Jun 28, 2018 | Volume 8 - Issue 2
Kristi A. Lee, Daniel J. Kelley-Petersen
The focus on human development is foundational to the field of counseling, with its importance codified in guiding documents and frameworks, such as the American Counseling Association’s Code of Ethics (2014). Many developmental theories have been established using single-gender or single-culture groups, yet they claim universal application to all humans. Although counseling students must learn these theories because of accreditation standards and licensure requirements, counselor educators need to prepare students for practice in a multicultural world. Counselors are now called to act as social justice advocates, and teaching strategies are needed to prepare students for this role. This study’s focus is on the use of service learning with community counseling students in a human development course. Results from a content analysis demonstrate how service learning enhances learning and broadens students’ perceptions of themselves, others, and social justice in counseling. Findings indicate a shift in participants’ perception of social justice in counseling.
Keywords: service learning, social justice, human development, developmental theories, content analysis
Distinct from the medical model that underlies psychology, the field of counseling has historically focused on developmental processes as the foundation to understanding what makes human life function well (Brady-Amoon, 2011; Kraus, 2008; Lewis, 2011; Stennbarger & LeClair, 1995). These processes of development are explained through theories about learning, normal personality development, and individual and family development, among others (Council for the Accreditation of Counseling & Related Educational Programs [CACREP], 2015). The American Counseling Association (ACA) identified “enhancing human development throughout the lifespan” as the first core value of the counseling profession (2014, p. 3). Further, human development has been established as one of eight knowledge areas by CACREP (2015), the national accrediting body for counselor education programs. Additionally, standardized tests, such as the National Counselor Examination for Licensure and Certification, require students to demonstrate mastery of studies that provide an understanding of the nature and needs of individuals at all developmental levels (National Board for Certified Counselors [NBCC], 2015).
Although understanding and promoting healthy human development across the lifespan are central themes in counselor education, there are critiques of the study of human development (Brady-Amoon, 2011). Many theories and models of human development reflect middle-class, Caucasian-American value systems and culture (Brady-Amoon, 2011; Broderick & Blewitt, 2015; Dixon, 2001; Henrich, Heine, & Norenzayan, 2010), and thus lack utility in developing both a robust and a nuanced understanding of groups who are outside of this demographic. Broderick and Blewitt (2015) stated that there is a “growing concern that traditional theories are insufficient to explain development because they are biased in favor of single-culture or single-gender models” (p. 351). The role of culture in human development is crucial to consider (Rogoff, 2003), yet many theories consider culture an extraneous variable. Systematic misapplication of theories designed for the dominant population may not adequately account for the accepted indicators of development for diverse cultural and societal contexts (Broderick & Blewitt, 2015;
Dixon, 2001; Kraus, 2008). Recognizing challenges in applying developmental theories to diverse populations is critical for counselors who promote social justice in counseling and in society (Kiselica & Robinson, 2001; MacLeod, 2013).
The Movement Toward a Social Justice Perspective in Counseling
Counselors have a unique position as frontline witnesses to how social inequities impact clients. Individual, couples, family, and group counseling are critical in helping clients in non-dominant groups navigate and survive systems of oppression and opportunity. However, these modalities of counseling may not be sufficient to prevent or meaningfully address mental health issues that have systemic causes (Toporek, Gerstein, Fouad, Roysircar, & Israel, 2006). The recognition for the need to adjust counseling approaches to work with issues of healthy human development in a pluralistic society has contributed to the growth of the social justice movement within the field of counseling (Ratts & Wood, 2011). At times identified as the “fifth force” (Ratts, 2009) in counseling, the social justice perspective not only addresses the individual needs of clients, but also seeks to change systems that inhibit human development for oppressed groups. Counselors are challenged to determine how to balance individual counseling interventions with advocacy interventions on local, state, or national levels. A social justice approach to counseling emphasizes the importance of healthy human development for individuals and social groups and necessitates a broader array of skills, knowledge, and perspectives, including advocacy skills (Bemak & Chung, 2011; Brady-Amoon, 2011; Lewis, 2011; Ratts, 2009).
Acceptance of the social justice counseling perspective is evidenced by its codification in important documents that guide many practitioners and educators in the field of counseling. In the preamble to the 2014 Code of Ethics, ACA identified “promoting social justice” (p. 3) as a core principle. Ethical counselors are called to “advocate at individual, group, institutional, and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients” (2014, p. 5). In 2003, ACA endorsed the Advocacy Competencies (Lewis, Arnold, House, & Toporek, 2002), a document that describes skills and activities for counselor advocacy. Additionally, the 2016 CACREP standards call for preparation of counselors in “advocacy processes needed to address institutional and social barriers that impede access, equity, and success for clients” (2015, p. 10). These documents provide evidence that segments of the profession of counseling, particularly some counselor education programs, are embracing a social justice perspective that can be enacted through counselor advocacy.
Although many counselors may want to advocate for marginalized populations, they may not be comfortable doing so or they may not know how (West-Olatunji, 2010). Further, it is unclear whether counselor educators are adequately preparing students with the skills necessary to practice from a social justice perspective upon graduation (Bemak & Chung, 2011; Constantine, Hage, Kindaichi, & Bryant, 2007). Preparing counselors with effective and culturally relevant advocacy skills for work in today’s pluralistic society requires that counselor educators rethink historically used teaching methods (Brady-Amoon, Makhija, Dixit, & Dator, 2012; Burnett, Long, & Horne, 2005; Herlihy & Watson, 2007; Hoover & Morrow, 2016; Manis, 2012). Rethinking traditional teaching methods and curricula is particularly important for courses such as human development, which have traditionally focused on universalist theories established using single-gender or single-culture groups (Broderick & Blewitt, 2015). However, for the foreseeable future students will be required to demonstrate their mastery of these traditional theories on licensing exams (NBCC, 2015). To meet the dual challenge of preparing students for licensure and preparing them for practice in a pluralistic society, new teaching approaches are needed. The role of social justice advocacy has been conceptualized as central for counselors (Chang, Crethar, & Ratts, 2010; Lewis, Lewis, Daniels, & D’Andrea, 1998), yet few studies have demonstrated how to prepare students for this role.
Service Learning: A Pedagogy for Counselor Education
Defining Service Learning
Teaching that is active, experiential, and addresses real-world problems is needed to meet the call to prepare students as social justice advocates in the context of rapidly changing and diversifying demographics (Bemak, Chung, Talleyrand, Jones, & Daquin, 2011; Constantine et al., 2007; Manis, 2012). As an experiential teaching strategy that combines academic content learned in the classroom with activities in the community that address “human and community needs” (Jacoby, 2015, p. 6), service learning provides a potential avenue for more adequately preparing counseling students for work in today’s pluralistic society.
Although similar to experiential learning, service learning has a set of characteristics that make it distinct from internships and volunteerism (Furco, 2002). With an emphasis on collaboration with community partners (CPs) who represent historically marginalized communities, all participants enter the service-learning experience as learners and as contributors. Community members and students benefit from a collaborative learning partnership through which a solution to a community-articulated problem is developed (Warter & Grossman, 2002).
Service learning can take two forms: placement-based and project-based. Placement-based service learning usually involves a requirement for students to spend a set number of hours at a community organization where a student completes agreed-upon tasks (Parker-Gwin & Mabry, 1998). In project-based service learning, small student groups work with CP organizations on specific projects that help to meet a need or solve a community-articulated problem (Hugg & Wurdinger, 2007).
Service Learning in Counselor Education
A growing number of counselor educators have called for the use of service learning within counselor education to provide students with an avenue for understanding complex systemic social inequities (Bemak & Chung, 2011; Bemak et al., 2011; Constantine et al., 2007; Manis, 2012). Additionally, the use of service learning within counselor education has been the focus of a limited number of studies. A qualitative study by Jett and Delgado-Romero (2009) focused on the impact of using service learning with pre-practicum counseling students. Results showed that service learning “was perceived to facilitate student counselors’ professional development” (p. 116) through promoting a deeper understanding of counselors’ roles and contexts. Exposure to counseling environments promoted student counselors’ understanding of what counseling is, as opposed to what they imagined it to be (Jett & Delgado-Romero, 2009).
