Digest Volume 13, Issue 1 The Professional CounselorTM The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE Since 2011 TM Spring 2023
7 Understanding Racial Trauma: Implications for Professional Counselors Examining Social Self-Efficacy as a Mediator for Insecure Attachment and Loneliness 4 “I’m So #OCD”: A Content Analysis of How Women Portray OCD on TikTok 3 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 © 2023 NBCC, Inc. and Affiliates | 3 Terrace Way, Greensboro, NC 27403-3660
1 A Qualitative Investigation of Guyanese American Perceptions of Mental Health Shainna Ali, John J. S. Harrichand, M. Ann Shillingford, Lea Herbert 3 Understanding Racial Trauma: Implications for Professional Counselors Warren Wright, Jennifer Hatchett Stover, Kathleen Brown-Rice 4 “I’m So #OCD”: A Content Analysis of How Women Portray OCD on TikTok Erin E. Woods, Alexandra Gantt-Howrey, Amber L. Pope 7 Examining Social Self-Efficacy as a Mediator for Insecure Attachment and Loneliness Claudette Brown-Smythe, Shirin Sultana 9 Lifetime Achievement in Counseling Series: An Interview with Cherylene McClain Tucker Joshua D. Smith, Neal D. Gray The Professional Counselor Digest TM Volume 13, Issue 1 Table of Contents the team Richelle Joe, Editor Catherine Clifton, Managing Editor Gretchen C. Porter, Editing Team Lead Rachel P. Sommers, Graphics Team Lead Kristin Rairden, Sr. Graphics Specialist Kylie P. Dotson-Blake, Publisher
iv TPC Digest Shainna Ali, John J. S. Harrichand, M. Ann Shillingford, Lea Herbert A Qualitative Investigation of Guyanese American Perceptions of Mental Health T his article explores the lived experiences of 30 Guyanese American individuals to understand their perceptions of mental health. The authors discuss how these perceptions affect the lived experiences of the participants and present recommendations for counselors and counselor educators assisting Guyanese Americans in cultivating mental wellness. Guyana has the highest rate of suicide in the Western Hemisphere. Despite this, there is a gap in the literature regarding exploring mental wellness in this diaspora. For this reason, more information is needed on Guyanese mental health and suicide reduction. A review of the literature on Guyanese mental health, suicide prevention, and suicide protective factors revealed a limited number of studies. Although the country currently has a few mental health awareness and suicide prevention programs to address suicide risks, there are many issues of incongruence in the awareness of mental health in the West and the Caribbean, as well as few studies examining Guyanese American populations. Data collection for this remote qualitative research occurred in February 2021, amidst COVID-19. A central aspect of the study was the transition of mental health awareness and accessibility. Specifically, the study found that the initial perceptions of all participants included viewing mental health as a taboo topic and the seeking of mental health services as negative. Not surprisingly, these perceptions stemmed from fear, mistrust, and limited awareness of the benefits of mental health services. Cultural and familial influences also affected individual perceptions of mental health. The stigma associated with mental health remains a common experience for Guyanese Americans, and when coupled with limited communication, insufficient funding, and lack of providers, Guyanese individuals hold negative views of mental health, which significantly impacts their help-seeking. The results lend themselves to mental well-being implications for counseling practice. In this study, personal resources such as motivation to grow and learn, self-awareness, and determination, as well as external resources such as community services, education, and social media, enabled participants to augment their negative abstractions of mental health care. Resources related to access, such as counselors available at schools, insurance coverage, social media, and positive narratives of mental health from acquaintances, were encouraging to the participants and thus contributed to the shift in perception. The results highlight how Guyanese Americans should be provided with mental health experiences to enable them to recognize and act upon the benefits of mental health services. Based on the findings from this study, counselors should focus on three key strategies to support Guyanese American clients: (a) mental health awareness, (b) mental health education, and (c) mental health experience. Counselors and counselor educators can be instrumental in offering mental health education to Guyanese Americans. Counselors can apply these findings by facilitating mental health education that reflects the clients’ culture and may demonstrate an appreciation of the cultural relevance of the clients’ narratives while incorporating the family and community, such as faith-based and other organizations. Results empower counselors to be mindful of the collectivistic nature of Guyanese American culture, which causes personal and familial illnesses alike to be perceived as personal problems. Finally, the findings provide a rationale for mental health counselors, school counselors, and counselor educators to inspire dialogue to foster mental wellness. Shainna Ali, PhD, NCC, ACS, LMHC, is the owner of Integrated Counseling Solutions. John J. S. Harrichand, PhD, NCC, ACS, CCMHC, CCTP, LMHC, LPC-S, is an assistant professor at The University of Texas at San Antonio. M. Ann Shillingford, PhD, is an associate professor at the University of Central Florida. Lea Herbert is a doctoral student at the University of Central Florida. Correspondence may be addressed to Shainna Ali, 3222 Corrine Drive, Orlando, FL 32803, hello@drshainna.com.
