11 May Eloise is a high school counselor who is presently experiencing a traumatic personal crisis. Her only son was killed in a drive-by shooting. Many

Ch. 2 The Counselor as a Person and as a Professional

Motivations for Becoming a Counselor

Ask yourself these two questions: “What motivates me to become a counselor?” and “What are my rewards for counseling others?” There are many answers to these questions. You might experience a sense of satisfaction from being with people who are struggling to achieve self-understanding and who are willing to experience pain as they seek a healthier lifestyle. Addiction counselors who are themselves in recovery, for example, may appreciate being part of the process of change for others with substance abuse problems. Indeed, many counselors have been motivated to enter the field because of their own struggles in some aspect of living. It is crucial to be aware of your motivations and to recognize that your way of coping with life’s challenges may not be appropriate for your clients. In many ways therapeutic encounters serve as mirrors in which therapists can see their own lives reflected. As a result, therapy can become a catalyst for change in the therapist as well as in the client.

Of course, therapists do have their own personal needs, but these needs can- not assume priority or get in the way of a client’s growth. Therapists need to be aware of the possibility of working primarily to be appreciated by others instead of working toward the best interests of their clients. Therapeutic progress can be blocked if therapists use their clients, even unconsciously, to fulfill their own needs. Although therapists may meet some of their needs through their work, this should be a by-product rather than a primary aim.

Out of an exaggerated need to nurture others or to feel powerful, professional helpers may come to believe that they know how others ought to live. Some coun- selors may be tempted to use their value system as a template for their clients, but giving advice and directing another’s life encourages dependence and promotes a tendency for clients to look to others instead of to themselves for solutions. Part of the therapist’s job is to empower clients so they can function independently and discover their own unique solutions. Therapists who need to feel powerful or important may begin to think that they are indispensable to their clients or, worse still, try to make themselves so.

The goals of therapy also suffer when therapists with a strong need for approval focus on trying to win the acceptance, admiration, and even awe of their clients. When we are unaware of our needs and personal dynamics, we are likely to satisfy our own unmet needs or perhaps direct clients away from exploring con- flicts that we ourselves fear. Some clients may feel a need to please their therapist, and they are easily drawn into taking care of their therapist’s psychological needs. Relying too heavily on personal self-disclosure when working with clients moves the focus away from our clients and puts the spotlight on the therapist.

Some therapists feel ill at ease if their clients fail to make immediate progress; consequently, they may push their clients to make premature decisions or may make decisions for them. As a way of understanding your needs and their possible influence on your work, ask yourself these questions:

• How will I know when I’m working for my own benefit at the expense of my client’s benefit?

• If I have personal experience with a problem a client is having, how can I work to be objective enough to relate to this person professionally and ethically?

40 / chaPter 2 Copyright 2019 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202

Copyright 2019 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.

• How much do I depend on being appreciated by others in my own life? Do I depend primarily on sources outside of myself to confirm my worth?

• Am I getting my needs for nurturance, recognition, and support met from those who are significant in my life?

• Do I feel inadequate when clients don’t make progress? If so, how could my atti- tude and feelings of inadequacy adversely affect my work with these clients?

• Do I have healthy boundaries in place and set limits for myself both person- ally and professionally?

Personal Problems and Conflicts

Mental health professionals can and should be aware of their unresolved problems and conflicts. Personal therapy may reduce the intensity connected with these problems, yet it is not realistic to believe that such problems are ever fully resolved. Clearly, then, we are not implying that therapists should have resolved all their per- sonal difficulties before they begin to counsel others. Indeed, such a requirement would eliminate most of us from the field. In fact, a counselor who rarely struggles may have real difficulty relating to a client who feels desperate or is caught in a hopeless conflict. The critical point is not whether you happen to be struggling with personal problems but how you are dealing with problems you face.

Reflect on the following questions: Do you recognize and try to deal with your problems, or do you invest a lot of energy in denying that you have problems? Do you find yourself blaming others for your problems? Are you willing to con- sult with a therapist, or do you tell yourself that you can handle it, even when it becomes obvious that you are not doing so?

When you are in denial of your own problems, you will most likely be unable to pay attention to the concerns of your clients, especially if their problem areas are similar to yours. Suppose a client is trying to deal with feelings of hopelessness and despair. How can you explore these feelings if in your own life you are deny- ing them? Or consider a client who wants to explore her feelings about her sexual orientation. Can you facilitate this exploration if you feel uncomfortable talking about sexual identity issues and do not want to deal with your discomfort? Some- times it can be difficult to identify strengths and weaknesses. We encourage you to ask colleagues, peers, and your personal counselor for honest feedback as to how they perceive you and what they see as your strengths and areas needing further work for you as a person and a professional. Asking for this type of feedback requires courage, yet doing so can be an illuminating experience and well worth the effort. When engaged in this discussion, willingly suspend any tendency to be defensive. Reflect on the information shared and create a plan to learn from it, integrate it, make changes, and move forward.

