Taking Action: Reflections on Forming and Facilitating a Peer-Led Social Justice Advocacy Group

Sunanda M. Sharma, Jennifer E. Bianchini, Zeynep L. Cakmak, MaryRose Kaplan, Muninder K. Ahluwalia

According to the American Counseling Association and the Council for Accreditation of Counseling and Related Educational Programs, social justice advocacy is an ethical imperative for counselors and a training standard for counseling students. As a group of socially conscious mental health counseling students and faculty, we developed and facilitated a social justice advocacy group to learn about tangible ways to engage in social justice action. Using the S-Quad model developed by Toporek and Ahluwalia, we formed and facilitated a social justice advocacy group for our peers. This paper will serve as a reflection of our experiences engaging in the process.

Keywords: social justice, advocacy, counseling students, S-Quad model, mental health

When describing the motivation for her political aspirations, Georgia gubernatorial hopeful Stacey Abrams (2019) stated, “We have to have people who understand that social justice belongs to us all.” This quote speaks to this group of authors who feel strongly about the importance of social justice in mental health counseling. This ethos served as the motivation to create a peer-led group to foster the development of our social justice advocacy skills. We used the S-Quad model (Toporek & Ahluwalia, 2020) to form and facilitate a social justice advocacy group for master’s and doctoral counseling students at our institution.

Historically, the counseling profession has been rooted in social justice advocacy (SJA) with Frank Parsons’s efforts to support White European immigrants in the United States to develop their vocational goals (Gummere, 1988; Toporek & Daniels, 2018). However, SJA has not been consistently operationalized across counselor training programs (Counselors for Social Justice [CSJ], 2020). Although ethical standards established by the American Counseling Association’s ACA Code of Ethics (ACA; 2014) encourage counselors to advocate for clients and communities when appropriate (A.7.a, A.7.b.), and training standards established by the Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2015) state that SJA should be a part of counseling curriculum (2.F.2.b.), counselors have reported receiving little guidance about how to implement advocacy in practice (Field et al., 2019; Ratts & Greenleaf, 2018). As counseling students, we experienced the same concern. To address this gap in our educational experience, we created and facilitated a group based on the S-Quad model (strengths, solidarity, strategies, and sustainability) of SJA (Toporek & Ahluwalia, 2020). As a group of socially conscious mental health counseling students, our aim was to grow in our roles as professionals by learning about, teaching, and engaging in SJA. In the process, we learned about ourselves as budding counselors and educators.

Literature Review

In their foundational article, Vera and Speight (2003) called on the counseling profession to expand its understanding of multicultural competence; they asserted that without SJA, counselors are perpetuating the systems of oppression from which their clients are attempting to heal. Utilizing intrapsychic approaches which neglect to account for contextual factors not only perpetuates oppressive counseling practices, but it also does a disservice to those with marginalized identities (Ratts, 2009; Vera & Speight, 2003). In order to properly serve clients, counselors must step beyond the classroom, expand the original conceptualization of our roles, and explore beyond the counseling office (Ratts, 2009; Ratts & Greenleaf, 2018; Vera & Speight, 2003). Despite the increase in available resources such as the ACA Advocacy Competencies (Toporek et al., 2009) and the Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016), the number of sociocultural forces such as racial demographics of counseling programs and reliance on theories and interventions developed for White European clients prevents social justice from being a central force in the profession (CSJ, 2020).

As mental health professionals, we are positioned to understand the impact that oppression has on health (Nadal et al., 2021), which speaks to the need for operationalizing social justice counseling and SJA so counselors may support client wellness. Counseling students require more knowledge and practice to obtain appropriate resources and tools in order to intervene and resist systemic oppression (Vera & Speight, 2003). Ratts (2009) named social justice as the “fifth force” in counseling in an attempt to concretize the relevance and importance of challenging the status quo in counseling. However, the perceived attitude of the counseling profession toward social justice is reflected in the definition of counseling. The 20/20 initiative was a movement to unify the profession and solidify professional identity by arriving at the definition of counseling. Delegates from 31 counseling-related organizations (e.g., CACREP, Chi Sigma Iota) participated in a Delphi-method study to achieve consensus on a definition; however, only 29 organizations ultimately endorsed the definition (Kaplan et al., 2014). Although the definition for counseling includes the word “empower”; it does not include the words “social justice” or “advocacy.” Thus, CSJ was one organization that did not support the new definition (Kaplan et al., 2014). Despite these challenges, Ratts and Greenleaf (2018) assert that counselors must develop the advocate part of their identity, yet they note that there is more of a focus on traditional counseling skills rather than acknowledging the shifting sociopolitical climate and equipping counselors with the skills to address these concerns. The leadership and advocacy course (or the content in another course; CACREP, 2023) in CACREP-accredited counseling doctoral programs often only focuses on leadership and advocacy within and for the profession. Although CACREP (2023) standards do not dictate the courses a counseling program must offer, there continues to be limited discussion of SJA and social justice, nor are there solid instructional methods for counselor educators to use in the classroom (Chapman-Hilliard & Parker, 2022). This situation hinders students’ understanding of the role systemic issues have on minoritized communities, further deterring people in those communities from seeking help.

As counselors and counseling students, we understand our responsibility to advocate for clients, but we feel unprepared to fulfill our ethical (and for many of us, moral) duty. We did not learn enough about the concrete, tangible skills that a professional counselor can utilize to challenge oppression and inequity. We were unable to locate any studies regarding peer-led SJA groups for counseling students, thus we hope to contribute something novel to the counseling literature and encourage counseling students to better understand and grow into their roles as social justice advocates. Counselors-in-training (CITs) and practicing counselors within the profession sometimes question the relevance of SJA and report feeling confused about how to implement SJA in counseling (Field et al., 2019; Ratts & Greenleaf, 2018). hooks (1994) notes it is imperative that a student accepts responsibility for their education and becomes “an active participant, not a passive consumer” (p. 14). Thus, we engaged in this process to support our colleagues in the counseling student body and take accountability for our education.

Taking Action: Social Justice Advocacy Group

Leading organizations in the profession claim a two-pronged approach to advocacy: one prong advocating for the legitimacy of the counseling profession, and the other advocating on behalf of the clients and students whom counselors serve (Chang et al., 2012). In our educational experience, SJA on behalf of and in partnership with clients was emphasized, but tangible interventions were not discussed. Further, systemic issues and inequities were often left unaddressed. Thus, we developed this group to more concretely address the second “prong” of advocacy in counseling. First and fourth authors Sunanda M. Sharma and MaryRose Kaplan were part of the executive board of Chi Sigma Mu (Chi Sigma Iota chapter at Montclair State University) and co-founded the social justice committee. Second and third authors Jennifer E. Bianchini and Zeynep L. Cakmak were the first members of the committee who proposed ideas and facilitated events and activities related to social justice that they felt passionately about. Bianchini proposed a social justice book club ahead of a presentation that the CSI chapter organized (hosting the authors of the book Taking Action). The book club met three times with up to three students, from whom we received feedback to help us form the SJA group.

The following semester, fifth author Muninder K. Ahluwalia proposed restructuring the book club into an advocacy group by utilizing the Taking Action text as a framework to teach students about systemic SJA. CACREP (2015) standards state that multiculturalism and social justice must be discussed throughout counseling courses (2.F.2.b.); however, in our experiences, we found that social justice is addressed as an ethical and moral imperative, but curricula do not address concrete SJA skills and strategies to combat systemic oppression. The counseling program in which the first four authors are enrolled and the fifth author is a faculty member offers a social justice counseling class as an elective. However, the class is not consistently offered every semester and has only been taught by that one faculty member. Thus, our aim with this group was to provide a space for our colleagues in which we could collaboratively learn about how to enact social justice. This section will describe the S-Quad model, explain the group structure, outline the proposed learning objectives, and provide a table that outlines the curriculum of the group.

The S-Quad Framework
     As a profession, mental health counseling is positioned to “buffer” against challenges with oppression and changes to the status quo (Kivel, 2020). There is an emphasis on intrapsychic interventions to combat systemic issues, rather than attempt to uproot the oppression itself (Kivel, 2020; Ratts, 2009; Toporek, 2018). Toporek (2018) noted that upon reflection of the way the profession is positioned and her privileged identities, she developed a framework through which to take social justice action despite the challenges she continues to encounter. The S-Quad model includes four Ss for social justice advocates to formulate a way to address systemic injustices: strengths, solidarity, strategy, and sustainability (Toporek & Ahluwalia, 2020).

Strengths are described as a combination of one’s existing “skills, knowledge, and expertise” (Toporek & Ahluwalia, 2020, p. 27). Although strengths can be qualities one already has, both personal and professional, the authors also encourage budding advocates to reflect upon strengths that they would like to develop. Solidarity has multiple facets to its definition, as advocates are asked to support, honor, and respect communities they intend to engage with and to also seek support from their personal networks to remain grounded (Toporek & Ahluwalia, 2020). Solidarity is enacted through collaborative efforts and through the lens of cultural humility (Toporek & Ahluwalia, 2020). Strategy is the implementation of strengths and solidarity to construct a plan of action (Toporek & Ahluwalia, 2020). It is important to evaluate the efficacy, efficiency, and impact of different strategic plans to ensure they work toward the stated goal and—most importantly—benefit the community that the action is intended for (Toporek & Ahluwalia, 2020). Finally, a unique facet of the S-Quad model is the fourth “S,” sustainability. Sustainability addresses the wellness of advocates; without it, there is a higher likelihood they may abandon their efforts. SJA can be an enriching and healing practice, but it can also be an emotionally draining pursuit, and one can feel helpless when attempting to combat the gravity and breadth of oppression (Toporek & Ahluwalia, 2020). Thus, the authors encourage budding advocates to take an inventory of the practices that replenish and nourish them in order to remain engaged in their work.

Group Structure
     Sharma proposed structuring this SJA group as a biweekly, one-hour, peer-led, open (students were free to join at any point) psychoeducation group, whose grounding framework would be the S-Quad model (Toporek & Ahluwalia, 2020). Due to COVID-19 restrictions, we facilitated the group through Zoom. The objectives of the group were: to describe all components of the S-Quad model, to describe the ethical responsibility of being a social justice advocate, to create a solidarity network of fellow advocates, to increase awareness of how one’s positionality impacts their advocacy work, and to apply the S-Quad model (Toporek, 2018) through the creation of a social justice action plan (Sheely-Moore & Kooyman, 2011). Initially, the intention was to divide each group session into two parts. The first part of the session would be didactic, in which we would discuss the “S” of that week and ground it in a case study. The second half of the session would offer members the chance to process the content so they can apply what they are learning to their social justice plan. Upon reflection and discussion as co-facilitators, we recognized the challenges associated with attempting to address so much content in a 60-minute session and collectively agreed to shift the group and make it akin to a flipped classroom by including pre-recorded didactic videos. This afforded members the chance to view the videos at their own pace and come to the session prepared to engage in dialogue.

In our experiences, instructors who taught our counseling theories courses recommended for us to select one theory to learn about before declaring our theoretical orientation. Similarly, we asked members to narrow down their focus for the purposes of this group to a cause within a community that they feel passionately about. The other structural component we addressed with group members was that this curriculum is cumulative but not necessarily linear; so, an application of the previous “S” is necessary to study the following “S.” For example, once a group member identifies their strengths, we apply those strengths to inform what strategies they will use, but it does not necessarily mean that strengths are not revisited.

Given that this was a psychoeducation group rather than a traditional course, we did not want to use typical didactic methods to engage with this material. We intentionally paired each part of the S-Quad model with a story about an advocate from a minoritized community of whom others likely may not be aware. This demonstrated that SJA is not always done on a public stage. This narrative form of teaching (Hannam et al., 2015) allowed us to contextualize stories of advocates who are quietly resisting oppression in their respective communities. We spotlighted those stories so members could feel less intimidated by the prospect of SJA. In the interest of social justice and accessibility, the Chi Sigma Iota Counseling Honor Society’s Chi Sigma Mu chapter at Montclair State University funded books for interested members so they could follow along with the activities and didactic content. After the second session, we also introduced the idea of the social justice action plan. Table 1 shows the structure/syllabus of the group that we utilized for the semester and describes the ways in which we adapted to agreed-upon changes.

Table 1

Taking Action Group Structure

Week Topic & Activity Assigned Content/Activities
Week 1 Introducing

Taking Action

S-Quad Model

• Purpose, rationale, and structure of group

• Group agreements/norms

• Overview of S-Quad model (Toporek & Ahluwalia, 2020)

• ADDRESSING model (Hays, 2022), a framework that explores individual identity in context

• Difference between justice, charity, philanthropy

Week 2 1st S: Strengths

Activity 4.2, p. 29**



• Reviewing agreed-upon group norms

• Defining strengths

• Case study: Arunachalam Muruganantham (“The Pad Man”)

Processing case study as a group

• Introducing the social action plan

Week 3 Co-facilitators reflection meeting • This session was initially planned to address the 2nd S in the S-Quad, but no members attended the group this day. Instead, as co-facilitators, we met to discuss the progress of the group.


Week 4* 2nd S: Solidarity

Activity 5.1, p. 55

• Defining solidarity

• Case study: 4 young Black women, Black Lives Matter protests

Combining strengths and solidarity

Processing case study as a group

Week 5 3rd S:


Activity 6.1, p. 66

• Defining strategy

• Case study: Cakmak

Strength, solidarity, and strategy

Processing case study as a group

Cakmak’s social action plan

Week 6 4th S:


Activity 7.6, p. 176


• Defining sustainability

• Case study: Alexandria Ocasio Cortez

Strength, solidarity, strategy, and sustainability

Processing the importance and guilt of self-care

Processing burnout

Week 7 Final Group


• Case study

Apply ADDRESSING, S-Quad model

• Feedback from members

*Marks shift to videos for the didactic portion
**All activities listed are from Ahluwalia & Toporek (2020).



In this section, we offer our reflections on the group and extract salient collective themes that have come about through our processing. In our first session, we informed the group members that we intended to write a reflection paper, and they gave implicit consent to this writing; we did not collect data from group members for the purposes of this article. We begin by grounding the discussion of the group by acknowledging our positionality and social location and how that influenced how we approached our facilitation and planning of the group. Sharma, Bianchini, and Cakmak will provide their most salient takeaways from the forming and facilitation of the Taking Action group.

      Sharma identifies as a cisgender, South Asian (Indian), middle-class, able-bodied woman who is a doctoral candidate in a CACREP-accredited counseling program and a full-time lecturer in a CACREP-accredited counseling program. I bring a bicultural perspective to my counseling practice and education, and I have attended primarily White institutions (PWIs) for most of my life. As a master’s and doctoral National Board for Certified Counselors Minority Fellowship Program fellow, I learned about the importance and practice of SJA. I am a practicing clinician in private practice (working mostly with White clients), and I engage in advocacy work with South Asian intimate partner violence survivors.

Bianchini identifies as a White, cisgender woman who grew up in a predominantly White community in the United States. My family has lived in the United States for several generations and the majority of my extended family identifies as part of the middle class. I do not have any disabilities and am a practicing Christian. I am a master’s-level graduate student and joined Chi Sigma Iota’s social justice committee in my first semester of coursework.

Cakmak identifies as a Muslim American, cisgender woman of Turkish origin. I do not have any physical disabilities, but I have been diagnosed with general anxiety disorder (GAD) and major depressive disorder (MDD). I identified as part of the upper middle class in Turkey as a child, and I am middle class as an immigrant in the United States. I have two graduate degrees, one in literature and one in counseling. I have done volunteer work with underrepresented religious and cultural communities since I was in high school.

     As cocreators and coauthors, we reflected on our collective and individual experiences of facilitating our Taking Action group. We each completed individual reflection sheets within 48 hours of each group session to capture our takeaways, and we processed our experiences together after each group session. We reviewed our reflection sheets individually and noted themes that arose for each of us. We then collectively reviewed the sheets to determine what themes arose across our reflection sheets. We reengaged in the reflection process as we wrote this manuscript. In this section, we highlight the major themes among our experiences.

     The most significant theme of our collective experience was fear. Throughout each session, fear came up under several different guises, which served as an umbrella for additional themes: judgment, self-efficacy, and humility. Fear was the main antagonist preventing us from doing social justice work before this program. Fear of not knowing the necessary information, fear of saying or doing the wrong thing, and fear of not helping enough or adequately were examples of how this feeling manifested. However, engaging in this group helped us alleviate that fear through resources, support, and a plan of action. In the first session, we felt tentative and timid, and optimistic yet stagnant. After providing members with more information and concrete steps to create real social justice action, our fear dissipated, our passion for working as a group was ignited, and the motivation to take action began.

     In our first session, when we engaged members in a dialogue about group agreements, we noticed that there was more focus on the importance of the group serving as a judgment-free space than as a confidential one. We felt that members wanted to feel safe in the group because they feared being judged due to their self-perceived incompetence. We recognized they did not want to feel judged by others if their ideas were deemed unacceptable or incorrect. Establishing a nonjudgmental space permitted members to try, even if the outcomes were not as they hoped. We believe it allowed members to have a safe space to begin processing what they understand about SJA.

