Tag Archives: Counseling

What’s Happening at the 2018 American Counseling Association Conference in Atlanta?

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The American Counseling Association annual world conference is coming to Atlanta next week (4/25-29) . . . and so am I.

This year, the ACA conference includes inspiring keynotes, 500+ unique sessions and up to 33.5 hours of CEs. I’m honored to be a part of this exciting learning and networking event. Here’s a link to general conference information: https://www.counseling.org/conference/atlanta-2018

As a part of the 500+ sessions, I’m involved in several events and would love to see you there. Here’s where you can catch me.

On Wednesday, April 25, I’m doing a full-day (6 hour) workshop titled, Tough Teens, Cool Counseling. There are plenty of seats left and you can get registration and other information at the ACA conference website: https://www.counseling.org/conference/atlanta-2018/sessions-events/pre-conference-learning-institutes

On Friday, April 27, from 2 to 3:30pm in Room A313, Kindle Lewis, Kim Parrow, and I will present: Building Therapeutic Relationships: The Heart of Evidence-Based Counseling

On Saturday, April 28, from 10:30 to Noon in Room A410, Sara Polanchek, Maegan Rides At The Door, Salena Beaumont Hill, and I will present: Using (Magic) Words to Influence Challenging Parents . . . With Cultural Commentary

Also on Saturday, April 28, from 1pm to 2pm, John Wiley and Sons is having an event in the Exhibit Hall to launch the publication of 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. There will be coffee and cookies. Although I was tempted to select excerpts of this exciting new textbook and offer dramatic readings, instead, Rita and I will just be low key at the Wiley booth, meeting and greeting people, and answering any questions that might come up about the book or about life. Please come have a cookie with us so that we’re not standing there awkward and alone.

Last, but far more than least, on Saturday night I have the honor of receiving the Don Dinkmeyer Social Interest Award. The ACA National Awards event is from 6-7pm at the Omni Hotel at CNN Center, in the International Ballroom E & F.

Whether you attend ACA or not, I hope you’ll join the 55,000 members (and me) in working to facilitate greater mental and emotional health around the world.

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Can Male Therapists Do Feminist Therapy with Male Clients? You Decide — A Feminist Case Example

Fishing Big Davis

The 3rd edition of Counseling and Psychotherapy Theories in Context and Practice will be available very soon. Just in case you’re longing to see the cover as much as I am, there’s a link to the new edition on Amazon. Although I’m betting your longing is much smaller than my longing, here’s the link anyway: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119279127/ref=dp_ob_title_bk

To celebrate this forthcoming epic publication (it’s not really epic, but some days it felt like a long poem), I’m posting a case presentation from the feminist chapter. Honestly, I don’t know who gets to decide what’s epic or what’s feminist therapy. That being the case, you can decide on both points. Or you can decide you’ve had enough of JSF for today.

Here we go.

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In an interesting twist, we’re featuring a case with a male therapist and male client in the feminist chapter to illustrate how working within a feminist model can work for boys and men. This case focuses on a 16-year-old male’s struggle with emotional expression. John SF is the therapist.

Josh was a White, 16-year-old heterosexual sophomore in high school. He had never met his biological father and lived in a middle-class neighborhood with his mother and three younger sisters. His mother was diagnosed with bipolar disorder. Josh’s main loves were consistent with his gender identity. They included basketball, cars, girls, and sarcasm. He very much disliked school.

Josh and I met for therapy for several years. At the beginning of one of our sessions Josh handed me a packet of photos.

“Hey, what’s this about?” I asked.

He responded with a half-mumble about a recent awards ceremony. I thought I discerned pride in that mumble. I looked through the pictures while he told me about each one. There was one in particular that he gently lifted from my hands. It was a picture of him in a line-up with five other people. He carefully pointed out that he was standing next to the Lieutenant Governor of Oregon. I teased him because there were no pictures of him and the actual governor.

“What’s the deal?” I asked. “Wouldn’t the Guv pose with you?” Josh rolled his eyes and signaled for me to move on to the next photo.

The Problem List and Problem Formulation

Unlike CBT, feminist therapy doesn’t involve collaboratively generating a concrete problem list and formulating problems as if the problems resided in the client. Instead, because problems and problem-formulation are inseparable, we can’t talk about the problems without also talking about cultural factors creating and contributing to the problems.

