LEWIS LEWIS DANIELS D’ANDREA
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COMMUNITY COUNSELING
Your helping hands in the helping professions
FOURTH EDITION
COMMUNITY COUNSELING A Multicultural -Social Justice Perspective FOURTH EDITION
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JUDITH A. LEWIS
MICHAEL D. LEWIS
JUDY A. DANIELS
MICHAEL J. D’ANDREA
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Community Counseling A Multicultural-Social Justice Perspective FOURTH EDITION
JUDITH A. LEWIS Governors State University, ret.
MICHAEL D. LEWIS Governors State University, ret.
JUDY A. DANIELS University of Hawaii at Manoa
MICHAEL J. D’ANDREA National Institute for Multicultural Competence
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This is an electronic version of the print textbook. Due to electronic rights restrictions, some third party content may be suppressed. Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. The publisher reserves the right to remove content from this title at any time if subsequent rights restrictions require it. For valuable information on pricing, previous editions, changes to current editions, and alternate formats, please visit www.cengage.com/highered to search by ISBN#, author, title, or keyword for materials in your areas of interest.
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Community Counseling: A Multicultural-Social Justice Perspective, Fourth Edition Judith A. Lewis, Michael D. Lewis, Judy A. Daniels, and Michael J. D’Andrea Publisher/Executive Editor: Linda Schreiber-Ganster Acquisitions Editor: Seth Dobrin Editorial Assistant: Rachel McDonald Marketing Coordinator: Gurpreet Saran Marketing Communications Manager: Tami Strang Content Project Management: PreMediaGlobal Art Director: Caryl Gorska
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Printed in the United States of America 1 2 3 4 5 6 7 14 13 12 11 10 Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
To all the counselors and other mental health professionals who work hard to foster their clients’ psychological empowerment and personal well-being by promoting social justice in our society.
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Contents
PREFACE
x iii
ABOU T TH E AU THORS
x vi
Chapter 1 Community Counseling for the 21st Century
1
21st-Century Community Counseling: Fundamental Assumptions 4 Environmental Contexts 4 Client Strengths and Resources Multiculturalism 8
6
The Link between Individual and Community Development Community Counseling Defined 9 Community
9
10
Multicultural Competence Social Justice 12
11
Healthy Development of Clients and Communities Community Counseling Strategies 14 Facilitating Human Development: Focused Strategies
13 15
Facilitating Human Development: Broad-Based Strategies 16 Facilitating Community Development: Focused Strategies 17 Facilitating Community Development: Broad-Based Strategies A Unified Approach 18
18
Summary 19 References 21 v Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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CONTENTS
Chapter 2 The Evolution of the Community Counseling Model A People’s History of the Counseling Profession 25 The Progressive Movement
23
27
Jesse Davis: The Genesis of School Guidance Counseling 28 Frank Parsons: The Father of the Counseling Profession 28 The Mental Hygiene Movement The 1910s and 1920s 30 The Impact of World War I The 1920s–1930s 31
29
31
Dealing with the Challenges of the Great Depression The 1940s–1950s 33 The Impact of Carl Rogers’s Counseling Theory
32
33
Advocating Governmental Support for World War II Veterans Extending Vocational Counseling Services to Women During the 1940s 35
34
The Development of New Counseling Organizations in the 1950s 36 Unprecedented Growth of Counselor Education Programs in the 1950s 37 The 1960s and 1970s 38 Lessons Learned 39 New Developmental Counseling Approaches
39
Broadening the Counseling Profession’s Perspective and Effectiveness 40 The Passage of the Community Mental Health Centers Act Managed Care Organizations (MCOs) in the 1970s The 1980s and 1990s 42 The Continued Professionalization of Counseling Acknowledging Professional Contradictions 44
40
41
43
The Rise of the Multicultural Counseling Competency Movement 45 New School Counseling Initiatives in the 1990s 46 Counselors for Social Justice (CSJ) Summary 48 References
47
50
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CONTENTS
Chapter 3 Counseling in Context 53 The RESPECTFUL Counseling Framework Religious/Spiritual Identity
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Economic Class Background Sexual Identity 56
55
Psychological Maturity Ethnic/Racial Identity
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57 57
Chronological/Developmental Challenges 58 Trauma and Other Threats to One’s Well-Being Family Background and History
59
60
Unique Physical Characteristics 60 Location of Residence and Language Differences
61
Relevance of the RESPECTFUL Framework 61 The RESPECTFUL Counseling Model and Counselor Self-Assessment 62 Assessment 62 The Collaborative Approach to Assessment Strengths-Based Assessment 65 Balancing Demands and Resources Client Conceptualization
63
66
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Minority Identity Development 70 Counseling Approaches with a Social Justice Orientation Empowerment-Focused Counseling Ecological Counseling 77
74
Feminist Counseling and Therapy Relational-Cultural Therapy 83
79
Summary References
73
84 85
Chapter 4 Outreach to Distressed and Marginalized Clients Addressing Community-Wide Trauma 91
90
Multicultural Competence 91 Community Recovery 93 Addressing Personal Crises 94 Definition of Crisis 94
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CONTENTS
The Phases of Crisis
95
Suicide Prevention 97 Addressing Difficult Transitions Model Outreach Programs
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101
Reaching Out to Marginalized Populations 115 Addressing the Mental Health Needs of Latinos/Latinas: The Inquilinos Boricuas en Acción 116 Gaza Community Mental Health Programme 118 Brazilian Institute for Innovations in Public Health (IBISS) Summary 121 References
120
123
Chapter 5 Developmental/Preventive Interventions An Equation for Psychological Health A Rationale for Prevention 129
127
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Multicultural Considerations 130 Conceptualizations of Stress 131 The Cultural Specificity of Stress Reactions
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The Universality of Stress Reactions 133 Stress Management Interventions 133 Altering the Environment 134 Altering Cognitive Responses to Stress Lifestyle Changes 135 Altering Physiological Responses to Stress The Stress Management Workshop
134 136
138
Health Promotion/Wellness Programs 139 Surviving Cancer Competently Intervention Program Team Awareness 141 Wellness Outreach at Work
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142
Botvin Life Skills Training Health & Wellness Program
142
Parenting and Family-Focused Programs 143 Prevention and Relationship Enhancement Program (PREP) Strengthening Families Program Parenting Programs 144
143
144
Life Skills Training: Promoting Personal Competence Effectiveness of Life Skills Training Programs 146 Promoting Intrapersonal and Interpersonal Competencies
145 147
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CONTENTS
Gazda’s Life Skills Training Model
ix
148
The Prepare Curriculum: Goldstein’s Problem-Solving Program 149 Building Social Justice and Advocacy Skills
151
School-Based Programs 151 Community-Based Programs 153 Workshop Development Summary 155 References
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156
Chapter 6 Client Advocacy 165 Both/And: Decision Points in the Counseling-Advocacy Process 166 The Counseling-Advocacy Process: Examples Example 1: A Runaway Youth 170
170
Example 2: A Physically Challenged Adult 171 Example 3: A Mature Woman Continuing Her Education Client Advocacy and Multiple Oppressions
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The Guerrero Family 173 The Soto/Torres Family 174 Carlos 175 Ramon 176 Fostering a Responsive Helping Network Coalition Building 178 Community-Based Planning
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179
Summary 181 References 182 Chapter 7 Community Collaboration and Advocacy
184
Community Collaboration 186 Neighborhood Programs 187 Self-Help Organizations
191
Family and Community Projects Community Advocacy 201 Overcoming Powerlessness Summary 203 References
199
203
204
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CONTENTS
Chapter 8 Social/Political Action Strategies The Counselor’s Contribution to Social/Political Activism 207 Stories to Tell 207 Organizing Skills to Offer Expertise to Share Risks and Benefits
206
207
208 208
Counselors and Social/Political Advocacy: Beginning with the Client 209 Amber and Her Family 210 Linguicism and Immigration Issues Issues Affecting Women 217
214
Chris: An Experience of Middle School Bullying Social/Political Advocacy: The Big Picture Summary 223 References
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Chapter 9 Community Counseling in Diverse Community Agency Settings 226 Community Mental Health
227
Facilitating Human Development 227 Facilitating Community Development 231 Career, Vocational, and Employment Settings Facilitating Human Development 234 Facilitating Community Development Family Counseling 237 Facilitating Family Development
232
236
239
Facilitating Community Development 240 Population-Specific Agencies and Programs 242 Populations Defined by Culture, Ethnicity, or National Identity 242 Populations Defined by Gender or Age Group
244
Summary 246 References 247
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CONTENTS
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Chapter 10 Community Counseling in School Settings 251 A Brief History of School Counseling: Striving for Comprehensiveness 252 The Comprehensive School Guidance Program 252 American School Counselor Association National Standards
253
National Initiative for Transforming School Counseling 254 American School Counselor Association National Model for School Counseling Programs 255 The Current Challenge: Comprehensiveness and Systemic Change 256 School Counseling Components 258 Group Work and Individual Counseling Educational Interventions
259
260
Student Advocacy 260 Systemic Interventions 261 Unifying the Program Components Multicultural Programming 262 Programming for Safe Schools
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264
Summary 267 References 267 Chapter 11 Managing the Community Counseling Program Planning 270 Needs Assessment
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270
Goal Setting 273 Decision Making 273 Planning for Implementation
274
Organizing 274 Contrasting Two Organizational Models Future Organizational Challenges Leadership and Supervision 278
275
277
Leadership Style 278 The Five Components of Effective Leadership The Supervisory Relationship Multicultural Supervision Evaluation 288
280
281
284
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CONTENTS
Process Evaluation
289
Outcome Evaluation 289 Unique Managerial Challenges Summary References
290
291 292
Chapter 12 Preparing the Competent Community Counselor Counselor Education
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296
Program Missions 296 Curriculum Infusion 298 Expansive and Contextual Approaches to Counseling Experiential Learning 304 Lifelong Learning
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306
Summary 309 References 309 Appendix A Multicultural Counseling Competencies
311
Appendix B American Counseling Association (ACA) Advocacy Competencies 316 Appendix C Competencies for Counseling Lesbian, Gay, Bisexual, and Transgender (LGBT) Clients 321 Appendix D Advocacy Competencies Self-Assessment Survey CREDITS
326
328
AUTHOR INDEX S UBJECT INDEX
329 334
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Preface
W
ith the advent of the 21st century, helping professionals have begun to view their work quite differently from their 20th-century counterparts. In the past, helpers usually scrutinized their clients through the equivalent of a microscope, attempting to identify individual problems that needed attention. Now, the most effective helpers try to use instead a wide-angle lens that helps them see their clients in the broadest possible context. This book’s community counseling model helps to move this change process forward by providing both cutting-edge theory and practical methods for combining counseling and social justice advocacy. This edition rests on the foundation of an updated definition of community counseling: Community counseling is a comprehensive framework that is grounded in multicultural competence and oriented toward social justice. Because human behavior is powerfully affected by context, community counselors use strategies that facilitate the healthy development both of their clients and of the communities that nourish them. This definition informs the organization of the text. Chapters 1 and 2 introduce the assumptions and strategies underlying community counseling and provide a historical perspective on the evolution of the community counseling model. The second section of the book, Facilitating Healthy Human Development, addresses the concepts and methods that community counselors use to facilitate the development of their clients. Chapter 3, “Counseling in Context,” helps readers learn how to use assessment and counseling methods that are consistent with a multicultural-social justice orientation. Chapter 4 focuses on outreach to distressed and marginalized clients and Chapter 5 describes developmental/prevention interventions that are designed for the community at large. The book’s third section, Facilitating Healthy Community Development, focuses on environmental interventions, with Chapter 6 addressing client advocacy, Chapter 7 discussing community collaboration methods, and Chapter 8 emphasizing social/political activism. The final section of the book is Implementing the Community Counseling Model. The authors describe practical applications of community xiii Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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PREFACE
counseling in diverse community agency settings (Chapter 9) and in school settings (Chapter 10). Chapter 11 concentrates on managing community counseling programs and Chapter 12 describes successful methods for preparing the competent community counselor.
NEW IN THIS EDITION
The previous editions of Community Counseling all made the case for a comprehensive and multifaceted approach to helping that combined direct services to clients with indirect, environmental interventions. This edition preserves the material related to program development but has a new, individual focus as well. Readers will see how clients are helped by broad community change strategies and how individual counselors can achieve success through the community counseling model. This approach will prove helpful for students who might feel distant from the possibility of designing a program but hungry for information about how they, personally, can become competent community counselors. The following material is new to this edition: 1. Examples of individual clients and families are introduced in Chapter 1 and revisited throughout the book as readers learn how to work with the clients from a multicultural-social justice perspective. 2. Chapter 3, “Counseling in Context,” examines strengths-based approaches to assessment. 3. Also in Chapter 3, the authors identify counseling approaches that are consistent with a social justice orientation and show, through examples, how they can be used with clients. 4. Chapter 4 presents multicultural and international examples of outreach strategies for reaching distressed and marginalized people. 5. Chapters 6 and 7, which focus on client advocacy and community collaboration, provide ongoing examples of advocacy on behalf of clients who are affected by multiple oppressions. 6. Chapter 8, “Social/Political Action Strategies,” introduces the process for beginning with the needs of the individual client and moving in the direction of advocacy in the larger public arena. In addition to this focus on the individual counselor and client, this edition has several completely new chapters and appendices that did not appear in the previous edition. The new chapters include Chapter 2, which follows the evolution of the counseling profession from the early 1900s to the present as it has moved in the direction of the community counseling model; Chapter 10, which is devoted to the application of the community counseling model to school settings; and Chapter 12, which provides examples of successful models for preparing competent community counselors.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
PREFACE
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The emphasis on competent practice can also be seen in the new appendices: Appendix A, The AMCD/ACA Multicultural Competencies; Appendix B, The ACA Advocacy Competencies; Appendix C, The Competencies for Counseling Gay, Lesbian, Bisexual, and Transgender Clients (Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling); and Appendix D, Advocacy Competencies Self-Assessment Survey (Ratts and Ford). Finally, the emphasis on competent practice can also be seen in the expansion of the Competency-Building Activities, which appear in every chapter and encourage creative thinking among students and, in fact, among all readers.
ACKNOWLEDGMENTS
The authors of this book recognize the importance of the Multicultural Competencies and the Advocacy Competencies in helping to pave the way for this new issue, with its clear emphasis on multiculturalism and social justice. We would like to applaud the work of Derald Wing Sue, Patricia Arredondo, and Roderick McDavis, the authors of the Multicultural Competencies, and Thomas Parham, who, as president of the Association for Multicultural Counseling and Development, charged Sue, Arredondo, and McDavis to take on this important task. We would also like to acknowledge Mary Smith Arnold, Reese House, and Rebecca L. Toporek, the co-authors of the ACA Advocacy Competencies, and Jane Goodman, the American Counseling Association president who appointed the Advocacy Competencies Task Force. We also thank Manivong Ratts, who was kind enough to give us permission to use his Advocacy Competencies SelfAssessment Survey. These competency documents have been cited in this book because they have been so important to the efforts of helping professionals like ourselves who value the multicultural and social justice perspectives. We would like to acknowledge the reviewers of previous editions whose wise counsel led us toward significant improvements. Reviewers who helped to guide this edition and gave us permission to acknowledge their work include G. Miguel Arciniega, Arizona State University; Evelyn Biles, Regent University; Nancy G. Calley, University of Detroit, Mercy; Dana Comstock, St. Mary’s University; Jerry Fischer, University of Idaho; Karen Koch, National-Louis University; Christopher Maglio, Truman State University; Shon Smith, Edinboro University of Pennsylvania; and Cirecie West-Olatunji, University of Florida. And finally, we want to recognize our publisher, especially Seth Dobrin and the outstanding staff who supported us in completing this project. We always recommend Brooks/Cole Cengage to talented authors who are looking for excellence in publishing.
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About the Authors
Judith A. Lewis, PhD Dr. Judith A. Lewis retired in 2008 from Governors State University, where she served as Professor and Chair of the Department of Addictions Studies and Behavioral Health. She is a past president of the American Counseling Association and is first author of the ACA Advocacy Competencies. Dr. Lewis is the co-author of several texts for Brooks/Cole Cengage, including Substance Abuse Counseling and Management of Human Service Programs. She received her PhD from the University of Michigan and is a licensed psychologist in Illinois as well as a National Certified Counselor. She is very active in social justice advocacy. Michael D. Lewis, PhD Michael D. Lewis received his master’s degree from Eastern Michigan University in 1964 and his doctorate from the University of Michigan in 1969. His first awareness of the need for a newer approach to counseling rose out of his experience working with children at the Hawthorn Center in Michigan. This awareness increased while he worked as a high school counselor and grew as he became one of the first elementary school counselors in the nation. Teaching the community counseling model during his years as a college professor, he went on to train students throughout the world. He worked for ten years as a consultant for the National Institute for Mental Health, where he advocated for grants to agencies and universities utilizing the community counseling model. He discovered early on that the community holds the keys to both cause and cure. As president of Educational World Charities, he continues to give back through scholarships and grants to programs that advocate prevention, many of them highlighted in this book. Judy Daniels, PhD Judy Daniels is a professor at the University of Hawaii and currently the president of Counselors for Social Justice, a division of the American Counseling Association (ACA). She has been a counselor educator for 20 years. Dr. Daniels has received xvi Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
ABOUT THE AUTHORS
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numerous awards, including several teaching awards at the University of Hawaii, the prestigious Fellow award, and the Wrenn “Counselor of the Year” award from ACA. She uses the community counseling model in her work as a counselor educator, an advocate, and change agent in organizational settings. Michael D’Andrea, PhD Michael D’Andrea is executive director of the National Institute for Multicultural Competence. Michael D’Andrea received his master’s degree in school counseling from Fairfield University in 1975 and his doctoral degree from Vanderbilt University in Human Development Counseling in 1982. He has served as a counselor educator, researcher, theorist, and advocate for more than 35 years. Dr. D’Andrea has used and continues to use the community counseling framework extensively when training graduate students as well as in his counseling practices and organizational development consultation endeavors. Michael has also drawn from the community counseling model when implementing leadership initiatives as the 2009–2010 president of Counselors for Social Justice and the president of the Hawaii Counseling Association (2007–2009), and when holding many other leadership positions in the fields of counseling and psychology.
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CHAPTER 1
Community Counseling for the 21st Century
C
ommunity counselors play a vital role in society, helping countless clients as they try to bridge the gaps between the lives they are currently living and the lives they seek. Sometimes these gaps seem vast and the challenges daunting. Consider the following examples: A counselor who works primarily with Spanish-speaking clients in an urban mental health agency is optimistic about his ability to help his new client, Ramon. Ramon’s mental health concerns have become complicated by a recently developed heroin habit, but he is unequivocally motivated toward change and could benefit from the services provided by the agency’s methadone program. Unfortunately, the methadone program is required to check for United States citizenship, and this young man, who was born in Mexico, is afraid to take the chance of even walking through the door of a program that is located right down the hall. A family counselor has been working with a white middle-class family through the coming-out process of their only child, a fourteen-year-old son. The parents are glad their son trusted them enough to talk with them about his sexual orientation and they want to be supportive. At the same time, they feel very cautious about the family’s privacy and wish that secrecy were 1
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2
CHAPTER
1
possible in their small, conservative town. Now their son, Chris, is having a problem with bullying at his middle school. The teachers and administrators have not been helpful and have suggested that Chris might do well to modify his own behaviors in the direction of masculinity. At this point, the parents’ feelings have begun to change from nervous protectiveness to helpless anger. A counselor is employed at a community mental health agency that bases its services on the recovery model. The counselor is committed to this model, appreciating its emphasis on self-direction and empowerment for people grappling with mental health-related concerns. Sometimes, however, she and her clients feel frustrated at the difficulties faced by people who simply want to participate fully in their communities. Several consumers of the agency’s services have joined together in a peer support group to share their hopes and challenges. Marie, George, and Rachel find that they are all coming up against the same barrier of stigmatization as they seek to meet basic needs like housing, employment, education, and health care. A counselor at a Vet Center in a southern town enjoys helping combat veterans make successful transitions to civilian life. This Vet Center, like hundreds of others, is part of the network of community-based services provided by the United States Department of Veterans Affairs (the VA). One of the counselor’s most difficult challenges is helping veterans deal with problems related to what the VA terms military sexual trauma, which encompasses sexual harassment and sexual assault in military settings. Currently, he is counseling Jeanette, a young white woman who experienced ongoing gender harassment while in the military. Coming from a large family that could not afford higher education, Jeanette had hoped for a military career that would give her opportunities for education and advancement. Her experience of harassment, however, made her feel that her dreams had been unrealistic. Having left the military, she is now having difficulty making a transition to civilian employment. She knows that sexual harassment can happen anywhere, and she can no longer picture herself as a respected member of a workplace team. A community counselor with extensive experience in crisis intervention and disaster response is providing assistance to families whose lives have been disrupted by a tornado that almost destroyed their small Midwestern city. One of these families, the Townsends, felt fortunate at first when they realized that their home had been spared from the worst of the disaster and
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remained habitable. Unfortunately, the garage where Ned Townsend made his living as a mechanic has been destroyed and the owner has decided to close the business and not rebuild. Margaret Townsend’s position as a teacher’s aide does not come close to providing enough income to pay the mortgage on the house. They know that they and their three children will have to give up their home, possibly to live with relatives in another state. Although it might seem obvious that the fault for this crisis is not their own, Ned and Margaret both express a deep sense of shame for having to uproot their children from the lives they knew. A mental health counselor in private practice has as a client an African American woman who has experienced mild depression and anxiety since the birth of her second child. When Carole and her husband, Franklin, were married ten years ago they both had active and stimulating corporate careers. Carole’s career has suffered as she has tried to balance child care and work. At the same time, Franklin’s career has flourished and his current executive job places high demands on his time. He reminds Carole that he is the first African American to reach this level in his company and reminds her that there are people who opposed his promotion. Franklin has been vehement in insisting that Carole stay home after her current maternity leave has ended, saying that once they have paid for child care her salary has no effect on their family income except to put them in a higher tax bracket. Carole wanted her children and enjoys being a parent, but she is surprised—even disappointed—about the direction her life has taken. The clients who serve as our examples differ across a number of variables, including culture, race, gender, sexual orientation, geography, and family dynamics. The concerns they bring to the counseling process vary in kind and in gravity. Yet, these exemplars also share some key commonalities that should not be overlooked. Their commonalities include the following: (a) the things that are most important about each of them include their strengths and resources—not just their problems, (b) the desire for positive change is present in all of them, and (c) many of the barriers that disrupt their development come not from their own characteristics or behaviors but from their environments. Their counselors exhibit variation as well, both in professional settings— from private practice to small agencies to large bureaucracies—and in specialization. But they, too, share a common viewpoint. Experience has taught them to “avoid using the psychological equivalent of a microscope to magnify and define the deficits within their clients” (Lewis, 1997, p. 95). They use, instead, the equivalent of a wide-angle lens.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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21ST-CENTURY COMMUNITY COUNSELING: FUNDAMENTAL ASSUMPTIONS
Twenty-first-century community counseling has moved definitively away from the diagnostic microscopes of a previous era and toward the contextual strategies made possible by the wide-angle lens. This movement reflects more than anything else a major change in the attitude and perspective of the typical counselor and in the profession as a whole. But this change in attitude has practical implications for the day-to-day work of the professional counselor as well. When counselors began to take note of the context within which people live, they also opened their eyes to a host of new ways to help their clients. The fundamental assumptions underlying 21st-century community counseling include the following: 1. Human development and behavior take place in environmental contexts that have the potential to be nurturing or limiting. 2. Even in the face of devastating stress, people who are treated respectfully can demonstrate surprising levels of strength and access resources that a pessimistic helper might not see. 3. Attention to the multicultural nature of human development is a central component of community counseling. 4. Individual development and community development are inextricably linked.
Environmental Contexts
Conyne and Cook (2004) look with a critical eye at what they term the “person-oriented” counseling focus of the past: A client’s behavior (or thinking or feelings) seems to be getting him or her into some type of trouble. The obvious solution is to help the client change this problem so that the difficulties ease. The target of the behavior change process is the client; the problem is some aspect of his or her functioning; the goal of counseling is substitution of a more adaptive way of being. The counselor serves as a remediation expert, skilled at identifying the nature of one’s personal dysfunction and helping the client develop alternatives that are more satisfying (pp. 3–4). Although some counselors remain comfortable with this limited focus (the microscope), “the limitations of the person-focused paradigm have become increasingly obvious in recent years” (Conyne & Cook, 2004, p. 5). Jordan (2010) refers specifically to the devastating impact of oppressive environments in her discussion of the need for a broader perspective: If we constantly work only at the individual level of understanding, we become complicit with the existing forces of disconnection and oppression in the culture. We fail our clients and a society that needs healing as well. (Jordan, 2010, p. 3) Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Jordan emphasizes the fact that her theoretical perspective, RelationalCultural Therapy, remains hopeful even in the face of oppression. “While [Relational-Cultural Therapy] recognizes the power of relationships to violate and hurt, most importantly it recognizes the power of relationships to heal us, to help us grow, to nourish us, to free and empower us” (Jordan, 2010, p. 99). Counseling theories that emphasize the connections between person and environment have become central tenets of 21st-century counseling because the power of the environment to nurture or limit human development has become increasingly clear. People continually interact with their surroundings in ways that help or harm them. As people develop, they rely on their interpersonal environment as a source of learning and support, meeting their needs chiefly through interactions with others. Even so, the environment can also affect them negatively, stunting growth and limiting their development. Because the environment affects people so significantly, counselors who use the 21st-century paradigm realize that attempts to promote their clients’ psychological development without also dealing with their social systems are often ineffective. Environmental factors clearly contribute to the development of almost any kind of problem a client may face. Sometimes the connection between such factors and an individual’s personal problems is clearly definable. For instance, political policies may place unnecessary barriers between individuals and their goals. (This happened in the case of our earlier example, Ramon, who was actually barred from the help he needed for his heroin problem because of harsh immigration-related policies.) Clear connections between the environment and personal problems are also present when racism or sexism denies people career options, as happened overtly with the military veteran, Jeanette, and more subtly with Carole, whose challenges involve conflicts between career and parenthood that her husband is spared. When an ex-offender or a person with chronic mental health problems cannot gain free entry into the mainstream, as happened with Marie, George, and Rachel, the connection between marginalization and individual harm is undeniable. Sometimes clients develop in a psychologically noxious environment; when counselors focus only on their clients’ personal attributes (such as depression, apathy, and anger), they inadvertently undermine their clients’ sense of personal power. Without the support to deal with and change environmental conditions that negatively impact their lives, clients usually feel increasingly powerless, lack a sense of purpose in counseling, and continue to feel trapped in highly restricted roles and unrewarding relationships. Although the environment can work against an individual’s growth, it can just as surely aid personal development. In this regard, people vary in their ability to cope with life’s stresses. At least some of this variation proceeds from differences in the degree and type of social support available to them. An actively supportive environment tends to foster healthy development. Because the environment affects people in so many ways—both negative and positive—counselors do well when they focus on both individual and community empowerment. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Client Strengths and Resources
At least since the time of Aristotle, scholars, philosophers, and religious leaders have pondered the question “How can we become lastingly happier?” Yet until recently, the only guiding question in clinical psychology and psychiatry has been “How can we reduce suffering?” (Seligman, Steen, Park, & Peterson, 2005, p. 420) At times in the history of the counseling profession, counselors also lost sight of their clients’ strengths, resources, and potential for happiness and focused their microscopes narrowly on the internal sources of suffering. This emphasis on the negative often had the unintended consequence of increasing a client’s pessimism and decreasing his or her sense of self-efficacy. Now the trend has clearly turned in a new direction. Seligman et al. (2005) point out that “psychotherapy has long been where you go to talk about your troubles,” and suggest that “the psychotherapy of the future may also be where you go to talk about your strengths” (p. 421). For community counseling, this positive future may well have arrived. Helping clients recognize and build on their strengths and resources is a central tenet of the community counseling approach. Use of a narrow and negative focus on problems has been particularly devastating for clients who are marginalized and stigmatized because of the particular challenges they face in their lives. The people who are most in need of a respectful and optimistic approach are the ones who have been most likely to receive the opposite! Consider, for example, two groups that share the characteristics of marginalization and stigmatization: clients dealing with long-term mental health concerns and clients dealing with the effects of substance abuse. For both of these populations, the judgmental approaches of the past are giving way to respectful approaches that emphasize empowerment and self-direction. Mental Health. Marie, George, and Rachel, who served as examples at the opening of this chapter, find it difficult to get people to see beyond their personal histories. They want to have useful roles in their community, but come up against prejudice and stereotyping when they try to meet such basic needs as housing and employment. Fortunately, the mental health agency that provides them with ongoing support and treatment, as needed, is based on a model that reinforces consumers’ strengths and resources.
The recovery model emphasizes that responsibility and control of the recovery process must be given in large part to the person who has the condition.… Mental health interventions are designed to be empowering, enabling the persons themselves to take responsibility for decisions about their lives. (Frese, Stanley, Kress, & Vogel-Scibilia, 2003, p. 22) The components of the recovery model include the following (Substance Abuse and Mental Health Services Administration, 2004): Self-direction Individualized and person-centered Empowerment Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Holistic Non-linear Strengths-based Peer support Respect Responsibility Hope With these components in place, “mental health recovery not only benefits individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life” (Substance Abuse and Mental Health Services Administration, 2004, p. 2). Substance Abuse. People grappling with substance abuse also find it difficult to be accepted as valuable members of their communities. This predicament has often been exacerbated by the fact that even professional helpers may assume that the respect accorded other clients should be withheld for clients whose presenting issues relate to drug or alcohol use.
In the field of substance abuse, a set of myths has been disseminated throughout the United States. This mythology as a whole is built on the premise that people who are grappling with issues related to addictions or substance abuse somehow belong in a different category of species from other human beings. The implication of the myths is that the collaborative partnerships that counselors like to build with their students and clients must suddenly be put aside when alcohol or other drugs find their way into the conversation. The stereotype about how substance abuse counselors must operate has become a self-propelling “conventional wisdom” that inspires avid belief with no basis in fact. (Lewis & Elder, 2010, p. 161) This “conventional wisdom” has been largely discredited, as it has become apparent that a respectful and collaborative approach to substance abuse counseling is, in fact, an evidence-based practice. A counselor who has a respectful attitude toward people grappling with addiction recognizes that clients hold the ultimate responsibility for their own recovery. Encouraging clients to accept this challenge is not just humane; it is also empirically supported. (Lewis, Dana, & Blevins, 2011 p. 7) It has long been known that “people’s belief that they can motivate themselves and regulate their own behavior plays a crucial role in whether they even consider changing detrimental health habits or pursuing rehabilitative activities” (Bandura, 1997, p. 119). In recent years, a solid body of research support has also been built around Motivational Interviewing (Miller & Rollnick, 2002; Hettema, Steele, & Miller, 2005; Rubak, Sandboek, Lauritzen, & Christensen, 2005). The spirit of this approach to helping “arises from the basic idea that the motivation for change comes from within the client and is elicited by a skilled Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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and supportive interviewer who recognizes that the client holds the decisionmaking power for his or her own life” (Lewis, Dana, & Blevins, 2011, p. 7). Hope. Counselors who recognize their clients’ strengths and respect their potential for self-direction can nurture optimism in people who have long since abandoned hope. Ongoing problems frequently lead to an erosion of a client’s hope for a better future. Because the absence of such hopefulness compromises one’s psychological health and well-being in many ways, the community counseling model emphasizes that counselors serve a crucial function in promoting hopefulness among their clients. Hopefulness refers to an inner anticipation of new potentials and a greater sense of satisfaction and connection with life. It fuels the belief that though we are who we are at the present time, we are also capable of developing new insights, new skills, and new interpersonal connections that will bring about a greater sense of personal well-being. Multiculturalism
Sue (2006, p. 16) quotes a traditional Asian saying: “All individuals, in many respects, are (a) like no other individuals, (b) like some individuals, and (c) like all other individuals.” The tripartite framework (Sue, 2001) reflects these three levels of personal identity. At the individual level, a person is identified in terms of his or her unique qualities. The group level of identity reflects the cultural groups that affect a person’s worldview and, at the same time, reflect the way the individual may be viewed by society. The universal level of identity recognizes the common human characteristics and experiences that cross all boundaries. In general, people—even helping professionals—tend to feel comfortable with thinking about the uniqueness of an individual or the universality of human nature. They feel less comfortable with the complexities of the group level of identity. Focusing on the group level, Sue cites a number of variables that relate to human similarities and differences, including race, sexual orientation, marital status, religious preference, culture, disabilities/abilities, ethnicities, geographic location, age, socioeconomic status, and gender. Any one individual has multiple cultural identities, some of which, such as marital status or geographic location, may be changeable while others are assumed to be permanent. At any given moment in a person’s life, one or more of his or her group identifiers may gain special importance. For Margaret and Ned Townsend, the couple whose lives were changed by the tornado that hit their town, geographic location and socioeconomic status gained a central place in their lives that might not be permanent. For Jeanette, the veteran who had been subjected to sexual harassment, the financial problems that had been fundamental to her enlistment ceded centrality to gender identification. The practice of competent counseling necessitates that counselors understand the complexities of culture and group identity as their clients experience them. Remaining “uncomfortable” with any level of identity is not an option. In fact, community counselors who are steeped in multiculturalism take a further step beyond understanding to action. It is a short step from becoming aware of the impact of the cultural milieu to noticing the role of oppression in our clients’ lives. Once we begin to Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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notice systemic oppression, it is just one more short step to accepting our responsibility for social action. (Lewis & Arnold, 1998, p. 51) The Link between Individual and Community Development
As counselors attempt to respond to the needs of community members, especially the most vulnerable people, the need to negotiate environmental changes becomes apparent. Their work brings counselors face to face with the victims of poverty, racism, sexism, and stigmatization; with political, economic, and social systems that leave individuals feeling powerless; with governing bodies that deny their responsibility to respond; with social norms that encourage isolation. In the face of these realities, counselors have no choice but to promote positive changes in the systems that affect the well-being of their clients. Community counselors know that human beings constantly interact with their surroundings and that these interactions influence their development. The reason counselors have this knowledge is their direct experience. In our work with students and clients we see firsthand the impact of detrimental environments on vulnerable individuals. We are often the first to notice a systemic problem because we see its effects. Once we do take note of a problem, we have human-development knowledge to share with the public and human-relations skills to work with others toward common solutions. (Lewis, Toporek, & Ratts, 2010, p. 241) In fact, the connection between the counselor as direct-service provider and the counselor as social-change agent mirrors the connection between individual and community development. “The empathy of the counselor and the courage of the advocate” (Lewis, Toporek, & Ratts, in press) are inextricably linked. In terms of the counseling profession, the concept of advocacy has been defined as “action taken by a counseling professional to facilitate the removal of external and institutional barriers to clients’ well-being” (Toporek & Liu, 2001, p. 387). In addition to confronting unhealthy aspects of the environment, however, community counselors also recognize the potential for healing that healthy environments provide. For this reason, counselors work to facilitate both healthy human development and healthy community development.
COMMUNITY COUNSELING DEFINED
The fundamental assumptions that underlie community counseling lead in the direction of a multifaceted approach to helping. The model of community counseling that is explored in this book can be defined as follows: Community counseling is a comprehensive helping framework that is grounded in multicultural competence and oriented toward social justice. Because human behavior is powerfully affected by context, community counselors use strategies that facilitate the healthy development both of their clients and of the communities that nourish them. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Because this definition imparts the central theme of the book and lays the groundwork for discussion of practice strategies, we will provide more detailed explanations of each of the definition’s primary components. The following sections provide detailed definitions of (a) community, (b) multicultural competence, (c) social justice, and (d) healthy development of clients and communities. Community
The word community means different things to different people. To some it may refer to people living in a specific geographic area (e.g., a rural versus an urban community). To others it may mean a group of people related by their unique cultural, ethnic, or racial background, such as the Asian American community. Still others may use the term to refer to the interdependence each has to one another as members of a much broader “global community.” In this book, we refer to community as “a group or gathering of people who share common interests and needs” (Paisley, 1996). When we refer to communities as systems we mean that they have unity, continuity, and predictability. Individuals, groups, and organizations that compose a community are interdependent. Communities also link individuals to other communities, including the greater society. Thus, communities serve as a medium through which individuals can act on the world and through which society as a whole transmits norms. Under this working definition, families and neighborhoods can be communities, as can a school, a hospital, or a corporation. Accordingly, an individual may belong to more than one community at a time. Also, communities have such presence and power that anyone working with individuals as a helper must, at some point, examine how they are affected by the various communities of which they are a part. We purposely chose a general definition of the term community because we intend it to include a wide range of human collectives—from families and schools to larger communities, such as gay, lesbian, bisexual, and transgender groups, and further to much larger and more complex sociopolitical systems, such as the North American community. Because this definition implies that community members have both a direct and an indirect impact on one another, human connections and interdependence serve as important concepts on which we base the community counseling model. Dr. Martin Luther King (1963) insisted that developing a healthy and respectful sense of interdependence as members of a national and world community was the single most important challenge of his time. Although he presented this message decades ago, we believe that Dr. King’s insight applies directly to counselors today as they seek new ways to address the mental health needs of the 21st century. We hope that counselors will find the community counseling model helpful as they strive to foster the mental health of clients as well as to promote more tolerant, responsive, and caring communities. To do so, mental health practitioners must acquire the types of multicultural competencies that are necessary to work effectively, ethically, and respectfully with persons who come from diverse groups and backgrounds. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Multicultural Competence
The multicultural counseling movement represents a revolutionary force that has clearly taken center stage in the counseling profession. This force is forging a paradigm shift in which culturally biased constructions of such fundamental concepts as mental health, psychological maturity, human development, psychological disorder, and appropriate helping strategies are being expanded to include more culturally respectful and responsive ways of thinking. (Cartwright, Daniels, & Zhang, 2008, p. 318) A sizable portion of this momentum toward multiculturalism can be attributed to the multicultural counseling competencies that were first published in 1992 (Sue, Arredondo, & McDavis, 1992). The authors of the competencies, Derald Wing Sue, Patricia Arredondo, and Roderick McDavis, developed the competency document in response to a charge from the Association for Multicultural Counseling and Development (AMCD). The quality and importance of the document were quickly recognized, leading to its concurrent publication by both AMCD and the American Counseling Association. Over the decades since their introduction to the profession, the Multicultural Counseling Competencies (see Appendix A) have proven successful in disseminating the idea that counseling competency without multicultural competency is impossible. The competency document is organized around three major areas: (1) counselor awareness of own cultural values and biases, (2) counselor awareness of client’s worldview, and (3) culturally appropriate intervention strategies. Within each of these sections, the competencies are listed under the categories of (a) attitudes and beliefs, (b) knowledge, and (c) skills. It is important to note that the first section highlights the importance of the counselor’s awareness of his or her own cultural values and biases. The quest for competency is an ongoing process that begins with self-interrogation and never stops. Sue and Sue (2002) provide the following definition of the culturally competent helping professional: First, a culturally competent helping professional is one who is actively in the process of becoming aware of his or her own assumptions about human behavior, values, biases, preconceived notions, personal limitations, and so forth. Second, a culturally competent helping professional is one who actively attempts to understand the worldview of his or her culturally different client…Third, a culturally competent helping professional is one who is in the process of actively developing and practicing appropriate, relevant, and sensitive intervention strategies and skills in working with his or her culturally different client. Sue and Sue go on to point out that “these three goals make it clear that cultural competence is an active, developmental, and ongoing process and that it is aspirational rather than achieved.” Multicultural competence is in fact a living, growing concept. Proof of this notion can be found in the degree to which proponents of multicultural Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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counseling have expanded the boundaries of multiculturalism to attend to sociopolitical change (Arredondo, Tovar-Blank, & Parham, 2008) and find common cause with social justice counseling (Crethar, Torres Rivera, & Nash, 2008). Social Justice
What do we mean when we say that community counseling is oriented toward social justice? Because community counselors use the wide-angle lens to view their clients in context, they have every reason to know that their clients need and deserve a just and equitable community environment. Social justice involves promoting access and equity to ensure full participation in the life of a society, particularly for those who have been systematically excluded on the basis of race/ethnicity, gender, age, physical or mental disability, education, sexual orientation, socioeconomic status, or other characteristics of background or group membership. Social justice is based on a belief that all people have a right to equitable treatment, support for their human rights, and a fair allocation of societal resources. (Lee, 2007, p. 1) When community counselors become aware that their clients are denied these rights, they know that the time has come for environmental intervention in the form of social justice advocacy. For counselors, guidance in selecting and carrying out environmental interventions is provided by the American Counseling Association (ACA) Advocacy Competencies (Lewis, Arnold, House, & Toporek, 2002). The Advocacy Competencies (see Appendix B) are organized around three intervention levels: the client or student, the community or school, and the broader public arena. At each level of intervention, competencies for bringing about change are outlined. At the level of the individual client, the competencies are categorized as client empowerment and client advocacy. At the level of the community, the competencies are focused on community collaboration and systems change. Finally, in the broader public arena, counselors carry out public-information programs and social/political advocacy. The ACA Advocacy Competencies provide a vehicle for counselors to bring about change, whether the immediate task involves an opportunity to create positive change or the need to redress an injustice. Levy and Sidel (2006) provide an interesting set of definitions for social injustice. They define social injustice first as “the denial or violation of economic, socio-cultural, political, civil, or human rights of specific populations or groups in the society based on the perception of their inferiority by those with more power or influence.” This definition of course represents the polar opposite of the typical definitions of justice. Their second definition of social injustice, however, takes the discussion in a new direction. This second definition of social injustice refers to policies or actions that adversely affect the societal conditions in which people can be healthy. Although this type of social injustice is more communitywide, nationwide, or even global, the populations described in our first definition of Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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social injustice—especially the poor, the homeless, the ill or injured, the very young, and the very old—usually suffer more than others in the population as a result of these policies and actions. (Levy & Sidel, 2006) This second definition of social injustice is relevant to our discussion of the community counselor’s role in facilitating human and community development. What the community counselor hopes to accomplish in facilitating community development is to create communities that make healthy human development possible. Healthy Development of Clients and Communities
The question of what constitutes healthy human development is complicated at best. Traditional theories of human development that were prominent throughout the 20th century emphasized development in the direction of individual autonomy. These theories and their utility for counseling and therapy are now being called into question. Relational-Cultural Therapy (RCT), for instance, “challenges not only the prevailing developmental theories, which frame independence as the hallmark of mature development, but some of the basic tenets of 21st century culture, which celebrates autonomy, self-interest, competition, and strength in isolation” (Jordan, 2010, pp. 1–2). RCT criticizes individualistic human development tenets because they suggest as ideal the state of isolation, which is actually a source of suffering, rather than connection, which is a source of growth. The autonomy-focused ideology has also been reproached as a basis for counseling because it is based on a narrow, Euro-American view of the human experience that is not shared across cultures (Sue & Sue, 2002). Many counselors have inadvertently damaged their clients by emphasizing individuation at the expense of interdependence. Consider, for instance, the commonly held view that the important tasks of adolescence include separating from the family of origin and gaining an independent self-identity.… Placing a premium on the adolescent’s attainment of individualism and independence reflects a value that is central to the dominant culture in the United States but that is not shared by all ethnic groups … helpers who overemphasize the goal of personal autonomy may inadvertently be imposing definitions of normality that are at odds with a client’s culture. (Lewis, 2007, p. 4) Community counselors need a broader perspective on what constitutes healthy human development. The following definition of human development comes from the Human Development Reports, which fall under the auspices of the United Nations Development Programme. Human development is a process of enlarging people’s choices. Enlarging people’s choices is achieved by expanding human capabilities and functioning. At all levels of development the three essential capabilities for human development are for people to lead long and healthy lives, to be Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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knowledgeable and to have a decent standard of living. If these basic capabilities are not achieved, many choices are simply not available and many opportunities remain inaccessible. But the realm of human development goes further: essential areas of choice, highly valued by people, range from political, economic and social opportunities for being creative and productive to enjoying self-respect, empowerment and a sense of belonging to a community. (Human Development Reports, nd) This conceptualization of human development provides a comfortable fit for counselors due to its emphasis on expanding people’s choices and building capabilities. The fit with the community counseling model is especially strong because stress is placed on empowerment and the sense of belonging within community. In work that is complementary to the direction taken by the Human Development Reports, Nussbaum (1999) lays out the capabilities that should be available to all human beings. These capabilities include life; bodily health; bodily integrity; senses, imagination, and thought supported by freedom of expression; emotions, including attachments to things and persons outside ourselves; practical reason; affiliation; concern for other species; play; and control over one’s environment. Nussbaum believes that human beings, by their very nature, possess basic capabilities that can develop into the high-level capabilities that appear on her list. Human capabilities exert a moral claim that they should be developed.… When these capabilities are deprived of the nourishment that would transform them into the high-level capabilities that figure on my list, they are fruitless, cut off, in some way but a shadow of themselves. They are like actors who never get to go on the stage, or a person who sleeps all through life, or a musical score that is never performed. (Nussbaum, 1999, p. 43) Nussbaum’s thoughts help to shed light on the role of the community counselor. Effective counselors believe that all their clients have the potential for growth in the direction of complex and fulfilling lives. These counselors have always known that they can best facilitate this growth through respectful, positive, and empowering relationships and methods. What the community counseling model offers is an expansion of these basic assumptions. The client’s progress depends not just on the excellence of the direct service the counselor provides but also on the sustenance provided by the larger community environment. Nussbaum explains—and the community counselor understands—that the difference between the person who sleeps through life and the one who is zestful and awake depends on the ability of the community to provide sufficient nourishment and support.
