• Abstract and Figures
• Public Full-text

Louisiana Journal Counseling Volume XXII of Fall 2015

A Branch of the American Counseling Association

Peter Emerson, Meredith Nelson Editors Louisiana Journal of Counseling

CO-EDITOR LCA WEBSITE Peter Emerson www.lacounseling.org Southeastern Louisiana University CO-EDITOR The Louisiana Journal of Counseling (LJC) is Meredith Nelson the official journal of the Louisiana Counseling LSU Shreveport Association (LCA). The purpose of LCA is to foster counseling and development services to EDITORIAL BOARD elementary, high school, college, and adult Mary Ballard populations. Through this united focus, LCA Southeastern Louisiana University maintains and improves professional standards, Reshelle Marino promotes professional development, keeps Southeastern Louisiana University abreast of current legislation, and encourages Tim Fields communication among members. Louisiana State University Hsin-Ya Tang Manuscripts: See inside back cover for LSU Shreveport guidelines. Kacie Blalock LSU Shreveport Membership: Information concerning LCA and Robert Minniear an application for membership may be obtained LSU Shreveport from the Executive Director. Krystal Vaughn Louisiana Health Sciences Change of Address: Members should notify the June Williams Executive Director of any change of address. Southeastern Louisiana University Advertising: For information concerning LCA OFFICERS advertising contact the co-editor as Meredith Tim Fields – President Nelson, LSUS, One University Place, Iman Nawash – Pres.-Elect Shreveport, LA 71115 or by email at Christine Ebrahim– Pres.–Elect-Elect [email protected] or [email protected]. LCA John Crawford – Past President reserves the right to edit or refuse ads that are Bruce Galbraith– Parliamentarian not appropriate. LCA is not responsible for claims made in ads nor does it endorse any LCA STAFF advertised product or service. Diane Austin – Executive Director Austin White – Business Manager Copies: The LJC is published annually as a 353 Leo Ave. member service. Additional copies may be Shreveport, LA 71105 purchased from the Executive Director for $15. 1.888.522.6362 Annual subscriptions are available to non- members for $15.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 2 Louisiana Journal of Counseling

Fall 2015 • Volume XXII

3 From the Editors: Complementary and Alternative Medical Therapies: A Second Look Peter Emerson and Meredith Nelson

6 Utilizing Cognitive-Behavioral Therapy with Bullied Obese Adolescents in Schools Kellie Giorgio Camelford

13 Supervisory Triad in Multicultural Supervision Hsin-Ya Tang and Erik Braun

22 Reading the Code of Ethics as Literature: The Application of Hermeneutical Principles to Enhance Counselor Knowledge and Competence Jan Case, Megan Long, and Andrea Sanders

33 Reflective Supervision as a Key Support for Counselors Krystal M. Vaughn, Allison B. Boothe, and Angela W. Keyes

42 Ethical Gatekeeping for LPC Supervisors Christian J. Dean

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 3 From the Editors

Complementary and Alternative Medical Therapies: A Second Look

Holistic, wellness, developmental, and will increase as insurance coverage expands. preventative are some of the terms used to Kessler et al. (2001) suggests that asking clients define counseling. These terms definitively link about their CAM use could maximize the physical and psychological health (i.e., mind and usefulness of therapy. body). Western medicine is slowly coming to In one study, De Lisle, Dowling, and Allen realize that Eastern healing concepts, which (2012) suggest that mindfulness can improve have been around for thousands of years, also problem gambling outcomes, and call for more have merit in our current health care system research in this area to improve therapeutic (Koshikawa, Nedate, & Haruki, 1992). Jung outcomes with problem gamblers. In another embraced the Eastern symbolism and study, Witkiewitz, Marlatt, and Walker (2005) conceptualization of the mandala to explain the offer preliminary data that provides initial concept of wholeness and relatedness (Smith, support for the effectiveness of one type of 1990). In addition to these characteristics of the mindfulness practice in reducing alcohol and mandala, Jung admonishes that “…the centre of drug use, and substance use-related problems. In the circle [mandala] as an expression of addition, research into the clinical utility of wholeness would correspond not to the ‘I’, but Buddhist-derived interventions (BDIs) has the self as the epitome of the total personality” increased greatly over the last decade (Shonin, (Jung, p. #, 1968). This article is a call to the Van Gordon, & Griffiths, 2014). Although counseling community that we need to clinical interest has predominantly focused on incorporate more of these Eastern treatments mindfulness meditation, there has also been an into our therapeutic work. increase in the scientific investigation of Since the 1950’s, the United States has seen interventions that integrate other Buddhist an increase in the use of complementary and principles such as compassion, loving kindness, alternative medical therapies (CAM). Research and non-self. Shonin et al. (2014) conclude that shows that in the next 25 years the demand for integrated Buddhist principles may be effective CAM will continue to increase. Most CAM treatments for a variety of psychopathologies therapies are used to prevent future illness or to including mood-spectrum disorders, substance- maintain health (Kessler et al., 2001). Examples use disorders, and schizophrenia. They also of these treatments include: massage suggest more research into this area and, more (bodywork), chiropractic care, acupuncture, importantly, a need for greater dialogue between yoga, tai chi, meditation, breathing, Buddhist teachers and mental health clinicians diet/nutrition, and aromatherapy (Morgan, and researchers to safeguard ethical practices 2001). (Shonin et al., 2014). Many clients visiting conventional mental health In 2008, LCA implemented a “Gratitude providers also use complementary and Project” that was embraced by counselors alternative therapies. In fact, individuals with throughout the state. In actuality, this project self-defined anxiety and severe depression use certainly incorporated the concept that gratitude CAM therapies more than conventional = mindfulness. Recently, study after study has therapies. It is very likely that these therapies proven the myriad health (physical and mental)

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 4 benefits of gratitude = mindfulness = kindness. References The impact of the project renders similar De Lisle, S. M., Dowling, N. A., & Allen, J. S. conclusions to those that were established by the (2012). Mindfulness and problem Institute of HeartMath, which found that “when gambling: A review of the literature. people consciously experience appreciation and Journal Of Gambling Studies, 28(4), 719- gratitude, they can restore the natural rhythms of 739. doi:10.1007/s10899-011-9284-7 their heart” (Science of Coherence, 2001). Jung, C. G. (1968). The collected works of C. G. When we look at prevention, we need to look at Jung (Vol. 12). Psychology and alchemy: the developmental stages of our clients. What if Bollingen series xx. Princeton, NJ: we were teaching our children and adolescents Princeton University Press. to practice mindfulness, Buddhism, yoga, and to Kessler, R. C., Davis, R. B., Foster, D. F., Van incorporate more of these Eastern philosophies Rompay, M. I., Walters, E. E., Wilkey, S. into their everyday lives? This might prevent A., & Eisenberg, D. M. (2001). Long-term more serious physical and/or mental illnesses trends in the use of complementary and and/or help control them (Nilsson, 2014). alternative medical therapies in the United For example, Milligan (2006) discusses a States. Annals of Internal Medicine, yoga program on college campuses that is 135(4), 262-268. doi:10.7326/0003-4819- considered an approach for addressing student 135-4-200108210-00011. stress problems and increasing the diversity of Koshikawa, F., Nedate, K., and Haruki, Y. services offered by university counseling (1992). When west meets east: centers. A student who is reluctant to seek Contributions of eastern traditions to the traditional counseling may see this type of future of psychotherapy. Psychotherapy, therapy as an acceptable alternative. Barriers and 29(1), 1-9. doi: 10.1037/0033- stereotypes held by some students about seeking 3204.29.1.141. counseling services can be overcome by offering Milligan, C. K. (2006). Yoga for stress an alternative type of therapy service (Milligan, management program as a complementary 2006). Often as counselor educators, the authors alternative counseling resource in a convey this journey as a process that the client is university counseling center. Journal of assisted through by the counselor, and as a College Counseling, 9(2), 181-187. journey that the counselor must go through to be doi:10.1002/j.2161-1882.2006.tb00105. of assistance to others. Smith (1990) describe Morgan, D. (2001). Assimilation from the east this journey from Jung’s perspective that and the spectrum of consciousness. Journal “through the process of individualization, the of Psychotherapy Integration, 11(1), 87- psyche is unified, and one’s life is transformed; 104. doi: 1053-0479/01/0300-0005. the symbol of this new, unified state of being Nilsson, H. (2014). A four-dimensional model (i.e. the mandala)” (p.#). of mindfulness and its implications for These editors have seen firsthand how health. Psychology of Religion and Eastern treatments such as yoga, breathing, Spirituality, 6(2), 162-174. doi: massage, chiropractic care, acupuncture, diet, 10.1037/a003. and aromatherapy can help manage a variety of Science of coherence (2001). Institute of disorders. Many times, these CAM treatments HeartMath. Retrieved from: will never fully “cure” the disorder. However, in http://www.heartmath.org/research/overvie many cases the disorder is managed by these w.html treatments and not by psychotropic drugs, and, Shonin, E., Van Gordon, W., & Griffiths, M. D. in most instances, there are minimal to none of (2014). The emerging role of Buddhism in the negative side effects associated with western clinical psychology: Toward effective drug treatments. As a result, if we can have integration. Psychology of Religion and transformed lives with our hearts in rhythm then Spirituality, Vol. 6, No. 2 , 123-137. a look into these approaches is well worth their Smith, C.D. (1990). Jung’s quest for wholeness: inclusion into each of our journeys. A religious and historical perspective. State University of New York, Albany.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 5 Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy: An International Quarterly, Vol. 19, No. 3 , 211-228. doi:10.1891/jcop.2005.19.3.211

- Meredith Nelson and Peter Emerson Editors

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 6 Utilizing Cognitive-Behavioral Therapy with Bullied Obese Adolescents in Schools

Kellie Giorgio Camelford, Ph.D., LPC-S, NCC

Thrive Counseling Center LLC

In today's culture obesity is becoming an epidemic for individuals of all ages. Research shows that obese adolescents have higher risks of being the victims and perpetrators of bullying in a school setting. School counselors should focus on this specialized population as a way to create prevention and intervention strategies. This paper reviews current literature demonstrating obese adolescents as a marginalized population, and how school counselors can utilize cognitive-behavioral therapy in working with obese adolescents.

Keywords: adolescent obesity, overweight teenagers, cognitive-behavioral therapy, bullying, school counseling

Adolescent obesity has reached least preferred group among youth. These epidemic proportions in the United States, where social problems and physical health concerns 34 % of adolescents have a Body Mass Index may predict both short-term and long-term (BMI) at or above the 85 percentile (Janssen, problems for obese adolescents (Janssen et al., Craig, Boyce, & Pickett, 2004; Puhl, Luedicke, 2004). & Heuer, 2011; Quinlan, Hoy, & Costanzo, The short-term effects for obese 2009), making obesity the most common health adolescents include lower high school academic concern for adolescents (Quinlan et al., 2009). performance as well as college acceptance Often the general public assumes that obese (Janssen et al., 2004). Puhl and Heuer (2010) individuals are responsible for their weight, found that obese adolescents do not participate which fosters a prejudice against these people in sports or physical activity as often as (Puhl & Heuer, 2010). According to Puhl and adolescents with healthy BMI due to fear of peer Heuer (2010), “recent estimates suggest that the victimization. Obese adolescents reported prevalence of weight discrimination has heightened levels of loneliness, sadness, and increased by 66 % over the past decade and is nervousness compared to healthy adolescents now comparable to prevalence rates of racial (Janssen et al., 2004). These psychological discrimination in America” (p. 1019). issues could cause obese adolescents to suffer Additional studies have documented the from body dissatisfaction (Puhl & Heuer, 2010). misconceptions and stereotypes about obese Because adolescence is a key period for personal individuals including that they are lazy, development, school counselors need to be unsuccessful, lacking willpower, and concerned about the vulnerability of obese unintelligent (Flodmark, Lissau, Moreno, adolescents Pietrobelli, & Widhalm, 2004; Puhl & Heuer, The long-term effects of obesity 2010). include potential deleterious effects on health by increasing the risk of preventable diseases such Obese Adolescents as cardiovascular diseases and diabetes Obese adolescents are socially (Flodmark et al., 2004). Janssen et al. (2004) marginalized based on their physical features suggested that obese adolescents are less likely (Adams & Bukowski, 2008). A replication of to marry or complete school, and have less Richardson (1970) found that peers liked obese household income compared to non-obese children less than wheelchair bound children. adolescents. Obesity is often a lifetime struggle Latner and Stunkard (2003) replicated this study for those attempting to lose weight; for example, more than 30 years later, confirming these in one study individuals reported regaining 30 to findings and finding obese adolescents to be the

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 7 35 % of their weight back after one year of harm in obese adolescents’ psychological well treatment (Puhl & Heuer, 2010). being (Flodmark et al., 2004). Several studies link peer victimization in obese adolescents with Obesity and Bullying depression (Adams & Bukowski, 2008; Puhl et Obese adolescents are at risk of al., 2011; Quinlan et al., 2009). Psychological becoming victims of bullying. In 2011, the issues may include rejection from peers and Youth Risk Behavior Surveillance System victimization of peer aggression and bullying indicated that 20 % of students nationwide in (Janssen et al., 2004). Weight-based bullying grades 9-12 experienced some type of bullying has a positive correlation with various negative (StopBullying.Gov, 2012). “Bullying is psychosocial factors in obese adolescents such unwanted, aggressive behavior among school as low self-esteem, body distortions, or eating aged children that involves a real or perceived disorders (Quinlan et al., 2009). Therefore, power imbalance. The behavior repeats, or has school counselors should examine how the potential to be repeated, over time” cognitive behavioral therapy (CBT) can be used (StopBullying.Gov, 2012). Bullying may be in the school setting for both prevention and verbal, social, or physical. Risk factors for intervention with bullied obese adolescents. bullied adolescents include being different (e.g., wearing glasses, being overweight), appearing weak to peers, current psychological issues (e.g., CBT in Schools with Obese depression, anxiety, low self-esteem), lack of Adolescents social support, and difficulties in getting along Thoughts, behaviors, and feelings with others (StopBullying.Gov, 2012). When compromise the tenets of CBT. The goal of obese adolescents suffer from bullying, they CBT is to help clients become aware and modify need to be able to share what has happened and irrational beliefs regarding emotional and need protection from future bullying, behavioral concerns (Vernon, 2004). Through encouraging relationships with peers, and using CBT with students in schools, counselors reassurance so that they do not blame can teach students how to think which is a themselves (StopBullying.Gov, 2012). powerful skill (Vernon, 2004). School Adolescence is a time of physical counselors teach students to identify change; therefore, appearance is often a primary dysfunctional thinking, appraise the validity of focus within peer interactions (Janssen et al., thoughts and create a response or action plan by 2004). Janssen et al. (2004) studied a sample of using a variety of techniques to change thinking, 5,749 adolescents between the ages of 11 to 16 mood, and behavior (Beck, 1995). Therefore, to assess the relationship between obesity and CBT could be utilized to help adolescents see bullying behaviors. They found that the victims other aspects of their lives and build upon these and perpetrators of bullying often were obese strengths. Many school counselors may find adolescents (Janssen et al., 2004). Puhl, CBT to be effective based on the concrete Luedicke, and Heuer (2011) examined concepts that allow students to grasp hold of perceptions of weight-based bullying and their own thoughts, feelings, and behaviors. reported that 84 % of participants observed The key to using CBT in a school obese adolescents being bullied, which included setting is to help a student identify a problem isolation, exclusion from group activities, name where the student would have distorted calling, and teasing. Puhl et al. (2011) also cognitions, irrational beliefs, negative feelings, found that as an adolescent's BMI increased, the and / or problematic behaviors (Vernon, 2004). likelihood of bullying also increased. The school counselor helps the student review Other researchers have confirmed rational and irrational thoughts (Vernon, 2004). that obese adolescents receive victimization by School counselors should notice a student's their peers more frequently than non-obese distortions through the language used in a adolescents (Puhl & Heuer, 2010; Tang- session (Vernon, 2004), for example, if a student Peronard & Heitmann, 2008). Any negative states “must” often or seems to blow a basic social experience, such as bullying, may cause problem out of proportion these could be signs