If client issues are discussed as problems, they’re likely discussed as situational challenges. In Josh’s case, his mother initially had brought him to therapy for anger management. Anger was consistently a regular focus in Josh’s therapy. Like many 16-year-old boys immersed in the dominant U.S. culture, Josh’s emotional life was highly constricted. He was living by Pollack’s boy code (2000) and unable or unwilling to risk feeling anything other than anger and irritation. From the feminist worldview, this wasn’t Josh’s problem; his issues around anger stemmed from him living in a culture that kept him in an emotional straitjacket.

Josh’s issues (and case formulation from a feminist perspective) looked like this:

  1. Learning to deal more effectively with sadness, grief, and anger within the context of a repressive emotional environment.
  2. Coming to an understanding that his beliefs and views of emotional expression were not in his best interest, but instead, foisted upon him by toxic cultural attitudes about how boys and men should experience and express emotion.
  3. Developing trust and confidence in himself—despite not having a father figure or a mother who could provide him and his sisters with a consistently safe and stable home environment.
  4. Learning to talk about what he really feels inside and pursue his life passions whatever they might be instead of reflexively pursuing culturally “manly” activities.
  5. Expanding Josh’s limited emotional vocabulary through consciousness-raising.

Interventions

Feminist therapists are technically eclectic; they use a wide range of interventions imbedded in an egalitarian and mutually empathic relationship:

  1. Encouraging Josh to speak freely and openly about his life experiences.
  2. Empathic listening with intermittent focusing on more tender emotions, depending on how much of this Josh was willing or able to tolerate.
  3. Therapist self-disclosure and modeling.

As Josh and I looked at photos together, I responded with interest and enthusiasm. Because interpersonal connection is a core part of therapy, I didn’t rush him to move on to our therapy agenda. Instead, I shifted back and forth between saying, “Cool” or “What’s going on there?” to making sarcastic wisecracks like “Why exactly did the government let you into the capital building?” Sarcasm was used to express interest and affection indirectly, mirroring Josh’s humor and style. After seeing most of the photos I asked, “Who’s the person standing next to you?” I could tell from his response that I had asked a good question.

“Oh, yeah, her. Her name is Sharice; her mentor was getting the same award as my mentor. I danced with her. She’s a good dancer.”

We talked about dancing and what it was like for him to feel attracted to her. We were ten minutes into therapy and both of us had completely ignored the fact that we hadn’t been able to see each other for five weeks. Finally, I decided to break the avoidance pattern. I asked “So…how are you doing with all that’s been going on?”

He looked toward me, glancing downward.

“I’m doing okay, I guess.”

Because this was a young man who had been socialized to keep his emotions tightly wrapped, I probed, but gently.

“I understand it’s been pretty wild times?”

He looked up, eyes fixed on some invisible spot on the ceiling. I recognized this strategy—a surefire way avoid crying in public. An upward gaze constricts the tear ducts; tears cannot flow.

He looked back down and said, “I’ve been busy. My mom’s been in the hospital for about a month.”

“I heard she had a pretty hard time.”

He grunted and then, in a quiet growly voice, the words, “Let-me-tell-you-about-it” seeped out from behind his teeth. Silence followed. I cautiously probed a bit more by sharing more of what I knew.

“I talked with your mom yesterday. She told me that she got pretty caught up in some housing project.” This statement lit a fire in Josh and he plunged into the story.

“You won’t believe what she did. It was so f*ing stupid. Some punk developer is gonna build three houses. Three houses at the end of our street. This is no big deal. She just f*ing freaked out. She chained herself up to a tractor to stop them from building a house. Then she called the f*ing senator and road department and I don’t know who in hell else she called. She was totally nuts. So I told her she had a choice. I told her that she could go back home or I’d call the police and have her committed. She wasn’t taking care of my sisters. She was being a shit for a mom. So I just gave her a choice.”

I nodded and said, “You must be practicing to be a parent. That’s the kind of choice parents give their kids.”

His voice grew louder: “I gave her the choice five times. Five f*ing times! She tried to buy a Mercedes and a Volvo over the phone. So I called the cops. And the woman asked ME what to do. I’m f***ing 16 years old and they f *ing ask me what to do. I didn’t know what to say. I told ‘em to come get her. They finally sent some really big cops over to take her away.”

“Then what happened?”

