Sep 5, 2014 | Article, Volume 1 - Issue 2
Michelle Perepiczka, Nichelle Chandler, Michael Becerra
Statistics plays an integral role in graduate programs. However, numerous intra- and interpersonal factors may lead to successful completion of needed coursework in this area. The authors examined the extent of the relationship between self-efficacy to learn statistics and statistics anxiety, attitude towards statistics, and social support of 166 graduate students enrolled in master’s and doctoral programs within colleges of education. Results indicated that statistics anxiety and attitude towards statistics were statistically significant predictors of self-efficacy to learn statistics, yet social support was not a statistically significant predictor of self-efficacy. Insight into how this population responds to statistics courses and implications for educators as well as students are presented.
Keywords: graduate students, statistics, anxiety, self-efficacy, attitudes, social support
More graduate programs in various social science fields are requiring students to complete research methods including statistics courses or a blended combination thereof (Davis, 2003; Schau, Stevens, Dauphinee, & Del Vecchio, 1995). These course requirements pose a dilemma for educators and students because many students perceive statistics as difficult and unpleasant (Berk & Nanda, 1998). Some students can struggle in statistics courses as a related complication of this perception as well as other intrapersonal factors related to the course.
To investigate graduate students’ experiences in statistics courses, researchers studied different avenues to understand what occurs with students so steps can be taken to improve learning as well as satisfaction in college statistics courses. For instance, researchers suggested non-cognitive factors such as motivation for further learning (Gal & Ginsburg, 1994; Finney & Schraw, 2003), statistics self-efficacy (Onwuegbuzie & Wilson, 2003), and attitude toward statistics (Araki & Schultz, 1995; Elmore, Lewis, & Bay, 1993; Waters, Martelli, Zakrajsek & Popovich, 1988; Wise, 1985) should be assessed and addressed with students. Finney and Schraw theorized that the difficulty students experience with statistics is not necessarily due to lack of intelligence or poor aptitude, but may be a result of the above mentioned factors. Bonilla (1997), Cohen and McKay (1984), and Solberg and Villarreal (1997) hypothesized that social support may act as a buffer against the development of these psychological manifestations.
The purpose of this study was to examine the various factors that have been introduced in previous research in one comprehensive study. The goal was to determine how graduate student self-efficacy to learn statistics is predicted by statistics anxiety, attitude toward statistics, and social support (Gall, Gall, & Borg, 2007). The overarching intent was to document graduate student self-efficacy to learn statistics and identify how certain variables influence statistics self-efficacy (Pan & Tang, 2005).
Self-Efficacy to Learn Statistics
In order to understand the implications of this research, an explanation of the key variables found in the literature review must first be discussed. Self-efficacy to learn statistics is the dependent variable in this study. Bandura (1977) originally defined general self-efficacy as one’s judgments of his or her capabilities to organize and carry out courses of action required to attain specific types of performances. Bandura asserted that self-efficacy beliefs are manifested from four primary sources, which include the following: (a) personal accomplishments, (b) vicarious learning experiences, (c) verbal persuasion, and (d) emotional arousal. These primary sources lay the foundation for building the concept of self-efficacy to learn statistics. Finney and Schraw (2003) defined self-efficacy to learn statistics and developed an assessment to measure this phenomenon. Self-efficacy to learn statistics is an individual’s confidence in his or her ability to successfully learn statistical skills necessary in a statistics course.
A large amount of information is available on self-efficacy related to academic performance (Lent, Brown, & Larkin, 1984, 1986; Pajares, 1996; Pajares & Miller, 1995; Zimmerman, 2000; Zimmerman, Bandura, & Martin-Pons, 1992). However, little is known specifically about self-efficacy to learn statistics. Finney and Schraw (2003) investigated whether self-efficacy to learn statistics is related to performance in a statistics course and whether self-efficacy to learn statistics increased during a 12-week introductory statistics course. One hundred and three undergraduate students from a large Midwestern university participated in the survey. Finney and Schraw reported a positive relationship between statistics self-efficacy and academic performance as well as an increase in self-efficacy to learn statistics over the duration of the course. Onwuegbuzie (2000) also reported students with the lowest levels of perceived competence had the highest levels of statistics anxiety. Additionally, Pajares and Miller (1995) documented an inverse relationship between self-efficacy and math anxiety.
Statistics Anxiety
Statistics anxiety is one of the three independent variables in this study. Researchers have documented a large amount of information on statistics anxiety over the years. For instance, there are multiple definitions of statistics anxiety available in the literature. Onwuegbuzie, DaRos, and Ryan (1997) defined statistics anxiety as “a state-anxiety reaction to any situation in which a student is confronted with statistics in any form and at any time” (p. 28). Cruise, Cash, and Bolton (1985) defined statistics anxiety as “the feelings of anxiety encountered when taking a statistics course or doing statistical analyses: that is, gathering, processing, and interpret[ing]” (p. 92). The latter is the definition utilized for this study.
We know that instructors of research and statistics courses often encounter students with high levels of statistics anxiety upon their arrival to class (Perney & Ravid, 1991). According to Onwuegbuzie, Slate, Paterson, Watson, and Schwartz (2000), 75% to 80% of graduate students in the social sciences appeared to experience high levels of statistics anxiety. Statistics anxiety was found to be higher among female and minority graduate students in comparison to their male and Caucasian counterparts (Onwuegbuzie, 1999; Zeidner, 1991).
Researchers identified three categories of variables—situational, dispositional, and environmental—that are related to statistics anxiety (Onwuegbuzie & Wilson, 2003). Situational antecedents are factors that surround the student, including previous statistics experiences (Sutarso, 1992). Researchers found a negative connection between the number of completed mathematics courses and statistics anxiety (Auzmendi, 1991; Robert & Saxe, 1982; Zeidner, 1991). Forte (1995) found minimal previous math experience, late introduction to quantitative analysis, anti-quantitative bias, lack of appropriation for the significance of analytical models, and lack of mental imagery were factors contributing to statistics anxiety among social work students.
Dispositional antecedents are intrapersonal factors students bring to the classroom (Onwuegbuzie & Daly, 1999), which includes issues such as perfectionism and perception of abilities at developmental stages in life (Pan & Tang, 2004). Walsh and Ugumba-Agwunobi (2002) found evaluation concern, fear of failure, and perfectionism provoked statistics anxiety. Environmental antecedents are interpersonal factors related to the classroom experience (Onwuegbuzie & Daly, 1999), which can include the student’s experiences with the professor. Tomazie and Katz (1988) reported previous experiences in statistics courses have influenced learning in a current course. Moreover, the environmental antecedent has the least research available in the literature.
Attitude Toward Statistics
Attitude toward statistics is the second independent variable in this study. Attitude towards statistics is defined in this study as a combination of a students’ attitude toward the use of statistics in their field of study and the students’ attitudes towards the statistics course (Cashin & Elmore, 1997; Wise, 1985). Researchers explored this area; however, there are many gaps left to fulfill. Gal and Gingsburg (1994) reported students often enter statistics courses with negative views or later develop negative feelings regarding the subject matter of statistics. Researchers found no statistically significant differences among females’ and males’ attitudes towards statistics (Araki & Schultz, 1995; Cashin & Elmore, 2005; Harvey, Plake, & Wise, 1985). However, conflictingly, Waters et al. (1988) and Roberts and Saxe (1982) found male students had more positive attitudes towards statistics than female students.
According to Perney and Ravid (1991), statistics courses are viewed by most college students as a road block to obtaining their degree. Students often delay taking their statistic courses until the end of their program. Researchers found students’ negative attitudes toward statistics is an influencing factor in low student performance in statistics courses (Araki & Schultz, 1995; Elmore et al., 1993; Harvey et al., 1985; Schulz & Koshino, 1998; Robert & Saxe, 1982; Waters et al., 1988; Wise, 1985).
Perceived Social Support
Perceived social support is the final independent variable in this study. Perceived social support for this study is defined as the level of support an individual self identifies as received from friends, family, and significant others (Zimet, Dahlem, Zimet, & Farley, 1988). This variable is influential in this study in terms of the potential buffering effect it may have on the other independent variables, statistics anxiety and attitude towards statistics.
According to Bonilla (1997), social support acts as a buffer to dysfunctional thoughts or attitudes. In 1985, Cohen and Wills investigated the process through which social support has a beneficial effect on well-being. The buffering model maintains that support is related to well-being primarily for persons under stress. Cohen and Wills identified four support resources, which include the following: (a) esteem support such as the person is valued and accepted, (b) informational support, (c) social companionship such as engaging in leisurely activities with others, and (d) instrumental support such as an individual providing a person with financial aid, material resources, or need-based services.
Solberg and Villarreal (1997) conducted a study to explore the interactions between social support and physical as well as psychological distress of Latino college students. The authors reported social support moderated the distress. Specifically, the Latino students who believed social support was available had lower psychological distress than students who believed that social support was less accessible.
Research Questions
Six research questions were included in this study. The first four focus on descriptive information from our sample and include the following: (a) what is the graduate student self-efficacy level, (b) what is the graduate student statistics anxiety level, (c) what is the graduate student attitude toward statistics, and (d) what is the graduate student level of perceived social support? The predominate research question driving this study is, what is the extent of the relationship, if any, between graduate students’ self-efficacy to learn statistics and statistics anxiety, attitude towards statistics, and social support? A supplemental research question was, what is the influence of social support on statistics anxiety and attitude towards statistics?
Method
Participants
Participants were recruited by the researcher emailing faculty members of doctoral and master’s programs within colleges of education at 250 universities within the United States. The faculty members were asked to forward information about the opportunity to participate in the study to their students. One hundred sixty-six graduate students within colleges of education representing 27 states fully completed the online survey within the 8-week data collection timeframe. An a priori power analysis was conducted considering involvement of three predictors in the multiple regression equation and estimating a moderate effect size based on similar studies. It was determined that 119 participants are needed to achieve adequate power in the study (Faul, 2006); thus, an appropriate sample size was achieved to obtain adequate power in the analysis (Gall et al., 2007).
The sample was predominately female (N = 136, 81.9%) compared to males (N = 30, 18.1%). Participants’ age ranged from 21 to 71 with 34.4 as the mean age. The cultural makeup of the sample consisted of 4 Native American (2.4%), 4 Asian/Pacific Islander (2.4%), 24 African American (14.5%), 124 Caucasian (74.7%), and 10 Latino participants (6%).
The academic level of the participants was close to evenly split with 92 master’s students (55.4%) and 74 doctoral students (44.5%). The majority of the sample (N = 144, 86.7%) were enrolled in counseling or related educational programs such as mental health counseling, school counseling, rehabilitation counseling, student affairs, and counselor education and supervision. Twenty-two (13.3%) participants were enrolled in education graduate programs such as educational leadership, curriculum and instruction, and educational technology. One hundred thirty-six participants (81.9%) were enrolled in programs that were accredited by at least one accreditation body appropriate to their program.
Participants had different backgrounds in terms of taking statistics courses. The mean number of completed graduate statistics classes at the time of participating in the study was 1.63 classes for the sample. The range of courses was 0 to 6, and the mode was 0 classes with 45 participants (27.1%) not having completed a single graduate level statistics course. Of the 121 who completed a statistics course previously, the mean final grade was 89.34% with the lowest grade earned reported as 70%.
Instruments
A demographic questionnaire was used to collect information related to participants’ personal characteristics as well as previous experiences with graduate statistics classes. The Self-Efficacy to Learn Statistics (SELS) scale was used to measure the dependent variable (Finney & Schraw, 2003). The SELS measures confidence in one’s ability to learn necessary statistics while in a statistics course in order to successfully complete 14 specific tasks using a 1 (no confidence at all) to a 6 (complete confidence) response scale. Only a total score is obtained from the instrument. Internal consistency reliability was reported as .975 Cronbach’s alpha. Validity evidence of SELS to other variables was reported. The SELS was positively correlated with the Math Self-Efficacy scale and negatively correlated to the general and statistics Test Anxiety Inventory subscale providing evidence of concurrent validity. The norm group for the instrument was a total of 154 college students enrolled in an introductory statistical methods course.
The Statistics Anxiety Rating Scale (STAR) was used to measure the independent variable statistics anxiety (Baloglu, 2002; Cruise &Wilkins, 1980). The assessment is a 51-item Likert scale ranging from 1 (no anxiety) to 5 (very much anxiety) and measures anxiety in two parts. The first part includes 23 statements related to statistics anxiety and the second part has 28 items related to dealing with statistics. A total score as well as six subscores including the following are generated with this instrument: Worth of Statistics, Interpretation Anxiety, Test and Class Anxiety, Computation Self-Concept, Fear of Asking for Help, and Fear of Statistics Teacher. Reliability for each of the subscales ranged between .68 to .94 with a median of .88 (Worth of Statistics .94, Interpretation Anxiety .87, Test and Class Anxiety .69, Computational Self-Concept .88, Fear of Asking for Help .89, and Fear of Statistics Teachers .80). Validity evidence of STARS to other variables was reported. The STARS had a strong correlation (r = .76) to the Math Anxiety Scale (Roberts & Bilderback, 1980). The instrument was normed with 1,150 university students enrolled in statistics courses.
The independent variable, attitude toward statistics, was measured by the Attitude Toward Statistics (ATS) scale (Schultz & Koshino, 1998). This is a 29 item, 5-point Likert scale ranging from strongly disagree to strongly agree. A total score and two subscale scores, Attitudes Toward the Field and Attitudes Toward the Course, are obtained from the instrument. Both subscales were reported as reliable with Cronbach’s alpha at .92 for Attitudes Toward the Field and .91 for Attitudes Toward the Course (Wise, 1985). The ATS was reported to have strong concurrent validity with the Statistics Attitude Survey. The norm group consisted of 162 university students enrolled in an introductory educational statistics course.
The third independent variable, social support, was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet, Powell, Farley, Werkman, & Berkoff, 1990). The instrument has 12 items and utilized a 7-point Likert scale ranging from very strongly disagree to very strongly agree. A total score and three subscale scores (support from significant others, support from family, and support from friends) were obtained. The instrument was reported as reliable with Cronbach’s alpha coefficients reported as .85 to .91 for the three subscales. Test-retest values ranges from .72 to .85. Zimet et al. reported significant correlations between the MSPSS subscales and the Depression and Anxiety subscales of the Hopkins Symptom Checklist as evidence of construct validity for their instrument. The norm group consisted for 275 university students at Duke University.
Data Analysis
A simultaneous multiple regression was analyzed to determine the extent of the relationship between graduate students’ self-efficacy to learn statistics and statistics anxiety, attitude towards statistics, and social support. Alpha level was set at .05 for the analysis and semipartial correlation coefficients were assessed for practical significance. The multiple regression was repeated, removing social support from the analysis to explore any moderating effects of social support on the model.
Results
Descriptive statistics of the sample data are displayed in Table 1 and sample scores for the assessments with a comparison to the maximum and minimum scores for the instruments are included in Table 2. Self-efficacy to learn statistics scores were normally distributed (SW(173) = .986, p = .076) and the box plot for the criterion variable confirmed normality as well. Standardized residuals also were normally distributed (SW(173) = .988, p = .159) and the box plot for the standardized residuals and scatterplots confirmed normality of the error variance or homoscedasticity. Scatterplots were analyzed for linearity, and it was determined no curvilinear relationships between the criterion variable and predictor variables were evident. Statistics anxiety and attitude towards statistics were highly correlated (-0.83), indicating multicollinearity.
There was a statistically significant relationship between self-efficacy to learn statistics and statistics anxiety, attitude towards statistics, and social support: F(3, 162) = 60.489, p < .001. A moderate effect size was noted with 52.8% of the variance accounted for in the model, R2 = .528. Statistics anxiety and attitude towards statistics were statistically significant predictors of self-efficacy to learn statistics and accounted for 3% and 7% of the variance, respectively. Social support was not a statistically significant predictor of self-efficacy to learn statistics and accounted for .1% of the variance. When social support was removed from the analysis, there was no change in statistical or practical significance.
Discussion
This study sought to explore the relationships of graduate students’ self-efficacy to learn statistics, statistical anxiety, attitudes towards statistics, and social support. The scores from the various instruments identifying each of the aforementioned variables produced both negative and positive correlations among each other. A statistically significant relationship was found among self-efficacy and statistical anxiety, attitudes towards statistics and social support indicating the importance of the graduate students’ belief in their competence of facing the challenges of learning statistics. However, there was no change in the relationship when social support was removed from the analysis; thus, it was not a contributing variable. Statistics self-efficacy scores from participants indicated moderate responses which mirrored the prior studies involving undergraduate students (Pajares, 1996; Zimmerman, 2000). As this was the first study that investigated graduate students, these results create a path for future research.
There was a negative correlation between self-efficacy to learn statistics and statistical anxiety of the graduate students. The negative correlation is consistent with Onwuegbuzie’s (2000) findings. Participants reported the lowest responses in the Fear of Asking for Help and Worth of Statistics subscales, signaling graduate students reluctance for asking for assistance from the professor and peers as well as a low belief in the applicability and purpose of statistics. Overall, these results and the negative correlation between self-efficacy and anxiety seem to depict a kind of self-fulfilling prophecy that graduate students assume when faced with taking statistics which is similar to Perney and Ravid’s (1991) report.
A positive correlation was found between self-efficacy to learn statistics and attitudes towards statistics. This results indicated that the better the attitude of the graduate students towards statistics, the higher self-efficacy beliefs to learn the subject. Results indicated a more moderate response to attitudes not found in other studies where students were coming in with a negative attitude or were developing negative attitudes towards the end of the course (Gal & Gingsburg, 1994). It may be considered that graduate students in this study were neutral in their attitudes towards learning statistics without extreme reactions.
