Time Period Predicts Severity of Depression and Anxiety Symptoms Among Individuals Exposed to COVID-19: Findings From a Southeastern U.S. University

Wesley B. Webber, W. Leigh Atherton, Kelli S. Russell, Hilary J. Flint, Stephen J. Leierer

The COVID-19 pandemic and efforts to manage it have affected mental health around the world. Although early research on the COVID-19 pandemic showed a general decline in mental health after the pandemic began, mental health in later stages of the pandemic might be improving alongside other changes (e.g., availability of vaccines, return to in-person activities). The present study utilized data from a mental health service intervention for individuals at a southeastern university who were exposed to COVID-19 following the university’s return to in-person operations. This study tested whether time period (August–September 2021 vs. January–February 2022) predicted individuals’ likelihood of being mild or above in depression and anxiety ratings. Results showed that individuals were more likely to be mild or above in both depression and anxiety ratings during August–September of 2021 than January–February of 2022. Suggestions for future research and implications for professional counselors are discussed.

Keywords: COVID-19, mental health, depression, anxiety, university

     The novel coronavirus (COVID-19), first detected in 2019, spread globally at a rapid pace, with the first confirmed case in the United States occurring on January 20, 2020, in the state of Washington  (Centers for Disease Control and Prevention [CDC], 2023). By April 2020, the United States had the most reported deaths in the world due to COVID-19. It was not until December of 2020 that the first round of vaccines, authorized under emergency use authorization, was made available (Food and Drug Administration [FDA], 2021). As of October 2022 in the United States, a total of 97,063,357 cases of COVID-19 had been reported, from which there were 1,065,152 COVID-19–related deaths (CDC, 2023). A reported 111,367,843 individuals aged 5 and above in the United States had received their first booster dose of a COVID-19 vaccine as of October 2022 (CDC, 2023). Previous research has shown that the COVID-19 pandemic and efforts to manage it (e.g., lockdowns, quarantine, isolation) had negative effects on mental health in the United States and internationally (Huckins et al., 2020; Pierce et al., 2020; Son et al., 2020). Based on the extended duration of the pandemic and changes that have occurred during it (e.g., vaccine availability, lessening of initial social restrictions), more recent research has investigated possible changes in mental health in later stages of the COVID-19 pandemic (Fioravanti et al., 2022; McLeish et al., 2022; Tang et al., 2022). The present study adds to this literature by exploring whether psychosocial symptomatology (i.e., depression and anxiety) at a university in the Southeastern United States differed in individuals exposed to COVID-19 during August–September 2021 as compared to individuals exposed to COVID-19 during January–February 2022 (following the university’s return to on-campus operations in August 2021).

Challenges to Mental Health During the COVID-19 Pandemic
     Since the beginning of the COVID-19 pandemic, conceptual and empirical research has focused on ways in which the pandemic and associated stressors might impact mental health (Bzdok & Dunbar, 2020; Marroquín et al., 2020; Şimşir et al., 2022). Implementation of lockdowns to deter spread of the virus led to concerns that social isolation might have severe impacts on mental health (Bzdok & Dunbar, 2020). This hypothesis was empirically supported, as stay-at-home orders and individuals’ reported levels of social distancing were positively associated with depression and anxiety (Marroquín et al., 2020). Individuals’ views on the COVID-19 pandemic evolved quickly at the outset of the pandemic, and perceptions of risk were shown to increase during the pandemic’s first week in the United States (Wise et al., 2020). Growing awareness of the dangers of the virus likely had deleterious effects on mental health; Şimşir et al. (2022) found through a meta-analysis that fear of COVID-19 was associated with a variety of mental health problems. Mental health was also negatively affected by stigmatization associated with the COVID-19 pandemic, as was the case for those exposed to COVID-19 while at their place of work (Schubert et al., 2021). Such stigmatization associated with COVID-19 exposure was found to increase risk for depression and anxiety (Schubert et al., 2021).

The lockdowns and social distancing measures that accompanied early stages of the COVID-19 pandemic also resulted in changes to routines that likely impacted mental health. For some individuals facing lockdowns or other disruptions to typical routines, reductions in physical activity occurred. Individuals who reported greater impact of COVID-19 on their level of physical activity showed greater symptoms of depression and anxiety (Silva et al., 2022). Early in the COVID-19 pandemic, based on people’s increased time spent at home and their concerns about COVID-19 developments, some people increased their media usage (e.g., news outlets, social media). Such increases in media usage were associated with decreases in mental health (Meyer et al., 2020; Riehm et al., 2020). The COVID-19 pandemic had less significant impact on mental health for those with greater tolerance of uncertainty (Rettie & Daniels, 2021) and psychological flexibility (Dawson & Golijani-Moghaddam, 2020). Thus, some individuals were uniquely suited to face the many changes and stressors brought about by the COVID-19 pandemic.

One population that previous research has identified as being especially at risk for negative mental health outcomes during the COVID-19 pandemic is college students (Xiong et al., 2020). For college students, the COVID-19 pandemic occurred alongside other stressors known to be typical for this population such as adjusting to leaving home, navigating new peer groups, and making career decisions (Beiter et al., 2015; Liu et al., 2019). Thus, for many college students, the COVID-19 pandemic disrupted a period of life already filled with many transitions. For example, shortly after the COVID-19 pandemic began, many college students were forced to leave their dormitories and peers as universities transitioned to online delivery of classes (Copeland et al., 2021). Xiong et al. (2020) found through a systematic review that college students were especially vulnerable to negative mental health outcomes at the outset of the COVID-19 pandemic as compared to others in the general population. In the United States, college students’ reported degree of life disruption due to the COVID-19 pandemic was positively associated with depression at the conclusion of the spring 2020 semester (Stamatis et al., 2022). During fall 2020, COVID-19 concerns and previous COVID-19 infection were each found to be associated with higher levels of depression and anxiety among U.S. college students (Oh et al., 2021). Overall, previous research has supported the notion that changes associated with the COVID-19 pandemic had general negative effects on mental health in the general population and in college students specifically.

Changes in Psychosocial Symptomatology Across the COVID-19 Pandemic
     Although research has shown that the COVID-19 pandemic introduced unprecedented challenges and stressors that were associated with mental health problems, another important direction for research has been to characterize overall changes in psychosocial symptomatology as the COVID-19 pandemic progressed. Such research is important given that individuals might psychologically adapt to constant COVID-19 stressors or might benefit from changes that have occurred as the COVID-19 pandemic has progressed (e.g., vaccine availability, lessening of societal restrictions). Initial longitudinal studies comparing individuals’ symptomatology before the COVID-19 pandemic and after its beginning showed that mental health deteriorated after the COVID-19 pandemic began (Elmer et al., 2020; Huckins et al., 2020; Pierce et al., 2020). Prati and Mancini (2021) conducted a meta-analysis of 28 studies that used longitudinal or natural experimental designs and found that depression and anxiety showed small but statistically significant increases after implementation of the initial lockdowns in response to COVID-19. The various changes to ways of life associated with the COVID-19 pandemic appeared to result in a general deterioration in mental health.

Previous research has also explored possible changes in mental health beyond those that were observed in the initial phase of the COVID-19 pandemic. In support of the notion that individuals adapted to changes associated with the COVID-19 pandemic, Fancourt et al. (2021) found that anxiety and depression decreased across the initial lockdown period in the United Kingdom. In contrast, Ozamiz-Etxebarria et al. (2020) found that levels of depression and anxiety were higher 3 weeks into the initial lockdown period in Spain as compared to the beginning of the lockdown. Fioravanti et al. (2022) assessed psychological symptoms longitudinally in an Italian sample at three time points—the beginning of the COVID-19 pandemic and first lockdown (March 2020), the end of the first lockdown phase (May 2020), and during a second wave of COVID-19 with increased societal restrictions (November 2020). Their findings pointed to possible influences of COVID-19 waves and societal restrictions on specific psychosocial symptoms­. Specifically, depression, anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder all decreased at the end of the first lockdown phase (Fioravanti et al., 2022). However, all symptoms besides obsessive-compulsive disorder significantly increased from the end of the first lockdown phase to the second wave of COVID-19 (Fioravanti et al., 2022).

Recent research on mental health among college students in later stages of the COVID-19 pandemic has also focused on possible mental health changes over time (McLeish et al., 2022; Tang et al., 2022). Tang et al. (2022) reported reductions in anxiety and depression in a longitudinal study of university students in the United Kingdom between a first time point (July–September 2020, after the end of lockdown) and a second time point (January–March 2021, when vaccinations were becoming available). In contrast, McLeish et al. (2022) found through a repeated cross-sectional study that depression and anxiety among students at a specific university increased from spring 2020 to fall 2020, with the increases being maintained in spring 2021. The authors noted that vaccines were not widely available at the university until the end of spring 2021 (McLeish et al., 2022). Thus, recent studies have found mixed results as to whether psychosocial symptomatology improved over time during the COVID-19 pandemic. These discrepancies may be due to contextual differences between studies (e.g., differences in data collection time periods, availability of vaccines, or levels of COVID-19 restrictions being implemented during data collection).

The Present Study
     The present study was conducted based on the need for continued research on mental health across the evolving COVID-19 pandemic and based on previous conflicting findings on possible mental health changes in later stages of the COVID-19 pandemic. Given previous research showing detrimental effects of the COVID-19 pandemic on mental health in the general population and in college students, the present study utilized data from a university population. Specifically, an archival dataset was used in the present study to examine data collected during 2021–2022 at a university in the Southeastern United States and to test whether time period would predict severity of depression and anxiety symptoms. Individuals in the study had been exposed to COVID-19 between August–September 2021 or between January–February 2022 and had requested a mental health contact during university-conducted contact tracing. These two time periods corresponded to surges in COVID-19 cases at the university due to the delta and omicron COVID-19 variants, respectively. August–September 2021 also coincided with a return to on-campus operations at the university and therefore captured psychosocial symptomatology at the beginning of a significant transition in the COVID-19 pandemic (i.e., a return to organized in-person activities on a college campus during the evolving pandemic). This study was designed to answer the following research questions:

  1. Among those requesting mental health contact after COVID-19 exposure, was the likelihood of having at least mild depression symptoms different for those whose contact occurred between August–September 2021 as compared to those whose contact occurred between January–February 2022?
  2. Among those requesting mental health contact after COVID-19 exposure, was the likelihood of having at least mild anxiety symptoms different for those whose contact occurred between August–September 2021 as compared to those whose contact occurred between January–February 2022?


     A retrospective research design was used to analyze the possible effect of time period on severity of depression and anxiety symptoms among members of a university population who had been exposed to COVID-19 and requested a mental health check-in. The study used a de-identified dataset obtained from the service providers who completed the mental health check-in. We confirmed through consultation with the IRB that the use of archival, de-identified data does not necessitate IRB review.

COVID-19 Mental Health Check-In Dataset
     The archival, de-identified dataset used in the present study was compiled as part of a mental health service occurring between February 2021 and February 2022. Participants in the dataset had tested positive for COVID-19 or been exposed to COVID-19 without a positive test. During university-conducted contact tracing, they were offered and elected to receive a subsequent mental health check-in. Individuals who were contact traced and thereby offered a mental health check-in had become known to contact tracers through one of two routes: (a) they reported their own COVID-19 diagnosis or exposure through a self-reporting mechanism as instructed by the university, or (b) they were reported by another individual as having been diagnosed with or exposed to COVID-19. The dataset used in this study included data collected during the mental health check-ins for those who elected to receive them. This data was collected over the phone and documented in RedCap (a secure web browser–based survey protocol designed for clinical research) at the time of the phone call or within 24 hours. The dataset consisted of data for 211 individuals’ check-ins. For each check-in, the dataset included participants’ demographic information, screening data (for depression, anxiety, and trauma), identified needs of the participant, resources shared with the participant, and the date of data entry.

The present study focused on check-in data for all individuals from the COVID-19 Mental Health Check-in Dataset whose check-in had occurred during one of the two time periods of focus—August–September 2021 or January–February 2022. These two time periods corresponded to surges in COVID-19 cases at the university associated with the delta and omicron COVID-19 variants, respectively. The 149 individuals who checked in during these 4 months represented 70.62% of the total number of check-ins over the 12-month dataset (N = 211), reflecting the surges in COVID-19 cases during these two periods. Of the 149 individuals in the present study, 96 (64.43%) received their check-in during August–September 2021, and 53 (35.57%) received their check-in during January–February 2022. The selection of these two time periods from the larger dataset allowed for comparison of psychosocial symptomatology during comparable levels of COVID-19 infection (i.e., surges associated with two subsequent COVID-19 variants) at comparable points in subsequent academic semesters (i.e., the first 2 months of the fall 2021 and spring 2022 semesters). The present study used only the screening data for depression and anxiety, as the scales for each of these constructs showed good internal consistency (Cronbach’s alpha > .80).

     The sample in the present study consisted of 149 individuals. The selected individuals’ ages ranged from 17 to 52 (M = 22.21, SD = 7.43). With regard to gender, 67.11% identified as female, 32.21% as male, and 0.67% as non-binary. The reported races of individuals in the study were as follows: 60.4% White, 20.13% African American, 6.71% Hispanic, 3.36% Other, 2.68% Two or more races, 1.34% Middle Eastern, 1.34% Native American, and 0.67% Asian. Some participants preferred not to indicate their race (3.36%). In responding to a question about their ethnicity, 87.25% of individuals identified as not Latinx, 9.40% identified as Latinx, and 3.36% preferred not to answer. With regard to academic level/job title, 32.89% were freshmen, 20.13% were sophomores, 14.09% were juniors, 15.44% were seniors, 7.38% were graduate students, 8.05% were faculty/staff, and 2.01% preferred not to answer. Regarding employment, 53.69% were not employed (including students), 30.20% were employed part-time, 12.75% were employed full-time, and 3.36% preferred not to answer. The relationship statuses of individuals were reported as the following: 87.92% single (never married), 4.7% married, 2.01% single but cohabitating with a significant other, 1.34% in a domestic partnership or civil union, 1.34% separated, 0.67% divorced, and 2.01% preferred not to answer. Table 1 summarizes demographic responses within each of the two time periods and for the full sample.

Demographic Questionnaire
     Participants responded to seven demographic questions (age, gender, race, ethnicity, academic year/job title, current employment status, and relationship status). They were informed that this information was optional and that they could choose not to answer particular questions.


Table 1
Demographic Characteristics of the Sample




August–September 2021 January–February 2022 Full Sample
n % n % n %
   Female 69 71.88 31 58.49 100 67.11
   Male 27 28.13 21 39.62 48 32.21
   Non-binary 0 0 1 1.89 1 0.67
   White 56 58.33 34 64.15 90 60.40
   African American 23 23.96 7 13.21 30 20.13
   Hispanic 8 8.33 2 3.77 10 6.71
   Other race 1 1.04 4 7.55 5 3.36
   Two or more races 4 4.17 0 0 4 2.68
   Middle Eastern 2 2.08 0 0 2 1.34
     Native American 1 1.04 1 1.89 2 1.34
     Asian 1 1.04 0 0 1 0.67
     Prefer not to answer 0 0 5 9.43 5 3.36
     Not Latinx 82 85.42 48 90.57 130 87.25
     Latinx 12 12.50 2 3.77 14 9.40
     Prefer not to answer 2 2.08 3 5.66 5 3.36
Academic Year / Job Title
     Freshman 38 39.58 11 20.75 49 32.89
      Sophomore 18 18.75 12 22.64 30 20.13
      Junior 15 15.63 6 11.32 21 14.09
      Senior 15 15.63 8 15.09 23 15.44
      Graduate Student 6 6.25 5 9.43 11 7.38
      Faculty/Staff 4 4.17 8 15.09 12 8.05
      Prefer not to answer 0 0 3 5.66 3 2.01
      Not Employed (including student) 62 64.58 18 33.96 80 53.69
      Employed Part-Time 26 27.08 19 35.85 45 30.20
      Employed Full-Time 8 8.33 11 20.75 19 12.75
      Prefer not to answer 0 0 5 9.43 5 3.36
Relationship Status
      Single, never married 87 90.63 44 83.02 131 87.92
      Married 3 3.13 4 7.55 7 4.70
      Single, but cohabitating with a

significant other

2 2.08 1 1.89 3 2.01
      In a domestic partnership or civil union 2 2.08 0 0 2 1.34
      Separated 2 2.08 0 0 2 1.34
      Divorced 0 0 1 1.89 1 0.67
      Prefer not to answer 0 0 3 5.66 3 2.01
Note. Average age was 21.51 (SD = 6.98) in August–September 2021 group, 23.49 (SD = 8.11) in January–February 2022 group, and 22.21 (SD = 7.43) in the full sample.