Service learning also has been found to increase multicultural competencies in counseling students. In utilizing service learning in a multicultural counseling class, Burnett, Hamel, and Long (2004) found that it provided “an opportunity to build community learning and cultural sensitivity” (p. 190). They found that service learning had merit in multicultural counseling competency training and in reducing a “missionary ideology” (p. 191) in students. These results suggest that service learning can be a useful strategy for helping students understand how to advocate with and on behalf of marginalized communities. In addition, service learning may give students the opportunity to practice advocacy skills in real-world contexts.
In order to explore the relationship between service learning and students’ understanding of the role of social justice advocacy in counseling, the present study documented and analyzed community counseling students’ experiences in project-based service learning in a human development course in a CACREP-accredited program. The study’s research question has four foci: In what ways does the use of service learning in a human development course impact students’ (a) understanding of course content; (b) understanding of development of people in non-dominant populations; (c) perceptions of themselves; and (d) understanding of a social justice perspective in counseling?
Method
Description of Participants and Sampling Procedures
The study included data from 40 participants. Seventy-six percent of participants identified as female, 24% identified as male, and no participant identified as “other,” an option allowing for non-binary gender identities. Participants’ age range was 22 to 56 with an average age of 31, and they identified with the following race or ethnic categories: Black, 5%; Hispanic, 22%; Native American, 2%; Two or More Races, 10%; White, 49%; and No Response, 12%.
To gain a broad understanding of students’ experiences, data from nearly all community counseling students (hereafter called participants) who participated in the course over four academic terms were included in the study. The data for one student was left out of the study because of participation in the research process. Each participant was in the first of a three-year community counseling program while enrolled in the course with service learning. The program was in its final cycle of CACREP
re-accreditation as a community counseling program at the time the data were collected. This study was approved by its host institution’s Internal Review Board.
Class as Context
Service learning is grounded in a specific “academic house” (Lee & McAdams, 2017) that informs the type of service activities. The academic house for the current research project was a course designed to meet the CACREP human growth and development curriculum requirement. Entitled Counseling Across the Lifespan, it was positioned as the first course in a three-year community counseling program located in a private, urban, medium-sized university in the northwest region of the United States. Taught over a 10-week academic term, the course utilized a text that covered theories and models of human development across the lifespan (i.e., theories of learning, personality development, cognitive development, ecological models). Course elements included reading, class lectures, small and large group discussions, papers, and quizzes. Many theories of development included in the course to help students meet the requirements of licensure were developed using a single-gender, monocultural group. To incorporate a social justice perspective, the course instructor (first author) believed it was essential for students to understand how Euro-Western theories of development may or may not apply to populations for whom they were not developed. To provide context for critical analysis of class content, students engaged in a major class project, the Developmental Service-Learning Project (DSLP).
Developmental service-learning projects. In keeping with high-quality service-learning pedagogy with a social justice focus, the DSLPs were designed in collaboration with CP organizations working with marginalized populations. The primary instructor worked with a center on campus that supported faculty in developing service-learning courses to identify potential partners whose organizations serve people across the lifespan. Project examples included needs assessments, resource manual development, and socio-emotional lesson plan development. All project ideas were suggested by CPs and planned collaboratively with the course instructor. CPs visited class to introduce their organizations and projects to students during the second class session. Students then selected a project and met with their CPs during class time to launch the collaborative project work.
The DSLP had several requirements. For students to gain an understanding of the organization and the population with whom they were working, students visited the site under the supervision of the CP. Each project included the development of a product that could go into immediate use at the CP organizations and that would continue to benefit the site after the project ended. Students also were required to read, analyze, and report how relevant scholarly literature informed their project work. A project proposal detailing what would be accomplished during the DSLP was submitted for approval to the CP and the course instructor. Upon approval, students carried out their projects while remaining in contact with their CPs. During the study’s time period, there were a total of 24 completed DSLP projects. In collaboration with CPs, students completed projects on curriculum development, program evaluations, needs assessments through focus groups and interviews, and intake process development, among others. CP organizations served individuals across the lifespan and in historically marginalized communities ranging from a program on kindergarten readiness with refugee families, to developing resources for housing for an older African immigrant community.
CPs attended the final class session for DSLP group presentations. Partners asked questions, gave verbal feedback, and completed formal written evaluations of the projects. Project groups wrote a final report for their CP detailing their work and product. Digital and physical copies of all products were given to CPs for their continued use. The last class session served to celebrate partnerships and accomplishments. After the term ended, the course instructor met with each CP to discuss the experience, solicit feedback, and plan future collaborations; several CPs collaborated on projects over multiple academic terms.
Data Collection and Analysis
Data were collected from three sources, each a required class assignment. The first two sources were reflection papers—one written by participants at midterm, and one at the end of the term. The third assignment was a self-evaluation completed by participants at the end of the DSLP experience. Participants responded to specific prompts such as “Did your experience with the Developmental Service-Learning Project impact your comprehension of the material from the text and lectures? If so, how?” and “Through the Developmental Service-Learning Project, what did you learn about: Yourself? Your community? Working with people who may have had a different developmental trajectory than you?”
Content analysis is a qualitative methodology that can be used for analyzing and drawing meaning from large amounts of textual data. It allows for the “subjective interpretation of the content of text or data through the systematic classification process of coding and identifying themes or patterns” (Hsieh & Shannon, 2005, p. 1278). This methodology has been widely used in counselor education research (Avent, Wahesh, Purgason, Borders, & Mobley, 2015; Burkholder, Hall, & Burkholder, 2014; Cook, Hayden, Gracia, & Tyrrell, 2015).
Using content analysis of secondary data, researchers analyzed existing textual data collected from study participants enrolled in the course over four academic terms, for a total of 120 documents (N = 40 students with three documents each). To maintain participants’ confidentiality and to minimize possible researcher bias, all identifying information was removed from the data sources by the first author prior to analysis. Each participant was assigned a numerical identifier linking them to the course section in which they participated. These identifiers were kept in an Excel file that was password protected and was kept away from the rest of the data in order to reduce bias.
Data were analyzed in two phases to identify central themes associated with the participants’ experiences and perceptions with DSLP. First, data corresponding to each of the four foci of the research question were grouped into the following a priori categories: (a) understanding of course content,
(b) understanding of human development in non-dominant groups, (c) perception of self, and (d) a social justice perspective in counseling. During the second phase of analysis, data within each category were coded by meaning units, which was defined as a collection of words, sentences, or paragraphs that referred to a discrete idea. Closely related codes were collapsed into themes. Researchers used NVivo 10 (QSR International, 2012) for the coding process and to calculate interrater reliability statistics.
Trustworthiness
During the study, the researchers engaged in several strategies to ensure the study’s trustworthiness. The research team consisted of the course instructor and a graduate student research assistant who was trained in the research procedures. Prior to the study’s design and again before data analysis, researchers examined their potential biases. As recommended by Rossman and Rallis (2003), researchers engaged in reflexivity through writing, discussing, and revising researcher-as-instrument statements throughout the process. This process was done to bracket the researchers’ beliefs and opinions to ensure that the participants’ voices could be heard fairly and clearly.
Data were collected from documents that participants completed at two different points during the academic term (midterm and end of term), providing the basis of a longitudinal analysis. At the beginning of data analysis, researchers spent several hours coding data together to support shared meaning of codes and ensure credibility of the analysis. Additionally, researchers engaged in peer debriefing of codes and the coding process at weekly research meetings. Within each phase of coding, the researchers calculated interrater reliability statistics in NVivo 10 (QSR International, 2012) to determine the credibility of the analysis. After each coding session, researchers documented their reflections, questions, and ideas in a reflexive journal designed to document decision making related to the analysis. An audit trail was kept ensuring confirmability of the study’s findings.