1 TPC Digest Read full article and references: Ali, S., Harrichand, J. J. S., Shillingford, M. A., & Herbert, L. (2023). A qualitative investigation of Guyanese American perceptions of mental health. The Professional Counselor, 13(1), 1–16. doi: 10.15241/sa.13.1.1 1
2 TPC Digest Read full article and references: Wright, W., Stover, J. H., & Brown-Rice, K. (2023). Understanding racial trauma: Implications for professional counselors. The Professional Counselor, 13(1), 17–26. doi: 10.15241/ww.13.1.17 2 TPC Digest
3 TPC Digest Warren Wright, Jennifer Hatchett Stover, Kathleen Brown-Rice Understanding Racial Trauma 3 TPC Digest lack, Indigenous, and people of color (BIPOC) endure persistent manifestations of racism. The atrocities BIPOC experience impacts their mental health and well-being. Experiencing racism can result in anxiety, depression, lower self-esteem, and chronic diseases. Researchers have coined many names for the traumatic responses to the racism that BIPOC individuals and communities experience: race-based stress, race-based traumatic stress, racism-related stress, and racial trauma. These terms all highlight the underbelly of this persistent trauma as racism. Although racism was just recently declared an official public health issue by the Centers for Disease Control and Prevention, many BIPOC scholars have written about racism and its impact on BIPOC communities since the 1970s. Professional counselors are called to stand in the gap and become agents of change to help BIPOC individuals heal from the effects of racial trauma with appropriate education and training. The mission of the American Counseling Association, as stated in their Code of Ethics, is “to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.” Therefore, understanding the effects of racism on the mental health and well-being of BIPOC requires immediate attention from the counseling profession. The authors of this article provide an overview of racial trauma and its effects, offering strategies and clinical implications for professional counselors in various roles (i.e., counselor educators, practitioners, and supervisors). Thus, we can reimagine humanity by interrupting the violence BIPOC communities frequently experience with culturally appropriate and trauma-informed practices. Healing racial trauma takes an intentional practice informed by frameworks, theories, and modalities that center humanity. Culturally responsive and trauma-informed techniques create space for reflection, wellness, and growth. Additionally, integrating a trauma-informed curriculum in counselor education programs will provide the best education and training to prepare counselors-in-training (CITs) to address concerns related to racial trauma. Therefore, professional counselors should reflect on how to disrupt racial trauma and help reduce trauma exposure from racism in American society. It is both the professional and ethical duty of all professional counselors to provide counseling services within their scope of training. Therefore, professional counselors, educators, and supervisors should seek out training opportunities to increase their knowledge and skills related to racial trauma. Without the proper training of seasoned professional counselors, CITs will not be prepared to address racial trauma when working with BIPOC clients. The counseling profession must build competence in working with clients with racial trauma concerns. Ignoring the call to address racism with BIPOC clients can deepen their wounds and silence their pain. This article is an invitation to do the work and help BIPOC individuals and communities heal. Warren Wright, MEd, NCC, LPC, CCTP, is a doctoral student at Sam Houston State University. Jennifer Hatchett Stover, MA, NCC, LPC, CCTP, CSC, is a doctoral student at Sam Houston State University. Kathleen Brown-Rice, PhD, NCC, ACS, LPC, LCMHC, LCAS, is a professor at Sam Houston State University. Correspondence may be addressed to Warren Wright 1932 Bobby K. Marks Drive, Huntsville, TX 77340, wbw007@shsu.edu. Implications for Professional Counselors B
4 TPC Digest Erin E. Woods, Alexandra Gantt-Howrey, Amber L. Pope “I’m So #OCD” Read full article and references: Woods, E. E., Gantt-Howrey, A., & Pope, A. L. (2023). “I’m so #OCD”: A content analysis of how women portray OCD on TikTok. The Professional Counselor, 13(1), 27–38. doi: 10.15241/eew.13.1.27 Obsessive-compulsive disorder (OCD) is a serious mental health condition often misunderstood by the public and mental health providers. Individuals with this disorder experience recurrent unwanted, intrusive thoughts, urges, or images, also known as obsessions. Obsessions are unpleasant and result in distress, which individuals attempt to reduce or negate through repetitive mental or behavioral actions called compulsions. This disorder, which occurs slightly more frequently in women, can cause significant impairment. Despite the seriousness of the disorder, OCD has become a commonly used term to describe someone who likes things organized, clean, or just so. The use of