COMMUNITY COUNSELING STRATEGIES
Because they hold the assumption that individual development and community development are inextricably linked, community counselors acknowledge that their professional responsibilities include both serving their clients directly and Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
COMMUNITY COUNSELING FOR THE 21ST CENTURY
T A B L E 1.1
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The Community Counseling Model FACILITATING HUMAN DEVELOPMENT
FACILITATING COMMUNITY DEVELOPMENT
Focused Strategies
Counseling in Context Outreach to Distressed and Marginalized Clients
Client Advocacy Community Collaboration
Broad-Based Strategies
Developmental/Preventive Interventions
Social/Political Advocacy for Macro-Level Change
working to build nurturing environments. The counselor’s role, then, includes strategies that facilitate human development and strategies that facilitate community development. Across both of these two categories, the counselor uses focused strategies that address the needs of particular individuals or groups and broad-based strategies that affect the general population. The four quadrants of the community counseling model are shown in Table 1.1. The comprehensive nature of the community counseling model affects both the way programs are designed and the way individual counselors assist their clients. Community counseling programs are planned so that interventions are offered in each of the model’s facets. Community counselors, no matter where they might be employed, move comfortably across the four quadrants, demonstrating the characteristics of optimism, activism, and vision that give the community counseling model its zest. Facilitating Human Development: Focused Strategies
The fact that 21st-century counselors pay heed to the community environment does not mean that they reject the role of providing direct, person-to-person services that make full use of their helping skills. It does mean, however, that the way they ply their skills should reflect their awareness of context. There needs to be an unbroken line between counseling and advocacy strategies. That line abruptly breaks when a therapeutic approach involves diagnosing deficits and focusing attention solely on intra-psychic phenomena. Counselors can find a sense of wholeness in their work only if the theoretical perspectives that inform their direct counseling are broad enough to encompass a variety of roles. (Lewis, Toporek, & Ratts, 2010, p. 241) In order to find that sense of wholeness, community counselors tend to use contextual and strengths-based perspectives that serve them well in the counseling office and also adapt well across all facets of their work. Focused strategies for facilitating human development include not only office-based counseling but outreach activities as well. Community counselors know that people go through times in their lives when they confront powerful stressors. The sources of their distress may originate in crisis situations or in ongoing experiences of oppression or marginalization. In either case, counselors use Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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active outreach methods to make sure that individuals and groups in distress have access to supportive and empowering assistance. Consider the situation of Ned and Margaret Townsend, whose lives were turned upside down when a tornado destroyed the garage where Ned made his living. It was important that the family have access to crisis counseling services like the ones provided by their community counselor. Individual Crisis Counseling Services assist disaster survivors in understanding their current situation and reactions, reviewing their options, addressing their emotional support and linking with other individuals and agencies who may assist them. During individual services, crisis counseling staff are active listeners who provide emotional support. (Substance Abuse and Mental Health Services Administration [SAMHSA, nd]) This is precisely the kind of help that the Townsend family needed, but they might not have sought out assistance of any kind if they had not been the recipients of active outreach efforts. As SAMHSA states, “Crisis counselors take services into the communities rather than wait for survivors to seek them out.” In an ideal situation, person-to-person outreach is joined by educational efforts that help individuals and communities understand their new challenges and learn the skills they will need for dealing with them. These educational efforts can strengthen people’s ability to deal with stressors and, in some cases, prevent long-lasting effects on mental health.
Facilitating Human Development: Broad-Based Strategies
Developmental/preventive interventions allow community counselors to educate or train members of the population at large. Sometimes, as in the case of disaster relief in Ned and Margaret’s town, a particular situation provides a teachable moment when training in specific coping mechanisms meets an immediate community need. Just as often, these educational interventions are entirely developmental and preventive in that they are offered to community members who do not necessarily see themselves as having “problems” of any kind. The purpose of such broad-based strategies for facilitating human development is to help community members gain new knowledge and skills that are useful in dealing with the as-yet-unknown challenges that they are likely to encounter in their lives. Participants increase their awareness of potential life challenges and develop skills that can help them deal with these challenges more competently. Such programs may run the gamut from values-clarification seminars to assertiveness training, from courses in decision making and life planning to workshops in cross-cultural understanding, from relaxation training to cross-cultural activities. The possibilities are endless. For each of these and many other programs, counselors have developed techniques, concepts, and even course outlines. The simple challenge for practitioners is to implement these programs, techniques, and concepts among a broad range of people. By using preventive educational
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programs such as these, counselors can help people experience their own competence. Counselors and community members alike come to recognize that effective life skills serve to prevent a variety of problems. The emphasis on prevention makes community counseling highly active. One should not wait passively for the next task, the next problem, or the next crisis to appear. Instead, practitioners continually look for situations in which they can help, planning and initiating new programs to meet the needs of clients and their communities. This emphasis on prevention also makes the community counseling model a more viable and relevant framework than the traditional direct-counseling-only paradigm for working with people who are uncomfortable with or distrustful of the counseling experience. Facilitating Community Development: Focused Strategies
In many situations, the counselor’s empowerment-focused approach is all that is needed to prepare clients to be their own self-advocates. Often, however, individual clients or families need additional voices to speak up on their behalf. Advocacy is integral to the counseling process. When counselors become aware of external factors that act as barriers to an individual’s development, they may choose to respond through advocacy. The client/student advocate role is especially significant when individuals or vulnerable groups lack access to sorely needed services. (Lewis et al., 2002) The Townsend family again provides an example of a case in which the complexity involved in accessing services might necessitate additional help. The barriers between the Townsends and their well-being might be too high to be surmounted without assistance. The family needed social, economic, career, educational, and crisis services at the precise time that the community service network was likely to be stretched beyond normal capacity. The counselor’s role in that case would include identifying scarce resources and negotiating services on the family’s behalf. Of course, the barriers confronting the Townsend family would not be unique to them. The counselor would take note of the fact that similar community-based barriers affected any number of individuals and families. When counselors identify systemic factors that act as barriers to their students’ or clients’ development, they often wish that they could change the environment and prevent some of the problems that they see every day. Counselors who view themselves as change agents and who understand systemic change principles are able to make this wish a reality. (Lewis et al., 2002) In their role of facilitating community development, counselors identify factors that negatively affect their clients’ development and take action—often in collaboration with others—to bring about necessary changes. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Facilitating Community Development: Broad-Based Strategies
The community counselor’s experience in advocacy within the immediate community that affects his or her clients is often a step toward recognizing that advocacy at a broader level is necessary. Counselors regularly act as change agents in the systems that affect their own students and clients most directly. This experience often leads toward the recognition that some of the concerns they have addressed affect people in a much larger arena. When this happens, counselors use their skills to carry out social/political advocacy. (Lewis et al., 2002) Competencies in the broader public arena focus on the counselor’s ability to “distinguish those problems that can best be resolved through social/political action” and “identify the appropriate mechanisms and avenues for addressing these problems” (Lewis et al., 2002). Community counselors may be uniquely qualified to recognize and act on the need for change. First, the practice of counseling makes counselors particularly sensitive to environmental problems that affect human development. Second, the nature of the counseling profession itself means that counselors possess the requisite knowledge and skills to communicate about the need for change and to embark on collaborative actions. Our vision of advocacy must expand so that we see as part of our domain the act of influencing policy on a broader stage. This change in vision will help us become more actively involved in advocating for the kinds of social, political, and economic changes that tend to counter oppression in all its forms. (Lewis & Arnold, 1998, p. 61) A Unified Approach
The community counseling model has both programmatic and professional implications. In terms of program, the model suggests that services should be offered across all four of the quadrants presented in the Community Counseling Table. In professional terms, the model suggests that the community counselor should be prepared to view his or her role as broad and multifaceted. By combining the four components of community counseling into a unified framework, counselors can begin to conceptualize the types of intervention strategies likely to have the greatest impact on the largest number of clients. When using the community counseling model, counselors need not choose between helping individuals or acting as agents of social change. The skills involved in facilitating human development and facilitating community development complement each other. In addition to being programmatic, the community counseling model asks counselors to develop a more complex set of competencies than what would
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be needed if their roles were limited to direct, one-to-one services inside the walls of a small office. But counselors can take heart from the fact that the multifaceted nature of community counselors does not require piling on new responsibilities. Rather, their responsibilities to client and community are woven from the same cloth. Their counseling makes them better advocates; their advocacy makes them better counselors.
SUMMARY
The fundamental assumptions underlying the practice of 21st-century community counseling include the following: (1) human development and behavior take place in environmental contexts that have the potential to be nurturing or limiting; (2) even in the face of devastating stress, people who are treated respectfully can demonstrate surprising levels of strength and access resources that a pessimistic helper might not see; (3) attention to the multicultural nature of human development is a central component of community counseling; and (4) individual development and community development are inextricably linked. These assumptions lead toward a comprehensive and multifaceted definition of the community counselor’s role. Community counseling is a comprehensive helping framework that is grounded in multicultural competence and oriented toward social justice. Because human behavior is powerfully affected by context, community counselors use strategies that facilitate the healthy development both of their clients and of the communities that nourish them. Fidelity to this definition entails a community counseling program based both on facilitating human development (providing direct interventions with clients and community members) and facilitating community development (using advocacy interventions to build positive environments and break down external barriers to client well-being). Each of these two areas of emphasis includes focused strategies, which are designed to meet the needs of particular individuals or groups, and broad-based strategies, which are more developmental and preventive in nature. The community counseling model has not only programmatic implications but also professional implications for competent counseling practice. The competencies required for effective community counseling go beyond the more limited skills that would be needed if the definition of the counseling role were constrained by a narrow definition of the counselor solely as deliverer of direct services to one client at a time. The role of the 21st-century community counselor goes beyond the four walls of a traditional office but, fortunately, the work contained in the four quadrants of the community counseling model is highly complementary. Among effective practitioners of community counseling, this can be said: their counseling makes them better advocates; their advocacy makes them better counselors.
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EXHIBIT 1.1 Competency-Building Activity
Evaluating Real-Life Programs When using the community counseling framework, it is important that counselors are able to evaluate the degree to which a particular program is providing comprehensive services. Visit a local community agency. Using the community counseling model as a tool, take a few minutes to answer the following evaluation questions: What kinds of focused strategies are used to facilitate human development? What kinds of broad-based strategies are used to facilitate human development? What kinds of focused strategies are used to facilitate community development? What kinds of broad-based strategies are used to facilitate community development?
1. In what ways does the program address the unique cultural, ethnic, and/or racial backgrounds of the clients?
EXHIBIT 1.2 Competency-Building Activity
Program Development The community counseling framework emphasizes a comprehensive approach. This competency-building activity is designed to help you carry out program planning for clients/community members who come from particular groups in our society. With this background in mind, think about a particular group or population. What social, economic, political, or psychological pressures affect the well-being of this population? Taking these factors into account, develop some ideas for appropriate services for the population you have selected. You will probably notice that direct counseling services alone are unlikely to meet the group’s needs! Beginning with a clear statement of your goals, lay out your general ideas for what kinds of services should be included if you were designing a community counseling program for this population. Be sure to pay attention to each of the four quadrants in the community counseling framework, but you can keep your ideas fairly general for now. As you read later chapters, you will be able to develop your ideas for more specific strategies.
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REFERENCES Arredondo, P., Tovar-Blank, Z. G., & Parham, T. A. (2008). Challenges and promises of becoming a culturally competent counselor in a sociopolitical era of change and empowerment. Journal of Counseling and Development, 86, 261–268. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman. Cartwright, B. Y., Daniels, J., & Zhang, S. (2008). Assessing multicultural competence: Perceived versus demonstrated performance. Journal of Counseling and Development, 8, 318–322. Conyne, R. K., & Cook, E. P. (Eds.). (2004). Ecological counseling: An innovative approach to conceptualizing person-environment interaction. Alexandria, VA: American Counseling Association. Crethar, H. C., Torres Rivera, E., & Nash, S. (2008). In search of common threads: Linking multicultural, feminist, and social justice counseling paradigms. Journal of Counseling and Development, 86, 269–278. Frese, J., Stanley, J., Kress, K., & Vogel-Scibilia, S. (2003). Integrating evidence-based practice and the recovery model. In R. Drake & H. H. Goldman (Eds.), Evidencebased practices in mental health care (pp. 21–28). Washington, DC: American Psychiatric Association. Hettema, J., Steele, J., & Miller, W. R. (2005, April). Motivational interviewing. Annual Review of Clinical Psychology, I, 91–111. Human Development Reports (nd). Glossary of terms. Retrieved March 9, 2010, from http://hdr.undp.org/en/humandev/glossary/. Jordan, J. V. (2010). Relational-cultural therapy. Washington, DC: American Psychological Association. King, M. L. (1963). Strength to love. New York: Walker. Lee, C. C. (2007). Social justice: A moral imperative for counselors. (ACAPCD-07). Alexandria, VA: American Counseling Association. Levy, B., & Sidel, V. (2006). Social injustice and public health. Oxford: Oxford University Press. Lewis, J. A. (2007). Challenging sexism: Promoting the rights of women in contemporary society. In C. C. Lee (Ed.), Counseling for social justice (2nd ed., pp. 95–110). Alexandria, VA: American Counseling Association. Lewis, J. A., & Arnold, M. S. (1998). From multiculturalism to social action. In C. C. Lee & G. R. Walz (Eds.), Social action: A mandate for counselors (pp. 51–64). Alexandria, VA: American Counseling Association and Educational Resources Information Center Counseling and Student Services Clearinghouse. Lewis, J. A., Arnold, M. S., House, R., & Toporek, R. L. (2002) ACA advocacy competencies. Retrieved February 3, 2009, from http://wwwcounseling.org/ Publications. Lewis, J. A., Dana, R. Q., & Blevins, G. A. (2011). Substance abuse counseling (4th ed.). Belmont, CA: Brooks/Cole, Cengage Learning. Lewis, J. A., & Elder, J. (2010). Substance abuse counseling and social justice advocacy. In M. Ratts, R. Toporek, & J. Lewis (Eds.), ACA advocacy competencies: A social justice framework for counselors (pp. 161–172). Alexandria, VA: American Counseling Association.
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Lewis, J. A., Toporek, R. L., & Ratts, M. (2010). Advocacy and social justice: Entering the mainstream of the counseling profession. In M. Ratts, R. Toporek, & J. Lewis (Eds.), ACA Advocacy Competencies: A social justice framework for counselors (pp. 239–244). Alexandria, VA: American Counseling Association. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press. Nussbaum, M. C. (1999). Sex and social justice. New York: Oxford University Press. Paisley, P. O. (1996, January). Creating community: Group work and the arts. Presentation made at the annual meeting of the Association for Specialists in Group Work, Athens, GA. Rubak, S., Sandboek, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: A systematic review and meta-analysis. British Journal of General Practice, 55(513), 305–312. Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60(5), 410–421. DOI: 10. 1037/0003-66x.60.5.410. Substance Abuse and Mental Health Services Administration (nd). Federal Emergency Management Agency crisis counseling assistance and training program guidance. Retrieved 12/19/09 from http://download.ncadi.samhsa.gov/ken/pdf/cmhs/CCP_Program_ Guidance_ver1.1.pdf. Substance Abuse and Mental Health Services Administration. (2004). National consensus statement on mental health recovery. Retrieved 11/27/09 from http://download.ncadi .samhsa.gov/ken/pdf/SMA05-4129/trifold.pdf. Sue, D. W. (2001). Multidimensional facets of cultural competency. The Counseling Psychologist, 29, 790–827. Sue, D. W. (2006). Multicultural social work practice. Hoboken, NJ: John Wiley & Sons. Sue, D. W., Arredondo, P., & McDavis, R. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70, 447–486. Sue, D. W., & Sue, D. (2002). Counseling the culturally diverse. Hoboken, NJ: John Wiley & Sons. Toporek, R. L., Lewis, J. A., & Crethar, H. C. (2009). Promoting systemic change through the ACA advocacy competencies. Journal of Counseling and Development, 87, 260–268. Toporek, R. L., & Liu, W. M. (2001). Advocacy in counseling: Addressing race, class, and gender oppression. In D. B. Pope-Davis & H. L. K. Coleman (Eds.), The intersection of race, class, and gender in multicultural counseling (pp. 285–413). Thousand Oaks, CA: Sage.
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CHAPTER 2
The Evolution of the Community Counseling Model
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hapter 1 outlines fundamental assumptions and concepts upon which the community counseling model is built. It also discusses a broad range of intervention strategies counselors can use to promote healthy human development when implementing this theoretical model in their work. Among this helping model’s distinguishing features include the recognition that clients’ environmental contexts often perpetuate different forms of injustice, oppression, and stressors that negatively impact people’s mental health and psychological well-being. As stated in Chapter 1, practitioners operating from the community counseling model instill hope by supporting their clients’ empowerment potential and promoting a greater level of social justice in the environments where their clients live and work. Upon reading Chapter 1, some individuals may think that this model represents a new, more expansive, and very different way of thinking about the professional counselor’s role and functions. However, a close examination of the history of the counseling profession indicates that many people in the field have promoted similar changes among individual clients and the social contexts in which their clients were situated for more than 100 years. Besides being rooted in a long history of helping services provided by many counselors over an extended period of time, it is important to point out that the 23 Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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application of the community counseling model is not limited to community agency settings. On the contrary, the community counseling model’s multifaceted framework has been used in different ways by counselors working in a broad range of settings. This includes using various aspects of the community counseling framework in schools, universities, career counseling agencies, rehabilitation agencies, community mental health centers, and other public- and private-funded mental health care organizations across the United States. Thus, rather than viewing the community counseling theory as a new framework that is relevant for a single work setting, it is important to view this helping system as being comprehensive in its perspective, application, and history. Its perspective is grounded in a broad range of human development, psychological, and multicultural counseling theories. Its application includes numerous interventions that build on people’s intrapsychic strengths and foster environmental change strategies that promote justice and support healthy human development. Its history is directly tied to the genesis and continuing development of the counseling profession. The present chapter traces the history of the counseling profession with particular attention directed to the evolution of the community counseling model. There are a couple of reasons why it is important to describe the historic context from which this model has developed early in this book. First, many students and practitioners are simply not aware of the various factors and people who have contributed to the development of the community counseling theory over an extended period of time. This includes the implementation of a broad range of education, empowerment, prevention, and advocacy services by numerous people from the late 1800s and early 1900s through the present time. Without this historical knowledge, individuals may misperceive the community counseling framework as a theoretical model that is new and untested. Second, it is important to clarify how the roots of the community counseling framework are historically grounded in intervention strategies that have been used to address different forms of inequality, injustice, and oppression that adversely impacted millions of people in our society. Previous publications describing the history of the counseling profession tend to downplay the many ways that a social justice advocacy perspective has and continues to be an important aspect of this field. These historical accounts have primarily focused on issues related to the professionalization of counseling in the United States. It is indeed important to be knowledgeable of the people and events that contributed to the professionalization of counseling in this country. However, it is equally important to know how the pioneers of the counseling profession
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and many counselors who followed them promoted social justice, equality, and fairness throughout the “people’s history of the counseling profession” (Toporek, Lewis, & Crethar, 2009, p. 260). Howard Zinn (2003), one of this nation’s foremost historians and social justice advocates, emphasizes the importance of taking the people’s perspective into consideration when describing historical phenomena. As Zinn notes: If history is to be creative, to anticipate a possible future without denying the past, it should emphasize new possibilities by disclosing those hidden episodes of the past when, even if in brief flashes, people showed their ability to resist, to join together, occasionally to win. I am supposing, or perhaps only hoping, that our future may be found in the past’s fugitive moments of compassion. (Zinn, 2003, p. 11) By grounding this chapter in a people’s history of the counseling profession, we extend previous historical publications that describe the professionalization of counseling. We do so by illuminating how the evolution of the profession has and continues to be impacted by many people who are committed to fostering healthy human development. This involves documenting the factors that led many mental health practitioners to implement counseling services that were designed to stimulate individual/intrapsychic changes as well as using a broader set of environmental interventions to stimulate a greater level of justice in society. Upon reading this chapter, you will gain a new understanding of the ways that many historic figures refused to accept various environmental factors that adversely impacted healthy human development. This will increase your understanding of the types of advocacy, community organizing, educational, organization development, and individual counseling services and methods that characterized the work that has been done by many people in the profession over an extended period of time.
A PEOPLE’S HISTORY OF THE COUNSELING PROFESSION
The origin of the counseling profession in the United States can be traced to the late 19th and early 20th centuries. At that time, the United States was undergoing significant changes in its social-economic landscape. These changes were largely attributed to the unprecedented shift in our nation from an agrarian society to one where large numbers of people moved to growing industrialized urban areas in search of new work and prosperity. The movement of large numbers of people from farming areas to rapidly expanding industrialized urban
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locations was catalyzed by three major factors. This included substantial changes in our country’s means of economic production, new technological advancements in many workplaces, and a growing need for workers to do new work tasks. The unprecedented transformation of the United States from an agrarian society to an industrialized nation during a 50-year time period (from the 1880s to the 1930s) resulted in numerous psychosocial problems among large numbers of people. These problems included a dramatic rise in violence and substance abuse; increased reports of alienation, depression, and suicide; the breakdown of many families; and negative reactions to the influx of new immigrants—to name a few. Aubrey (1986) describes the connections between the industrialization of the United States and the increasing stressors that compromised people’s mental health during this time in the following way: The industrialization of America did not benefit everyone. There were many losers in the not-so-gradual transition from an agrarian and small village society to one of metropolitan living (remember, no suburbs as we know them today existed at this time in history). Among the losers were individuals who previously had taken pride in making clothing, furniture, utensils, and tools by hand. Many now found themselves on assembly lines, putting together pieces stamped by machinery. Instead of creating their own products from beginning to end, they now complemented machinery in a boring and tedious hourly routine. Although life on farms and in small villages was arduous and routine, individuals had some say in what tasks they would do and when they would do them. It was a major adjustment, therefore, for individuals to find their lives suddenly highly regulated by time clocks, the need to travel to a place of employment, the loss of family mealtimes, insensitive supervisors, dangerous working conditions, and job uncertainty. In particular, an unwelcome regimentation of much of individuals’ waking hours led to a dehumanization of spirit and a loss of personal initiative. In terms of mental health, the combination of a loss of selfesteem in one’s work and manner of living and a growing feeling of powerlessness in coping with the external environment could hardly contribute to individual mental health. Indeed, it was a time when masses of people needed advocates, individuals who would intervene on their behalf and in their best interest. The injustices and suffering wrought by massive technological change shaped the early destiny of the guidance and counseling profession. The leaders of this emerging profession would come essentially from the ranks of idealistic and committed advocates and reformers for human rights. (Aubrey, 1986, pp. 3–5) Many social justice advocates worked to create reforms in various parts of society as the 19th century was ending and the 20th century beginning. Although using similar types of social justice advocacy interventions that would Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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be utilized by supporters of the community counseling model almost a hundred years later, the people seeking environmental reforms in the late 1800s and early 1900s were not called counselors per se. This is simply because the counseling profession had not yet been formally established. However, it was during the late 19th and early 20th centuries that the seeds of the profession were planted by people who worked to make the kinds of reforms that were designed to stimulate the healthy development of those in marginalized groups. These reformers were committed to ensuring that the fundamental rights upon which the United States was founded applied to people who were harmed by the major social-economic transformation occurring at that time. This included ensuring that common people’s rights to life, liberty, and the pursuit of happiness were guaranteed and not negated by those in power positions. However, as reflected in Aubrey’s (1986) documentation of the counseling profession’s history, the rights of many people were seriously undermined in ways that adversely impacted their physical and mental health in the late 1800s and early 1900s. This included violations of people’s right to life (e.g., by being subjected to dangerous work conditions resulting in high rates of workplace injuries and deaths), violations of many people’s liberty (e.g., by being denied the right to organize unions), and restrictions in people’s pursuit of happiness (e.g., as a result of the poor educational opportunities, oppressive work environments, and substandard housing conditions that characterized people’s lives at the time). These basic human rights violations resulted in much consternation and increasing activism by many people committed to promoting a greater level of justice, opportunity, and mental health in society. The activism manifested by these people was consistent with the goals and objectives of the Progressive Movement that was a part of the zeitgeist of the times. The Progressive Movement
The Progressive Movement represented an effort to cure many of the ills American society had developed during the great spurt of industrial growth in the last quarter of the 19th century. Although the domestic frontier had been conquered, great cities and businesses developed, and an overseas empire established at that time; not all citizens shared in the new wealth, prestige, and optimism of these accomplishments. Originating in the mid-1800s, the Progressive Movement advocated for a broad range of social-political changes to ensure that the majority of people in the United States were given the opportunity to exercise their rights to life, liberty, and the pursuit of happiness. Such efforts included supporting the struggle for women’s rights, worker’ rights, racial justice, more humanistic approaches in the treatment of mentally ill people and prisoners, and new interventions in the public schools to assist young people to deal with the new demands of the emerging industrialized society of which they were a part. These educational interventions came to be known as guidance activities and marked the genesis of the counseling profession in the late 1800s and early 1900s (Aubrey, 1986). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Jesse Davis: The Genesis of School Guidance Counseling
Educational counseling historians generally credit Jesse B. Davis with the first efforts to systemize guidance into the accepted school curriculum (Aubrey, 1986; Brewer, 1942; Miller, 1971). Employed as a school administrator in the rapidly growing industrial city of Detroit between 1889 and 1907, Davis was concerned with the vocational, social, and moral problems students faced during a time of tremendous societal change. Interestingly, Davis selected English composition as the curriculum area he thought was best suited to implement “vocational and moral guidance” (Davis, 1914, p. 17). Davis used this subject area to foster the healthy psychological development of students in his school. He did so by incorporating classroom-based writing activities and discussion groups that focused on moral issues and vocational challenges students faced in their lives. As Davis (1914) explained: in assisting the pupil to gain a better understanding of his own character; it means an awakening of the moral consciousness that will lead him to emulate the character of the good and great who have gone before; it means a conception of himself as a social being in some future occupation, and from his viewpoint the appreciation of his duty and obligation toward his business associates, toward his neighbors, and toward the law. (Davis, 1914, p. 17) As you continue to read this book you will see how Davis’s goals, objectives, and methods are consistent with the empowerment, prevention, and social justice advocacy concepts described in the community counseling theory. Frank Parsons: The Father of the Counseling Profession
Commonly viewed as the father of the counseling profession (Aubrey, 1986) and founder of vocational psychology (O’Brien, 2001), Frank Parsons was a versatile individual who worked as an engineer and college professor and later as a social justice advocate in Boston in the early 20th century. His experiences growing up in Boston led him to become appalled by the inhumane living and working conditions that represented the downside of the Industrial Revolution among Boston’s poorest young residents. Working with other concerned social justice advocates, Parsons established a settlement house (the Breadwinners’ Institute) in Boston in 1908 (Fouad, Gernstein, & Toporek, 2006). In addition to establishing the Breadwinners’ Institute, Parsons also oversaw the creation of the first Vocational Bureau in the United States. This vocational agency addressed the needs of poor young adults who were adversely impacted by the oppressive and unjust aspects of the Industrial Revolution. Parson’s primary work in this area included training counselors, who provided vocational guidance, referral, and supportive services, to foster the healthy development of unemployed young adults (Aubrey, 1986). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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A close study of Parsons’s work reflects his understanding of the intimate linkages that exist between social justice and healthy human development. Writing about these issues Parsons (1909) pointed out that Not till society wakes up to its responsibilities and its privileges … shall we be able to harvest more than a fraction of our human resources to develop and utilize the genius … in each new generation. (p. 165) Parsons’s efforts to create community-based resources to help young people develop the knowledge and attitudes necessary to secure employment and his advocacy for their job placement were precursors to the preventive education and client advocacy services included in the community counseling model. His commitment to social justice was evident in the work he did as an advocate for youth, women, the poor, and the disadvantaged. These advocacy efforts were grounded in “principles of cooperation, love of justice, and hatred of oppression and discrimination reflected in the services provided by the Vocational Bureau” (Davis, 1969, p. 23). Despite his innovative work in these areas, Parsons’s efforts were met with ambivalence by some people in the fields of psychology and education at the time. Nevertheless, Parsons persisted in developing multifaceted interventions to meet the personal, moral, and vocational needs of young and poor individuals during this era in the people’s history in the United States. His emphasis on the importance of using multifaceted interventions to address people’s needs was another precursor to the community counseling model. The Mental Hygiene Movement
While efforts were being made to introduce vocational guidance counseling services in schools and community settings during the early 1900s, institutional initiatives were implemented by other mental health care advocates as well. These latter efforts were linked to what was referred to as the mental hygiene movement. Most historians credit Dorothea Dix as the founder of the mental hygiene movement in the early 1800s. Dix’s efforts were aimed at promoting a greater level of social justice among individuals experiencing emotional problems by humanizing the treatment these people received in government and privately run psychiatric institutions. Clifford Beers was credited with extending the impact of the mental hygiene movement in the early 1900s. Beers was born into an affluent family in 1876 in New Haven, Connecticut. He was one of five children, all of whom suffered from psychological distress requiring psychiatric hospitalizations, including Beers himself. Beers was first confined to a private mental institution in 1900 and treated for depression and paranoia. He was later transferred to another private hospital and eventually treated at a state-funded institution for his ongoing mental health problems. Having directly experienced it himself as well as witnessing serious maltreatment of other patients at the hands of the hospital staff, Beers (1908) wrote a book entitled, A Mind That Found Itself. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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This autobiographical account of Beers’s experiences drew interest from numerous people in the medical profession as well as other advocates for the humane treatment of the mentally ill. As Glosoff (2009) points out: The publication of this book served as a catalyst for the mental hygiene movement and studies of people with emotional and behavioral problems. Early studies of children with emotional problems supported the concept of providing counseling for all children in schools. (p. 8) In essence, Beers’s book resulted in the implementation of new outreach services to distressed and marginalized children as well as other advocacy initiatives. These early outreach and advocacy services have evolved over time to become important components of the community counseling model. Beers’ book also drew the attention of a respected physician named Dr. William Healy. Inspired by Beers’ work, Dr. Healy successfully advocated for the establishment of the first community psychiatric clinic for juveniles in the United States. This clinic called, The Juvenile Psychopathic Institute, was subsequently founded in Chicago in 1908. To accomplish its goals, the institute “used testing, modified psychoanalysis, and the involvement of family members” in the care of troubled juveniles (Glosoff, 2009, p. 9). Healy’s work included advocacy for macro-level changes to support the needs of juveniles and their families as well. These advocacy initiatives resulted in legislative funding for the establishment of child guidance clinics countywide in Illinois in 1909 (Glosoff, 2009). Jesse Davis, Frank Parsons, Clifford Beers, and William Healy all understood the powerful ways that social, economic, political, and institutional factors influence people’s development. The impact these individuals had on fostering a broad range of environmental changes as a result of their advocacy efforts is highlighted in this section because they represent important historical factors that contributed to the genesis of the counseling profession in general and the evolution of the community counseling theory in particular. THE 1910S AND 1920S
The budding counseling profession took a number of twists and turns during the 1910s and 1920s. Interest in vocational guidance and counseling services increased after Parsons and Davis’s groundbreaking work in these areas. As a result, additional school guidance services were introduced in the public schools in Seattle in 1910 (Brewer, 1942) and New York in 1916 (Reed, 1916). The increasing interest in guidance services during this era led to the formation of the National Vocational Guidance Association (NVGA) in Grand Rapids, Michigan, in 1913. Stressing the importance of the work that guidance counselors did for the nation at that time, Frank Leavitt, the first president of the NVGA, stated that “the economic, educational, and social demands for guidance and the counseling it entailed were necessary for the preservation of society itself” (cited in Glosoff, 2009, p. 9). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Increasing support for school-based guidance counseling services and the establishment of a national guidance organization helped a fledgling new profession secure a foothold in numerous school and community settings across the United States. As a result, educational and preventive interventions became the services of choice in nurturing the healthy development of children and adolescents and assisting other individuals to make informed vocational decisions. The Impact of World War I
The most significant event impacting the evolution of the counseling profession at this time related to the onset of World War I. Hollis (2000) summarizes the affect of this historic event on the early development of the profession, noting that “counseling became more widely recognized as the military began to employ people for testing and placement practices for great numbers of military personnel” (p. 45). The increased demand for testing and placement practices did enhance the professional identity of counselors during that time, but, at a cost. By directing counselors’ efforts to administering and scoring psychological tests among large numbers of people drafted into the army, newly hired counselors were responsible for matching draftees’ interests and skills with specific military jobs. This resulted in practitioners moving away from the multifaceted roles and services implemented by the early pioneers in the counseling profession as practitioners embraced a narrower professional role and function in society.
THE 1920S–1930S
The 1920s and 1930s would see counselors slowly increasingly their visibility and employment in diverse settings. This included the growing number of counselors employed as guidance workers in public school systems, student personnel workers in colleges and universities, job counselors hired in various government employment agencies, personnel workers in private business and industry settings, rehabilitation counselors in health clinics and hospitals, and testing and placement service providers for war veterans (Aubrey, 1986). The growing number of counselors working in these areas was accompanied by early efforts to promote their professional identity. Such efforts were manifested in the development of early certification standards for guidance counselors in Boston and New York during the 1920s. Additional support for the professional development of counselors came from Harvard University, which began to offer courses for people working in the newly emerging field of guidance counseling in 1921. These new course offerings were criticized, however, as being too narrow because they almost exclusively addressed vocational guidance issues in school settings (Gladding, 2009). The perpetuation of this narrow view of the counselor’s role and function was challenged by other practitioners dissatisfied by this limiting perspective. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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What ensued from this dissatisfaction were individuals who redirected attention to broader issues related to the work many counselors were doing in the field. This resulted in directing counselors’ attention to personality issues, human development, and the impact of family dynamics on their clients’ lives (Gladding, 2009). Abraham and Hannah Stone addressed the latter issue by founding the first marriage and family counseling center in New York City in 1929. The emphasis that these early marriage and family counselors placed on the need to address contextual issues when working with clients complements the community counseling model’s counseling in context concept that is discussed in Chapter 1. Another accomplishment that helped expand the view of counselors as professional development and systems change specialists came from the work of John Brewer in the 1930s. In a book entitled, Education as Guidance, Brewer (1932) described how teachers could be trained to greatly extend the work that was being done by guidance counselors. Brewer recommended that teachers be trained to address the knowledge and skills youngsters needed to lead productive and satisfying lives in the core of the school curriculum. The ideas that Brewer advocated in this regard are consistent with the broad-based preventive, developmental, and systems advocacy interventions that later became integral parts of the community counseling model. Dealing with the Challenges of the Great Depression
Beyond the important work that was done to expand the concept of guidance counseling in this era, the Great Depression of the 1930s challenged counselors to address the collective misery that millions of people experienced during this period in the people’s history of the United States. One of the practical ways that counselors addressed this challenge was manifested by faculty members and practitioners at the University of Minnesota. These persons developed and implemented the Employee Stabilization Project, a multifaceted approach to career counseling and development in the early 1930s (Fouad et al., 2006). This multiservice project included career education, counseling, assessment, and advocacy services to support the mental health and psychological well-being of many people adversely impacted by the Great Depression. The multifaceted nature of this intervention mirrors the community counseling model’s emphasis on using a broad range of services to effectively foster healthy human development. Other factors contributed to counselors’ expanded thinking about the potential roles they could play in promoting their clients’ mental health by implementing various advocacy services during the 1930s. One of these factors involved the publication of another book, entitled, Men, Women, and Jobs (Patterson, Darley, & Elliott, 1936). This groundbreaking publication discussed how systemic factors affect human and vocational development and described the roles counselors could play in addressing these variables. Such considerations expanded counselors’ thinking about the roles they could play as social-organizational change agents. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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They also complemented the community counseling model’s later emphasis on the need to implement systemic advocacy services to promote healthy human development. The evolution of the counseling profession was further enhanced by the printing of the first counseling theory textbook in 1939. Gladding (2009) discusses this historic accomplishment by noting that: the Great Depression influenced researchers and practitioners, especially in university and vocational settings, to emphasize helping strategies and counseling methods that related to employment. A highlight of the decade was the development of the first theory of counseling, which was formulated by E. G. Williamson and his colleagues (including John Darley and Donald Paterson) at the University of Minnesota. Williamson modified Parson’s theory and used it to work with students and the unemployed. His emphasis on a directive approach came to be known by several names—for example, as the Minnesota point of view and traitfactor counseling. His pragmatic approach emphasized the counselor’s teaching, mentoring, and influencing skills. (Williamson, 1939, p. 11) The emphasis Williamson and his colleagues’ placed on having counselors use educational strategies to promote clients’ development was another precursor to the community counseling model’s later emphasis on similar services. As discussed in Chapter 1, the use of such educational services is particularly important when counselors use the community counseling framework to facilitate human development and environmental-contextual changes.
THE 1940S–1950S
Four historic factors contributed greatly to the evolution of the counseling profession during the 1940s and 1950s. These factors included (1) the impact of Carl Rogers’s counseling theory; (2) new challenges counselors faced in addressing the needs of veterans returning from World War II; (3) the effect that World War II had on changing traditional sex roles, especially as they related to women’s career/vocational development; and (4) major breakthroughs in the professionalization of counseling. The Impact of Carl Rogers’s Counseling Theory
The most significant breakthrough for the counseling profession during the 1940s was the publication of Carl Rogers’s (1942) book entitled Counseling and Psychotherapy. This book ushered in an era of client-centered (later renamed as person-centered) counseling that swept aside existing models of trait-factor and directive counseling (Williamson, 1939). Rogers’s theory led many counselors to focus on the specific techniques they could use to build unconditional empathic relationships with clients that resulted Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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in positive counseling outcomes. The primary focus of this popular helping approach was the client’s intrapsychic experiences (D’Andrea, Ivey, & Ivey, 2011). The increased popularity of Rogers’s counseling theory dramatically increased the professionalization of the counseling field at that time (Aubrey, 1986). However, the individual and intrapsychic emphasis that characterized Rogerian counseling in the 1940s and 1950s redirected many counselors’ attention from external contextual-environmental stressors that adversely impacted people’s lives to clients’ internal experiences. It is interesting to note that Carl Rogers underwent his own personal and professional evolution during his career. In doing so, Rogers demonstrated how many principles associated with his counseling theory could be used in various social justice and peace advocacy initiatives that he implemented later in his life (Kirschenbaum, 2009). These latter developments in Rogers’s career are consistent with the evolution of the community counseling model’s emphasis on using similar advocacy services to promote healthy human development and social justice in different environmental settings.
