected]. created! But I am especially impressed by and other communications that bombard Anti-Discrimination Policy what he said to me upon his being elected. each of us daily. We want to help you There shall be no discrimination against any Don told me he had been part of ACA separate the useful from the not-so-useful. individual on the basis of ethnic group, race, for five decades and had learned a great We will do our best to aggregate timely and religion, gender, sexual orientation, age and/or disability. deal about the association during that time. relevant information for you through our And then, without skipping a beat, he said, enhanced ability to curate resources. Mission Statement “And I also have five decades of things to The mission of the American Counseling So, to all who served in addition to ACA Association is to enhance the quality of life unlearn.” What a bold and progressive President Don W. Locke this past year in society by promoting the development statement. I admired the foresight he as volunteers at the Governing Council, of professional counselors, advancing the possessed in recognizing that today’s counseling profession and using the profession committee, task force, region, division and and practice of counseling to promote respect ACA was in many ways a very different branch levels, please accept our thanks for a for human dignity and diversity. organization. It told me Don was going to job well done. be a president with an understanding of the As always, I look forward to your past but also a willingness to embrace the comments, questions and thoughts. Feel “new” ACA. free to contact me at 800.347.6647 ext. 231 As our program year closes, I am pleased or via email at [email protected]. You can by how much your leadership team has also follow me on Twitter: @RichYep. accomplished. But we owe a great deal Be well. u

June 2012 | Counseling Today | 7 Letters

Time is ripe to push requirements that different states have. for license portability Although the profession of counseling As a new student in the counseling can be divided at times, most fields profession, employability is a main agree on certain core requirements to concern. One of the first things graduate becoming a counselor. With the ball students become familiar with is the rolling on 20/20: A Vision for the Future incredibly convoluted process to of Counseling’s portability initiative, it is Editorial policy becoming licensed. Although students the perfect time for all current counselors Counseling Today welcomes usually live in the same state where they and all soon-to-be counselors to become letters to the editor from ACA go to school, it does not mean they will more vocal about license portability stay there. As someone who has already issues. members; submissions from lived in three different states by age 24, In February, the U.S. Department nonmembers will be published the thought of sticking to one state for of the Treasury and the Department only on rare occasions. the rest of my career is not appealing. of Defense released a report titled Only one letter per person per Neither is the thought of doing all the “Supporting Our Military : Best topic in each 365-day period work to obtain my counseling license in Practices for Streamlining Occupational will be printed. Letters will be one state and then moving to another Licensing Across State Lines.” This published as space permits and are state. After reading Thomas J. Sherman’s report focuses on ways to make military subject to editing for both length article about his frustrating experience life a little easier, and license and clarity. Submissions can be (see “License portability: One counselor’s portability is one of the main topics. sent via email or regular mail and journey across state lines,” January), Due to the publicity this report must include the individual’s full I began to worry whether my desired has received, and coinciding with the name, mailing address or email career might prevent me from being very increased attention to license portability address and telephone number. mobile in the future. issues in the counseling community, now ACA has the sole right to Other health professions have unified is the perfect time to become aware of determine if a letter will be national certifying boards that make the issue and to be open to change. I can accepted for publication. state-to-state portability of their licenses guess that within my lifetime, state-to- Counseling Today will not much easier, but these laws seem state portability issues will be somewhat publish any letter that contains nonexistent for professional counselors. I resolved and national standards will be unprofessional, defamatory, am just getting familiar with counseling, in place that will make it much easier for incendiary, libelous or illegal but for the profession to move forward, counselors to move around. I say within statements or content deemed it seems as though license portability my lifetime, but for most, the next five as intended to offend a person should be a main concentration of or group of people based on political agitation for all counselors and years are a lot more crucial. their race, gender, age, ethnicity, all counseling organizations. The more counselors are aware of and religion, sexual orientation, When I began looking into the issue willing to help find solutions to fix this gender identity, disability, of license portability for counselors, I problem, the sooner it will no longer be discovered countless stories of counselors a problem. language, ideology, social class, who felt trapped in their states because Anna Sumerlin occupation, appearance, mental of the incredibly varied licensure Montclair State University u capacity or any other distinction that might be considered by some as a liability. ACA will not print letters that include advertising or represent a copy of a letter to a third party. The editor of Counseling Today will have responsibility for determining if any factors are present that warrant not publishing a letter. Email your letters to ct@ counseling.org or write to Counseling Today, Letters to the Follow Counseling Today on Twitter Editor, 5999 Stevenson Ave., @ACA_CTOnline Alexandria, VA 22304.

8 | Counseling Today | June 2012 Offer good for the rst 3 therapists in each zip code. Use Promo Code: ctjune

June 2012 | Counseling Today | 9 Washington Update - By Scott Barstow & Art Terrazas

Pressure increases on VA to improve treatment

he American Counseling staffing and productivity are too complex facilities. In addition to being trained Association has been fighting and unreliable to be of much use. and licensed therapists, many of these Tfor years with frustratingly The VA has thus far responded to the counselors are veterans themselves and little success to get counselors hired as report with press releases. On April 19, are thus uniquely qualified to provide mental health clinicians within veterans the VA announced that it would add treatment and support to their fellow hospitals, facilities and Vet Centers. It 1,600 new mental health clinicians to its veterans. Counselors are an untapped now appears that even the Department of workforce. On April 24, another press resource for the VA — a resource Veterans Affairs’ (VA’s) own analysts are release announced that the VA would veterans in need of mental health frustrated too. In a report released at the be recruiting mental health counselors treatment could use desperately. end of April, the Veterans Affairs Office and marriage and family therapists to its Congress is becoming increasingly of Inspector General (OIG) faulted workforce as part of the hiring for those frustrated with the VA’s failure to the Veterans Health Administration new positions. provide adequate mental health care, (VHA) for providing highly misleading Although ACA is pleased with the and ACA is working with members of information that paints an inaccurate VA’s announcement regarding the hiring the Senate and House of Representatives picture of veterans’ access to mental of licensed professional mental health health services. The report was the subject counselors (LPMHCs), we need action, to let them know that opening the door of a hearing by the Senate Committee on not words. For the past three months, to LPCs should be part of the solution. Veterans’ Affairs. ACA has tracked VA mental health During the hearing on the OIG report The VHA has claimed that 95 percent position postings on the USAJOBS.gov by the Senate Committee on Veterans’ of first-time patients receive a full mental website. During that time, 350 positions Affairs, Sen. Jerry Moran (R-Kan.) told health evaluation within 14 days. What were posted for social workers; only eight VA officials that among other steps, he the OIG discovered, however, was that positions were posted for LPMHCs. wanted to see the VA begin hiring more the VHA was measuring how long it In its initial press release touting the LPCs. He also expressed dismay that took to conduct the evaluation, not hiring of new mental health clinicians, the VA has not done more to recruit how long the patient waited to get the the VA listed the new hires as consisting counselors in recent years. The House evaluation. Analyzing the data more of “nurses, , Committee on Veterans’ Affairs is likely closely, OIG found that only half of and social workers as well as nearly 300 to hold its own hearings, and we will patients received evaluations within 14 support staff.” The same day this release work with committee members to raise days; for the other half of patients, the came out, VA Undersecretary for Health the issue of counselor hiring again. VHA took about 50 days to conduct a Robert Petzel wrote to our coalition, Congress is likely our best hope for full mental health evaluation. which includes ACA, the National ensuring appropriate recognition of Similarly, although the VHA claimed Board for Certified Counselors and the counselors within the VA. The VA that 95 percent of patients received American Mental Health Counselors central office can take several steps to appointments to begin treatment within Association, denying our request for begin recruiting and hiring counselors 14 days of the desired date, OIG found counselor trainee positions because and incorporating the counseling that this happened for only 64 percent “[i]t has been determined that at this profession into its mental health service of patients. The OIG report is available time there is not a need to set up a delivery system. ACA will work both at va.gov/oig/pubs/VAOIG-12-00900-168. training program for this discipline.” pdf. The law establishing recognition with the VA and Congress to see that The lack of adequate staffing of licensed professional counselors these steps are carried out. Counselors undoubtedly is one source of the (LPCs) as mental health specialists (P.L. can help in this effort by sharing their problem. According to an informal VHA 109-461) was enacted five and a half stories. Please see “The Two-Minute survey, 71 percent of front-line mental years ago, and it has been over a year Advocate” on page 11 for more health professionals reported that their and a half since the VA adopted an information, and contact Art Terrazas facilities didn’t have enough staff to meet occupational standard for LPMHCs. with ACA’s public policy staff at treatment demand. However, the OIG Yet counselors are still being told no [email protected] if you have any report concluded that the VHA’s data on positions are available for them at VA questions or concerns. u

10 | Counseling Today | June 2012 The Two-Minute Advocate - By Scott Barstow & Art Terrazas Ask Congress to make counselors part of the solution at the VA

s part of the American This month, we need you to contact Representatives, especially if you have Counseling Association’s your senators and representatives to contacted the VA about working as a A ongoing efforts to establish tell them that you want the VA to get mental health clinician and have been full recognition of counselors within the serious about including counselors as turned away. It’s important that the staff Department of Veterans Affairs (VA), this full-fledged members of the VA mental people associated with these committees month we are asking you to contact your health treatment system. Tell them it has know what is really going on in the members of Congress directly about this been more than five years since Congress counseling community and that they hear issue. established recognition of counselors counselors’ stories from the front lines. With the recent Office of Inspector within the VA, but so far almost no Counselors can be part of the solution at General report making news in the media licensed professional mental health the VA, but only if the VA allows them counselors are being hired. This needs (see page 10), there is renewed focus on to be part of the solution. to change, and the VA could take several the quality of mental health care being You can locate your senators by visiting steps to make this happen. These steps provided (or, in this case, not being senate.gov and your representative by include establishing paid internships for provided) to our nation’s veterans. This visiting house.gov. After identifying who counselors, creating a liaison to work with represents a new window of opportunity groups such as ACA to create recruitment represents you in Congress, you can call for counselors to highlight the important and retention programs for counselors, their Washington office by using the U.S. contributions they can make to the well- and incorporating the counseling Capitol switchboard at 202.225.3121. being of veterans and their families. We profession within broader mental health To contact the House Committee on need to bring this to the attention of planning boards and processes. Veterans’ Affairs, call 202.225.3527. members of Congress and help make In addition to calling your senators To contact the Senate Committee on sure that the VA follows through on and representatives, we also want to Veterans’ Affairs, call 202.224.9126. its promises to begin hiring counselors ask you to take a moment to call the For more information, contact Art and improve access to mental health offices of the veterans’ affairs committees Terrazas with ACA at 800.347.6647 ext. treatment at its facilities. in both the Senate and the House of 242 or [email protected]. u

June 2012 | Counseling Today | 11 Counselor Career Stories - By Rebecca Daniel-Burke

Counselor, manager, connector

Anna White

nna White, a licensed center during college. When I graduated, turned to colleagues in the corporate professional counselor and my mentors at the mental health center world for advice on how to maximize A certified clinical mental health encouraged me to get a master’s degree in program potential and fully utilize boards counselor, was looking for counselors to counseling. of directors. fill vacant positions at the company where I enrolled at the University of Virginia I believed that my experience in she worked, so I invited her to interview (UVA) in the master’s program in 1976, family systems work, groups, etc., candidates at the American Counseling just one month after graduating from would enhance an understanding of Association Annual Conference & Expo. Presbyterian. The UVA master’s in organizations. I have found that to be In striking up conversations during brief counseling program was at the forefront generally true. However, I am enjoying breaks in our schedules, I found her to be of developing professional counseling as a learning more about how to translate a very interesting counselor and person. field. It provided a great foundation. clinical theory and understanding to Here is her story. Last year, I had the opportunity to organizations. Rebecca Daniel-Burke: What is your take an ethics class at a local university. I RDB: In what ways is it different for current position, and what primary tasks needed the class for Maryland licensure. you working as a manager as opposed to do you perform there? I was overwhelmed by the quality of the practicing face-to-face counseling? Anna White: I am currently a regional students in the master’s of counseling AW: I am enjoying not doing clinical manager for a psychological health program, the excellence of the faculty and work right now. I have the opportunity program on a contract for the military. I the level of professionalism demonstrated to flex other muscles and build new skills. lead 15 licensed professional counselors, in the program. Professional counseling Full-time clinical work is intense and social workers and psychologists on a education has really flourished in the past very tiring for me. I want the best of both team that covers seven states. I assist 30 years. worlds and will eventually do some part- in recruiting and hiring, overseeing RDB: When did management of time clinical work to keep those skills documentation quality and making site programs come into the equation for you? visits to the 15 military bases. One of the AW: I am currently working as a sharp. exciting aspects has been the challenges manager. I have completed about half of RDB: As you look back on your career involved in “standing up” a new program. the requirements for a Ph.D. in industrial in counseling, which position that you RDB: What led you down the path and organizational psychology at Grand held was your favorite? toward a career in counseling? Canyon University. I have noticed over AW: I have to say that my favorite AW: I knew, probably in junior high the years while working in nonprofits and position is the one I am doing right now. school, that I wanted to be a healer of agencies that the better counselors are I am privileged to work with a group of some sort. I grew up in a family with often selected for managerial positions. people who represent the very best in a chronically ill parent, which gave me However, the skill set that makes one a their respective fields. It is an amazing some experience in actively caring for great counselor is often different from experience to be able to serve our military others. While attending Presbyterian that of an effective manager. I enjoy members. My family has served in the College in South Carolina, my ideas studying leadership styles, organizational military dating back to the Revolutionary about becoming a counselor were consulting, etc. In the nonprofit sector, I War. My aunt was one of the first women nurtured by the faculty of a counseling- have seen a great need for more-effective to be wounded in Europe during the focused psychology program. I business practices to enhance the bottom Second World War when her hospital volunteered at the local mental health line of providing quality services. I often was bombed in France.

12 | Counseling Today | June 2012 RDB: That is an amazing piece of lives through understanding human family history. Is there one particular development and behavior. FREE Shipping theoretical orientation that you gravitate RDB: Is there a saying, a book or a on ALL Books & Games toward? quote that you lean on when you need AW: I know this dates me, but I am inspiration? What do you try to think really influenced by Carl Rogers. I believe about when the going gets tough? that counselors must connect with people AW: Not to be too silly, but the quote to effect change. If that connection or that I remember is from a children’s show rapport isn’t there, it really doesn’t matter that aired in the 1960s in Charlotte, N.C. what theoretical stance is taken. Joey the Clown always closed the show by Counseling RDB: Was there someone in your saying, “Remember, boys and girls, all we life who saw something special in you have in this world is each other.” early on? Who valued you as a unique I have suffered many losses during children individual? Who is your hero? my life, which has led me to realize the AW: My mother was my hero. She importance of living in the moment. just got always believed in me. As an elementary We say, sometimes tritely, that life is too school teacher, she was bothered by the short. To fully understand and grasp increasing number of students who came the fleeting nature of life minimizes the easier! from troubled families. She worried tough times and underlines that need to about the children not getting what be there for each other. they needed. She saw the impact on the A wonderful colleague and excellent students’ performance and self-esteem. pastoral counselor, Dr. Ernie Hall, once She encouraged me to be of help to told me that we can be in the manure pile families. She also challenged me to be and fight and flail to get out — which there for marginalized people who had succeeds in us covering ourselves with limited resources. manure — or we can settle down and I knew in college and graduate school grow violets. I try to grow as many violets that the classroom experiences would not as possible. be enough. Getting a master’s degree did RDB: I can tell your work is intense at not make me a good clinician. I actively times. What ways do you find to take care sought mentoring from more-experienced of yourself and fill yourself back up? therapists. I did some personal work AW: I am fortunate to work for a with a Jungian analyst for several years. I manager who focuses on wellness and encourage other novice counselors to do self-care. I enjoy playing word games, the same. Ask the questions, look inward watching movies and going to baseball Toys, Puppets, and don’t be afraid to face the answers. games. My favorite thing is to cook for RDB: Has working in the counseling my friends, enjoy long dinners and tell games, sand, field been transformational for you? entertaining stories. AW: Absolutely! Being with people as RDB: Is there anything I have left out sand trays, they share feelings of great pain, sadness, that you want our readers to know about loss, etc., is a humbling experience. you and your work? workbooks, When a solid connection is made AW: Counselors can and do change the between a counselor and a client, both are world — one connecting moment at a miniatures, bop transformed. time. u bags, Sand Play RDB: What mistakes have you made along your career path? What lessons have & Play Therapy you learned from those mistakes? AW: When I graduated from UVA, books, children’s I thought I had made a mistake by not Rebecca Daniel-Burke is the getting a degree in . I often director of professional projects books, and felt discounted as a professional. As time and career services at the moved forward, it became exciting to American Counseling Association. much more! see the field of professional counseling Contact her at rdanielburke@ come to fruition. I have come to respect counseling.org. We Carry Spanish Language Books & Games the contributions that professional counselors, social workers, pastoral Letters to the editor: www.childtherapytoys.com counselors and psychologists bring to the [email protected] Enter coupon code: ACA and get 10% off business of helping people lead better

June 2012 | Counseling Today | 13 Through a Glass Darkly - By Shannon Hodges

‘Value-added’ moments from the ACA Conference

ight and glass, space and crowds, and colleagues. No doubt, the stitch that in videos, and a sense of unworthy angst joyous sunshine and moody binds ACA’s disparate fabric together is while standing in their shadows. Lclouds, crowds of women and the social connections forged through During that initial conference, I men sporting two-tone shoulder bags, divisions, committees, task forces, attended a reception where Gerald lanyards dangling like acolytes’ icons, social hours and impromptu encounters Corey, Sam Gladding, Allen and Mary crisscrossing the marble floors of the between graduate students, counselors Bradford Ivey, and Courtland Lee, among futuristic Moscone Center, moving and counselor educators. Everyone who others, were milling about. Profoundly staircases ferrying counselors to and fro, expressed enthusiasm for the conference intimidated, I took refuge among a herd the famous — Jerry Corey, Sam Gladding related at least one significant social of graduate students quietly grazing at the et al. — mixing with unknowns in the interaction that occurred while seated in hors d’oeuvres table before Reese House, robust, twisting kaleidoscope that was the a session, in the coffee line, at a reception, my former professor, cut me from their 2012 American Counseling Association etc. Networking in the “old” world ranks and drove me toward the august Annual Conference & Expo in San fashion is clearly still very much in vogue, group. Francisco. even in this high-tech, postmodern era of Despite a perpetual feeling of being out Although I have been a regular attendee LinkedIn, Facebook and iPhones. of my element, my first ACA Conference of ACA Annual Conferences for well experience was rewarding. I resolved What’s new? over a decade, each year brings forth new to become an annual attender, extend There were also the “new” aspects experiences to share in and reflect on. my comfort zone and become more of the ACA Conference, including the There are the usual sights: a cavernous engaged with our flagship organization. rock-star-length lines in which attendees exhibition hall with scores of booths ACA Conferences have become an stood in hopes of sharing a personal representing affiliate organizations, book annual pilgrimage for me ever since, and moment and receiving a scribble from company representatives (all of whom my official involvement has increased renowned Irvin Yalom. Craig nod in sage fashion at your new book exponentially. pitch), universities both traditional and Windham, previously just a “voice” for virtual, and residential treatment centers, NPR aficionados, gamely held up his Windows to the future their pictures promising only glorious end of the keynote sessions. First-time Despite a hectic schedule, I was able sunny days. There are graduate students attendees, including many bright- to make it to some educational sessions with confident or nervous smiles; eyed graduate students brimming with other than my own. Conference sessions counselors and counselor educators enthusiasm, showed their eagerness to provide opportunities to view a concept, mincing about, making small talk with seize the yoke of professional leadership idea or philosophy through the eyes new acquaintances and trading hugs roles and transform the organization and of the presenter. Craig Windham’s with old friends; the harried ACA staff, profession. keynote allowed me to put a face with including ACA Director of Publications In fact, I find students attending their the radio voice. Seeing this famed NPR Carolyn Baker pirouetting deftly from first ACA Conference to be the most correspondent and practicing counselor, one situation to another; and the look of interesting of all attendees — above whom I listen to regularly, sent a jolt of dazed wonderment etched on the faces of keynote speakers, famous names, A-list pride through me. first-time attendees. ACA luminaries and high-ranking In his presentation on the International Although promoted primarily for its officers — because they represent the Association for Counselling, Courtland educational offerings, ACA Conferences unblemished future. Generally easy to Lee provided his perspective on the are all about engaging the social vestiges spot, their faces oscillate between flushed progress of the international counseling of our DNA. Naturally, there are excitement and the dazed squint of profession, what has been accomplished, educational sessions (legion in number), sensory overstimulation. I can empathize. what challenges remain and the committee meetings and editorial board During my neophyte experience, adaptations necessary for our profession meetings, but also the grand Opening everything at the conference seemed to become sustainable in non-Western Party, numerous receptions, coffee break larger than life. I vacillated between giddy countries. He also posed a question in recesses (Starbucks was ooh so close by!), excitement at spotting the big names I’d the reasonable tone of an elder who has happy hours and dinners with friends seen previously only on book covers and witnessed the evolution of the counseling

14 | Counseling Today | June 2012 profession from the vantage points of graduate student, professor, ACA president, IAC president and co-founder of the University of Maryland/University of Malta transcultural counselling program: “What is the value added of ACA 60th Anniversary counseling to a given society?” The most significant impression Members-Only Sale! I took away from his presentation is that a great deal of work remains Save $19.95! to be done in adapting the Western now through December 31, 2012 counseling model in societies that possess cultural norms and practices that differ significantly from our own. The good news is that our profession has spread The ACA Encyclopedia to countries as diverse as China, Saudi Arabia and Singapore, as well as to the of Counseling United Kingdom, New Zealand and Australia. Hopefully, within a decade, “Like no other reference in professional the international counseling profession counseling. Whether preparing for will be vibrant and the “value added” well understood from Argentina to Zambia. a credentialing examination or an This conference, which celebrated unfamiliar client issue, this book will the 60th anniversary of ACA, also serve as a review of salient information represented a further step in my or a quick resource.” professional evolution. I came of age —Thomas J. Sweeney, PhD as a counselor working in the very Professor Emeritus, Ohio University distinct spheres of student affairs and community mental health, which This premiere counseling reference conditioned me to cram in as many book is ideal for students, educators, sessions and CEUs (CEUs does sound supervisors, researchers, and practitioners seeking to quickly better than CEs, right?) as possible. update or refresh their knowledge of the most important topics Through the years, my professional responsibilities (pedestrian as they are) in counseling. More than 400 entries span the 2009 CACREP at ACA Conferences have multiplied. At core areas used in counselor preparation, continuing education, my initial ACA Conference, I longed for and accreditation of counseling degree programs, making this such responsibility. In 2012, my wish a perfect text for introductory counseling classes or for use as a came exhaustingly true, causing me to study guide when preparing for the National Counselor Exam. spend the entire conference in motion, Includes instructive examples that connect readers to practice, seemingly dashing from meeting to teaching, supervision, and research; helpful cross-referencing meeting, gasping for breath and longing of entries; boldfaced important terminology; and suggested to attend sessions. This year was about resources for further study. 2009 • 672 pages editorial board meetings, a town hall presentation, task force work sessions, Order #72879 ISBN 978-1-55620-288-9 meetings with various book, journal and magazine editors, and the sundry other List Price: $104.95 Regular Member Price: $ 79.95 minutiae that vacuum up time during ACA Member Price: $60.00 — such gatherings. My Zen and monastic now through December 31, 2012 background has much to say regarding human “grasping” and the manner in Please include $8.75 for shipping of the first which it complicates life. Perhaps I need book and $1.00 for each additional book. to reread Pema Chödrön’s When Things Fall Apart: Heart Advice for Difficult 800-422-2648 x222 Times as a reminder of the perils of counseling.org ambition. M-F 8am – 6pm, eT The good, the bad, the concerning My favorite experiences at the ACA Conference always involve renewing