 Patient Health Questionnaire-9 (PHQ-9)
     The Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001) is a 9-item self-report questionnaire that measures the frequency and severity of depression symptoms over the past 2 weeks. The PHQ-9 has been validated for screening for depression in the general population (Kroenke et al., 2001; Martin et al., 2006). The questionnaire measures frequency of symptoms such as “feeling down, depressed, or hopeless,” and “little interest or pleasure in doing things.” The PHQ-9 uses a 4-point Likert scale to measure frequency of symptoms over the past 2 weeks with the response options of not at all, several days, more than half the days, and nearly every day. Scores of 0, 1, 2, and 3 are assigned to each of the four response categories, and a PHQ-9 total score is derived by adding the scores for each of the nine PHQ-9 items. Minimal depression is indicated by PHQ-9 total scores of 0–4, mild depression by scores of 5–9, moderate depression by scores of 10–14, moderately severe depression by scores of 15–19, and severe depression by scores of 20–27. Question 9 on the PHQ-9 is a single screening question assessing suicide risk. Interviewers were trained in appropriate protocol in the event of a positive screen for this question. Cronbach’s alpha for the PHQ-9 in the present study was .86.

Generalized Anxiety Disorder 7-Item Scale (GAD-7)
     The Generalized Anxiety Disorder 7-Item Scale (GAD-7; Spitzer et al., 2006) is a 7-item self-report anxiety questionnaire that measures the frequency and severity of anxiety symptoms over the past 2 weeks. The GAD-7 has demonstrated reliability and validity as a measure of anxiety in the general population (Löwe et al., 2008). The questionnaire measures symptoms such as “feeling nervous, anxious, or on edge,” and “not being able to stop or control worrying.” The format of the GAD-7 is similar to the PHQ-9, using a 4-point Likert scale to measure frequency of symptoms over the past 2 weeks with response options of not at all, several days, more than half the days, and nearly every day. GAD-7 scores are calculated by assigning scores of 0, 1, 2, and 3 for response categories and then adding the scores from the 7 items to derive a total score ranging from 0 to 21. Minimal anxiety is indicated by total scores of 0–4, mild anxiety by scores of 5–9, moderate anxiety by scores of 10–14, and severe anxiety by scores of 15– 21. Cronbach’s alpha for the GAD-7 in the present study was .86.

Analytic Strategy
     Total scores for the PHQ-9 and GAD-7 were found to be positively skewed for both groups of participants. Binary logistic regression was therefore an appropriate method of analysis for this dataset, as binary logistic regression does not require normality of dependent variables (Tabachnick & Fidell, 2019). For two separate binary logistic regression models, individuals were classified as being either minimal or mild or above in depression (PHQ-9) and anxiety (GAD-7) to create binary outcome variables. This choice of cutoff allowed each model (with time period as predictor) to satisfy the recommendation of Peduzzi et al. (1996) that there be at least 10 cases per outcome per predictor in binary logistic regression.

Prior to performing these intended primary analyses to answer the research questions, preliminary analyses were conducted to determine whether adding control variables to the logistic regression models was warranted. Chi-square tests of independence, Fisher-Freeman-Halton Exact tests, Fisher’s Exact tests, and an independent samples t-test were used to test for possible differences between the two time periods in individuals’ responses to demographic questions. In cases in which responses to demographic questions were shown to be significantly different across the two groups, appropriate tests were used to determine whether the demographic responses in question were associated with either of the two intended dependent variables.

Following the preliminary analyses, the intended two binary logistic regressions were conducted to answer the research questions. In the first binary logistic regression, time period was the predictor
(1 = August–September 2021, 0 = January–February 2022) and PHQ-9 depression category was the outcome (1 = mild or above, 0 = minimal). In the second logistic regression, time period was the predictor (1 = August–September 2021, 0 = January–February 2022) and GAD-7 anxiety category was the outcome (1 = mild or above, 0 = minimal). All analyses were conducted using SPSS Version 28.


Preliminary Demographic Analyses
     Prior to the primary analyses, preliminary analyses were conducted to determine whether the two groups differed in their responses to demographic questions. Fisher-Freeman-Halton Exact tests and an independent samples t-test were used to test for differences between groups in their responses to the seven demographic questions. Two of the seven tests were statistically significant at Bonferroni-corrected alpha level. Specifically, Fisher-Freeman-Halton Exact tests found significant differences between time periods on the race (p = .004) and employment (p < .001) demographic variables.

Based on the above significant results for the race and employment variables across the time periods, 2 x 2 tests were conducted to test for differences between specific race responses and specific employment responses across the two time periods. For these 2 x 2 tests, a chi-square test of independence was used when all expected cell counts were 5 or greater and Fisher’s Exact test was used when any expected cell counts were less than 5. To follow up the significant result for race, 2 x 2 tests were conducted for all pairs of race responses in which 2 x 2 tests were possible (i.e., in which there was at least one observation for each of the two race responses at both time periods). These follow-up 2 x 2 tests of responses to the race question across time periods found no statistically significant differences between pairs of race responses across time periods using Bonferroni-corrected alpha level. Follow-up 2 x 2 tests comparing all pairs of responses to the employment question across time periods found two statistically significant differences using Bonferroni-corrected alpha level. A chi-square test of independence showed that individuals were more likely to be employed full-time during January–February 2022 than August–September 2021 as compared to those not employed (including students), X2 (1, N = 99) = 9.29, p = .002. Fisher’s Exact test showed that individuals were more likely to indicate “prefer not to answer” during January–February 2022 than during August–September 2021 as compared to those indicating “not employed (including students),” p = .001.

The statistically significant tests for race and employment across time periods were followed up with additional tests to determine if depression or anxiety category (minimal vs. mild or above for each) was associated with individuals’ responses to the relevant race and employment questions. A Fisher-Freeman-Halton Exact test showed that depression category was not associated with individuals’ responses to the race question, p = .099. A Fisher-Freeman-Halton Exact test also showed that individuals’ anxiety category was not associated with individuals’ responses to the race question,
p = .386. With regard to employment, tests of association were conducted between the intended dependent variables and the specific employment responses that were found to differ between the two groups. A chi-square test of independence showed that individuals’ status as “not employed” vs. “employed full-time” was not associated with depression category, X2 (1, N = 99) = .63, p = .429. A chi-square test of independence also showed that these employment statuses were not associated with anxiety category, X2 (1, N = 99) = .27, p = .601. Similarly, Fisher’s Exact tests showed that individuals’ employment responses of “prefer not to answer” vs. “not employed (including students)” were not associated with depression category (p = .156) or anxiety category (p = .317). These results were interpreted as indicating that the ways in which individuals in the two time periods differed demographically did not have significant impact on the study’s dependent variables of interest. Therefore, binary logistic regressions were conducted with only time period as a predictor of each dependent variable.

Relationship Between Time Period and Severity of Depression Symptoms
     Most individuals in the study were in the minimal depression range on the PHQ-9 as compared to the other four categories. Figure 1 shows the percentage of individuals falling into each of the five PHQ-9 categories during each of the two time periods.

Figure 1
Percentages of Individuals Falling Into Each of the PHQ-9 Categories for Each of the Two Time Periods

Across both time periods combined (August–September 2021 and January–February 2022), 51 individuals (34.23%) were mild or above in depression while 98 (65.77%) were in the minimal range. Binary logistic regression was used to test whether time period predicted severity of depression symptoms. Time period was entered as a predictor (1 = August–September 2021, 0 = January–February 2022) of depression (1 = mild or above, 0 = minimal depression). The overall binary logistic regression model was found to be statistically significant, χ2(1) = 14.46, p < .001, Cox & Snell R2 = .092, Nagelkerke R2 = .128. In the model, time period was found to be a significant predictor of depression, Wald χ2(1) = 12.17, B = 1.52, SE = .44, p < .001. The model estimated that the odds of being mild or above in depression were 4.56 times higher during August–September 2021 than during January–February 2022 for individuals requesting a mental health check-in following COVID-19 exposure. Specifically, the predicted odds of being mild or above in depression were .81 during August–September 2021 and .18 during January–February 2022.

Relationship Between Time Period and Severity of Anxiety Symptoms
     Most individuals in the study were in the minimal anxiety range on the GAD-7 as compared to the other three categories. Figure 2 shows the percentage of individuals falling into each of the four GAD-7 categories during each of the two time periods.

Figure 2
Percentages of Individuals Falling Into Each of the GAD-7 Categories for Each of the Two Time Periods

Across both time periods combined, 40 individuals (26.85%) reported anxiety at levels of mild or above and 109 individuals (73.15%) reported minimal anxiety. Binary logistic regression was used to test whether time period predicted severity of anxiety symptoms. Time period was entered as a predictor (1 = August–September 2021, 0 = January–February 2022) of anxiety (1 = mild or above, 0 = minimal anxiety). The overall binary logistic regression model was statistically significant, χ2(1) = 6.16, p = .013, Cox & Snell R2 = .041, Nagelkerke R2 = .059. In the model, time period was a significant predictor of anxiety, Wald χ2(1) = 5.51, B = 1.03, SE = .44, p = .019. Odds of being mild or above in anxiety were estimated by the model to be 2.81 times higher during August–September 2021 than during January–February 2022 for individuals requesting a mental health check-in after exposure to COVID-19. Specifically, the predicted odds of being mild or above in anxiety were .50 during August–September 2021 and .18 during January–February 2022.


     This study examined whether time period would predict severity of depression and anxiety symptoms in a sample of individuals exposed to COVID-19 at a university in the Southeastern United States. More specifically, the study addressed the possibility that the likelihood of being mild or above in depression and anxiety would differ between two time periods following the university’s return to in-person operations in August 2021. The results of the study showed that the likelihood of being mild or above in depression and the likelihood of being mild or above in anxiety after exposure to COVID-19 were both higher during August–September 2021 than during January–February 2022. This finding is in line with previous research that found improvements in psychosocial symptomatology in later stages of the COVID-19 pandemic (Tang et al., 2022) and in contrast to research that did not find such improvements (McLeish et al., 2022). Based on the results of the present study, it appears likely that factors that differed between the two assessed time periods (first two months of fall 2021 vs. first two months of spring 2022) contributed to the observed difference in likelihood of depression and anxiety symptoms. McLeish et al. (2022) noted that vaccines were not widely available in their study that did not find such differences, while Tang et al. (2022), who did find significant differences, noted that vaccines were available at their second data collection point (January–March 2021). For individuals in the present study, COVID-19 vaccinations were available. Vaccination was strongly encouraged by university administrators following the return to campus, and more individuals on campus were vaccinated in spring 2022 than in fall 2021. Vaccinations might have lessened individuals’ COVID-19 concerns and contributed to more positive psychosocial outcomes during spring 2022 than fall 2021.

Besides vaccinations possibly lessening depression and anxiety symptoms, other environmental circumstances might also have played a role. The two time periods on which this study focused also differed in their proximity to a significant environmental event—a return to in-person operations on the campus where the individuals studied and/or worked. Early research on the mental health impact of COVID-19 highlighted the negative mental health effects of factors such as reduced physical activity (Silva et al., 2022), life disruptions due to the COVID-19 pandemic (Stamatis et al., 2022), and social distancing (Marroquín et al., 2020). Therefore, it is possible that symptoms of depression and anxiety in spring 2022 were affected by changes in specific circumstances known to have negatively impacted mental health earlier in the COVID-19 pandemic. For example, individuals’ physical activity likely increased because of a return to campus, and they might have perceived less disruption to their lives through being able to resume in-person activities. Although individuals in the present study who were exposed to COVID-19 during the first 2 months after the return to campus might have reaped some benefits from the return to more normal environmental circumstances, they might also have faced a period of adjustment. In contrast, individuals exposed to COVID-19 between January and February 2022 might have been more readjusted and reaped greater benefits from the return to campus, thereby reducing depression and anxiety symptoms.

     This study’s findings on psychosocial symptomatology across time during the COVID-19 pandemic have important implications for the work of counselors. Based on the results of the present study, counselors planning outreach efforts to individuals exposed to COVID-19 should consider that as time passes, these individuals might be more stable with regard to symptoms of depression and anxiety. However, some individuals directly affected by COVID-19 might still be interested in receiving mental health information despite low levels of depression and anxiety. Many individuals in the present study scored as minimal in depression and anxiety but were still interested in receiving a mental health check-in. Thus, counselors should advocate for mental health information and resources to be made available to individuals who are known to be facing stressors related to COVID-19. Counselors should be prepared to have conversations to determine the contextual needs of individuals exposed to COVID-19 rather than relying only on standardized measures of psychosocial symptomatology. For example, counselors working with employees (such as university employees in the present study) should be attentive to the possibility that employees exposed to COVID-19 may be concerned about facing stigma in their workplace due to their exposure (Schubert et al., 2021).

Given that the present study focused on individuals from a university population, the study’s results also have specific implications for college counselors. College counselors should develop approaches to reach students during circumstances that might make traditional outreach challenging. For example, the present study used data from a mental health intervention in which service providers collaborated with university contact tracers to safely provide mental health resources by telephone to individuals exposed to COVID-19. College counselors should be prepared to connect clients with services at a distance. Previous research during the COVID-19 pandemic found that college students were interested in using teletherapy and online self-help resources, particularly if such services were made available for free (Ahuvia et al., 2022).

Besides preparing for flexible modes of service delivery, college counselors should be prepared to deliver interventions most likely to be useful to college students during the COVID-19 pandemic or similar pandemics. Those recently exposed to COVID-19 might benefit from discussing possible fears associated with COVID-19, experiences of stigmatization they might have experienced due to their exposure, and ways to maintain mental health during any period of quarantine or isolation that might be required. Those not recently exposed to COVID-19 might instead benefit from interventions that address other issues that might have resulted from the COVID-19 pandemic or societal responses to it. For example, if circumstances associated with the COVID-19 pandemic led to reductions in a client’s amount of exercise, a counselor can help the client identify ways they might increase their physical activity. Interventions promoting physical activity were found to reduce anxiety and depression in college students during the COVID-19 pandemic (Luo et al., 2022).

     This study had limitations that should be considered. First, with the study being retrospective and using secondary data from a clinical intervention, it was not possible to include measures that might have better clarified mechanisms of the changes that were observed in psychosocial symptoms. Thus, the possible explanations above of what might have driven these changes are tentative and future research should test them more directly. Second, individuals in the present study were likely to have been in greater distress than the general university population based on their exposure to COVID-19, which might limit the generalizability of the study’s findings. Third, individuals in the present study were from a single university in the Southeastern United States. Thus, our findings might not generalize to other regions where university-related COVID-19 policies might have differed. Fourth, the decision to create a binary independent variable to reflect time periods (August–September 2021 and January–February 2022) in the present study also entails a limitation. This decision was justifiable on the basis that it allowed for comparisons of individuals at similar points in academic semesters and during comparable periods of COVID-19 infection. However, this analysis decision means that inferences from the study’s results are limited to the two specific time periods that were analyzed. Fifth, individuals in the present study responded to items on the GAD-7 and PHQ-9 through a phone conversation with interviewers. Interviewer-administered surveys have been previously associated with greater tendencies toward socially desirable responses than self-administered surveys (Bowling, 2005). This might limit the present study’s generalizability in contexts where self-administrations of the GAD-7 and PHQ-9 are used.