Participants reported a high level of social support, which indicates that most of the graduate students believed they had adequate support. The sample perceived social support as an influential factor in their lives, which is similar to most college student population reports (Solberg & Villarreal, 1997). However, social support was not a statistically significant predictor of self-efficacy to learn statistics. Also, when this variable was removed from the multiple regression analysis, there was no statistical or practical change in the regression. The insignificant result implies that social support was present for students, but it did not interact as a buffer between variables and possibly decrease anxiety or increase positive attitudes as indicated by Bonilla (1997), Cohen and McKay (1984), and Solberg and Villarreal (1997). Thus, social support may possibly help one cope but not necessarily remove the problem, change attitudes, or change thinking.
Multicollinearity between statistics anxiety and attitude toward statistics suggests an interrelationship between the two variables (Gall et al., 2007). Both variables may be measuring the relatively same characteristic; thus, neither variable may have brought something completely new to the analysis. It is interesting to note that statistics anxiety and attitude toward statistics as measured by the instruments in this particular study may be focusing on the same phenomenon.
Significance
There were multiple benefits of this study. First, this study contributed to counselor education and student support services by increasing our knowledge of self-efficacy to learn statistics as experienced by graduate students. It also is significant because it documented students’ experiences, which may act as a spring board for (a) future research, (b) implementing support interventions to increase statistics self-efficacy or success in statistics courses, and (c) helping students prepare for intrapersonal challenges that might impact their success in statistics. Each of these improvements are beneficial because they may increase graduate student self-efficacy and success in statistics courses as well as increase the incorporation of statistics into professional work after graduation.
Recommendations for Counselor Educators
Decreasing anxiety among graduate students is vital to developing high levels of self-efficacy towards statistics. Implementing numerous opportunities for students to engage in research throughout their graduate studies allows for opportunities to be exposed to statistics, thus increasing students’ confidence when faced with taking a statistics course. Also, inserting research and statistics into the curriculum of every graduate course exposes graduate students to the terminology and the function statistics play in their development as professionals. Possible ways to decrease statistical anxiety are through language and experience. Allowing graduate students to learn what is being said in a statistics course through weekly vocabulary tests can be one example of decreasing their anxiety. Also, getting the students involved with their own research throughout their course of study will help in promoting statistics mastery.
Improving attitudes towards statistics can help graduate students reframe their negative views towards the course. Helping graduate students to choose a positive view, explore origins or core of negative attitudes, and to appreciate the usefulness of statistics in their profession are good starting points for developing salient attitudes towards the subject. Counselor educators in a position to help graduate students confront negative attitudes, model positive attitudes and enthusiasm for statistics, and place a high value on statistics through verbal support and high expectations of research and statistics for students in graduate programs. The professor teaching statistics can play a key role in positively impacting their students’ attitude toward the subject. Injecting humor, displaying empathy, providing a safe space for students to talk about their challenges, and celebrating their small successes can be tools in combating negative attitudes. Anecdotal stories of statistics professors engaging in statistical rap songs have been reported to successfully alleviate attitudes towards the subject as well as provide a positive environment to engage in learning.
Limitations of the Study
There were limitations to this study. For instance, graduate students in counseling and education related programs were recruited for the study; thus, due to the general nature of the population, there were a disproportionate number of females and Caucasian students in the sample. As a result, a diverse sample was not obtained. However, a representative sample was acquired. Also, there were four scales for participants to answer in the study, therefore putting a time constraint burden on students to finish the instruments. Finally, these instruments were self-reporting, which can promote bias in how the graduate students answered (Gall et al., 2007).
Suggestions for Future Research
Future research should expand investigations into statistics self-efficacy predictor variables that include number of statistics courses taken, previous statistics experience, and broad demographics of graduate students to include more participants representing the various races and ethnicities, marital status, and life experiences. Longitudinal studies to monitor how statistics self-efficacy changes for graduate students over time would provide a snapshot of the development of attitudes throughout their graduate study tenure. Experimental designs to assess classroom and counseling based intervention effectiveness in reducing anxiety and improving attitudes should be conducted to improve the reliability of students learning statistics and influence the participation of conducting their own research for the betterment of the counseling profession. Finally, qualitative studies need to be conducted to better capture students’ experiences in statistics classes.
Conclusion
Researching predictors of graduate students’ statistical self-efficacy beliefs is important to identifying possible barriers to professional growth and development. Exploring how statistical self-efficacy beliefs relate to predicting future academic expectations, performance, effort, persistence, and course selection (Pajares, 1996; Zimmerman, 2000) also is important to explore as a means of promoting professional development (Lent et al., 1984, 1986).
Graduate students who believed they were incapable of achieving success in a statistics course demonstrated higher levels of anxiety (Onwuegbuzie, 2000). This anxiety was pervasive among the 75% to 80% of graduate students in the social sciences profession in previous research studies (Onwuegbuzie et al., 2000), as well as to the 53% of the graduate students in this study. Additionally, graduate students hold off from taking a statistics course due to their negative attitudes towards the subject matter (Gal & Gingsburg, 1994). Teaching graduate students how to reduce their anxiety and improve their attitude will likely enhance their value of statistics and further encourage their professional development in the counseling profession.
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Michelle Perepiczka, NCC, and Nichelle Chandler, NCC, are professors at Walden University. Michael Becerra, NCC, is an Assistant Professor at the University of Alabama. Correspondence can be addressed to Michelle Perepiczka, Walden University, School of Social Work and Human Services, 100 Washington Avenue South, Suite 900, Minneapolis, MN, 55401,
mperepiczka@gmail.com.
Sep 5, 2014 | Article, Volume 1 - Issue 1
Lisa Camposano
Despite increasing awareness, the childhood disorder of selective mutism is under-researched and commonly misdiagnosed. The purpose of this article is to highlight current issues related to this disorder as well as describe various treatment approaches including behavioral, cognitive-behavioral, psychodynamic, family, and pharmacological interventions. Suggestions for counselors working with children with selective mutism and implications for future research are offered.
Keywords: selective mutism, childhood disorder, children, etiology, treatment approaches
Although early references occurred 125 years ago, very little has been written about selective mutism (Steinhausen, Wachter, Laimbock, & Metzke, 2006). This disorder remained relatively obscure until 2006 when Newsday published an article entitled “Behind a Wall of Silence” that described an eight year-old girl’s struggle with speaking at school. Selective mutism appeared in the news again the following year when it was revealed that Seung-Hui Cho, the shooter in the Virginia Tech massacre, was diagnosed with selective mutism as an adolescent (Kearney & Vecchio, 2007). Despite media coverage and growing public awareness, little research is being dedicated to examining this unique condition.
The lack of quality research and general awareness of selective mutism are serious barriers to helping children who suffer from this disorder. Too often, these children are misdiagnosed or labeled as “just shy.” Schwartz, Freedy, and Sheridan (2006) surveyed 27 parents having a total of 33 children with selective mutism. Their survey revealed that primary care physicians either misdiagnosed or never referred about 70% of these children. The authors explained: “Selective mutism has largely gone unnoticed by most physicians who are not familiar with the key signs and symptoms. Pediatricians commonly assume that the patient with selective mutism is simply exhibiting excessive shyness and reassure the parents that it is something the child will outgrow” (pp. 43–44). Within the same group of survey participants, an accurate diagnosis did not occur until an average of nearly a year after the parents expressed concerns to a medical doctor (Schwartz et al., 2006). Within school settings, labels such as autistic, language delayed, defiant, or learning disabled saddle such children with inappropriate or ineffective interventions. In many circumstances, parents simply wait for the child to “outgrow” this disorder, not realizing that the absence of proper treatment can lead to lifelong psychological problems (Shipon-Blum, 2007).
The purpose of this article is to increase awareness about selective mutism as well as provide an overview of current issues associated with this disorder. Major themes related to etiology and current trends in treatment will be addressed. The importance of early intervention and participation of family members and school personnel in the treatment process will be stressed. This article will conclude with suggestions for future research, the counseling profession, and counselor training.
Definition of Selective Mutism and Prevalence
Selective mutism is described as “persistent failure to speak in specific social situations (e.g., school, with playmates) where speaking is expected, despite speaking in other situations” (American Psychiatric Association, 2000, p. 125). Children with selective mutism often engage, interact, and communicate verbally within comfortable surroundings, such as at home or with trusted peers. These children are capable of speaking and understand their native language. However, when placed in structured social settings such as school, they are mute and socially withdrawn (American Psychiatric Association, 2000).
Social skills among children affected by selective mutism vary greatly (Amir, 2005). These children are usually unable to verbally communicate when approached by an adult, yet social interaction among peers can vary. Some children interact easily with peers in and outside of the home. Other children interact with peers, but do not verbally communicate with them. A third group remains completely withdrawn in social settings (Amir, 2005). Aside from verbal communication, many children with selective mutism are inhibited in other ways as well (McHolm, Cunningham, & Vanier, 2005). Avoidance of eye contact, lack of smiling, tantrums, blushing, and fidgeting are common symptoms associated with selective mutism (Dummit et al., 1997; Kristensen, 2001; Shipon-Blum, 2007).
Recent studies suggest that selective mutism may occur in .7 to 2% of early elementary students, although many researchers agree that these prevalence rates may be underrepresented due to the lack of knowledge of the disorder (Cunningham, McHolm, & Boyle, 2006; Lescano, 2008; Schwartz et al., 2006; Sharkey, McNicholas, Barry, Begley, & Ahern, 2007). Most investigators report that selective mutism seems to occur more frequently among girls (Cohan, Chavira, & Stein, 2006; Dummit et al, 1997; Lescano, 2008; Mendlowitz & Monga, 2007; Sharkey et al., 2007; Steinhausen & Juzi, 1996). Symptoms of selective mutism are usually present by the age of three, but this disorder is frequently not identified until the child enters school where there is an increased expectation to speak within social settings (Cunningham, McHolm, & Boyle, 2006; Sharkey & McNicholas, 2008). Entrance into the school environment appears to be a salient and definitive landmark for children with selective mutism.
Etiology
There is little consensus regarding the etiology of selective mutism. Psychoanalysts have cited unresolved internal conflicts as the cause of selective mutism (Cohen et al., 2006). Family systems theorists argue that children with selective mutism are part of faulty family relationships (Anstendig, 1998). Kratochwill (1981) states that behavioral therapists “have perceived mute behavior as a function of antecedent and consequent environmental events that vary across situation, people, and time” (p. 137). Early theorists argued that trauma or major life events, such as abuse or the death of a loved one, trigger the onset of selective mutism (Dow, Sonies, Scheib, Moss, & Leonard, 1995). However, according to more recent studies, children who have experienced trauma are not more likely to develop selective mutism, and early childhood trauma is rarely associated with the development of the disorder (Gray et al., 2002; Steinhausen & Juzi, 1996). In fact, Dummit et al. (1997) found no evidence of trauma among their case study participants. Therefore, isolating a single cause or traumatic event does not appear to be helpful in identifying selective mutism, thereby confusing diagnostic attempts.
Current conceptualizations of selective mutism link the disorder to anxiety, namely social phobia (Cunningham et al., 2006; McHolm et al., 2005; Sharkey & McNicholas, 2008). This particular phobia prohibits children from interacting and communicating within social settings, such as school and birthday parties. McHolm et al. (2005) explain that just as a young child can develop a fear of spiders or heights, for example, children with selective mutism have developed a fear of talking that is further crippled by anxiety.
Research has shown that anxiety disorders generally run in families. With regard to selective mutism, parents of children who have selective mutism are likely to exhibit signs of moderate to severe anxiety (Kristensen & Torgersen, 2001; Schwartz, Freedy & Sheridan, 2006; Shipon-Blum, 2007). Kristensen and Torgerson (2001) regarded selective mutism as a “family phenomenon” after they examined personality traits of parents of children with selective mutism (p. 652). According to their study, parents of selectively mute children were significantly more likely to have a history of shyness or social anxiety as compared to a control group. In a survey conducted by Schwartz et al. (2006), 33% of the participants reported a family member with social anxiety disorder and 12.1% had a family member with selective mutism. Despite the information obtained from the aforementioned case studies, it remains unclear how genetic and environmental factors affect the development of selective mutism among young children.
There also is mixed evidence concerning the association between developmental delays and selective mutism. In a study of 100 children with selective mutism (Steinhausen & Juzi, 1996), 38% of participants had a history of language delays or disorders. In contrast, other studies report no evidence of developmental delays among the participants (Black & Uhde, 1995). Definitive research in this area is lacking, and the link between developmental factors and selective mutism remains unclear.
Although the exact cause of selective mutism is unknown, researchers generally agree that selective mutism does not fall under the realm of speech/language disorders, communication disorders, defiant behavior, or shyness. In a recent article written by Kearney and Vecchio (2007), the researchers point out that “this disorder is not due to a communication disorder such as stuttering and it is not due to a lack of knowledge or comfort with language” because affected children speak well in certain situations (p. 917). A case study conducted by Schwartz et al. (2006) revealed that a very small percentage of children with this disorder have speech and/or language difficulties. Selective mutism is distinctly dissimilar from shyness due to the severity of anxiety and duration of symptoms. Shyness is not paralyzing like selective mutism and the vast majority of children who suffer from selective mutism do not fully overcome their anxiety without formal intervention (Stanley, n.d.). Finally, selective mutism has been described by some as oppositional; however this assumption implies that mutism is a conscious choice. This viewpoint is clearly disputed by recent research on this disorder (e.g., Cunningham et al., 2006; McHolm et al., 2005; Sharkey & McNicholas, 2008). Anxiety appears to be the most likely culprit at the core of this disorder. There is evidence that family history of anxiety often plays a role in the disorder while speech and language problems, along with willful opposition, do not seem to contribute to the development of selective mutism.
Approaches to Treatment
Because the etiology of selective mutism is unclear, there is much disagreement among researchers regarding effective treatment approaches. Additionally, scarce quality research has been dedicated to examining the effectiveness of individual treatment approaches and interventions. As Sharkey et al. (2007) notes: “Despite the very handicapping nature of this disorder and its negative impact on both short- and long-term functioning in children and adolescents, the evidence for effective treatments is sparse and predominantly in the form of single case reports or small series using a variety of techniques” (p. 539).
Although a systematic approach has not yet been developed, there are some common goals among varying treatment programs. An initial goal of treatment is to lower the child’s anxiety and develop healthy coping mechanisms for dealing with anxiety (Shipon-Blum, 2007). Interventions aimed at achieving this goal include relaxation skills, meditation, and breathing techniques. Increasing self-esteem and confidence in social settings is another integral objective of most treatment programs. The last and most evident goal is to increase verbal communication in social settings. As the final stage in the treatment process, increasing verbal communication may take years as well as long-term therapeutic intervention depending on factors such as the duration of the mutism and severity of symptoms.
Psychodynamic Approach
Early treatment approaches for selective mutism were mainly derived from psychodynamic theories. Interventions and techniques from this realm of therapy seemed to be the best fit as selective mutism was historically viewed as a result of unresolved inner conflicts or traumatic events during early childhood years (Kratochwill, 1981). Psychodynamic theorists describe mutism as a defense mechanism which the child utilizes rather than expressing feelings directly towards a parent, most commonly the mother (Cline & Baldwin, 1994). Through this approach, the primary goal of the counselor is not to directly address the mutism, but rather understand its origin (Cohen et al., 2006). This is accomplished by carefully examining the child’s early psychosexual stages of development as well as the mother-child relationship, then eventually addressing the fears directly with the child (Cline & Baldwin, 1994).
There exists a major pitfall in this type of therapeutic approach. Symptoms of this disorder are deeply rooted in anxiety; therefore, pressure to verbalize thoughts and feelings can overwhelm the child. While expression can be accomplished through nonverbal means such as art therapy, substantial conversation and uninhibited free association are extremely difficult to achieve. It is more likely that the child will become tense and freeze up when placed in the structured setting of the counselor’s office and asked to communicate. Shipon-Blum (2007) explains that psychological approaches are effective only when “all pressure for verbalization is removed and emphasis is [placed] on helping the child relax and open up” (p. 6). When pressure to verbalize is reduced, anxiety decreases and therapeutic interventions can subsequently occur.
In 1963, Browne, Wilson, and Laybourne (as cited in Garcia, Freeman, Francis, Miller, & Leonard, 2004) examined the effectiveness of psychodynamic therapy for selective mutism and concluded that the treatment was costly and commonly yielded a poor outcome. Freeman, Garcia, Miller, Dow, and Leonard (2004) added that there are no major case studies or research to provide evidence that these approaches are successful. While psychotherapy is rarely utilized as a primary mode of treatment for selective mutism today, psychodynamic projective interventions such as play, music, and art therapy are commonly utilized by counselors in conjunction with other treatment approaches. Research has shown that these projective, less verbal interventions have been effective to some degree (Shreeve, 1991; Tatem & DelCampo, 1995).
