May 2018 - Issue 2
From the Editor:
Welcome to the Student and Associate Professional Clinical Counselor Newsletter! You’ll find that it is filled with helpful hints and tips, educational information, and features stories of counseling experiences—all written by current Counseling Students, Associates, and a LPCC! This shared Newsletter is an opportunity for young professionals to publicly voice their experiences, strengths, clinical insights, and hope with one another.
Our 2018 annual conference in San Francisco was an absolute success! Thank you for your participation in the conference, and to the many volunteers that assisted in making the event a success. We received overwhelming feedback that the conference met its goal of providing necessary educational experiences to compliment clinical practice, and foster job prospects for students and associates. My hope is you continue the energy for our profession by participating in networking opportunities hosted by local CALPCC chapters. And remember, keep a look out for our announcement of the 2019 conference in sunny Southern California! I hope to see you there!
In this Issue:
Issue 1 - August 2017
Stealing Mindful Moments
Jessica Lowry, B.A. (Counseling Masters Candidate)
Counseling Student at California State University Northridge
Using mindfulness in a therapeutic setting is nothing new. In fact, mindfulness has become the word of the day, the subject of articles, and on the cover of books and TIME. In a recent book on counseling theory and treatment planning, Dr. Diane Gehart describes the Mindfulness-Based Approach as “…the third wave of behavioral therapy” (2016). However, abundant the information on mindfulness is, for many, the concept is still vague, while, for others, the concept is clear but its practice feels uncomfortable or weird. And still, for others, the concept, its value, and practice are understood but these folks may still ask, “Who has the time to do “nothing?”
Susan Kaiser Greenland wrote my favorite definition of mindfulness. It is “a stance of attention where we notice where our mind is and our state of mind, in real time” https://www.susankaisergreenland.com/). When a person is mindful, they are not getting distracted by thoughts or carried away by emotions that take their attention from the present moment. It is a simple concept, yet challenging in its practice.
When mindful, a person is aware that an experience is happening. When someone is “mindful,” they are open to new information, and with this information a new “category of experience” is formed (Langer, 1989, 2014). This new category of experience is not colored by past experiences or expectations; it is formulated in the present moment and by the present moment. A mindful practice allows an individual to be less reactive because it increases the “space of performance,” which is the time when a person who is aware in the moment, can see a situation more objectively and recognize they have choice on how to respond (Yeager & Yeager, 2013). It is the space that allows a person time to get a sense of what is going on inside and time to consider what might be going on for someone else. Mindfulness carries with it an attitude of empowerment, a belief that all human beings have, deep within them, the potential to heal, learn, grow, and thrive (Kabat-Zinn, 2005). It is a practice that can be self-soothing. It is not difficult to understand how a mindfulness practice can be therapeutic, or how a therapist can use this practice to cultivate personal therapeutic qualities in addition to enhancing personal well-being. It is certainly an avenue for the therapists who do utilize mindfulness interventions to directly practice what they preach and therefore speak confidently from experience.
I have cultivated a mindfulness practice made from mindful moments. I realized that if I expected my clients to find the time to “do the work,” I needed to find the time to do the work that works for me. (It is not about finding time after all; that rascal “time” is so elusive. It is, however, about making time.) I believe that mindful meditation is very effective when practiced in longer intervals, (I am getting better at it!), but I want to share that I have seen results from a practice that does not involve long intervals but instead simple “mindful moments.” When strung together, maybe they add up to five minutes, but I have noticed that these five minutes have made a difference. My mindful moments are short practices that simply require me to take notice of something. I incorporate these moments throughout my day whenever I think about it, and I have come to find that the more moments I insert, the more I think about it. Here are some of my favorite mindful moments to steal…
After my mindful moment, I ask myself some of the same questions I hear myself ask my clients. What has changed for me? What do I notice in my mind and in my body? What is new? The answers keep me coming back for more.
Gehart, D. R. (2016). Theory and treatment planning in counseling and psychotherapy. Boston, MA: Cengage Learning.
Kabat-Zinn, J. (2005). Coming to our senses: healing ourselves and the world through mindfulness. New York: Hyperion.