June 2012 | Counseling Today | 15 old friendships and crafting new ones. after protracted years as counseling about a sense of community. The ACA On opening day, while lingering at practitioners. Most significantly, we Conference represents many career the American College Counseling each harbor strong desires to create facets (school counseling, mental health Association booth devastating their free international links between our respective counseling, counselor education, etc.), chocolate supply, two longtime friends counseling programs and those in offers much in the way of professional and colleagues, Perry Francis and Mark locations such as Barbados, China, India, education (sessions on individual, group, Scholl, strolled past. We performed the Australia and other diverse geographic couples, family, career counseling and appropriately affectionate bonding rituals locations. By the time we deplaned, Julia more) and displays a literary mountain that sensitive postmodern counseling seemed like family! of books and journal articles. These males observe when greeting after an Having covered what I liked about the aspects of the conference help us to extended absence. My wife and I shared a 2012 ACA Conference, I’ll briefly address measure the miles we have traveled on steaming Thai dinner with Allison Smith the less attractive flip side. With any large the road toward parity with our mental on a dank, chilly, inhospitable evening. I conference, there will always be mistakes, health siblings. But I refuse to believe chatted with Brooke Collison about our things that go wrong, people who aren’t such concrete representations, although mutual desire to travel and teach in Africa where they’re supposed to be, equipment important, adequately address the “spirit” and held numerous informal tête-a-têtes that abruptly refuses to work at the least of the counseling profession. over coffee with counselor educators. opportune moment, the occasional lifeless For me, the ACA Conference is about Perhaps this annual social renewal, presentation and disgruntled attendees. relationships — personal connections more so than educational sessions, This year, I heard complaints about the that call out above the clamor of famous lengthy line for Dr. Yalom’s book signing, training, committees, presentations people, dueling textbooks and exotic and given his stature, perhaps that could and politicking, is what draws so locations. Although we are scholars, have been anticipated. The Moscone many habitual attendees to set aside practitioners and students, licensed Center charging for Wi-Fi seemed significant time and money to return and certified, notable and anonymous, nitpicky. My personal cavil was the rainy every year. Perhaps ACA Conferences are the ACA Conference is a broad-based schlep from the Moscone Center to the a refutation of the social isolation that therapeutic community — one that Hilton, where various meetings were Robert Putnam details in his popular and preserves traditions while strategizing for held. (“Oh, stop kvetching and pull depressing book Bowling Alone. and adapting to a dynamic future. More up your big boy pants!” my wife might Each year it seems I make at least poetically, the conference represents one notable contact during the ACA say.) But these were minor annoyances as opposed to major detractions. To me, keepers of the professional flame and Conference. This occasionally leads artisans diligently molding the profession to scholarly collaboration, ongoing the biggest disappointment was that only about 60 people attended the Ethics in exacting detail. Whatever the future consultation or simply an email “buddy.” holds for ACA Conferences — and rest Occasionally, these relationships are born Revision Task Force’s Town Hall Meeting. assured it will be different given this not at the conference per se but during Given that professional ethics are the global, high-tech, virtual era (I predict idle moments. This year was a good case operating standards of the profession, this we will soon have virtual attendees and in point. modest turnout was concerning. international counseling organizations On our return flight from San Regardless, the San Francisco representing many countries) — we must Francisco to Atlanta, my wife and I conference was as smooth as any I keep our eyes focused on the collective sat next to Julia, a friendly counselor have attended. After all, no one was gestalt. Otherwise, our annual gathering educator and native of Barbados. threatening to start anything close to a runs the risk of becoming yet another Squeezing into that ridiculously tight schism. Younger members might scoff, dinosaur unable to adapt to a rapidly aisle seat beside me, we spent most of but some 20 years ago, we had a “divorce” evolving future. u the flight swapping personal stories from the college student personnel association, so one never knows what (grandparents), exchanging shop talk drama might unfold. (colleagues, research), comparing our respective occupational settings (large Capturing the spirit flagship institution with a doctoral of the profession Shannon Hodges is a licensed program vs. small private university with To paraphrase Courtland Lee, what is mental health counselor and master’s programs), concerns (far too the value added of an ACA Conference? associate professor of counseling many meetings), joys (our students), Through the years, my contacts and at Niagara University. Contact him frustrations (our students!) and future responsibilities at the conference have at [email protected]. dreams (teaching internationally). diversified considerably. What has not Though we had grown up in different changed, however, is my belief that our Letters to the editor: cultures, we shared the common bond of grand homecoming is not about famous [email protected] having influential relatives who nurtured authors, notable keynote speakers, new and cultivated our aspirations. We both and improved educational sessions or had somewhat nontraditional academic flashy exposition booths with sparkling careers in that we became faculty trinkets. Above all else, I believe it is

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June 2012 | Counseling Today | 17 Learning Curve: Notes from a novice - By Suze Hirsh

Pushing paper: Forms follow function

ounselors by definition are knows.) And, of course, the dreaded with one major exception: progress notes. People Persons, not Paper Progress Note. (That’s a grand total just Because mental health counseling was for CPushers. So, on my first day short of two dozen forms, in case you me a midlife career change, I am happy to of practicum at the local community were wondering.) report that my previous work experience mental health agency to which I had Is it any wonder I fled the office at as a journalist has provided a distinct been assigned, I was woefully unprepared my lunch break that first day and called advantage on three fronts. First, I have for the sheer volume of forms required. Husband for moral support? At first he a natural affinity for writing narratives. Since there are so many, I will start a new couldn’t understand what I was saying Second, I write fast. Third, I scored points paragraph to list them (and some I will because I was crying, babbling and with Supervisor, who shared early on that omit because my editor allots a max of hyperventilating all at the same time. By she actually looked forward to reviewing 1,600 words for this column). Just for this point I felt more like Tree Killer than my notes. “It’s like reading a novel!” she fun, take a really deep breath and see Counselor. To top it off, I envisioned in marveled. Then she schooled me on if you can read this list out loud before my future a crippling case of carpal tunnel proper format. “We use burp here,” she passing out: syndrome because each form was to be said. “Oh, I think I have some TUMS W-2 (even though “student intern” is filled out by hand. Shoestring budget at in my purse,” I responded. Supervisor: not a paid position); Daily Time Sheet; agency = no computer for underlings. (polite laughter). Me: (embarrassed Weekly Schedule of Clients; Time Off Adding insult to wrist injury, I even was silence). I hadn’t been joking. Requests; Reimbursement Requests; required to provide my own writing “B-I-R-P, not ‘burp,’” she explained. Informed Consent indicating I have instruments. “That stands for presenting Behavior, explained office policies, including Sufficiently soothed by Husband, I therapist Intervention, client Response, confidentiality and its limits; HIPAA; returned to the office and began the Plan.” You sign at the end. If your Income Verification; Fee Verification; onerous task of acquainting myself with signature is illegible, you must print Consent for Treatment; Proof of the various forms. To my delight, I your name underneath and include your Insurance (or, rather, proof of no discovered an upside to my obsessive- designation as “State-Registered Intern, insurance; as we all learned in our Ethics, compulsive tendencies. I broke out the Mental Health Counseling.” Joy of joys! Laws and Professional Issues course, state three-hole punch miraculously provided Office supply maven that I am, weeks law dictates interns are not permitted to by the agency and dutifully threaded each before the practicum start date I had treat those who are insured); an eight- form on the three rings of a ginormous mail-ordered a nifty hand stamp custom page Bio-Psycho-Social report; Treatment binder — yet another office supply I printed with precisely this information. Plan for Medical Management (if had to purchase with my own money. Supervisor: “That’s great! You can use applicable); Treatment Plan Addendum Between the pricey graduate school the stamp. But you’ll also have to sign for Individual Therapy; Medication tuition and this unpaid position, I by hand anyway, to prove it is really Inventory; General Assessment of calculated I was already in the red to the you who wrote the note.” Me: (visibly Functioning (GAF) score; Functional tune of five figures and counting. I say deflated) “Liability, right?” Supervisor: Assessment Rating Scale (essentially a “red” metaphorically, of course, because (clearly impressed) “You’re a quick GAF rating, but required nevertheless); Medical Professionals must write in study!” Me: (sheepish grin) Then silently Consent Releases and Record Requests black ink only — to avoid liability issues, to myself: “I’m certainly racking up the for Client’s primary and prescribing Supervisor explained to me after noticing points with this one!” physicians and (if applicable) previous I had composed my first set of progress In any case, the TUMS came in handy mental health care professionals; notes in a cheery shade of lavender ink. when I later learned the agency allowed Treatment Plan update; and something Back to Office Depot I must go! Then I only an approved list of abbreviations to cryptically labeled “OMG.” (Yes, I did collared Supervisor to explain to me the be used when writing progress notes. In ask. And no, it is not an acronym for ins and outs of completing each form, my previous incarnation as a journalist, “Oh My God,” although no one at the taking copious notes on cheery hot-pink I had developed a unique shorthand agency could tell me what the initials Post-its. Thankfully, the agency enforced that proved virtually useless in this new stood for. What they could tell me was no color requirements for sticky notes. setting. To make matters worse, my that OMG was required to be filled What a relief to learn that most of the shortcuts were thoroughly ingrained. out quarterly to document treatment forms had to be completed either one When I inadvertently reverted to progress. Required by whom, God only time only, quarterly, biannually, or yearly, contraband abbreviations, I cursed myself

18 | Counseling Today | June 2012 and scribbled over them in frustration. completed any later than 24 hours after a I am very careful to take pen to paper Yet another no-no. “You must cross them given session. I resigned myself to staying sparingly and to maintain frequent eye out with a single line only and then initial late, muttering epithets under my breath contact. To my surprise, I have received your mistake to prove you are the one at the injustice of it all. Plan B was not consistent feedback from Client after who altered the note,” Supervisor chided foolproof, however. I once was locked in Client, each of whom indicates feeling me. “Liability agaaaaaaaaaaaaaaain!?” the building in my attempt to comply all the more tended to and is delighted I groaned. “Yep,” she said, through with the edict. Alas, the final co-worker that what has been expressed is of such clenched teeth. “Brownie Points trending to leave that evening had failed to check value that Therapist is compelled to make downward,” I thought. for stragglers before going home. I had no note of it before their very eyes. At times In the end, I saw the wisdom of the key, no alarm code and no armed escort when Client clearly requires grounding, I system. I realized it was easier to keep to ensure I made it safely to my car. (Day have discovered that witnessing me gently track of homework assigned to Client so had given way to night, and the agency place the paper and pen on my desk that I would remember to process it at was located in a part of town replete with before turning my full attention to them the next session. Also, making a habit of barred windows and establishments for renders the act all the more soothing. And noting presenting behavior each week, I procuring bail bonds. Enough said.) when a particular intervention requires could track Client’s ups and downs. This Fortunately, the one thing I did have that I read (such as scripts for certain was especially helpful in determining was Supervisor’s cell phone number. She relaxation exercises) or that I write (to several treatment aspects. For example, graciously agreed to return to the agency complete an assessment inventory, for the practice gave me a reference point to to set the alarm and lock the door behind example), I’ll either take care to end the determine whether Client was applying me as I left. When she arrived, I was not session at 50 minutes or resign myself to coping skills effectively, what were the surprised by her rather cool reception. writing the progress note later, on the fly. major triggers in Client’s experience and Yet another point deduction. Drats! I Over time, I have changed my if a change in strategy was necessary. consoled myself, knowing it likely had paperwork perspective. For the most On the flip side, I discovered that dawned on Supervisor that leaving the part, I now realize that documentation BIRP required writing in detail and agency’s doors unlocked and the alarm is valid, designed to protect and to serve therefore was rather time consuming. off until the next business day would Client ethically, legally, emotionally Because I have a tendency to run over have constituted a major liability. I also and otherwise. The most important the customary 50 minutes, routinely reminded myself that before too long, I lesson and the one inviolable rule of our providing a full hour of face time, I was would arrive safely at my own doorstep profession, however, is this: Person comes in constant catch-up mode with the — devoid of bullet holes, with all major first, not Paper. u documentation. By the time I found the credit cards and cash still on my person. time to write a note, I often had forgotten In the end, my journalism background what occurred in session. I developed came in handy once again. As a Suze Hirsh is a state-registered a fail-safe. I would jot key words and newspaper reporter, I had cultivated intern in mental health counseling phrases on a legal pad in session, with the ability to take notes in Real Time, at a not-for-profit community the intention of consulting them to jog as people spoke. I even could do this social services agency in Florida. my memory when, at a later date, I could while listening! For the most part, I have Contact her at suze.hirsh@ steal a moment to dash off an officially found this method works for me. I can gmail.com. chart-worthy progress note. give Client 10 minutes of Bonus Time, Good plan, I thought. Except that maximizing my post-session allotment of Letters to the editor: Supervisor stipulated that progress Me Time in the process. At first, I worried [email protected] notes must, under no circumstances, be that Client would feel disconnected. So

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June 2012 | Counseling Today | 19 Private Practice Strategies - By Anthony Centore

Electronic health records in today’s private counseling practice

hile some counselors today the generous incentives have served thousands to get started with his web- are reaching for their pens to inflate the price of EHR programs based EHR-PM program. But when he Wand notepads, others are across the board. This makes sense when loaded his patient list of several thousand reaching for their laptops. With the help considering that even if an EHR-PM into the system, it slowed to a crawl. of electronic health record (EHR) and software suite costs $50,000, a group Fred explains, “We would watch the practice management (PM) software, practice of four medical doctors will still appointment calendar load, one line of counselors are trashing their metal filing turn a six-figure bonus for implementing text at a time. It could take 10 minutes cabinets and announcing that they’re the EHR-PM software. to check a patient in.” In addition, there “going green.” Eco-friendship aside, Wendy Molinaroli, a counselor in were state-specific regulations for filing a good EHR-PM program can help Charleston, S.C., is no stranger to EHR. insurance claims that the out-of-state a practice to organize files, improve In fact, she’s been looking for suitable software vendor wasn’t used to, so claims treatment planning, measure client software for her solo private practice since were getting denied. sessions and attrition, monitor client 2000 and has logged hundreds of hours And so began a ritual for Fred of balances and accounts receivable, track in the search. One of her findings: Most finding bugs and calling the software authorizations, file insurance claims, EHR-PM programs are priced too high company to try to get them fixed. “If you schedule appointments and more … or at for counselors. For example: deal with a larger company like Siemens, least that’s what it says on the box! n Amazing Charts: $1,999 per year you won’t have delays, and they have The technological learning curve for the first provider, $995 for each experience with practices nationwide,” aside, counselors today face numerous additional provider Fred says, “but a small practice can’t roadblocks when implementing EHR- afford that. So I’d call [the software n All Scripts: $699 per month per PM software into their practices. This company] and say, ‘This or that doesn’t column will address a couple of those doctoral-level provider, $474 for master’s level work,’ and they’d say they’d look into roadblocks and share several counselors’ it. It felt to me like I was teaching the journeys into the paperless. n Soapware: $3,000 per year per vendor.” provider Roadblock No. 1: The cost A month into his implementation, Fred “Go paperless and earn up to $44,000 n Praxis: $6,995 per year for the first received an unexpected bill in the mail in incentives.” This is the sales pitch provider, $2,995 for each additional for customer support. “I couldn’t believe many EHR software companies use. provider it — I’m helping them fix their software,” he says. “But what are you going to do? And it’s true. In 2009, President Barack n AdvancedMD: Nearly $1,000 per Obama signed into law the Health month per provider Once you’ve committed to a program, had it installed, trained your staff, it’s a Information Technology for Economic What’s notable is that many programs and Clinical Health (HITECH) Act. nightmare to switch. They not only have aren’t just expensive — their prices are Under HITECH, qualified providers can all your data, all your insurance claims are incompatible with counseling practices receive as much as $44,000 in Medicare in their software.” of any size. Even if a group counseling bonus incentives if they demonstrate the It’s hard to believe the lack of viable practice made lots of money, it still “meaningful use” of an EHR system. programs, especially when an Internet wouldn’t be able to afford the per user cost But wait … did you catch that? search turns up pages of results. In the of these programs. Master’s-level clinicians Medicare. Counselors can’t accept past year, both Wendy and I have test- don’t bill enough to justify a software fee Medicare! In fact, even if they could, driven dozens of programs, sharing our of several hundred (or thousand) dollars a “qualified provider” is defined as a notes (and disappointments) about each. per month. The same is true for practices physician — not a licensed professional Names have been removed to protect the that include part-time clinicians. counselor. Unfortunately, the HITECH guilty, but the problems are numerous stimulus package doesn’t account for Roadblock No. 2: Software problems and pervasive and render many EHR-PM mental health professionals trying to Fred Porter (name changed), owner of software options on the market unusable. turn the electronic corner. Worse yet, a New England psychiatry practice, paid Among the problems we encountered:

20 | Counseling Today | June 2012 n Help tickets go unanswered going to tie myself to the EHR,” he those sections there because those features n Software has downtime explains. “I’m already paying for it. I’ve don’t apply to us.” just been reluctant to use it.” Today, several years into our Office n Software is cripplingly slow He says he feels fortunate that his Ally subscription, our staff still dislikes it, n Broken features software developer “got it” and was able as does our in-house billing department, to make adjustments to the software. n Basic features missing which warns that the software will He plans to begin using the EHR soon become decreasingly able to meet our n A difficult-to-use interface and is excited about some of the other needs as the practice grows. Also, it only features such as automated reminder n Billing claims sent improperly or works well on Internet Explorer, and it calls. “Reminder calls keep the no-show not at all has regular bugs, crashes and downtime. rates down to 5 percent, but it takes n Billing claims sent repeatedly (in error) an enormous amount of resources for In 2011, in an attempt to phase out n Reports are faulty or altogether receptionists to manually make each call,” Office Ally, we tested a new software unavailable Fred says. program with a handful of staff. Although As Wendy observes, “Some software Fred also shared one final issue. Despite the notes side worked well, the PM side is OK on the notes [EHR] side, but choosing a small EHR-PM vendor, even was wrought with problems. We are now the practice management and billing one add-on feature is out of his budget. in the process of implementing a third side is poor. Some software is the other “The electronic prescription writing is a software program. This time, the practice way around. No one seems to have a bit expensive,” he says. “It’s $60 a month purchased a higher-priced solution in complete, usable package.” per provider. I have 12 prescribers, but hopes that it will lead to better outcomes. some only work one day a week, so I can’t In the next year, we will be spending Trial and error justify the cost.” Ryan Neace, a counselor based in north of $10,000 on EHR-PM software Still, Fred is positive about the central Virginia, has gone paperless (we’ll let you know how it goes). prospects of EHR-PM. “We’re getting without the use of EHR software. In his Despite the troubles, overall EHR- there,” he says. “Slower than I had hoped, practice, every therapy office is assigned PM software has helped the practice. but we’re getting there.” its own iPad loaded with a simple Note taking has improved, as has the note-taking program called smartNote, My experience organization of client files. We can view available in the iTunes app store for As for my practice, we began using a history of sessions at a glance as well as $2.99. “The client files are password EHR-PM software in 2009. We thought how much has been paid to each clinician protected,” Ryan explains. “Besides that, that an EHR system would help us to from insurance and copays. It’s also a nice the application couldn’t be more basic. better organize records and make records perk not to have a growing mountain of It can’t run reports, such as sessions easier to retrieve when clients requested filing cabinets crowding the office. booked, and it has no billing capabilities them. As director, I also saw value in whatsoever. The program works for us having a solution that combines note No one’s missing the boat because we don’t need much in the realm taking with insurance billing. Sometimes it’s not worth being an of reporting and because we’re a cash-only In choosing an EHR-PM platform, early adopter. As someone who has practice.” our team sorted through which features spent hundreds of hours searching for Meanwhile, Wendy is on her fourth would be most helpful for our practice. and testing EHR-PM programs, it’s software suite in as many years. Her first We wanted to find a web-based program infuriating to know that at some point in software had “updating and syncing” that didn’t need installation on every the future — perhaps even soon — there problems, the second company went out office computer. This eliminated many will be a clear industry leader. Choosing of business and the third software never options. Price eliminated others. Trying software will be quick, easy and maybe ran properly (“They blamed Bill Gates for demo versions of various suites eliminated even affordable. But if you feel like you’re even more because many looked like a their software being crappy,” according to missing the boat on EHR-PM software at Wendy). As for the fourth program, the flashback to DOS. In the end, we found the moment, you’re not. The boat isn’t note-taking side works well, but the PM a low-cost program called Office Ally. even in the water yet! u side has so many serious billing problems (Cost for EHR is $29.95, plus $15 per that Wendy is being forced to switch provider per month. The PM software is software vendors again. “Even after all basically free.) Anthony Centore is the founder my searching, I haven’t found a single The team was excited about the of Thriveworks, a company that software program I could recommend to program. Once implementation began, helps counselors get on insurance however, excitement waned. The software counselors,” she laments. panels, find new clients and build Fred has stuck it out with his software was not nearly as easy to use as we had thriving practices. Contact him at provider through what he describes as “a hoped, and the learning curve was brutal. [email protected]. year and a half of struggles.” The PM side There is a lot of dialogue during the of the software is working, but he has yet training process that goes like this: “You Letters to the editor: to begin using the EHR side. “Because need to click here, then here, then click [email protected] the financials weren’t working, I wasn’t the drop-down menu here, and ignore