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 8 of irrational thoughts. Other irrational thoughts is “too fat” and that it is “disgusting to watch could include overgeneralizing, self-downing, her eat.” Additionally, a month ago the popular personalizing, or awfulizing (Vernon, 2004). girls started "oink-ing" at her and called her The student can build confidence and identify names at school. Emily also reports that she cognitive alternatives by testing different skips PE class because she does not want to go thought patterns and behaviors. Ultimately the into the locker room or be teased. Emily school counselor can teach the student over time acknowledges that she is overweight and she the various CBT techniques to allow the student acknowledges her frustration with her struggle to counsel his or herself individually. The goal is to manage her weight. She tells the school for the student to correct and replace his or her counselor that she is “just worthless and a own faulty logic with rational thoughts (Beck, loser.” 1995). Through CBT, the school counselor can The school counselor should, before empower the student to make changes through implementing CBT with Emily, assess to ensure one’s own thoughts and beliefs. that Emily is safe from repetitive bullying School counselors can contribute to (StopBullying.Gov, 2012). Emily should feel the prevention of bullying of obese adolescents comfortable with the school counselor, as the by creating effective prevention programs. CBT therapeutic alliance is key in working with this can be a theoretical orientation to utilize with specialized population. The counselor can use this specialized population. School counselors interventions with Emily that focus on automatic implementing cognitive interventions and thought identification, cognitive restructuring, methods may help an obese student cope, ask for coping strategies and behavioral activation, and help, build self-esteem, and gain a healthy problem solving (Beck, 1995). Emily and the lifestyle. A goal for CBT with obese adolescents school counselor need to discuss and agree upon is to "investigate small, meaningful and the counseling goal and understand that Emily's maintainable improvements” (Brennan, goals will guide the counseling sessions. For Walkley, Lukeis, Risteska, Archer, Digre, example, Emily's goal may not be to lose weight Fraser, & Greenway, 2009). Although CBT has but to be able to cope with teasing from peers. It not been documented as an intervention into is important for the school counselor to support peer victimization for obese adolescents, Emily in her goal and avoid creating goals for techniques found in the literature linking CBT to Emily. adolescent depression, self-esteem, or weight- The school counselor should orient loss programs can be adapted. Adam and Emily to CBT (Ledley et al., 2010), and then Bukowski (2008) suggested that obese work with Emily on the basic idea that events, adolescents blame themselves for their thoughts, and feelings occur in relation to one appearance. Self-blame can create irrational another (Ledley et al., 2010). Specifically, for thoughts for many obese adolescents. Quinlan et Emily, this would include an evaluation of her al., (2009) found that when obese adolescents thoughts about her own weight and how others had positive outlets, such as academic success or are utilizing her weight against her. From higher levels of self-esteem, they maintained a Emily’s initial statement, Emily’s core belief positive view of self. Students with rational seems to be that she is worthless and a loser. thoughts are able to cope better with weight Throughout the initial sessions, the school concerns than students with irrational thoughts. counselor can assess Emily and together they can create an interactive treatment plan. Case Scenario The school counselor can then focus The following case scenario on helping Emily identify thoughts or feelings demonstrates how school counselors can regarding body image, confidence, friendships, implement CBT with obese adolescents. peers, and self-esteem to illuminate Emily’s A 16 year old female, Emily, comes into rational and irrational beliefs about her identity. the high school counseling office crying. The school counselor may ask questions such as She states that her friends will not let her sit at these: What was your initial thought when your the lunch table with them any more because she friends ignored you? How did you feel when

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 9 you could not sit by your friends at lunch? What CBT thoughts diary with obese clients as a body was your initial thought when those girls image diary exploring situations, feelings, 'oinked' at you? How did you feel when they thoughts, behaviors, consequences, and oinked at you? What do you think to yourself alternative thoughts. This can be a helpful tool when you are in the locker room? Through with Emily because it is designed to track the open-ended questions, the school counselor bullying situations as well as her internal collaborates with Emily and collects empirical thoughts and behaviors regarding those evidence to determine whether Emily’s situations. CBT activities allow Emily to be cognitions are serving her in a useful or harmful empowered in and outside of the counseling manner. session. The school counselor helps Emily The school counselor and Emily apply the cognitive model to her underlying core will ideally have the opportunity to meet beliefs. One can assume, for this scenario, that regularly, and there is no limit to the amount of Emily’s core belief is that she is worthless, sessions. Therefore, once Emily begins to pathetic, and a loser because she is overweight. translate her irrational thoughts into rational For instance, one troubling situation for Emily is thoughts and master the CBT techniques, she PE class that triggers an automatic thought of, would not need to see the school counselor as “They will think I cannot run because I’m fat.” frequently. Also, CBT can be a powerful tool for Emily's thought creates anxiety, fear, and Emily to use when the school counselor cannot sadness, leading to her to avoid the situation by be reached. Emily will continue to check-in to skipping class. As CBT focuses explicitly on reinforce the CBT principles throughout the thoughts, Emily’s thoughts can turn into year. Based on the structure of school activities within the counseling session. In one counseling, CBT can be an effective approach activity, “When You Need a Helping Hand,” well with obese adolescents. Emily would trace an outline of her hand on a piece of paper and place her irrational thought in Summary the palm, “I am worthless because I am fat.” Obese adolescents are a Then Emily can write potential solutions or marginalized population and school counselors rational thoughts on the fingers (e.g., “I’m a can help obese adolescents by implementing straight A student,” “I am loved by my family,” CBT into their practices. The main goal for “My teachers say I am a talented artist") school counselors is to help obese adolescents showing that rational thoughts outweigh the one separate out irrational thoughts, such as self- irrational thought (Vernon, 2004). The school blame for their weight issues, to create rational counselor helps Emily think of more rational thoughts and positive self-esteem. Research has thoughts for this example and other similar demonstrated that obese adolescents have a scenarios. After the extensive exploration of higher risk of various peer interaction issues, Emily's thoughts, Emily and the school including peer victimization and bullying counselor will move further into the CBT (Adams & Bukowski, 2008). With obesity on process. the rise, school counselors must view obese A main objective of CBT is psycho- adolescents as a specialized at-risk population. It education. The school counselor teaches is the duty of school counselors to create students techniques to utilize when not in the prevention and intervention programs for obese counseling session (Ledley et al., 2010). The adolescents so that they are not a targeted group. school counselor will teach Emily techniques Although weight stigma is well such as cognitive restructuring and graduated documented, it seems that only limited research exposures to help her deal with bullying on her has been conducted on counseling techniques to own (Ledley, Marx, & Heimberg, 2010). help obese adolescents. Although the literature Through homework assignments like a body demonstrates the weight stigma that obese image checklist or a thoughts journal, the school adolescents suffer, it does not present concrete counselor helps Emily review her thoughts and techniques on how school counselors can use actions. Ledley et al. (2010) suggested using a CBT to help obese adolescents cope with

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 10 bullying and other psychological concerns Flodmark, C-E., Lissau, I., Moreno, LA., (Adams & Bukowski, 2008; Janssen et al., 2004; Pietrobelli, A., & Widhalm, K. (2004). Puhl & Heuer, 2010; Puhl et al., 2011; Quinlan New insights into the field of children and et al., 2009; Tang-Peronard & Heitman, 2008). adolescents' obesity: The European The limited literature in the field may perspective. International Journal of demonstrate the need for further research into Obesity, 28, 1189-1196. adolescent obesity and types of counseling Janssen, I., Craig, W. M., Boyce, W. F., & interventions to utilize with the population. Pickett, W. (2004). Associations between With adolescent obesity on the rise it is overweight and obesity with bullying essential for school counselors to develop behaviors in school-aged children. strategies and interventions specifically targeting Pediatrics, 113(5), 1187-1194. this specialized population. Obese adolescents Latner, J. D., & Stunkard, A. J. (2003). Getting are often the objects of bullying; therefore, it is worse: The stigmatization of obese essential for school counselors to work with children. Obesity Research, 11, 452-456. obese adolescents regarding personal Ledley, D. R., Marx, B. P., Heimberg, R. G. development (Falcone, 2012). Schools are one (2010). Making cognitive-behavioral of the main areas that can make a difference in a therapy work: Clinical process for new child's life, along with family, health practitioners. (2nd ed.). New York: The professionals, government, industry, and media Guilford Press (Flodmark et al., 2004). School counselors Puhl, R. M., & Heuer, C. A. (2010). Obesity should encourage obese adolescents to create stigma: Important considerations for public healthy lifestyles while helping them cope with health. American Journal of Public Health, peer pressures or potential bullying with age- 100(6), 1019-1028. adjusted information and techniques. The Puhl, R.M., Luedicke, J., & Heuer, C. (2011). application of CBT within a school setting could Weight-based victimization toward assist school counselors by creating preventative overweight adolescents: Observations and and intervention strategies to help obese reactions of peers. Journal of School adolescents. Empirical research is needed to Health, 81(11), 696-703. validate the above recommendations. Quinlan, N. P., Hoy, M. B., & Costanzo, P. R. (2009). Sticks and stones: The effects of References teasing on psychosocial functioning in an Adams, R. E., & Bukowski, W. M. (2008). Peer overweight treatment-seeking sample. victimization as a predictor of depression Social Development, 18(4). 978-1001. doi: and body mass index in obese and non- 10.1111/j.1467-507.2008.00521.x obese adolescents. Journal of Child StopBullying.Gov (2012). Working with young Psychology and Psychiatry, 49(8), 858- people who are bullied: Tips for mental 866. doi: 10.1111/j.1469- health 7610.2008.01886.x. professionals. Retrieved from Beck, J.S. (1995). Cognitive therapy: Basic and http://www.stopbullying.gov/resources- beyond. New York: The Guilford Press. files/young-people-who-bully-others- Brennan, L., Walkley, J., Lukeis, S., Risteska, tipsheet.pdf. A., Archer, L., Digre, E., Fraser, S., & Tang-Peronard, J. L. & Heitman, B.L. (2008). Greenway, K. (2009). A cognitive Stigmatization of obese children and behavioural intervention for overweight adolescents, the importance of gender. and obese adolescents illustrated by four Journal compilation, International case studies. Behaviour Change, 26(3), Association for the Study of Obesity, 190-213. Obesity reviews, 9, 522-534. Falcone, N. (2012). Leaving Bullies Behind. Vernon, A. (2004). Using Cognitive Behavioral Scholastic.com Parent and Child, 20(2), Techniques. In B. T. Erford (Ed.), 46. Professional school counseling: A handbook of theories, programs, &

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 11 practices (91-100). Austin, TX: CAPS Press.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 12 Supervisory Triad in Multicultural Supervision

Hsin-Ya Tang, Ph.D., NCC Louisiana State University in Shreveport

Erik Braun Ph.D. Northwestern State University

This paper will provide a summary of the available literature on the supervisory triad and multicultural supervision. Topics identified will include the triadic supervisory relationship; the goal of multicultural supervision; and the potential benefits and drawbacks of supervisory models. The authors will also present a model of supervision, the Multicultural Triadic Network (MTN) model, to address the direct and indirect relationship network between supervisor, counselor, and client. A discussion will be provided of how multicultural competence flows within this triadic system. Finally, the authors recommend some strategies for implementing the MTN.

Keywords: supervisory triad, multicultural supervision

Supervision is an important vehicle for supervisee relationship impact the supervisee’s counselor professional development in that it learning but also impacts how well the can influence clients’ welfare and supervisees’ supervisee is able to counsel a client (Brown & competence (Ladany & Inman, 2012; Bradley, Landrum-Brown, 1995; Chen, 2003; Frawley- Ladany, Hendricks, Whiting, & Rhode, 2010). O’Dea & Samat, 2001; Holloway, 1992; Due to the growing diversity of the U.S. Holloway & Dunlap, 1989). Frawley-O’Dea and population, the supervisory triad of client, Sarnat (2001) described the supervisee as the supervisee, and supervisor will increasingly relational pivot point in the supervisory triad and reflect differences in race, ethnicity, nationality, the triadic relationship is illustrated in Figure 1. religion, gender, sexual orientation, socio- economic status, disability, and language (Ancis & Ladany, 2010; Toporek, Ortega-Villalobos, & Pope-Davis, 2004). Research on multicultural competence that focuses upon the supervisory triad of client, supervisee, and supervisor can illuminate what works and does not work in multicultural supervision (Brown & Landrum- Brown, 1995; Frawley-O’Dea & Samat, 2001; Counseling is devoted to helping clients Holloway, 1992; Holloway & Dunlap, 1989). reach their self-determined goals and two parties are involved, including clients and counselors. The Triadic Supervisory Relationship Supervision is a critical factor in promoting As with any topic in counseling, when one clients’ welfares and counselors’ service quality, moves from discussing multiculturalism in the and three parties are involved, including context of counseling to the context of supervisees, supervisors and clients. To illustrate supervision, a new layer of complexity is added. the supervisory relationship is based upon the Specifically, the triadic relationship creates a counseling relationship, Chen (2001) developed new network of relationships, which means that a model to describe clients interact with supervisors need to pay attention to counselors directly and interact with supervisors multiculturalism in all components of that indirectly. Her model is illustrated in Figure 2. network. Not only does the supervisor Chen (2001) makes a solid line between two

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 13 parties who interact with each other directly, knowledge, and skills, as well as their personal including supervisees and supervisors, and characteristics, and ways of connecting can clients and counselors. Also, she makes a dotted affect the supervisee’s clients (Ancis & Ladany, line between two parties who interact with each 2010; Magnuson et al., 2000). Although other indirectly, including clients and supervisors do not directly interact with clients, supervisors. Figure 2 describes that clients exist the way supervisors identify clients’ needs and in supervisory relationships through an indirect situation will definitely influence the goals and way. Clients do not interact with supervisors process in counseling and supervision. directly, but clients and supervisors relate to Supervisors with multicultural competence are each other through counselors as conduits. That able to help supervisees develop multicultural is to say, supervisors have impact on counseling competence to work with culturally diverse relationships through supervisory relationships. clients (Constantine & Sue, 2007; Magnuson at al., 2000).