Interrater Reliability
During each phase of coding, researchers conducted interrater reliability testing using NVivo 10 (QSR International, 2012) to ensure credibility of the coding process. In the first phase of grouping data into four a priori categories for further coding, an interrater reliability test resulted in a kappa coefficient of .68. This outcome is considered a “substantial” benchmark for kappa coefficients by Landis and Koch (1977). During the second phase of coding into emergent categories, the kappa coefficient for data that was coded by both researchers was .96. This is an “almost perfect” benchmark for kappa coefficients (Landis & Koch, 1977). These results demonstrated that raters consistently coded the data in a similar matter and increased the data’s credibility.
Results
The study’s results indicated the level of impact the DSLP experience had on participants’ understanding of course content, understanding of people in non-dominant groups, perceptions of themselves, and what social justice in a counseling context meant to them. For participants, the DSLP experience became a lens to look at the world in a different way and was a primary frame of reference for the course. In this section, results for each of the four a priori categories is reported, including qualitative results from the content analysis, as well as a narrative description of the data’s emergent themes.
Understanding of Course Content
The first a priori category focused on the impact of the DSLP on participants’ understanding of content in the human development course. Content analysis resulted in 374 meaning units that coalesced into two themes: connecting class material and reflections on learning.
Participants articulated coming away with a more complex and nuanced understanding of seemingly straightforward developmental theories because of the DSLP experience. The messiness of lived experience became real in a way participants did not believe the theories always described. For example, one participant stated that the DSLP experience “muddied the overly clear waters of the text’s simplistic approach to the behavior of complex systems. The service-learning project was a much more realistic approach, introducing us to complex systems and their interactions.” The hands-on nature of the DSLP, as well as the real-world context it provided, facilitated learning that participants described as broader, deeper, and more relevant to their professional futures. Participants reported that the class content was more accessible, more understandable, and easier to absorb because of the DSLP experience. One participant stated that the service-learning experience “required me to broaden my scope of what we were learning in the class. The focus can often be narrow in the classroom setting, but we were able to consider the ‘big picture’ in a realistic way because of this project.”
Further, the context provided by the service-learning experience offered the opportunity for critical analysis of class content. Consistencies and inconsistencies between class content and the lives of the people at their DSLP sites became apparent to participants. Many times, students came away realizing the gaps between theoretical models and lived experiences, particularly for people in non-dominant groups. One participant stated that the experience “made me more critical of the dominant views of development presented in our text. . . . While I understand there are certain fundamental human needs, I really believe in thinking about context as much as content.”
Human Development in Non-Dominant Groups
The next a priori category focused on how the experience with the DSLP impacted participants’ understanding of development of people in non-dominant groups. As CP agencies worked with populations outside the dominant culture, the DSLP provided an opportunity for participants to learn about these groups. Data analysis resulted in 291 meaning units in five themes: access to resources, creating community, cultural awareness, cultural differences, and systems of oppression.
Because of the DSLP experience, participants noted better understanding of the challenges a person in a non-dominant group faces when creating or maintaining their identity. Several participants reported seeing community members’ struggles by incorporating a social construct or standard that did not fit with their own cultural experiences. One participant stated, “As an immigrant parent, the stress is likely increased because the ‘outside influences’ are coming from a culture that is at the very least unfamiliar, and at worst, in conflict with cultural values important to the parents.”
Participants observed a strong sense of resiliency in community members as they overcame obstacles to seek out support. Participants identified that engaging in wellness activities and having a sense of purpose and pride in their lives contributed to resiliency for community members. These wellness activities included groups offered at mental health agencies and informal gatherings where stories and experiences were shared. A participant stated that at her DSLP site she witnessed “strength and resiliency with which people can create meaning and community that is not based on dominant cultural values.”
Furthermore, participants witnessed that when faced with conflicts or challenges, community members found support by referring to their own cultural values and norms. A participant stated, “For an immigrant in a new country, believing that there are others around who not only speak the same language, but have the same values and interests can be powerful in promoting feelings of efficacy instead of helplessness.”
Perceptions of Self
The third a priori category focused on how the DSLP experience impacted participants’ perceptions of themselves. Content analysis resulted in 227 meaning units with three themes that focused on working with new populations, their personal role in social justice, and specific work-related skills.
As CP organizations worked with marginalized communities, such as the East African immigrant community and the youth of the Asian and Pacific Islander community, most participants interfaced with communities with whom they had not previously worked. These interactions spurred participant reflection on the similarities and differences between themselves and those with whom they were working. Participants expressed surprise in what they learned about communities new to them, expecting to find more similarities or more differences. One participant stated, “As a first-generation person, I assumed that I could relate to the issues that the families face. However, I learned that their experience here in (location) is much different than the one I had growing up.” Another participant stated, “Although the students that were in the (CP program) may have a different developmental trajectory than me, there were still many similarities between us. Their values and work ethic reflected the same as mine.”
The interaction with CPs and clients through the DSLP provided a lens for participants to see how structural inequities in society impact the health and development of people in marginalized groups. Because of this, participants were better able to see and understand their own privilege, whether that privilege was related to race, gender, socioeconomic status, or educational attainment. One participant stated, “To be able to briefly see through the eyes of another individual who does not have the same background or privilege as I do, I am better able to understand my own privilege.” Another participant stated, “We all have our own biases and stereotypes and maybe even racist ideologies that we need to get rid of.”
Many participants articulated their perspectives on what social justice meant to them personally and how to move social justice goals in society forward. These were general definitions of social justice not specific to how social justice related to counseling. One participant said, “I believe that being an advocate for social justice involves understanding that many factors in people’s lives influence their development, and that not everyone has equal opportunity to environments conducive to healthy development.” Another participant stated, “To me, social justice means recognizing human dignity across social categories and engaging in some way to distribute power more equitably among people.”
A Social Justice Perspective in Counseling
The final a priori category was focused on how engagement in the DSLP experience impacted participants’ understanding of a social justice perspective in counseling. Data analysis resulted in 416 meaning units with three themes: definitions of social justice in counseling, counselor social justice knowledge, and counselor action through advocacy.
Participants articulated what social justice in the counseling sphere meant to them. One participant stated, “In order to successfully incorporate a social justice approach to counseling, socioeconomic status, culture, academic proficiencies and group membership must be considered.” Empowerment was identified by multiple participants as key to social justice approaches to counseling. According to one participant, “Empowering individuals is at the heart of social justice.” Additionally, participants pointed to understanding each client as a whole individual, including their unique social location, as important in counseling from a social justice perspective.
Participants shared new knowledge of recognizing systems that impacted people in non-dominant groups and acknowledging that the external factors of barriers and injustices may play a role in the need for mental health services. One participant said, “A counselor can promote social justice by helping clients identify the foundation of their behavior and understand that their feelings of insecurity are valid.”
Participants identified that a social justice perspective in counseling included a call to advocate for clients. One participant defined advocacy as, “Part of being a therapist who believes in social justice is advocating for and empowering those individuals who feel they have no voice or feel their voice has been extinguished through societal or institutional oppression.” Participants stated that the goal of social justice counseling was, in fact, to strengthen and support the resiliency of their clients who experience challenges brought on by external factors. One person said, “Social justice advocacy seeks not only to fight oppression but to empower individuals and communities that have been historically oppressed to be self-determinant to live lives of meaning and hope through equitable redistribution of resources, power, and opportunities.”
Discussion
The results of this study offer insight about how using service learning in a human development course impacted community counseling students. Because these findings document a shift in understanding the nature of human development in a pluralistic society, they may be useful for counselor educators who teach human development and who strive to prepare counseling students with a social justice perspective.
The Teaching and Learning of Human Development
As a core curricular area of accredited programs, coursework in human development is required for all counseling students (CACREP, 2015). Students who seek to become licensed counselors must demonstrate their mastery of this content area on national exams (NBCC, 2015). Therefore, counselor educators have an obligation to prepare students with this knowledge base. However, universalist theories of human development may not sufficiently explain development of all groups in a society (Broderick & Blewitt, 2015; Henrich et al., 2010). There is growing acknowledgement that often embedded in models are the worldviews of those who developed them (Rogoff, 2003). Counselor educators are called to teach human developmental theory in such a way that students will be able to responsibly apply (or not apply) theories to clients from whom and for whom they were not developed.
