Digest Volume 12, Issue 2 The Professional CounselorTM The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE S i nce 2011 TM Summer 2022
8 Herbal Remedies, Overthe-Counter Drugs, and Dietary Supplements: A Primer for Counselors Moderation Effects of Supervisee Levels on the Relationship Between Supervisory Styles and the Supervisory Working Alliance 4 Trajectory of Journal Article Publications for Counselor Educators at Comprehensive Universities 1 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 © 2022 NBCC, Inc. and Affiliates | 3 Terrace Way, Greensboro, NC 27403-3660 1 Herbal Remedies, Over-the-Counter Drugs, and Dietary Supplements: A Primer for Counselors Sabina Remmers de Vries, Christine D. Gonzales-Wong 3 Counselor Educators’ Experiences of Dissertation-Chairing Relationship Dynamics Phillip L. Waalkes, Daniel A. DeCino, Maribeth F. Jorgensen, Tiffany Somerville 4 Trajectory of Journal Article Publications for Counselor Educators at Comprehensive Universities Gregory T. Hatchett 7 Child Abuse Reporting: Understanding Factors Impacting Veteran School Counselors Lacey Ricks, Malti Tuttle, Sara E. Ellison 8 Moderation Effects of Supervisee Levels on the Relationship Between Supervisory Styles and the Supervisory Working Alliance Dan Li The Professional Counselor Digest TM Volume 12, Issue 2 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 1 TPC Digest TPC Digest Sabina Remmers de Vries, Christine D. Gonzales-Wong T he purpose of this article is to provide counseling professionals with an overview of the most commonly used psychoactive herbal remedies, over-the-counter drugs (OTCs), and dietary supplements. This article also addresses ways in which counselors consider client use of psychoactive substances in the areas of education, assessment, diagnosis, case conceptualization, treatment planning, and advocacy. Lastly, the authors provide ethical and cultural considerations for counselors to promote competent clinical treatment. U.S. consumers spend billions of dollars on complementary and alternative medicines, which include herbal remedies and dietary supplements. Many of these substances are pharmaceutically active. As such, some clients may choose to take herbal remedies, OTCs, and dietary supplements in an attempt to treat mental health concerns. Some clients may rely on these remedies in addition to prescription medicine. Others may take them instead of their prescribed medication. Clients do so for a variety of reasons, which are discussed in this article. It is common for clients not to disclose to their physicians or counselors that they are taking herbal remedies, OTCs, and dietary supplements. Clients may not be aware of the pharmacological properties and side effects of these products. One aspect of herbal remedies and dietary supplements that is particularly worrisome is that these substances do not undergo the same stringent research and development as prescription drugs. Additionally, herbal remedies and dietary supplements are poorly regulated in terms of dosage and purity. It is professionally and ethically prudent for counselors to have a working knowledge of herbal remedies, OTCs, and dietary supplements when providing services to clients who self-treat with such substances. Counselors are required to practice within the limits of their training as well as within the limits of their licensure. It is important that counselors refrain from providing advice regarding medication, even those that are available over the counter. Counselors are obliged to refer clients with concerns regarding herbal remedies, OTCs, and dietary supplements to medical professionals. Withholding such a referral could be considered unethical. Diversity and inclusion are also considered in this article. It is important to be aware that individual differences in clients can lead to significant variations in responses to drugs. Furthermore, racial and ethnic inequalities are common in health care, and racial and ethnic minority clients may experience considerable barriers when seeking health care. Some of these clients may reach for herbal remedies, OTCs, and dietary supplements to treat mental health concerns. An increasing number of training programs and licensing boards require education in psychopharmacology. Herbal remedies, OTCs, and dietary supplements should be part of this training because these compounds potentially impact the mood, thought processes, behaviors, and well-being of clients. Sabina Remmers de Vries, PhD, NCC, LPC-S, is an associate professor at Texas A&M University–San Antonio. Christine D. Gonzales-Wong, PhD, NCC, LPC, is an assistant professor at Texas A&M University–San Antonio. Correspondence may be addressed to Sabina de Vries, One University Way, San Antonio, TX 78224, sabina.devries@tamusa.edu. Read full article and references: de Vries, S. R., & Gonzales-Wong, C. D. (2022). Herbal remedies, over-the-counter drugs, and dietary supplements: A primer for counselors. The Professional Counselor, 12(2), 105–122. doi: 10.15241/srdv.12.2.105 1 | i t Herbal Remedies, Over-the-Counter Drugs, and Dietary Supplement A Primer for Counselors