Future Research
     The results of this study provide important directions for future research. Future researchers who can conduct prospective studies or who have access to larger retrospective datasets should aim to determine specific factors that might lead to improvement in mental health outcomes over time during the COVID-19 pandemic. Knowledge produced by such studies could contribute to clinical applications in the future regarding COVID-19 or other pandemics that might occur. Relatedly, future research with larger samples of demographically diverse participants should explore possible demographic differences in specific mental health trajectories in later stages of the COVID-19 pandemic.

Future research should continue to focus specifically on those who are interested in mental health information and interventions during the COVID-19 pandemic. To follow up this study’s findings, future quantitative and qualitative studies should aim to identify which individuals are interested in receiving mental health services and determine the best ways to deliver services to them. As a globally experienced stressor, the COVID-19 pandemic might have changed some individuals’ views of mental health and/or their receptiveness to mental health outreach. More specifically, some might be more receptive to available mental health information even at lower thresholds of anxiety, depression, or other psychosocial symptoms. Such clients might be interested in preventive services or their interest in mental health information might be driven by other factors. Future studies should address these possibilities more directly than was possible in the present retrospective study.

     Overall, the present study provided a positive picture regarding psychosocial symptomatology in later stages of the COVID-19 pandemic. Results from this study of students and employees at a university in the Southeastern Unites States following their return to campus found that many individuals requesting mental health information after exposure to COVID-19 showed minimal levels of depression and anxiety. Individuals in the study were more likely to be in these minimal ranges during January–February 2022 than August–September 2021. COVID-19 will continue to have effects in individuals’ lives through future infections and potentially through lasting effects of previous stages of the COVID-19 pandemic. As organized in-person activities resume and COVID-19 infections continue, counseling researchers and practitioners should continue efforts to best characterize and address individuals’ mental health needs associated with the COVID-19 pandemic.

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


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Wesley B. Webber, PhD, NCC, is a postdoctoral scholar at East Carolina University. W. Leigh Atherton, PhD, LCMHCS, LCAS, CCS, CRC, is an associate professor and program director at East Carolina University. Kelli S. Russell, MPH, RHEd, is a teaching assistant professor at East Carolina University. Hilary J. Flint, NCC, LCMHCA, is a clinical counselor at C&C Betterworks. Stephen J. Leierer, PhD, is a research associate at the Florida State University Career Center. Correspondence may be addressed to Wesley B. Webber, Department of Addictions and Rehabilitation Studies, Mail Stop 677, East Carolina University, 1000 East 5th Street, Greenville, NC 27858-4353, webberw21@ecu.edu.

School Counseling in the Aftermath of COVID-19: Perspectives of School Counselors in Tennessee

Chloe Lancaster, Michelle W. Brasfield

The COVID-19 pandemic led to an unparalleled disruption of student learning, disengaged students from school and peers, increased exposure to trauma, and had a negative impact on students’ mental health and well-being. School counselors are the most accessible mental health care professionals in a school, providing support for all students’ social and emotional needs and academic success. This study used an exploratory survey design to investigate the perspectives of 207 school counselors in Tennessee regarding students’ COVID-19–related mental health, academic functioning, and interpersonal skills; interventions school counselors have deployed to support students; and barriers they have encountered. Results indicate that students’ mental health has significantly declined across all grade levels and is interconnected with academic, social, and behavioral problems; school counselors have provided support consistent with crisis counseling; and caseload and non-counseling duties have created significant barriers in the provision of care.

Keywords: COVID-19, school counselors, student mental health, interventions, barriers

The psychological cost of the COVID-19 pandemic has been profound and wide-reaching. Although the K–12 population has been less susceptible to the adverse physical effects of COVID-19, for many, the pandemic has left an indelible mark on their mental health (Karaman et al., 2021). Before the outbreak of COVID-19 in 2020, youth mental health had become an issue of national concern, with one in six minors struggling with mental illness (Whitney & Peterson, 2019). Research has emerged to indicate that COVID-19 has further elevated the mental health problems of K–12 students across the nation (Ellis et al., 2020; Karaman et al., 2021; Magson et al., 2021). The end of COVID-19 lockdown restrictions may have alleviated immediate issues associated with social isolation and online learning; however, for those students experiencing COVID-19–related trauma and crisis, symptomatology has persisted beyond school reentry (Centers for Disease Control and Prevention [CDC], 2022; Patterson, 2022). As frontline helping professionals with training in mental health and school systems, school counselors are often the first responders to students in crisis (Karaman et al., 2021; Lambie et al., 2019), yet researchers have not explored reentry problems from the school counselor’s perspective. We conducted this study to understand school counselors’ experience of COVID-19–related student issues, their strategies to assist students, and their encountered barriers. We theorized that persistent problems related to the organizational structures within which counselors work, such as large caseloads, assignment of non-counseling duties, and under-resourced schools and communities (Lambie et al., 2019), may have greatly impacted their ability to meaningfully help students in high need of mental health support.

Literature Review

Students and COVID-19–Related Distress
     From the outset of the COVID-19 pandemic, scholars predicted that disruptions to schooling, COVID-19–related stress, family conflict, and frequent media exposure to the pandemic would amplify mental health problems in children and youth (Imran et al., 2020). Empirical studies published in 2020 and 2021 have substantiated this concern, with findings indicating that COVID-19 restrictions adversely affected youth in multiple ways, including the development of unhealthy eating habits, increased screen time, reduced physical activity, sleep disturbances, academic delays, social problems, and an overall escalation in mental health concerns (Ellis et al., 2020; Karaman et al., 2021; Magson et al., 2021). The preponderance of research focused on adolescents, particularly as extended time in social isolation disrupted their developmental reliance on peer interactions for social and emotional support (Imran et al., 2020). Multiple studies found that not feeling connected to friends, high social media usage, and general COVID-19–related fears were associated with higher levels of depression and anxiety (Ellis et al., 2020; Karaman et al., 2021; Magson et al., 2021).

Although less is known about the impact of COVID-19 on younger children, evidence is emerging to indicate that the COVID-19 pandemic has elevated adverse childhood experiences (ACEs; Bryant et al., 2020). From a developmental perspective, children are less able to communicate and process their thoughts and feelings and are greatly affected by the emotional state of their caregivers (Zimmer-Gembeck & Skinner, 2011). Thus, exposure to parental anxieties related to housing, food, and economic insecurity likely exerted a destabilizing effect on children during the stay-at-home mandate and beyond (Imran et al., 2020). Further, children in poverty may be particularly vulnerable to an amplification of ACEs due to their families being disproportionately impacted by economic hardships and family mortality during the pandemic (Bryant et al., 2020).

Students’ Mental Health Pre-Pandemic
     The COVID-19 pandemic increased intra-family adversity, which has long-term implications for the well-being of children and adolescents (CDC, 2022). However, in pre–COVID-19 times, with the rise in school shootings and teen suicide, the mental health of K–12 populations had already become a public health concern. According to the National Alliance on Mental Illness, one in six children aged 6–17 experienced a mental health disorder (Whitney & Peterson, 2019). Since reentry following COVID-19 shutdowns, indicators suggest the COVID-19 pandemic has worsened children’s mental health (CDC, 2022; Karaman et al., 2021), with widespread reports of student learning gaps, chronic absenteeism, declines in social skills, and increased behavior problems (CDC, 2022; Patterson, 2022). Further, previous research on children’s responses to a variety of traumatic events has found that children and adolescents can develop long-term mental illness following a traumatic experience, which is unlikely to abate without intervention (Udwin et al., 2000). For youth, the experience of mental health problems increases their risk factors in other areas, such as a decline in academic performance, poor decision-making, drug use, and high-risk sexual behaviors (CDC, 2022). In this regard, the responsiveness of schools to flex their organizational resources to address the psychological changes in their student body seems instrumental in assuaging the long-term effects of COVID-related trauma and the mitigation of adverse educational outcomes (Savitz-Romer et al., 2021).

School Counselors’ Role in Provision of Mental Health Services
     Schools have long been discussed as a primary access point for mental health services, given that children spend much of their day in school, and children and adolescents in need of mental health care are more likely to receive assistance in a school as opposed to a clinical setting (Lambie et al., 2019). Conversations about students’ access to mental health care in school settings segue to the role of school counselors and students’ access to school counseling services. School counselors are the most accessible mental health care professionals in schools, with 80.7% of schools employing full-time or part-time school counselors (Lambie et al., 2019). By contrast, only 66.5% employ a school psychologist, and 41.5% employ a school social worker (National Center for Educational Statistics, 2016). Further, school counselors are trained in crisis prevention and responsive services, including individual and group counseling; consultation with administrators, teachers, parents, and professionals; and coordination of services within a multi-tiered system of supports (MTSS; Pincus et al., 2020).

Evidence to support school counselors’ work in times of crisis comes from multiple sources. Salloum and Overstreet (2008) found that a school counselor–led small group implemented after Hurricane Katrina improved PTSD symptoms among elementary school students. Similarly, Udwin and colleagues (2000) found that students who received psychological support at school following a national crisis experienced a reduction in PTSD symptomology. Additionally, scholars have proposed that school counselors utilize their skill set in assessment to administer universal mental health screenings to identify students at greater risk of having or developing mental health concerns (Lambie et al., 2019; Pincus et al., 2020).

Barriers School Counselors Face in the Provision of Services
     Although school counselors have the training and skills necessary to assist students transitioning back to school from a disruption like COVID-19, they face multiple barriers to their work. Most notably, they struggle with unmanageable caseloads. The American School Counselor Association (ASCA) recommends that counselor-to-student ratios not exceed 1:250 (ASCA, 2019). Yet, the average ratio in the United States is 1:455, with Tennessee experiencing an average ratio of 1:450 (Patel & Clinedinst, 2021). Research indicates that large school counselor caseloads adversely affect student outcomes, insofar as attendance, graduation, and disciplinary problems are more prevalent in schools with high school counselor caseloads (Parzych et al., 2019). Unfortunately, minority students in under-resourced schools are disproportionately impacted by high counselor ratios (Whitney & Peterson, 2019) and are more likely to experience adverse educational outcomes, as well as unmet mental health needs (Kaffenberger & O’Rorke-Trigiani, 2013). These findings raise concern for students whose mental health and academics have declined since the emergence of COVID-19 who attend schools with overstretched counselors struggling to meet the needs of their student body. This study was conducted in part to explore if caseload correlates to school counselors’ perceived ability to attend to students’ COVID-related problems and if differences were more pronounced in schools with lower socioeconomic status (SES).

In addition to ratios, ASCA recommends that school counselors spend 80% of their time providing direct and indirect services to students. Program elements within direct service include curriculum delivery, individual student planning, and responsive services. Indirect services include referrals to other agencies and programs within and outside the school system and consultation and collaboration with stakeholders, particularly for crisis response (ASCA, 2019). Researchers have documented the favorable effects on student academics and behaviors when school counselors follow these national guidelines for time and role allocations (Cholewa et al., 2015). Nonetheless, school counselors are often assigned non-counseling duties by their campus and district administrators (Gysbers & Henderson, 2012), preventing them from fulfilling their appropriate roles. These duties include test coordination, record keeping, attendance monitoring, substitute teaching, and student discipline (ASCA, 2019). Data indicate that non-counseling duties may be more problematic at the secondary level, with high school counselors over-reporting non-counseling duties, when compared to elementary school counselors (Chandler et al., 2018). Geographic differences have also been documented, with rural school counselors reporting higher levels of non-counseling duties in comparison to urban school counselors (Chandler et al., 2018). In the current study, we were curious to understand the impact of non-counseling duties on school counselors’ response to students’ COVID-19 concerns and to explore the intersection of counselor responsiveness to COVID-19 by non-counseling duties, grade level, and geographic region (e.g., urban, suburban, rural), respectively.

School Responses to COVID-19 in Tennessee
     In response to the COVID-19 pandemic, Tennessee’s governor ordered all Tennessee public schools closed from March 20 until March 31, 2020, and extended this closure through the end of the 2019–2020 school year. To complete the school year outside of the physical educational space, districts created their own plans to address student learning, often dependent on available technology and resources (Tennessee Office of the Governor, 2020). Districts made decisions for returning in the fall 2020 semester based on guidelines from the Tennessee Department of Education (DOE), which included social distancing, smaller class size, assigned seats, and alternating in-person days with distance learning (Tennessee DOE, 2020). To provide further context to our survey responses, in 2019, the state DOE (Tennessee State Board of Education, 2017) updated its school counseling policy and standards to require school counselors to spend 80% of their time in direct service to students, a specification consistent with the ASCA National Model for allocation of school counselor time. Although the policy stated counselor ratios should not exceed 1:500 in elementary and 1:350 in secondary schools, this specification falls short of the ASCA 1:250 recommendation. Further, because of the state funding formula that permits school districts to hire administrators in lieu of school counselors, depending on school needs, we expected many of the school counselors would have caseloads that exceeded DOE policy.

Purpose of Study
     School counselors are uniquely positioned to assist students with their mental health, including COVID-19–related concerns, in a school context (Pincus et al., 2020). Yet, even before the COVID-19 pandemic, school counseling programs were frequently under-equipped to meet the magnitude of students’ mental health needs (DeKruyf et al., 2013). This study was conducted to understand, from the perspective of school counselors in Tennessee, the ongoing impact of COVID-19 upon students’ mental health, examine strategies they have deployed to assist students, and discover barriers encountered in providing care to meet their students’ needs. Because poor mental health manifests in a plethora of academic, behavior, and social skill adjustment issues for children and adolescents (CDC, 2022), we also examined school counselors’ perceptions of changes in those domains from pre-pandemic to current times. Given documented patterns of variability in school counselor programs, we also investigated school counselors’ perceived barriers to assisting students by location, SES, and assigned non-counseling duties. To address the aim of the study, we posited three related research questions (RQs):

RQ1: How has COVID-19 affected students’ mental health, academics, and social skills in Tennessee? What issues presented the greatest concern, and how did interventions differ by grade level (elementary, middle, or high school)?
RQ2: What interventions do school counselors in Tennessee use to assist students with their COVID-19–related concerns, and how do interventions differ by grade level (elementary, middle, or high school)?
RQ3: What barriers do school counselors in Tennessee report as interfering with their ability to address students’ COVID-19 concerns? Do reported barriers differ by grade level (elementary, middle, or high), location (urban, suburban, or rural), socioeconomic status, non-counseling duties, size of caseload (small, medium, or large), or following the state guideline for spending 80% of the time in student services?



Study Design and Instrumentation
     Given the absence of research examining school counselors’ perspectives of how the pandemic has affected student mental health, their response to students’ COVID-19 issues, and barriers encountered in their efforts, we employed an exploratory research design. Exploratory designs are used when there is limited prior research to warrant the examination of a directional hypothesis (Swedberg, 2020). Within the framework of an exploratory design, we developed a non-standardized instrument to answer the three research questions. Although this constitutes a limitation of the study, we endeavored to address validity concerns by following the principles of the tailored design method of survey research (Dillman, 2007). Prior to constructing the survey, we reviewed the extant literature on students’ COVID-19–related issues, school counselors’ roles, and professional issues, in addition to conducting a focus group (N = 7) with school counselors and school counseling supervisors from across the state in which the study was conducted to explore their perceptions in changes to student functioning, strategies they have deployed to assist students, and obstacles they have encountered. Focus group data were used to inform the development of survey items and ensure the instrument covered relevant content. For example, the focus group provided expert insight into the non-counseling duties that are frequently assigned to counselors in the state, as well as the nature of students’ psychological, academic, and behavioral problems witnessed since the onset of COVID-19. Before launching the survey, we piloted the survey with 19 school counselors in Tennessee to elicit feedback about the flow and coverage of the survey. Based on their responses, we added an item addressing universal intervention and edited language on multiple items to align with state-specific terminology (e.g., “MTSS coordination” was expanded to “RTI2B/MTSS/PBIS coordinator” to reflect more state-recognized school counselor titles when operating in these capacities).