This study’s findings demonstrate that service learning provides participants with a deeper and more nuanced understanding of human development course content through its application in real settings. Participants witnessed how theories did not always match the lives of people at their service-learning sites. Further, participants articulated witnessing how systems of oppression negatively impacted the development of marginalized people. These results build on the evidence that the use of service learning can promote multicultural competence (Burnett et al., 2004) and help students be more prepared to move into the professional role of counselor with a more realistic perspective of what the role means (Jett & Delgado-Romero, 2009).
Preparing Counseling Students as Social Justice Advocates
According to the Code of Ethics (ACA, 2014), counselors should be ready to advocate for removing barriers to healthy growth and development, yet specific strategies for preparing students to do so are lacking. Participation in collaborative service learning focused on important issues for marginalized populations facilitates new awareness of what social justice counseling means. The need for counselors to be aware of their own privilege was stated clearly by participants. In addition, being a counselor for social justice also meant advocating for clients at multiple levels. Working with CPs provided opportunities to witness important work in the community and to practice enacting social justice advocacy. The results demonstrate that service learning can be used as a teaching strategy to meet CACREP requirements and to meet the call for using new “structures, requirements, and goals” (Constantine et al., 2007, p. 27) to prepare students as social justice advocates.
Limitations and Future Research
This study’s findings demonstrated that service learning can be used to teach academic content as well as promote students’ understanding of social justice and advocacy. However, limitations are important to note. First, the primary researcher was the course instructor and the co-researcher participated in the class as a student, although data for the co-researcher was not included in the analysis. Although steps were taken to ensure trustworthiness and authenticity, future studies should include an outside researcher to strengthen the methodology. Second, data for the study was drawn from written text. As such, there were no opportunities to ask participants follow-up or clarifying questions. Although content analysis was chosen to examine the participants’ experiences of the DSLP while they were occurring, future studies using interviews or focus groups could provide more sources of data. Third, the current study focused only on the student experience in the DSLP. Although CPs were involved in every aspect of project creation, execution, and evaluation, they were not included in the systematic study of outcomes. Future studies should examine the impact of service learning on CPs, clients, and communities.
Conclusion
The demographics of the United States are rapidly changing, and soon there will be no one majority group (Cárdenas, Ajinkya, & Gibbs Léger, 2011). Continuing to teach monocultural theories is no longer sufficient; it risks further marginalizing non-dominant groups in society. If we were to better understand how different groups and cultures experience development through their own lenses and a shared pluralistic lens, the problem of applying theories to those from whom and for whom they were not developed would be eliminated. Counselor educators should work with CPs and community members to develop, research, and apply culturally appropriate theories of human development. Until that time, counselor educators must use effective teaching strategies that prepare students to work responsibly and competently in a multicultural world. Service learning, as an educational tool for social justice in counselor education, can contribute to meeting this need.
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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Kristi A. Lee, NCC, is an associate professor at Seattle University. Daniel J. Kelley-Petersen, NCC, is an adjunct faculty member at Seattle University. Correspondence can be addressed to Kristi Lee, College of Education, 901 Twelfth Avenue, Seattle, WA 98122, leekrist@seattleu.edu.
Feb 3, 2017 | Volume 7 - Issue 1
Edward Wahesh, S. Elizabeth Likis-Werle, Regina R. Moro
This content analysis includes 210 articles that focused on addictions topics published between January 2005 and December 2014 in the journals of the National Board for Certified Counselors (NBCC), Chi Sigma Iota (CSI), the American Counseling Association (ACA), and ACA member divisions. Results include the types of addictions content and behaviors studied as well as the populations and data analytic techniques used in the addictions research articles. Whereas most articles discussed addictions counseling techniques, addictions issues among non-clinical populations, and professional practice issues, fewer articles addressed clients in treatment, utilized clinical populations, or analyzed intervention outcomes. Implications for addictive behaviors and addictions counseling scholarship in professional counseling are discussed.
Keywords: addictive behaviors, addictions counseling, content analysis, NBCC, ACA
Professional counselors have an ethical obligation to be actively involved in continuing education in order to remain current on relevant professional issues and scientific information related to their client population and setting (American Counseling Association [ACA], 2014). Continuing education also is required by licensing and certification bodies for credential renewal. One way continuing education is achieved is through reading and contributing to peer-reviewed journal articles. Publications can expose professional counselors, counselor educators and counselors-in-training to new and innovative practices grounded in empirical research.
Professional journals represent “the repository of the accumulated knowledge of a field” (American Psychological Association, 2010, p. 9). A number of journals are produced by the major counseling certification and professional organizations, including The Professional Counselor, published by the National Board for Certified Counselors (NBCC); the Journal of Counselor Leadership and Advocacy, published by Chi Sigma Iota International (CSI); and the Journal of Counseling & Development (JCD), which is the flagship journal of ACA. In addition to JCD, there are 20 journals published by ACA member divisions. ACA member division-sponsored journals publish articles that inform counseling practices and contribute to the body of research on topics that are salient to the particular settings, populations, interest areas, and issues associated with the division. An area that is relevant to most professional counselors, regardless of specialty area or setting, is addiction.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2014 there were an estimated 21.5 million Americans (8% of the population aged 12 or older) living with a substance use disorder (SUD; SAMHSA, 2015). It is likely that many individuals with SUDs also have other co-occurring mental health conditions. In fact, 2014 estimates suggest 7.9 million adults (i.e., 18 years and older) in the United States had both a past-year SUD and a mental illness diagnosis. Among adolescents, approximately 1.3 million reported a past-year SUD; 28.4% of these (over 300,000) had experienced a major depressive episode in the past year (SAMHSA, 2015).
While not all professional counselors will specialize in addictions counseling, given this prevalence it is likely counselors will need to provide services to individuals with an SUD (Chandler, Balkin, & Perepiczka, 2011; Harwood, Kowalski, & Ameen, 2004; Salyers, Ritchie, Cochrane, & Roseman, 2006). In addition, professional counselors are more than likely to come into contact with clients of any age who are impacted by someone else’s addiction (e.g., friend, family member). This may explain why the Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2016) requires that all counselors-in-training, regardless of counseling specialty, learn about the theories and etiology of addictions. Salyers et al. (2006) found little consensus among CACREP-accredited programs in how addictions issues were addressed; in fact, when asked where substance abuse was covered in the curriculum, more than 25 different courses were listed by CACREP program representatives. Counselors-in-training learn about addictions in a variety of ways, such as by taking a course in addictions, encountering clients with addictive behaviors in practicum or internship, or learning about addictions in other courses. Since addictions-related training seems to occur throughout the counseling curriculum, all counselor educators, regardless of their particular area of specialty, should maintain an awareness of current trends in addictions science and theory.
Given that knowledge of addictive behaviors is an important aspect of professional counselor identity (CACREP, 2009; 2016), it is necessary that professional counselors have access to scientific information and practice-oriented resources on addiction that are consistent with the philosophical orientation of the profession. Whereas related professions, such as psychology, public health and social work, produce peer-reviewed publications on addictions and addictions treatment that can be utilized by professional counselors, these resources may not reflect the qualities that make professional counseling unique. Examining the state of the counseling literature on addictive behaviors and additions counseling can inform efforts to improve access to scientific information and evidence-based practices that represent the core philosophy of the counseling profession. Further, an assessment of available addictions research can help to shed light on the state of the counseling profession, as production of original research has been regarded as a standard for measuring the identity development of a profession (Mate & Kelly, 1997).