Play therapy can offer a safe environment in which the counseling relationship is established without placing pressure on the child to speak (Hultquist, 1995). While describing the benefits of using psychotherapy with anxious children, Terr (2008) claims that effective therapy for anxiety disorders such as selective mutism “won’t truly begin until [the spirit of play] is established” (p. 101). Additionally, music therapy can assist children with selective mutism to express their thoughts or feelings via nonverbal means as well as reduce anxiety through musical expression. Amir (2005), the director of a music therapy program at an Israeli university, describes her two-year experience of working with a selectively mute child. She concluded that the therapy sessions encouraged “feelings of safety” and served as “a container and foundation where heavy feelings and emotions [could] be explored” (p. 75). Furthermore, Amir claims that a trained music therapist can interpret music created by the child in order to establish a bridge to the child’s “inner world” (p. 76). Similar to music therapy, art therapy provides a mute child with a nonverbal way to articulate feelings and fears. Cline and Baldwin (1994) noted that art therapy provides a “springboard for verbal communication” (p. 80). While these interventions are not generally used as primary modes of treatment, play, music, and art therapy can improve self-esteem and provide the counselor with an opportunity to build rapport and create a safe, inviting environment for the child.
Behavioral Approach
Researchers from the behavioral perspective view selective mutism as a learned behavior developed as a coping mechanism for anxiety. Therefore, the purpose of treatment is to decrease anxiety and increase verbal communication in settings such as school (Cohan et al., 2006). This approach incorporates practice and reinforcement for speaking in subtle and non-threatening ways. Emphasis is placed on observable behavior rather than early childhood development (McHolm et al., 2005).
Behaviorists rely on various techniques, such as shaping, self-modeling, and contingency management, to increase verbal communication and lower anxiety. Shaping, sometimes referred to as a ritual sound approach, is the procedure in which the counselor reinforces mouth movements and sounds that resemble speech (Mendlowitz & Monga, 2007; Shipon-Blum, 2010). This strategy involves breaking down the target goal of verbal communication into smaller steps in order to minimize anxiety. The exact sequence will vary according to the child, but some steps may include mouthing words, making sounds, whispering, repeating a word the counselor has said, and eventually increasing volume of speech (Cline & Baldwin, 1994; Lescano, 2008).
Another commonly-used strategy to elicit speech is a two-part process known as self-modeling. Using an audio or video recorder, the child speaks and answers questions within a comfortable environment. The tape is then edited to portray the child speaking in settings such as school. The child listens to the tapes repeatedly, often in the company of family members or friends, in order to become accustomed to hearing him/herself speak in these settings (Blum, Kell, & Starr, 1998). A variation of this strategy may include family members who are recorded while asking questions such as those the child might hear in school (Cline & Baldwin, 1994). The child then practices giving oral answers. Case reports (e.g., Kehle & Owen, 1990; Pigott & Gonzales, 1987) have noted successful treatment outcomes after utilizing this strategy with selectively mute clients. This technique is frequently used in many behavioral and eclectic treatment approaches, but Blum, Kell, and Starr (1998) note that taping can increase anxiety and may not be suitable for all clients.
Contingency management refers to the use of positive reinforcement as encouragement for the child to practice verbalizations. As early as the 1930’s, Skinner (1938, 1971, as cited in Neukrug, 2007, p. 101) showed that specific behaviors would be repeated if positive reinforcement were given as soon as the behavior occurred. Contingency management is often used in conjunction with systematic desensitization in which the counselor sets goals of increasing difficulty with corresponding rewards for each leveled task that is completed (Lescano, 2008). This hierarchy of tasks is created with a consideration of locations, activities, and people that affect the child’s comfort level (McHolm et al., 2005). Similar to systematic desensitization, stimulus fading is commonly used to gradually increase the number of people in the room or classroom as the child practices verbalizations. Positive reinforcement often accompanies treatments involving stimulus fading.
While psychodynamic approaches were formally the treatment of choice by many counselors and researchers, behavioral interventions are currently included in most treatment programs for selective mutism. This type of treatment provides a step-by-step approach that can be easily modified to fit the changing needs of the child. Behavioral techniques, such as shaping and self-modeling, are rarely used in isolation so it is difficult to assess the effectiveness of any single strategy. As a complete entity, behavioral treatment has been carefully researched and numerous studies have shown efficacious outcomes of this type of treatment (e.g., Gray et al., 2002; Kehle & Owen, 1990; Lescano, 2008).
Cognitive-Behavioral Approach
While the success of behavioral interventions is rarely disputed, the behavioral approach to therapy does not place emphasis on an individual’s anxious thoughts. Some researchers consider this a major flaw and stress the importance of restructuring thought processes. The cognitive-behavioral approach to treatment, or CBT, is a practical, action-based treatment program that incorporates many of the aforementioned behavioral techniques such as systematic desensitization and stimulus fading. However, CBT is different from behavioral approaches because it has an additional dimension that stresses anxiety management education (Chansky, 2004). Chansky (2004) explains that during CBT, both children and parents develop “a specific set of skills to address the thoughts, physiological responses, and behaviors associated with anxiety” (p. 47). Treatment also requires children to use problem-solving and employ self-talk (McHolm et al., 2005). The ultimate goal of CBT is to help children modify their behavior by assisting them in redirecting their anxious fears and worries in healthy ways (Shipon-Blum, 2007).
Cognitive-behavioral treatment includes several components in addition to behavioral techniques. An important aspect of CBT is assessment. Many early sessions are solely dedicated to identifying factors that contribute to the child’s anxiety (Chansky, 2004). The information obtained in these interviews guides treatment and provides a foundation when planning therapeutic activities. Shipon-Blum (2002), for example, has developed a continuum for ongoing assessment that ranges from non-communicative to initiating verbal communication, with many stages of nonverbal and verbal communication in between. This continuum is used to assess a child’s level of anxiety within different settings as well as to set and modify goals for treatment. Since levels of anxiety are likely to elevate during behavioral interventions, particularly systematic desensitization and stimulus fading, children are taught relaxation skills in order to manage anxiety before applying such techniques (Cohan et al., 2006). These skills may include breathing techniques, muscle relaxation, or story telling (Sharkey & McNicholas, 2008).
Once research linked selective mutism to anxiety, evidence-based CBT interventions that were previously used to treat other anxiety disorders in children and adolescents were commonly incorporated in the treatment of selective mutism (Mendlowitz & Monga, 2007). One of these interventions, cognitive restructuring, has been utilized to call attention to and minimize negative or anxiety-producing automatic thoughts (Chansky, 2004). In its conventional form, this type of intervention requires the client to share and express feelings to the counselor. This clearly presents an obstacle when working with children who are selectively mute and are not comfortable talking in certain situations, such as a counselor’s office (McHolm et al., 2005). If a child can be expressive using nonverbal means, or if a child is comfortable enough to speak to the counselor, cognitive restructuring can assist a child in learning to cope by thinking realistically. It is important to mention that a child’s cognitive development dictates how well this intervention may work. Therefore, this intervention may be most effective with older children having average to above-average intelligence and the ability to think flexibly and in abstract ways. Despite these limitations, cognitive restructuring is an important element in the treatment process for some children.
Cognitive-behavioral treatment has gained attention from researchers of this disorder. Recent case studies and reviews (e.g., Cohan et al., 2006; Mendlowitz & Monga, 2007; Schwartz et al., 2006; Woodcock, Milic, & Johnson, 2007) have demonstrated the success of CBT in treating children suffering from selective mutism. Additionally, the safe nature of this type of treatment along with its high success rates, make it popular. Perhaps its most significant drawback is the amount of time and patience required of the counselor. Mendlowitz and Monga (2007) estimated that children suffering from selective mutism require five to six times more CBT intervention sessions than children suffering from generalized anxiety or separation anxiety.
Pharmacological Approach
Sometimes a child’s symptoms are so debilitating that fully engaging in a counseling treatment program seems challenging. In such cases, researchers may initially utilize pharmacological interventions to assist the child in overcoming anxiety associated with the disorder so that other treatments can subsequently occur. This type of intervention may include selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs) (Kearney & Vecchio, 2007). While pharmacotherapy is not generally recommended as the primary treatment, the use of medication can often facilitate CBT or other interventions (Kumpulainen, 2002). Once anxiety levels have been reduced via medication, verbal communication may become less challenging for the child.
The effectiveness of pharmacological interventions is perhaps one of the most widely debated issues related to this disorder. Shipon-Blum (2007) deems a combination of behavioral techniques and medication the best approach to treating selective mutism, while Black and Uhde (1995) noted that the differences between pharmacologically treated and non-treated groups were mostly insignificant. Kumpulainen (2002) reported that pharmacological interventions could be helpful when treating selectively mute children, but also warns that medication should be used in conjunction with other therapy modalities only when they are not independently successful. It is important to note that the short- and long-term effects of pharmacotherapy remain unclear. While Kumpulainen (2002) reported that participants seldom reported any harmful effects of the medication, Kearney and Vecchio (2007) admit that there are no large-scale studies of pharmacotherapy for selective mutism.
Family Counseling/Therapy
Family counseling or therapy is often a necessary component of an effective treatment plan for children with selective mutism. Meyers (1984) noted dysfunction within the families of children with selective mutism. Other studies have cited higher rates of marital conflict and divorce among families of children with selective mutism when compared to controls (Viana, Beidel, & Rabian, 2009). Researchers from the family systems perspective have hypothesized that a child’s mutism serves a certain function within the family (Anstendig, 1998). Therefore, it may be beneficial for all members of the family to participate in counseling in order to resolve underlying family issues that may have maintained the mutism. In general, the goal of family intervention in relation to selective mutism is to identify faulty family relationships and communication patterns that may have contributed to the development of the child’s anxiety. The counselor would subsequently aim to help family members remove conditions that are causing the child’s anxiety and maintaining the mutism (Cohan et al., 2006).
While research concerning the effectiveness of family counseling is scarce, it is evident that the cooperation and participation of parents in the treatment has a positive impact on recovery (e.g., Kumpulainen, 2002; Mendlowitz & Monga, 2007; Sharkey et al., 2007). In fact, Sharkey and McNicholas (2008) deemed parental involvement as the “key ingredient in treatment success” (p. 544). Acceptance and understanding of the disorder is crucial, and parents should not place emphasis on the lack of verbal communication. Shipon-Blum (2007) emphasizes the importance of parent participation during the treatment process: “Praise should be given for the child’s accomplishments and efforts, and support and acknowledgement should be given for their difficulties and frustrations” (p. 5). Treatment programs often require parents to modify their parenting styles as well as develop healthy coping skills for handling stress and fear. Anxiety management education is often integrated with treatment so that parents are equipped to model healthy coping abilities for their children (Mendlowitz & Monga, 2007).
Counselors also may encourage parents to consider the amount of attention that is given to the child’s nonverbal behavior (Beidel & Turner, 1998). A child’s lack of verbal responses can result in a sibling or parent consistently answering for the child or overcompensating by frequently calling attention to the child’s strengths or talents. In a case study by Sharkey et al. (2008), researchers trained parents to ignore their child’s mutism and reinforce verbal behaviors by consistently responding to these behaviors with empathy, enthusiasm, and warmth. Shifting attention to verbal behaviors rather than nonverbal behaviors provides positive reinforcement for such actions.
Multifaceted Approaches
Due to the complex nature of this disorder, there exists strong support for treatment programs for selective mutism to be multifaceted, address anxiety in a variety of settings, and involve teachers, peers, parents, and other family members during the treatment process. Therefore, an eclectic approach is the most common treatment option currently used by counselors. Countless researchers have successfully combined psychodynamic, behavioral, cognitive-behavioral, pharmacological, and/or family counseling interventions. An example of a successful eclectic treatment approach was described by Wright, Cuccaro, Leonhardt, Kendall, and Anderson (1995) in a preschool-aged child. This treatment included behavioral interventions, play therapy, family therapy, and pharmacotherapy. Jackson, Allen, Boothe, Nava, and Coates (2005) also used a multifaceted approach consisting of shaping, systematic desensitization, play therapy, parent journaling, and relaxation training to successfully treat a six-year-old boy with selective mutism. While this type of treatment approach has consistently appeared to be effective in published case studies, more research is needed to reveal which components of these programs are essential.
Importance of Early Diagnosis and Intervention
Early, accurate diagnosis and intervention are crucial to overcoming selective mutism regardless of the type of treatment program. Research suggests that treatment for this disorder is most effective if it begins as soon as symptoms of the disorder become apparent, thus minimizing the amount of negative reinforcement for these behaviors (e.g., Schwartz et al., 2006; Stone & Kratochwill, 2002). Shipon-Blum (2007) explains: “The earlier a child is treated for selective mutism, the quicker the response to treatment and the better the overall prognosis. If a child remains mute for many years, his or her behavior can become a conditioned response where the child literally becomes accustomed to nonverbalization as a way of life” (p. 5).
Shipon-Blum (2007) warns that if selective mutism is left untreated, the academic, social, and emotional repercussions may include depression, social isolation, poor academic performance, self-medication with drugs and alcohol, and suicide. Furthermore, Chansky (2004) points out that untreated anxiety associated with selective mutism also can lead to adverse health effects including cardiac, immune, and respiratory problems. Thus, early intervention provides more opportunity for successful treatment and, in the long term, a healthier, more functional child.
Role of School Personnel in Treatment
School personnel, especially teachers, play crucial roles in the treatment of selective mutism. Because the symptoms of this disorder are more evident once the child begins school, teachers often become responsible for making a referral for diagnosis. Most school personnel do not have the expertise or experience to deal with this disorder single-handedly, but it is important that teachers recognize anxious tendencies among these children and solicit the help of a school psychologist or counselor in order to make prompt referrals. Once an accurate diagnosis is made, studies (e.g., Kumpulainen, 2002; Lescano, 2008; McHolm et al., 2005) have shown that the willingness of the teacher and other school personnel to collaborate with the parent(s) and counselor affects the outcome of the treatment program. A multidisciplinary team that includes the child’s teacher, principal, school counselor, and/or school psychologist may collaborate with the parent and contribute observations and feedback to the counselor (Lescano, 2008; McHolm et al., 2005). Vecchio and Kearney (2007) indicated that this team approach may be helpful in treatment “because of the widespread nature of the child’s [speech] avoidance” (p 41).
Teachers may assist in reinforcing behavioral treatment techniques as well. For example, a teacher may provide positive reinforcement for verbalizations in school or participate in a video recording which the child will use to practice formulating verbal responses to questions. The teacher also may help to minimize anxiety while the child is in school. Shipon-Blum (2003) emphasizes the importance of a caring classroom teacher who understands the behavioral characteristics of the disorder and allows the child to communicate by nonverbal means as long as necessary. A nurturing, comforting classroom environment and flexibility within the classroom setting and schedule also are important factors in a multifaceted treatment program (Shipon-Blum, 2003). Overall research, therefore, supports both an individual and systematic approach that includes school personnel for the treatment of selective mutism.
Summary and Commentary
As described in this article, selective mutism is a complex psychological disorder with an unknown origin. There is general agreement that selective mutism is characterized by a child’s inability to speak in certain social settings despite the ability to speak in other situations. Nonetheless, there is disagreement among researchers regarding the most efficient and definitive treatment approach. Treatment has included a variety of psychodynamic, behavioral, cognitive-behavioral, pharmacological, and family systems methods. It seems that these approaches are rarely used in isolation; rather treatment programs for selective mutism are usually multifaceted. The cooperation of parents and school personnel during treatment is crucial for positive outcomes, and early intervention can minimize the long-term psychological effects (Kumpulainen, 2002; Shipon-Blum, 2007).
Suggestions for Counselors
While the main purpose of this article is to raise awareness of this disorder and its varying treatment options, counselors who are treating children with selective mutism should prioritize goals during treatment. Less emphasis should be placed on the absence of verbal communication, especially during the initial stages of counseling. An immediate goal is to build rapport and a trusting counseling relationship with the child. Once rapport is established, anxiety reduction is a vital component of any treatment plan for selective mutism. Behavioral strategies, such as stimulus fading and systematic desensitization, that are implemented before healthy coping skills are established will likely increase a child’s anxiety and delay further treatment. In addition, it is important that the counselor and parent(s) work together to build the child’s self-esteem and confidence, especially in social settings. Once anxiety levels are lowered and a child’s confidence is established, verbal communication interventions will likely follow.
Additionally, it is vital that counselors design multifaceted therapy programs when treating children with selective mutism. Due to the complex nature of this disorder, eclectic treatment addresses varying symptoms and psychological effects caused by selective mutism. A multidisciplinary team should be established to assist the child in treatment. As discussed earlier, school personnel play an important role on this treatment team since the child’s mutism is likely to be most apparent at school. These professionals may aid the counselor by providing regular monitoring of progress and implementation of behavioral interventions.
Lastly, it is important that a counselor take into consideration the amount of time and patience required to implement a treatment program for selective mutism. A thorough and detailed assessment is first required to determine factors affecting the child’s mutism. Jackson et al. (2005) recognized “an in-depth analysis of the client and his or her environment” as a precursor for treatment (p. 107). After the initial stages of treatment and assessment, it is anticipated that the counselor will spend a considerable amount of time working outside of the office (Vecchio & Kearney, 2007). The counselor may conduct observations at the child’s school, meet with the child’s teacher and school counselor, and interact with the child in various social settings in order to effectively monitor and adjust treatment goals and implement appropriate interventions. If the counselor is unwilling or unable to devote such a level of time and dedication, a referral to another counseling professional with knowledge of this disorder should be provided to the client.
Suggestions for Future Research
Selective mutism has gained considerable national and global attention, particularly due to several magazine and professional articles recently published about this disorder. As a result, awareness is increasing while quality research on this serious disorder is scarce. Evidence for effective treatment has been predominantly presented in the form of single-case studies using a variety of techniques. Within these studies, the duration of treatment and follow-up time is brief and the age range is narrow, usually addressing only the needs of younger elementary school children (Cohan et al., 2006). In order to better understand selective mutism and the treatment approaches that best minimize its associated symptoms, it is imperative that large-scale studies are conducted with a focus on the efficacy of isolated techniques.