2 3 TPC Digest TPC Digest Read full article and references: Waalkes, P. L., DeCino, D. A., Jorgensen, M. F., & Somerville, T. (2022). Counselor educators’ experiences of dissertation-chairing relationship dynamics. The Professional Counselor, 12(2), 123–137. doi: 10.15241/plw.12.2.123 | TPC Digest According to the Council for Accreditation of Counseling and Related Educational Programs (CACREP), doctoral students must develop research skills and complete counseling-focused dissertation research. Research mentorship is often important to counselor education doctoral students’ development as researchers. One of the central research mentoring relationships in doctoral programs is the dissertation-chairing relationship. Supportive research mentoring relationships in counselor education are invaluable to students and are necessary to successful dissertation chairing. In fact, a meaningful connection between students and their dissertation chairperson predicts students’ successful completion of their dissertations and positive dissertation experiences. Yet, doctoral students can struggle with isolation, motivation, time management, self-regulation, and self-efficacy. Doctoral students in counselor education have reported negative experiences when their dissertation chairs were unenthusiastic, unsupportive, and unavailable, and when their guidance was not concrete. In contrast, doctoral students in counselor education value when faculty take time with them, express genuine caring, offer guidance, communicate clearly and authentically, validate and believe in them, and celebrate their efforts and achievements. In fact, beginning counselor educators have reported faculty mentoring, care, and support were the most valuable components of their doctoral training. Therefore, in this study, we interviewed 15 counselor educators to help promote intentional and supportive dissertationchairing relationships by examining counselor educators’ experiences of relationship dynamics with doctoral students. Counselor educators experienced relationships characterized by expansive connections, growth in student autonomy, authenticity, safety and trust, and adaptation to student needs. Expansive connections mean that chairing relationships defy compartmentalized definitions and can have wide-ranging and mutually beneficial impacts that extend beyond the dissertation project. Growth in student autonomy refers to the importance of using the dissertation relationship to help students take initiative and learn to conduct research on their own. Authenticity includes how counselor educators value genuine conversations with students, in which there is a mutuality in sharing vulnerable parts of themselves. In terms of safety and trust, counselor educators believed mutual trust deepened their connections and helped students feel like their chairperson would help them grow without leaving them floundering. In adaptation to student needs, counselor educators believed in assessing their students’ personalities and tailoring their approaches to meet unique student needs with a mix of support and challenge. Our findings provide counselor educators with examples of how empathy and encouragement may help doctoral students overcome insecurities and how authentic and honest conversations may help doctoral students overcome roadblocks. Doctoral students can apply these findings by identifying their needs in a chairing relationship and learning more about faculty members who might help meet their needs when choosing a chair. Counselor educators can initiate authentic conversations that help set expectations and broach culture, possibly rooted in relational–cultural theory. Counselor education programs can apply these findings by building structures to help facilitate safe and trusting relationships between doctoral students and counselor educators, including methods that counselor educators and students can utilize to build relationships before engaging in dissertation chairing. Phillip L. Waalkes, PhD, NCC, ACS, is an assistant professor at the University of Missouri – St. Louis. Daniel A. DeCino, PhD, NCC, LPC, is an assistant professor at the University of South Dakota. Maribeth F. Jorgensen, PhD, NCC, LPC, LMHC, LIMHP, is an assistant professor at Central Washington University. Tiffany Somerville, MS, is a doctoral student at the University of Missouri – Saint Louis. Correspondence may be addressed to Phillip L. Waalkes, 415 Marillac Hall, 1 University Blvd., St. Louis, MO 63121, waalkesp@umsl.edu. Phillip L. Waalkes, Daniel A. DeCino, Maribeth F. Jorgensen, Tiffany Somerville Counselor Educators’ Experiences of Dissertation-Chairing Relationship Dynamics | TPC Digest
4 TPC Digest 5 TPC Digest Gregory T. Hatchett Trajectory of Journal Article Publications for Counselor Educators at Comprehensive Universities | TPC Digest Read full article and references: Hatchett, G. T. (2022). Trajectory of journal article publications for counselor educators at comprehensive universities. The Professional Counselor, 12(2), 138–148. doi: 10.15241/gth.12.2.138 All graduates of doctoral programs accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) are required to attain multiple research competencies that will equip them to make long-term contributions to the knowledge base of professional counseling. Yet, most graduates of these programs do not become faculty members in counselor education programs, let alone faculty at universities at which high levels of scholarly productivity are required for successful tenure and promotion decisions. The graduates of counselor education programs who do become faculty members are more likely to be employed at comprehensive universities—institutions at which faculty have high teaching loads and low expectations for scholarly productivity—than at