Research on trends in addictions publications in professional counseling is scarce. Moro, Wahesh, Likis-Werle, and Smith (2016) utilized content analysis to investigate the frequency and type of addictions content within a sample of Association for Counselor Education and Supervision conference programs and four ACA-sponsored journals (JCD, Counselor Education and Supervision, Counseling Outcome Research and Evaluation [CORE], and Measurement and Evaluation in Counseling and Development) that appeal to counselor educators. These authors found that about 2% of conference sessions and articles between 2007 and 2011 addressed addictions counseling. Most of the articles identified in this analysis focused on treatment strategies, particularly among diverse populations. Although the study by Moro et al. is informative, it is limited in that it comprised a 5-year time period and included only a small subset of professional counseling journals. Examining all professional counseling journals during a lengthier time frame would provide professional counselors and researchers with a more comprehensive snapshot of what aspects of addictions theory, prevention, intervention and treatment have been discussed within the counseling literature. This information can be used to inform efforts to promote the production of research and publications that address specific areas of addiction that are currently lacking.
The purpose of the present study was to provide an overview of available literature on addictions topics in professional counseling journals published between January 2005 and December 2014. Moreover, the types of addictions content, addictive behaviors and addictions-related research were examined. The research questions that guided this study were: (1) To what extent do counseling journals address addictions topics? (2) What addictive behaviors and types of content were addressed? (3) How much addictions research was published in counseling journals? and (4) What types of populations and data analytic techniques were represented in this research?
Methods
Content analysis was utilized to address the research questions. This methodology was selected because content analysis is a systematic approach to summarize and make valid and replicable inferences from written communication (Krippendorff, 2013). A review of the literature shows that content analysis has served as a valuable methodology to identify publication trends over time and highlight attention on specific topics within the counseling profession. Content analysis has been used in the counseling literature to examine topics such as multicultural counseling (Arredondo, Rosen, Rice, Perez, & Tovar-Gamero, 2005), pedagogy in counselor education (Barrio Minton, Wachter Morris, & Yaites, 2014), and research in counseling (Ray et al., 2011). Studies by Barrio Minton et al. (2014), Arrendondo et al. (2005), and Ray et al. (2011) were of journal articles during a similar time frame as the present study (i.e., 10 years). Content analysis procedures used in this study include identifying articles, generating and refining the content analysis protocol, conducting a pretest, data collection, assessment of reliability and validity, and reporting the results.
The research team consisted of three professors and two master’s-level graduate students. The professors each possess a doctoral degree in counselor education and specialize in addictions counseling. Two professors identify as White females and one professor is a White male. The graduate assistants, both White females, hold bachelor’s degrees in psychology, completed a course in counseling research methods, and participated in a workshop on content analysis facilitated by the first author before joining the research team. The graduate assistants were responsible for searching for applicable articles using predetermined keywords and identifying the total number of articles for each journal during the time period; the three assistant professors (first, second, and third authors) participated in the search for articles as well as in the development of the content analysis protocol and coding process.
The Professional Counselor, published by NBCC, the Journal of Counselor Leadership and Advocacy, published by CSI, and 21 ACA and ACA member division peer-reviewed journals (Table 1) were identified as having published articles on addictions between the years 2005 and 2014. Because the purpose of the study was to present a survey of all available articles on addictions content in professional counseling journals between 2005 and 2014, all journals were included in the analysis even if they were not in press during the entire 10-year period under analysis.
A set of keywords was generated to identify relevant articles to be used in the study. These keywords included: (a) general terms taken from the literature on addiction and addictions treatment (e.g., addiction, prevention, relapse, recovery, abstinence, co-morbidity, behavioral and process addictions, and mutual support groups); (b) terminology drawn from the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), such as substance use disorders, dependence, intoxication, withdrawal, substance abuse and opioid maintenance; and (c) a list of drug classifications (and common pseudonyms) from the DSM-IV-TR and DSM-5, including alcohol (drinking), amphetamine, cannabis (marijuana), cocaine, hallucinogen, opioid, stimulant, gambling, inhalant, sedative, caffeine and nicotine (tobacco, smoking).
Two graduate assistants independently conducted electronic searches using PsycINFO, EBSCO and ERIC of the keywords, titles and abstracts of all articles (editorial statements, book reviews, errata and advertisements excluded) during the specified time period to identify relevant articles and provide the total number of articles published for each journal. Journals not indexed within these electronic databases were searched by reading the electronic version of each issue’s table of contents and article abstracts and keywords. Following this process, the first author met with the graduate assistants in order to reconcile any differences between their lists of applicable texts and total number of journal articles found. A preliminary list of 226 articles was identified and reviewed by each author to determine suitability for the study. Fifteen articles were removed from the analysis because they did not discuss addictions or addictions treatment; for example, two articles included the keyword “substance abuse” in the abstract, but not in the article itself. To maintain independence, one article was removed because it had been published twice.
The authors developed a content analysis protocol that included definitions and categories for each coding variable. To address research questions 1–3, the following variables were developed: (a) addiction-related content topic, (b) addictive behavior and (c) type of research article. In order to assess research question 4, (d) data analytic technique and (e) research population also were included as variables. Categories of each variable were initially developed by the authors based on their knowledge of the addictions literature as well as past content analysis research of counseling journals. The authors then pretested the protocol by coding 40 randomly selected articles within the sample (approximately 20%) to purify the coding scheme and conduct a preliminary assessment of coder agreement. Following this process, the authors met to refine existent category definitions, agree on the inclusion of additional variable categories and determine which variables would be single versus multiple classification. High inter-rater agreement (85% or higher) across all five study variables was observed among the three coders during the pilot phase. A pattern was not observed in the disagreements among the coders, suggesting that the framework possessed acceptable construct validity (Insch, Moore, & Murphy, 1997).
Once the protocol was refined, all articles were coded independently by two members of the research team (first, second, and third authors). Krippendorff’s alpha (Krippendorff, 2013), with a minimum acceptable value set at α = .80, was utilized to assess agreement among the coders. This coefficient was selected to capture inter-rater reliability because it estimates error in observed agreement attributable to chance and accounts for small sample sizes. Using a reliability measure designed for small samples was an important consideration because research question 4 relates only to a smaller subset of the sample used in the study. Further, the use of two coders for each article was to ensure that the total number of observations for each variable in this study exceeded the minimum number recommended by Krippendorff (2013) for an alpha value greater than .80 at the .01 level of significance (i.e., according to Krippendorff [2013] two coders would have to code at least 103 units). The “odd-man-out” procedure recommended by Insch et al. (1997), in which a third coder determined the final category when differences emerged, was used to reconcile disagreements between coders.
Coding Variables
Five variables were identified by coders in the study. All articles (N = 210) were coded utilizing three of the variables: addiction-related content topic, addictive behavior and type of research. Two variables were used to code research articles identified within the sample. Percentage of agreement (observed agreement [OA]) and Krippendorff’s alpha (α) were calculated for each variable.
Addiction-related content topic. The purpose of this variable was to identify the area of addictions counseling and research that the article addressed. Categories were initially drawn from content analyses by Ray et al. (2011) and Moro et al. (2016) and modified for the present study. Because the purpose of this variable was to identify the main content focus of the articles, a single classification system was used, which meant that coders were required to assign each article to one category. The use of a single classification system is recommended when coding variables that represent latent meaning and require greater interpretation by the coder (Insch et al., 1997). The variable included the following categories: approaches to counseling, professional practice, population variables, client variables, counselor variables, measurement, and effectiveness of counseling and preventative interventions (OA = 87.6%; α = .85). Approaches to counseling included articles that presented specific addictions-related counseling techniques, models or treatment programs. The professional practice issues category contained articles that described addiction-related counselor training, credentialing, ethics, diagnosis or trends in the field. Population variables included articles that described characteristics of a non-clinical population; the client variables category contained articles that addressed addictions or addictions counseling within a clinical population. Articles on the characteristics or perceptions of professional counselors were assigned to the counselor variables category. The measurement category included any article with a focus on instrument development, formal assessment or psychometrics. Effectiveness of counseling and preventative interventions represented articles that focused on evaluating an intervention or prevention program or technique.