The final survey consisted of 64 items in predominantly binary, checkbox, and Likert scale formats. Demographic items were informed by categories outlined by the U.S. Census, the Tennessee DOE, and inclusive practices for data collection (Fernandez et al., 2016). Twenty-one items gathered demographic data related to school counselor characteristics (e.g., age, race, gender), counseling program variables (e.g., caseload, division of time, non-counseling duties, fair-share responsibilities), and school variables (e.g., school level, Title I status, location, staffing patterns). SES was measured using a school’s designated Title I status, with response categories of “yes,” “no,” and “unsure.” Likewise, to determine if school counselors dedicated 80% of their time to direct service, we created a multiple-choice item with the options of “yes,” “no,” and “unsure.” A concise description of the state guidelines was embedded into the survey to promote accurate responses to this item. We gathered data on counselors’ perspectives of their students’ current functioning in areas of mental health, academics, social skills, and behaviors through multiple-choice items with a 5-point range of “much better” to “much worse.” For each area of functioning, school counselors were required to indicate the areas of concern via a checkbox item. Additionally, checkbox items were used to identify school counselors’ strategies to assist students, barriers encountered, and needed resources. As noted, these response categories were based on extant literature and expert input.

Cronbach’s alphas were computed to determine the reliability of the survey items in indicating overall post–COVID-19 functioning of students according to school counselors. These values indicate that these four areas were moderately related with acceptable consistency (α = .653). When making additional comparisons among the four constructs, two areas—behavior and social skills—were found to be more consistent (α = .705; Sheperis et al., 2020). Further, reliability scores likely reflect the exploratory design, which requested participants respond to conceptually related but not converging constructs (e.g., academics, mental health, social skills, and behavior). For example, a change in student academics would not necessarily signify a change in student mental health and vice versa. Thus, participant responses would not necessarily be uniform across items measuring students’ mental health, academics, and social skills, and overall instrument consistency would not be affected in turn.

     We recruited a state-level sample of professional school counselors employed in K–12 public schools in Tennessee. Following the pilot study, in December 2021, we recruited participants through an anonymous Qualtrics link utilizing multiple platforms: the state school counselor association’s listserv, social media, respondent referrals, and dissemination via school counseling supervisors. Participants were eligible to complete the survey if they were currently employed in a K–12 public school in Tennessee. Upon examination of our survey data, we found 276 total responses with 220 complete for a completion rate of 79.7%. Because the survey was distributed through the above-mentioned methods, we were unable to calculate the response rate without knowing how many of the approximately 2,000 public school counselors in Tennessee received the survey. Upon further examination of the survey respondents, we removed one school counseling supervisor; four school counselors whose students were remote/hybrid; and eight school counselors in private, charter, or alternative schools to maintain focus on the experiences of traditional public school counselors working with students in person during the ongoing COVID-19 pandemic for a final sample of 207 participants. An examination of the respondents’ demographics revealed a sample that was predominantly female and White/Caucasian and worked in Title I, suburban, or rural elementary schools. The sample’s mean years serving as a school counselor was 11.7 (SD = 7.5), with mean years at current school of 6.8 (SD = 6.4). See Table 1 for more demographic information. For analysis purposes, we divided the school counselors into three groups by the size of their reported caseload. These categories were informed by a national study of school counselor ratios (National Association of College Admission Counselors, 2019) and consisted of ratios in the range of small (1:100–1:300; 14.0%, n = 29), medium (1:301–1:550; 69.6%, n = 144), and large (1:551 and higher; 15.0%, n = 31).

Table 1
Demographic Characteristics of the Sample

Characteristic n %
     18–24 years   3  1.4
     25–44 years 99 47.8
     45–64 years          102 49.3
     65 years plus   3   1.4
     Black/African American 17  8.2
     Latinx/Hispanic   1  0.5
     White/Caucasian          183 88.4
     American Indian/Alaskan Native   1   0.5
     Other   5   2.4
     Female 192 92.8
     Male   15   7.2

Note. N = 207.

Data Analysis
     We ran a post hoc power analysis using the G*Power statistical software to determine if our sample size was sufficient at the .80 power level with α = .05 and found that a minimum sample size of 100 was required for our analyses. Given our sample size of 207 participants, the power analysis indicated that our sample size was sufficient (Faul et al., 2007). We utilized SPSS version 26 to calculate the following analyses for this study: (a) descriptive statistics; (b) Fisher’s exact test for two dichotomous nominal variables; (c) an extension of Fisher’s exact test, the Freeman-Halton exact test, for one dichotomous nominal variable and one nominal variable with three levels; and (d) point-biserial correlation analysis for one nominal variable and one interval variable (Frey, 2018). We also examined effect size to determine practical importance using the following levels for examining nominal data (Rea & Parker, 1992), precedence for which has been established by complementary studies in educational research (K. Erickson & Quick, 2017; Kotrlik et al., 2011): negligible [0, .1), weak [.1, .2), moderate [.2, .4), relatively strong [.4, .6), strong [.6, .8), and very strong [.8, 1.0). Phi (ϕ) indicates the effect size for the exact tests, and the correlation is the effect size for the point-biserial correlation. We only included statistical analyses that resulted in moderate associations or higher. Three school counselors (1.4%) who reported caseloads that were unusually small (< 100) and outside our specified caseload parameters were removed from the analysis. Additionally, we excluded school counselors who indicated “unsure” in the categories of location (rural, suburban, urban), Title I status, and adherence to state policy for direct service to students. See Table 2 for school characteristics.


Research Question 1
     RQ1 examined school counselors’ perspectives of the impact of COVID-19 on students’ mental health, academics, and social skills as well as variation by grade level (elementary, middle, or high school). When asked about the mental health changes they have witnessed in their students post–COVID-19 pandemic, 93.7% (n = 194) of school counselors reported negative changes with 42.5% (n = 88) reporting “much worse” and 51.2% (n = 106) reporting “somewhat worse” changes. Specifically, school counselors reported issues regarding anxiety (92.8%, n = 192), depression (77.3%, n = 160), family dysfunction (71.0%, n = 147), COVID-19–related grief and loss (63.8%, n = 132), technology addiction (52.7%, n = 109), suicidality (50.7%, n = 105), fear of COVID-19 (49.8%, n = 103), substance use issues (21.7%, n = 45), and other issues (12.6%, n = 26) such as separation anxiety, self-harm, and anger. The Freeman-Halton exact test revealed a significant relationship between grade level (n = 183) and depression (p < .001, ϕ = .301) with a moderate positive association, suicidality (p < .001, ϕ = .499) with a relatively strong positive association, and substance use (p < .001, ϕ = .583) with a relatively strong positive association. For depression, 90.0% (n = 54) of high school counselors and 85.7% (n = 36) of middle school counselors reported this issue as compared to 63.0% (n = 51) of elementary school counselors. For suicidality, 76.2% (n = 32) of middle school counselors and 71.7% (n = 43) of high school counselors reported this concern as compared to 23.5% (n = 19) of elementary school counselors. For substance use, 58.3% (n = 35) of high school counselors and 20.0% (n = 8) of middle school counselors reported this concern as compared to 1.2% (n = 1) of elementary school counselors. All other mental health concerns were not significant with grade level.

When queried regarding academic changes post–COVID-19, 90.3% (n = 187) of school counselors reported negative changes to students’ academics with 35.3% (n = 73) reporting “much worse” and 55.1% (n = 114) reporting “somewhat worse” changes. School counselors reported an overall decline across all subjects (80.7%, n = 167). Additionally, school counselors reported non-cognitive factors regarding lack of motivation (84.1%, n = 174), lack of parental support during the school day (75.4%, n = 156), attention issues (71.0%, n = 147), poor mental health (64.7%, n = 134), sleep deprivation (41.1%, n = 85), limited technology during virtual learning (33.3%, n = 69), lack of space to work at home during virtual learning (30.4%, n = 63), poor physical health (17.9%, n = 37), and other (3.9%, n = 8). The Freeman-Halton exact test revealed a significant relationship between grade level (n = 183) and lack of motivation (p = .001, ϕ = .265), poor mental health (p = .001, ϕ = .269), and attention issues (p = .009, ϕ = .232), all with positive moderate associations. For lack of motivation, 96.7% (n = 58) of high school counselors and 88.1% (n = 37) of middle school counselors reported this issue as compared to 75.3% (n = 61) of elementary school counselors. For poor mental health, 78.3% (n = 47) of high school counselors and 69.0% (n = 29) of middle school counselors reported this outcome as compared with 49.4% (n = 40) of elementary school counselors. For attention issues, 79.0% (n = 64) of elementary school counselors and 73.8% (n = 31) of middle school counselors reported concerns as compared to 55.0% (n =33) of high school counselors.

Table 2
School/Program Characteristics

Characteristic n %
     Urban 31 15.0
     Suburban 95 45.9
     Rural 72 34.8
     Unsure  9   4.3
Title I Status
     Yes        121 58.5
     No          57 27.5
     Unsure          29 14.0
Grade Level
     Elementary 81 39.1
     Middle 42 20.3
     High 60 29.0
     Other 24 11.6
Follows 80% Direct Service Guideline
     Yes         112 54.1
     No 65 31.4
     Unsure           30 14.5
School Counselor-to-Student Ratio (caseload)
     1:1–1:300 29 14.0
     1:301–1:550          144 69.6
     1:551 and higher 31 15.0
     Other   3   1.4

Note. N = 207

When asked about behavioral changes, 87.4% (n = 181) of school counselors reported negative changes to behaviors with 30.4% (n = 63) reporting “much worse” and 57.0% (n = 118) reporting “moderately worse” changes. Comparably, when asked about social skills changes, 87.0% (n = 180) of school counselors reported negative changes to students’ social skills with 36.2% (n = 75) reporting “much worse” and 50.7% (n = 105) reporting “moderately worse” changes. Specifically, school counselors reported trouble socializing with peers (84.1%, n = 174), absence of social flexibility (58.0 %, n = 120), increase of physical aggression (55.1%, n = 114), increase in relational aggression (50.7%, n = 105), increase in cyberbullying (23.7%, n = 49), increase in bullying (19.3%, n = 40), and other (8.2%, n = 17) such as issues with conflict resolution and preference for technology. The Freeman-Halton exact test revealed a significant relationship between grade level (n = 183) and cyberbullying (p = .003, ϕ = .255), with a moderate positive association with 42.9% (n = 18) of middle school counselors, 23.3% (n = 14) of high school counselors, and 14.8% (n = 12) of elementary school counselors reporting an increase in this area. All other social skills changes were not significant with grade level.

Research Question 2
     RQ2 examined the interventions that school counselors used in assisting students with their COVID-19–related concerns and if this differed by grade level. School counselors reported the various supports that they provided to their students who struggled with COVID-19–related issues, including individual counseling (95.7%, n = 198), consultation with parents/teachers (85.5%, n = 177), referrals (80.7%, n = 167), collaboration with other school-based helpers (77.3%, n = 160), coping skills instruction (71.5%, n = 148), group counseling (44.0%, n = 91), universal health screenings (17.9%, n = 37), and other interventions (4.3%, n = 9) such as food programs, holiday donation programs, peer support, and academic support meetings. We used the Freeman-Halton exact test to examine the relationship between grade level (n = 183) and these supports and found that small group counseling (p < .001, ϕ = .405) and coping skills instruction (p = .028, ϕ = .200) were significant, both with moderate positive association. For small group counseling, 63.0% (n = 51) of elementary school counselors and 45.2% (n = 19) of middle school counselors provided this support as compared to 16.7% (n = 10) of high school counselors. For coping skills instruction, 77.8% (n = 63) of elementary school counselors and 71.4% (n = 30) of middle school counselors reported this intervention as compared to 56.7% (n = 34) of high school counselors.

Research Question 3
     RQ3 examined the barriers school counselors encountered in their ability to provide services and if this differed by grade level, SES, location, number of non-counseling duties, caseload size, and following the state guideline to spend 80% of time providing student services. When asked if they had encountered barriers to assisting their students with their COVID-19–related needs, 54.6% (n = 113) of school counselors reported that they had experienced barriers, and 45.4% (n = 94) reported that they had not. For those counselors who answered “yes,” barriers included: high caseload (44.4%, n = 92), number of non-counseling duties (20.3%, n = 42), lack of administrator support (12.1%, n = 25),  being included on master schedule for guidance classes (10.1%, n = 21), lack of training to address COVID-19 needs (8.2%, n = 17), too much time coordinating the MTSS program (7.7%, n = 16), and other reasons (9.7%, n = 20). Examples of other reasons include students’ attendance, lack of resources (both space and personnel), and focus on academics over mental health. Of note, 47.3% (n = 98) of school counselors reported an increase in non-counseling duties since COVID-19, ranging from a substantial to a slight increase.

We used the Freeman-Halton exact test to examine the aforementioned barriers by grade level (n = 183) and found that being on the master schedule (p < .001, ϕ = .297) was significant with moderate positive association with 19.8% (n = 16) of elementary school counselors reporting this task as compared to 2.4 % (n = 1) of middle school counselors and 1.7% (n = 1) of high school counselors. We used point-biserial correlation analysis to examine how the number of new post–COVID-19 non-counseling duties related to the perceived barriers to providing services to students and found this to be significant (rpb = .211, p = .002) with a positive moderate association. School counselors who reported barriers to providing services had been allocated more non-counseling duties since the pandemic (n = 113, M = 1.22, SD = 1.49) than those who did not report barriers (n = 94, M = .66, SD = 1.04). We used a Freeman-Halton exact test to examine the specific barriers by caseload (n = 204) and found school counselors with a high caseload reported significantly more difficulty in addressing students’ COVID-19–related needs (p < .001, ϕ = .284), with a moderate positive association for large (58.1%, n =18) and medium (47.2%, n = 68) caseloads, as compared to those with a small (10.4%, n = 3) caseload. Investigating the state DOE guideline for 80% of time in service to students (n = 177), excluding those who were unsure, revealed that 63.3% (n = 112) followed the guideline and 36.7% did not (n = 65). We used a Fisher’s exact test to examine the relationship between following the 80% guideline and specific barriers and found that reporting too many non-counseling duties (p < .001, ϕ = -.358) was significant, with a moderate negative association for those who did not follow the guideline (41.5%, n = 27) in comparison to those who did follow the 80% guideline (10.7%, n = 12). All other barriers were not significant with grade level, SES, location, number of non-counseling duties, caseload size, and following the 80% state guideline. We used a Fisher’s exact test to examine SES by Title I (n = 178) classification and found that it was not significant with any of the barriers.


