A Qualitative Investigation of the Experiences of Entry-Level Professional Counselors Working in Community Mental Health Settings and Potential Impacts to Wellness
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BLAKE, SUSAN D., Ph.D. Ready Or Not: A Qualitative Investigation of the Experiences of Entry-Level Professional Counselors Working in Community Mental Health Settings and Potential Impacts to Wellness. (2015) Directed by Dr. Todd F. Lewis and Dr. Keith Mobley. 403 pp. It is well known that professional counselors may experience physical and emotional symptoms that may ultimately affect their quality of work (Figley, 1995; Figley, 2002; Maslach, 2003). Furthermore, deficits in wellness of counselors can have significant consequences in the ethical care of clients (ACA, 2005; 2014; Kocet, 2006; Neumann & Gamble, 1995; Pearlman & Saakvitne, 1995). Specifically, entry-level professional counselors in community mental health (CMH) settings may be at a higher risk of experiencing these deficits to wellness compared to their more experienced counterparts (Farber, 1985; Lawson & Myers, 2011; Lent & Schwartz, 2012; Pearlman & MacIan, 1995; Sprang, Clark & Whitt-Woosley, 2007). In addition, entry-level counselors may not have the skills or support to maintain their wellness and thus protect them from impairment stemming from organizational variables within the CMH setting (Lawson, 2007; Farber, 1985; Pearlman & MacIan, 1995; Sprang et al., 2007). As such, the challenging clientele, organizational factors, and supervision experiences in CMH settings may have unique influences on entry-level professional counselors’ experiences with wellness. Unfortunately, a common trend in CMH agencies is that the least experienced counselors work with the most severe of client needs (Pearlman & MacIan, 1995; Wachter Morris & Barrio Minton, 2012). Researchers have begun to examine elements of wellness among counseling students (Lambie, Smith, & Ieva, 2009; Myers, Mobley & Booth, 2003; Perepiczka & Balkin, 2010; Roach & Young, 2007), counselor educators (Wester, Trepal, & Myers, 2009) and professional counselors (Lawson, 2007; Lawson & Myers, 2011; Lent & Schwartz, 2012; Mobley, 2004; Randolph, 2010). Surprisingly, however, greater emphasis on wellness and prevention of impairment as well as calls in the literature for managing impairment factors within the field of counseling (Lawson & Venart, 2005; Sheffield, 1998; Witmer & Young, 1996) has not spurred empirical investigation related to the experiences of entry-level professional counselors. Furthermore, the work environment of entry-level professional counselors, and how this impacts their experiences of wellness, has been largely neglected (Borders & Hamilton Usher, 1992; Fall & Sutton, 2003; Freadling & Foss-Kelly, 2014). As such, continuing to overlook the needs of entry-level professional counselors poses not only a risk to counselor wellness but also to client welfare (Lawson & Venart, 2005). Therefore, the purpose of this study was to investigate the experiences of entry- level professional counselors working within CMH agencies and how these experiences impact their wellness. In particular, the experiences of entry-level professional counselors were explored within the context of the clientele they typically serve, the organizational factors they face on a daily basis, and the supervision they receive as entry-level counselors. Consensual Qualitative Research (CQR) was utilized to analyze the interviews of 11 participants. Participants in this study identified multiple factors that impacted their experiences of working in the CMH setting. The research team reviewed data presented by participants and developed eight domains. These domains included categories that were labeled general, typical, and variant. The domains were developed based on literature review and participant responses. These included: (a) job title or role, (b) ProQOL experience, (c) career choice, (d) organizational factors, (e) client factors, (f) self-care/ wellness, and (g) supervision. Of the 42 categories, 3 were labeled general, 20 were labeled typical, and 19 were labeled variant. READY OR NOT: A QUALITATIVE INVESTIGATION OF THE EXPERIENCES OF ENTRY-LEVEL PROFESSIONAL COUNSELORS WORKING IN COMMUNITY MENTAL HEALTH SETTINGS AND POTENTIAL IMPACTS TO WELLNESS by Susan D. Blake A Dissertation Submitted to the Faculty of The Graduate School at The University of North Carolina at Greensboro in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Greensboro 2015 Approved by ______________________________ Committee Co-Chair ______________________________ Committee Co-Chair APPROVAL PAGE This dissertation written by SUSAN D. BLAKE has been approved by the following committee of the Faculty of The Graduate School at The University of North Carolina at Greensboro. Committee Co-Chair _________________________________ _________________________________ Committee Members _________________________________ _________________________________ ____________________________ Date of Acceptance by Committee _________________________ Date of Final Oral Examination ii ACKNOWLEDGMENTS So many people have been involved in the process of completing this project that I am sure one page will not come close to noting all of them. First, I would like to thank my committee for the long-term support that you offered. Dr. Todd Lewis, you have been there through all the changes and challenges. I appreciate your support and very calming energy. Dr. Keith Mobley, you have such a mentor’s spirit and approach. I cannot thank you enough for all your encouragement. Dr. Darlene Xiomara Rodriguez, your challenges and high expectations certainly pushed me through to completion. You never gave up and I thank you for that. Dr. Kelly Wester, your feedback was helpful and I truly appreciate you stepping onto the committee after so many changes had occurred. To the late, Dr. Jane E. Myers, you may not have seen this project to its end but your influence certainly continues. Your research agenda continues through the lives of so many. I hope I made you proud. To my research team: Dr. Amber Pope and Dr. Denisha Champion, I couldn’t have done this without you both. Your words of encouragement went further than you know. Your help in sorting out the data and taking precious time out of your busy lives to get me to this point is nothing less than inspiring. To the amazing people at Tree of Life Counseling, you help to create an environment of healing not only for the clients we see but also for each other. Jennifer Rosenbluth, you always supported and encouraged me. I appreciate you all listening to my worries and victories along this journey. iii To the Tenacious Ten, we met when life was uncertain for me in many ways. You each had a part in making me the woman I am today. My family and friends, you had no idea what I was doing all those long nights and weekends when I had to turn down invitations. You loved and supported me in spite of it all. To Sonya, my love, my partner, you have only known me with this present in my life. You loved me anyway. You consistently make me a better and kinder soul in this world. You are my soft place to land. I love you with all my heart and I am so excited to see what is in store for our lives together. I am grateful. iv TABLE OF CONTENTS Page LIST OF TABLES ...............................................................................................................x CHAPTER I. INTRODUCTION ...................................................................................................1 Entry-Level Professional Counselors .........................................................3 Counselor Development and Supervision ....................................................5 Community Mental Health Settings .............................................................7 Organizational Factors .....................................................................8 Challenging Clientele .......................................................................9 Counselor Wellness and Impairment .........................................................12 Purpose of the Study ..................................................................................16 Statement of the Problem ..........................................................................17 Research Questions ....................................................................................18 Need for the Study .....................................................................................19 Definitions of Terms ..................................................................................20 Brief Overview. ..........................................................................................22 II. REVIEW OF THE RELATED LITERATURE .....................................................24 Introduction ................................................................................................24 Entry-Level Professional Counselors ........................................................24 Challenges in Defining the Entry-Level Professional Counselor................................................................26 Distinguishing CITs from Entry-Level Counselors .......................................................................27 Counselor development and supervision ............................29 Personal reactions. .................................................30 Counseling philosophy ..........................................31 Competence ............................................................32 Professional identity ...............................................33 Supervision ............................................................35