Perceptions of the Importance and Utilization of Clinical Supervision Among Certified Rural School Counselors

Dec 2, 2014 | Article, Volume 4 - Issue 5

Kelly Duncan, Kathleen Brown-Rice, Gerta Bardhoshi

This study explored rural school counselors’ perceptions of clinical supervision. School counselors working in rural communities commonly encounter issues that challenge their ability to provide competent counseling services to the students they serve. School counselors serving in these areas are often the only rural mental health provider in their community, and they may lack access to other professionals to meet supervision needs. Participants’ (n = 118) current experiences and future needs were investigated concurrently with supervision training and delivery methods most desired. The majority of school counselors in the study reported that they perceive clinical supervision as an important element in their continued personal and professional growth. However, these school counselors reported not receiving supervision at an individual, group or peer level. The need for the supervision is apparent; however, access to supervision in rural areas is limited. Implications for school counselors and recommendations for future research are discussed.

Keywords: rural school counselors, clinical supervision, supervision training, personal and professional growth, rural mental health

With increasing regularity, school counselors are finding themselves on the front lines of using clinical counseling skills to address issues their students bring to school (Teich, Robinson, & Weist, 2007; Walley, Grothaus, & Craigen, 2009). Despite an increase in the mental health needs of school-aged children (Perfect & Morris, 2011), limited mental health services are a reality in rural areas (Bain, Rueda, Mata-Villarreal, & Mundy, 2011). Although there is not a clear definition of the term rural, the U.S. Census Bureau (2010) has characterized urban areas as those with 50,000 or more people, and urban clusters as those communities with a population of 2,500–49,999. School counselors working in rural communities commonly encounter issues that challenge their ability to provide competent counseling services to students (Cates, Gunderson, & Keim, 2012). In fact, school counselors serving in rural areas are often the only mental health provider in their community, and they may lack access to other professionals to meet supervision needs (Bardhoshi & Duncan, 2009).With mental health needs in rural areas being greater than the resources available, and rural school counselors indicating a need for more mental health training and resources to close this gap (Bain et al., 2011), meeting the professional needs of rural school counselors becomes imperative.

Bradley and Ladany (2010) described the competent school counselor as a skilled clinician able to identify and meet the unique needs of the students he or she serves. They further asserted that rural areas provide unique demands for the school counselor, who is often expected to provide a wide range of services to a diverse population. Despite recommendations that professional counselors obtain supervision throughout their careers, traditional face-to-face supervision meetings are not always feasible and rural counselors may not have direct access to a supervisor, even though they have a desire for one (Luke, Ellis, & Bernard, 2011;Tyson, Pérusse, & Stone, 2008). Although there is a need for trained professional supervisors, supervision in rural areas is difficult to obtain for many counselors because of the distance between professionals, which creates geographic isolation (Wood, Miller, & Hargrove, 2005).

There are a number of challenges to receiving quality supervision. Rural school counselors encounter isolation, lack of time and money, a lack of specialists, and decreased personal interaction (McMahon & Simons, 2004). All of these characteristics of working in a rural setting make supervision and consultation, which are essential in the development of a professional identity, difficult to obtain (McMahon & Simons, 2004).

Clinical supervision is designed to aid the professional counselor in enhancing professional skill and ethical competency (Bradley & Ladany, 2010). A clinical supervisor in the schools must be a professional who is not only competent in the realm of school counseling functions, but also in supervision practices (Gysbers & Henderson, 2000). The supervision element of school counseling is further complicated as there often is a need for different types of supervision. There is need for both administrative and clinical supervision for practicing school counselors (Bradley & Ladany, 2010), and at times these different types of supervision may conflict with one another. Administrative supervision focuses on policies and procedures governing the school community, and this form of supervision in a school setting is most often performed by a school administrator who may not have a counseling background (Henderson & Gysbers, 1998). In comparison, clinical supervision is an intervention that a senior member of the profession delivers to a junior member in order to enhance professional abilities and monitor the counseling services offered (Bernard & Goodyear, 2009). This reality of school counseling supervision would suggest that those providing clinical supervision need to not only be certified as school counselors in order to qualify as senior members of the profession, but also have supervision training in order to effectively carry out supervision interventions.

For school counselors, supervision is a direct venue for providing or receiving support and feedback (Lambie, 2007). Both peer consultation and supervision are related to lower levels of stress in school counselors (Culbreth, Scarborough, Banks-Johnson, & Solomon, 2005). There is evidence that obtaining clinical supervision is indeed beneficial to school counselors, with research pointing to professional and personal gains, including enhanced counseling skills, sense of professionalism, support and job comfort (Agnew, Vaught, Getz, & Fortune, 2000). There also are a number of studies examining the protective utility of clinical supervision regarding school counselor burnout. Prevention of burnout is an important issue for rural school counselors who report feelings of frustration as they struggle to provide as much counseling as possible to their students (Bain et al., 2011).

When assessing the effect of clinical supervision on burnout, Feldstein (2000) reported that clinical supervision had a positive effect on reducing levels of emotional exhaustion and burnout in school counselors. In a recent study, Moyer (2011) reported that the amount of clinical supervision received was a significant predictor of overall burnout in school counselors (as well as the dimensions of incompetence, negative work environment and devaluing clients). These findings support the notion that clinical supervision may serve as an important protective factor against burnout for school counselors, and even ameliorate burnout levels once manifested. A similar recommendation was provided by Lambie (2007), who identified clinical supervision as an essential resource that can be utilized to overcome school counselor burnout.

Even though administrative supervision generally is available to school counselors, clinical supervision usually is not (Herlihy, Gray, & McCollum, 2002). Page, Pietrzak, and Sutton (2001) reported in their national survey (n = 267) that only 13% of school counselors were receiving individual clinical supervision and only 10% were receiving group clinical supervision, despite a desire to obtain supervision. A study examining rural school principals’ perceptions of school counselors’ role noted that approximately 12% of all respondents deemed professional development of little importance for school counselors (Bardhoshi & Duncan, 2009). Consequently, clinical supervision may not be supported in rural settings, as time spent in supervision may be seen as time taken away from understaffed schools.

Clinical supervision is best delivered by a counselor who is not only trained in supervision but who is also familiar with K–12 school settings (Bradley & Ladany, 2010). Despite school counselors’ desire to obtain more clinical supervision once working in a school setting, many face a challenge in obtaining such supervision. Peterson and Deuschle (2006) also discussed hesitation from school counselors to be supervisors, which could result from discomfort with the requirements of site supervision, or a feeling of being poorly trained in supervision. Supervision is, however, an important part of developing the professional and ethical decision-making skills that benefit clients and their stakeholders (Lambie, Ieva, Mullen, & Hayes, 2011). Due to these needs, developing trained school counselor supervisors is a vigorous step in meeting the supervision needs of school counselor trainees and practicing professionals (Page et al., 2001).

The purpose of the current study was twofold. The first purpose was to assess the current perceptions of certified school counselors serving in rural settings (RCSCs) regarding their clinical supervision experience and needs. The second purpose was to compare and contrast the current data with empirical data obtained 9 years ago in this same state from RCSCs, in order to examine whether the supervision needs of counselors in rural settings has changed. Specifically, the study was designed to answer the following research questions: (a) What are RCSC perceptions of the importance of individual, group and peer supervision? (b) What are participants’ current experiences with individual, group and peer supervision? (c) What are participants’ perceptions of their future need for clinical supervision? (d) If the training were available to equip a participant with the theory and skills to provide clinical supervision, how would respondents rate the importance of this training and by what means would participants prefer to receive this training? (e) How do current RCSC experiences and perceptions of individual, group and peer clinical supervision compare to the findings in a 2003 study of RCSCs?

In this study, RCSC refers to an individual certified by a state department of education working in a school in a state where the majority of school districts have fewer than 1,000 students. The terms certified and licensed are interchangeable. Clinical supervision is defined as an intensive, interpersonal focused relationship, usually performed one-to-one or in a small group, in which the supervisor facilitates the counselor(s) learning to apply a wider variety of assessment and counseling methods to increasingly complex cases (Bradley & Ladany, 2010). A clinical supervisor refers to a certified school counselor, licensed mental health professional counselor, social worker or psychologist who has at least 5 years’ experience in the field. Administrative supervision is defined as an ongoing process in which the supervisor oversees staff as well as the planning, implementation and evaluation of individuals and programs (Henderson & Gysbers, 1998).

Method

Participants

The target population for this study included all certified school counselors (CSCs) in a Midwestern state who were employed in a public or private school setting during the school year 2011–2012. Recruitment of participants was conducted by obtaining a list of all CSCs from the state’s Department of Education. All individuals who were identified as meeting these criteria received an e-mail. The e-mail directed participants to an online survey titled The 2012 School Counselor Survey. The number of CSCs provided by the Department of Education was 476. A total of 127 CSCs responded to the invitation to take part in this study, all of whom met the criteria for employment in a rural setting, resulting in a response rate of 27%. Respondents with missing or invalid data (n = 9, less than 7%) were eliminated via listwise deletion, leaving a total number of 118 participants in this study. Listwise deletion entails eliminating participants with missing data on any of the variables and is the appropriate method for removal of missing data due to this study’s sufficient sample size (Sterner, 2011).

Of the 118 participants (91 women, 27 men), 110 identified their cultural/racial background as Caucasian, five identified as Native American and three identified as Multiracial. Thirty-four participants stated their age as 25–35 years, 31 as 36–45 years, 30 as 46–55 years and 23 as 56 years or older. The majority of the respondents identified as married (n = 96), 15 as single and seven as having a life partner or being in a committed relationship. Twelve of the participants stated that they had 2 or fewer years of experience as school counselors, 18 had 3–5 years, 25 had 6–10 years, 42 had 11–20 years, 19 had 21–30 years and two stated that they had 40 or more years of experience. Regarding licenses and certifications held, 109 of the participants stated that they were South Dakota CSCs, 36 were National Certified Counselors, 12 were Licensed Professional Counselors, two held the Licensed Professional Counselor–Mental Health designation and one participant identified as a National Certified School Counselor.

Regarding the number of schools under participants’ direct responsibility, 86 indicated that they had one school, 21 had two schools, five had three schools, four had four schools and two had five schools. Five participants stated that they were responsible for direct counseling services for 100 or fewer students, 14 for 101–200 students, 22 for 201–300 students, 29 for 301–400 students, 18 for 401–500 students, 14 for 501–600 students, 10 for 601–700 students and six for 701 or more students. Twenty-one stated that there were no other school counselors in their school district, 15 stated that there was one other school counselor, 17 stated that there were two others, 13 stated that there were three to five, 29 stated that there were six to 11, seven stated that there were 12–18, six stated that there were 20–25, four stated that there were 45–50, five stated that there were 52–56 and one stated that there were 60 other school counselors in the participant’s district. Regarding the number of other school counselors working with them in the same building, 58 respondents stated that there were no other counselors, five stated that there was another part-time counselor, 29 stated that there was one other full-time counselor, 11 stated that there were two, four stated that there were three, five stated that there were four and six participants stated that there were five other counselors in their building.

Instrumentation

Participants completed a modified version of the school counselor survey used by Page et al. (2001) in their national survey of school counselor supervision. The modifications included additional questions related to participants’ perceptions of the usefulness of receiving supervision and supervision training via distance methods. Distance methods included the statewide video conferencing system, teleconference and e-mail. The Statistical Package for Social Sciences (SPSS) software (version 19.0) was utilized to screen the data, gather descriptive data and analyze the data, as well as to determine frequencies and percentages for the demographic variables. To answer the research questions, data were analyzed by creating tables using SPSS to determine frequencies, averages and percentages. For research questions 1, 2 and 3, a Fisher’s Exact Test (a variant of the chi-square test for independence for small sample sizes) with an alpha level of .05 was used to determine whether there was a relationship between a participant’s age, years of experience, number of schools under the participant’s direct responsibility, number of students for whom the participant had to provide counseling services, the presence of other CSCs in the building and district, and the participant’s responses.

Results

Importance of Supervision

Participants ranked the importance of individual clinical supervision based on a 6-point Likert scale (1 = not important to 6 = extremely important). When the participants’ indications of the top three options were combined, 79% (n = 93) rated the importance of obtaining clinical supervision as important, very important or extremely important, leaving 21% (n = 25) of participants who reported it being somewhat important, minimally important or not important. When asked about the importance of obtaining administrative supervision, 72% (n = 85) rated it as important, very important or extremely important, leaving 28% (n = 33) who reported it being somewhat important, minimally important or not important.

Cross-tabulation tables were conducted for each of the following variables: (a) age, (b) years of experience as a school counselor, (c) number of schools for which the counselor is responsible, (d) number of students for whom the counselor is responsible, (e) other school counselors in the district and (f) other school counselors in the building. A Fisher’s Exact Test with an alpha level of .05 was used to determine whether there was a relationship between these variables and participants’ perceptions of the importance of individual clinical and administrative supervision. These analyses determined that there was no significant relationship between these variables (age, p = .641; years of experience, p = .597; number of schools for which counselor is responsible, p = .516; number of students for whom counselor is responsible, p = .228; other school counselors in district, p = .319; other school counselors in building, p = .382).

Current Experiences with Supervision

When participants described the current supervision they were receiving, 94% (n = 111) stated that they were receiving no individual clinical supervision, and 6% (n = 7) stated that they were receiving individual clinical supervision. Of the participants receiving this type of supervision, one received supervision once a week, three received supervision once a month and three received supervision less than once a month. Ninety-one percent (n = 108) stated that they were not engaging in group supervision and 8% (n = 10) stated that they were, with seven of these respondents stating that they participated in group supervision once a month and three stating that they participated less than once a month. When asked to describe their clinical supervisor, seven stated that the supervisor was a guidance director, two stated that he or she was another school counselor and one stated that he or she was a psychologist.