The Goal of Multicultural Supervision The goals of multicultural supervision are to help supervisees become more aware of cultural issues, develop reflective practice skills, and enhance professional skills (Arredondo, Toporek, Brown, Jones, Locke, Sanchez, & Stadler, 1996). Bennett (1986) proposed the Developmental Model of Intercultural In addition, Brown and Landrum-Brown Sensitivity (DMIS) and highlighted the (1995) put the supervisory triad into difficulty in understanding individuals from multicultural context for identifying the various different cultures and the stages in approaching aspects of supervision and their differences. The developmental process in the interrelationships (Holloway, 1992; Holloway & DMIS spans from ethnocentric orientation to Dunlap, 1989). In Brown and Landrum-Brown’s ethnorelative orientation. Ethnocentric model (1995), supervisors shoulder three major orientation includes three subtypes, which are responsibilities. The first responsibility is to denial of difference, defense against difference, identify how their own awareness, knowledge, and minimization of difference. Ethnorelative and skills, along with their personal orientation also includes three subtypes, which characteristics, and ways of connecting, are acceptance of difference, adaptation of interrelate with those of supervisees. Personal difference, and integration of difference. For insight and growth experienced by the example, a person with an ethnocentric supervisors could determine supervisees’ insight orientation might respond critically to the notion and growth during the supervisory process that racial differences have an impact on (Ancis & Ladany, 2010; Constantine, 2001; peoples’ lives, because it would mean that if Garrett, Borders, Crutchfield, Torres-Rivera, they are a part of a dominant group, that they Brotherton, & Curtis, 2001; Magnuson, Norem, have unearned privilege. Conversely, a person Jones, McCrary, & Gentry, 2000). Supervisors with an ethnorelative orientation would also help their supervisees in becoming more acknowledge these differences have an impact cognizant of how the supervisee’s awareness, and be an advocate where they are in a position knowledge, and skills, as well as their personal to do so. Also, Ancis and Ladany (2010) characteristics, and ways of connecting interact presented a comprehensive model of with clients in counseling sessions (Ancis & multicultural supervision competence named the Ladany, 2010; Ivey, D’Andrea, Ivey, & Simek- Heuristic Model of Nonoppressive Interpersonal Morga, 2007; Magnuson et al., 2000; Torres- Development (HMNID). The HMNID gives Rivera, Phan, Maddux, Wilbur, & Garrett, supervisors a framework for understanding 2001). An additional responsibility of feelings, thoughts, and behaviors about supervisors is to know how their awareness, themselves, their supervisees, and clients with

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 14 various backgrounds. Ancis and Ladany also posited that for each demographic variable, Strategies for Applying the Multicultural individuals progress through phases of Means of Triadic Network (MTN) Model Interpersonal Functioning (MIF), which It is important to discuss the complexity of represented thoughts, feelings and behaviors teaching multicultural competence. Therefore based on one’s identification with a particular supervisors are models of multicultural demographic variable. For Ancis and Ladany, competence as well as educators of content in people have the ability to developmentally multi-culturalism. The complex nature of both progress through four phases of MIF: adaption, supervision and multiculturalism make the incongruence, exploration, and integration. See proposed Multicultural Triadic Network (MTN) Figure 3 to see how Ancis and Ladany (2010) model useful in helping supervisors defined each phase. conceptualize multiculturalism in the context of supervision. The MTN is illustrated in Figure 4.

Both DMIS and HMNID dwell into the process of learning and offer a method for understanding the multicultural competence of both supervisors and the supervisees with whom they work. However, Bourjolly, Sands, Solomon, Stanhope, Pernell-Arnold, and Finley (2005) conducted a ten-month longitudinal study, which found the development of multicultural sensitivity is circular rather than linear. Hence, as with many other developmental theories, both DMIS and HMNID models should not be considered to be a rigid standard when evaluating supervisees’ cultural sensitivity. In addition, Cook (1994) pointed out that The supervisory relationship is not linear, supervisors and supervisees at different but rather, it is a complex network of professional development stages would relationships between client, counselor, and encounter different issues and manage these supervisor. Interactions and perceptions between issues in their own ways. Given that supervisors any two affect the other. The counselor-client bear much of the responsibility for improving alliance needs to be strong to foster trust. The supervisees’ cultural awareness, knowledge, and counselor-supervisor alliance needs to be strong skills, supervisors must develop various teaching to foster the counselor's professional strategies based upon the supervisees’ stages of development and ensure client welfare. The development in order to facilitate discussions of relationship between the supervisor and the cultural issues (Inman & Soheilian, 2010). client is largely through the counselor's Therefore, this article will provide perspective on the counselor-client relationship, recommendations for applying these ideas in the but it is an important one; the supervisor practice of counselor education and supervision. provides valuable insights about the client that

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 15 the counselor may not have otherwise seen. competently in supervision and ways of helping Therefore, the supervisor's understanding of the supervisees develop these skills to prepare them client must be deep enough to provide such for helping clients. insight and to explore parallel processes in the Broaching in counseling. While the counseling and supervisory relationship. Though beginning counselor's instinct may be to avoid the supervisor facilitates client conceptualization addressing cultural differences until they come and helps sharpen the counselor's skills, the up organically, Day-Vines, Wood, Grothaus, supervisor is not merely the counselor's Craigen, Holman, Dotson-Blake, and Douglass puppeteer. Rather, through teaching, (2007) argued that continuous broaching, in collaborating, and counseling, the supervisor which the counselor or supervisor broaches helps the counselor become better prepared to cultural difference in the relationship almost treat the client. immediately (perhaps in the first session), is The authors conceptualize two layers of most advantageous. Advantages and multicultural competence in supervision. The disadvantages exist for both strategies. first layer is the supervisor's multicultural With continuous broaching, the counselor competence in the supervisor-supervisee risks appearing abrupt or perhaps even making relationship, and the second is the supervisor's the diverse client feel as though their cultural competence in fostering the supervisee's status is all the counselor sees. However, with multicultural competence in the counselor-client continuous broaching, the counselor also may relationship. Finally, the authors propose that show the client that cultural issues are multicultural competence has internal and acceptable and important issues to discuss early external components. Supervisors address on therefore validating any possible culturally culture in the supervisory relationship using influenced feelings the client may have, which internal competencies (monitoring assumptions, may strengthen the relationship and help the and maintaining the cultural lens) and through client reach insight sooner (Day-Vines et al., external competencies (broaching and 2007). advocacy). The internal and external are When using the strategy of allowing cultural connected. External is driven by internal, and discussion to arise organically, the client may neither one alone is enough. not feel comfortable discussing cultural issues Counselors may understand multiculturalism because of uncertainty about the counselor’s internally and even have an internal empathy for receptivity to cultural discussion or perhaps a their clients of diverse backgrounds. However, difficulty recognizing cultural issues. Therefore, unless that understanding and empathy is cultural issues may be afoot but are not being expressed externally, the relationship between addressed, and thus, the relationship building in the counselor and client may not be adequately the session as a whole is not as productive as it built. The aim of the MTN is to help supervisors could be. However, when the counselor allows conceptualize the triadic relationship and how this cultural discussion to arise organically, the internal understanding of multiculturalism advantage is that there is less risk of damage to impacts the external multicultural competence, the counselor-client relationship due to which will ultimately help build the relationship abruptness or the client’s perception that the between supervisor and supervisee, and counselor only sees the client for her or his counselor and client. cultural status. However, Day-Vines et al., (2007) argued that when the counselor is skilled Multicultural Discussion in Supervision enough in other cultural competencies, the Multicultural discussion is an important disadvantages of the organic broaching strategy aspect of relationship building and client can be mitigated more easily. conceptualization in counseling and supervision. The issue of broaching and the two Here, the authors will discuss multicultural strategies described above can also be applied to broaching and the facilitation of multicultural the supervisor-supervisee relationship. discussion. For each subsection, the authors will Therefore, in this section, the authors will address possible ways of using these skills discuss broaching in the context of supervision,

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 16 how to help counselors develop the necessary Helping counselors develop broaching skills for broaching, and ways to help counselors skills. When preparing counselors for broaching develop the necessary understanding and the two main concerns might be when to broach intuition for formulating broaching strategies. and how to broach. To address the when, the Broaching in supervision. Broaching in supervisor might use a constructivist perspective supervision has a different meaning than to help the counselor develop her or his own broaching in counseling. When counselors working theory of when broaching is broach, it is to help develop the counselor client appropriate. If the counselor decides that the relationship whereas when supervisors broach it continuous strategy is appropriate for the when, is also for relationship building purposes, but, then this decision is made easier. However, the depending on the supervision model being used, authors encourage supervisors to think critically it may also be for the purposes of helping about whichever strategy or criteria that the counselors become aware of their cultural supervisee decides is appropriate, as part of the identity, cultural assumptions, and cultural supervisor role is helping counselors move more dynamics between the counselor and client. toward intentionality. Supervisors may become aware of cultural After some constructivist discussion about issues when reviewing their supervisees’ session the when of broaching, the supervisor should videos or when discussing client then address the how. One way of doing this, if conceptualization. If the continuous broaching the supervisor finds it appropriate based on the strategy was used, then the supervisor may have model being used, might be to create a role- laid the groundwork for addressing these playing scenario so that the counselor can have cultural issues already, but for those using the experiential practice with this skill that may organic strategy, these may be opportune times bring some supervisees anxiety. The supervisor to broach culture. There need not be a cultural may start by asking the supervisee to play the difference between supervisor and supervisee in role of the client (perhaps even the client that the order to broach. For instance, the supervisor and supervisee wishes to broach with). The supervisee may be of the same cultural supervisor could then demonstrate how she or he background, but perhaps the supervisee is not would broach to model the skill for the aware of cultural dynamics happening with the supervisee. Next, the roles would be reversed, client in a session video or is not aware of her or and this time, the supervisee will play the role of his own cultural assumptions. Again, these are counselor, and the supervisor would play the opportune times to broach in supervision. role of client. Finally, a process discussion There are a number of cultural dynamics would be held afterward, addressing the that a supervisor might notice in a supervisee’s supervisee’s thoughts and feelings, what went session video, including: minority client’s well, and what the supervisee would have done distrust of the counselor of the dominant cultural differently. status, a counselor’s hesitancy to broach when The authors also propose the strategy of cultural issues are clearly in the foreground, or bracketing assumptions when addressing the counselor’s cultural assumptions arising. The broaching in the context of a specific client. In supervisor may also detect these and other issues phenomenology, researchers routinely write while simply discussing client issues with the down thoughts and possible biases and supervisee. For example, while viewing a White assumptions they may have about the qualitative counselor’s session video with a client who is a data so that they can monitor themselves while minority, the supervisor may notice some analyzing the data (Hays & Singh, 2011). A assumptions or biased language. This could be similar strategy could be applied to preparing an opportunity to unravel the counselor’s counselors for cultural broaching. assumptions (e.g., Where do these assumptions The supervisee could take a few minutes to come from? What are the advantages and write down thoughts and assumptions she or he disadvantages to accepting these assumptions?) has about the client’s culture and her or his own and make a plan to effectively broach the culture in the context of the specific counseling cultural difference with the client. relationship. Then, borrowing from the feminist

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 17 technique of gender analysis wherein the sensitivity. International Journal of counselor helps the client to identify internalized Intercultural Relations, 10(2), 179–196. messages about gender and to explore the Bernard, J. M., & Goodyear, R. K. (2013). advantages and disadvantages of accepting these Fundamentals of clinical supervision (5th messages (Evans, Kincade, & Seam, 2010), the ed.). Upper Saddle River, NJ: Merrill. same idea could be applied to race or other Bourjolly, J. N., Sands, R. G., Solomon, P., aspects of culture in supervision. The supervisor Stanhope, V., Pernell-Arnold, A., & Finley, could help the supervisee conduct a cultural L. (2005). The journey toward intercultural analysis in which the supervisee looks at each of sensitivity: A non-linear process. Journal the thoughts and assumptions individually and of Ethnic & Cultural Diversity in Social identifies advantages and disadvantages to Work, 14 (3/4), 41-62. accepting each of these thoughts and Bradley, L. J., Ladany, N., Hendricks, B., assumptions. The aim of this exercise is to help Whiting, P. P., & Rhode, K. M. (2010). the supervisee recognized thoughts and Overview of counseling supervision. In N. assumptions about culture to help the supervisee Ladany & L. Bradley (Eds.), Counselor monitor these thoughts assumptions and notice supervision (4th ed., pp. 3-14), their impact on the cultural dynamics in the Philadelphia, PA: Taylor & Francis. counseling session. Brown, M. T., & Landrum-Brown, J. (1995). Counselor supervision: Cross cultural Summary perspectives. In J. G . Ponterotto, J. M. The recognition that supervisors bear much of Casas, L. A. Suzuki, & C. M. Alexander the responsibility for improving supervisees’ (Eds.), Handbook of multicultural service quality as counselors has heightened the counseling (pp. 263-286). Thousand Oaks, importance placed on the supervisory triad and CA: Sage. supervisory strategies for initiating cultural Chen, C. (2003). Self-awareness in the discussions (American Counseling Association, counseling profession. Research in Applied 2014; Bernard & Goodyear, 2013). The authors Psychology, 18, 59-87. propose the MTN to illustrate the two layers of Constantine, M. G. (2001). Introduction to a the network and suggest various supervisory special issue: Perspectives on multicultural strategies based upon the supervisees’ stages of supervision. Journal of Multicultural development in order to facilitate discussions of Counseling & Development, 29, 98–101. cultural issues. Constantine, M. G., & Sue, D. W. (2007). Perceptions of racial microaggressions References among black supervisees in cross-racial American Counseling Association. (2014). ACA dyads. Journal of Counseling Psychology, code of ethics. Alexandria, VA: Author. 54 (2), 142–153, doi: 10.1037/0022- Ancis, J. R., & Ladany, N. (2010). A 0167.54.2.142 multicultural framework for counselor Cook, D. A. (1994). Racial identity in supervision. In L. J. Bradley & N. Ladany supervision. Counselor Education and (Eds.), Counselor supervision: Principles, Supervision, 34, 132-141. process, and practice (4th ed., pp. 53-96). Day-Vines, N. L., Wood, S. M., Grothaus, T., Philadelphia: Brunner-Routledge. Craigen, L., Holman, A., Dotson-Blake, K., Arredondo, P., Toporek, R., Brown, S. P., Jones, & Douglass, M. J. (2007). Broaching the J., Locke, D. C., Sanchez, J., & Stadler, H. subjects of race, ethnicity, and culture (1996). Operationalization of the during the counseling process. Journal Of multicultural counseling competencies. Counseling & Development, 85(4), 401- Journal of Multicultural Counseling and 409. doi:10.1002/j.1556- Development, 24, 42-78. 6678.2007.tb00608.x Bennett, M. J. (1986). A developmental Evans, K., Kincade, E., & Seem S. (2010). approach to training for intercultural Introduction to feminist therapy: Strategies