You will have difficulty helping a client in an area that you are reluctant to look at in your own life. It is important to recognize the topics that make you uncomfortable, not just with clients, but in your personal life as well. Knowing that your discomfort will most probably impede your work with a client can sup- ply the motivation for you to change and to realize that you also have an ethical responsibility to be present with your clients. One of the gifts of being a counselor is that it is a career choice that can lead us to becoming better versions of ourselves.

the counselor as a Person and as a Professional / 41 Copyright 2019 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202

Copyright 2019 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.

• How much do I depend on being appreciated by others in my own life? Do I depend primarily on sources outside of myself to confirm my worth?

• Am I getting my needs for nurturance, recognition, and support met from those who are significant in my life?

• Do I feel inadequate when clients don’t make progress? If so, how could my atti- tude and feelings of inadequacy adversely affect my work with these clients?

• Do I have healthy boundaries in place and set limits for myself both person- ally and professionally?

Personal Problems and Conflicts

Mental health professionals can and should be aware of their unresolved problems and conflicts. Personal therapy may reduce the intensity connected with these problems, yet it is not realistic to believe that such problems are ever fully resolved. Clearly, then, we are not implying that therapists should have resolved all their per- sonal difficulties before they begin to counsel others. Indeed, such a requirement would eliminate most of us from the field. In fact, a counselor who rarely struggles may have real difficulty relating to a client who feels desperate or is caught in a hopeless conflict. The critical point is not whether you happen to be struggling with personal problems but how you are dealing with problems you face.

Reflect on the following questions: Do you recognize and try to deal with your problems, or do you invest a lot of energy in denying that you have problems? Do you find yourself blaming others for your problems? Are you willing to con- sult with a therapist, or do you tell yourself that you can handle it, even when it becomes obvious that you are not doing so?

When you are in denial of your own problems, you will most likely be unable to pay attention to the concerns of your clients, especially if their problem areas are similar to yours. Suppose a client is trying to deal with feelings of hopelessness and despair. How can you explore these feelings if in your own life you are deny- ing them? Or consider a client who wants to explore her feelings about her sexual orientation. Can you facilitate this exploration if you feel uncomfortable talking about sexual identity issues and do not want to deal with your discomfort? Some- times it can be difficult to identify strengths and weaknesses. We encourage you to ask colleagues, peers, and your personal counselor for honest feedback as to how they perceive you and what they see as your strengths and areas needing further work for you as a person and a professional. Asking for this type of feedback requires courage, yet doing so can be an illuminating experience and well worth the effort. When engaged in this discussion, willingly suspend any tendency to be defensive. Reflect on the information shared and create a plan to learn from it, integrate it, make changes, and move forward.

You will have difficulty helping a client in an area that you are reluctant to look at in your own life. It is important to recognize the topics that make you uncomfortable, not just with clients, but in your personal life as well. Knowing that your discomfort will most probably impede your work with a client can sup- ply the motivation for you to change and to realize that you also have an ethical responsibility to be present with your clients. One of the gifts of being a counselor is that it is a career choice that can lead us to becoming better versions of ourselves.