Of the 14% (n = 17) of respondents who stated that they were receiving individual and/or group supervision, 11 reported that their school system was incurring the cost for supervision, four stated that they were shouldering all the cost themselves and two stated that they and their school system were paying the cost together. Eighty-eight percent (n = 104) indicated that their school district did not provide release time for them to attend supervision; the remaining 12% (n = 14) did receive release time. Eighty-two percent (n = 97) reported that they were not engaging in peer supervision, and 18% (n = 21) were obtaining peer supervision. Of the respondents receiving peer supervision, ten stated that it occurred once a week, one stated that it was every other week, eight stated that it was once a month, and two stated that it was less than once a month. Regarding administrative supervision, 81% (n = 97) stated that they were engaging in it; 19% (n = 21) were not. Sixty-four participants stated that their administrative supervision was conducted by a principal, seven stated that it was a vice principal, seven stated that it was another school counselor, five reported that it was a superintendent, five stated that it was a guidance director, five that stated it was a director of a specific program area (e.g., special education, student services) and three stated that their administrative supervision was conducted by a vice superintendent.

Cross-tabulation tables were conducted for each of the following variables: (a) age, (b) years of experience as a school counselor, (c) number of schools for which the counselor is responsible, (d) number of students for whom the counselor is responsible, (e) other school counselors in the district and (f) other school counselors in the building. A Fisher’s Exact Test with an alpha level of .05 was used to determine whether there was a relationship between these variables and participants’ current experiences with individual and/or group clinical supervision and/or peer supervision. The results indicated that there was a relationship between receiving group supervision and the number of other school counselors in participants’ district (p = .010), and a relationship between participants’ age and current participation in peer supervision (p = .017). All other analyses for these variables determined no significant relationship.

Future Need for Clinical Supervision

Participants ranked their need for future clinical supervision based on a 6-point Likert scale (1 = not important to 6 = extremely important). When the participants’ indications of the top three options were combined, 54% (n = 64) rated the importance of receiving clinical supervision in the future as important, very important or extremely important, leaving 46% (n = 54) who reported it being somewhat important, minimally important or not important. When respondents were asked whom they considered the most desirable person to be their clinical supervisor, 64% (n = 75) indicated another school counselor with specific training in supervision. Eighteen percent stated that the best supervisor would be a professor in counselor education, 6% indicated a mental health counselor, 6% specified a school psychologist, 5% indicated a psychologist, 2% identified a psychiatrist and 1% specified a social worker with a master’s degree.

Cross-tabulation tables were created for each of the independent variables: (a) cultural/racial background, (b) age, (c) years of experience as a school counselor, d) licensure/certification status, e) number of schools for which the counselor is responsible, f) number of students for whom the counselor is responsible, g) other school counselors in the district and h) other school counselors in the building. A Fisher’s Exact Test with an alpha level of .05 was used to determine whether there was a relationship between these variables and participants’ perceptions of their future need for clinical supervision. The results indicated that there was a relationship between participants’ age and their perception of their need for future clinical supervision (p = .016). All other analyses for these variables determined no significant relationship.

Future Training and Education Needs

When asked about the level of perceived importance of training and education regarding supervision theory and clinical supervision skills, when those were provided, participants ranked importance on a 6-point Likert scale (1 = not important to 6 = extremely important). After the participants’ indications of the top three options were combined, 67% (n = 79) rated the importance of receiving future clinical supervision training as important, very important or extremely important, leaving 33% (n = 39) who reported it being somewhat important, minimally important or not important. Of the 118 participants, the majority (n = 90) had access to the state’s video conferencing system. Fifty-three of the participants stated that they had access to Skype or another real-time communication system; therefore, over half of the participants (n = 65) stated that they did not have access. Fifty-three percent (n = 62) of the participants rated receiving supervision training via face-to-face workshop or conference as either very important or extremely important, whereas 32% (n = 27) rated receiving future clinical supervision training via video conferencing or teleconference as very important or extremely important.

Regarding the type of supervision training they wished to receive, 81% (n = 96) of the participants characterized training on developing specific supervision skills and techniques as important, very important or extremely important. When asked about wanting training to be able to assist supervisees in developing a respectful outlook on individual differences, 71% (n = 84) of the participants noted this type of training as either important, very important or extremely important. Regarding developing supervisees’ clinical skill set for counseling others of a different age, ethnicity, race, religion or sexual orientation, 75% (n = 89) of the participants ranked this type of training as either important, very important or extremely important. Seventy-seven percent (n = 91) of the participants ranked the development of supervision skills to assist supervisees in developing independence and self-directedness as important, very important or extremely important.

Comparing 2012 and 2003 Findings

In 2003 the first author completed a study of 267 RCSCs who took the 2003 School Counselor Survey (Duncan, 2003). Nearly 67% of the 2003 participants rated individual clinical supervision as important, very or extremely important; however, 91% stated that they were not receiving individual clinical supervision, and 92% stated they were not receiving group clinical supervision. In the current study, conducted 9 years later, we note an increase in the importance that school counselors place on receiving clinical supervision, but similar low rates of actually receiving clinical supervision. Specifically, in the current study, 79% of participants rated receiving clinical supervision as important, very important or extremely important; however, 94% stated that they were not receiving individual clinical supervision, and 91% stated they were not receiving group clinical supervision. Those receiving group supervision appear to work in settings where they are not the only counselor in their school.

Limitations

This study has three main limitations. First, the sample was obtained from an e-mail list of certified school counselors in one Midwestern state. The ability to generalize the findings to other states may be limited—especially to states that do not have a similar rural nature. Future research that examines all RCSCs would be beneficial. The second limitation of this study is that those who chose to participate may have answered the survey questions differently than members of the population who did not agree to participate might have answered them. The third limitation is due to the survey being a self-report measure, as the participants may have given answers that they believed to be socially desirable. In spite of being informed in advance that their responses would remain anonymous, the participants still may have answered in a way that did not portray their true feelings or knowledge.

Discussion

The results of this study indicate that the large majority of school counselors surveyed (79%) perceive clinical supervision as important. This number is in stark contrast to the actual number of school counselors receiving supervision, with the overwhelming majority of the participants stating that they are not receiving any individual or group supervision (94% and 91%, respectively). Although these findings confirm the results of previous studies conducted with school counselors that point to a clinical supervision deficit (Borders & Usher, 1992; Page et al., 2001; Roberts & Borders, 1994; Shanks-Pruett, 1991), the extremely low clinical supervision rates from the current study also may be tapping into challenges specific to rural school counselors. It is possible that many practicing rural school counselors have not engaged in supervision since their university training program and feel unequipped to answer questions about its nature or importance, which could potentially have larger implications regarding these counselors’ clinical skill application. Similarly, Spence, Wilson, Kavanagh, Strong, and Worrall (2001) noted that lack of skill application contributed to counselors’ difficulty in obtaining supervision. Compared to results obtained from a 2003 study with this population, although school counselors increasingly perceive clinical supervision as important (79% vs. 67% in the 2003 study), rates of obtaining clinical supervision have not changed substantially in almost 10 years. This may indicate that challenges for rural school counselors persist and that they may be at a disadvantage regarding their clinical skills and professional development.

Even for those few school counselors who reported receiving individual or group clinical supervision, current supervision practices are far from ideal. Of the seven participants who reported currently receiving supervision, four reported receiving it only once a month or less, and over 88% of participants shared that their school will not provide release time for them to pursue supervision. This may imply that school administrators do not understand the importance of clinical supervision. Herlihy et al. (2002) pointed out the erroneous perception that school counselors do not have the same need for clinical supervision as their mental health counterparts as a factor that impedes clinical supervision for school counselors. The possibility also exists that even though school counselors in this study see the need for clinical supervision, they may not be advocating for it. Rural school counselors may have to consider ways to receive clinical supervision in a manner that does not take time away from their duties or occurs outside school time. Although this may place additional strain on school counselors, forgoing clinical supervision altogether may have negative implications for their personal and professional well-being. Crutchfield and Borders (1997) warned that school counselors who do not receive supervisory support may find themselves dealing with increased stress and may feel overworked, burned out and isolated; and the literature clearly points out the benefits of clinical supervision for school counselors, including increased feelings of support, job satisfaction, enhanced skill development and competencies, and greater accountability (Herlihy et al., 2002; Lambie, 2007).

Although the majority of participants (81%) reported receiving administrative supervision, this form of supervision is conducted by noncounselors. This result supports other literature indicating that school counselors typically receive administrative supervision (Herlihy et al., 2002; Page et al., 2001). However, administrative supervision conducted by school personnel who are not trained in counselor supervision or the professional school counselor’s role does not assist school counselors in enhancing clinical skills and does not meet their professional development needs.

More than half of the participants (54%) said that they can see a need for clinical supervision in their future, an increase from 47% in 2003, and the majority of participants would want to receive this clinical supervision from another school counselor. Of extreme importance, is the fact that there is no supervision training in most master’s-level school counseling preparation programs. The majority of school counseling practitioners who might be asked to supervise others (colleagues or counselors-in-training) do not have specialized training to provide this service. Even though 45% of respondents had supervised interns, 85% shared that they had no formal training. Over 67% of school counselors surveyed reported that they desired supervision training, with over half (53%) stating that they would prefer a face-to-face approach. Participants identified the following areas as ones in which they wanted training: gaining specific supervision skills (81%), acquiring skills to assist supervisees in developing individual skills and self-direction (77%), learning how to develop their supervisees’ skills (75%) and developing respect for individual differences (71%).

Implications for School Counselors

Use of technology for supervision delivery is still a relatively new concept for some professionals. Even though the American Counseling Association clearly states in its Code of Ethics (American Counseling Association, 2014) that reviewing supervisee practice, in addition to live observation, can occur through the use of technology, most school counselors have not had an opportunity to utilize technology as an avenue to gain supervision. Technological advances have made supervision delivery more available, and the use of these technologies may ultimately save individuals travel time and money. While the majority of respondents share a preference for supervision in a face-to-face format, school counselors may become more comfortable with electronic formats as they utilize them more often or with further training.

Counselor educators and supervision trainers will need to use creative methods when scheduling supervision training for professional school counselors. Weekend workshops, intensive summer courses and cooperative in-service programs might be used to provide supervision training. Collaborative efforts between university counselor training programs and state school counselor professional organizations could further orchestrate these opportunities. Counselor educators also might advocate to the Counsel for Accreditation of Counseling and Related Education Programs that supervision training be required in master’s-level school counselor training programs. School counselors desiring supervision may need assistance in advocating for these services. Research indicates that engaging school principals in counseling education can result in a deeper understanding and collaboration between the school counselor and the principal (Shoffner & Williamson, 2000). It is essential to help administrators understand the benefits of clinical supervision and make a case for the provision of opportunities for professional development and clinical supervision for rural school counselors, especially as these opportunities may positively impact burnout incidence.

Recommendations for Future Research

The results of this study provide potential directions for future research. Given the limited literature on clinical supervision for rural school counselors, it is important to fully examine any potential factors that may help conceptualize this phenomenon. Following up with a qualitative study would expand on the quantitative findings and provide a richer context for some of the results discussed. This might help identify additional factors of importance specific to rural school counselors.

Replicating the results of the current study with a random sample of rural school counselors who are practicing nationwide might increase the representativeness of the sample. Utilizing a sampling of rural school counselors who are practicing in only one state presents inherent limitations, as the results discussed may be specific to geographic location and may not apply to rural school counselors in other states.

Conclusion

     The majority of school counselors in both the 2003 and 2012 studies reported that they perceive clinical supervision as an important element in their continued personal and professional growth. However, these same groups reported that they are not receiving supervision at an individual, group or peer level. The need for the supervision is apparent, but the access to supervision is limited.

This situation calls for collaborative and coordinated action from counselor educators and leaders in the field. Creation of supervision training opportunities for practicing school counselors is warranted. Methods such as the utilization of technology to allow access to supervision for school counselors, especially for those in remote rural areas, are also important elements in the creation of an effective and efficient statewide supervision plan.

Buy-in from school administrators, school officials at the state level, school boards and counselor educators will be an important aspect of the origination of a statewide system. The need for supervision for rural school counselors is supported through these survey results. It will be imperative to create methods for continued evaluation of a statewide supervision plan to show how the ultimate consumers—the students—are benefitting from school counselors who are receiving supervision.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of

interest or funding contributions for

the development of this manuscript.

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Kelly Duncan, NCC, is an associate professor at the University of South Dakota. Kathleen Brown-Rice, NCC, and Gerta Bardhoshi, NCC, are assistant professors at the University of South Dakota. Correspondence can be addressed to Kelly Duncan, Division of Counseling and Psychology in Education, The University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069, Kelly.Duncan@usd.edu.

Group Counseling with South Asian Immigrant High School Girls: Reflections and Commentary of a Group Facilitator

Dec 2, 2014 | Article, Volume 4 - Issue 5

Ulash Thakore-Dunlap, Patricia Van Velsor

The diversity of the U.S. school population speaks to a need to provide support for youth from various backgrounds. As a school-based mental health counselor, the first author observed that the South Asian immigrant students at her school did not utilize any of the counseling services provided. Because South Asians are typically collectivistic, the counselor chose group counseling as a potential intervention and hoped to provide a place for the students to address issues related to orienting to a new school in a new country. In this article, the authors weave information about the South Asian population into the first author’s reflections and commentary on initiating and conducting a group with South Asian high school girls. Recommendations for group counseling in schools with South Asian immigrants are provided.