“My mom was still acting nuts and my sisters were crying. So I just picked them up and held them and they took her away. We sat and they cried and we snuggled a while. And then I drove us home. I don’t have my license, but I can drive. My mom is still pissed at me about that, but I don’t give a shit!”

While listening to Josh, I formed an image of him in my mind. I saw an awkward 16-year-old boy “snuggling” his sobbing sisters, as the cops take their mother away. The girls were 9 and 6 and 4 years old—the same sisters he had complained about in previous therapy sessions.

Talking with teenage boys about emotional issues is tricky. Too much empathy and they retreat. No empathy and you’re teaching the wrong lesson. Throughout Josh’s storytelling, I used sarcasm, empathy, and emotional exploration, like, “What was that like for you to gather up your sisters and take care of them?” I suspected that if I asked too much about feelings or forced him to go too deep too fast, I would lose my “coolness rating” and there would be a relationship rupture.

Much of the session focused on empathy for Josh’s anger. Josh ranted and I listened. He was immensely angry and disappointed and hurt about his mother’s behavior. But I wanted to find a way to let Josh know that it’s okay, even a positive thing, for boys and men to feel and express more tender feelings.

About halfway through our session, I asked:

“So Josh,” I said, “When was the last time you cried?”

After a short pause he spoke with extreme deliberation, “I… don’t… cry… I… just… get… pissed.”

Josh expressed this masculine emotional principle very efficiently and then offered more about his socially coerced, but internalized emotional philosophy.

“Crying doesn’t do any good. It doesn’t change anything. It’s just stupid.”

“I know, I know” I said. “The whole idea of crying sounds pretty stupid to you. It’s not like crying will change your mom and make her better.”

“Nothing will ever change her.”

I renewed my pursuit of when he last cried. He insisted that was so long ago that he couldn’t recall, but we both knew that several years ago, after an especially hard week with his mother, he had sat on my couch and sobbed himself to sleep. Instead of bringing that up, I asked him what might make him cry now. Would he cry if his girlfriend broke up with him… if he lost his cell phone… if one of his sisters got cancer… if he didn’t graduate high school? Josh fended off my questions about tears by repeating his resolve to get “pissed” about everything that might make him feel sad. But the question about one of his sister’s getting cancer stumped him. He admitted, “Yeah, I might cry about that…” while quickly adding, “…but I’d do it alone!”

I responded, “Right. Absolutely. Some things might be worth crying about… even though it wouldn’t change things… but you’d want to do the crying alone.”

We talked indirectly and intellectually about sadness and tears, trying to model that we can talk about it—once removed—and if he cried someday, it would be perfectly okay, there would be no need to feel ashamed.

Toward the end of the session, I decided to lighten things up by teasing Josh about his social insensitivity. I said, “I can’t believe that we’ve talked this whole hour and you never asked a single thing about me.”

Josh grinned. He knew therapy was all about him and not about me. He probably thought I was playing some sort of therapy game with him. He was a good sport and played along.

“Okay. So what am I supposed to ask?”

I acted offended, saying, “After all those questions I asked you, at least you should ask me when I last cried.”

“God you don’t know when to drop things. Okay. So when did you cry?”

I said, “I think it was yesterday.”

Our eyes met. He looked surprised. I continued, “Yeah. I feel sad sometimes. It can be about really hard stories I hear in here or it can be about my own life. Even though it doesn’t change anything, it can feel better to let my sadness out.”

It was time for the session to end. We both stood and I said, “We have to stop for today, but we can talk more about this or whatever you want to talk about next time.”

 

New Journal Article – Conversations about suicide: Strategies for detecting and assessing suicide risk

Hey Blog Readers.

For those of you who might be interested, I just published a new article on suicide assessment and interventions in the Journal of Health Service Psychology. The article title is, “Conversations about suicide: Strategies for detecting and assessing suicide risk.” The article is designed to help practitioners who work or may find themselves working with suicidal clients.

Here’s a link to the article: https://www.nationalregister.org/pub/the-national-register-report-pub/journal-of-health-service-psychology-winter-2018/conversations-about-suicide-strategies-for-detecting-and-assessing-suicide-risk/

John Semi Prof

Feminist Theory and Spirituality

Woman Statue

Continuing on our stroll through counseling and psychotherapy theories and spirituality, we come now to complicated crossroad; this is where feminism and spirituality intersect. Our focus is on how feminist theorists and feminist therapists deal with spirituality.

