Susan Jennifer Polese

I recently watched the original film version of Neil Simon’s “The Odd Couple” and it was as funny and touching as when I first saw it. Viewing the classic flick as a counselor-in-training I have rediscovered Felix as a person with obsessive compulsive disorder who would benefit from a combination of cognitive behavioral therapy and medication. And Oscar? Clearly Mr. Madison has executive functioning challenges and really could use some help from a professional organizer. On a more psychoanalytical note: I don’t even want to consider how either of these two were toilet trained!

Being a playwright I am aware that both comedy and tragedy are built on emotional dysfunction. The rule of thumb is: comedy happens when somebody slips on a banana peel and doesn’t get hurt and tragedy ensues when somebody trips on a banana peel and breaks his or her neck. The great Irish playwright Samuel Beckett said there is nothing funnier than unhappiness – true, at least in fiction.

Take the old sitcom “I Love Lucy,” for example. Ricky, her band director husband, doesn’t let Lucy perform in his shows – she keeps trying and gets herself in hilarious predicaments and the audience laughs because we identify with Lucy. Could these two use couples counseling?

Oh, yes! As could many a sitcom couple. Veering off into the world of animation The Simpsons would benefit greatly from more than a few sessions of family sculpting.
I’ve spent my writing career creating characters that ache for something and face obstacles on stage. This conflict always creates an energy for the both the actors and the audience. I’ve come to sometimes view counseling through a similar lens – one that is neither comic nor tragic, but simply focused on our shared human condition. We are all in this together.

Like characters on a stage our clients are faced with a myriad of obstacles. I feel a counselor is kind of a guide, or perhaps more of a companion, to help a client experience, overcome and move past such obstacles. Through this pursuit behavior change can occur and more meaning may be found in life. As counselors, our theories may be used as a roadmap to enable our clients to get where they want and need to be. On this roadmap you can’t avoid dysfunction junction because everybody faces adversity.

Relationships are nuanced and perfection doesn’t exist. Awareness and acceptance of as well as the willingness to face the dysfunction is the work of the client and is the essence of therapy.

Susan Jennifer Polese is a counselor in training, a personal coach and a freelance writer. Her areas of interest are mindfulness, divergent thinking, and creativity in counseling.
www.evolutionlifecoachingstudio.com

Susan Jennifer Polese

As I begin personal therapy at my graduate school student counseling center I realize that I am analyzing everything the therapist is saying. What is her theoretical orientation? Was that an open or closed question? Will we be goal setting? How much money does she make? Yes, I was more than a little “in my head” during that first session.

For years when I was in my twenties I went to therapy with a psychologist who was psychoanalytically oriented, although I didn’t know that at the time. I just knew I was experiencing a lot of difficulty in life and needed someone to talk to and work out my problems with and this therapist was available at my local mental health center.

I spoke a lot, she rarely did. I smiled nervously and often, she sat with a flat affect. I spoke of my dreams at length and about the intricacies of my childhood with her, albeit subdued, guidance. I made great insights into the serious issues I was facing at the time. I came to know why I was, well, the way I was – and to a certain extent, why I am the way I am currently. The insight has been priceless, but the therapeutic experience lacked direction and specifically lacked any kind of skill building to help integrate my insights into behavior change. Of course, not yet being a student of counseling I was unaware that other types of therapy existed and at the time psychoanalysis was all the rage. However, I keenly felt that something was missing and that thing was real-world application of what I discovered in session.

As I go through school and see, as both a healthcare consumer and a counselor-in-training, what modalities are reimbursed by insurance it is obvious that pure psychoanalysis is not made available to the masses as it was in the 80s. But I truly don’t want that road to insight and of the unconscious closed for good. There is so much to be gained by realizing your unconscious motivations and finding unhealthy patterns in your life that you can change.