Keywords: South Asian, immigrant, youth, schools, group counseling

The United States has seen a marked increase in the number of children who have at least one parent born outside the United States (Capps et al., 2005). Between 1995 and 2012, the population of first- and second-generation immigrant children in the United States increased by 66% (Child Trends Data Bank, 2013). This sharp rise is important for American cities because 95% of all children of immigrants attend urban schools (Fix & Capps, 2005). Furthermore, according to a recent update from the Asian American Federation and South Asian Americans Leading Together (2012), the South Asian American population was the fastest growing major ethnic group in the United States from 2000–2010. Relationship building is part of acclimatizing to a new country for immigrant youth, and it is in the schools that these youth build new friendships and create social networks (Suárez-Orozco, Suárez-Orozco, & Todorova, 2008). For South Asian youth in American schools, group counseling can provide a setting for students to connect to others who share similar stories and experiences. Groups can offer a safe place for them to discuss their cultural norms, exchange stories of challenges and hope, and enhance their social development in a new country as they form emerging adult identities.

As a school-based mental health counselor in a public urban high school on the northern California coast, the first author’s responsibility is to provide overall behavioral health support through assessments, counseling (short- and long-term, individual, group, crisis), staff and teacher consultations, and presentations on mental health issues to students, parents and teachers. When two South Asian students were referred for individual counseling, the first author wondered if other South Asian students might be experiencing challenges associated with adjusting to a new school in a new country. She also was personally aware of difficulties associated with identity development for adolescents negotiating different home and school cultures. She decided that counseling focused on prevention of problems related to acculturation and identity could be helpful to the South Asian students in her school. Because the South Asian collectivistic orientation is consistent with the goals of group counseling (Sharma, 2001), she chose this approach. As a South Asian herself, the first author believed that her understanding of South Asian culture could contribute to her effectiveness as facilitator of a group with this population. Thus, the first author developed a simple strategy for recruitment and set out to create a group for South Asian immigrant high school students.

Although in many cases the first author’s expectations about the group were met, she also confronted surprises and challenges. This article is the result of discussions with the second author in which the first author shared her reflections and commentary on the facilitation of students’ exploration of issues in the group. The goal is to impart the first author’s personal knowledge and perceptions, so that counselors working with South Asian youth may consider how her experience might inform their group work with this population. A secondary goal is to inspire other counselors to find ways to meet the needs of immigrant youth in their own schools and clinics through group counseling. A very brief overview of South Asian culture will provide a context for understanding these reflections.

South Asian Culture

This section provides information about South Asian culture as it relates to the first author’s personal experience facilitating a group with South Asian immigrant girls; the authors do not intend stereotypical representation of South Asian adolescents or their families. The girls with whom the first author worked had both similarities and differences based on their cultural backgrounds, level of acculturation and individual personalities.

The term South Asian is used to describe people of various religions and nationalities who trace their cultural origins to the Indian subcontinent (Assanand, Dias, Richardson, & Waxler-Morrison, 1990; Ibrahim, Ohnishi, & Sandhu, 1997). Countries of South Asia include Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka (The World Bank, 2011). According to 2010 estimates (Pew Research Center, 2012), the majority of South Asians practice Hinduism or Islam, but there also are South Asians who practice Buddhism (the majority religion in Bhutan and Sri Lanka), Christianity or other religions. Overall, there is great diversity within this population with regard to religious affiliation, language, immigration history, socioeconomic status and education (Inman & Tewari, 2003). Despite their differences, South Asians generally share some common characteristics including customs, values, family expectations and beliefs that relate to mental health (Maker, Mittal, & Rastogi, 2005). Specific values include formality in interpersonal relationships, inhibition of strong feelings, respect of elders, primary allegiance to the family and deep respect for religion (Kim, Atkinson, & Yang, 1999).

Unlike other Asian American groups, South Asian immigrants have not been studied by social scientists to any appreciable degree (Maker et al., 2005). Existing research on South Asian individuals and counseling suggests that South Asian Americans have neutral or positive perceptions of mental health care, but infrequently use mental health services (Panganamala & Plummer; 1998; Sue & Sue, 2008). This reality may be due to South Asians’ lack of awareness of available services, cultural and language barriers, or fear of confidentiality breaches. Another reason for this infrequent use of mental health services may relate to the South Asian belief that disclosing mental problems or mental illness brings shame and stigma to the entire family (Atkinson, 2004). Moreover, research suggests that South Asians are likely to make external attributions and spiritualize emotional problems while emphasizing somatic complaints and academic or career concerns (Sandhu & Madathil, 2007). The first author used her personal understanding of South Asian culture to help inform recruitment and facilitation of the group.

Recruiting Participants for the Group

Recruiting immigrant and minority populations for counseling services involves providing an accessible service delivery location (Yuen, 1999). Recommended approaches for attracting group members include advertisements (e.g., hallways posters), referral networks (e.g., teachers) and announcements (e.g., classroom presentations; Gladding, 2008; Kline, 2003). The first author decided to take a straightforward approach by putting up posters and flyers around the school—in hallways and homerooms, and on bulletin boards. Because it was important to use language that lacked stigmatization, she carefully planned the posters. She used a term familiar to South Asians, Desi, which describes individuals who identify themselves as South Asian or with South Asian culture (e.g., music, traditions, films, food). The flyers read, “Come and meet other Desi’s in the school! Want to learn more? Come to room 200.” That approach, however, proved ineffective; after two months not a single student had inquired about the group. Next she asked teachers for referrals, approached the identified students during their homeroom period and described the group. Again, she used terms such as support group, sharing, confidential place and time to meet others in lieu of the more stigmatized language of mental health counseling. Although most students showed interest, they communicated skepticism about joining a group.

Refusing to give up, she pondered Yuen and Nakano-Matsumoto’s (1998) suggestion highlighting the importance of finding an appropriate point of entry for recruiting immigrant populations. She walked around campus targeting the places where South Asians congregated during passing hall periods and lunchtimes. She introduced herself, discussed her role at the school, disclosed her own ethnic identity as a South Asian and invited students to drop by her office at lunchtime. After an entire semester of drop-in encounters, a group of girls agreed to participate and the idea of a group for South Asian students became a reality.

Background of the Group Facilitator and Participants

When contemplating recruitment for the group, the first author believed that her background would be advantageous. Born in London, England, she was raised in an Asian Indian family; she speaks Hindi and Gujerati (Asian Indian languages) in addition to English. It seemed intuitive that her commonalities of background and language with the students would facilitate initial recruitment as well as rapport building. (As she learned, however, this was only partially true).

The group participants were first-generation immigrants, born outside the United States, or second-generation immigrants, born in the United States. All group members identified culturally as South Asian, but came from different countries in South Asia. They shared similar customs, food, clothing and popular culture (film and music). However, because the students’ home countries were different, the students spoke various languages. Moreover, as the group progressed, distinct cultural traditions (e.g., age of marriage) and values (e.g., definitions of beauty) emerged, along with differences in the girls’ perspectives on those beliefs and values. As the authors describe the first author’s reflections of the group, they carefully maintain the anonymity of the girls’ disclosures and share only overall themes and activities in the context of South Asian culture in general.

Reflections on Facilitating the Group

When the first author chose group work for the South Asian girls, she identified the counseling group as the most appropriate type of group. The counseling group utilizes members’ interactive feedback and support to help address problems of living, which may be related to transitions or development (Corey, Corey, & Corey, 2010). For adolescent immigrant students, these everyday problems often involve the challenges of adjusting to a new culture and developing a cultural identity (Ahmad-Stout & Nath, 2013; Shariff, 2009). The first author sought to provide a safe place for the South Asian girls to explore these issues of acculturation and identity. She presented topics at each session designed to encourage this exploration.

The first author’s approach to counseling this group was integrative; she borrowed concepts from relational-cultural theory as well as multicultural counseling. Relational-cultural theory is based on the idea that psychological growth takes place in the context of relationships characterized by empathy, mutuality and empowerment (Comstock et al., 2008; Jordan, 2000). Multicultural counselors also promote empowerment by helping clients develop strategies for exercising control in their lives (Crethar, Rivera, & Nash, 2008; Toporek, Lewis, & Crethar, 2009). Based on these concepts, the first author’s goal was to provide a safe space in which the South Asian girls could build mutually supportive relationships and where she could help promote the girls’ self-confidence as South Asian females.

Consistent with the beginning stage of a group, the members were initially reluctant to disclose information (Corey et al., 2010). Despite the first author’s similarity in background to the South Asian girls in her school, it still took time for them to perceive her as a safe person with whom they could share. She allowed time to build rapport and trust to aid the girls in overcoming their reluctance about help seeking. Openly discussing the expectations and goals of the group was helpful in creating safety and served to ease student anxieties about committing to a weekly group. The first author clearly laid out group expectations in the first session, invited input from all group members and highlighted confidentiality. Although members initially avoided sharing personal experiences about family, boyfriends and sexuality, two girls were very vocal about less intimate issues. After approximately 12 sessions (halfway through the group), there was a noticeable shift as all members began to disclose their experiences. At this point, the level of trust in the group allowed the girls to explore issues at a deeper level, which is one characteristic of a working stage (Corey et al., 2010). Two outcomes of the group suggested movement toward the relational-cultural theory and multicultural counseling goals of relationship building and empowerment. About midway through the group, the girls began socializing at school; and later, toward the end of the group, they continued to build relationships by spending time at each other’s homes. Additionally, the girls’ confidence showed at termination when they asked to form their own South Asian group, which the first author helped them create.

The topics presented for discussion in the group involved asking the girls to answer a list of questions that the first author formulated: “What does it mean to be a South Asian female in our school?,” “What is it like to navigate dissimilar home and school cultures?,” “What gender messages do you receive as a South Asian girl?” and “How do media messages shape your identity as a South Asian female?” The following discussion provides additional information about South Asian culture as a backdrop for the first author’s reflections on the girls’ exploration of these topics.

South Asian Lifestyle in a U.S. School

Asian Indian immigrants in Western cultures often continue to base their lifestyle on traditional values, beliefs and expectations (Farver, Bhadha, & Narang, 2002). This includes unwritten rules, such as respecting adults, so adults do not tolerate rude or disrespectful speech from children. South Asian girls must heed strict family rules regarding girls’ roles (which may include caring for younger siblings), respect for elders and male members of the family, and choices related to school and college. For example, family rules often prohibit dating, having male friends and being out after school. In group sessions, these topics permeated the discussion, as expected.

Also guiding South Asian lifestyle is collectivism. South Asian girls are taught to respect the importance of community as part of what it means to be South Asian. In the context of the group and their collectivistic orientation, it was especially important for the girls to feel connected and understood by the other girls. Sharing enjoyment of similar foods (e.g., roti, samosas), conversing in English and Hindi, and exploring what it is like to be a South Asian girl in the United States created a sense of group cohesion. This cohesion established an environment in which the girls could feel emotionally supported and empowered in an unfamiliar school environment.

Despite the apparent safety of the group environment, however, the first author noticed that the girls were sensitive to feedback and needed to consult with each other on decisions (e.g., what school clubs to join). The power of group decision making became significant in the group. When the first author initially asked for individual opinions (i.e., “What do you think?”), the girls were reticent. This restraint reminded the first author of her own upbringing, in which older members of the family made decisions jointly, and the message she internalized was that she was not supposed to offer a viewpoint. The first author felt an urge to overcome any sensitivity a girl might have to rejection or shame due to expressing ideas different from those of other group members. She found herself helping the girls to express their own thoughts and opinions, even if they differed from those of the other girls. When the first author explained that the group was a place to express thoughts and feelings that they were unable to express at home, many of the girls began to open up.

South Asian Girls’ Challenges in Negotiating Dissimilar Cultures

The dialogue around navigating home and school cultures was not surprising. The first author expected identity development to be a major issue, along with struggles to integrate South Asian cultural identity with mainstream American norms, expectations and culture. Facilitating the group brought up memories of negotiating home and school cultures in the first author’s own adolescence in London. As an Indian/South Asian in an urban high school that was over 90% Caucasian, she often felt different from others not only in terms of physical appearance (e.g., skin and hair color), but also because of family cultural activities. She felt embarrassed explaining her Indian/South Asian cultural beliefs and values to peers. Her role as a teenager was to follow family rules, respect elders and play a traditional female role (e.g., learning to cook, taking care of siblings). Her non-Asian school friends could not understand this cultural dilemma or the cultural restrictions placed on her behaviors (e.g., not going out after school). She was forced to adopt a dual identity—at home, the traditional Indian/South Asian girl, and at school, a more stereotypically British teenager. The girls’ dilemmas mirrored the first author’s experience as a teenager and she was able to understand their disclosures in a personal way. She was sometimes viewed as didi (“sister” in Hindi). It seemed advantageous to be perceived as a family member, yet this was only partially true (and explained later).