Our results render a disturbing picture of students’ post–COVID-19 mental health functioning and school counselors’ perceived ability to effectively meet their students’ needs since a return to in-person learning, as reported by this sample of 207 school counselors in Tennessee. For RQ1, over 93% of our respondents indicated that their students’ mental health had worsened, with anxiety and depression identified as the most pronounced psychological concern, followed by family dysfunction, grief, technology addiction, and suicidality. These results confirm our predictions that the COVID-19 pandemic would exert a harmful impact on the mental health of children and adolescents (Bryant et al., 2020; Cénat & Dalexis, 2020). Depression and suicidality were significant concerns for middle and high school counselors, and substance abuse was significant at the high school level. The reported spike in diagnosable mental health problems by secondary school counselors aligns with research indicating that half of all mental health and substance use disorders begin at 14 (Quinn et al., 2016). The CDC recently reported that depression, substance abuse, and suicide have increased among adult populations since COVID-19, with young adults presenting the most significant risk (Czeisler et al., 2020). Our results provide preliminary evidence indicating that COVID-19–related trends have similarly impacted adolescents. Further, given the relationship between ACEs and substance misuse (CDC, 2022; Quinn et al., 2016), it may be reasonable to conjecture that an increase in family dysfunction, grief, fear of COVID-19, and severance of social relationships underscored a rise in substance use problems, particularly among high school students.

In addition to mental health, student academics notably declined according to school counselors in Tennessee, with 90.3% of participants reporting negative changes to students’ academics. Previous research attributed students’ COVID-19 pandemic–related academic issues to the vagaries of online instruction, a lack of parental supervision, inadequate technology, and limited workspace, among other factors (Ellis et al., 2020; Karaman et al., 2021; Magson et al., 2021). Our results aligned with these findings by explicitly connecting delays in students’ academic progress to psychological factors. Of note, we found a significant relationship between grade level, lack of motivation, poor mental health, and attention issues, with middle and high school counselors reporting greater concerns in the areas of motivation and mental health, and elementary and middle school counselors identifying attention problems as the greatest concern. The developmental onset of mental health disorders (Lambie et al., 2019) likely accounts for increased student mental health problems reported by middle and high school counselors. However, motivation and attentional issues across the grades were problematic, and because both are symptomatic of depression and anxiety, they raise a red flag for the mental health of all K–12 students in Tennessee.

Alongside academics, 87.0% of school counselors reported negative changes in students’ social skills and 87.4% reported worsened behaviors among students, with trouble socializing with peers, absence of social flexibility, and an increase in physical and relational aggression being the most pronounced problems. Declines in students’ ability to get along with peers may be uniquely linked to social isolation during lockdown (Ellis et al., 2020; Karaman et al., 2021); however, of great concern is the increase in all forms of bullying, with cyberbullying being particularly problematic in middle school. Youth aggression is a long-term consequence of ACEs and has implications for overall school safety, with victimization and perpetration both positively associated with school violence (Forster et al., 2020).

RQ2 investigated what interventions school counselors used to assist students with their COVID-19–related concerns and examined interventions by grade level. The preponderance of school counselors relied on individual counseling (95.7%), consultation (85.5%), referrals (80.7%), collaboration with other school-based helpers (77.3%), and coping skills instruction (71.5%), all of which are consistent with crisis-level supports. Nonetheless, only 44% of the sample, primarily elementary school counselors, had used small group counseling, despite its proven efficacy with children exposed to trauma (Salloum & Overstreet, 2008). The underutilization of group work at the high school level presents a concern, given that group work provides context for peer support and social learning, both considered critical therapeutic factors for adolescents (Gysbers & Henderson, 2012). Nonetheless, this finding resonates with previous results that high school counselors are more apt to assume administrative roles in place of the provision of direct student services (Chandler et al., 2018). Universal assessment has been proffered as an efficient and empirically grounded method for the early identification of at-risk students in need of COVID-19–related interventions (A. Erickson & Abel, 2013; Karaman et al., 2021; Pincus et al., 2020). Unfortunately, only 17.9% of the sample reported administering universal mental health screeners, a finding aligned with other studies that indicate schools have resisted adopting mental health screeners because of inadequate resources and related concerns about following up with students identified as being at risk (Burns & Rapee, 2022).

For RQ3, we explored the school counselors’ perspectives of the barriers they have encountered in assisting their students with their COVID-19 concerns. The proliferation of barriers reported by school counselors (high caseload, non-counseling duties, lack of administrator support, being on the master schedule for guidance classes, and a lack of training) verifies our concern that school counselors in Tennessee did not receive the support instrumental to their ability to provide effective student services at this critical time. Our state-level findings resonate with studies conducted in other states that indicate school counselors’ non-counseling duties increased during the pandemic while administrator support declined (Savitz-Romer et al., 2021). Other studies have also drawn attention to widespread staffing shortages associated with COVID-related absences and a reduced pool of substitute teachers (Patterson, 2022). Although we did not examine staff resources explicitly, with almost 50% of our Tennessee sample witnessing an increase in their non-counseling duties, it would be reasonable to infer that campus administrators are deploying school counselors to triage critical gaps in staffing patterns. Interestingly, despite a widespread increase in non-counseling duties post–COVID-19, only 20.3% of counselors reported non-counseling duties as a barrier to providing care. The discrepancy between these two results may be indicative of the phenomenon of role diffusion in school counseling, a problem that emerges when school counselors begin to integrate non-counseling duties as part of their accepted role and thus do not perceive them as antithetical to their professional identity (Astramovich et al., 2013). Furthermore, neither SES (Title I) nor location (rural, suburban, urban) were significant with barriers, and although this could reflect our relatively small sample, it could also be indicative of staff shortages adversely affecting the role of school counselors across all settings, regardless of the school’s demographic status.

The most notable barrier reported by respondents was a large caseload. School counselors with large and medium-sized caseloads reported more barriers and were less likely to follow the 80% guideline. Thus, those students who were negatively impacted by large counselor caseloads before COVID-19 faced further obstacles in accessing their school counseling services despite an overall increase in their mental health and academic needs. Further, elementary school counselors listed on the master schedule for guidance classes faced additional barriers to addressing their students’ needs outside of their prevention-focused (Tier 1) activities. Classroom guidance is considered helpful in elementary school for building social skills and study habits; however, when counselors are placed on the master schedule, it can impact their ability to provide responsive student services (Gysbers & Henderson, 2012) which seemed to be the case with our respondents.

Implications for Professional Advocacy
     The results of this study illustrate a decline in student functioning, pronounced in the area of mental health, and have implications for school counselor advocacy in the areas of policy and practice. Advocating for policy change takes time and is beyond the individual efforts of school counselors, who are often beholden to their principal’s limited understanding of school counselors’ appropriate role and function (Lancaster & Reiner, 2022) and subsumed by untenable caseloads in under-resourced schools (Lambie et al., 2019). We, therefore, assert that advocacy is the professional imperative for all vested school counseling professionals (state counseling associations, school counselor educators, school counseling supervisors, and school counselors), all of whom could be working in tandem to advance the profession.

At the policy level, state and national counseling associations should reconsider the important role school counselors play in supporting students’ mental well-being and re-examine policies that delineate the appropriate use of school counselors’ time. Currently, the state school counseling model (Tennessee Policy 5.103) mirrors the national model (ASCA, 2019), perennially focusing on school counselors’ role in supporting student academics and delimiting their counseling role to prevention services, crisis counseling, and referrals to other mental health professionals. For state and national counseling associations, positioning school counselors as primarily focused on student academics demonstrated their value during the No Child Left Behind Act (NCLB; 2001) era, which prioritized unidimensional outcome measures of student success, particularly in math and reading (Savitz-Romer, 2019). However, the Every Student Succeeds Act (ESSA) replaced NCLB in 2015 and emphasizes more holistic aspects of student development and school climate. Many scholars argue that the ESSA (2015) combined with the rise in mental health issues has created a policy window for school counselors, led by their state and national professional associations (Savitz-Romer, 2019), to focus on the non-cognitive aspects that undergird healthy student development and to reclaim mental health as a domain central to school counselor practice (Lambie et al., 2019).

Redefining school counselors’ role in terms of mental health would require them to receive more clinical supervision (Lambie et al., 2019). In comparison to counselors in clinical settings, school counselors receive little to no supervision for their clinical efforts, which affects their clinical identity and weakens their counseling skills over time (Lancaster & Reiner, 2022). To address this gap, symbiotic partnerships could be formed with counselor education programs, particularly those that offer doctoral degrees in counselor education and supervision, to provide clinical supervision to local school counselors. Progress in this area may be forthcoming in the state, as institutions of higher education that operate school counseling, school psychology, and school social work programs have been invited to apply for grants funded through COVID-19 relief funding to support student internships in high-need schools. In addition, funds are available to support clinical supervision experiences that extend beyond students’ graduate training programs (Tennessee DOE, 2023).

MTSS programs also offer a promising prevention and intervention framework for meeting students’ comprehensive needs, including mental health, and align to both state and national school counseling models (Goodman-Scott et al., 2019). Further, the Tennessee DOE (2018) has developed a resource guide based on a tiered model for supporting students’ differential mental health needs, which school counselors could efficiently implement within their existing MTSS programs. Of note, within the Tennessee model, Tier 1 mental health practices build a foundation for mental wellness for all students. Advanced supports at Tiers 2 and 3 provide students who are at risk because of behavioral and/or mental health concerns with access to small groups and mental health interventions. One dimension of the state’s tiered mental health model is universal screening to identify students with internalizing behavioral disorders. Although few counselors in this study utilized universal screening, we recommend school counselors and their supervisors leverage the preexisting Tennessee DOE guidelines to petition their districts to adopt universal mental health screening.

Although the state mandated reduced counselor ratios in 2017 (Policy 5.103.), the funding formula allowed for uneven adoption of this policy (Tennessee Comptroller of the Treasury, n.d.), and target ratios fell short of national recommendations (ASCA, 2019). Thus, a function of this research was to utilize results in policy contexts to advocate for ratio realignments. In partnership with the state school counselor association, we produced a one-page results summary, written in simple language, to disseminate to state politicians to illuminate the acuity of mental health issues faced by K–12 students and proposed a solution through increased school counselor access. An advocacy effort led by the state association resulted in proposed legislation TN HB0364/SB0348, which would require one licensed full-time professional school counselor position for every 250 students and is currently advancing through the state Senate and House committees. A significant takeaway from this study is the importance and potency of coordinated partnerships between researchers, state counseling associations, and school counselors—an alliance that could be replicated in other states by school counselor stakeholders to advocate for the profession.

     The generalizability of these findings is limited because of the use of a state-level sample and a non-standardized, self-report survey. First, self-report surveys are sensitive to respondents’ tendency to rate themselves more favorably. Thus, it would be reasonable to conjecture that school counselors overestimated their adherence to the state guideline to spend 80% of their time in service to students and underreported their non-counseling duties. Second, although the items were informed by previous research on the psychological issues faced by children and adolescents during COVID-19 (Ellis et al., 2020; Karaman et al., 2021; Magson et al., 2021) and those factors that affect school counselors’ ability to provide direct services (Kaffenberger & O’Rorke-Trigiani, 2013; Parzych et al., 2019; Whitney & Peterson, 2019), the use of an ad hoc survey precluded us from performing more robust analyses (e.g., regression analysis). Third, because we only gathered data on students’ mental health issues and academic functioning post–COVID-19 pandemic, we have no benchmark data of students’ pre–COVID-19 functioning with which to make objective comparisons.

Fourth, although the sample was large enough to find some significant results, it was a small percentage of the state’s total population of public school counselors, which is estimated to be over 2,000. A larger sample would have increased the generalizability of findings and impacted the significance levels and practical importance of the results. Fifth, our sample lacks racial and gender diversity; however, it does align with the state’s overall population of educators (Tennessee DOE, 2021). Finally, regarding data analysis, interpreting correlations on a small population sample needs to be performed cautiously because of the possibility of sampling error. Additionally, point-biserial correlation can be impacted by the dichotomous nature of one of the variables, which constrains the variability of the results (Hinkle et al., 2002). Nonetheless, correlational analyses of ordinal and nominal variables in small-scale research are consistent with our exploratory design, and the results provide evidence that the variables examined share some type of relationship and provide direction for future research.

Future Research
     Given that we conducted this study in the aftermath of the COVID-19 pandemic and have utilized data and policy to advocate for expanded student access to school counseling services in Tennessee, this study design could be replicated by future researchers in the event that another pandemic or crisis of similar scale affects K–12 populations. Nonetheless, our exploratory design is an inherent limitation with the preponderance of our findings based on correlational analysis of largely non-parametric data. Future studies could explore dimensions of students’ mental health utilizing student data from empirical inventories. Rather than relying on school counselor perception data, researchers could use results from universal screenings, such as the Behavior Assessment System for Children-3rd edition (BASC-3), to better understand the nature of student issues and examine differential risk by demographic factors (e.g., age, gender, ethnicity), which could be used to inform evidence-based interventions with at-risk and high-risk populations. Further, researchers could employ quasi-experimental designs to assess outcomes of school counselor-led interventions, such as small groups, with students who have scored as being at risk based on universal screening. Studies of this nature can help build a case for the efficacy of school counselors and, in turn, protect them from role misallocation. Qualitative research could also be conducted in those schools in which school counselors implement a universal screening, intervention, and referral system to glean an implementation blueprint practical to other school counselors within and outside the state.


With elevated rates of depression, anxiety, substance use, and bullying, it is reasonable to conjecture that students in Tennessee have experienced COVID-19–related trauma, which according to research is unlikely to abate without intervention (CDC, 2022; Savitz-Romer et al., 2021). Although our state-level respondents indicated that they provided services consistent with crisis counseling (e.g., individual counseling, group counseling, consultation, and referrals), almost 50% of the counselors had been burdened with additional non-counseling duties, which could reduce their capacity to work with students at different levels of risk. Large caseload was a significant barrier, leaving counselors struggling to provide an appropriate level of care. This finding raises considerable concern about the risk faced by students who have experienced deterioration in their mental health and academics since the onset of COVID-19, yet attend schools in Tennessee with elevated school counselor-to-student caseloads. Nationally and at the state level, school counselors are the most prevalent mental health professionals in schools and are trained in crisis response (National Center for Education Statistics, 2016). Unfortunately, Tennessee school counselors appear to be facing barriers in the provision of student services related to high caseload and non-counseling duties, which presents cause for professional advocacy within the state and beyond.

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


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Chloe Lancaster, PhD, is an associate professor at the University of South Florida. Michelle W. Brasfield, EdD, LPSC, is an assistant professor at the University of Memphis. Correspondence may be addressed to Chloe Lancaster, 422 E. Fowler Ave, EDU 105, Tampa, FL 33620, clancaster2@usf.edu.

Experience of Graduate Counseling Students During COVID-19: Application for Group Counseling Training

Bilal Urkmez, Chanda Pinkney, Daniel Bonnah Amparbeng, Nanang Gunawan, Jennifer Ojiambo Isiko, Brandon Tomlinson, Christine Suniti Bhat


The COVID-19 pandemic resulted in many universities moving abruptly from face-to-face to online instruction. One group of students involved in this transition was master’s-level counseling students. Their experiential group counseling training (EGCT) program started in a face-to-face format and abruptly transitioned to an online format because of COVID-19. In this phenomenological study, we examined these students’ experiences of participating and leading in six face-to-face and four online EGCT groups. Two focus groups were conducted, and three major themes emerged: positive participation attributes, participation-inhibiting attributes, and suggestions for group counseling training. The findings point to additional learning and skill development through the online group experience as well as its utility as a safe space to process the novel experience brought about by COVID-19.

Keywords: experiential group counseling training, phenomenological, COVID-19, face-to-face, online format


Most of what is known about group counseling and the training of group counselors has been learned from groups that occur in face-to-face group environments (Kozlowski & Holmes, 2014). This includes seminal works on group counseling’s therapeutic factors, such as universality, altruism, instillation of hope, cohesiveness, existential factors, interpersonal learning, self-understanding, and catharsis (Yalom & Leszcz, 2005). Researchers have found positive contributions of group therapeutic factors toward therapy outcomes (Behenck et al., 2017), and they have explored the experiences of group members in face-to-face group counseling settings, including the interpersonal and intrapersonal processes of members (Holmes & Kozlowski, 2015; Krug, 2009; Murdock et al., 2012). By contrast, there is considerably less research on online group counseling (Kozlowski & Holmes, 2014) or group counselors’ training in online modalities (Kit et al., 2014; Kozlowski & Holmes, 2017).