Langer, E.J., (2014). Mindfulness (2nd ed). De Capo Press, Boston. (Original work published in 1989)
Yeager, M., & Yeager, Daniel. (2013). Executive function and child development (Norton professional book). New York: W.W. Norton.
Licensed Professional Clinical Counselor
In 2009, I had just graduated with my masters in Clinical Psychology with the intent on getting licensed as a Licensed Clinical Professional Counselor (LCPC in Illinois). Born and raised in the Midwest, there are many qualities about California that appeal to me. I was considering a drastic move from Chicago to Orange County when I unfortunately discovered that my license was not recognized in California. I was discouraged and confused, but in January 2010, California passed a bill to begin accepting licensed professional counselors. I was thrilled and began to plan my move across country.
As I began to job search, I quickly realized what I was up against. There were absolutely no jobs for professional counselors! I learned that the LMFT, which I was taught was a specialty license, was the primary counseling license in California. I was fortunate enough to have found the California Coalition for Counselor Licensure (CCCL). The website was tremendously helpful in explaining the requirements for reciprocity and each of my emails was promptly responded to about licensure. What I discovered is that, although I already had a year of supervision in Illinois, I would have to first enroll in a graduate level Psychopharmacology class and obtain several CEUs to make up for the requirements that my out of state program did not meet. Then I would have to apply to become an “intern” and start from scratch to log hours under clinical supervision.
I applied to countless counseling jobs but never got so much as a call back. While job searching is never an easy task, I found it impossible to get considered for a counseling job, as I imagine my application material was easily weeded out from MFTI and ASW applicants. I sent emails or letters with every application with my best explanation of the LPCC and its place in California - to no avail. With my background and experience, I was hired as a clinical researcher at a university. This turned out to be a great opportunity for me, as it required the use of my clinical skills and allowed me to develop other important professional areas, yet I fell behind in my goal to become a licensed clinician.
I finally received my PCC intern number and was ready to begin logging clinical hours in 2013. At this time, the LPCC was starting to gain slightly more recognition and of course, having a BBS registered intern number was helpful in landing a job as a therapist. I was feeling discouraged and frustrated about my progress in my career. I continued to hear about people from my cohort who were licensed and getting jobs as supervisors or starting private practices. Even though I had been working diligently, I felt like I had fallen behind in my professional goals. Being referred to as an “intern” was frustrating, as I already had acquired years of relevant work experience that, in other states, would have qualified me to sit for the licensure exam.
My passion for my profession kept driving me towards my goal. The LPCC continued to gain recognition. The CCCL had become CALPCC, and I was attending conferences and networking events with others with a similar story to my own. As my 3000 hours neared, I enrolled for and passed the Ethics exam, building steam for the licensure exam. When I finally took and passed the NCMHCE earlier this year, I had never felt more prepared for anything. Now a Licensed Professional Clinical Counselor in the State of California, I am very passionate about my profession and its role in California.
It has been an exhausting and at times frustrating journey, but as I look back, I realize that no time was wasted. I gained so many useful experiences and opportunities since my move to California, and thankfully CALPCC supported me through the process. Becoming an LPCC is a major accomplishment, but I hope the journey doesn’t end here. Please navigate my webpage for further inquiry! www.scsprofessionalcounseling.com
My Experience in a Christian-Oriented Counseling ProgramBy Cherrie Phillips, B.A. (Counseling Masters Candidate)
Bethel University Mental Health Counseling
My journey at Bethel as a Mental Health Counseling student has shaped me into a dynamic professional because I have been provided opportunities to promote my professional development, personal growth, and spiritual formation. These experiences have infused me with hope, fear, and exhilaration all at the same time. Knowing that while I wanted more opportunities to mature into a fine counselor and spiritual person, it would come at a price, but a price I knew would be worth it.
I knew I wanted to grow but had no idea what that would look like in the context of graduate school and seminary. My desire to do whatever it took to become all that I know God had called me to be, overshadowed any fear I had, and so I applied to a Christian based Mental Health Counseling program. The application process was more difficult than I expected, and I began to question if I was really cut out for graduate study. Little did I know or even realize, the process had already begun. The personal growth, professional development and spiritual formation ignited before I received the acceptance letter. It began the minute I said yes in my heart, and so I persevered and started a new chapter and immediately started to see that this was going to be one of the most challenging, yet most rewarding times of my life.