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 18 for social and individual change Thousand psychotherapy: A multicultural perspective Oaks, CA: Sage Publications. (6th ed.). Boston, MA: Allyn & Bacon. Frawley-O’Dea, M. G., & Sarnat, J. E. (2001). Ladany, N. & Inman, A. G. (2012) Training and The supervisory relationship. New York: supervision. In E. Altamaier & J. Hansen Guilford Press. (Eds.), The Oxford Handbook of Garrett, M. T., Borders, L. D., Crutchfield, L. Counseling Psychology (pp. 179-207). New B., Torres-Rivera, E., Brotherton, D., & York, NY: Oxford University Press. Curtis, R. (2001). Multicultural Magnuson, S., Norem, K., Jones, N., McCrary, supervision: A paradigm of cultural J. C., & Gentry, J. (2000). The triad model responsiveness for supervisors. Journal of as a cross-cultural training intervention for Multicultural Counseling and supervisors. The Clinical Supervisor, 19, Development, 29, 147-158. 197-210. doi: 10.1300/J001v19n02_12 Hays, D., & Singh, A. (2011). Qualitative Toporek, R., Ortega-Villalobos, L., & Pope- inquiry in clinical and educational Davis, D. (2004). Critical incidents in settings (1st ed.). New York, NY: The multicultural supervision: Exploring Guilford Press. supervisees' and supervisors' experiences. Holloway, E. L. (1992). Supervision: A way of Journal of Multicultural Counseling & teaching and learning. In S. D. Brown & R. Development, 32 (2), 66-83. W. Lent (Eds.), The handbook of Torres-Rivera, E., Phan, L. T., Maddux, C., counseling psychology (2nd ed.). New Wilbur, M. P., & Garrett, M. (2001). York: Wiley. Process versus content: Integrating Holloway, E. L., & Dunlap, D. M. (1989, April). counseling skills to meet the multicultural The power of the involvement of the century. Counselor Education and supervision relationship. Paper presented at Supervision, 41 (1), 28-40.Counselor the annual meeting of the American Education and Supervision, 41 (1), 28-40. Education Research Association, Boston. Inman A. G., & Soheilian, S. S. (2010). Training supervisors: A core competency. In N. Ladany, & L. J. Bradley (Eds.) Counselor supervision: Principles, process and practice (4th ed.) (pp. 411-433). New York, NY: Routledge, Taylor and Francis. . Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2007). Counseling and

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 19 Reading the Code of Ethics as Literature:

The Application of Hermeneutical Principles to Enhance Counselor Knowledge and Competence

Jan Case, Megan Long, Andrea Sanders

In anecdotal conversations and course reviews Masters-level rehabilitation counseling students have often noted that Codes of Ethics (Codes) are initially regarded as somewhat complex, cumbersome, and even “mysterious” documents. Utilizing several principles of literary interpretation (hermeneutics), the Codes can readily become more understandable and applicable for counseling practitioners, educators, and students alike. This article reacquaints readers with several principles of literary interpretation and summarizes the assimilation and the application of these principles in the ethics teaching tool “The Baker’s Dozen.” The tools consists of a series of “ingredient cards” (one for each Standard of the Code of Ethics), sample ethical scenarios in counseling that require the creation of “best ethical practice recipes,” and a general introduction to the tool’s utilization in the enhancement of a counselor’s ethical decision-making process. The results of this initial learning experience suggest that the sample principles of literary interpretation have much potential in teaching aspiring and current counselors alike, and doing so in such a way that learners are better equipped to extract essential meanings from the Codes and more thoroughly utilize the complete Codes as essential resources in their ongoing pursuit of best practice. A companion tool, “The Baker’s Dozen-II,” is currently being developed for specific use with the newly- revised ACA Code of Ethics (2014).

One of the hallmarks of a profession is the knowledge or misunderstanding of an ethical development, teaching, and enforcement of responsibility is not a defense against a charge Codes of Ethics (Codes) that are designed to of unethical conduct” (L.1). This precise provide guidance for the ethical practice of responsibility is echoed in the ACA Code of counseling. The ACA Code of Ethics (2014), as Ethics (2014): “Counselors know and well as other Codes such as the Code of understand the ACA Code of Ethics and other Professional Ethics for Rehabilitation applicable ethics codes from professional Counselors (2010), represents such organizations or certification and licensure accomplishments. Meticulously written, these bodies of which they are members. Lack of essential documents have undergone numerous knowledge or misunderstanding of an ethical revisions based upon careful research, the responsibility is not a defense against a charge expressed needs and input of counseling of unethical conduct” (I.1.a.). While differences practitioners, and the anticipation of emerging exist in the Codes, it is clear to see that, in many ethical issues in counseling (Saunders & Leahy, ways, they walk together with the purpose of 2010, Tarvydas & Barros-Bailey, 2010). lifting counselors to best practice. Although the charge to read, understand, and Codes not only set forth guiding principles for follow the Codes is commendable, counseling ethical practice, but the respective Codes in the students and counselors in practice may often field of counseling also insist that counselors are find difficulty in acquiring this skill (Tarvydas responsible for reading, understanding, and & Barros-Bailey, 2010). For example, following the Codes, and seeking clarification of rehabilitation counseling students have been any standard that is not understood. In fact, the known to express a basic lack of familiarity with Code of Professional Ethics for Rehabilitation certain terms used in the Codes, lack of Counselors (2010) specifically notes, “Lack of familiarity with the Codes’ organizational

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 20 formats, and lack of familiarity with precisely understanding and appreciation of such how the standards in one section relate to one favorites: another and to other Sections and Standards elsewhere in the Codes. Aspiring rehabilitation We interpret a given work of literature as being counselors are not the only ones who may in harmony with itself. struggle with the proper reading and understanding of the Codes. Counselors We interpret a part in light of the whole. demonstrate their struggle in understanding the We identify the central message of a given work Codes through their continued seeking of of literature and interpret in light of this central advisory opinions, which help counselors of all message. levels of expertise aspire to best practice (Neulicht, McQuade, & Chapman, 2010). The We interpret unclear passages about a given violations of the Codes that result in published subject by clearer passages about the same disciplinary actions (http://www.crcc.org) also subject. suggest that counselors continue to grapple with the meaning of the Codes and their applications. We identify word meanings. In an effort to further demonstrate the essential principles of literary interpretation We use the entire work to interpret a given (several espoused and modeled in the Codes work. themselves), a teaching tool, “The Baker’s We pay attention to context. Dozen,” was developed by the first author and introduced to Master-level rehabilitation We stick with the plain and obvious meaning of counseling students and practicing rehabilitation a text. professionals. This tool and its accompanying teaching scenarios focused on the Code of We give careful attention to genre. Professional Ethics for Rehabilitation Counselors (2010). At this time a companion We examine a given work in terms of its plot, tool, the “Baker’s Dozen-II,” is being developed character, and setting. to enhance the reading, understanding, and application of the newly-revised ACA Code of Perhaps you recognize many of these Ethics (2014). This article will discuss the principles, likely introduced to you as early as background of both teaching tools and the elementary school. Each principle plays a potential applications of these tools in both the valuable role in helping a reader to better classroom and in the field. Readers are understand, appreciate, and even apply the tenets encouraged to further explore these learning of a given piece of literature, be those respective resources. literary genres biography, history, or fiction. These principles also help the reader to Background accurately read a given piece of literature, As a type of literature, albeit a rather distinct extracting the message or theme the author type of literature, the Codes require that their intended rather than “reading into” a given work readers subscribe to sound principles of literary of literature meanings that were not intended. interpretation. Teaching tools that could Interestingly enough, other professional facilitate one’s proper reading and interpretation fields have also utilized similar principles of of the Codes could, thereby, enhance one’s literary interpretation (hermeneutical principles) application of the Codes. Consider this list of to equip their respective members for properly such pertinent principles of literary reading and applying the core documents of the interpretation suggested by such authors as respective professions (e.g., fields such law, Burgland (1998). As you do so, reflect on one or archeology, theology). Gallagher (2004) notes two of your own favorite books and the that hermeneutics as a discipline (usually important role many of the following literary defined as the theory and practice of interpretation guidelines lend to your interpretation) involves a long and complex

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 21 history, starting with concerns about the proper Principle 1: We interpret a given work of interpretation of literary, sacred, and legal texts. literature as being in harmony with itself. Hermeneutics evolved from the interpretation of only religious texts into other disciplines, which What the Code says about consultation allows for much knowledge to be gained. in “Section X” squares with what the Science and literary interpretation have quite an Code says about consultation in important relationship. Science involves “Section Y.” explaining why a phenomenon occurs, while What the Code says about consultation hermeneutics works to create a deeper in “Section T” squares with what the understanding of the phenomenon (Gallagher Code says about records in “Section W.” 2004; Olesen, 2010). A sample of principal rules of statutory Principle 2: We interpret a part in light of the interpretations (Dworkin, 1982; Fiss, 1982) whole. includes the following: An act must be construed as a whole, so that internal We interpret what the Code says about inconsistencies are avoided; Words that are distance counseling in terms of the reasonably capable of only one meaning must be entire Code, e.g., the six principles of given that meaning (the literal rule); When a ethics, disclosure, competence, record- prior act is found to be on the like manner it can keeping, etc. be used as an aid in construing the statute in question (in pari materia) and; When a word or Principle 3: We identify the central message of a phrase is of uncertain meaning it should be given work of literature and interpret in light of construed in the light of surrounding words (the this central message. rule noscitur a sociis). Kerr (2007), in his essay “How to Read a Legal Opinion,” notes the We manage extension of boundaries necessity of following precise rules of through the central message of the Code interpretation because these “explain what - the welfare of the client. judicial opinions are, how they are structured, and what law students should look for in reading them.” Shiff (2012) similarly affirms the Principle 4: We interpret unclear passages about importance of precise rules of interpretation a given subject by clearer passages about that regarding art and art history, and concludes that same subject. lacking such principles “an interpretation threatens to reflect back on the interpreter, “Counselor impairment” may sound like exposing not the artist’s interests and desires but an unclear concept. However, the the writer’s.” Preamble of the Code could clarify this As we continue to learn from other fields, it topic because here the Code teaches us behooves us in the field of counseling to about our obligations to the client and to familiarize ourselves with interpretation the society. “Involvement of significant guidelines, and, in doing so, enhance our others” may also seem unclear. reading, interpretation, and application of our However, what the Code has to say own core documents such as the Codes. about “joint rehabilitation and Consider once again the basic principles of counseling plans consistent with the literary interpretation suggested by Burgland circumstances of the client” helps clarify (1998) and the sample applications of such this a bit. principles in reading, understanding, teaching, and applying the Codes. The examples herein cited are from the Code of Professional Ethics for Rehabilitation Counselors (2010): Principle 5: We identify word meanings.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 22 Consider the avalanche of potentially- “Termination” appears in the section confusing word meanings in the Code: “Counseling Relationships” and impairment, extension of boundaries, “Business Practices,” implying… testimonials, sexual harassment, test Consider all the contextual clues in security, disclosure, growth experiences, deriving meaning. minimal disclosure, etc. Ignorance of the precise meaning of these words could prove troublesome. Principle 10: We examine a given work in terms of its plot, character, and setting.