Advocating Governmental Support for World War II Veterans
Counselors were also involved in a number of interventions that addressed the needs of the thousands of World War II veterans in the 1940s. Addressing the psychological needs of veterans, who experienced physical and emotional warrelated injuries, were among the services counselors were increasingly called upon to provide during this historic era. In addition to helping these people cope with their injuries, counselors also assisted veterans in adjusting to civilian life and securing gainful employment in a postwar workforce. While this often involved the use of individual counseling interventions, many counselors also advocated for increased governmental support for veterans’ educational and vocational training benefits (Fouad et al., 2006). As a result of these advocacy efforts, a number of systemic developments occurred that contributed to the evolution of the counseling profession in the 1940s. Reporting on these developments, Glosoff (2009) points out that In 1944, the War Department established the Army SeparationClassification and Counseling Program in response to the emotional and vocational needs of returning soldiers. The Veterans Administration (VA) established counseling centers within hospitals for injured veterans (Shertzer & Stone, 1986). The VA coined the term counseling psychology and established counseling psychology positions and training programs to fill these positions. The National Institute of Mental Health (NIMH) was established just after World War II and created a series of training stipends for graduate programs in professional counseling and psychology. (p. 12) Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Other advocacy efforts resulted in the establishment of the U.S. Employment Service that was initiated under the War Manpower Commission in 1944. This government-funded program established 1,500 offices across the country where counselors provided a host of vocational testing, training, and placement services (Glosoff, 2009). The passage of the George-Barden Act in 1944 was another example of successful legislative advocacy efforts. This federal action provided government support for the establishment of additional counseling training programs. The programs funded from this act primarily focused on training individuals to provide vocational guidance and counseling services to WWII veterans.
Extending Vocational Counseling Services to Women During the 1940s
In addition to addressing the needs of veterans, other people in the civilian population also required assistance in facing unique challenges during the 1940s. As a result of WWII, many people in the United States faced years of family disruption, geographical moves, and serious stressors associated with warrelated deaths and disabilities of family members. Then, suddenly, peacetime came. But with it arose uncertainties about massive social and economic changes occurring during that epoch in the people’s history of the United States (Aubrey, 1986). One of the important social-economic changes that occurred during and after World War II related to the new roles women played in the workforce. In the absence of many male workers, women were called upon to meet the needs of a wartime industrial and manufacturing base. As Gladding (2009) points out: Many women worked outside of the home during the war, exemplified by such personalities as Rosie the Riveter. Women’s contributions to work and the well-being of the United States during the crisis of war made a lasting impact. Traditional occupational sex roles began to be questioned, and greater emphasis was placed on women’s personal freedom. (p. 13) The personal freedom that some women experienced as a result of these historic phenomena resulted in a new sense of psychological liberation that contributed to the desire to move beyond the confining sex roles traditionally perpetuated in society. These dynamics challenged counselors to rethink the services they used when previously addressing the needs of female clients. Recognizing that systemic factors contributed to the unequal treatment of women in society in general and in the workforce in particular, some counselors implemented new system advocacy services to address this injustice and stimulate women’s development during the 1940s (Gladding, 2009). These social justice advocacy services were similar to comparable efforts enacted later by counselors operating from the community counseling model. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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The Development of New Counseling Organizations in the 1950s
Additional events impacting the history of the counseling profession included organizational initiatives that took place during the early 1950s. As the counseling professional expanded in scope and purpose in the 1940s and 1950s, it became evident that there was a need for a professional organization to unify the diverse concerns of counselors. This certainly could not be the American Psychological Association (APA) because many practicing counselors were not psychologists, nor were they eligible for membership in APA. Also, at a fateful conference in 1950 at Boulder, Colorado, clinical psychology closely aligned itself with the psychiatric community. This meant a close and almost exclusive focus on the use of a medical model which proved to be too narrow a focus for the vast majority of practicing counselors in the 1950s. As a consequence, in July 1952, the American Personnel and Guidance Association (APGA) (now called the American Counseling Association) was formed. APGA represented a merging of numerous guidance, education, and counseling organizations. This included the National Vocational Guidance Association (now called the National Career Development Association) and the American College Personnel Association with the cooperation of the National Association of Guidance and Counseling Trainers (now called the Association for Counselor Education and Supervision) and the Student Personnel Association for Teacher Education (now called the Association for Humanistic Counseling, Education and Development). One year later, in 1953, the American School Counselor Association would join APGA. (Aubrey, 1986, p. 13) These organizational initiatives greatly increased the professionalization of counseling as well as the perceived legitimacy of the field among people in other disciplines and the general public. One of the mainstays of these organizational initiatives was the acknowledgement of the ways that the counseling profession was distinguished from other professional groups. Among the differences emphasized were the ways that counselors implemented prevention services to foster human development and their commitment to working to promote both individual and environmental changes in their practices (Aubrey, 1986). As previously discussed, the impact of Carl Rogers’s counseling theory at this time led many counselors to direct increasing attention to individual-intrapsychic factors when working with clients. Despite the popularity of Rogers’s theory, numerous counseling practitioners employed in diverse settings (especially school counselors) implemented intervention strategies that were intentionally designed to stimulate both individual and environmental changes. In doing so, these practitioners contributed to the evolution of the community counseling model that is described in this book.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Unprecedented Growth of Counselor Education Programs in the 1950s
Another historic phenomenon occurring in the 1950s was the anxiety, fear, and concern the general citizenry experienced in response to the perceived scientific and technological superiority of the Soviet Union. This national concern was greatly heightened when the Soviet Union successfully launched the first earthorbiting satellite, called Sputnik, in October of 1957. The heightened national anxiety associated with the launching of Sputnik led to bipartisan legislative support for the passage of the National Defense Education Act (NDEA) of 1958 by the Congress of the United States. As a result of this legislative action, the number of counselors in our nation’s public schools quadrupled in a few short years. The ratio of counselors to students in public schools decreased from 1 to 960 in 1958–1959 to 1 in 450 by the middle of the next decade. There were also unprecedented gains in the number of counselor education programs instituted across the United States during this historic period as a result of fiscal support appropriated by the NDEA (Aubrey, 1986). The significant expansion in the number of counselor education programs and practitioners in the late 1950s was accompanied by substantial advancements in the knowledge-base from which they operated. The expanding knowledgebase included new thinking about human development and psychological distress from research findings generated in such diverse disciplines as psychiatry, psychology, sociology, and social work. Psychodynamic counseling theories were also gaining popularity in the mental health professions during this time. These theories generally stressed individualintrapsychic approaches to mental health care. However, in the 1950s a number of psychodynamic theorists described how these theories could be used to promote environmental changes in schools, workplaces, and communities-at-large so that larger numbers of people would realize increased mental health and psychological well-being (Fromm, 1955; Sullivan, 1953). About the same time, Lewin’s (1951) field theory further delineated the interactional nature of human development, mental health, and people’s environmental settings. Lewin’s simple formula, B = f(P, E,), noted that one’s behavior (B) is a function of the individual’s personal characteristics (P) and environmental interactions (E). Lewin’s theoretical perspective further affected the way counselors conceptualized the etiology of people’s problems and the need to promote environmental changes to foster healthy human development in the 1950s. The insights gained from this expanded knowledge-base led counseling theorists and practitioners to explore how new intervention strategies might be used in school settings to stimulate the development of larger numbers of clients than could be achieved by using individual counseling interventions alone. One of the first writers to formally publish guidelines related to the use of a developmental framework in counseling was Robert Mathewson (1949). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Mathewson’s developmental views were different than the trait-factor and Rogerian counseling approaches used by most counselors at the time. In distinguishing his approach from other theoretical orientations, Mathewson wrote: Of crucial importance in this stage of cultural development in American democracy is the question of whether we can any longer depend solely upon the individual’s natural motivation for such essentials as civic responsibility, effectiveness in human relations, and the congruent matching of talents and tasks in work settings. (p. 66) Mathewson (1949, 1962) outlined guidelines that counselors were encouraged to use in creating environmental conditions in schools and communities that nurtured healthy human development. Growing interest in the roles counselors could play to promote such conditions was an important factor that contributed to the on going evolution of the community counseling model.
THE 1960S AND 1970S
The 1960s and the 1970s represented times of substantial changes in the counseling profession and the evolution of the community counseling model. These changes occurred during an era characterized by much questioning of many of our nation’s social, political, and cultural institutions and established ways of operating. Describing the impact of this historic epoch on the counseling profession, Aubrey (1986) indicated that The counseling profession in the 1960s faced a number of serious questions and challenges. One of these problems centered on clientele. Should the profession deal exclusively with the normal developmental concerns (and their ups and downs) of individuals, or should it tend to the psychological problems of a smaller and needier portion of the population? On the surface, this dilemma seemed clear and amenable to resolution. Events in the 1960s, however, would blur this simple dichotomy by suddenly expanding counseling audiences to include minority groups, dissenters to the war in Vietnam, returning veterans, alienated hippie and youth movements, experimenters and advocates of the new drug culture, disenchanted students in high schools and colleges, victims of urban and rural poverty, and disenfranchised women. Like all societal institutions, the counseling profession was being subjected to its own questioning and challenges from individuals within and outside of the field. (pp. 16–17) Two factors were particularly challenging when it came to addressing the needs of the new client populations mentioned above. First, most of the people in these groups needed support in developing the knowledge and skills necessary to realize their individual and collective empowerment. Assisting clients in Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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becoming empowered meant supporting these persons in acquiring new competencies that enabled them to make the individual-intrapsychic and environmental changes that were necessary to lead healthy and satisfying lives. Unfortunately, many counselors were unable to effectively implement counseling strategies that resulted in these outcomes, largely due to a second, related, historic phenomenon occurring at the time. The second phenomenon was that the counseling profession had become inundated with a plethora of new theories that gained much popularity during the 1960s. The new theoretical models used by many counselor educators and practitioners at the time included behavioral counseling, reality therapy, existential therapy, person-centered counseling, and psychodynamic counseling theories. These theories expanded counselors’ counseling skills and techniques in many ways. They did not, however, match up well with the needs and interests of many new clients counselors were called upon to serve. This was largely due to the fact that the new theories mentioned above overemphasized the importance of helping clients make the kinds of personal adjustments that were necessary to meet the demands of their environmental contexts. However, the problems that many clients experienced in their lives were often rooted in toxic, unjust, and oppressive environmental conditions that were in need of change themselves. Consequently, the mismatch between the counseling strategies used by many practitioners and the needs of many clients often resulted in ineffective outcomes and heightened frustrations among clients and counselors alike. Lessons Learned
In hindsight, it is clear that the overuse of counseling strategies that focused on the clients’ intrapsychic experiences without addressing other relevant environmental-contextual factors greatly contributed to the abovementioned ineffective outcomes and frustrations. These negative outcomes represented important learning opportunities that contributed to the evolution of the community counseling model. The primary lesson learned in this regard related to the need for counselors to use multifaceted approaches in their work. Implementation of such multifaceted approaches included the use of outreach services to distressed and marginalized clients, client advocacy services, social/political advocacy initiatives to foster macro-level changes, and new developmental/preventive interventions. New Developmental Counseling Approaches
The evolution of the community counseling concept in the 1960s was further enhanced by advancements made in the application of human development theories in counseling practices. The first book on this subject, bearing the title Developmental Counseling, was written by Donald Blocher in 1966. Other counseling theorists began increasing their attention to lifespan development theories as a basis for their counseling interventions as well. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Like the plethora of new counseling theories discussed above, developmental counseling strategies focused on stimulating individual changes that reflected clients’ growth potential. The new developmental counseling approaches that were increasingly used by counselors in the 1960s distinguished counselors from many other practitioners in the mental health professions. This distinction would be further illuminated in the 1970s when the community counseling theory formally emerged as a multifaceted helping framework in the field.
Broadening the Counseling Profession’s Perspective and Effectiveness
Aubrey (1986) explained why the counseling profession worked to broaden its perspective and effectiveness in the following way. The broadening of counseling perspective in the later 1960s and early 1970s was accomplished largely through direct pressure by those seeking help. Many of these individuals sought help from those proclaiming to have skills in counseling and psychotherapy. Counselors, psychiatrists, social workers, psychologists, pastoral counselors—all were approached as potential helpers. Few of the potential helpers, however, were able to satisfy these individuals. Numerous help seekers, in fact, found more relief within their own groups (Alcoholics Anonymous, Synanon, Daytop, women’s and other self-help groups) than they did from professional counselors. Much of this resulted from counselors’ failure to address the causative factors underlying clients’ problems while many of the newly emerging self-help groups made important headway into dealing with such environmental conditions. (p. 21) Another factor that contributed to a broadening of counselors’ professional perspective involved a growing recognition of the ways that group interventions were being used to foster the empowerment of numerous clients experiencing similar problems in their lives. A third factor that led counselors to broaden their professional perspective was an increasing willingness to reconnect with the longstanding tradition of using prevention, advocacy, and environmental change strategies in the field. The Passage of the Community Mental Health Centers Act
Efforts to expand the use of prevention and advocacy services in the 1960s and 1970s were bolstered by the passage of the 1963 Community Mental Health Centers Act. This legislative action was considered “to be one of the most crucial laws dealing with mental health that has been enacted in the United States” (Glosoff, 2009, p. 15). The passage of this historic legislation occurred, in part, because of the advocacy efforts of many counselors, psychologists, social workers, and their professional organizations. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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The Community Mental Health Centers Act mandated the creation of more than 2,000 mental health centers nationwide. This enabled counselors to provide direct counseling services to tens of thousands of people in local communities as well as implementing a broad range of advocacy, consultation, outreach, preventive education, and training services. These services not only held the potential to positively impact clients’ psychological well-being but also to elevate the mental health of entire communities. Such is the intent of counselors operating from the community counseling theory described in this book; to foster the healthy development of individual clients and the mental health of broader environmental contexts in which they are situated (see Chapter 1). Unfortunately, the lack of ongoing funding for this national communitybased initiative undermined counselors’ efforts to realize the full potential of the mental health care system in the United States. Initial plans for expanding and maintaining a comprehensive, community-based mental health care system in this nation were replaced by new managed care organizations (MCOs). These privately operated MCOs greatly increased during the 1970s and thereafter.
Managed Care Organizations (MCOs) in the 1970s
MCOs have existed in the United States for decades. However, there was a substantial boost to the financial arrangements made for the reimbursement of medical care in general and mental health care services in particular during the early 1970s. The passage of the Health Maintenance Organization Act of 1973 was a major factor that contributed to this boost in financial payments for mental health care services to privately operated MCOs at that time. These shifting financial arrangements for mental health care payments resulted in an agreement for MCOs to reimburse licensed practitioners for services rendered. The specific payment agreements were limited to qualified mental health professionals who adopted a medical model in their work. Adopting such a model for financial reimbursement from MCOs resulted in increasing provision of individual, intrapsychic-focused counseling and psychotherapy services for clients in need (Cooper & Gottlieb, 2000). The rising medicalization of mental health care in the 1970s and the decades that followed was, in many ways, antithetical to the community counseling perspective. This was largely due to the fact that reimbursable services from MCOs did not include many of the other interventions that are associated with the community counseling model. Among the services not reimbursed by these financial entities included contextually based counseling services, outreach services to marginalized and distressed clients, client and system advocacy services, developmental/preventive interventions, and social/political macrosystem-change services. Despite these barriers, two factors contributed to the ongoing evolution of the community counseling model. The first factor involved the publication of the first two textbooks on community counseling in the 1970s (Amos & Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Williams, 1972; Lewis & Lewis, 1977). The second factor was the birth of the multicultural movement in the late 1960s and early 1970s (D’Andrea et al., 2001). At this time, a small group of Black counselors and psychologists publically called for changes in the mental health professions to ameliorate the cultural biases and institutional racism that was perpetuated by the fields of counseling and psychology. These professional advocacy efforts resulted in the founding of the Association for Non-White Concerns (now referred to as the Association for Multicultural Counseling and Development [AMCD]) in the American Counseling Association and an independent organization called the Association for Black Psychologists in the early 1970s. Leaders in these newly developed professional organizations were particularly critical of the ways that practitioners’ continued to implement a culturally biased approach to mental health. Such an approach involved directing an inordinate amount of time and energy on individual clients’ intrapsychic issues while failing to also address environmental factors and social injustices that were known to adversely impact the mental health of millions of people in culturally and racially marginalized and devalued groups in the United States. Researchers affiliated with these organizations provided evidence that substantiated the ineffective and harmful counseling outcomes that ensued from such practices. These multicultural researchers also supported proposals for increasing the use of preventive, outreach, educational, client, and system advocacy services as well as macro-system change strategies to increase counselors’ effectiveness when working within a culturally diverse society. The critical analysis and recommendations made by multicultural advocates led to the creation of numerous multicultural counseling competencies that all counselors were encouraged to acquire to work more effectively and ethically with culturally diverse clients (Ivey et al., 2007). These competencies called for new forms of individual counseling as well as the implementation of the kinds of advocacy, educational, preventive, and environmental change services that are key components of the community counseling model (Sue & Sue, 2007).
THE 1980S AND 1990S
According to Aubrey (1986), the public that counselors faced in the 1980s was largely characterized by “apathy, rootlessness, fear and despair” (p. 26). The tumultuous times of the preceding two decades contributed to these psychological reactions as millions of people continued to face steady challenges related to changes in family structures, an everincreasing divorce rate, two futile wars, an increase in the possibility of nuclear annihilation, drug abuse on an unprecedented scale, a rise in street crime, excessive political transgressions, erosions in our economic system coupled with high unemployment, the spectrum of high technology forcing people out of work or into lower-paying jobs, an Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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increase in school dropouts for the first time in two decades, and new forms of media that bring instantaneous change to one’s attention around the clock during the 1980s. (Aubrey, 1986, p. 26) The apathy, rootlessness, fear, and despair exhibited by many people in the general public proved to be fertile terrain for an increasingly conservative mood in our society. The rising conservative zeitgeist was manifested in many ways including the election of Ronald Reagan as president of the United States in 1980 and 1984 as well as popular support for a steady flow of conservative governmental policies and legislative actions. This broad-based conservative sentiment served as a balm that soothed many people’s frustration and fatigue with the transformative changes that occurred during the 1960s and 1970s. Many counselors found solace from the growing sense of apathy, rootlessness, fear, and despair that plagued much of the nation in the 1980s by embracing a myopic professional identity in their work. As a result, many counselor educators and practitioners based their professional efforts on intrapsychicfocused, rehabilitative counseling approaches without directing much time and energy in supporting or implementing ecological, habilitative, and culturally responsive practices. In short, it seemed as though these counseling professionals found refuge from the controversies and revolutionary spirit of the 1960s and 1970s by embracing helping strategies that maintained the existing status quo (Sue & Sue, 2007). The Continued Professionalization of Counseling
These conservative reactions were accompanied by numerous efforts intended to enhance the professionalization of counseling during the 1980s. Among such efforts included the implementation of a host of organizational development and professional advocacy projects that were designed to (a) standardize counseling training programs, (b) create mechanisms for national counselor certification, and (c) lobby support for new counselor licensure laws in state legislatures across the country. Gladding (2009) summarized these accomplishments in the following way: The move toward standardized training and certification was one that began early in the decade and grew stronger yearly. In 1981, the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) was formed as an affiliate organization of APGA (The American Personnel and Guidance Association [now called the American Counseling Association]). It refined the standards first proposed by ACES (the Association of Counselors Educators and Supervisors) in the late 1970s and initially accredited four programs and recognized others that had been accredited by the California state counselor association and ACES (Steinhauser & Bradley, 1983). In 1987, CACREP achieved membership in the Council of Postsecondary Accreditation (COPA), bringing it “into a position of accreditation power parallel to” such specialty accreditation areas as the APA (Herr, Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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1985, p. 399). CACREP standardized counselor education programs for master’s and doctoral programs in the areas of school, community, mental health, and marriage and family counseling as well as for personnel services for college students. Complementary to CACREP’s efforts, the National Board for Certified Counselors (NBCC), which was formed in 1982, began to certify counselors on a national level. It developed a standardization test and defined eight major subject areas in which counselors should be knowledgeable: (a) human growth and development, (b) social and cultural foundations, (c) helping relationships, (d) groups, (e) lifestyle and career development, (f) appraisal, (g) research and evaluation, and (h) professional orientation. To become a National Certified Counselor (NCC), examinees have to pass a standardized test and meet experiential and character reference qualifications. By the end of the 1980s, there were approximately 17,000 NCC professionals in the United States. Finally, in collaboration with CACREP, the National Academy of Certified Clinical Mental Health Counselors (NACMHC), an affiliate of AMHCA (the American Mental Health Counselors Association), continued to define training standards and certify counselors in mental health counseling, a process it had begun in the late 1970s (Seiler, Brooks, & Beck, 1987; Wilmarth, 1985). It also attracted thousands of new professionals into counseling and upgraded the credentials of those already in the field. (Gladding, 2009, pp. 18–19) Acknowledging Professional Contradictions
The abovementioned efforts to professionalize counseling had both a positive and a negative impact on the evolution of the community counseling model. On a positive note, the abovementioned CACREP accomplishments resulted in the increased legitimization of the community counseling concept in general and professional training programs that focused on this specialty area in particular. On a negative note, the conservative perspectives that were reflected in some of the professional advocacy efforts of the 1980s resulted in a narrower view of the value of community counseling than had been previously manifested by allies of this helping perspective. Aubrey (1986) pointed out that From the perspective of the 1980s, what seemed to be a major evolutionary leap appears to be as yet incomplete. Counselors have learned to feel comfortable dealing with groups as well as with individuals. They have also come to regard training as a natural ally of counseling. They have ventured into new settings and dealt with new audiences. Despite this increase in the number and focus of interventions, the basic perspective of counselors has not changed to the extent one might expect. Counselors still tend to overlook the impact of environmental factors on individual functioning, to distrust the efficacy of preventive interventions, and to narrow the scope of their attention to the individual Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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psyche. If anything, a careful observer can begin to see the return of trends away from “giving skills away” and toward professional protectiveness, away from educational approaches and toward the traditional concept of therapy vis-à-vis the medical model. As difficult economic times threaten their survival, counselors like many other mental health professionals, seem to be falling back on the methods that seem safe and familiar. (pp. 26–27)
The Rise of the Multicultural Counseling Competency Movement
The safe and familiar methods Aubrey (1986) referred to largely involved the continued overuse of individual-intrapsychic counseling theories that were based on culturally biased assumptions about mental health and human development. Despite the conservative backlash at this time, multicultural counseling advocates remained united in expressing concern about this situation. They did so by noting how the continued overuse of culturally biased counseling interventions resulted in ineffective and even harmful outcomes when used in multicultural settings. These expressed concerns frequently resulted in antagonistic and hostile resistance by conservative counselor educators and practitioners. The negative reactions to the growing multicultural movement during the 1980s and 1990s suggested that many counseling professionals were more interested in perpetuating individual counseling practices that were grounded in a host of cultural biases than supporting the paradigm shift that was being promoted by multicultural advocates as well as supporters of the community counseling model (D’Andrea et al., 2001). Multicultural counseling advocates responded constructively to the reactionary antagonisms that many counseling professionals manifested during the 1980s and 1990s. These responses included efforts to develop more detailed professional competencies that counselors were urged to acquire to work more effectively and ethically in a culturally diverse 21st-century society. The culmination of these efforts resulted in the publication of a set of 31 multicultural competencies that were developed and formally endorsed by the Association for Multicultural Counseling and Development (AMCD) in 1992 (Sue, Arredondo, & McDavis, 1992). Three additional multicultural competencies focusing on organizational development, advocacy, and racial identity development issues emerged from a multicultural competency task force convened by Division 17 The Society of Counseling Psychology in the American Psychological Association in the mid-1990s (Sue et al., 1998). A copy of the 34 multicultural counseling competencies that have been developed and formally endorsed by various counseling organizations are included in Appendix A. Upon reviewing Appendix A, you will note that several multicultural competencies complement various aspects of the community counseling model. This includes multicultural counseling competencies that underscore the importance of having counselors become proficient in implementing advocacy, educational, Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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empowerment, and systems-change services in their work. The specific multicultural counseling competencies that complement the community counseling model in this regard include: Multicultural Competency #27. Culturally competent counselors are able to exercise institutional intervention skills on behalf of their clients. Multicultural Competency #31. Culturally competent counselors strive to eliminate biases, prejudices, and discriminatory practices. They are cognizant of clients’ sociopolitical contexts when conducting evaluations and providing interventions. They also continually attempt to develop greater sensitivity to issues of oppression, sexism, and racism, especially as they affect their clients’ lives. Multicultural Competency #32. Culturally competent counselors take responsibility in educating their clients to the processes of psychological intervention by talking about goals, expectations, legal rights, and the counselor’s orientation early in the helping process. Multicultural Competency #34. Culturally competent counselors are able to engage in psychoeducational and systems-intervention roles, in addition to their clinical roles. Although conventional counseling and clinical roles are valuable, other roles such as consultant, advocate, adviser, teacher, and facilitator of indigenous healing practices may prove more culturally appropriate for many of the culturally diverse clients served by counselors. New School Counseling Initiatives in the 1990s
Professional school counselors initiated a number of transformative projects during the 1990s that rebuffed the myopic trends associated with the professionalization of the field described earlier in this chapter. Like the multicultural counseling competency movement, these school counseling initiatives contributed to the evolution of the community counseling model in a number of ways. Among these initiatives is the Transformational School Counseling Initiative (TSCI). Toporek and her colleagues (2009) describe this initiative in the following way: The 1990s brought new concepts about the school counselor’s role. The TSCI of the Education Trust involved the development of a new vision for school counseling that had advocacy at its core (House & Martin, 1998; Martin & House, 1999). As described by Martin and House (1999), the Education Trust model views school counseling as “a profession that focuses on the relations and interactions between students and their school environment with the expressed purpose of reducing the effect of environmental and institutional barriers that impede student academic success” (p. 1). This focus on systemic change and advocacy is central to the American Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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School Counselors Association National Model (2003). To reach this goal, school counselors must be assertive advocates for all students, focusing especially on poor and minority children who would otherwise continue to experience an achievement gap. This rethinking of the central goal of the school counseling program brings with it a new set of ideas about the scope of counselors’ work. Moreover, the model of partnerships between counselor education programs and school districts has brought many new counselors into the profession with advocacy competencies in their repertoires. When one counseling specialization or setting moves in the direction of innovation, a radiating effect to other areas of practice can be expected. (p. 261) The TSCI emphasizes the need for school counselors to expand their role and function beyond providing one-to-one counseling for students’ experiencing problems and fulfilling quasi-administrative responsibilities that occupy an inordinate amount of their time, energy, and attention (House & Martin, 1998). Its emphasis on implementing advocacy services to foster environmental changes in school settings to stimulate the healthy development of all students builds on the precedent set by Jesse Davis, Frank Parsons, and supporters of the community counseling model. In doing so, the TSCI counteracted the narrower views of the role and function of professional counselors that resurfaced during the 1980s and 1990s. Counselors for Social Justice (CSJ)
A number of counselors met on several occasions during the 1990s to informally discuss their concerns about the conservative trends in the counseling profession. Individuals, who attended the meetings, specifically talked about the need to recapture the historic precedent for more expansive professional roles and services in the work counselors do. These meetings contributed to the ongoing development of the counseling profession and the community counseling model in several ways that are briefly discussed below. First, the meetings provided opportunities for counselors from across the country to come together to discuss the present and future directions of the counseling profession. Such discussions involved reminders of the history of the profession as a force that advocated for both individual-intrapsychic and progressive environmental changes to foster healthy human development. Second, these meetings provided a chance for concerned counselors to analyze the conservative social-political zeitgeist of our society in general and its impact on the counseling profession in particular. Third, the meetings ultimately led the participants to make a commitment to implement a number of formal organizational development initiatives. These initiatives were aimed at moving the profession beyond the narrow perspectives that were being articulated during the 1990s. The counselors involved in implementing the organizational initiatives that emerged from the meetings hoped to build on the counseling profession’s progressive legacy as well as the Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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contemporary multicultural counseling movement by developing a new organizational entity. The initiatives described above ultimately resulted in the formation a new division in the American Counseling Association (ACA) called Counselors for Social Justice (CSJ). Initially organized as an ACA Interest Group in the late 1990s, CSJ was later accepted as a formal ACA division in 2001. The primary rationale for moving from outsider to official status was that, as a division of the largest counseling association in the world, CSJ would be in a good position to (a) act as a clearinghouse for the dissemination of scholarship concerning the impact of oppression on human development, (b) develop collaborations with other entities, and (c) maintain a visible and accessible support network for counselors involved in social justice advocacy activities. The existence of CSJ as a division of ACA means that counselors will always have a venue for developing and disseminating cutting-edge information about the macrosystems that affect their clients and students. CSJ is committed to disseminating information, including information related to the ACA Advocacy Competencies, through collaborations with counselors in all settings and organizations. The presence of an entity devoted to such efforts reinforces the recognition of the centrality of social justice advocacy in the work counselor’s do. (Toporek et al., 2009, p. 266) Professional initiatives like the TSCI and CSJ provided an alternative view of counseling goals and methods than those espoused by more conservative members of the profession during the 1980s and 1990s. This alternative perspective was not new but, rather, built on many of the historic precedents described earlier in this chapter.
SUMMARY
In closing, this chapter describes the history of the counseling profession in general and the antecedents of the community counseling model in particular. As a result of reading this chapter you will better understand how the evolution of the community counseling model has been an inherent part of the profession for more than a century. The following chapters will further expand your knowledge of specific aspects of this model. Particular attention is directed to the ways that counselors can implement the different services that compose this model when working with diverse client populations. We hope that your increased understanding of the historic antecedents and evolution of the community counseling model will further stimulate your interest in and motivation to use this model when addressing the unique needs and circumstances of people you will work with in the future. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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EXHIBIT 2.1 Competency-Building Activity
Developing New Awareness, Knowledge, and Skills Instructions: This competency-building activity encourages you to reflect on and further develop your professional competencies as they relate to the community counseling model. In doing so, you are encouraged to direct your attention to three components of your current level of professional competence. These components include issues related to your professional awareness, knowledge, and skills as they relate to the community counseling model. This competency-building activity will require about 20–30 minutes to complete and should be done in a place where you can reflect on the following points without interruption. You will need a pen and paper to write down how your awareness and knowledge of the community counseling model has been impacted by reading this chapter and in describing one action strategy you will implement in the near future that will further increase your competence in this area. Step #1: Take a few minutes to reflect on the information presented in Chapter 2. After you have had a chance to think about the new information you have gained as a result of reading this chapter, write down how your awareness of the counseling profession has changed by learning about the history of the counseling professional and the evolution of the community counseling model. Step #2: After you have completed Step #1, take time to write down how you think your work as a professional counselor might be affected as a result of learning about the history of the counseling profession and the evolution of the community counseling model in Chapter 2. Step #3: Your awareness of the evolution of the community counseling model is likely to have been expanded by the new knowledge you acquired about the specific events and interventions that various persons have been involved in and used throughout the history of the counseling profession. Take a few minutes to write down as specifically as you can how your thinking about the role and function of the professional counselor has changed as a result of reading Chapter 2. It is particularly important to describe the specific actions, skills, and interventions that various people used in contributing to the history of the counseling profession in general and the evolution of the community counseling model in particular when completing Step #3. Step #4: Now that you have taken time reflect on some of the new awareness and knowledge that you gained as a result of reading Chapter 2, it is important to move to the skill component of the professional competency framework. With this in mind, take a few minutes to think of the various intervention strategies that underlie the community counseling model and the specific skills that are necessary to use when utilizing these interventions effectively in the future. Then, write down one action strategy you will Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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take in the next 30 days that is intentionally designed to increase your competence in one of the interventions that has evolved over time as a part of the community counseling model. Among the actions that one can take in completing Step #4 include: [a] Reviewing the multicultural counseling competencies that are presented in Appendix A and deciding to take specific action to increase your competence level on one of these competencies in the next 30 days; [b] Reviewing the ACA Advocacy Competencies listed in Appendix B and making a commitment to try out one of the specific advocacy competencies in your work as a practitioner or as a student in your professional training program; [c] Making a list of the specific preventive education programs and services you might be interested in using in your work as a mental health professional and doing an Internet search on one specific preventive intervention to find information as to how other professionals implemented this sort of intervention among a client population you are likely to work with in the future; and/or [d] Taking time to make a telephone call, send an email message, or write a letter to an elected official in your area to express your support for or position against an issue that is of particular relevance for your community.
The suggestions listed above represent only a few examples of the many concrete actions you can take to exercise different skills that are necessary to effectively implement the community counseling model in your future professional practices.
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Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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D’Andrea, M., Daniels, J., Arredondo, P., Ivey, M. B., Ivey, A. E., Locke, D. C., O’Bryant, B., Parham, T. A., & Sue, D. W. (2001). Fostering organizational changes to realize the revolutionary potential of the multicultural movement: An updated case study. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), The handbook of multicultural counseling (2nd ed., pp. 222–253). Thousand Oaks, CA: Sage. D’Andrea, M., Ivey, A. E., & Ivey, M. B. (2011). Theories of counseling and psychotherapy: A multicultural perspective (7th ed.). Thousand Oaks, CA: Sage. Davis, H. V. (1969). Frank Parsons: Prophet, innovator, counselor. Carbondale, IL: Southern Illinois University Press. Davis, J. (1914). Vocational and moral guidance. Boston: Ginn. Fouad, N. A., Gerstein, L. H., & Toporek, R. C. (2006). Social justice and counseling psychology in context. In R. L. Toporek, L. H. Gernstein, N. A. Fouad, G. Roysircar, & T. Israel (Eds.), Handbook for Social Justice Counseling Psychology: Leadership, vision, and action (pp. 1–16). Thousand Oaks, CA: Sage. Fromm, E. (1955). The sane society. New York: Holt, Rhinehart, & Winston. Gladding, S. T. (2009). Counseling: A comprehensive profession (6th ed.). Upper Saddle River, NJ: Pearson. Glosoff, H. L. (2009). The counseling profession: Historical perspectives and current issues and trends. In D. Capuzzi & D. R. Gross (Eds.), Introduction to the counseling profession (5th ed.). Boston: Pearson. Herr, E. L. (1985). AACD: An association committed to unity through diversity. Journal of Counseling and Development, 63, 395–404. Hollis, J. W. (2000). Counselor preparation: Programs, personnel, trends (10th ed.). Muncie, IN: Accelerated Development. House, R. M., & Martin, P. J. (1998). Advocating for better futures for all students: A new vision for school counselors. Education, 119, 284–291. Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2007). Theories of counseling and psychotherapy: A multicultural perspective (6th ed.). Boston: Allyn & Bacon. Kirschenbaum, H. (2009). The life and work of Carl Rogers. Alexandria, VA: American Counseling Association. Lewin, K. (1951). Field theory in social science. New York: Harper & Row. Lewis, J. A., Arnold, M. S., House, R., & Toporek, R. L. (2002). ACA advocacy competencies. Retrieved January 1, 2010, from http://www.counseling.org/Publications. Lewis, J. A., & Lewis, M. D. (1977). Community counseling: A human services approach. New York: Wiley. Martin, P., & House, R. (1999, June). Counselors as leaders: Behaving as if you really believe in all children. A paper presented at the meeting of the American School Counselor Association, Phoenix, AZ. Mathewson, R. (1949). Guidance policy and practice. New York: Harper & Row. Mathewson, R. (1962). Guidance policy and practice (rev. ed.). New York: Harper & Row. Miller, C. H. (1971). Foundations of guidance (2nd ed.). New York: Harper & Row. O’Brien, K. M. (2001). The legacy of Parsons: Career counselors and vocational psychologists as agents of social change. Career Development Quarterly, 50, 66–76.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Parsons, F. (1909). Choosing a vocation. Boston: Houghton Mifflin. Patterson, D. J., Darley, J., & Elliott, J. (1936). Men, women, and jobs. Minneapolis, MN: University of Minnesota Press. Reed, A. Y. (1916). Vocational guidance report 1913–1916. Seattle, WA: Board of School Directors. Rogers, C. R. (1942). Counseling and psychotherapy. Boston: Houghton. Romano, J. L., & Netland, J. D. (2008). The application of the theory of reasoned action and planned behavior to prevention science in counseling psychology. The Counseling Psychologist, 36, 777–806. Seiler, G., Brooks, D. K. Jr., & Beck, E. S. (1987). Training standards of the American Mental Health Association: History, rationale, and implications. Journal of Mental Health Counseling, 9, 199–209. Shertzer, B., & Stone, S. C. (1986). Fundamentals of counseling. Boston: Houghton Mifflin. Steinhauser, L., & Bradley, R. (1983). Accreditation of counselor education programs. Counselor Education and Supervision, 25, 96–108. Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70, 477–486. Sue, D. W., Carter, R. T., Casas, J. M., Fouad, N. A., Ivey, A. E., Jensen, M., LaFromboise, T., Manese, J. E., Ponterotto, J. G., & Vasquez-Nuttal, E. (1998). Multicultural counseling competencies: Individual and organizational development. Thousand Oaks, CA: Sage. Sue, D. W. & Sue, D. (2007). Counseling the culturally diverse: Theory and practice (5th ed.). New York: Wiley. Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: W. W. Norton. Toporek, R. L., Lewis, J. A., & Crethar, H. C. (2009). Promoting systemic change through the ACA advocacy competencies. Journal of Counseling and Development, 87, 260–268. Williamson, E. G. (1939). How to counsel students: A manual of techniques for clinical counselors. New York: McGraw-Hill. Wilmarth, R. R. (1985, Summer). Historical perspective, part two. AMHCA News, 8, 21. Zinn, H. (2003). The people’s history of the United States. New York: HarperCollins.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
CHAPTER 3
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espite the importance of prevention, outreach, and advocacy, direct counseling interventions remain an essential part of the community counseling model. Counselors, by definition, do counsel, helping clients directly through individual, family, or group counseling. Although the provision of direct, one-on-one services should not be viewed as the only avenue toward promoting clients’ mental health, it should be seen as a basic building block in the community counseling framework. In order for direct counseling to complement the overall framework of the community perspective, it would have to be characterized by multicultural competence, a strengths-based approach, and a strong focus on context. The discussion in this chapter will emphasize theoretical perspectives and counseling strategies that adhere to these criteria. The RESPECTFUL approach (D’Andrea & Daniels, 1997, 2001) lays the groundwork for an approach to assessment and counseling that is based on a broad and deep appreciation for multiculturalism, diversity, and social context. THE RESPECTFUL COUNSELING FRAMEWORK
The RESPECTFUL counseling framework (a) recognizes the multidimensional nature of human development and (b) addresses the need for a comprehensive model of human diversity that has practical utility for the work of mental health professionals (D’Andrea & Daniels, 1997, 2001). Because the community counseling model addresses many concerns that have been raised by multiculturalists over 53 Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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the past several years, it is important to clarify what we mean by cultural diversity in terms of its practical application in direct services. The RESPECTFUL model of assessment and counseling embraces a broad and inclusive definition of the term cultural diversity. This comprehensive diversity framework consists of 10 factors. These factors were selected because they are noted to affect clients’ psychological development and personal well-being in many important ways. It is important to realize, however, that the components contained in this model do not represent an exhaustive listing of all the factors that impact human development. Following are the specific factors to which the RESPECTFUL framework directs attention: R—religious/spiritual identity E—economic class background S—sexual identity P—level of psychological maturity E—ethnic/racial identity C—chronological/developmental challenges T—various forms of trauma and other threats to one’s sense of well-being F—family background and history U—unique physical characteristics L—location of residence and language differences The 10 factors that make up the RESPECTFUL counseling framework represent what we consider to be important aspects of “cultural diversity.” Thus, although ethnic/racial considerations are indeed addressed in the community counseling model that is presented in this book, many other factors are viewed as representing vital “cultural” considerations that counselors need to address when working with persons from diverse client populations. In presenting this perspective, it is acknowledged that women constitute a cultural group that is uniquely distinguishable from the way men are generally socialized in our society. The differences that are typically manifested in the language usage, unique life situations, and challenges that poor, middle-class, and upperclass persons routinely experience represent what we consider to be additional cultural distinctions that markedly distinguish persons in these groups. Additional cultural differences are noted between gay/lesbian/bisexual persons and heterosexual individuals, physically challenged persons and people who are temporarily able, and individuals who develop within different geographic/regional locations. The following description of the 10 components of the RESPECTFUL counseling framework is provided to enhance understanding of the various factors that are associated with our broad definition of cultural diversity. Religious/Spiritual Identity
The first component of the RESPECTFUL counseling model focuses on the way that individuals personally identify with established religions or hold beliefs Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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about extraordinary experiences that go beyond the boundaries of the strictly objective, empirically perceived world that marks Western, modern, psychological thought (D’Andrea, 2000; D’Andrea & Daniels, 2001). As used in the RESPECTFUL counseling framework, religion and spirituality generally refer to a person’s belief in a reality that transcends physical nature and provides individuals with an “extra-ordinary” meaning of life in general and of human experience in particular (Kelly, 1995). Because clients’ religious/spiritual identity may play an important role in the way they construct meaning-of-life experiences, interpret personal difficulties they encounter in life, and cope with stressful situations, it is important that counselors assess the degree to which this factor impacts a client’s psychological development early in the counseling process. Beyond making such individual assessments within the context of counseling, it is also apparent that individuals who exhibit different religious/spiritual identities (e.g., those persons who adhere to Jewish or Muslim beliefs) are often stereotyped, discriminated against, and oppressed by persons who identify with various Christian groups in American society. Because this stereotyping, discrimination, and oppression often result in unique stressors that have the potential to adversely impact the psychological wellbeing of those persons who identify with these and other religious/spiritual groups, it is important to use intervention strategies that are intentionally designed to promote ecological changes that foster positive changes among larger numbers of people in our society. This includes using preventive psycho educational interventions with school-aged youngsters that are aimed at increasing a more respectful and accurate understanding of persons who come from diverse religious groups and backgrounds, organizing community projects that involve persons from diverse religious groups, and advocating for the development and implementation of laws and institutional policies in schools, universities, workplaces, and communities that support the rights and dignity of persons who manifest different religious/spiritual identities. Besides thinking about the types of intervention strategies that are useful in promoting the mental health of persons who manifest different religious/spiritual identities, it is equally important for counselors to recognize that they are susceptible to developing negative attitudes and views about persons whose religious/ spiritual identities are different from their own. For this reason, it is vital that counselors take time to consider how their religious/spiritual identity and beliefs may positively or negatively impact on the work they do with clients who embrace different perspectives in these areas. Economic Class Background
Numerous researchers have explained how a person’s attitudes, values, worldview, and behaviors are all affected by one’s economic class standing and background. Recognizing the influence that this aspect of clients’ multidimensionality has on their development, mental health practitioners need to be attentive to the ways in which this factor contributes to individuals’ identified strengths and expressed problems in direct counseling settings. However, because poverty Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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clearly has an adverse physical and psychological effect on the lives of millions of persons in the United States, it is important for counselors to use their advocacy skills to support various ecological changes that are intentionally designed to eradicate the problems that poor people routinely experience in their lives. Ivey et al. (2002) also note that many counselors develop inaccurate and negative views and prejudices about persons who come from economic class backgrounds that are different from their own. For this reason, it is important that mental health professionals evaluate their own class-based assumptions, biases, and stereotypes when working with individuals from diverse economic class groups. It is particularly important for practitioners to examine closely how economic factors impact the psychological health and personal well-being of poor clients and to be mindful that traditional counseling theories were developed by middle-class individuals who did not usually give these issues enough weight. Sexual Identity
One of the most complex, though often understudied, aspects of an individual’s psychological development involves the sexual identity development of persons from diverse groups and backgrounds in our society. As used in the RESPECTFUL counseling model, the term sexual identity relates to a person’s gender identity, gender roles, and sexual orientation. The term gender identity refers specifically to an individual’s subjective sense of what it means to be either male or female. A person’s gender identity is clearly affected by the different roles men and women are socialized to play within a given cultural/ethnic context. A person’s sexual identity is also influenced by one’s sexual orientation. There are a number of ways to conceptualize this dimension of a person’s sexual identity. Generally, sexual orientation includes such concepts as bisexuality, heterosexuality, and homosexuality. Bisexuality refers to individuals who demonstrate a sexual interest in both males and females. Heterosexuality, in contrast, relates to individuals whose sexual interest is directed toward persons of the opposite sex. A third way of viewing this dimension of one’s sexual identity involves the concept of homosexuality, which is a term that has been used to identify individuals whose sexual orientation involves persons of the same sex. In light of the negative stereotypes that have historically been associated with the term homosexuality, terms such as gay males, gays, and lesbians are considered more acceptable and respectful in describing this dimension of a person’s sexual identity (D’Andrea & Daniels, 2001). Ethical counseling practice necessitates respectful acknowledgment and acceptance of a client’s unique sexual identity. However, given the intense negative views and reactions that many people have toward feminist advocates and gay/lesbian/bisexual persons in our nation, counselors must work beyond the confines of individual counseling settings if they are to promote the dignity and healthy development of larger numbers of persons who exhibit diverse sexual identities. Such efforts may include, but are not limited to, providing preventive education, outreach, consultation, advocacy, and organizational development Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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services that are specifically designed to foster ecological changes that promote more respectful treatment of persons who adhere to different sexual identities. Given the antifeminist and heterosexist attitudes and beliefs that exist in our society, it behooves counselors to assess how their own personal beliefs and biases about sexual identity may negatively impact the work they do with persons who are different from themselves in this regard. Psychological Maturity
Counselors often work with clients who share similar identities (e.g., religious/ spiritual, ethnic/racial, and sexual identities) and demographic characteristics (e.g., age, gender, and economic class) but who appear to be very different psychologically. In these situations, we might refer to one client as being “more psychologically mature” than another client who is the same age, identifies with the same ethnic/racial group, and shares a similar sexual and/or religious/spiritual identity as other persons with whom one works. Some descriptors that are commonly used by mental health professionals to describe “immature” clients include statements such as “He demonstrates limited impulse control in social interactions” or “She has a low capacity for self-awareness.” Statements that are commonly used to describe “more mature” clients include the following: “He is able to discuss his problems with much insight,” “She is highly self-aware,” and “She has developed a much broader range of interpersonal and perspective-taking skills than many of my other clients.” Structural-developmental theories view psychological development as a process in which individuals move from simple to more complex ways of thinking about themselves and their life experiences. This movement can be traced along a set of invariant, hierarchical stages that reflect qualitatively different ways of thinking, feeling, and acting in the world (Sprinthall, Peace, & Kennington, 2001). From the perspective of the community counseling framework that is presented in this book, we suggest that persons operating from these psychological stages reflect what might be considered to be uniquely different psychocultural mind-sets that represent qualitatively different attitudes, beliefs, and views of themselves and the world. When assessing clients’ levels of psychological maturity, counselors are better positioned to design intervention strategies that are more respectfully tailored to meet their unique psychological strengths and needs. It is also important that mental health professionals take time to reflect on their own development, as the helping process can easily be undermined when practitioners are matched with persons who are functioning at a higher level of psychological maturity than they are themselves.