this clinical term to describe preferences or cleaning habits is reductive and can minimize the experience of individuals living with this disorder. Social media has the power to spread information to large groups of people quickly. If the information presented is accurate, it can facilitate education, understanding, and advocacy. If the information is inaccurate, it can perpetuate stigma and misunderstanding. It is not uncommon to see or hear individuals referring to themselves as “OCD,” especially on social media. In this study, we conducted a critical content analysis of 50 TikTok videos with the tag #OCD to better understand how women portray OCD on social media. We found two main themes—minimizes OCD symptoms and accurately depicts OCD symptoms. Within the first group, many videos fit into the subtheme uses OCD as a synonym for cleanliness and organization. The second theme included two subthemes, corrects misunderstanding and shares obsessive fears. These themes illuminate the need for increased education and advocacy concerning OCD in the realm of counseling, as well as in the public sphere. Implications for mental health counselors are discussed and include practice efforts by counselors and consideration of counselor training issues. For example, counselors can seek continuing education on OCD and make specific efforts to become aware of and address the biases and stigmatizing views they may hold. Similarly, to assist in these efforts, counselor educators can broach discussions concerning OCD and its portrayal on social media in the counseling classroom, connecting such discussions to diagnostic criteria. Implications from study findings also include the need for advocacy that addresses the importance of public education in decreasing stigma. Counselors may consider how their own use of social media can serve to decrease the stigmatization of OCD, and in future studies, researchers may explore how OCD is portrayed on other social media platforms and how social media may serve as a source of support for those diagnosed with OCD. Erin E. Woods, PhD, LPC, serves as Clinic Director at the College of William & Mary. Alexandra Gantt-Howrey, PhD, NCC, is an assistant professor at New Mexico State University. Amber L. Pope, PhD, LPC, LMHC, CCTP, is an assistant professor at the College of William & Mary. Correspondence may be addressed to Alexandra Gantt-Howrey, P.O. Box 30001, MSC 3AC, Las Cruces, New Mexico 88003, aghowrey@nmsu.edu. A Content Analysis of How Women Portray OCD on TikTok
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6 TPC Digest Read full article and references: Brown-Smythe, C., & Sultana, S. (2023). Examining social self-efficacy as a mediator for insecure attachment and loneliness. The Professional Counselor, 13(1), 39–54. doi: 10.15241/cbs.13.1.39 6 TPC Digest
7 TPC Digest Loneliness is endemic across the life span. This is important for college counselors given the transitional challenges and developmental issues that predispose the typical college-age student to experience loneliness. The issue of loneliness is further compounded by the social isolation and remote learning due to COVID-19 that impacted traditional social interaction and relationship building for students. Life is about connections and relationships. These are informed by our early experiences with caregivers. Through these early interactions, we develop attachment patterns; some develop secure attachments and others develop insecure attachments. These attachment patterns set the blueprint for how we interact and build and maintain relationships in later life. Individuals with secure attachment styles have prosocial skills and social competency to initiate, build, and maintain close relationships, while those with insecure attachment styles struggle in relationships, predisposing them to experience loneliness. Insecure attachment falls into two groups—anxious attachment or avoidant attachment. Those with anxious attachment tend to be fearful of rejection and of being abandoned, and as a result, they are not trusting of others. Those with an avoidant attachment style have a fear of intimacy and being dependent and view themselves in a negative light. Both sets of individuals are said to possess low social self-efficacy. They display maladaptive interpersonal behaviors resulting in dissatisfaction with relationships, which leads to increased feelings of loneliness. This research explored the relationship between social self-efficacy, loneliness, and the two insecure attachment styles. We examined the extent to which anxiety attachment and avoidant attachment predicted social self-efficacy. We also examined the extent to which social self-efficacy mediated the relationship between loneliness and anxious and avoidant attachment styles. Data was collected over the last 2 months of the fall 2020 semester. This spanned two learning periods, as the college pivoted to online learning after students went home for the Thanksgiving break due to the uptick in the number of COVID-19 cases. A total of 863 college