universities denoted by the Carnegie Classification System as either R1 (Very high research activity) or R2 (High research activity). In recent years, there has been increased research on the extent to which counselor educators at comprehensive universities engage in scholarly activity and how their level of scholarly activity compares to counselor educators at more research-intensive universities. However, researchers had not yet examined how the scholarly productivity of counselor educators at comprehensive universities is sustained over time. In response to this deficiency, this study examined the journal article publication counts of counselor educators at comprehensive universities over the first 20 years since completing their terminal degrees. A second objective of this study was to evaluate how well these journal article publication counts could be predicted from inferred binary gender, academic rank, and terminal degree date. At the end of the first 20 years since receiving their terminal degrees, these counselor educators had accrued a median of just three journal article publications. One-fourth of the sample did not have any journal article publications indexed in any of three electronic databases. Publication counts were higher for male counselor educators, full professors, and those with more recent terminal degree dates. Longitudinal analyses indicated trends for both inferred binary gender and academic rank, and for the entire sample, a relative decline in publications across time. For the most part, the counselor educators at comprehensive universities in this sample accrued a negligible number of journal article publications across the first 20 years of their careers. Thus, it seems that many of these counselor educators are not fully utilizing the research competencies developed as part of their graduate school training. This finding—combined with the large number of doctoral program graduates who do not become counselor educators—raises questions about the nature and purpose of doctoral-level training in counselor education. The extensive research training required in doctoral programs accredited by CACREP may be suited to the small percentage of doctoral program graduates who attain faculty positions at research-intensive universities. Because of this, counselor educators should reexamine the extent to which the curriculum required in their doctoral programs matches the career outcomes of their graduates Gregory T. Hatchett, PhD, NCC, LPCC-S, is a professor at Northern Kentucky University. Correspondence may be addressed to Gregory T. Hatchett, MEP 211, Highland Heights, KY 41099, hatchettg@nku.edu. 5 | TPC Digest
6 TPC Digest 7 TPC Digest Read full article and references: Ricks, L., Tuttle, M., & Ellison, S. E. (2022). Child abuse reporting: Understanding factors impacting veteran school counselors. The Professional Counselor, 12(2), 149–166. doi: 10.15241/lr.12.2.149 I n 2019, approximately 4.4 million reports alleging maltreatment were made to U.S. child protective services. Of these reports, nearly two-thirds were made by professionals who encounter children as a part of their occupation. Voluntary disclosure of childhood abuse is relatively uncommon; one study found that less than half of adults with histories of abuse reported disclosing the abuse to anyone during childhood, and only 8%–16% of those disclosures resulted in reporting to authorities. For this reason, mandated reporting by professionals is an integral piece of child abuse prevention. School counselors, by virtue of their ongoing contact with children, are uniquely positioned to identify and report child abuse. Previous literature has focused on the reporting behaviors and experiences of novice school counselors; however, the child abuse reporting behaviors and needs of veteran school counselors are understudied. The purpose of this quantitative study was to examine (a) the prevalence of child abuse reporting by veteran school counselors within the school year; (b) the factors affecting veteran school counselors’ decisions to report or not report suspected child abuse; (c) reasons for reporting or not reporting suspected child abuse by veteran school counselors; and (d) veteran school counselors’ self-efficacy levels related to child abuse reporting. Responses from 303 veteran school counselors in the Southeastern United States were included in the sample. Veteran school counselors were defined as having 6 or more years of experience working as a school counselor within a public or private school. Participants completed a demographics survey, the Child Abuse Reporting Questionnaire, the School Counselor SelfEfficacy Scale, and the Knowledge of Child Abuse Reporting Questionnaire. The analysis results revealed that veteran school counselors, on average, reported more than five cases of child abuse in a 12-month period. Additionally, academic setting, number of students within the school, and the students’ engagement in the free or reduced lunch program were significantly correlated with higher reporting among veteran school counselors. Moreover, veteran school counselors’ self-efficacy levels were moderately correlated with their decision to report. Highly rated reasons for choosing to report suspected child abuse included professional obligation, following school protocol, and concern for safety of the child. The highest rated reason for choosing not to report was lack of evidence. This study has meaningful