Ethnic/Racial Identity
Tremendous psychological differences exist among persons who come from the same ethnic/racial groups. This sort of psychological variation is commonly referred to as “within-group” differences. Given the within-group variation Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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that is notably manifested among persons from the same ethnic/racial groups, it is important that counselors develop the knowledge and skills necessary to assess accurately these important differences and respond to them in effective and respectful ways in their work settings. It is also very important that mental health practitioners understand how their own ethnic/racial experiences have affected their development, the way they construct meaning of the world, and the types of biases they have acquired toward others in the process. Recent findings from the U.S. Census underscore the transformational changes that are occurring in the ethnic/racial makeup of the United States. These findings indicate that the United States is rapidly being transformed into a country in which most of its occupants will come from nonwhite, non-western European, non-English speaking backgrounds (D’Andrea & Heckman, 2008). Mental health care practitioners are increasingly realizing that it is not possible to work effectively or ethically within the context of a pluralistic society without acquiring an awareness of the broad range of issues related to human diversity and racial/ethnic group identity development. Because many of the stressors that persons from different ethnic/racial groups routinely experience emerge from various forms of stereotyping, discrimination, and racism that are perpetuated in various forms in our contemporary society, counselors are increasingly expected to work outside their offices. They are encouraged to do so to promote ecological changes that are designed to eradicate these environmentally based social toxins. Given the rapid ethnic/racial transformation that is occurring in the United States, it is expected that mental health professionals will continue to be called on to promote both individual and contextual-environmental changes that foster a greater level of respect for the rights and dignity of persons who come from ethnic/racial groups that have historically been marginalized. Chronological/Developmental Challenges
Age-related developmental changes represent what are referred to as “chronological challenges” that individuals face at different points across the life span. Mental health practitioners are familiar with many of these developmental challenges, because they represent characteristics commonly associated with childhood, adolescence, and adulthood. The specific changes individuals predictably develop from infancy through adulthood include physical growth (e.g., bodily changes and the sequencing of motor skills development), the emergence of different cognitive competencies (e.g., the development of perceptual, language, learning, memory, and other types of thinking skills), and the manifestation of a variety of psychological skills (e.g., the ability to manage one’s emotions and the demonstration of more effective interpersonal competencies) that occur over time. Human development researchers have greatly helped counselors refine their thinking regarding the unique challenges individuals face at different points across the life span. Practically speaking, this knowledge enables practitioners to work more effectively with persons who face difficult chronological challenges in their lives by implementing age-appropriate intervention strategies in the Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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counseling setting. This also allows practitioners to be mindful of the challenges they are likely to encounter when significant chronological differences exist between themselves and their clients. Elaborating on this point further, D’Andrea and Daniels (1997) suggest that many young practitioners are likely to encounter major challenges in terms of gaining a high degree of trust, respect, and professional validation when working with some clients who may be much older than they are. Much progress has been made in terms of gaining a greater understanding of the types of counseling interventions that are thought to be appropriate when working with clients of different ages in individual and small-group counseling settings. Despite the advanced understanding that has occurred in this area, it is clear that many youngsters and older adults are subjected to various types of environmental stressors (e.g., child abuse and neglect, physical assaults, and lack of financial resources to secure basic needs among many older adults) that compromise the mental health and personal well-being of millions of children, adolescents, and elderly persons in our society. Because individual, remedial counseling services represent inadequate responses to the types of environmental barriers that many youngsters and older adults encounter in their lives, other intervention strategies are needed to positively impact the lives of large numbers of persons who are subjected to various forms of age-related, environmentally based conditions that are unfair, unjust, and oppressive. The community counseling model describes numerous services and programs that are intentionally designed to promote positive ecological changes that are specifically aimed at fostering the overall health, well-being, and dignity of persons of all ages and particularly those children, adolescents, and older persons who are vulnerable to a host of mental health problems as a result of being subjected to the types of environmental stressors they face in their lives. Trauma and Other Threats to One’s Well-Being
Trauma and threats to one’s well-being are included in the RESPECTFUL counseling model to emphasize the complex ways in which stressful situations put people at risk of psychological danger and harm. Such harm typically occurs when the stressors that individuals experience in their lives exceed their ability to cope with them in constructive ways. One’s personal resources (coping skills, selfesteem, social support, and an individual’s sense of personal power) may be overtaxed when one is subjected to ongoing environmental stressors. Individuals who experience stressors for extended periods of time are vulnerable to future mental health problems. Such problems are often grounded in the different ways people are marginalized as a result of being a part of a devalued group in our society. Counselors are frequently called on to work with persons in various vulnerable groups, including poor, homeless, and unemployed people; adults and children in families undergoing divorce; pregnant teenagers; individuals with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS); persons with cancer; and individuals who are victimized by various forms of ageism, racism, sexism, and cultural oppression. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Because culturally competent mental health practitioners are aware of the ways environmental stressors threaten personal well-being, they implement intervention strategies that can help ameliorate these problems. For instance, counselors who work with persons from historically marginalized ethnic/racial groups need to be particularly aware of the ways in which intergenerational trauma is sustained over time. It is also important for practitioners to consider how various life stressors and traumatic events may have had a lasting impact on their own psychological development. Family Background and History
The rapid cultural diversification of the United States includes an increasing number of families that are very different from the traditional notion of “family” that many counselors have historically used as a standard for determining “normal family life” and “healthy family functioning.” The different types of families (e.g., single-parent families, blended families, extended families, and families headed by gay and lesbian parents) that mental health practitioners increasingly encounter in their work challenge them to reassess the traditionally held concept of the nuclear family that has been typically used as a standard to which all other types of families have been compared. In the 21st century, counselors are pressed to (a) understand the unique strengths that clients derive from these diverse family systems and (b) implement interventions that are intentionally designed to foster the healthy development of these familial units. In addition to learning about the personal strengths that individuals derive from these diverse family systems, mental health practitioners are encouraged to assess their own assumptions and biases about family life. If left unexamined, these biases and assumptions may adversely impact the helping process that involves clients who come from diverse family systems. Unique Physical Characteristics
The RESPECTFUL counseling framework emphasizes the importance of being sensitive to the ways in which our society’s idealized images of physical beauty negatively impact the psychological development of many individuals whose physical characteristics may not fit the narrow view of beauty fostered by our dominant culture. When working with clients whose physical characteristics may be a source of personal stress and dissatisfaction, it is important for counselors to consider how the myth of idealized physical beauty may lead many persons to internalize negative views and stereotypes about themselves. It is also important for mental health practitioners to consider how this myth may lead them to make inaccurate assessments and misinterpretations of our clients’ personal strengths. When counselors work with women and men whose psychological development is negatively affected by some aspect of their unique physical nature, practitioners need to be able to assist them in understanding the ways in which gender socialization contributes to irrational thinking about their own sense of Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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self-worth. Counselors need to be particularly sensitive to and knowledgeable about issues related to physical disabilities when working with persons who experience various types of physical challenges in their lives. This includes being knowledgeable of the environmental barriers that compromise physically challenged persons’ ability to realize their personal potential and sense of wellbeing. To address all these considerations, counseling practitioners need to operate from a comprehensive helping model, such as the community counseling framework that is presented in this book. Location of Residence and Language Differences
The location of one’s residence refers to the geographic region and setting where one resides. D’Andrea and Daniels (2001) identify five major geographic areas in the United States: the northeastern, southeastern, midwestern, southwestern, and northwestern regions. These geographic areas are distinguished by the types of persons who reside there and differ in terms of climate patterns, geological terrain, and to some degree the types of occupations and industry available to workers who reside in these locations. When mental health practitioners work with persons from geographic regions that are different from their own (including rural, urban, and suburban settings), it is important to reflect on the possible stereotypes and biases they may have developed about such persons and locations. This is particularly important when working with persons who use a different dialect or language in interpersonal interactions. As is the case with the other components of the RESPECTFUL counseling model, this sort of self-assessment is very important because unexamined biases about clients from different locations who use varied linguistic styles may unconsciously lead to unproductive and even negative outcomes in the counseling process. Relevance of the RESPECTFUL Framework
There are three aspects of the RESPECTFUL counseling model that are particularly relevant for the community counseling framework. First, it repeatedly emphasizes the need for counselors to address the multidimensional nature of human development in their work. As was mentioned earlier, although the 10 factors that make up the RESPECTFUL counseling model do not represent an exhaustive listing of all the factors that underlie the diversity that counselors commonly face when working with clients, they do constitute important considerations that practitioners are encouraged to keep in mind when working with persons from diverse groups and backgrounds. Second, this model underscores the need for counselors to use multiple helping approaches to promote the psychological health and personal well-being of large numbers of persons from diverse client populations. Although counselors will always be expected to provide individual counseling services to persons who are having difficulty coping with various stressors in their lives, research findings suggest that individual, remedial counseling is in and of itself insufficient to meet Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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the rising mental health needs of persons in the United States. To this end, it is argued that counselors will need to foster positive changes in clients’ environments by taking an ecological approach in their work (Neville & Mobley, 2001). Failing to do so, professional counselors are likely to be increasingly viewed in irrelevant and obsolete terms by many individuals whose personal well-being is undermined by environmental toxins that are embedded in many of our institutions, organizations, and communities (Locke et al., 2001). Third, the RESPECTFUL framework repeatedly emphasizes the need for counselors to assess themselves on each of the factors that make up this model. This is important because, like anyone, counselors are vulnerable to developing inaccurate beliefs, stereotypes, and biases about persons who are characterized by the various components of the RESPECTFUL model as a result of their own life experiences. When left unexamined, these beliefs, stereotypes, and biases can unintentionally and adversely affect the work that counselors do with persons who come from diverse client populations. Thus, the adage, “Counselor, know thyself,” is a central consideration that underlies the theory of counseling that is presented in this book. For this reason, the first competency-building activity is designed to assist you in reflecting on your own development and the multiple factors that have impacted your growth as a person. The RESPECTFUL Counseling Model and Counselor Self-Assessment
We are all “multidimensional” beings who have been and continue to be affected by the various factors listed in the RESPECTFUL counseling model. All these factors influence the way we construct meaning of ourselves, the people in our lives, and the world in which we live. Inevitably, all of us make inaccurate assumptions and develop biases about others as a result of the way these factors influence our own development. With this in mind, it is very important that counselors take time to reflect on the assumptions and biases that they have developed regarding clients who are different from them. In some cases, the assumptions and biases we have developed may be helpful in terms of working with clients from diverse groups and backgrounds. On the other hand, it is possible that some of the assumptions and biases we have acquired may result in ineffective and even harmful outcomes when they are interjected into the work that counselors do. (See Exhibit 3.1.)
ASSESSMENT
Because the community counseling framework operates from an empowerment perspective, assessment is guided by the premise that clients are responsible for running their own lives. Counselors can help identify problem areas and suggest possible solutions. To be most effective, however, the assessment process must elicit the client’s active participation. By participating in assessment, clients can Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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EXHIBIT 3.1 Competency-Building Activity
Using the RESPECTFUL Model for Counselor Self-Assessment Now that you have read about the RESPECTFUL counseling model, use this framework to evaluate yourself on each of the dimensions. After reflecting on the 10 components that make up the RESPECTFUL counseling framework, take a few minutes to write a short description of how your own development has been impacted by the different factors that are listed on this model (see the following list of factors). Be sure to identify as many personal strengths and biases as you have acquired from being impacted by the 10 components in this framework. Then briefly write a statement that describes the types of persons whom you are likely to be most effective working with given your own development. Finally, briefly describe the types of clients whom you are likely to be less effective with given the various assumptions and biases you have developed during your life. R—religious/spiritual identity E—economic class background S—sexual identity P—level of psychological maturity E—ethnic/racial identity C—chronological/developmental challenges T—various forms of trauma and other threats to one’s sense of well-being F—family background and history U—unique physical characteristics L—location of residence and language differences
both learn about themselves and begin to increase their sense of control over their actions. These benefits can occur only through a strengths-based, contextual, and culturally sensitive assessment process that is easily understood by clients. Unlike client evaluation approaches that are strictly diagnostic, the purpose of using this kind of assessment process is not just to place clients in appropriate treatment. Rather, the primary aim of such evaluation is to help clients devise a plan by which they can transcend problematic situations and improve the quality of their lives. From this perspective, the question to be answered through assessment is not “What is wrong with this person?” but “What is keeping this person from effectively managing his or her life right now?” and “How can these barriers be overcome?” The Collaborative Approach to Assessment
Regardless of what specific issues might bring people to a counselor’s office, most clients have in common the need to increase their sense of control over events Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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going on in their lives. What happens when the assessment process is taken out of a client’s hands to be performed by “experts”? The client’s presenting problems might be identified, but his or her sense of control and personal responsibility will ultimately be damaged. Assessment in the community counseling context, then, is a mutual effort in which both counselors and clients strive to identify barriers that can be overcome. Through this collaborative process, clients can make better use of their personal resources and increase their sense of empowerment. In the past, the clients who could benefit most from this respectful and collaborative approach were sometimes the ones least likely to receive it. Even now, people who are part of stigmatized groups or who are seen as particularly problematic are often distrusted, even by helping professionals, and assumed to lack the ability to participate actively in decisions about their own lives. In fact, however, the collaborative assessment process is demonstrably effective with these clients. Consider, for example, the use of the Collaborative Assessment and Management of Suicidality (CAMS) process with clients at risk for suicide (Jobes & Shneidman, 2006). Within CAMS there is a basic belief that suicidal thoughts and behaviors represent a fundamental effort to cope or problem-solve in pursuit of meeting legitimate needs (e.g., needs for control, power, communication of pain, or an end to suffering). From this perspective, a CAMS counselor approaches suicidality in an empathic, matter-of-fact, and non-judgmental fashion. Ironically, the counselor’s capacity to understand and appreciate the viability and attraction of suicide as a means of coping provides the essential ingredient for forming a strong therapeutic alliance where more adaptive methods of coping can be evaluated, explored, and tested. Philosophically speaking, CAMS emphasizes an intentional move away from the directive “counselor as expert” approach that can lead to adversarial power struggles about hospitalization and the routine and unfortunate use of coercive “safety contracts.” (Jobes, Moore, & O’Connor, 2007) Clients at risk for suicide have clearly been among the people least likely to be trusted with goal setting and decision making; yet, they can participate actively in a collaborative assessment and problem-solving process. Similarly, clients dealing with issues related to addictions have in the past been subjected to coercive treatment based on the belief that they could not be trusted to make decisions about their lives. Now, however, the research base showing the effectiveness of Motivational Interviewing (MI) for clients with addictions is too broad and deep to ignore (Hettema, Steele, & Miller, 2005; Rubak, Sanback, Lauritzen, & Christensen, 2005). A central purpose of MI is to help individuals resolve the ambivalence they feel when considering the possibility of change. Resolving ambivalence can be a key to change, and, indeed, once ambivalence has been resolved, little else may be required for change to occur. However, attempts to force resolution in a particular direction
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(as by direct persuasion or by increasing punishment for inaction) can lead to a paradoxical response, even strengthening the very behavior they were intended to diminish. (Miller & Rollnick, 2002) An assessment process that emphasizes diagnosis and attempts to move clients toward accepting a label for their problem often leads to defensiveness rather than movement toward change. In contrast, the spirit of MI is “collaborative, evocative, and honoring of patient autonomy” (Rollnick, Miller, & Butler, 2008, p. 6). Strengths-Based Assessment
Strengths-based and collaborative approaches to assessment are closely intertwined. Morgan (2004), in his discussion of strengths-based practice, emphasizes that these practices are based on building trusting relationships, empowering people to take the lead in decisions about their care, working collaboratively, and tapping into personal resources of motivation. Strengths-based assessment is “the measurement of those emotional and behavioral skills, competencies, and characteristics that create a sense of personal accomplishment; contribute to satisfying relationships with family members, peers, and adults; enhance one’s ability to deal with adversity and stress; and promote one’s personal, social, and academic development” (Epstein & Sharma, 1998, p. 3). In applying strengths-based assessment to children and their families, Epstein and Rudolph (2008) state that this approach is founded on four basic assumptions: Every child, regardless of his or her personal and family situation, has strengths that are unique to the individual. Children are influenced and motivated by the way significant people in their lives respond to them. Rather than viewing a child who does not demonstrate a strength as deficient, it is assumed the child has not had the opportunities that are essential to learning, developing, and mastering the skill. When treatment and service planning are based on strengths rather than deficits and pathologies, children and families are more likely to become involved in the therapeutic process and to use their strengths and resources (p. 5). In support of strengths-based assessment, especially with children and youth, several instruments have been developed. The Behavioral and Emotional Rating Scale (BERS) (Epstein & Sharma, 1998) measures the domains of childhood strengths: interpersonal strength, family involvement, intrapersonal strength, and school functioning. The Social Emotional Assets and Resiliency Scales (SEARS) is “a strength-based assessment system, aimed at assessing positive social-emotional attributes of children and adolescents, including social and emotional knowledge and competence, peer acceptance and relationships, resilience in the face of
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difficulties, coping skills, problem-solving abilities, empathy, global self-concept, and other positive traits” (Cohn, Merrell, Felver-Grant, Tom, & Endrulat, 2009, February 7, p. 1). The SEARS is designed for children and adolescents from the ages of five to eighteen. The Youth Competency Assessment (YCA) was designed by the Northwest Professional Consortium, Inc. (2004) with a focus on youth in the juvenile justice systems, where strengths-based approaches can be especially important. Whether they are young people or adults, clients who have traditionally been the recipients of deficit-based assessment are the ones who are most likely to benefit from a strengths-based approach. Balancing Demands and Resources
Clients generally have no trouble understanding that anyone could, because of genetic or other physiological factors, be vulnerable to specific stress-related problems or disorders. This susceptibility might never be triggered, however, if the individual were not subjected to severe and prolonged levels of stress. Even under stress, people protect themselves from dysfunction by mobilizing social support, using effective coping skills, and maintaining their self-esteem, all of which stimulate increased feelings of personal power. Counselors and clients can use the assessment process to focus both on demands and resources, stressors and strengths. Seeing their situations in this way helps clients to understand that they can take steps to reduce stress and/or to strengthen their resources and personal power. They can then more responsibly plan action strategies to address the issues that have come to light during the assessment. Purely personal change, without attention to context, may be impossible, impractical, or damaging to the individual’s integrity. Counselors who use the community counseling framework, therefore, should help clients do the following: Identify and own their strengths and resources. Make plans for increasing these resources if necessary. Identify and draw on sources of help in the environment. Make plans for reducing stressful elements in the environment, whether by avoiding them or directly confronting and changing them. The counselor and the client must jointly identify possible sources of support. No one can tell another person what his or her support system should be. Relationships are supportive and helpful only if people experience them that way. Thus, no objective standard can help one distinguish between a “good” environment and a “bad” one. Rather, the interaction between individuals and their surroundings determines this distinction; therefore, only the people involved can know when their own needs are being met in ways that promote positive and constructive psychological outcomes. The attention given to the environment distinguishes the community counseling model from other traditional counseling approaches. Most counselors have, in the past, assumed that the attitudes, feelings, or behavior of the client Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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should be the objects of change. Counselors are becoming more aware, however, that the obstacles to clients’ meeting their goals may lie in the environment rather than in the clients themselves. Intervention in the environment is therefore often imperative if an individual’s problems are to be truly resolved. At the same time, even when environmental factors have clearly contributed to the development of a problem, as when economic changes cause an individual’s unemployment, one must separate responsibility for the etiology of the problem from responsibility for the resolution of the problem. Otherwise, as Romano and Hage (2000) note, clients may suffer feelings of passivity, helplessness, and immobilization if they are portrayed as victims of economic and social circumstances beyond their control. Personal and environmental factors are closely interrelated. To choose sides, that is, to insist that most client problems arise either within the individual or from a destructive environment, is unrealistic and counterproductive. An assessment process that addresses both clients and context can lay the groundwork for practical and effective action plans. Client Conceptualization
Although it is readily apparent that strengths-based and contextual approaches to assessment and counseling are valuable, it is not always easy for counselors to put aside a natural inclination to focus on deficits. Counselors are more likely to conceptualize their clients’ situations from a positive and empowering perspective when they make purposeful efforts in that direction. The client conceptualization (what is often called a case conceptualization) reflects the way the counselor perceives the client, which in turn affects the helping strategies the counselor chooses. It takes structure to move a counselor in a direction that is in harmony with the community counseling model. Counselors should consider structuring their conceptualizations by asking themselves the following questions about each of their clients: 1. How can this client’s issues or problems be redefined in an empowering way? What strengths and competencies can be identified and encouraged? 2. How has this client been affected by oppression, injustice, or marginalization? 3. What counseling strategies can be used to overcome oppression-based barriers to healthy functioning? 4. What positive environmental resources might be available to this individual? Comparable questions can be asked not just about individual clients but also about families. 1. How can this family’s concerns be redefined in an empowering way? What strengths and competencies can be identified in individual family members and in the family as a whole? 2. How has this family or its members been affected by oppression, injustice, or marginalization? Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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3. What counseling strategies can be used to overcome oppression-based barriers to healthy functioning? 4. What positive environmental resources might be available to this family? Carlson, Sperry, & Lewis (2005) make the following case for a family counselor’s use of this type of conceptualization: The value of these questions lies in the necessity of helping family members and the family as a whole recognize their potential for strength. Oppression is insidious because external discrimination is combined with socialization processes that bring about internalized oppression; victims learn to accept the negative views of themselves that have been inculcated by the mainstream society.… The therapist’s ability to view families as having adaptive strengths … makes the first steps toward empowerment possible. (p. 137) Consider, as an example, a family that was introduced in Chapter 1 of this book. A family counselor has been working with a white middle-class family through the comingout process of their only child, a fourteen-year-old son. The parents, George and Carla Sparks, are glad their son trusted them enough to talk with them about his sexual orientation and they want to be supportive. At the same time, they feel very cautious about the family’s privacy and wish secrecy might be possible in their small, conservative town. Now their son, Chris, is having a problem with bullying at his middle school. The teachers and administrators have not been helpful and have suggested that Chris might do well to modify his own behaviors in the direction of masculinity. At this point, the parents’ feelings have begun to change from nervous protectiveness to helpless anger. Each member of this family is in pain, and it would be easy to fall into the trap of concentrating the counseling process solely on identifying and alleviating the pain. The counselor’s work can be enhanced, however, if he or she makes a conscious effort to identify strengths and to focus on the larger systems affecting the nuclear family. The Sparks family is clearly demonstrating that they have important strengths, including intense loyalty to one another, mutual supportiveness, and courage in facing a very difficult social environment. These strengths are clearly needed because of the fact that they are being forced to take a stand against a virulent form of oppression: heterosexism. Chris is being marginalized within the school, not just by other students but by educators as well. The family system is, in effect, standing up to an assault. This conceptualization of the situation carries implications regarding appropriate counseling strategies. In working with this family, the counselor should make sure to emphasize the strengths that the family has shown, helping to buoy up their courage. Oppression (in this case, heterosexism) is a powerful stressor that often leads individuals to look within themselves for the source of problems that are, in reality, externally based.
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Oftentimes these questions lead queer clients/students to negatively internalize heterosexist values, beliefs, and ideals. This is a process referred to as internalized heterosexism, and addressing internalized heterosexism is an empowering form of client/student advocacy. (Singh, 2010, p. 32) The “helpless anger” that George and Carla Sparks are feeling is understandable, but might interfere with their ability to achieve their primary goal: helping their son. Ideally, the counselor can help the family members recognize that their strengths have the potential to make them a powerful force. If their feelings of frustration can be channeled toward action, the quality of family life can be enhanced. It would of course be inappropriate for the counselor to press the family toward action that they might find too risky for their security and well-being within the community. The best step here is to follow up on the fourth question of the client conceptualization format: What positive environmental resources might be available to this family? Their caution in reaching out to a community characterized by conservatism might be warranted, but they should not assume that no support at all is available. Part of the process of counseling within the community counseling framework is to help clients assess their environments and seek positive sources of support. Added to the potential for support from people they know are organizations that have specific missions of advocacy. For example, Parents, Families, and Friends of Lesbians and Gays (PFLAG) can provide valuable help and support to George and Carla. Even if there is no PFLAG group in their own community, they can make use of the wealth of materials provided by the national organization. Similarly, an organization like the Gay, Lesbian and Straight Education Network (GLSEN) can provide significant help, given their mission of working toward schools that are safe for everyone. GLSEN envisions a world in which every child learns to respect and accept all people, regardless of sexual orientation or gender identity/ expression. GLSEN seeks to develop school climates where difference is valued for the positive contribution it makes to creating a more vibrant and diverse community. (Gay, Lesbian and Straight Education Network, 2010) The middle school attended by Chris may not have a gay-straight alliance in place, but awareness of GLSEN could help the family access information about what they have the right to expect from their school and what actions have proven useful to others. Through advocacy organizations, clients like Chris and his parents can gain access to resources that might not otherwise have reached their awareness, including such clearly applicable materials as Bullying among Children and Youth on Perceptions and Differences in Sexual Orientation, a tip sheet disseminated by the Health Resources and Services Administration (HRSA) as part of its Stop Bullying Now project (Health Resources and Services Administration,
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EXHIBIT 3.2 Competency-Building Activity
Client Conceptualization Exercise Is there a person you know, either personally or professionally, who worries you? Someone who seems to be dealing with difficulties that he or she cannot seem to overcome? Think about that person—or, if no one comes to mind, choose one of the client examples in Chapter 1. Conceptualize the person’s situation by using the Client Conceptualization Questions. 1. How can this client’s issues or problems be redefined in an empowering way? What strengths and competencies can be identified and encouraged? 2. How has this client been affected by oppression, injustice, or marginalization? 3. What counseling strategies can be used to overcome oppression-based barriers to healthy functioning? 4. What positive environmental resources might be available to this individual?
2010). Finally, the Sparks family might be able to find sources of support within the school. An especially promising possibility, of course, would be the school counselor, who would want to help Chris directly and who might decide to move in the direction of impacting school policy. Minority Identity Development
When working with clients from diverse populations, counselors must understand how a person’s cultural, ethnic, and racial background affects his or her psychological development (Sue & Sue, 1999). The Minority Identity Development (MID) model (Atkinson et al., 1998) provides an interesting explanation of how people from nonwhite minority groups develop a sense of personal identity within the context of a social environment that frequently devalues their cultural, ethnic, and racial background. In this model, minority refers to people who continue to be oppressed by the dominant societal group “primarily because of their group membership” (Atkinson et al., 1998, p. 13). This model is extremely relevant to the RESPECTFUL counseling framework that was outlined earlier in this chapter, as it directs attention to how a person’s group membership and environmental experiences impact his or her psychological development. Although they focus on people from diverse cultural/racial backgrounds, Atkinson et al. (1998) note that this definition allows women to be considered “minority group members,” even though they constitute a numerical majority in the United States, because they continue to endure various forms of oppression. The MID model is “anchored in the belief that all minority groups experience the common force of oppression, and as a result, will all generate a strong sense of Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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self- and group-identity in spite of their oppressive conditions” (Ponterotto & Pedersen, 1993, p. 45). Although the MID framework presents stages, the authors point out that one can best conceptualize it as a continuous process in which the characteristics of the various stages blend into one another without clear or abrupt demarcations (Atkinson et al., 1998). The MID model comprises five stages. Each of these stages is defined with respect to one’s (a) attitudes toward oneself, (b) attitudes toward others from the same racial/ethnic background, (c) attitudes toward people in other minority groups, and (d) attitudes toward the white majority in the United States. Though not intended to serve as a comprehensive personality theory, the MID model serves as a framework to help counselors understand minority clients’ attitudes and behaviors. The model can help counselors become more sensitized to the following: 1. The role oppression plays in a minority person’s psychological development 2. The differences that can exist between members of the same minority group with respect to their cultural identity 3. The potential developmental changes that people from various cultural, ethnic, and racial groups may manifest during their life span These developmental changes have been described in the following stages. The Conformist Stage. Minority individuals operating at the conformist stage show an unequivocal preference for the dominant cultural values over those of their own cultural-racial group. Their choice of role models, lifestyles, and values all follow the lead of the dominant societal group. Those physical and cultural characteristics that single them out as minorities cause them pain and embarrassment; they often view these characteristics with disdain or repress them from consciousness. Unlikely to seek counseling services for issues related to their cultural identity, clients at the conformist stage instead tend to seek out counselors from the dominant cultural group rather than those with the same minority background as themselves. Such clients usually present issues amenable to decision-making, problem-solving, and goal-oriented counseling approaches and techniques. The Dissonance Stage. In the dissonance stage, people from minority groups encounter information and experiences inconsistent with the values and beliefs associated with the conformist stage. These experiences and information stimulate an increased level of cognitive dissonance that leads these people to question and perhaps even challenge attitudes acquired in the conformist stage. At this stage, individuals are preoccupied with questions concerning their personal identity, self-concept, and self-esteem. They typically perceive personal problems as related to their cultural identity and background. Emotional problems may develop when they cannot resolve conflicts that arise when dominant cultural views and values conflict with those of their minority group. Clients at this stage prefer to work with counselors who possess a good working knowledge of their cultural, ethnic, and/or racial group. Recommended counseling Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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approaches for clients operating at this stage include those that facilitate selfexploration and the acquisition of stress management skills. The Resistance and Immersion Stage. In this stage of development, clients experience strong discontent and discomfort with the views and values of the dominant cultural group. These feelings are accompanied by a heightened desire to eliminate the oppression and injustice that minority groups experience. At this stage, clients typically express negative reactions and anger toward members of the dominant societal group. The likelihood that people functioning at the resistance and immersion stage will seek formal counseling is slim. However, those instances when counseling is sought tend to occur as responses to immediate personal crises and with a counselor from the same minority group as the client’s. Clients at this stage usually view all psychological problems as a product of their oppression. Useful counseling strategies include group process interventions and referrals to community or social action groups and organizations. The Introspection Stage. Clients operating at this stage manifest discontent and discomfort with many of the rigidly held views associated with the resistance and immersion stage. As such, they often focus on their personal and psychological autonomy. Clients at the introspection stage are torn between identification with their minority group and the need to exercise greater personal freedom and decision making. Much more likely to seek counseling than those at the resistance and immersion stage, people at the introspection stage generally prefer counselors from their own cultural group. These clients, however, may view counselors from other cultural backgrounds as credible sources of help if their worldviews resemble those of the clients. Counseling approaches recommended at this stage include problem-solving and decision-making methods as well as techniques that promote stress management skills and encourage self-exploration of culturally relevant issues and concerns. The Synergistic Articulation and Awareness Stage. At this stage, clients feel self-fulfillment regarding their personal and cultural identity. The conflicts and discomforts manifested at the introspection stage have generally been resolved, allowing individuals to experience a greater sense of personal control and flexibility in their lives. Clients objectively examine the cultural values of other minority groups as well as the dominant group and accept or reject them on the basis of experience gained in earlier developmental stages. Clients at the synergistic articulation and awareness stage manifest a heightened desire for psychological freedom. Their sense of minority identity is wellbalanced by a genuine appreciation of other cultures. Attitudinal similarity between the counselor and the client, rather than issues related to the client and counselor’s group membership similarity, becomes an important determinant of successful counseling outcomes (Atkinson et al., 1998). The MID model complements the community counseling framework because it focuses on how the broader sociopolitical environment influences Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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the psychological development of people from devalued groups. As mentioned in Chapter 1, the community counseling model centers on the belief that counselors need to be keenly aware of the ways in which the environment impacts clients’ development and be able to provide counseling services that foster their ability to constructively negotiate oppressive environmental circumstances. Using the MID model can greatly help counselors understand how participation in various environmental institutions, organizations, and systems can affect culturally diverse clients’ psychological development.