Principle 6: We give careful attention to genre. Consider your work with a client and the understanding and practice of the Code The Code is not allegory, satire, fable, in terms of plot, characters, and setting - diary…It is what it is. each dimension is unique and each dimension is important. What is a story without a plot? Without characters? Without a setting? For example, how Principle 7: We stick with the plain and obvious does one achieve best practice in meaning of a text. assessment without due attention to “Sexual harassment” is defined (in part) these same three variables? Best practice by whether or not it is “perceived” as in the wake of a natural disaster without such by another person. Whether you due attention to these same three like or dislike the ambiguity of the word variables? Best practice in generating “perception,” “perception” is what it counseling plans without due attention says it is. to these same three variables? Explore these three factors. Doing so could help the rehabilitation practitioner and the client. In a sense, the Code itself has a Principal 8: We use the entire work to interpret a distinct plot and characters. Its plot given work. (The work interprets the work.) could be summarized as “best practice for the welfare of the client.” Its Material in section E of the Code character, even its distinct “personality,” (“Relationships with Other could be described as Social, Artistic, Professionals”) can be used to help us and Investigative. And its settings? understand and practice what the Code These are diverse, spanning the Scope of says in section A.1.b. (“Rehabilitation Practice for various counselors and the and Counseling Plans”). numerous public/ private, individual/group context, in which Principle 9: We pay attention to context. rehabilitation counselors strive for best The sections, sub-sections, sentences, ethical practices. and words of the Code are arranged in a

certain way and convey important contextual clues for us. Note the As you can see, many of the principles and relationships and the positioning of the properties of hermeneutics can be readily clues in their context. For example, applied for use in better understanding, “family counseling” appears in Section interpreting, and applying the Code of B (“confidentiality”), implying … Professional Ethics for Rehabilitation “Referral” appears in sections such as Counselors (2010). These principles allow the professional responsibility, accessibility, Code to make better sense to counselors and, and termination, implying… also, to make true meaning within their practice.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 23 It is likely that many of these same principles sound decision (“a best practice recipe”). The and properties of hermeneutics can also be Baker’s Dozen is a collection of 77 “ingredient readily applied in better understanding, cards” (one for each Standard). Each ingredient interpreting, and applying the ACA Code of card (corresponding to each of the 77 Sections Ethics (2014) or other pertinent Codes in the of the Code) conveys the essentials of each counseling field. Perhaps certain principles are respective Standard. Several sample ingredient especially noteworthy to you right now. While cards are noted in Figure 1. The basic format for the Codes guide the actions a counselor should each ingredient card consists of the name of the take, properly interpreting a given Code can ingredient (the title of the Standard), a winsome create a deeper understanding of the Code and quote regarding the ingredient, a visual that the essential relationships between different illustrates the ingredient, and a brief, thought- sections in the Code. Codes are examples of a provoking summary of the ingredient. The piece of literature calling for “a kind of respective Standards themselves (directly quoted interpretation which is not just a mechanical from the Code) appear on the back of the linking of words, but a search for meaningful respective ingredient cards. Equipped with such coherence between the whole and the parts” a “pantry” of ingredients, learners are equipped (Gallagher 2004, p. 8). The Codes, when to generate their best ethical practice recipes in properly understood, are more than simply legal response to sample ethical dilemmas. Although documents. When understood, the documents each ingredient has its own distinct flavor per se, can make real meaning in the practice of the respective ingredients can and should be counselors. combined with other pertinent ingredients in order to offer the chef (the rehabilitation The Development and Introduction of the counselor) and the table guests (the clients) the Teaching Tool best dish possible. Several “Ethical Dilema Scenarios” (see Theoretical constructs such as hermeneutics examples in Figure 2) were also developed. (i.e., the principles of literary interpretation) can First, students in the graduate class “Ethics in be quite helpful in unlocking the rich meaning of Rehabilitation Counseling” were introduced to Codes. However, while theory is necessary, it is the ingredients, section by section, and were not always sufficient to meet the learning needs then given the opportunity to create their best of aspiring and practicing counselors, practice recipes in response to the selected particularly so with regard to the topic of ethics. scenarios posed to the class. Students worked Engaging and enjoyable learning tools can individually or in small groups to formulate their supplement such theory, and, thereby, help best practice recipes, being careful to eavesdrop learners achieve important learning goals. Using on the insights and perspectives of the other the winsome analogy “cooking up best ethical chefs in their work group. Students (individually practices,” the authors developed a tool that or in small work groups) then presented their leveraged the basic analogy of “cooking” in the respective best practice recipes to the class, and teaching of the Code of Professional Ethics for in doing so shared their conceptualization of the Rehabilitation Counselors (2010) and in the respective dilemmas and how their respective proper reading and interpretation of this Code. recipes worked to address the respective ethical The title of this learning tool, “Baker’s Dozen,” dilemmas. stems from the fact that there are 13 Sections of This same tool and this same basic teaching the Code, including the Preamble. A further approach were also introduced in a two-hour review of the Code indicates that in addition to workshop setting at the Commission on the Preamble there are 76 Standards Rehabilitation Education conference in April (“ingredients”) that are to be taught and utilized 2013. In this workshop, rehabilitation as necessary in developing “best ethical practice practitioners became acquainted with the recipes.” In a sense, rehabilitation practitioners Baker’s Dozen and had the opportunity to utilize encounter ethical challenges of one nature or this learning tool as individuals and as small another that require a thoughtful and ethically work groups. The presentations of the respective

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 24 best practice recipes for any given ethical use the principles and the tool daily as a scenario offered the participants the opportunity rehabilitation counselor. I also enjoy the format to present their own best practice recipes and to and structure it is written in because it is eavesdrop on the conceptualizations of the other organized and easy to utilize.” chefs. Ratings by current students ranged from 3 to 5, with a modal response of 3 and a mean Preliminary Feedback response of 3.57. Sample student explanations of their ratings included: “…helped with In order to obtain both current student and understanding the Code as a living document graduated student evaluations regarding the tool and understanding it as a guide not a rule”; “I and the process used in introducing and teaching appreciated the exercise/tool to be useful for the tool, current MHS-RC students (N=7) who digging in an analyzing how the principles recently completed the Ethics course and complemented one another…”; “It keeps what recently-graduated MHS-RC students employed would otherwise be dry information interesting.” as rehabilitation counselors (N=12) were asked to complete a brief written survey. Subjects Theme 2: Appreciation for and an enhanced were asked to respond to four thematic ability to apply several basic principles of statements by rating (on a scale of 1 to 5, 1 literary interpretation to the reading of the Code. being “no value at all” to 5 being “extremely Ratings by recently graduated students helpful”) the overall value of the tool on each ranged from 4 to 5, with a bi-modal response of respective theme. Participants were also asked to 4 and 5 and a mean response of 4.5. Sample provide brief explanations of their respective graduates’ explanations of their ratings included: ratings. The four thematic guided inquiries, the “I found the basic principles of literary responses of the two participant groups (current interpretation a very effective tool for MHS-RC and recently graduated students who interpreting the Code. The Code is essentially a are employed in rehabilitation counseling written work, and using principles of literary settings), and sample participant summaries are interpretation to examine any written work as follows: forces the student to move beyond simple comprehension of the work and examine the Theme 1: Appreciation for the Code – its work’s structure and meaning more deeply. It content and its structure, and, in particular, an also encourages the student to interact with the appreciation for the relationships between the Code actively through analysis.” “Both the respective Standards and Sections of the Code. principles and the tool were very useful in Ratings by recently graduated students understanding and implementing the Code to the ranged from 4 to 5, with a modal response of 5 best of my ability as a rehabilitation counseling and a mean response of 4.63. Sample graduates’ student and now as a young rehabilitation explanations of their ratings included: “The tool counselor.”; “Every Section and Standard can be helped me recognize the full worth of the referenced to another Section or Standard which Standards by teaching the most direct purpose makes it easy to connect principles and and meaning which enabled my understanding meaning.”; “The tool allowed the learner to be of the connectedness of the Standards and creative with recipes and to practice applying all Sections. By breaking it down into ‘ingredients,’ the 10 principles of literary interpretation to any I was able to work through one small piece at a given Section of the Code. By creating multiple time to ensure my understanding of the value recipes, the learner was able to practice and each ingredient offered and how it altered the sharpen their ability to interpret and apply the overall taste of my creations.”; “I also found the Code.” tool very useful because it allowed us to look at Ratings by current students ranged from 3 to individual ‘ingredients’ or Sections and 5, with a modal response of 4 and a mean Standards of the Code and then see how those response of 4.14. Sample student explanations of ‘ingredients’ come together to make the Code their ratings included: “Because the tool whole.”; “…of course I remember the Code and emphasized and required us to pretty much

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 25 constantly scan the Code, it became simple to Ratings by recently graduated students make connections and to start remembering the ranged from 4 to 5, with a modal response of 5 principles.”; “’Cookin Up’ was very clever and and a mean response of 4.63. Sample graduates’ the analogy provided a different way to look at explanations of their ratings included: “The use it. It was exciting to see all the ‘ingredients’ that of the ingredients, specifically the scenarios, can be mixed to gather for best practice.” “The provided a more tangible way to conceptualize concept of ingredients to come to a conclusion is the adaptability of the Standards and the various a great metaphor; very useful for looking at the ways they could be applied. Being able to create entire Code and backing your arguments up; more than one recipe for a given situation would be good in the field of law.” expands the ability to interpret and apply the Code in an ethical manner.”; “One of the most Theme 3: The tool (“The Baker’s Dozen: effective aspects of this was the collaboration Cookin’ Up Best Ethical Practices”) and the with other students. Through collaborative scenarios provided “hands-on” experiences with discussion, analysis, and sharing of many of the principles of literary interpretation understandings, students gained a greater in generating their best practice recipes. understanding of the Code.”; “This was very helpful to me because I was able to apply the Code more easily as I used the tool and the scenarios. It made is easier to grasp, which allowed me to fall in love with ethics.”; “The hands-on experiences/scenarios helped me understand unclear parts of the Code, allowing us to make best practice recipes that were relevant to issues we may come across one day.” Ratings by current students ranged from 3 to 5, with a bi-modal response of 4 and 5 and a mean response of 4.28. Sample student explanations of their ratings included: “This is really the only way I could see approaching this material without it being painful.” “Without the ‘hands-on’ it would have been just ink on paper. It painted the picture with all the colors ethics and life throw at you…not just black and white.” “It helped make the ‘right recipe’ with various ethical standards to fit the proposed dilemmas.”

Theme 4: An appreciation for the analogy itself (Cooking Up Best Ethical Practices) and the ready assimilation of the Code’s content through such an analogy

Ratings by recently graduated students ranged from 4 to 5, with a modal response of 5 and a mean response of 4.75. Sample graduates’ explanations of their ratings included: “The analogy of ‘Cookin Up’ is a great way to assist future rehabilitation counselors in all facets of appreciating the Code, developing their ethical guidelines and actions, and allowing the individual to individualize his or her best practices.” “The scenarios provided in the class

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 26 were essentially analogies for using the Code in enhanced ability to apply several basic practice. The scenarios prepared us as future principles of literary interpretation to the reading practitioners to apply the Code to individual of the Code. Third, the tool and the scenarios situations. The exercise is analogous to our provided to students insightful “hands-on” current practice of rehabilitation counseling and experiences with many of the principles of applying the Code to that practice. The entire literary interpretation in generating their best experience was something of an analogy, and practice recipes. Finally, students expressed an reflecting on the experience reveals how we appreciation for the analogy itself (Cooking Up studied the Code through the context of Best Ethical Practices) and spoke of the ready analogy.”: “The principles of literary assimilation of the Code’s content through such interpretation and the tool increased the an analogy. appreciation of the analogy by making Although this present evaluation was modest something complex seem less daunting. For a in scope and featured a relatively small sample person new to cooking, the task can seem size of MHS-RC students trained in a relatively overwhelming. By teaching the cook how to small rehabilitation counseling department, the interpret a recipe (measurements, temperatures, teaching of hermeneutics, coupled with a etc.) and giving them the items necessary “hands-on” tool, offers promise for enhancing (ingredients, measuring cups, etc.), the cook can knowledge of, analysis of, and application of the practice and build on the experience. The cook Code. In particular, this was readily affirmed by will soon be able to create new concoctions and recent graduates who have now made the combine ingredients in a variety of ways. It transition from the classroom into their offers creativity and fun to what initially seems respective rehabilitation counseling practices. banal and laborious.”; “This is a great reference Enhanced and extended follow along of the that I keep in my office and refer back to when graduates in the years to come could provide needed. I have showed this to my other co- further insights as to the long-term viability of workers and they thought this was a neat idea.” this teaching approach and also the relative Ratings by current students ranged from 2 to effectiveness of such teaching for specific 5, with a bi-modal response of 4 and 5 and a rehabilitation counseling contexts (e.g., State mean response of 4.14. Sample student Vocational Rehabilitation Agencies such as explanations of their ratings included: “I felt the Louisiana Rehabilitation Services, private tool’s purpose was to teach those in the vocational rehabilitation agencies, forensic profession about the dynamic nature of the Code rehabilitation practices, etc.). The assimilation of and its relation to professional best ethical hermeneutical principles and the tool “The practices.” “It kept it fun and not such a scary Baker’s Dozen: Cooking Up Best Practice” into topic.” the continuing education of rehabilitation “Loved it! Provided great insight and different practitioners could also provide further insights viewpoint; it brought things to ‘life’ for me.” regarding the effectiveness of this pedagogical approach and its enrichment of best ethical Discussion and Conclusions practices in the context of ever-expanding service opportunities and ever-changing ethical Preliminary student evaluations (gathered challenges. from the graduate-level course “Ethics in The Code of Professional Ethics for Rehabilitation Counseling”) indicate that the Rehabilitation Counselors (2010) is designed to Baker’s Dozen serves as an effective way to provide guidance for the ethical practice of help accomplish several educational objectives. rehabilitation counseling. The proper reading, First, students expressed an enhanced interpretation and application of the Code appreciation for the Code – its content and its necessitates that the basic principles of literary structure, and, in particular, an appreciation for interpretation become assimilated into how we the relationships between the respective teach the Code. The Baker’s Dozen offers one Standards and Sections of the Code. Second, modest tool through which such instructional students expressed an appreciation for and an aspiration can be enhanced. Rehabilitation