In this qualitative study, we utilized the phenomenological method to explore and compare master’s-level students’ experiences of participating in and leading during six face-to-face and four online experiential group counseling training (EGCT) groups as part of an introductory group counseling course. The master’s-level counseling students began their EGCT in face-to-face groups, and because of the COVID-19 pandemic, they continued to meet in four online groups after their university decided to suspend all face-to-face instruction.

Experiential Groups in Counselor Education
     Group counseling training is one of the eight core areas of required training for counselors stipulated by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP; 2015). In order to learn the complex group processes necessary for effective group counseling, master’s-level counseling students are required to participate in EGCT (Association for Specialists in Group Work [ASGW], 2007; CACREP, 2015). For CACREP-accredited master’s programs, at least 10 clock hours of group participation during one academic semester are required (CACREP, 2015). During this experiential training, students learn to be both group counseling participants and group counseling leaders (Ieva et al., 2009) and gain valuable experience in and insight into group dynamics, group processes, and catharsis (Ohrt et al., 2014).

Master’s-level counseling students “benefit a great deal when allowed to develop practical and relevant clinical skills” (Steen et al., 2014, p. 236). Experiential training in group counseling also promotes self-awareness, personal growth, and a greater understanding of vulnerability and self-disclosure in the learners (Yalom & Leszcz, 2005). The experiential component of group counseling training provides an environment for counseling students to experience vicarious modeling, self-disclosure, validation, and genuineness from their classmates (Kiweewa et al., 2013). Finally, these experiential opportunities promote students’ self-confidence (Ohrt et al., 2014; Shumaker et al., 2011; Steen et al., 2014).

Online Counseling
     Barak and Grohol (2011) defined online counseling as “a mental health intervention between a patient (or a group of patients) and a therapist, using technology as the modality of communication” (p. 157). Counselors are increasingly using more digital modalities in their practice (Anthony, 2015; Richards & Viganó, 2013), and it is being seen as a viable alternative to support clients (Hearn et al., 2017). Since the start of the COVID-19 pandemic, counselors have begun to use more online modalities to provide counseling services (Peng et al., 2020). Online counseling began to emerge as a potential solution for mental health services when providers were forced to discontinue or scale down in-person services and adjust to virtual formats during the pandemic (Békés & Aafjes-van Doorn, 2020; Peng et al., 2020; Wind et al., 2020). Peng et al. (2020) noted the effects COVID-19 have had on the delivery of mental health services in China. They mentioned the governmental and authorities’ support for preparedness and response and the multidisciplinary enhancement of remote intervention quality for clients. They also suggested that governments should integrate the mental health interventions related to COVID-19 into existing public mental health emergency preparedness and response structures.

Because of the growing importance of online counseling, it is essential to train counseling students to conduct online counseling, including online group counseling, effectively. Understanding master’s students’ experiences in online EGCT can help identify potential challenges they may face during their training. It is also important to explore students’ experiences in face-to-face and online EGCT groups to better understand possible future training needs and help counselor educators create an educational curriculum that addresses group counseling knowledge and skills for online groups. There is currently a lack of information about how to train counseling students in the delivery of online counseling (Kozlowski & Holmes, 2014), and specifically group counseling (Kit et al., 2014).

Professional and Accreditation Bodies’ Guidance on Technology
     The American Counseling Association (ACA) Code of Ethics states, “Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions” (2014, p. 17). The ASGW Best Practices Guidelines require that “Group workers are aware of and responsive to technological changes as they affect society and the profession” (ASGW, 2007, p. 115, A.9). Similarly, CACREP (2015) indicates “students are to understand the impact of technology on the counseling profession” (2.F.1.j) as well as “the impact of technology on the counseling process” (2.F.5.e). CACREP also emphasized that students understand “ethical and culturally relevant strategies for establishing and maintaining in-person and technology-assisted relationships” (2.F.5.d). Additionally, the Association for Counselor Education and Supervision (ACES; 2018) provides guidelines for online instruction featuring descriptions regarding course quality, content, instructional support, faculty qualifications, course evaluation procedures and expected technology standards.

Online Group Counseling
     Textbooks on group counseling have mainly approached EGCT in face-to-face formats (e.g., G. Corey, 2016; Yalom & Leszcz, 2005). Given the growing interest and demand for online counseling in recent years (Holmes & Kozlowski, 2015; Kozlowski & Holmes, 2017), COVID-19 has highlighted the need for greater awareness and understanding of online group counseling training. However, there is limited research on online group counseling and counseling students’ training in online group counseling.

Kozlowski and Holmes (2014) explored master’s-level counseling students’ experience in an online process group, reporting themes of participants’ experiences of a linear discussion, role confusion, and feelings of being disconnected, isolated, and unheard. In 2015, Holmes and Kozlowski expanded on their work with a study on master’s-level counseling students’ experiences in face-to-face and online group counseling training. They found that the online group participants felt significantly less comfortable than participants in the face-to-face group. Further, participants in the study evaluated face-to-face groups as preferable for participation, social cohesion, and security (Holmes & Kozlowski, 2015). Lopresti (2010) compared students’ group therapy experiences between face-to-face and online group counseling methods using synchronous text-based software. This research involved six master’s-level students engaging in an 8-week, 60-minute, weekly online group counseling session using the WebCT chat system. Results indicated that in the online format, some participants reported self-disclosure more easily, but they also shared that it was easy to hide behind the screen and to censor themselves.

Effectiveness of Online Group Counseling
     Some researchers have observed the efficacy of online support groups (Darcy & Dooley, 2007; Freeman et al., 2008; Lieberman et al., 2010; Webb et al., 2008). Haberstroh and Moyer (2012) reported that professionally moderated online support groups could supplement face-to-face counseling, especially for clients who want regular daily support during the process of recovering from self-injury. They also found that online group interaction provided clients with opportunities to engage in healthy self-expression and reduce their sense of loneliness and isolation (Haberstroh & Moyer, 2012). King et al. (2009) examined the effectiveness of internet-based group counseling to treat clients with methadone substance abuse, reporting that internet-based group counseling could reduce resistance and non-adherence in clients. Clients expressed satisfaction with the process and reported convenience and higher levels of trust in confidentiality because they were able to participate from home.

Similarly, Gilkey et al. (2009) reported the advantages and disadvantages of synchronous videoconferencing (SVC) web-based interventions. This study involved families with children with traumatic brain injury. The results revealed that SVC had the potential for family-based therapy delivery. However, it required important factors such as client readiness to address their issues and patience with the technology’s imperfections. SVC could reduce barriers to treatment with motivated families from diverse backgrounds. Nevertheless, the online group experience is vulnerable to the impact of technology glitches, privacy issues, disruptions in connectivity, and personal detachment (Amulya, 2020). In online group therapy, Weinberg (2020) identified four obstacles: managing the frame of the treatment, the disembodied environment, the question of presence, and the transparent background.

Purpose of Study and Research Questions
     In March 2020, as a result of the pandemic, our university moved most face-to-face classes to virtual environments following statewide restrictions for in-person gatherings. This sudden change led to a unique experience for first-year master’s-level counseling students enrolled in an introductory group counseling course at a CACREP-accredited program in the Midwest. It was planned that students would participate in 10 face-to-face EGCT groups of 90 minutes each to fulfill the CACREP (2015) group counseling experiential training requirements. Doctoral students facilitated the first five group counseling experiences for the counselors-in-training. The plan was for two master’s students to lead face-to-face groups under the supervision of doctoral students for the remaining five groups (6–10). However, the university closed for 2 weeks after Session 6 was completed. As a result, when classes resumed, they were online. EGCT Sessions 7 through 10 were conducted online using Microsoft Teams with master’s students leading and doctoral students supervising. Thus, in a single semester, the master’s students had the experience of participating in and leading both face-to-face and online groups. Our study was guided by the following research question: What were master students’ experiences of participating and leading in both face-to-face and online EGCT groups?


Research Design
     Qualitative methodology was used to explore first-year master’s students’ experiences of participating and leading in both face-to-face and online formats of EGCT. Our aim was to build an understanding of their experience shifting to an online modality with a specific interest in their attitudes, learning, facilitating, and adaptation to these two environments. For this purpose, a phenomenological approach was appropriate for investigating students’ unique experiences in both versions of the EGCT groups. Moustakas (1994) defined phenomenology as an approach for “comprehending or having in-depth knowledge of a phenomenon or setting and . . . attained by first reflecting on one’s own experience” (p. 36). In a phenomenological study, the aim is to describe the essence of individuals’ experiences with a certain phenomenon (Creswell & Creswell, 2018).

Participants and Procedures
     IRB approval was obtained, and purposive sampling was implemented with a recruitment email. All participants were recruited from a CACREP-accredited counseling program in the Midwest  United States. Our inclusion criteria were that participants must be current master’s-level counseling students and must be enrolled in a group counseling course. In addition, each participant must have experienced both participating in and leading at least one EGCT session during the prior term.

The invitation to participate in a focus group was emailed to all students enrolled in the group counseling course in the prior term. It included information about the study, addressed voluntary participation, and explained the entirely separate nature of participation in the focus group from evaluation of performance in the group class that had concluded. This recruitment email was sent out a total of three times within a 3-week period before the study was conducted.

Nine students agreed to participate in the study, and written consent forms were sent to them via email to read and review. Of the nine participants, three self-identified as male and six self-identified as female. Seven participants identified as White and two identified as “other,” and the age range was 18–34 years old. Two participants were specializing in school counseling, three in clinical mental health counseling, three in clinical mental health/clinical rehabilitation counseling, and one in clinical mental health/school counseling.

Before the focus group, prospective participants were emailed a copy of the semi-structured interview questions to alleviate any anxiety or concerns about the questions that would be asked during the study. Prospective participants were also invited to ask any questions at the start of the focus group and were then invited to provide verbal consent. To secure confidentiality, participants were assigned a code consisting of letters and numbers to protect their identity. Participants’ identification codes, with corresponding names, were kept securely in the possession of the first author, Bilal Urkmez.

Focus Groups
     Focus groups were used because they allow students to share their experiences with EGCT groups and compare points of view (Krueger & Casey, 2014). Two online focus groups were held—one with five participants (one male, four females) and one with four participants (two males, two females). Participants received invitation links from the focus group facilitator via Microsoft Teams. All participants were familiar with Microsoft Teams because they had used it for their experiential groups and classes after moving to online instruction. Urkmez contacted the university’s IT department regarding the protocol of recording and securing the video and audio of the focus groups on Microsoft Teams.

Our fifth and sixth authors, Jennifer Ojiambo Isiko and Brandon Tomlinson, who led and supervised the original EGCT groups, conducted the focus groups. Care was taken to ensure that master’s students were not placed in a focus group led by the same doctoral student who had previously led and supervised their 10-session EGCT groups.

We used Krueger and Casey’s (2014) guidelines to create a semi-structured focus group protocol. Open-ended questions were built in for the focus group leaders to use as prompts to facilitate discussion when necessary. The online focus groups lasted approximately 60 minutes. All the conversations were recorded and then transcribed verbatim by the designated focus group facilitator.

Authors’ Characteristics and Reflectivity
     Our research team consisted of two counselor educators with experience teaching and facilitating group counseling courses and five counselor education doctoral students. All doctoral students were part of a single cohort, and all had prior experiences facilitating group counseling. The counselor educators were Urkmez, who self-identifies as a White male, and Christine Suniti Bhat, an Asian female. The doctoral students were Chanda Pinkney, an African American female; Daniel Bonnah Amparbeng, an African male; Nanang Gunawan, an Asian male; Isiko, an African female; and Tomlinson, a White male. Before data collection, we met to discuss focus group questions, explore biases and assumptions, and assign focus group leaders for the study.

Our team used multiple strategies to establish trustworthiness. As two of the researchers taught group counseling and five of the researchers had led and supervised the EGCT groups, it was necessary to discuss possible biases before and during the data analysis process to ensure that the resulting themes and subthemes emerged from participants’ responses (Bowen, 2008).

First, some of the researchers shared that they believe face-to-face group counseling is better than online group counseling because they do not personally like to take or teach online courses in their education. All research members taught, learned, and supervised EGCTs predominantly in face-to-face environments prior to the study and pandemic. Secondly, some of the researchers also mentioned their frustrations with learning and supervising online. These discussions were held to promote awareness of potential biases so as to avoid focusing on the negative experiences of the master’s students. Bracketing was implemented throughout the study to reduce researchers’ possible influence on participants of favoring face-to-face counseling environments (Chan et al., 2013). This measure helped ensure the validity of the study’s data collection and analysis by having the researchers put aside any negative experiences of online learning environments during the pandemic (Chan et al., 2013). Urkmez, Pinkney, Bonnah Amparbeng, Gunawan, Isiko, and Tomlinson analyzed the data first, fulfilling investigator triangulation (Patton, 2015). This same group then met several times to discuss their analyses of the transcripts and agree upon the significant statements and themes.

Experiential Group Counseling Training
     Twenty-eight first-year master’s students were enrolled in an introductory group counseling course in the spring 2020 academic semester. The EGCT groups were a required adjunct to the didactic portion of the course. EGCT sessions for the master’s students met weekly for 90 minutes and were set up so that the master’s students were participants for Sessions 1 through 5 (led by doctoral students) and were leaders for Sessions 6 through 10 (supervised by doctoral students). All 10 sessions were planned to be face-to-face sessions. Doctoral students were enrolled in an advanced group counseling course, and their participation was a required component of the course.

During the first five sessions, doctoral students’ responsibilities as leaders included facilitating meaningful interaction among the participants, promoting member–member learning, and encouraging participants to translate insights generated during the interaction into practical actions outside the group (G. Corey, 2016). For Sessions 6–10, in the role of supervisors, doctoral students’ responsibilities were to mentor and monitor the master’s students’ group leadership skills and provide verbal feedback immediately after the session. Doctoral students also provided written feedback to both the master’s students and group counseling course instructors. Additionally, the doctoral students engaged in peer supervision with each other under the tutelage of the advanced group counseling course instructor, discussing how EGCT could be supervised more effectively.

As stated previously, two master’s students started to co-lead the EGCT groups during Session 6, which was conducted face-to-face. After Session 6, in-person classes were canceled by the university in response to COVID-19, so the remaining four sessions of EGCT were conducted online on Microsoft Teams. The online groups were conducted synchronously on the same day and time as the face-to-face groups had been conducted in the earlier part of the semester.

Session 7 was the first synchronous online session of the EGCT and deserves special mention. Prior to Session 7, the doctoral students received brief training on Microsoft Teams. The master’s students had no previous exposure to Microsoft Teams. Thus, during Session 7, the doctoral students provided support by demonstrating how Microsoft Teams worked and processing the master’s students’ thoughts, feelings, and levels of wellness in relation to the sudden pandemic. Students resumed leading the online synchronous groups for Sessions 8, 9, and 10 under doctoral students’ supervision.

Data Analysis
     Isiko and Tomlinson led the two focus groups and transcribed the data collected from the participants who shared their experiences in the focus groups. We utilized the phenomenological data analysis method described by Moustakas (1994). Urkmez, Pinkney, Bonnah Amparbeng, Gunawan, Isiko, and Tomlinson conducted the data analysis while Bhat served as a peer debriefer because of her position of seniority in terms of expertise in not only qualitative methodology, but also group counseling research, as well as her experience of more than 15 years in teaching both master’s- and doctoral-level group counseling courses at the CACREP-accredited program. Her primary role was to read the transcripts, review the raw data and analysis, and scrutinize established themes to point out discrepancies (Creswell & Creswell, 2018).