COUNSELING APPROACHES WITH A SOCIAL JUSTICE ORIENTATION
Ratts (2009) suggests that a social justice paradigm “is related to a growing need to connect human development issues with toxic environmental conditions” (p. 163). Ratts accentuates the fact that this paradigm has impact on the counselor’s view of the locus of client problems. Environmental factors, such as racism, sexism, heterosexism, and classism, can delay people’s growth and development and hinder people’s ability to reach their potential. This is especially true for clients who have been historically marginalized in society, such as people of color, those in poverty, and individuals who are lesbian/gay/bisexual/transgender (LGBT). Helping clients recognize the presence of oppressive factors is important because it prevents them from blaming themselves for their plight. (Ratts, 2009, pp. 163–164) Ratts emphasizes the social justice counselor’s role of advocacy and social activism, stating that “a social justice counseling approach uses social advocacy and activism as a means to address inequitable social, political, and economic conditions that impede on the academic, career, and personal/social development of individuals, families, and communities” (Ratts, 2009, p. 160). It is clear, however, that the assumptions underlying the social justice paradigm and the community counseling model have relevance for direct counseling services as well. A social justice orientation would lead a counselor toward (a) approaching each client with an understanding of the situation in the broadest possible context, (b) helping the client gain this understanding as well, and (c) working from a strengths-based perspective. In other words, the counselor would use the wideangle lens, rather than the microscope. This general paradigm leaves room for different theoretical perspectives. Among the counseling theories or approaches that adhere to the social justice paradigm are (a) empowerment-focused counseling, (b) ecological counseling, (c) feminist counseling, and (d) relational-cultural counseling. Many other theories contain certain elements of this approach as well, but these four have a social justice orientation at their core. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Empowerment-Focused Counseling
In the past, counselors across most theoretical perspectives were encouraged to keep their clients’ focus on the things they could control. Counselors were trained to pass on to clients the belief that both the cause of problems and the solutions lay within the individual. But “problems are not always developed or solved inside one person’s skin” (Ratts, 2009, p. 163). As most counselors are aware, one’s mental health is affected by experiences of oppression.…Traditional counseling, however, has focused on working with clients on internal issues (e.g., depression, stress management) as opposed to external forces (e.g., racism, oppression, discrimination) that create stressors and disempowerment. (Holcomb-McCoy & Mitchell, 2007) Although it might seem counterintuitive at first, the fact is that clients can be more empowered—not less empowered—if they learn to recognize the ways they are affected by their environmental contexts. Exhibit 3.3 differentiates between empowerment and disempowerment. The fact that “awareness of context, including oppression” versus “selfblame” appears first in the empowerment-disempowerment table reflects the notion that dealing with this phenomenon lays the groundwork for the client’s readiness to move on to action. As long as the client is mired in self-blame, he or she will have difficulty meeting the challenges of developing life skills, finding sources of support, getting beyond victimization, and perceiving options that seemed invisible before. “Clients who recognize the role of oppression in their lives are most likely to be able to move from the morass of self-blame to the solid ground of self-management” (Carlson, Sperry, & Lewis, 2005, p. 128). The impact of oppression remains insidious until it is recognized for what it is. Oppression can be defined as “the systemic disadvantaging of one group by another group that holds the collective power of the state or society” (Arnold,
EXHIBIT 3.3 Competency-Building Activity
Empowerment versus Disempowerment Empowerment
Disempowerment
Awareness of context, including oppression
Self-blame
Skills for self-management
Lack of self-management skill
Mutual support
Isolation
Self-esteem
Victimization
Ability to recognize options and make choices
Perceived lack of choices
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1997). Oppression differs from prejudice because, unlike prejudice, oppression has the power of culture, society, and the state behind it. The power of systemic oppression is what makes internalized oppression so pervasive. Internalized oppression is the acceptance, most often unconscious, of the myths, misinformation, and stereotypes the dominant culture constructs about a person’s own group. Victims take on the values and norms of the dominant group and cast aspersions on the experiences and traditional values of their own group. (Lewis & Arnold, 1998, p. 53) Systemic oppression, with the accompaniment of internalized oppression, makes positive individual action difficult. Consider, for example, the impact on women of sexism, which is one form of oppression. Many women lack awareness that the boundaries confining them are constructed as part of the apparatus of oppression. Without this awareness, they become mired in self-blame. “Why,” they ask, “can’t I get a job that’s good enough to support my kids?” “What is it about me that makes me so disorganized that I can’t seem to do my job, take care of the house, be patient with my children, and take better care of my aging parents?” “What should I have done differently to keep my husband from hitting me?” “Why did I make the mistake of going to a place that put me in danger of being raped?” “Why do other people seem to be able to take action and get what they need when I can’t?” “Why am I stuck?” Empowerment involves, first, recognizing that these problems do not stem from a defect within the individual but are instead violations of her selfhood. Perhaps what the client needs to be asking is “How can we get past a situation in which women’s salaries are a fraction of white men’s?” “How can we get past a situation in which women are expected to carry out all of these family roles without the responsibilities being shared and without support from the community?” “Why is even unpaid family leave being questioned by the government?” “How can women and men work together to end the culture of violence and victimization?” “Now that I realize these things that have happened in my life are not my fault, how can I get out of stuckness and into action?” (Lewis, 2007, p. 103). The effect of sexism on women is no more or less than the effects of the other “isms” on victims of oppression. In fact, everyone is hurt by oppression, even those in positions of power. We often act as if oppression hurts only the victim of oppression. Therefore, we think that sexism hurts women and not men, that racism wounds people of color and not White people, and that gay oppression has no impact on heterosexuals. It is important to note that victims and oppressors are hurt differently but that each is still hurt. People who identify with their oppressor status often feel that they have a stake in maintaining what they believe is their power. However, many persons Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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are totally unaware that the cost of holding on to such “power” is disconnectedness and alienation from one’s self and others. Another cost is having their own lives constrained and limited by the prescriptions that oppression imposes. (Arnold, 1997, p. 42) An empowerment approach, then, is appropriate for all clients, not just those whom the counselor perceives as being minority-group members. The competencies that underlie an empowerment-based approach to counseling are explicated in the ACA Advocacy Competencies (Lewis et al., 2002): Advocacy-oriented counselors recognize the impact of social, political, economic, and cultural factors on human development. They also help their clients and students understand their own lives in context. This understanding helps to lay the groundwork for effective self-advocacy.… In direct interventions with clients and students, the advocacy-oriented counselor is able to: Identify the strengths and resources that clients/students bring to the counseling process. Identify the social, political, economic, and cultural factors that affect the client/student. Recognize the signs indicating that an individual’s behaviors and concerns reflect responses to systemic or internalized oppression. At an appropriate developmental level, help the individual identify the external barriers that affect his or her development. Train clients and students in self-advocacy skills. Help clients and students develop self-advocacy action plans. Assist clients and students in carrying out self-advocacy action plans. The situation of Jason, a 17-year-old African American high school student provides an example of empowerment-based counseling (Lewis & Elder, 2010). Jason is an all-A student at a predominantly white suburban high school. Jason and his parents chose this school because its reputation for academic excellence seemed appropriate, given his goal of attending a good Ivy League university. He has always seemed well adjusted in the school environment, but has in fact had some problems being assigned to honors and advanced-placement classes. He hasn’t always felt that he fit in, so when a popular, athletic, and academically superior classmate invited him to join a group outside while his girlfriend was in the restroom he was flattered and happy to do so. When it turned out that this group of male students was drinking beer, he joined them even though he had no interest in drinking. When they reentered the school, Jason was singled out by a teacher he didn’t know, accused of showing the effects of alcohol, and referred to the principal for disciplinary action. Jason was worried that he might actually get suspended or expelled and thereby lose all hope of achieving his dreams for college. Fortunately, he was allowed to see Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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his counselor before being disciplined. The purpose of the counseling visit, he was told, was so that the counselor could evaluate his drinking problem. When the counseling appointment began, Jason expressed his anger that he had been singled out for discipline, given that he was the only student of color included in the group and none of the others had been confronted. Some counselors might have insisted that he focus on his own mistakes, but this empowerment-oriented counselor knew how important it was to spend time exploring the possibility that racism had played a part in this crisis. Counselor and client talked about the fact that he had often experienced less-than-respectful treatment from people, whether students or teachers, who did not know him. Those experiences were more subtle, of course, and this situation was potentially disastrous. Once the exploration of the role of race in this situation was explored in an open and respectful way, Jason was ready to begin looking at plans for lessening the damage to his life plan (Lewis & Elder, 2010, p. 165). JASON: My parents being disappointed in me might be the worst thing. I can’t look my mother in the eye. COUNSELOR: So as much as you know that there’s racism involved in this and you’re mad about that, you’re also mad at yourself for being in a position that this teacher could get at you. JASON: I should never have let myself be in that position. Never … I’d been feeling like I’d like to hang out with these other guys. Like maybe I didn’t have to be so super-careful any more. What a joke. I wasn’t brought up to ever think that. At this point, the counselor could help Jason and his parents to develop some plans for self-advocacy. Because the counselor had understood the urgency of exploring the racism underlying this crisis, she was accepted as an advocate and able to play a strong role in helping the family through an all-important conference with the principal. Once the pervasive impact of racism is acknowledged as a force in a Black family’s experience, the family can move on to confront other issues. But if the impact of racism is ignored, it’s unlikely that therapy will go anywhere. (Franklin, 1993, p. 36) Once Jason’s crisis situation was addressed the counselor would also need to look clearly at what actions she would need to take to address what appeared to be a systemic problem in the school as a whole. Ecological Counseling
Conyne and Cook (2004) differentiate between a traditional, person-oriented focus, on the one hand, and an ecological focus on the other. A client’s behavior (or thinking or feelings) seems to be getting him or her into some type of trouble. The obvious solution is to help the client change this problem so that the difficulties ease. The target of the Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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behavior change process is the client; the problem is some aspect of his or her functioning; the goal of counseling is substitution of a more adaptive way of being. The counselor serves as a remediation expert, skilled at identifying the nature of one’s personal dysfunction and helping the client develop alternatives that are more satisfying. This characterization of counseling has widespread support, and for good reason: it has helped countless clients live happier lives. Yet this view is only part of a broader perspective on what constitutes, maintains, and changes human behavior. This broader perspective … has the potential to dramatically increase a counselor’s scope for action—and his or her success with a broad range of client concerns (pp. 3–4). It is noteworthy that Conyne and Cook are respectful in their assessment of person-oriented counseling. They recognize that counseling has always been, and continues to be, a power for good. They also recognize, however, that viewing clients from a broader perspective adds value to the counselor-client interaction and to the effectiveness of the counseling profession as a whole. This attitude is in keeping with the notion of social justice counseling as the “fifth force” in counseling, following chronologically the predominance of the psychodynamic, cognitive-behavioral, existential-humanistic, and multicultural forces (Ratts, D’Andrea, & Arredondo, 2004). Social justice counseling does not serve as a replacement for what came before, but rather adds a key ingredient that might previously have been overlooked. This new ingredient can give added meaning to the forces that came before. That process certainly describes what took place with the advent of multicultural counseling as the fourth force: now every counselor, regardless of theoretical perspective, is expected to be multiculturally competent. What was once perceived as a theory to be differentiated from others is now recognized as a basic building block of all approaches to counseling. Those approaches are not erased, but they are clearly enhanced. Ecological counseling is “contextualized help-giving that is dependent on the meaning clients derive from their environmental interactions, yielding an improved ecological concordance” (Conyne & Cook, 2004, p. 6). The environmental interactions are many, since each individual is part of an ecosystem that is the “sum total of interacting influences operating in a person’s life, including such diverse factors as biological makeup, interpersonal relationships, the physical environment, and the broader socio-cultural context” (Conyne & Cook, 2004, p. 11). The concept of ecological concordance involves “a mutually beneficial interaction between person and environment” (Conyne & Cook, 2004, p. 24). The counseling process can help clients make changes—whether focused on themselves, their environments, or the person-environment interaction—to enhance ecological concordance. Just as important is the idea that the counselor working from an ecological framework has a number of options in terms of intervention targets, including the following: Counseling an individual client. Carrying out counseling or educational interventions with a primary group, e.g., a counseling group or a family. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Intervening at the level of an associational group, e.g., carrying out organizational consultation. Intervening at an institutional level by carrying out community development, social advocacy, primary prevention, or system change. The ecological counseling model gives further clarity to the case of Jason, which was discussed in the previous section of this chapter. The concept of ecological concordance, for instance, sheds light on Jason’s life in several aspects of his eco-system, including his family, his friendships, and his school. His life had appeared to be going smoothly, with his trajectory toward his life goals solidly in place. The situation he encountered opened up the need—and the opportunity— for counselor and client to look more closely at his ecosystem and the meaning he derived from it. At first glance, Jason’s goals are his own and his parents’ role is one of support. Yet, it would be worth exploring his family niche to get a better sense of the balance between support and pressure. The problems related to ecological concordance in Jason’s relationship to his peers and his school are more obvious. Because his academic life had been going well, even he, himself, thought his school was a comfortable fit for him. Did he hold to an expectation that he could expect nothing more from his school than a first-class diploma and a good college recommendation? Might this current predicament provide him with an opportunity to think more about what kind of environment his school should provide and what kind of personal support he should expect? The ecological model provides guidance for ways in which the counseling experience can help in the search for answers to these questions. Moreover, the model lays the groundwork for the counselor to decide on appropriate intervention targets. In this case, interventions should clearly focus on the individual, the family, and the school. Moreover, because Jason’s experience is far from unique, the counselor might focus on social advocacy and system change at an institutional level.
Feminist Counseling and Therapy
The feminist wave of the 1960s and 1970s brought with it the concept that “the personal is political.” Many women began to realize that problems that they perceived to be their own were, in fact, systemic. They began to perceive that what they thought were personal shortcomings were actually rooted in social/political realities. How else could they explain the coincidence of their shared realities? The means for exploring this concept involved a network of “consciousnessraising” groups through which women’s stories could be expressed—and compared. We are learning that it has to be more than coincidence that almost all of the bright, competent women we know are bogged down by nagging doubts about their own ability to think, work, or live effectively. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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We are learning that we don’t have to see ourselves as nit-picking weirdos doomed to go through life without personal support because we object to being called Mrs. John Jones… We are learning that experiences we thought were unique to our own lives have been shared by women of different ages, localities, and backgrounds—just because they are women… We are learning that we no longer have to accept male-oriented economic values that classify men who work for bread as persons, women who work for bread as semi-persons, and women who work in their homes as nonpersons. We are learning that we do have options and role choices—personal as well as vocational—and that these options and choices can be enhanced through our solidarity and mutual support. (Lewis, 1972, p. 148) The consciousness-raising groups followed an egalitarian model and did not make use of helping professionals as leaders and did not take place in institutional settings. We are going that route because we must, for fear of what would happen to us if we depended on professionals. We are afraid that counselors would try to make us content with being called Mrs. John Jones. We are afraid that counselors might force us to ignore the commonality of our experiences. We are afraid that counselors would “help” us adjust to values that are harmful to our own self-concepts. We are afraid that counselors would actually limit our options. And we know that, even if we found professionals who wanted us to get strong individually, they might never care whether we got strong collectively. (Lewis, 1972, p. 148) These fears were all too often based in reality. “Therapy can easily take the political and make it highly private and personal; a political stance of anger about discrimination can quickly be transformed by a therapist into a ‘dysfunctional cognition’ or a sign of ‘issues with parents’” (Brown, 1994, p. 37). Feminist counseling and therapy grew out of the realization among helping professionals that the status quo in counseling and therapy was too damaging to continue. The impact of cultural norms, social expectations, and political structures in the lives of women was virtually ignored. Therapeutic approaches developed by and based on culturally empowered White men were indiscriminately and systemically misapplied to culturally disempowered women (and other disempowered people). (May, 2001, p. 6) Feminism has always concentrated on gender as a political construct and still does to this day. But the fact that “the personal is political” has obvious implications not just for women but for other oppressed groups as well. Consider again,
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for example, the case of Jason. If his counselor had narrowed the focal point of the counseling process only to his own behaviors, without exploring systemic racism in the school, her intervention would have failed. Many counselors and therapists view the feminist model as appropriate for men as well as women and use it to increase their understanding of all forms of oppression. The feminist movement itself, however, did not progress smoothly in this direction. “It has been the challenge of the modern feminist movement to integrate issues of race, culture, and class into feminist philosophy and feminist therapy practice” (Evans, Kincade, Marbley, & Seem, 2005, p. 273). This conflict has played out not just at a theoretical level but also in the day-to-day experience of women of color, many of whom viewed the feminism of the 1960s and 1970s as being too focused on the needs of white women to be helpful to them. Due to the oppressive, brutal, and violent nature of slavery and racism over the last four centuries, sexism is viewed by many African Americans, both male and female, as a factor of minimal importance. The prevailing sentiment was, and still remains, that the survival of the African American family and community is primary. (Evans et al, 2005, p. 273) The overwhelming presence of racism affects male-female relationships and makes it necessary for counselors—especially family counselors—to understand the reality of multiple oppressions. Women of color share racist oppression with the men in their lives: their fathers, brothers, male relatives, friends, lovers, and sons. Counselors need to be aware of important aspects of the dynamics that influence male-female relationships among people of color, including (a) racial barriers that hinder men of color from performing the provider role and (b) feelings of fear for, and protectiveness toward, men of color that have been inculcated in women of color…. Feminists, for the most part, recognize that all men are not equally powerful in this society given race and class differences. However, many feminist family counselors do not understand the concerns of women of color regarding the safety and protection of the men in their lives. (Arnold, 2001, p. 23). The complexity of relationships that exist in a context of multiple oppressions is illustrated by Carole and Franklin, a couple introduced in Chapter 1 of this book. A mental health counselor in private practice has as a client an African American woman who has experienced mild depression and anxiety since the birth of her second child. When Carole and her husband, Franklin, were married ten years ago they both had active and stimulating corporate careers. Carole’s career has suffered as she has tried to balance child care and work. At the same time, Franklin’s career has flourished and his
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current executive job places high demands on his time. He reminds Carole that he is the first African American to reach this level in his company and reminds her that there are people who opposed his promotion. Franklin has been vehement in insisting that Carole stay home after her current maternity leave has ended, saying that once they have paid for child care her salary has no effect on their family income except to put them in a higher tax bracket. Carole wanted her children and enjoys being a parent, but she is surprised— even disappointed—about the direction her life has taken. A feminist counselor would recognize that the limitations Carole feels in her life are a function of the social/political context that goes far beyond her immediate family. Her husband, Franklin, was not the inventor of the idea that women’s careers are less important than men’s. Not only Franklin but Carole as well have internalized stereotypical and limiting messages about gender that remain ubiquitous even in the 21st century. Not only are women’s careers assumed to be less important than men’s but men’s attention to parenting is viewed as less important than women’s. Carole’s feelings of sadness and frustration are focused inwardly and she has not yet made the connection between her personal situation and the cultural imperatives that have made it what it is. Carole’s counselor would, of course, help this client to explore what she has learned about the nature of family life and the gender roles that men and women are expected to play. The feminist counselor would also be aware, however, of the devastating effects of competing oppressions. One of the reasons Carole hesitates to confront her husband is her recognition that what he says about his own career is true: as an African American man, his job, even at this high executive level, can be in jeopardy. Both Carole and Franklin have work to do as a couple in analyzing the impact of the forms of oppression that are hurting them both. Arnold (2001) suggests that counselors can help their clients best if they recognize the complexity of relationships that are affected by competing oppressions. This process includes “assuming the best about each client and not blaming clients for the double-bind that they find themselves in with intimate partners because of racism and sexism” (p. 24). The womanist movement, as described by Evans et al. (2005), provides a broad conceptualization that helps to move the conversation from a focus on a single example of oppression to a focus on multiple oppressions. Womanists participate in combating racial, gender, heterosexual, and class oppression simultaneously so that they can honor and confront the multiple oppressions faced by woman of color. For womanists, the belief that the “personal is political” is as critical as it is for those who call themselves feminist. The womanist, however, is less focused on uplifting females in isolation or in using gender as its primary focus to combat oppression. Womanists are primarily concerned with uplifting an entire culture and, in doing so, believe that women will be uplifted as well. (p. 274)
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Relational-Cultural Therapy
Relational-cultural therapy represents a model that has become broader and deeper over the years since its creation as self-in-relation. The progress of this model has been much more direct and purposeful than is the case with feminist therapy. This model has always had a home in the Stone Center at Wellesley University, and the scholars associated with the Center published each expansion of the theory through a series of working papers. Early publications ( Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Miller, 1976) used the term self-in-relation to introduce the idea that, for women, the self was relational. While women’s development took place in the context of connections and relationships, psychological and developmental theories told a different story, emphasizing autonomy and separation as the ideals toward which people should strive. The contrast between what was true for women and what was expected by a society valuing separation was seen as harmful for women, especially when “therapeutic practices reflect the dominant culture of separation and power over others” ( Jordan & Walker, 2004). The second set of Stone Center papers was published as Women’s Growth in Diversity ( Jordan, 1997). This publication held firm to the centrality of connection but now used the term relational model, continuing to emphasize relations but moving away from the concept of self. Moreover, “Women’s Growth in Diversity … sought to move the model away from the biases of white, middle-class, heterosexual experience, from woman’s voice to women’s voices” (Jordan & Walker, 2004). The Complexity of Connection ( Jordan, Walker, & Hartling, 2004) built on this foundation, underlining culture to the extent that the term relational-cultural therapy now describes with accuracy the work of counselors and therapists who follow the model. Relational-cultural therapy not only emphasizes culture in working directly with clients but also views the counselor-client relationship within the context of a culture—and a psychology—that can harm all of society’s members. As Jordan and Walker (2004) point out, Theories about human development must answer the question: What purpose and whose interests does the theory serve? The history of psychological theory is replete with evidence of complicity with cultural arrangements and power practices that divide people into groups of dominants and subordinates. In therapeutic practice, counselors and therapists work with their clients in accordance with a very different view of healthy human development. Relational-cultural theory (RCT) is built on the premise that, throughout the life span, human beings grow through and toward connection. It holds that we need connections to flourish, even to stay alive, and isolation is a major source of suffering for people, at both a personal and cultural level. ( Jordan, 2010, p. 1) The cultural context within which the individual develops can be positive or negative, depending on the degree to which relationships are encouraged or disrupted. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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EXHIBIT 3.4 Competency-Building Activity
Theory Application Earlier in this chapter, Exhibit 3.2 (Client Conceptualization) suggested that you identify an individual about whom you were concerned and answer the Client Conceptualization Questions with this individual in mind. Now, think again about the same individual. Choose one of the four counseling models discussed in this chapter. If you were a counselor using this theory, what ideas would you have about how you would work with this client?
RCT practitioners believe in the validation of the client’s experience, including naming the power of contextual factors to create psychological suffering. RCT pays particular attention to the effects of privilege, racism, sexism, classism, and heterosexism. This includes acknowledging all the ways that our contexts affect us. ( Jordan, 2010, pp. 57–58) Even a cursory review of the clients whose situations have been reviewed in this book makes the contribution of RCT clear. Consider Jason, who seems on the surface to be well adjusted in his school life. A counselor knowledgeable in RCT would see how isolated he actually is in the school environment and how powerfully racism feeds into that isolation. Carole and Franklin perceive themselves as people who should be pleased with their lives, but each is to some extent alone within the family relationship. Carole feels the lack of connection and suffers from it. Chronic disconnections result from the unresponsiveness of important people in our lives. When we are hurt, misunderstood, or violated in some way, when we attempt to represent our experience to the injuring person and we are not responded to, we learn to suppress our experience and disconnect from both our own feelings and the other person. If, on the other hand, we are able to express our feelings and the other persons respond with care, showing that we have had an effect, then we feel that we are effective in relationship with others, that we matter, that we can participate in creating growth-fostering and healthy relationships. Ultimately we feel anchored in community and we experience relational competence. ( Jordan & Walker, 2004) These healthy experiences require not just mutually empathic relationships with other individuals but a cultural context that supports them. SUMMARY
Direct counseling interventions are an essential component of the community counseling framework, especially if these interventions are characterized by multicultural competency, a strengths-based approach, and a strong focus on context. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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This chapter emphasized assessment and counseling perspectives that adhere to these criteria. The RESPECTFUL framework gives direction to both assessment and counseling by helping to focus the counselor’s attention on multiple factors affecting human development. Assessment processes should be collaborative and strengths-based, helping the client to balance demands and resources. A client conceptualization that helps the counselor move away from a natural inclination to focus on deficits asks counselors to (a) recognize the client’s strengths and resources; (b) consider how the client has been affected by oppression, injustice, or marginalization; (c) identify counseling strategies that can be used to overcome oppression-based barriers to healthy functioning; and (d) cite environmental resources that could be of help to the individual. Counseling theories that are oriented toward social justice were reviewed in this chapter. These theories include empowerment-focused counseling, ecological counseling, feminist counseling, and relational-cultural counseling. EXHIBIT 3.5 Competency-Building Activity
Program Development Consider once again your own hypothetical community counseling program—the one you began designing after Chapter 1. Given what you have read in Chapter 3, you should be ready to address part of the quadrant listing focused strategies for facilitating human development. Given the client population you selected, what ideas do you have about the counseling strategies you would use? What particular aspects of the environment would influence the counseling process?
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Brown, L. S. (1994). Subversive dialogues: Theory in feminist therapy. New York: HarperCollins. Carlson, J., Sperry, L., & Lewis, J. A. (2005). Family therapy techniques. New York: Routledge. Carter, R. T. (1995). The influence of race and racial identity in psychotherapy: Toward a racially inclusive model. New York: Wiley. Cohn, B., Merrell, K. W., Felver-Grant, J., Tom, K., & Endrulat, N. R. (2009, February 27). Strength-based assessment of social and emotional functioning: SEARS-C and SEARS-A. Presented at the National Association of School Psychologists, Boston. Retrieved January 15, 2010, from http://strongkids.uoregon.edu/SEARS/Cohn2009.pdf. Constantine, M. G., & Ladany, N. (2001). New visions for defining and assessing multi-cultural competence. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 482–498). Thousand Oaks, CA: Sage. Cross, W. (1995). The psychology of Nigrescene: Revisiting the Cross model. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 93–122). Thousand Oaks, CA: Sage. D’Andrea, M. (1988). The counselor as pacer: A model for the revitalization of the counseling profession. In R. Hayes & R. Aubrey (Eds.), New directions for counseling and human development (pp. 22–44). Denver: Love Publishers. D’Andrea, M. (1994, April). Creating a vision for our future: The challenges and promise of the counseling profession. Paper presented at the meeting of the American Counseling Association, Minneapolis. D’Andrea, M. (2000). Postmodernism, social constructionism, and multiculturalism: Three forces that are shaping and expanding our thoughts about counseling. Journal of Mental Health Counseling, 22, 1–16. D’Andrea, M. (2001). Comprehensive school-based violence prevention training: Testing the effectiveness of using a developmental-ecological training model. Unpublished manuscript, University of Hawaii. D’Andrea, M. (2002). Notes on counseling practice at Meharry Medical College. Unpublished manuscript, University of Hawaii at Manoa. D’Andrea, M., & Daniels, J. (1992). Measuring ego development for counseling practice: Implementing developmental eclecticism. Journal of Humanistic Education and Development, 31, 12–21. D’Andrea, M., & Daniels, J. (1994). Group pacing: A developmental eclectic approach to group work. Journal of Counseling and Development, 72(6), 585–590. D’Andrea, M., & Daniels, J. (2001). RESPECTFUL counseling: An integrative multidimensional model for counselors. In D. B. Pope-Davis & H. L. K. Coleman (Eds.), The intersection of race, class, and gender in multicultural counseling (pp. 417–466). Thousand Oaks, CA: Sage. D’Andrea, M., Daniels, J., Arredondo, P., Ivey, M. B., Ivey, A. E., Locke, D. C., O’Bryant, B., Parham, T., & Sue, D. W. (2001). Fostering organizational changes to realize the revolutionary potential of the multicultural movement: An updated case study. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 222–254). Thousand Oaks, CA: Sage.
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D’Andrea, M., & Heckman, E. F. (2008). A forty-year review of multicultural counseling outcome research: Outlining a future research agenda for the multicultural counseling movement. Journal of Counseling and Development. A special issue on multiculturalism, 356–363. Epstein, M. H., & Rudolph, S. (June 12, 2008). Empowering children and families through strength-based assessment. Retrieved January 15, 2010, from the Community Alliance for the Ethical Treatment of Youth website at http://www.cafety.org/ research/121-research/587-empowering-children-and-families-through-strengthbased-assessment. Epstein, M. H., & Sharma, J. M. (1998). Behavioral and Emotional Rating Scale: A strengthbased approach to assessment. Austin, TX: PRO-ED. Evans, K. M., Kincade, E. Z., Marbley, A. F., & Seem, S. R. (2005). Feminism and feminist therapy: Lessons from the past and hopes for the future. Journal of Counseling & Development, 83, 269–277. Fetterman, D. M., Kaftarian, S. J., & Wandersman, A. (Eds.). (1996). Empowerment evaluation: Knowledge and tools for self-assessment & accountability. Thousand Oaks, CA: Sage. Franklin, A. J. (1993, July/August). The invisibility syndrome. Family Networker, 33–39. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226. Gay, Lesbian, & Straight Education Network (2010). About us. Retrieved March 9, 2010, from http://www.glsen.org/cgi-bin/iowa/all/about/index.html. Health Resources and Services Administration (2010). Bullying among Children and Youth on Perceptions and Differences in Sexual Orientation. Retrieved 1/30/09 from http:// stopbullyingnow.hrsa.gov/HHS_PSA/pdfs/SBN_Facsheet_GLBT.pdf. Helms, J. (1995). An update of Helms’s white and people of color racial identity models. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 181–191). Thousand Oaks, CA: Sage. Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual Review of Clinical Psychology, I, 91–111. Holcomb-McCoy, C., & Mitchell, N. (2007). Promoting ethnic/racial equality through empowerment-based counseling. In C. C. Lee (Ed.), Counseling for social justice (2nd ed., pp. 137–157). Alexandria, VA: American Counseling Association. Ivey, A. E. (1986). Developmental therapy: Theory into practice. San Francisco: Jossey-Bass. Ivey, A. E. (1991). Developmental strategies for helpers: Individual, family, and network interviewing. Pacific Grove, CA: Brooks/Cole. Ivey, A. E. (1994). Intentional interviewing and counseling: Facilitating client development in a multicultural society (3rd ed.). Pacific Grove, CA: Brooks/Cole. Ivey, A. E. (1995). Psychotherapy as liberation: Towards specific skills and strategies in multicultural counseling and therapy. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 53–72). Newbury Park, CA: Sage. Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2002). Theories of counseling and psychotherapy (5th ed.). Boston: Allyn and Bacon. Jobes, D. A., Moore, M., & O’Connor, S. S. (2007). Working with suicidal clients using the Collaborative Assessment and Management of Suicidality (CAMS). Journal of Mental Health Counseling.
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Jobes, D. A., & Shneidman, E. S. (2006). Managing suicidal risk: A collaborative approach. New York: Guilford. Jordan, J. V. (1997). Women’s growth in diversity: More writings from the Stone Center. New York: Guilford Press. Jordan, J. V. (2010). Relational-cultural therapy. Washington, DC: American Psychological Association. Jordan, J. V., & Walker, M. (2004). Introduction. In J. V. Jordan, M. Walker, & L. M. Hartling (Eds.). The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. New York: Guilford. Jordan, J. V., Walker, M., & Hartlings, L. M. (Eds.). (2004). The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. New York: Guilford. Jordan, J. V., Kaplan, A. G., Miller, J. B., Stiver, I. P., & Surey, J. L. (Eds.) (1991). Women’s growth in connection. New York: Guilford. Kelly, E. W. (1995). Spirituality and religion in counseling and psychotherapy: Diversity in theory and practice. Alexandria, VA: American Counseling Association. Lerner, R. M., & Kauffman, M. M. (1985). The concept of development in contextualism. Developmental Review, 5, 309–333. Lewis, J. A. (1972, October). Counselors and women: Finding each other. The Personnel and Guidance Journal, 51, 147–150. Lewis, J. A. (2007). Challenging sexism: Promoting the rights of women in contemporary society. In C. C. Lee (Ed.), Counseling for social justice (2nd ed., pp. 95–110). Alexandria, VA: American Counseling Association. Lewis, J. A. (1993). Farewell to motherhood and apple pie: Families in the postmodern era. The Family Journal: Counseling and Therapy for Couples and Families, 1(4), 337–338. Lewis, J. A., & Arnold, M. S. (1998). From multiculturalism to social action. C. C. Lee & G. R. Walz (Eds.), Social action: A mandate for counselors. Alexandria, VA: American Counseling Association. Lewis, J. A., & Elder, J. (2010). Substance abuse counseling and social justice advocacy. In M. J. Ratts, R. L. Toporek, & J. A. Lewis (Eds.), ACA advocacy competencies: A social justice framework for counselors (pp. 161–173). Alexandria, VA: American Counseling Association. Lewis, J. A., Dana, R. Q., & Blevins, G. A. (1993). Substance abuse counseling: An individualized approach (2nd ed.). Pacific Grove, CA: Brooks/Cole. Lewis, J. A., Sperry, L., & Carlson, J. (1993). Health counseling. Pacific Grove, CA: Brooks/Cole. Marecek, J. (1995). Gender, politics, and psychology’s ways of knowing. American Psychologist, 50(3), 159–161. May, K. M. (2001). Feminist family therapy defined. In In K. M. May (Ed.), Feminist family therapy (pp. 3–14). Alexandria, VA: American Counseling Association and International Association of Marriage and Family Counselors. McWhirter, E. H. (1994). Counseling for empowerment. Alexandria, VA: American Counseling Association. Miller, J. B. (1984). Toward a new psychology of women. Boston: Beacon. Miller, J. B. (1991). The development of women’s sense of self. In J. Jordan, A. Kaplan, J. B. Miller, I. P. Stiver, & J. Surrey (Eds.), Women’s growth in connection (pp. 11–26). New York: Guilford. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press. Morgan, S. (2004). Strength-based practice. Retrieved January 24, 2010, from http://www .practicebasedevidence.com/strengths/strengths_based_practice.html. Neville, H. A., & Mobley, M. (2001). Social identities in contexts: An ecological model of multicultural counseling psychology processes. The Counseling Psychologist, 29, 471–486. Nussbaum, M. C. (1999). Sex and social justice. New York: Oxford University Press. Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. (Eds.). (2001). Handbook of multicultural counseling (2nd ed.). Thousand Oaks, CA: Sage. Ponterotto, J. G., & Pedersen, P. B. (1993). Preventing prejudice: A guide for counselors and educators. Thousand Oaks, CA: Sage. Ratts, M. J. (Fall, 2009). Social justice counseling: Toward the development of a fifth force among counseling paradigms. Journal of Humanistic Counseling, Education and Development, 48, 160–171. Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York: Guilford Press. Romano, J. L., & Hage, S. M. (2000). Prevention and counseling psychology: Revitalizing commitments for the 21st century. The Counseling Psychologist, 28, 733–763. Rubak, S., Sandback, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: A systematic review and meta-analysis. British Journal of General Practice, 55 (513), 305–312. Scheier, M. E., & Carver, C. S. (1987). Dispositional optimism and physical wellbeing: The influence of generalized outcome expectancies on health. Journal of Personality, 55, 169–210. Seligman, M. E. P., & Csiksentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5–14. Sheldon, K. M., & King, L. (2001). Why positive psychology is necessary. American Psychologist, 56, 216–217. Singh, A. A. (2010). It takes more than a rainbow sticker! Advocacy on queer issues in counseling. In M. J. Ratts, R. L. Toporek, & J. A. Lewis (Eds.), ACA advocacy competencies: A social justice framework for counselors (pp. 29–42). Alexandria, VA: American Counseling Association. Sprinthall, N. A., Peace, S. D., & Kennington, P. A. D. (2001). Cognitive-developmental stage theories for counseling. In D. C. Locke, J. E. Myers, & E. L. Herr (Eds.), The handbook of counseling (pp. 109–130). Thousand Oaks, CA: Sage. Sue, D. W., Ivey, A. E., & Pedersen, P. D. (1996). A theory of multicultural counseling and development. Pacific Grove, CA: Brooks/Cole. Sue, D. W., & Sue, D. (1999). Counseling the culturally different: Theory and practice. (3rd ed.). New York: Wiley.
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CHAPTER 4
Outreach to Distressed and Marginalized Clients
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hen people are forced to contend with environmental stressors that outweigh their personal resources and coping abilities, they need help that is practical, positive, and empowering. Sometimes a person is forced to deal with completely unexpected pressures, whether caused by a personal crisis or by a disaster affecting an entire community. In other situations, people are victimized by the chronic, unceasing stress of oppression and marginalization. Whatever the immediate stressor, an individual might feel pessimistic, distrustful, or even fearful at the thought of seeking out a member of the helping professions. Even when people desire counseling, impediments to immediate access might exist. In the case of a community-wide disaster, for instance, an officebased, single-client model might be impractical and even unmanageable. Often, the potential clients who are most in need of assistance are the ones least likely to receive it. Fortunately, the community counseling model, with its emphasis on outreach, empowerment, and community context, provides a way forward. In a discussion of strategies for dealing with emergency situations, Solomon (2003, p. 12) points out that “although professionals working in the mental health arena are seldom trained or prepared to work at a broader community level, the scale of these emergencies may require abandoning dyadic interventions for 90 Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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those that can be implemented via community action using a public health approach.” Community counselors tend to be comfortable with this stance.
ADDRESSING COMMUNITY-WIDE TRAUMA
Recognition that a strength-based, community-focused approach should be used in emergency situations has reached the level of consensus, with this model guiding the Federal Emergency Management Agency (FEMA) Crisis Counseling and Assistance Training Program (Substance Abuse & Mental Health Services Administration, nd). Helpers in disaster situations are trained to offer services based on the following general principles (pp. 14–15): Strengths based. Crisis counselors assume natural resilience in individuals and communities, and promote independence rather than dependence … Outreach oriented. Crisis counselors take services into the communities rather than wait for survivors to seek them. More practical than psychological in nature. Crisis counseling is designed to prevent or mitigate adverse repercussions of disasters rather than to treat them … Diagnosis free. Crisis counselors do not classify, label, or diagnose people.… Services are supportive and educational in nature. Conducted in nontraditional settings. Crisis counselors make contact with survivors in their homes and communities, not in clinical or office settings. Culturally competent. Crisis counselors strive to understand and respect the community and the cultures within it … Designed to strengthen existing community support systems. Crisis counselors support, but do not organize or manage, community recovery systems. Provided in ways that promote a consistent program identity. It is especially noteworthy that the concept of multicultural competence is recognized as being central to effective practice. Multicultural Competence
Marsella, Johnson, Watson, and Gryczynski (2008) point out that the effectiveness of disaster mental health workers depends on their ability to demonstrate multicultural competence. Absent that competence, the best of intentions have frequently gone awry. Responses to disasters often failed to consider the variations in the cultural worldviews, values, and lifestyle preferences of disaster victims. Too often, the assistance that is rendered is based upon a preconceived Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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set of assumptions and policies rooted within the Western cultural traditions of the providers, especially ideas about how one must construe a disaster and what is necessary for recovery and rehabilitation from a disaster’s impact. (p. 4) Fortunately, notions of the centrality of culture have found their way into accepted practices for intervening in situations of community-wide trauma. Consider, for instance, the principles for cultural competence disseminated by the Substance Abuse and Mental Health Services Administration (2003), which include the following: 1. Recognize the importance of culture and respect diversity. 2. Maintain a current profile of the cultural composition of the community. (Listed factors include race and ethnicity, age, gender, religion, refugee and immigrant status, housing status, income and poverty levels, percentage of residents living in rural versus urban areas, unemployment rate, languages and dialects spoken, literacy level, number of schools, and number and types of businesses.) 3. Recruit disaster workers who are representative of the community or service area. 4. Provide ongoing cultural competence training to disaster mental health staff. 5. Ensure that services are accessible, appropriate, and equitable. 6. Recognize the role of help-seeking behaviors, customs and traditions, and natural support networks. 7. Involve as “cultural brokers” community leaders and organizations representing diverse cultural groups. 8. Ensure that services and information are culturally and linguistically competent. 9. Assess and evaluate the program’s level of cultural competence. Culture is a key factor not just in addressing the immediate aftermath of a disaster but also in dealing with the longer-term impact on the community. “While there are obvious variations in cultural factors that should optimally be considered in the acute and emergency phases … many of the cultural determinants of responses to disasters emerge in the subsequent phases involving rehabilitation, rebuilding, and reconstruction” (Marsella et al., 2008, p. 4). Norris and Alegria (2005) suggest that, in the aftermath of disasters, culturally responsive interventions focus on providing accessible services, reducing stigma and mistrust, validating both feelings of distress and help-seeking actions, accepting the fact that interdependence is as valid a goal as independence, and promoting community action. Norris and Alegria also remind mental health service providers to leave a legacy, given the fact that “disasters create opportunities to educate the public, destigmatize mental health problems, and build trust between providers and minority communities” (Norris & Alegria, 2008, p. 29).
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Community Recovery
Community counselors may have a role to play in helping to facilitate the collaborative efforts that make renewal and rejuvenation possible. Consider, for instance, the experience of Greensburg, Kansas, which was almost totally destroyed by a tornado in 2007. Subsequently, “the town has made a remarkable comeback, reinventing itself as a model for sustainable building and green living now recognized around the world” (Greensburggreentown.org, 2010). Although the visible results of Greensburg’s efforts may be the measured in ecologically sound buildings and solar electrical systems, collaborative efforts among community members made progress possible. As GreenTown executive director Daniel Wallach stated in an interview with Mother Earth News (Phelps, 2009, AugustSeptember), It’s all about community. I talk about that a lot, that there are roots and shoots. The shoots are green building, renewable energy, everything that’s material. But the roots are where all of that started. And that’s about caring, shared visions, shared problem solving. That’s one thing our organization wants to help with, to be sure the community doesn’t lose that shared bond—because once you’re out of crisis mode it’s really easy to slip back into the status quo. When community collaboration is needed, counselors could conceivably be part of the effort to “leave a legacy” after an immediate crisis has ended. Another example of rejuvenation can be seen in a location that is halfway around the world from Greensburg, Kansas: Sri Lanka. The Foundation of Goodness has worked since 1999 to narrow the gap between urban and rural life in Sri Lanka, creating sustainable development programs and addressing the problem of rural poverty (Gunasekera, 2009). The horror of the December 2004 tsunami could have interrupted this progress, but instead “compassion overpowered destruction” (Gunasekera, 2009). On the fifth anniversary of the tsunami, Geuter (2009, December 28) wrote, But out of the destruction that took away all hope, somehow, in our villages hope has been reborn. Though lives will be forever touched by sadness, there is energy of achievement and opportunity amongst the children and youth of the Seenigama region. The work of the Foundation of Goodness, along with the compassion and support of donors worldwide, the hard work of volunteers from many different walks of life, and the enthusiasm and incredible learning capacity of villagers and the Foundation of Goodness team, stands as testimony to successful post-disaster relief management and long-term, sustainable community development. The Foundation includes among its many programs the Rebuilding Lives Psychosocial Support Unit. The counseling sessions offered through this project not only help villagers process the trauma caused by the tsunami but also use a more developmental approach to enhance self-esteem and confidence. Individual
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counseling sessions are complemented by group workshops designed for empowerment and life-skill development. The Foundation also provides programs in several other categories. Programs in the category of livelihoods help villagers move from the illegal industry of coral mining toward more sustainable and rewarding work, including new industries and self-employment opportunities. Health care programs provide medical care and health education services. Programs related to children and education are designed to provide young people with the tools they will need to take advantage of new opportunities. The Environmental Management Programme focuses both on environmental education and on such practical applications as recycling, composting, and individual gardens for consumption. Programs related to sport give young people new opportunities for community involvement and leadership. The force of water, which hit Sri Lanka and South East Asia on 26 December 2004, destroyed much of our previous work and tragically took hundreds of lives, leaving the Seenigama village lying in rubble. But our spirit has not been broken and we are completely committed to rebuild and fulfill all the needs of the village people. We will turn this catastrophic setback into a blessing. (Foundation of Goodness mission statement, nd)
ADDRESSING PERSONAL CRISES
Just as community-wide crises hold the potential for rejuvenation and growth, so do crises that are experienced by individuals. When an individual possesses effective coping skills, strong social support, and a sense of personal power, he or she has the tools that are needed to withstand stress. When an individual lacks these assets, even temporarily, he or she might respond to a crisis by underestimating the options that might be available, becoming depressed, or even contemplating suicide. The community counseling framework includes practical strategies for intervening with clients in crisis and implementing suicide prevention programs. Definition of Crisis
A crisis is a critical phase in a person’s life when his or her normal ways of dealing with the world are suddenly interrupted. A personal crisis may stem from a sudden life-affecting change or from a combination of problems. Distinctions among crises may have to do with the level of severity or the degree to which the situational stressors relate to life transitions that might be expected to occur. If an individual is having difficulty coping with an anticipated life transition, the counselor and client might pursue a strategy of crisis prevention. But if the individual has been victimized by crime or stricken with unexpected illness, the counseling focus would turn the search for new coping mechanisms. Regardless of the cause, the suddenness, or the severity of the situation, people in crisis find they have lost an even keel. They typically need help Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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from others in exploring the immediate problem, finding appropriate resources, and developing a practical plan to deal effectively with the crisis. People in crisis also need personal support and encouragement to cope with their feelings of helplessness and frustration. (Ivey et al., 2002) Although crises represent highly stressful situations, they do not imply pathology. Rather, personal crises can occur at any time to any person who is in a situation that requires problem-solving abilities and other resources he or she has not yet developed or used. Personal crises are usually temporary. They can, however, have long-lasting effects on individuals’ physical health and psychological wellness. The likelihood that long-term negative outcomes will occur largely depends on the way individuals respond to their particular crisis. It is useful, therefore, for counselors to help clients think of a crisis as a process that follows a set of predictable phases. The Phases of Crisis
In the first phase in crisis, a person is confronted with a new or unexpected event that causes anxiety, depression, and/or other types of stress. Second, individuals often find that their usual problem-solving methods do not work. Third, this leads most people to try new ways of dealing with the immediate problem. Finally, individuals either emerge stronger if the new approaches were effective or experience continued and perhaps even greater levels of stress than before if the new approaches were not effective. It is often noted that the Chinese characters that represent the word “crisis” mean both danger and opportunity. The impact of a crisis can carry a degree of danger if the individual does not navigate the shoals of change successfully. On the other hand, however, the opportunity for positive change is also implicit in the situation. In a crisis, then, the timeliness of the intervention is very important. Accordingly, crisis counseling serves mainly to affect the outcome of the crisis positively. This sort of counseling is, of course, temporary; it aims at helping clients (a) regain a sense of control over their lives and (b) develop the resources they need to experience an increased level of wellness after the crisis has passed. Crisis interventions may take place in an agency specifically designed for that purpose, such as domestic violence centers; in an organization with a wider service mandate, such as community mental health centers; or in school counseling programs. Regardless of the setting, crisis counseling adheres to the same principles: 1. It focuses on specific, time-limited treatment goals. Attention is particularly directed to helping clients reduce the level of tension that currently exists in their lives. The time limits associated with crisis counseling can enhance and maintain clients’ motivation to examine new ways of dealing with the crisis and attain specified goals. 2. Crisis interventions involve helping clients clarify and accurately assess their perceptions of the source and the meaning of the stressors. This method of counseling entails an active and directive approach that facilitates clients’ cognitive restructuring of the perceived stressors. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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3. Crisis counseling is designed to help clients develop more effective and adaptive problem-solving mechanisms so that they can return to their precrisis level of functioning. 4. Because crisis intervention is reality oriented, it is specifically designed to help clarify clients’ cognitive perceptions, to confront denial and distortions, and to offer emotional support without providing false reassurances. 5. Whenever possible, and especially when working with people from diverse cultural, ethnic, and racial backgrounds, crisis intervention strategies usually include members of the client’s existing relationship networks to help determine and implement effective coping strategies. 6. Crisis interventions may serve as a prelude for further counseling and development services in the future. (Ivey et al., 2002) All these principles point to the importance of making crisis counseling practical and realistic. As such, counselors need to focus on the client’s current situation, encouraging the client to identify the salient points of the problem as he or she experiences it. Because the client may have difficulty focusing on the problem and identifying alternative solutions, the counselor should be prepared to use a directive approach, following organized problem-solving procedures to help the client identify relatively permanent sources of support in his or her environment. This process typically includes the following steps: 1. Assess the nature of the crisis: The counselor’s first step in crisis counseling is to learn as much as possible about what precipitated the crisis, what coping mechanisms have been attempted, and what patterns of coping the individual usually follows. Of course, counselors must also assess the seriousness of the situation by asking the question, “Is the individual or family in any immediate danger?” If the answer to this question is yes, mental health practitioners are ethically responsible to take whatever action is necessary to help protect the safety of the client and his or her family. 2. Help the client clarify the immediate problem: As mentioned earlier, clients in crisis usually find it hard to make a realistic assessment of the major issues associated with their crisis. Counselors can help clients frame problems in concrete and realistic terms. 3. Make the problem manageable: Individuals in crisis typically feel overwhelmed by the demands they must face. However, clients can begin to increase their sense of control and personal power over the problem once they have broken it down into manageable parts. As action is taken to resolve aspects of the problem, individuals can begin to regain equilibrium and a sense of personal power. 4. Identify additional sources of support: As clients prepare to address the crisis, counselors should encourage them to identify sources of social support from family members, friends, and others. In reaching out, clients can gain emotional support and assistance.