Judgment was a recurrent theme and shifted from self-judgment to judging others. Members reported feeling frustrated and upset when their peers in the program were not at the same level of advocacy awareness and action as they were. They reported feeling angry about others’ ignorance. Through a shared reflection on these feelings, the group acknowledged that the judgment of others reinforces the barriers to change that we are trying to knock down. Members recognized the importance of being humble regarding other people (another theme discussed below) and empathetic to help manage feelings of judgment.

When discussing sustainability and self-care, members and facilitators shared our hesitations to implement sustainability practices, despite it being an ethical responsibility. This hesitancy revealed itself to be motivated by self-judgment of our productivity levels. It appeared that the group members would not allow themselves the breaks they needed to provide self-care because of the importance they gave to SJA. We then discussed the need to be unapologetic in our self-care as advocates and counselors.

     Related to judgment of self and others, we found self-efficacy was another significant and recurrent theme. Almost every group member expressed that they were struggling to feel like they could contribute enough to society to perform real social justice action rather than charity. Having members share similar insecurities resulted in an insightful and vulnerable conversation that helped us to feel connected and inspired. In the second session, members reported experiencing imposter syndrome, likely resulting from their low self-efficacy in social justice work. Our self-efficacy grew throughout the sessions as members received the information and tools they needed to take concrete steps in SJA. Once we clarified a reasonable idea of what was expected of them and had some direction, they felt more prepared to take action.

     Lastly, the theme of humility appeared in several different iterations. The humility through humor with which we, as facilitators, approached this process helped break the ice and create a comfortable atmosphere in our initial meeting. Humility emerged in our second session when discussing the first “S” of the S-Quad model, strengths. In our reflection process, we noted that both facilitators and members appeared to be uncomfortable when sharing what they are “good” at. We, as female-identifying co-facilitators, noted the societal pressure and shame that have historically come with feelings of discomfort for behavior commonly regarded as boastful.

In the fourth session, the group discussed the importance of humility within their community. Members discussed how it was easy to humble oneself when trying to assist a community from the outside, but that it was an important lesson that we must be humble within our own communities. Members seemed to realize that their experience of their community and identity would not be the same as the next person’s, highlighting the importance of intersectionality within the human experience.

Humility was next discussed in the fifth session in terms of failure. Members acknowledged the importance of possessing humility and patience regarding our work because we will generally fail more than we will succeed in our efforts to create change. If we never failed, we would never learn from our mistakes and there would be no more SJA to do. However, knowing this instills the hope to persevere, for you never know what your planted seeds of action will grow into.

Combining Themes
     As facilitators, we noticed a parallel between what we were experiencing and our members’ experiences. From the start of our group, we felt we needed to be more qualified to be teachers of SJA. This was our campus’s first peer-led advocacy group, which meant we did not have any models to reference, and we had to rely on our own ideas, skills, and judgment. With faculty support, we went outside the confines of our curriculum because we wanted to share and engage with this content in a meaningful way. This was a large undertaking, with little training and even less confidence. Similar to what we observed in our members, we were afraid of making mistakes in the content, direction, and discussion of this group because of the weight of the topic of social justice—especially as the first group any of us attempted to create or lead. We had to adapt to constantly developing circumstances, and this felt inappropriate for us as leaders. Something we recognized much later was that we could teach and learn simultaneously; we did not need to reach a point of expertise before developing this group. Although we do not consider ourselves experts in SJA, the work we did to prepare for each session, combined with the humility with which we presented ourselves and our work, effectively allowed us to lead the group to the best of our ability.

Another source of our fear was that there was an ulterior motivation for creating this group, which was not purely social justice–oriented. We sought a sense of community, particularly given the isolating COVID-19 pandemic we were living through, and running this group gave us that community, support, and friendship. This longing for connection played into our feelings of being unqualified to do social justice work because a few of us became involved in this project out of a desire to work with friends, and not solely because we wanted to devote ourselves to social justice. However, this search for connection and participation in this SJA group gave us a passion for this work if it was not present beforehand. That feeling of connection and belonging provided us with the inner power to attempt something bigger than ourselves. The bond we authors created while facilitating this group instilled the importance of collaboration, especially when doing something new, significant, and daunting. The “S” for solidarity was also particularly salient in this case; we recognize that we could not have created or run this group alone. We needed each other to not only complete all the work required but also to hold each other accountable, support each other in times of need, and encourage each other to keep going even when our hopes dimmed. In a sense, this group and the connection to each other provided the “S” for sustainability and wellness for ourselves and our work.

While reflecting on these two sources of our fear as facilitators, we discovered our desire to make this call to the counseling profession: to strengthen the bridge between academia and counseling in practice. Applying the knowledge gained from our courses to daily practice could be less intimidating and feel more like the natural progression of our nascent counseling careers. However, once the opportunity arose to test our skills, we felt hesitant and unprepared. Creating an advocacy group is not the only venue in which this fear of practice appears. As students, we authors felt a similar fear when stepping into our practicum and internship sites. It is natural to feel afraid when seeing clients for the first time as CITs, but this fear could be lessened by academic leaders guiding students into the field before their final year of studies. If more opportunities to work with real issues affecting communities were available to students and supported by faculty, the transition between the classroom and fieldwork would feel less daunting.


Although this project was not an empirical study, our reflective process taught us about how it feels to learn about SJA and the labor required to teach about SJA. With this knowledge, we have identified potential implications for the counseling profession and counselor education training programs. We also acknowledge the limitations of the group we formed and facilitated.

     Per our experience, we believe social justice counseling—and advocacy skills more specifically—must have a more prominent place in counseling curricula. Potential solutions may include consistently operationalizing social justice counseling and SJA in counselor training programs (CSJ, 2020). Furthermore, it is imperative to have more guidance from our institutional standards such as CACREP (2023) and to have more ethical standards regarding SJA in the next iteration of the ACA Code of Ethics. CACREP (2023) requirements establish content that should be covered throughout all coursework, rather than specific classes; however, each program might have a different approach to operationalize these standards because they are vaguely defined (Austin & Austin, 2020).  For example, in the current CACREP (2023) standards, there is more frequent mention of social justice compared to the 2016 CACREP standards; however, there is still ambiguity about how this may present in a counseling course. Standard 3.B.1 (CACREP, 2023) says that counseling curricula must state how “theories and models of multicultural counseling, social justice, and advocacy” are addressed, but there is no mention of techniques, interventions, or skills for SJA. As a point of comparison, there are specific guidelines with respect to content like group counseling which delineate time that students must spend engaged in direct experience. However, it appears that social justice and SJA are still referred to in broader terms with fewer contingencies about how they must be addressed. We recognize that out-of-class work like advocacy might be left out of the curriculum because there are many required courses and training standards filling up students’ time in graduate school (Vera & Speight, 2003). However, we urge counseling leaders to consider the importance of SJA and the core role it plays in our healing work and our counseling identity.

Limitations and Future Directions
     This group was developed and facilitated to encourage counseling students to develop their social justice advocate identity, but it was not an empirical study, and our collective reflections can only offer so much insight to facilitating such groups in the future. As this was an extracurricular group for which attendees took time out of their personal schedules, we do not know what motivated our peers to attend sessions that we offered. This would be important knowledge to address in future offerings of this group and to understand students’ attitudes toward social justice in counseling. Another limitation of our group was our inability to reach students who are unsure of what social justice is and might not recognize it as an inherent and imperative part of mental health counseling. Practicum and other service-learning opportunities for SJA within the profession have been explored in the literature (Farrell et al., 2020; Field et al., 2019; Langellier et al., 2020), but perhaps peer encouragement can help CITs to feel more confident as advocates. Although we intentionally kept the group open for accessibility, new introductions and catching up took time away from the group plan and content. We do not have data to explicate a group like this, but we hope our master’s and doctoral peers feel encouraged to start similar groups within their own programs. Finally, we wrote this article more than a year after our group ended; although we relied on our reflection sheets and notes from our experience, we are aware that there may be gaps in our recollections.

For future groups, we would be interested to complete an empirical study through an IRB in order to collect data regarding peer-led SJA groups. Screening or surveys before and after the group could not only provide valuable data, but also offer guidance for attendees even before the group starts and an opportunity for reflection after the group ends. Our decision to keep our group open led to attrition of members; thus, empirical studies might also investigate factors that contribute to student engagement. Collecting quantitative and qualitative data may provide further insight into effective strategies for describing and encouraging students to engage in concrete SJA skill development.


The experience of facilitating an SJA group was new, challenging, transformative, and important to our growth as CITs and budding counselor educators. As counselors, we understand our ethical duty to engage in SJA; however, we have not had adequate training in tangible strategies to utilize when advocating on behalf of our clients. The S-Quad model is an important guide that helped facilitate our understanding of how to implement SJA as mental health professionals. As co-facilitators and coauthors, we learned a great deal about ourselves as developing social justice advocates, CEs, and CITs and confronted fears parallel to those of the group members. Although SJA is a growing focus in the counseling literature, there is a great deal of research and training that must continue to occur so current and future counselors can develop their social justice advocate identities.


Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.



Abrams, S. (2019, January). 3 questions to ask yourself about everything you do [Video]. TED Talks. https://www.youtube.com/watch?v=3zJHwOwirjA

American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/docs/default-source/default-document-library/2014-code-of-ethics-finaladdress.pdf?sfvrsn=96b532c_8

Austin, J. T., II, & Austin, J. A. (2020). The counselor educator’s guide: Practical in-class strategies and activities. Springer.

Chang, C. Y., Barrio Minton, C. A., Dixon, A. L., Myers, J. E., & Sweeney, T. J. (Eds.). (2012). Professional counseling excellence through leadership and advocacy (1st ed.). Routledge.

Chapman-Hilliard, C., & Parker, B. (2022). Embodied social justice learning: Considerations for curriculum development and training in counseling programs. Journal for Social Action in Counseling and Psychology, 14(1), 77–93. https://doi.org/10.33043/JSACP.14.1.77-93

Council for Accreditation of Counseling and Related Educational Programs. (2015). 2016 CACREP standards. https://www.cacrep.org/wp-content/uploads/2017/08/2016-Standards-with-citations.pdf

Council for Accreditation of Counseling and Related Educational Programs. (2023). 2024 CACREP standards. https://www.cacrep.org/wp-content/uploads/2023/06/2024-Standards-Combined-Version-6.27.23.pdf

Counselors for Social Justice. (2020). A call for social justice in the American Counseling Association (ACA). Journal for Social Action in Counseling and Psychology, 12(1), 2–12. https://doi.org/10.33043/JSACP.12.1.2-12

Farrell, I. C., DeDiego, A. C., & Marshall, R. C. (2020). Service learning to foster advocacy training in CACREP accredited programs. Journal of Creativity in Mental Health, 15(4), 522–534. https://doi.org/10.1080/15401383.2020.1733724

Field, T. A., Ghoston, M. R., Grimes, T. O., Sturm, D. C., Kaur, M., Aninditya, A., & Toomey, M. (2019). Trainee counselor development of social justice counseling competencies. Journal for Social Action in Counseling and Psychology, 11(1), 33–50. https://doi.org/10.33043/JSACP.11.1.33-50

Gummere, R. M., Jr. (1988). The counselor as prophet: Frank Parsons, 1854–1908. Journal of Counseling & Development, 66(9), 402–405. https://doi.org/10.1002/j.1556-6676.1988.tb00899.x

Hannam, F. D. (2015). Teaching through narrative. Forum on Public Policy Online, 2015(2).

Hays, P. A. (2022). Addressing cultural complexities in counseling and clinical practice: An intersectional approach (4th ed.). American Psychological Association.

hooks, b. (1994). Teaching to transgress: Education as the practice of freedom. Routledge.

Kaplan, D. M., Tarvydas, V. M., & Gladding, S. T. (2014). 20/20: A vision for the future of counseling: The new consensus definition of counseling. Journal of Counseling & Development, 92(3), 366–372. https://doi.org/10.1002/j.1556-6676.2014.00164.x

Kivel, P. (2020). Social service or social change? Who benefits from your work. https://paulkivel.com/wp-content/uploads/2011/07/Social-Service-or-Social-Change-2020-Update.pdf

Langellier, K. A., Astramovich, R. L., & Horn, E. A. D. (2020). Infusing service learning into the counselor education curriculum. The Professional Counselor, 10(2), 194–203. https://doi.org/10.15241/kal.10.2.194

Nadal, K. L., King, R., Sissoko, D. R. G., Floyd, N., & Hines, D. (2021). The legacies of systemic and internalized oppression: Experiences of microaggressions, imposter phenomenon, and stereotype threat on historically marginalized groups. New Ideas in Psychology, 63, 1–9. https://doi.org/10.1016/j.newideapsych.2021.100895

Ratts, M. J. (2009). Social justice counseling: Toward the development of a fifth force among counseling paradigms. The Journal of Humanistic Counseling, Education and Development, 48(2), 160–172.

Ratts, M. J., & Greenleaf, A. T. (2018). Counselor–advocate–scholar model: Changing the dominant discourse in counseling. Journal of Multicultural Counseling and Development, 46(2), 78–96. https://doi.org/10.1002/jmcd.12094

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K, & McCullough, J. R. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28–48. https://doi.org/10.1002/jmcd.12035

Sheely-Moore, A. I., & Kooyman, L. (2011). Infusing multicultural and social justice competencies within counseling practice: A guide for trainers. Adultspan Journal, 10(2), 102–109. https://doi.org/10.1002/j.2161-0029.2011.tb00129.x

Toporek, R. L. (2018). Strength, solidarity, strategy and sustainability: A counseling psychologist’s guide to social action. The European Journal of Counselling Psychology, 7(1), 90–110. https://doi.org/10.5964/ejcop.v7i1.153

Toporek, R. L., & Ahluwalia, M. K. (2020). Taking action: Creating social change through strength, solidarity, strategy and sustainability. Cognella.

Toporek, R. L., & Daniels, J. (2018). American Counseling Association advocacy competencies (updated 2018). American Counseling Association. https://www.counseling.org/docs/default-source/competencies/aca-advocacy-competencies-updated-may-2020.pdf

Toporek, R. L., Lewis, J. A., & Crethar, H. C. (2009). Promoting systemic change through the ACA advocacy competencies. Journal of Counseling & Development, 87(3), 260–268. https://doi.org/10.1002/j.1556-6678.2009.tb00105.x

Vera, E. M., & Speight, S. L. (2003). Multicultural competence, social justice, and counseling psychology: Expanding our roles. The Counseling Psychologist, 31(3), 253–272. https://doi.org/10.1177/0011000003031003001


Sunanda M. Sharma, MS, NCC, LPC (NJ), LPCC (OH), is a lecturer at Wright State University. Jennifer E. Bianchini, BFA, is a master’s student at Montclair State University. Zeynep L. Cakmak, MA, LAC (NJ), is a mental health counselor at Montclair State University. MaryRose Kaplan, PhD, NCC, LPC, is a school counselor and adjunct professor at Montclair State University. Muninder K. Ahluwalia, PhD, is a professor at Montclair State University. Correspondence may be addressed to Sunanda M. Sharma, 3640 Colonel Glenn Hwy., Millett Hall 370, Dayton, OH 45435, sharmas1@montclair.edu.

Teen Dating Violence: Examining Counseling Students’ Responses to Gendered Vignettes

Kelly Emelianchik-Key, Bridget Glass, Adriana C. Labarta

Teen dating violence (TDV) is an ongoing epidemic in the United States. Subsequently, gender symmetry regarding the experience and perpetration of violence continues to be a prevalent debate in American society. TDV is a clinical concern that can impact clients’ safety; therefore, counselors must be adequately trained and cognizant of any biases that may influence the assessment and treatment of survivors of abuse. We conducted a qualitative research study using case vignettes to explore how counseling students conceptualize and propose treatment of TDV with male and female clients. Six overarching categories and 19 corresponding themes emerged, with gender bias as the most notable finding of the study. We conclude by discussing the implications for counseling and providing recommendations for educational standards and best practices to reduce gender bias and promote more inclusive treatment.

Keywords: teen dating violence, abuse, counseling students, gender bias, educational standards

Teen dating violence (TDV) is an adverse childhood experience that often shapes future relationship patterns throughout adulthood (Emelianchik-Key et al., 2022; Offenhauer & Buchalter, 2011). As a result, TDV has become a significant public health concern among adolescents in the United States (Centers for Disease Control and Prevention [CDC], 2021). After a compilation of prevalence rates, dating violence victimization rates range from 20%–53% in early adolescence (Goncy et al., 2017). In 2019 alone, one in 12 high school students reported physical and sexual violence within a dating relationship (CDC, 2021). Of those who reported intimate partner violence, 11 million women and 5 million men noted experiences of TDV before age 18 (CDC, 2021). TDV is characterized by physically or sexually violent acts that one adolescent perpetrates against another whom they are dating (CDC, 2021). This is inclusive of maladaptive behaviors, such as stalking and emotional abuse. In fact, emotional abuse (e.g., stonewalling, insulting language, social isolation, name-calling, gaslighting) exceeds the expression of physical violence within most teen dating relationships (Offenhauer & Buchalter, 2011).

TDV compromises the physical and emotional safety of American youth and can potentially impair adolescent development (CDC, 2021; K. E. Hunt et al., 2022), including how young people learn emotional regulation and form healthy relationships. K. E. Hunt et al. (2022) noted that many complicated variables play a role in the development and the prevention of dating violence, with family of origin belief systems and peers contributing to social learning. This was apparent in Emelianchik-Key et al.’s (2022) qualitative study, which determined that young college-aged females consistently normalized and accepted toxic relationship behaviors as common and justified because of norms created by family, peers, and society.