Beare, Torgerson, and Creviston (2008) described interventions used to increase the verbal behavior of a 12-year-old boy with selective mutism. These researchers exclusively utilized positive reinforcement to successfully increase verbalizations in three different settings. This is the only known case study where a single intervention was isolated and its effectiveness examined. It is important to note that case studies have limitations, involve a limited number of participants, and often lack control groups, as did this study. Despite such limitations, this study provides a springboard for further research on isolated interventions and will hopefully precipitate large-scale research devoted to examining effective treatment interventions for selective mutism.
In addition, research should be specifically devoted to examining the impact selective mutism has on long-term social development. It is logical to expect some level of social maladjustment regarding development of social relationships with peers given that children with selective mutism have limited social interactions. This is supported by research that has linked anxiety disorders, specifically social phobias, with social withdrawal and other difficulties regarding sociability (Beidel, Morris, & Turner, 2004). Nonetheless, case studies (e.g., Cunningham et al, 2004; Kumpulainen, 1998; Pelligrini, Bartini, & Brooks, 1999) imply that children with selective mutism are not bullied or victimized more than children who do not have selective mutism. More research is needed in this area to determine the extent of social maladjustment among children with selective mutism. Additionally, research should be devoted to investigate long-term effects of this disorder after the mutism is overcome. For example, exploring the ability to form relationships during teenage and adult years may help clarify the impact of mutism on long-term social development.
While an increasing amount of literature on selective mutism has been published during the last fifteen years, studies involving school personnel are virtually nonexistent. Children with selective mutism spend several hours each day with school professionals who are often involved in treatment interventions. More importantly, school is frequently the setting in which these children have the highest level of anxiety and mutism. Research has shown that teachers’ involvement in the treatment process is vital to positive treatment outcomes (e.g., Kumpulainen, 2002; Lescano, 2008), yet their role in the treatment process is rarely described in the research. There is an urgent need to carefully examine these children’s behaviors and interactions in the classroom during treatment, as well as interventions performed by the teacher. Such information would be vital to determining the overall effectiveness of treatment programs, specifically within the school setting.
Suggestions for Counselor Training
In addition to the recommendations pertaining to research and the counseling profession, it is important that counselor education provide training for treating this disorder. It is imperative that counselors, especially school counselors or counselors working with children, be trained in identifying the signs and symptoms of selective mutism. This training should stress that selective mutism be treated as an anxiety disorder, and the difference between this disorder and shyness, autism, or speech/language disorders should be emphasized. Additionally, instruction on non-verbal assessment tools should be provided as this is an ongoing aspect of treatment. Finally, counselors should be trained to work cooperatively with school personnel and parents when treating children with anxiety-related disorders, including selective mutism, because empathetic and knowledgeable school personnel are assets to successful treatment programs.
References
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Lisa Camposano is a fourth grade teacher at Millstone Township Elementary School, Millstone Township, NJ, and a graduate student in the CACREP-accredited program in School Counseling at The College of New Jersey, Ewing, NJ. The author thanks Dr. Mark Kiselica, The College of New Jersey, for his mentorship and encouragement throughout the writing process. The author also thanks the Sciscente family (with permission) for the inspiration to write this article. Correspondence can be addressed to Lisa Camposano, 308 Millstone Rd, Millstone, NJ, 08510,
LisaCamposano@yahoo.com.
Sep 4, 2014 | Article, Volume 1 - Issue 3
Shannon Hodges
The counseling profession has experienced significant growth and diversification to become a viable member of the global mental health profession. Originally founded in the U.S. as the American Personnel and Guidance Association (APGA), the profession has expanded to the flagship American Counseling Association, 19 divisional affiliates, and licensure in all 50 states, Washington D.C., and Puerto Rico, the National Board for Certified Counselors, the International Association of Counselling (IAC) and numerous other global professional organizations. This manuscript will outline the counseling profession’s genesis, growth, enumerate current challenges, speculate on the profession’s future and offer concrete suggestions to ensure the profession’s continued viability in a rapidly evolving global age.
Keywords: counseling profession, professional organizations, global age, professional identity, future development
During its nearly six decades, the counseling profession has experienced significant growth, struggle, and division to emerge as a viable mental health profession. The world’s largest counseling organization, the American Counseling Association (ACA), began as the American Personnel and Guidance Association (APGA). Conceived in 1952 by a loose confederation of organizations, APGA was primarily “concerned with vocational guidance and other personnel activities” (Harold, 1985, p. 4). ACA has evolved from its “guidance” infancy into a multifaceted profession of over 45,000 members (D. Kaplan, personal communication, April 8, 2011) and 19 divisional affiliates (American Counseling Association, [ACA] 2010). In 1976 the State of Virginia passed the first counselor licensure law and 49 other states, the District of Columbia and the territory of Puerto Rico have since followed, making the counseling profession credentialed in all states and major territories. Most states have passed legislation establishing a counselor’s right to bill private health insurance (Remley & Herlihy, 2007) and recently the Veteran’s Administration has approved licensed counselors to work in VA hospitals. Currently, some 635,000 counselors work in schools, addictions, corrections, and public and private agency settings (Bureau of Labor Statistics, 2010–2011). The U.S. Bureau of Labor Statistics (2010) projects “employment for counselors is expected to grow much faster than the average for all occupations through 2016” (p. 209). Relative to its mental health colleagues, the counseling profession has achieved a stakeholder position in a shorter timeframe than the psychology and social work professions (Remley & Herlihy, 2007). The counseling profession also has expanded to Europe, Asia, Africa, Australia and South America. Achievements notwithstanding, the global counseling profession faces numerous pressing challenges. This manuscript will address key issues confronting the counseling profession and offer concrete suggestions to twenty-first century realities. Since the past, present, and future are interconnected, speculation on the counseling profession’s future requires a brief review of its past.
The Past: From Genesis to the Present
Frank Parsons created the guidance movement by opening an office for vocational counseling in 1909. By creating an approach where the counselor actively attended to what adolescents said about themselves, he countered the prevailing distant, Freudian orthodoxy. Parson’s approach was soon adopted by schools in 35 U.S. cities and collegiate training in counseling began at Harvard University in 1911. University counseling emerged as a specialty in the 1930s when E.G. Williamson published How to Counsel Students: A Manual of Techniques for Clinical Counselors (1939). Williamson’s method was diagnostic in orientation and soon became the prevailing approach in colleges, schools and agencies (Nugent & Jones, 2009).
Carl Rogers (1942) moved the mental health field in a radically different direction with the publication of Counseling and Psychotherapy. Rogers advocated a more process oriented nondirective approach referred to as client-centered therapy (Rogers, 1951). Though schooled in Freudian analysis, Rogers developed an approach focused on a present, humanistic encounter between counselor and client. Additional theoretical approaches emerged in the post-Holocaust era, as many prominent European Neo-Freudian analysts and existentialists such as Alfred Adler, Karen Horney, Eric Fromm, Erik Erikson and Victor Frankl immigrated to the United States, challenging leading humanistic theorists such as Maslow and Rogers (Nugent & Jones, 2009).
The proliferation of diverse philosophical approaches and disparate organizations splintered the field resulting in various organizations representing the “guidance” movement. Finally, in 1952 four independent associations, The National Vocational Guidance Association (NVGA), the National Association of Guidance and Counselor Trainers (NAGCT), the Student Personnel Association for Teacher Education (SPATE), and the American College Personnel Association (ACPA) convened in Los Angeles for the purpose of building a stronger, unified coalition (Sheeley & Stickle, 2008). This meeting gave birth to the American Personnel and Guidance Association (APGA). APGA’s founding is usually referenced as the birth of the counseling profession, though as evidenced by the fact that “counseling” was absent from the title, it was an inauspicious start. APGA was primarily focused on high school academic and vocational counseling and training college student personnel (Aubrey, 1977). The fledging profession faced numerous obstacles: qualifications to become a “guidance” professional were ambiguous; there was no uniform program of study; no written code of ethics; no accreditation standards; and no credential such as licensure. Judging by contemporary standards, the early guidance movement was arguably a semi-profession (Etzoni, 1969).
Despite challenges, the counseling movement demonstrated remarkable resilience during the period from the 1950s through the 1960s. Humanistic approaches spearheaded by Rogers and Fritz Perls became readily accessible to the general public through the group encounter movement (Corey, 2009). The phrase “third force” in psychology was coined to differentiate existential-humanistic approaches from psychoanalytic and behavioral ones (Nugent & Jones, 2009). In the late 1950s notables like Murray Bowen and Virginia Satir, members of related mental health professions, popularized family counseling (Gladding, 2009). The school counseling movement, buoyed by the Soviet’s launch of Sputnik, escalated from around 7,000 counselors to nearly 30,000 (Aubrey, 1977). All these various forces within and outside the counseling profession resulted in popularizing counseling with the general public. By the mid-1970s the counseling profession and counselor education programs had grown exponentially (Nugent & Jones, 2009). Despite counseling’s proliferation however, ethical standards, accreditation, and credentialing still lagged behind related mental health professions (Remley & Herlihy, 2007).
The 1980s to 2000: The Post-Modern Era
In the early 1980s counselor education leaders created the Council for the Accreditation of Counseling and Related Programs (CACREP) to provide standardization and accreditation (Hollis & Dodson, 2001). CACREP, which began as part of the Association of Counselor Educators and Supervisors (ACES), is now an independent agency recognized by the U.S. Council for Higher Education Accreditation (CHEA) to accredit masters’ degrees in six counseling specialties and doctoral programs in counselor education and supervision (CACREP, 2009). Although counselor education programs are not required to be accredited, CACREP’s curricular guidelines form the basis for most states’ licensure laws (Remley & Herlihy, 2007).
During the same time frame as CACREP’s inception, the National Board for Certified Counselors (NBCC) was created. NBCC established a national credential for professional counselors that preceded states seeking licensure. As of November 2009, all 50 states, Washington D.C., Puerto Rico, and Guam have passed counselor licensure laws. Counselor certification, a credential offered by the National Board for Certified Counselors, has consequently transitioned from “licensure substitution” to identifying counseling specialty areas. The advantage of national certification over licensure, however, is that certification is a credential with uniform standards, unlike licensure where requirements vary from state to state. NBCC offers certifications in three professional counseling specialty areas (National Board for Certified Counselors, 2011). Though NBCC’s utility has been debated in the post-licensure era (Emner & Cottone, 1989; Weinrach & Thomas, 1993), Remley (1995) has argued that a license should be for general practice while national certification should identify specialty areas. NBCC also advocates for the counseling profession on a national level (J. S. Hinkle, personal communication, May 12, 2011). The field has moved towards Remley’s specialization model and NBCC credentials have become popular with professional counselors.
Previous to the post-modern era, the counseling profession was based on Eurocentric models and was almost exclusively a U.S. profession (Corey, 2009; D’Andrea & Arrendondo, 2002). Since the late-1980s, however, multicultural considerations have become mainstream, and counseling is becoming an international profession. Often called the fourth force in counseling (D’Andrea & Arredondo, 2002) multiculturalism has had a profound impact on the profession, especially regarding culturally and linguistically diverse populations (Arthur & Pedersen, 2008). Since the late 1980s multicultural task forces have been set up and special editions of various counseling journals have addressed issues such as culture, ethnicity, gay, lesbian and transgender issues. Counseling Today, a monthly magazine published by ACA, also features a regular column on diversity. Multicultural competencies developed by Sue, Arrendondo and McDavis (1992) were adopted in the early 1990s by the Association for Multicultural Counseling and Development (AMCD) and adopted by all 19 ACA division affiliates. CACREP identifies diversity as one of the eight core counseling areas (CACREP, 2009) and coursework in multicultural counseling is a staple in counselor education curricula. Although debate regarding its parameters continues (Dunn, Smith, & Montoya, 2006; Weinrach, 2003), multiculturalism will continue to play a pivotal role in shaping the counseling profession, particularly given the globalization of the field (Arthur & Pedersen, 2008).
The Current Situation: Success and Strife
The counseling profession has achieved numerous goals (e.g., name recognition, licensure, third party billing, emerging international presence, etc.) in nearly 60 years of existence. Nevertheless, concerns loom large over the counseling horizon. One of the most pressing issues is the counseling profession’s attempts to achieve marketplace parity with their mental health colleagues (Gladding, 2009; Remley & Herlihy, 2007). In the U.S., the first significant steps on this long journey towards parity were the profession’s successes in achieving state licensure. Historically, achieving rights coincides with long-term struggle against established forces who seldom abdicate power and privilege willingly (Marx & Engels, 1985). The counseling profession’s experience has been no exception to this maxim, as psychiatrists, psychologists, and social workers have vigorously opposed the counseling profession with regard to licensure, third-party billing, Medicare reimbursement, use of psychological tests and many other areas. Undaunted, the American Counseling Association, American Mental Health Counselors Association (AMHCA), American School Counselors Association (ASCA), and the National Board for Certified Counselors (NBCC) have pressed forward in the aforementioned areas. Such efforts have yielded considerable success (e.g., licensure and third-party billing) while leaving some major privileges unachieved (e.g., Medicare billing rights). Although ACA and its affiliates’ lobbying efforts have witnessed a Medicare reimbursement bill for counselors passing both houses of Congress at separate times, Medicare reimbursement remains unachieved, though well within reach. TRICARE, the U.S. military’s version of Medicare, recognizes licensed counselors as reimbursable providers, and recently has agreed to waive requiring physician referral for soldiers and their dependents desiring to access services of a licensed counselor (Barstow & Holt, 2010). The Veteran’s Administration also has approved licensed counselors to work in VA hospitals, although the VA has been very slow to hire counselors.
Challenges from Within the Counseling Profession: A Commentary
As indicated above, the counseling profession has struggled with many “turf” battles, namely with psychology and social work. But perhaps the counseling profession’s most serious challenge is the splintering of membership and resources among the various counseling organizations. For most of its existence, ACA required members to join one affiliate divisions. For example, applicants desiring membership in, say, the American School Counselor Association (ASCA), also were required to join ACA. For years the requirement to join the flagship organization was the source of controversy, bickering and threats of disaffiliation (B. Collison, personal communication, June 4, 2008). ACA’s membership numbers had already been reduced in the early 1990s when the American College Personnel Association (ACPA) disaffiliated, taking more than 10,000 members from ACA (B. Collison, personal communication, June 4, 2008).
The case of ASCA illustrates an important question for counselors: does the identity and loyalty of a school counselor lie with the flagship organization (i.e., ACA), or with the division/professional organization for school counselors (i.e., ASCA)? This splintering among the professional organizations operating under the counseling umbrella creates the possibility of further reduction, division, and disaffiliation. While ASCA and AMHCA remain divisional affiliates, each collects separate membership dues, holds separate national conventions, retains their own lobbyists and publicizes themselves as primary organizations representing their respective counseling specialties. From an outside perspective, ASCA and AMHCA’s relationship with ACA appears tenuous and one can only speculate whether they will remain divisional affiliates. Since ACPA’s disaffiliation, ACA membership has plunged from a high near 60,000 to the current number of just over 45,000 (D. Kaplan, personal communication, April 8, 2011). It’s also likely that most of the members who left ACA retained their membership in a divisional affiliate. Splintering may partly explain why such a small percentage of the 655,000 U.S. counselors (Bureau of Labor Statistics, 2010–2011) join neither ACA nor their respective divisional affiliate. The high degree of counselor non-affiliation with the profession’s established organizations is alarming and illustrates a disconnect between counseling professionals and the organizations that ostensibly represent them.
Fortunately, there has been recent good news regarding ACA’s membership, which has grown 8% over the past 18 months (D. Kaplan, personal communication, April 8, 2011). Most of this growth in membership has been graduate student members who now receive liability insurance as student members. While any growth in membership is a positive sign, whether graduate students will continue their membership in ACA after graduation is uncertain. The fact also remains that ACA’s membership is composed of a small percentage of counseling professionals cited by the Bureau of Labor Statistics (2010–2011). A more robust sign of growth would be an increase in the numbers of professional counselors currently unaffiliated with ACA.
ACA’s composition has been compared to a “ball of multi-colored yarn with an emphasis on the specialties of counseling as opposed to the overall profession” (Bradley & Cox, 2001, p. 39). This phenomenon of separatism seems likely to continue for the foreseeable future. For example, I regularly receive mailings from national, regional, state, and local counseling organizations, all of whom actively and separately solicit membership. Which of these various organizations to join can be confusing and expensive, and further illuminates the question of where professional loyalty should lie: with the national organization, specialty division, state affiliate, state specialty affiliate or local organization. In many states, separate organizations representing school counselors, mental health counselors, rehabilitation counselors and the state affiliates of ACA compete for membership, hold separate conventions, publish separate state journals and engage in separate lobbying efforts. Such duplication and splintering cannot be healthy for the profession.
Duplication concerns are not confined to the U.S. In Australia, where this author taught in a counseling program, three different organizations claimed to represent the counseling profession. It is likely such scenarios are common worldwide. While there is no easy resolution to this complex identity dilemma, it would seem prudent for leaders of all counseling organizations to recognize antagonism, division and duplication of resources that are working against the overall goal of establishing counseling as a strong, unified, and influential profession. Ironically, counseling’s most insidious adversary may not be psychiatrists, psychologists, or social workers, but the counseling profession itself. Unification is arguably the counseling profession’s most pressing challenge and if left unresolved, potentially leads to the counseling profession’s own “Tower of Babel” with confusion over what’s being said, who’s speaking, and which organization actually represents the profession. Perhaps former ACA president Samuel Gladding (2009) said it best:
“Since 1952 most counselors in the United States and a number of other countries have held membership in ACA…with an emphasis on the specialties of counseling as opposed to the overall profession…other professions, such as medicine, have overcome the divisiveness that comes within a profession where there is more than one professional track practitioners can follow. ACA has not been as fortunate (pp. 26–27).”