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5. Identify personal strengths: In a crisis, individuals can lose sight of their own positive attributes. Helping them identify personal resources can increase a sense of their personal assets and self-responsibility. 6. Explore feelings: Normally, a crisis stirs up deep emotions. Clients can deal with these feelings most effectively if they can identify and express them. 7. Develop a strategy for coping with the situation: The counselor should work to increase the client’s problem-solving abilities. The strategies employed during this phase of crisis counseling resemble those used with clients not in crisis. However, the client in crisis needs concrete direction and more emotional support when trying out new problem-solving strategies. 8. Plan for the prevention of future crises: As clients return to a less stressful level of functioning, counselors can encourage them to take stock of the crisis situation and identify possible ways to prevent problems. If new problemsolving skills are accompanied by attempts to maintain an increased level of personal resources, the crisis can cause the client to grow. Suicide Prevention
The early development of crisis counseling models in the late 1950s and early 1960s paralleled an increased interest in suicide prevention. Contemporary approaches to suicide prevention are based largely on the groundbreaking work of Farberow and Shneidman at the Los Angeles Suicide Prevention Center (Farberow, 1974; Farberow & Shneidman, 1961). This center developed the concept of the 24-hour telephone crisis line and was the first to train volunteers to provide crisis counseling services by telephone. After workers at the center studied and developed effective methods of telephone counseling, they shared this information widely so that crisis intervention programs could be initiated throughout the nation. The escalating number of suicides and suicide attempts reportedly occurring among people of all ages and backgrounds in the United States at that time was viewed as an urgent national problem, one needing study and active preventive measures. The Los Angeles Suicide Prevention Center served as a model not only because it broke ground in developing scientific methods of intervention but also because it consistently generated significant research on the nature of suicidal thinking and behavior. This research began with Farberow and Shneidman’s (1961) discovery and analysis of hundreds of suicide notes. McGee (1974) provided the following comments about the pioneering efforts of these two researchers: However one chooses to tell the story, certain elements must be included, such as the fortuitous discovery by two behavioral scientists of several hundred actual suicide notes filed in the office of the Los Angeles County Medical Examiner-Coroner. This discovery, together with the realization of its scientific worth, led Norman Farberow and Edwin Shneidman to make the first of many explorations into the psychological processes of a person [who takes] his own life. They analyzed the thinking processes and identified the “logic of suicide”; they looked into affective states and uncovered the ambivalence; they dissected Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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the communications and discovered the clues which foretell an act of selfdestruction. Thus, they became convinced that suicide could be prevented. (p. 5) These initial research efforts continued, with Shneidman (1987) developing a detailed postmortem mental history that provided much insight into the thoughts of people who chose suicide as their only option. Shneidman (1987) coined the term “psychological autopsy” when referring to these findings. The highly personalized nature of the information Shneidman gathered in conducting his studies led him to draw the following conclusions: Suicide, I have learned, is not a bizarre or incomprehensible act of selfdestruction. Rather, suicidal people use a particular logic, a style of thinking that brings them to the conclusion that death is the only solution to their problems. This style can be readily seen, and there are steps we can take to stop suicide, if we know where to look. (Shneidman, 1987, p. 56) Shneidman used his research findings to develop a number of guidelines for preventing suicide. For example, he pointed out that because suicidal people usually experience a great deal of unendurable pain in their lives, counselors should work to reduce that feeling of distress as quickly as possible. Sometimes this requires them to include significant others in the suicide prevention strategy. Furthermore, because Shneidman’s (1987) research findings clearly indicate that suicidal people act out of different needs, mental health practitioners must remember to tailor their crisis counseling interventions to each individual. Because suicidal people cannot themselves find alternative solutions, counselors need to point out repeatedly that other options are indeed available. Finally, because many suicidal people hint at their intention, counselors can learn to read some of the warning signs of suicide accurately and intervene in time. Although people of all ages commit suicide, its occurrence among adolescents has dramatically escalated over the past few decades (National Institute of Mental Health, 2000). Drawing a single portrait of the typical teenage suicide victim is nearly impossible. However, some of the conditions most often linked with adolescent suicide include families plagued by divorce; communication barriers between parents and teenagers; dual-career families; drug and alcohol addiction; parental, academic, and peer pressures; rootlessness and family mobility; fear of future jobs and opportunities; and personal relationship problems. (Peach & Reddick, 1991, p. 108) Researchers have noted that some teenagers tend toward suicide more than others. The characteristics associated with such at-risk adolescents include the following: A previous suicide attempt Suicidal gestures (e.g., cutting off one’s hair, self-inflicted cigarette burns, other abuse of self) A tendency to be socially isolated (having no friends or only one friend) Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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A record of school failure or truancy A broken home or a broken relationship with a significant other (family member, boy/girlfriend) Talk of suicide, either one’s own or that of others A close friend or relative who was a suicide victim Not living at home Preoccupation with death or dying A recent significant loss or the anniversary of one Sudden disruptive or violent behaviors Being more withdrawn or uncommunicative and isolated from others than usual (National Institute of Mental Health, 2000) Schools are excellent settings for implementing suicide prevention programs. The professional counseling literature suggests that to be effective, school-based suicide prevention programs must be comprehensive and systematic. Using the community counseling framework as a guide, counselors can implement the following microcosm of the community counseling model: Facilitating Human Development: Focused Strategies—provide individual and small-group counseling, as well as educational and referral services, to students identified as at risk for suicide. Facilitating Community Development: Focused Strategies—offer in-service training that helps teachers identify suicide warning signs; develop a written statement that describes specific criteria that administrators, counselors, and teachers can use to assess the lethality of suicidal students; and make suicide prevention materials available to parents Facilitating Human Development: Broad-Based Strategies—develop and distribute suicide prevention materials to students; implement classroombased prevention projects; and conduct schoolwide psychological screening activities to identify at-risk students. Facilitating Community Development: Broad-Based Strategies—work with school administrators and teachers to develop a written formal suicide policy for the school; develop a set of written procedures to address the needs of students identified as at risk for suicide; and consult with people in the greater community who have expertise in suicide prevention counseling.
ADDRESSING DIFFICULT TRANSITIONS
A transition, broadly speaking, is any event or non-event that results in changed relationships, routines, assumptions, and roles. Transitions include not only obvious life changes (such as high school graduation, job entry, marriage, the birth of one’s first child, and bereavement) but Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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also subtle changes (such as the loss of career aspirations or the nonoccurrence of anticipated events such as an expected job promotion that never comes through). (Goodman, Schlossberg, & Anderson, 2006) Transitions are of course a normal part of everyday life and in no way lead inevitably to crises. Often, however, they do require adaptive skills and behaviors that might not have been used before. Some life transitions are inherently difficult and people going through them can be helped by outreach methods designed to facilitate successful navigation and prevent problems. Counselors can help prevent or mitigate many problems by recognizing potentially stressful situations and reaching out to people when they are most vulnerable. By reaching out, we mean that counselors will leave the office and work directly with clients in their homes, schools, churches, neighborhoods, and workplaces to help them learn new ways of coping with their life stressors. Such programs target individuals and groups that, at particular times, might be more vulnerable to stress than the general population and therefore need more focused programming. Preventive outreach occurs when counselors identify certain situations as particularly stressful and intervene to help healthy individuals develop the resources to cope with them. When prevention is not possible and chronic problems or crises occur, counselors use outreach services to provide support and assistance. Counselors can help clients significantly improve their own wellbeing by assisting them to learn better ways to cope with new or difficult situations. Any situation that makes demands on an individual can cause stress or damage. However, whether a situation will cause stress depends on such factors as one’s view of one’s ability to handle new demands, previous success in dealing with similar situations, the degree to which one feels in control of events, one’s perception of being overloaded or having conflicting needs, and the standards one sets for one’s own performance. In choosing methods to enhance their clients’ positive coping abilities and decrease stress-related dysfunctions, counselors need to consider those factors that mediate the effects of potential crises. Once mental health practitioners become aware of the personal characteristics and situations that favor successful coping, they can intentionally design counseling strategies that foster similar conditions with their clients. Researchers have identified several factors that characterize people who successfully adapt to trying conditions: 1. Successful persons tend to have strong social support systems: The availability of supportive associates serves as a buffer against the effects of stressful situations. These relationships provide both personal validation and practical assistance. For example, when faced with troublesome situations, successful copers reportedly turned to family members, friends, or associates for information, advice, and concrete resources as well as emotional sustenance. 2. Successful copers tend to have a sense of control over the environment: Whether we term this factor “self-efficacy” or “internal locus of control,”
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we know that people who cope effectively do so because they believe their actions can have an effect on the world. Individuals differ in their general belief systems concerning their ability to exert power and control when needed. In addition, the sense of control in a specific situation can be affected by the appraisal of the stressor and the presence or absence of adequate personal and environmental resources. 3. Successful copers have the information and tools needed for effective problem solving: Individuals’ coping success depends, at least in part, on their ability to solve immediate problems and develop appropriate new behaviors. This factor involves both general life competencies and situation-specific knowledge. 4. Successful copers tend to be confident that they can adapt to new situations: Realistic feelings of confidence come from the availability of adequate personal and financial resources and from having coped successfully with similar transitions in the past. One aspect of confidence building, then, is recognizing commonalities between the current situation and prior experiences. For example, although the victim of a job loss may never have been fired in the past, he or she has been successful in obtaining a position. Thus, the planning skills that were used to secure past employment positions may still be valid and useful in the current situation (Ivey, D’Andrea, Ivey, & SimekMorgan, 2002; Sue & Sue, 1999). These factors are interrelated. People’s support systems help them solve problems, increasing both their sense of control and their confidence. Confident people are more likely to have strong social support systems and to apply their problem-solving skills effectively. Recognizing that social support systems help buffer the debilitating effects of environmental stressors, counselors can strive to become “buffer builders,” creating new opportunities for clients to develop the social resources they need to survive and grow during periods of heightened stress. For example, when counselors help clients form peer support groups, they simultaneously help build new social support systems, provide the context for skill development, and help people experience a greater sense of control over their lives. In this way, counselors can help their clients create and maintain buffers against present and future stressors. Buffer-building efforts can assist people dealing with expected transitions, unexpected crises, or ongoing stressors. However, the key to providing this sort of outreach service is the ability to recognize those stressors and situations likely to lead to major personal crises. Model Outreach Programs
Successful helping programs that follow the community counseling framework build on what is known about high-risk situations and the resources that enable people to cope with them. Ideally, outreach programs for vulnerable clients should adhere to the following guidelines:
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1. Use all available sources of client support, including family members, extended family members, peers, co-workers, church affiliates, counselors, and others who can serve as role models for successful coping. 2. Provide opportunities for clients to help themselves and one another. 3. Inform clients about the nature of the new roles or situations they face. 4. Help clients develop the coping skills they will need to manage their specific situations effectively. 5. Use methods that enhance clients’ sense of control over their situations and their lives. 6. Implement services that reflect an accurate understanding of and demonstrate a genuine respect for the cultural integrity and needs of clients. Such actions help clients gain confidence and a greater sense of control as they learn to cope with life’s challenges more effectively. Many programs that serve diverse populations have successfully helped clients face high-risk situations. These programs commonly use various types of outreach services to help empower people in vulnerable populations. The following sections discuss several programs designed to empower people in specific at-risk groups. The diverse populations served by these programs include adults and children dealing with marital disruptions, teenagers making the transition to parenthood, at-risk high school students, and battered women. Here, then, are several models of outreach interventions used to address the needs of vulnerable populations. Keep in mind, however, that counselors who use the community counseling model must adapt such programs to meet the special needs and characteristics of their own clients. Helping Adults Cope with Marital Disruption. Marital separation and divorce are consistently identified as among the most stressful events of an adult’s life. It is no wonder that marital disruptions put people at risk for mental and physical health problems. When a marriage breaks up, family members must cope with radical life changes while their social support systems are severely disrupted. Given the general agreement that marital disruption is a high-risk situation, counselors can intervene preventively by developing programs for people going through this transition. Ideally, such programs should focus on rebuilding support systems and developing newly relevant skills for life planning and problem solving. Bloom, Hodges, and Caldwell (1982) developed one such program. Although this program was developed decades ago, it represents a prototype on which many other marital disruption counseling services and programs have subsequently been based. With this 6-month preventive program, Bloom et al. (1982) focused on recently separated people living in Boulder, Colorado. Using mass media and mailings targeted for appropriate referral sources, the program developers recruited 153 people, 101 of whom were assigned to the intervention program and 52 of whom composed the untreated control group. Participants in the separation and divorce program were offered two types of services: individual Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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assistance from paraprofessional helpers and study groups that addressed issues of special concern to newly separated people. Each participant was assigned to a paraprofessional counselor who was to provide emotional support, intervene in possible crises, and link the individual with other components of the program. Referred to as “program representatives,” these paraprofessionals played an active outreach role, contacting the participants on a regular basis, developing opportunities for social interaction on both a group and an individual basis, making referrals to other parts of the program and to appropriate community agencies, and following up with their clients throughout their participation in the intervention program (Bloom et al., 1982). As mentioned, the program participants were encouraged to take part in regularly scheduled study groups that focused on practical issues commonly faced by recently separated or divorced persons. These groups included the following: Career planning and employment: This study group helped participants find or change jobs, make long-range career plans, and develop marketable skills. Legal and financial issues: Led by an attorney, this group explored ways to establish credit, loan eligibility, child custody and visitation, child support, and the divorce litigation process, among other issues. Child-rearing and single-parenting: In this group, participants could discuss their children’s reactions, visitation issues, behavior problems, and ways to help their children adjust to the separation or divorce. Housing and homemaking: This group, led by a home economist, stressed such issues as finding a new place to live, making home repairs, managing money, purchasing and preparing food, and managing time. Socialization and self-esteem: This group helped participants deal with their loneliness, damaged self-concepts, and feelings of social and personal inadequacy. A formal evaluation of this program indicated that those who participated in the intervention group reported significantly fewer physical and mental health problems than the control group 6 months after their separation or divorce. Members of the intervention group also demonstrated a significant decrease in general psychological problems across time, along with a reduction in psychological distress, maladjustment, and anxiety (Bloom et al., 1982). A separate study was also conducted to determine the long-term impact of the program 2½ years after the participants completed their involvement in the project. The results of this investigation indicated that “the early gains were either maintained or increased over time. These findings suggested that the program achieved its primary prevention objective, i.e., to forestall the psychological fallout that often follows marital dissolution” (Cowen, 1985, p. 36). Helping Children Cope with Family Disruption. Researchers have identified a number of cognitive, affective, behavioral, and psychological problems commonly manifested among children whose parents have divorced (Amato, 1993; Behrman & Quinn, 1994; Carbone, 1994). Recognizing the special needs that Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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children may have during the transition from an intact to a separated family has led counselors to develop several preventive outreach projects. One such intervention is the Divorce Adjustment Project, a “structured twopart primary prevention program intended to enhance pro-social skills and to prevent acting out, the development of a poor self-concept, and academic failure among children of divorced families” (Stolberg & Garrison, 1985, p. 113). Designed for psychologically healthy children who had never before used mental health services, the program offered both school-based Children’s Support Groups (CSGs) and community-based Single Parents’ Support Groups (SPSGs). The CSGs taught cognitive-behavioral skills to and provided emotional support for 7- to 13-year-olds to help them adjust to their parents’ divorces. In this highly structured, 12-session program, the children discussed issues directly related to divorce and received training in skills such as problem solving, controlling anger, communication, and relaxation. The assumption underlying the complementary SPSGs was that the children’s ability to adjust could be enhanced indirectly by improving the parenting skills and postdivorce adjustment of their primary caregivers. This support and skill-building program, also 12 weeks long, assisted divorced mothers who had custody of their children develop new skills and attitudes that would help them meet the challenges of being single persons and parents. Personal development topics incorporated into these study groups included “The Social Me,” “The Working Me,” “The Sexual Me,” and “Controlling My Feelings.” Parenting topics included “Communicating with My Child,” “Disciplining My Child,” and “Communicating with My Former Spouse about Child-Rearing Matters” (Stolberg & Garrison, 1985). This well-researched project evaluated outcomes among four different groups of children: (a) children who participated in the CSG alone, (b) children who participated in the CSG and whose parents took part in the SPSG, (c) children whose only treatment was their parents’ participation in the SPSG, and (d) a control group of children receiving no treatment. The researchers found that the self-concepts and social skills of the children who participated in the CSG alone (Group 1) improved substantially. Further, the children in Group 3 appeared more psychologically adjusted in follow-up studies than the children in the other groups. Thus, the combination of the two interventions did not necessarily bring about the strong improvements expected. A modified version of the CSG was implemented in Pedro-Carroll and Cowen’s (1985) Children of Divorce Intervention Program. While helping youngsters develop new skills that would increase their ability to cope with their parents’ divorces, this intervention also included activities designed to enhance the children’s emotional adjustment and development. These activities included group discussions and role playing, which encouraged the children to explore their emotional responses to their parents’ divorces. In the first three sessions, the children concentrated on getting to know one another, sharing common experiences, and discussing divorce-related anxieties and other feelings. Sessions 4 through 6 focused on problem solving and Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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cognitive-skill building. These group sessions specifically involved teaching the youngsters various methods for resolving interpersonal problems and dealing with negative feelings related to their parents’ divorce. During these sessions, counselors directed particular attention toward helping the children understand that they were not responsible for their parents’ divorce. The counselors also focused on increasing the youngsters’ understanding of the types of problems that were beyond their control and thus not solvable (e.g., parental reconciliation) versus those that lay within their control (e.g., appropriately communicating their feelings to others). Once the children understood the importance of disengaging from their parents’ conflicts, they began to work more diligently on expressing and controlling their anger. In the last session, the children had a chance to evaluate their group experience and discuss their feelings about its ending. The program evaluation indicated that the participants made significantly greater gains in adjustment than did youngsters in a comparable control group. Pedro-Carroll and Cowen (1985) have attributed these gains, in part, to the supportive group context that allowed the children to break through their sense of isolation and talk about their feelings about their parents’ divorce. The researchers also consider the skill-building aspects of the program to be equally important in promoting these positive outcomes. As they point out, However important a supportive environment is in helping children to identify, express, and deal with salient feelings about their parents’ divorce, it may not by itself be enough…. Acquiring specific competencies for dealing with the concrete challenges that parental divorce pose is a co-equal need. Interpersonal problem-solving strategies, including the communication and anger control skills that the program offered, stressed a differentiation between problems that could and could not be solved and, for the latter, stressed ways of disengaging from their parents’ disagreements. Thus, the intervention’s positive effects appear to reflect a combination of its support and skill building components. (p. 609) Programs for Stepfamilies. Effective coping skills are also needed to deal with the new stressors brought about when one or both partners remarry. Stepfamilies—that is, families formed through remarriage—represent a promising, though sparsely researched, area of intervention:
Because remarriage families start with children and yet have had no time to build a history, the family must deal with the tasks required of more mature families while possessing the skills of a family just starting out. Because they lack a common set of experiences, remarriage families typically hold limited or unrealistic expectations that paralyze them into inaction or galvanize them into a reaction against people or events they little understand. (Hayes & Hayes, 1988, pp. 473–474) Such blended families need to clarify and stabilize members’ roles and relationships, replace myths with realistic expectations, develop appropriate limits for Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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children, and acknowledge the impact of children’s allegiances to noncustodial parents. Hayes and Hayes (1988) suggest that counselors can help blended families accomplish these tasks in the following ways: Encouraging family members to identify and relinquish myths they may hold about the remarriage family Helping blended family members understand their new family system, its differences from their past family, and involvement of non–family members in the new system Teaching members more effective communication skills Helping blended family members, especially children, to mourn the loss of previous relationships and encouraging the development of new relationships Providing a forum in which blended family members can work out their relationship differences with new family members and explore their feelings about the absent parent Offering structured programs of parent training and lists of readings that family members can use as self-instructional devices Informing members of the latest research findings and clinical evidence that may be helpful in understanding the blended family reorganization process Identifying the tasks of parenting and the relationships that are necessary to enact those roles Running groups for remarriage parents in the community or for stepchildren in the schools (pp. 474–475) The comprehensiveness of such an approach to working with blended families makes it an appropriate model for preventive outreach. The Family Development Project: Helping Pregnant Adolescents. Each year, nearly 1 million adolescent girls in the United States get pregnant (U.S. Bureau of the Census, 2000). Researchers have identified a variety of negative outcomes that can follow pregnancy during the high school years. These include forgoing one’s education by dropping out of school prematurely, becoming dependent on government support at a young age, and attempting to deal with one’s own personal and social development while simultaneously trying to meet an infant’s 24-hour needs (Centers for Disease Control and Prevention, 2001; Hanson, 1992). The community counseling model’s emphasis on outreach and preventive services particularly suits this vulnerable population because it stresses positive prevention, for example, assisting young parents in developing new coping skills. Providing such services implies going beyond a crisis-oriented and restorative intervention orientation and, essentially, focuses on strengthening and adding to the client’s set of skills and competencies. Thus, rather than viewing a teenage pregnancy as a personal deficit or a psychological problem, counselors who use the community counseling model
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interpret this phenomenon as a unique developmental crisis that can result in either negative or positive outcomes (Brodsky, 1999). The following discussion of the Family Development Project (FDP) demonstrates how the communitycounseling framework was used to promote the well-being of a group of pregnant African American adolescents residing in an economically impoverished urban area. Sponsored by the Meharry Community Mental Health Center in Nashville, Tennessee, the FDP was entirely funded by private donations. Using the community counseling model as their guide, the program developers built on several theoretical premises: 1. Adolescents’ interactions with their environment can have either negative or positive effects on their mental health and personal development. 2. A multifaceted approach is more efficient than a single-service approach. 3. Outreach, prevention, and educational services are more appropriate to use in promoting the personal development of teenage mothers than remedial services. 4. When providing counseling services to vulnerable populations, counselors need to be sensitive and responsive to the unique cultural, ethnic, and racial characteristics of the persons in the targeted group. (D’Andrea, 1994, p. 186) The first step in planning the FDP program involved soliciting input and support from several key persons in the schools and community within the targeted service area. With this in mind, the program’s counseling coordinator set up several “community meetings” with key persons in the targeted areas to see whether they perceived a need for a primary prevention program for pregnant youth in their schools and community. The persons who attended these meetings included an obstetrical-gynecological physician, a clinical psychologist, a licensed nurse-midwife, several social workers, three school counselors, four high school teachers, and the FDP counseling coordinator (D’Andrea, 1994). During these community meetings, participants not only indicated the vital need for such a program but also expressed a willingness to plan the FDP. After several meetings, which focused primarily on community assessment and program-planning issues, all agreed that a preventive counseling program would best meet the needs of the pregnant adolescents in the community. As a prevention program, the FDP emphasized the need to support teenagers who, while in the midst of a major life crisis, had not yet manifested any outstanding psychological problems. The program developers also hoped that by providing this at-risk group of youth with opportunities to develop basic parenting skills, the new parents could learn to care for their infants in ways that would enhance their children’s overall health and avert potential problems. While those who attended the program-planning meetings unanimously agreed that the FDP should focus primarily on prevention, they also indicated that many pregnant teenagers experience personal crises during their pregnancy and shortly after the birth of their babies. Thus, the need to incorporate remedial counseling services within the FDP program was clearly acknowledged and supported. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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On the basis of these and other suggestions, a comprehensive program plan developed. This plan included the following components: preventive education, outreach-consultation, individual counseling, and program research and evaluation. Given their limited financial resources, the program planners agreed that they must immediately recruit and train paraprofessionals in the community. To address this need, the FDP coordinator set up meetings with several officials at a local university. This outreach effort aimed at identifying undergraduate students willing to help adolescents in the program. With the university’s permission, the FDP counselors visited undergraduate classes at Tennessee State University to solicit support. As a result, 15 African American women from the departments of education, psychology, and social work volunteered. These students agreed to take part in 32 hours of training (8 hours per week for 4 weeks) during which they covered issues related to early childhood and adolescent development. These training sessions also introduced the volunteers to the community counseling framework and helped them develop basic individual counseling and interviewing skills. Having successfully completed this training, the university students began direct work with the adolescents who were referred to the FDP. The program coordinator provided clinical supervision to these volunteers throughout their involvement in the project (D’Andrea, 1994). The adolescents who participated in the FDP were referred from the Department of Obstetrics and Gynecology at Meharry Medical College and the Nashville Metropolitan School System’s Office of Guidance and Counseling. To qualify as a participant in the project, one had to be at or below the federal guidelines for poverty, between 12 and 18 years old, pregnant for the first time, a resident of one of the city’s public subsidized housing communities, and currently enrolled in high school. On entering the program, the teenagers were assigned to one of the paraprofessionals, who were directly responsible for their case management. The paraprofessionals’ duties included setting up individual interviews with the adolescents to assess their personal concerns and needs (e.g., medical, food, housing, and financial), evaluate their educational needs and develop a plan to help them avoid dropping out of school, and identify community resources. By consulting with the other FDP counselors and the program coordinator about the information gathered from those interviews, the paraprofessionals developed an individualized action plan for each participant. These plans included making referrals to local human service agencies, such as Medicaid and the Metropolitan Public Housing Office; consulting with the schools’ counselors and teachers about their clients’ academic progress; and setting up individual counseling sessions to give the adolescents additional opportunities to explore other personal concerns, interests, and goals in a supportive and confidential environment (D’Andrea, 1994). All the adolescents in the FDP project were also encouraged to participate in a series of parenting classes. The classes met every other Thursday evening and lasted 2 hours. Transportation was provided. Because the classes overlapped with most of the participants’ dinner times, a nutritious meal was also provided. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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These classes helped the adolescents understand healthy prenatal care and the birth process as well as examine ways they could promote their infants’ overall health and well-being. Particular attention was given to the types of things the teenagers themselves could do to help cope with the stress of raising a child. Further, these parenting classes offered opportunities for the teenagers to learn about helpful community resources. Finally, the classes provided a source of mutual support; the participants became increasingly comfortable discussing common interests, concerns, frustrations, personal fears, goals, and values with others experiencing similar challenges. As a result, the class meetings evolved into what was later referred to as an “empowerment group,” where new friendships were established and maintained months after the adolescents gave birth. The FDP used an ecological-systems approach to promote the participants’ development (Neville & Mobley, 2001). For example, by participating in the FDP parenting classes, the adolescents became an integral part of a new human system (the class) that provided opportunities to increase their sense of selfesteem and personal power. The direct client services just mentioned were designed to promote these positive developmental outcomes. In addition to these services, the FDP staff sought to strengthen the natural social support networks to which the pregnant teenagers already belonged. To accomplish this objective, the counselors and paraprofessionals used several outreach-consultation services, including visiting the adolescents’ homes and consulting with school personnel. These efforts aimed at fostering environments in which the teenagers would find greater support and respect. The FDP staff made home visits throughout the duration of the project, with the paraprofessionals making at least one home visit per month. However, they often made two and even three visits a month as the adolescents’ parents found how resourceful the paraprofessionals were in supporting their daughters’ needs as well as serving as a sounding board for many of the parents’ own frustrations and concerns. For example, most parents wanted their daughters to graduate from high school. To address this concern, the FDP staff regularly consulted with the adolescents’ teachers and school counselors regarding their academic performance. They often found that the teenagers needed tutorial help to keep up with their teachers’ expectations and academic assignments. This need became particularly apparent when the adolescents’ schooling was temporarily interrupted by their infants’ birth. As such, the FDP counselors and paraprofessionals worked especially hard to maintain the link between the new mothers and their schools by continuing to make regular home visits and having ongoing contact with teachers. These efforts aimed at preventing the adolescents from dropping out of school for an extended period. Program evaluation formed another important component of the FDP. The results of these evaluative efforts indicate that the FDP participants manifested higher positive self-concept scores and a significant increase in the level of social support they experienced during their pregnancies compared with a control group of teenage parents who did not take part in the program (D’Andrea, 1994). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Beyond these formal evaluation efforts, the counselors and paraprofessionals obtained additional data from numerous other sources, including comments made by the participants and their parents, teachers, and school counselors. Reactions to the program consistently reflected strong support for it. The adolescents themselves stated that they had learned a great deal about their infants’ needs and reported acquiring many useful parenting skills. They had also learned many new ways to cope with the multiple stressors associated with the transition to parenthood. The adolescents’ parents consistently expressed appreciation for the types of outreach services that the program offered and the genuine sense of concern extended by the staff. The teachers and school counselors noted that the project provided a host of mental health services that were clearly important for pregnant adolescents but lay beyond the purview of the schools’ resources. These school officials also said that the project’s success was due largely to the high level of commitment manifested by the FDP counselors and paraprofessionals, who had initiated and maintained numerous types of outreach services on behalf of the teenagers. These program evaluation efforts were important for three reasons. First, they provided the program planners with data that allowed an assessment of the FDP’s overall effectiveness. Second, these efforts generated valuable information about the program’s strengths as well as weaknesses. Third, the evaluation results provided documentation of the FDP’s success, which was used to lobby for additional funding from persons in the public and private sectors. The results of these formal and informal evaluations demonstrate that the strategies employed by the FDP staff helped strengthen several variables listed in the numerator of the equation presented earlier in this chapter. As a result of participating in a program that offered a variety of individual, preventive, outreach, and consultative services, members of this vulnerable population reported developing new coping skills, increased self-esteem, greater social support, and a heightened sense of personal power. Promoting the Wellness of Battered Women. Although domestic violence has existed for centuries, communities across the United States have only recently begun to address this problem in any substantial way. In response to the rising number of women who report domestic violence each year, many human service agencies and shelters have been established to address the needs of battered women and their children. Hage (2000) reports that since the 1970s, the battered women’s movement has resulted in the formation of more than 1,500 shelters for victims of domestic violence in the United States. Shelters for battered women and their children fall generally into one of two categories: first-stage or second-stage shelters. In describing the difference between these two categories, Donaghy (1995) explains that “first-stage shelters primarily focus on short-term, immediate care, and second-stage shelters focus on integrating women into society after they have left their batterers” (p. 4). An increasing number of domestic violence shelters incorporate “transitional second-stage” intervention strategies into their
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programs by providing women with opportunities to move toward independent living at their own rate (Roberts, 1996; Sullivan, 1991). Along with the trend to help battered women move toward independent living, interest in the total wellness of this population has recently risen. Adopting a wellness perspective in battered women’s shelters means making a commitment to using multidimensional interventions intentionally designed to increase clients’ coping abilities, social support, self-esteem, and sense of personal power. This approach requires counselors to provide a broad range of direct and indirect client and community services. Donaghy (1995) discusses a model program for victims of domestic violence. This program originated at the University of Wisconsin–Stevens Point. Like the other projects described in this book, it reflects the goals and objectives of the community counseling framework. The program also shows how counselors can use preventive and wellness strategies while also providing remedial and supportive counseling to battered women. In discussing the types of programs available to battered women in the United States, Roberts (1996) notes that, with the exception of occasional support groups, few wellness-oriented programs exist for survivors of domestic battery. Thus, the preventive and wellness counseling strategies that Donaghy (1995) describes represent new ways of thinking about and working to empower the victims of domestic violence. In discussing reasons to use a wellness approach with this population, she notes, An advantage of a wellness program is that many of its components reflect a preventive orientation. Not only can a person’s enhanced wellbeing work to reduce the chance for future incidents, but the empowerment arising from a sense of increased personal well-being can serve to reduce the chance that women will be placed in a position of economic or emotional vulnerability in the first place. (p. 7) A wellness approach to counseling battered women starts with an initial assessment of each client’s needs. By taking the time to assess these needs, counselors can design counseling strategies tailored to their clients’ unique situations. Counselors interested in using a wellness model in battered women’s shelters should conduct a holistic appraisal of their clients’ disposition, which includes the following: 1. Assessing each woman’s history of being battered 2. Identifying each client’s short- and long-term needs and goals 3. Evaluating each battered woman’s overall state of wellness Unstructured intake interviews provide excellent opportunities to gather this sort of evaluative information. Donaghy (1995) recommends two structured assessment tools to complement this evaluation process: the Lifestyle Assessment Questionnaire (LAQ) (Elsenrath, Hettler, & Leafgren, 1988) and the Conflict
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Tactics Scale (CTS) (Herzberger, 1991; Straus, 1989). The results of these instruments provide much useful information that a counselor should share with the client as they work together to develop a plan of action. Program administrators may also find these instruments useful for evaluating the impact of wellness programming on this population. These instruments generate information related to five dimensions of a person’s wellness: physical, emotional, intellectual, occupational/career, and spiritual. The following discussion examines these dimensions in more detail and outlines the types of community counseling services that help victims of domestic violence realize a greater degree of physical health and psychological wellness in their lives. The physical dimension of wellness encompasses many behaviors and factors that directly and indirectly affect a person’s physical health. Nutrition, alcohol and drug misuse, stressors, frequency of physical exercise, sexual activity, body esteem, and average amount of sleep all influence physical wellness. Further, a battered woman’s overall physical wellness is clearly compromised by the threat of being subjected to domestic violence in the future. Both the actual battering and the psychological stress that accompany domestic violence adversely affect the client’s general physical health and body esteem. Interventions to enhance battered women’s physical wellness may include helping them obtain a temporary restraining order to increase their sense of personal safety, offering stress management workshops, securing free passes to the YWCA and other organizations that have exercise facilities, and providing direct counseling services that help clients address issues and plan strategies for improving their body esteem. Emotional wellness involves “the person’s ability to own and express one’s emotions in a healthy manner” (Donaghy, 1995, p. 10). To help nurture this wellness, survivors team up to express a full range of feelings and reactions regarding the violence their spouses have inflicted on them. The important work counselors do with battered women usually occurs during individual and group counseling sessions. When provided with opportunities to examine the emotional dimension of their own wellness, battered women not only gain important insights into themselves and their interpersonal needs but also begin to change the way they relate to people in their environment. Because family members and friends are often surprised and perhaps even confused by these changes, offering indirect client services (e.g., consultations) to them is important. By sharing with family members and close friends the emotional needs and changes battered women normally experience, counselors can help expand the family’s understanding and encourage their continued support. The intellectual dimension of wellness is also a key element. One can easily overlook the importance of battered women’s intellectual development while addressing other, more basic needs. However, the cognitive-intellectual dimension is an important component of wellness. This sort of wellness involves using
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“formal and informal means that enhance an individual’s level of knowledge and enlightenment” (Donaghy, 1995, p. 10). Strategies counselors might use to stimulate growth in this dimension include the following: 1. Working with educational professionals in the community to set up a General Education Degree (GED) program at battered women’s shelters 2. Offering psychoeducational workshops that specifically focus on relationship issues 3. Providing small peer counseling groups where battered women can discuss their concerns and learn from others’ experiences 4. Using bibliotherapy as a way to help survivors understand the dynamics of abusive relationships The occupational/career dimension of wellness refers to a person’s vocational/career experiences and skills, past and present employment satisfaction, and past and current income levels. As Donaghy (1995) emphasizes, Many unskilled, unemployed battered women remain in abusive situations due to economic dependency on their abusers. Another deterrent for many women is that the salary of an unskilled laborer is insufficient to live on with the added expense of child care; therefore, many of them enter the welfare system and remain dependent. (p. 9) Counselors can do much to support occupational wellness by offering vocational/career counseling services and encouraging and assisting survivors to enroll in occupational training programs. Counselors can also recruit volunteers from the greater community to provide instruction in writing resumes and help clients develop employment interview skills. The spiritual dimension of wellness may be the most elusive and least discussed dimension of wellness. In attempting to define the spiritual dimension of wellness, Donaghy (1995) states, Because spirituality carries with it many different connotations, it can be perceived in as many ways as there are individuals. Spirituality can be expressed within the tradition and structure of a church setting, or experienced simply through an engagement with nature, in a moment of quiet contemplation, or while engaging in a simple day-to-day activity such as changing a baby’s diaper. (p. 9) McFadden (1992) adds that spiritual wellness can be experienced within the self, in meaningful and healthy relationships with others, in connections with one’s environment, or with a higher being. During the recovery process, battered women may experience the need to reconnect with their own spirituality. Counselors can help address this need simply by acknowledging the importance
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of the spiritual dimension for a person’s overall well-being. The ethics of community counseling, however, do not allow mental health professionals to impose any religious beliefs on clients. Instead, they can encourage battered women to take time for themselves (perhaps even away from their children and the shelter) to reflect on their own spiritual development. Outreach to Children Who Witness Domestic Violence. The psychological effects on children who witness domestic violence are well documented in the professional literature (Alessi & Hearn, 1998; Carlson, 1996; Hage, 2000). These children have been specifically noted to be at risk for a host of psychological problems that include the manifestation of aggressive behaviors in solving problems, abusive language, a high degree of anxiety, the tendency to somaticize their feelings, and expressing a sense of responsibility for the conflict their parents experience (Alessi & Hearn, 1998). The community counseling model’s emphasis on providing outreach services to persons in vulnerable populations is well suited to address the needs of children who witness domestic violence. In fact, intervention on behalf of children exposed to domestic violence has emerged as one of the newest areas of early intervention and prevention over the past several years (Hage, 2000). Using a model that was initially developed by Wilson, Cameron, Jaffe, and Wolfe (1986), Hage (2000) illustrates how counselors who use the community counseling model can effectively provide outreach services to this at-risk group of children. In describing this intervention strategy, Hage (2000) emphasizes the need for counselors to use preventive, educational, and support services when working to promote the psychological development and personal well-being of children who have been exposed to domestic violence. The intervention strategy that Hage (2000) discusses is a psychoeducational, group-oriented approach designed for children between the ages of 8 and 13 years who have been exposed to familial violence during their childhood. Hage (2000) notes that children who fit this criteria are invited to participate in 10 weekly group sessions that intentionally “focus on learning how to label feelings, how to deal more effectively with anger, and how to keep themselves safe in conflict situations as well as on skills promoting social competence” (Hage, 2000, p. 806). Counselors who use this group model are also encouraged to help children understand the nature of family violence and separate themselves from responsibility for parental violence. Although such counseling strategies offer much potential in meeting the needs of young children in this vulnerable population, little research has been done to assess the impact that these kinds of interventions have in helping youngsters overcome the forceful impact of domestic violence on their longterm psychological development. For this reason, Hage (2000) stresses the ethical need for counselors to evaluate such programs and services, including the use of longitudinal research approaches that utilize both qualitative and quantitative methodologies to assess the degree to which such interventions are indeed useful in promoting the psychological health of persons in this vulnerable population. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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REACHING OUT TO MARGINALIZED POPULATIONS
People who are marginalized are denied power and access to resources in their communities or societies. Their potential contributions to the community are overlooked and they tend to be stigmatized as incapable of accomplishment. The process of marginalization is so ubiquitous that it can occur on a continuum from the disempowered individual to the oppressed population. Marginalization is at the core of exclusion from fulfilling and full social lives as individual, interpersonal and societal levels.… People who are marginalized have relatively little control over their lives and have few resources available to them; they become stigmatized and are often at the receiving end of negative public attitudes. Their opportunities to make social contributions may be limited.… (Kagan & Burton, 2005, p. 296) When individuals experience a similar kind of stressor for extended periods, they may become just as vulnerable as people who are grappling with personal crises. Counselors commonly work with such marginalized population as poor, homeless, and unemployed people; individuals dealing with acute or chronic health problems; and people victimized by ageism, racism, heterosexism, sexism, and the other forms of oppression. Although these populations differ from one another, they routinely experience a higher level of environmental stress than anyone should be expected to bear. The realities of marginalization and oppression make it clear that the role of community counselors must be to work with their clients within the broadest possible context. “Because oppression likely contributes to marginalized individuals’ vulnerabilities to mental health problems, individualistic interventions must be accompanied by societal and systemic solutions” (Israel, 2006, p. 151). Community counselors can help marginalized clients develop a greater sense of personal power in four fundamental ways: 1. End the self-devaluing and internalized oppression that result from external limitations and labeling. 2. Bring marginalized individuals currently excluded from various aspects of school or community life into the mainstream of social interaction. 3. Facilitate efforts to increase the power of the marginalized group to strive for needed social changes. 4. Increase community responsiveness to the needs and rights of marginalized individuals and groups. It is important to note that, as much as marginalized individuals might benefit from the help of community-oriented counselors, they might be among the most unlikely to seek the services. People are frequently victimized by the very systems and institutions that have been set up to serve them. Impersonal bureaucracies such as Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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welfare and child protective services may intrude in and constrict the lives of individuals through the imposition of dominant cultural values. Health care, educational, and legal systems often play abusive roles in the lives of people who should be able to receive help them from them.… Because of these negative experiences with the human service network, people who are members of oppressed groups may distrust counseling and the counseling process. (Lewis & Arnold, 1998, p. 57) Within this context, the provision of competent help depends on outreach strategies that are practical, empowering, and community-based. Addressing the Mental Health Needs of Latinos/Latinas: The Inquilinos Boricuas en Acción
The United States has a long legacy of racial divide, which continues in the various forms of individual, institutionalized, and cultural racism manifested in communities and campuses across this country ( Jones, 1997). Such racism sometimes results in physical violence. More often, however, people of color experience increased psychological stress from regular exposure to subtler types of discrimination and prejudice (Atkinson, Morten, & Sue, 1998; Locke, 1998; Sue & Sue, 1999). Despite this psychological vulnerability, the U.S. mental health care system has generally failed to address effectively the unique mental health needs of people from diverse cultural, ethnic, and racial backgrounds (Atkinson et al., 1998; Surgeon General Report, 2001). As a result, marginalized individuals have had to choose between two relatively negative options when they need psychological services: (1) choosing treatment that is not provided in a culturally sensitive or appropriate manner or (2) refusing to work with mental health practitioners at all, even when in obvious need of such services (Sue & Sue, 1999). Fortunately, the number of organizations that serve the unique needs of diverse cultural, ethnic, and/or racial groups has increased. One such model program, Inquilinos Boricuas en Acción (IBA), was designed to support the needs of Latinos and Latinas residing in a major urban setting in the eastern part of the United States. IBA is a private, nonprofit organization established in 1968 to empower a predominantly Latino community called Villa Victoria, located in Boston’s South End. IBA emerged when the Latino community came together in the mid-1960s to fight the city’s proposal to displace most of the people residing in the Villa Victoria area. The community rallied to lobby support for an alternative plan: to create subsidized housing units for low- to moderate-income Latino families who resided in the area. These efforts ultimately led to the building of 857 apartments, which currently house more than 3,000 residents (Merced, 1994). IBA has evolved and changed since its inception in 1986. Today, this community organization is dedicated to three goals: 1. Promoting the psychological, social, and economic well-being of the Villa Victoria residents Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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2. Advocating for Latinos and Latinas citywide 3. Perpetuating the rich Latino cultural and artistic heritage in the greater Boston area (IBA Factsheet, 1994) This community organization uses a proactive, holistic approach that includes a wide range of outreach, educational, and counseling services to promote the psychological and cultural well-being of the residents in Villa Victoria. These services aim primarily to foster the leadership skills of adolescents and adults living in the community, provide support for resident-driven community change projects, and organize other sociocultural awareness programs designed to enhance the empowerment of the families in the area. The following discussion briefly examines some of the services offered by the IBA staff and explains how these services fit into the community counseling model. IBA’s direct-service mission is shaped by the belief that community members are the ideal agents for solving the critical psychological, social, and economic problems occurring in their neighborhoods. This organization’s philosophy stems from three general premises about the health of their community. That is, the overall health of the entire community improves when residents (a) strive to lead health-promoting lifestyles, (b) participate in projects that elevate the community from a devalued to a valued status, and (c) avoid behaviors that put them at risk for physical and/or mental health problems (IBA Factsheet, 1994). To help the Villa Victoria residents achieve these goals, IBA provides leadership training services and peer counseling projects for children, adolescents, and adults living in the community. The emphasis placed on these training opportunities reflects IBA’s strong commitment to preventive education and the value that the organization places on working with local residents to enhance their sense of pride and responsibility for the entire community. In the IBA youth programs, youngsters learn to help their peers see the dangers of leading an unhealthy lifestyle and see ways to cope with various developmental and cultural stressors. Topics covered in these peer counseling programs include the physical and psychological effects of abusing alcohol, tobacco, and other drugs; unsafe sex; school desertion; alternatives to violence; and issues related to racism and discrimination. These adolescents frequently work with adults learning how to organize various community projects, including workshops, dances, neighborhood video projects, and other events that send a positive message and encourage healthy choices among their peers (Merced, 1994). In addition to providing leadership training and preventive education services, IBA also offers one-to-one and small-group counseling services, support groups, academic tutoring, crisis intervention services for adolescents and adults, translating for adults, recreational programming, and art classes. These direct client services complement IBA’s community-wide prevention programs by extending assistance and support to those individuals who manifest various personal, educational, and social needs or problems (Merced, 1994). In addition to direct services, IBA also works in the community. Those who try to empower community residents must face many environmental factors Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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counterproductive to their clients’ physical health and psychological well-being. These factors include dealing with various forms of racism and discrimination, poverty, language and cultural barriers, high unemployment rates, and a lack of sensitivity in and responsiveness by many elected city officials regarding these problems. The IBA counselors use several indirect community services to address these negative environmental conditions. In commenting on these services, Merced (1994) notes, IBA politicizes residents, builds coalitions with persons and organizations in other communities, collaborates with human service providers, registers and educates voters, trains residents to be community leaders, supports members of the community in their efforts to become elected representatives on the City Board of Directors, and conducts public demonstrations against or in support of policies which affect the Villa Victoria community. (p. 2) Many of the IBA’s clients have gone through experiences that have left them feeling personally devalued. This is especially true for clients living with the negative social stigma imposed on people with chronic mental health difficulties and/or clients who have been involved in antisocial behaviors such as illegal, violent acts. The devaluation that these people experience in society tends to both undermine their sense of personal power and heighten their sense of powerlessness. Recognizing the negative long-term consequences that these environmental dynamics tend to have on clients’ psychological well-being, the IBA counselors work to help guarantee that they receive the treatment and services to which they are entitled. In attempting to support clients’ rights, the IBA counselors spend much time and energy advocating with other community officials for housing services, entitlement benefits, family services, health care services, appropriate school services, and legal aid for these clients. These types of interventions are important in developing comprehensive, culturally appropriate services for diverse client populations. Gaza Community Mental Health Programme
The Gaza Community Mental Health Programme provides services to a community that is characterized by a high level of stress and a low level of resources. The Gaza Strip—one of the most densely populated areas in the world, with two thirds of the population being refugees and 50% being younger than sixteen years—has witnessed extreme forms of violence and suffering.…This has made the extent of mental health problems in the Gaza reach unprecedented levels. (Gaza Community Mental Health Programme, 2010a, p. 1) Given these pressing needs, the Mental Health Programme strategies include both public awareness campaigns and outreach focused on the most vulnerable groups: children, women, and victims of violence. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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The program’s public awareness efforts attend both to community members’ need for mental health-related information and to the importance of breaking through the cultural barriers to help seeking. “Public meetings, brochures, posters, articles, lectures, workshops, and other tools are being utilized to reduce the ignorance about mental health and erase the stereotype linking it with insanity” (Gaza Community Mental Health Programme, 2010a, p. 2). The program’s direct-service outreach methods are also influenced by the stigma attached to mental health issues. Although mental health clinics do exist as part of the program’s services, a majority of the work takes place in community locations. Home visits work better than asking people to come to the clinic because of the stigma. If you come to the clinic, all of your friends and relatives think you’re sick. Instead, you enter the house, where you’ll find an extended family and a number of children. You bring information about trauma so that adults can take note of symptoms among the children. Then you try to see as many people as possible within the informal setting. It can take a long time—up to as much as three hours. (Celinska, 2009) Programming for Children. The programming for children is almost completely dependent on community outreach, with clinic visits tending to be reserved for the more serious mental health problems. Play therapy is provided by units that are located within the schools. The outreach methods are designed not just to provide direct assistance but also to build a network of helpers who are trained to recognize signs of trauma. In the schools, training is provided for students, teachers, counselors, and parents. A large kindergarten program enlists kindergarten teachers, teaching them how to detect problems and provide help. The trained teachers, with assistance from mental health professionals, then carry out workshops for parents. Additional outreach for children is provided through summer camp projects. Women’s Empowerment Project. The Women’s Empowerment Project addresses the needs of women, particularly those who have been victims of violence. Services are located in several centers in order to reach women who reside in the cities of Gaza or in the refugee camps. The activities offered in each center include the following (Gaza Community Mental Health Programme, 2010b):
Psychotherapy Counseling (social, psychological, legal) Legal rights and awareness Follow-up of cases Court representation Vocational training Training of trainers Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Weekly lectures covering topics raised by participants Educational/awareness lectures Physical fitness Workshops conducted by local professionals covering issues of concern within the community Community meetings conducted by the community development leaders Coordination/liaison by staff with other professional, local/international organizations/institutions Child care Community development leaders work alongside professional staff after receiving training in the areas of human rights, leadership, basic counseling, conflict resolution, communication, and public health issues. As residents of the refugee camps in which they work, they are aware of local issues and problems as they arise, and appropriate methods for their solutions. Developing these key positions within the community ensures that the leaders will reach groups who may otherwise be indifferent or reluctant to intervention. (Gaza Community Mental Health Programme, 2010b) Brazilian Institute for Innovations in Public Health (IBISS)
The distance between the favelas (slums or squatter settlements) of Rio de Janeiro and the rest of Brazilian society is so vast as to virtually define the concept of marginalization. In a Radio Netherlands interview carried out by Beauchemin in 2006, IBISS executive director Nanko Van Buuren described his organization’s efforts in the favelas this way: “We work in the most violent and socially excluded slums,” says van Buuren, “where the government and the police don’t enter. These favelas form a state within a state and are ruled by organized crime.…You have to understand that these slums are really socially excluded: there are no schools, no health posts, nothing.” (Beauchemin, 2006, p. 2) The IBISS teams were initially able to enter a favela because they began by establishing a relationship with an association that represented the people living within its environs. Little by little—one small project after another—they have made progress toward goals that can readily be recognized as ambitious. Van Buuren (2009) describes the healthy environment that should replace the current social exclusion of the favelas in terms of the following list: Access to public services Social and economic inequality minimized Exploitation of child labor eradicated
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Human rights respected Racism and discrimination eliminated Crime and violence reduced The IBISS approach is holistic and involves “building bridges between the socially and economically excluded and the society as a whole” (Van Buuren, 2009). Each project is small-scaled but each plays a role in the forward momentum toward health. Consider, for example, the unique project entitled Soldados Nunca Mais (Soldiers Never More). This program reaches out to the very young men who work as armed “soldiers” on behalf of the drug trade. Many of these youthful “soldiers,” some as young as 10 or 11, would prefer to get out of the drug trade. They believe that they lack other options but, when given an opportunity, they accept it or even seek it out (Soldados trailer video, 2008). The Soldados Nunca Mais project includes the following components (Van Buuren, 2009): Providing alternative experiences that are attractive to the soldiers, e.g., the chance to play soccer or to participate in hip-hop music activities Negotiating with drug bosses to release soldiers who want to leave the drug trade Negotiating with prosecutors Referrals to schools Vocational training, including an IBISS-developed Vocational Training Center Jobs program What does it mean to move from drug-trade soldier to student and employee? What does it take to shift from complete marginalization toward the possibility of playing a role as an accepted member of the larger community? For residents of the Brazilian favela, for children growing up in the refugee camps of Gaza and even for Americans subjected to discrimination, change can take place only when empowering outreach is combined with efforts at systemic change.