Further, the consequences of TDV on an adolescent’s psychological well-being and decision-making may be severe and persist over time, causing problems later in life. For example, Temple et al. (2013) determined a significant increase in the internalization of emotions in adolescent girls who experienced TDV. Youth with pre-existing mental health conditions are also at increased risk for traumatization by a relationship partner (Temple et al., 2013). Because TDV may lead to various mental health concerns, such as substance misuse, eating disorders, antisocial behaviors, self-injury, and suicidality (Foshee et al., 2013), counselors play an integral role in TDV prevention and intervention. Many young clients may choose to initially disclose personal experiences of TDV or unhealthy relationship behaviors in a therapeutic setting, making counselor preparedness critical.

Gender Symmetry in TDV
     TDV has also led to strong debates regarding the issue of gender symmetry. Several studies have found that TDV is reciprocal, with both partners exhibiting aggressive or toxic behaviors in response to each other (Eisner, 2021; Emelianchik-Key et al., 2022; K. E. Hunt et al., 2022). However, some studies indicate vastly disproportionate rates of TDV victimization among adolescent girls (Kann et al., 2018), mainly in instances of extreme physical brutality or sexual violence (Swahn et al., 2010). The inconsistent rates may be related to social perceptions of TDV as a female concern, decreased male reporting (often attributed to stigma), conceptualization and understanding of violence, and a lack of validated measures that encompass diverse cultural and gendered experiences (Eisner, 2021; Walker et al., 2020). These contradictory reports make it even more challenging for clinicians.

Counselor Preparedness
     Currently, there are several gaps in the literature regarding counselor education and TDV, including training, competency, and expertise (Murray et al., 2016). In a small sample of programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), Henriksen et al. (2010) found that graduate counseling programs minimally addressed specialty training areas, requiring graduates to acquire additional skills independently. CACREP (2015) standards do not include TDV in training criteria, thus leaving the inclusion of these topics to the discretion of faculty. Further, Wozny (2005) found that 34% of marriage and family therapy programs had a domestic violence course, compared to 4% of counselor education programs. Similarly, in a sample of practicing school counselors, only 10% reported specific domestic violence training and continuing education at their workplace in the past 2 years (Khubchandani et al., 2012). Among the participants, 19% reported no formal education or training on TDV, and 83% of the participants’ settings did not assess TDV amongst the students within their school system (Khubchandani et al., 2012). This is alarming, given that 72% of sexual harassment and 28% of dating violence incidents occur in schools (Turner et al., 2011). A lack of preparation for crisis training, intervention, and prevention may cause serious detriment and endangerment to clients and counselors (Morris & Minton, 2012).

Counselor Bias
     Gender bias related to survivors of relationship abuse is prevalent among trainees and professional counselors, reflecting stigmas among the general population (Maghsoudi, 2018). Karakurt et al.’s (2013) study on counselor attitudes toward perpetrators of violence revealed that most participants believed female offenders were justified in their violent actions and were not as dangerous as their male counterparts. Results also indicated that participants expressed less empathy for male survivors and more confidence in treating male perpetrators (Karakurt et al., 2013). Counselors may perpetuate stigma regarding female survivors by over-pathologizing, minimizing their complaints, and invalidating their feelings (Maghsoudi, 2018). Maghsoudi (2018) contended that there is a lack of training, but more importantly, there are limited opportunities within the educational curriculum for trainees to explore implicit biases regarding violence among partners.

The development of counselor self-awareness regarding personally held biases and beliefs can mitigate widespread assumptions about TDV. In addition, counselor self-awareness is a focal point of counselor education programs. This study sought to examine if there were differences in how counseling students conceptualize and work with male and female survivors of TDV. Using a qualitative design, we utilized case vignettes to examine how counseling students conceptualize, assess, and treat TDV. The overarching research question was: How do counseling students conceptualize and propose treatment for the experience of TDV in both female and male clients?


Data Collection
     After receiving IRB approval, the primary researcher, Kelly Emelianchik-Key, recruited a convenience sample of participants over 6 months in three counselor education programs. Emails were sent to the clinical placement coordinators to request the dissemination of the study details to their students. The three clinical placement coordinators agreed and sent the email with links to a Survey Monkey for students 2 years or more into their academic studies. The students received an email containing study information, a link to the electronic consent forms, demographic questions, and a case scenario with open-response questions. After completing the consent and demographic form, participants were randomly assigned one of two client case vignettes. The scenarios were identical vignettes (located in the Appendix) containing details of a struggling teen client experiencing TDV. The only difference in cases was the identified gender of the client. One case had a male client with a female partner while the other had a female client with a male partner. Counseling students were then asked questions about the vignette to better understand their clinical impressions of the client, a diagnosis (if warranted), any concerns regarding the case, and treatment ideas and considerations. The case vignettes and written responses were collected and analyzed until saturation was achieved (Braun & Clarke, 2021). To assess data saturation, we evaluated the data for completeness and at specific intervals of the data analysis process. Data saturation was met with 45 participants, with 22 responses to the female case and 23 responses to the male case.

     The inclusion criteria for this study required that participants 1) were current students in a CACREP-accredited counseling program (any specialization) and 2) had completed all program-related content coursework, with only clinical field placements remaining. Of the 45 participants, eight self-identified as male and 37 self-identified as female. The participants’ degree track specializations were as follows: clinical mental health counseling (n = 21; 51%), school counseling (n = 8; 17%), rehabilitation counseling (n = 6; 13%), marriage and family therapy (n = 2; 4%), doctoral counselor education students (n = 3; 6%), and non–degree seeking students who already held a master’s degree in counseling (n = 3; 6%). All students were either enrolled in a clinical experience or had completed their clinical experiences. Participants ranged from 21 to 52 years of age, with a mean of 26.8. We did not collect data on participants’ race/ethnicity or sexual orientation in the demographic form, as it was not a variable of consideration in our study.

     In the present study, we aimed to understand how counseling students conceptualize clients experiencing TDV while considering differences in approach based on client gender. We used a qualitative case vignette design with a deductive approach to better understand gender-based assumptions, myths, or stigmas that may affect counseling students’ conceptualization and approach to treating TDV. The vignette design allows for assessing attitudes, values, norms, and perceptions regarding sensitive social science issues in qualitative research (Hughes, 1998). It may also be beneficial in exploring topics such as gender equality, gender norms, gender discrimination, drug use, mental illness, and emotional and behavioral difficulties (de Macedo et al., 2015). The case vignettes were created using a three-phase approach to test for content validity in health care education research (St. Marie et al., 2021): 1) Developing the vignette and associated questions, 2) sending the vignette to three experts in counseling and domestic violence research, and 3) testing the revised vignette with a small group of participants that suggested edits for clarity. The Appendix contains the vignette for a female teen client. An identical vignette for a male teen client was also utilized during the study. The only difference in the cases was the identified gender of the client and their partner; names, scenarios, and all non-gendered wording remained the same.

We approached this research from a post-structural feminist theoretical lens, conceptualizing TDV as reciprocal and challenging the common sociocultural notions of women as “powerless” and men as “powerful” in a patriarchal society. For this reason, we did not specify the client’s cultural background and used binary gender identities and heterosexual relationships in the case examples. Case vignettes with varying intersecting identities may have elicited other forms of bias, such as internalized homophobia, heteronormativity, gender-normative assumptions, and ethnocentric views, further compounding the dynamics and potentially leading to misinterpretations of the qualitative findings. Our hope is that this study can provide a framework for future research to incorporate additional layers of identity and address existing gaps in the TDV literature.

Research Team Positionality
     The researchers’ experiences, qualities, personalities, or histories can potentially influence qualitative research outcomes (B. Hunt, 2011). Therefore, we engaged in reflexivity throughout the research process to minimize bias during data analysis. Our research team consisted of three cisgender female faculty in counselor education. All are licensed mental health counselors and one is also a licensed marriage and family therapist. We also have diverse counseling experiences in various mental health settings, including schools, university counseling centers, residential treatment facilities, domestic violence shelters and outreach programs, and private practice. Our related research interests include TDV, intimate partner violence, gender issues, sexuality, and culturally responsive approaches to counseling and research. Consistent with the qualitative research process, we continually engaged in dialogue and a self-reflective process to examine personal beliefs and challenge biases in TDV literature to ensure that our positionality did not impede the research process.

Data Analysis and Trustworthiness
     Thematic analysis is a grouping of methods that examines commonalities and differences in research. Theoretically flexible, thematic analysis is a useful and practical approach to counseling research (Clarke & Braun, 2018). In this study, we utilized reflexive thematic analysis to form themes from codes, which were also grouped by major categories based on our questions to participants (Braun & Clarke 2013, 2021). Thematic analysis can also be expansive, ranging from research with rich descriptions to research that aims to describe and summarize (Clarke & Braun, 2018). The recommended steps for a reflexive thematic analysis were followed (Braun & Clarke, 2013, 2021; Clarke & Braun, 2018). We independently reviewed all data for familiarization, which included detailed documentation of thoughts, field notes, and decisions that were made individually. We met weekly to develop initial codes that were placed into a codebook to chart the developing analysis. Per Braun and Clarke’s (2013) recommendations, we set the data into central organizing concepts or categories to communicate and develop the themes. Within each category, we further grouped data by gender of the client to assess gender normative assumptions that may be guiding counseling students’ decision-making processes. Meetings took place over 6 weeks (one category per week) to discuss and group initial overarching themes for each vignette. Once this phase was complete, the themes were refined, defined, and named; the outcome was a final report.

To promote trustworthiness, we followed Nowell et al.’s (2017) recommendations for methodological rigor within Braun and Clarke’s (2013, 2021) steps for thematic analysis. These included a review of responses at various points prior to analysis. Peer debriefing took place during the 6-week coding process, along with an audit trail of documentation and codebooks connecting themes and content. Based on consensus coding, codebook refining took place weekly (Nowell et al., 2017). As a final step, member checking took place by sending the resulting themes and subthemes to the respective programs where students were recruited. Because the participants were anonymous, the programs disseminated findings to all students, asking anyone who initially participated to check for credibility in the results and reach out via email or anonymously through a Qualtrics link if they found inaccuracies (Braun & Clarke, 2013; Nowell et al., 2017). No participants responded or objected to the findings after three rounds of email blasts.


We determined six emergent categories that spanned across both cases: (a) case conceptualization and clinical impressions, (b) diagnostic impressions, (c) relationship considerations, (d) clinical concerns, (e) treatment approaches, and (f) gender bias. Within these six categories, 19 themes emerged, which are defined below in their corresponding category.

Case Conceptualization and Clinical Impressions
     The case conceptualization and clinical impressions category captured counseling students’ perceptions of the presenting problem, resulting in the two themes of interpersonal and intrapersonal concerns. Although both vignettes aimed to illustrate specific cases of TDV, counseling students presented various explanations regarding the cause of the client’s symptoms. The interpersonal theme focused on aspects outside the client’s immediate control, including limited peer support, the dating relationship, and academic concerns. For example, a counseling student responding to the male client’s case suggested that he needs “to get involved in more extracurricular activities and find things that he enjoys doing” or “extra support from school and family.” Students responding to the female case also focused on relational issues, indicating that “she needs to build better relationships with her family, friends, and partner.” Participants also considered intrapersonal factors related to the client’s mood, level of assertiveness, self-esteem, and self-confidence. For example, in responding to the male client case, counseling students indicated that the client “has poor or low self-esteem” or “should be able to stand up for himself in all areas of his life.” The female case elicited similar responses from participants, such as “she needs to stop being so codependent” and “she could get better if she wanted to.”

Diagnostic Impressions
     The second category was grouped based on diagnostic criteria. Four themes emerged: mood disorders, personality disorders, stress disorders, and neurodevelopmental disorders. Three subthemes were also identified: insufficient information, no diagnoses warranted, and only symptomology. Counseling students provided various responses regarding whether a diagnosis was warranted in the case vignette. Some participants responded with multiple possible diagnoses for the client presented in the case scenario. Others prefaced the diagnosis with statements alluding to uncertainty with making a concrete diagnosis, such as “possibly is experiencing depression,” or noting a diagnosis followed by “but more information will be needed to confirm.” About half of the participants stated a concrete diagnosis while providing support and examples from the case vignette.

Although many diagnoses overlapped in both scenarios, there were differences regarding the frequency of endorsement. The most common diagnoses for the male client included adjustment disorder (n = 9) and attention-deficit/hyperactivity disorder (ADHD; n = 7). Conversely, the female client was most frequently diagnosed with a dependent personality disorder or style (n = 8). The female client was never diagnosed with ADHD and was only determined to have “attention problems.”

Dating Relationship Considerations
     Participants drew attention to relational concerns in the client’s life within this category. The identified themes included unhealthy relationships, support, and dating violence. The unhealthy relationship theme was evident in both client cases. Several participants (n = 15; seven in the male client case and eight in the female client case) noted comments like “unhealthy relationship” while providing examples of unhealthy behaviors, such as the partner’s communication style and controlling behaviors. Several responses highlighted the theme of support. Participants appeared to skirt around labeling relationship violence and resorted to more general comments, such as “the client needs relationship support” or “better communication in the relationship is needed.” Additionally, one counseling student noted the lack of support in the relationship and questioned the need for such a serious relationship at this “young age,” demonstrating judgment and bias (further discussed in Category 6). This theme also captured counseling students’ recommendations for enhanced relational support (e.g., date nights).

The final theme within this category, dating violence, was evident in six responses that labeled the relationship as “violent” or mentioned “dating abuse” as a concern. In responses that noted abuse, three mentioned “emotional abuse,” and two identified “sexual abuse” in the female case. The word “sexual pressure” was also used by two counseling students that completed the female case, but it was not explicitly noted as abuse or violence. In the female case, two participants mentioned “rape” four times, whereas “rape” was never mentioned in the male case. In the male case, the only comment that slightly implied relationship violence noted: “needs to discuss relationship boundaries with his partner, so she doesn’t pressure him to advance sexually.”

Treatment Approaches
     Treatment approaches were categorized and counted based on theoretical orientations. Most participants responded with similar treatment considerations for both presented cases. The five grouped themes included cognitive behavioral therapy (n = 15), solution-focused therapy (n = 11), family therapy (n = 9), couples counseling (n = 3), and other (n = 7). The other theme resulted from various suggestions that were not specific approaches for individual therapy but could support the client. These suggestions included tutoring, group therapy, and peer support. Several counseling students made referral recommendations instead of offering treatments or approaches that the counselor could directly utilize with these clients. For example, a suggestion included psychiatric evaluation or referral for the female survivor (n = 10). This suggestion was not recommended as often for the male survivor (n = 2). Additionally, one respondent suggested that the female survivor should “get a referral for a gynecologist.” In contrast, no responses indicated a medical referral for the male client.

Practice Considerations
     Participants answered questions regarding any apprehension or reservations they might experience while treating the proposed clients, categorized as practice considerations. The themes that emerged were ethical and legal concerns, family concerns, and school concerns. Almost a quarter of participants (n = 11) indicated clinical concerns related to ethical or legal implications or limits of confidentiality because of the clients’ ages. Some counseling students mentioned “involving parents” or “disclosing to parents” without explaining what warranted disclosure. One participant was concerned for the client’s safety because of sexual violence (i.e., rape) and specifically mentioned reporting to authorities. Nearly half of the participants (n = 20) identified the client’s family issues as problematic, offered solutions to repair relationship ruptures within the family dynamic, and mentioned strategies for improved communication. Additionally, participants (n = 22) identified school-related difficulties, such as decreased grades, as an area of concern for the client. Examples of commentary provided by those participants included, “Jordan needs a tutor” or “Jordan needs to be evaluated educationally at school to see if there are learning challenges and get an IEP.”

Gender Bias
     The sixth category was identified because of the overwhelming gender biases that emerged throughout the participants’ responses. This category was further grouped into two themes: language and judgments and myths. The researchers compared the language counseling students used to describe male and female clients. Although the counseling students described the male and female clients with similar terms (i.e., influenced, boundaries, codependence), the frequency across all responses grossly varied. For example, participants used the term “abuse” twice as many times when describing the female client’s relationship (n = 23) as opposed to the male client’s relationship (n = 11). Similarly, counseling students utilized the term “survivor” to describe the female client (n = 13), but not the male client (n = 0). The male client was often described as “withdrawn” (n = 28) and experiencing “attention” difficulties (n = 43), “adjustment” (n = 29), and “codependence” issues (n = 23). Conversely, the female client was more likely to be described as “influenced” (n = 19), “manipulative” (n = 22), and experiencing “dependency” (n = 47) concerns. Although these counts could highlight one participant using the word one or more times in a response, they illuminate the disparity and lack of discernment in the language used to describe both clients.

Within the theme of judgments and myths, the counseling students consistently referenced and discussed the female partner (perpetrator) in the male client scenario. These comments made inferences or judgments about the female partner (perpetrator) even though she was not the identified client. Counseling students made various comments about the female perpetrator, including, “she is controlling,” “nasty,” or “needy,” alluding to the fact that she is causing these issues for the male client. Counseling students also provided clinical impressions, recommendations, and diagnoses for the male client’s partner (female perpetrator). Conversely, participants who completed the female client case noted clinical recommendations for the female client’s partner (male perpetrator), such as general “relationship help” and “anger management and self-help.” These comments and recommendations were less frequent and judgmental of the female client’s partner (male perpetrator). Relatedly, no participants provided a diagnosis for the male perpetrator. Overall, counseling students frequently mentioned the female partner (perpetrator) rather than focusing on the identified client, although this was less frequent for the male partner (perpetrator).