June 2012 | Counseling Today | 21 Resource Reviews - With Kelly Duncan

Stress Management and Prevention: vous systems. This overview is beneficial to by practicing good study habits, prioritiz- Applications to Daily Life, Second those who are not familiar with the intrica- ing workloads, preventing burnout and Edition cies involved in executing human functions. integrating fun into their schedules. By Jeffrey A. Kottler & David D. Chen, This is followed by a chapter on various The closing section encompasses what 2011, Routledge, 432 pages, $65, ISBN: stressors throughout the life span, including the student has learned and describes 978-0415885003 peer relationships, academics, career how to stay focused and motivated to Rarely do stu- decisions, intimate relationships, raising a create lasting change. Emphasis is placed dents have the op- family, retirement and death, and how each on resilience as a character trait that contributes to positive change and portunity to enroll phase of life attempts to resolve the stress. Chapter 4 details adaptive and maladaptive reduction throughout the life span. in a class that behaviors as applied to psychoanalytic, This text is an excellent resource for focuses entirely on cognitive behavior and humanistic theories. college students and clinicians. It would themselves. The Next is a discussion of , anxiety, be ideal for first-year students as part of authors of Stress aggression and eating disorders and how an orientation class, but it would also be Management and these issues either contribute to or result a useful resource in college counseling Prevention: Appli- from stress. This information may be a centers to promote cations to Daily Life review for social science majors, but it either in individual sessions, groups or have written a text is helpful in understanding the possible educational trainings. that not only describes how all students feel origins of behavior. The section ends at times — overwhelmed, frustrated, anx- Reviewed by Stephanie McGuire Wise, with a discussion of individual differences ious, stressed — but also provides insightful clinical counselor, the University of Toledo that have an impact on stress and stress strategies for preventing and overcoming Counseling Center, and doctoral student, management. Personality traits, gender the obstacles of college life. University of Toledo counseling education differences and cultural differences are and supervision program. This comprehensive manual is divided among the factors that help determine how into three sections: understanding the individuals develop and respond to stress. nature of stress, strategies for stress manage- This transitions readers into Part 2, How to Help Children Through a ment and prevention, and stress prevention which focuses on stress management in- Parent’s Serious Illness, Second Edition and synthesis of self. The introduction of- terventions. The authors take a holistic By Kathleen McCue with Ron Bonn, 2011, fers a personal account of the life challenges approach to stress management, believing St. Martin’s Griffin, 368 pages, $16.99, ISBN: that led the authors, Jeffrey A. Kottler that individuals need to care for the mind, 978-0312697686 and David D. Chen, to the practice and body and spirit to overcome obstacles. In the second eventual teaching of stress management Their interventions are also comprehensive edition of How and prevention. Each chapter features “For in that they provide techniques that can to Help Children Reflection” exercises that readers can apply positively affect thoughts, feelings and be- Through a Parent’s to gain insight into their own lives. Each haviors. Reframing, thought stopping, time Serious Illness, chapter also contains personal accounts of management, organization, yoga, exercise, Kathleen McCue students who have faced similar challenges mindfulness and relaxation techniques provides tangible and learned how to apply stress manage- such as progressive muscle relaxation and guidance for ment techniques. Checklists and tables pro- meditation are just a few of the methods facilitating healthy vide additional resources, information and the authors introduce. They also devote a child development quick reference guides. The text is written chapter to nutrition and other healthy liv- in the midst of in a conversational style, as though the ing options (such as good medical care and chaos and tragedy. This edition maintains authors are speaking directly to students, abstinence from substances) to keep the the central thesis that children need to creating an informal and intimate relation- body — and thus the mind and spirit — know the truth about a parent’s illness ship between them. prepared to manage stress. All of these tech- and the situation in which they currently In Part 1 of the book, the authors define niques have the added benefit of reducing find themselves living. Through case stress as a survival mechanism from early the impact of stress before it starts, which is examples, she provides clear guidance for evolution, a “physiological and psychologi- a good message for college students learn- communicating these truths with children cal response to a real or perceived threat,” ing how to manage their new responsibili- ranging from infants to adolescents at that enables us to make split-second deci- ties. Finally, the authors emphasize the different points of the illness trajectory. sions. They devote a section to the “fight importance of preparing for the future to The book is organized to take the reader or flee” response and provide a detailed prevent unnecessary stress. College and oc- from diagnosis to the end of treatment. overview of the body’s stress mechanisms cupational stress are listed as challenges for There are chapters detailing special housed in the central and peripheral ner- which students can at least partly prepare circumstances such as preparation for

22 | Counseling Today | June 2012 a parent’s death, family adjustment to Clinical The next section covers the substance of chronic illness or disability, well-parent supervision is an supervision, with Chapter 5 continuing to and child coping with parental mental integral part of examine the preliminary session, the envi- illness, preparing children for illness and counseling practice. ronment and requirements for an effective disability of a loved adult other than a Therefore, Practical supervision process. Chapter 6 focuses parent and navigating single parenthood Clinical Supervision attention on elements of the supervisory as a parent with a serious illness. McCue for Counselors: An relationship and ways to navigate the outlines clearly and concisely the benefits Experiential Guide multiple roles of manager and supervisor. and dangers of the Internet as it relates to is a useful resource Chapter 7 examines factors that enhance life-threatening, chronic and genetically for counseling or drain the supervisory relationship and linked medical conditions. At the end of professionals, offers solutions to resolve such issues as many chapters, she provides reputable especially supervisors and educators who needed. Chapters 8 and 10 look at meth- and supportive websites for families and are engaged in gate keeping, intervention, ods of conducting supervision, whether children learning about and coping with training, evaluating, monitoring ethical in individual, dyadic, triadic or group serious illnesses. practice, mentoring and shaping the formats. The advantages and disadvantages The book reads like a letter written both identity of new professionals, as well as of each format are outlined. Chapter 9 to the ill parent and the well parent. Mc- maintaining the safety and welfare of clients summarizes emotional issues that may Cue vacillates her address between the two being seen by trainees and supervisees. continue to arise in the supervision process parents throughout the book and empha- Supervisors and educators alike will and offers tools and tips to address them. sizes the importance of both parents main- find this text valuable in understanding Chapter 11 calls on counselor supervisors taining their parenting role to whatever their roles and responsibilities and to be innovative and to employ techniques extent is possible. Although the primary grounding them in the supervisory process using simple or complex technologies and audiences for this book are parents diag- and relationship. Author Lisa Aasheim materials as their abilities allow. nosed with a serious illness and their well examines clinical supervision and its The final section covers challenging partners, other support people will find its components in a comprehensive manner, and vital aspects of clinical supervision. contents indispensable. Relatives and fam- with insights provided by guidelines Chapter 12 focuses on ethics, competence, ily friends will learn how to facilitate their from the Association for Counselor confidentiality, malpractice, liability grandchild’s, niece’s or child neighbor’s Education and Supervision, a division of and the ethical decision-making adjustment to a parent’s illness as well as the American Counseling Association. model. Chapter 13 examines the core how to identify when a child’s struggle to Activities at the end of each chapter of supervision experience, including cope would best be addressed by mental enhance reflection and problem-solving evaluation, documentation and case health professionals. The book provides skills tied to the topics being discussed. In review. Chapter 14 highlights the integral wise insight into how medical personnel addition, the appendices include samples role that feedback plays in supervision. can assist children across development of forms used in supervision. This text contains extensive practical with visits to intensive care settings, inpa- Chapters 1 through 4 provide an information for counseling supervisors and tient wards and in-home hospice. introductory lens into clinical supervision, educators. It is well-written and consistent McCue has written the book covering its definition, occurrence, with relevant counseling terms and current chronologically, beginning with diagnosis. purposes, ethical practices, the supervisor’s matters in supervision. I recommend it for It is possible to read chapters in isolation stage of growth, reflection and what a any counselor or educator who wants to if a parent or family support person proficient supervisor looks like. This become an expert in clinical supervision. needs guidance about a specific phase of a serious, terminal or chronic illness. section also examines the tools necessary Reviewed by Mary Ollor Onungwe, However, reading the book in its entirety to prepare for efficient supervision. The doctoral student, counselor education and and chronologically will yield the richest qualities of a competent supervisor are supervision program at North Dakota and fullest experience regardless of your outlined, as are issues of role clarity when State University. u role in the child’s life. This newest edition functioning as both a supervisor and is a valuable resource both for laypeople counselor. The importance of identifying and health care professionals. and choosing a model of supervision on Kelly Duncan is an associate the basis of evidence-based practice is professor of counseling and Reviewed by Alyson L. Hatten, licensed also highlighted. Explanations of each professional counselor and certified director of the University of model of supervision are provided, giving rehabilitation counselor, Oregon Health and South Dakota Counseling and counselors the opportunity to revisit, Sciences University, Child Development and Psychological Services Center. reflect on and ground themselves in their Rehabilitation Center. Contact her at Kelly.Duncan@ chosen style. Finally, this section offers a usd.edu. preamble to the beginning of supervision Practical Clinical Supervision for sessions, including do’s and don’ts, Letters to the editor: Counselors: An Experiential Guide interviews, fees, schedules, contracts, [email protected] By Lisa Aasheim, 2011, Springer Publishing, informed consent and professional 344 pages, $65, ISBN: 978-0826107862 disclosure statements.

June 2012 | Counseling Today | 23 Spotlight on Journals - By Sheri Bauman

Males may be more influenced by gender stereotypes, adult role modeling

his will be my final “Spotlight Although not statistically significant country. Of this sample, 75 had a school on Journals” column for (perhaps due to sample size), 45 percent counseling specialization, while the rest TCounseling Today. Each of the girls listed stereotypically male were in community agency counseling quarter for the past three years, I’ve had jobs for their career aspiration. Only 21 specialties. All were currently enrolled in the pleasure of scouring the journals percent aspired to traditionally female internship classes, so they already would published by the American Counseling jobs, while the remainder chose gender- have completed much of their course Association and its divisions and sharing neutral occupations. work. my reactions to current research articles. Participants were also asked to give The sample was ethnically diverse and But it is time for readers to hear from a a reason for their choice. Although no also included 16 students who identified new voice in these pages — someone who statistical differences were detected, 58 as lesbian, gay, bisexual, transgender or will choose different articles than I might percent of the entire sample made their questioning (LGBTQ). Of the LGBTQ have and who will bring his or her own choice on the basis of interest; 38 percent students, 13 were in the community lens to the column. I will remain an avid of girls and 21 percent of boys explained agency specialization. On the measure of reader of the column. their choice by mentioning a role model LGB counselor competence, the school In most counseling programs, career who inspired them. Furthermore, counseling students had significantly development is a required course because although boys’ aspirations were related to lower total and subscale scores than future counselors need to possess skills the occupation of the male with whom did the community agency students. In to assist clients and students with career they identified in the demographic addition, the school counseling students and advanced educational decisions. section of the survey, this was not true also scored lower on the measure of It is important to be aware of research for the girls. Although not statistically multicultural counseling knowledge and that might shed light on the career significant, the researchers also detected awareness, although the magnitude of the development process. a trend toward the students choosing difference was not as large as it was on the In the March 2012 issue of The Career occupations of higher status than did the LGB competence scale. Development Quarterly, researchers adults with whom they identified. Although the researcher acknowledges Christine T. Schuette, Michael K. Ponton On the basis of their findings, the the study’s limitations, as one does for and Margaret L. Charlton report findings researchers note that gender stereotypes all research, these findings cannot be from their study of the career aspirations and adult role modeling may be more dismissed. As Bidell accurately notes, the of students in a single middle school in a influential for adolescent males than for political climate in many school districts low-income suburban neighborhood in adolescent females. That is good news makes it quite risky for employees in Norfolk, Va. (“Middle School Children’s about females, but career counselors at any position to be strong advocates Career Aspirations: Relationship to Adult all levels might work toward encouraging for minority groups, whether sexual Occupations and Gender”). Students more flexibility among males. or cultural. I work in Tucson, Ariz., (N = 89) participating in the study and readers may be familiar with the had two adults of different genders in Multicultural, sexual orientation controversy surrounding the Mexican the home who held occupations the competence appears lower among American Studies program that was students could identify. The researchers school counseling students canceled in the largest school district investigated the relationship between As an educator of school counselors in a in the area. I believe school counselors the occupations of those adults and the program that highly values multicultural must be especially sensitive to and students’ occupational aspirations. Aspects competencies, I found Markus P. Bidell’s skilled in working with students in these of those occupations that were of interest study, “Examining School Counseling groups precisely because students in to the researchers were the status of the Students’ Multicultural and Sexual such environments are likely to need job, the student’s interest in the job and Orientation Competencies Through considerable support and may otherwise gender. a Cross-Specialization Comparison,” find it to be a scarce commodity. Their findings were quite intriguing. in the April 2012 issue of the Journal Bidell also notes that the national rate The boys all aspired to stereotypically of Counseling & Development to be of self-identified LGBTQ students is male jobs or gender-neutral jobs, and especially relevant. The sample included lower in school counseling programs than their choices were significantly different 164 second-year master’s students in in counseling programs in general, which from what would be expected by chance. four counseling programs around the may be a consequence of the perception

24 | Counseling Today | June 2012 that schools are not always welcoming to this population. The analysis also showed Recovery from Grief Is Possible. that LGB counselor competence was related to the number of LGBTQ friends Learn How to Help. the counselor had. Having fewer LGBTQ classmates reduces the possibility of students expanding their network of LGBTQ friendships within their school counseling programs. Certification Training Another relevant observation was 2012 that although multicultural course JULY AUGUST work predicted scores on the measure 27–30 Milwaukee, WI 10–13 Juneau, AK of multicultural competencies, the 27–30 Hartford, CT 10–13 Cleveland, OH relationship was minimal for course 27–30 Memphis, TN 24–27 San Diego, CA work and LGB competencies. This may 27–30 Sherman Oaks, CA 24–27 Richmond, VA 24–27 Sherman Oaks, CA indicate that existing course work does SEPTEMBER not sufficiently address sexual orientation 7–10 Atlanta, GA OCTOBER as a cultural group or, as Bidell 7–10 Phoenix, AZ 12–15 Portland, OR 21–24 Chicago, IL 12–15 Detroit, MI suggested, that those in school counseling 21–24 Meadowlands, NJ 26–29 Austin, TX specializations need specialized training 21–24 Sherman Oaks, CA 26–29 Jacksonville, FL for work with LGBTQ students in 4-Day Training  30 CEU Hours  Maximum 15 Participants educational settings. It is well established Tuition $1995 (Early Registration Discount $200) that these students experience harassment and bullying at higher rates than do their For more information or to register heterosexual and gender-typical peers. It Call 800-334-7606 is necessary that school counselors be well prepared to assist and advocate for these www.griefrecoverymethod.com students. These articles remind me once again that research is necessary to inform counseling practice at all levels and provides an empirical basis for professional decisions. Counselors must be well-informed consumers of research, and I have been pleased to have had the opportunity to alert readers of Counseling Today to studies that have particular relevance to practitioners. w Counseling Today and ACA would like to thank Sheri Bauman for serving as the column editor of “Spotlight on Journals” and for her commitment to raising awareness of the research being conducted in the counseling community. u

Sheri Bauman is a professor and director of the school counseling program at the University of Arizona. Contact her at sherib@ u.arizona.edu.

Letters to the editor: [email protected]

June 2012 | Counseling Today | 25 A loss like no other Although loss is a universal experience, every person’s grief process is unique, meaning practitioners are wise to leave behind one-size-fits-all approaches to grief work

By Lynne Shallcross magine this scenario: You are a is unique. The meanings I attach to my counselor, and you have two clients. losses and my ways of grieving are specific IThey are the same age and same to me.” gender, and both experienced the death Understanding that notion of of a partner at roughly the same period uniqueness and applying it in session as a in life. So, you can reasonably expect that counselor means there is no one “right” both will have similar reactions to that approach to grief-related counseling parallel loss and both will benefit from work, Humphrey asserts. Rather, to work similar counseling techniques to deal with effectively with these clients, practitioners the residual grief, right? Not likely. must be capable of drawing from a In fact, says Vincent Viglione, an variety of counseling skills and techniques adjunct professor of counseling at and tailoring a therapeutic approach Kean University and Montclair State that is custom fit to the client’s specific University in New Jersey, one of the personality, situation and needs. most important things for counselors A good starting point for counselors is to to understand about grief and loss is take the role of “witness” and realize that that although the experience of loss is the client is the expert, Humphrey says. universal, every individual’s grief process “It’s a time for you to shut up and facilitate is unique. “We as counselors recognize the client in telling [his or her] story. We that certain client responses are not too often in counseling jump too quickly necessarily pathological,” says Viglione, into reflecting feelings and attending and who is doing his doctoral dissertation on worrying about the next thing we’re going adult sibling grief and continuing bonds to say to the client. That interferes with at Montclair State. “As such, we attempt [clients] telling their story. Back off of to normalize our client’s feelings. In those automatic responses and just allow doing so, however, we must preserve the clients to tell their story of loss.” idea that their circumstance is unique to A loss is the absence of something we them. Normalizing, then, is never saying, deem meaningful, Humphrey explains, ‘You’re just like everyone else.’” while grief is our response to that sense of Keren Humphrey, a retired professor loss. People normally associate loss with of counseling at Texas A&M University- the death of a family member or close Commerce, agrees about the unique friend, but it can also be inclusive of the nature of each person’s grief experience, loss of a house, a relationship, a job or any not only because of her work with clients number of other things. Sometimes, says but also because of her own experience Anne Ober, an assistant professor in the with grief and loss. “In the last two Department of Counseling and Human years, I have experienced a number of Development at Walsh University, it can significant losses, including breast cancer even be the loss of a particular feeling. with a double mastectomy, my husband’s For instance, Ober points out that after extended illness and death, [and] my 9/11, even people who weren’t directly mother’s decline from Alzheimer’s and her affected by the terrorist attacks might have death only a month after my husband’s felt a loss of the sense of security they had death,” says Humphrey, whose book, presumed previously. Counseling Strategies for Loss and Grief, was Elizabeth Doughty Horn, an assistant published by the American Counseling professor in the Department of Association in 2009. “These experiences Counseling at Idaho State University, have certainly reiterated my view that says grief can also stem from the loss of each person’s experience of loss and grief expectations that weren’t met. From the

26 | Counseling Today | June 2012 outside, to those observers who aren’t says, especially as it relates to death. But depressing — but there can be an element experiencing the loss personally, the loss many times, she says, clients either think of these in much of day-to-day life in might not appear particularly significant they should be “over” something already varying extremes.” — for example, a high school student or they don’t even recognize that their pain Viglione, an ACA member who runs a failing to make the cheerleading squad. stems from an issue of grief and loss. private practice in Denville, N.J., agrees. Many of the losses people experience are “I believe that once counselors begin to “For every client that I see, I find an disenfranchised, Horn says, meaning they view transitions in terms of grief and loss,” element of loss in what they’re presenting aren’t recognized or appreciated as losses Horn says, “they really won’t have to look if I look closely enough.” by society. Hallmark doesn’t make cards for these issues in their clients. Rather, for disenfranchised losses, she notes. they will see an aspect of them in almost Stepping away from the stages In some instances, only certain aspects every client issue. I’m not suggesting that Counselors say one of the more of loss get recognized, while other often everything in life is grief and loss — how significant changes in the area of grief more complicated aspects go overlooked. Consider a person recently diagnosed with cancer. “Once someone has been diagnosed with cancer, his or her identity is often linked with the disease,” says New! Horn, a member of ACA who has researched, published articles, taught classes and presented at conferences on Rooted Sorrows— the topic of grief and loss. “The bulk of their day-to-day life is spent focused on Emotional Burden to cancer — scheduling, getting to and from doctor appointments, reassuring well- Emotional Health: wishers, letting people know about their illness, processing their own emotions as Veterans With PTSD well as their family’s. Obviously, people acknowledge grief and loss associated with presented by Mitchell Young getting cancer, but they may not view it in terms of the loss of self.” In this compelling and heart-wrenching Many times in cases of disenfranchised loss, clients themselves don’t recognize DVD, Dr. Mitchell Young, a licensed the issue as one deserving of feelings of psychotherapist and combat veteran who grief. They come to a counselor saying, “I has counseled Vietnam veterans for more than 15 years, discusses shouldn’t be so upset about this,” Horn says. One of the most helpful things PTSD and the lasting effects of combat and severe trauma. counselors can do is to acknowledge Drawing from his own experiences in Vietnam as a member of the the extent of the losses clients have Marine Corps, he examines the emotional scars that occur after experienced and assist them in connecting the way they are feeling with those losses. a traumatic event, night terrors, chronic isolation, and emotional Even in situations in which loss is numbness. He also discusses complex PTSD and secondary PTSD, generally recognized by society at large, the most common form of PTSD he has seen in Vietnam veterans counselors say it is common for clients to come into counseling feeling unsure about and their families. why they are struggling. “It happens so often,” Horn says. “People come in and recognize there has been a major change, Produced by R-Squared Productions, LLC but they’re not seeing it in terms of grief. 2010 50 minutes DVD Order #78241 They might say, ‘I know I lost my job, but List Price and ACA Member Price: $59.95 I have a new job, so why am I still focused on the job I lost a year ago?’” Society often emphasizes getting over Order Online: counseling.org things and moving on, Horn says, but in many situations of loss, the process of By Phone: 800-422-2648 x222 “getting over it” doesn’t happen quickly, if (M-F 8am – 6pm) ever. One of the newer trends in grief and loss counseling is the rejection of the idea of “closure” as a completed process, Horn

June 2012 | Counseling Today | 27 and loss counseling in recent years has if clients went all the way through each to them, Horn says. That might mean been the move away from using Elisabeth of the stages — denial, anger, bargaining, encouraging clients to disregard outside Kübler-Ross’ stages of grief model. Ober, depression and acceptance — they would influences or the internal “shoulds,” she a member of ACA who has researched, encounter an end point to their grief, says. For instance, a person who has just counseled and taught on the topic of Horn says. “But grief is an ongoing process experienced the death of a loved one might grief, points out that Kübler-Ross herself of adaptation,” she says. “The idea of get the message from his church that the said her stages were misapplied and that closure is no longer seen as being possible death was “meant to be” and that it is she originally designed them to be used for most people. Rather, it’s ‘How do I time to let the person go. “Maybe that with individuals coming to terms with adapt or integrate this loss into who I am ends up making the client feel they should their own death. Although Kübler-Ross’ and into everyday life?’” be happier this has happened or that work was very beneficial and started a Humphrey again emphasizes that they shouldn’t be feeling so sad,” Horn larger societal conversation about death the trend in grief and loss counseling says. When clients refer to what family and dying, Ober says applying the stages in the past decade or two has been members, their religious community or to clients going through grief and loss toward realizing there is no one-size- some other outside influence thinks, Horn isn’t very helpful and in some cases can fits-all model or therapeutic approach to suggests counselors raise clients’ awareness even be harmful. helping clients. “Instead, the counselor of this and ask what they are experiencing. The problem is that the stages model helps clients focus on useful material Helping clients find their natural doesn’t fit everyone’s experience, Horn and implements therapeutic strategies grieving style starts with listening to them says, especially in light of how each appropriate to the uniqueness of a given and supporting what they say they’re person’s reaction to loss is unique. client,” she says. “For example, I would thinking or feeling. “A client might say, Humphrey agrees, saying the model use nondirective methods with a client ‘I’m really sad, but I haven’t cried and I suggests that everyone experiences grief who is uncomfortable with more directive feel guilty for not crying. I’m more focused the same way. “That just simply is not approaches. I might use narrative therapy on the logistical details of what led up to true,” Humphrey says. “It does not respect strategies to help a client explore cultural the person’s death,’” Horn says. “So we the differences among people in terms of influences and later use solution-focused try to help foster that rather than putting personality, social-cultural influences and or behavior-based strategies for specific pressure on them to cry or telling them that kind of thing. We need models that problems or to increase awareness of that they’re in denial.” allow us to focus on uniqueness of people. personal strengths for the same client. In fact, Horn says, one of the newer It also ignores process. Instead, we need to I might use cinematherapy to highlight models some counselors are using in loss understand that clients are in a process of multiple issues, but not with people and grief work, the adaptive grieving styles adapting, renewing and reviewing. They’re who hate movies. It is important that model from Terry Martin and Kenneth in a process, not in a stage.” counseling professionals remember that Doka, recognizes that certain clients will Horn says research conducted on how effective grief counseling is not about the be more affective in their grieving style, the stages were used in therapy has shown counselor’s specialty. … Rather, it is about some will be more cognitive and others that counselors were doing harm to some selecting and adapting various therapeutic will find themselves along the continuum clients by trying to shoehorn them into approaches to the particular needs, in between. Understanding that different stages. For example, if a client wasn’t preferences, personal history, grieving grieving styles exist and encouraging having the particular experience the style and multiple contexts of a given clients to grieve in the way that’s most counselor thought he should be having client. Using only one approach with natural to them is key, Horn says. For according to the stage model, the client every client is ineffective and, worse, very instance, grief groups are often helpful may have tried specifically to have that disrespectful.” to affective grievers, who might want to experience, she explains. “And that’s when share and cry with others, she says. On the people get into trouble — when they’re Go with what’s natural other hand, cognitive grievers might want not following their own natural process, The main goal in working with to focus on problem-solving associated when they try to do something that clients who have experienced a loss is to with the loss and could find talking about doesn’t fit into who they are,” Horn says. help them experience and express their the loss repeatedly with a group to be The stages also gave the impression that grief in the style that is most natural overwhelming.