Within the context of navigating two cultures, the theme of academics came up frequently. Because a primary motivation for the immigration of South Asian parents is educational opportunity, high aspirations for their children are common (Ghuman, 2003). It did not surprise the first author that the girls had internalized messages from parents and put pressure on themselves to succeed in school. However, South Asian immigrant youth have an added pressure that stems from the fact that they must contend with schools that differ from those in their native countries. Immigrant students may come from South Asian schools that have very strict rules with rigid guidelines regarding teacher–student interaction, but they must adapt to the less formal educational approach in U.S. high schools. U.S. teachers often encourage students to express their thoughts and feelings, while South Asian parents instill in their children that openly expressing their opinions to adults shows disrespect. The first author supported the education of the girls in their U.S. school by helping them build self-confidence in expressing their viewpoints. She initiated discussion about ways for the girls to voice their opinions in the classroom to help them succeed in U.S. schools and provided an opportunity for them to practice these strategies.

In addition to these internal struggles, attempting to fit into a mainstream American school often comes with other costs for a South Asian girl. Because of the differences between Western and South Asian traditional value systems, adolescence can be a difficult time for South Asian immigrant families (Ranganath & Ranganath, 1997). An exacerbating factor borne out in research is that “children of immigrants adapt more quickly to the new culture than do their parents” (Farver et al., 2002, p. 13). These circumstances can create conflicts with parents around issues such as choice of friendships, dating and education. South Asian immigrant girls may observe their mainstream American peers having different adolescent experiences (e.g., spending time with boys) and may want to have the same experiences. In doing so, or even considering doing so, they may deal with anxiety and helplessness as well as fears of parents finding out. Although the girls’ dilemmas were similar to those in the first author’s experience as an adolescent, she was nonplussed at times by the depth of the struggles of the first-generation girls in negotiating the two cultures. As a second-generation South Asian, the first author was born and raised in London. In contrast, many of these girls were born in their home countries and immigrated to the United States, some of them as teenagers. Thus, the first author was sometimes challenged to grasp their difficulties in comprehending American culture, and she had to work assiduously to facilitate their understanding of foreign ideas and practices. She was sometimes unnerved by the intensity of the girls’ internal struggles to process the conflicts between the values and beliefs of their home and school cultures. Therefore, she realized the critical importance of giving careful attention to providing a nonjudgmental space for the expression of the girls’ frustrations related to these differences.

Gender Messages Received by South Asian Girls

Within traditional societies such as India, there are different expectations for male and female behavior (Farver et al., 2002). In traditional South Asian families, males are permitted greater independence, personal autonomy and educational opportunities, whereas females are restrained (Dasgupta, 1998; Ghuman, 1997). For example, females are expected to perform household chores and take care of younger siblings, while boys are allowed more freedom (e.g., going out after school). According to Ghuman (2003), South Asian families in the West also tend to be more lenient with boys, even overlooking breaking of social and family rules, precipitating distress for many South Asian girls. In particular, exposure to mainstream American culture may further increase girls’ distress in response to South Asian culture’s seemingly unfair expectations of girls and boys. Girls may feel overprotected by their parents, inferior to their male counterparts and envious of American-born South Asian girls who follow less traditional roles. It is important to remember, however, that there is variation in the messages that South Asian youth receive depending on a number of factors including socioeconomic status. In her middle-class family, the first author was socialized on how to behave (e.g., what to say, how to dress) as a female in order to obtain a husband. Coming from a high Hindu caste family, however, afforded more privileges such as access to education and social connections, which can result in opportunities outside the home.

Media Messages and South Asian Girls’ Identity Development

Youth often look to role models in identity development, and there are few South Asian public figures and role models in the media to whom South Asian youth can relate. Research in which Asian American children reported admiring Black figures first and White figures next (entirely overlooking Asian and Latino figures) supports this idea (Cortés as cited in Aoki & Mio, 2009). In the group, the first author helped the girls examine how South Asians are viewed in American media and discussed Bollywood (i.e., Indian film industry) movies, which present current Hindi film stars. In the film Om Shanti Om (Khan & Khan, 2007) the heroine, Shanti, is a beautiful, tall, slender Indian woman who has an unfulfilled relationship with a man because of her parents’ disapproval. Role models such as Shanti represent beauty in South Asian culture, and exposure to standards of beauty that differ from Western beauty ideals is helpful for young South Asian females’ self-image. Additionally, however, South Asian girls need exposure to a broader range of role models to enhance their development. Currently, there are many successful South Asian American individuals who integrate South Asian and American identities in the worlds of academia, business, entertainment, politics, media and the sciences, and the first author deemed it important to expose the girls to the accomplishments of these people. An array of examples includes Sri Srinivasan (judge of the U.S. Court of Appeals for the District of Columbia circuit), Anita Desai (novelist), Sanjay Gupta (neurosurgeon & CNN chief medical correspondent) and Norah Jones (singer). The author’s hope was that exposure to this diverse range of role models might motivate the girls to explore different careers and inspire them to consider nontraditional career tracks. Moreover, a future goal was to bring in local South Asian role models from the surrounding community.

South Asian youth also draw from traditional Hindi music to shape their identity and represent a sort of new ethnicity (Dawson, 2005). In the group, listening to traditional South Asian music supported the South Asian girls’ roots, and listening to music such as Indian music with hip-hop and rap fusion represented a blending of the girls’ American and South Asian cultural identities. Sharing music provided a sense of group connectedness, while analyzing lyrics led to fruitful discussions about characteristic gender themes related to being South Asian.

 Common Adolescent Issues Among South Asian Immigrants

In addition to the previous topics, the group discussed other issues that are typically important to adolescents. Though South Asian girls tend not to date and often struggle to follow rigid and unyielding norms around relationships (Ayyub, 2000; Durham, 2004), immigrant girls in American schools may want to explore the topic of dating and relationships. In the first author’s experience, some South Asian girls may never date, while others may simply refrain from informing their parents that they are involved in relationships. Fear of being caught by parents, family members and friends may precipitate girls’ avoidance of dating or permeate the experiences of girls who date.

Related to dating is the topic of ideal partners for relationships. South Asian girls from traditional families are expected to marry a person from the same cultural background (Bhatia & Ram, 2004). For example, families would not accept a union between a Pakistani girl and an Indian boy, even though both individuals are South Asian. For some girls, even thoughts of relationships with boys from different cultural backgrounds may result in sentiments about conflict as well as feelings of shame and guilt about disrespecting the family. Having a space in a school group to discuss these feelings was particularly important because South Asian girls often cannot discuss these topics with family members; and even girls who have no desire to be in a relationship in high school may be curious about such topics. The first author presented the topic of what relationships might look like for the girls in a South Asian community as well as what relationships might look like for their non-South Asian peers. She wondered about the value of disclosing that her spouse was non-South Asian, and decided to do so to address the girls’ curiosity about her non-South Asian last name. This information provided a space for the girls to process fantasies they might have about marrying a non-South Asian or someone outside their identified community.

Recommendations for Counseling Practice

From reflections and discussion of the group experience, the authors have developed recommendations for counselors serving South Asian girls in their schools. A primary component in this group counseling experience is the provision of a safe space within which South Asian students can discuss salient issues with other South Asian youth. Equally important, as authors (e.g., Shariff, 2009; Sue & Sue, 2008) have explained, is the counselor’s ability to employ culturally appropriate helping skills and interventions. Counselors must pair these skills and interventions with knowledge of topics that are relevant to the particular youth they are serving. Because identity development is a significant issue for adolescents in general and a more challenging task for South Asian girls who must straddle two cultures, it is critical to focus on this issue.

Creating A Safe Space at School

A primary goal of a group for South Asian girls is to provide a space for them to interact with students from similar backgrounds. Due to size of the student population and variety of schedules in urban schools, it may prove difficult for South Asian adolescents to connect with each other in classes. Moreover, cultural mores may make it prohibitive to meet other students after school, excluding another avenue for interaction. Therefore, group counseling offers a social sphere for interaction, but must of course be a safe space. Moreover, as Chung (2004) explains, a focus on confidentiality is critical in working with any Asian American group because disclosing family matters to outsiders is frowned upon.

Providing a safe psychological space depends not only on sensitive recruitment and open communication, but also on the counselor’s ability to analyze personal racial/ethnic beliefs and values in relation to those of South Asians. As part of this self-examination, non-South Asian counselors must explore any preconceived notions based on the portrayal of South Asians in the American media. Additionally, White European-American counselors who seek to develop groups with South Asian youth must carefully and continually explore their willingness to confront their level of privilege. In a study of graduate students in clinical psychology and social work, findings showed a correlation between White privilege attitudes and multicultural counseling competencies (Mindrup, Spray, & Lamberghini-West, 2011). Counselors committed to working with South Asian immigrants should be ready to accept responsibility for change at not only the personal level to better meet the needs of South Asian students in group counseling, but also at the institutional (i.e., school) level to enhance the experience of South Asian students in the school.

Counselors can broaden their knowledge of the South Asian culture by reading as well as watching films about South Asian life. Some recommended films for counselors include The Namesake (Pilcher & Nair, 2006) and Monsoon Wedding (Baron & Nair, 2001). Suggested books are Brick Lane: A Novel (Ali, 2004), Fasting, Feasting (Desai, 1999) and Indivisible (Banerjee, Kaipa, & Sundaralingam, 2010), an anthology of South Asian American poets who trace their roots to Bangladesh, India, Nepal, Pakistan and Sri Lanka. Another way to learn is by going to a South Asian neighborhood and immersing oneself. The counselor might observe the interactions between parents and their children, as well as how teens interact among their peer groups. Familiarity with the latest fashion trends in clothes, food, music and films can further help counselors to understand the commonalities and differences within the South Asian population, and in particular with South Asian adolescents. Moreover, community leaders can serve as valuable resources in understanding Asian American populations (Chung, 2004). For example, counselors can build relationships with persons who run community centers and organizations that serve South Asians or with faith-based leaders in the South Asian community.

Counselors who are South Asian may have an easier experience initiating a South Asian group. However, it seems important for the first author to share an observation she has made in her 13 years of working with South Asian students: First-generation students have been more likely to seek her out than to approach her non-South Asian colleagues. However, as students have become more acculturated to mainstream American schools, they seem to be more wary of this student–counselor shared ethnic background. Some students have disclosed concerns about possible connections with the South Asian community in which they live (e.g.,“Will you tell my auntie about my activities?”). In those instances, the students seem to seek out counselors who are not South Asian. (Although this cannot be generalized to all South Asian populations, it suggests an interesting area for exploration).

Creating Culturally Appropriate Counseling Interventions

The importance of knowing the backgrounds of the particular members of a group in order to design culturally appropriate interventions cannot be overstated. As many authors have asserted, not all Asians are alike (e.g., DeLucia-Waack & Donigian, 2004; Sue & Sue, 2008), and within-group differences among Asian groups is often overlooked (Sandhu, 2004). This idea holds true for South Asians who may come from a variety of different countries such as India, Pakistan, Sri Lanka or Bangladesh. In addition to within-group differences, counselors must consider each adolescent’s level of acculturation when identifying counseling strategies.

When designing interventions for group counseling, counselors may look to focus on individual disclosure, individuation and autonomy, and direct types of communication (e.g., confrontation; Corey et al., 2010)—ideals based firmly in Western culture. These goals, however, might not apply to Asians who value humility and modesty (rather than open sharing) as well as group harmony (instead of individual goals), and who might be uncomfortable with direct communication (Chung, 2004; Sue & Sue, 2008). In light of this situation, there are several issues that the counselor must keep in mind when designing interventions.

     Personal disclosure. Even within a safe environment, South Asian students may still exhibit a disinclination to share personal information. Counselors can model disclosure by sharing their own family experiences, which can prove beneficial in getting youth comfortable and involved in a group (Sandhu, 2004). However, it is still important that counselors are sensitive to any member’s reluctance (communicated either verbally or nonverbally) to disclose, especially because of the cultural value of respect for authority figures (i.e., the counselor), which could precipitate member disclosure and subsequent shame over exposing family information.

     Goal setting. Individual goal setting is consistent with Western culture and is often encouraged in group counseling literature (Corey et al., 2010; Gladding, 2008). Because of their collective orientation, South Asians may be reluctant to set individual goals and may want to focus on group goals. Potential goals may involve achieving academic success, exploring family pressures, examining gender roles and discussing taboo topics such as sexuality. The counselor must not, however, overlook a member’s desire to set individual goals. (Over time, certain members in this South Asian girls’ group did set personal goals.)

     Direct leadership. Asians’ values related to respect for adults/elders and authority figures (DeLucia-Waack & Donigian, 2004) suggest that a direct leadership role within a structured group format might work best. Initially, the first author provided a structure for the group sessions using expressive art media through which the girls could explore. For example, having the girls create individual collages from magazine cuttings helped them to share about their lives (e.g., favorite foods, clothing, places), and using South Asian and non-South Asian films and books offered metaphors that helped the girls explore their identity. After a few months of leader direction, the first author was surprised to find that the girls felt comfortable setting the group’s agenda and openly suggesting session activities. Therefore, counselors should be aware of any indication on the part of the group members that they want to self-direct.

Topics for Exploration

Through group counseling, the first author was able to identify topics that were particularly important to these high school South Asian girls; these areas could serve as a starting point for other counselors working with South Asian immigrant girls. Although the topics were often consistent with salient adolescent issues (e.g., dating, relationships), they were shaped by the girls’ South Asian backgrounds. The girls discussed the often contradictory values and beliefs of home and school culture. They explored dual identities related to being South Asian and American as well as multiple identities related to culture and gender.