Personal Therapy for Counselors Throughout this chapter we stress the importance of counselors’ self-awareness. A closely related issue is whether those who wish to become counselors should experience their own personal psychotherapy, and also whether continuing or peri- odic personal therapy is valuable for practicing professionals. We strongly support the value of personal therapy for counselors in training because it provides a win- dow into what counseling might be like for clients. Wise and Barnett (2016) identify engaging in personal psychotherapy on a periodic basis as a self-care strategy and as a form of positive self-development. Personal therapy can be one of the ways to maintain self-care and competence throughout one’s career. We recommend that you involve yourself in therapeutic experiences that increase your availability to your clients. There are many ways to accomplish this goal: individual therapy, group counseling, consultation with trusted colleagues, continuing education (especially of an experiential nature), keeping a personal journal, and reading. Other less formal avenues to personal and professional development are reflecting on and evaluating the meaning of your work and life, remaining open to the reactions of significant people in your life, traveling to experience different cultures, taking a yoga or a meditation class, practicing mindfulness in daily living, engaging in spiritual activ- ities, enjoying physical exercise, spending time with friends and family, and being involved with a hobby. The common theme throughout these activities is that they focus on your own self-care and physical and emotional health. Taking care of your- self is paramount in helping you guide others through their therapeutic journey. Experiential Learning Toward Self-Understanding Experiential learning is a basic component of many counseling programs, provid- ing students with the opportunity to share their values, life experiences, and per- sonal concerns in a peer group. Many training programs in counselor education recognize the value of having students participate in personal-awareness groups with their peers. Such a group experience does not necessarily constitute group therapy; however, it can be therapeutic in that it provides students with a frame- work for understanding how they relate to others and can help them gain a deeper insight into their shared concerns. A group can be set up specifically for the explo- ration of personal concerns, or such exploration can be made an integral part of training and supervision. Whatever the format, students will benefit most if they are willing to focus on themselves personally and not merely on their clients. Begin- ning counselors tend to focus primarily on client dynamics, as do many supervi- sors and counselor educators. Being in a group affords students the opportunity to explore questions such as these: “How am I feeling about being a counselor?” “How do I assess my relationships with my clients?” “What reactions are being evoked in me as I work with clients?” “Can I be open with my own reactions as a counselor?” “Am I willing to appropriately self-disclose in my work as a coun- selor?” By being personally invested in their own therapeutic process, students can use the training program as an opportunity to expand their abilities to be helpful. It is important for counselor educators and supervisors to clarify the fine line between training and therapy in the same way that fieldwork agencies must main- tain the distinction between training and service. Although these areas overlap, it is clear that the emphasis for students needs to be on training in both academic and clinical settings, and it is the educator’s and supervisor’s responsibility to maintain that emphasis. It is essential that students be informed at the outset of the program of any requirement for personal exploration and self-disclosure. Students have a right to know about the nature of courses that involve experiential learning. The informed consent process is especially important in cases where the instructor also functions in the role of the facilitator of a group experience. We discuss this topic at greater length in Chapters 7, 8, and 9. The Case of a Required Therapeutic Group Miranda is a psychologist in private practice hired by the director of a graduate program in counseling psychology to lead an experiential group. she assumes that the students have been informed about this therapeutic group, and she is given the impression that students are eagerly looking forward to it. When she meets with the students at the first class, however, she encounters a great deal of frustration. they express resentment that they were not told that they would be expected to participate in a therapeutic group. some students fear negative consequences if they do not participate. • if you were a student in this group, how might you feel and react? • is it ever ethical to mandate self-exploration experiences? • the students knew from their orientation and the university’s literature that this graduate program included some form of self-exploration. in your opinion, was this disclosure suffi- cient for informed consent? • if you were Miranda, what would you do in this situation? how would you deal with the students’ objections? Commentary. informing students prior to entering the program that self-exploration will be part of their training only minimally satisfies the requirement for informed consent. students have a right to be informed about every aspect of the experiential group: the rationale for the group, issues pertaining to confidentiality, and their rights and responsibilities regarding participation in experiential activities. shumaker, Ortiz, and brenninkmeyer (2011) recommend that experiential groups include a detailed informed consent process and teach students what constitutes appropriate self-disclosure in such a group. clear guidelines must be established so students know what their rights and responsibilities are. in addition to this general orien- tation by the program, each instructor (in this case, Miranda) has an obligation to ensure that students have been properly informed about these expectations and requirements. Miranda has an obligation to ensure that group participation is genuinely voluntary and, if not, that the experience is clearly related to program training objectives. Miranda could explain to trainees the value of an experiential group in terms of gaining insights into their personal dynamics, such as potential areas of countertransference. by identifying areas that can lead to counter- transference, trainees are in a position to do further work in their own therapy outside of the group. in our view, Miranda needs to provide an opportunity for students to share their con- cerns at the initial group meeting. she needs to provide a rationale for experiential learning and explore with students how participation in an experiential group can equip them with the awareness and skills to become effective group facilitators. • Personal Therapy During Training