Solution focused therapy and reality therapy certainly are amazingly useful methods to help clients improve their lives, but how can the road to the unconscious and the path to active creative change merge? Many therapists are doing just this. A wonderful starting point for those interested in an integrative approach is “Integrative and Eclectic Psychotherapy” edited by Stephen Palmer and Ray Woolfe. It covers the history of these approaches and each chapter is by a different author and puts forth a useful viewpoint.

http://books.google.com/books/about/Integrative_and_eclectic_counselling_and.html?id=pS03MeOamVEC

As I look forward to working in a agency and eventually launching my practice I hope that in addition to goal setting and problem solving the unconscious can be tapped into and insight can be gained by my clients this way as well – even if the sessions are limited by the demands of managed care.

Susan Jennifer Polese is a counselor in training, a personal coach and a freelance writer. Her areas of interest are mindfulness, divergent thinking, and creativity in counseling.
www.evolutionlifecoachingstudio.com

Diana Pitaru

This blog post is an encouragement for those students in non-traditional programs everywhere. This blog will hopefully help you gain the confidence of leaving anonymity behind and recognizing that regardless of your school format, what you have to say is relevant and important –be it via email- to continuing building a great counselor community.

Ever since I joined the ACA, a couple of years ago, I have been diligently working towards getting involved with the various chapters and divisions in order to grow and offer my support to the wonderful counseling community. The task of getting involved in our professional organization can be quite challenging, especially if you are like me, a non-traditional student. The lack of face to face interaction in a brick and mortar institution can pose certain limitations, particularly if the only time spent networking must revolve around conferences. Still, it was the non-traditional format of learning that helped me become more resourceful to find creative ways of giving back to a community that does so much for me (us).

I had to rely extensively on email in order to build and maintain relationships that otherwise could have been lost, as soon as a conference was over; finding common interests and engaging someone via email can be quite difficult particularly if you believe that email is an artificial media of communication. Nevertheless, I managed to get past my initial awkwardness while keeping in mind that 1) there is no way of failing if I will not try, and 2) building a community does not happen over night, but in time. At the same time, I became convinced –through these email interactions- that what I have to say is important, not because I am saying it, but because my concerns were shared by others, I was not alone in thinking or feeling in a certain way.

Aside from the projects I could work on from home, I also wanted to start presenting at professional conferences on topics that interest me, that I have a passion for. It was through one of the contacts I made at TCA, with whom I maintained contact over time, that invited me to present at a local conference (RGVCA). It was then, that I was truly able to see the ways in which I was creating obstacles for myself: non-traditional school, communicating via email is not effective, etc.

I took these lessons with me and during the conference I presented at, I was able to network more and start new relationships with like-minded, like-passionate people that are as eager to foster growth within the counseling community as I am.

This is not a recipe book or how to post on becoming involved in the counseling profession; this is an encouragement from one non-traditional student to another that if we stop coming up with excuses to defend our introversion, or simply say that what we have to say is not worthy of hearing, we are truly doing a disservice to our community, by depriving it from ideas that are worth following up on.

Diana C. Pitaru is a counselor-in-training, and a student at Walden University. Her theoretical interests are in Gestalt, Art, and Narrative therapy while focusing on multicultural issues and eating disorders.

David P. Diana

When I was very young I would wake up in the middle of the night from a particular dream that I could not escape. It would begin innocently enough with the arrival of a soft drumbeat. The drumming would grow louder and louder until I found myself in a forest standing at a distance behind an odd looking old man sitting on a rock by a river. He would be sitting peacefully in a lotus position crowned in an incredible headdress filled with colors of fire and light. The drumming would continue to get louder until the pinnacle moment of the dream when he would turn his head to face me. He had a look about him of hope and knowing but at my young age I couldn’t bear it any longer. I would awaken in a panic, sweat rolling down my cheeks, and my heart racing.

This old man stayed in my dreams for years and years. He became such a presence that I found myself writing to him and even attempting to paint the old man to give him life. When I see all the interesting work people are doing in my community and beyond, I am reminded of the wise old man sitting by the river with promises of possibility. He reminds me of the importance of finding your own inner wisdom and connecting with others at a level that is personal and powerful.

This self-reflective process is serious business for my career in the mental health field because it begins with being able to organize my work around something I believe in. And interestingly enough, this “turning inward” becomes the foundation for building a rich and rewarding career. It gives you the ability to speak with a genuine voice and to find those people who want and need to hear your message.

We are in the beginning stages of a new way of doing business and Doc Searls of “The Cluetrain Manifesto” explains the implications of that change beautifully.