The first semester was overwhelming and filled with a lot of loneliness and tears as the process, processed me. But each chapter I read and assignment I did, I could feel myself beginning to change. The way I perceived, thought about and even spoke about things were different. I began to see that there was so much I did not know about myself. Specifically, I desired to know my life purpose under God, and how I was to go about living that out.
The second semester was more difficult than the first. There were more tears, pain and suffering, but much healing. Some days, I did not think I would make it. I procrastinated more and more with the assignments that were once easily completed. However, I realized they were designed to show me how far the Lord has brought me, and how faithful He truly is to challenge my spiritual growth as a mental health counseling student.
My Church History class kept me spiritually fed, as I was challenged psychologically, emotionally and spiritually by the other two mental health counseling classes I took that semester. It was if the Lord was saying to me, “be not afraid, for I am with you always, even to the end of the age.” Against all the things I saw as obstacles, I made it through with flying colors.
The summer semester was my most challenging yet in a different way than all the others, but I still finished my first year learning more about myself and the character and grace of God. Particularly as they manifested through those around me; my fellow classmates, unbelievably gracious professors and accommodating staff whom I have come to know, and love as my family, which is I think is the real lesson I am meant to learn here.
Now I am in my second year and continue to be challenged in many different ways, but I would not have it any other way. For I know it is all part of the molding, shaping and fashioning of God in my life. With each encounter I see the fruit of the ongoing transformation just after a mere year here and I cannot wait to see what I look like when I graduate! It has been vital for my counseling training, and personal growth, to engage in Christian oriented master’s level studies.
Bridging the Divide Between Medical Model and Recovery Model Through Carefully-Chosen Words
David Johnson, M.A., APCC
“How are you feeling today?” “Euthymic! And you?”…said no person ever.
Euthymic is one of those counseling jargon terms alongside 5150ed, anhedonia, and Tarasoff that I use regularly when documenting counseling sessions but rarely speak aloud with clients. I am fortunate to have an internship at a community mental health clinic funded in part by the California Mental Health Services Act. Although I find the work deeply rewarding and satisfying, perhaps the most difficult duty has been learning to document according to strict MediCal standards. As a result, I often find myself engaging in a bemused code-switching driven by the stark differences between how I practice counseling and how I must document my practice of counseling.
To be clear, I am not talking about doing one thing and then documenting something different. Rather, I am referring to the intersection of two different philosophical approaches to working with clients; let’s call them a recovery-model and a medical model. The agency where I work stresses a recovery-oriented, strengths-based, holistic approach in working with clients and their families. However, the insurance systems and the human service systems of care have evolved from a medical model, which holds customs and expectations that focus on disease, diagnosis, and treatment. As much as I might try to avoid language in my documentation that could stigmatize, pathologize, or disempower clients, it’s a challenge to do that while also hitting the right keywords auditors look for in routine chart reviews.
I struggled with imposter syndrome in my graduate training program, particularly in my Diagnosis and Treatment Planning class. I have an arts background, so I felt a special need to beef up my vocabulary with the psychiatric terms and symptoms that were unfamiliar. I looked up to my professor, a stern-faced psychologist who often asked students, “Are you sure you want to be a counselor?” My DSM grew thick with Post-its as I read and reread the descriptions and criteria of disorder after disorder, trying to sound smarter than I was. Emphasis was placed on using only evidence-based practices, so I read up on research journals as well. I internalized the idea that success as a counselor was predicated on the arriving at a correct diagnosis and ability to prescribe the most effective evidence-based treatment.
I have come to understand this approach as the medical model. There are obvious advantages to being adept at this approach to counseling: it’s widely accepted, most systems of payment require it, and you have to know it to pass the NCMHCE for starters. But until I started my internship, I hadn’t considered some of the problems of the medical model: it’s hierarchical and disempowering, the influence from the insurance and pharmaceutical industries, and focus on problems instead of people.