Additionally, many judgments about the survivors arose, perpetuating myths and the stigma surrounding TDV and survivors. For example, one student noted the female survivor “could get better if she wanted to” and “she needs to express her feelings to her partner.” Another student wrote that the male survivor needed to “be more assertive in the relationship and not get walked all over” and “seems like he is a people pleaser and needs to take more control over his situation.” Furthermore, the few times relationship violence was discussed, the female client was always referred to as a “victim” or “survivor,” whereas the male client was referred to by name or “the client.”


This study aimed to examine how counseling students conceptualize and propose treatment for the experience of TDV in both female and male clients. The results indicate that gender played a significant role in counseling students’ responses to a survivor’s clinical needs. Data were grouped using the following categories that corresponded with questions: (a) case conceptualization and clinical impressions, (b) diagnostic impressions, (c) relationship considerations, (d) practice considerations, (e) treatment approaches, and (f) gender bias. Within these categories, 19 themes emerged, which we discuss further below.

     The counseling students presented similar challenges in their case conceptualizations and diagnoses for each scenario. Sperry and Sperry (2020) noted that case conceptualization is essential for counseling students to inform clients of diagnostic, treatment, and clinical formulations. Many responses demonstrated counselor bias, limitations in practical skills and case conceptualization, and minimal depth of knowledge. As found in this study, there was a misdiagnosis of the client’s presenting issue as a mental health disorder and an overemphasis on comorbid symptoms (e.g., failing grades) instead of evaluating these phenomena as a response to the trauma (i.e., TDV). This failure to conceptualize clients accurately leads to improper diagnosis and ineffective treatment.

Interestingly, although the study did not include a requirement to diagnose the fictitious clients, many of the participants still provided a diagnosis. In a systematic review of the literature, Merten et al. (2017) found that misdiagnosis and unintended overdiagnosis of mental health disorders in children and adolescents is likely more common than expected, leading to improper treatment. Qualitative research illuminates how cognitive information processing obscures diagnostic and clinical decision-making (Hays et al., 2009). This phenomenon, known as availability bias, is when clinicians determine the mental health status of clients based on personal experiences or stigma rather than the observable criterion. It is plausible that the counseling students in this qualitative study demonstrated availability bias (based on gender or age), inhibiting their future work with TDV in young clients.

Further, the study’s findings show that many counseling students are unaware of evidence-based interventions to treat TDV appropriately. Students mentioned interventions like cognitive behavioral therapy (CBT), solution-focused therapy, couples counseling, and academic tutoring to reduce client distress and increase self-esteem. Although CBT is a viable treatment approach, none of the responses suggested the implementation of trauma-informed modalities or protocols (such as STAIR; American Psychiatric Association, 2019) for teens recovering from emotional and physical abuse. Trauma-informed approaches focusing on empowerment and advocacy are incredibly powerful in healing relationship trauma (Ogbe et al., 2020). Most strikingly, the counseling students appeared to overlook many critical aspects of treating trauma survivors, including screening, risk assessment, safety planning, and psychoeducation (Ogbe et al., 2020).

A promising aspect of this study is that some counseling students suggested peer support and group therapy as appropriate treatment responses for TDV. Research indicates that school-based peer groups can decrease the rate of abuse among middle and high school–aged students (Ball et al., 2015) and reduce physical dating violence following treatment (Temple et al., 2013). Studies also reveal higher success rates for the prevention of TDV when survivors perceive consistent emotional safety. Factors like school climate, group setting, peer interactions, perspectives on abuse, and opportunities for adaptive skills-building can contribute to survivor care (Ball et al., 2015).

Regarding relationship considerations, only 15 participants noted relationship concerns related to a toxic relationship, regardless of the perpetrator’s gender. Only six of those who indicated relationship discord reported concerns related to sexual abuse or rape. The staggering implication is that novice clinicians cannot identify unhealthy relationship patterns and violence. Research also indicates that young people often misinterpret or minimize partner violence because of unrealistic or distorted relationship beliefs (Eisner, 2021; Walker et al., 2020), continuing into early adulthood with difficulty conceptualizing violence upon entering college (Emelianchik-Key et al., 2022). When clients and clinicians cannot label and conceptualize relationship violence, it leaves room for error in intervention and prevention measures. This extends to the demonstrated lack of knowledge regarding legal, ethical, and clinical responsibilities for treating TDV, particularly within the scope of mandatory reporting laws for the protection of minors. This issue extended to the appropriate disclosure of TDV to parents and caregivers, mainly because young people are more apt to discuss TDV in confidential settings (Cutter-Wilson & Richmond, 2011).

Other practice concerns in the data stemmed from a general inability to conceptualize the presented cases. Although the case vignette highlights academic and interpersonal problems, the client’s presenting problem was TDV. The counseling students neglected to recognize adolescent relationship abuse, leading to the symptomology of academic decline, lowered self-esteem, dysthymia, and isolation (Cutter-Wilson & Richmond, 2011). Recommendations to treat other problems outside of TDV to resolve trauma from abuse can lead to the revictimization of the client by the counselor (Maghsoudi, 2018). Counseling students must be cognizant of their capacity to retraumatize TDV survivors, as victims who perceive any shame or blame during their disclosure may be reluctant to seek help in the future (Maghsoudi, 2018; Walker et al., 2020). Counselor bias is often attributed to poor training at the graduate level (Maghsoudi, 2018). With more informed preparation, counseling students may shift from a pathologized response to a strengths-based approach founded on client self-efficacy and resilience.

Consistent with prior research (Karakurt et al., 2013; Machado et al., 2020; Maghsoudi, 2018; Walker et al., 2020), gender bias was prevalent across all categories and ultimately emerged as an independent category upon final analyses. Gender discrepancies were evident in clinical diagnosis, treatment planning, ethical implications, and client descriptors. Although the content presented in each scenario was identical, counseling students diagnosed the male and female survivors differently. For example, the female survivor was diagnosed with borderline personality disorder and bipolar disorder while the male survivor received depression, anxiety, and ADHD diagnoses. With many criteria for these disorders overlapping, misdiagnosis can occur (Fruzzetti, 2017; Scott, 2017). Yet, gender bias is a common factor in misdiagnosis, especially with a diagnosis of borderline personality disorder, bipolar disorder, and ADHD (Bruchmüller et al., 2012; Fruzzetti, 2017). Counselors perpetuate stigma regarding female survivors by over-pathologizing, minimizing their complaints, and invalidating their feelings (Maghsoudi, 2018).

We contend that the most alarming finding of this study was how the counseling students portrayed several gender disparities when identifying relationship abuse. The divide between gender treatment of TDV was apparent when comparing the counseling students’ view of the female client as a “survivor” and not using strengths-based terminology to identify the male client. Many statements continued to perpetuate societal stigmas about female survivors being passive while male survivors were described as needing to assert “control,” further exacerbating common notions about power and control. A recent qualitative study of male survivors explained that professionals minimized and ridiculed most participants for not being the “stereotypical victim of domestic violence” (Machado et al., 2020, p. 9). Counselors must develop the necessary skills to provide equal support and resources to populations navigating stigma concurrently with TDV (Walker et al., 2020). These findings affirm that even professional counselors are subject to the inherent and socially constructed biases regarding relationship abuse and further emphasize the importance of counselor training to increase one’s professional capacity to treat all survivors of TDV. These outcomes also support a feminist conceptualization of TDV to dismantle gender disparities in treatment and the importance of empowering survivors of all genders experiencing TDV.

Implications for Counselors and Counseling Programs
     Collectively, the study’s findings point to the need for enhanced counselor training, reflexivity, and knowledge on the intersection of age, relationship status, violence, and gender issues. Counseling students must understand that relationship violence can happen at any age and has damaging, long-lasting impacts on an adolescent’s well-being, future relationships, and mental health (e.g., depression, suicidal ideation, drug use, self-injury; CDC, 2021; Kann et al., 2018). TDV has detrimental consequences on an adolescent’s psychological well-being and decision-making (CDC, 2021; K. E. Hunt et al., 2022), thus making it critical that counselors do not underestimate the impact dating violence can have on a relationship regardless of age. Because counselors may encounter the presence of relationship violence in teens within various settings (e.g., counseling centers, schools, and universities), they must be familiar with and adept at recognizing and addressing these factors for client safety and aid in ending the abuse cycle.

Although counselor education programs produce very competent and knowledgeable counselors, there remains an inability to comprehensively cover all the necessary content to prepare counselors for working with clients (Henriksen et al., 2010; Khubchandani et al., 2012). Some of these topic areas, like TDV, must be explored further in continuing education. More emphasis must be placed on trauma-informed approaches to assist all clients, including teens in a critical developmental age at which TDV threatens current and future mental health (Foshee et al., 2013; Temple et al., 2013). Strengths-based and advocacy-informed trauma approaches have been influential in healing relationship trauma (Ogbe et al., 2020) by assisting teens in preventing pervasive patterns of violence in future relationships.

At the same time, other relevant factors, such as unacknowledged biases, should be examined personally and within supervision. Counseling students, new professionals, and supervisors must be willing to broach biases and assumptions regarding gender in counseling and supervision to prevent them from affecting clients. Counselors must understand the impact of gender and age on highly stigmatized topics, such as TDV and sexuality, to prevent biases and misunderstandings from guiding assessment and treatment. Counselor educators can teach students about TDV using theoretical lenses that deconstruct stigma. For example, a feminist perspective could lend to classroom dialogue uncovering societal power differentials. At the same time, structural functionalism theory or conflict theory could offer unique lenses to discuss systemic inequities in the quality and delivery of mental health care.

Counselor education programs are essential in helping counseling students develop strong case conceptualization skills that affirm diverse clients and consider strengths-based and trauma-informed interventions. Therefore, counselor training must incorporate instruction and practice for adolescent risk assessment of TDV. Counseling students who gain experience using TDV screening tools may increase their confidence when clinical decision-making is required, such as disclosing abuse. Mandatory reporting is not always transparent for students. Instructional role plays and a review of the limitations of confidentiality may also prompt further growth and development for counseling students, in addition to reviewing state laws and any differences with our profession’s ethical guidelines. Research demonstrates that teens fear the information counselors report to their parents or caregivers from counseling sessions. In contrast, caregivers can often lack the ability to respond appropriately to this information (Black et al., 2015). Thus, counselors must understand the critical role of establishing trust and rapport with teens experiencing TDV to strengthen the therapeutic relationship and ability to work together and increase support and trust within the family system.

Limitations and Future Research Directions
     Research findings must always be considered in the context of the existing limitations. One limitation was that the study included a sample of counseling students across three universities in the southern region of the United States and we did not delineate the number of students affiliated with each university. The study may have benefited from a more diverse sample across many CACREP-accredited programs. The students in the study pertained to four different tracks (school, mental health, marriage and family therapy, and rehabilitation counseling), with some non–degree-seeking students and doctoral students. Although this illuminates overarching gaps in the counseling profession, future researchers may examine differences between specializations, allowing for more in-depth assessments and recommendations for training and continuing education.

Additionally, we did not inquire about counseling students’ strategies and decision-making processes to develop their case conceptualizations and treatment decisions. This data would have been beneficial for counselor educators to address these areas early on in training. A final limitation of the study included the use of binary gender identities and heterosexual relationships in the case vignettes. Although the present research may provide a framework for future studies to build upon, it is essential to note that TDV occurs across diverse populations, including LGBTQ+ youth. As such, future research should examine counseling students’ conceptualization of TDV within diverse communities and relationships. This would further illuminate disparities and challenges in the conceptualization and treatment of TDV, shedding light on areas needing attention in counselor training.


     Counseling students must develop self-awareness and knowledge of TDV to treat the transgenerational cycle of violence, thereby preventing or addressing potential mental health consequences. To do so, students must understand the etiology of violence, manifestations of violence in relationships, and trauma-informed conceptualization and treatment of violence. Although such training must begin in counselor education programs and continue after graduation (Murray et al., 2016; Wozny, 2005), this study revealed the importance of reflexivity and self-awareness on existing biases, assumptions, and beliefs on TDV. Counselor biases can significantly impact client treatment outcomes (Karakurt et al., 2013). Therefore, personal biases must be recognized early in training to prevent harmful and stigmatizing treatment of clients experiencing TDV.

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.



American Psychiatric Association. (2019). Treating women who have experienced intimate partner violence.

Ball, B., Holland, K. M., Marshall, K. J., Lippy, C., Jain, S., Souders, K., & Westby, R. P. (2015). Implementing a targeted teen dating abuse prevention program: Challenges and successes experienced by Expect Respect facilitators. Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 56(2), Supp. 2, S40–S46. https://doi.org/10.1016/j.jadohealth.2014.06.021

Black, B. M., Weisz, A. N., Preble, K. M., & Sharma, B. (2015). Parents’ awareness of and anticipated responses to their teens’ reports of dating violence. Journal of Family Social Work, 18(1), 3–20.

Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. SAGE.

Braun, V., & Clarke, V. (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport, Exercise and Health, 13(2), 201–216. https://doi.org/10.1080/2159676X.2019.1704846

Bruchmüller, K., Margraf, J., & Schneider, S. (2012). Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal of Consulting and Clinical Psychology, 80(1), 128–138. https://doi.org/10.1037/a0026582

Centers for Disease Control and Prevention. (2021). Fast facts: Preventing teen dating violence. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html

Clarke, V., & Braun, V. (2018). Using thematic analysis in counselling and psychotherapy research: A critical reflection. Counselling and Psychotherapy Research, 18(2), 107–110. https://doi.org/10.1002/capr.12165

Council for Accreditation of Counseling and Related Educational Programs. (2015). 2016 CACREP standards. http://www.cacrep.org/wp-content/uploads/2017/08/2016-Standards-with-citations.pdf

Cutter-Wilson, E., & Richmond, T. (2011). Understanding teen dating violence: Practical screening and intervention strategies for pediatric and adolescent healthcare providers. Current Opinion in Pediatrics, 23(4), 379–383. https://doi.org/10.1097/MOP.0b013e32834875d5

de Macedo, J. Q., Khanlou, N., & Luis, M. A. V. (2015). Use of vignettes in qualitative research on drug use: Scoping review and case example from Brazil. International Journal of Mental Health and Addiction, 13(5), 549–562. https://doi.org/10.1007/s11469-015-9543-4

Eisner, M. (2021). The gender symmetry problem in physical teen dating violence: A commentary and suggestions for a research agenda. New Directions for Child and Adolescent Development, 2021(178), 157–168. https://doi.org/10.1002/cad.20443

Emelianchik-Key, K., Byrd, R., & Gill, C. S. (2022). Dating violence and the impact of technology: Examining the lived experiences of sorority members. Violence Against Women, 28(1), 73–92.

Foshee, V. A., McNaughton Reyes, H. L., Gottfredson, N. C., Chang, L.-Y., & Ennett, S. T. (2013). A longitudinal examination of psychological, behavioral, academic, and relationship consequences of dating abuse victimization among a primarily rural sample of adolescents. Journal of Adolescent Health, 53(6), 723–729. https://doi.org/10.1016/j.jadohealth.2013.06.016

Fruzzetti, A. E. (2017, October 3). Why borderline personality disorder is misdiagnosed. National Alliance on Mental Illness. https://www.nami.org/Blogs/NAMI-Blog/October-2017/Why-Borderline-Personality-Disorder-is-Misdiagnose

Goncy, E. A., Sullivan, T. N., Farrell, A. D., Mehari, K. R., & Garthe, R. C. (2017). Identification of patterns of dating aggression and victimization among urban early adolescents and their relations to mental health symptoms. Psychology of Violence, 7(1), 58–68. https://doi.org/10.1037/vio0000039

Hays, D. G., McLeod, A. L., & Prosek, E. (2009). Diagnostic variance among counselors and counselor trainees. Measurement and Evaluation in Counseling and Development, 42(1), 3–14.

Henriksen, R. C., Jr., Nelson, J., & Watts, R. E. (2010). Specialty training in counselor education programs: An exploratory study. Journal of Professional Counseling: Practice, Theory & Research, 38(1), 39–51.

Hughes, R. (1998). Considering the vignette technique and its application to a study of drug injecting and HIV risk and safer behaviour. Sociology of Health & Illness, 20(3), 381–400. https://doi.org/10.1111/1467-9566.00107

Hunt, B. (2011). Publishing qualitative research in counseling journals. Journal of Counseling & Development, 89(3), 296–300. https://doi.org/10.1002/j.1556-6678.2011.tb00092.x

Hunt, K. E., Robinson, L. E., Valido, A., Espelage, D. L., & Hong, J. S. (2022). Teen dating violence victimization: Associations among peer justification, attitudes toward gender inequality, sexual activity, and peer
victimization. Journal of Interpersonal Violence, 37(9–10), 5914–5936. https://doi.org/10.1177/08862605221085015

Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Queen, B., Lowry, R., Chyen, D., Whittle, L., Thornton, J., Lim, C., Bradford, D., Yamakawa, Y., Leon, M., Brener, N., & Ethier, K. A. (2018). Youth Risk Behavior Surveillance – United States, 2017. Morbidity and Mortality Weekly Report Surveillance Summaries, 67(8), 1–114. https://doi.org/10.15585/mmwr.ss6708a1

Karakurt, G., Dial, S., Korkow, H., Mansfield, T., & Banford, A. (2013). Experiences of marriage and family therapists working with intimate partner violence. Journal of Family Psychotherapy, 24(1), 1–16.