The motto “e pluribus unum” (one out of many) has much relevance for the counseling profession as a large, vibrant flagship likely is in a stronger advocacy position than numerous smaller ones. The American Psychological Association (APA) is one professional model to emulate as APA, despite representing scores of branches, remains a vibrant flagship organization. For any hope of achieving parity with its mental health colleagues, the various counseling “professions” must set aside differences and unite around core national organizations. Fortunately, there has been recent movement in this direction. The 20/20 counseling initiative, composed of 29 different counseling-related organizations, has recently reached consensus on how counseling is defined and ACA as the flagship organization (Cashwell, 2010). Unfortunately, ASCA, the largest divisional affiliate, has yet to sign onto the 20/20 initiative. The 20/20 initiative likely represents the counseling profession’s best chance at unity. One can only hope the initiative will be an opportunity seized and not one missed.
Besides splintering, the profession faces additional “in-house” challenges. During the 1960s and 1970s a significant debate involved humanistic versus behavioral approaches. Different views of mental health counseling have evolved, including those that are developmental (Ivey, 1989); relationship focused (Ginter, 1989); and slanted towards treatment, advocacy, or personal and environmental coping (Gladding, 2009; Hershenson, Power, & Seligman, 1989). The argument has now shifted to one of maintaining counseling’s traditional developmental, wellness approach moving towards an outcomes-oriented, pathology-based medical model (McAuliffe & Eriksen, 1999), or yet to be defined approach (J. S. Hinkle, personal communication, May 12, 2011). In the U.S., the influence of insurance corporations (e.g., HMOs) has moved the field towards cheaper, time-limited therapy, requiring particular Diagnostic & Statistical Manual-Fourth Edition-Text Revised (DSM-IV-TR; 2000) Axis I diagnoses to bill for counseling services (Remley & Herlihy, 2007). Faculty educated in a traditional wellness model are likely dismayed when counselor education programs adopt a pathology-based approach (Hansen, 2005; Remley & Herlihy, 2007). CACREP accreditation standards for mental health counselors appear to be aligned to a psychiatric rather than a developmental philosophy (CACREP, 2009) and credentialing boards (e.g., for licensure and certification) and influential organizations such as the World Health Organization (WHO) and related mental health professionals (e.g., psychiatrists, psychologists) create pressure on counselor education programs to educate their students in the DSM-IV-TR nomenclature. Accreditation standards and the marketplace demand adherence to a psychiatric model making it critical for counselors to become facile in understanding and applying the DSM-IV-TR. Although the psychiatric model has many critics (Gladding, 2009; Glasser, 2003) it remains the standard within the mental health field (Maddux & Winstead, 2010; Gladding, 2009; 2008; Remley & Herlihy, 2007).
University counselor education departments also have expanded and diversified. School counseling programs frequently are offered alongside mental health counseling programs; two counseling disciplines moving in radically different directions. Given that the emphasis in counseling divisions varies from a developmental model (e.g., school counseling) to a DSM-driven model (e.g., mental health counseling), can traditionally-minded, developmentally-oriented counselor education faculty ethically support a pathological, DSM-based approach? Conversely, can mental health counseling faculty support a non-pathology driven approach? What about the potential confusion among graduate counseling students enrolled in programs offering these disparate philosophies? Do the philosophical differences dividing the various counseling specialties mean such divisions will be perpetuated in the classroom and among the faculty? Furthermore, what should be the driving force in shaping counselor education programs: philosophical orientation or marketplace demands (e.g., the need to be facile with and use the DSM-IV-TR)? According to Hansen (2003), “It is not unreasonable to assume that the juxtaposition of these completely opposite models in counselor training has an impact on the development of counselor trainees and the profession as a whole” (p. 98).These foundational fault lines within counselor education have yet to be adequately resolved, as developmental approaches are taught alongside medical-pathological approaches, likely resulting in confusion for students and disharmony among faculty. Perhaps the most realistic statement to make is that counseling is a broad profession encompassing both developmental approaches (e.g., school counseling) and clinical, diagnostic approaches (e.g., mental health counseling) for the purposes of insurance reimbursement.
Gazing into the Future: Challenges and Opportunity
Besides fractionalization, differences in training and concerns regarding marketplace parity, additional challenges have recently emerged. The highly technical nature of the twenty-first century has created challenges and opportunities unforeseen in previous eras. In his seminal opus The World is Flat, Friedman (2005) argues the Internet age has transformed the media, financial markets, the military, education and virtually everything else. For the counseling profession, the Internet represents more tidal wave than ripple effect, impacting types of institutions offering programs (e.g., traditional vs. virtual), where and how they are offered (e.g., residential vs. web delivery) and who will teach them (e.g., full-time faculty or adjunct faculty). In June 2010, a national conference titled “Who Needs a College Campus” was held (EduComm, 2011).The past decade has seen a spike in the numbers of college students enrolled in virtual institutions. The University of Phoenix, primarily a virtual, for-profit institution, sports a CACREP-accredited counseling program and though they hold counseling classes in-person, one wonders if this will soon change. The University of Phoenix now boasts the largest collegiate enrollment in the U.S. with over 400,000 students (Lederman, 2010). Many elite brick-and-mortar institutions including Harvard University now offer virtual degrees. Small liberal arts institutions have begun offering web degrees and using satellite campuses. For example, Tiffin University, a small institution in the U.S. Midwest, has doubled the number of its graduate students and seen its total enrollment rise more than 50% in five years (Blumenstyk, 2008). The increasing options and delivery methods for course offerings and degrees are likely to change the number and types of counselor education programs as well.
Internet delivery means institutions and programs are no longer thwarted by geography, nationality, enrollment restrictions, number of faculty, distance, language, culture, etc. Instead of strolling through ivy-covered campuses, students can simply walk across their living room to access a college or graduate education through numerous virtual options. Besides the University of Phoenix, several online universities such as Capella University (2011) and Walden University (2011) also offer CACREP-accredited counseling programs. Web-based education poses several challenges for the counseling profession: advising and mentoring are virtual, not in person; web programs are staffed primarily by part-time faculty; when courses are delivered across state and international borders, which state or nation’s rules apply? Technology occasionally fails, leaving students and faculty “virtually” stranded. Finally, given huge enrollments and reliance on adjuncts as opposed to full-time faculty, questions regarding for-profit institutions’ principal concern (e.g., profit over academic quality) are likely to be raised.
There also is pressure for U.S. institutions to establish international partnerships to educate students on diverse cultures and plan for a global, interconnected world (American Council on Education, 2008). The Under Secretary of Commerce recently was quoted saying, “Education is one of our most valuable exports” (Sanchez, 2011). Numerous U.S. institutions have built satellite campuses in Europe, the Middle-East, Asia and Australia. Madeline Green, Vice President for the American Council on Education’s International Initiatives, along with her colleagues, opined current international initiatives are insufficient and pressed further: “Every institution needs to pay attention to internationalization if it is to prepare students for the multicultural and global society of today and tomorrow” (American Council on Education, 2008, p. 2). Even non-elite institutions have heeded Green’s message. A job advertisement in a recent edition of The Chronicle of Higher Education (Chronicle Careers, 2010) revealed that Troy University in rural Alabama has locations in 15 states and 14 countries.
The counseling profession also has begun to heed the call for globalization. Edith Cowen University in Perth, Western Australia, offers an off-shore counseling program in Singapore (Edith Cowen University, 2011) and California State University-Fullerton offers a joint counseling doctoral program with the University of New England in Australia (J. Kottler, personal communication, July 23, 2010). International partnerships offer numerous advantages. For example, perhaps a program in New York doesn’t offer a specialty course in trauma counseling, but a cooperating institution in New Zealand does. In this scenario, students could access the missing course via the Internet. Furthermore, students could travel to, say, Bhutan for an internship, profoundly enhancing a student’s multicultural experience. International partnerships also pose challenges for accrediting organizations such as CACREP (e.g., creating global, unifying standards), sponsoring institutions (e.g., differing guidelines), credentialing boards (e.g., licensure and certification bodies), faculty (e.g., full vs. part-time), ethical codes (e.g., cultural variations), and the future direction of the counseling profession (from Euro-American to an international focus). CACREP’s response was to create the International Registry of Counsellor Education Programs (IRCEP) in 2008 (IRCEP, 2011). IRCEP is not a credentialing body like CACREP, but a branch of CACREP designed to empower international counselor education programs appropriate to their country (IRCEP, 2011). IRCEP represents CACREP’s recognition that a uniform accreditation credential may not be realistic given the wide variation in global social and cultural norms.
Widely varying social and cultural norms inherent in the emerging global counseling movement also pose numerous challenges for the profession. Western counseling organizations have taken a social justice stance in promoting multiculturalism, gender equality, freedom of and from religion, and pluralism for sexual minorities in their various codes of ethics. ACA’s support in a high-profile court case involving the Eastern Michigan University counseling program and a conservative Christian dismissed from the program for refusing to counsel a gay client is a notable example of advocacy (Shallcross, 2011. “The EMU ruling upheld the ideals of the profession,” (Kaplan, 2011, p. 33). Such advocacy is commendable, especially as culturally relevant counseling practice is imperative in a global age (Arthur & Pedersen, 2008; Sue & Sundberg, 1996). Nevertheless, even within segments of Western civilization, issues of ethnicity, gender, religion and sexual orientation often form contentious points of debate. Though tensions can run high, Western academia offers a forum for discussing controversial issues. But what happens when constructivist, post-modern, pluralistic-oriented counselor education programs are offered in countries where discrimination plays a pivotal role? Saudi Arabia, for example, is an absolute monarchy that prohibits men and women from sharing the same classroom, restricts women’s movement outside the home, prohibits women from divorcing their husbands and provides no legal protection against domestic abuse. Furthermore, homosexuality and a Saudi’s practice of a religion other than Islam are potentially punishable by death (Saudi Arabia Guide, 2011). How will a Western social justice-oriented counseling profession address such restrictions on gender roles, religious identity, and sexual orientation in restrictive societies? Equally problematic, how will the counseling profession advocate equality without, ironically, appearing culturally insensitive in societies with rigid social caste systems? Moreover, is it even realistic to expect unilateral agreement on social and cultural issues in an increasingly internationalized counseling profession spread across diverse cultures? A larger question remains, however: are there some universal social justice principles the counseling profession should promote regardless of culture (e.g., gender and sexual equity, religious freedom, freedom to have no religion, etc.)? In this writer’s opinion, ACA, AMHCA, NBCC, etc. should encourage an ongoing dialogue about the realities and parameters of Western, social justice-oriented counseling expectations, particularly with regard to nonwestern societies.
Ironically, the counseling profession’s advocacy of pluralism, although noble and well-intentioned, is a concept framed largely through a Western mindset. This gulf between a pluralistic counseling profession and rigid, non-democratic societies creates great potential for conflict. Consequently, debate regarding cultural competence will likely become more complex and contentious with the counseling profession’s continued global expansion. The point is not that the profession should abandon its support for equality, nor should it force our social justice model on other societies, but rather it must be strategic in where and how it advocates pluralism.
Counselor education also must make programmatic adaptations in this new era. In the 1970s, Psy.D. programs emerged as an alternative to the traditional research-oriented doctorate for psychologists seeking careers outside higher education. Psy.D. programs have become quite popular and psychologists with such degrees now hold academic appointments. As the counseling profession evolves, it may be worthwhile to develop a Psy.D.-like degree. Some counseling programs already offer practitioner-oriented doctorates. In 2007, I taught as a visiting counselor education scholar at the University of Notre Dame–Australia (UNDA). UNDA’s counselor education program offers a Doctorate of Counselling (D.Coun.) modeled roughly on the Psy.D. (M. Philpott, personal communication, February, 18, 2008). Traditionally, the Ph.D. in counselor education has been a research degree specifically developed and marketed for counseling professionals planning academic careers. A D.Coun. doctorate with an emphasis on professional practice, clinical supervision, and developing management expertise, and less on research might seem more compelling to masters’ level counselors in community clinics or schools who desire a doctorate, but are not contemplating research careers. Moreover, doctoral students in counselor education are largely supervised in clinical internships by non-counselors due to a dearth of clinical counselors at the doctoral level (J. S. Hinkle, personal communication, May 12, 2011).
Along similar educational lines, the front end of the higher educational spectrum also presents opportunity for the counseling profession. For decades, bachelor’s-level addictions counselors have worked at the margins of the profession. In many countries, BA/BS degree professionals are the norm, not the exception (Arthur & Pedersen, 2008; Selles et al., 2007). The University of Notre Dame–Australia offers a baccalaureate counseling degree, with a job placement rate for graduates approaching 100% (M. Philpott, personal communication, February, 18, 2008). Although the profession maintains the masters’ degree is the entry-level degree, large numbers of bachelor’s degree counselors continue to work in addictions. Perhaps it’s time to recognize baccalaureate counselors as legitimate professionals. Counselor education programs could create baccalaureate programs, market them for entry-level positions, educate undergraduates regarding the counseling profession, and steer them into graduate counselor education programs. While counselor educators may be aghast at such a proposal, it’s worth remembering that our social work colleagues have long maintained bachelor’s degree programs with no noticeable detriment to their profession. In addition, bachelor’s degrees in human services are dramatically on the rise (J.S. Hinkle, personal communication, May 12, 2011).Undergraduate psychology departments also are among the most vibrant on any college campus even though the American Psychological Association maintains that psychology is a doctorate-level profession (APA, 2002). Moreover, undergraduate social work and psychology programs provide a forum to guide and mentor future social workers and psychologists. Counselor education’s undergraduate mentoring role has been abdicated to social work and psychology faculty, neither of whom have a stake in supporting a separate, competing profession. Undergraduate counseling programs would create a stronger professional identity at the baccalaureate level, provide early mentoring for future counselors, and preferably increase membership in national as well as affiliate counseling organizations.
Rapid changes brought about by our technologically advanced era require an increasing need for the counseling profession to develop flexible, visionary leadership and set planning priorities (Gladding, 2009; Glasser, 2005). While on one hand graduate counseling programs do a good job providing leadership and clinical skills training, on the other hand, performance reviews, political networking, and entrepreneurship are seldom covered in the curriculum (Curtis & Sherlock, 2006). Curtis and Sherlock (2006) use the term managerial leadership (p. 121) as a means of becoming more strategic with regard to future development. ACA certainly is engaged in leadership development regionally and nationally, and strategic planning has recently become a major focus of the ACA’s 20/20 initiative (Gladding, 2009). Given its importance, strategic planning and management training should become an integrated part of counselor education curricula as counselors essentially are managers in schools, community clinics, university and community college counseling centers, and in professional organizations such as ACA.
Summary
APGA’s original narrow, guidance-oriented, Eurocentric profession now consists of multiple identities, numerous theoretical approaches, a comprehensive research base, Internet-based institutions, and a global, multicultural presence (Arthur & Pedersen, 2008; Herr, 2004). Multiculturalism and a social justice approach to counseling have become ubiquitous in counseling, permeating professional organizations, ethical codes, and mission statements, and they are prominently featured in journal articles and textbooks. Though disagreement on multicultural parameters continues (Dunn, Smith, & Montoya, 2006; Weinrach, 2003) with the profession’s internationalization, cultural issues will become even more significant and complex given the broad social, geographic, ethnic, religious, and political variations among global societies.
Because of the dynamic, interconnected, global nature of the 21st -century marketplace (Friedman, 2004), the counseling field is likely to undergo dramatic change. Some 150 years ago Charles Darwin (1859) theorized it wasn’t necessarily the smartest or strongest organisms that survive, but those most willing to adapt to external demands. Demands challenging the counseling field include unifying a fractious profession, achieving market place parity, maintaining relevant counselor education programs, addressing global cultural conflicts, and proactively responding to the vast challenges and opportunities of a dynamic era. To flourish, the counseling profession must chart a bold, progressive, global, strategic course of action to address post-modern challenges. An effective course of action is likely to result in numerous changes both for counselor education training and in the delivery of counseling services to an increasingly diverse, global clientele. How effectively the counseling profession adapts to meet 21st-century demands will largely determine its future success and viability.
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Shannon Hodges, NCC, is an Associate Professor of Counseling in the College of Education at Niagara University. Correspondence concerning this article can be addressed to Shannon Hodges, Niagara University, College of Education, Niagara University, NY, 14109, shodges@niagara.edu.
Sep 4, 2014 | Article, Volume 2 - Issue 1
Keith Morgen, Geri Miller, LoriAnn S. Stretch
This article addresses the obstacles of effectively integrating addiction counseling into a nationwide definition of professional counseling scope of practice. The article covers an overview of issues, specific licensure and credentialing frameworks (LPC, CADC, LCADC) in two U.S. states, and recommendations to effectively bridge the gap between professional and addiction counseling. Historical origins and an overview of addiction counseling are presented.