Addictive behavior. This variable represented the types of addictive behavior addressed in the articles. Coders were instructed to record all addictive behaviors and substances described in each article (i.e., multiple classification) using a list of categories that included relevant keywords developed by the researchers for the text search. If a specific type of behavior or substance was not discussed, coders labeled the article as general substance use. Categories representing specific behaviors and substances included: general substance use, alcohol, nicotine, opioids, cannabis, stimulants, ecstasy and behavioral addictions (OA = 95%; α = .90).
Type of research. Each article was coded as non-research, qualitative, quantitative or mixed methods (OA = 98.5%; α = .98). Classifications were based on past content analysis research of counseling journals (Moro et al., 2016; Ray et al., 2011), and coders were required to assign each article to one category. Articles that were assigned to the three research categories (i.e., qualitative, quantitative and mixed methods) were used to address research question 4.
Data analysis. All research articles were coded in order to determine the types of data analytics used by the authors. The coding variable included 15 categories (i.e., descriptive statistics, regression analysis, theme analysis and coding, chi-square test, multivariate analysis of variance/multivariate analysis of covariance, correlation, analysis of variance/analysis of covariance, structural equation modeling, t-test, confirmatory factor analysis, exploratory factor analysis, other nonparametric test, discriminant analysis, canonical analysis, and cluster analysis), and coders were instructed to assign each article to multiple categories when appropriate (e.g., case where a single research article included multiple types of analysis; multiple classification). The scheme for grouping different types of data analysis was based on a framework by Erford et al. (2011) in their content analysis of articles published in JCD. Percentage of agreement among coders in the present study was 82.4% and α = .79. Because inter-rater reliability is slightly below the recommended minimum of .80 (Krippendorff, 2013), readers are encouraged to interpret these results with caution.
Research population. The various populations examined in the research articles were recorded using this variable (OA = 91%; α = .88). Because an article could potentially include multiple populations (e.g., African American, male, college students), coders were instructed to code each article with as many categories as necessary (i.e., multiple classification). When coding, research team members used a preliminary list of possible categories derived from several previous content analysis studies of counseling journals (Byrd, Crockett, & Erford, 2012; Smith, Ng, Brinson, & Mityagin, 2008). This resulted in 11 discrete categories: undergraduates, children and adolescents, adults (non-college, 18 years and older), families, men only, women only, clients in addictions treatment, addictions professionals, counseling students, multicultural populations and LGBT populations. To improve the conciseness of the findings, several smaller categories were combined to create the multicultural populations category. A twelfth category was designated for articles that did not include a research sample.
Results
Research Question 1: To What Extent Do Counseling Journals Address Addictions Topics?
Table 1 provides a listing of counseling journals as well as the number of addictions-related articles in relationship to total publication. The percentage of the total number of addictions-related articles in comparison to total number of published articles was 4.5%. As expected, the Journal of Addiction & Offender Counseling (JAOC) published the highest percentage of addictions articles (76.1%). The journal with the next highest percentage of addictions articles was the Journal of Military and Government Counseling (13.8%), followed by the Journal of LGBT Issues in Counseling (9.6%), the Journal of College Counseling (8.6%), and CORE (8.3%). Six journals published less than 1% of their articles on addictions: The Career Development Quarterly (0.0%), Journal of Counselor Leadership and Advocacy (0.0%), Journal for Social Action in Counseling and Psychology (0.0%), Counselor Education and Supervision (0.5%), Journal of Multicultural Counseling and Development (0.5%), and Professional School Counseling (0.9%).
The authors also examined the first research question by calculating the percentage of addictions-related articles during each year of publication. The number and percentage of addictions articles published for each year is as follows: 2005 (n = 18; 4.0%), 2006 (n = 20; 4.5%), 2007 (n = 20; 4.7%), 2008 (n = 14; 3.0%), 2009 (n = 17; 3.9%), 2010 (n = 21; 4.5%), 2011 (n = 30; 6.3%), 2012 (n = 30; 6.4%), 2013 (n = 20; 4.0%), and 2014 (n = 20; 4.7%). The percentage of addictions articles remained relatively stable during this period; however, a slight increase in the percentage of articles published on addictions was observed in 2011 and 2012.
Research Question 2: What Types of Addictive Behaviors and Content Topics Were Addressed?
All seven categories included in the addiction-related content topic variable were represented in the data. The highest number of addictions articles focused on population variables (n = 57; 27%), or addictions issues within non-clinical groups. The content topics approaches to counseling (n = 43; 20%) and professional practice issues (n = 39; 19%) were the second and third most represented categories. Fewer addiction-related articles were published on the following content topics: client variables (n = 20; 10%), measurement (n = 18; 9%), effectiveness of counseling and preventative interventions (n = 17; 8%), and counselor variables (n = 16; 7%).
Additional analysis revealed that among the 18 articles in the measurement category, 14 different assessment instruments were represented. Whereas most instruments (n = 10) were discussed in only one article each, the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; Miller & Lazowski, 1999) was included in eight of the articles in this category. Three instruments were included in two articles: the Core Alcohol and Drug Survey (Core Institute, 1994), CAGE questionnaire (Ewing, 1984) and the Michigan Alcohol Screening Test (Selzer, 1971). Further, additional analysis of the effectiveness of counseling and preventative interventions category found that only four articles addressed prevention; three of these articles discussed a similar intervention to prevent college student drinking and one presented findings of an evaluation of a school-based substance abuse prevention program.
Table 1
Addiction Articles in Professional Counseling Journals, 2005–2014
| Journal |
No. of Addiction Articles Found
|
No. of Total
Possible Articles
|
% Addiction to No. of Total
Articles
|
| The Professional Counselor |
5
|
113
|
4.4
|
| Journal of Counselor Leadership & Advocacy |
0
|
13
|
0.0
|
| Journal of Counseling & Development |
9
|
561
|
1.6
|
| Adultspan Journal |
5
|
101
|
5.0
|
| The Career Development Quarterly |
0
|
282
|
0.0
|
| Counseling and Values |
6
|
191
|
3.1
|
| Counselor Education and Supervision |
1
|
199
|
0.5
|
| Journal of Addiction & Offender Counseling |
70
|
92
|
76.1
|
| Journal of College Counseling |
14
|
163
|
8.6
|
| Journal of Employment Counseling |
5
|
182
|
2.8
|
| Journal of Humanistic Counseling |
3
|
175
|
1.7
|
| Journal of Multicultural Counseling and Development |
1
|
194
|
0.5
|
| Counseling Outcome Research and Evaluation |
4
|
48
|
8.3
|
| The Family Journal |
17
|
554
|
3.1
|
| Journal of Creativity in Mental Health |
15
|
251
|
6.0
|
| Journal of LGBT Issues in Counseling |
13
|
136
|
9.6
|
| Journal of Mental Health Counseling |
11
|
244
|
4.5
|
| Journal for Social Action in Counseling and Psychology |
0
|
87
|
0.0
|
| The Journal for Specialists in Group Work |
5
|
209
|
2.4
|
| Measurement and Evaluation in Counseling and Development |
8
|
176
|
4.6
|
| Professional School Counseling |
4
|
432
|
0.9
|
| Rehabilitation Counseling |
10
|
208
|
4.8
|
| Journal of Military and Government Counseling |
4
|
29
|
13.8
|
| Total |
210
|
4,640
|
4.5
|
| Note. The first issue of The Professional Counselor was published in 2011; Counseling Outcome Research and Evaluation was first published in June 2010; Journal of LGBT Issues in Counseling was first published in October 2008; Journal for Social Action in Counseling was first published in April 2007; Journal of Creativity in Mental Health was first published in September 2007; the first issue of Journal of Military and Government Counseling was published in January 2013; the first issue of the Journal of Counselor Leadership and Advocacy was published in 2014. |
The addictive behavior coding variable also was used to assess this research question. General substance use was by far the most represented addictive behavior in the articles (n = 142; 68%), followed by alcohol consumption (n = 46; 22%) and behavioral addictions (n = 11; 5%). Specific substances were addressed in fewer articles: nicotine (n = 8; 4%), opioids (n = 4; 2%), stimulants (n = 4; 2%), cannabis (n = 3; 1%) and ecstasy (n = 1; 0.5%). The total values exceed the actual number of research articles included in the analysis because some articles addressed more than one addictive behavior. In the behavioral addictions category, sex addiction was addressed in three articles, three articles included a general discussion of behavioral addictions, and addictions to gambling, gaming, Internet, self-injury and food were each mentioned once.