Khubchandani, J., Price, J. H., Thompson, A., Dake, J. A., Wiblishauser, M., & Telljohann, S. K. (2012). Adolescent dating violence: A national assessment of school counselors’ perceptions and practices. Pediatrics, 130(2), 202–210. https://doi.org/10.1542/peds.2011-3130

Machado, A., Hines, D., & Douglas, E. M. (2020). Male victims of female-perpetrated partner violence: A qualitative analysis of men’s experiences, the impact of violence, and perceptions of their worth. Psychology of Men & Masculinities, 21(4), 612–621. https://doi.org/10.1037/men0000285

Maghsoudi, M. (2018). Addressing counselor stigma in working with female intimate partner violence survivors. Journal of Professional Counseling: Practice, Theory & Research, 45(1), 33–44.

Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and Adolescent Psychiatry and Mental Health, 11(5), 1–11.

Morris, C. A. W., & Minton, C. A. B. (2012). Crisis in the curriculum? New counselors’ crisis preparation, experiences, and self-efficacy. Counselor Education and Supervision, 51(4), 256–269.

Murray, C. E., King, K., & Crowe, A. (2016). Understanding and addressing teen dating violence: Implications for family counselors. The Family Journal, 24(1), 52–59. https://doi.org/10.1177/1066480715615668

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the
trustworthiness criteria. International Journal of Qualitative Methods, 16(1), 1–13.

Offenhauer, P., & Buchalter, A. (2011). Teen dating violence: A literature review and annotated bibliography. Library of Congress, Federal Research Division. https://www.ojp.gov/pdffiles1/nij/grants/235368.pdf

Ogbe, E., Harmon, S., Van den Bergh, R., & Degomme, O. (2020). A systematic review of intimate partner violence interventions focused on improving social support and mental health outcomes of survivors. PLOS ONE, 15(6), e0235177. https://doi.org/10.1371/journal.pone.0235177

Scott, N. P. (2017). Misdiagnosis or comorbidity: Borderline personality disorder in a patient diagnosed with bipolar disorder. The American Journal of Psychiatry Residents’ Journal, 12(10), 4–5.

Sperry, L., & Sperry, J. (2020). Case conceptualization: Mastering this competency with ease and confidence. Routledge.

St. Marie, B., Jimmerson, A., Perkhounkova, Y., & Herr, K. (2021). Developing and establishing content validity of vignettes for health care education and research. Western Journal of Nursing Research, 43(7), 677–685. https://doi.org/10.1177/0193945920969693

Swahn, M. H., Alemdar, M., & Whitaker, D. J. (2010). Nonreciprocal and reciprocal dating violence and injury occurrence among urban youth. Western Journal of Emergency Medicine, 11(3), 264–268.

Temple, J. R., Le, V. D., Muir, A., Goforth, L., & McElhany, A. L. (2013). The need for school-based teen dating violence prevention. Journal of Applied Research on Children: Informing Policy for Children at Risk, 4(1), 1–11. https://doi.org/10.58464/2155-5834.1136

Turner, H. A., Finkelhor, D., Hamby, S. L., Shattuck, A., & Ormrod, R. K. (2011). Specifying type and location of peer victimization in a national sample of children and youth. Journal of Youth and Adolescence, 40, 1052–1067. https://doi.org/10.1007/s10964-011-9639-5

Walker, A., Lyall, K., Silva, D., Craigie, G., Mayshak, R., Costa, B., Hyder, S., & Bentley, A. (2020). Male victims of female-perpetrated intimate partner violence, help-seeking, and reporting behaviors: A qualitative study. Psychology of Men & Masculinities, 21(2), 213–223. https://doi.org/10.1037/men0000222

Wozny, D. A. (2005). The prevalence of suicide and violence assessment/intervention courses in CACREP and COAMFTE-accredited counseling curriculums. In G. R. Waltz and R. Yep (Eds.), VISTAS: Compelling perspectives on counseling 2005 (pp. 271–274). American Counseling Association.


Female Case Vignette

Jordan is a 17-year-old female in her junior year of high school. Her teacher referred her for assistance from the school counselor after she began struggling academically. Jordan’s parents had also become concerned when Jordan’s grades dropped from As and Bs to Cs and a D in less than one school year, and she had begun isolating herself from her friends, even quitting the basketball team that she had loved.

During her initial session with her school’s guidance counselor, Jordan discussed being increasingly distracted in class and being unable to complete her assignments on time. Jordan also discussed being happy and in her first serious relationship with a boyfriend during this past year but reports that she hasn’t quite felt like herself lately. Jordan disclosed that she quit the basketball team to spend more time with her boyfriend because she wanted to prove her love to him, as he would become anxious whenever she was without him. She states they love each other very much and proves this by spending as much time as she can with him and sharing everything, including the passwords for all her social media accounts. Jordan notes that her boyfriend was more physically experienced with relationships, and her past boyfriends “strayed,” so these were things she wanted to do to make him feel “safe and secure.” She also stated that she had past relationships, but nothing serious or that went beyond kissing. The couple recently advanced in their sexual relationship because her boyfriend said he couldn’t date someone who wasn’t physically and emotionally close to him. Jordan didn’t want to lose him and went ahead with what she called the “next step” in their sexual relationship so he would not break up with her.

Jordan wasn’t sure why her grades were slipping but said things were fine at home, and she loved having a boyfriend. She appears to discuss her friends and basketball teammates fondly, but says her relationship is better without them. When Jordan was in basketball, her boyfriend would call and text her 20 plus times after practice let out until he heard back. She said quitting helped with his anxiety and her stress of dealing with all the calls. She stated that she had no energy to commit to basketball or hanging out with friends. Her focus was on school and her boyfriend.

Jordan appeared willing to try to improve her grades and said her boyfriend and parents supported these efforts. She reports her boyfriend has been tutoring her and helping her study when they are together because he told her he doesn’t want a “stupid girlfriend.” Jordan reports this as “playful teasing” and his “way to motivate” her. Jordan wants to go to college, but she is concerned that her recent drop in grades will affect her school admission. She is unsure why she cannot concentrate. She has been tired lately and said she’s just “in a funk” that she needs to shake off.

Her parents reported wanting her grades to improve, and Jordan seems preoccupied lately. Her parents don’t know how to improve her focus in school and at home but seem supportive. They said they appreciate her boyfriend’s “tutoring” as Jordan refers to it. Jordan was cooperative and pleasant in the session.

Note. The case vignette presented here is that of a female teen client. An identical vignette for a male teen client was also utilized during the study. The only difference in cases was the identified gender of the client and their partner; names, scenarios, and all non-gendered wording remained the same.


  1. Provide a brief case conceptualization for this client. Be as specific as possible and note any clinical impressions.
  2. What is your diagnosis (if you feel one is warranted) or any diagnostic impressions related to Jordan’s behaviors? Please be specific and include any V codes if you believe they are justified.
  3. What would be your treatment approach when working with Jordan, and what areas would be your treatment goals for Jordan?
  4. Are there any relationship considerations to incorporate in your work with Jordan?
  5. Are there any additional clinical or practice concerns you might have in working with Jordan?
  6. Is there anything else you would like to share about working with Jordan that has not been mentioned elsewhere?

Kelly Emelianchik-Key, PhD, NCC, ACS, LMFT, LMHC, is an associate professor at Florida Atlantic University. Bridget Glass, PhD, LMHC, is an assistant professor at South University. Adriana C. Labarta, PhD, LMHC, is an assistant professor at Florida Atlantic University. Correspondence may be addressed to Kelly Emelianchik-Key, 777 Glades Road, Bldg 47, Room 275, Boca Raton, FL 33431, Kemelian@fau.edu.

The Research Identity Scale: Psychometric Analyses and Scale Refinement

Maribeth F. Jorgensen, William E. Schweinle

The 68-item Research Identity Scale (RIS) was informed through qualitative exploration of research identity development in master’s-level counseling students and practitioners. Classical psychometric analyses revealed the items had strong validity and reliability and a single factor. A one-parameter Rasch analysis and item review was used to reduce the RIS to 21 items. The RIS offers counselor education programs the opportunity to promote and quantitatively assess research-related learning in counseling students.

Keywords: Research Identity Scale, research identity, research identity development, counselor education, counseling students

With increased accountability and training standards, professionals as well as professional training programs have to provide outcomes data (Gladding & Newsome, 2010). Traditionally, programs have assessed student learning through outcomes measures such as grade point averages, comprehensive exam scores, and state or national licensure exam scores. Because of the goals of various learning processes, it may be important to consider how to measure learning in different ways (e.g., change in behavior, attitude, identity) and specific to the various dimensions of professional counselor identity (e.g., researcher, advocate, supervisor, consultant). Previous research has focused on understanding how measures of research self-efficacy (Phillips & Russell, 1994) and research interest (Kahn & Scott, 1997) allow for an objective assessment of research-related learning in psychology and social work programs. The present research adds to previous literature by offering information about the development and applications of the Research Identity Scale (RIS), which may provide counseling programs with another approach to measure student learning.

Student Learning Outcomes

When deciding how to measure the outcomes of student learning, it is important that programs start with defining the student learning they want to take place (Warden & Benshoff, 2012). Student learning outcomes focus on intellectual and emotional growth in students as a result of what takes place during their training program (Hernon & Dugan, 2004). Student learning outcomes are often guided by the accreditation standards of a particular professional field. Within the field of counselor education, the Council for Accreditation of Counseling & Related Educational Programs (CACREP) is the accrediting agency. CACREP promotes quality training by defining learning standards and requiring programs to provide evidence of their effectiveness in meeting those standards. In relation to research, the 2016 CACREP standards require research to be a part of professional counselor identity development at both the entry level (e.g., master’s level) and doctoral level. The CACREP research standards emphasize the need for counselors-in-training to learn the following:

The importance of research in advancing the counseling profession, including how to critique research to inform counseling practice; identification of evidence-based counseling practices; needs assessments; development of outcome measures for counseling programs; evaluation of counseling interventions and programs; qualitative quantitative, and mixed research methods; designs in research and program evaluation; statistical methods used in conducting research and program evaluation; analysis and use of data in counseling; ethically and culturally relevant strategies for conducting, interpreting, and reporting results of research and/or program evaluation. (CACREP, 2016, p .14)

These CACREP standards not only suggest that counselor development needs to include curriculum that focuses on and integrates research, but also identify a possible need to have measurement tools that specifically assess research-related learning (growth).

Research Learning Outcomes Measures

The Self-Efficacy in Research Measure (SERM) was designed by Phillips and Russell (1994) to measure research self-efficacy, which is similar to the construct of research identity. The SERM is a 33-item scale with four subscales: practical research skills, quantitative and computer skills, research design skills, and writing skills. This scale is internally consistent (α = .96) and scores highly correlate with other components such as research training environment and research productivity. The SERM has been adapted for assessment in psychology (Kahn & Scott, 1997) and social work programs (Holden, Barker, Meenaghan, & Rosenberg, 1999).

Similarly, the Research Self-Efficacy Scale (RSES) developed by Holden and colleagues (1999) uses aspects of the SERM (Phillips & Russell, 1994), but includes only nine items to measure changes in research self-efficacy as an outcome of research curriculum in a social work program. The scale has excellent internal consistency (α = .94) and differences between pre- and post-tests were shown to be statistically significant. Investigators have noticed the value of this scale and have applied it to measure the effectiveness of research courses in social work training programs (Unrau & Beck, 2004; Unrau & Grinnell, 2005).

Unrau and Beck (2004) reported that social work students gained confidence in research when they received courses on research methodology. Students gained most from activities outside their research courses, such as participating in research with faculty members. Following up, Unrau and Grinnell (2005) administered the scale prior to the start of the semester and at the end of the semester to measure change in social work students’ confidence in doing research tasks. Overall, social work students varied greatly in their confidence before taking research courses and made gains throughout the semester. Unrau and Grinnell stressed their results demonstrate the need for the use of pre- and post-tests to better gauge the way curriculum impacts how students experience research.

Previous literature supports the use of scales such as the SERM and RSES to measure the effectiveness of research-related curricula (Holden et al., 1999; Kahn & Scott, 1997; Unrau & Beck, 2004; Unrau & Grinnell, 2005). These findings also suggest the need to continue exploring the research dimension of professional identity. It seems particularly important to measure concepts such as research self-efficacy, research interest, and research productivity, all of which are a part of research identity (Jorgensen & Duncan, 2015a, 2015b).

Research Identity as a Learning Outcome

The concept of research identity (RI) has received minimal attention (Jorgensen & Duncan, 2015a, 2015b; Reisetter et al., 2004). Reisetter and colleagues (2004) described RI as a mental and emotional connection with research. Jorgensen and Duncan (2015a) described RI as the magnitude and quality of relationship with research; the allocation of research within a broader professional identity; and a developmental process that occurs in stages. Scholars have focused on qualitatively exploring the construct of RI, which may give guidance around how to facilitate and examine RI at the program level (Jorgensen & Duncan, 2015a, 2015b; Reisetter et al., 2004). Also, the 2016 CACREP standards include language (e.g., knowledge of evidence-based practices, analysis and use of data in counseling) that favors curriculum that would promote RI. Although previous researchers have given the field prior knowledge of RI (Jorgensen & Duncan, 2015a, 2015b; Reisetter et al., 2004), there has been no focus on further exploring RI in a quantitative way and in the context of being a possible measure of student learning. The first author developed the RIS with the aim of assessing RI through a quantitative lens and augmenting traditional learning outcomes measures such as grades, grade point averages, and standardized test scores. There were three purposes for the current study: (a) to develop the RIS; (b) to examine the psychometric properties of the RIS from a classical testing approach; and (c) to refine the items through future analysis based on the item response theory (Nunnally & Bernstein, 1994). Two research questions guided this study: (a) What are the psychometric properties of the RIS from a classical testing approach? and (b) What items remain after the application of an item response analysis?



The participants consisted of a convenience sample of 170 undergraduate college students at a Pacific Northwest university. Sampling undergraduate students is a common practice when initially testing scale psychometric properties and employing item response analysis (Embretson & Reise, 2000; Heppner, Wampold, Owen, Thompson, & Wang, 2016). The mean age of the sample was 23.1 years (SD = 6.16) with 49 males (29%), 118 females (69%), and 3 (2%) who did not report gender. The racial identity composition of the participants was mostly homogenous: 112 identified as White (not Hispanic); one identified as American Indian or Alaska Native; 10 identified as Asian; three identified as Black or African American; eight identified as multiracial; 21 identified as Hispanic; three identified as “other”; and seven preferred not to answer.


There were three instruments used in this study: a demographic questionnaire, the RSES, and the RIS.

Demographics questionnaire. Participants were asked to complete a demographic sheet that included five questions about age, gender, major, race, and current level of education; these identifiers did not pose risk to confidentiality of the participants. All information was stored on the Qualtrics database, which was password protected and only accessible by the primary investigator.

The RSES. The RSES was developed by Holden et al. (1999) to measure effectiveness of research education in social work training programs. The RSES has nine items that assess respondents’ level of confidence with various research activities. The items are answered on a 0–100 scale with 0 indicating cannot do at all, 50 indicating moderately certain I can do, and 100 indicating certainly can do. The internal consistency of the scale is .94 at both pre- and post-measures. Holden and colleagues reported using an effect size estimate to assess construct validity but did not report these estimates, so there should be caution when assuming this form of validity.

RIS. The initial phase of this research involved the first author developing the 68 items on the RIS (contact first author for access) based on data from her qualitative work about research identity (Jorgensen & Duncan, 2015a). The themes from her qualitative research informed the development of items on the scale (Jorgensen & Duncan, 2015a). Rowan and Wulff (2007) have suggested that using qualitative methods to inform scale development is appropriate, sufficient, and promotes high quality instrument construction.

