DIGEST-Volume-11-Issue-4

Digest Volume 11, Issue 4 The Professional CounselorTM The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE S i nce 2011 TM Winter 2021

8 Grounded Theory of Asian American Activists for #BlackLivesMatter Addressing Anxiety: Practitioners’ Examination of Mindfulness in Constructivist Supervision 6 Informing Consent: A Grounded Theory Study of Parents of Transgender and Gender-Diverse Youth Seeking GenderConfirming Endocrinological Interventions 2 The stock photos in this publication are not intended to indicate an endorsement, attitude, or opinion by the models, or to indicate that the models suffer from the mental health concerns mentioned. The Professional Counselor DIGEST is an abbreviated version of the journal, The Professional Counselor, intended for the general public. The National Board for Certified Counselors, Inc. and Affiliates publishes The Professional Counselor and The Professional Counselor DIGEST. The Professional Counselor DIGEST © 2021 NBCC, Inc. and Affiliates | 3 Terrace Way, Greensboro, NC 27403-3660

1 Access to School Counseling and the Connection to Postsecondary STEM Outcomes Dana L. Brookover 2 Grounded Theory of Asian American Activists for #BlackLivesMatter Stacey Diane Arañez Litam, Christian D. Chan 5 Behind the Curtain: Ballet Dancers’ Mental Health J. Claire Gregory, Claudia G. Interiano-Shiverdecker 6 Informing Consent: A Grounded Theory Study of Parents of Transgender and Gender-Diverse Youth Seeking Gender-Confirming Endocrinological Interventions Charles F. Shepard, Darius A. Green, Karli M. Fleitas, Debbie C. Sturm 8 Addressing Anxiety: Practitioners’ Examination of Mindfulness in Constructivist Supervision Jennifer Scaturo Watkinson, Gayle Cicero, Elizabeth Burton 11 Experience of Graduate Counseling Students During COVID-19: Application for Group Counseling Training Bilal Urkmez, Chanda Pinkney, Daniel Bonnah Amparbeng, Nanang Gunawan, Jennifer Ojiambo Isiko, Brandon Tomlinson, Christine Suniti Bhat The Professional Counselor Digest TM Volume 11, Issue 4 Table of Contents the team Kylie P. Dotson-Blake, Publisher Amie A. Manis, Editor Catherine Clifton, Managing Editor Gretchen C. Porter, Sr. Copy Editor Kristin Rairden, Sr. Graphics Specialist Rachel P. Sommers, Digital Communications Specialist

iv TPC Digest Dana L. Brookover Access to School Counseling and the Connection to Postsecondary STEM Outcomes C ollege and career readiness are key outcome targets of school systems across the United States. Another national priority is the focus on increasing the workforce in science, technology, engineering, and math (STEM) fields. As part of their positions, school counselors play an integral role in their students’ college readiness through providing college-readiness counseling. Within college-readiness counseling, school counselors can educate their students on the possibilities in STEM at the college level. They also should seek to increase their students’ self-efficacy in STEM areas. The hope is to promote and support students’ attainment of their STEM-related college and career goals. Further, college-readiness counseling as it’s connected to STEM outcomes is an important area in which school counselors can expand their repertoire, because there are continuing inequities in who is persisting and attaining degrees in STEM majors at the college level. There has been great growth in the numbers of traditionally underrepresented students persisting in STEM majors in college. Still, there are disparities in STEM degree persistence and attainment by gender (with women less likely to attain), race/ethnicity (with minoritized students less likely to attain), first-generation college student (FGCS) status (with FGCSs less likely to attain), and socioeconomic status (SES; with those of lower SES less likely to attain). Hence, the opportunity gap in STEM education is a social justice issue, which school counselors should target in their college-readiness counseling efforts with students. The current study sought to understand the connection between school counseling access and postsecondary STEM outcomes in a nationally representative sample of students in the United States. School counseling access was determined through school counselor caseload and the percentage of time spent on college-readiness counseling as part of their roles.