  Examining values and beliefs. Family and culture are important topics for South Asians, but telling stories of family and culture in mainstream American culture may raise challenges. Especially significant is the discomfort adolescents may experience when sharing their cultural stressors with non-Asian peers. A group with peers from similar backgrounds can facilitate open sharing of cultural stories that would be difficult to disclose to those who could not identify with their experiences. In this group, the first author followed Sue and Sue’s (2008) recommendation and facilitated discussions about values, beliefs and behaviors characteristic of both the home culture and host culture, so the girls could discover those that fit for them, those with which they identified and those about which they were ambivalent. These discussions pervaded the group sessions, and counselors are advised to explore these topics in depth.

When examining values and beliefs, South Asian girls may broach topics that are unacceptable for discussion with their own families and community members. Because they are often expected to adhere strictly to the role of the “perfect” South Asian girl (e.g., attaining good grades and following family rules), girls may feel judged by family and community members when expressing curiosity about issues such as love, sexuality and relationships. A counselor can help girls examine their roles within their families and explore unique circumstances of developing peer relationships as a South Asian female growing up in mainstream American culture.

An issue that may arise with South Asian girls as they explore behaviors related to values and beliefs involves being under the watchful eyes of other South Asian immigrants. Girls might dwell in a neighborhood where they are in close proximity to local mosques, temples and community centers as well as businesses owned by South Asians. In addition to close and extended family members, they may interact frequently with South Asian peers and neighbors. This can present challenges related to the different values and beliefs of the two cultures the girls are negotiating. For example, some girls may want to talk to boys in the neighborhoods, but fear that South Asian community members might tell their parents. This anxiety underscores the girls’ need for support from trusted adults and peers both at school and in their communities as they grapple with these issues.

     Coping with dual identities. Because immigrant students are straddling home and school cultures, it is important to explore ways to cope and deal with multiple identities. One goal of a discussion of values and beliefs involves supporting girls’ positive connections to their home and community culture. According to Farver et al. (2002), several studies of adolescents from a variety of ethnic backgrounds showed a positive connection between commitment to/identification with ethnic group and self-esteem. A counselor must encourage discussion around cultural topics, emphasize the importance of family traditions and help foster pride in South Asian identity. For example, it is important to recognize religious holidays and explore the meaning of the holidays and their significance in girls’ lives.

The group setting can provide a safe environment for girls to explore challenges and voice frustrations related to dual identity. A counselor can help girls deal with the conflict of self versus collective identity through using culturally appropriate self-empowerment and self-esteem exercises. For example, the first author offered the girls an activity in which they made a collective collage (using magazine cutouts, drawings and words) of what it means to be a South Asian female. After the activity, they processed the meanings of the images on the paper, the role of women in South Asian society and school, and the similarities and differences between group members. The activity highlighted the girls’ cultural commonalities and differences as well as their shared challenges of dual identities.

An important discussion may involve decision making around behaviors that diverge from home cultural norms, because South Asian youth may choose to deviate from parental and cultural expectations in spite of the consequences. The counselor’s responsibility is to help girls explore the pros and cons of pursuing their personal happiness at the expense of their parents’ wishes or demands (Segal, 1991). For example, if the topic of dating (an area of conflict between home and school culture) arises, the counselor must help girls explore what it means to them to date, their reasons for wanting to date, and if they are dating, issues related to dating without family permission.

     Addressing racism. Racism is an important topic for South Asian immigrants, especially due to the impact of the World Trade Center attacks on September 11, 2001 (9/11). In the aftermath of 9/11, a climate of racial profiling emerged in the United States, and South Asians have been subjected to prejudicial attitudes affecting both personal autonomy and group identity (Inman, Yeh, Madan-Bahel, & Nath, 2007). In the first author’s experience, as well as that of many of her South Asian colleagues, racial profiling is not uncommon when traveling, even for professional women. It also is not atypical for South Asians to experience microaggressions, such as being stared at or asked personal questions about ethnicity by strangers. Racism has psychological impacts (Astell-Burt, Maynard, Lenguerrand, & Harding, 2012) and also can create fear. South Asians wearing traditional dress may be subjected to name calling, racial slurs and even physical violence. Adolescents with whom the first author has worked report experiencing teasing or bullying at school as well as other forms of racism when walking with a family member wearing traditional dress (e.g., headscarves, turbans). In a study of South Asian women in Canada, Beharry and Crozier (2008) found that racism in youth had a more marked effect on self-esteem and self-efficacy than that in adulthood. Moreover, social support networks were critical in helping women address negative experiences. A counseling group offers a space for South Asian girls to share their experiences, express their fears and devise ways of coping with racism in a supportive environment.

Reaching Beyond the Girls’ Counseling Group

The one challenge that eluded the first author during her recruitment of South Asian adolescents was how to meet the needs of boys. Although it made sense because of gender roles to have an all-girl group, she also recognized the need to address issues for South Asian boys. When the girls’ group terminated, she helped them form a South Asian student club within the school. All the girls from the group were members of the wider South Asian club, but in addition to girls, a number of South Asian boys joined. The cosponsor of the South Asian club is a male teacher who, although not South Asian, is Latino and well-liked and respected by students, including South Asians. In addition to finding ways to unite the group, the cosponsor and the first author have supported the boys and girls in working together to explore issues that South Asian students encounter in the school and to develop strategies to help the wider school community understand what it means to be South Asian.

An additional way for counselors to reach beyond the group is to identify any needs of the South Asian families in the school community. One way that the first author has supported parents of South Asian students is by helping them understand the school system (e.g., how grades are interpreted). Parental support is significant in light of findings that suggest parental difficulties in adjustment to a new culture may result in adolescents with more psychological problems (Farver et al., 2002). Thus, support and advocacy for families may in turn reap benefits for adolescents. A significant way to identify needs and issues of families is to connect with community leaders, who can “act as a cultural bridge” to developing relationships with parents and other community members (Chung, 2004, p. 206).

Conclusion

There is a need for research focusing on South Asian American families and a further need for research focused specifically on the issues of South Asian immigrant youth. As the population of South Asian immigrant youth in U.S. communities and schools increases, it is critical to understand the unique needs of these youth who are learning to forge an identity based on their home cultures and mainstream American culture. Because there are differences in the U.S. communities in which South Asians live, researchers also must explore the differences in identity development of South Asian immigrant youth living close to a South Asian community versus those who live in a heterogeneous (non-South Asian) environment. Understanding the South Asian experience in the United States will pave the way for developing culturally appropriate interventions for working with South Asian immigrant youth.

Growing diversity in American schools demands that counselors develop culturally appropriate strategies for working with youth from a wide variety of cultures, including those individuals who come from immigrant families. Today’s immigrant families struggle with cultural differences, racism and oppression of earlier generations, but do so in the context of easier access to transatlantic travel and global communication technology (Bhatia & Ram, 2004). Practically speaking, these closer family connections with the home country may create more challenges for adolescents forging an identity while balancing the demands of home and school. The responsibility of helping to enhance the development of these youth falls to counselors along with other school and community personnel, and group counseling is one useful strategy for meeting student needs. Before initiating a group, counselors must explore their own cultural background and biases, understand the culture of the students in the group and, from this knowledge, develop culturally appropriate interventions that highlight culturally relevant and adolescent-specific topics. Through the group described here, the first author attempted to promote the positive development of South Asian girls in her school. The authors’ hope is that these efforts will challenge other counselors to find ways to do the same with the immigrant youth in their schools and clinics.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of

interest or funding contributions for

the development of this manuscript.

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 Ulash Thakore-Dunlap is a licensed marriage and family therapist at Richmond Area Multi-Services, San Francisco. Patricia Van Velsor, NCC, is an associate professor at San Francisco State University. Correspondence can be addressed to Patricia Van Velsor, Department of Counseling, BH 524, 1600 Holloway Avenue, San Francisco, CA 94132, pvanvels@sfsu.edu.

Students’ Perceptions of School Counselors: An Investigation of Two High Schools in Beijing, China

Dec 2, 2014 | Article, Volume 4 - Issue 5

Qi Shi, Xi Liu, Wade Leuwerke

This study sought to examine students’ perceptions of their school counselors in two high schools in Beijing, China. Independent t tests found that female students rated school counselors’ availability significantly higher than male students did. Also, students who had received prior counseling services rated counselors significantly higher in the following areas than did students who had never received counseling services: knowledge of achievement tests, friendliness and approachability, understanding students’ point of view, advocating for students, promptness in responding to requests, ability to explain things clearly, reliability to keep promises, availability, and overall effectiveness. A 2 × 2 between-subjects ANOVA found an interaction effect between gender and use or nonuse of counseling services. In general, students gave positive evaluations of school counselors and were satisfied with counseling services.

Keywords: school counselors; counseling services; students’ perceptions; high schools; Beijing, China

China has been experiencing dramatic economic and social changes in the past 3 decades (Guthrie, 2012). During this time there has been increased attention to both mental health problems and student development (Cyranoski, 2010; Lim, Lim, Michael, Cai, & Schock, 2010; Xin & Zhang, 2009). It has been estimated that at least 17.5% of the Chinese population has some form of mental illness, one of the highest rates in the world (Phillips et al., 2009), accounting for about 20% of hospitalizations in the country (Fei, 2006). Facing significant mental health challenges, several authors have noted the need for more counseling professionals and mental health service providers (Cook, Lei, & Chiang, 2010; Davey & Zhao, 2012). In rural areas with fewer resources, the demand for mental health care is even greater (Ji, 2000).

Given such great needs for mental health services, China has been making tremendous efforts in reforming its mental health service system (Tse, Ran, Huang, & Zhu, 2013). In 2004, China launched the 686 Project, a mental health reform initiative modeled on the World Health Organization’s recommended framework for integrating hospital-based services with a community mental health service system (Ma, 2012). By the end of 2011, 1.83 million Chinese people with severe mental illness had been treated as a result of the project.

While China has witnessed growth in the counseling profession, at the same time it has struggled to build national certification and licensing standards, and create comprehensive counselor training (Chang & Kleinman, 2002; Cook et al., 2010; Davey & Zhao, 2012; Ding, Kuo, & Van Dyke, 2008; Hou & Zhang, 2007). In 2002, China’s National Counseling Licensing Board was formed, and there is currently a three-tier national licensing program. More than 30 locations throughout China offer the qualification exams for counselors, and recently a national exam to license school counselors was instituted (Lim et al., 2010). Results from a nationwide survey of professional training of mental health practitioners in China showed that quality of training and supervision were among common concerns (Gao et al., 2010). Also, more accredited professional training programs at the university or college level must be designed and established. Beijing Normal University, in collaboration with Rowan University in the United States, was reported to be the first university in China to offer a school counseling training program (Lim et al., 2010).

Mental Health of Students in China

Increased attention to student well-being has shown high prevalence of mental health problems among Chinese students (Cook et al., 2010; Wang & Miao, 2001). Common psychological problems among students included test anxiety, academic pressure, loneliness, social discomfort, video game addiction (Thomason & Qiong, 2008), Internet addiction, child obesity, self-centeredness and reclusion (Worrell, 2008). A study from a metropolitan area in southeastern China showed that 10.8% of high school students had mental health concerns including hostility, compulsions, depression and interpersonal relationship sensitivity (Hu, 1994). A more recent survey conducted by Wu et al. (2012) among 1,891 high school students in a southern city in China showed that 25% of the adolescents reported a perceived need for mental health services, while only 5% of the sample had used school-based mental health services, and 4% had used non-school-based services.

Researchers are starting to identify factors that contribute to Chinese students’ mental health problems, including the pressure to achieve academic success (Corbin Dwyer & McNaughton, 2004; Thomason & Qiong, 2008; Worrell, 2008), being an only child (Liu, Munakata, & Onuoha, 2005; Thomason & Qiong, 2008; Worrell, 2008), prevalence of physical abuse (Wong, Chen, Goggins, Tang, & Leung, 2009), inability to cope with multiple expectations and requirements (Tang, 2006), increased attention to personal and social development (Corbin Dwyer & McNaughton, 2004), and the generation gap between children and their parents (Thomason & Qiong, 2008). Zheng, Zhang, Li, and Zhang (1997) suggested that parents and teachers who did not attend to students’ psychological problems contributed to the high rates of mental health problems among students. Because they have the most direct interaction with students, homeroom teachers and subject teachers in China are well-positioned to help students address their mental health concerns. In fact, Chinese homeroom teachers perform a wide variety of counseling tasks (Shi & Leuwerke, 2010). However, teachers do not receive sufficient training in providing counseling services.

School Counseling in China

     School counselors are uniquely positioned to impact the mental health and academic success of students in China. As would be expected with developing professions, there are numerous challenges to school counseling in China: (a) a tremendous shortage of qualified school counselors (Cook et al., 2010; Shi & Leuwerke, 2010; Thomason & Qiong, 2008; Yan, 2003; Zheng et al., 1997), (b) an urgent need for more accredited training programs (Gao et al., 2010; Leuwerke & Shi, 2010; Lim et al., 2010) and (c) a lack of support and respect from teachers and other school staff (Jiang, 2005; Leuwerke & Shi, 2010). Although many schools in China, especially in urban areas, have begun to establish counseling offices and hire school counselors, this profession is still in its primitive developmental stage (Leuwerke & Shi, 2010). Moreover, school counselors themselves have expressed great need for more training and standard education to better serve their students (Leuwerke & Shi, 2010). A standardized training system is imperative to provide training, assessment, issuance of licenses and continued education (Cook et al., 2010; Davey & Zhao, 2012; Yan, 2003; Zheng et al., 1997).
Facing the serious situation of Chinese students’ mental health concerns and school counseling challenges, the Chinese government has turned greater attention to advanced mental health education in K–12 schools. Government policies on education reform have put more emphasis on students’ mental health and the availability of psychological services (Ding et al., 2008). The Ministry of Education in China has published two important government guidelines in the past 2 decades. “Several Suggestions on Improving Mental Health Education in Elementary & Secondary Schools” (Zhong guo jiao yu bu, 1999) identified moral and politics teachers, homeroom teachers, Communist Youth League cadres, and school counselors as the personnel in schools responsible for the mental health needs of students. K–12 schools with available resources and funding were required to establish counseling offices, and school counselors were identified as the leaders of this system (Ministry of Education of the People’s Republic of China, 1999). In 2012, the Ministry of Education released the updated version of “Guideline of Mental Health Education in Elementary & Secondary Schools.” This guideline described the goals, content and methods of mental health education as well as the personnel responsible for delivery. The report specifically called for educating students about basic knowledge and skills regarding interpersonal relationships, career development, and living and socialization (Zhong guo jiao yu bu, 2012).