“…More and more power is in the hands of the consumer. We have the ability to ask for the things we want. This is the promise of the intention economy, where people tell the market what they want and barriers are disintegrated so the market has the ability to listen. Soon…the attention economy will crash…the PR teams, the measured promotion campaigns, the direct marketing efforts…Be that listening ear and create the kind of relationship that is truly special for a select group of people. Not everyone, but a small few. Think about the limitations you assume are there or that prevent you from seeing your service in a new light. Then build from there. Be extra ordinary in that circle because a seed gets planted. Generic services get lost, they drown in a sea of white noise. So create even a small space to allow this to grow!”

You do not have to be everywhere with your message, you just need to be there for those who need you.

Be that mentor, guide, or problem solver for your particular audience. Get them to the edge of new possibilities, a place of extra ordinary circumstances, of dragons, dreams, and strange old men sitting by the river.

David P. Diana is a counselor, author, and a director for a behavioral healthcare organization. He writes a weekly blog on sales and marketing for counselors (www.davidpdiana.com)

Gurpreet Kaur

Quantum mechanics has changed the picture of the reality. According to quantum mechanics, the reality does not already exist out there but it is created in here. Humans are a part of nature and integrated in the observed reality. We cannot stand outside of the reality and pretend to observe it without influencing what we are observing. Mindell (2000) in his book Quantum Mind provides a beautiful illustration of how concepts in quantum physics (e.g., nonlocality, entanglement, etc.) are similar to the ones in psychology (unconsciousness, consciousness, dreams, synchronicity, etc.) and how they both complement each other. He depicted an image of spanning tree with both above and below the ground. He illustrated that above the ground is the consensus or observable reality, but below is non-consensus reality that is as weird as quantum mechanics. He provided the example of a fairy tale Alice in Wonderland to illustrate how reality exists in the rabbit’s hole (below the ground). The question is how far down the rabbit’s hole we want to go?

Quantum mechanics has been around for over a century now, but the popularity of the principles recently took off. Quantum mechanics principles are being applied to many different fields and branches of science (e.g., neuroscience, biology, chemistry, psychology, etc.). Counseling has not yet explored ways how quantum mechanics findings change what we do on daily basis. I propose we need to explore ways how quantum mechanics can be applied to counseling.

I believe quantum mechanics principles can effect what we do on daily basis as counselors. If what quantum mechanics is revealing is true then we really need to evaluate what we do and how we do it. We should have the knowledge and understanding of these principles so we know how they change and affect our work. I have written blogs about applying quantum mechanics to counseling and now I am doing my dissertation on the same topic. The title of my dissertation is Quantum Mechanics Applied to Counseling: A Q Method Study. The purpose of the study is to explore ways quantum mechanics principles can be applied to the counseling field. I am looking for certified or licensed counselors and physicists with interest in quantum mechanics, Eastern philosophy, spirituality, and/or exploring to apply cutting edge research to counseling/psychology. Please contact me at gurpreetkm@gmail.com if you would be interested in this study or have more questions. Please feel free to pass this message along if you know someone who would be interested. Thank you in advance for the consideration and time.

Gurpreet Kaur is a counselor who works at an outpatient clinic and also has a private practice. She is a doctoral student with professional interests in quantum physics, spirituality, self-actualization, and mindfulness practices as they all relate to counseling.

Susan Jennifer Polese

I admit it, I’m green. I’d like to think I possess good intuition and that a firm foundation for my counseling future is being laid in graduate school. But I feel very confused about which populations I want to ultimately work with. I alternate between an unrealistic wanting to work with virtually everyone and a steady yearning to find a more comfortable niche. My comfort zone is cradling me as I urge to break free.

A fellow counseling student and I had a discussion recently about what niche(s) we would like to focus on in regard to internship and ultimately work. I expressed concern about working with clients with whom I don’t share their experience – for instance those with substance abuse issues or veterans with PTSD. How could I counsel someone when I hadn’t been “there” myself? I know that this is on one level a silly question. Counselors can’t possibly share experiences with all of their clients and the desire to do so is futile. However, I still feel that as an intern and a counselor I should be familiar with what my client has gone through. Irrational thought, perhaps? I may be an ideal candidate for CBT!