Keywords: addiction, licensure, credentialing, LPC, CADC, LCADC
The question of professional identity within the counseling profession, first considered during the founding of the American Personnel and Guidance Association (Sweeney, 1995), still exists today (Calley & Hawley, 2008; Cashwell, Kleist, & Schofield, 2009; Mellin, Hunt, & Nichols, 2011; Myers, Sweeney, & White, 2002; Nassar-McMillan & Niles, 2011; Remley & Herlihy, 2009). One possible reason for the continual debate around professional identity may lie in the multitude of specialty fields (e.g., addiction, career, and school) within counseling (Gale & Austin, 2003; Myers, 1995; O’Brien, 2010). Remley (1995) underscores that unlike psychology, psychiatry and social work, counseling is the only mental health profession that licenses specialty areas. Specialty areas such as career and school counseling only denote a practice area or population; whereas addiction counseling actually entails a DSM-IV-TR Axis I disorder (i.e., Substance Use Disorders; American Psychiatric Association, 2000). No other Axis I or Axis II disorder receives such attention.
Addiction is considered a part of professional counseling as implied by the latest CACREP standards (2009). However, a separate licensure track exists for the profession of addiction counseling. If the practice of addiction counseling really is a part of counseling (as implied by the latest 2009 CACREP standards), then the time has come to recalibrate the rest of the counseling profession to better fit an inclusive and unifying professional counseling identity that includes addiction counseling. Thus, the purpose of this paper is to start the dialogue regarding the mixed messages on the issue of counselor identity and specialization for addiction counseling (Morgen, Miller, Culbreth, & Juhnke, 2011; Tabor, Camisa, Yu, & Doncheski, 2011). The article is divided into an overview of issues, specific licensure and credentialing frameworks in two sample states (New Jersey and North Carolina), and recommendations in response to the concerns discussed.
Overview of Issues
Henriksen, Nelson, and Watts (2010) criticize the counseling specialty system by arguing that counseling specialties do not define counseling but merely denote a practice area, and that counseling specialty licensure/credentialing implies that only a small proportion of the counseling profession is qualified to work with this population. The addiction area is one such area of specialization that comes with a separate licensure/credentialing process. The authors believe that in regard to addiction counseling, the additional supervisory and training hours required for addiction licensure/credentialing (in addition to the supervisory and training hours required for licensure as a professional counselor) implies that addiction content falls outside the professional counseling scope of practice.
For instance, if the graduate counseling program does not possess an addiction track, a cursory review of curriculum at CACREP and non-CACREP programs found the typical option of one addiction course as an elective. However, curricular reviews of numerous programs find few to no electives on other DSM-IV-TR disorders (e.g., mood, anxiety). Thus, the authors argue this produces a confusing mixed message in that licensure as a professional counselor covers practice areas that typically receive minimal exclusive attention (e.g., one-week discussion on anxiety disorders in a maladaptive behavior course), yet an area where one (or more) electives are typically offered for in-depth study of a disorder (such as addiction) comes with an entirely unique and separate licensure process.
The presence of a separate licensure/credentialing process for addiction counseling seems antiquated considering the extensive training required for a graduate counseling degree. Furthermore, most states consider addiction work within the professional counselor scope of practice (Tabor et al., 2011). Thus, the pioneering issue this paper addresses is whether it is time to thoughtfully reconsider how addiction is conceptualized in professional counseling (beyond the inclusion in the most recent CACREP standards) and recalibrate the education and licensure processes accordingly. In order to begin this dialogue a brief review of the history of the licensure/credentialing process of addiction counselors needs to be provided.
Historical Origins of the Issue
Historically across most states, the advent of addiction counseling licensure/credentialing standards occurred parallel with the professionalization of the counseling field (i.e., the master’s-level state licensure laws). States mandated that graduate school-level professionals conduct counseling, leaving many long-time and effective addiction counselors (many of whom possessed only a high school diploma or GED) out of the counseling mainstream. Consequently, addiction licensure/credentialing boards were established to achieve two goals. The first goal was to professionalize the addiction counseling field in a manner similar to professional counseling via mandated supervised practice hours and education across a subscribed addiction curriculum. The second goal was to provide a mechanism to grandfather into the profession those addiction counselors who had long worked in the field and provided outstanding services. Without the grandfather clause, many of these addiction counselors would have lost their profession or would have needed to put their career on pause as they obtained the required education and/or training.
The professionalization of addiction counseling, including licensure and credentialing, strengthened the field and provided a higher quality of care to those struggling with addiction. Unfortunately, a system also was established that over 30 years reinforced the notion that addiction falls outside the scope of practice for professional counseling (i.e., the presence of a separate licensure and certification processes focused on addiction counseling). While the addiction counseling field did need professionalization, perhaps the original high standards (e.g. upwards of 3,000 hours of clinical practice with supervision) now require recalibration that takes into account a new era where counselor training for those engaged in addiction work extends far beyond a high school diploma or GED.
Professionalization or Deterrent?
The authors’ perspective in this paper is that imbedded in the current licensure and credentialing process for addiction counseling is the message that LPCs cannot or should not do addiction work. The message comes from a confusing mixed array of information. Using the graduate trainee (the next generation of counseling professional) as an example, it becomes clear as to how future LPCs may shy away from addiction work. For instance, in the classroom graduate students read about how counseling includes working in the addiction area (as per the latest CACREP standards). Graduate students are trained in a graduate counseling curriculum that offers advanced addiction course electives and the possibility of doing practicums or internships at an addiction facility. Many of these graduate students may even attend school in a state where addiction work is covered in the professional counseling scope of practice. But, these students also see professional counselors with separate addiction licenses (e.g., LPC and LCADC) and employment announcements requesting/requiring an addiction license. Even the National Board of Certified Counselors (NBCC) Master Addiction Counselor Credential (MAC) focused on this one DSM-IV-TR disorder class (with no other NBCC credential so narrowly focused on one DSM-IV-TR disorder). Because the student does not see an NBCC credential for mood disorders or sees a licensure for anxiety disorders, the imbedded message is strengthened.
The mixed messages coupled with the burdensome task of meeting the mandates for two professional bodies (professional counseling and addiction) may drive some new counselors from the addiction field. For example, at the end of a panel discussion on this topic at the 2011 American Counseling Association Conference (Morgen et al., 2011), a new graduate of a professional counseling master’s program said she would like to start accruing practice hours in a substance use disorders clinic as she had completed some internship hours there and took a course on substance use disorders. However, the facility where she wanted to work required her to obtain an addiction license in addition to her professional counseling license. She subsequently indicated that she did not have the time, money, or the energy to do both and was thus looking outside the substance use disorders field for employment. This anecdote clearly demonstrates how newly graduated counseling professionals (especially those working in the provisional licensure period) may be inhibited from entering the addiction counseling field.
How many qualified, talented and motivated students are we turning away from the addiction counseling field due to these extra training requirements unique to working with the specific DSM-IV-TR Axis I Substance Use Disorder diagnosis at a time when there is an ever-growing need for services (e.g., addiction in returning veterans or the chronically unemployed)? Effective training of LPCs who work with addiction requires coordination between educational training institutions and actual practice that reflects reasonable experienced-based requirements for working in the area of addiction as well as respect for the graduate-level degree (e.g., master’s or doctorate) and training the counselor has already received. Such coordination varies from state to state and without a guarantee of such coordination the danger is that well-intentioned, well-trained counselors will enter the field technically qualified to counsel individuals, but philosophically lacking the integration of theory and practice necessary for treating addiction. This could mean, for example, that the counselor is more vulnerable to enabling the active addictive process and thereby not providing counseling in the best interest of the client.
In an effort to initiate the dialogue on how to perhaps recalibrate the system, it first seems warranted to review the professional and addiction counseling licensure laws and policies within two states. The authors intend to (over the next few years) review the state laws and policies for all 50 states. However, for the purposes of this initial paper, New Jersey and North Carolina will be discussed below.
Specific State Issues
New Jersey
New Jersey operates a professional counseling license (LPC) with a minimum education of a graduate counseling degree, a certified alcohol and drug abuse counselor credential (CADC) requiring a minimum education of bachelor’s degree, associate degree, high school diploma or GED, and a licensed clinical and alcohol and drug abuse counselor (LCADC) with a minimum education of a graduate counseling degree and qualification for the CADC. The LPC is governed by the Professional Counselor Examiners Committee (imbedded within the Marriage and Family Therapy Board), whereas the CADC/LCADC is governed by the Alcohol and Drug Counselor Committee.
According to the regulations for professional counseling, New Jersey defines counseling in part as “using currently accepted diagnostic classifications including, but not limited to the DSM-IV” (NJ Board of Marriage and Family Therapy Examiners, 2009, 13:34-10.2, p. 34-22). Substance use disorders fall within Axis I of the DSM-IV-TR, thus work with substance use disorders seems in line with the professional regulations of the LPC. Further evidence of this fact exists within the LCADC regulations (NJ Alcohol and Drug Counselor Committee, 13:34C-2.6, p. 34C-10) that states the following individuals are exempt from the LCADC licensure requirement:
A person doing work of an alcohol or drug counseling nature, or advertising those
services, when acting within the scope of the person’s profession or occupation and
doing work consistent with the person’s training, including physicians, clinical social
workers, professional counselors, marriage and family therapists, psychologists, nurses
or any other profession or occupation licensed by the State, or students within accredited
programs of these professions, if the person does not hold oneself out to the public as
possessing a license or certification issued pursuant to the Act or this chapter.
As long as an LPC does not advertise oneself as an addiction or substance abuse counselor, they are completely free to practice counseling with individuals presenting with addiction.
However, new counselors and LPCs who wish to accrue hours toward addiction licensure/credentialing face obstacles within the hiring process for addiction-focused positions. For example, despite the clear language in the LPC and CADC/LCADC regulations, advertised positions in the addiction counseling field in New Jersey typically include language stating “actively pursuing CADC/LCADC” or “must hold a New Jersey CADC/LCADC.” These requirements (which again, contradict the language of the New Jersey LPC and LCADC regulations) are typically in place due to a mandate of the program funding source (e.g., state or federal). Private practice counselors (who do not operate any funded programs with the above-mentioned requirements) are free to practice addiction work if qualified. However, most (if not all) of the addiction counseling positions where a new professional counseling graduate can accrue hours are housed in some type of treatment facility that very likely must adhere to the LCADC mandate, thereby limiting access to positions for those seeking to accrue LPC hours within the addiction counseling field.
In New Jersey, the typical master’s student who wants to accrue hours for licensure as an LPC must produce approximately 4,500 supervised counseling hours. This process comes immediately after the challenging two to three years of graduate study and passing the National Counselor Exam (NCE). However, to obtain the LCADC these students must complete an additional and separate 3,000 supervised addiction counseling hours, 270 clock hours of education focused on counseling and addiction, and 300 hours of supervised practical training in core counseling areas such as screening, intake, assessment, etc. The primary and most time-consuming problem lies in the need to accrue the supervised addiction counseling hours. Since the supervised counseling hours cannot be combined (e.g., there is no language in either the LPC or LCADC regulations permitting or denying the “double-dipping” of an hour for inclusion in both the LPC and LCADC hours accrual for licensure; this alone is confusing and indicates a need for clarification), the trainee working towards licensure who wishes to work in an addiction facility must accrue thousands of extra hours or opt to only work towards the LCADC. No other DSM-IV-TR disorder class comes with this burdensome extra mandated training requirement.
Recent efforts to integrate the mental health and addiction licensure processes in New Jersey are in motion, but still in an early phase. Much of this work is coming from a project sponsored by the New Jersey Division of Mental Health and Addiction Services designed to train the next generation of dual-licensed and trained (mental health and addiction) practitioners. However, this need to streamline the process is only present because of the dual licenses already in place. Furthermore, the premise of the program (though an excellent contribution) still propels the notion that addiction falls outside the scope of LPC practice and there needs to be a process to merge the two together. Despite the benefits of this new initiative, the end result is still the same: two different licenses. Again, this is the only DSM-IV-TR disorder that receives this treatment.
North Carolina
North Carolina has a well-coordinated system for addiction counselors. All professionals who want to be licensed to work in the addiction counseling field need to go through the same board, the NC Substance Abuse Professional Practice Board (the Board), which is “recognized as the registering, certifying, and licensing authority for substance abuse professionals” (Practice Act, 2005, Senate Bill 705, North Carolina General Assembly, § 90 113.32). One board eliminates competition between boards and the related issues that arise. In fact, the Licensed Professional Counselors Act (LPC law) specifically exempts substance abuse counselors from the counseling law by declaring that nothing in the LPC law “shall prevent a person from performing substance abuse counseling or substance abuse prevention consulting” (NC Board of Licensed Professional Counselors, 2009, § 90-332.1.d). Having one board brings together individuals from various professions in a concerted effort to address the issues related to addiction counseling and to advocate for the field at a state level. This framework has the strength of cooperation between different professional groups and the absence of competition within a state.
This cooperation is enhanced by a tiered system (licensure and credentialing). Individuals may apply for licensure as a Licensed Clinical Addictions Specialist. With regard to entry at the licensure level, there are four main routes or criteria (Criteria A, Criteria B, Criteria C, and Criteria D). Although initially the system may be confusing to determine the criteria under which one fits, the advantage is that there is greater flexibility for the individual applying for licensure. This flexibility is the result of minimum requirement variation in the areas of education, training, experience, and supervision (Criteria A, B, & C), as well as professional discipline (e.g., psychology, social work, counseling—Criteria D). For specific guidelines and clarification of this summary, the reader is referred to: http://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_5C.html.
In terms of similarities for the individual applying for licensure, there are two aspects that remain the same under Criteria A, B, and C: the submission of three letters of reference (there is some variation allowed for the individuals who can write these letters) and a passing score on a master’s level written examination administered by the Board. The variations under these criteria are as follows. In the area of education, Criteria A and B require a minimum of a master’s degree with a clinical application in a human services field from a regionally accredited college or university. In addition, in terms of training, Criteria A requires 180 hours of substance abuse specific training from either a regionally accredited college or university, which may include unlimited independent study or from training events of which no more than fifty percent (50%) shall be in independent study. Criteria C combines the education and training requirement in the minimum requirement of a master’s degree in a human services field with both a clinical application and a substance abuse specialty from a regionally accredited college or university that includes 180 hours of substance abuse specific education and training. In the area of experience, Criteria A requires two years postgraduate supervised substance abuse counseling experience, while Criteria B requires the applicant to be certified as a substance abuse counselor. Finally, regarding supervision, Criteria A requires documentation of a minimum of 300 hours of supervised practical training and provision of a board-approved supervision contract between the applicant and an applicant supervisor, while Criteria C requires one year of postgraduate supervised substance abuse counseling experience. Criteria D simply requires that the applicant has a substance abuse certification from a professional discipline that has been granted deemed status by the Board (i.e., possession of a certification to practice addictions work under another discipline, such as social work, and that certification is recognized by the counseling board).
Note that the Board also offers numerous credentials through certification for non-master’s-level professionals. These include the Certified Substance Abuse Counselor (CSAC), Certified Substance Abuse Prevention Consultant (CSAPC), Certified Criminal Justice Addictions Professional (CCJP) and the Substance Abuse Residential Facility Director (CSARFD) credentials. In terms of the CSAC and the CSAPC, the applicant needs to be of good moral character, not be (or have been) engaged in any practice or conduct that would be grounds for disciplinary action, have a minimum of a high school diploma or a high school equivalency certificate, sign a form attesting to the intention to adhere fully to the Board’s ethical standards, and submit a complete criminal history record check.
Additionally, a CSAC who completes a clinical master’s degree program in a human services field can seek the LCAS via Criteria B as outlined above. This criterion recognizes the fact that the CSAC has already completed a 300-hour supervised clinical practicum and has substance abuse specific work experience. In addition to submitting proof of one’s master’s degree, all one has to do to obtain the LCAS via this criteria is to submit three letters of reference from LCAS’s and/or master’s level CSAC’s and pass the LCAS examination.
This tiered system allows the counselor to enter the field with or without a masters’ degree and allows the master’s=level counselor to have an accelerated process if they acquire clinical application experience enhancing the possibility they are both technically and philosophically prepared to work in the addiction counseling field. The requirement of the clinical application experience may be a barrier for some counselors, but the intent is to serve the best interests of the public.
Finally, there is collaboration between the Board and specific university degree programs regarding the type and quality of the courses, thus increasing the chance that counselors are effectively trained to work in the addiction counseling field. While there is not “board approval” on the content areas, programs are approved for addiction counseling. Students who graduate from these master’s degree programs may seek the LCAS license via Criteria C (outlined above). The Board maintains a current list of school programs approved for application under Criteria C on its website: http://www.ncsappb.org/certificationssteve/criteriaschools2.htm.
While North Carolina’s tiered system of licensure and credentialing allows for greater flexibility for the individual applying to work in the addiction counseling field, the system can be overwhelming and does contribute to the perception that addiction counseling is a separate profession with separate education, training, supervision and practice. Kaplan and Gladding (2011), King (2011), and Gladding, Kaplan, Linde, Mascari, and Tarvydas (2011) have advocated along with others about the importance of a unified counseling identity with common skills, training and practice (particularly among counseling specialties).
Recommendations
Overall, there appears to be a need for a recalibration of the experienced-based training required for LPCs at a national level that will enhance their entrance into the field of addiction counseling. Currently, states that do not allow for multiple entries into the field have a tiered system of entry, or an approval mandate of the type or quality of the addiction training program, that may inhibit LPCs from practicing in the addiction counseling field. In states where there are significant barriers, professional counselors (fully licensed or in-training) entering the addiction counseling profession with a graduate degree may be required to complete additional training requirements that were created during a time when the addiction counseling professional possibly possessed no more than a high school diploma or GED, and such credentialing requirements (e.g., thousands of supervised hours) were imposed as a mechanism to professionalize the field. Considering the graduate counseling degree (and associated supervised counseling hours) held by a LPC or counselor-in-training accruing licensure hours, these mandates currently seem excessive and possibly even redundant. Presently, the North Carolina system may be one of the few in the United States that provides the fewest barriers for LPCs entering the addiction counseling field.