1 TPC Digest These two variables were included because the opportunity to access school counseling services is an important part of a student’s schooling background, and lack of access could limit the ability to receive college-readiness counseling that could positively impact STEM outcomes. The participants were part of the High School Longitudinal Study of 2009 (HSLS:09) developed by the National Center of Educational Statistics (NCES). Over 23,000 students provided information from the ninth grade until they would be in their third year of college. The author of this article looked at relevant student variables, including gender, SES, FGCS status, race/ethnicity, and math and science self-efficacy. The author also included school counselor caseload (either meeting the 250:1 recommended ratio or not) and percentage of time spent on college-readiness counseling as variables (above or below the national average of 21% of time). The outcome studied was whether a student persisted in a STEM major or attained a STEM postsecondary degree three years after high school graduation. Results suggest several student characteristics and access to school counseling/college-readiness counseling does have an impact on long-term STEM outcomes. Access to school counselors who spend 21% or more of their time on college-readiness counseling predicted persistence and attainment of a STEM postsecondary degree. Additionally, when all other variables were controlled, Hispanic- and Asian-identifying students were more likely to persist and attain, and females were less likely to persist and attain. Math and science self-efficacy predicted persistence and attainment, and STEM GPA was a positive predictor. School counselors can use this information to inform their college-readiness counseling work with students. First, it appears that spending 21% or more of time on college-readiness counseling predicts STEM major attainment and persistence in students. Again, the disparities in STEM outcomes are an opportunity gap, not an achievement gap, and all students need the opportunity to receive STEM education and self-efficacy support and interventions. This can include providing STEM occupation information, verbal persuasion and encouragement to pursue STEM goals, addressing school climate so that it’s inclusive for female and minoritized students to pursue futures in STEM, and conducting group interventions to improve math and science self-efficacy. Dana L. Brookover, PhD, NCC, is a licensed school counselor and an assistant professor at the University of Scranton. Correspondence may be addressed to Dana L. Brookover, McGurrin Hall Room 435, McGurrin Hall, The University of Scranton, Scranton, PA 18510, brookoverdl@gmail.com. Read full article and references: Brookover, D. L. (2021). Access to school counseling and the Connection to postsecondary STEM outcomes. The Professional Counselor, 11(4), 383–399. doi: 10.15241/dlb.11.4.383 1 | i t

2 TPC Digest Read full article and references: Litam. S. D. A, & Chan, C. D. (2021). Grounded theory of Asian American activists for #BlackLivesMatter. The Professional Counselor, 11(4), 400–422. doi: 10.15241/sdal.11.4.400 | TPC Digest