SUMMARY
An important part of the community counseling role involves reaching out to people who are contending with environmental stressors that may outweigh their resources and coping skills. Whether the specific event reflects a community-wide disaster or a personal transition, people grappling with overwhelming stress need help that is practical, positive, and empowering. In the case of a traumatic event affecting an entire community, help to individuals should be based on an assumption that people will be resilient if they receive assistance that is accessible, practical, and culturally competent. Once
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the immediate emergency has passed, community-wide efforts also should focus on collaborative efforts at rebuilding. Examples of drawing positive opportunities from calamitous situations include the Greensburg, Kansas, progress toward a sustainable green community and the post-tsunami community development strategies of Sri Lanka’s Foundation of Goodness. Just as disasters can hold the potential for community growth, so can personal crises bring positive growth for individuals. Whether individuals can cope with acute stress may depend on buffers such as their social support systems, sense of self-efficacy, and problem-solving skills. In addition to providing structured and supportive counseling to clients in the midst of crisis, community counselors also identify groups of people, for example adults or children dealing with family disruption or violence, whose life transitions make them vulnerable to developing mental health-related problems. Outreach to these potential clients can help them adapt more effectively to their current situations and prevent future problems. Stressful situations are not limited to sudden emergencies. Many people, because of their membership in oppressed and marginalized groups, are subjected to unrelenting stress that may continue through their lifetimes. Community counselors can play a role in alleviating barriers to development and enhancing positive life experiences through outreach programs. Examples of these programs include Inquilinos Boricuas en Acción, for Latinos and Latinas; the Gaza Community Mental Health Programme and the Brazilian Institute for Innovations in Public Health, for residents of the favelas of Rio de Janeiro. All of these programs have in common a duel strategy of empowering marginalized individuals while seeking systemic change in oppressive environments.
EXHIBIT 4.1 Competency-Building Activity
Program Development As you consider the community counseling program you have been developing, you will probably realize how important it is to have outreach programs that meet the needs of your client population. As you make your plans for these human development strategies, take into account the following questions: 1. In what ways might the clients served by your program be considered marginalized? Are there certain sub-groups that might be marginalized even if the same isn’t true for the entire population? What outreach programs might you want to design? 2. Think, too, about the potential for your clients to deal with the stress of immediate crises or transitions. What outreach programs might help?
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REFERENCES Alessi, J. J., & Hearn, K. (1998). Group treatment of children in shelters for battered women. In A. R. Roberts (Ed.), Battered women and their families: Intervention strategies and treatment programs (pp. 49–61). New York: Springer. Amato, P. R. (1993). Children’s adjustment to divorce: Theories, hypotheses, empirical support. Journal of Marriage and the Family, 55, 23–38. American Association of Suicidology. (1989). Postvention guidelines, school suicide prevention program committee. Boulder, CO: Author. Atkinson, D. R., Morten, G., & Sue, D. W. (1998). Counseling American minorities (5th ed.). Boston: McGraw-Hill. Beauchemin, E. 2006, 3/10. Interview with Nanko van Buuren. Retrieved January 10, 2010, from http://static.rnw.nl/migratie/www.radionetherlands.nl/thenetherlands/ underforeignskies/060104ufs-redirected. Behrman, R. E., & Quinn, L. S. (1994). Children and divorce: Overview and analysis. The Future of Children, 4(l), 4–14. Bloom, B. L. (1984). Community mental health: A general introduction. Pacific Grove, CA: Brooks/Cole. Bloom, B. L., Hodges, W. E., & Caldwell, R. A. (1982). A preventive program for the newly separated. American Journal of Community Psychology, 10, 251–264. Brodsky, A. E. (1999). “Making it”: The components and process of resilience among urban, African-American, single mothers. American Journal of Orthopsychiatry, 69, 148–160. Carbone, J. R. (1994). A feminist perspective on divorce. The Future of Children, 4(1), 183–209. Carlson, B. (1996). Children of battered women: Research, programs, and services. In A. Roberts (Ed.), Helping battered women: New perspectives and remedies (pp. 172–187). New York: Oxford University Press. Celinska, B. (12/17/2009). Personal Communication. Centers for Disease Control and Prevention. (2001). National vital statistics reports: Births 1999 (DHHS Publication No. [PHS] 2001–1120). Hyattsville, MD: U.S. Department of Health and Human Services. Cowen, E. L. (1985). Person-centered approaches to primary prevention in mental health: Situation-focused and competence-enhancement. American Journal of Community Psychology, 33, 31–48. D’Andrea, M. (1994). The Family Development Project (FDP): A comprehensive mental health counseling program for pregnant adolescents. Journal of Mental Health Counseling, 16(2), 184–195. Donaghy, K. (1995). Beyond survival: Applying wellness interventions in battered women’s shelters. Journal of Mental Health Counseling, 17(1), 3–17. Farberow, N. L. (1974). Suicide. Morristown, NJ: General Learning Press. Farberow, N. L., & Shneidman, E. S. (1961). The cry for help. New York: McGraw-Hill. Foundation of Goodness mission statement (nd). Retrieved January 4, 2010, from Foundation of Goodness website: http://www.unconditionalcompassion.org/ whoweare_missionstatement.htm.
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Friedrich, M. C., Matus, A. L., & Rinn, R. (1985). An interdisciplinary supervised student program focused on depression and suicide awareness. New York: New York Department of Education. Gaza Community Mental Health Programme (2010a). What is GCMHP? Retrieved January 13, 2010, from http://www.gcmhp.net/. Gaza Community Mental Health Programme (2010b). Women’s empowerment project. Retrieved January 13, 2010, from http://www.gcmhp.net/File_files/Women/WEP .html. Geuter, Q. (2009, December 28). Five-year tsunami anniversary—a moment for reflection. Retrieved January 4, 2010, from Foundation of Goodness website: http:// www.unconditionalcompassion.org/sub/20091228_5year.htm. Goodman, J., Schlossberg, N. K., & Anderson, M. (2006). Counseling adults in transition: Linking practice with theory. New York: Springer. Greensburggreentown (2010). Retrieved January 6, 2010, from greensburggreentown website at http://www.greensburggreentown.org. Gunasekara, K. (2009, December 17). Joint plenary keynote. Pathways to Reconciliation Summit, Amman, Jordan. Hage, S. M. (2000). The role of counseling psychology in preventing male violence against female intimates. The Counseling Psychologist, 28, 797–828. Hanson. S. L. (1992). Involving families in programs for pregnant teens: Consequences for teens and their families. Family Relations, 41, 303–311. Hayes, R. L., & Hayes, B. A. (1988). Remarriage families: Counseling parents, stepparents, and their children. In R. Hayes & R. Aubrey (Eds.), New directions for counseling and human development (pp. 465–477). Denver: Love Publishing. IBA Factsheet. (1994). IBA VIVA! [Brochure]. Boston: Author. Israel, T. (2006). Marginalized communities in the United States: Oppression, social justice, and the role of counseling psychologists. In R. L. Toporek, L. H. Gerstein, N. A. Fouad, G. Roysircra, & T. Israel (Eds.). Handbook for social justice in counseling psychology: Leadership, vision, and action (pp. 149–154). Thousand Oaks, CA: Sage Publictions. Ivey, A. (1995). Psychotherapy as liberation: Toward specific skills and strategies in multicultural counseling and therapy. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 53–72). Newbury Park, CA: Sage. Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2002). Counseling and psychotherapy: A multicultural perspective (5th ed.). Boston: Allyn and Bacon. Jones, J. M. (1997). Prejudice and racism (2nd ed.). New York: McGraw-Hill. Kagan, C., & Burton, M. (2005). Marginalization. In G. Nelson & I. Prilleltensky (Eds.), Community psychology: In pursuit of liberation and well-being (pp. 293–308). New York: Palgrave Macmillan. Lewis, J. A., & Arnold, M. S. (1998). From multiculturalism to social action. In C. C. Lee & G. R. Walz (Eds.), Social action: A mandate for counselors (pp. 51–65). Alexandria, VA: American Counseling Association. Locke, D. (1998). Increasing multicultural understanding: A comprehensive model (2nd ed.). Thousand Oaks, CA: Sage.
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Marsella, A. J., Johnson, J. L., Watson, P., & Gryczynski, J. (2008). Essential concepts and foundations. In A. J. Marsella, J. L. Johnson, P. Watson, P., & J. Gryczynski (Eds.), Ethnocultural perspectives on disaster and trauma: Foundations, issues, and applications (pp. 3–14). New York: Springer. McFadden, S. (1992, April). The spiritual dimensions of a “good old age.” Paper presented at the 38th Annual Kirkpatrick Memorial Conference on Mental Health and Aging, Ball State University, Muncie, IN. McGee, T. F. (1974). Crisis intervention in the community. Baltimore: University Park Press. Merced, N. (1994). Description of IBA’s community counseling strategy. Boston: Inquilinos Boricuas en Acción. National Institute of Mental Health. (2000). Suicide facts. Washington, DC: U.S. Government Printing Office. Available: www.nimh.gov/research/suifact.htm. Neville, H. A., & Mobley, M. (2001). Social identities in contexts: An ecological model of multicultural counseling psychology processes. The Counseling Psychologist, 29, 471–486. Norris, F. H., & Alegria, M. (2005). Summary: Mental health care for ethnic minority individuals and communities in the aftermath of disasters and mass violence. Retrieved January 6, 2010, from http://www.diversitypreparedness.org/Topic/ Subtopic/Record-Detail/18/resourceId__17760/. Norris, F. H., & Alegria, M. (2008). Promoting disaster recovery in ethnic-minority individuals. In A. J. Marsella, J. L. Johnson, P. Watson, & J. Gryczynski (Eds.), Ethnocultural perspectives on disaster and trauma: Foundations, issues, and applications (pp. 15–38). New York: Springer. Peach, L., & Reddick, T. L. (1991). Counselors can make a difference in preventing adolescent suicide. School Counselor, 39, 107–110. Pedro-Carroll, J. L., & Cowen, E. L. (1985). The children of divorce intervention program: An investigation of the efficacy of a school-based prevention program. Journal of Consulting and Clinical Psychology, 53, 603–611. Phelps, M. (2009, August-September). Rebuilding green: Greensburg, KS. Mother Earth News. Retrieved January 6, 2010, from http://www.motherearthnews.com/greenHomes/Rebuilding-Greensburg-Eco-Homes.aspx. Roberts, A. R. (Ed.). (1996). Helping battered women: New perspectives and remedies. New York: Oxford University Press. Shneidman, E. S. (1987, March). At the point of no return. Psychology Today, 54–58. Snyder, C. R. (1995). Conceptualizing, measuring, and nurturing hope. Journal of Counseling and Development, 73(3), 355–360. Solomon, S. D. (2003). Introduction. In B. L. Green, M. J. Friedman, T. V. M. Joop, & S. D. Solomon et al. (Eds.), Trauma interventions in war and peace: Prevention, Practice, and policy (pp. 3–13). New York: Kluwer Academic/Plenum. Sprenkle, D. H. (1990). The clinical practice of divorce therapy. In M. R. Textor (Ed.), The divorce and divorce therapy book (pp. 37–91). Northvale, NJ: Jason Aronson. Stolberg, A. L., & Garrison, K. M. (1985). Evaluating a primary prevention program for children of divorce. American Journal of Community Psychology, 13, 111–124. Substance Abuse & Mental Health Services Administration (2003). Developing cultural competence in disaster mental health programs: Guiding principles and recommendations 2003.
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Retrieved December 15, 2009, from http://mentalhealth.samhsa.gov/publications/ allpubs/sma03-3828/default.asp. Substance Abuse & Mental Health Services Administration (nd). Federal Emergency Management Agency crisis counseling assistance and training program guidance, Version 1.1. Retrieved December 15, 2009, from http://download.ncadi.samhsa.gov/ken/pdf/ cmhs/CCP_Program_Guidance_ver1.1.pdf. Sue, D. W., & Sue, D. (1999). Counseling the culturally different: Theory and practice (3rd ed.). New York: Wiley. Sullivan, C. M. (1991). The provision of advocacy services to women leaving abusive partners: An exploratory study. Journal of Interpersonal Violence, 6, 45–54. Surgeon General Report. (2001). Mental health: Culture, race, and ethnicity. Department of Health and Human Services. Washington, DC: U.S. Government Printing Office. SWBBrasil (2008). Soldados trailer video. Retrieved January 1, 2010, from http://swbbrasil .blogspot.com/ U.S. Bureau of the Census. (2000). Household and family characteristics. Washington, DC: U.S. Government Printing Office. Van Buuren, N. (2009, Dec. 15). Health care plenary keynote. Pathways to Reconciliation Summit, Amman, Jordan. Wilson, S. D., Cameron, S., Jaffe, P. G., & Wolfe, D. (1986). Manual for a group program for children exposed to wife abuse. London, ON: London Family Court Clinic.
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CHAPTER 5
Developmental/Preventive Interventions
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his chapter reviews broad-based strategies for facilitating human development and preventing mental health problems that might otherwise occur. Nelson and Prilleltensky (2005) differentiate among universal, selective, and indicated approaches to prevention, stating that “everyone is served in a universal intervention, only those who are ‘at risk’ are served in a selective intervention, and only those who are already showing signs of a problem are served in an indicated intervention” (p. 80). The broad-based interventions described in this chapter can be equated with universal intervention or with what is usually termed primary prevention. The activities encompassed by broad-based strategies are designed to be of use to the general population that a community counselor might serve. They strengthen people’s ability to withstand stressors, thereby enhancing healthy development and preventing the onset of problems.
AN EQUATION FOR PSYCHOLOGICAL HEALTH
One can use the following equation to conceptualize the delicate balance between people’s resources and their life circumstances in the development of mental health problems: 127 Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Coping Skills Self Esteem Social Support Personal Power Stress Powerlessness Organic Factors
This equation represents a modified version of one devised by George Albee and cited by the National Mental Health Association (NMHA) Commission on the Prevention of Mental-Emotional Disabilities (1986, p. 13). We have added two factors, powerlessness and personal power, to Albee’s original equation. In the previous chapters, we have alluded to many parts of this equation, including environmental stressors, coping skills, and social support. However, we have not yet defined what is meant by organic factors, feelings of powerlessness, and personal power, nor have we examined how these variables usually impact one’s mental health and psychological well-being. Organic factors refer to those biological conditions that compromise a person’s mental or physical functioning. Examples include individuals born with congenital defects or natural brain damage. A combination of these conditions and ineffective and inappropriate environmental responses to them produces stress that tends to adversely affect a person’s overall psychological well-being and that frequently nurtures a sense of personal hopelessness and powerlessness. McWhirter (1994) describes powerlessness as a condition in which individuals cannot direct the course of their own lives because of societal conditions and/or power dynamics that place them in devalued positions in society. These power dynamics often hinder many individuals from acquiring the life skills needed to lead satisfying and productive lives. These dynamics also frequently undermine a person’s belief in his or her own ability to develop the personal competencies needed to prevent negative situations. Finally, as used in the equation, personal power refers to two important processes. First, it reflects the belief that one can control one’s life in ways that lead to positive and health-promoting outcomes. Bandura (1982) refers to this aspect of personal power as “self-efficacy.” Second, personal power depends largely on the acquisition of a variety of life skills one can use to negotiate developmental and environmental challenges effectively (Salzman & D’Andrea, 2001). Many environmental factors influence a person’s ability to develop a broad range of life skills and use these skills productively in society. For example, it has been well established that the complex set of variables associated with living in poverty negatively impacts an individual’s ability to realize her or his career/ economic, educational, social, and psychological potential (Langston, 1995; Persell, 1993). The Albee equation makes clear the idea that there are two routes to enhancing the mental health of a client population: (a) taking steps to change the environment so that stress and powerlessness are lessened or (b) improving people’s ability to withstand environmental stress by increasing such factors as coping skills, social support, and personal power. The next section of this book, Facilitating Healthy Community Development, reviews strategies for lessening environmental stressors.This current chapter focuses on educational interventions that are available to the client population as a whole.
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EXHIBIT 5.1 Mental Health Equation Exercise
Is there a person you know, either personally or professionally, who you are worried about? Someone who seems to be dealing with difficulties that he or she cannot seem to overcome? Think about that person—or, if no one comes to mind, choose one of the client examples in Chapter 1. Now, draw a copy of Albee’s equation. Fill in what you think might be some of this individual’s “above-the-line” and “below-the-line” factors. What might be some ways to increase the values of the individual’s positive factors through educational interventions? How might these educational interventions help to prevent further problems?
A RATIONALE FOR PREVENTION
The 21st century has brought with it an increased interest in prevention. It makes sense that individuals want to learn about and implement preventive strategies that positively affect their daily lives. Simply stated, more and more people see it as smarter, more economical, and more fun to avoid developing an addiction to cigarettes than to have lung cancer, to brush their teeth with fluoride than to lose teeth, and to exercise regularly than to develop a stress-related illness. Counselors are well positioned in the educational, employment, and health care systems to initiate preventive programs and services that positively impact their clients’ development. Whether employed in mental health centers, schools, universities, career settings, human service agencies, or other settings, counselors often work with clients who as a group manifest similar difficulties and challenges. This includes people whose psychological problems stem from their inability to effectively manage stress, individuals who lack information about their physical and psychological wellness, and people who have not developed an adequate array of life skills to meet the demands of a highly complex, rapidly changing, 21st-century society. This chapter discusses the limitations of individual counseling and emphasizes the importance of having counselors expand their impact by incorporating preventive education strategies into the work they do. Professionals who counsel clients on a one-to-one basis often spend hours on hours helping them solve problems the clients might have avoided if they had developed certain life skills earlier on. Commenting on the overuse of the traditional counseling paradigm, Conyne (1987) discusses several reasons why the repeated use of individual counseling services does not work: It is a no-win proposition because these remedial services are after-thefact approaches that can do nothing to stem the tide of new cases. It is no-win because the access to traditional clinical services is becoming
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increasingly more difficult and expensive as cost containment and efforts to monopolize the health care industry become commonplace. It has always been a no-win situation for the typically underserved—or nonserved—in our society. Thus, the poor, the unemployed, the culturally different, the homeless, and the untold others who are most in need are least able to get this sort of help. And it is a no-win situation because professional counseling, counseling psychology, and other helping professions are restricting the list of available practitioners in their efforts to protect the consumer (and the provider) through licensing, registries, and the like. (p. 12) Recognition of these limitations has caused many counselors to reassess the overall effectiveness of individual counseling (D’Andrea et al., 2001; Sue & Sue, 1999), not to abandon direct counseling services but to enhance their effectiveness in fostering clients’ development. In this regard, many have noted that professional counselors are particularly well suited to take on the roles of psychological educator and life-skills trainer to foster the mental health and well-being of their clients (Donaghy, 1995; Goldstein, 1992; Robinson & Howard-Hamilton, 2000). The community counseling model strongly supports these alternative roles because they reflect the proactive and preventive values on which the framework is based.
MULTICULTURAL CONSIDERATIONS
Preventive counseling involves helping people develop effective ways of dealing with daily stress. All human beings experience similar needs that, when left unsatisfied, stimulate heightened stress levels. Maslow’s description of the hierarchy of human needs provides a useful framework to conceptualize those needs common to all people. According to Maslow (1970), individuals experience stress when their basic needs (e.g., the need for food) go unsatisfied for an extended time. This is also true when their sense of personal safety and/or self-esteem is threatened over prolonged periods. Clearly, universal stressors exist. Even so, many people of color, for example, experience unique stressors because of the various types of interactions, discrimination, and oppression they experience (D’Andrea, Locke, & Daniels, 1997; McNeilly, 1996). People of color have a long history of oppression, discrimination, and marginalization in the United States. Although much of the current rhetoric in the counseling profession embraces cultural diversity, most practitioners would readily agree that racism and prejudice continue as institutionalized sources of stress for many people (D’Andrea et al., 1997; Hwang, 2000). The rise in racially based violence that has occurred in the United States over the past 10 years is a particularly destructive source of stress (Boland, 1992; D’Andrea & Daniels, 1995; Harvey, 1991). Beyond the threat of physical violence, people of color must also routinely face unique environmental barriers that limit their ability to realize their own occupational (Arbona, 1990; McWhirter, Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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1992), educational (Carter & Wilson, 1993; National Research Council, 1991), and economic (Kozol, 1991) potential. Given the unique stressors that people of color experience in a racist society and the ineffectiveness of many traditional remedial counseling services to meet their needs, preventive counseling interventions present a much more useful and ethical way to promote the psychological wellbeing of persons in culturally diverse populations (D’Andrea et al., 1997; Sue & Sue, 1999). Whether providing preventive or remedial counseling services to people from diverse backgrounds, counselors must become culturally competent service providers in the 21st century. Recognizing the importance of this issue, the community counseling model emphasizes that ethical counseling practice in a pluralistic society requires practitioners to develop the specific competencies outlined by the Association for Multicultural Counseling and Development (AMCD) (Arredondo et al., 1996; Sue, Arredondo, & McDavis, 1992). By developing these competencies, counselors can best help people from diverse backgrounds learn ways to prevent problems in their lives. Typically, this involves assisting individuals to expand their repertoire of coping and life skills. Some of the many promising preventive strategies found effective across a broad range of client populations include stress management programs, health promotion projects, life skills training, parenting classes, and programs oriented toward oppression reduction and social justice. Conceptualizations of Stress
Stress is an inevitable part of life. Although people have directed much attention to the debilitating effects of stress, some level of stress is necessary for growth and development to occur. Thus, the community counseling model is not designed to help people live a “stress-free life” but rather to help create opportunities in which individuals team to develop a broad range of stress management skills they can use in different situations throughout their lives. Two fundamental premises underlie this approach to counseling. First, individuals can best realize their own optimal level of personal health and well-being when they learn how to manage their unique life stressors. Second, physical illness and mental health problems can often be avoided by strengthening an individual’s or group’s capacity to handle environmental stressors and life crises effectively (Conyne, 2000; Romano & Hage, 2000). Romano and Hage (2000) state that stress management programs are exceptionally well suited for preventive counseling and educational interventions. Mental health practitioners should, however, have a well-defined understanding of what stress is before attempting to train others to manage their reactions to stressful life events and situations. Ivancevich and Matteson (1980) define stress as “an adaptive response, mediated by individual characteristics and/or psychological processes, that is a consequence of any external action, situation or event that places special physical and/ or psychological demands upon a person” (pp. 8–9). Using this definition as a guide, the following section provides a brief overview of three different theories Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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of stress that are useful for one to keep in mind when planning preventive interventions among a broad range of clients. The Cultural Specificity of Stress Reactions
Many events and interactions can cause stress-related problems and challenge a person’s sense of well-being. However, few experiences are universally stressful. Only those situations an individual views as personally threatening seem stressful to him or her. Stressors often relate to such contextual factors as gender ( Jordan, Kaplan, Miller, Stiver, & Surrey, 1991), age (Craig, 1992), socioeconomic class (Bassuk, 1993; Knitzer & Aber, 1995), and cultural/ethnic/racial background (Slavin, Rainer, McCreary, & Gowda, 1991). Despite the importance of considering these variables when planning stress management interventions, counselors frequently fail to address one or more of these factors when working with clients (D’Andrea, 1995). Several researchers note that traditional models of psychological stress minimize or completely fail to address the role that one’s cultural, ethnic, and/or racial background plays in determining the presence of and reactions to stressful situations (Ivey et al., 2002; Slavin et al., 1991). Given the rapid cultural diversification of the United States, counselors must expand their understanding of stress from an ethnic/racial perspective. In attempting to extend the monocultural frameworks that have dominated the thinking of most mental health professionals in the past, Slavin et al. (1991) have developed a more expansive, culturally sensitive theoretical framework of stress. By identifying several culturally relevant issues that many people of color routinely experience in their lives, these researchers provide a more accurate and comprehensive understanding of some of the underlying cultural and racial determinants of stress. These investigators identify four specific variables that contribute to an increased level of stress but frequently go unnoticed by white counselors. First, many people in underrepresented groups in the United States experience stress simply because they are identified as members of a “minority group.” For example, African American adolescents may often find themselves to be the only one of their race in a restaurant, store, or classroom; they may have difficulty finding a hairdresser who is skilled in handling their hair; or they may find themselves called upon regularly in classroom discussions to represent their race. (Slavin et al., 1991, p. 158) Second, these researchers refer to the stress that occurs from the discrimination and prejudice that plague people of color. Discriminatory acts may be overt and intentional, such as being taunted with racial slurs or stopped by the police for no apparent reason, or they may be covert, such as being addressed in a patronizing manner by white people (D’Andrea, 1996; Locke, 1998; Ridley, 1995). Third, a disproportionate number of people from nonwhite cultural groups are often overrepresented in the lowest socioeconomic class. Without Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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political or financial clout, these economically disadvantaged persons are more vulnerable to such stressful life events as criminal victimization, eviction, interference by state agencies in family life, not having enough money to eat, and not being able to secure adequate health care. Because these factors are often interrelated, Slavin et al. (1991) report that the occurrence of one of these events tends to catalyze other stressful situations. Fourth, members of some cultural groups experience unique stressors directly related to the customs of their group. For example, a Cambodian American woman may experience heightened stress because of her parents’ expectations of an arranged marriage (Slavin et al., 1991). The community counseling model not only emphasizes the environmentalinteractional dimensions of stress but also recognizes that a person’s interpretation of stressful situations is often culturally determined. Thus, a particular cultural, ethnic, or racial group may find certain events stressful, but others may not interpret them as such. When using the community counseling framework to help clients learn more effective ways of coping with life’s challenges, counselors conceptualize stress from a contextual perspective. In doing so, mental health practitioners will gain a better understanding of how clients’ cultural, ethnic, and racial backgrounds relate to the unique stressors they experience in their lives. The Universality of Stress Reactions
Whereas one’s cultural background, gender, sexual orientation, socioeconomic status, and age may affect the types of situations one finds stressful, one’s physiological responses to threatening events are universal. That is, given an event perceived as personally threatening, all people show similar physical reactions. To cope with stressful situations, the human body automatically prepares for vigorous physical activity. This involuntary reaction, or “fight, flight, or freeze” response, occurs regardless of the nature of the stressor. These physical reactions stimulate one to take adaptive action when confronted with a stressful situation. However, when these stress responses build up tension that is not released, they use energy that is not restored. Over time, this can ultimately lead to physical and psychological exhaustion. When this occurs, the stress response is not adaptive and tends to cause problems instead of helping one solve them. The ongoing effects of stress are many. Individuals consistently under stress may find themselves troubled with such physical symptoms as respiratory problems, backaches, chronic high blood pressure, generally low energy levels, and even cardiovascular diseases. Stress also affects psychological health, frequently resulting in depression and anxiety. STRESS MANAGEMENT INTERVENTIONS
Because stress-related difficulties result from a combination of external demands, individual perceptions, cultural factors, and physiological responses, one can reduce them by providing interventions at any of these points. Counselors can help individuals examine the stressors in their lives, study their own responses, Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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and make purposeful choices to manage and reduce the stress they will likely experience. The options for interrupting the stress-response cycle include the following: Taking action against the stressor by altering the environment Altering one’s cognitive responses to the stressor Making lifestyle changes Learning how to modify one’s physiological responses to stress Altering the Environment
People can lower stress by learning to control their environments effectively. As a first step toward this end, counselors can help clients examine those stressors amenable to change. Although they will always experience some stress, individuals can learn to control environmental stressors by developing and implementing problem-solving, time management, and interpersonal skills in their daily lives. Another important mechanism people use to cope with stress involves social support. Having supportive people in one’s life greatly improves one’s ability to withstand stress. These people not only provide a buffer from life stressors but also can encourage and reinforce change. Helping clients develop strategies aimed at expanding their social support networks is especially important in work with people who value collectivism over individualism. Whereas many European Americans extol the latter, those from non-European backgrounds might have learned to favor a collectivistic orientation (Carter, 1991; Sue & Sue, 1999). Thus, strengthening existing support networks and encouraging people to participate in support groups can help culturally diverse clients alter some of the stressful conditions associated with their environments (Parham, White, & Ajamu, 1999). African Americans, Asian Americans, Latinos/Latinas, Native Americans, and people from Pacific Island groups often experience stressors directly related to their membership in a minority group in the United States. As we have mentioned earlier, ethnic discrimination and racism continue to represent insidious sources of stress for many. The community counseling model emphasizes the importance of addressing these culturally based stressors from a preventive perspective. This may involve helping expand oppressed clients’ social support by referring them to culturally specific self-help, political, or social action groups that strive to create changes at the community, state, or national level. Clients’ involvement in such groups offers a powerful way to help them become a part of broad-based environmental modification efforts (McWhirter, 1994; Parham et al., 1999). Altering Cognitive Responses to Stress
Besides learning to influence external conditions, people can also learn stress management skills and techniques that give them greater control over the way Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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they react to environmental situations. For example, counselors can teach clients how to reframe the way they think about stressful situations in their lives. Ellis (1993) has written extensively about the types of dysfunctional thinking that lead people to experience self-induced stress. According to Ellis’s Rational Emotive Behavior theory, stress reactions can be self-induced when individuals use faulty thinking to interpret their situations and experiences. Beck and Weishaar (1995) discuss several types of dysfunctional thinking that create stress reactions: All-or-nothing thinking leads people to think in dualistic terms; that is, they view situations and/or people as being either good or bad or right or wrong; they do not consider a middle position. Perfectionistic thinking causes people to believe that anything less than perfect is unacceptable. Overgeneralizations occur when individuals make broad generalizations about other people and/or experiences, with little evidence to back them up. Catastrophizing refers to interpreting events and bodily sensations as much worse than the available information suggests. Self-punishing thinking involves excessive blaming of oneself when events do not happen as one wishes. Each type of faulty thinking produces heightened levels of self-induced stress. Thus, counseling aims at helping clients restructure the way they have learned to think about themselves, others, and events in their lives. In doing so, individuals begin to gain a greater sense of internal control over the types of stress they experience. This process is referred to as cognitive restructuring (or rational restructuring) (Ivey et al., 2002; Neimeyer, 1993). The use of cognitive restructuring techniques to help clients alter their mental processes involves five steps: 1. Counselors help clients recognize that cognitions mediate emotional arousal. 2. Clients examine the irrationality of their dysfunctional thinking style. 3. Counselors help their clients understand the ways in which unrealistic cognitions affect clients’ maladaptive emotions and promote stress reactions. 4. Clients explore ways to change their faulty thinking. 5. Counselors support clients as they strive to restructure their thinking; they also help clients evaluate the outcomes of these efforts. Lifestyle Changes
Another major component of stress management relates to a person’s ability to maintain a healthy lifestyle. Whereas providing clients information about the dangers of smoking, using drugs and alcohol, eating poorly, and refraining from exercising may not be new for many counselors, identifying the relationship between living a healthy lifestyle and managing stress may be (Romano, 1992). Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Psychoeducational and life skills training interventions are excellent strategies for reaching more people in at-risk populations who will benefit from learning how to manage stress effectively. When providing these services, counselors must help clients understand that unhealthy lifestyle behaviors represent faulty attempts to manage stress, such as using alcohol to reduce social anxiety (Romano, 1992). Psychoeducational interventions that encourage people to develop a broad range of health-promoting, stress management behaviors work particularly well in school, business, and community agency settings. Some examples of the types of psychoeducational interventions that help clients learn to alter their lifestyles constructively include smoking cessation programs; classes that focus on weight reduction and healthy nutrition; parental training; assertiveness training; conflict resolution classes; comprehensive health courses in the elementary, middle, and secondary schools; and classes designed to promote problem-solving and decision-making skills. Altering Physiological Responses to Stress
One cannot always control environmental factors or one’s cognitive responses. Counselors, however, can help individuals learn to intervene at the physiological level of the stress response. Through such techniques as biofeedback training, relaxation training, mental imagery, self-hypnosis, and meditation, people can constructively deal with stressors and thus avoid the long-term negative effects stress could have on their physical health and psychological well-being. Biofeedback training teaches individuals ways to control their physiological functioning when they experience stress. By using instruments that provide immediate feedback about certain physiological functions less involuntary than scientists once thought, clients can learn to bring stress-related physical symptoms under control and achieve an increased state of calm at will (Heil & Henschen, 1998; Wolpe, 1990). Similarly, relaxation training can help people gain control over the physical tension that occurs from acute or chronic stress. Counselors can use a variety of relaxation training techniques in helping clients of all ages to alter their physiological reactions to stress (Forman, 1993; Taylor, 1998). Mental imagery involves teaching people to relax by picturing scenes they associate with comfort and ease or through related techniques, such as muscle relaxation. In this method, clients alternately tense and relax each of their major muscle groups as they picture this movement in their minds. After clients learn to distinguish between tensed and relaxed states, they can consciously trigger physical relaxation during stressful situations by focusing on muscle groups (Forman, 1993; Gould & Damarjian, 1998). Intentionally striving to achieve a relaxed state is the first step in self-hypnosis. However, this technique differs from relaxation training in that in self-hypnosis, individuals imagine that what is being suggested is actually happening: Doing hypnosis successfully requires the subject to shift into a literally extraordinary frame of mind. While ordinarily we direct our mental processes toward coping with the outer world as we reconstruct or
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define it within our self-interactions, in hypnosis you shift your attention away from the objective universe, to focus instead upon the imaginary universe you construct internally. In doing so, you literally forget about the “real world” and concentrate upon the ever-shifting inner reality you are creating for yourself as you think, feel, and imagine along with the suggestions. (Straus, 1982, p. 51) The suggestions used in self-hypnosis training can relate to changing behavior, modifying attitudes and perceptions, or learning to manage specific environmental stressors. Some important self-suggestions are those for absolute calmness and total relaxation. These kinds of deep-relaxation suggestions, which are typically given sub-vocally to oneself while alone, with eyes closed, are especially helpful for relieving stress and tension and for alleviating psychosomatic ailments (Barber, 1982, p. v). Another effective tool for relieving stress and tension involves the use of meditation. The meditative experience produces a level of consciousness best described as a state of inner calmness and clarity, which is both self-empowering and pleasurable. One can meditate in many ways, including the popularized breath meditation, transcendental meditation techniques, and other, more sophisticated approaches ( Jaffe & Scott, 1984; Wallace, D’Andrea, & Daniels, 2001). Breath meditation is an easy way for clients to gain control over stressrelated physiological reactions. This technique requires approximately 10 to 20 minutes per day and involves four basic steps. First, clients must locate a quiet, safe place where they will be free from interruptions. Second, after finding a comfortable sitting position, they must close their eyes and consciously shift their attention from the outside world to their own breathing. Their concentration should specifically focus on the air going into their lungs and out again. While directing their attention this way, they continue to concentrate on their breathing patterns for the first few minutes. If their minds begin to wander, they should gently refocus attention on their breathing. Third, after taking a few minutes to focus on their breathing, individuals then begin silently to count, “One,” as they inhale through their nose and mouth. As they begin to exhale, they say, “And.” At the next inhalation, they continue their count—“Two”—and as they exhale silently say, “And.” When they have counted to four, they begin the count over again, following this procedure in a focused and relaxed manner for about 10 to 15 minutes or as long as they feel comfortable doing so. Finally, they slowly open their eyes and sit still for about a minute to reflect on their own inner feelings. It is important to remind clients (particularly those new to meditation) that distracting thoughts usually occur when one initially begins practicing these sorts of exercises. So that they do not get frustrated with these normal distractions, individuals need the counselor’s encouragement to accept them when they do occur and to let them go as they turn their attention back to their breathing (Wallace et al., 2001). These and other meditation techniques are derived largely from Eastern religious groups and traditions. As a result, they may prove particularly comfortable
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for people with Asian backgrounds. The increased popularity that various forms of meditation have received in the United States over the past several decades gives counselors additional resources to help others learn new ways of altering their physiological reactions to stress. THE STRESS MANAGEMENT WORKSHOP
Providing stress management workshops in school, business, and community settings is a practical way of fostering this important life skill among people of different ages and backgrounds. Stress management workshops generally use a preventive education format designed to provide a safe and mutually supportive environment in which clients can develop new insights and skills to cope with stress. Although one clearly needs to tailor these workshops to meet the participants’ unique developmental and cultural needs, most share the following characteristics: 1. Identifying stressors: Stress management begins with accurately recognizing the stressors that occur in one’s life. To promote self-awareness and build mutual support within stress management groups, the workshop leader can divide participants into small groups and ask them to generate lists of typical work, school, or social stressors. After sharing their lists of stressors in the small groups, the workshop participants discuss commonalities and potential solutions to the problems presented by the group members. 2. Cognitive restructuring: The workshop leader can deepen participants’ selfawareness by inviting them to look for patterns in how they deal with stressful situations. To accomplish this, the leader asks participants to list recent events that made them anxious. By analyzing these situations and their reactions to them, clients can discover what kinds of events they tend to perceive as threatening and stressful. A short lecture and discussion can then help them consider alternative ways to deal with stress in their lives. 3. Stress reduction: The workshop leader usually provides an overview of the universal physiological reactions people have to stress. Once participants know more about the body’s physical fight-or-flight response to stress, they are better positioned to learn new ways of coping with their particular life stressors. By focusing on ways to relieve anxiety, such as enhancing their own ability to relax, workshop participants receive the opportunity to explore the methods that work best for them. 4. Identifying successful strategies: This exercise requires participants to talk about ways they have successfully dealt with specific stressors in their own lives. As they discuss these strategies, participants often notice that the commonly used stress reduction tactics run the gamut from environmental problem solving through changes in one’s thoughts to physical relaxation methods. Because this exercise invites participants to talk about their successes rather than their problems, it provides an encouraging counterpoint to the workshop’s early focus on their stressors and problems. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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5. Making stress management plans: Creating personalized stress management plans can enhance the long-term benefits of the stress management workshop. Counselors encourage each participant to select several stress-related situations and generate immediate strategies for dealing with them. A follow-up session helps monitor and reinforce clients’ successes in managing stress.
