DIGEST - Volume 11, Issue 1

14 TPC Digest | T h e counseling field has a nascent history of investigating the significance of neurons, neurochemistry, and associated neural pathways to mental health disorders, counseling interventions, and outcomes. Even less attention has been given to epigenetics. Epigenetics is defined as the interaction between an individual and their environment at the genetic level without a change to their genetic code (i.e., DNA sequence). The key concept for counselors to comprehend is that clients exist in the context of “nature and nurture” rather than “nature or nurture.” This biological dance between the client and their environment elicits genetic changes that correlate to mental health disorders. These epigenetic modifications are active across the life span but most adaptable early in the life span (0–5 years). Epigenetics describes how chemical tags will modify a cellular structure called the epigenome. These chemical tags do not alter the actual genetic sequence, but act “upon” the genetic code. When activated by environmental influences, the chemical tags modify the epigenome through epigenetic mechanisms—DNA methylation, histone modification, and microRNA. Poor environmental conditions (e.g., neglect, abuse, poor dietary intake, no exercise) can influence chemical tags on the client’s genome that later increase the likelihood of a mental health disorder such as schizophrenia, depression, anxiety, or addiction. These negative effects can span generations. For example, the Nazis occupied the Netherlands between 1944–45. During this time, the population had restricted food availability. Children of pregnant mothers during the famine had increased risk of obesity and heart disease in adulthood. T he beneficial nature of counseling interventions is equally important in supporting epigenetic wellness. Cognitive behavioral therapy, mindfulness, healthy dietary intake, psychotropic medication, and exercise have all been found to elicit positive changes to the epigenetic landscape. Mindfulness is a common counseling intervention that has shown efficacy in reducing stress as well as eliciting positive changes at the epigenomic level. Applying cognitive behavioral therapy in children with severe anxiety has shown changes in DNA methylation. An epigenetic counseling lens has several implications. As counselors, we observe emotional, cognitive, and behavioral changes in our clients and now know that our work effects changes at the cellular level. Additional implications connect to counseling core values of wellness and prevention. Epigenetic changes are most modifiable between the ages of 0–5. This illuminates the need for counseling intervention early in the life span, where change is most readily available. Finally, the epigenetic dance calls our attention to not only the client but their “embeddedness” within the micro and macro client environments. Counseling interventions are critical at the individual level, but advocating for change at the community level is equally important. David E. Jones, EdD, NCC, LPC, is an assistant professor at Liberty University. Jennifer S. Park, PhD, NCC, ACS, LPC, is an assistant professor at Colorado Christian University. Katie Gamby, PhD, LPC, CWC, is an assistant professor at Malone University. Taylor M. Bigelow, PhD, is an assistant professor at the University of New Haven. Tesfaye B. Mersha, PhD, is an associate professor at the Cincinnati Children’s Hospital Medical Center (CCMHC), University of Cincinnati College of Medicine. Alonzo T. Folger, PhD, MS, is an assistant professor at the CCMHC, University of Cincinnati College of Medicine. Correspondence may be addressed to David E. Jones, 1971 University Blvd., Lynchburg, VA 24515, dejones14@liberty.edu. David E. Jones, Jennifer S. Park, Katie Gamby, Taylor M. Bigelow, Tesfaye B. Mersha, Alonzo T. Folger Mental Health Epigenetics A Primer With Implications for Counselors