The first step in developing the RIS items involved the first author analyzing the themes that surfaced during interviews with participants in her qualitative work. This process helped inform the items that could be used to quantitatively measure RI. For example, one theme was Internal Facilitators. Jorgensen and Duncan (2015a) reported that, “participants explained the code of internal facilitators as self-motivation, time management, research self-efficacy, innate traits and thinking styles, interest, curiosity, enjoyment in the research process, willingness to take risks, being open-minded, and future goals” (p. 24). An example of scale items that were operationalized from the theme Internal Facilitators included: 1) I am internally motivated to be involved with research on some level; 2) I am willing to take risks around research; 3) Research will help me meet future goals; and 4) I am a reflective thinker. The first author used that same process when operationalizing each of the qualitative themes into items on the RIS. There were eight themes of RI development (Jorgensen & Duncan, 2015a). Overall, the number of items per theme was proportionate to the strength of theme, as determined by how often it was coded in the qualitative data. After the scale was developed, the second author reviewed the scale items and cross-checked items with the themes and subthemes from the qualitative studies to evaluate face validity (Nunnally & Bernstein, 1994).
The items on the RIS are short with easily understandable terms in order to avoid misunderstanding and reduce perceived cost of responding (Dillman, Smyth, & Christian, 2009). According to the Flesch Reading Ease calculator, the reading level of the scale is 7th grade (Readability Test Tool, n.d.). The format of answers to each item is forced choice. According to Dillman et al. (2009), a forced-choice format “lets the respondent focus memory and cognitive processing efforts on one option at a time” (p. 130). Individuals completing the scale are asked to read each question or phrase and respond either yes or no. To score the scale, a yes would be scored as one and a no would be scored as zero. Eighteen items are reverse-scored (item numbers 11, 23, 28, 32, 39, 41, 42, 43, 45, 48, 51, 53, 54, 58, 59, 60, 61, 62), meaning that with those 18 questions an answer of no would be scored as a one and an answer of yes would be scored as a zero. Using a classical scoring method (Heppner et al., 2016), scores for the RIS are determined by adding up the number of positive responses. Higher scores indicate a stronger RI overall.


Upon Institutional Review Board approval, the study instruments were uploaded onto the primary investigator’s Qualtrics account. At that time, information about the study was uploaded onto the university psychology department’s human subject research system (SONA Systems). Once registered on the SONA system, participants were linked to the instruments used for this study through Qualtrics. All participants were asked to read an informational page that briefly described the nature and purpose of the study, and were told that by continuing they were agreeing to participate in the study and could discontinue at any time. Participants consented by selecting “continue” and completed the questionnaire and instruments. After completion, participants were directed to a post-study information page on which they were thanked and provided contact information about the study and the opportunity to schedule a meeting to discuss research findings at the conclusion of the study. No identifying information was gathered from participants. All information was stored on the Qualtrics database.


All analyses were conducted in SAS 9.4 (SAS Institute, 2012). The researchers first used classical methods (e.g., KR20 and principal factor analysis) to examine the psychometric properties of the RIS. Based on the results of the factor analysis, the researchers used results from a one-parameter Rasch analysis to reduce the number of items on the RIS.

Classical Testing

Homogeneity was explored by computing Kuder-Richardson 20 (KR20) alphas. Across all 68 items the internal consistency was strong (.92). Concurrent validity (i.e., construct validity) was examined by looking at correlations between the RIS and the RSES. The overall correlation between the RIS and the RSES was .66 (p < .001).

Item Response Analysis

Item response theory brought about a new perspective on scale development (Embretson & Reise, 2000) in that it promoted scale refinement even at the initial stages of testing. Item response theory allows for shorter tests that can actually be more reliable when items are well-composed (Embretson & Reise, 2000). The RIS initially included 68 items. Through Rasch analyses, the scale was reduced to 21 items (items numbered 3, 4, 9, 10, 12, 13, 16, 18, 19, 24, 26, 34, 39, 41, 42, 43, 44, 46, 47, 49, 61).

The final 21 items were selected for their dispersion across location on theta in order to widely capture the constructs. The polychoric correlation matrix for the 21 items was then subjected to a principal components analysis yielding an initial eigenvalue of 11.72. The next eigenvalue was 1.97, which clearly identified the crook of the elbow. Further, Cronbach’s alpha for these 21 items was .90. Taken together, these results suggest that the 21-item RIS measures a single factor.

This conclusion was further tested by fitting the items to a two-parameter Rasch model (AIC = 3183.1). Slopes were constrained to unity (1.95), and item location estimates are presented in Table 1. Bayesian a posteriori scores also were estimated and strongly correlated with classical scores (i.e., tallies of the number of positive responses [r = .95, p < .0001]).


This scale represents a move from subjective to a more objective assessment of RI. In the future, the scale may be used with other student and non-student populations to better establish its psychometric properties, generalizability, and refinement. Although this study sampled undergraduate students, this scale may be well-suited to use with counseling graduate students and practitioners because items were developed based on a qualitative study with master’s-level counseling students and practicing counselors (Jorgensen & Duncan, 2015a).

Additionally, this scale offers another method for assessing student learning and changes that take place for both students and professionals. As indicated by Holden et al. (1999), it is important to assess learning in multiple ways. Traditional methods may have focused on measuring outcomes that reflect a performance-based, rather than a mastery-based, learning orientation. Performance-based learning has been defined as wanting to learn in order to receive external validation such as a grade (Bruning, Schraw, Norby, & Ronning, 2004). Mastery learning has been defined as wanting to learn for personal benefit and with the goal of applying information to reach a more developed personal and professional identity (Bruning et al., 2004).

Based on what is known about mastery learning (Bruning et al., 2004), students with this type of learning orientation experience identity changes that may be best captured through assessing changes in thoughts, attitudes, and beliefs. The RIS was designed to measure constructs that capture internal changes that may be reflective of a mastery learning orientation. A learner who is performance-oriented may earn an A in a research course but show a lower score on the RIS. The opposite also may be true in that a learner may earn a C in a research course but show higher scores on the RIS. Through the process of combining traditional assessment methods such as grades with the RIS, programs may get a more comprehensive understanding of the effectiveness and impact of their research-related curriculum.


Table 1.

Item location estimates.

RIS Item Location Estimate
Item 3 -2.41
Item 4 -1.80
Item 10 -3.16
Item 13 -.86
Item 16 -.94
Item 19 -3.08
Item 24 -2.86
Item 9 -1.10
Item 12 .42
Item 18 -2.24
Item 26 -2.20
Item 39 .20
Item 42 -1.28
Item 44 -.76
Item 34 -1.27
Item 41 -.76
Item 43 -1.47
Item 46 -2.03
Item 47 -2.84
Item 49 1.22
Item 61 -.44


Limitations and Areas for Future Research

The sample size and composition were sufficient for the purposes of the initial development and classical testing and item response analysis (Heppner et al., 2016); however, these authors still suggest caution when applying the results of this study to other populations. Endorsements of the participants may not reflect answers of the population in other areas of the country or different academic levels. Future research should sample other student and professional groups. This will help to further establish the psychometric properties and item response analysis conclusions and make the RIS more appropriate for use in other fields. Additionally, future research may examine how scores on the RIS correlate with traditional measures of learning (e.g., grades in individual research courses, collapsed grades in all research courses, research portion on counselor licensure exams).


As counselors-in-training and professional counselors are increasingly being required to demonstrate they are using evidence-based practices and measuring the effectiveness of their services, they may benefit from assessments of their RI (American Counseling Association, 2014; Gladding & Newsome, 2010). CACREP (2016) has responded to increased accountability by enhancing their research and evaluation standards for both master’s- and doctoral-level counseling students. The American Counseling Association is further supporting discussions about RI by publishing a recent blog post titled “Research Identity Crisis” (Hennigan Paone, 2017). In the post, Hennigan Paone described a hope for master’s-level clinicians to start acknowledging and appreciating that research helps them work with clients in ways that are informed by “science rather than intuition” (para. 5). As the calling becomes stronger for counselors to become more connected to research, it seems imperative that counseling programs assess their effectiveness in bridging the gap between research and practice. The RIS provides counseling programs an option to do exactly that by evaluating the way students are learning and growing in relation to research. Further, the use of this type of outcome measure could provide for good modeling at the program level; in that, the hope would be that it would encourage counselors-in-training to develop both a curiosity and motivation to infuse research practices (e.g., needs assessments, outcome measures, data analysis) into their clinical work.


Conflict of Interest and Funding Disclosure 

The authors reported no conflict of interest or funding contribu tions for the developmentof this manuscript.



American Counseling Association. (2014). 2014 ACA code of ethics. Alexandria, VA: Author.

Bruning, R. H., Schraw, G. J., Norby, M. M., & Ronning, R. R. (2004). Cognitive psychology and instruction (4th ed.). Upper Saddle River, NY: Pearson Merrill/Prentice Hall.

Council for Accreditation of Counseling & Related Educational Programs. (2016). 2016 CACREP standards. Retrieved from http://www.cacrep.org/wp-content/uploads/2017/07/2016-Standards-with-Glossary-7.2017.pdf

Dillman, D. A., Smyth, J. D., & Christian, L. M. (2009). Internet, mail, and mixed-mode surveys: The tailored design method (3rd ed.). Hoboken, NJ: John Wiley & Sons, Inc.

Embretson, S. E., & Reise, S. P. (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum.

Gladding, S. T., & Newsome, D. W. (2010). Clinical mental health counseling in community and agency settings (3rd ed.). Upper Saddle River, NJ: Prentice Hall.

Hennigan Paone, C. (2017, December 15). Research identity crisis? [Blog post]. Retrieved from https://www.counseling.org/news/aca-blogs/aca-member-blogs/aca-member-blogs/2017/12/15/research-identity-crisis

Heppner, P. P., Wampold, B. E., Owen, J., Thompson, M. N., & Wang, K. T. (2015). Research design in counseling (4th ed.). Boston, MA: Cengage Learning.

Hernon, P. & Dugan, R. E. (2004). Four perspectives on assessment and evaluation. In P. Hernon & R. E. Dugan (Eds.), Outcome assessment in higher education: Views and perspectives (pp. 219–233). Westport, CT: Libraries Unlimited.

Holden, G., Barker, K., Meenaghan, T., & Rosenberg, G. (1999). Research self-efficacy: A new possibility for educational outcomes assessment. Journal of Social Work Education, 35, 463–476.

Jorgensen, M. F., & Duncan, K. (2015a). A grounded theory of master’s-level counselor research identity. Counselor Education and Supervision, 54, 17–31. doi:10.1002/j.1556-6978.2015.00067

Jorgensen, M. F., & Duncan, K. (2015b). A phenomenological investigation of master’s-level counselor research identity development stages. The Professional Counselor, 5, 327–340. doi:10.15241/mfj.5.3.327

Kahn, J. H., & Scott, N. A. (1997). Predictors of research productivity and science-related career goals among
counseling psychology doctoral students. The Counseling Psychologist, 25, 38–67. doi:10.1177/0011000097251005

Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York, NY: McGraw-Hill.

Phillips, J. C., & Russell, R. K. (1994). Research self-efficacy, the research training environment, and research productivity among graduate students in counseling psychology. The Counseling Psychologist, 22, 628–641. doi:10.1177/0011000094224008

Readability Test Tool. (n.d.). Retrieved from https://www.webpagefx.com/tools/read-able/

Reisetter, M., Korcuska, J. S., Yexley, M., Bonds, D., Nikels, H., & McHenry, W. (2004). Counselor educators and qualitative research: Affirming a research identity. Counselor Education and Supervision, 44, 2–16. doi:10.1002/j.1556-6978.2004.tb01856.x

Rowan, N., & Wulff, D. (2007). Using qualitative methods to inform scale development. The Qualitative Report, 12, 450–466.

SAS Institute [Statistical software]. (2012). Retrieved from https://www.sas.com/en_us/home.html

Unrau, Y. A., & Beck, A. R. (2004). Increasing research self-efficacy among students in professional academic programs. Innovative Higher Education, 28(3), 187–204.

Unrau, Y. A., & Grinnell,, R. M., Jr. (2005). The impact of social work research courses on research self-efficacy for social work students. Social Work Education, 24, 639–651. doi:10.1080/02615470500185069

Warden, S., & Benshoff, J. M. (2012). Testing the engagement theory of program quality in CACREP-accredited counselor education programs. Counselor Education & Supervision, 51, 127–140.


Maribeth F. Jorgensen, NCC, is an assistant professor at the University of South Dakota. William E. Schweinle is an associate professor at the University of South Dakota. Correspondence can be addressed to Maribeth Jorgensen, 414 East Clark Street, Vermillion, SD 57069, maribeth.jorgensen@usd.edu.

Factors Influencing Counseling Students’ Enrollment Decisions: A Focus on CACREP

Eleni M. Honderich, Jessica Lloyd-Hazlett

A purposeful sample of 359 graduate counseling students completed a survey assessing factors influencing program enrollment decisions with particular attention to students’ awareness of and importance ascribed to accreditation from the Council for Accreditation of Counseling and Related Educational Programs (CACREP) prior to and following enrollment. Results indicated that accreditation was the second most influential factor in one half of the students’ enrollment decisions; nearly half of participants were unaware of CACREP accreditation prior to enrollment. Accreditation was a top factor that students attending non-CACREP-accredited programs wished they had considered more in their enrollment decisions. Findings from the survey indicate that prospective counseling students often lack necessary information regarding accreditation that may influence enrollment decisions. Implications for counseling students and their graduate preparation programs, CACREP and the broader counseling profession are discussed.

Keywords: CACREP, accreditation, counseling students, enrollment decisions, graduate preparation programs


The Council for Accreditation of Counseling and Related Educational Programs (CACREP) provides specialized accreditation for counselor education programs. Within higher education, accreditation is a “quality assurance and enhancement mechanism” premised on self-regulation through intensive self-study and external program review (Urofsky, 2013, p. 6). Accreditation has been reported to be particularly relevant to prospective counseling students, given increases in both the number of programs seeking CACREP accreditation (Ritchie & Bobby, 2011) and implications of program accreditation status for students’ postgraduation opportunities. Research to date has not surveyed counseling students about their knowledge of CACREP accreditation prior to or following enrollment in graduate-level counseling programs.


Graduate Program Enrollment Decisions


For prospective counseling students, selecting an appropriate counselor preparation program for graduate-level study is an exceedingly complex task. Prospective students must choose from a myriad of options across mental health fields, areas of specialization and program delivery formats (i.e., traditional, virtual and hybrid classrooms). Those prospective students who are unfamiliar with CACREP accreditation and potential implications of program accreditation status for postgraduation opportunities may not sufficiently consider accreditation a relevant criterion during selection of a graduate-level counselor education program.


To date, the majority of higher education enrollment research has focused on undergraduate students. Hossler and Gallager (1987) outlined a three-stage college selection model that integrates econometric, sociologic and information-processing concerns of prospective enrollees. The first stage, predisposition, culminates with a decision to attend college or not. Past student achievement, ability and level of educational aspiration, along with parental income, education and encouragement, are important influences at this stage. The second stage, search, includes gathering information about prospective institutions, submitting applications and receiving admission decision(s). Finally, choice, describes the selection of a college or university. Factors influencing enrollment decisions include a variety of personal and institutional characteristics including socioeconomic status, financial costs and aid, academic qualities, location, and recruitment correspondence (Hossler & Gallager, 1987).


Academic reputation, job prospects for graduates, campus visits, campus size and financial aid offerings have been identified as critical factors influencing undergraduate student enrollment decisions (Hilston, 2006). Research also has underscored the weight of parental opinions in shaping undergraduate student enrollment decisions. More limited research has examined factors influencing graduate student enrollment decisions, but appears necessary given differences across contexts of individuals making undergraduate versus graduate-level enrollment decisions.


Within a non-field-specific survey of 2,834 admitted graduate students, Kallio (1995) found the following factors to be most influential in participants’ program selection and enrollment decisions: (a) residency status, (b) quality and other academic environment characteristics, (c) work-related concerns, (d) spouse considerations, (e) financial aid, and (f) campus social environment. A more recent examination of doctoral-level students within higher education administration programs (Poock & Love, 2001) indicated similar influential factors with location, flexibility of accommodations for work–school–life balance, reputation and friendliness of faculty of highest importance. Flexibility of program requirements and delivery format also were indicated. Ivy and Naude (2004) surveyed 507 MBA students and identified a seven-factor model of variables influencing graduate student enrollment decisions. The seven factors were the following: program, prominence, price, prospectus, people, promotion and premium. Students indicated elements of the program, including range of electives and choice of majors; prominence, including staff reputation and program ratings; and price, including tuition fees and payment flexibility, as the most salient factors.


Accreditation and Graduate Program Enrollment Decisions

In a review of the status of accreditation within higher education, Bardo (2009) delineated major trends with implications for both current and prospective students. First, across higher education fields, there is heightened emphasis on accountability through documented student learning outcomes that transcend individual course grades. Second, there are calls for greater transparency around accreditation procedures and statuses. Parallel attention also is given to ethical obligations of institutions and accrediting bodies to provide clearer information to students, not only about the requirements of enrollment in accredited institutions, but also about the significance of accreditation to postgraduation outcomes (Bardo, 2009).


Accreditation is a critical institutional factor that appears to have both a direct and an indirect impact on graduate program enrollment decisions. Most directly, accreditation may be a specific selection criterion used by prospective students when exploring programs for application or when making an enrollment decision among multiple offers. Indirectly, the accreditation status of an institution likely influences each of the seven p’s identified by Ivy and Naude (2004) as informing graduate student enrollment decisions. For example, accreditation may dictate minimum credit requirements, required coursework, program delivery methods and acceptable faculty-to-student ratios. Thus, the need emerges to examine factors informing counseling students’ decisions regarding enrollment in graduate-level programs, with specific attention to students’ levels of awareness and importance ascribed to CACREP accreditation. To contextualize the current study, a brief history of CACREP and perceived benefits and challenges of accreditation are provided.