Research Question 3: How Much Addictions Research Was Published in Counseling Journals?
This research question was addressed using the type of research coding variable. Approximately 60% of addictions-related articles (n = 127) were original research. Among these articles, 82% were quantitative (n = 104) and 13% were qualitative (n = 17). Mixed methods was the smallest category (n = 6), representing 5% of all addictions research. Articles coded as “non-research” (n = 83) included innovative methods papers, professional practice papers, interviews, and literature reviews on topics such as counseling theory and special populations.
Research Question 4: What Types of Populations and Data Analytic Techniques Are Represented in the Addictions Research?
Research population and data analysis were the coding variables used to assess this research question. Table 2 lists the various types of participants used in the addictions-related research articles. The most common population examined was adults (n = 49; 40%), or individuals (18 years and older) not enrolled in college, followed by undergraduates (n = 36; 29%) and addictions professionals (n = 26; 21%). The total values exceed the actual number of research articles included into the analysis because some articles included more than one population. The multicultural populations category represented a number of ethnic groups including African Americans, Native Americans and Hispanic Americans, as well as a sample of participants in Korea. Three articles were not included in this analysis because they did not involve research with human subjects (e.g., content analysis of substance use screenings).
| Table 2 Types of Participants Used in Addictions Research Articles |
| Population |
Count |
%
|
| Adults |
49
|
40
|
|
| Undergraduates |
36
|
29
|
|
| Addictions Professionals |
26
|
21
|
|
| Clients in Addictions Treatment |
18
|
15
|
|
| LGBT Populations |
13
|
10
|
|
| Children and Adolescents |
9
|
7
|
|
| Multicultural Populations |
9
|
7
|
|
| Men Only |
8
|
6
|
|
| Families |
5
|
4
|
|
| Women Only |
4
|
3
|
|
| Counseling Students |
2
|
2
|
|
| Note. Three articles were removed because they did not include human subjects (n = 124). Some articles include more than one population. Therefore, the total values may exceed the actual number of research articles accepted into the analysis. |
|
|
|
|
|
All 15 data analytic techniques were represented within the addiction-related research articles (Table 3). Descriptive statistics (n = 34; 27%), regression analysis (n = 31; 24%) and theme analysis/coding (n = 22; 17%) were the most used techniques. Data strategies less likely to be utilized include discriminant analysis (n = 4; 3%), canonical analysis (n = 3; 2%) and cluster analysis (n = 1; 1%). The total values exceed the actual number of research articles included in the analysis because some articles utilized more than one data analysis strategy.
| Table 3 Type of Data Analysis Used in Addictions Research Articles |
| Data Analytic Procedure |
Count
|
%
|
| Descriptive Statistics |
34
|
27
|
|
| Regression Analysis |
31
|
24
|
|
| Theme Analysis/Coding |
22
|
17
|
|
| Chi-Square Test |
16
|
13
|
|
| MANOVA/MANCOVA |
14
|
11
|
|
| ANOVA/ANCOVA |
13
|
10
|
|
| Correlation |
12
|
9
|
|
| Structural Equation Modeling |
10
|
8
|
|
| t-test |
9
|
7
|
|
| Confirmatory Factor Analysis |
7
|
5
|
|
| Exploratory Factor Analysis |
5
|
4
|
|
| Other Nonparametric |
5
|
4
|
|
| Discriminant Analysis |
4
|
3
|
|
| Canonical Analysis |
3
|
2
|
|
| Cluster Analysis |
1
|
1
|
|
| Note. Some articles used more than one procedure. Therefore, the total values may exceed the actual number of research articles accepted into the analysis (n = 127). MANOVA = multivariate analysis of variance; MANCOVA = multivariate analysis of covariance; ANOVA = analysis of variance; ANCOVA = analysis of covariance. |
|
|
|
|
|
Discussion
Articles published in 23 professional counseling journals between January 2005 and December 2014 were examined to assess the scope with which addictions were represented in the professional counseling literature. Overall, 210 (4.5%) of the 4,640 articles published addressed addictions content. Not surprisingly, JAOC, a publication sponsored by the International Association of Addictions and Offender Counselors, contained the most articles on addictions. It also is noteworthy that several journals with higher percentages of addictions articles were launched within the period of time the analysis was conducted (e.g., Journal of Military and Government Counseling and Journal of LGBT Issues in Counseling). The introduction of these journals may suggest that increased attention is being given to addictions issues or, at the very least, to populations that are more vulnerable to experiencing the consequences of addictive behaviors.
The higher percentage of articles in 2011 and 2012 may have been associated with changes to addictions-related professional training and diagnostic considerations that occurred around these years. In 2009, CACREP introduced an addictions counseling specialty area and added language in their standards requiring all students to learn about the etiology, prevention and treatment of addictions; therefore, it is possible that during the years following these changes, there was an increased interest in the teaching of addictions content to counselors-in-training. Alternatively, the revised formulation for the diagnosis of SUD in the DSM-5, published in 2013, also may have contributed to the increase in addictions articles. Leading up to the publication of the DSM-5 there may have been greater discussion as to how addictive disorders are conceptualized and assessed.
The most common type of article published addressed addiction-related issues within non-clinical populations; fewer articles focused on topics specific to individuals receiving addictions counseling. Even fewer articles included research on outcomes of prevention and counseling interventions. The presence of only four articles in the sample (1.9%) that assessed the efficacy of prevention efforts is concerning given that prevention has been found to be a key facet of professional counselor identity (Mellin, Hunt, & Nichols, 2011) and is considered by CACREP (2016) as “foundational knowledge” (p. 8) for all counseling professionals. This discrepancy may suggest that despite being regarded as an important component of professional training and identity, little is actually done pertaining to prevention practice and research by professional counselors.
Although relatively few articles in the sample included addictions outcomes research, it is promising that CORE was established by the Association for Assessment and Research in Counseling in 2010 as a venue for outcomes research and program evaluation findings (Hays, 2010). Since the inception of CORE, its publication of addiction research has resulted in it being one of the top five journals in our study publishing on addiction topics.
Among the assessment instruments in articles that focused on addictions-related measurement issues, the SASSI-3 (Miller & Lazowski, 1999) was the most commonly discussed. The amount of attention given to the use of the SASSI-3 appears to be warranted considering the popularity of this instrument among professional counselors and clinical mental health counselors in particular. In a national survey of counselor assessment practices by Peterson, Lomas, Neukrug, and Bonner (2014), the SASSI-3 was the highest ranked test of addictive behaviors among all professional counselors. Among clinical mental health counselors, it was the third highest ranked inventory overall, behind the Beck inventories for depression and anxiety. Further, Neukrug, Peterson, Bonner, and Lomas (2013) found that more than three-quarters of counselor educators who teach assessment use the SASSI-3 in their courses. Despite the widespread use of the SASSI-3, it does have its limitations; the SASSI-3 can be cost prohibitive for some clients and requires that those who use it receive specialized training. As a result, examining the psychometric properties of other instruments, specifically measures that are free or more cost effective and do not require specialized training to interpret, seems prudent.
The limited number of articles addressing specific types of addictive behaviors is problematic. Although common physiological and psychosocial processes exist across all addictive behaviors, there also are unique factors associated with the etiology, prevention and treatment of the various drug classifications and behavioral addictions (Brooks & McHenry, 2015). Indeed, prevention and intervention efficacy often correlate with information tailored to each need. In light of the current opioid and prescription drug epidemic—a 137% increase in drug overdose deaths and 200% increase in opioid deaths from 2000 to 2014 (Rudd, Aleshire, Zibbell, & Gladden, 2016)—examining the prevention and treatment of this specific classification of substances would be a prudent area of research.