28 | Counseling Today | June 2012 “Counselors use this model to help Meaning-making, which Robert story of who they are today. “Sometimes better conceptualize and work with Neimeyer, Thomas Attig and Michael people can be stuck with their old story, clients,” Horn says. “They educate clients White have researched, is another looking at the past as if time stops,” about the uniqueness of grief and help potentially helpful concept, Ober says. It Humphrey says. “They’re living physically them to identify their personal style, provides a way of helping clients determine in the present and the world is moving on, [which is] usually blended, with one more what the loss means to them in their but they’re stuck. That brings them into prominent than the other [affective versus life and their life story, she says, and has counseling. What you’re trying to do as a cognitive]. This helps to normalize their similarities to narrative therapy. However, counselor is help them create a narrative natural style and helps to remove some Ober says, counselors need to let clients that builds onto their old story by taking of the perceived pressures to grieve in a guide them before using this technique. into account their losses.” particular way. Counselors can then use Clients need to indicate on their own in “Creating a post-loss story of one’s life techniques that complement a client’s some way that they are trying to make involves making sense of the losses; dealing predominant style, allowing them to sense of why the loss happened and what it with disrupted beliefs, assumptions and experience and express [their grief] more means to them. “That won’t be the case for expectations; and developing revised but naturally.” everyone,” Ober says. “You shouldn’t apply enduring bonds with the loss object,” Horn also mentions Margaret Stroebe it unless your client is really at that place.” she continues. “Many clients respond and Henk Schut’s dual-process model as Ober also points to continuing bonds positively to simply introducing the notion potentially beneficial because it focuses theory as potentially helpful. The theory of building or creating a post-loss story, so on different aspects of the loss. It looks is in contrast to Sigmund Freud’s idea it becomes an ongoing theme in treatment. at both loss-oriented stressors, which that a person needs to cut ties with Thematic genograms, therapeutic writing, deal with thoughts and feelings related whomever has died and focus instead objections of connection, loss timelines, directly to the loss, and restoration- on the here and now. The continuing decisional balance, client-generated oriented stressors, which refer in part to bonds theory suggests that a person metaphors and wisdom letters are the life roles that have been changed after who has lost a loved one can still have a particularly useful strategies here.” the loss. The model suggests that people nonphysical relationship and some sort The difference between primary experiencing a loss will oscillate between of communication with the deceased and secondary losses is an important the two, Horn says. person. Letter writing, putting up photos distinction for counselors to make, Ober’s take on the dual-process model at home, returning to a special place that Humphrey says, and one that can help is that people need to move between the was important to the deceased person and guide the course of treatment. For emotional impact of the loss and the day- celebrating the deceased person’s birthday example, in a scenario in which a client’s to-day logistical impact of the loss. For or death anniversary are a few examples of spouse has died, the primary loss is the example, a recent widower might have an ways to continue the bond, Ober says. spouse. The secondary losses might intense emotional response in which he Viglione recommends William Worden’s include companionship, a sexual partner tasks of grief approach as another potential cries and talks about his deceased wife, and expectation of a future together. tool for helping grieving clients. The tasks but he may also have to figure out how to “The secondary losses are really the guts take clients through accepting the reality of cook because she previously prepared all of the loss, and that’s where the focus of the loss, working through the pain of the of their meals. “What this theory suggests counseling should always be,” Humphrey grief, adjusting to the new environment is that it’s healthy for the person to move says. “When you focus on the secondary and reinvesting in life. between those two [responses] and have a losses, it helps you understand what the balance,” Ober says. “People who are able A life story that continues client sees as meaningful and what should to do both fare better in the long run than Humphrey says helping clients to be addressed in counseling.” people who focus on one or the other explore and tell their story of loss is “Counseling professionals focus on research shows.” important, as is helping them create a new secondary losses because this reveals Become Masterful

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June 2012 | Counseling Today | 29 the unique meanings, influences, coped with stressors in the past and what Ober suggests that practicing individualized adaptive processes, client has helped them get through hard times counselors seek supervision or strengths and potential problematic before, she says. consultation with other professionals so issues that constitute client grieving,” they can talk through what’s going on When grief and loss Humphrey continues. “I ask a lot with their clients and in their own lives. hit close to home of open-ended questions that invite This process can help counselors become Of course, counselors aren’t immune exploration and that recognize the client aware of how losses might be affecting as the expert on their grief. ‘What does to experiencing loss and grief in their them and their work, Ober says. that mean to you? Tell me what works own lives. Dealing with that reality goes Most people deal with loss in an and doesn’t work for you. What feelings/ hand-in-hand with all types of counselor effective way, Humphrey says. However, thoughts/behaviors go with this or that? self-care, Horn says. “We need to be if counselors are feeling “stuck,” What should I know about you that will acknowledging our own grief and loss Humphrey says they should consider help us understand your experience? Tell and allow ourselves to have that unique seeking counseling for themselves, just as me the story.’ Their responses provide experience and expression,” she says. they would recommend that clients do. clues to potential issues and direction for “We tend to feel that we’re above it all or should be immune to losses. We also Getting prepared to address grief therapy.” Because there are no CACREP Jane Newman, an ACA member who tend to believe that as counselors, we’re supposed to be so together and that with standards that deal specifically with grief runs a private practice in Portland, Ore., and loss, Horn says it’s rare that graduate says one of the first steps she takes with all of our coping skills, we’re not supposed to hurt.” These misguided beliefs can lead counseling programs require a course on grieving clients is to validate their loss the topic. “It’s really criminal to a certain and express empathy for the difficulties counselors to discount their own grief and loss, Horn says, even as they carefully extent that we do not require students they are experiencing. Counselors have to to learn about grief and loss when every be sure never to minimize or diminish a guide clients to do otherwise. One of the best things counselors can client we see will likely present with client’s loss in any way, she cautions. some element of grief and loss,” she do is to raise awareness of their own loss After validating their loss and pain, says. “More likely than not, counselors histories and their thoughts surrounding Newman says she asks clients, “Now are graduating without having taken grief and loss, Ober says. Ober uses what?” In her current caseload, Newman formal training on grief and loss. There an exercise from Humphrey’s book, has a male client recently diagnosed with is preliminary research showing that Counseling Strategies for Loss and Grief, to terminal cancer. He is a respected scientist having some type of formal education help her counseling students become more who has been forced to sideline his career on death and dying or grief and loss does mindful of their personal experiences of because of the cancer. “He’s mad and reduce anxiety around working with these loss and grief, which in turn will lead them unhappy because within weeks, his whole issues.” For the very reason that it might to better assist future clients. The exercise identity changed,” says Newman, who not have been part of their training, Horn involves the counselors-in-training making previously worked as a hospice counselor urges counselors to educate themselves on and in a cancer center as a bereavement a timeline of grief and loss through their the topic by going to workshops, reading counselor. “As a scientist, he doesn’t lives by detailing specific losses. Ober current literature and taking continuing operate much on a feeling level. He’s mad then asks the students to write about education classes on the topic. because he’s not productive right now. I what it was like to complete the exercise, Counselors need to educate themselves need to honor that and talk to him about including if anything bothered them while not only on how to work with clients how that must feel and not try to take exploring past losses or whether they experiencing grief and loss but also how any of those feelings away. And then the identified something that provided them to identify it in the first place, Horn says. [conversation] is, ‘So, now this is part of with encouragement and hope during “Almost every client we see is going to your life too. This is a new phase of your tough times. have an element of grief and loss within life. Let’s talk about what you think you The exercise is one that these counselors- their story. [When counselors] don’t have might want from this part of your life.’ I in-training might choose to repeat with the lenses of being able to identify aspects want to help him identify those things so future clients. But the main objective, of their story as being grief and loss, I that he can get closer to making this part Ober says, is to get the students to think we miss a larger picture with that of his life productive, even if that means build their personal awareness of grief client.” having some wonderful conversations and loss, which can help them avoid Humphrey recommends that counselors with his family. I wouldn’t say, ‘How do countertransference with future clients who are just starting out stay theoretically you make the most of it?’ I would say, and become knowledgeable of their own grounded so they will be ready and able to ‘Let’s talk about what you might want cultural backgrounds and biases related integrate any number of theories into grief from this part of your life.’” to grief and loss. For instance, she says, work depending on the client’s particular Newman says part of a counselor’s students might learn that their families had needs. Meanwhile, Humphrey urges more role in working with clients who are specific rules related to grief and loss, such experienced counselors to keep current experiencing loss and grief is to illuminate as not talking about the deceased person with work in the field because the thinking the strengths and support systems they or not crying about the loss. “We can’t concerning how best to address grief and might be overlooking. Ask how they have impose those [rules] on clients,” Ober says. loss has changed through the years.

30 | Counseling Today | June 2012 The advice Newman offers to counselors, regardless of experience level, is to remember that work with grief and loss issues remains tied to the fundamentals of counseling. “It’s not about what I have to say to them, it’s Counseling Strategies about what they have to say to me. It’s really listening, being as present as you for Loss and Grief can be with that person, not judging, not Keren M. Humphrey thinking I’m the expert,” she says. “It’s giving that respect that [clients] have the “Keren Humphrey has given mental expertise for what they’re going through.” health professionals a complete guide In combination with that expertise, for working with diverse clients it’s trusting that clients also possess experiencing grief in a variety of forms. the strength and resilience to carry on, This book is well written, easy to Newman says. “Doing this work gave me understand, and is an excellent tool so much faith in the human spirit,” she for beginning counselors or seasoned says. “I was face-to-face with people who professionals.” had to find the strength to get themselves —Elizabeth A. Doughty, PhD through probably the hardest times of their lives, and I don’t think I’ve met the Idaho State University person yet who curled up in a ball and didn’t do that. There’s sadness attached Based on contemporary understandings of the to it, but it’s inspiring the way that nature of personal and interpersonal loss and the people find their way through. It’s about ways in which people integrate loss and grief into the resilience of the human spirit. People their lives, this innovative book focuses on tailoring find strength that they didn’t know they effective interventions to the uniqueness of the had, and that is inspiring. We’re survivors griever’s experience. In Part 1, Dr. Humphrey discusses and we are resilient. And at times, when a variety of death- and non-death-related loss and it looks like it’s the worst time ever, it is grief experiences, offers conceptualization guidelines, the worst time ever — but when you feel outlines selected psychosocial factors, and describes that pain, then you begin to find your way through it.” intervention based on two contemporary grief models. w Part 2 provides detailed therapeutic strategies organized To contact the individuals interviewed according to focus or theoretical origins along with in this article, email: suggestions for implementation and customization to n Elizabeth Doughty Horn at client uniqueness. Specific chapters include cognitive– [email protected]. behavioral and constructivist strategies, emotion-focused n Keren Humphrey at strategies, narrative therapy, solution-focused therapy, [email protected] and adjunctive activities. The final chapter focuses on counselor roles and recommended professional and n Jane Newman at personal practices. 2009 • 260 pgs [email protected] n Anne Ober at [email protected] Order #72887 • ISBN 978-1-55620-246-9 n Vincent Viglione at List Price: $52.95 • ACA Member Price: $39.95 [email protected] u Please include $8.75 for shipping of the first book and $1.00 for each additional book. Lynne Shallcross is a senior writer for Counseling Today. American Counseling Association Contact her at lshallcross@ counseling.org. 800-422-2648 x222 counseling.org Letters to the editor: [email protected]

June 2012 | Counseling Today | 31 When the vows break D-I-V-O-R-C-E doesn’t always spell the end of counseling

By Stacy Notaras Murphy

or some counselors, helping pies focus on the individual, this therapy their clients through a divorce provides a simple vocabulary for a com- Fmay feel like accepting failure. mon language between partners, as well as After all, shouldn’t “good counseling” between individuals and their counselor,” help couples avoid an unhappy end to Carter explains. “Divorcing couples often marriage? But the reality, according to want to get along but repeatedly lock them- research released in March by the Centers selves in conflict. A troubled marriage usu- for Disease Control and Prevention, ally has too much covert/crossed communi- is that half of all first end in cation, much of it outside Adult awareness. divorce, which means counseling services One effective way to help them handle their are equally necessary on the other side of differences is to teach them to negotiate couples therapy, where custody battles and from their Adult.” complicated financial arrangements can act If a couple chooses to pursue divorce as stressors that contribute to depression, while working with Carter, he often anxiety and trouble adjusting to a new continues to meet with one or both post-marriage reality. spouses. The purpose is to help guide When working with couples trying to them through “unresolved issues that often stay together, counselors have a choice sabotage future relationships,” he says. of many models — emotionally focused Carter urges counselors working with couples therapy, imago relationship couples to assess the underlying level of therapy, sex therapy and the religiously marital distress during the first session based Marriage Encounter programs, because this maps the proper treatment to name only a few. The options are ahead. Carter has found that couples less well-known when working with enter counseling during one of five stages: couples who have decided to divorce, contemplation, commitment, divorce, but many counselors are using a variety recovery or rebuilding. During the of innovative techniques to help meet contemplation stage, the couple is hoping these clients where they are rather than the counselor can help change certain dwelling on where they used to be. aspects of the behavior in the relationship to David Carter is an American see if the relationship can be saved, he says. Counseling Association member in “The commitment stage is when the Omaha, Neb., whose private practice has relationship has ended in the mind of one evolved from working with individuals of the partners, and the hope is that the struggling with marital issues to working counselor can develop a relationship with with couples actively pursuing divorce. the other member and help him or her He uses transactional analysis techniques through the divorce,” says Carter, who is to help these couples examine the ways also a professor of counselor education at they communicate and choose more the University of Nebraska in Omaha. effective strategies for moving through The divorce stage involves emotions the divorce. Specifically, he teaches clients of anger, resentment and rage. Here, to identify which of the three ego states counseling helps the couple channel — Parent, Adult or Child — they inhabit these emotions appropriately rather than to negotiate various transactions in their turning to alcohol or acting-out behaviors relationship with their spouse. in an attempt to cope. In the recovery “While many of the other psychothera- stage, individuals may feel helpless,

32 | Counseling Today | June 2012 hopeless and abandoned by their partner. pathologize. Instead, I think it is essential to homework to divorcing clients as part Counseling helps them survive and begin take an ecological view and understand how of counseling. “These clients have great the journey of rebuilding. During this final ‘crazy’ the circumstances for these [clients] difficulty after the sun goes down and feel stage, counseling assists the individual in have become.” These circumstances might disconnected from the world,” she says. exploring feelings and taking ownership include compromised finances, disrupted “Helping them create some structure of over his or her own issues, Carter says. childhoods for any children involved, loss of what to do during these ‘witching hours’ social support, loss of a life partner and “the can be enormously helpful. Many are often Support for the individual safety of what was and would have been,” in the same home they cohabited with Counselors are taking various approaches, Meyer says. She adds that these clients their former partner, and at night the home including coaching-type interventions, might also face legal battles, loss of libido, becomes filled with ghosts of the past.” support groups and psychoeducation biological changes and an increased risk of Meyer says counselors can collaborate with focused on co-parenting, to help individuals . these clients to determine healthy coping navigate the post-divorce recovery stage. Meyer works predominately with behaviors, including positive nighttime Laura Meyer, a counseling doctoral middle-aged or older women who have routines, and provide or recommend student and ACA member at Barry been married for 10 or more years, and bibliotherapy resources. University in Miami Shores, Fla., entered she asserts that age and length of marriage Percival Ricketts, an ACA member and the counseling profession specifically to make a significant difference in the client’s author in private practice in Pembroke work with divorcing populations. She ability to get through the divorce. “Many of Pines, Fla., specializes in helping clients who started working with divorcing clients the women I worked with had a significant are facing divorce and co-parenting issues. during her five-year stint as a life coach, drop in income, had very limited job skills He warns counselors against expecting the maintaining a practice called Divorce due [to their] focus on child rearing, were same reactions from each divorcing client, Recovery Coaching Unlimited. left for younger women and did not have noting that this complicated and life- “As someone who had been divorced experience dating for over a decade or changing process results in very different myself, I was drawn to this population,” more,” she says. “Many experienced shock responses and emotions. she says. “I suggest using a client-directed, when attempting to return to the dating He adds that clients coming to counseling strength-based approach. Oftentimes, the world and described a scene where they had during divorce proceedings might also behavior of these clients can seem dramatic, little social capital as an ‘aging woman.’” be searching for more than emotional and if one is not careful, it would be easy to Meyer highly recommends assigning support. They “might really be seeking

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June 2012 | Counseling Today | 33 READ Counseling Today, June 2012 TAKE the CT Learning Test, EARN Continuing Education Credit

Earn 1 CE Credit by reading the selected article in this issue. Read the article identified below and answer 3 of 4 questions correctly to earn 1 CE credit. It’s that simple! By reading Counseling Today every month, you can earn up to 12 CE credits each year. And you’ll be well-informed. Start reading now! Article: A loss like no other Learning Objectives: Reading this article will help you: 1) Understand that every client’s experience with loss is unique 2) Recognize how grief counselors can tailor their therapeutic approach to the client’s specific personality, situation and needs

Continuing Education Examination

1) A good starting point for grief counselors is to take the role of: 3) A significant change in grief counseling has been the adaptation of a) Advocate process models that are unique to the client rather than traditional b) Witness stage models such as Elisabeth Kübler-Ross’ stages of grief model. c) Teacher ___ True ____ False d) Expert 4) Professional counselors interested in learning more about grief 2) In addition to the loss of a family member or close friend, grief can also counseling can educate themselves by: be associated with: a) Going to workshops or taking continuing education classes on a) The loss of a house, relationship or job grief b) A lost sense of security following a traumatic event b) Reading historic literature and research c) Unmet personal expectations c) Seeking supervision or consultation with other professionals d) A physical illness d) A and C e) All of the above

q I certify that I have completed this test without receiving any help. Signature ______Date ______

Rate the following: Profession: Strongly agree Agree No opinion Disagree Strongly disagree ______Alcoholism & Drug Abuse Counselor 5 4 3 2 1 ______Counselor ______I learned something I can apply in my current work ______Counselor Educator ______The information was well presented ______Psychologist ______Fulfillment of stated Learning Objectives were met ______Social Worker ______Student ______This offering met my expectations ______Other

Complete the test online at counseling.org/Resources/OnlineLearning.aspx. You will be able to pay online and download your CE certificate immediately! Mail: Complete the test and mail (with payment made out to American Counseling Association) to: ACA Accounting Department/CT, American Counseling Association, 5999 Stevenson Ave., Alexandria, VA 22304. Your CE certificate will be emailed, unless noted otherwise, in 2–3 weeks. Questions? 800-347-6647, x306.

