It’s the end of my first year of becoming a counselor, and in a class reflection the other night I commented that I felt like we had all been “Made.”

There’s an MTV show by the same name, in which teenagers want to be “made” into something they currently are not; a cheerleader, an artist, a BMX biker, a soap actor. With the help of a coach and inevitable adolescent whining, the show generally ends in tears and a sense of accomplishment on behalf of the teenager.

Well, we didn’t necessarily have tears in the last class, and we really didn’t whine all that much on the way… but with our professors, supervisors and peers as coaches, we have been made into beginning counselors. A couple of my classmates agreed that if we were to go back in time and shake hands with ourselves on the first day of classes, we might not recognize our new professional selves. We are now armed with both theory and practice as we head towards our summer classes and internship year.

One Louder Entertainment. Producer. (2003). Made (Television series). New York: Music Television (MTV).

Therapy in “How I Met Your Mother”

“How I Met Your Mother” is one of my favorite tv shows.  That being said, a recent couple of episodes had me cringing and shouting at the tv the majority of the time.  I felt a little bit like my mother, who often gets frustrated with exciting hospital tv shows.  She was trained and worked for many years as a nurse in the emergency room, and readily picks up on the reality (or lack thereof) of the situations portrayed in television hospitals.  As a budding counselor, I felt a similar frustration with this portrayal of a therapist.

This particular set of episodes of “How I Met Your Mother” involved one of the characters, Robin, seeing a therapist for a court-mandated session after assaulting a woman on the street.  The show unfolds through Robin’s telling of the scenario in a therapy session and frequent quips by the therapist (or psychiatrist or counselor, it is unclear) to hurry up her story (“Can we just get to the assault?”).  Throughout the show he also breaks confidentiality on several counts by describing his other clients (in one case, he describes how one of his other patients – mostly “disturbed felons” – sent him a bag of his own feces for the therapist’s birthday).  In the following episode, the therapist actually starts to date Robin.  Ted tells his friend Robin, “Robin, if you asked a hundred people who is the worst person you could possibly date, they’d all say your therapist.”  What the show fails to regard is the fact that therapists, and in fact, the American Counseling Association (ACA), agree with Ted and those hundred people he mentioned.  Dating a former client is prohibited for counselors for 5 years after the cessation of treatment, according to the ACA’s Code of Ethics.  While the tv therapist acknowledged that he was not supposed to date Robin, he continued on to do so without much apparent concern for this violation of ethics.

I found the portrayal to be unprofessional and, while the therapist’s humor aided the ridiculous nature of Robin’s story, it was not so over-the-top as to be a satirical portrayal of a therapist.  In addition, this character only seemed to care for Robin’s well-being after he established a personal romantic interest in her; there was no demonstration of professional (and ethical) empathy.  While it may not be as interesting, humorous or contextually appropriate to have a caring and empathetic counselor in this situation, it is a shame that a counselor or therapist may be portrayed without ideal qualities (or even, some could argue, decent ones).  Unfortunately, for many who have never participated in a counseling session, watching this stereotype on television may be the closest they get to counseling.

American Counseling Association. (2005). Code of Ethics. Alexandria, VA: Author.

Thomas, C. & Bays, C.  Producer. (Producers). (2005).  How I Met Your Mother (Television series).  Los Angeles: CBS Broadcasting, Inc.

Online Counseling

Upon the death of Steve Jobs, a friend of mine* posted on Facebook, “Three apples changed the world: the one that Eve ate, the one that hit Newton on the head, and the one Steve Jobs offered us all.”  Jobs, the founder of Apple, certainly changed the way we use technology today.  It is more accessible, and constant, and personal. But how has Jobs (and his technology) impacted the world of counseling?

Well, in the trend of online counseling, he has enabled clients to literally keep their counselor in the palm of their hand.  Some counselors offer services via Skype or other live internet communication; clients can be in touch on their iphone or ipad while maintaining physical distance.  Some counselors also offer email communication (known as asynchronous communication, where the interaction does not occur in real time).  Clients also have access to lots of information about mental health, both accurate and inaccurate, through the web (Gladding & Newsome, 2010).

With email, counselors and clients can keep in touch conveniently and work with a flexible schedule, in a way that may even out the spread of power between client and counselor (each can communicate with a home court advantage).  However, email shares many risks with other internet counseling methods; namely crises in which the counselor is not present, issues of confidentiality and protecting privacy in a secure manner, as well as third-party payments (Gladding & Newsome, 2010).  In addition, there is a greater chance of miscommunication when technology is involved.  When videochatting, there is the potential for the connection to break up at a key moment.  In email, a sarcastic phrase may be taken as fact or adolescent slang may be difficult to decode.