students voluntarily participated in this study. We explored the relationships between anxious attachment, avoidant attachment, and loneliness. Additionally, we examined the extent to which social self-efficacy bolstered the anxious and avoidant attachment styles and reduced feelings of loneliness. The study found that individuals with high avoidant attachment or anxious attachment experienced greater degrees of loneliness. We also found that high social self-efficacy explained decreased loneliness in those with both anxious and avoidant attachment. Mediation analysis revealed that loneliness was mediated by social self-efficacy, with high social self-efficacy explaining decreased loneliness in those with avoidant attachment. This was not always the same for those with anxious attachment. Implications for counseling include the need for counselors to broach the subject of loneliness with their college clients and assess for low social self-efficacy, which could contribute to interpersonal difficulties the clients experience. Given the mediation results, counselors can help clients build their social self-efficacy and prosocial skills to enhance their interpersonal confidence. Individual and group counseling interventions can be ways to model how to deal with interpersonal difficulties and teach new skills while promoting clients’ strength and resiliency. Claudette Brown-Smythe, PhD, NCC, ACS, LMHC, CRC, is an assistant professor at SUNY Brockport. Shirin Sultana, PhD, MSS, MSSW, is an assistant professor at SUNY Brockport. Correspondence may be addressed to Claudette Brown-Smythe, 350 New Campus Drive, Brockport, NY 14420, cbrownsm@brockport.edu. Claudette Brown-Smythe, Shirin Sultana Examining Social Self-Efficacy as a Mediator for Insecure Attachment and Loneliness
8 TPC Digest Joshua D. Smith, Neal D. Gray Lifetime Achievement in Counseling Series An Interview With Cherylene McClain Tucker
9 TPC Digest Read full article and references: Smith, J. D., & Gray, N. D. (2023). Lifetime achievement in counseling series: An interview with Cherylene McClain Tucker. The Professional Counselor, 13(1), 55–59. doi: 10.15241/jds.13.1.55 T his is the eighth article in the ongoing Lifetime Achievement in Counseling Series. The purpose of this series is to highlight seminal figures in the profession of counseling and counselor education and their contributions to the profession. We hope that readers will utilize this series to better examine the state of the counseling profession and be encouraged to reflect on current and future challenges presented by the interviewees. The eighth interviewee in this series is Cherylene McClain Tucker, NCC, MAC, LPC, LCDC, who is a Program Supervisor with the Tarrant County Community Supervision and Corrections Department (CSCD) in Fort Worth, Texas. She holds a Bachelor of Science in criminal justice from St. John’s University, and a Master of Arts in professional counseling and marriage and family therapy from Amberton University. Tucker is an active member of several organizations. She is a board member of the Texas Certification Board of Addiction Professionals, and she is a member of the Tarrant County College Mental Health Advisor Committee. Recently, she has been selected to be a mentor with the NBCC Foundation and the Association for Addiction Professionals (NAADAC) Minority Fellowship Program for Addiction Counselors, where she will be mentoring future addiction counselors. Tucker has also received several awards: 2016 Counselor of the Year Award from the local chapter of the Texas Association of Addiction Professionals; 2016 Elves Smith Counselor of the Year Award from the State Board of the Texas Association of Addiction Professionals; and the 2017 Lora Roe Memorial Addiction Counselor of the Year Award from the Association for Addiction Professionals (NAADAC). Prior to her current position, Tucker has worked with the addicted population as a case manager, as an addiction counselor in a hospital setting, and in the criminal justice system as a parole officer. In Tucker’s current position, she is the program supervisor over the day treatment program in an intensive treatment program within adult probation. She currently oversees eight different modalities of treatment that address substance use disorders, mental health issues, and cognitive distortions. Tucker also collaborates with stakeholders in the community to assist probationers to gain autonomy and become pro-social members of their community. Joshua D. Smith, PhD, NCC, LCMHC, is an assistant professor at the University of Mount Olive. Neal D. Gray, PhD, LCMHC-S, is a professor at Lenoir-Rhyne University. Correspondence can be emailed to Joshua Smith at jsmith@umo.edu.
Digest Volume 13, Issue 1 The Professional CounselorTM The Professi onal Counsel or The Professi onal Counsel or PUBLICATION EXCELLENCE Since 2011 TM Spring 2023 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 © 2023 NBCC, Inc. and Affiliates, 3 Terrace Way, Greensboro, NC 27403-3660
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