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34 | Counseling Today | June 2012 guidance in terms of ascertaining how the adhering to this mission of mutually separated parenting population during his process works, what they should reasonably acceptable settlements and shared solutions. initial counseling studies. As a counseling expect as they go through the process, This could be work that could be higher intern, he provided in-home services for how their roles and expectations might risk for client complaints, especially a community mental health center in change afterward and what they could do by those clients who haven’t made the southern Florida and noticed that single to make the process less painful and less cognitive shift to solutions for the greater women headed most of the families he traumatic for themselves and especially for good.” visited. In many instances, fathers were their children,” Ricketts says. “Counselors Despite the challenges, Phillips says she absent from the lives of their children. should ensure, therefore, that they are believes “this approach is the direction of “Research consistently confirms that knowledgeable about the divorce process the future. Counselors can be an important when children are raised without fathers so that they might be more adequately part of the solution because we can help or when fathers are not actively involved equipped to answer a wide variety of foster healing and cooperation by the in their lives, they are at much greater risk questions on the subject.” adults, who then model this for their for abuse, for academic failure, for ending Specifically, he advises counselors to children.” up in jail, for using drugs and even for become knowledgeable about options for committing suicide,” Ricketts says. “These legal support, financial guidance, mediation Co-parenting support findings were pretty alarming to me. So, and parenting coordination. Co-parenting is a common post-divorce I decided then that this was an area in struggle that can arrive as an afterthought which I could probably make a significant Legal proceedings following complicated legal proceedings. difference.” Florida requires divorcing Supporting clients through the end Custody arrangements typically do not parents to take part in parenting classes, and of a marriage might come naturally to stipulate parenting styles or conflict Ricketts provides programs that meet those most counselors, but even experienced resolution strategies, so divorced parents requirements, so he has come into contact professionals might be surprised at are often left to sort these issues out with with countless couples facing the challenges the need to support these same clients a reluctant or wounded ex-partner. In an of parenting out of separate households. through the traumatic experience of the effort to fill this gap, some counselors offer Lori Frazier is an ACA member and legal proceedings required to finalize that support and education concerning post- licensed mental health counselor at Hope breakup. Rhonna Phillips, an ACA member divorce co-parenting. Haven Children’s Clinic and Family and licensed professional counselor in Ricketts was drawn to the divorced or Center in Jacksonville, Fla. She leads Birmingham, Ala., has found that the legal system often creates additional topics to address in the counseling room. “I was frustrated with the number of sessions that were needed to debrief my clients from their own frustration with their own lawyers — clients who recognized that their lawyers were making the conflicts worse but whom they felt trapped to work with after having spent thousands on a retainer,” she says. As a result, Phillips STUDY GUIDE found herself drawn to collaborative practice (CP) and sought to work with like- for the NCE & CPCE minded family practice lawyers. and CP is a voluntary process that takes a team approach to divorce that includes mental health, legal and financial services. GUÍA DE ESTUDIO PARA “We recognize that these people must go on to have some type of functional relationship NCE y CPCE in the future, especially those [couples] with children. The children’s needs are given Dr. Andrew Helwig’s very popular Study Guide for the NCE and CPCE special attention, and a parenting plan is (2011, 6th ed.) is also available in Spanish. This book has all eight CACREP mapped out in detail,” says Phillips, who content areas as well as information about the NCE and CPCE. Included adds that CP is a time-consuming process. are exam-taking tips, study strategies, 2 practice exams and the ACA Code “This work requires much collaboration, of Ethics. This user-friendly Study Guide has 400 pages (430 Spanish). communication and coordination. It’s PDF FORMAT FOR DOWNLOAD TO YOUR COMPUTER a team approach,” she says. “If you are NOW AVAILABLE used to or prefer to work independently, For more information or to purchase the Spanish or English editions of this may not be a fit for you. If your the Study Guide ($79.95) or Workshop DVDs, visit: www.counselor-exam- orientation is to be a strong advocate for a prep.com. E-mail Dr. Helwig at: [email protected]. select population, you may have difficulty

June 2012 | Counseling Today | 35 “One of the most difficult things is to help parents accept that despite their own hurt and anger, their child loves and needs the other parent . ... The child-focused parent takes the high road and prioritizes the needs of the child.” a six-session class called “Co-Parenting fault, and they may lose not only their Counselor awareness Beyond Divorce” that aims to help parents identity as a member of a family but also Although many counselors would agree improve communication, thus protecting their sense of joy and playfulness. Many that getting couples into counseling earlier their children from parental conflict. become the psychological caregiver of the might be the key to keeping them out Frazier is firm in her assertion that parents mother. of divorce court altogether, that is easier must not place their children in the middle “One young man told me that as he said than done. “The sad reality is that of their divorce. She explains that even observes his parents moving from one counseling takes place years after the couple “very good parents” can make painful partner to another, it looks to him like has divorced each other emotionally and mistakes such as letting the child choose they just keep doing the same thing over physically,” Carter observes. “Prevention when to see the other parent and giving and over again — just with different counseling has a much greater outcome children too much information under the partners. I try to help these children than intervention counseling will ever have. guise of “being honest.” The course assists appreciate both of their parents whenever Yet, many couples come for counseling participants in understanding the basic possible and let them know it is OK to in the hope that the counselor can fix the expectations of co-parenting, learning love both of them, even when each parent other partner and salvage a marriage that to become “child-focused” and learning may tell them negative things about the has deteriorated to the point of disrepair.” how to negotiate communication tools, other. I also tell them that one day they Instead, what often results is that these including email and text messaging. will be able to make their own decisions couples wind up sitting on well-defended, Frazier’s group is psychoeducational in about spending time with their parents.” opposite sides of the counseling room, nature and discourages therapeutic venting. According to Adelman, counselors with a counselor attempting to guide them “There is a lot of support for feelings would do well to dispel the myth that toward the most useful topics, from how and pain, but we are geared to practical children can live life unaffected by their to humanely explain the divorce to their problem-solving,” she says. “I would say parents’ divorce. “Couples in trouble need children to navigating the legal system. one of the most difficult things is to help to know how devastating divorce is on “It is critical that the couple seek an parents accept that despite their own hurt children,” she says. “Children of divorce experienced counselor who provides honest and anger, their child loves and needs the are constantly trying to keep both of and compassionate feedback, manages other parent, and that being healthily child- their parents happy and are unable to do crises before more serious issues arise and focused is by definition ‘not fair’ because so. This grieves these children deeply. It will establish a clear, actionable counseling the child-focused parent takes the high affects their schoolwork [because they are] plan with accountability,” Carter says. road and prioritizes the needs of the child.” frequently worrying about their parents.” Ricketts agrees: “With the institution of Ricketts also recommends same-sex Adelman asserts that divorce is always marriage changing so rapidly, divorce has therapy groups for divorcing couples on a traumatic event. “Divorce has a lifetime unfortunately become a very harsh reality the basis of his observation that fathers in effect on everyone in the family,” she says. that many families find themselves facing his parenting classes appear reserved when “The couple may come from a divorced for one reason or another. Counselors will women are present. “When I facilitate family setting themselves. If they do not, find it beneficial to recognize that divorce fathers-only groups, I notice that men tend they may be the first marriage in their to be less reserved and … are more willing is a major traumatic event and one that family to [end in] divorce. The words ‘I affects the lives of Americans of various to express their views openly on a variety feel like a failure’ come up again and again. of feelings and beliefs,” he notes. backgrounds, very often for generations. They desperately need all the emotional Increasing their knowledge about divorce Children of divorce support a counselor can give them. Every and how individuals are often affected by Amy Adelman, a licensed professional facet of their lives is affected, from sleep to it could prove very beneficial, both for appetite to self-esteem.” counselor and ACA member in Laurel, counselors and for the clients they serve.” u Miss., runs the employee assistance Her advice to counselors is to encourage program at a rural county hospital where these parents to engage in simple and joyful activities with their children. “Children she works with children, adolescents Stacy Notaras Murphy is a need to feel cherished and loved, and and adults from divorced families. She licensed professional counselor divorce makes them question whether they characterizes the counselor’s role when and certified imago relationship are still loved and cherished,” Adelman working with children of divorce as therapist practicing in says. “Family counseling where everyone difficult. “Children of divorce are fragile Washington, D.C. To contact her, and are suffering emotionally as they gets a chance to say what’s working in visit stacymurphyLPC.com. try to cope with the disruption of what this newly shaped family and what’s not in many cases was already an unstable [working] can be very supportive. Don’t Letters to the editor: environment,” she explains. “These underestimate the encouragement you as a [email protected] children may believe the divorce is their counselor can give these grieving souls.”

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June 2012 | Counseling Today | 37 Bridging the separation between behavioral and general health care

An ACA interview with HHS Secretary Kathleen Sebelius Interview by Frank Burtnett

athleen Sebelius was sworn in Studies suggest that health care as the 21st secretary of costs can be reduced by providing K the Department of Health effective mental health treatment and Human Services (HHS) on April for patients with comorbid general 28, 2009. Since joining the Obama medical conditions such as diabetes or administration, she has been a key congestive heart failure. What is HHS strategist in the federal effort to improve doing to explore — and realize — the the health of Americans and enhance the potential health care cost savings from delivery of human services to some of the providing timely, appropriate mental nation’s most vulnerable populations, health services? including young children, those with According to a study of health disabilities and older Americans. care expenditures by the Agency for Before becoming HHS secretary, Healthcare Research and Quality Sebelius served as governor of Kansas (AHRQ), 5 percent of the population from 2003–2009 and was recognized accounted for almost 50 percent of total as one of America’s top five governors costs. Chronic conditions, multiple by Time magazine. Born in Ohio and comorbidities and severe mental illness, educated in Michigan and Washington, as well as services that are fragmented D.C., Sebelius moved to Kansas in among multiple providers, are key drivers 1974. She served as executive director of this high utilization. and chief lobbyist for the Kansas Trial To address health care quality, care Kathleen Sebelius Lawyers Association (now the Kansas coordination and access for people with Association for Justice) from 1977–1986. comorbidities, HHS has implemented Her public service includes eight years as a number of new initiatives, including a representative in the Kansas Legislature HHS consider endorsing Medicare health homes. Specifically addressing and eight years as the state’s insurance coverage of state-licensed professional behavioral health, the Substance commissioner. counselors? Abuse and Mental Health Services Sebelius is the daughter of former Ohio Mental illness and substance abuse Administration (SAMHSA) and Gov. John J. Gilligan. Upon her election can be significant issues for Medicare the Health Resources and Services as governor of Kansas, they became the beneficiaries. Growing life expectancy, Administration are working with first father/daughter governor pair in the coupled with the aging of the baby community-based health agencies to United States. boom generation, makes these issues initiate or expand the integration of more critical than ever. Preventing these primary care services for people in Congress and President Obama are problems from occurring in the first treatment for serious mental illnesses and finalizing legislation to postpone place and addressing signs and symptoms co-occurring substance use disorders. changes in Medicare’s sustainable These efforts, along with implementation promptly when they do arise can enhance growth rate payment formula for of the Affordable Care Act, will vastly the lives and health of millions. Changes physicians to help ensure that improve the quality of and access to in Medicare payments go through a long Medicare beneficiaries have adequate care for people with multiple chronic access to providers. Given the need process that involves public comment conditions, including behavioral health for better access to outpatient and sometimes changing the law itself. conditions. mental health service providers and Behavioral health services and who the wide recognition of licensed provides the services are certainly areas The portion of overall counselors as mental ripe for assessment as part of the health care spending devoted to mental health professionals in both private care reforms taking place under the health treatment has dropped and public sector health plans, will Affordable Care Act. significantly over the past decades,

38 | Counseling Today | June 2012 and reimbursement rates to mental The Affordable Care Act is already association’s members in the delivery of health professionals in both public and changing the American health care high-quality, life-improving services. landscape. People who currently have private sector health plans continue w to fall. How can HHS help reverse health coverage for behavioral health this trend as it works to implement services are seeing improvements in their Editor’s note: Frank Burtnett originally the Patient Protection and Affordable coverage as a result of the implementation conducted this interview for publication Care Act? People with mental illnesses of [MHPAEA]. For people who have no in the Spring 2012 issue of ACAeNews and substance use disorders often lack health coverage at all, exchanges created for Mental Health, Private Practice and health insurance coverage. Even if they under the Affordable Care Act will Community Agency Counselors. u have access to health insurance and provide new access to coverage, and that can navigate the enrollment process, coverage will have to include essential Frank Burtnett is the editor of health benefits, one of which is behavioral the cost can be high, and there is no ACAeNews and ACA’s four special health services. requirement that the insurance even focus electronic newsletters for In addition, the Affordable Care Act provide coverage for behavioral health. school counselors; counselor will help bring together behavioral There are a number of steps being educators; counseling students health services and the general health taken to eliminate the barriers to care for and new professionals; and mental care system, which historically have people with behavioral health needs. First, health, private practice and been separated. Integrating services is the Centers for Medicare & Medicaid community agency counselors. increasingly recognized as important Services and SAMHSA are working to Contact him at fburtnett@ to achieving both the quality and support implementation of the Paul counseling.org. Wellstone and Pete Domenici Mental cost-savings goals of health reform. Health Parity and Equity Act For example, according to the World To opt in to any of the free of 2008 (MHPAEA) through stakeholder Health Organization, mental health ACA electronic newsletters, and employer engagement and ongoing and substance use disorders will surpass contact ACA Member Services at all physical diseases as a major cause educational efforts. Additionally, in many 800.347.6647 ext. 222 or email of disability worldwide by 2020, and cases, MHPAEA requirements apply to [email protected]. according to AHRQ, almost one-fourth Medicaid and CHIP (Children’s Health of all adult stays in U.S. community Insurance Program) beneficiaries. Letters to the editor: hospitals involve mental health or The Affordable Care Act will improve [email protected] substance use disorders. Additionally, access to behavioral health services by the rapid adoption of health information including those services as part of the technology, including electronic health essential health benefits that must be records, opens new vistas for coordinating provided by health plans offered in the and improving the quality of patient care. Affordable Health Exchanges beginning These system changes are occurring in 2014. in parallel with scientific advances in ACA The expansion of benefits will be prevention and treatment services for substantial for people with behavioral mental health and substance use disorders THANKS OUR health concerns. Of the currently and a growing understanding of the uninsured population eligible for importance of consumer self-direction premium subsidies through the exchanges in the prevention and treatment of SPONSORS! in 2014 — 19.9 million individuals — an behavioral health conditions. estimated 6 percent have a serious mental Clearly, prevention, treatment and Argosy University illness and 14.6 percent have a substance recovery support services for behavioral use disorder. To raise awareness about health are important parts of health California University of new eligibility for insurance coverage service delivery and communitywide Pennsylvania and care, HHS will be reaching out to strategies that work to improve health people with mental health and substance and lower costs for individuals, families, Capella University use disorders and providers of behavioral businesses and governments. In order health services. to reach the optimal potential of the HPSO [MHPAEA], ACA must remain engaged What challenges and opportunities in the dialogue about implementation Liberty Mutual lie ahead for implementation and of the Affordable Care Act and enforcement of the MHPAEA, and take proactive steps to educate state University of Phoenix how can the American Counseling governments, employers, insurers and Association and its 50,000-plus insurance consumers of the importance Walden University counselor members help make sure the of coverage for behavioral health legislation achieves its goals? disorders and the appropriate role for the

June 2012 | Counseling Today | 39 Knowledge Share - By Barry G. Ginsberg Improving couples’ attachment security, intimacy, stability and satisfaction

orking with couples and families requires a different Wstance from working with individuals. I like that I can experience the relationship dynamics directly by being in the same room with the couple. It’s so different seeing the dynamics in action as opposed to having one individual describe it to you from her or his view. With couples work, you can witness how quickly one person’s response is cued by the other. Before you know it — before the couple knows it, for that matter — they launch into defensiveness and negativity almost other to recover the smoothness (stability) intimate and vulnerable or too disengaged as if you weren’t there. When you try to and satisfaction. For as long as they dance and threatening. We never get it right. We mediate, it either makes it worse or they with each other, this will be a lifetime just learn to adjust it so it doesn’t become both become angry with you. It quickly pursuit. I know! My wife and I have been too emotionally extreme. escalates. married 50 years, and we are still adjusting I believe the primary objective in I have learned to cope with this by our dance. couple therapy is to help couples improve acknowledging from the beginning that I work with relationships because I the stability and satisfaction in their the relationship (or as Harville Hendrix has believe that everything we experience relationship and learn to stay flexible, called it, the “in-between”) is my client. I occurs in relationship. Without not rigid. It’s important for couples like to think of it as a circle, the reciprocal relationship, there is no existence. It’s the to maintain a context of intimacy nature of all relationships — in this case, stress of relationship that keeps us alive — and engagement that allows them to close and intimate relationships. just not too much stress. experience a sense of trust and security I often describe relationship to There is no more significant relationship in which they can be “safely vulnerable.” couples as a dance in which they have to than the couple relationship. It is unique Couples can do this if they feel attached, coordinate their actions so they won’t kick because it’s a peer relationship, not which in turn depends on their ability to each other in the shins. The more they hierarchical like most other relationships. emotionally engage with each other. The practice with each other, the smoother It is an intimate friendship that can quality of emotional engagement enables it becomes, the less they hurt each other become the basis for our security and people to develop in healthy ways, to trust and the more satisfying it is. If the music fulfillment. But as Murray Bowen said, themselves and each other. changes — as it often does in life — they a two-person relationship is inherently I believe that our personalities are have to adjust their rhythm with each unstable — too close or too distant, too shaped by our relationships, and

40 | Counseling Today | June 2012 particularly formed in our earliest of origin, while the other comes from a maintain the trust attachment relationships. Out of this close family. It’s likely that this couple will and security of experience, we tend to trigger the same continue to have differences concerning the relationship. kind of responses from others that we the involvement of extended family in If this becomes learned beginning in childhood. These their lives. This is an example of the a consistent responses operate mostly beyond our reciprocal responses (habits) we see in all pattern over awareness (implicit emotional memory). relationships. their life span, To understand any couple interaction, it’s So, the habitual way couples learn to they will have important to consider that there are cues relate to each other is derived from how achieved a stable from each person that elicit a response each individual learned to relate to others and satisfying Barry G. Ginsberg from the other partner, which in turn from childhood. Partners in a couple pick relationship. elicits a reciprocal response from the each other because they fit complementary The key in original partner, ad infinitum. These are to each other, and the habits derived from couple therapy is not to directly help the habits that we see in all relationships. this become the underlying forces driving couples solve problems but rather to What draws us together the process of their relationship. have them skillfully remain emotionally can also push us apart If couples have the skills to transform engaged when under stress. In fact, it is In marital and couple relationships, I the emotions responsible for the negative likely that the difficulty couples face in believe it is typical to form a bond with patterns in their relationship to more resolving conflict has more to do with someone most like ourselves. However, positive ones, they will improve their emotional disengagement than with an what draws us to each other are opposite recovery from the defensiveness and inability to solve problems. characteristics — the complementary hurt derived from these negative cycles. Consider what John M. Gottman and aspects of our relationship — that are If their recovery is improved, they will Robert W. Levenson wrote in their article then difficult to live with the rest of have “softened,” thus strengthening the “How Stable Is Marital Interaction Over our lives. These difficulties become the intimacy and stability of their relationship. Time?” for the Family Process journal in themes of our relationships, repeated It is important for the relationship to 1999: “It’s not the problems a couple over and over again as long as we are be flexible enough to cope with these solves but how they deal with their together. For example, one partner comes forces. At the same time, couples have to emotions connected to the perpetual from a distant and noninvolved family remain sufficiently emotionally engaged to problems they never solve that leads Souldrama® The International Institute of Souldrama ® Connie Miller, NCC, LCP, TEP, ACS • 800-821-9919 www.souldrama.com • [email protected] SOULDRAMA®, is a therapeutic technique which combines group and individual therapy, psychodrama and transpersonal therapy. The main objective of Souldrama is the psychological and spiritual development of the person. Souldrama can be applied to all aspects of recovery including the 12 steps, relationships, grief, divorce, corporate, career and money issues. Participants will learn action based interventions for individual and , basic psychodramatic and sociodramatic tools such as doubling and role reversal and how to put spirituality into action. Special attention will be paid to creatively working within a group and discovering the group issue. If you desire training at your facility, we will gladly come to you. Puglia, Italy ONGOING June 30–July 7, 2012 Second Annual International Conference for Early recovery groups and training for addiction counselors and mental Souldrama, 50 hrs health professionals in group action methods. These workshops can be used for personal growth and or training. Coming 2013 January 10–13 Souldrama, St Petersburg Beach, Florida Long Beach Island, NJ March 2013 Souldrama in Holland June 11–15, 2012 Souldrama, 30 hrs May 18-25, 2013 Sedona, Arizona, Third International Souldrama Workshop and Conference, 50 hours The International Institute for Souldrama ® is an NBCC approved continuing education provider (5971) and may offer NBCC approved clock hours for events that meet NBCC requirements. The ACEP is solely responsible for all aspects of the program. Hours of certification in psychodrama, group psychotherapy and sociometry as approved by the American Board of Psychological Examiners in Sociometry, Group Psychotherapy and Psychodrama. Souldrama ® is an internationally registered trademark US 903

June 2012 | Counseling Today | 41 to stability and satisfaction in their which is physiological, in the partner’s the meaning of the relationship (“Your relationship.” emotion (disappointment) is the cue for feelings affect my feelings”). This skill is It’s important to help couples become how the couple subsequently will engage. taught when they switch roles (listener resilient in the face of the many stresses, If the other partner feels criticized and and speaker). The instruction to the new challenges, disruptions and developmental becomes defensive (arousal), there will be speaker is, “How does it make you feel to changes that threaten to disengage them. a “fight.” However, if the other partner know that she [or he] feels that way — This involves helping them remain listens by recognizing and accepting the good or bad?” Together, these three skills softened to each other and equipping partner’s disappointment, the arousal and constitute the basic training of RE. them to recover when life’s experiences defensiveness are reduced, and they are Generalization and maintenance create disengagement. Being able to in a better position to collaborate and In RE, each member of a couple recover restores the emotional engagement restabilize their relationship. This is the practices expressing his or her feelings (intimacy) of the relationship. Quicker “softening” so often acknowledged in and owning these feelings; this then and more frequent recovery reduces the couple therapy. enables each person to accept the other. likelihood of disengagement, defensiveness The primary skills in couple interaction By reciprocally practicing the skill of and hostility. This, in turn, leads to have to do with expressing one’s self acknowledging the feelings (internal satisfaction and stability. so that the other person recognizes the experience and emotional motivation) of Emotion-focused relationship underlying feeling that motivates the the other through empathic listening, a enhancement therapy expression and having the other person context of acceptance and nonjudgment Relationship enhancement (RE) focuses acknowledge it. So, speaking and listening is created. Ultimately, through supervised on emotion as the transformative agent in constitute the first two skills of emotion- and then unsupervised practice, couples therapy and relationships. How couples focused RE. Essentially, the speaker learn to create an ongoing relationship manage their emotions — a reciprocal is learning to improve self/emotional context of acceptance, nonjudgment and process — is central to maintaining an regulation (owning expression), and emotional engagement that operates in intimate and satisfying relationship. The the listener is learning to accept and their day-to-day lives. Establishing this struggle around the emotions elicited acknowledge an understanding of the context is a critical outcome of RE therapy. by the couple’s differences becomes the other person’s emotional motivation The success of any therapy lies in vehicle that changes the relationship, (empathic understanding). the ability of clients to take what they improves its flexibility and keeps the In RE, the partners who make up a have learned and make it a part of their couple safely engaged. Learning the skills couple learn to understand themselves everyday lives. That is why the next two to improve this process is the objective of and each other by exploring the emotions skills, generalization and maintenance, emotion-focused RE therapy. that motivate their behavior. When are essential for an optimal outcome. The Relationship skills, particularly in close, people perceive that their relationship is development of clients’ generalization and interdependent and attached relationships safe enough, they are freer to reveal these maintenance skills begins with the very such as couple relationships, are essentially underlying, primary feelings to themselves first session of RE. emotional regulation skills. Underlying as well as to their partners, which softens Taken together, the five core RE skills each couple interaction are deeply the relationship. By revealing these deeply allow couples to maintain a reciprocally important and implicit (nonconscious) owned feelings to themselves, individual stable relationship and become more reciprocal emotional cues and reactions partners are better able to understand emotionally engaged. However, couples that emerge spontaneously. These their experience and regulate their will internalize these skills only after they constitute the “interpersonal habits” emotions, giving them a sense of greater have attained a certain level of proficiency discussed earlier. mastery. And when these deeply owned and experienced enough satisfaction from To get a grasp on these nonconscious, feelings are accurately recognized without incorporating the skills regularly. Thus, emotional habits that contribute to stress judgment and with acceptance by their homework assignments of various kinds and conflict in couple relationships, respective partners, a context is created are systematically included in the program it is useful to understand how couples that fosters deeper sharing of feelings and to encourage generalization into everyday communicate. Essentially, one person in understanding. life. Homework is described to couples as the relationship, motivated by emotion, is I have observed that when couples an acknowledgment of their responsibility trying to convey information and perceives create such a context, the partners feel for the therapy and, ultimately, their that the other person understands the closer, more trusting and more open relationship. From the beginning, it importance (meaning) of what is being with each other. This does not secure the establishes the value of home practice. expressed. relationship, however, unless the couple Supervision of this homework is What most needs to be understood is also practices the third and probably designed to improve and reinforce the underlying feeling that motivates the most important RE skill, known as the generalization and maintenance of RE expression. For example, if one partner relationship (emotional engagement) skill. skills. If clients encounter difficulties says to the other, “You forgot to bring This skill asks couples not only to take applying the skills in everyday life, role- milk home,” both parties recognize the ownership of their feelings and respond playing is used in the therapy session to feeling (disappointment) as the reason empathically with acceptance and without improve the couple’s ability to use the skills (meaning) for the statement. The arousal, judgment, but also to acknowledge in a variety of challenging situations.