CACREP History


CACREP held its first board meeting in 1981 and was founded in part as a response to the development of accreditation standards in other helping professions, such as the American Psychological Association, the National Council for Accreditation of Teacher Education and the Council on Rehabilitation Education. In its history of over 30 years, a primary goal of CACREP has been to assist in the development and growth of the counseling profession by promoting and administrating a quality assurance process for graduate programs in the field of counseling (Urofsky, Bobby, & Ritchie, 2013). Currently, just over 63% of programs falling under CACREP’s jurisdiction hold this accreditation; specifically, by the end of 2013, CACREP had accredited 634 programs at 279 institutions within the United States (CACREP, 2014). In the 2012–2013 school year alone, CACREP-accredited programs enrolled 39,502 students and graduated 11,099 students (CACREP, 2014).


As described by Urofsky and colleagues (2013), some revisions to the CACREP standards represent intentional efforts toward growth, self-sufficiency and effectiveness. Such modifications reflected in the 2009 CACREP standards include greater emphases on unified counselor professional identity through specifications for core faculty members and increased focus on documented student learning outcomes in response to larger trends of accountability in higher education. In contrast to these CACREP-directed modifications, Urofsky and colleagues (2013) highlighted that some historical revisions to CACREP standards have been influenced by the larger context of the counseling field. Pertinent contextual issues include licensure portability and recognition from larger federal agencies, including the U.S. Department of Veteran Affairs, Department of Defense and TRICARE, a government-funded insurance company for military personnel. Following the passing of House Bill 232 (License as a Professional Counselor, 2014), Ohio became the first state to require graduation from a CACREP-accredited program (clinical mental health, rehabilitation or addictions counseling) for licensure beginning in 2018. More than 50% of states accept graduation from a CACREP-accredited program as one path for meeting licensure educational requirements (CACREP, 2013). Further, while not directly advocated for by CACREP, graduation from a CACREP-accredited program is required for counselors seeking employment consideration in the Department of Veteran Affairs and the Department of Defense, and for TRICARE reimbursement (TRICARE, 2014).


Perceived Benefits of CACREP Accreditation


Specific benefits of CACREP accreditation have been identified in the literature at both the individual student and institutional levels, which may inform prospective students’ decisions regarding enrollment in graduate-level counseling programs. Perceived benefits of CACREP accreditation identified by entry-level counseling students include increased internship and job opportunities, improved student quality, increased faculty professional involvement and publishing, and increased acceptance into doctoral-level programs in counselor education and supervision (Mascari & Webber, 2013). Doctoral students are assured training that will qualify them to serve as identified core faculty members in CACREP-accredited counseling programs (CACREP, 2009).


Counseling students’ graduate program enrollment decisions also might be influenced by differential benefits afforded to graduates of CACREP-accredited programs who are pursuing professional licensure. Though licensure requirements vary from state to state, a growing number of states place heavier emphasis on the applicant’s receipt of a counseling degree from an accredited program (CACREP, 2013). Some states associate “graduation from a CACREP-accredited program as evidence of meeting most or all of the educational requirements for licensure eligibility” (Ritchie & Bobby, 2011. p. 52). Licensure applicants graduating from non-CACREP-accredited programs may need to provide supplemental documentation to substantiate their training program’s adherence to licensing criteria. In some instances, applicants graduating from non-CACREP-accredited programs may need additional coursework to meet criteria for licensure, which incurs additional costs and delays application processes.


Graduate programs’ CACREP accreditation status might impact counseling students’ enrollment decisions relative to postgraduation insurance reimbursement and qualification for certain job placements (TRICARE, 2014). Specifically, following intensive professional advocacy initiatives, TRICARE began recognizing and reimbursing counseling professionals as mental health service providers without the need for physician referral. However, as of now, counselors graduating from non-CACREP-accredited training programs after January 1, 2015 will be unable to receive approval to practice independently within the TRICARE system. Considering the estimated 9.5 million people insured by TRICARE (TRICARE, 2014), this contingency may present serious implications for counseling professionals who have graduated or will graduate from non-CACREP-accredited training programs. Johnson, Epp, Culp, Williams, and McAllister (2013) noted that thousands of both currently licensed mental health professionals and counseling students will be affected as they “cannot and will not ever be able to join the TRICARE network” (p. 64).


Existing literature also highlights benefits of CACREP accreditation at the program and institutional levels, which may impact counseling students’ graduate program enrollment decisions. Achievement and maintenance of CACREP accreditation entails exhaustive processes of self-study and external peer review. Self- and peer-review processes contribute to shared quality standards among accredited counselor preparation programs and demonstrated student learning outcomes based on standards established by the profession itself (Mascari & Webber, 2013). Faculty members employed by CACREP-accredited counselor education programs also appear to differentially interface with the counseling profession. Specifically, a statistically significant relationship has been found between CACREP accreditation and professionalism for school counselor educators, as reflected by contributions to the profession (i.e., journal publications and conference presentations), leadership in professional organizations and pursuit of counseling credentials (Milsom & Akos, 2005).


Perceived Challenges of CACREP Accreditation


     In addition to highlighting potential benefits of CACREP accreditation, extant literature delineates potential challenges associated with CACREP accreditation, which may directly or indirectly impact counseling students’ graduate program enrollment decisions. Primary among identified challenges are time and financial resources related to the attainment and maintenance of CACREP accreditation (Paradise et al., 2011). Financial requirements associated with CACREP accreditation include application expenses and annual fees, the costs of hiring faculty to meet core faculty requirements and student-to-faculty ratios, and labor costs associated with compiling self-studies.


Considering that the 2009 CACREP standards identify 165 core standards and approximately 60 standards per specialty area (Urofsky, 2013), attaining accreditation can be a cumbersome process. Curricular attention given to each standard can vary widely across programs. In response to significant and longstanding calls for increased accountability in higher education, CACREP-accredited programs are required to identify and provide evidence of student learning outcomes (Barrio Minton & Gibson, 2012). To address this requirement, it may be necessary for some programs to reorganize curricular elements, as well as to integrate assessment software and procedures to support this data collection within their programs.


An additional challenge of CACREP accreditation surrounds perceived limitations placed on program flexibility and innovation. Paradise and colleagues (2011) found that of the counseling program coordinators they interviewed (N = 135), 49% believed that the 2009 CACREP standards “would require all programs to be ‘essentially the same” (p. 50). Among changes ushered in by the 2009 CACREP standards, education and training requirements of core faculty and the designated student-to-faculty ratios have received critical attention (Paradise et al., 2011). Clinical experience beyond the requirements of graduate-level internship is not specifically considered within requisites for identified core faculty members (CACREP, 2009, I.W.). While adopted largely to foster counselors’-in-training internalization of a clear counselor professional identity (Davis & Gressard, 2011), these standard requirements may influence program hiring decisions and curriculum content and sequencing (CACREP, 2009; Paradise et al., 2011).


Over CACREP’s history of more than 30 years, the landscape of the accrediting body, as well as the larger counseling profession it serves, has dramatically shifted. Bobby (2013) called for greater research examining the effects of CACREP accreditation on programs and student knowledge, skill development and graduate performance. A specific gap exists in the literature related to factors influencing counseling students’ graduate program enrollment decisions, including the potential relevance of students’ knowledge of CACREP prior to and following enrollment. Research in this area not only would illuminate counseling students’ propensities for making informed choices as consumers of higher education, but might also reveal critical implications for and ethical obligations of students, programs and CACREP itself within contemporary and complex accreditation climates. Consequently, the current study examined the following research questions: (a) What factors influence students’ decisions regarding enrollment in graduate-level counseling programs? (b) How aware are students of CACREP accreditation prior to and following program enrollment? (c) How important is CACREP accreditation to students prior to and following program enrollment? (d) Is there a difference in CACREP accreditation awareness between students in CACREP- and non-CACREP-accredited programs prior to program enrollment? (e) Does students’ awareness of CACREP-accreditation increase after program enrollment?





In total, 40 graduate-level counseling programs were contacted to participate in this study. A purposeful sample was chosen, seeking participation from four CACREP-accredited and four non-CACREP-accredited programs from each of the five geographic regions within the United States (i.e., Western, Southern, North Atlantic, North Central, Rocky Mountain). For each geographic region, CACREP-accredited and non-CACREP-accredited programs were selected based on the criteria of student body size and status as a public versus private institution. Specifically, within each of the five geographic regions, four institutions (one small [n < 10,000], one large [n > 10,000], one private, one public) were purposefully selected for each accreditation status (CACREP, non-CACREP). Selection criteria did not include cognate focus; however, participants included students within clinical mental health; school; marriage, couple and family; counselor education and supervision; and addictions counseling programs.


A request for participation was made to the counseling department chairs of the 40 purposefully selected programs via e-mail. In total, representatives from 25 of the 40 contacted programs (62.5%) agreed that their programs would participate in this study. The participation rate of CACREP-accredited programs was higher than that of non-CACREP-accredited programs; the overall participants included 15 of the 20 contacted CACREP-accredited programs (75%) and 10 of the 20 contacted non-CACREP-accredited programs (50%). At the institutional level, counseling program participation across the five regions was representative of national program distribution. Following attainment of consent from the counseling department chairs, an electronic survey was provided to each of the 25 participating programs for direct dissemination to students meeting the selection criteria.


A total of 359 master’s and doctoral students currently enrolled in counseling programs nationwide responded to the survey. The exact response rate at the individual student level is unknown, as the number of students receiving the survey at each participating institution was not collected. Of the 359 participants surveyed, 22 surveys were deemed unusable (e.g., sampling parameter not met, blank survey response) and were not included in analyses. Of the remaining 337 participants, missing data were addressed by providing sample sizes contingent on the specific research question.


Participants’ ages (n = 332) ranged from 20–63, with a median age of 28. Gender within the sample (n = 335) consisted of 14.3% male, 85.1% female and 0.3% transgender; the remaining 0.3% of participants preferred not to answer. In regards to race/ethnicity (n = 334), 84.1% of the sample identified as Caucasian, 7.2% as African-American, 2.7% as Latino/a, 1.8% as Asian, 1.5% as biracial, 0.3% as Pacific Islander and 0.3% as Hawaiian; the remaining 2.1% preferred not to answer. The reported educational levels (n = 331) included 90.4% of participants in a master’s program and 9% in a doctoral program; the remaining 0.9% participants were postdoctoral and postgraduate students taking additional coursework. Participants reported enrollment in the following cognate areas (n = 331): mental health and community counseling (48.8%), school counseling (27.7%), marriage and family counseling (5.4%), counselor education and supervision (5.1%), other (4.0%), rehabilitation counseling (3.0%), addictions counseling (2.1%), multitrack (1.8%), assessment (1.2%), and career counseling (0.9%).


In order to obtain program demographic information based on the aforementioned purposeful sampling design, participants were asked to identify the university attended. However, as 15.5% of participants provided an unusable response (e.g., preferred not to answer), self-reported program descriptive demographic data were analyzed instead. Participants classified their institution as public or private (n = 332) as follows: 68.7% reported attending a public university and 31.3% a private university. Student population of the university also was self-reported (n = 326) as follows: 38.7% of the participants attended universities with a student population of fewer than 10,000, 23.3% with a student population of 10,000–15,000 and 38% with a student population of over 15,000. The program accreditation status per participants’ self-report (n = 307) indicated that 56.7% were enrolled in CACREP-accredited programs, 34.9% were enrolled in non-CACREP-accredited programs and 8.5% were uncertain about program accreditation status.



The researchers implemented Qualtrics to house and distribute the electronic survey. Survey items included participant and counseling program demographics, factors influencing decisions on enrollment in graduate-level counseling programs, awareness of CACREP accreditation prior to and following enrollment, and importance ascribed to CACREP accreditation prior to and following enrollment. Relative to factors influencing decisions on enrollment in graduate-level counseling programs, participants first were asked to list the top three factors influencing their enrollment decision. Participants then were asked to select the most important factor among their top three. Additionally, participants responded to the following question: “When choosing your graduate program, is there a factor you now wish had been more influential in your decision?” Questions pertaining to participants’ awareness of and ascribed importance to CACREP accreditation included the following: (a) “When first applying to graduate school, how familiar were you with CACREP accreditation?” (b) “When first applying to graduate school, how important was CACREP accreditation for you?” (c) “Currently, how familiar are you with CACREP accreditation?” (d) “Currently, how important is CACREP accreditation for you?” Participants used a four-point Likert scale for their responses, which ranged from “very familiar/very important” to “not familiar/not important.” The category of “I was/am not aware of accreditation” also was provided where appropriate.




Research question one examined the top factors participants considered and wished they had considered more when making a counseling program enrollment decision (n = 328). As shown in Table 1, results indicated the following rank order for the top 10 factors that influenced participants’ enrollment decisions: (a) location at 33.6%, (b) program accreditation at 14.0%, (c) funding/scholarships at 12.2%, (d) program prestige at 8.6%, (e) faculty at 7.7%, (f) program/course philosophy at 4.2%, (g) program acceptance at 3.9%, (h) faith at 3.9%, (i) schedule/flexibility at 3.6% and (j) research interests at 2.4%. The top 10 factors that participants wished they had considered more when making their enrollment decisions included the following: (a) “none” at 42.3%, (b) funding/scholarships at 15.2%, (c) program accreditation at 12.8%, (d) faculty at 6.8%, (e) research interests at 5.1%, (f) program prestige at 4.5%, (g) networking opportunities at 3.6%, (h) location at 2.4%, (i) schedule/flexibility at 1.5% and (j) personal career goals at 1.2%. Further analysis indicated the following three factors that participants at non-CACREP-accredited programs (n = 106) wished they had considered more when making an enrollment decision: (a) program accreditation at 31.8%, (b) “none” at 30.8% and (c) funding/scholarships at 9.3%.


Table 1


Counseling Students’ Enrollment Decision Factors

Factors Participants Considered

Factors Participants Wished They Had Considered More

Factor ranked order

% of n

Factor ranked order

% of n

Location 33.6 None 42.3
Program accreditation 14.0 Funding/scholarships 15.2
Funding/scholarships 12.2 Program accreditation 12.8
Program prestige   8.6 Faculty   6.8
Faculty   7.7 Research interests   5.1
Program/course philosophy   4.2 Program prestige   4.5
Program acceptance   3.9 Networking opportunities   3.6
Faith   3.9 Location   2.4
Schedule/flexibility   3.6 Schedule/flexibility   1.5
Research interests   2.4 Career goals   1.2
Note. n = 328




Research question two explored participants’ awareness of CACREP accreditation prior to (n = 308) and following enrollment (n = 309) in graduate-level counseling programs. Before enrollment, only one quarter (24.7%) of the sample indicated being “familiar” (n = 49) or “very familiar” (n = 27) with CACREP accreditation. The remaining 75.3% of the sample reported less awareness of CACREP accreditation prior to enrollment, with these participants reporting only being “somewhat familiar” (n = 93) or “not familiar” (n = 139) with CACREP accreditation. In contrast, following enrollment in graduate-level counseling programs, nearly three quarters (73.1%) of the sample noted either being “familiar” (n = 124) or “very familiar” (n = 102) with CACREP accreditation. The remaining 26.9% of participants reported being “somewhat familiar” (n = 66) or “not familiar” (n = 17). Overall, the percentage of all students reporting that they were either “familiar” or “very familiar” with CACREP accreditation increased by 48.4% following enrollment in graduate-level counseling programs.


Consideration was given to potential differences in familiarity with CACREP accreditation among (a) doctoral- and master’s-level students and (b) students attending CACREP- and non-CACREP programs. For those students enrolled in a master’s-level program (n = 276), regardless of program accreditation status, 21% reported being either “familiar” or “very familiar” with CACREP accreditation pre-enrollment. For doctoral-level students (n = 27), 63% indicated familiarity with CACREP accreditation prior to enrolling in a graduate program. These results indicated that doctoral-level students appeared to show more awareness of CACREP accreditation pre-enrollment, as a 42% difference in familiarity level existed. Post-enrollment, familiarity levels increased for both groups, as evidenced by 72.8% of master’s-level students (n = 201) and 81.5% of doctoral-level students (n = 22) reporting either being “familiar” or “very familiar” with CACREP accreditation. The difference between the two groups was now 8.7%, with doctoral students exhibiting more familiarity with CACREP post-enrollment.


Students’ familiarity with CACREP prior to and following enrollment also were considered between students in accredited (n = 173) and non-CACREP-accredited (n = 107) programs, as well as among students who reported being unsure of their program’s accreditation status (n = 26). Prior to enrollment, the following percentages of students reported being either “familiar” or “very familiar” with CACREP accreditation: 31.8% in CACREP-accredited programs, 18.7% in non-CACREP-accredited programs and 0.0% among those unaware of program accreditation status. Post-enrollment, 78.2% of students in a CACREP-accredited program, 77.4% of students in a non-CACREP-accredited program and 23.1% of those unaware of their program’s accreditation status reported being either “familiar” or “very familiar” with CACREP accreditation. Overall, the results indicated that higher percentage levels of CACREP familiarity existed both pre-enrollment and post-enrollment for students in CACREP-accredited programs when compared to students in either non-CACREP programs or who were unaware of their program’s accreditation status.