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 27 educators and practitioners alike are invited to 3. The basic theme of this article is that incorporate this learning tool into their own many of these same basic principles of respective teaching and practices and to develop literary interpretation can also help us further applications. better understand and apply the content of the Codes. Do you see how this could The Development and Introduction of be so? Explain. “Baker’s Dozen-II” 4. Finally, although theory is necessary it Building on the theoretical and practical is not always sufficient, particularly in experiences of the “Baker’s Dozen,” a learning and applying ethical principles companion tool (“Baker’s Dozen-II”) is now and standards. How could the tools being developed by the authors for specific use discussed in this article (“Baker’s with the ACA Code of Ethics (2014). This new Dozen” and “Baker’s Dozen-II”) tool will also have its unique set of “ingredient” enhance your understanding and cards and specific scenarios that will present application of the Codes in your many of the potential ethical dilemmas that counseling practice? In your teaching? counselors of various specializations may encounter. Using this new tool and its scenarios, it is the authors’ anticipation that counseling References students and currently practicing counselors who American Counseling Association. (2014). 2014 practice under this newly-revised Code will also ACA Code of Ethics. Alexandria, VA: acquire enhanced skills in reading, ACA. understanding, and applying the ACA Code of Burgland, L. (1998). Reading the Bible with Ethics (2014). Copies of “Baker’s Dozen” and understanding. St. Louis, MO: Concordia “Baker’s Dozen-II” are available from the Publishing House. authors upon request. Commission on Rehabilitation Counselor Certification. (2010). Code of Professional Reflection Questions Ethics for 1. What are some of the challenges you Rehabilitation Counselors. Schaumberg, have experienced with the reading, IL: CRCC. understanding, and application of the Dworkin, R. (1982). Law as interpretation. Codes? To what extent are your Critical Inquiry, 9, 179-200. experiences similar to those noted in this Gallagher, S. (2004). Hermeneutics and the article? cognitive sciences. Journal of Consciousness Studies, 11, 1-14. 2. You likely recognized several of the Fiss, O. (1982). Objectivity and interpretation. principles of literary interpretation that Stanford Law Review, 34, 739-763. were discussed in this article; perhaps Kerr, O. (2007). How to read a legal opinion: A you even remember the teacher who guide for new law students. The Green first impressed these upon you in Bag, 11, 51-63. preparing book reports long ago. To Neulicht, A.T., McQuade, L.J., & Chapman, what extent do these principles help you C.A. (2010). The CRCC desk reference on more fully appreciate the meaning of professional ethics: A guide for your favorite books? What principles rehabilitation counselors. Athens, GA: have you found most helpful? Elliott & Fitzpatrick. Olesen, H.S. (2012). The societal nature of subjectivity: An interdisciplinary methodological challenge. Forum: Qualitative Social Research, 13, Art. 4. Retrieved from FQS http://www.qualitative-research.net/.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 28 Saunders, J.L. & Leahy, M.J. (2010). Empirical Tarvydas, V. & Barros-Bailey (2010). Ethical influences on the 2010 Code of dilemmas of rehabilitation counselors: Professional Ethics for Rehabilitation Results of an international qualitative Counselors. Rehabilitation Counseling study. Rehabilitation Counseling Bulletin, Bulletin, 53, 197-203. 53, 204-212. Shiff, R. (2012). Regarding art and art history. Art Bulletin, XCIV, 339-343.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 29 Reflective Supervision as a Key Support for Counselors

Krystal M. Vaughn, Allison B. Boothe, Angela W. Keyes Tulane University School of Medicine

Reflective supervision is a protected time and space for a counselor to consider his or her work from multiple perspectives with a trusted mental health professional (Shahmoon-Shanok, 2009). The authors present reflective supervision as an important component of on-going counselor practice that is separate from clinical supervision provided during counselor training. Theories of clinical and reflective supervision are discussed as they relate to the development of reflective practice for counselors. Reflective supervision is differentiated from clinical and administrative supervision as well as from periodic case consultation. The authors discuss how reflective supervision for counselors is a foundational component of their early childhood mental health consultation program, and they delineate challenges and considerations for implementing reflective supervision into a program or practice.

Keywords: reflective supervision, reflective practice, counselor development, early childhood mental health consultation

Supervision, a staple of counselor training opportunity to consider: (a) multiple beliefs; (b) and education, is a necessary component of effects of programmatic practices; (c) the impact practice for counselor interns, counselors in of history, culture and experiences on training, and other mental health professionals in relationships; (d) patterns within a system; and training. However, should supervision cease (e) relationships (Copa, Lucinski, Olsen, with the onset of licensure? Is consultation-as- &Wollenburg, 1999). As the concept of needed sufficient for counselors in practice or is reflective supervision has been better there another answer? Reflective supervision operationalized, the reflective process itself has may be a solution. While it differs from clinical undergone further exploration. supervision, reflective supervision may provide Neufeldt, Karno, and Nelson (1996) on-going support to counselors in the field. The proposed four dimensions of the reflective use of reflective supervision spans professions to stance: intention, active inquiry, openness, and support service providers, strengthen skills, and vulnerability. They believed “reflectivity results enhance services provided to clients. Here we in change in the therapist’s understanding and will define and differentiate reflective the therapist’s work with a client” (p. 8) and that supervision, discuss its importance to counselors over time this could result in a deeper ability to in the field, describe its central role in our create meaning through the therapeutic mental health consultation programs, and how to relationship. They proposed that counselors implement reflective supervision into one’s own attend to one of two dimensions while reflecting. practice. Specifically, a counselor must attend to his or Reflective supervision is related to the her own thoughts, emotions, and actions, while clinical supervision that most mental health also being aware of their interactions with their professionals received in training. Formally client. defined by Shahmoon-Shanok (2009) as “the While considering the client’s subjective stepping back to consider the work from experience, Neufeldt et al. (1996) reminded us multiple perspectives, including from what one that “maintaining that position of not knowing is and others observe, feel, and think” (p. 9), an extremely important aspect of the process.” reflective practices allow clinicians the This may be seen in play therapy or early childhood mental health consultation when a multiple perspectives. Additionally, the counselor is “wondering” with a client. supervisor supports the supervisee’s ability to Supervisors may use a similar tool when process information, solve problems, inquiring or modeling “not knowing” during the conceptualize cases, diversify his or her development of a working alliance, thereby approach, and engage in hypothesis testing. allowing the supervisee to more fully explore his As supervisees enter the skill acquisition phase, or her work with the client. In doing so, the they are independently providing reflections, supervisor demonstrates that one person will not considering multiple perspectives and know everything (Young, Lambie, Hutchinson, processing feelings during their work with the & Thurston-Dyer, 2011). This is a particularly client as well as during supervision. Lastly, important aspect of reflective supervision for supervisees enter the professional transition early career counselors who may be discovering phase wherein the supervisees gain professional their identities as mental health professionals. autonomy and understand how one may impact others (Young et al., 2011). The model of Reflective Developmental Supervision Reflective Developmental Supervision combines One aspect of reflective supervision is clinical and reflective aspects of supervision to Reflective Developmental Supervision, a support new counselor development; however, method of supporting counselors’ professional to more fully understand the utility of adopting a development through reflective supervision reflective stance as part of or as the focus of (Young et al., 2011). From this perspective, a supervision, we must first explore the supervisee’s development occurs through the similarities and differences among supervision supervisor-supported processes of supervision models. relationship, developmental assessment, contextual adjustment, skill acquisition, and Similarities and Differences to Other Types of professional transition (Young et al., 2011). Supervision The first aspect of Reflective Developmental There are a variety of similarities and Supervision highlights the importance of differences between types and models of developing a working alliance. The supervisor supervision. A similarity across many theories must establish a relationship through the use of may be the idea that the supervisory relationship genuineness, empathy, and warmth, which may parallels the counselor-client relationship develop a sense of safety, openness and (Young et al., 2011). This idea is also a key vulnerability by the supervisee. The next aspect of reflective supervision. In work with important aspect is the assessment of counselor young children and families, in particular, development. This method is comparable to reflective supervision may allow for a other theories of counselor development, such as multilayered parallel process where the the integrated developmental model supervisor supports the counselor, who supports (Stoltenberg, 1981), but explicitly includes the the parent or caregiver, who then supports the reflective aspect of supervision, which may be child (Gatti, Watson, & Siegel, 2011). This valuable to counselor growth. A supervisor may reflective practice allows the clinician to bring assess the supervisee’s counseling skills by awareness to how one’s thoughts, feelings, using open-ended questions throughout the beliefs, and attitudes may influence interactions supervision session. Specifically, the supervisor with another (Tomlin, Weatherston, & Pavkov, should inquire about the counselor’s feelings in 2014). Reflective supervision may encourage session with a client, the counselor’s insight into counselors to examine their own reactions, a client’s possible feelings, and potential which allows them to process how they interventions for a client. experience the relationship and continued Next, the process of contextual adjustment collaboration (Franklin, 2011). This protected involves a supervisor supporting the continued reflective time to consider one’s feelings as a growth of the supervisee, aiming for the counselor may not be consistently present in all development of enhanced reflective skills, models or styles of supervision. Instead, increased confidence, and greater ability to take supervision may be clinical and focus on the

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 31 client, a crisis, or a dilemma presented in a reflective or clinical supervisor. This dual role consultation. may present challenges in reflective supervision; however, it may also provide opportunities to Clinical support a counselor with administrative issues The licensing board or state often requires through a supportive and reflective process. The clinical supervision in the counseling field prior supervisor should be explicit at the outset of to licensure. The functions of clinical supervision about how he or she will occupy supervision may include: (a) review of cases; (b) both roles, and model forthright discussions diagnoses; (c) interventions; (d) treatment when he or she must “put on the administrative planning; and (e) clinical progress (The hat.” Oklahoma Association for Infant Mental Health, 2011). While providing clinical supervision, a Consultative supervisor may use one of several models or Many mental health professionals use approaches to clinical supervision, such as clinical consultation when they are grappling psychodynamic, person-centered, integrated or with a particularly difficult client or have systems (Bernard & Goodyear, 2004). This specific ethical concerns. Consultation has many type of supervision may be utilized in practicum, meanings depending on the context or setting internship, and pre-licensure processes and the (Caplan & Caplan, 1993). However, in the one commonly associated with “supervision.” mental health field, we commonly refer to the While clinical supervision may, and in our process of “consulting” to refer to two opinion should, require reflection from the professionals discussing another person (i.e., the supervisee, there are basic differences between identified client). This consultation may be used clinical and reflective supervision. A full review to improve knowledge about treatment of clinical supervision is beyond the scope of interventions for the client or to ensure this article; however, while both reflective and professional ethics or boundaries are within clinical supervision are accomplished through reasonable limits. One of the key differences the relationship between the supervisor and between consultation and reflective supervision supervisee, in reflective supervision, the is consistency. Consultation is used on an as- supervisor may be from a different field and is needed basis and is an important aspect of not legally responsible for practice decisions mental health practice. Regular reflective made by the supervisee. At times, a supervisee supervision, on the other hand, allows for a may be participating in both clinical and continued discussion about how the counselor reflective supervision. In these situations, the can work through issues specific to a client, and reflective supervisor must differentiate him or allows the counselor the opportunity to herself from the supervisee’s clinical supervisor, consistently reflect upon his or her own and when necessary, supervisors can collaborate contributions to the client-counselor to support the supervisee. relationship.

Administrative Usefulness Administrative supervision may attend to With the many supports discussed above, the “housekeeping” duties associated with reflective supervision may seem like yet another operating a program, such as regulatory hoop through which mental health professionals guidelines or program policies. Many times, must jump. We assert that reflective supervision administrative supervision may be seen as the is a key component of good clinical practice and “supervisor” in the clinical setting. The when counselors regularly build it in to their Oklahoma Association for Infant Mental Health practice they will reap the benefits. A (2011) defined administrative supervision duties significant aspect of reflective supervision is the as: (a) hiring; (b) training; (c) paperwork; (d) continued development of reflective thought. report writing; (e) rules and policies; (f) The supervisor may encourage the supervisee to coordination of services; and (g) evaluation. An consider or attend to thoughts, interactions, administrative supervisor may also be the actions, and emotions (Young et al., 2011) that

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 32 may initially be missed when working with a perspectives of diverse clients and to guide the client. As counselors are encouraged to pause, supervisee to examine his or her beliefs about gain insight, and consider multiple perspectives, others with the goal of developing greater they are able to apply that understanding when empathy and providing culturally sensitive creating client-specific interventions. Moreover, services. The American Counseling counselors are able to consider which Association’s Code of Ethics (F.2.b) requires interventions are working and which are not that, “Counseling supervisors are aware of and during this reflective process (Gatti et al., 2011). address the role of multiculturalism/diversity in Reflective thought can also be used to focus on the supervisory relationship.” By doing so, one’s own range of emotions when working supervisors model the recognition of with clients. As many individuals in need of individuality of clients as well as the need to counseling are working through multiple consider multiple perspectives when difficulties, it is important that counselors are conceptualizing cases and providing treatment. encouraged to reflect on how the client’s issue The supervisory relationship is strengthened may bring the counselor’s own past experiences when issues of diversity are addressed to mind (Emde, Mann, & Bertacchi, 2001). By competently, with respect and sensitivity. examining these thoughts within a safe Cultural competence should not be viewed as a relationship, the counselor is better able to discrete endpoint that is reached after a series of provide appropriate services for the client. courses, but rather as active engagement in In a similar way, reflective supervision may lifelong process of self-reflection and growth decrease professional burnout, allowing (Tervalon & Murray-Garcia, 1998). This counselors to problem solve in difficult process requires that counselors are humble situations and provide a variety of approaches to enough to admit when they do not know and meet their client’s needs (Young et al., 2011). seek out resources that will increase their Again, the reflective supervisor’s ability to understanding of a client’s experience so that provide a safe non-judgmental place for they may provide better clinical service. The act professionals to explore thoughts and feelings of “wondering” becomes more comfortable and about their work may be what provides a familiar, and ostensibly leads to increased protective experience for the supervisee (Gatti et knowledge and a change in attitudes about al., 2011). For example, a home visitor may use others. When counselors approach their work reflective supervision to examine her own from a place of humility, it creates a model for beliefs about gender roles within families and being with clients and a mutually respectful how to reconcile those beliefs with what occurs dynamic partnership can then emerge in the families with whom she works. While counselors learn in graduate school to be aware Challenges of their own beliefs and cultures (American As with all supervision relationships, Counseling Association, 2014) and to be challenges arise. One must consider the mindful of countertransference that may occur, safeness of a supervisory relationship reflective supervision allows for a protected time (Ronnestad & Skovholt, 1993). The idea of “not and space for the continued exploration of these knowing” and wondering may be ideas. Importantly, while reflective supervision uncomfortable. However, through the safeness has considerable utility for early career of a supervisory relationship, the supervisee’s counselors, it can also be beneficial to even growth in reflective practice is supported. Some seasoned professionals as a time to focus on counselors may be better prepared to reflect than professional growth and client service. others (Neufeldt et al., 1996); therefore, the practice of reflecting may help one prepare for Multicultural Considerations uncertainty in the field and increase one’s ability An essential consideration in the supervisory to understand complex situations (Griffith & role involves the awareness of diversity. One of Frieden, 2000). This may be a challenge for a the roles of the reflective supervisor is to supervisor who holds administrative encourage the supervisee to consider the responsibilities as well. For example, if a