Studies on Personal Therapy for Trainees Personal therapy can be a valuable component for the growth of clinicians. In many theoretical traditions, and par- ticularly in the psychodynamic tradition, personal therapy is deemed essential in the development of therapists (Ronnestad, Orlinsky, & Wiseman, 2016). An assumption of many training programs is that personal counseling should be a requirement for students planning to go into the counseling profession. Gold and Hilsenroth (2009) demonstrated that graduate clinicians who had personal ther- apy felt more confident in their role and delivered treatments that were twice as long as those of graduate clinicians who did not experience personal therapy. Their study also found that graduate clinicians who had experienced personal therapy developed strong agreement with their clients on the goals and tasks of treatment. Dearing, Maddux, and Tangney (2005) emphasized the responsibil- ity of faculty, supervisors, and mentors in educating trainees about appropriate pathways to self-care and prevention of impairment. Students are more likely to seek personal therapy when faculty members convey favorable and supportive attitudes about student participation in therapy. Faculty can provide modeling for students by appropriately sharing their own experiences with therapy dur- ing their training and later. Dearing and colleagues indicate that confidentiality issues, general attitudes about therapy, and the importance of personal therapy for professional development were key predictors for trainees seeking their own therapy. They suggest that students consider the potential benefits, both person- ally and professionally, of psychotherapy during their training, including alle- viation of personal distress, a means of gaining insight into being an effective therapist, and development of healthy and enduring self-care habits. Ronnestad and colleagues (2016) report that studies pertaining to the influence of psycho- therapy on therapists as people include “positive increments in self-awareness, self-knowledge, self-understanding, self-care, and self-acceptance as well as reduction in symptoms and improved relationships and personal growth gen- erally” (p. 230). Furthermore, personal therapy can teach us more about the pro- fession as we observe and learn new strategies by participating as a client. Our capacity for empathy increases as we begin to understand how challenging it may be for clients to come to us and the courage it takes to share intimate details with a helping professional. Counselor education programs would do well to work with therapy pro- viders outside the program or at their university’s counseling center to offer psychological services to graduate students in their programs. Because of the ethical problems of counselor educators and supervisors providing therapy for their students and supervisees, faculty members have an obligation to become advocates for their students by identifying therapeutic resources students can afford. Some training programs provide a list of practitioners who are willing to see students at a reduced fee. There are both practical and ethical reasons to prefer professionals who are not part of a program and who do not have any evaluative role in the program when providing psychological services for train- ees. Practitioners from the community could be hired by a counselor-training program to conduct therapeutic groups, or students might take advantage of either individual or group counseling from a community agency, a college coun- seling center, or a private practitioner. Reasons for Participating in Personal Psychotherapy In your own therapy you can take an honest look at your motivations for becoming a helper. You can explore how your needs influence your actions, how you use power in your life, and what your values are. Your appreciation for the courage your clients show in their therapeutic journey will be enhanced through your own experience as a client. In addition, we believe personal therapy is a valuable form of ongoing self-care. As therapists, we are often in the role of giver; to preserve our vitality, we need to create spaces in which the “giver” can be supported. Personal therapy affords opportunities for you to learn how to establish and maintain a working alliance and how to deal with the challenges and uncertainties involved in therapeutic work (Ronnestad et al., 2016). As Wise and Barnett (2016) state: “Good personal therapy is good not only for therapists as clients but also, in the long run, for the therapists’ clients” (p. 231). When students are engaged in practicum, fieldwork, and internship experi- ences and the accompanying individual and group supervision sessions, the fol- lowing personal themes may surface: • A tendency to tell people what to do • A strong need to alleviate clients’ pain • Discomfort with intense emotion • A need for quick solutions • A fear of making mistakes • An intense need to be recognized and appreciated • A tendency to assume too much responsibility for client change • A fear of doing harm, however inadvertently • A tendency to deny or not recognize client problems when they activate your own problems • A preoccupation with winning approval and for clients and supervisors to like you • An internal focus on what you should say or do next rather than on what the client is saying and experiencing When trainees begin to practice psychotherapy, they sometimes become aware that they are taking on a professional role that resembles the one they played in their family. They may recognize a need to preserve peace by becoming caretakers. When trainees become aware of concerns such as these, therapy can provide a safe place to explore them. Trainees are likely to struggle with creating a sustainable balance between caring for clients and caring for others. Personal therapy can help trainees become aware of the interplay between care of the self and care of the other (Wise, Hersh, & Gibson, 2012). It is important for graduate programs to provide a safe context for training, and the rights and welfare of students must be con- sidered. However, we believe counselor educators can go too far in the direction of protecting the rights of counselor trainees, for example, by not requiring any form of self-exploratory experience as part of their training program. Educators must also be concerned about protecting the public. In Chapter 8 we provide some real cases that elaborate on this point. One way to ensure that clients will get the best help available is