3 TPC Digest T he ongoing problem of police brutality on Black and Brown people has reignited conversations about systemic oppression and illuminated the importance of civil rights, racial coalitions, and the dismantling of White supremacy. Although Asian American and Black communities have historically been pitted against one another by White supremacist–driven narratives, Asian American and Pacific Islanders (AAPIs) have a longstanding history of pursuing thick solidarity and activism alongside the Black community. Obtaining a deeper understanding of the processes through which Asian Americans begin pursuing activism alongside the Black community is of paramount importance to maintain racial coalitions, overcome anti-Black notions embedded within AAPI ethnic subgroups, and challenge systemic forms of racial oppression that impact all communities of color. We employed a grounded theory approach with 25 Asian American activists to examine the following research question: “What is the process that mobilizes Asian American activists to pursue thick solidarity with the Black Lives Matter (BLM) movement in 2020?” Participants in the study described feeling “primed” to act because of the combined causal conditions of George Floyd’s murder and experiences of COVID-19–related anti-Asian discrimination. Participants were able to mobilize because of the contextual factors of alignment with personal and community values, awareness and knowledge, and perspectives of oppression. The phenomenon of Asian American activists mobilizing in thick solidarity with the BLM movement was additionally influenced by intervening conditions, which included affective responses, intergenerational conflict, conditioning of “privileges” afforded by White supremacy, and organized communities. Each of these conditions and factors interacted to influence non-action, performative or unhelpful action, and action toward thick solidarity. Participants explained how pursuing thick solidarity with the Black community resulted in pathways that promoted interracial and intraracial healing, led to an ongoing commitment to personal and community values as well as human rights initiatives, and created opportunities to restructure policies and redistribute power. Finally, participants identified achieving a collective oppressed identity as absolutely critical for mobilization to occur. This core category occurred as a result of George Floyd’s murder, because of experiences of COVID-19–related anti-Asian discrimination, and as a result of awareness and knowledge. Professional counselors can leverage this theoretical process to embolden AAPI clients to engage in collective social action. For example, mental health professionals can help AAPI clients recognize how achieving a collective oppressed identity and contextualizing the historical and nuanced relationship between the Asian American and Black communities are critical to forming racial coalitions and healing from racial trauma. Based on the results of this study, professional counselors and counselor educators alike are encouraged to engage in meaningful racial dialogues that help Asian Americans heal from their own racial and intergenerational trauma, support other communities of color, and navigate cultural barriers. Mental health professionals can additionally validate experiences of oppression following COVID-19–related racial trauma and help Asian American clients redirect their affective experiences to promote awareness and knowledge, challenge proximity to whiteness, and cultivate meaningful action. Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC-S, is an assistant professor at Cleveland State University. Christian D. Chan, PhD, NCC, is an assistant professor at the University of North Carolina at Greensboro. Correspondence may be addressed to Stacey Litam, 2121 Euclid Ave., Cleveland, OH 44115, s.litam@csuohio.edu. Stacey Diane Arañez Litam, Christian D. Chan Grounded Theory of Asian American Activists for #BlackLivesMatter | TPC Digest

4 TPC Digest J. Claire Gregory, Claudia G. Interiano-Shiverdecker Behind the Curtain | TPC Digest Our study focused on exploring professional ballet dancers’ mental health experiences. Most research involving ballet dancers and elite athletes focuses on eating disorders, injury, and performance enhancement. Although these topics are important for overall wellness, there is a lack of research exploring ballet dancers’ mental health and there are no current standards for athletic counseling. This gap in the literature may leave counselors with a lack of knowledge or competencies when counseling professional dancers. Our main goal of this study was to explore professional ballet dancers’ culture and identity and how these influence their mental health experiences. Our three guiding research questions were (a) How do professional ballet dancers define ballet culture and identity? (b) What are the mental health experiences of professional ballet dancers? and (c) What are professional ballet dancers’ suggestions for counseling and advocacy with this population? We interviewed eight dancers identifying as either former, freelance, or current professional ballet dancers between the ages of 25 and 37. Data analysis resulted in four prevalent themes about professional ballet dancers’ mental health experiences. The first theme was ballet culture and how ballet is ingrained with tradition that dates to the 14th century. For the dancers, ballet culture was experienced on a continuum including both positive and negative qualities. All the dancers felt that professional ballet dancing required extreme physical and mental demands, which sometimes resulted in injury or anxiety. Additionally, the dancers all revealed positive aspects of ballet culture such as a sense of community and using the body for storytelling. In the second theme, the dancers identified how ballet is a part of their identity and development. They shared how professional ballet dancers possess strong tenacity and grit that extends even beyond their dance careers. The dancers felt that professional ballet dancing involves determination but also artistic expression. Four dancers specifically expressed that dancing was more than just a job; it was part of who they were. The third theme was mental health experiences of the dancers and how the dancers felt the need to compartmentalize their emotions. For example, the dancers voiced their experiences with depression and anxiety due to maintaining a certain physical appearance or competing for performance roles. However, the skill of compartmentalizing and setting feelings aside was needed to succeed. The four former professional ballet dancers shared that their mental health improved when they stopped dancing professionally. The final theme included the dancers’ recommendations for counselors when working with professional ballet dancers. Some dancers mentioned that ballet is a unique profession and that they would suggest that counselors develop an awareness of ballet culture. Recommendations also included counselors having an awareness of the rigors and demands of the profession and how society can view dancers as glamorous or celebrities, when in reality they are human with many challenges going on behind the curtain. J. Claire Gregory, MA, NCC, LPC, LCDC, is a doctoral candidate at the University of Texas at San Antonio. Claudia G. InterianoShiverdecker, PhD, is an assistant professor at the University of Texas at San Antonio. Correspondence may be addressed to J. Claire Gregory, Department of Counseling, 501 W. César E. Chávez Boulevard, San Antonio, TX 78207-4415, jessica.gregory@utsa.edu. Ballet Dancers’ Mental Health