HEALTH PROMOTION/WELLNESS PROGRAMS
Many contemporary health problems are preventable. To prevent health problems, however, clients often need assistance in developing new attitudes and behaviors that enhance wellness. The importance of using preventive educational interventions seems clear if only because vast expenditures on traditional remedial health care services have not reduced the occurrence of preventable health problems that millions of people experience in the United States each year. A century ago, infectious diseases were the leading cause of death in this country. During the 20th century, however, health patterns changed. Because of scientific advancements, diseases such as tuberculosis, measles, poliomyelitis, influenza, and pneumonia are no longer the killers they once were. Although these diseases have mostly subsided, other threats to people’s health and wellbeing have greatly increased. This includes a rise in the number of people whose health is seriously compromised by conditions linked to their lifestyle. Such conditions include lung cancer, major cardiovascular disease, drug and alcohol abuse, and motorcycle and drug-related automobile accidents (Lewis et al., 1993; Romano & Hage, 2000). Even those infectious diseases currently on the rise in the general population, such as acquired immune deficiency syndrome (AIDS), correlate highly with lifestyle variables. Today, many early deaths can be avoided or at least mitigated by changes in the way one lives (Conyne, 2000; Witmer & Sweeney, 1992). Cardiovascular disease alone accounts for half the annual mortalities among Americans. Cancer and accidents are also major causes of death in the United States. Often preventable, these problems do not respond well to traditional medical interventions (Lewis et al., 1993; Romano & Hage, 2000). Experts have noted how individuals can both improve the state of their health and reduce the costs of medical care during their life span (Zimpfer, 1992). These health-promoting behaviors include eliminating cigarettes and misuse of alcohol, minimizing excess calories and fats, exercising moderately each day, undergoing periodic screening for the early detection of major disorders such as high blood pressure and certain cancers, adhering to traffic laws, and using seat belts (Lewis et al., 1993). In the community counseling model, counselors foster these types of behaviors by developing programs designed to promote the well-being of targeted populations. When developed in schools, community agencies, hospitals, or business settings, health promotion programs affect large numbers of people. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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More important than a program’s setting, a holistic approach to the enhancement of wellness requires two fundamental considerations. First, one must consider the physiological, environmental, psychological, and cultural factors that affect a client’s health and well-being. Second, at its core, the holistic approach involves encouraging clients to take personal responsibility for their own health. Thus, a key element in this preventive approach is the individual’s willingness and ability to take greater control of his or her wellness. Wellness refers to a holistic way of thinking about one’s overall well-being. Witmer and Sweeney (1992) claim, The concept of wellness is inextricably connected with several major themes related to wholeness in mind, body, spirit, and community. As individuals and families strive to meet their daily responsibilities in work, friendships, and love relationships, there is a need to maintain a perspective not only on what is adequate health and what is normal but also what is necessary and desirable for optimum health and functioning. (p. 140) Health promotion programs designed to promote “optimal functioning” direct counselors to foster a greater understanding of wellness, to help clients discover their power to prevent illness through personal initiative, and to encourage clients to take responsibility for meeting their own health needs. In these ways, counselors can help clients acquire a sense of personal power that enhances what Kobasa (1979) has referred to as “psychological hardiness.” Many have cited psychological hardiness as one of the most important factors in helping people avoid chronic illness (Lichtenberg, Johnson, & Arachtingi, 1992; Romano & Hage, 2000). Kobasa (1979) has also pointed out that, among people facing comparable degrees of stress, the factors distinguishing those who remained healthy from those who became ill included a vigorous attitude toward the world, a strong self-commitment, a sense of meaning in life, and an internal locus of control. Other researchers have added to Kobasa’s list by pointing out that people who had faith in themselves, believed that they could control events through their own behavior, and experienced a sense of mutual support within the context of a meaningful community manifested a psychological hardiness that protected them against psychological stress and illness (Albee, 2000; Lewis et al., 1993). These observations suggest that health-promotion programs should be designed to accomplish three central purposes: Helping people adapt to immediate health concerns so that longer term effects on mental and physical health can be prevented. Helping people develop attitudes that foster an orientation toward personal wellness. Helping people learn how to implement behaviors associated with optimal levels of health and well-being.
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Surviving Cancer Competently Intervention Program
The Surviving Cancer Competently Intervention Program (SCCIP) (Kazak et al., 2004; Surviving cancer competently intervention program, 2008) provides a good example of helping people adapt to health problems so that long-term, negative effects can be avoided. SCCIP is an intensive, one-day intervention that addresses the needs of teenage cancer survivors and their parents and siblings. The program is designed “to promote individual and family coping, competence, and resilience” (Surviving cancer competently intervention program, 2008, p. 1). Structured sessions are conducted with groups of families. Four sequential group sessions are conducted on a Saturday or Sunday with six to eight participating families. The two morning sessions emphasize the use of cognitive-behavioral skills to reduce persisting distress around the cancer experience. These sessions are conducted separately for teenage survivors, mothers, fathers, and teenage siblings. Session 3, the first session of the afternoon, starts with separate group conversations with survivors, mothers, fathers, and siblings about the cancer experience and concludes with the sharing of these discussions with the whole group. The final session asks the families to identify what they have learned about the impact of cancer on different family members and how this knowledge can help place the cancer experience into a historical context that allows them to move on with their lives individually and as a family unit. (p. 1) This program, which is identified by The Substance Abuse and Mental Health Services Administration (SAMHSA) as an evidence-based program, has implications across all of the central purposes of health and wellness programs, helping participants to adapt to immediate health concerns in the interest of preventing long-term effects and focusing on both cognitive and behavioral competencies. Team Awareness
The Team Awareness program also focuses on a health problem: in this case substance abuse prevention. Unlike many substance abuse prevention programs, which tend to be designed for youth, this one reaches adults in their work settings. Moreover, the program emphasizes not just individual attitudes and behaviors but also the workplace as an environment that affects all employees. The training focuses on six components: the importance of substance abuse prevention; team ownership of policy (embracing policy as a useful tool for enhancing safety and well-being for the whole workgroup); stress, including stressors, individual coping styles, and other methods for coping; tolerance and how it can become a risk factor for groups; the importance of appropriate help-seeking and help-giving behavior; and access to resources for preventive counseling or treatment…. Training is highly interactive and includes group discussions, Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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videos, role-playing, quizzes, games, communication exercises, and optional homework assignments. (Team awareness, 2007, p. 1) This workplace-oriented program helps to illustrate the fact that, even when developmental/preventive interventions are designed as direct services for participants, the interaction between person and environment always remains a key factor. Wellness Outreach at Work
The workplace may well provide an ideal setting for reaching adults who can benefit from wellness-oriented educational interventions. When the Wellness Outreach at Work (2008) program is offered in a workplace, employees have access to health screening with follow-up. The program also provides developmental/preventive education. Within the context of personalized, one-on-one coaching for cardiovascular health improvement and cancer risk, wellness coaches provide employees with education and counseling on alcohol use, tobacco use, weight control, and health management. Employees attend one to four 20-minute individual sessions per year thereafter. Computerized records allow employees to track their own health status and to access tools and information that can help them sustain their progress. Individual employees’ health information is confidential, but profiles of changing risk factors for the workforce as a whole are made available periodically to employees and to management. The program includes long-term support for employees, both directly and through the corporate environment (e.g., alcoholfree public functions, peer encouragement of health promotion). (Wellness outreach at work, 2008, p. 1) This program, like Team Awareness, makes good use of the workplace setting by influencing the work environment as well as the workers. Botvin Life Skills Training Health & Wellness Program
Botvin’s Life Skills Training programs, which are recognized as evidence-based practices, have long been offered in school settings (Botvin, 2009). His Life Skills Training Health & Wellness Program uses similar practices but focuses on wellness interventions for adults in the workplace. The program empowers employees to successfully balance their work and personal lives by developing skills in seven essential areas: goal setting, problem-solving, stress and anger management, effective communication and conflict resolution, time and financial management, healthy behavior, and workplace safety. Participants learn behavioral, social and cognitive coping strategies while building key skills for work and life. (Botvin life skills training, nd, p. 1)
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This skill set prepares individuals with the skills that are needed for healthy development and work effectiveness. At the same time, the program also provides tools for preventing personal health problems such as substance abuse and health-related stress. PARENTING AND FAMILY-FOCUSED PROGRAMS
The wellness and health promotion programs described in the previous section make clear that the health of an individual is closely connected with his or her immediate setting. The evidence-based programs that have been discussed are all designed to influence both personal behaviors and environmental factors, with each program attending to either a workplace or a family context. The context of family life is a key factor in facilitating healthy development and preventing new problems from arising. Parenting programs, of course, have obvious impact on child development, but they also affect the stability of life for all family members. Parenting programs and a variety of other family-focused preventive strategies play important roles in healthy human development. Individual wellness requires relational wellness (Prilleltensky, Dokecki, Frieden, & Wang, 2007). Prevention and Relationship Enhancement Program (PREP)
The Prevention and Relationship Enhancement Program is usually offered to groups of three to eight couples but can also be adapted for use with still larger groups. The goal of the Prevention and Relationship Enhancement Program (PREP) is to modify or enhance those dimensions of couples’ relationships that research and theory have linked to effective marital functioning, such as communication, problem-solving skills, and protecting positive connections and expectations. Using techniques of cognitivebehavioral marital therapy and communication-oriented marital enhancement programs, PREP aims to help couples maintain high levels of functioning and prevent marital problems from developing. (Prevention and relationship enhancement program, 2006, p. 1) Among the topics addressed through group interactions and homework assignments are the following: Communication Conflict management Commitment Friendship Sensuality Problem-solving Emotional supportiveness Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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The effectiveness of this program has been implemented with various populations, including at-risk couples (Halford, Sanders, & Behrens, 2001) and in diverse settings including, for instance, marriage education programs in military settings (Stanley, Allen, Markman, & Saiz et al., 2005) and in religious organizations (Markman, Whitton, Kline, & Thompson et al., 2004). Strengthening Families Program
The Strengthening Families Program is designed to increase family resiliency and to prevent problems such as substance abuse (DeMarsh & Kumpfer, 1986). The program includes an interesting combination of skill-training courses: (a) parenting skills sessions, (b) children’s life skills sessions, and (c) family life skills training sessions. The Parenting Skills sessions are designed to help parents learn to increase desired behaviors in children by using attention and rewards, clear communication, effective discipline, substance use education, problem solving, and limit setting. The Children’s Life Skills sessions are designed to help children learn effective communication, understand their feelings, improve social and problem-solving skills, resist peer pressure, understand the consequences of substance use, and comply with parental rules. In the Family Life Skills sessions, families engage in structured family activities, practice therapeutic child play, conduct family meetings, learn communication skills, practice effective discipline, reinforce positive behaviors in each other, and plan family activities together. (Strengthening Families Program, 2007, p. 1) Once families have participated in the initial skill training sessions, they have opportunities to take part in continuing family support groups and booster sessions. Parenting Programs
A number of evidence-based programs focus very specifically on parenting. Active Parenting Now, for instance, applies Adlerian theory and “teaches parents how to raise a child by using encouragement, building the child’s self-esteem, and creating a relationship with the child based upon active listening, honest communication and problem solving” (Active Parenting Now, 2008, p. 1). Parenting Wisely is a preventive program that was designed to help parents communicate effectively with children and youth who might otherwise be at risk for developing problems with substance abuse, delinquency, or school dropout. Based on social learning, cognitive-behavioral, and family systems theories, the programs aim to increase parental communication and disciplinary skills. The original Parenting Wisely program, American Teens, is designed for parents whose preteens and teens are at risk for or are exhibiting behavior problems such as substance abuse, delinquency, and Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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school dropout. Parents use this self-instructional program on an agency’s personal computer or laptop, either on site or at home, using the CD-ROM or online format. During each of nine sessions, users view a video enactment of a typical family struggle and then choose from a list of solutions representing different levels of effectiveness, each of which is portrayed and critiqued through interactive questions and answers. Each session ends with a quiz. All nine sessions can be completed in 2 to 3 hours. Parents also receive workbooks containing program content and exercises to promote skill building and practice. (Parenting Wisely, 2008, p. 1) Additional Parenting Wisely programs have been developed for other groups, including parents of young children. Parenting Through Change also focuses on the skills of effective parenting, helping parents learn such practices as setting limits, solving problems, maintaining positive involvement in their children’s lives, and using positive reinforcement rather than coercion. In this program, the focus is placed on skill development for recently separated single mothers (Parenting Through Change, 2006, p. 1). These family and parenting programs represent developmental/preventive interventions that strengthen families and improve children’s chances for healthy growth toward adulthood. At the heart of these programs one can always recognize the key role played by life skills training. Parenting is an important life skill, but it is only one of many.
LIFE SKILLS TRAINING: PROMOTING PERSONAL COMPETENCE
Everyone faces myriad challenges, conflicts, confusion, and difficult choices in life. How people react to these challenges affects their physical health and psychological well-being. In attempting to navigate the various environmental demands and stressors they encounter at different points in their development, people rely on many life skills. Life skills refer to those competencies that enhance one’s ability to realize a personally satisfying and productive life in the face of challenging and stressful times. Though acquiring a broad range of such skills does not guarantee personal success and satisfaction, an absence of these skills clearly makes it more likely that individuals will experience unhealthy levels of psychological stress over which they have little control (Danish, Nellen, & Owens, 1998). The idea that helping professionals have a role to play in the area of life skills training is not new. In fact, the importance of teaching desirable behaviors that promote psychological health was supported by many in the American educational establishment during the early part of the 20th century. The Character Education Movement in the 1920s represents one of the first organized efforts
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to help youngsters systematically acquire such important life competencies as effective decision-making and problem-solving skills within the public school system (Goldstein, 1992). The Character Education Movement foreshadowed other life skills projects, including the moral education and values clarification programs implemented in public schools during the 1970s and 1980s (Kirschenbaum, 1975; Kohlberg & Turiel, 1971). These programs were specifically designed to help students develop the cognitive reasoning abilities necessary to make responsible decisions. Several other innovative life skills training projects also found a tremendous degree of popularity during the 1970s. Often referred to as “psychological skills training” (Goldstein, 1992) or “deliberate psychological education” (Mosher & Sprinthall, 1971), these programs gained a strong foothold in counseling and psychology at a time when the public had begun to seriously doubt the effectiveness of many traditional counseling and psychotherapeutic interventions. Various life skills training programs currently operate in public schools, community colleges, universities, mental health agencies, hospitals, and businesses across the United States. Further, hundreds of thousands of people purchase self-help books to learn how to realize their human potential, develop healthy lifestyles, acquire effective interpersonal skills, and become proficient decision makers and life planners. Given the increasing demands of a rapidly changing, complex, technological society and the broad-based interest in life skills training among the general public, counselors should understand this popular and important area of work. Effectiveness of Life Skills Training Programs
Empirical evidence supporting the effectiveness of life skills training programs, especially those designed to promote clients’ social and problem-solving abilities, has steadily increased. Researchers have noted that the emphasis on the prevention and the development of personal competencies—the core of most life skills training programs—has substantially enhanced the successful adjustment and personal satisfaction of people of diverse backgrounds and ages (Albee, Bond, & Monsey, 1992; Albee & Ryn-Finn, 1993; Bond & Compas, 1989; Commission on Prevention of Mental/Emotional Disorders, 1987; Salzman & D’Andrea, 2001). Bloom (1984) asserts that an individual’s level of personal competence, particularly in social situations, can moderate many of the negative effects of stressful life events. From his own research, Bloom concludes, Much human misery appears to be the result of a lack of competence— that is, a lack of control over one’s life, a lack of effective coping strategies, and the lowered self-esteem that accompanies these deficiencies. This opinion is emerging out of an analysis of a substantial body of research from a variety of domains that appears to converge on competence building as one of the most persuasive preventive strategies for dealing with individual and social issues in many communities. (p. 270)
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Thus, even without knowing the unique biological, social, or psychological source of a particular problem, one may be able to prevent that problem, along with others, by strengthening the coping skills and general competency of people who have not yet developed dysfunctions. Preventive intervention strategies found to be effective include stress management (Baker, 2001; Romano, 1992), health promotion (Gebhardt & Crump, 1990; Winett, 1995), parenting (D’Andrea, 1994), prejudice reduction (Ponterotto & Pedersen, 1993; Salzman & D’Andrea, 2001), and school-based (Baker, 1996; McCarthy & Mejia, 2001) and community-based (Danish et al., 1998; Goldstein, 1992; Wilson & Owens, 2001) life skills training. Promoting Intrapersonal and Interpersonal Competencies
The life skills training perspective is primarily preventive in theory and practice. Interventions designed to promote life skills view individuals less as clients than as students who would benefit from opportunities to foster various intrapersonal and interpersonal competencies. Intrapersonal competencies refer to those attitudes and skills that allow individuals to negotiate their social environments in constructive, responsible, and assertive ways (Kieffer, 1984; McWhirter, 1994). This includes but is not limited to developing a positive sense of self-esteem (Bowman, 1992), self-efficacy (Bandura, 1982), and self-management skills ( Jaffe & Scott, 1984; Wallace et al., 2001). The intra personal dimension of life skills training also involves acquiring a broad range of decision-making skills and coping strategies that one can use in stressful situations. Interpersonal competencies, on the other hand, include skills that increase one’s ability to communicate effectively with others. To do so, individuals must learn to converse with others in ways that reflect an understanding of one’s own perspective as well as respect for that of any other person with whom one interacts (Salzman & D’Andrea, 2001; Selman, 1980). McWhirter (1994) points to interventions designed to help individuals from diverse cultural backgrounds develop the types of interpersonal skills that “facilitate an individual’s efforts toward greater self-direction, an increased sense of personal competency and mastery, and greater effectiveness in communicating, relating to, and working with others” (p. 51). These interventions include school-based leadership training for culturally diverse student populations (Fertman & Long, 1990); school-based conflict resolution, mediation training, and violence prevention among youngsters from multiracial backgrounds (D’Andrea & Daniels, 1996; Larson, 1994); public speaking classes for culturally diverse adult clients (Powell & Collier, 1990; Wallace et al., 2001); and assertiveness training for Asian Americans (Sue & Sue, 1999). Although many psychological and life skills training models have appeared over the past several decades, the developmental approach (Gazda, 1984; Ivey, 1993) is particularly consistent with the community counseling framework.
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Gazda’s Life Skills Training Model
A training model designed by Gazda and others (Danish et al., 1998; Gazda, 1984; Gazda, Childers, & Brooks, 1987), which they call “Life Skills Training,” successfully applies developmental theory to the task of building personal competence. This model emphasizes four basic skills: (a) interpersonal communication and human relations, (b) problem solving and decision making, (c) physical fitness and health maintenance, and (d) identity development. Assumptions. Gazda and his colleagues have identified more than 300 life skills, categorizing them according to their age appropriateness and the area of human development to which they relate. Here is a summary of the basic assumptions that underlie their Life Skills Training model:
1. Across the seven dimensions of human development—psychosocial, physicalsexual, vocational/career, cognitive, ego, moral, and affective—there are stages through which all people must progress to lead effective lives. Some of these are age related; some are not. 2. Satisfactory progression through each stage depends on the successful accomplishment of developmental tasks specific to each. 3. Accomplishment of these developmental tasks depends on the mastery of life skills appropriate to a given stage and task. 4. Each person encounters many agents (parents, siblings, teachers, peers, social institutions, and so on) through which she or he may learn life skills. 5. There are certain age ranges during which particular life skills can be most easily teamed. 6. Though individuals inherit their capacity for learning, the degree to which they can achieve their maximum potential depends on their environment and life experiences. 7. Individuals achieve optimal functioning when they fully acquire fundamental life skills. 8. Neuroses and functional psychoses result from a failure to develop life skills. Persons experiencing such dysfunctions usually suffer from multiple life skills deficits. 9. Life skills can be taught most effectively through small groups, provided that members are developmentally ready. Therefore, the most satisfactory means of ensuring positive mental health and of remediating psychological dysfunction is through direct teaching/training in life skills, especially if two or more life skills deficits are addressed concurrently (Gazda, 1984, p. 93). Four Steps. In accordance with these general principles, Gazda’s Life Skills Training program fosters various competencies by analyzing the coping behaviors appropriate to the tasks of a given age or stage across the seven dimensions of human development mentioned in the first assumption. Gazda and his colleagues use small-group settings to teach life skills appropriate to the needs and strengths Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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of the individual participants. The same approach applies to both prevention and remediation work. Regardless of the degree of dysfunction among the trainees, the goal of the training is the same: to escort the participants through a series of group sessions that help them move from being trainees through gaining competencies to becoming trainers themselves. Here are four steps that make up this training format: STEP 1. Training in generic life skills: 1. Tell: The trainers explain the purpose of teaching the generic life skill to be taught. 2. Show: The trainers model the behaviors or response(s) to be mastered. 3. Do: The trainees practice the skills in the group setting. 4. Transfer: The trainees receive homework assignments and try to apply the new skill(s) in their daily life. 5. Feedback: The trainers and trainees assess the progress the students have made toward achieving the skills. STEP 2: The trainees are encouraged to help other students develop those life skills they themselves have successfully learned during the group training sessions’ peer bonding. This involves co-training with a “master” trainer (usually a staff member or trainee who has “graduated” from Step 4). STEP 3: Training other trainees under the supervision of a “master” trainer. STEP 4: Conduct group training sessions alone (Gazda, 1984, p. 95). The Prepare Curriculum: Goldstein’s Problem-Solving Program
Another example of a systematic approach to life skills training is the Prepare Curriculum (PC) (Goldstein, 1992). The PC is based on more than 20 years of research on the effectiveness of interventions designed to promote the psychological competencies and prosocial behaviors of children and adolescents (Spivack & Levine, 1973; Spivack & Shure, 1974; Salzman & D’Andrea, 2001; Straink, 1981). Although originally designed to teach an array of prosocial skills to youngsters who manifested interpersonal deficits, the PC provides a useful preventive framework as well. The PC comprises 10 courses in which youngsters participate in structured learning activities designed to foster their cognitive, interpersonal, and moral development. These courses include training in the following areas: problem solving, interpersonal relations, situational perception, anger control, moral reasoning, stress management, empathy, cooperative learning and behaving, and understanding and participating in groups (Goldstein, 1992). These courses aim at building skills that will do the following: 1. Help youngsters develop realistic ways to achieve personal and interpersonal goals and acquire a better understanding of their self-concepts, emotions, and conflicts, as well as their wishes and goals 2. Help them learn more effective ways to elicit the help and cooperation that will enable them to meet their personal and career goals Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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3. Help youngsters learn ways to become more personally appealing to others who are important to them 4. Help them understand others’ self-concepts, emotions, conflicts, problems, desires, and goals 5. Help youth to more effectively help others by learning to offer suggestions for constructive change appropriately 6. Help youngsters understand and resolve problems between themselves and others in a constructive and enduring way—a way that takes all realities, including emotional ones, into account and that comes closest to satisfying all parties 7. Increase participants’ ability to enrich their relationships with people important to them in love, work, and play—that is, enable them to discover more ways to increase the enjoyment and productivity they experience in such relationships 8. Help participants increase their ability to generalize and transfer these skills to their daily life and to maintain them over time 9. Help participants increase their ability to teach significant others the skills necessary to accomplish these nine goals (Goldstein, 1992, pp. 8–9). The PC framework assumes that effective living depends on an individual’s ability to give understanding, to empathize with others, and to generate their empathy in return. In short, this training model teaches youngsters how to respond more effectively to others. To accomplish this, cognitive and behavioral instruction are systematically combined to help foster the following: 1. Expressive skills to promote self-understanding and the ability to communicate this understanding effectively to others 2. Empathic skills to help youngsters see the world as others see it, emotionally identify the feelings of others, and show respect and compassion to others 3. Mode switching to help them learn to use expressive and empathic skills appropriately 4. Interpersonal conflict and problem resolution skills to foster tolerance, understanding, and respect for human diversity 5. Facilitation abilities to help youngsters learn to elicit reactions from others that enrich their relationship with them as well as contribute to their own personal growth 6. Generalization and maintenance to encourage the youngsters to make the newly learned behaviors integral parts of their lives Although traditional counseling and therapy can nurture many of these attitudes and behaviors, Goldstein (1992) emphasizes the importance of basing this sort of training on educational models rather than clinical or medical ones. Consequently, the counselor acts as a trainer by (a) motivating, (b) explaining, (c) demonstrating, (d) modeling/prompting, (e) supervising skill practice within the
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training sessions, (f ) preparing the learner to be successful with homework, (g) assessing homework assignments, (h) preparing the learner to use the skills spontaneously in everyday living, (i) supervising the transfer of skills into everyday living, and ( j) supervising the acquisition of maintenance skills.
BUILDING SOCIAL JUSTICE AND ADVOCACY SKILLS
Prilleltensky et al. (2007, p. 19) say that “wellness cannot flourish in the absence of justice.” The equation that was introduced at the beginning of this chapter supports that viewpoint, showing that powerlessness puts people under severe stress, thus requiring stronger coping mechanisms than people should ever be expected to need. The community counseling model, of course, sees social justice advocacy as part of the counselor’s role. At the same time, the model also recognizes that the clients we serve reap benefits from understanding the impact of oppression and gaining skill in confronting injustice. School-Based Programs
As is the case with life skills programs, the bulk of the work in curriculum development for social justice and advocacy has taken place in school settings. Portman and Portman (2002) suggest that educating students in the knowledge and skills related to social justice serves two related purposes: “prevention of social injustice and promotion of social justice advocacy skills” (p. 17). Teachers for Social Justice (2004) also advocate for the idea that students should learn to “talk back” to the world. Stating that “schools must empower students to be decision-makers in their own lives and to become active participants in our society,” this group of educators recommends that social justice curricula should be Grounded in the lives of students Critical, in the sense that students should learn to pose critical questions about society and connect with real-world problems Multicultural, anti-racist, and pro-justice Participatory and experiential Hopeful, joyful, kind, and visionary Activist, with children coming to see themselves as “truth-tellers and change-makers” Academically rigorous Culturally and linguistically sensitive These principles have a good fit with the kind of educational interventions that are carried out in the context of community counseling programs. Good examples of appropriate and well-thought-out curricula abound. Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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Empowering Students for Social Justice is a structured group model developed by Portman and Portman (2002) for upper elementary, middle school, and junior high school students. The design calls for eight group sessions. In the first three sessions participants are introduced to the concept of social justice, learn about cultural populations, and explore oppression and prejudice in relation to diverse populations. Sessions 4 and 5 are devoted to increasing awareness of the historical context of social justice issues. With this knowledge in place, students are ready to embark on a social justice advocacy project of their own choosing. The goals of this learning project include the following: (a) to create a sense of empowerment for students that they can make a difference, (b) to instill a sense of altruism for helping others, (c) to create a sense of togetherness and community for students while contributing to the school or community, (d) to promote visible activity for addressing social justice concerns in the school and community, and (e) to encourage a sense of self-responsibility in students for addressing social justice concerns in an appropriate manner. (Portman & Portman, 2002, p. 28) Once debriefing of the social justice project has taken place, students move to examine their emotions, review their new learning, and recognize the personal power they can implement as social justice advocates. Youth action is also at the heart of Take Charge: A Youth Guide to Community Change published by the Constitutional Rights Foundation (2002). The guide takes students through five action steps for addressing a community problem. In carrying out Action Step 1, students get to know their own communities, exploring potential resources and profiling local organizations. With Action Step 2, students begin to identify problems in their community and learn how to use research tools to investigate problems in greater depth. Action Step 3 focuses on analyzing public policies that relate to the community problems that have been identified. With these first tasks having been completed, students are ready to move on to Action Step 4: exploring options for addressing the problem. Finally, Action Step 5 involves planning, implementing, and evaluating the action project. When the project has been carried out, students evaluate their progress, their results, and their own learning. Teachablemoment.org, a project of the metropolitan New York Educators for Social Responsibility, offers a detailed activity designed for grades 4–6. First Thoughts (teachablemoment.org, 2004) explores stereotypes through an experiential, small-group exercise. First, children list their “first thoughts” when think about “teenagers.” The resulting list of characteristics often includes negative ideas. The discussion asks Do some teenagers fit this description? Do all teenagers fit this description? Who can describe a teenager you know who is not like this? Is it fair to say or imply that all teenagers are like this?
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What negative results could come from people having stereotypes of teenagers? The exercise is repeated with the students exploring stereotypes of senior citizens or other groups that are subject to stereotyping and prejudice. Community-Based Programs
According to Bell (2007, p. 2), “the goal of social justice education is to enable people to develop the critical analytical tools necessary to understand oppression and their own socialization within oppressive systems, and to develop a sense of agency and capacity to interrupt and change oppressive patterns and behaviors in themselves and in the institutions and communities of which they are a part.” Clearly, most adults cannot look back at their childhood education and remember many occasions in which they were taught about interrupting or changing oppressive patterns. This is an area of study that is both new to and important for the adults who are served by community counselors. Social Justice Education for adults tends to take one of two alternate approaches: (a) educational interventions that facilitate learning about social justice (and its opposite, oppression) as a ubiquitous situation and (b) educational interventions that focus on one or more of the specific “isms” that oppression brings. Unlearning Oppression (Arnold, 1996; Arnold, 2002) is a workshop that has been conducted hundreds of times by Mary Smith Arnold and her colleagues. Defining oppression as “prejudice plus power,” the leader begins the workshop with an explanation of a set of assumptions about oppression, including the following: Oppression is pervasive; it is everywhere, like the dust. Oppression is not our fault, but it is our responsibility. It’s not our differences but our attitudes about our differences that cause problems. We all have multiple cultural identities; we all stand at times in the shoes of the oppressor and at other times in the shoes of the oppressed. We learned to fear difference and play our part in oppression; we can unlearn it. Unlearning oppression is a lifelong process. Exercises that simulate experiences of oppression give participants opportunities to examine and discuss the strategies that make oppression possible. Participants also explore their own participation in oppression through the “stand-up exercise.” In this exercise, the group leader calls out the names of various groups that can be characterized as oppressed. Participants who feel comfortable doing so stand up when a group with which they identify is called. When participants stand, they are self-identifying as one of many targets of oppression. When seated, they are playing, at least at that moment, the role of oppressor. In the
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ensuing discussion, participants explore their feelings when they are in the shoes of the oppressor or the shoes of the oppressed. They become aware of the ways in which they take part in oppressive processes and see the harm done when members of oppressed groups notice only their own victimization. The workshop ends with discussions of the ways in which people can embark on a path of anti-oppression in their own lives. The importance of “ally relationships” is emphasized. Many social justice training sessions focus on a particular issue, e.g., racism, but may still facilitate understanding of the complexities of oppression and injustice. Single-issue courses, although examining one form of oppression in depth, also notice how different issues intersect in order to help participants understand the many parallels and connections among different forms of oppression. For example, a course may have a single-issue focus on sexism but also examine how women from different social classes, racial groups, religions, abilities, or sexual orientations experience sexism. (Bell & Griffin, 2007, p. 68) Among the many established and published social justice curricula are a Racism and White Privilege Curriculum Design (Bell, Love, & Roberts, 2007), a Sexism Curriculum Design (Botkin, Jones, & Kachwaha, 2007), a Heterosexism Curriculum Design (Griffin, d’Errico, Harro, & Schiff, 2007), and a Transgender Oppression Curriculum Design (Catalano, McCarthy, & Shlasko, 2007).
WORKSHOP DEVELOPMENT
Central components of community counseling include identifying the needs of the community or school in which one works and implementing prevention programs capable of reaching large numbers of people who have not yet manifested dysfunctional behaviors. Preventive education programs can particularly help people of all ages acquire the types of life skills and competencies that will buffer the negative effects of stress and help maintain their physical and mental health. Such programs work best when they are tailored to the unique personal and cultural needs of people in the community or school where counselors work. One can, however, identify several general preventive approaches that hold a great deal of promise for general populations and people in at-risk groups. Some of the most useful intervention strategies for a broad range of client populations include stress management training, health and wellness promotion, parenting and family programs, life skills training, and curricula addressing problems of oppression and social justice. Use Exhibit 5.2 to try your hand at designing a workshop.
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EXHIBIT 5.2 Competency-Building Activity
Designing a Workshop Community counselors must frequently develop and implement workshops to foster physical health and psychological wellness, teach life skills, or address problems of oppression and injustice. They can do this most effectively if they plan the workshops step by step. Think of a particular topic and audience you would like to address and develop a workshop plan by following these steps: 1. Consider the specific audience you will be addressing. Direct particular attention to the developmental and cultural characteristics and needs of your audience. 2. State the specific objectives of the workshop. For example, you should ask yourself how the participants will be affected by participating in the workshop. What new skills, attitudes, or knowledge are you trying to instill? 3. Select the kinds of activities you think are most likely to meet your objectives. Consider lectures, discussion groups, case conferences, creative use of computers and other types of media, role playing, simulations, or other preventive education approaches that might meet the developmental and cultural needs of your participants. Which activities would increase the participants’ active involvement and ensure their interest in the workshop? 4. In planning the workshop, be sure to consider the resources likely to be available to you, including your own skills. 5. On the basis of your analysis so far, develop a detailed design for the workshop. 6. Design a general evaluation component that will help you determine whether the workshop’s objectives have been met.
SUMMARY
This chapter reviewed the rational and practical applications of developmental/ preventive interventions designed for the population at large. These broad-based interventions enhance human development and prevent problems, largely through educational methods. Early in this chapter, an equation that illustrated the delicate balance between people’s resources and their life circumstances in the development of mental health problems was introduced. The kinds of interventions described in this chapter are designed to strengthen people’s skills and resources, which can act as protective factors in the face of stressors. The educational approaches discussed in the chapter include training sessions devoted to stress management, parenting and family skills, health and wellness, life skills, and social justice.
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EXHIBIT 5.3 Competency-Building Activity
Program Development Continue your work on designing a hypothetical community counseling program. Consider the group of people you have selected as the population to be served by your program. How might you fill in the quadrant that is devoted to broad-based strategies for facilitating human development? What developmental/preventive projects would be likely to fit the needs of your clients?
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