This intersection is complex primarily because the manner in which many religions characterize women’s roles and women’s potential is, shall we say, limiting. In contrast, feminist theory views the limiting of women as inappropriate, inaccurate, unacceptable, oppressive, and pathology-creating. All this is to say that when religion and women’s rights converge, there’s ample room for conflict.

The following excerpt from Counseling and Psychotherapy Theories in Context and Practice is a lazy stroll. It’s lazy because we don’t go very deep. Instead, because adherents of both perspectives may have strong beliefs (and emotions), we leave the going deep to you. As you contemplate going deeper, it’s nice to keep in mind the theological, philosophical, and practical idea of “Both-And.” There may be paths for becoming both profoundly spiritual and profoundly feminist. And, at least from the surface, the spiritual-feminist path has the look of something quite different from a lazy stroll.

Here’s the short excerpt:

Feminist Theory and Spirituality

Most dominant world religions have rules or practices that restrict women’s freedoms. In some cases, feminists view religion as abusive, coercive, and dangerous toward women. In most cases, feminists view dominant religions as laden with conservative, patriarchal values (Hagen, Arczynski, Morrow, & Hawxhurst, 2011; Jiménez, Almansa, & Alcón, 2017).

The naturally activist orientation of feminism can create tension between feminist therapists and specific religious practices. For example, female genital mutilation is considered a male-perpetuated human rights violation that sanctions systemic violence toward girls and women. Despite the feminist general philosophy of openness to diverse ways of being, feminists view systematic oppression of females in the name of religion to be intolerable (Jiménez et al., 2017).

Feminists see potential for affirmation and liberation in spiritual alternatives. Specifically, feminist writers have discussed ways in which sexually diverse women can use spirituality to enhance their resilience within oppressive sociocultural contexts (Hagen et al., 2011). Integrating affirming spirituality into feminist therapy is an acceptable and, for many clients and therapists, preferred practice (Funderburk & Fukuyama, 2001; Hagen et al., 2011)

Adherents to male-oriented religious or cultural norms are unlikely to welcome feminist critique of their values. This is where the potential for conflict is highest and where feminists could be viewed as imposing their values on other cultural or religious groups. Feminists view the systematic oppression of women as unacceptable, regardless of political, religious, or cultural justifications that might be used to support oppression.

 

 

Upcoming Workshops!

John II

Coming up in March and April, I’ve got two, two-day professional workshops scheduled at the University of Montana. Together, these workshops can earn you 2-credits through the U of M . . . or you can enroll for continuing education credit (one workshop = 2 days = 13 CE hours). Whatever you decide, coming to Missoula in early March and early April is pretty fabulous. We’ve scheduled these workshops for the first Friday and Saturday in Missoula to coincide with the First Friday Art Walk. That way you can workshop during the day and walk around downtown Missoula and check out fantastic Montana art Friday evening.

The workshops and their descriptions are below:

March 2 and 3, 8:30am to 4:30pm: Working with Challenging Youth and Parents . . .  and Loving It

Counseling difficult youth and challenging parents can be immensely frustrating or splendidly gratifying. The truth of this statement is so obvious that the supportive reference, at least according to many teenagers is, “Duh!” Using storytelling, video clips, live demonstrations, group discussion, and skill-building break-out sessions, John will present essential evidence-based principles and over 20 specific techniques for influencing “tough” clients or students. Techniques for working with youth will include, but are not limited to: (a) the affect bridge, (b) what’s good about you?, (c) empowered storytelling, (d) generating behavioral alternatives, (e) the three-step emotional change technique, and many more. Dr. Sara Polanchek will join John for the parenting portion of the workshop. They will describe essential principles for working effectively with parents, how to conduct brief parenting consultations using a positive, solution-focused model, and strategies for providing parents with specific suggestions and advice to parents. Issues related to ethics and culture will be highlighted and discussed throughout this two-day workshop.