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 33 counselor tells the reflective supervisor (who is reported valuing structure (e.g., regularity, quiet also the administrative supervisor) that she left a space to reflect). While these are important home visit early because she was uncomfortable aspects to consider, one must also consider the with the “dirty home,” the supervisor may central properties for a supervisory relationship, choose to refrain from addressing the decrease such as planning and training. in direct service hours in the session to instead Whether starting a new program or reflect with the supervisee about the feelings implementing reflective supervision into an brought on by the state of the home. While the existing one, planning and training are key supervisor may be faced with the dilemma of aspects to consider. Frequency and location how, when, and if to address the decrease in (e.g., office, telephone, web-based camera) of service provision, she can be confident that by supervision, caseload for supervisors, group addressing the reason the supervisee left the visit and/or individual supervision, and balancing she is supporting that individual in handling the administrative and reflective supervision must situation differently the next time. be addressed. Flexibility is also a key component, as adjustments may need to be made Ethical Considerations based on supervisor and supervisee feedback. The American Counseling Association’s While making changes too often may be Code of Ethics (section C.2.d.) states that disruptive to all members of the team, measured counselors should “continually monitor their change in response to feedback works well and effectiveness as professionals and take steps to allows team members to be a part of decision improve when necessary. Counselors take making. Clearly, the geographical reach of a reasonable steps to seek peer supervision to program affects whether reflective supervision evaluate their efficacy as counselors.” Through will occur in person or via telephone or web- reflective practices, counselors are able to based camera. Since reflective supervision is not consider how their feelings and actions may clinical supervision, it can be appropriate for it impact the effectiveness of the working alliance, to occur from a distance. Telephone supervision which is particularly important when working is useful to mental health professionals who with clients with multiple needs or those with consult in multiple locations or work in home chronic crises. For example, while it may appear visiting programs and allows programs to make that a client with multiple needs is consistently efficient use of supervisor resources. working towards treatment goals, the counselor Training the professionals who will be providing may need support to explore how his or her and receiving supervision is essential to an relationship with the client may be impacting the effective supervision program. Many tools are client’s “neediness.” Is the client making available to support supervisees and supervisors progress or should treatment interventions be in understanding their roles and maintaining revisited? Through reflective supervision, the fidelity (see Heller & Gilkerson, 2009, for more counselor can consider if treatment is information). Face-to-face meetings between progressing appropriately or if a referral should supervisor and supervisee at the beginning of the be made. supervisory relationship can help jumpstart the relationships and the same may be true for Implementation of Reflective Supervision supervision groups. Additional face-to-face When implementing a reflective supervision meetings or trainings may assist in the continued program, one must consider who will provide development of this supervisory alliance. the reflective supervision. Tomlin et al. (2013) found that reflective supervisors exhibited How We Use Reflective Supervision certain qualities and behaviors that explained In Tulane’s Early Childhood Mental Health “how the supervisor is” (e.g., compassionate, Consultation Program (see Heller et al., 2011, tolerant, reliable). Participants identified for a detailed description), we use both group behaviors that are important to reflective and individual reflective supervision. Our supervision, such as attentiveness, awareness, program strongly believes in the premises set skillfulness, engagement, and curiosity, and forth by the Early Childhood Mental Health

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 34 Consultation field that relationships and the New consultants are interviewed and trained by importance of understanding other’s experiences the Director and Assistant Director of the are central to our work (Johnston & Brinamen, program. During that time, we informally assess 2006). We value the consistent and predictive clinical styles, theoretical orientation, and qualities of the supervisory relationship. Since personality. Consultants are then assigned to the the inception of the program, the consultation core team supervisor believed to be the best fit group has used reflective supervision as a for them. The core team has identified its primary support. Our consultants consistently members’ strengths and which consultant styles provide feedback that reflective supervision is may fit best with each member. The idea of highly valued in our statewide program. The goodness of fit has consistently been explored use of reflection allows consultants to consider during the core team’s reflective supervision multiple perspectives when faced with uncertain with an expert in the field of Early Childhood situations (Griffith & Frieden, 2000). Our Mental Health Consultation. This supervision consultants are often faced with crises within also allows the supervisors a protected time and centers that may involve child abuse or neglect, space to freely discuss and process their interpersonal conflict among teachers and/or emotions regarding the work and information we administrators, or personal challenges “hold.” experienced by teachers (e.g., domestic violence, substance abuse). Because of their relationships Conclusion with their reflective supervisors, our consultants While reflective supervision may be a key feel supported even while in the field and are component in supporting the development of then able to support their clients through these early career counselors, it remains beneficial for crises. Consultants have consistent access to counselors throughout their careers. As a their reflective supervisors so that they may method of professional support that provides a “step out” and have a quick telephone protected time and space for counselors to supervisory session when immediate support is reflect upon their work with clients, explore needed. their personal beliefs and the impact on their In addition to participating in their own work, reflective supervision should be a key reflective supervision monthly, the core team, component of a counselor’s professional consisting of doctoral level clinicians, provides practice. While counselors are encouraged to individual supervision to the statewide team of seek consultation when needed after licensure, licensed mental health professionals. Each consistent reflective supervision serves to consultant participates in individual supervision enhance ethical and cultural considerations. twice a month, with each session ideally lasting for one hour. The importance of the relationship References between supervisors and consultants cannot be American Counseling Association (2014). ACA overstated, and we believe that this valued time Code of Ethics, Section A. Retrieved from must be protected from other time intrusions. http://www.counseling.org/resources/aca- The consultants and supervisors have long code-of-ethics.pdf standing relationships, some of which span over Bernard, J. M. & Goodyear, R. K. (2004). seven years. Fundamentals of clinical supervision (3rd Consultants are also divided into reflective ed.). Needham Heights, MA: Allyn & groups (consisting of three to five members), Bacon. which meet once a month. A core team member Caplan, G. & Caplan, R. (1993). Mental health leads the majority of these groups; however, consultation and collaboration. San each quarter, one group is facilitated by peers. Francisco, CA: Jossey-Bass, Inc. These reflective groups remain connected for Copa, A., Lucinski, L., Olsen, E., & one to two years, at which time the groups Wollenburg, K. (1999). Promoting rotate, allowing for the sharing of new ideas, professional and organizational perspectives, and viewpoints. development: A reflective practice model. Zero to Three, 20(1), 3-9.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 35 Emde, R. N., Mann, T. L., & Bertacchi, J. reflective supervision/consultation, 1-7. (2001). Organizational environments that Retrieved from support mental health. Zero to Three, 22(1), http://www.okaimh.org/uploads/Best_Pract 67-69. ice_Guidelines_for_Reflective_Consultatio Franklin, L. (2011). Reflective supervision for n.pdf the green social worker: Practical Ronnestad, M. H., Skovholt, T. M. (1993). applications for supervisors. The Clinical Supervision of beginning and advanced Supervisor, 30, 204-214. graduate students of counseling and doi:10.1080/07325223.2011.607743 psychotherapy. Journal of Counseling and Gatti, S., Watson, C., & Siegel, C. (2011). Step Development, 71, 396-405. back and consider: Learning from reflective doi:10.1002/j.1556-6676.1993.tb02655.x practice in infant mental health. Young Shahmoon-Shanok, R. (2009). What is reflective Exceptional Children, 14(2), 32-45. supervision? In S. Scott Heller & L. doi:10.1177/1096250611402290 Gilkerson (Eds.), A practical guide to Griffith, B. A. & Frieden, G. (2000). Facilitating reflective supervision (pp. 7-23). reflective thinking in counselor education. Washington, DC: Zero to Three. Counselor Education and Supervision, Stoltenberg, C. (1981). Approaching supervision 40(2), 82-93. doi:10.1002/j.1556- from a developmental perspective: The 6978.2000.tb01240.x counselor complexity model. Journal of Heller, S. S., Boothe, A., Keyes, A., Nagle, G., Counseling Psychology, 28(1), 59-65. Sidell, M. & Rice, J. (2011). doi:10.1037/0022-0167.28.1.59 Implementation of a mental health Tervalon, M. & Murray-Garcia, J. (1998). consultation model and its impact on early Cultural humility versus cultural childhood teachers' efficacy and competence: A critical distinction in competence. Infant Mental Health Journal, defining physician training outcomes in 32, 143–164. doi:10.1002/imhj.20289 multicultural education. Journal of Health Heller, S. S. & Gilkerson, L. (2009). A practical Care for the Poor and Underserved,(9)2, guide to reflective supervision. 117-125. doi: 10.1353/hpu.2010.0233 Washington, DC: Zero to Three. Tomlin, A. M., Weatherston, D., & Pavkov, T. Johnston, K. & Brinamen, C. (2006). Mental (2014). Critical components of reflective health consultation in child care: supervision: Responses from expert Transforming relationships among supervisors in the field. Infant Mental directors, staff, and families. Washington Health Journal, 35(1), 70-80. DC: Zero to Three. doi: 10.1002/imhj.21420 Neufeldt, S., Karno, M. P., & Nelson, M. L. Young, T. L., Lambie, G. W., Hutchinson, T., & (1996). A qualitative study of experts’ Thurston-Dyer, J. (2011). The integration conceptualization of supervisee reflectivity. of reflectivity in developmental Journal of Counseling Psychology, 43, 3-9. supervision: Implications for clinical doi:10.1037/0022-0167.43.1.3 supervisors. The Clinical Supervisor, Oklahoma Association for Infant Mental Health 30(1), 1-18. (2011). Best practice guidelines for doi:10.1080/07325223.2011.532019

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 36 Ethical Gatekeeping for LPC Supervisors

Christian J. Dean, Ph.D., LMFT, Core Faculty

Walden University, School of Counseling

Counseling supervisors have an ethical responsibility to be gatekeepers to the profession and to protect the public from harm. When a Licensed Professional Counselor – Supervisor (LPC-S) in Louisiana is not also the Provisional Licensed Professional Counselor’s (PLPC) on-site supervisor, insight regarding the PLPC’s behaviors may be lacking and therefore decreases the ability of the LPC-S to identify potential remediation areas. The author presents a method to help supervision only LPC-Ss ensure their gatekeeping responsibilities through consented communications with on-site administrative supervisors.

Keywords: counselor supervision, gatekeeping, gateslipping

identifies the importance of not only counselors Ethical Gatekeeping Strategies for LPC self-monitoring for impairment but also the Board Approved Supervisors responsibility of colleagues to intervene when a Gatekeeping is often viewed as a counselor is showing signs of impairment that process to protect the public by limiting or could cause harm to clients (Code C.2.g). stopping anyone who would potentially cause Researchers in the counseling field have harm to others in the process of their brought up concerns regarding the concept of professional duties. For the purpose of this gateslipping, which refers to “…potentially article, gatekeeping will be defined as “…the deficient trainees…” completing a graduate responsibility of all counselors, including program in counselor education without student counselors, to intervene with receiving necessary remediation (Gaubatz & professional colleagues and supervisors who Vera, 2006, p. 32). engage in behavior that could threaten the The concept of gateslipping can also be welfare of those receiving their services” (Foster applied to post-graduate deficient, impaired, or & McAdams, 2009, p. 271). The role of problematic counselors working towards gatekeeping within many professions often lies independent licensing without either necessary within the education and training of remediation or intervention. Researchers in professionals as well as with the post training counselor education have identified different supervision by an experience, credentialed, and terminology for the identification of counselors, trained veteran of the profession. Within the in particular counseling students, who may be counseling profession, counselor educators have impaired. For example, Kress and Protivnak been assigned a role as gatekeepers within (2009) recommended referring to trainees graduate training programs. In particular, exhibiting concerning behaviors as guidelines established by the Council for “problematic” versus “impaired”. Kress and Accreditation of Counseling and Related Protivnak explained that the term impaired could Educational Programs (CACREP), which result with some ethical or legal repercussions accredits graduate programs (masters and for graduate training programs. Additionally, doctorate), dictate the role of gatekeeping of Rusk, Raskin, and Hills (2009) suggested the counselor educators (CACREP, 2009, Section 1, phrase of trainees with problems of professional Standard P). Additionally, the American competence (TPPC) to help address concerning Counseling Association Code of Ethics (2014) behaviors of trainees. Although researchers also identify the role of gatekeeping within within the counseling profession have identified counseling supervision, which can be attributed the significant concern about TPPCs and/or the to supervision during and after graduate training role of counselor educators as gatekeepers (Code F.6.b). Beyond the responsibility of (Kress & Protivnak, 2009; Rusk, Raskin, & supervisors, the ACA Code of Ethics also Hills, 2009), little has been written regarding the

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 37 potential for licensing supervisees with mental health professional; however, one problems of professional competence. The individual may meet all three roles. purpose of this article is to address steps that Louisiana Licensed Professional Counselor – Licensing Supervisors as Gatekeepers Supervisors can take to ensure appropriate Licensed Professional Counselor – gatekeeping procedures and reduce the potential Supervisors in Louisiana are able to work with for gateslipping among Provisionally Licensed PLPCs through individual and group Professional Counselors. supervision. Although supervision often includes discussions of clinical cases along with Current state of Licensed Professional reviews of audio or video recordings of sessions, Counselor Supervision in Louisiana the material presented and processed is often As of April 24, 2015, there were focused on clinical concepts. The integration of approximately 970 Counselor Interns, now multicultural and ethical considerations often referred to solely as Provisionally Licensed enters the supervision process as well. Professional Counselors (PLPCs), in Louisiana If an LPC-S of a PLPC has multiple roles as registered with the LA LPC board of examiners the site administrative supervisor and/or licensed and actively receiving supervision from an LPC mental health professional on site for clinical Board Approved Supervisor (Licensed consultation, then the LPC-S is informed of the Professional Counselor – Supervisor [LPC-S]) PLPC’s daily work functions and behaviors. (LA LPC Board Administrators, personal However, an LPC-S who only serves as the communication, April 24, 2015). licensing supervisor and meets with the PLPC There were also approximately 779 LPC-Ss, once a week for an hour, may not have a clear of which 250 are active in the supervision of picture of what the PLPC does at work or their PLPCs (LA LPC Board Administrators, personal professional behaviors at work. Therefore, LPC- communication, April 24, 2015). Any PLPC and Ss are not necessarily exposed to or informed of LPC-S are obligated to follow the statutes the regular day-to-day activities (administrative, outlined in the Louisiana Professional and interactive, etc.) that occur at PLPCs’ Occupational Standards, Title 46, Part LX, workplaces when only serving as a licensing Subpart 1. supervisor. Additionally, the Documentation of In order to provide adequate and timely experience form (LA LPC Board of Examiners, clinical assistance, PLPCs must work at a setting 2014), section III includes an Areas of where there is at least one licensed mental health Evaluation section where the LPC-S of the professional (i.e. Licensed Psychologist, PLPC is required to evaluate the PLPC on nine Licensed Clinical Social Worker [LCSW], different skills, which include: “Ability to Licensed Marriage and Family Therapist develop therapeutic alliance with clients” and [LMFT], Licensed Professional Counselor “Exhibits qualities of the professional self” (p. [LPC], etc.) present to help with case 3). The two previously identified skills would be consultation, if needed (§603.6.h Provisional difficult to fully evaluate without Licensed Professional Counselors Licensing feedback/information from the on-site Requirement). PLPCs must also have an administrative supervisor, which could be the administrative supervisor as well (§603.6.f licensed mental health professional on staff. Provisional Licensed Professional Counselors Therefore, regular communication between the Licensing Requirement), which can be the same LPC-S and the on-site administrative (possibly as the LPC-S (if provided at the work setting) or licensed) supervisor is warranted for appropriate the other licensed mental health professional insight and gatekeeping responsibilities of LPC- outlined in the previous sentence. Therefore, a Ss. PLPC may have up to three administrative/supervisory personnel: 1) the Case Study Board Approved LPC-S; 2) an administrative The following case study/scenario will supervisor at the work setting; and 3) a licensed be used as example to highlight the importance of communication between an LPC-S and the