Luckily, my insightful classmate reminded me of something that is in a certain way obvious, yet is quite easy to lose sight of: we all, clients and therapists alike, share the human experience. We have all experienced loss, pain, joy, hopes, – the lows and highs that accompany life on earth. Although I may not have been in battle I can, with my counselor’s toolbox in-hand, empathize with a returning vet or relate to an addiction I haven’t suffered with. Along the same lines I am currently attracted to working in bereavement counseling largely because I my mom passed away this past May – it’s fresh and I feel I can relate. Seems that the pendulum swings both ways. But how to strike a balance?

My graduate advisor wisely told me that although as a counselor-in-training you may have misgivings in regard to working with a particular population and find yourself, for whatever reasons, drawn to another if may not be indicative of whom you ultimately work with. He explained that once you are out there interning and through early work experiences you’ll discover that you enjoy working with clients in settings that surprise will you. I, for one, am looking forward to those surprises.

Susan Jennifer Polese is a counselor in training, a personal coach and a freelance writer. Her areas of interest are mindfulness, divergent thinking, and creativity in counseling.
www.evolutionlifecoachingstudio.com

Christian Billington

A huge part of the practicum experience was supervision and planning. I spent at least two hours a week discussing cases and planning what to do next. As laborious as this felt at times I am grateful that my supervisors allowed me to use their experience as a guide, enhanced by my ideas, a systems perspective and four years of school. So how did the planning work?

For the most part, it went well. There were weeks where supervision was brief. There were weeks where only one side of the co-therapy partnership could attend and there were weeks when there was no guidance at all. In the end it all worked out and the clients suffered no ill benefits. Clients were happy and, interestingly, the structure of the session often took on a life of its own despite the most careful planning. There was one session in particular that sticks with me. My supervisor, co-therapist and I spent a considerable amount of time planning systematically what directions to take and what topics to discuss. I felt well prepared and excited for the work we were about to undertake. At the beginning of the session, an act of violence in the client’s world that had taken place since our last meeting rendered our careful plan moot and the session looked very different from what we had intended. The clients simply needed our assistance in a different capacity. Acknowledging that the time spent together is the clients helped me to forgo the planning and be with the client in whatever capacity they needed me.

I actually quite enjoyed the more ‘free range’ sessions, there unscripted nature and ability to just join with the client with no pre-emptive plan. These “improvised” sessions often felt less contrived and more responsive to the clients’ specific needs. As with all planning and good therapy, do not forget the basics of active listening, reflection and summaries all of which went a long way towards joining and helping the client – planned or not – realize what they first sought therapy for. When there was no plan it sometimes worked, but I left a few sessions feeling like little was achieved despite positive feedback from the client.

So was all the time spent in supervision and planning worth it? I think so. I enjoyed the processing of the previous session with my supervisor, learning about and discussing my own reactions and being able to devise a plan of action that fit the treatment plan I was required to create after three sessions. The treatment plan involves short and long term goals and a brief description of interventions that might aid the client in achieving what they initiated therapy for. One aspect that was somewhat bothersome was the scheduling and timing of supervision, but that is the nature of striving to be the best possible help to the clients you work with and balancing full time employment.

Additionally, co therapy supervision was great because it allowed for a variety of perspectives, experience and knowledge to blossom into some of the most productive and satisfying therapy sessions I have so far experienced. Planning with experienced and thoughtful professionals is worth the time and effort if you can make it work.
So what’s your plan? And how good are you at improvising?

Christian Billington is a counselor in training. He is passionate about end of life issues, grief and loss, trauma and the development of training to better prepare the emergency services for what they experience in the field.

Deb Legge

Yesterday I got an urgent email from a coaching client regarding a situation she encountered many times when working in agencies, but for the first time now in private practice. This question almost immediately triggers my “supervision” mode, so I really had to pull back and grab my coaching hat to respond.