implications for school counselor training and advocacy related to child abuse reporting. Based on the findings from this research study, standardization in reporting policies, updated or increased training opportunities, and additional mental health services in low-income and elementary districts may be supportive of veteran school counselors’ ability to effectively engage in reporting child abuse. Additionally, school counselors may need more training on both the risk factors associated with poverty and the ways in which they can assess self-bias as a factor in identifying and reporting suspected child abuse. Further research is needed to understand how self-efficacy impacts school counselors’ decision-making processes. It is also important to examine how school support can increase school counselors’ self-efficacy levels. Lacey Ricks, PhD, NCC, NCSC, is an associate professor at Liberty University. Malti Tuttle, PhD, NCC, NCSC, LPC, is an associate professor at Auburn University. Sara E. Ellison, MS, NCC, LAPC, is a doctoral student at Auburn University. Correspondence may be addressed to Lacey Ricks, 1971 University Blvd, Lynchburg, VA 24515, lricks1@liberty.edu. Lacey Ricks, Malti Tuttle, Sara E. Ellison Child Abuse Reporting Understanding Factors Impacting Veteran School Counselors | TPC Digest 7 | TPC Digest
8 TPC Digest 9 TPC Digest Dan Li Moderation Effects of Supervisee Levels on the Relationship Between Supervisory Styles and the Supervisory Working Alliance Supervisee development is integral to counselor training. Although it is widely acknowledged that supervisors should adopt different styles when supervising counselor trainees at varying levels, little is known about how to measure supervisee levels using reliable and valid psychometric instruments, other than a broad categorization of supervisees based on their training progression (e.g., master’s level vs. doctoral level; practicum vs. internship; counselor trainee vs. postgraduate), and how the matching of supervisory styles and supervisee levels relates to supervision processes and/or outcomes. The supervisory working alliance is key to the supervision process and outcome. Accordingly, this study examined the hypothesized moderation effects of supervisee levels on the relationship between supervisory styles and the supervisory working alliance (i.e., whether the relationship between supervisory styles and the supervisory working alliance varies under different contexts). This study revealed two groups of major findings. First, the positive correlation between the interpersonally sensitive supervisory style and the supervisory working alliance was stronger for supervisees at lower levels of professional development than for supervisees at higher levels. Furthermore, this significant moderation effect was evident not only when supervisee levels were treated as an overarching construct but also when each indicator of supervisee levels (self and other awareness, motivation, and autonomy) was independently examined. Moreover, this moderation pattern was echoed by the positive association between the task-oriented style and the supervisory working alliance, wherein the correlation was stronger for supervisees at lower levels of self and other awareness (one indicator of supervisee levels) but weaker for those at higher levels of self and other awareness. It is worth noting that, although such correlation was more sensitive among supervisees at lower levels of development, supervisees at higher developmental levels (including indicators of supervisee levels) in all models with significant moderation effects reported a stronger supervisory working alliance than did their counterparts at lower levels. Entry-level supervisees typically focus more on their own anxiety and their lack of skills and knowledge and are in greater need of structure and guidance. Naturally, as they perceive more interpersonally sensitive or task-oriented characteristics in their supervisors, they are more likely to report a stronger supervisory working alliance. As they progress to higher levels of development with accumulated knowledge, skills, and competencies, supervisees become more aware of clients and themselves, more intrinsically and consistently motivated, and more independent as practitioners, which may in part explain why their ratings of the supervisory working alliance were less related to their perceptions of supervisor characteristics but generally higher than supervisees at lower levels of development. This may imply that different supervisory styles help maintain the working alliance that has been established early on in supervision. Dan Li, PhD, NCC, LSC (NC, K–12), is an assistant professor of counseling at the University of North Texas. Correspondence may be addressed to Dan Li, Welch Street Complex 2-112, 425 S. Welch St., Denton, TX 76201, Dan.Li@unt.edu. | TPC Digest 9 | TPC Digest Read full article and references: Li, D. (2022). Moderation effects of supervisee levels on the relationship between supervisory styles and the supervisory working alliance. The Professional Counselor, 12(2), 167–184. doi: 10.15241/dl.12.2.167
Digest Volume 12, Issue 2 The Professional CounselorTM The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE S i nce 2011 TM Summer 2022 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 © 2022 NBCC, Inc. and Affiliates, 3 Terrace Way, Greensboro, NC 27403-3660
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