42 | Counseling Today | June 2012 Homework assignments are designed to Couples are informed at the beginning Through the years, I have attended review the principles and skills learned in of therapy that this will be part of the workshops and conferences, taken the sessions, encourage clients to set aside structure. Prior to starting this process, various training programs and fulfilled specific times for additional skill practice couples are given a home practice my continuing education requirements. and help participants use the skills in handout, which includes a time-out I marvel at how often I keep returning their daily lives. Thus, at the beginning procedure, to review together. (For a copy to the RE model. It seems to me that it of each session, valuable time is devoted of this handout, contact me at barry@ achieves the best outcomes for couples. u to a report by the couple about their relationshipenhancement.com.) homework assignments and their use of At this point, the therapy shifts RE skills outside of the therapy session. from an emphasis on office sessions to Barry G. Ginsberg founded Often, couples must first be taught to home practice, with the weekly home the Center of Relationship set aside a consistent time in their busy practices being taped. Subsequent in- Enhancement (CORE) in 1981. lives to devote to their relationship office sessions focus primarily on home He serves as the director of and to practice. A simple homework practice and involve a coaching process. CORE and Ginsberg Associates, exercise (often the first homework Emphasis during these sessions is placed a child and family clinical assigned) is to have the couple schedule on identifying underlying positives and practice. He received the a “playtime” each week at the same time. improved skills. Once couples develop 2011 Research/Practitioners In this context, play should be defined as a confidence and consistency in home Award from the International spontaneous and not outcome-based. practice, the office sessions become Association of Marriage and Probably the most critical method less frequent. Couples understand that Family Counselors, a division of the American Counseling of generalization and maintenance is subsequent sessions will be devoted to Association. Contact him at barry@ home practice of the first three emotion- reviewing the most recent home practice relationshipenhancement.com focused RE skills. After a period of skill tape, and therapy shifts to a consultative and visit the CORE website at training that involves a tutorial process, process, with couples taking responsibility relationshipenhancement.com. couples are encouraged to schedule home for their own therapy and relationship. practice sessions for an hour at the same Couples can then choose to come in for Letters to the editor: booster and/or refresher sessions if they time each week. The decision to move to [email protected] home practice is a collaborative decision haven’t seen the therapist for a period between the couple and the therapist. of time.

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June 2012 | Counseling Today | 43 Recent books by ACA members How to Listen So Parents Will Talk tool for counselors, this book highlights Person-Centered Diagnosis and Talk So Parents Will Listen the importance of asking questions, and Treatment in Mental Health: By John Sommers-Flanagan & Rita exploring viewpoints and discovering a A Model for Empowering Clients Sommers-Flanagan, John Wiley & Sons few surprises prior to getting married. It By Peter D. Ladd & AnnMarie Churchill, This book provides counselors with covers common issues faced by all couples Jessica Kingsley Publishers guidance on how to work effectively as well as some issues that are unique to This resource is a reference manual with parents. Blending person-centered, gay and lesbian couples. for diagnosis and treatment of mental solution-focused and behavioral w health conditions using a person- approaches, it offers professional centered, holistic approach. Designed counselors clear strategies for connecting The Internet: A Tool for Career to complement DSM assessments, it with parents, as well as more than 20 Planning, Third Edition covers a range of conditions and patterns specific parenting interventions and By Debra S. Osborn, Margaret Riley Dikel including depression, bulimia, obsessive- homework assignments that can be given & James P. Sampson Jr., National Career compulsive disorder, abuse, bullying and to parents. If you work directly with Development Association loss. In each case, the client is involved parents, this book will give you many This book provides counselors and in the diagnosis and treatment plan and concrete ideas that you can implement in career development professionals with a is regarded as the unrecognized expert on your practice … tomorrow. valuable resource to help persons engage in his or her condition. w effective career planning. It describes how w to integrate Internet tools in the career Asylum on the Hill: History process, gives annotations of websites, Healing From Childhood Abuse: of a Healing Landscape provides guidelines for evaluating websites, Understanding the Effects, Taking By Katherine Ziff, Ohio University Press highlights potential problems and ethical Control to Recover concerns, discusses the use of social By John J. Lemoncelli, Praeger ABC-CLIO This is the story of a great American networking sites and outlines strategies experiment in psychiatry, a revolution for developing a virtual career center. This Written directly to individuals who in care for those with mental illness, as third edition will become an important have experienced childhood abuse or seen through the example of the Athens resource for counselor educators to trauma, this book provides essential Lunatic Asylum. Built in southeast Ohio enhance their career courses, for practicing information that allows victims to begin after the Civil War, the asylum embodied career counselors and career development recovering from their immense pain and the 19th-century “gold standard” facilitators to improve programs and for suffering and empowers them to examine specifications of moral treatment. Stories students or clients to identify and use their specific issues in order to become of patients and their families, politicians, career websites. true survivors. This book enables those caregivers and community members who suffer in silence to understand what illustrate how a village responded w happened, take control and both begin to a national impulse to provide and maintain a program of recovery while compassionate care based on a curative Using Assessment Results for Career altering their negative self-perceptions. landscape, exposure to the arts, outdoor Development, Eighth Edition It also serves as an excellent text for exercise, useful occupation and personal By Debra S. Osborn & Vernon G. Zunker, clinicians treating victims of abuse or attention from a physician. Cengage trauma. This book is often used both in career w w counseling and measurement courses and includes chapters that review the Premarital Counseling for Gays & Ready, Willing, and Able: psychometric properties of interest, Lesbians: Case Studies and Helpful A Developmental Approach aptitude, values, nonstandardized and Questions other inventories/assessment tools. to College Access and Success By Pamela Milam, ASD Publishing Application of test results are also By Mandy Savitz-Romer & Suzanne This book focuses on premarital included through the use of case studies, M. Bouffard, Harvard Education Press counseling for gay and lesbian couples by in which readers are presented with Drawing on decades of research using composite case studies with vivid case background information as well and theory, this book explains how stories and interesting details from the as assessment information and how developmental processes such as identity author’s practice. As a counseling guide to integrate the two into a counseling and motivation influence college access for couples and as a diversity training session. and success. It describes essential

44 | Counseling Today | June 2012 components of adolescent development that best suits your interests, strengths psychology? In this autobiography, the and how they operate at all stages of and personality. Exploring a wealth of author shares her evolution from victim the college pipeline, including identity career opportunities in both traditional to victor with a deep conviction that Jesus development, motivation and goal and nontraditional settings, including the Christ is the only source of deep, lasting setting, aspirations and expectations, self- most exciting emerging fields, this useful change. regulatory skills such as planning, and reference describes the many benefits formation and maintenance of strong found in the work of a professional w peer and adult relationships. It provides counselor. Each career listing includes concrete strategies that counselors, an overview, salary range, employment Stay Tuned: To Positive Thinking educators, youth workers, faculty prospects, best and most challenging By M. Cristina Quilantan Diaz, members who prepare practitioners, and aspects of the job, and educational and AuthorHouse practice and policy leaders can use to licensing requirements. Children may increase positive social engage young people in developing and interactions and self-confidence through realizing postsecondary aspirations and w positive thinking. These positive-thinking opportunities, with a special focus on patterns and beliefs may be developed strategies for engaging low-income, first- On the Count daily by staying tuned to their positive generation college-bound students. By Mike Boccia, AuthorHouse messages and memories. With the help This book exposes readers to many of adults and educators, children can be w challenging, interesting and true reminded that staying positive is an active experiences to enrich their understanding and conscientious effort that may help The Wellness Activity Book of the often-bloodstained mosaic of daily them lead happy and productive lives. By Camella Jones, Trafford Publishing life in the corrections community during This unique self-help tool includes a the 1970s and beyond. It also focuses on w revolutionary approach to wellness in the the author’s first 10 years as a developing form of an exciting wellness challenge. forensic in corrections A User’s Guide to Your Mind, Vol. II: It promotes self-discovery while also settings. The many fascinating vignettes How to Win in Love & Get Along With drawing readers closer to others through are permeated with messages of realism, Each Other fun and meaningful activities that have hope, danger, humor, perseverance and By Michael Ra Bouchard, iUniverse positive effects on health. the potential rewards for the formidable, If we are to make the very best choices, sometimes successful work of correctional we must strive to rationally consider and w care. reconcile all of the oftentimes opposing aspects of our personhood. In this Finding Love That Lasts: Breaking the w second of three volumes, the emphasis Pattern of Dead End Relationships is on promoting the growth of social By Vera S. Maass, Rowman & Littlefield Managing My Anger: Weekly and emotional intelligence for couples Publishers Inc. Meditations & Journal Exercises so they can deepen their connection. This book explains why people repeat for Growth Fifty-seven REBT guidelines are offered the patterns that cause them to end up By Mary J. Clark, iUniverse on dating, mating and relating within a in failed relationships. Case histories This book has individual pages with soulfully connected, pair-bonded kind of from patients, volunteers from the a story or meditation about anger love relationship, together with detailed general community and participants in and recovery from rage, followed by a guidance on healing and moving on from personal growth groups offer insight into suggested journal exercise. The book a relationship that has ended. u the negative patterns people commonly also includes appendices with relaxation repeat in their search for lasting love exercises, websites for other anger and companionship. Readers will come management ideas/information and Book descriptions have been away with a better understanding of websites for various 12-step recovery provided by the authors or their those patterns, how to recognize and programs. publishers. Book announcements break them, and how to move forward are for informational purposes to healthier and more rewarding w only and do not indicate an relationships. Jesus Removed My Grave Clothes endorsement by Counseling Today w By Joy Wilson, Tate Publishing or the American Counseling Association. ACA members who How does a girl cope with being told have had a book published in the 101 Careers in Counseling as a child, “You are ugly”? How does she past six months can email jrollins@ By Shannon Hodges, Springer live life while constantly feeling used and counseling.org for information on Publishing Co. dirty? How does she grow from a sickly having the book announced in This comprehensive and easy-to-use foster child who had a cardboard box Counseling Today. guide is an invaluable resource to help instead of a playpen to a motivational you choose a rewarding counseling career speaker with a master’s in counseling

June 2012 | Counseling Today | 45 Opinion - By Marte Ostvik-de Wilde, Jordan P. Hammes, Gitima Sharma, ZiYoung Kang & Denise Park

A student perspective on 20/20: A Vision for the Future of Counseling

he 20/20: A Vision for the Future master’s and doctoral levels, classes have which enhances the versatility of counselors. of Counseling initiative calls been composed of individuals specializing As counseling unifies as a profession, focus Ton all counselors and counselor in different areas. However, regardless of should be placed not only on building educators to recognize and consider our specialties, we all acquire foundational confidence in theory and practice, but changes necessary for the sustainability counseling knowledge and skills through also on enlisting current professionals to and growth of the counseling profession. curriculum and practice. The future reality subscribe to our unified front. As emerging counselor educators, we’d of counselor training programs will likely Improving public perception/ like to offer our perspective on the vision incorporate students from separate and of 20/20 in the only way that we are able: distinct counseling specialties. recognition and advocating as counselors trained to practice within Emphasizing this foundation while for professional issues this millennium, and with a specific set of simultaneously expanding our reach into The 20/20 vision suggests that promot- beliefs and values informed by our entrance specializations unifies us as a profession. ing our profession at the state and federal into the profession within this past decade. Recognizing and reflecting on this levels and educating the insurance industry Because it is not clear to what extent future philosophy clarifies our identity of a are and have been crucial to our profes- counselor educators have participated in single profession. With a strong unified sion’s growth. As the profession continues the 20/20 initiative, and because graduate professional identity, we can focus on to diversify and expand internationally, we students constitute almost 40 percent of strengthening our foundation, advocating believe our efforts to promote public per- the American Counseling Association for the profession and propelling the ception should go beyond the boundary of membership, we hope to offer an authentic profession forward. our professional association, state or nation. voice and comment on what we consider To improve the public’s perception of Presenting ourselves to be the most relevant strategic areas in the the field, we have worked to distinguish as one profession vision. ourselves from other mental health profes- As emerging counselor educators, we are In 2006, delegates representing 30 sions. For example, we make a distinction empowered to shape new directions for the counseling organizations (now 31 between ourselves and psychiatrists by future of counseling. If we hope to expand organizations) first convened for the 20/20 explaining that counseling focuses not just the reach of our field both nationally and initiative. In 2008, these delegates released on alleviating symptoms but on developing internationally, it is key that those outside of their seven Principles for Unifying and the individual’s agency and well-being. We our profession, as well as those proximate to Strengthening the Profession. Since that time, should also consider improving the public our profession, see us as a unified group of many responses to this proposed vision have recognition of the counselor’s role interna- scientists and practitioners with a common been published, and in this article, we offer tionally. In some countries, for example, the purpose/mission. Although this mission our own response. We represent diverse role of counselors as traditional “healers” is should be fluid to adapt to the growing counseling specialty areas across cultures not well recognized. and changing needs of clinical work, and nationalities, and our perspective comes One way to improve worldwide recogni- presentation of ourselves as one profession out of a commitment to address the needs tion of the profession is by working col- should become more solidified. Because of a more globalized and diverse society. laboratively with counseling professionals counseling is becoming increasingly In the sections that follow, we identify throughout the world while promoting our international in scope, a need exists to create the most relevant aspects of each 20/20 understanding of diverse indigenous and a unified curriculum for the education of principle from our perspective as diverse contemporary healing practices. Those of us counselors that will promote a singular students and future counselor educators. who are future counselor educators should identity. As more international students take responsibility for collaborating with Strengthening identity enroll in graduate programs in the United international counseling associations to As future counselor educators, we States, the transferability of curriculum develop standards and competencies for the anticipate encountering a more austere across countries becomes even more profession that are culturally sensitive and economic reality than has previously existed important. Additionally, gaining exposure acceptable in a global context. in higher education. Therefore, we may be to different specialties worldwide allows called on to expand and apply our common counselor education students to assist in Creating licensure portability set of core principles, knowledge and skills bringing this universal curriculum to life. In In his December 2011 column for across diverse specializations. In our own the United States, specialties provide a basis Counseling Today, ACA President Don W. academic training programs, both at the for the development of highly specific skills, Locke asserted that licensure portability

46 | Counseling Today | June 2012 is “the single-most-voiced professional institutional research capacity is endorsing ourselves in undergraduate campus life? concern” he encounters among counselors. the strength of interdisciplinary partnerships This would further solidify and integrate How can we expect to reflect a professional and collaboration, which can be instilled in our role in the academy. In the same way we identity when educational practices and students at every level. train counselors to work in a collaborative licensure certification standards are not In response to the 20/20 vision, manner within schools, agencies and other uniform? All states should be held to the it is important that counselors and settings, we should model collaboration same degree of accountability and training, counselor educators contribute to the across university campuses by reaching thus ensuring that all counselors are equally science that informs our practices by out to diverse undergraduate majors as able and qualified to practice. Maintaining developing partnerships in practice and potential new members of our field. Even these high standards of practice, counseling in qualitative and quantitative research. if our efforts do not result in recruiting licensure should also expand to national/ While directly serving clients, we should new counselors-in-training, they can international regulation. Transitioning also be researching solutions. It might be improve students’ perception of our role to this should not be much of an issue time for a unified professional effort to universitywide, which will in turn positively logistically with organizations such as articulate our vision for advancing the affect the way future members of other ACA, the National Board for Certified future of counseling research by engaging professions view us. Counselors, the Council for Accreditation practitioners in the identification of Promoting client welfare of Counseling and Related Educational important research directions, design and and advocacy Programs, and the American Association implementation. As counselors, our role is not only to of State Counseling Boards to defend Focusing on students support individual clients in resolving and advocate for the profession in terms and prospective students their concerns but also to promote social of standards and oversight of graduate The importance of defining our unified change that can help ensure equity and programs. The real accountability rests with vision as counselors and counselor educators inclusiveness. As counselors, we can engage those practicing to push for this national naturally extends to those who come after in interfaith, intercultural, intercountry licensure to happen. Among the benefits us — namely, counselors-in-training. As and interdisciplinary dialogue to promote of national licensure would be that future indicated by the 20/20 initiative, focusing mutual understanding and collaboration counselors and counselor educators would on current and prospective students through worldwide. Recent events such as the global not be deterred by complex licensure networking, mentorship, supervision and economic recession, several natural disasters portability issues as they develop their membership in professional associations and political upheaval require counselors to careers in an increasingly challenging job is critical to the vitality and international play an active role in advocating for global market. relevance of our field. As emerging harmony and alleviating international Expanding and promoting counselor educators within a global context, tension. the research base of we believe that we need to move beyond Therefore, counseling programs should professional counseling approaches traditionally used in universities continue to provide education and training Building research capacity in counseling and colleges as we focus on recruiting and in areas of multiculturalism, social justice, is integral to the growth of the profession retaining new professionals. advocacy and holistic well-being. However, and critical to informing our practices and One way we can move beyond traditional instead of incorporating these concepts in policies. Often, the focus in counseling approaches is to engage in interdisciplinary separate classes, it is important to infuse and related journals has been on clinical and intercultural mentorship. Due to our learning about these areas throughout interventions, practices and relevant training and educational backgrounds, the curriculum through open dialogue, societal issues, even while the 20/20 vision mentorship comes naturally to most self-reflection and social-action research. suggests the need to expand and improve counselor educators. Therefore, why not By designing a comprehensive counseling counseling research. Central to the process expand our roles as mentors beyond the curriculum, we can train counselors of building and sustaining individual and scope of counselors-in-training and involve to empower people and contribute to

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June 2012 | Counseling Today | 47 a positive change at the individual, organizational, community and policy New! levels. Conclusion Our profession has achieved some Understanding People in Context: significant benchmarks in the recent past, including licensure recognition in all 50 The Ecological Perspective in states, ACA membership exceeding 50,000 individuals and growing acknowledgment Counseling of CACREP accreditation in state licensure requirements. In addition, counselors edited by Ellen P. Cook have responded to various national and “Dr. Cook and her colleagues international disasters. Despite these provide elegant applications of advances, however, there are areas in which we still need to grow to ensure that we ecological theory in practice settings. are meeting the needs of an increasingly Understanding the powerful role diverse society. This article represents our of human ecology is of critical collectivistic ideals as emerging counselors importance in training the next and counselor educators to expand the generation of counselors.” 20/20 principles to address the importance of empowering a global clientele. —Mary J. Heppner, PhD Our aspiration is that this article will University of Missouri–Columbia serve as a call for counseling students to engage in active dialogue regarding the “After reading this book, counselors critical decisions that shape the future of will have a better understanding of themselves and how to our profession. We must make our voices enhance their effectiveness with clients.” heard for further advancement of our profession. —Karen O’Brien, PhD University of Maryland, College Park w For an overview of the 20/20 initiative, This exceptional book emphasizes uniquely designed including complete text of the seven interventions for individual counseling, group work, and Principles for Unifying and Strengthening as well as the consensus community counseling that consider clients as individuals the Profession, definition of counseling, current 20/20 within the contexts of families, cultural groups, workplaces, and activities and concepts for future communities. Part I describes the theoretical research base and exploration, visit counseling.org/20-20/index. major tenets of the ecological perspective and its applications aspx. Also see the November 2011 article to counseling practice. In Part II, experts who have used the “20/20 delegates pushing toward licensure ecological perspective in their work discuss its usefulness in portability” in Counseling Today (available at ct.counseling.org). CT expects to publish various applications, including counseling diverse clients with another update on the 20/20 initiative later specific life challenges; assessment, diagnosis, and treatment this year. u planning; and in schools, substance abuse programs, faith-based communities, and counselor training programs. 2012 | 335 pgs Marte Ostvik-de Wilde, Jordan P. Order #72918 | ISBN 978-1-55620-287-2 Hammes, Gitima Sharma, ZiYoung Kang and Denise Park are doctoral List Price: $54.95 | ACA Member Price: $39.95 counseling students at the Please include $8.75 for shipping of the first book University of Maryland, College and $1.00 for each additional book. Park. For more information or to share your thoughts, contact Marte Ostvik-de Wilde at Order Online: counseling.org [email protected]. By Phone: 800-422-2648 x222 Letters to the editor: (M-F 8am – 6pm) [email protected]

48 | Counseling Today | June 2012 NBCC Perspective - By Thomas W. Clawson Advocating for one profession ecently, the National Board for professionals to effectively use psychology the careful communication with all aspects Certified Counselors received testing. But we have never opposed a of the profession. CACREP’s is the only R an email from an instructor in a proposed law licensing any other profession. counseling accreditation we recognize psychology department that trains master’s- Throughout the 35 years of legislative because CACREP alone interacts with all level counseling psychology students. In process — starting with Virginia and ending of our profession and was created for our the email, the instructor suggested that with California — many state counselor profession. CACREP, as is the case with counseling organizations have begun to licensure committees took the practical NBCC, represents only our profession — coalesce around a professional identity for position of including “related professionals” the profession of counseling. Both NBCC counselors that strongly opposes psychology when establishing counselor licensing. This and CACREP promote our professional and asked for NBCC’s position concerning was necessary to pass many of our laws. Back identity and encourage the profession to the Council for Accreditation of Counseling in the 1970s, degrees in “counseling” came continue making progress toward standards and Related Educational Programs. from diverse academic departments such as defined solely for and by counselors. The simple answer is that NBCC has home economics and even business schools. NBCC has worked with other counseling never created a policy or position statement Even NBCC, in an attempt to be inclusive, organizations to make important gains in concerning CACREP. The CACREP created the early standard of specific course the profession of counseling, including Standards were in place when NBCC was work with a degree in counseling or a licensure in all 50 states, the District developing its first set of standards, and “related profession.” That was in 1982. of Columbia, Puerto Rico and Guam; we aligned with the thought leaders in Then, in 1994, NBCC enhanced the federal recognition of counselors as service counseling credentialing at that time. This standards to a 48-semester-hour master’s providers; public recognition of the means that from the beginning and to degree in counseling that matched the counseling profession; media attention; and this day, NBCC recognizes the CACREP CACREP Standards for most accredited testing and insurance privileges. Standards as the preeminent and only fully specialty areas. Further, this coincided with NBCC will continue to support counsel- vetted standards for the education of each the trend of higher numbers of clinical ing as a unified profession. We should favor new generation of counselors. NBCC and hours being required for state licenses. counselors, not other professions. NBCC CACREP both grew out of the American NBCC completed the first major national does not advocate for other professions, nor Counseling Association and the Association job analysis of practicing counselors in the do we endorse them as part of the coun- for Counselor Education and Supervision, early 1990s. We studied the profession and seling profession. We encourage them to so we have always been aligned in our professional identity. Since that time, advocate for their own professionals as vig- promoting the profession of counseling. we have produced multiple job analyses of orously as NBCC advocates for National NBCC has never taken a position counselors, and we continue to study the Certified Counselors.u opposing psychology or any other defining roles and behaviors of professional profession. We have taken protective counselors. Thomas W. Clawson is president and proactive actions for the counseling As NBCC continues to gather data, and CEO of NBCC Inc. and profession when psychology, social work CACREP contemporaneously studies Affiliates. Contact him at and psychiatry opposed many counselor the needs of counselor education as well [email protected]. licensure initiatives. Since 1996, we have as the current and changing practices in staffed and funded the Fair Access Coalition counselor education programs. We respect Letters to the editor: on Testing (FACT) organization, which the seven-year cycle of CACREP Standards [email protected] defends the rights of counselors and other evaluation, the open comment cycles and