As required by the Chinese government, schools in large cities have begun to hire school counselors to provide counseling for their students (Jiang, 2005). In K–12 schools in China, school counseling is called school guidance or mental health education, which is actually a part of political and moral education (Jiang, 2005). School guidance in K–12 school settings has been taught as a subject course like math or science (Hou & Zhang, 2007). In addition to school counselors, homeroom teachers also play an important role in mental health services for students by performing a large range of counseling tasks (Shi & Leuwerke, 2010; Wang, 1997). Chinese students access psychological services in schools through a variety of channels: individual counseling, group activities, lectures on common psychological concerns, parent and teacher consultation, and classroom guidance (Leuwerke & Shi, 2010).

The expansion of services in the Chinese school system has made counseling more accessible than ever to students (Thomason & Qiong, 2008). However, empirically based literature examining the role, function and scope of school counseling in China is virtually nonexistent (Jiang, 2005; Leuwerke & Shi, 2010; Shi & Leuwerke, 2010; Thomason & Qiong, 2008). Very little is known about the amount of counseling that students actually receive at school, let alone how students perceive school counselors and the school counseling services they receive (Leuwerke & Shi, 2010). The present study sought to examine some of these questions. Through surveys of students at two high schools in Beijing, the authors explored students’ use of counseling in school as well as their perceptions of the school counselors. The authors also examined possible differences among students who sought services or not, as well as any differences across gender. Correspondingly, the research questions in this study were as follows: (a) How many students seek counseling services and how often do they meet their school counselors in these two high schools in Beijing? (b) Do students’ perceptions of the school counselors differ across gender? (c) Do students’ perceptions of the school counselors differ depending on whether or not they seek counseling services? (d) Do male and female students’ perceptions differ depending on whether or not they seek counseling services?

Methods

Participants

A total of 137 (47 male, 90 female) students from two high schools in Beijing completed questionnaires; 293 surveys were distributed, resulting in a return rate of 46.76%. The sample was recruited through the first author’s contacts in Beijing. Among the students who completed the survey, 126 were from a high school affiliated with Beijing Normal University and 11 were from a high school affiliated with Beijing Renmin University. The sample consisted of 12.4% (n = 17) senior 1 students (equivalent to 10thgraders in the United States), 78.8% (n = 108) senior 2 students (equivalent to 11th graders in the United States) and 8.8% (n = 12) senior 3 students (equivalent to 12th graders in the United States). The two high schools recruited for the study are among the top ranked high schools in Beijing. The school counselors being evaluated in these two high schools had an average of 8 years of experience working as professional school counselors. Students from these schools typically perform very well in academics and gain admission to universities after high school. As for plans after high school, 97.8% (n = 134) of the students surveyed stated that the plan was a 4-year college, with only three students indicating “other plans.” No student indicated planning to attend a 2-year college or vocational training school or get a job right after graduating from high school.

Instrument

Participants completed a brief demographic questionnaire as well as the Chinese High School Students’ Perceptions of School Counselors Survey. All information students provided in the survey was anonymous. The demographic questionnaire included items such as students’ grade level, gender and postsecondary plans. The Chinese High School Students’ Perceptions of School Counselors Survey used in this study was adapted from McCullough’s (1973) survey that was originally designed to determine high school students’ perceptions of school counselors’ services in the United States. Some changes were made to adapt to Chinese students’ cultural background, including adding two questions about the number of times that students had tried to see the school counselor and the actual number of times that they had met with the school counselor. After indicating the number of times they had tried and actually met with a school counselor, participants rated their counselor’s ability and effectiveness on a four-point Likert scale (4 = excellent, 3 = good, 2 = fair, 1 = poor) in the following 11 areas: knowledge of college admission, knowledge of vocational information, knowledge of achievement tests, friendliness and approachability, understanding students’ point of view, advocate for students, promptness in responding to requests, ability to explain things clearly, reliability to keep promises, availability to students, and overall effectiveness.

Translation

The authors created all materials utilized in this study in English, and the first author then translated the documents into Mandarin Chinese. To examine translation quality, a bilingual, native Chinese speaker who was not part of the research team subsequently translated all documents back into English. The authors evaluated and considered these translated documents equivalent. This approach is consistent with common practice in research requiring translation of documents (Larkin, de Casterlé, & Schotsmans, 2007; Liu et al., 2005).

Design

Data analyses were conducted based on the four research questions in this study. First, descriptive statistical analysis was conducted to learn the number of students who had sought counseling services and the frequency of their meetings with a counselor. Second, an independent t test was conducted to determine the differences between male and female students’ perceptions of their school counselors’ services. Third, another independent t test was performed to examine the differences between students’ perceptions of their school counselors’ services depending on whether or not the students had sought prior counseling services. Finally, a 2 × 2 between-subjects ANOVA was done to determine whether there was a statistically significant interaction effect between gender and whether or not students sought prior counseling services.

The data from students who had never had individual meetings with counselors were included in these analyses. These data were included because these students had had contact with school counselors in other circumstances (e.g., lectures, classroom guidance, school-wide gathering), even though they had not met with school counselors individually (Leuwerke & Shi, 2010).

Procedure

Five teachers at the two high schools assisted with data collection. Since research participation and the protocol were new to most of the teachers, explanation of the confidential and voluntary nature of the project was provided through teleconference. Questions from the teachers were answered via e-mail. One of the teachers in Beijing was in charge of the informed consent forms and data storage. Parents of the students in the classrooms of all five teachers received one copy of the informed consent and all granted consent for their child to participate in the research. Students then received e-mails. An online survey tool (http://www.surveymonkey.com) was used to administer the questionnaire.

Results

The first goal of this study was to examine how many students had sought services from school counselors and the number of meetings they had had with their school counselors since they entered high school. Descriptive statistics were obtained in order to achieve this goal. Nearly half of the participants (48.9%, n = 67) reported having seen counselors at least once. Among these 67 students, the majority (n = 41) had met once individually with a school counselor, 22 had seen a school counselor individually two to three times, and four students had talked with school counselors four to five times. No student reported having met with a school counselor more than five times. Information on the length of these individual counseling sessions was not obtained in the survey.

The second goal of this study was to examine the students’ perceptions of their school counselors. Fifty-three students provided a complete evaluation of their school counselors in the survey. Among these 53 students, 36 had used counseling services before, whereas 17 reported no individual meetings with a counselor. As shown in Table 1, students’ most positive ratings of their school counselors were for friendliness and approachability (M = 3.20, SD = 1.25) and ability to explain things clearly (M = 2.99, SD = 1.33). The lowest rated attributes were knowledge of college admission (M = 1.30, SD = 1.42) and knowledge of vocational information (M = 1.10, SD = 1.30).

Table 1

Descriptive Statistics on Students’ Evaluations of School Counseling Services

Furthermore, independent t tests were conducted to determine whether students’ ratings of counseling services differed significantly between genders and between students who had or had not sought counseling services. A statistically significant result was found in students’ ratings of school counselors’ availability in the independent t test based on gender. Female students rated school counselors’ availability significantly higher than male students did (F = 4.196, p < .05). Statistically significant results also were found based on whether or not the students had sought counseling services. As shown in Table 2, students who had received prior counseling services rated counselors significantly higher in the following areas than did students who had never received counseling services: knowledge of achievement tests, friendliness and approachability, understanding students’ point of view, advocate for students, promptness in responding to requests, ability to explain things clearly, reliability to keep promises, availability, and overall effectiveness.

Table 2

Students’ Evaluations of School Counselors Depending on Whether or Not They Seek Services

 ^aLevene’s test for equality of variances. ^bt test for equality of means.

A 2 × 2 between-subjects ANOVA was conducted to evaluate the effects that gender and students’ experiences with counseling services had on students’ perceptions of counseling services. Levene’s test and Fmax indicated that the homogeneity of variances assumption was met. A statistically significant interaction effect was found between gender and whether or not the students had received counseling services, F(1, 133) = 5.923, p = .016. As shown in Figure 1, the relationship between whether or not students had received counseling services and their perceptions of school counselors differed depending on gender. Among students who had had individual meetings with their counselors, males rated the counselors higher than females did, while females rated the counselors higher than males did if they had never received counseling services.

Figure 1. Mean differences on gender and whether or not students received counseling services.

Discussion

     In this study, almost half of the participants reported seeking help from a school counselor at least once. Interestingly, over 60% of the students who had met with a counselor had not returned for a subsequent meeting. Although China has seen the presence of school counselors increase in urban schools, it is still not common for students to seek counseling services (Thomason & Qiong, 2008). While the specific reasons why the students discontinued meeting with school counselors in this study are not clear, the following factors might help explain this phenomenon: (a) students have been found to be most concerned with physical health and to have failed to consider other aspects of health such as mental/psychological, behavioral and social (Wang, Zou, Gifford, & Dalal, 2014); (b) stigma toward mental illness exists among Chinese students (Thomason & Qiong, 2008; Wang, Huang, Jackson, Chen, & Laks, 2012); (3) Chinese cultural beliefs promote solving family-related issues inside one’s own family (Cook et al., 2010); and (4) students spend the majority of their time preparing for the National College Entrance Exam (NCEE), which Chinese school counselors perceived as an impediment to students’ utilization of school counseling services and future school counseling development in China (Leuwerke & Shi, 2010).

As for the modal number of counseling sessions that school counselors hold in secondary schools in China and the United States, little is presented in the current literature. More research has been conducted on college students’ attendance of counseling sessions offered by university counseling centers. For example, Draper, Jennings, Baron, Erdur, and Shankar (2002) found that, on average, college students met with counselors only three times. A number of studies have confirmed that most college students attend only a few sessions and that 50% terminate counseling prematurely (Ledsky et al., 2000; Renk, Dinger, & Bjugstad, 2000; Whipple et al., 2003). The number of counseling sessions that school counselors have with high school students could be likewise related. Students who visit school counselors by referral normally do not return for a second session, even though more sessions are indicated (E. Zhang, personal communication, June 5, 2007).

In China’s current school system, homeroom teachers have close, day-to-day interaction with students in their own homerooms; these teachers are responsible for students’ behavior, academic performance, mental health and all-around development (Lim et al., 2010; Shi & Leuwerke, 2010). Homeroom teachers may refer students to school counselors if they feel that students’ problems are beyond the teachers’ ability to solve (E. Zhang, personal communication, June 5, 2007). Future research could help explain why students tend to meet with their counselor only one time, and could explore the factors associated with students’ premature termination. It might be that Chinese counselors are giving an intentional or unintentional message that only one session is appropriate. Additional research is necessary to explore how school counselors could reach out to more students and reduce the stigma attached to mental problems, which might encourage more students to utilize individual counseling in school settings.

The descriptive results of this study provide some preliminary information about the level of students’ satisfaction with particular areas. Based on the students’ perceptions in two high schools in Beijing, it appears that school counselors are doing quite well in many different areas, such as friendliness and approachability to students, ability to explain things clearly, and availability. However, there are some areas in which school counselors must improve their knowledge and skills (e.g., college admission, vocational information and opportunities, achievement tests). When interpreting the results of this study, it is important to keep in mind that participants in this study are all from top-ranking high schools in Beijing, where students have a general college-going mindset and therefore place significant emphasis on academic achievement; in addition, these students have a higher expectation and interest in seeking counseling services related to applying for college. Also, in the current school systems in China, homeroom teachers are normally in charge of handling students’ academic testing, disseminating college-related information and helping students prepare for college (Shi & Leuwerke, 2010). Therefore, school counselors might not be as prepared as homeroom teachers to provide information regarding college admission and achievement tests.

As for the low ratings in the area of vocational information and opportunities, it is critical to consider the fact that the practice and profession of career counseling is still in the developmental stage in China (Leuwerke & Shi, 2010; Zhang, Hu, & Pope, 2002). Unfortunately, a thorough literature search revealed no information on the current conditions of school counselors’ training in China. However, a few studies have briefly mentioned the training or education that school counselors receive. For example, Gao et al. (2010) conducted a national survey on professional training experience among mental health practitioners in China, with only half of their sample working in educational settings such as high schools and universities. The researchers found that mental health practitioners reported receiving only short-term training and continuing education that focused on theories; a majority reported receiving no supervision or case consultation (Gao et al., 2010). Although there is a lack of literature on school counselors’ training in particular, several authors have indicated an urgent need for a more regulated, comprehensive and standardized training and qualification system for school counselors in China (Cook et al., 2010; Leuwerke & Shi, 2010; Lim et al., 2010; Thomason & Qiong, 2008).