Research question three explored the level of importance participants placed on CACREP accreditation prior to (n = 309) and following enrollment (n = 308) in graduate-level counseling programs. Before enrollment, 39.5% of the sample noted that CACREP accreditation was either “important” (n = 50) or “very important” (n = 73). The remaining 60.5% of participants reported the following levels of importance ascribed to CACREP accreditation prior to enrollment: “somewhat important” (n = 51) or “not important” (n = 34), or indicated they were “not aware” (n = 102) of accreditation. After enrollment, participants’ levels of importance ascribed to CACREP accreditation increased, with 79.6% of the sample describing CACREP accreditation as “important” (n = 80) or “very important” (n = 165). Approximately one fifth (20.4%) of the sample reported low levels of importance ascribed to CACREP post-enrollment, rating CACREP accreditation as “somewhat important” (n = 33) or “not important” (n = 22), or indicated they were “not aware” (n = 8) of accreditation. From pre-enrollment to post-enrollment, the percentage of students identifying CACREP as “important” or “very important” increased by 40.1%.


Potential differences in the results as a function of program accreditation status also were examined. The following percentages of students believed CACREP accreditation was either “important” or “very important” prior to graduate school enrollment: 58% if the program was reported to be accredited (n = 101), 17.8% if not CACREP accredited (n = 19), and 3.8% if the participant was unsure of the program’s accreditation status (n = 1). Post-enrollment, ascribed levels of importance increased for all students regardless of program accreditation status, as follows: 89.7% of students in CACREP-accredited programs (n = 156), 72.6% of students in non-CACREP-accredited programs (n = 77) and 38.5% of students unaware of their program’s accreditation status (n = 10) indicated that CACREP accreditation was either “important” or “very important” to them.


Research question four explored potential differences in levels of awareness of CACREP accreditation prior to enrollment in graduate-level counseling programs between participants in CACREP-accredited programs, those in non-CACREP-accredited programs and those unaware of program accreditation status. Descriptive results indicated that a difference existed between CACREP accreditation awareness levels prior to enrollment contingent on self-reported program accreditation status; to determine whether a significant statistical difference existed, a one-way ANOVA was used. The omnibus F statistic was interpreted, which is robust even when sample sizes within the different levels are small or unequal (Norman, 2010). The results indicated that self-reported CACREP accreditation statuses (i.e., accredited, non-accredited, unaware of accreditation status) were found to have a significant effect on participants’ awareness of CACREP accreditation prior to enrollment into a graduate-level counseling program, F(2,303) = 15.378, MSE = 0.861, p < 0.001. The Levine’s test was significant, indicating nonhomogeneity of variance. To account for the unequal variance, post hoc analyses using Tamhane’s T2 criterion for significance were run to determine between which accreditation levels the significant difference in the mean scores existed. The post hoc analyses indicated that prior to graduate school enrollment, participants who self-reported attendance in accredited programs were significantly more aware of CACREP accreditation (n = 173, M = 2.88, SD = 0.976) than the following: (a) participants who self-reported attending non-accredited programs (n =  107, M = 3.36, SD = 0.934; p < 0.001) and (b) participants who reported uncertainty of their program’s current accreditation status (n = 26, M = 3.77, SD = 0.430; p < 0.001). Additionally, the analysis indicated that participants who self-reported enrollment in non-CACREP-accredited programs were significantly more aware of CACREP accreditation compared to participants who were uncertain of their program’s current accreditation status, p = 0.004. Overall, the results for research question four suggested the following information regarding awareness of CACREP accreditation prior to enrollment for all students: (a) those enrolled in CACREP-accredited programs indicated the most awareness, (b) those enrolled in non-CACREP-accredited programs exhibited the second most awareness and (c) those unaware of their program’s accreditation status reported the least awareness.


The omnibus F test for research question four was re-run, looking at only students currently enrolled in a master’s-level program, teasing out potential outlier effects produced by doctoral students’ knowledge base; descriptive statistics had indicated that doctoral-level students exhibited more awareness of CACREP accreditation prior to enrollment. When examining only master’s-level students (n = 274), the results indicated that self-reported CACREP accreditation statuses (i.e., accredited, non-accredited, unaware of accreditation status) were found to have a significant effect on these students’ awareness of CACREP accreditation prior to enrollment in a graduate-level counseling program, F(2,274) = 14.470, MSE = 0.724, p < 0.001. Tamhane’s T2 post hoc analyses suggested similar results for master’s-level students’ CACREP awareness contingent on the program’s accreditation status when compared to results found for all participants (i.e., both master’s- and doctoral-level students). For master’s-level students, the following results were found: (a) those enrolled in CACREP-accredited programs indicated the most awareness, (b) those enrolled in non-CACREP-accredited programs exhibited the second most awareness and (c) those unaware of their program’s accreditation status reported the least awareness.


Research question five assessed whether participants’ levels of CACREP accreditation awareness increased after enrollment in graduate-level counseling programs. Overall, the descriptive results indicated that participants’ awareness of CACREP accreditation increased after enrolling in a counseling program regardless of other factors (e.g., grade level, program accreditation status). The two-tailed dependent t test indicated that the mean score for CACREP accreditation awareness significantly increased for all students after enrollment in a graduate-level counseling program (M = 1.130, SD = 1.046, t(306) = 18.934; p < .001), with the following mean scores reported: prior to enrollment (n = 307), M = 3.11, SD = 0.975, and following enrollment (n = 307), M = 1.98, SD = 0.869.




The purpose of this research was to examine factors that influence students’ decisions regarding enrollment in graduate-level counseling programs, with specific attention to students’ knowledge of CACREP accreditation prior to and following enrollment. The findings of this study were congruent with previous research, indicating that counseling students deemed program location to be the most influential factor in their enrollment decision-making process (Poock & Love, 2001). A dearth of previous research existed on the role of program accreditation in enrollment decisions; the current study suggests that program accreditation status signifies the second most influential factor, reported by 14% of the participants surveyed. Across the sample, program accreditation ranked third among factors participants wished they had considered more prior to making an enrollment decision. For participants attending non-CACREP-accredited programs, the ranking of accreditation increased to the number one factor these students wished they had considered more (31.8%), closely followed by no other factors (30.8%). Results of this study suggest that while CACREP accreditation is important to some students when choosing a program, ultimately, enrollment decisions are influenced by a number of factors whose weight varies from student to student.


A critical finding emerging from this research is that nearly half of participants (45.1%) were not familiar with CACREP accreditation prior to enrollment in a graduate-level counseling program. In contrast, only 8.8% of students reported being very familiar with CACREP accreditation prior to enrollment. These results support the assertion that counseling students may lack information necessary to make an informed program enrollment choice. Specifically, if prospective students are not aware of the existence of accrediting bodies or the potential implications of CACREP accreditation for postgraduation opportunities, they may omit accreditation as a decision-making criterion for enrollment. The ranking of CACREP accreditation as the first and third most important factors that students in non-CACREP and CACREP programs, respectively, wished they had considered more appears to reflect this omission.


Relatedly, one third of participants reported being unaware of the importance of CACREP accreditation prior to enrollment in a graduate-level counseling program. Drastically, post-enrollment, less than 3% of participants reported lacking awareness of the importance of CACREP accreditation. Post-enrollment, the participants appeared to perceive CACREP accreditation as very important, with over half of the participants (53.6%) reporting this perception. Significant differences existed in participants’ awareness of CACREP accreditation prior to enrollment between participants enrolled in CACREP- and non-CACREP-accredited programs. A possible grounding for this finding may be that participants who were aware of CACREP accreditation prioritized this factor differently when making an enrollment decision. Regardless of the CACREP accreditation status of their graduate-level counseling programs, participants’ knowledge of CACREP accreditation increased significantly following program enrollment. This result suggests that accreditation is an effectively shared domain of professional socialization within counselor preparation programs, but largely not communicated to students outside formal entry into the field.


Overall, the results of this study provide a valuable window to the varied factors that prospective counseling students consider when making graduate program enrollment decisions. Interestingly, while accreditation signified an important factor in this decision-making process, many students lacked awareness of accreditation and subsequent implications of attending a CACREP-accredited program prior to enrollment. Post-enrollment, awareness of and importance ascribed to program accreditation increased for students, indicating that some students’ selection priorities changed with increased knowledge about accreditation. Ultimately, though enrollment decisions are personal choices in which students consider a number of factors, this study’s findings suggest that unfamiliarity with accreditation might impact the subsequent decisions.


Limitations and Recommendations for Further Research


Several limitations to this study must be noted. First, the results might have been biased by the use of a purposeful volunteer sample, with counseling program representatives electing whether to participate based on unknown motivations. Additionally, while the participation rate was ascertainable at the institutional level, the participation rate at the individual student level was unknown, as the number of students receiving the instrument at each participating institution was not collected. Second, the binary designation of CACREP-accredited and non-CACREP-accredited programs is broad and may not sufficiently account for rich variation across and within programs. For example, the research design did not account for programs working toward accreditation. Further, the use of self-reported program demographic information (e.g., accreditation status, institution name) may have impacted findings, as over 15% of participants preferred not to answer or gave incorrect data. Finally, data analysis did not address potential differences in participants’ responses across program cognate areas, full- and part-time enrollment statuses, or traditional and virtual program delivery formats. Future research may be informed by consideration of these demographic variables, as well as the possible relationship of students’ gender, age and race/ethnicity on graduate program enrollment decisions. Additionally, given that many participants lacked awareness of CACREP accreditation prior to enrollment, but ascertained this knowledge while enrolled, future research should examine specific educative venues through which students learn about CACREP accreditation prior to and following enrollment in graduate-level counseling programs. Results of research examining how counseling students become, or fail to become, knowledgeable about CACREP accreditation can inform outreach efforts. Qualitative examination of these questions, as well as of students’ lived experiences within and outside CACREP-accredited programs, would be particularly helpful. Examination of counselor educators’ levels of awareness of and importance ascribed to CACREP, within both accredited and non-accredited programs, also is suggested.


Implications for Counselor Preparation Programs and the Broader Profession


Results of this study suggest critical disparities among counseling students’ awareness and perceptions of CACREP accreditation prior to and following enrollment in graduate-level counseling programs. Considering the increased implications of accreditation within the counseling profession, this study’s findings substantiate a professional need to assist individuals in making optimally informed decisions about graduate school. Such an intervention moves beyond the individual student level, bringing renewed attention to the obligations of counselor preparation programs and professional associations. Though prospective students bear the responsibility of the enrollment decision, such an argument becomes confounded (and circular) when one considers that about 50% of students surveyed were unfamiliar with CACREP accreditation prior to graduate school enrollment.


Program Level

This study supports Bardo’s (2009) assertion of the responsibility of programs to educate students about the benefits, challenges and rationale of accreditation. Transparent and educative dissemination of facts relative to the significance of accreditation is becoming paramount, particularly in light of new state-level requirements for licensure (License as a Professional Counselor, 2014) and continued movements toward portability, which may introduce new liabilities for programs not accredited by CACREP. Programs may wish to integrate such information about CACREP accreditation into recruitment processes and application materials, such as program websites, on-campus visits and open houses, and prospective student communications. The intention is to assist students in making well-informed decisions when choosing a counseling graduate program related to individual preferences and goals. For non-accredited programs, such transparent discussions may pose additional implications, considering that participants of this study deemed accreditation an important enrollment decision factor. However, because students prioritize enrollment decision factors differently, non-accredited programs still have the potential to attract students through their program’s prestige, philosophy, faculty, location and other factors that individuals prioritize.


Broader Professional Level

Among contemporary influences on the counseling profession, the TRICARE resolution is a particularly significant event. Graduation from a CACREP-accredited counselor preparation program increasingly differentiates students’ postgraduation employment and licensure opportunities. It is essential to recognize the differing, and potentially incongruent, contexts emerging for CACREP-accredited and non-CACREP-accredited programs. While complex, there is a clear need for proactive and inclusive dialogue across the profession that both minimizes potential collateral damage and maximizes the power of unified preparation standards for achievement of broader goals of professional recognition and licensure portability.


Results of this study lend support to the assertion that CACREP and other professional associations must find new ways of reaching out to non-accredited programs in order to assist them in recognizing the benefits and importance of accreditation, not only for their graduating students and individual institutions, but also for the counseling profession as a whole (Bobby, 2013). It also is essential that both financial support and mentorship continue to be provided to counselor preparation programs seeking and maintaining CACREP accreditation. Directed professional advocacy efforts to inform various stakeholders about the importance of CACREP accreditation as a national preparation standard also are recommended (Mascari & Webber, 2013).




The history of CACREP as an accrediting body has been and continues to be inextricably connected to broader movements of the counseling profession. Ultimately, the credibility and importance of CACREP accreditation remains grounded in the larger profession it serves. Ongoing respectful and critical dialogue related to CACREP is imperative within the general profession, and more specifically, with potential students of graduate-level counseling programs. Such transparent discussions are grounded by this study’s findings—although many students considered accreditation an influential factor when making enrollment decisions, nearly half of the participants sampled were unaware of accreditation prior to enrollment in a counseling graduate program. Assisting vested stakeholders, including institutions and students, in making informed decisions is an important part of the dialogue that is introduced through this research and invites subsequent conversation.



Conflict of Interest and Funding Disclosure

The authors reported receiving a grant contribution

from CACREP for the development of this manuscript.





Bardo, J. W. (2009). The impact of the changing climate for accreditation on the individual college or university: Five trends and their implications. New Directions for Higher Education, 145, 47–58. doi:10.1002/he.334

Barrio Minton, C. A., & Gibson, D. M. (2012). Evaluating student learning outcomes in counselor education: Recommendations and process considerations. Counseling Outcome Research and Evaluation, 3, 73–91.

Bobby, C. L. (2013). The evolution of specialties in the CACREP standards: CACREP’s role in unifying the profession. Journal of Counseling & Development, 91, 35–43. doi:10.1002/j.1556-6676.2013.00068.x

Council for Accreditation of Counseling and Related Educational Programs. (2009). 2009 standards. Retrieved from http://www.cacrep.org/wp-content/uploads/2013/12/2009-Standards.pdf

Council for Accreditation of Counseling and Related Educational Programs. (2013). CACREP position statement on licensure portability for professional counselors. Retrieved from http://www.cacrep.org/wp-content/uploads/2014/02/CACREP-Policy-Position-on-State-Licensure-adopted-7.13.pdf

Council for Accreditation of Counseling and Related Educational Programs. (2014). Annual report: 2013. Retrieved from http://issuu.com/cacrep/docs/cacrep_2013_annual_report_full_fina

Davis, T., & Gressard, R. (2011, August). Professional identity and the 2009 CACREP standards. Counseling Today, 54(2), 46–47.

Hilston, J. (2006, April 24). Reasons influencing college choice in the US. Pittsburgh Post Gazette, p. A1.

Hossler, D., & Gallagher, K. S. (1987). Studying student college choice: A three-phase model and the implications for policymakers. College and University, 62, 207–221.

Ivy, J., & Naude, P. (2004). Succeeding in the MBA marketplace: Identifying the underlying factors. Journal of Higher Education Policy and Management, 26, 401–417. doi:10.1080/1360080042000290249

Johnson, E., Epp, L., Culp, C., Williams, M., & McAllister, D. (2013, July). What you don’t know could hurt your practice and your clients. Counseling Today, 56(1), 62–65.

Kallio, R. E. (1995). Factors influencing the college choice decisions of graduate students. Research in Higher Education, 36, 109–124. doi:10.1007/BF02207769

License as a Professional Counselor, 47 Ohio Rev. Code 232 § 4757.23 (2014).

Mascari, J. B., & Webber, J. (2013). CACREP accreditation: A solution to license portability and counselor identity problems. Journal of Counseling & Development, 91, 15–25. doi:10.1002/j.1556-6676.2013.00066.x

Milsom, A., & Akos, P. (2005). CACREP’s relevance to professionalism for school counselor educators. Counselor Education and Supervision, 45, 147–158. doi:10.1002/j.1556-6978.2005.tb00137.x

Norman, G. (2010). Likert scales, levels of measurement and the “laws” of statistics. Advances in Health Sciences Education, 15, 625–632. doi:10.1007/s10459-010-9222-y

Paradise, L. V., Lolan, A., Dickens, K., Tanaka, H., Tran, P., & Doherty, E. (2011, June). Program coordinators react to CACREP standards. Counseling Today, 53(12), 50–52.

Poock, M. C., & Love, P. G. (2001). Factors influencing the program choice of doctoral students in higher education administration. Journal of Student Affairs Research and Practice, 38, 203–223.

Ritchie, M., & Bobby, C. (2011, February). CACREP vs. the Dodo bird: How to win the race. Counseling Today, 53(8), 51–52.

TRICARE. (2014, October 31). Number of beneficiaries. Retrieved from http://www.tricare.mil/About/Facts/BeneNumbers.aspx?sc_database=web

Urofsky, R. I. (2013). The Council for Accreditation of Counseling and Related Educational Programs: Promoting quality in counselor education. Journal of Counseling & Development, 91, 6–14. doi:10.1002/j.1556-6676.2013.00065.x

Urofsky, R. I., Bobby, C. L., & Ritchie, M. (2013). CACREP: 30 years of quality assurance in counselor education: Introduction to the special section. Journal of Counseling and Development, 91, 3–5. doi:10.1002/j.1556-6676.2013.00064.x


Eleni M. Honderich, NCC, MAC, is an Adjunct Professor at the College of William and Mary. Jessica Lloyd-Hazlett, NCC, is an Assistant Professor at the University of Texas-San Antonio. Correspondence can be addressed to Eleni M. Honderich, College of William & Mary, School of Education, P.O. Box 8795, Williamsburg, VA 23187-8795, emhond@gmail.com.