Our research team (except for Bhat) met to discuss our potential biases and bracket our assumptions about the phenomenon under investigation. Then, each of us independently read all transcripts multiple times to become familiar with the data. Next, we reviewed the transcripts according to the horizontalization phase of analysis (Moustakas, 1994). Moustakas defined the horizontalization phase as the part of the analysis “in which specific statements are identified in the transcripts that provide information about the experiences of the participants” (Moustakas, 1994, p. 28). During this step, we independently reviewed each transcript and identified significant statements that reflected the participants’ interpretations of their experiences with the phenomenon. We identified these significant statements based on the number of times they were mentioned both within and across participants. From this point, we each independently created a list of significant statements.

Subsequently, we met to review our lists to establish coder consistency, create initial titles for the themes, and place data into thematic clusters (Moustakas, 1994). Each of our themes and related subthemes were similar in content and typically varied only in the titles used. Titles for themes and subthemes were discussed until consensus was obtained. We revisited the horizontalized statements and discussed our different perspectives. Next, we evaluated the most commonly occurring themes and created a composite summary of each theme from the participants’ experiences. After these steps, we arrived at a consensus about each theme’s essential meaning and decided on specific participant quotes that represented each theme.


We identified three main themes related to the participants’ experiences of taking part in and leading both face-to-face and online EGCT. The three main themes were positive participation attributes, participation-inhibiting attributes, and suggestions for group counseling training.

Positive Participation Attributes
     The central theme of positive participation attributes focused on exploring master’s students’ perceptions about what helped them actively participate in both online and face-to-face EGCT groups as a group member. Five subthemes were identified in the main theme of positive participation attributes: (a) knowing other group members, (b) physical presence, (c) comfortability of online sessions, (d) cohesiveness, and (e) leadership interventions.

Knowing Other Group Members
     The EGCT group involved graduate-level counseling students who knew each other for a semester before engaging in the EGCT. Study participants shared that seeing familiar faces provided a safe and supportive environment for them to participate in both face-to-face and online group sessions as a group member. One participant noted that “a part of it helped because it was many people I had already known,” and another participant stated that “it was easier to have face-to-face after we had already kind of met everybody in the semester and so I wasn’t worried about confidentiality. I wasn’t in this group with a whole bunch of strangers.” Participants noted that knowing other group members helped them to participate actively in EGCT. They reported that having familiar faces in the group made them feel comfortable and connected, and that it helped them engage more fully during the ECGT groups.

Physical Presence
     Study participants shared that group members’ physical presence during the face-to-face sessions enhanced their willingness to participate. The physical presence provided access and a better ability to understand group members’ content and emotion through their body language, eye contact, vocal tone, and other nonverbal cues during sessions. As one participant shared, “I feel so much more in touch and present with people when I can see them, but just kind of feel their physical presence rather than just watching the faces online.” Furthermore, the study participants shared that being physically present during the face-to-face sessions allowed for the incorporation of more icebreaker activities by both doctoral and master’s student group leaders, enhancing their participation in groups. One participant noted that “the small icebreakers, I just remember doing those at the beginning during our face-to-face sessions; those were a lot of fun.”

Comfortability of Online Sessions
     Participants reported that they felt comfortable engaging in online EGCT from their familiar surroundings at home. They appreciated the convenience of participating in ECGT groups from wherever they were. One participant reported that “people could be outside or eating or drinking or whatever, which I think is cool.” Another participant shared that before the state-issued quarantine, they already used online technology to communicate with friends, so it was easy to use Microsoft Teams for online experiential training groups. Another participant noted:

We were doing them (EGCT) from the comfort of our own home; it just increased how comfortable you were in general. We were all at home, rocking in sweatpants and not having to worry about stuff. I feel we were in our own comfortable, safe space, and that made the online easier for me.

     Participants reported they felt “anxious,” “lonely,” and “isolated” and experienced other difficulties during the COVID-19 pandemic. They noted that they actively engaged in online EGCT sessions because it provided them with the opportunity to connect, share, and process their thoughts and emotions. A group participant reported, “We all had to isolate. [It] made it exciting to be able to connect with everyone again, to talk about how it (COVID-19) was affecting us, to vent out our emotions and check in with others.” Additionally, another participant reported:

When we started these sessions [online], it was at the beginning of these COVID-19 issues, and I was feeling more stressful, and there was nothing to do. It was so difficult to adjust to this environment, even staying at home. This was like an opportunity for me to connect with classmates in the group and [it] helped me to reflect on my anxiety and how other people were thinking around these COVID-19 issues.

     As a result of the online EGCT groups, participants gained a means of personal interaction during isolation. The subthemes presented above capture the positive participation factors that helped participants to engage actively in both online and face-to-face sessions.

Leadership Interventions
     Participants shared leadership interventions that helped them to participate during face-to-face and online sessions. The sudden transition to online groups due to COVID-19 was characterized by trial and error and uncertainty for everyone. Participants noted that while working with the new online EGCT group and different processes than what they experienced before COVID-19, doctoral students and master’s student leaders demonstrated a sense of flexibility and adaptability to the prevailing situation and could steer the groups in the changing environment. Both the doctoral and master’s student leaders were aware of the effect of COVID-19 on the participants, and they allowed the participants to get support from each other before they could get into the session plan for the group. One participant mentioned that “we kind of partly used that [the group] as a social support group . . . and reflect on how we’re feeling during social isolation.” Another participant shared that “the facilitators were flexible. So, even if they had a topic or something like that, they would allow for flexibility, to check in [with participants], and be able to kind of shift focus to what we all needed.”

Participants explicitly mentioned that the doctoral and master’s students’ leadership interventions, such as encouraging, checking in, and being present, helped them engage in the EGCT groups. Participants highlighted the strength of the group leaders’ encouragement of reflection (“I appreciated that the leader really put emphasis on encouraging us to answer questions”) and overall presence and attention (“[The leader] was attending our behavior and was really good with reflecting”). The participants also found the aspect of “checking in” by the leaders as something that enhanced their participation: “The leaders were always pretty quick to check in on someone if something seemed off.”

Group leaders’ ability to coordinate and successfully facilitate group sessions can significantly influence group outcomes (G. Corey, 2016; Gladding, 2012). Study participants shared that group facilitators demonstrated leadership skills and techniques to facilitate meaningful discussions and participation among members in both face-to-face and online sessions: “Like she [group leader] was always there to answer questions if there is silence; like she didn’t want us to rely on her to do the entire conversation, so her encouragement was beneficial for me.”

Participation-Inhibiting Attributes
     For this main theme, we examined attributes that negatively influenced participation and leading in the online and face-to-face formats of the EGCT groups. Three subthemes were identified: (a) group dynamics, (b) challenges with online EGCT, and (c) technological obstacles for online EGCT. The most prominent subtheme that arose and spread across both group formats was that of the group dynamic. Friction within the group dynamic was one of the primary issues reported by participants. The remaining subthemes were related to challenges with online EGCT groups. These challenges include the importance of “being with” or physically present with the rest of the group, problems with missing nonverbal communication in the online meetings, difficulties navigating awkward silences and pauses in the group, and technical obstacles.

Group Dynamics
     Study participants shared that the group dynamics dictated how much of a connection developed among group members and significantly influenced the progression to the working phase in the groups. In the words of one participant, “I feel like that was definitely something with our group dynamic. . . . There was definitely still good conversations, but I think that impacted it.”

Some participants reported their initial concerns about fostering rapport with group mates chosen randomly for them. Participants expressed thoughts that personalities did not mesh well in their group and that there were issues of building good rapport. Some participants indicated that having a reserved personality made it hard to participate: “For me, it was more about a personal thing because I am an introverted personality, so I find it difficult to talk in groups anyway, so that’s what hindered my participation sometimes.” Another participant stated: “I felt like the others protect themselves by not talking, so why should I open myself and put myself into risk? I thought about that.”

Challenges With Online EGCT
     Participants in this study emphasized that one of the main difficulties of the online EGCT experience that affected their participation and leadership negatively was missing body language and physical cues. Participants shared that they could use nonverbal cues and body language to know when it was a good time to speak without interrupting other group members during the face-to-face ECGT. Because these were missing in online EGCT, the students did not have immediate awareness to participate in group conversation without interrupting other group members. For example, one participant noted the difficulties of “just not being able to read body language as well and not being able to see everyone at once.” As a result of these online environment limitations, study participants indicated they had a sense of “stepping on toes” while trying to participate in online EGCT: “I think that one of the biggest challenges with doing it [EGCT] online is that you want to be respectful and make sure that you are not gonna talk over somebody else.”

Kozlowski and Holmes (2014) previously noted that the unfamiliar environment of online counseling, the time delay because of technology, and the inability to utilize group members’ body language can all create a one-dimensional or “linear” experience in online group counseling environments. These factors appeared to hinder the natural growth and development of the EGCT groups in our study as well. In an effort to reduce the perception of being rude, there were times of awkward silence as participants avoided constant interruptions during the sessions; this difficulty gave the feeling of a linear environment.

One other factor the participants noted in the online format more so than the in-person group was what students described as an awkward silence. This occurrence serves as a subtheme of missed physical cues because the participants noted that the lack of said cues complicated determining when to speak and when to wait: “Online, the silence almost felt like it was much longer than what it really would have been if it was face-to-face.” Another participant stated that they “feel pretty comfortable with silences, but it’s a lot harder to gauge that when it’s online.” This issue presented itself in several circumstances, though one group did attempt to figure out a solution, per the report of one participant: “For our group . . . to help with people talking over each other, we had people type in a smiley face in the chat when they wanted to share.”

Notably, participants in this study also mentioned that there was some physical presence that they could not describe but found to be relevant to them in their connection with the group. Although students were unable to identify it precisely, several study participants agreed on its importance. One participant said that they “enjoy the voice and the video, but I feel like when we are talking, especially in a group dynamic and group processes, especially to grasp something important, I really need to be with this person in a physical space.”

The participants emphasized the importance of physical presence, from the ability to see and greet one another to having space to do activities that got them up and moving. Many participants mentioned some intangible quality they could not name but that was missing when the groups convened electronically instead of in person. A participant shared that “you can observe the body language—what is happening in the group actually, but in online sessions, it’s like you don’t know, you are just talking.”

As noted in other sections, the group members appreciated the space for doing activities together when they were in person. Master’s student group leaders reported that they felt anxious when facilitating icebreaker activities in their online EGCT sessions because of the missing physical presence and noted the loss of face-to-face icebreakers. Study participants lamented that the online format did not allow for these bonding and icebreaking exercises, which when utilized in the usual face-to face format tended to put them in a position to feel better equipped to share with their group members, almost like a metaphorical entryway to the group process: “Some of the exercises are not possible to execute [online] because we were doing some physical things in our group, like throwing balls to each other and stuff.” Without these social warm-ups, the group flow and process suffered; according to those in the focus group, leaders needed more assistance to run activities in online EGCT sessions. One participant added a similar sentiment: “How do we lead a group online with proximity activities or icebreakers we would use? We can’t really do [that] because of the virtual interaction, [it] can’t work.”

Overall, the online EGCT environment limited the interpersonal relationships of the EGCT members and group leaders. Group members could not use their nonverbal communication skills or participate in physical group activities. Lastly, online EGCT appears to provide added pressure on group leaders to keep members engaged during the session. Master’s students had to choose topics where all members felt comfortable enough to participate with minimal encouragement, which was a challenge.

Technological Obstacles for Online EGCT
     Participants reported some technological difficulties that inhibited their ability to participate and lead the online EGCT sessions. Some participants noted that when participants turned off their cameras, it exacerbated disengagement levels within the group and hampered group dynamics. Some speculated that technical difficulties might be an excuse to disengage from the group: “Like in online, I can be mute, I can turn off my camera, I can not talk, and I can accuse the technology for that.” This capacity to disengage negatively impacted the group for several of the focus group participants, who noted that they felt this closed off the group and circumvented the ability to engage with all members of the group.

The limitations of the university-sanctioned online platform used for the EGCT groups, Microsoft Teams, adversely affected engagement during the online sessions as it only allowed four members (at the time of the online EGCT sessions) to be seen on the screen at a time. As one participant stated, “I cannot see all the group members . . . my attention is not with all members. This was difficult. It was difficult to lead the group.” Several group members were vociferous in their dislike for this limitation of the platform. Further, internet connectivity issues were problematic: “Sometimes like a group member would disconnect [because of technology problems], and there would be several minutes before they could come back.” These types of interruptions were frustrating to all group members and group leaders. Master’s student group leaders had a difficult time leading with interruptions.

One focus group participant noted, and others agreed, that it was challenging to learn how to lead a group online because they were missing so many elements of the in-person process of leading a group, and they did not have previous group leadership experience in an online environment. A participant shared that “it’s hard [leading group online]. It’s maybe harder for leaders because they cannot observe what’s going on . . . like body language.” 

Suggestions for Group Counseling Training
     Participants were invited to share their concerns and ways to develop and improve face-to-face and online EGCT group experiences. Three subthemes were identified: (a) software issues and training, (b) identified group topics, and (c) preferred EGCT environment.

Software Issues and Training
     Participants shared common concerns about the software for their online experiential training groups. Specifically, they found Microsoft Teams’ display of only four people at one time prevented them from seeing all group members on the screen. Members who were not speaking were displayed at the bottom of the computer screen with their profile picture or initials, which was not conducive to interaction. One participant suggested that they should “probably just use Zoom instead . . . I like Zoom better, seriously, because I can see absolutely everyone.” Another participant agreed, “But for the reason, at least, in Zoom, I can see everyone’s faces, not, um, not just four.”

Another participant similarly emphasized the importance of seeing everyone on one screen during their meeting: “If you don’t see the faces [at one time], you’re just clueless. I mean, have to, like, awkwardly check in with this person all the time.” Participants also brought another suggestion about training on leading online experiential training groups. Participants shared their anxiety about leading groups using online software because it is a new and unique experience. Because of the sudden onset of COVID-19, the students did not have a chance to get training on how to lead online experiential training groups. A participant mentioned that having training where students could learn how to facilitate online groups before leading weekly sessions would help alleviate anxiety and build competence: “Perhaps allowing a small period where everyone kind of gets adjusted to it and becomes more familiar with it might help facilitate [online] group sessions better.”

Identified Group Topics
     Another suggestion by participants regarding their EGCT experience was using one selected topic for each group. For example, a participant shared: “I think part of what was hard about this that might be something to change is, like having the group just be all over the place in terms of topics from week to week.” Another participant added: “If the group was more, like, a little bit more specific and clearer about like, the goal, or something like that, that might be—might help it flow a little bit better.” Some participants also suggested allowing students to select which group they wanted to attend, instead of having groups pre-assigned to them. In other words, participants preferred to join a specific group based on their interests. A participant mentioned: “I think that would be like a really good option to give like a list of ten types of groups or topics in the groups.” Another participant similarly suggested “giving an opportunity to all students to choose one group. For example, like the one group would work specifically on self-esteem problems or the other one would work on grief problems.”

Some participants noted that they felt there was a lack of purpose for the group, indicating that they were not sure of the group’s goals or objectives and that this hindered their ability to participate fully. Some also shared having confusion about their role and the boundaries of the group and what they could or could not share. One participant noted: “In the first session when we were trying to set up our goals, it was difficult for us to find what the goals will be as a group leader candidate, or as a person.” The focus group participants suggested giving more concrete topics overall for the EGCT group to understand better how to participate. This notion spanned across the online and face-to-face format as a more general recommendation.