June 2012 | Counseling Today | 49 Stacey Davidson essay takes first place in Ross Trust Graduate Student Competition

tacey Davidson of the University quality of human relationships and the Second Life, and Twitter give school of San Diego won the grand counseling profession? counselors a one-click way to disseminate Sprize in the Ross Trust Student Steve Jobs, the late CEO of Apple and information to hundreds of students. With Essay Competition for Future School technological genius, was known by one advances like these, counselors can spend Counselors. Her essay addressed how adage: “Let’s put a dent in the universe.” more of their day counseling and less time technological advancements have affected This now iconic statement sums up the managing paperwork. the quality of human relationships and impact he desired through technology: a The school counseling profession needs the counseling profession. forever changed world. Thanks in part to to adapt as rapidly as the technology For submitting the top-rated essay, Steve Jobs, technology has changed the changes if counselors hope to stay relevant Davidson received a $1,000 scholarship world, positively impacted the quality to their students. As more students use the grant and free registration for the of human relationships, and profoundly Internet and mobile technology for good, ACA 2012 Annual Conference in influenced the counseling profession. For it is also being used for harm. Stories of San Francisco. In addition, four other future school counselors, understanding cyber bullying and sexting fill the news. graduate students each received a $350 and using technology is vital to reach this If counselors are not aware of new social scholarship grant for writing the top- generation of students who never knew life media and its effects on students, they will rated runners-up essays. The competition without technology. quickly be far behind, reactively manag- was open to counseling graduate students Schools have used technology for years, ing crises instead of proactively preventing working toward a career in school giving students the opportunity to learn issues. The more school counselors utilize counseling at the elementary, middle or more efficiently and with greater access and understand the newest technology, high school level. to resources. However, school counsel- the better equipped they will be to counsel Note: The following essays have been ing lags in its adoption of technological victims of online crimes and cyber harass- reprinted as they were submitted, without advancements. While nothing can replace ment. A technologically savvy counselor is editing. The views expressed are those of the personal interaction and social benefits an invaluable resource to any school. the essay authors. of traditional counseling, technology can As technology continues to evolve, the be incorporated to help students thrive. counseling field also adds new dimensions like virtual counseling or video game play Grand Prize Winner Online resources like Second Life and pro- grams like Paint work much like tradition- therapy. New techniques and theoretical al play or art therapy, helping the client to approaches add quality to a school relax and giving the counselor insight into counselor’s work, and students view the the client’s world. counselor as attuned to their needs. It is through technological relevance that This knitting together of technology school counselors will continue to “put a and traditional interaction gives added dent in the universe” for generations to quality to the human relationships and come. provides incredible opportunities. With more communication mediums, students and counselors can expand the size of Runners-Up their personal networks. Social media Stacey Davidson gives students chances to see life through Stacey Davidson is a master’s student multiple lenses by “trying out” a career in in the school counseling program at Second Life, or meeting college mentors the University of San Diego. She will on Facebook. These online connections graduate in May 2013 and hopes to help students make informed decisions pursue a career as an elementary school about their future. counselor. Her goal as a counselor Technological advances also allow is to help children succeed socially, school counselors to effectively work with emotionally and academically so they large caseloads of students. In order to can become thriving citizens of their keep up with the demand, counselors communities. must use technology. Organizational tools like Google Docs, Doodle and Drop Box Monica Monismith Technological advancement seems make scheduling group meetings and Monica Monismith has worked with to be the order of the day. How have contributing to teamwork like IEPs simple children and adolescents in various these advancements impacted the and organized. Group text messaging, capacities for many years. She is a 2012

50 | Counseling Today | June 2012 graduate from the master’s in counseling profession. On one hand, technological University of Virginia (UVA) with a program at Geneva College in Beaver advances have made it possible for bachelor’s degree in psychology in 2007. Falls, Pa. While at Geneva, she served counselors to provide valuable services Her following years of enjoyable and as a graduate assistant at the counseling to clients including online surveys, rewarding work with a mental health center and completed her internship at tests, and inventories; current and easily agency inspired her to return to UVA the Avonworth School District. She is accessible information on a variety of to pursue a master’s degree in school pursuing a career as a school counselor. topics; and even virtual or computer- counseling. She graduated in May and based counseling. In addition, technology is very excited to begin her career as a Technological advancement seems has made it possible for counselors to school counselor. to be the order of the day. How have communicate more effectively with these advancements impacted the clients as well as other professionals and Technological advancement seems quality of human relationships and the to manage records and files much more to be the order of the day. How have counseling profession? efficiently. Technology has also provided these advancements impacted the There are few, if any, areas of modern wonderful opportunities for counselor quality of human relationships and the life that are untouched by technology. education and professional development counseling profession? From the internet to email to cell phones through online training, access to The immeasurable advantages of to social networking, technology has research, video conferencing, etc. technological advancement cannot changed the way we live, work, play, Nevertheless, it is imperative that be denied. As a result of these rapid communicate, and interact with each counselors be aware and vigilant developments, we now live in a world regarding the effects of technology on other. Technology will continue to exert a in which we can communicate with human relationships. The disconnection powerful influence over our lives well into someone on the other side of the world, and isolation that people are experiencing the future. learn about other cultures, and build become important issues for counselors Advances in technology have relationships with individuals who to address not only in the therapeutic profoundly affected our relationships with may not have the ability to verbally relationship but also through advocacy one another. It is now not only possible communicate. Used appropriately in and education. Counselors must but commonplace to communicate with these ways, technology can deeply enrich be mindful that the bedrock of our people in virtually any part of the world our lives and the relationships we have profession is understanding and at any time of the day not only through with others. Given that relationships experiencing the human condition. Our email and the internet but also “face to are inevitably a source of stress and focus must remain on helping people face” and in real time through Skype, a source of support throughout the experience full, deep, healthy, and Twitter, and video streaming. We have counseling process, technology impacts intimate relationships with themselves truly become a global community with the profession by providing an abundance and with others. Technological advances opportunities to connect with people of resources that could not be previously then become valuable tools to further this all over the world socially, economically, accessed. Clients are better able to overarching goal. professionally, politically, etc. through obtain information, find resources, Technology can and will change, technology. connect with others dealing with similar but the basic needs of people remain However, despite all of the difficulties, and seek support from friends the same. It is incumbent upon the opportunities for human connections and family who are not physically near counseling profession to utilize all provided by technological advances, them. Technology can serve to enhance available methods to meet people’s needs. many people feel increasingly isolated relationship support in this way. In this way, counselors can integrate and disconnected. It would seem that However, from a school counseling technology and human relationships and, in gaining a multitude of relationships, and developmental perspective, I cannot hopefully, enhance both. we have lost the experience of intimacy. help but acknowledge the increase in Much of the interactions people have relationship stress that I have witnessed online is anonymous or impersonal in students as it relates to technology, which contributes to an ultimate sense such as social networking sites and of isolation. People may have up to the text messaging. The ability to instantly minute information about each other communicate with others at all moments through tweets yet not really know each of the day has challenged human other in a meaningful way at all. It is interaction, emotion, and cognition common for people to have literally in ways that developing children may hundreds of “friends” on Facebook yet not be able to appropriately handle. no deep, personal, real-life friendships. Technology causes students to spend We are increasingly connected yet more time in isolation with technological simultaneously increasingly disconnected devices and less time interacting with through technology. Katie Myers the physical world around them, which In a similar manner, technology is a Katie Myers was raised in Northern could negatively impact learning, social double-edged sword for the counseling Virginia and graduated from the skills, physical health, and mental health.

June 2012 | Counseling Today | 51 Furthermore, students may be less able counseling in May from Purdue point, one may have to rely on others to process information and respond University. While at Purdue, she for financial support which can result appropriately to conflict when they can was the secretary of Chi Sigma Iota, in the loss of pride and self-worth. The immediately react and forgo the time the international honor society for culmination of these factors and events necessary to take a deep breath and counselors, and completed research for can further strain relationships, marriages, reflect. Skills such as anger management her thesis, “School Counselor Support and the capacity to parent effectively. and conflict resolution may be lost for Military Students Facing a Parental A downward spiral of events may cause in these contexts. The impulsiveness Deployment.” symptoms of depression to emerge such as and immediate gratification allowed hopelessness, inadequacy, and anxiety. by technology today could potentially According to a recent article on A person who loses their job may also impact cognitive functioning at a deeper unemployment in The Washington question guiding principles by which level. Technology may also create a Post (Oct. 2, 2011), the Centers for they have lived. Work ethic, dedication, heightened level of stress for students Disease Control and Prevention reliability, and perseverance may be viewed throughout the day as they are faced with found that approximately 9 percent of as no longer equating to success. The ability negative interactions before they even Americans were defined as clinically to exhibit such qualities is diminished, arrive at school. They are put in situations depressed compared with an estimated resulting in a loss of purpose. This can in which individuals can conceal their 6.6 percent in 2001 and 2002. In that be a daunting thought to many, and can identity and boldly say things they would same article, another related study of cause overwhelming confusion about not ordinarily say in person. The way the long-term unemployed by Rutgers how to successfully move forward. When students express themselves, deal with University’s John J. Heldrich Center one is guided by anxiety and fear, it can conflict, and cope with difficult life for Workforce Development found result in paralysis and vacillation which events may continue to change as a result that 32 percent of the unemployed only perpetuates the situation. When the of technological advancements. were experiencing a good deal of magnitude of a choice can radically affect The school counseling profession stress, and an additional 47 percent daily living, it can cause increased panic is faced with a new set of unfamiliar stated that they had at least some over the possibility of making the wrong skills in addition to a loss of crucial stress over their joblessness. Discuss decision. This is a natural feeling for an relationship skills that are best developed the toll of joblessness on the mental unemployed person who may feel their in the physical context of social health of individuals most impacted by future is uncertain. For all of these reasons, interaction. The continually developing the uptick in unemployment and the it is important for someone suffering from profession must keep up with these current economic situation. an abundance of stress, anxiety, or signs technological advancements and remain of depression to seek the support of loved The current economic circumstance in as knowledgeable as possible in order to ones, and the help of a counselor. A mental the United States has many Americans appropriately serve all students. School health or career counselor can encourage experiencing heightened levels of stress and counselors have the challenge of helping people in search of a job to look positively symptoms of depression due to joblessness. all students develop healthy relationships on the future, and find self-worth in other Job loss and long term unemployment with others, and technology has become aspects of their life. can result in a cascade of off-putting life a significant part of that developmental happenings. Mental health can be affected process. As a result, we must continually because the loss of a job creates a large rift evaluate how we teach and understand in what one may have seen as their place in our students so that we may help them the world and their community. A major develop healthy social relationships life event, like losing a job, can mean drastic within the context of rapidly developing changes in daily routine, roles inside and technology. outside the home, loss of connections with co-workers, a decline in intellectual and physical activity, and the inability to use a skill set. Job loss can be thought of using systems thinking — when one factor in a system changes, all other factors are affected as a result. For example, the loss of a job Andrew Ritsema has the potential to create a monetary Andrew Ritsema is currently in his burden, which can lead to the inability second year of the master’s in school to make a mortgage payment. Losing the counseling program at Seattle Pacific capacity to make mortgage payments can University. He is excited to be preparing result in having to move, and establish a for a career he is extremely passionate new address. The process of moving can about — one in which he will advocate Courtney Oliver affect children if having to relocate to a new for all students at his school by working Courtney Oliver graduated with a school, delay job hunting, and perpetuate among the many systems that influence master’s degree in the field of school the cycle of financial instability. At this them.

52 | Counseling Today | June 2012 We have seen a startling decrease in and dialogue about those differences, allowing the P.S.C.s to conduct in-depth civility toward one another. Examples will allow students to better understand and meaningful discussions about what would be the political rhetoric by the the worldviews of others without culture means to people. leaders of our nation who attack the maligning the people who hold them. In Challenges to battling intolerance person as well as his/her ideas, and the line with a comprehensive and systemic in schools could include resistance media and its proclivity for focusing school counseling program, the school, from affected parties, as well as finding on the negative. People seem to be community, and families of students time to both research diversity in the unwilling to want to listen to the other should be involved with this process school, and implement interventions and only want to criticize a person whenever possible. accordingly. Yet despite these obstacles, whose ideas may differ from his or Anti-bullying curricula are already in utilizing methods such as classroom her own. They do this while offering being taught in schools across the presentations, small group, family and little by way of suggestion on how to country, and are a great place to individual counseling sessions, there are improve that to which they object. incorporate tolerance education. There amazing opportunities for P.S.C.s to Do you agree with this observation? are several effective curriculums available support students in exploring differences If so, from your point of view as a for use in classroom presentations within their diverse communities. counseling professional, what do you by P.S.C.s that challenge children to Whether students agree with the varying opinions or beliefs they encounter is predict will be the impact of this trend empathize with others. By considering up to them, but they are bound to on society should it continue, and how how they react to different situations, come out of their experiences with an can we as counselors address this issue? students become powerful allies in increased tolerance and respect for one Throughout its relatively short history, promoting safe and accepting learning another. u mankind has engaged in consistent environments. Various cultural events conflict over intolerance of differences and displays throughout the school can ranging from ethnicity, to ideology, also be planned that give children a to religion, to socio-economic status. taste of the diversity represented within Today one doesn’t need to look far before the student body and community. Check out what’s new noticing signs that we still struggle with Developmentally, middle and high school these issues here in the United States, at students are able to cognitively delve into at CT Online a time when diversity is increasing like deeper217-473 topics CalU ofSportCounseling_4.75x4.75 cultural significance, 4c_Layout 1 1/25/11(ct.counseling.org 9:56 AM Page 1 ) never before. All around the country each day, individuals who align themselves with a political party watch particular news networks that promote their held political views while vilifying those that differ. Additionally, our media oftentimes Graduate Certificate portrays minority groups in stereotypical in Sports Counseling and prejudiced ways that may be false, but are nonetheless influential on viewers’ 1 0 0 % O N L I N E opinions. We are acculturated to narrow- mindedness; we prefer the convenience Are you a practicing counselor, trainer or educator and freedom from inner conflict that with a strong interest in working with athletes? avoiding challenges to our worldview The 100% online Graduate Certificate in Sports Counseling provides us. Unless taught to be aware is designed for practicing counselors, counselors-in-training and tolerant of diversity, people tend to (post 48-credits), educators and/or other helping professionals be fearful when coming into contact with who desire a specialty area of training with youth, adolescent, other people and ideas with which they young adult, or adult athletes across a variety of settings. are unfamiliar, at times withholding the The Cal U Sports Counseling certificate program provides respect and justice those people deserve. counselor training competencies in: Professional school counselors (P.S.C.s) • Foundations of sports counseling are in a unique position to educate the • Contextual dimensions of sports counseling, and children of our country about tolerance TO LEARN MORE • Knowledge and skills for the practice of sports counseling e-mail [email protected], and respect so that they are able to Note: The Graduate Certificate in Sports Counseling will not certify you as a call 1-866-595-6348 professional counselor. 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June 2012 | Counseling Today | 53 In Memoriam

During his time as a counselor first met, I introduced myself to Larry educator, Larry served on numerous as “Marcheta.” My name can be pretty national and branch division tricky for some, but from that point on, committees and received many he would enunciate the last syllable of honors and recognitions for his my name so clearly and with such vigor commitment and contributions to that it would make me smile. Similarly, the counseling profession. While at I recall how Larry would affectionately UTSA, he implemented a practicum refer to Thelma Duffey, chair of UTSA’s site for school counselors through Department of Counseling and Larry’s the Northside Independent School chair at the time of his retirement, as Larry Bruce Golden District. This practicum experience “TD.” He would sing out her initials as Retired counselor educator, author and is well-known throughout the city he walked down the hall. I also remember editor had varied counseling interests as the Parent-Child Consultation how Larry’s face would light up when Center (PCC). Additionally, he was you walked into his office. He had a way nitially, when I was asked to write instrumental in supporting a UTSA of acknowledging people that was truly about the life of a dear friend, I student’s development of the Children’s special. Ithought to myself, where should Bereavement Center in 1997. This center Betty Merchant, dean of the UTSA I start? How could I possibly sum up provides much-needed counseling services College of Education and Human someone’s life and what they meant to to children and families experiencing loss. Development, shared the following about me in approximately 850 words? After Larry also authored several books that Larry: “My first impression of Larry considerable contemplation, I concluded focused on families, children, adolescents was that of a kind and intelligent man that a good start would be to focus on the and school counseling. His Case Studies with a brilliant, if not slightly quirky, formal or public information that others in Marriage and Family Therapy book was sense of humor. Together, we served as may know about Larry. translated into Chinese — a personal and the inaugural chairs of our respective Larry Bruce Golden was born in professional highlight that brought such departments, and his advice and witty Pittsburgh, Pa., and was the older of two a smile to Larry’s face. His most recent observations buoyed my spirits and brothers. At the age of 10, his family clinical focus concentrated on what guided me through the inexplicable at moved to Miami, where he remained he fondly called his “geezer” research, times maze of policies and practices that through college. He completed a Master working with older adults. As he aged, were associated with a newly formed of Science degree in guidance and Larry would say that this area of study College of Education and Human counseling at the City University of interested him personally, and in 2009 Development. I was always amazed by New York. Larry met his wife, Meredith, he edited Case Studies in Counseling Older his boundless energy for learning and while both were students at Arizona Adults. Larry indeed enjoyed editing. for experiencing new places, and more State University, where he received his For more than 15 years, he served as the than anything, I understood that he was doctorate in counseling psychology. editor for the “Family Stories” column in incredibly proud of his wife and family, Larry began his long career in education The Family Journal, the official journal of and that they were the centering force in as a fifth-grade teacher in Dade County the International Association of Marriage his life. Public Schools. He then spent two years and Family Counselors, and was the “It was his spirit of self-examination working for Teacher Corps as a team originator of the journal’s creative writing and scholarly inquiry that inspired him leader. The bulk of his professional life competition. Additionally, his interest to request a faculty development leave in was spent on the counselor education in creativity and innovative counseling which to write a book that would explore faculty of three universities: eight years interventions made him a loyal charter the issues of the aging baby boomer at Our Lady of the Lake University in member of the Association for Creativity generation while filling a significant San Antonio; one year at Texas Women’s in Counseling and a founding editorial gap in the literature. One of the most University in Denton; and more than 20 board member of the Journal of Creativity memorable images I have of Larry is of years at the University of Texas at San in Mental Health. him delivering a signed copy of his book Antonio (UTSA). On a more personal level, I asked to me. He was so proud of this work — Larry retired in 2010, and he and friends and colleagues about the justifiably so — and it was a wonderful Meredith moved to Asheville, N.C., impact Larry had on their lives. Many capstone to his career in academia. Larry where they became friends of the recalled his subtle humor, his gentle was a gift to us, and a particularly special Unitarian Universalist Congregation and and gracious demeanor, and the gift to me, and I am truly grateful for active in the College for Seniors at the distinctive characteristics that made having had the opportunity to know University of North Carolina Asheville. Larry … Larry. For example, when we him.”