In contrast, the Recovery Model of mental health as articulated in the Substance Abuse and Mental Health Services Administration (SAMHSA) working definition of recovery has roots in the 12-Step movements of the 20th Century and is rapidly moving toward integration with the medical model in public health systems of care. Recovery aligns with my particular theoretical orientation (Adlerian) in that it is holistic, encompassing the individual’s total wellness including mind, body, spirit, and community. I also find the emphasis on collaborative decision-making with the client at the center, rather than the psychiatrist, fits better with my personal commitment to social justice. Of course the Recovery Model has its critics. Recovery goals and progress can be self-defined and therefore highly subjective; one person’s major milestone can appear meaningless to another.
As I become more familiar with the history and foundations of both the Medical Model and Recovery Model, I am learning to effectively code-switch between them. Building skills in the use of language and concepts of both approaches are helping to me to become a better counselor.
Self-Compassion for TherapistsBy JoJo Lee, MA, NCC, APCC
Practicing Associate Professional Clinical Counselor
The task of a therapist is highly complex. Many therapists decide to become one because of their strong passion for helping others and contributing back to the community. Unlike other health care professionals, however, therapists cannot surgically remove trauma from clients’ brains nor utilize dialysis to filter out their unwanted emotions/ behaviors. We are the “medical tools” of our clients, which requires us to use our clinical judgment to evaluate and determine proper “operative” treatments. During psychotherapy sessions, we are listening to the client’s verbal and non-verbal expressions, internally triaging his/her concerns, regulating our own perceptions, and managing the countertransference reactions toward patients simultaneously. Outside of the session, we are responsible for recording clinical observations, updating treatment plans, managing the milieu of concerns and cases, and attending trainings and meetings. Without some form of self-compassion, these tasks can often gradually lead to self-doubt and compassion fatigue.
Not too long ago, I realized that I had developed an invalidating environment within myself. I started to evaluate and compare my clinical skills based on the outcomes of my clients and my colleagues’ clients. I felt incompetent when I sat across from my client and thought, “Man, I wish I had a better strategy to help you. I am stuck! Maybe you need a better therapist for this. ” I walked out from my session and felt defeated. Instead of turning to self-care, I spent hours researching articles and training, increasing self-doubt and self-invalidation.
One day, I started spiraling downward after a group session. Then I saw a quote that I wrote to myself a year ago. “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.” – The Dalai Lama. I recognized how harsh I was to myself. I was expecting that something good would happen if I kept pushing to improve myself. I had the wisdom of knowing the importance of mental well-being and the compassion to serve others. Yet, I forgot to cultivate self-compassion and be mindful of self-judgment. It eventually emptied out my positive energy, and I knew it was time to change it.
Having been bitten by the research bug, I looked into self-compassion. I felt some relief after finding that therapists spoke more critically of themselves and cultivated less self-compassion compared to intuitive healers (Barker, 2009). Moreover, there is research that highlights a positive correlation between cultivating self-compassion in therapists and positive treatment outcomes (Barker, 2009; Grepmair et al., 2007). Therapists who practice self-compassion are less likely to judge their emotional experience during sessions with clients, better able to be mindful of countertransference, and less defensive of experiences that threaten their ego. Self-compassion also helps foster a positive energetic change in therapists, which can assist clients to feel healing and calming.
Self-compassion can be practiced different ways. Practicing yoga, directing loving-kindness toward oneself, being mindful of self-critical thoughts, accumulating positive experiences, accepting our own shortcomings, recognizing the human experience, surrounding oneself with positive energy, and doing a lot of positive self-talk are all the ways to enhance self-compassion. The keys are to remember that self-care is non-negotiable and our self-worth is unconditional.
“If your compassion does not include yourself, it is incomplete” --- Jack Kornfield
Barker, J. E. (2009). Psychotherapist and intuitive healer's cultivation of self-compassion: how loving the self enhances therapist intuition and client interaction. Theses, Dissertations, and Projects, 471.
Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickle, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their parents: a randomized, double-blind, controlled study. Psychotherapy and psychosomatics, 76, 332-338.
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