My client (new to private practice, but an experienced, strong clinician) had just met with a new client with whom she spent an extra half hour in their first session (first red flag). This client presented with very complicated issues; most specifically, issues of addiction. My client could not be sure if he was high in their session or if his pressured presentation was typical or mood-related. Sometimes it’s tough to tell when you have no other point of reference. In addition, this client reported a long-standing history of addiction and that he had been clean for less than 2 weeks. He refused to sign a release for collateral information (second red flag). Clearly she was meeting with a very high-risk client.

So what do private practitioners do when faced with the high-risk client? No matter how much you try to screen your clients (i.e. asking just the right questions in an intake phone call; having the client submit screening tools/forms in advance of the first session), inevitably most private practitioners will face this frightening situation at some time in their careers.

My client told me that this type of situation was not uncommon when she worked in agencies; that there she felt safer and better able to respond because she was not alone and the support options were in place. But here, in her safe haven, she didn’t feel so safe – for her or for her client.

There are so many clinical issues that rush through your mind – lethality, medical complications, the need for a higher level of care, and so much more. Those go without saying and they were of primary concern to my client, the clinician.

The “other” issues are not so easy to talk out loud about, and are of primary concern to me, the coach.
• How can I feel and be safe working with this person?
• What do I do if something goes wrong and I end up in a legal situation?
• How can I turn away this person who I’m sure I can help?
• Can I really afford to turn away a new client when I’m trying to build my practice?
These questions are natural – and, they are a very real part of being a private practitioner.

My gut reaction to the call for guidance was to swoop in and pull my client out of the “muck”. As a clinician, I shared her clinical concerns regarding her client. As her coach, I was most concerned about her safety, her license, and her business.
Here are a few tips for protecting you and your practice when faced with difficult situations:
#1 Protect You!
I know I shouldn’t have to say this, but I do. I don’t know of a clinician (including me) who can say that they have never been in an unsafe situation (even for a few minutes) with a client. Most people in private practice work alone (or even if they are sharing space with others, they are alone behind closed doors with clients). Think about who you are seeing, when. Think about your safety leaving your office late at night.
• Consider a panic button that you can use in your office, and you can carry with you to the car
• Let people know when you are working and get them in the habit of you “calling in” from time to time in your day
• Above all else, your safety must be of primary concern to you – if you have a client with whom you do not feel safe either put in adequate safety measures or refer that client to the appropriate setting
#2 Protect Your License
How hard and long did you work to get your license? Are you really going to put it on the line to fill your book or accommodate an unstable client or business partner?
• Go online and read about how/why some professionals have lost their licenses in the past. I think you will be surprised. It is an eye-opening experience, and it will make you think twice about your record-keeping, the way you manage your personal life, and the decisions you make with clients
• Realize that at any point in time things can go south quickly and you could end up having to defend yourself in a malpractice situation. This could happen with any client at any time. Even if the legal action is unfounded, you’ll have to check off that little box on all of the insurance applications (the one about having been involved in a malpractice situation) for the rest of your career! Hopefully this realization will keep you vigilant to do whatever you can to reduce your risk
• Whether it is a business partner with a tendency toward insurance fraud, or a temptation to treat a client out of your scope of practice (i.e. the client requires a higher/different level of care) – ask yourself if that person is worth the risk of losing your license and your career
#3 Protect Your Business
No matter how new or small your private practice, it is your “family business”. You’ve taken on huge risks to have and run this business. It is probably a big chunk of your heart and soul. Protect it as such.
• Recognize that it takes a lot of time to build trust with your customers (referral sources) and the community, but it takes one ugly moment to destroy everything you have built
• People tend to remember the negative things they read and hear. Bad press can stick with you for a long time. Don’t do anything that might put you in a bad light
• Don’t forget that when you lie down with dogs you wake up with fleas. If you have a business or life partner that is involved in risky business, you can be taken down right along with them. You may not have the presence of mind to protect your heart, but for heaven’s sake, protect your business!

Clients or situations that put you or your business at risk (no matter how ill they may be) might elicit your concern and empathy, but it is up to you to protect you and yours. Don’t let one questionable situation or client keep you away from doing what you love and from helping hundreds or thousands of others.

Deborah Legge is a counselor, an assistant professor, specializes in coaching counselors in private practice, and is the founder of InfluentialTherapist.com