In the following section, two remedies for the licensure/credentialing problems are presented. Although myriad issues complicate the process (e.g., counselors are called different titles in different states and different state requirements are present for licensure/credentialing as an addiction counselor), the following suggestions in some conceptualization may spur more tangible action. Any formal action should likely come from a national committee set up through the American Counseling Association (ACA) and in conjunction with the ACA addiction division, The International Association of Addictions and Offender Counselors (IAAOC), as well as CACREP, and national bodies such as the National Association of Alcoholism and Drug Abuse Counselors (NAADAC) and the International Certification and Reciprocity Consortium (IC&RC). Committee representatives from these parties could examine the coordination of experience and training. Such a committee could develop guidelines for balancing these concerns for states to use in their individual recalibration of requirements.
Possible Solution #1: Nationally Recognized Tiered System of Addiction Counselor Credentialing
One of the difficulties in terms of the current state of addiction credentialing in the U.S. is the absence of uniform national curriculum training standards in the addiction field. Also, there are two main national credentialing groups: NAADAC and the IC&RC. Issues arise because affiliation with one of the two main credentialing groups and credentialing variations between these organizations can result in issues in terms of competition and the nature of the boards and exams required for credentialing. Miller, Scarborough, Clark, Leonard, and Keziah (2010) recommend the following with regard to addiction counseling: (a) portability of credentials, (b) competition reduction between credentialing groups and state boards, (c) national standards for addiction education and training, and (d) a standardized national licensure/credentialing process. Unfortunately, these recommendations have not yet been fully implemented.
One possible solution is to develop a tiered system of addiction counseling credentials at a national level that takes into account professional experience as well as educational training. There needs to be a balance between the idea that anyone with a general counseling degree can do addiction counseling and the idea that only a few select counselors can do the work. Furthermore, this balance should be firmly based upon the ACA Ethical Code that indicates that counselors only practice within their area(s) of competence (2005).
For example, graduates of professional counseling programs (e.g., those working towards LPC status) who have taken a nationally-approved addiction counseling curriculum and have completed practicum/internship experiences could be designated as having addiction credentials in addition to the LPC (i.e., a nationally approved addiction concentration). Therefore, graduate counseling coursework that includes addiction counseling education and practical experiences would enable new graduates to move seamlessly into the addiction counseling profession without the need for additional supervision hours or educational components (i.e., beyond the required supervised counseling hours and educational components required for the LPC). The system would eliminate the need for a professional counselor to acquire an additional and separate addiction license/certification. In addition, the national standards could promote portability of credentials. This compromise works to maintain the licensed/certified addiction counseling credentials in each state while also providing the LPC with the documented expertise required for many addiction facility positions. This tiered system also could facilitate enhanced training during the process of accruing hours for licensure by better focusing the training hours upon the interface between addiction and other mental health issues as opposed to the current parallel and disparate relationship between addiction and other mental health issues.
Possible Solution #2: Nationally Recognized Addiction Counseling Concentration Curriculum
There are issues regarding standardization of training that need to be addressed within the context of academia. In essence, what are the theoretical and practical skills required of an addiction counselor nationwide? There are numerous initial places to look into the process of establishing a nationally recognized addiction counseling concentration, such as the 2009 CACREP standards for addiction counseling and the Center for Substance Abuse Treatment’s (2006) Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice. By using these (and other) standards, all counseling programs (regardless of CACREP accreditation) can follow a standard recommended education experience for students who desire the addiction credential discussed in the first possible solution. Curricular issues would likely include standalone addiction courses, infusion of addiction content into other courses, faculty expertise in the addiction area and practicum and internship hours focused on addiction counseling practice.
In addition, the NCE and National Clinical Mental Health Counselor Examination (NCMHCE) would require some recalibration to take into account the curricular changes to a professional counseling education that includes the addiction counseling concentration. One caution is that any discussion of these and other training issues may produce opposing forces within academia, the counseling profession, the addiction counseling profession, state licensing/credentialing boards (both professional counseling and addiction) and individual counselor education professors and college/university departments. Again, that is why a national committee comprised of all involved parties is necessary to navigate this challenging process.
Concluding Comments
Two students graduate with a master’s degree in counseling. Both took elective courses in their area of interest; one in mood disorders, the other in addiction, and both did an internship in a counseling setting focused on their interest area. Upon graduation, the student with an interest in mood disorders can easily be brought onto the clinical roster of a mood disorders clinic and immediately start accruing hours towards licensure. Their provisional license is all that is required during the training period. Unfortunately, the graduate with an interest in addiction may face competing licensure and/or credentialing requirements between professional and addiction counseling, mandated extra training coupled with thousands of extra supervised hours, and/or the possibility of a denial of employment without the appropriate addiction credential.
The purpose of this article is to start the dialogue on how to effectively incorporate addiction counseling into the scope of practice and accepted role of the professional counselor. We firmly believe that effective counseling focused on addiction issues requires specific and rigorous counselor training. However, we also believe the current national practice of training and credentialing for addiction counseling must change. State-by-state, burdensome (and in some instances outdated) rules and regulations are keeping countless qualified, capable, and motivated counselors from entering the addiction field. The time has come to recalibrate the rest of the counseling profession to better fit an inclusive and unifying professional counseling identity that includes addiction counseling.
References
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New Jersey Alcohol and Drug Counselor Committee. NJSA 45:2D-1 through 45:2D-18, 13:34C-1.1 through 13:34C-6.4.
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Keith Morgen, NCC, teaches at Centenary College, Geri Miller teaches at Appalachian State University and LoriAnn S. Stretch teaches at Walden University. The authors thank Anna Misenheimer, Executive Director of the North Carolina Substance Abuse Professional Practice Board, for serving as a reader of the early drafts of this paper. Her feedback was critical in our sharpening the preliminary focus of the paper. Correspondence can be addressed to Keith Morgen, Centenary College, 400 Jefferson Street, Box 403, Hackettstown, New Jersey, 07840, morgenk@centenarycollege.edu.
Sep 4, 2014 | Author Videos, Volume 1 - Issue 2
Robert C. Reardon, Sara C. Bertoch
Educational counseling has declined as a counseling specialization in the United States, although the need for this intervention persists and is being met by other providers. This article illustrates how career theories such as Holland’s RIASEC theory can inform a revitalized educational counseling practice in secondary and postsecondary settings. The theory suggests that six personality types—Realistic, Investigative, Artistic, Social, Enterprising, and Conventional—have varying relationships with one another and that they can be associated to the same six environmental areas to assess educational and vocational adjustment. Although educational counseling can be viewed as distinctive from mental health counseling and/or career counseling, modern career theories can inform the practice of educational counseling for the benefit of students and schools.
Keywords: educational counseling, career theory, Holland, secondary education, postsecondary education
In searching for a formal definition of educational counseling, we found only one in the APA Dictionary of Psychology (VandenBos, 2007):
The counseling specialty concerned with providing advice and assistance to students in the development of their educational plans, choice of appropriate courses, and choice of college or technical school. Counseling may also be applied to improve study skills or provide assistance with school-related problems that interfere with performance, for example, learning disabilities. Educational counseling is closely associated with vocational counseling because of the relationship between educational training and occupational choice. (p. 314)
The Counseling Dictionary (Gladding, 2006) does not mention the term “educational counseling” in the following definition of counseling.
The application of mental health, psychological or human development principles, through cognitive, affective, behavioral or systemic interventions, strategies that address wellness, personal growth, or career development, as well as pathology. (Gladding, 2006, p. 37)
A renewed focus on educational counseling may be underway. The American Counseling Association meeting in Pittsburgh in 2010 brought together delegates from 29 major counseling organizations who agreed for the first time on a common definition of counseling. Educational goals were explicitly included in this definition: “Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education, and career goals” (Breaking News, May 7, 2010).
The purpose of this article is to describe five functions essential for educational counseling (Hutson, 1958) and to use them to illustrate how Holland’s RIASEC theory might inform this counseling practice: (a) choosing a college or school for postsecondary training, (b) selecting an academic program or major, (c) adjusting to the college or academic program, (d) assessing academic performance, and (e) connecting education, career, and life decisions.
Historical Perspective
In tracing what has happened to educational counseling, a brief historical review can be helpful. In the early days of the vocational guidance movement, Brewer (1932) shifted the focus of guidance from vocation and occupation to education and instruction. He went so far as to institutionalize guidance as a professional field by linking the terms education and guidance and even using them synonymously. This could have elevated educational counseling to a more prominent position in the profession, but that did not happen. Brewer and others viewed guidance as limited by the descriptive adjective “vocational” with an emphasis on occupational choice (Shertzer & Stone, 1976), and this resulted in an estrangement between vocational and educational counseling.
Shertzer and Stone (1976) reported that the term “educational guidance” was first used in a doctoral dissertation by Truman L. Kelley at Teachers College, Columbia University, in 1914, and that he used it to describe the help given to students who had questions about choice of studies and school adjustment. Stephens (1970) pointed out that the shift from vocational choice to “guidance as education” ruptured the basic nature of the vocational guidance movement, separating the focus on “vocation” to “education.” Thus, vocational theory became associated with occupational choice and only tangentially related to educational choice, and we view this as leading to the separation of educational guidance and counseling from career theory.
In a comprehensive review of educational guidance literature published from 1933–1956, Hutson (1958) saw the counseling element of the educational guidance program as its most important function. He devoted a chapter to “Counseling for Some Common Problems” in which he identified 10 discrete but overlapping counseling situations. Several elements focused on educational counseling, including choice of subjects and curriculums, college-going (choice of going to college or working; choice of a particular college), and length of stay in school. Each of these problem areas involved counseling related to student psychological and educational characteristics, goals, and decision-making skills. Of relevance to this article, Hutson identified no theory related to educational counseling and cited only the vocational theory of Eli Ginzberg (Ginzberg, Ginsburg, Axelrad, & Herma, 1946) as informing vocational counseling. Theory-based educational counseling had not yet arrived.
The practice of educational counseling has faded from view in contemporary guidance and counseling literature. We conducted a search of journal titles and abstracts within the social sciences area using the term “educational counseling” and our university’s online library database system using Cambridge Scientific Abstracts (CSA) and PsychInfo. We were interested in how many “hits” for the past 10 years we would find in the following journals: Career Development Quarterly, Journal of Career Assessment, Journal of College Counseling, Journal of College Student Development, Journal of Counseling & Development, and Journal of Counseling Psychology. The search provided a total of seven results with only four falling into one of these six journals.
Advising, Coaching, Brokering
While the field of educational counseling seems to have been in decline for the past 50 years, other specialties have emerged to take its place, including academic advising, academic coaching, and educational brokering.
The field of academic advising has been very active in the past 30 years. Ender, Winston, and Miller (1984) defined developmental academic advising as “a systematic process based on a close student-advisor relationship intended to aid students in achieving educational, career, and personal goals through the utilization of the full range of institutional and community resources” (p. 19). Later, Creamer (2000) defined it as “an educational activity that depends on valid explanations of complex student behaviors and institutional conditions to assist college students in making and executing educational and life plans” (p. 18). While generally careful to distinguish between the terms advising and counseling, the National Academic Advising Association (NACADA; http://www.nacada.ksu.edu/index.htm) has fully embraced most of the educational planning and adjustment issues faced by postsecondary students that heretofore might have been included in the domain of educational counseling.
It is beyond the scope of this article to fully explore the notion of academic coaching, so we will limit our comments to the general field of life and career coaching (Chung & Gfroerer, 2003; Patterson, 2008). In general, proponents view coaching as a service focused on a student’s future goals and the creation of a new life path based on less formal collegial mentoring relationships and a positive, preventive wellness model. Opponents view coaching as practicing counseling without proper training or certification because there are limited professional standards or requirements in the coaching field.
Finally, the educational brokering movement in the 1970s was focused on helping adult learners navigate their way through postsecondary educational experiences (Heffernan, 1981). The educational broker independently assisted learners in the process of exploring, researching, and deciding on educational alternatives available. Some educational brokering proponents (Heffernan, 1981) held the view that an educational counselor employed by a specific institution would be biased and “guide” prospective students into the academic programs offered by the employing organization. Brokers were seen as neutral guides to the full range of educational options available to postsecondary learners.
Modern Career Theories
In this article, we examine the topic of educational counseling and suggest that modern career theories could contribute to a revitalization of this function. These theories, identified and described by Brown (2002), include career contextualist theory (Young, Valach, & Collin, 2002); Gottfredson’s theory of circumscription, compromise, and self-creation (L. Gottfredson, (2002); cognitive information processing theory (Sampson, Reardon, Peterson & Lenz, 2004); life stage/life space theory (Super, Savickas, & Super, 1996); narrative construction theory (Savickas, 2002); person-environment correspondence theory (Dawis, 2002); RIASEC theory (Holland, 1997); and social cognitive career theory (Lent, Brown, & Hackett, 2002). We illustrate our idea of how career theory might be useful in educational guidance and counseling programs using Holland’s (1997) RIASEC theory, emphasizing the environmental aspect of the theory.
Thus far, we have identified the function of educational counseling as an early component of the developing field of guidance and counseling, and we have outlined trends that have negated that function more recently. The irony is that the need for educational counseling services remains strong today, but it needs revitalization. We believe that the application of new theory, especially career theory, would be useful in that process and inform practice and research in the field. In this article, we focus on Holland’s RIASEC theory as one theory for accomplishing this revitalization. At the same time, we draw upon some of the basic functions of educational counseling drawn from the literature (Hutson, 1958; VandenBos, 2007).
Holland’s RIASEC Theory
Holland’s theory and the related tools such as the Self-Directed Search (SDS; Holland, 1994) have become familiar icons in the career counseling field. Since the introduction of the SDS in 1972 and its use with over 29 million people worldwide (Psychological Assessment Resources, 2009), its incorporation into the Strong Interest Inventory (Harmon, Hansen, Borgen, & Hammer, 1994) and many other tools, we believe that most counselors feel comfortable and knowledgeable about this system. However, we also believe that the widespread familiarity with the hexagon and SDS is based on incomplete and outdated understandings of Holland’s contributions. For many, the theory is viewed as a simple matching model of three personality types, e.g., the three-letter SDS summary code, and the codes of occupations taken from some source, e.g., O*Net (http://online.onetcenter.org/), Occupations Finder (Holland, 2000).
One reason for the partial understanding of Holland’s theory and applications may be the result of the massive volume of research and literature that has been produced since 1957. Authors (2008) reported 1,609 reference citations from 1953–2007 in 197 different journals which make it extremely difficult to fully understand and utilize this body of work. Moreover, many articles have appeared in education journals not often read by counselors, e.g., Journal of Higher Education, Research in Higher Education, Higher Education, and the Review of Higher Education. It is no small irony that Holland’s early work was undertaken in educational settings examining students undecided about their major, adjustment to college, the nature of academic environments, and the work of the faculty within disciplines. Smart, Feldman, and Ethington (2000) recognized this gap in applying Holland’s work to higher education, and their research collaborators have published over 20 articles seeking to address it.
This article focuses on how college students struggle with varied educational decisions, e.g., undecided about their college major, and then examines the ways in which Holland’s RIASEC theory might be used in educational interventions. We begin with a review of Holland’s theory with respect to personality and environment, and then describe several practical tools based on the theory that might be used in educational counseling.
Personality
Holland’s typological theory (Holland, 1997) specifies a theoretical connection between personality and environment that makes it possible to use the same RIASEC classification system for both. Many inventories and career assessment tools use the typology to enable individuals to categorize their interests and personal characteristics in terms of combinations of the six types: Realistic (R), Investigative (I), Artistic (A), Social (S), Enterprising (E), or Conventional (C). These six types are briefly defined in relation to educational options in Table 1.
According to RIASEC theory, if a person and an environment have the same or similar codes, e.g., an Investigative person in an Investigative environment, then the person will likely be satisfied and persist in that environment (Holland, 1997). This satisfaction will result from individuals being able to express their personality in an environment that is supportive and includes other persons who have the same or similar personality traits. It should be noted that neither people nor environments are exclusively one type, but rather combinations of all six types. Their dominant type is an approximation of an ideal, modal type.
The profile of the six types can be described in terms of a number of secondary constructs, e.g., the degree of differentiation (flat or uneven profile), consistency (level of similarity of interests or characteristics on the RIASEC hexagon for the first two letters of a three-letter Holland code), or identity (stability characteristics of the type). Each of these factors moderates predictions about the behavior related to the congruence level between a person and an environment. These secondary constructs provide an in-depth schema for understanding a person’s SDS results with diagnostic implications regarding the amount of counselor involvement and skill that may be needed for an intervention (Reardon & Lenz, 1999). Given extended discussion of these ideas in other literature (Reardon & Lenz, 1998), we will not focus on them here but concentrate our attention on the environmental aspects of RIASEC theory in education.
Environments
While the personality aspects of Holland’s theory are widely known, the environmental aspects—especially of college campuses, fields of study, and work positions—are less well understood and appreciated (Gottfredson & Holland, 1996). Holland’s early efforts with the National Merit Scholarship Corporation (NMSC) and the American College Testing Program enabled him to look at colleges and academic disciplines as environments. It is important to note that RIASEC theory had its roots in higher education and later focused on occupations.