5 TPC Digest Read full article and references: Gregory, J. C., & Interiano-Shiverdecker, C. G. (2021). Behind the curtain: Ballet dancers’ mental health. The Professional Counselor, 11(4), 423–439. doi: 10.15241/jcg.11.4.423 5 | TPC Digest

6 TPC Digest Read full article and references: Shepard, C. F., Green, D. A., Fleitas, K. M., & Sturm, D. C. (2021). Informing consent: A grounded theory study of parents of transgender and gender-diverse youth seeking genderconfirming endocrinological interventions The Professional Counselor, 11(4), 440–458. doi: 10.15241/cfs.11.4.440 | TPC Digest

7 TPC Digest During the 21st century, transgender and gender-diverse (TGD) identity in the United States has been associated with pervasive patterns of mistreatment and discrimination across social, educational, occupational, legal, and health care experiences. Despite these trends, affirming stances toward TGD identity have been developing almost simultaneously, tracing their roots to Christine Jorgensen’s transition in the 1950s. About a decade later, endocrinological interventions were pioneered that aimed to medically support TGD patients who wished to feminize or masculinize their bodies to be more congruent with their gender identity without surgery. These gender-confirming endocrinological interventions (GCEI) have been associated with positive physical and mental health outcomes and have been made available to people across the developmental life span from pre-puberty through late adulthood. GCEI have been growing in popularity among TGD minors, but in the United States minors almost always need their parents or legal guardians to provide informed consent for GCEI. Nearly all of the research regarding GCEI has been conducted on adults. The literature on the long-term risks and benefits of GCEI on minors is ongoing but not complete. This leaves both TGD youth and their parents in a difficult position to make meaningful decisions without a body of rigorous research to instill confidence in giving or denying consent. This qualitative grounded theory study is the first of its kind aimed at better understanding the decision-making process that parents and guardians of TGD youth go through when providing informed consent for the minor in their care to undergo GCEI. Using primarily intensive interviews supported by observational field notes and document review, this study examined the decision-making processes of a national sample of participants who identified as a parent or legal guardian of at least one TGD youth and who have given informed consent for the youth in their care to undergo GCEI. A variety of inhibiting and contributing factors were illuminated as well as a “dissonance-to-consonance” model that participants used to combine contributing factors to overcome inhibitors and grant informed consent. Inhibiting factors included lack of knowledge and awareness of issues and concerns related to TGD identity, fear, doubt, grief over a lost parenting narrative, and rejection from health care providers (or payors) and parenting partners. Contributing factors included parental attunement to the experiences and emotions of the youth in their care, access to affirming education about TGD issues and GCEI, and the presence and/or development of affirming relationships and community. Participants used prior exposure to the experiences of historically minoritized people, openness to new ideas and information, and acceptance of new ideas and information to conduct a TGD-affirming cost-benefit analysis using contributing factors to overcome inhibitors, grant informed consent, and experience relief. The results of this study appear to provide a plausible model for professional counselors to follow when providing care for TGD youth and their families. They also provide fresh reference points for counselor educators employing multicultural perspectives for instruction on ethics, professional identity, and family systems counseling, among other considerations. Charles F. Shepard, PhD, NCC, LPC, is a visiting faculty member at James Madison University. Darius A. Green, PhD, NCC, is the PASS Program Assistant Coordinator at James Madison University. Karli M. Fleitas, MA, is a doctoral student at James Madison University. Debbie C. Sturm, PhD, LPC, is a professor at James Madison University. Correspondence may be addressed to Charles F. Shepard, MSC 7704, James Madison University, 91 E. Grace Street, Harrisonburg, VA 22807, sheparcf@jmu.edu. Charles F. Shepard, Darius A. Green, Karli M. Fleitas, Debbie C. Sturm Informing Consent A Grounded Theory Study of Parents of Transgender and Gender-Diverse Youth Seeking Gender-Confirming Endocrinological Interventions 7 | TPC Digest