It was expected that students who had had individual meetings with school counselors would rate counseling services differently than the students who had never seen school counselors individually. Students who had received counseling services before rated school counselors at a significantly higher level than students who had never had counseling services in many different areas, including the school counselors’ test skills, approachability, understanding, advocacy, promptness, ability, reliability, availability and overall effectiveness in providing counseling services. This finding is not surprising, considering that students who have had personal contact with the school counselors might have a better understanding of the role of school counselors and the services they provide, and therefore are more likely to give a higher rating of school counseling services. In a study conducted in Turkey, Yüksel-Şahin (2008) also found that the factor of whether students had met with school counselors was a significant predictor of students’ evaluations of counseling guidance service.

Similarly, gender differences were expected in students’ rating of school counselors. The results show significantly higher ratings from female students than male students of school counselors’ availability. From the descriptive results of this study, one can see that female students reported more contact with school counselors than male students did; this finding might help explain female students’ higher rating of school counselors’ availability.

Finally, an interaction effect was found in students’ ratings of the effectiveness of their counselors in the 2 × 2 between-subjects ANOVA based on gender and whether or not students seek counseling services. In a 2009 study, Hou, Zhou, and Ma examined high school and university students’ expectations of counseling in China. Results of their study showed that female students had significantly higher scores than males in terms of their own openness and counselors’ acceptance. Meanwhile, the researchers also found that students who did not have counseling experience had significantly lower scores on their motivation compared to their counterparts. These trends continued in the current study, which further supports the idea that students’ previous counseling experiences and gender relate closely to their expectations and perceptions of counselors and counseling services in general.

As a developing profession facing a huge student population, school counselors in China are doing a more than adequate job with limited resources. In the current study, most high school students reported seeking counseling services from their school counselors more than once, and they reported having generally positive experiences in counseling. Meanwhile, these students also had positive perceptions of their school counselors’ services; however, they reported the need for more vocational guidance or more knowledge of achievement tests from their counselors. An interaction effect was found in students’ perceptions of school counseling services based on students’ gender and whether they had met with school counselors before.

Implications

This study contributes to the literature by filling a research gap in Chinese students’ utilization and perceptions of school counseling. This line of inquiry is very important for the future development of the school counseling profession in China in that it provides implications for researchers and school counseling practitioners, as well as counselor educators. Future researchers could further investigate factors that might predict students’ utilization of school counseling services and what students need the most from counseling. More efforts need to be made in both conducting empirical research in the school counseling field and in exploring ways to improve the profession that will suit China’s cultural and social situations (Jiang, 2005; Thomason & Qiong, 2008). Moreover, the findings from this research are informative for school counseling practitioners in China. Chinese school counselors may want to self-evaluate their services and seek further training and education to improve their services in the areas that students rated lower. School counselors also could explore ways to make their services more accessible for students. Finally, the results of this research can be beneficial for counselor educators, who could contribute to improving the quality of school counselors’ training and education by providing opportunities for supervision, practice and professional development courses targeting the knowledge and skills that school counselors need most.

Limitations

     There were a number of limitations in this study that limit generalization and call for additional research. First, the sample in this study was a convenience sample; the majority of the participants were from one high school, also limiting the generalizability of the results. Second, the two high schools are similar to each other in that they are top-ranking high schools in Beijing, and their students have similar future plans. Therefore, the results of this study may not apply to other geographic areas in China, especially rural areas, because a difference exists in educational conditions between economically developed areas (e.g., Beijing, Shanghai, Guangzhou) and underdeveloped areas (e.g., rural areas in West China). Students from different geographical areas in China may encounter different mental health problems, and the development of school counseling in urban and rural China may be different (Yan, 2003). The position of school counselor may not even exist in some areas in China. Third, the sample lacks diversity in terms of gender and grade level. Most of the participants in this study were female students and senior 2 students. Gender may be a variable that influences how students perceive counseling and school counselors. Future research utilizing more diverse and larger samples from across the country will be able to provide a more detailed and general picture of school counseling in high schools across China. Lastly, the instrument used in this study was adapted from an instrument that was developed several decades ago. Although some modifications were made, the validity and reliability of the scale used for Chinese students are not clear at this time. Future studies may investigate the validity and reliability of this instrument and also develop new instruments that are specially designed to measure students’ perceptions of Chinese school counselors’ effectiveness, competence, expertise and contributions.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of

interest or funding contributions for

the development of this manuscript.

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Qi Shi is an assistant professor at Loyola University Maryland. Xi Liu is a doctoral student at George Washington University. Wade Leuwerke is an associate professor at Drake University. Correspondence can be addressed to Qi Shi, 2034 Greenspring Drive, Timonium, Maryland 21093, qshi@loyola.edu.

Identifying Gender Differences in Male and Female Anger Among an Adolescent Population

Dec 2, 2014 | Article, Volume 4 - Issue 5

Isaac Burt

This pilot study explored differences between the levels of anger expression and anger control by adolescent males and females. Eighteen participants (9 males and 9 females) completed a strength-based anger management group promoting wellness. Anger management group counseling consisted of a 10-week continuous intervention emphasizing anger reduction, anger control and appropriate anger expression. Results indicated gender differences in that females exhibited more anger expression, as well as less anger control. However, females had higher levels of overall improvement. The article concludes with limitations and implications for mental health counseling with adolescent populations.

Keywords: mental health counseling, group counseling, anger management, adolescent, gender differences

The profession of mental health counseling serves a diverse population with a variety of needs, including substance abuse and anger management issues (Gutierrez & Hagedorn, 2013). In order to provide services to clients, mental health counselors use a number of modalities, such as individual and group counseling. Research indicates that group counseling in particular can be useful with certain populations, such as excessively angry clients (Burt, Patel, Butler, & Gonzalez, 2013; Fleckenstein & Horne, 2004). Traditionally, anger management groups have focused on dealing with anger after it occurs. Recent developments in the field of counseling, however, suggest that a number of new trends are developing with mental health and anger management groups (Burt & Butler, 2011).

One of these trends focuses on early prevention with mental health counselors either providing facilitation or training others to facilitate anger management groups in schools (Curtis, Van Horne, Robertson, & Karvonen, 2010). The targeted clients of most of the early prevention interventions are middle and high school populations (Parker & Bickmore, 2012). Burt and Butler (2011) contended, however, that many early prevention and anger management groups are gender biased and focus excessively on adolescent males. The researchers suggested that while adolescent females experience anger as well, they often do not receive counseling services (Burt & Butler, 2011). As a result, a growing population with similar needs is potentially neglected. While numerous differences do exist between genders, anger is a common emotion experienced by both (Karreman & Bekker, 2012).

Research indicates that differences exist between adolescent males and females with regard to behavioral decision-making processes and expression of emotions (Brandts & Garofalo, 2012). Although research depicts females as more emotionally expressive, males have a reputation of being more predisposed to anger. According to Sadeh, Javdani, Finy, and Verona (2011), females experience anger, but may express it differently than males. For example, instead of expressing anger by striking objects, adolescent females may talk to friends or peers (Fischer & Evers, 2011). Conversely, other studies purport that females express anger similarly to males, but experience difficulty recognizing and admitting the emotion due to social expectations and constraints (Karreman & Bekker, 2012). Males, on the other hand, tend to display anger more commonly and comfortably (Fischer & Evers, 2011). One of the many reasons that adolescent males may feel comfortable expressing anger is because it is socially acceptable (Burt et al., 2013).

An extensive number of studies have investigated anger; however, there appears to be a lack of studies exploring anger differences between genders. Karreman and Bekker (2012) conducted a study on gender differences, investigating autonomy-connectedness between genders. Their study indicated differences related to anger and sensitivity between genders. However, the study did not attempt to determine whether males and females were equal in anger at the beginning or end of the study. Similarly, Burt, Patel, and Lewis (2012) reported that incorporating social and relational competencies into anger management groups reduced anger, but there was no discussion of anger differences between genders. Sadeh et al. (2011) indicated that women expressed more self-anger (i.e., anger directed internally toward themselves) than males, but did not investigate whether differences existed between genders before the study.

Although limited, a small number of studies have attempted to examine anger differences between genders. Similar to Sadeh et al. (2011), Fischer & Evers (2011) found that females expressed subjective anger, or self-anger, more often than males. Buntaine and Costenbader (1997) found that both genders’ self-reports (assessments) indicated no significant differences. Upon further examination of their data, however, they concluded that although self-reports specified no differences, males verbally reported higher responses of anger. In contrast, Zimprich and Mascherek (2012) determined that no anger differences existed between males and females. They declared that although genders may express anger and respond to situations differently, they generally experience similar levels of anger. As can be seen from the preceding studies, inconsistences exist in the literature. Contradicting studies indicate that researchers are unclear as to whether differences in anger exist between genders. As such, a research gap has emerged that needs to be filled (Zimprich & Mascherek, 2012). In order to understand how this research gap developed, it is necessary to examine cultural influences.

Cultural Influences and Misconceptions in Society

According to Carney, Buttell, and Dutton (2007), a misconception exists in Western society that women are less aggressive than men and do not express excessive anger. This fallacy persisted in Western culture until a report from the U.S. National Family Violence Survey of 1975 (as cited in Carney et al., 2007) found a disturbing trend: Females were just as angry as males and expressed excessive anger the same amount that men did. At the time, feminist theory and the feminist movement were developing and stood in stark contrast to these findings. Carney et al. (2007) stated that as such, the National Family Violence Survey findings were largely unreported, and in extreme situations, people reinterpreted or repudiated the survey’s findings. In either case, more misconceptions began to develop in Western culture (Carney et al., 2007), such as the idea that when females experience anger, it is always appropriate to the situation (i.e., anger is permissible). A second mistaken belief is that anger from females is less serious and not as negative. For example, the expression “you look so cute when you’re angry” portrays this biased and potentially chauvinistic thought. A third misconception is that females are more credible in reporting their emotions and, as such, females are more reliable when they state that they are not angry.

Western society has acted upon these cultural misconceptions. For example, certain myths in society (and mental health counseling) persist, declaring the following: (a) only males have angry feelings, (b) all male-comprised counseling groups are anger management groups, (c) males have a limited repertoire of emotions to express, (d) males are too angry and competitive to support one another in groups, and (e) males are not interested in meeting with other males (Andronico & Horne, 2004). Myths about female groups are that they are high functioning, conflicts are resolved faster, and a fair amount of reflection and processing exists (Gladding, 2012). According to researchers, these misconceptions can bias the truth regarding people’s beliefs. For example, Winstok (2011) stated that rates of excessive anger and intimate partner physical abuse among females equal or surpass those of males.

Clearly, cultural misconceptions of gender differences in excessive anger can lead mental health counselors to do a disservice to males and females alike. For example, culture can influence mental health and group counseling by causing a type to develop. This type is defined as best suited to be in anger management groups. As a result, mental health counselors may unconsciously choose more males than females to be members of anger management groups. Thus, a population that desperately needs services can go without an intervention (Carney et al., 2007). Mental health counselors need to reevaluate their thinking in order to avoid overlooking a population needing services due to implicit social misconceptions.

Bandura (2008a) believed that excessive anger was not sudden, but gradually manifested over time. His studies with youth corroborated this idea, as he observed modeling and negative behavioral patterns leads to excessive anger (Bandura, Ross, & Ross, 1963). Supporting Bandura’s work, Burt and Butler (2011) asserted that excessive anger begins in childhood and adolescence. They reinforced the notion that mental health counselors must be aware that both genders have common needs and issues. For females, not receiving services or having services denied, and being told that the emotion they feel is inappropriate, could cause personal damage (Gottfredson, 2002). For instance, society and mental health counselors often depict males as more in need of anger management (Burt & Butler, 2011). Conversely, mental health counselors sometimes neglect and ignore what females need (West-Olatunji et al., 2010). Stated succinctly, a gap exists between what clients need and the options mental health counseling interventions offer to both genders. It is the author’s contention that this gap is an unfair practice, as both genders have similar needs. Research has shown that males and females experience anger equally; as a result, both need anger management groups.

To determine whether both genders expressed anger similarly, the author implemented a pilot study with adolescents to explore the topic before proceeding with a full investigation. As Bandura (2008b) pointed out, anger begins early in life and timely prevention is critical. Provision of early services for children and adolescents can help to prevent issues later in life.

Method

Participants

Participants in this study were male and female middle school students in the sixth, seventh and eighth grades. Thirty potential participants (15 males and 15 females) received invitations for participation, and 20 returned signed parental informed consent forms (10 males and 10 females). Ages of participants ranged from 11–14 years and consisted of 75% Latino/Hispanic (15), 15% Black (3), and 10% White (2). Two participants did not complete the study.

Instrumentation

This pilot study used the State-Trait Anger Expression Inventory-2 Child and Adolescent (STAXI-2 C/A). A well-known and highly used instrument, the STAXI-2 C/A is a self-report assessment that indicates youths’ (ages 9–18) control and expression of their anger (Spielberger, 1999). The STAXI-2 C/A has provided reliable and consistent results across diverse cultures and settings (Chirichella-Besemer & Motta, 2008). The STAXI-2 C/A contains four scales assessing excessive anger in youths. The four scales are as follows: Anger State (S-Ang), Anger Trait (T-Ang), Anger Control (AC) and Anger Expression (AX). Each of the four scales measures a different indicator of anger, in order to provide counselors with a multifaceted perspective of the client’s anger behavior.