54 | Counseling Today | June 2012 One of my favorite ways of showing Wearing it around my neck Balleza, and their son, Andrew Balleza; Larry how special he was to me was I’m taking my freedom his mother, Gertrude Shurowitz; and his to sing the Jill Scott song “Golden.” I Putting it in my car brother, Ken Golden. u remember asking Larry if he had heard Wherever I choose to go of the song. He of course answered It will take me far Submitted by Marcheta Evans, “no” because he was not a regular R&B Living my life like it is golden, golden! immediate past president of the listener. I would then break out in song American Counseling Association with some of the lyrics: Larry, you truly lived your life like it and associate dean of the was Golden. Goodbye my friend! downtown campus of UTSA’s I’m taking my freedom Larry is survived by his wife of 36 College of Education and Human Pulling it off the shelf years, Meredith Norwood; his daughter, Development. Putting it on my chain Sarah Balleza, her husband, Martin

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June 2012 | Counseling Today | 55 division, region & Branch News

ACCA bylaws change allows House Hotel in beautiful and historic and educators to submit a proposal hiring of executive director Williamsburg, Va. The theme of the for presentation by June 15. For more Submitted by MJ Raleigh conference will be “Adult Development information on registration, local hotels [email protected] Matters: Fostering Resilience in Times and the call for proposals, visit iaaoc.org. Thank you to everyone who joined of Crisis and Transition.” Mark your us at our American College Counseling calendars for an exciting day of learning AACE plans conference, seeks Association reception in San Francisco. filled with opportunities to forge member input on bylaws changes The company and the food were connections with other counseling Submitted by Amy McLeod professionals. excellent. Thank you also to all the [email protected] This is an excellent way to earn members who participated in our The Association for Assessment in CEUs while developing new awareness, business meeting. Member votes passed Counseling and Education’s National techniques and skills covering a wide the changes in the ACCA bylaws that will Assessment and Research Conference variety of topics. Additionally, you can allow us to hire an executive director and will be held Sept. 14-15 in Orlando, meet friends you haven’t seen in awhile or hold our annual meetings solely at the Fla. The theme will be “Measurement of go enjoy the many local educational and ACCA conference. Although the online Outcomes in Counselor Preparation and entertainment possibilities. Opportunities voting bylaw was posted on our website Practice.” Come present and learn about include experiencing what daily life in October 2011 as an upcoming vote, research and assessment in counseling. was like when our country first began we will vote in October 2012 to allow The hotel rate is $97 for suites (book by in Colonial Williamsburg, exploring online voting for all future elections and Aug. 14) and includes complimentary North America’s first permanent English- bylaw changes. cook-to-order breakfast and a nightly speaking settlement at Jamestown, I had the privilege of honoring our cocktail reception for two adults. Your traversing Revolutionary War battlefields conference registration also includes a ACCA emerging leaders. Billie Bailey at Yorktown and discovering thrilling luncheon and a reception. is a doctoral student at Montclair rides and shows at Busch Gardens. For Visit theaaceonline.com/conference.htm State University in New Jersey. She has more information and to register, visit to register for the conference and submit experience counseling, advising and aadaweb.org. teaching at the collegiate level. Megan proposals. The deadline for proposal Hyland Tajlili is a doctoral student at submission and early registration is June North Carolina State University. She IAAOC holding conference on 1. Contact conference chair Jacqueline has experience and interest in career and offender counseling Swank at [email protected] with any counseling for college students. Tajlili also Submitted by Keith Morgen questions. participated in the American Counseling [email protected] In other news, AACE members will Association’s first clinical demonstration The International Association of be voting on important changes to the series at the ACA Annual Conference. Addictions and Offender Counselors is division name, mission and vision at the Michelle Ghoston is a doctoral student pleased to announce its first divisional September business meeting in Orlando. at Virginia Tech. She has worked as conference, planned for Sept. 15-16 Please review the proposed bylaw changes a counselor, adviser and instructor at in New York City. We are sponsoring at theaaceonline.com before this event. several four-year and community colleges. the event in conjunction with the “Be These changes were proposed to better Nicole Woodard is a doctoral student the Evidence” Social Work Project of reflect AACE’s expanded vision to address at George Mason University. She has Fordham University. The conference research and evaluation in our profession, experience working as a counselor, adviser theme is “United in Purpose: Counseling in addition to continuing its focus on and instructor in the community college and Social Work Perspectives on Clinical assessment and diagnostic considerations. setting. Practice and Training Issues in Addictions Send feedback regarding the changes to and Offender Counseling.” President Danica Hays at [email protected]. Registration for the conference is free AACE is also seeking 2013 conference AADA heads to Williamsburg for all IAAOC members. Presentation site proposals. AACE hosts an annual for summer conference topics will focus on therapeutic best assessment and research conference on Submitted by Radha Horton-Parker practices, counselor training and topics related to assessment, evaluation [email protected] multicultural, religious and spiritual and research in counseling and education. The Association for Adult issues in addictions and offender Submit an initial proposal (no more Development and Aging will host its counseling. A special session will be than two pages) and indicate why AACE annual summer conference on July devoted to graduate student posters. should hold a conference in the host 13 at the Williamsburg Hospitality We encourage counselors, students city, what the draw would be for people

56 | Counseling Today | June 2012 attending and your commitment to host AACE in the host city. Additionally, provide relevant information about available hotels and/or conference sites. New! You can also propose a conference theme. The AACE National Assessment and Research Conference is typically held Casebook for Counseling Lesbian, in mid-September. The conference site must accommodate 150 to 200 attendees Gay, Bisexual, and Transgender for approximately two days (Friday and Saturday). Send an electronic proposal to Persons and Their Families President Hays no later than July 1. u edited by Sari H. Dworkin and Mark Pope

Submit your news “By structuring the book through and upcoming events the lenses of competency models All divisions, regions and developed by ALGBTIC, one is able branches of the American to see clear connections between the Counseling Association clinical issues presented, effective can submit monthly news intervention strategies, and how counselors work ethically within the articles of up to 350 words to competency models. Kudos to Drs. “Division, Region & Branch Dworkin and Pope for this substantial News.” In addition, divisions, contribution.” regions and branches are —Ned Farley, PhD invited to list upcoming events Antioch University Seattle in “Bulletin Board.” For Editor, Journal of LGBT Issues in Counseling submission guidelines, contact Lynne Shallcross at lshallcross@ This captivating book contains 31 case studies that focus on what counseling.org. is said and done in actual counseling sessions with LGBTQQI clients, Please be advised of the including diagnosis; interventions, treatment goals, and outcomes; transference and countertransference issues; other multicultural following deadlines for considerations; and recommendations for further counseling or submitting items to either training. section. Due to production Experts in the field address topics across the areas of individual development, relationship concerns, contextual matters, and wellness. schedules, the traditional The cases presented include coming out; counseling intersex, submission deadlines have bisexual, and transsexual clients; couples, marriage, and family been changed in many cases: counseling; parenting issues; aging; working with rural clients and African American, Native American, Latino/a, Asian, and multiracial individuals; sexual minority youth; HIV; sexual and drug addictions; July issue: June 1 at 5 pm ET binational couples; work and career; domestic violence; spirituality and religion; sexual issues; and women’s health. 2012 | 395 pgs August issue: June 29 at 5 pm ET Order #72917 | ISBN 978-1-55620-306-0 September issue: July 27 at 5 pm ET List Price: $54.95 | ACA Member Price: $39.95 October issue: Aug. 30 at 5 pm ET Please include $8.75 for shipping of the first book and $1.00 for each additional book. November issue: Sept. 28 at 5 pm ET Order Online: counseling.org By Phone: 800-422-2648 x222 December issue: Oct. 26 at 5 pm ET (M-F 8am – 6pm) January 2013 issue: Nov. 30 at 5 pm ET

June 2012 | Counseling Today | 57 Bulletin board

Coming events aging strategies. For more information, FYI visit the AADA website at aadaweb.org. ASERVIC Conference on Call for submissions AACE National Assessment Spirituality in Counseling The Association for Lesbian, Gay, and Research Conference June 3-4 Bisexual and Transgender Issues in Sept. 13-15 Santa Fe, N.M. Counseling invites submissions for The Orlando, Fla. Journal of LGBT Issues in Counseling. The Association for Spiritual, Ethical Save the date for the Association and Religious Values in Counseling will for Assessment in Counseling and The intent of this journal is to publish host its third Conference on Spirituality Education’s National Assessment and articles that are both relevant to working in Counseling at the Inn and Spa at Research Conference, themed “Measuring with sexual minorities and of interest to Loretto. The keynote speaker will be Outcomes in Counselor Preparation and counselors, counselor educators and other William R. Miller, founder of motivational Practice.” For more information, contact counseling-related professionals who work Jacqueline Swank, conference chairperson, interviewing. For more information, visit across diverse fields. Topic areas include at [email protected]. aservic.org. new research, new/innovative practice and NCDA Global Career IAAOC Conference on Addictions theoretical or conceptual pieces (including Development Conference and Offender Counseling literature reviews) that reflect new ideas or June 21-23 Sept. 15-16 new ways of integrating previously held New York City Atlanta ideas. The journal is distributed quarterly. The International Association of The National Career Development For detailed submission guidelines, contact Addictions and Offender Counselors is Association Global Career Development editor Ned Farley at [email protected] sponsoring its first divisional conference, Conference will be themed “Building or visit the journal webpage at tandfonline. on the Dream.” Take advantage of more to be held on the Fordham University com/action/authorSubmission?journalCode= than 160 presentations, discussions and Lincoln Center campus in New York City. wlco20&page=instructions. workshops, and network with more than Registration is free for IAAOC members. 1,000 career practitioners and educators. Presentations and posters are being Call for submissions solicited in the following areas: counselor For more information, visit ncda.org. The Louisiana Counseling Association education and training in addictions invites submissions for the 2012 edition of ASCA Annual Conference and offender counseling; multicultural, June 23-26 religious and spiritual issues; therapeutic its annual Louisiana Journal of Counseling. Minneapolis best practices in addictions and offender Research and practice-based submissions The American School Counselor counseling; and graduate student poster written in APA style and related to the field Association Annual Conference will be sessions. Visit iaaoc.org for more details. of counseling will be considered for blind themed “Be Brilliant: Celebrating ASCA’s peer review. Please submit an electronic TCA Conference Diamond Anniversary.” Dan Savage of the copy to co-editor Meredith Nelson Nov. 17-20 It Gets Better project on YouTube, Stacey ([email protected]). Direct questions to Bess and Jamie Vollmer will give keynote Nashville, Tenn. The Tennessee Counseling Association either editor Peter Emerson (pemerson@ addresses. For more information, visit selu.edu) or Nelson. schoolcounselor.org. Conference will be held at the Sheraton Nashville Downtown. “Counseling as Call for reviewers AADA Summer Conference Music: Facilitating Harmony for Mind, The Canadian Journal of Counselling and July 13 Body and Spirit” will be the conference Psychotherapy, the flagship journal of the Williamsburg, Va. theme. Anyone interested in presenting at The Association for Adult Development this conference is asked to download the Canadian Counselling and Psychotherapy and Aging’s 2012 Summer Conference program proposal form at tncounselors.org. Association (formerly the Canadian will be themed “Adult Development The deadline for program submissions is Counselling Association), is seeking Matters: Fostering Resilience in Times of July 7. Questions regarding the submission reviewers from the United States. For Crisis and Transition.” The conference will process should be sent to Jeannine Studer further information, visit cjc-rcc.ucalgary. provide opportunities for networking and at [email protected]. Presentations may focus ca/cjc/index.php/rcc/announcement. professional development for counseling on practice or theory, a single technique, Bulletin Board professionals and students with an interest programs, innovative strategies and/ in adult development across the life span. or research. The keynote speaker will be submission guidelines Presentation topics will include spirituality author and motivational speaker Dave Items for the Counseling Today Bulletin and wellness, women and transition, adult Weber. Contact Mike Bundy, president- Board must be submitted to lshallcross@ bullying, career transition at midlife, elect and conference chair, at mbundy@ counseling.org. Please see page 61 for LGBT adults coming out and positive cn.edu with any questions. upcoming submission deadlines. u

58 | Counseling Today | June 2012 New Ideas, New Attitudes and Fresh Approaches for Working With Kids and Teens

Cyberbullying: What Counselors Play Therapy: Basics and Beyond Need to Know Second Edition Sheri Bauman Terry Kottman Written for counselors, teachers, Written for use in play therapy and child school leaders, and others who work counseling courses, this extraordinarily with children and teens, Cyberbullying practical text provides a detailed addresses the real-life dangers students examination of basic and advanced play face on the Internet. Includes a discussion therapy skills and guidance on when and of the different types of cyberbullying how to use them. After a discussion of and cyberbullying environments; an the fundamental concepts and logistical overview of prominent theories of aspects of play therapy, Kottman illustrates aggressive behavior; practical tips to both commonly used and more advanced identify and follow cyberfootprints; play therapy skills. A new chapter on working with parents and proactive responses to cyberbullying; effective, nonpunitive teachers is designed to increase the effectiveness of play therapy. strategies for responding to cyberbullying; useful information Practice exercises and “Questions to Ponder” facilitate the skill- on current technology and popular websites; and much more. building and self-examination process. 2011 | 375 pgs 2011| 215 pgs Order #72905 | ISBN 978-1-55620-305-3 Order #72900 | ISBN 978-1-55620-294-0 List Price: $54.95 | ACA Member Price: $39.95 List Price: $33.95 | ACA Member Price: $28.95 Bullying in Schools: Six Methods Counseling Children: A Core of Intervention Issues Approach presented by Ken Rigby Richard W. Halstead, Dale-Elizabeth Pehrsson, and Jodi Mullen This DVD gives clear, practical guidance This innovative book offers a means for on how to prevent and respond to bullying practitioners in community, mental health, in high schools. Using actors and role and school settings to better assess, treat, play, the DVD features a typical bullying and monitor children’s underlying issues. scenario and then demonstrates how the The diagnostic framework presented following methods can be applied to the helps uncover the nature of children’s core situation: the Disciplinary Approach, concerns and provides guidance on how Restorative Practice, Strengthening the to address the issues they are struggling Victim, Student Mediation, the Support with. Includes numerous strategies such Group Method, and the Method of Shared as narrative approaches, play therapy, Concern. By showing the advantages and weaknesses of each sand tray therapy, and expressive arts therapy. The book method, the counselor or teacher can see how each solution gives suggestions for bringing parents, teachers, and other might work. Includes a PDF booklet with a summary of professionals together as a collaborative team. 2011 | 192 pgs important information and discussion guidelines. Order #72901 | ISBN 978-1-55620-283-4 Produced by Loggerhead Films List Price: $29.95 | ACA Member Price: $24.95 2009 | 35 minutes | DVD Order #78239 List Price and ACA Member Price: $129.00

Please include $8.75 for shipping of the first book and $1.00 for each additional book.

Order by phone: 800-422-2648 x222 Order online: counseling.org/publications

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No ranked family & marriage counseling All manuals and materials provided to cancellations or refunds. Employment ads sites on the web. http://family-marriage- lead up to 14 different workshops. can be placed online only at a rate of $8 per line, based on 30 characters per line; 30-day counseling.com. Our training is licensed by Hay House, posting. Inc., and approved by Louise Hay. LICENSURE EXAM REVIEW Display ads in the employment classified www.healyourlifetraining.com section are available and can be designed by NCE & NCMHCE Exam Prep ACA’s graphics department. Call for details. Review. Multiple choice questions, Classified and employment ads are not mnemonics. Exam Tips, online and EDITOR SOUGHT commissionable and are billed at net rate interactive Check out our FREE only. SAMPLER!! [email protected] www. Editor Sought for the Counseling & u ACA Members: If you are seeking a position you may place a 45-word ad for $10. 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Its mission is to u Ads are subject to Counseling Today us on Facebook at www.facebook.com/ inform the readership of research, recent approval; however, Counseling Today cannot screen or evaluate all products or services shrinkrapt and follow us on Twitter at innovations, and critical issues related advertised in the classified section and does ShrinkRaptTweet. to the integration of spirituality and not guarantee their value or authenticity. The religion in counseling as well as ethical publication of an advertisement in Counseling DISSERTATION COMPLETION CONSULTING issues. The appointment of editor Today is in no way an endorsement by ACA is for a 3-year term beginning July of the advertiser or the products or services Individualized program assists with all advertised. Advertisers may not incorporate aspects of dissertation and thesis writing. 2013. Appointment is conditional in subsequent advertising or promotion By phone, by FAX, by e-mail, or in upon the following qualifications: the fact that a product or service has been (1) Experience as an editorial board person. Call “toll free” 1-(888) 463-6999 advertised in any ACA publication. ACA member of a professional publication endorses equal opportunity practices and will or [email protected] or similar experience (associate editor not knowingly accept ads that discriminate on the basis of race, sex, religion, national or editor of another publication); origin, sexual orientation, disability or age. (2) A record of scholarly publications in refereed journals; (3) A history of u Counseling Today reserves the right to edit CONTINUING EDUCATION all copy, request additional documentation involvement in and contribution to the where indicated and to refuse ads that are CRUISE & EARN 20 CEUs counseling profession, including a focus not in consonance with these practices. ACA on spirituality, religion, and ethics; (4) Fresh topics and fun ports all at great is not responsible for any claims made in An understanding of and commitment advertisements nor for the specific position rates. Approved for all Mental Health title or working of any particular position to the mission of ASERVIC, including listed in employment classified ads. Professions. www.LandOrSeaCEUs.com ASERVIC membership at the time of Debbie @ 877-901-4335. 818-734-4335. application submission. Demonstration

60 | Counseling Today | June 2012 of institutional or organizational support degree in Counselor Education and (if applicable) is highly desirable. Supervision or a closely related field; Interested individuals should submit EMPLOYMENT Licensed or license –eligible Professional a formal application containing the Counselor in state of Arizona (LPC) or following materials by September 21, National Certified Counselor (NCC) NATIONAL 2012: (1) A current curriculum vitae, certification; Evidence of ability to teach (2) A complete list of publications and core courses in a graduate CACREP- reprints of no more than five of the PRIVATE PRACTICE THERAPISTS – clinical mental health counseling applicant’s most significant publications, REFERRALS program; Basic Knowledge of MS Word Looking for licensed therapists in private (3) A statement of vision for the 2007, Basic Knowledge of MS Excel practice as independent contractors – editorial direction for the Counseling 2007. across the country, who are interested in & Values journal, and (4) A statement The University of Phoenix is an Equal from an administrator of the applicant’s working with couples. To learn more, Opportunity Employer and does not institution or organization describing please go to: www.YourMarriageCounselor. discriminate against persons on the support for the appointment (if com/therapist/or you can call Marty basis of age, disability, disabled veteran applicable). Phone interviews with top Tashman at 732/246-8484. or Vietnam-era veteran status, gender, candidates will take place October 2012. marital status, national origin, race, The appointment will be announced ARIZONA religion, or sexual orientation. as soon as possible, and the editor-elect Can apply online at www.phoenix. will be expected to begin working with UNIVERSITY OF PHOENIX edu/teach or by specific location below the current editor at that time so as to Core and non-core faculty Phoenix Contact: Patricia L. Kerstner, facilitate the official transition on July Master of Science in Clinical Mental PhD, NCC, Campus College Chair- 1, 2013. Inquiries should be sent to Health Counseling program College of Social Sciences, University of [email protected] University of Phoenix, Phoenix or Phoenix, Phoenix Campus, John Sperling Please send applications electronically Tucson campus Center for Educational Innovation, by September 21, 2012 to: JOB DUTIES: Core faculty — Teach a 1625 W. Fountainhead Parkway, CF- Dr. Harriet Glosoff, ASERVIC minimum of 18 credits per year. Advise S503, Tempe, AZ 85282 Direct 480- Search Committee Chair, Counseling & an average of 25 students. Serve on 557-2179, Fax: 480-643-3385 Email: Values Editor Search Committee Chair, committees and engage in scholarship. [email protected] web: [email protected] REQUIREMENTS: Earned doctoral phoenix.edu

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As an ACA member or supporter during 2012, you are a part of counseling history. To mark this occasion and support the counseling profession, purchase the special ACA 60th Anniversary Commemorative Coin. $25 Online: counseling.org Phone: 800-347-6647, x222 (M–F, 8 am – 6 pm) Order #83001

June 2012 | Counseling Today | 61 Tucson (Southern Arizona) Contact: and will be preparing application for Gundersen Lutheran is a physician-led, Chad M. Mosher, Ph.D., NCC Campus CACREP accreditation. For complete not-for-profit health system with a top- College Chair, College of Social Sciences/ details regarding qualifications, ranked teaching hospital and one of the College of Criminal Justice and Security, responsibilities, and application please largest multi-specialty group practices University of Phoenix, Southern Arizona go to: http://www.ursuline.edu/About/ with about 700 physicians and associate Campus, Academic Affairs, 300 S. Human_Resources/job_opportunities. medical staff. Telemedicine, specialty Craycroft Rd., Mail Stop CU-A101, html outreach, electronic health records and Tucson, AZ 85711 digital imaging connect Gundersen phone: 520-239-5208, fax: 520-514- WISCONSIN Lutheran with our many regional clinics, 0948 Email: [email protected] affiliate hospitals and practitioners. GUNDERSEN LUTHERAN HEALTH SYSTEM La Crosse, WI is a vibrant community MARYLAND Child/Adolescent Therapist of 50,000+ people nestled along the Gundersen Lutheran Health System, Mississippi River, offering an endless TARLETON STATE UNIVERSITY based in La Crosse, Wis., is seeking variety of recreation, entertainment and Multiple Positions a Child/Adolescent Therapist to join scenic beauty. The historic downtown College of Education and Department of professionals providing a full continuum and riverfront host many festivals and Psychology and Counseling of psychiatric care that includes child/ events. Excellent schools and universities, Searches are being conducted to fill the adolescent services, ECT, eating disorder parks, sports venues and affordable following positions: clinic, DBT, partial hospitalization and housing make this a great place to call Associate Professor/Professor and Head more. Join 8 adult psychiatrists, 5 child home. Please contact Cathy Mooney at of the Department of Psychology psychiatrists, 5 psychologists, 3 nurse [email protected] or phone 608- and Counseling (Tenure Track) at the practitioners and numerous Master’s level 775-3637 if you would like to find out Stephenville campus; therapists and other providers. more! www.gundluth.org/MedCareers Assistant/Associate Professor of Counselor Education and Program Director (Tenure Track) at the Fort Worth campus; Assistant Professor of Counselor Advertiser Index Education (Tenure Track) at the Fort ACA 60th Anniversary Coin...... 61 Child Therapy Toys...... 13 Worth campus; ACA Webinar...... 55 Assistant Professor of Counselor Exam Prep Study Guide Education (Tenure Track) at the Waco ACA PUBLICATIONS by Andrew Helwig, Ph.D...... 35 ACA Encyclopedia of Counseling, campus. Excelsior College...... 37 Review of applications will begin The ...... 15 immediately and continue until the Counseling Strategies for Loss and Grief Recovery Institute...... 25 position is filled: however priority will Grief ...... 31 HPSO Insurance...... c3 be given to applications received by June Casebook for Counseling LGBT Institute for Clinical 15, 2012. Applications may be submitted Persons and Their Families...... 57 through Tarleton State University’s online Social Work...... 29 New Textbooks from ACA...... 6 job posting and application system at International Institute https://jobs.tarleton.edu. Rooted Sorrows: Emotional Burden to Emotional Health: Veterans With of Souldrama...... 41 PTSD DVD...... 27 LicensedTherapists.com...... 9 OHIO Understanding People in Context....48 Mark Dworkin EMDR Working With Kids and Teens...... 59 URSULINE COLLEGE Training...... 47 Tenure Track Faculty, Counseling and Advertisers New Mind Technologies...... 25 Art Therapy Army Medical Civilian Corps...... 43 Peachtree Professional Ursuline College, a small liberal Association for Advanced Training in arts college near Cleveland, Ohio the Behavioral Sciences...... c4 Education...... 49 is seeking a full-time, tenure-track Brehm Preparatory School...... 11 Somatic Experiencing Trauma faculty member to assume teaching and California University of Institute...... 19 advising responsibilities in its graduate Pennsylvania...... 53 Art Therapy and Counseling Program Therapysites.com...... c2 California Southern University...... 43 beginning August 15, 2012. The Thriveworks...... 33 program is committed to providing Chicago School of Professional education and training in both Psychology, The...... 17 Walsh & Dasenbrook Consulting....40 professional counseling and art therapy,

62 | Counseling Today | June 2012 CT0212_CON-CT1211 12/22/11 3:33 PM Page 1

Alleged unprofessional conduct and inappropriate treatment – lead to a malpractice suit.

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This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company, and is offered through the Healthcare Providers Service Organization Purchasing Group. Coverages, rates and limits may differ or may not be available in all states. All products and services are subject to change without notice. This material is for illustrative purposes only and is not a contract. It is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, coverages, amounts, conditions and exclusions. CNA is a registered trademark of CNA Financial Corporation. Copyright © 2012 CNA. All rights reserved. Healthcare Providers Service Organization is a registered trade name of Affinity Insurance Services, Inc.; (AR 244489); in CA, MN & OK, AIS Affinity Insurance Agency, Inc. (CA 0795465); in CA, Aon Affinity Insurance Services, Inc., (0G94493), Aon Direct Insurance Administrator and Berkely Insurance Agency and in NY and NH, AIS Affinity Insurance Agency. © 2012 Affinity Insurance Services, Inc. CT0212

Endorsed by: Counselor’s Professional Liability Insurance Learn the value of having your own ACA-endorsed plan by visiting www.hpso.com/ct2 Doors Open Once You Pass Your Licensing Exam

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