In a recent New York Times article, one psychologist (Elaine Ducharme) discusses her long-distance practice. Ducharme uses Skype to videoconference with patients from her former practice, and is licensed to practice both in the state in which she counsels online and the one in which she lives.  She will only videoconference with a patient she has already met, and periodically returns to have face-to-face appointments.  “‘There is definitely something important about bearing witness,’ she said. ‘There is so much that happens in a room that I can’t see on Skype’” (Hoffman, 2011).  The article continues on to address the pitfalls and benefits of online counseling.

The National Board of Certified Counselors (NBCC) began putting together a task force to address technology-assisted counseling in 1995, an endeavor that tackles ethical and practical issues and led to today’s Standards for the Practice of Internet Counseling (Gladding and Newsome, 2010).  With the massive presence of the Internet in our lives, it is necessary to set these guidelines and enforce a standard in order to protect the professional integrity of counselors, both online and off.

As a beginning student, I see myself working in a more traditional face-to-face practice, as opposed to using Skype or email as a central mode of communication.  There are already so many concerns in the practice of counseling as to how to best work with a client and act in their best interest, without worrying about a dropped videocall or a crisis thousands of miles away.  I recently read what constitutes malpractice, and sat staring wide-eyed at the textbook for a good five minutes, contemplating all the ways I could screw up.  I don’t feel I need to add any additional potential for disaster to the list.  I appreciate the momentous contributions of Steve Jobs and the impact of the growth of technology on my daily and professional life, but as a starting counselor I think I may check the technology at the door.  I’ve been spending a lot of time lately learning how to be with someone, how to listen and share time and space in a therapeutic manner, and I plan to put those skills to use by counseling face to face.  As I learned in my orientation, the only real technology you need in a counseling session is a box of tissues and a clock.

Gladding, S. & Newsome, J. (2010). Clinical Mental Health Counseling in Community and Agency Settings  (3rd ed.).  Upper Saddle River, NJ: Prentice Hall.

Hoffman, J.  (2011, 23 September). When Your Therapist is Only a Click Away. New York Times, pp. ST1.

*Thanks to Michael Fleischmann for sharing this popular post.

You too, Sir

Last Wednesday I arrived to campus at approximately 9:00am. After having a quick conversation with a fellow doctoral student I decided to take a walk on campus. While on my walk I was greeted by a familiar face, a service worker who I often have a 30 second conversation with, usually consisting of the weather and weekend plans. We had our conversation as usual and when the conversation ended I said, “Have a nice day” and began to walk off, when I heard him say, “You too, sir.” I almost stopped in my tracks because I was unsure as to whether this gentleman who appears to be my senior by at least 20 years would call me sir, but I just looked back at him and smiled. As I continued my walk through campus I began to wonder and think to myself, “Why did this man call me sir?” I tried to remember whether he called me “sir” in any of our previous interactions, and I do not believe he did. Why today? I usually dress the same I thought to myself. Today was a class day and I did have on a dress shirt, tie, sweater, and slacks, but was my attire the reason he called me “sir”? Did he think I was a professor, or perhaps an administrator? All of these things swirled around in my mind like a tornado in early spring in the Midwest.

Once those thoughts began to disappear another thought came to me. I guess I am privileged. I walk around the University campus usually dressed up and try to smile or speak to everyone I pass. I usually see several custodians and other service workers everyday as they complete their rounds throughout campus, performing routine services for all of us; however, many of us do not think much of it. The fact is that we have a group of service workers who clean up after us while we walk around smiling and holding conversations that I am sure many of us would consider much deeper, more philosophical, and of more important than the weather and weekend plans.

I must admit that it did bother me that someone I believed I should call sir, even if only out of respect of age difference referred to me as “sir.” Later that day I had a conversation with a colleague about the interaction and we discussed what we thought it might mean. One of the first thoughts we discussed was that of class issues – was it a social class issue? Did this man call me sir because he felt or believed he should, or that it was necessary? Or did he call most people “sir” regardless of where he is or to whom he is having a conversation?

Furthermore, all of these questions reminded me of critical theory which focuses on an individual’s response to social, political, and economic oppression and assumes that social life functions at various levels of meaning (LeCompte & Preissle, 1993). Did this service worker call me “sir” because of social oppression and pressures in our society? Do I appear or exhibit aristocratic characteristics that might give the impression that I need to be called or referred to as “sir”? Or does my dress and status as a doctoral student represent a “higher class,” thereby placing me in a social and/or economic oppressive group?

Finally, I understand that this interaction may not seem like a “big deal,” but I believe that social and class issues are important. In fact, some may argue that critical theory lacks objectivity and that it is a theory that argues that complex interactions and situations are reduced to simplistic explanations and conclusions. I realize that many of us may not have thought twice about the interaction as I did, however, to be called “sir” outside of a formal interaction by a service employee requires some extra thought on my behalf.