8 TPC Digest Jennifer Scaturo Watkinson, Gayle Cicero, Elizabeth Burton Addressing Anxiety | TPC Digest Anxiety is a natural part of the developmental process of a counselor-in-training (CIT) and can be particularly evident during practicum. Anxiety often stems from CITs’ doubts about their competency, coupled with their desire to be perfect. Further, CITs often have a strong need for external validation, which creates anxiety and an overreliance on a supervisor’s judgment. Within a constructivist approach to supervision, mindfulness is used to help CITs work with their anxiety by bringing attention to their internal experiences of discomfort and helping them meet that discomfort with self-compassion and nonjudgment. As counselor educators who supervise practicum students and adhere to a constructivist approach to supervision, we recognized the amount of anxiety our students were experiencing and wanted to understand how integrating mindfulness within our supervision could support their growth and development. Mindfulness core concepts (e.g., being present, nonjudgement, and self-compassion) served as a framework for how practicum students made meaning of their internal experiences. To examine our practice, we utilized a practitioner inquiry approach and formed a professional learning community to explore how our practicum students experienced mindfulness as an integral approach to supervision. Through the examination of our practice, we attended to the tensions and opportunities that came with integrating mindfulness into our supervision as a way to highlight what worked and what should change. In this study, we described the various mindfulness exercises we used with our CITs. To understand how 25 of our practicum students were experiencing mindfulness, we analyzed their written reflections pertaining to their practicum experience, along with transcripts from two focus groups. Three themes emerged and were identified: openness to the process of becoming, reflection and self-care, and attention to the doing. When reflecting upon their practicum experiences, CITs accepted where they were in the developmental process and embraced anxiety with self-compassion and non-judgment. Further, CITs perceived reflection as a type of self-care and acknowledged that meditation helped them to stay in the present. Although CITs saw benefit in mindfulness as a part of their supervision, they also desired more focus on the day-today work school counselors were doing at their school sites. While we acknowledged the benefits to integrating mindfulness into supervision, we wrestled with how to create a balance between the amount of focus we placed on mindfulness versus the need our students had to hear stories about the work being done by school counselors. Reflecting upon what we learned, we proposed that balancing the need to focus on school counselor practice and mindfulness could be done by integrating the core principles of mindfulness into case conceptualization while keeping meditation as a central mindfulness exercise. Jennifer Scaturo Watkinson, PhD, LCPC, is a certified school counselor and serves as an associate professor and the School Counseling Program Director at Loyola University Maryland. Gayle Cicero, EdD, LCPC, is a certified school counselor and serves as an assistant clinical professor at Loyola University Maryland. Elizabeth Burton is a certified professional school counselor for Baltimore County Public Schools. Correspondence may be addressed to Jennifer Watkinson, Timonium Graduate Center, 2034 Greenspring Dr., Lutherville-Timonium, MD 21093, jswatkinson@loyola.edu. Practitioners’ Examination of Mindfulness in Constructivist Supervision

9 TPC Digest Read full article and references: Watkinson, J. S., Cicero, G., & Burton, E. (2021). Addressing anxiety: Practitioners’ examination of mindfulness in constructivist supervision. The Professional Counselor, 11(4), 459–474. doi: 10.15241/jsw.11.4.459 9 | TPC Digest

10 TPC Digest | TPC Digest Read full article and references: Urkmez, B., Pinkney, C., Bonnah Amparbeng, D., Gunawan, N., Isiko, J. O., Tomlinson, B., & Bhat, C. S. (2021). Experience of graduate counseling students during COVID-19: Application for group counseling training. The Professional Counselor, 11(4), 475–477. doi: 10.15241/bu.11.4.475