Past studies that utilized the STAXI-2 C/A focused on AC and AX because of the strong validity these scales have with other anger assessments (Freeman, 2004); thus, the AC and AX scales were used in this pilot study. Cronbach’s alphas were .92 and .67 for AC and AX respectively (Freeman, 2004). Barrio, Aluja, and Spielberger (2004) stated that Cronbach’s alphas demonstrated by the STAXI-2 C/A indicated a high degree of reliability. Additionally, Barrio et al. (2004) also exhibited high construct validity by correlating the STAXI-2 C/A with the Verbal and Physical Aggressiveness Scale (AFV; Caprara & Pastorelli, 1993). A significant correlation of .43 existed between the two assessments. According to Gladding (2012), numerous counselors fail to measure the successfulness of their groups accurately because of errors in measurement and evaluation. In groups, a large number of therapeutic factors are occurring, which affect members in varying ways (Corey, 2011). Focusing on too many factors can overwhelm counselors and undermine evaluation, which is critically important (Gladding, 2012). In order to avoid this potential problem, this pilot study focused on a limited number of factors.

Procedures

A large, urban public middle school in a metropolitan area provided the setting and participants for this pilot study. Serving 2,000 students in grades 6–8, the school has a standardized documentation system that keeps track of behavioral disruptions. The documentation system records in-school suspensions (ISS), out-of-school suspensions (OSS) and behavioral infractions for students (Burt, 2010). Each student has a personal identification number; the administration connects student infractions to these numbers in order to identify any student. The documentation system also contains a small description of what caused the issue. For instance, some students have behavioral outbursts of anger, while others have infractions for tardiness. Since the focus of this pilot was to determine anger differences between genders, it was imperative for the study to have participants who displayed excessive anger. To increase validity and correctly identify participants, the author used school administration recommendations.

The author conducted interviews with school staff to gather information as suggested by Bryan, Day-Vines, Griffin, and Moore-Thomas (2012). For example, the author asked school deans, teachers and professional school counselors (PSC) for recommendations about students. Many students had a high overall number of OSS and ISS, including a large number of behavioral infractions. However, some infractions were due to nonexcessive anger problems (e.g., tardiness). School staff could provide a safeguard against the author inappropriately recruiting a student who did not truly require services. The author asked school staff if a student’s number of OSS, ISS and infractions corresponded with actual behavior (i.e., excessive anger). Thus, the goal was to eliminate as much bias as possible to ensure the most appropriate candidates.

After interviewing school staff, a pool of candidates emerged, consisting of individuals with documentation of excessive anger, fights and legal procedures in the court system (Burt, 2010). School staff considered these candidates to be at high risk for excessive anger, and candidates’ records of OSS, ISS and behavioral infractions corroborated this belief. According to Burt et al. (2013), more than eight occurrences in a 12-week period constitute a high number of anger issues; thus, this study held the same parameters advocated by Burt et al. (2013). Once a list of eligible candidates emerged, the author interviewed school staff a second time. This second short interview was a safeguard measure before actually contacting candidates. The author wanted to meet with school staff again to reduce potential staff bias and ensure that candidates were still having anger issues. After the last interview, school staff explained the study to candidates in detail.

In order to increase client buy-in, school staff introduced the author of this article (who was also the group facilitator) to candidates. The author met with candidates and explained the study in more detail, in addition to answering any questions. If the candidates were interested in participating, the author gave them informed consent forms to have their parents sign. To increase the likelihood of the candidates returning the informed consent forms, candidates received tokens from the school, which allowed them to buy goods in the school store. If candidates returned signed informed consent forms, they received five tokens, comparable to five U.S. dollars. Out of 30 candidates, 20 returned signed informed consent forms. Although this is a small number, this quantity is permissible for pilot studies (Heppner, Wampold, & Kivlighan, 2008). The author split the participants in half based on gender (10 males and 10 females). One participant dropped out of each group, leaving 18 who completed the study. Each group met at a different time and was not aware of the existence of the other group (Burt, 2010). This pilot study assessed participants’ behavior via the STAXI-2 C/A, given pre- and post-intervention.

     Structure of the intervention/anger management group used in the pilot study. The anger management group consisted of eight counseling sessions and two assessment sessions (pretest and posttest assessment; Burt, 2010). Program duration was 10 weeks, and the author of this article conducted each session weekly. Corresponding with Blanton, Christensen, and Shakir (2006), each counseling session contained the following four essential components: an opening question (such as an icebreaker or introductory segment), a behavioral lesson (information gathering and learning), a behavioral activity (an experiential segment in which learned information is applied), and an appreciations and closings segment ending the group (a bonding piece for group members). Counseling sessions concluded after 60 minutes, with opening questions lasting approximately 5–10 minutes. Behavioral lessons took between 10 and 25 minutes and behavioral activities lasted 15–30 minutes. Appreciations and closing concluded after 5–10 minutes. Pre- and post-group paperwork sessions took approximately 15–30 minutes (Burt, 2010). As Burt et al. (2012) suggested, groups must be strength-based (i.e., accentuating members’ strong points), and incorporate collaboration and teamwork. The group was prosocial in nature, emphasized clients’ strengths and developed social bonding. Topics for the eight sessions included the following: improving communication skills, recognizing personal emotions, identifying emotions within others, improving observational skills, advanced detection of emotions in others, noticing anger cues in others, understanding personal anger cues, strategies for calming down, and problem-solving.

     Mental health counselor for the intervention. The mental health counselor for both groups was this author, who has experience as a group facilitator and counselor educator. Additionally, the author worked as a training liaison for anger management groups in the school system, teaching conflict resolution and peer mediation. He also has experience working with groups for adults and children with oppositional defiance disorder and anger management issues. The group facilitator used an integrative orientation, utilizing social cognitive theory (SCT) and cognitive-behavioral therapy (CBT; Burt, 2010).

Results

The focus of the study was to determine whether differences existed between male and female levels of excessive aggression. Table 1 displays descriptive statistics and indicates results from the one-way repeated measures ANOVA for AC and AX. Results for youths’ overall AC levels pre- and post-intervention indicated the following, F1, 8 = 6.36, p = .003, ES = .44. Thus, the pilot study showed preliminary findings that a significant difference existed between genders on AC. For the scale of AX, results indicated a statistically significant difference between genders pre- and post-intervention (F1, 8 = 4.06, p = .018, ES = .34). Although repeated measures indicated a statistically significant difference between genders, pair-wise comparisons allowed examination of exactly where differences lay between genders on AC and AX. Thus, a significant difference existed between gender on AC (p = .04), and on AX (.03; Table 1). At the beginning of the pilot study, males had less AC, but females had more AX. However, females had the larger increase in AC post-intervention, as well as the greatest reduction in AX between genders. Hence, females had the greater overall gains and improvement pre- and post-intervention as opposed to males.

Table 1

Outcome results for Anger Control and Anger Expression

Note. ^a N = 9 ^b N = 18

Discussion

Females had more AX than males, a finding which corresponds with Cross and Campbell (2011). Males appeared to have less AC and were somewhat less angry than females. A number of studies support the preceding findings, most notably Winstok (2011) and Carney et al. (2007). Further, this pilot’s findings corroborate the idea that both genders have equal problems with excessive anger (Carney et al., 2007). The results from this study also suggest that both genders can improve with interventions designed to address anger. According to Winstok (2011), a common misconception is that males have greater need for excessive anger interventions than females. However, in this pilot study, females responded better to the treatment than males did. This responsiveness to treatment is interesting in that few studies have directly compared sensitivity to interventions by gender. While sensitivity to treatment was not a focal point of this pilot, it is interesting to note and direct attention to this unexpected outcome.

The author believes that the primary underlying reason females responded better to the treatment is that they are an underserved population (West-Olatunji et al., 2010). This is not to say that other explanations are not contributing factors, but because the females in this study possibly represent an underserved population, the aforementioned factor likely has more influence. According to West-Olatunji (2010), an underserved population is one that needs services, but does not have access to help. In addition, a number of the females in this pilot qualify as an underserved population as defined by Burt and Butler (2011). For instance, background information provided by the school indicated that approximately 85% of males in this pilot study received prior services (e.g., counseling) before participating. Conversely, 40% of females in this pilot study received prior services. Although the purpose of this study was not to detail what causes an underserved population to develop, research indicates that it can be due to institutional, social or cultural constraints (West-Olatunji et al., 2010).

While this study did not use qualitative measures as advocated by McCarthy (2012), females verbally disclosed that the school rarely offers them anger management services. Female participants further stated that if those services were more readily available, they would use them. Conversely, males indicated being overwhelmed with staff attempting to persuade them to participate in anger management services. This dichotomy in access to treatment clearly marks the identification of an underserved population. Thus, the females’ higher responsiveness to the intervention is potentially due to the following: Perhaps this study was a first intervention for many of the female participants. For females who did receive prior services, it may have been the first intervention directly dealing with anger.

Day (2008) indicated three characteristics that clients need to increase the likelihood of a successful outcome: the client must be in distress, must actively seek help and must have high expectations for counseling. The female participants (as opposed to the majority of the males) in this study met the preceding three criteria. Members of both genders were in a state of distress (as evidenced by the school’s documentation system). However, females verbally admitted to wanting help and had higher expectations. Consequently, females in the pilot had larger, more consistent gains. As evidenced by West-Olatunji et al. (2010), when underserved populations receive desired treatments, the change is normally larger than average. Thus, the findings in this pilot study connect to previous research and provide a plausible reason for the differences between genders.

Limitations

This pilot study had limitations stemming from research methods. First, the groups were limited to one school, as well as to selection from a standardized school documentation system (Burt, 2010). The documentation system compiled an objective list of behavior issues in school, but did not differentiate between excessively angry and nonexcessively angry behaviors. For example, documented behaviors could range from threatening school staff to not returning school forms promptly. To account for this issue, this study included school staff and administration’s professional suggestions for possible candidates. However, school staff may have had subtle biases for or against certain students. There are limitations to each method of selection, including both the standardized documentation system and the school staff. An additional limitation is that the same mental health counselor (the author of this article) conducted the groups. Due to this limitation, some participants’ changes may be due to the facilitator’s style or personality. More importantly, this study lacked a control group and had a small number of participants. The lack of a control group makes generalizations difficult in that it is uncertain whether other extraneous variables influenced the results. Having a small number of participants decreases the power of the pilot study and makes it difficult to generalize results. However, the fact that a significant finding occurred with a small sample size indicates the strong influence of the intervention (Gay & Airasian, 2003). In schools, it is difficult to conduct full-scale studies due to a number of preexisting conditions, such as high-stakes testing (Burt et al., 2013). Therefore, having a study without a control group and with a small number of participants may be the most appropriate method if investigators are to conduct research in schools (Heppner et al., 2008).

Implications and Future Directions for Research

Implications for mental health counselors stemming from this pilot study are numerous. First, mental health counselors must be aware that both genders need services for excessive anger. Mental health counselors should not allow personal biases and media influences to sway professional opinion (Gladding, 2012). In addition, mental health counselors must advocate for fairness and oppose stereotyped biases and ideologies pushed by society (Burt et al., 2012). According to Gray and Rose (2012), discrimination and internalized oppression begin by ignoring discriminatory societal practices. Only by remaining reflective and cognizant of personal biases can mental health counselors reduce problematic issues and model appropriate behaviors (Young, 2012).

A second implication for mental health counselors is to understand that a strength-based model promoting wellness is critically important for clients (Hagedorn & Hirshhorn, 2009). Specific populations, such as youth, respond better to models incorporating empowerment, which can lead to increased behavioral self-efficacy (Bandura, 2008a). Furthermore, positive modeling by mental health counselors also increases growth and behavioral self-efficacy (Bandura, 2008a). A combination of strength-based approaches, empowerment and modeling improve groups’ interpersonal, intrapersonal and extrapersonal functioning (Gladding, 2012). Third, mental health counselors should seek to improve delivery of services and outcomes by evaluating the group process (Steen, 2011). For instance, Gladding (2012) and McCarthy (2012) reinforced the notion of improving counseling services through research and evaluation. This study provided a formal assessment of a group that could have otherwise gone unreported.

Future researchers may want to improve the overall research design. For example, researchers could include a larger number of participants, groups and multiple facilitators. Moreover, future studies must have a true experimental design, such as a control group with random assignment. Including participants’ personal perspectives and phenomenological views not only increases the validity of research, it improves mental health counselors’ skill levels as well (Gladding, 2012). Qualitative measures improve skill level by giving mental health counselors a clear idea of what actually worked and what did not (Burt & Butler, 2011). Lastly, future researchers may want to pay more attention to gender responsiveness (sensitivity) to treatments, to determine if males or females respond better to specific treatments.

Conclusion

The purpose of this pilot study was to determine whether gender differences existed among adolescents for excessive anger. Preliminary results indicate that differences existed, but that there also were distinctions between genders regarding the intervention itself. Females had better AC, but also had more AX compared to their male counterparts. However, females seemed to respond better to the intervention, as shown by their larger gains and improvement. Males improved as well, but did not have the substantial progress observed in females. While past research may not have lent strong support for gender differences, this author hoped to reinvigorate interest in gender discrepancies. Females are an underserved population with regard to anger management; research has indicated that they experience anger sometimes at a rate paralleling or surpassing males (Cross & Campbell, 2011). However, due to societal stigma and cultural biases, many females do not receive anger management services. Therefore, only rigorous research can determine whether these problems truly exist by improving group research and outcomes (McCarthy, 2012).

Conflict of Interest and Funding Disclosure

The author reported no conflict of

interest or funding contributions for

the development of this manuscript.

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Isaac Burt is an assistant professor at Florida International University. Correspondence can be addressed to College of Education, 11200 SW 8th Street, ZEB Building Room 236, Miami, FL 33199, iburt@fiu.edu.