to prepare students both academically and personally for the tasks they will face as practitioners. The ethics codes of various professions state that it is not appropriate for supervisors to function as therapists for their supervisees. However, good super- vision is therapeutic in the sense that the supervisory process involves assisting supervisees in identifying their personal problems so that clients are not harmed. Both trainees and experienced therapists must recognize and deal effectively with their countertransference, which can be explored in personal therapy. Consider the situation of a therapist who himself is a veteran with a disability working with other disabled veterans. He may be experiencing a great deal of anger and frustration over the lack of attention to the basic needs of his clients, but he may be suffering from the same neglect. As a result, the therapist’s personal problems may get in the way of focusing on his clients’ needs. Countertransfer- ence reactions also need to be considered for addiction therapists, especially for therapists who are in recovery themselves. For example, in inpatient substance abuse treatment programs, the daily intensity of treatment may affect both client and therapist. In this kind of environment, ongoing supervision is required. Par- ticipating in one’s own recovery group is often expected, and personal therapy can be most useful. When practitioners have been found guilty of a violation, some licensing boards require therapy as a way for practitioners to recognize and monitor their countertransference. We think this provides a rationale for psychotherapy for both trainees and practitioners as a way of reducing the potential negative con- sequences of practicing psychotherapy. On an ongoing basis, therapists must rec- ognize and deal with their personal issues and their potential impact on clients. Therapists should seek personal therapy before distressing life situations lead to burnout and harm to clients (Barnett, Johnston, & Hillard, 2006). Ongoing Therapy for Practitioners Experienced practitioners can profit from therapy that provides them with oppor- tunities to reexamine their beliefs and behaviors, especially as these factors pertain to their effectiveness in working with clients. In a study examining the personal therapy experiences of more than 4,000 psychotherapists of diverse theoretical ori- entations in more than a dozen countries, Orlinksy and Ronnestad (2005) found that more than 88% rated the experience as positive. Another large-scale study (3,995 psychotherapists in six English-speaking countries) found that personal therapy among therapists is a common practice and that it is considered bene- ficial (Orlinsky, Schofield, Schroder, & Kazantzis, 2011). In a meta-analysis, more than three-quarters of therapists across multiple studies believed that their per- sonal therapy had a strong positive influence on their development as clinicians (Orlinsky, Norcross, Ronnestad, & Wiseman, 2005). Norcross (2005) has gathered self-reported outcomes of personal therapy that reveal positive gains in multiple areas, including self-understanding, self-esteem, work functioning, social life, emotional expression, and intrapersonal conflicts. The most frequent long-lasting benefits to practitioners pertained to interpersonal relationships and the dynamics of psychotherapy. Some of the lessons learned are the centrality of warmth, empa- thy, and the personal relationship; having a sense of what it is like to be a ther- apy client; the need for patience in psychotherapy; and learning how to deal with transference and countertransference. Transference and Countertransference Although the terms transference and countertransference derive from psychoanalytic theory, they are universally applicable to many other approaches to counseling and psychotherapy, and to relationships in general. These concepts refer to the client’s general reactions to the therapist and to the therapist’s reactions to the client. The therapeutic relationship can intensify the reactions of both client and therapist, and how practitioners handle both their own feelings and their clients’ feelings will have a direct bearing on therapeutic outcomes. If a therapist’s own feelings are not attended to, the client’s progress will most likely be impeded. Therefore, this matter has implications from both an ethical and a clinical perspective. Transference: The “Unreal” Relationship in Therapy Transference is the process whereby clients project onto their therapists past feel- ings or attitudes they had toward their caregivers or significant people in their lives. Transference is understood as having its origins in early childhood and con- stitutes a repetition of past themes in the present. How the clinician deals with a client’s transference is crucial. If therapists are unaware of their own dynamics, they may miss important therapeutic issues and be unable to help their clients resolve the feelings they are bringing into the therapeutic relationship. The client’s feelings are rooted in past relationships, but those feelings are now felt and directed toward the therapist. This pattern causes a distortion in the way clients perceive and react to the therapist. By bringing these early memories to the relationship with the therapist, clients are able to gain insight into how their past relationships with significant others have resulted in unresolved conflicts that influence their present relationships. Safran and Kriss (2014) explain how thera- pists can assist clients in understanding how their past plays out in the present: “Because transference involves a type of reliving of clients’ early relationships in the present, the therapist’s observations and feedback can help them to see, under- stand, and appreciate their own contributions to the situation” (p. 36). Transference is not a catch-all concept intended to explain every feeling cli- ents express toward a therapist. Many reactions clients have toward counselors are based on the here-and-now style the counselor exhibits. If a client expresses anger toward you, it may or may not be transference. If a client expresses positive reactions toward you, likewise, these feelings may or may not be genuine; dismiss- ing them as infantile fantasies can be a way of putting distance between yourself and your client. It is possible for therapists to err in either direction—being too quick to explain away negative feelings or too willing to accept positive

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