11 TPC Digest Bilal Urkmez, Chanda Pinkney, Daniel Bonnah Amparbeng, Nanang Gunawan, Jennifer Ojiambo Isiko, Brandon Tomlinson, Christine Suniti Bhat Experience of Graduate Counseling Students During COVID-19 | Application for Group Counseling Training Group counseling training has traditionally been conducted in a face-to-face learning environment. COVID-19 created a situation in which training transitioned from the face-to-face format to an online learning format, forcing trainers and trainees to realign themselves to a new normal. This article provides the experience of nine students who started out their group counseling training in a face-to-face format and transitioned to an online format because of the in-person restrictions caused by COVID-19. The purpose of the study was to explore and compare first-year master’s students’ experiences of participating in and leading both face-to-face and online formats of experiential group counseling training (EGCT). The research question that guided the study was: What were master’s students’ experiences of participating and leading in both face-to-face and online EGCT groups? Qualitative methodology using an existential phenomenological approach was used to explore first-year master’s students’ experiences of participating in and leading both face-to-face and online formats of EGCT and understand how those experiences impacted their attitudes, learning, facilitating, and adaptation to these two environments. Data was collected through focus group discussions. The analysis of the findings yielded three main themes regarding the participants’ experience: positive participation factors, participation-inhibiting factors, and suggestions for group counseling training. The theme of positive participation factors focused on exploring master’s students’ perceptions of what helped them actively participate in both online and face-to-face EGCT groups as a group member. Five subthemes were identified in the theme of positive participation factors: knowing other group members, physical presence, comfortability of online sessions, cohesiveness, and leadership interventions. The theme of participation-inhibiting factors examined factors that negatively influenced participation and leadership in the online and face-to-face formats of the EGCT groups. In this main theme, three subthemes were identified, including group dynamics, challenges with online EGCT, and technological obstacles for online EGCT. Under the theme of suggestions for group counseling training, participants were invited to share their concerns and ways to develop and improve face-to-face and online EGCT group experiences. Three subthemes were identified: software issues and training, identified group topics, and preferred EGCT environment. The findings of this study were consistent with previous research regarding factors that promote and/or inhibit participation during the group counseling training process. One interesting finding that was dissimilar to previous literature was how the opportunity to process the challenges generated by the experience of isolation during COVID-19 promoted participation. The experience of COVID-19 created a situation in which counselor educators should be prepared to conduct training in both face-to-face and online formats. The choice of format, however, requires a unique skill set and proper planning for one to achieve positive training outcomes. The findings provide information that counselor educators can use as they plan group counseling training programs. Areas of focus during preparation for both face-to-face and online group training are reinforced by suggestions coming from the perspectives of the trainees Bilal Urkmez, PhD, LPC, CRC, is an assistant professor at Ohio University. Chanda Pinkney, MA, CT, is a doctoral student at Ohio University. Daniel Bonnah Amparbeng, MEd, NCC, LPC, is a doctoral student at Ohio University. Nanang Gunawan, MA, is a doctoral student at Ohio University. Jennifer Ojiambo Isiko, MA, is a doctoral student at Ohio University. Brandon Tomlinson, MA, NCC, LPC, is a doctoral student at Ohio University. Christine Suniti Bhat, PhD, LPC, LSC, is a professor at Ohio University. Correspondence may be addressed to Bilal Urkmez, Patton Hall 432P, Athens, OH 45701, urkmezbi@ohio.edu.

Winter 2021 The Professional CounselorTM The Professional Counselor DIGEST is an abbreviated version of the journal, The Professional Counselor, intended for the general public. The National Board for Certified Counselors, Inc. and Affiliates publishes The Professional Counselor and The Professional Counselor DIGEST. The Professional Counselor DIGEST © 2021 NBCC, Inc. and Affiliates, 3 Terrace Way, Greensboro, NC 27403-3660 Digest Volume 11, Issue 4 The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE S i nce 2011 TM

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