Analysis of addictions-related research revealed that nearly two-thirds of all articles in the sample represented original empirical research. This is higher than what Ray et al. (2011) found in their content analysis of 15 counseling journals in print between 1998 and 2007; these authors found that approximately one in three articles published included original research. These findings suggest that despite addictions not being a topic commonly discussed across counseling journals, there may be greater attention to conducting research on addictive behaviors by counseling researchers. Or, this may reflect an overall trend among counseling journals to publish research since the final year (2007) of the content analysis conducted by Ray et al. (2011). The level of sophistication of data analysis in the articles in this sample is comparable to findings from past content analyses of long term publication trends in specific counseling journals; for instance, descriptive statistical techniques were among the most commonly used methods of analysis in JCD (Erford et al., 2011) and Journal of College Counseling (Byrd et al., 2012).
One of the most commonly used groups in addictions research was college students, which may indicate an over-reliance on the use of convenience sampling across institutions of higher education. A concerning trend observed in the data was that addictions professionals were utilized more as research participants than were clients in addictions treatment. Greater attention to understanding individuals who are enrolled in treatment can help researchers and professional counselors identify successful ways to tailor and personalize counseling interventions to fit the needs of specific client populations. In addition, although several articles used diverse populations, fewer studies examined addictions issues among discrete groups of men and women only. Moreover, twice as many articles were found that focused on men compared to women only. Additional research examining gender differences is necessary considering that men and women face unique issues related to the development and treatment of addictive behaviors (National Institute of Drug Abuse, 2015).
Limitations
The findings of this study should be viewed within the context of several limitations. An advantage of content analysis is that it can be used to help organize and summarize large quantities of information; however, by assigning each individual article to a category, it is possible that some distinctive characteristics of the articles in the sample may have been lost or trivialized (Riffe, Lacy, & Fico, 2014). In addition, the process of creating categories for the articles is researcher-driven and, even though efforts were made to develop the coding framework using the available literature, it is possible that different researchers would not have created the same levels of the study variables.
Other limitations relate to data collection and the coding process. Since the purpose of the present study was to analyze articles that focused on addictions, the sample was developed through a review of journal titles, abstracts and keywords only—an approach utilized in previous content analyses of specific topics within the counseling literature (Barrio Minton et al., 2014; Evans, 2013). In the unlikely event that an article focusing on addictions did not include one of the search terms in these three areas, it would not have been included in this study. Also, this study did not include articles in counseling journals that are affiliated with regional or statewide counseling organizations, such as The Journal of Counselor Preparation and Supervision, published by the North Atlantic Region Association for Counselor Education and Supervision, or the Virginia Counselors Journal, which is the journal of the Virginia Counseling Association. The authors chose to restrict their data collection to include only journals produced by NBCC, CSI, ACA and ACA member divisions because they believed that a content analysis of articles sampled from these national publications would provide a general overview of the addictions-related content discussed throughout the counseling literature.
Although inter-rater agreement among coders for most variables was satisfactory, reliability for coding the data analysis variable was lower than the minimal acceptable threshold suggested by Krippendorff (2013). Possible reasons for low concordance include the number of categories for this variable and the inconsistencies in how data analytic techniques were described within the various articles in the sample. Finally, as this study presented an overview of the types of addictions-related articles published in counseling journals, the quality of the publications was not evaluated during the coding process. This may be a possible next step for counseling researchers that could yield more rigor and, subsequently, evidence-based practices for addictions prevention and counseling.
Implications for Professional Counselors
According to the ACA Code of Ethics (2014), “Counselors have a responsibility to the public to engage in counseling practices that are based on rigorous research methodologies” (Section C, p. 8). When addressing issues related to addictive behaviors, professional counselors have a modest yet relatively diverse literature available to help guide their practice. Despite the fact that a large number of articles in the sample described approaches to addictions counseling, many of these papers were conceptual in nature and did not include original empirical research to assess counseling outcomes. To better assist professional counselors in using research-informed approaches, it is necessary for greater attention to be given by counselor educators and researchers to producing addictions-related intervention research and program evaluations.
The limited number of articles that evaluated treatment approaches also may represent a more endemic issue in counseling and counselor education. Many professional counselors report not feeling adequately prepared to operationalize and measure client outcomes, despite recognizing the need for these skills in their work (Peterson, Hall, & Buser, 2016). Although these skills have been identified as key research competencies in counselor education (Wester & Borders, 2014), it is unclear how these competencies are addressed in entry-level and doctoral research curricula. Researchers may wish to examine the ways in which professional counselors and counselor educators learn how to evaluate treatment outcomes. This may help inform the development of new pedagogical strategies that lead to an increased production of outcomes research on approaches to counseling and prevention in counseling journals.
In addition to a call for research on counseling outcomes, it also seems apparent that there is a need for more sophisticated research questions and hypotheses in research conducted on addictive behaviors. Addiction is a multifaceted phenomenon that involves the interplay of multiple biological, psychological and social determinants (American Society of Addiction Medicine, 2011); therefore, the use of descriptive statistics or univariate procedures may not capture the complexities of how addictive behaviors are initiated, maintained and extinguished. The use of more sophisticated data analytic techniques by researchers may help address this issue. Structural equation modeling can be utilized to simultaneously test the fit of an explanatory model of addictive behavior comprised of multiple independent and dependent variables. For example, Wahesh, Lewis, Wyrick, and Ackerman (2015) utilized structural equation modeling to evaluate the fit of a mediational model of collegiate drinking that included multiple determinants of alcohol use. Alternatively, qualitative methods can be used by researchers to provide an in-depth understanding of how various interpersonal, social and cultural variables shape individual behavior (Likis-Werle & Borders, 2017).
One way that counseling journals can increase the publication of articles that address specific issues related to addiction is by offering a special issue or section on these topics. Journal editors can develop a call for papers that focus on addictions-related issues salient to their publication’s readership. Depending on the particular journal’s audience, this can include examining prevention, a specific classification of addictive behaviors, or intervention outcomes, areas that were not well represented in the current sample of articles. For example, in 2011 CORE dedicated a special section (Volume 2, Issue 1) to substance abuse outcome research and measures. The use of special issues or sections across counseling journals can ensure that professional counselors have access to information that is germane to their work. JAOC may seem like a natural venue for topics related to addictions in counseling; however, that perception is problematic because JAOC is geared toward addictions and offender counselors, making it possible that the particular populations studied, findings and implications in articles published in this journal are not as relevant to professional counselors in other settings.
Although journal articles represent an important source of professional development, it is possible that professional counselors utilize other venues for continuing education. Future researchers can examine continuing education practices of counselors to determine the particular sources of education and whether or not the information provided through these venues is consistent with the typical scope of practice and professional identify of the counseling profession. Relatedly, it also seems necessary to determine where else counseling researchers and counselor educators publish their research on addictions counseling. While counselor educators in CACREP-accredited programs are expected to demonstrate scholarly activity in counseling (CACREP, 2016), it is possible that some addictions counselor educators publish in journals outside of counseling that specialize in addictions or have higher impact factors. Journal impact factors are a method of determining a journal’s significance in comparison to other journals in the field. Some counselor educators may seek to publish in journals with a more favorable impact factor for evaluation purposes related to faculty tenure and promotion (Fernando & Barrio Minton, 2011). Assessing author publication trends by reviewing the curriculum vitae of addictions counselor educators can help identify the journals in which they most frequently publish. Examining these trends can identify the types of addictions-related research and other scholarly work that are being produced by counselor educators and counseling researchers but are not appearing in counseling journals.
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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Edward Wahesh, NCC, is an Assistant Professor at Villanova University. S. Elizabeth Likis-Werle is an Assistant Professor at East Tennessee State University. Regina R. Moro, NCC, is an Assistant Professor at Boise State University. Correspondence can be addressed to Edward Wahesh, Villanova University, Education and Counseling (SAC 302), 800 E. Lancaster Avenue, Villanova, PA 19085, edward.wahesh@villanova.edu.