Here’s a link to the registration form for both workshops. Registration Form for JSF Workshops 2018

If you want to call for more information: Call 406-243-5252 and leave a message if our administrative person is away. Or you can always email me: john.sf@mso.umt.edu

April 6 and 7, 8:30am to 4:30pm: Variations on the Clinical Interview: Collaborative Approaches to Mental Status Examinations, Suicide Assessment, and Suicide Interventions

The clinical interview is the headwaters from which all mental health assessment and interventions flow. In this workshop, following an overview of clinical interviewing principles and practice, skills training for conducting the mental status examination (MSE) and suicide assessment interviews will be provided. Participants will learn MSE terminology, common symptom clusters and presentations, and strategies through which the MSE can be more collaborative and user-friendly. Additionally, participants will learn a flexible model for conducting suicide assessments. This model features eight core suicide dimensions and techniques for directly and collaboratively questioning clients about suicide ideations, previous attempts, hopelessness, and more. Five suicide interventions will be featured: alternatives to suicide; separating suicide intent from the self; interpersonal re-connection; neodissociation; and safety-planning.

One last note: On Wednesday, February 14, I’ll be doing my annual 1/2 day workshop on Tough Kids, Cool Counseling in the Schools at the annual meeting of the National Association of School Psychologists (NASP). We’re in Chicago this year. So if you happen to be in Chicago, check out the NASP conference. https://www.nasponline.org/professional-development/nasp-2018-annual-convention

 

 

 

Choice Theory/Reality Therapy and Spirituality

John and Bob Wubbolding 2017 B

Counseling and psychotherapy theories are wildly variable and surprisingly convergent. What do I mean by this? Well, despite the fact that Sigmund Freud and Francine Shapiro and Steven Hayes and Marsha Linehan have very different ideas about what helps people change for the better, there’s also a boatload of commonality.

Based on my narrow range of experience and knowledge, nowhere is there more commonality than the theoretical outposts of Adlerian theory (i.e., Individual Psychology) and Choice Theory/Reality Therapy. Both of these approaches include a broad theoretical concept related to an individual’s personal and cultural construction of how they view themselves, others, and the world (i.e., Adlerians say “Lifestyle” while Reality Therapists say “Quality World”); both perspectives view individuals as pulled forward by internal values (and not driven by Freudian conflicts); both perspectives view behavior as purposeful, and perhaps not coincidently, they also view psychopathology as purposeful.

All this theory-speak is way for me to introduce this post as a continuation of my spirituality and counseling/psychotherapy theories series. What’s especially interesting about this post (IMHO) is that I’m writing about spirituality and Reality Therapy. I mean, how can a form of therapy that explicitly emphasizes “reality,” accommodate “spirituality?” We’ll see about that . . . maybe.

Chapter 9 of Counseling and Psychotherapy Theories in Context and Practice focuses on choice theory and reality therapy. Many people may not perfectly understand the definitions of choice theory and reality therapy. As a quick refresher, here’s an excerpt from the beginning of Chapter 9, followed by the brief spirituality section.

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Reality therapy is often oversimplified and confused with confrontational therapeutic approaches. In this chapter we describe and explain the nuances and clarify the confusion.

What is Choice Theory and Reality Therapy?

Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).

Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that they can correct behaviors and continue getting what they need and want (Wubbolding, 2012, p. 13).

Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).

Choice Theory, Reality Therapy, and Spirituality

In the 1989 Spring issue of the Journal of Reality Therapy, Brent Dennis, a certified reality therapist, wrote an article titled, “Faith: The fifth psychological need.” Glasser (1989) responded later that year. Glasser noted that he found the discussion interesting, but that there is “no possible way to resolve an argument about belief” (p. 29). He concluded with a statement embracing inclusiveness toward whatever anyone might place in their quality world. Consistent with this perspective, contemporary reality therapists have published book chapters on how to help interfaith and multicultural couples succeed in their partnerships and marriages (Minatrea & Duba, 2012; Olver, 2012). It’s interesting however, that Glasser described faith as residing in an individual’s quality world; he did not embrace it as a new psychological human need.

In an article on integrating reality therapy into Malaysian Islamic culture, Jusoh and Ahmad (2009) described many ways in which choice theory is consistent with Islam and can be practiced in Asian cultures. Specifically, they focused on the WDEP and SAMI2C3 systems and emphasized their compatibility with Islamic concepts. They concluded that “choice theory and reality therapy have universal attributes, and these can be interpreted in any religion or culture” (2009, p. 7). This statement seems consistent with Glasser’s (1989) inclusive statement on spirituality as a potential human need.

Overall, aside from the content briefly summarized here, little information exists on the integration of spirituality into reality therapy. However, given the growing international flavor of CT/RT, progress in this area seems inevitable.