Gottfredson and Richards (1999) traced the history of Holland’s efforts to classify educational and occupational environments. Holland initially studied the numbers of incumbents in a particular environment to classify occupations or colleges in terms of RIASEC categories, but he later moved to study the characteristics of the environment independent of the persons in it. College catalogs and descriptions of academic disciplines were among the public records used to study institutional environments. Astin and Holland (1961) developed the Environmental Assessment Technique (EAT) while at the NMSC as a method for measuring college RIASEC environments.
Smart et al. (2000) presented evidence concerning the way academic departments socialize students. They reported that “faculty members in different clusters of academic disciplines create distinctly different academic environments as a consequence of their preference for alternative goals for undergraduate education, their emphasis on alternative teaching goals and student competencies in their respective classes, and their reliance on different approaches to classroom instruction and ways of interacting with students inside and outside their classes” (p. 238). Furthermore, these environments “have a strong socializing influence on change and the stability of students’ abilities and interests—that is, what students do and do not learn or acquire as a consequence of their collegiate experiences” (p. 238). Smart et al. noted that faculty in Investigative, Artistic, Social, and Enterprising disciplines create academic environments in a manner consistent with Holland’s theory, and “the degree to which academic environments are ‘successful’ in their efforts to socialize students to their respective patterns of abilities and interests thus appears to differ considerably, with Artistic and Investigative environments being the most ‘successful’ and the Social and Enterprising environments being less ‘successful’” (p. 146).
These findings suggest that students might best view academic programs in terms of the IASE schema and focus on the kinds of abilities and interests they wish to develop while in college. Such understandings and goal setting could be explored in educational counseling.
Finally, Tracey and Darcy (2002) reported that college students without an intuitive RIASEC schema for organizing information about interests and occupations experience greater career indecision. This finding suggests that the RIASEC hexagon may have a normative benefit regarding the classification of occupations and fields of study. There is increasing evidence that a RIASEC cognitive structure is associated with positive career decision variables (Tracey, 2008). Persons adhering to this structure had stronger career certainty, interest-occupation congruence, and career decision-making self-efficacy at the beginning of a career course than those not using the RIASEC structure. Moreover, teaching this structure in a career course led to increased certainty, congruence, and self-efficacy at the end of the course for those adhering to the model.
Using RIASEC Theory in Educational Counseling
In this section, we discuss the five basic educational counseling functions identified by Hutson (1958), and how Holland’s RIASEC theory might inform this practice. To address these five problems in educational counseling from a RIASEC perspective, it would be important for the counselor to have a basic understanding of Holland’s theory (Holland, 1997). The client might complete the Self-Directed Search (Holland, 1994) and review the Occupations Finder (Holland, 2000), Educational Opportunities Finder (Rosen, Holmberg, & Holland, 1997), and You and Your Career (Holland, 1994) booklets. These materials operationalize and explain the theory in client terms. Armed with this basic information and these tools, the counselor and client can enter into a collaborative relationship to resolve educational problems and make educational decisions.
Choosing a College or School
The number of options for education and training is very large. Choices Planner (Bridges, 2009) was examined for one state and 196 postsecondary schools offering associate, bachelors, and professional (postgraduate) degrees were found. The Choices system makes it possible to use varied criteria for selecting among these options, including five school types, (e.g., public, private), specific miles from a designated ZIP postal code, six regions of the state, five campus or town settings of the school, eight tuition ranges, five affiliations (e.g., women, religious), on-campus housing, and over 30 sports options for men or women. If the student wanted to explore options in additional states the number of options would grow exponentially.
The array of postsecondary schools has very limited options for Realistic and Conventional types, which led Smart et al. (2000) to exclude these areas from their study of baccalaureate level colleges and universities. College level occupations are least frequently associated with the Conventional and Realistic categories, while Investigative and Artistic work are most likely associated with college level employment or the highest level of cognitive ability. Smart et al. found few college majors, faculty, or students in their samples categorized as Realistic or Conventional.
Taking this a step further, the number of associate, bachelors, and professional academic programs listed in the Educational Opportunities Finder (EOF; Rosen et al., 1997) were tabulated in relation to RIASEC categories. Of the 750 postsecondary programs of study listed in the EOF, there were 296 offered at the associate level, 492 at the bachelor’s level, and 645 at the professional level. Because some programs are offered at more than one degree level, the resulting total degree programs listed in the EOF number 1,517. Inspection of Figure 1 shows proportionally more Realistic and Conventional programs are available at the associate degree level in comparison to the other two degrees. Conversely, more professional degrees are offered in the IAS categories. This suggests that vocational technical schools and community colleges would be the types of schools most likely offering programs in these two areas. In this way, RIASEC theory could be used to guide selection of a school.
Authors (1996) documented this phenomenon in their research and reported that the student body at their postsecondary institution was composed predominately of S, E, and I types, creating an SEI-type school. They reported 153 fields of study at the university enrolled 10,439 students with declared majors in the following categories: R, 5%; I, 19%; A, 13%; S, 34%; E, 19%; and C, 10%. This suggests a student body with a profile of SEIACR. Such a student population would find C and R types in a minority.
RIASEC theory can inform the process of choosing a college by providing a conceptual schema of six environments and judging the priority and influence of each in socializing enrolled students. Students with E-type personalities (e.g., interests and skills) might have the best fit in a school that reinforced and prized those traits, and the same would be true for the remaining RIASC environments. In the following sections we will explain more how the environmental aspect of RIASEC theory may be used in educational counseling.
Selecting an Academic Program or Major
The Choices Planner (Bridges, 2009) lists over 780 specific academic programs or fields of study (majors) for students for the selected state. Large universities may have several hundred undergraduate majors and this can be overwhelming to students required to pick one field. Holland’s RIASEC schema can help to make the process of exploring and selecting options less daunting. This section describes some ways this might happen.
First, when students understand the basic elements of RIASEC theory they are armed with a schema for categorizing a great amount of academic information. Table 1 illustrates the operation of this schema in practical terms. Students intent on pursuing a bachelor’s degree can be informed that most college fields of study or disciplines are concentrated in Holland’s Investigative, Artistic, Social, and Enterprising areas (Smart et al., 2000), which reduces hundreds of options to four areas.
Second, the research by Smart et al. (2000) of bachelor’s programs was based on the idea that “faculty create academic environments inclined to require, reinforce, and reward the distinctive patterns of abilities and interests of students in a manner consistent with Holland’s theory” (p. 96). Moreover, “students are not passive participants in the search for academic majors and careers; rather, they actively search for and select academic environments that encourage them to develop further their characteristic interests and abilities and to enter (and be successful in) their chosen career fields” (p. 52). This is an important idea because it puts the power of informed choice in the hands of students as they explore educational options. They can actively select the type of environment in which they desire to spend their time and in which they wish to learn while in college.
Third, Smart et al. (2000) described primary and secondary recruits entering bachelor’s level academic programs. Primary recruits were freshmen entering disciplines directly from secondary school (discussed in this section) and secondary recruits (discussed in the next section) were those who changed their minds after entering college. Based on their research, Smart et al. found that two-thirds of freshmen (primary recruits) initially selected majors in the Social area and remained in that area over four years, while only slightly more than half of the students in the Enterprising area persisted in that area over four years. Students in the Artistic and Investigative areas both persisted over four years at 64%. Overall, about two-thirds of freshmen (primary recruits) persisted in one of the four disciplines initially selected and about 30% changed to another area.
The information gleaned from research by Smart and his colleagues of bachelor’s level programs can help inoculate students for relief of some of the anxiety regarding the selection of an academic program. Rather than simply focusing on the occupations related to a major in making a choice, students can focus on the nature and characteristics of the IASE environments and prioritize them according to their goals, interests, values, and skills. These understandings would also help students search for information about academic programs that provide details about whether or not the way life in the program is consistent or inconsistent with the theoretical RIASEC environment characteristics, e.g., student relationships with professors, classroom activities, nature of learning projects, leadership styles favored.
Adjusting to the College or Academic Program
Faculty in IASE disciplines create specialized academic environments that are shared by the students selecting these majors. The variability in the socialization styles and the effects of the environments on student behaviors and thinking were described by Smart et al. (2000) and are summarized below. Increased understanding of these environmental characteristics is important in educational counseling and for student decisions about preferred fields of study.
Faculty in Investigative environments place primary attention on developing analytical, mathematical, and scientific competencies, with little attention given to character and career development. They rely more than other faculty on formal and structured teaching and learning, they are subject-matter centered, and they have specific course requirements. They focus on examinations and grades. This environment has the highest percentage of primary recruits (e.g., students select it as freshmen).
Faculty in Artistic environments focus on aesthetics and with an emphasis on emotions, sensations, and the mind. The curriculum stresses learning about literature and the arts, as well as becoming a creative thinker. Faculty also emphasize character development, along with student freedom and independence in learning.
Varied instructional strategies are used in these disciplines.
Faculty in Social environments have a strong community orientation characterized by friendliness and warmth. Like the Artistic environment, faculty place value on developing a historical perspective of the field and an emphasis on student values and character development. Unlike the Artistic environment, faculty also place value on humanitarian, teaching, and interpersonal competencies. Colleagueship and student independence and freedom are supported, and informal small group teaching is employed.
The Enterprising environment has a strong orientation to career preparation and status acquisition. Faculty focus on leadership development, the development and use of social power to attain career goals, and striving for common indicators of organizational and career success. Teaching strategies in this environment are very balanced, but faculty like most to work with career-oriented students regarding specialized issues related to organizational and individual achievement.
Once an academic program is selected as a major field of study and the student begins to interact with other students and faculty in the program, more information of a personal nature is acquired which can lead to adjustments that the student will need to make to excel in that environment. For example, when Smart et al. (2000) examined college environments (the percentage of seniors in each of the IASE areas), they found that from 30–50% of the four environments were composed of primary recruits and about half were secondary recruits, e.g., the seniors who had changed their majors. This means that almost half the seniors ended up in an IASE discipline that was different from their initial choice.
Students migrated to and from the four environments in different ways. For example, two-thirds of the seniors in the Artistic environment were secondary recruits from one of the other areas; they did not intend to major in the Artistic area in their freshman year. In addition, about one third of the students migrating into the Social area came from Investigative, Enterprising, or undecided areas. Stated another way, the Social environments appear to be the most accepting and least demanding of the four environments studied by Smart et al. (2000) and Social disciplines seem to have the least impact and the least gains in related interests and abilities. Students moving into the Investigative area were most likely to come from the Enterprising area, and vice versa.
These findings (Smart et al., 2000) reveal the fluid nature of students’ major selections and the heterogeneous nature of the four environments with respect to the students’ initial major preferences. They also provide information regarding the migration of students among the IASE disciplines, and this can inform educational planning for students and counselors about the way in which these four disciplines interact with different types of students.
In summary, Smart et al. (2000) found that congruent students in Investigative, Artistic, and Enterprising environments increased their pattern of self-reported interests and abilities over four years by further developing what was already present in their personality. These three environments also increased the related traits for incongruent students, but the gap between the congruent and incongruent students did not decrease over time. In other words, students in both congruent and incongruent environments made equivalent or parallel changes in self-reported abilities and interests over four years, but students in congruent environments had higher levels of interests and abilities at the end of four years. Investigative and Enterprising environments had the most impact on student characteristics. These findings, if communicated to students in educational counseling, could affect the nature of discussions about students’ educational goals in college.
Assessing Academic Performance
Early in his career, Holland (1957) began to discuss the impact of college on students and how varied personality traits and beliefs other than aptitude were associated with success. Gottfredson (1999) noted that Holland’s early research demonstrated that much of the output from the college experience was related to what students brought into that experience. According to Gottfredson, Holland promoted the idea that college selection practices relying heavily on measures of academic potential resulted in much lost talent, e.g., selection of the top 10% of high school students based only on grades would exclude about 86% of high school class presidents (Enterprising types). The idea that noncognitive traits (e.g., RIASEC personality types) would be important in assessing academic performance is a noteworthy contribution of Holland’s theorizing and research.
Academic success is sometimes measured in terms of persistence on the part of the student or retention on the part of the institution. Other immediate outcome measures might include the grade point average, student satisfaction, awards received, or engagement in program activities, while longer term outcomes might include professional accomplishments, contributions, and recognitions. It should be noted that while all academic programs require cognitive skill and ability, some programs further emphasize interests and abilities related to the RIASEC areas identified in Table 1. These could include creativity, leadership, community service, and the like.
According to RIASEC theory, students in an environment that is highly congruent or matches with their personality will persist in that environment and achieve awards and recognition from the environment. In the process of educational counseling, students should have opportunities to clarify what it means to be in, or move to or out of, an environment that either matches their type or provides an opportunity to develop desired skills and interests. Their achievements and satisfaction would theoretically be related to the quality of the match between their personality and the environmental characteristics.
Connecting Education to Career and Life
Holland’s RIASEC theory provides a relatively simple, effective scheme for thinking about people (e.g., personalities, traits, interests, values, behaviors, attitudes) and their options (e.g., educational programs, occupations, work organizations, leisure activities). Conceptualizing people and options in these six areas can improve personal and career decision making.
Several examples of this strategy are apparent. For example, when students conduct information interviews they might structure questions and make observations about the degree to which the various RIASEC codes are prevalent in the life of the interviewee or characterize the organizational setting. In considering job offers, students might use the RIASEC schema to assess the quality of the fit between their personality and the culture of the organization, or more particularly, the personality of their immediate supervisor.
The UMaps project at the University of Maryland is a good example of applying RIASEC theory to life/career options (Jacoby, Rue, & Allen, 1984). The UMaps program operated out of the Office of Commuter Affairs in the Division of Student Affairs and was designed to help students become aware of diverse campus opportunities, options, and resources related to RIASEC types. Using both large posters displayed on bulletin boards and brochures distributed by advisors, each of the six RIASEC UMaps had a standard layout including areas of study (with office locations and phone numbers), sample career possibilities, internship and volunteer options, and student organizations and activities related to each type. Each map also had a brief description of the RIASEC type and a brief self-assessment related to interests and skills.
As reported earlier, Reardon, Lenz, and Strausberger (1996) used an earlier version of the Educational Opportunities Finder (Rosen et al., 1997) to classify all of the majors at a large university, and then used these data to assess the types of students seeking services in the career center and to design appropriate interventions. For example, it was judged that Realistic and Investigative students might prefer independent career planning using a computer-assisted guidance system, e.g., Choices Planner, rather than an individual counseling session.
Descriptive information about college majors could include the kinds of information summarized by Smart et al. (2000) about course structures, learning style expectations, faculty interests and activities, and program objectives. Other student information materials could list volunteer experiences related to the discipline (if any), introductory classes, sample employment opportunities, and profiles of graduates. Brochures and other descriptive information used in academic advising and educational counseling could be indexed or include information about Holland codes. These examples illustrate the ways in which RIASEC theory applied in educational counseling might be extended to broader life and career decisions.
Summary and Implications
This article illustrates how the educational counseling function has become estranged or lost in traditional counseling practice in secondary and postsecondary settings. While educational counseling can be viewed as distinctive from mental health counseling and/or career counseling, modern career theories can inform the practice of educational counseling for the benefit of students and schools. Holland’s RIASEC career theory, especially the extensive research on educational environments conducted by Smart and his associates (2000) and reported in more than six different journals, was used to illustrate this idea.
Educational counselors using RIASEC theory need to be fully informed about the theory, the research that supports it, the instruments that are based upon it, and the counseling techniques that could be derived from it. Such theory-driven practice might represent a new paradigm in educational counseling. Holland’s (1997) theory, like other career theories, has the most power when the extremes of wealth, social class, genetic traits, and health are not in effect. In other words, career theory probably works best in educational counseling for students in general rather than those at the extremes of any personal trait or situation.
RIASEC theory can be useful in educational counseling by specifying the kinds of conditions and traits associated with difficulties in educational decision making. Authors (1998, 1999) and Holland, Gottfredson, and Nafziger (1975) indicated that persons with poor diagnostic signs on the Self-Directed Search, e.g., lack of congruence between expressed and assessed summary codes, low differentiation, low consistency, low coherence among aspirations, low profile elevation, and a high point code in the Realistic or Conventional area, were likely candidates for more intensive counseling interventions. This is a special province of educational counselors because of their professional counselor training as opposed to the standard training for academic advisors or coaches. Students with high Artistic codes also may be problematic because of their preference for a non-rational approach to decision making (Holland et al., 1975). Persons with such diagnostic signs will likely need more time and professional, individualized counselor assistance in career problem solving and decision making.
Smart et al.’s (2000) research reveals some of the variations in academic departments and suggests implications for college and university organizational systems. It is important for counselors and other staff to inform students about the impact of majors and academic disciplines on the development of student interests and skills. At present, advisors make students aware of many aspects of a major, e.g., required courses, prerequisites, entrance requirements, and the occupations most closely aligned with the major. Providing additional information based on the research findings by Smart et al. regarding the way academic environments socialize or affect students pursuing that major will make students better “consumers” of majors or “shoppers” of academic programs.
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Robert C. Reardon, NCC, is Professor Emeritus and Sara C. Bertoch, NCC, is a career advisor, both at the Career Center at Florida State University. Correspondence can be addressed to Robert C. Reardon, Florida State University Career Center,
PO Box 3064162, Tallahassee, FL, 32306, rreardon@fsu.edu.