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 38 administrative (licensed and/or un-licensed) site mental health professional at the setting have to supervisors. sign any documents to acknowledge the Greg is a registered PLPC working at a responsibility as set forth by the statues where it community agency providing counseling states, “The control, oversight, and professional services to adults. He is being supervised by responsibility for provisional licensed Richard, LPC-S on a weekly basis as Greg professional counselors rests with the provides between 15-20 hours of direct client provisional licensed professional counselor’s services per week. Greg’s site supervisor, Ken is administrative supervisor in the setting in which an LCSW. After four months of working at the they are employed or contracted or are rendering community agency, Greg notifies Richard that counseling services on a volunteer basis” he is changing jobs and that he will be working (§803.A.3 Supervised Experience of Provisional with a state agency. Richard and Greg fill out Licensed Professional Counselors). the necessary paperwork with the LPC Board of Given the lack of clarity for Examiners to register the new site. Richard has administrative supervisors and the potential of never met or spoken to Ken and unbeknownst to different ethical responsibilities for different Richard, Greg was fired from the community mental health professions (LPCs compared to agency for having an inappropriate relationship LMFTs or LCSWs), PLPCs who demonstrate with one of the clients. problematic or unethical behaviors may slip by In the case of Greg, PLPC, Richard, LPC-S without necessary intervention or remediation has an ethical responsibility to address the and potentially threaten the welfare of future inappropriate relationship with Greg and clients. Therefore, LPC-Ss are encouraged to possibly report any unethical conduct committed include specific language in the supervision by Greg (ACA, 2014, Codes I.2.a and I.2.b); agreement/statement of supervision practice that however, the lack of communication between identifies the communication with Richard and Ken, LCSW has resulted with the administrative supervisors (both licensed and public potentially being in danger of being unlicensed) of PLPCs to ensure adequate, clear, harmed through unethical counseling practices. and necessary information regarding the PLPCs’ behaviors at their work setting. Discussion and Recommendations Regularly scheduled communication The case of Greg illustrates how between the LPC-S and administrative communication between the LPC-S and the supervisor(s) every quarter (3 months) will administrative supervisor (licensed mental provide the LPC-S with the necessary health professional – LPC, LMFT, LCSW, etc. information needed not only for potential and/or unlicensed supervisor) at the site would remediation but also for updates to quarterly help the LPC-S find out more about the day-to- evaluation (if desired) and areas of growth to be day activities of the PLPC and identify any areas processed during future supervision sessions. of growth. Referring back to the case of Greg, PLPC: If Additionally, although the LPC-S and PLPC Richard had a clause in the supervision rules and statues (§803.A Supervised Experience agreement/statement of supervision practice of Provisional Licensed Professional explaining the open communication with Ken, Counselors) identify that the administrative he would have called Ken after hearing about supervisor is responsible for the PLPC, such the job change to get some feedback regarding administrators may not be familiar with the Greg’s clinical skills and any area of growth or PLPC rules or the ACA code of ethics or concern. Through such dialogue, Richard would professional conduct expected of PLPCs. Even have found out about Greg’s inappropriate if the licensed mental health professional on relationship and would have been able to staff is the administrative supervisor, not all address such ethical concerns. Lastly, Richard licensed mental health professionals (LMFT, would benefit from the information provided by LCSW, etc.) may be familiar with the ACA code Ken regarding Greg’s counseling skills that fall of ethics or with the PLPC rules. Lastly, neither into the evaluation component of the LPC the administrative supervisor or the licensed documentation of experience form.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 39 Licensed Professional Counselors, Conclusion Chapter 6, §603. Provisional Licensed All LPCs and LPC-Ss in Louisiana are Professional Counselors Licensing required to adhere to the ACA code of ethics Requirement. (2014). Included in the ACA code of ethics (2014) are guidelines for the responsibility of Louisiana Professional and Occupational gatekeeping procedure of counseling Standards, Title 46, Part LX, Subpart 1. supervisors. In Louisiana, LPC-Ss who solely Licensed Professional Counselors, serve as licensing supervisors do not Chapter 8, §803. Supervised Experience automatically get necessary professional practice of Provisional Licensed Professional and day-to-day behavioral reports of PLPCs Counselors. under their supervision. The lack of information for supervision only LPC-Ss can result in Foster, V. A., & McAdams, C. R. (2009). gateslipping of PLPCs with problems of Transparency for professional professional competence or unethical behaviors performance assessment: Fostering resulting in the potential endangerment of the student investment in gatekeeping. welfare of current or future clients. Therefore, Counselor Education and Supervision, LPC-Ss can include clearly communicated and 48, 271-284. documented procedures in the supervision agreement/statement of supervision practice Gaubatz, M. D., & Vera, E. M. (2006). Trainee addressing communications with licensed and competence in master’s-level counseling unlicensed on-site supervisors of PLPCs to program: A comparison of counselor ensure adequate and appropriate evaluation and educators and students’ views. gatekeeping practices within the counseling Counselor Education and Supervision, profession. 41, 294-305.

References Kress, V. E. & Protivnak, J. J. (2009). Professional development plans to American Counseling Association (2014). ACA remedy problematic counseling student Code of ethics. Alexandria, VA: Author. behaviors. Counselor Education and Supervision, 48, 154-166. Louisiana Licensed Professional Board of Examiners. (2014). Documentation of Rusk, J. P., Raskin, J. D., & Hill, M. S. (2013). experience form. Retrieved from Problems of professional competence http://www.lpcboard.org/CI%20DOE among counselor trainees: %20Revised%20March%202014.pdf Programmatic issues and guidelines. Counselor Education and Supervision, Louisiana Professional and Occupational 52, 30-42. doi:10.1002/j.1556- Standards, Title 46, Part LX, Subpart 1. 6978.2013.00026.x

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 40 Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 41 Test Questions for Licensed Professional Counselors

A score of 100% is needed on the following items. You need to submit this test along with the request for a certificate to receive hours. Once scored, you will receive a certificate verifying 2.5 CLOCK HOURS of CEUs.

CEU questions for the Utilizing Cognitive-Behavioral Therapy with Bullied Obese Adolescents in Schools article: 1. Which of the following statements is true? A. Studies show that peers liked obese children more than wheelchair bound children. B. Studies show that peers liked obese children just as much as wheelchair bound children. C. Studies show that peers liked obese children less than wheelchair bound children. D. Studies show that peers liked obese children

2. According to this article, school counselors should notice a student’s distorted cognitions through their ______in a session. A. Physical movements B. Language C. Eye contact D. Emotional energy

CEU questions for the Supervisory Triad in Multicultural Supervision article: 3. Which of the following statements about the practice of “broaching” is untrue? A. Along with advocacy, broaching is seen as an external multicultural competency in the supervisory triad. B. Broaching is an appropriate practice for developing multicultural competency in the supervisor- counselor relationship, but should not be used in the counselor-client relationship because it can be confusing to the client. C. A danger of continuous broaching in the counselor-client relationship is that it may leave the client feeling that his or her cultural status is all that the counselor can see. D. Insight and experience developed through broaching in the supervisor-counselor relationship can help counselors become aware of the cultural dynamics at play in the counselor-client relationship.

4. The correct sequence of stages in the Means of Interpersonal Functioning (MIF) model is: A. Adaptation, Incongruence, Exploration, Integration B. Incongruence, Adaptation, Exploration, Integration C. Incongruence, Exploration, Adaptation, Integration D. Exploration, Incongruence, Adaptation, Integration

CEU questions for the Reading the Code of Ethics as Literature article: 5. What metaphor does "The Baker's Dozen" create with the interpreter and the Standards within the Code? A. Driver and passenger B. Baker and doe C. Chef and ingredients D. Pilot and rules

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 42 6. All the Hermeneutical Principles are applied to the Code except? A. We interpret a part in light of the whole. B. We pay attention to context only when there is confusion. C. We stick with the plain and obvious meaning of a text. D. We interpret unclear passages about a given subject by clearer passages about that same subject.

CEU questions for the Reflective Supervision as a Key Support for Counselors article: 7. Counseling supervisors address the role of multiculturalism in the supervisory relationship by A. Exploring different treatment plans and interventions B. The conceptualization of cases C. The recognition of individuality of clients and consideration of multiple perspectives D. Addressing certain qualities and behaviors in the supervisee

8. A key component of good clinical practice when built into practice is A. Creating client-specific interventions B. Focusing on one's range of emotions when working with clients C. Being mindful of countertransference C. Reflective supervision

CEU questions for the Ethical Gatekeeping for LPC Supervisors article: 9. When the PLPC’s LPC-S is not the PLPC’s on-site supervisor A. The PLPC is recommended to transfer to the LPC-S’s site B. The potential for gateslipping is increased C. The PLPC must obtain from the LPC board an administrative supervisor waiver D. The LPC-S must obtain from the LPC board an off-site supervision provision

10. Which of the following regarding the ethical gatekeeping article is not true? A. Describing an impaired trainee as having “problems of professional competence” is not recommended due to potential ethical and legal repercussions B. The article recommends that the supervisory agreement include language providing for communication between an off-site LPC-S and an on-site administrative supervisor C. The purpose of PLPC supervision is the protection of client welfare C. Off-site LPC-Ss are recommended to communicate with on-site administrative supervisors every 3 months.

The Louisiana Counseling Association is an NBCC-Approved Continuing Education Provider (ACEP) and may offer NBCC-approved clock hours for programs that meet NBCC requirements. Programs for which NBCC-approved clock hours will be awarded are identified in this Journal. The ACEP is solely responsible for all aspects of the Journal.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 43 Credit Verification Form for Licensed Professional Counselors

The Louisiana Counseling Association awards 2.5 CLOCK HOURS of continuing education for reading the Louisiana Journal of Counseling (LJC) and correctly completing the Study Questions. To receive a certificate verifying your participation in this easy and inexpensive way to earn valuable CEU’s, complete the form below and mail it, along with $10 and your completed test questions, to the following address: Diane Austin LCA Executive Director 353 Leo Street Shreveport, LA 71105

I verify that I have read the entire FALL 2015 edition of the Louisiana Journal of Counseling (LJC) and am now applying for 2.5 clock hours of continuing education credit in conjunction with correctly answering the Study Questions for this year’s journal.

Name (PRINT – as you wish to have it appear on your certificate):

______

Mailing Address

______Street

______City State Zip

Phone __(cell)______(other)______

E-mail______

Signature______

Date______

*Make checks payable to LCA A Verification form with your clock hours will be mailed directly to the address provided on this form.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 44 GUIDELINES FOR AUTHORS

The Louisiana Journal of Counseling (LJC) publishes articles that have broad interest for a readership composed mostly of counselors and other mental health professionals who work in private practice, schools, colleges, community agencies, hospitals, and government. This journal is an appropriate outlet for articles that (a) critically integrate published research, (b) examine current professional and scientific issues, (c) report research that has particular relevance to professional counselor, (d) report new techniques or innovative programs and practices, and (e) examine LCA as an organization. MANUSCRIPT CATEGORIES Manuscripts must be scholarly, based on existing literature, and include implications for practice. The following categories describe the nature of submitted manuscripts. However, manuscripts that do not fall into one of these categories may also be appropriate for publication. These categories were adapted from the American Counseling Association’s Journal of Counseling and Development (JCD). 1. Conceptual pieces. New theoretical perspectives may be presented concerning a particular counseling issue, or existing bodies of knowledge may be integrated in innovative ways. 2. Research studies. Both quantitative and qualitative studies are published in LJC. The review of the literature should provide the context and need for the study, followed by the purpose for the study and the research questions. The methodology should include a full description of the participants, variables, and instruments used to measure them, data analyses, and results. The discussion section includes conclusions and implications for future research and counseling practice. 3. Practice articles. Innovative counseling approaches, counseling programs, ethical issues, and training and supervision practices may be presented. Manuscripts must be grounded in counseling or educational theory and empirical knowledge. 4. Assessment and Diagnosis. Focus is given to broad assessment and diagnosis issues that impact counselors.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 45 MANUSCRIPT REQUIREMENTS

All manuscripts must adhere to the guidelines set forth in the Publication Manual of the American Psychological Association (6th ed.). The APA Publication Manual sets forth all guidelines concerning manuscript format, abstract, citations and references, tables and figures, graphs, illustrations, and drawings. Special attention should be given to the guidelines regarding the use of nondiscriminatory language when referring to gender, sexual orientations, racial and ethnic identity, disabilities, and age. Also, the terms “counselor” and “counseling” are preferred to “therapist” and “therapy.”

1. Submit an emailed, electronic, blind copy in Word of the entire manuscript to Meredith Nelson, [email protected], Psychology Dept., One University Place, Shreveport, LA 71115 or three (3) clean, hard copies of the entire manuscript with an electronic version to Peter Emerson, LJC Editor, [email protected], SLU Box 10863, Hammond, LA, 70402. 2. Include a cover letter with your manuscript submission that contains your name and title, place of employment and position, address, telephone number, and e-mail address. 3. Manuscripts should not exceed 18 pages, including references. 4. Lengthy quotations (330-500 words) require written permission from the copyright holder for reproduction. Adaptation of tables and figures also requires reproduction approval. It is the author’s responsibility to secure this permission and present it to the LJC editor at the time of manuscript submission. 5. Once a manuscript has been accepted for publication, the author will be required to submit a final copy electronically. 6. The LJC is published annually in the Fall. 7. Material that has been published or is currently under consideration by another periodical should not be submitted. 8. Generally, authors can expect a publication decision within 3 months after the acknowledgment of receipt. 9. Manuscripts that do not conform to the APA Publication Manual guidelines will be returned without review.

Louisiana Journal of Counseling • Fall 2015 • Volume XXII Page 46

Load more

  46

Copy Link