Preferred Training Environment
     Lastly, participants were asked about their preference for participation in a face-to-face or online EGCT experience, if given a choice. Even though participants reported a reasonably good experience with online EGCT groups, such as comfortability and cohesiveness, most of the participants voiced a preference for face-to-face sessions if they had to do the group counseling training over again. One participant stated: “Ultimately, face-to-face will probably still be better.” Another participant added: “Face-to-face for sure. I just think as like a profession, we all enjoy working with people. We would prefer to work with someone in person.” Similarly, another participant mentioned: “I would definitely choose face-to-face, but I was thankful that we had the opportunity to do it online.”

Asking the participants about their preferred experiential training group environment garnered the most reaction during the interviews. Most of the participants shared that they preferred face-to-face groups. Even though participants had personal connections in an online setting, they wanted to have face-to-face meetings to interact better. One participant mentioned that “we are doing online sessions right now. I wish that I [could] continue to do the group lab and connect with the group members, but if I have the opportunity to take face-to-face, absolutely, I would do that.” Lastly, another participant added: “Absolutely, it’s face-to-face, but if we are in a situation like this, COVID-19 issues, sometimes the online sessions can be helpful.”

Participants offered their perspectives on learning group counseling skills during the global COVID-19 pandemic. Despite the unprecedented circumstances, the students persevered and completed the course. Group leaders and professors encouraged the group members to participate to the best of their abilities. The concerns and suggestions shared in these focus groups could help counselor educators plan and develop for EGCT in both online and face-to-face formats.


This study investigated the experiences of master’s students in an online and face-to-face EGCT group. EGCT is an essential aspect of novice counselors’ preparation and is required by CACREP (2015) standards. In this study, participants identified positive factors related to their EGCT group participation, such as knowing other group members, group leadership skills, physical presence, and connection with other group members. They also reported participation-inhibiting factors such as the complexities of group dynamics, missing physical cues, and technological challenges. Our research findings are similar to Kozlowski and Holmes’s (2014) study on online group counseling training. Their participants reported problems with the group feeling artificial, lacking attending skills, and difficulties with achieving cohesion and connectedness.

In the current study, course instructors and student leaders did not have control over the choice of an online platform. The limitations of Microsoft Teams, which at the time of the online EGCT sessions only allowed four participants to be visible on the screen at one time, added to difficulties with engaging and feeling connected. For participants to remain engaged, leaders and instructors should have access to online platforms that allow students to see all group members simultaneously on the screen. Setting ground rules requiring that cameras remain on during sessions and utilizing the chat feature or the hand-raising feature to facilitate discussions would also help create and maintain a sense of connection. Outlining contingency plans such as the alternatives for not being able to join the group with the camera on are important for successful group outcomes.

Participants in this study appreciated the convenience of participating in online ECGT groups. This is similar to the findings of King et al. (2009) about the convenience of access to online group counseling. In the same study by King et al. (2009), the participants shared that online counseling sessions allowed them to participate from the comfort of their homes, thus improving both convenience and privacy. One of the difficulties participants reported was that of awkward silence. This experience, coupled with interruptions (“stepping on toes”), resulted in students finding that the experience online was more linear and less organic compared to face-to-face interactions. These findings are similar to those of Kozlowski and Holmes (2014). Yalom and Leszcz (2005) noted that the group leader’s role is to design the group’s path, get it going, and keep it functional to achieve effectiveness. Presence, self-confidence, the courage to take risks, belief in the group process, inventiveness, and creativity are essential leadership traits in leading groups (G. Corey, 2016). However, these traits are for in-person groups. It is possible that effectively leading online groups requires other skills that have not yet been identified. The sudden change to online training in this instance did not allow for a planful design. It is necessary for group leaders to possess specific group leadership skills and appropriately perform them to help group members participate in groups (M. S. Corey et al., 2018). However, participants appreciated that the doctoral and master’s student leaders demonstrated flexibility, allowing for additional time to check in with group members and process their experiences and emotions related to the pandemic.

One interesting finding related to how COVID-19 impacted participants’ experiences in the ECGT groups was that group participants actively engaged in the online sessions when they were allowed to process their anxiety and stress due to COVID-19, as it served as a support group. This result is dissimilar to findings of previous studies in which participants felt unsafe during online group sessions and being on online platforms impeded participants’ emotional connection and trust levels (Fletcher-Tomenius & Vossler, 2009; Haberstroh et al., 2007; Kozlowski & Holmes, 2014).

Bellafiore et al. (2003) emphasized online group leaders’ roles as “shaping the group” and “setting the tone.” They also expressed that “establishing and maintaining a leadership style is important in keeping the group going” (p. 211). In the current study, first-year master’s students, many of whom were participating in or leading groups for the first time, had the unexpected and sudden additional layer of learning how to lead online. Further, the abrupt transition from face-to-face to online groups because of COVID-19 did not allow for extensive instructor planning and preparation. Leading groups online was challenging and anxiety-provoking for members, as they lacked experience and were unsure how to proceed. Master’s students need additional training on facilitating online groups, establishing a leadership style, and managing silence. This information corresponds with Cárdenas et al.’s (2008) findings that master’s-level counseling students felt more confident to provide online counseling services after training.


Although the findings from this study are not generalizable, there may be implications for designing and leading EGCT groups that merit consideration based on the experience of the counselor trainees described in this study. Part of the group design entailed assigning different topics to focus on for each session. The rationale for having different topics for each session should be clearly explained to the participants. Any questions regarding the identified topics should be addressed early to enhance the group facilitation process for both leaders and participants. Additionally, group leaders or course instructors need to explain roles clearly, and group members should understand the group’s boundaries and how they fit with their didactic course.

With online EGCT groups, it is essential to consider how participation is influenced by a lack of natural communication signals, such as body language and physical presence. Counselor educators and EGCT student leaders need to establish ground rules about online group interactions such as having all cameras remain on during sessions, having a private and quiet space from which to participate, and minimizing distractions from pets or relatives, all of which are necessary for successful groups. Further, utilizing technology that allows all members to be seen on the screen may help build connection and cohesiveness. Utilizing methods such as using the chat to insert a symbol or using the hand-raising icon can also help facilitate participation.

Overall, students reported feeling unprepared to lead online counseling groups. However, as counselor educators, we are responsible for preparing our students to engage in online counseling successfully, especially as the COVID-19 pandemic continues into its second year and will continue to affect how much virtual counseling will take place in the future. The recent normalization of online counseling (individual and group) may persuade educators and counselors to “increase their skills in terms of development, comfortability, and flexibility in the online environment” (International OCD Foundation, 2020, p. 1). Therefore, counselor educators should cover online-specific facilitation skills in their training programs.

Limitations and Future Research Directions

This study was the first step in attempting to understand and describe master’s-level students’ experiences of participating and leading in both face-to-face and online formats of EGCT. As with all research, limitations should be considered in interpreting the findings. Further, some of the limitations point to potential research directions.

COVID-19 created a situation where the transition from face-to-face to online formats was compulsory. It is therefore not clear what the experience would have been like if the transition was planned and did not have a situation like COVID-19 in the background pushing the transition, or if the group had been entirely online. Because of unplanned adjustment, course instructors and student leaders did not have control over the choice of an online platform. Outlining contingency plans, such as alternatives when a group member cannot join the group with their camera on, are essential for successful group outcomes, and a lack of familiarity with online platforms may have prevented instructors and student leaders from providing these contingencies and therefore impacted the experience for students.

Further, the EGCT groups were conducted with master’s-level students, and participants already had preexisting relationships with each other. This may have contributed to their strong support of face-to-face groups over online groups. In future research, studies with participants who do not already know each other may help us assess the appeal of online groups to participants. Further, researchers in the future may wish to examine the efficacy of online group counseling training for counseling students compared to in-person group training by comparing two equivalent experiential groups.

The current study recruited master’s-level counseling students from a CACREP-accredited counseling program in the Midwest United States; thus, results cannot be generalized to other institutions. The sample size was small in the current study. Therefore, we caution against generalizing our findings. During the focus groups, participants shared some apprehension about how much information to disclose in group counseling, and they verbalized some confusion on group purpose, direction, or goals. For many, these EGCT groups were the students’ first experience in group counseling training, and this could contribute to them questioning if their feelings and experiences were appropriate (Ohrt et al., 2014).

There are methodological considerations to improve future studies. Focus groups were conducted to collect the data from the participants. In-depth individual interviews would enhance a deeper conversation in understating and reflecting on the challenges and needs of master’s-level students. Participants may have censored some of their true feelings, as they were aware that their group leaders were also part of the research team, even though they did not run the focus groups. We acknowledge that the students knowing each other from previous classes may have influenced how much they shared in groups. Participants in this study expressed comfort with knowing each other from a previous semester. However, it is also possible that students may have disclosed minimal personal information so as not to effect public perception of themselves or effect future professional relationships.

Another area to expand on would be investigating counselors’ self-efficacy while facilitating online counseling groups. For example, exploring positive participation attributes that increase online groups’ participation from the leader’s perspective could be useful. This may allow researchers and practitioners to identify how group counseling can best be leveraged in an online environment.


The purpose of this study was to explore and compare first-year master’s-level counseling students’ experiences of participating and leading in both face-to-face and online formats of EGCT. In summary, students considered that the online format was challenging because it added a layer of learning to their fledgling group work skills beyond the face-to-face setting. Technological barriers that were outside the control of participants inhibited their participation, but on the other hand, the online groups served as a safe and supportive space for students to alleviate their stress and loneliness due to COVID-19. Regardless of the teaching environment, thoughtful and well-planned EGCT groups are essential for student development in this area, and skilled group leaders can manage group dynamics and model group counseling skills. COVID-19 has necessitated a focus on teletherapy and online counseling. The group counseling profession should be proactive in addressing this training need, as conducting online group counseling sessions is likely to continue to be a much-needed skill in a post-pandemic world.


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



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Bilal Urkmez, PhD, LPC, CRC, is an assistant professor at Ohio University. Chanda Pinkney, MA, CT, is a doctoral student at Ohio University. Daniel Bonnah Amparbeng, MEd, NCC, LPC, is a doctoral student at Ohio University. Nanang Gunawan, MA, is a doctoral student at Ohio University. Jennifer Ojiambo Isiko, MA, is a doctoral student at Ohio University. Brandon Tomlinson, MA, NCC, LPC, is a doctoral student at Ohio University. Christine Suniti Bhat, PhD, LPC, LSC, is a professor at Ohio University. Correspondence may be addressed to Bilal Urkmez, Patton Hall 432P, Athens, OH 45701, urkmezbi@ohio.edu.

“It’s Never Too Late”: High School Counselors’ Support of Underrepresented Students’ Interest in STEM

Autumn L. Cabell, Dana Brookover, Amber Livingston, Ila Cartwright


The purpose of this study was to contribute to the literature surrounding school counselors and their support of underrepresented high school students who are interested in science, technology, engineering, and math (STEM). The influence of context on school counseling was also explored, in particular practicing during the COVID-19 pandemic. Through this phenomenological study, nine high school counselors were individually interviewed, and four themes emerged. These themes were: (a) professional knowledge surrounding issues of diversity in STEM, (b) training related to the needs of underrepresented students in STEM, (c) active engagement in supporting underrepresented students’ STEM career interests, and (d) barriers related to supporting underrepresented students’ STEM interests. This article includes implications for (a) how school counselors can support underrepresented students’ STEM interests, particularly during the COVID-19 pandemic; (b) how counselor educators can contribute to STEM-related research and training; and (c) how school administrators can support school counselors’ STEM initiatives. 

Keywords: STEM, school counseling, underrepresented students, high school, COVID-19


     The science, technology, engineering, and math (STEM) fields in the United States comprise a large and growing sector of the economy (National Science and Technology Council [NSTC], 2018). Currently, there are more than 9 million people employed in STEM careers (U.S. Bureau of Labor Statistics [BLS], 2020). This is approximately 6% of the United States workforce (BLS, 2020). According to the BLS (2020), computer science, engineering, and physical science occupations; managerial and postsecondary teaching occupations related to those areas; and sales occupations requiring scientific knowledge at the postsecondary level are considered STEM occupations. STEM occupations require the knowledge and skills to solve problems, make sense of information, and gather and evaluate evidence to make decisions (U.S. Department of Education [U.S. ED], n.d.). In order to meet the demands of the evolving workforce and society, the United States needs students who are fluent in STEM fields and are pursuing careers in STEM (U.S. ED, n.d.).

The demand for professionals and employees with STEM skill sets is a national priority (NSTC, 2018). Estimates indicate that there will be a shortage of over 1 million STEM workers (Xue & Larson, 2015), and the need for workers will grow by 8% before 2030 (BLS, 2020). In contrast, non-STEM occupations are only projected to grow by 3% before 2030 (BLS, 2020). Because of the need for professionals with STEM skill sets, choosing to pursue a career in the STEM sector leads to the potential for positive job marketability. In addition, students who major in STEM programs during college may earn a higher salary upon graduation than other students (Cataldi et al., 2014; Vilorio, 2014). However, not all students have equitable opportunities to pursue careers in STEM.

The Need for Diversity in STEM
     Diversity in STEM continues to be a concern in the United States (National Science Foundation, 2019). Beginning in high school, fewer women and minorities expect to have a career in STEM at age 30 (Mau & Li, 2018). Then, in college, significantly more men than women declare STEM majors and significantly more Asian and White students declare STEM majors (Mau, 2016). Although women now make up over half of the overall workforce, they are underrepresented in certain STEM sectors, such as computer jobs and engineering (Funk & Parker, 2018). Relatedly, in 2015–2016, more bachelor’s degrees were awarded to females (58%) than males (42%), yet females only made up 36% of bachelor’s degrees in STEM fields (National Center for Education Statistics [NCES], 2019). Additionally, the gender wage gap is wider in the STEM fields than in non-STEM jobs (Funk & Parker, 2018).

Further, Black, Latinx, and Native American workers are underrepresented in STEM occupations when compared to White and Asian workers (Funk & Parker, 2018; Mau, 2016). Though racial minorities are gradually becoming more represented in STEM fields, there is still more work to be done. For example, in 2015–2016, White students were awarded approximately 90% of the bachelor’s degrees in STEM fields (NCES, 2019). The percentages of Latinx (15%), Black (12%), and Native American (14%) students who received degrees in STEM was disproportionately lower than that of White students.

These gender and racial disparities in STEM begin even before students enter college. High school is a critical timepoint to address gender and racial disparities in STEM. High school provides students with an opportunity to engage in higher-level STEM coursework and gain self-efficacy in their STEM skills and abilities. Chen (2013) suggested that when students do not have the opportunity to engage with higher-level coursework in STEM, they are less likely to complete college degrees in STEM. Further, Grossman and Porche (2014) explained that during the high school years, encouragement to pursue STEM coursework is critical to developing students’ STEM self-efficacy. Mau and Li (2018) found that ninth grade students with higher math and science self-efficacy were more likely to have STEM career expectations and aspirations.

However, girls and underrepresented minorities in K–12 are more likely to experience stereotype threat (i.e., anxiety about their performance or ability based on negative stereotypes) and less likely to be enrolled in advanced STEM coursework during high school (Curry & Shillingford, 2015; Hamilton et al., 2015). This results in gaps in advanced STEM skills and a lack of further interest in STEM careers. Thus, professional school counselors must address the inequities in opportunity for their students through targeted STEM career interventions. Often, high school is a student’s last opportunity to develop their interest in STEM careers (Falco & Summers, 2019; Schmidt et al., 2012; Shillingford et al., 2017).

School Counselors and STEM
     Under their role as defined by the American School Counselor Association (ASCA) National Model (2012), professional school counselors play an integral part in utilizing career counseling to support and encourage students to pursue STEM education and careers (Schmidt et al., 2012). Falco (2017) provided a conceptual model for school counselors to guide their STEM academic and career support with their students, including: (a) encouraging students to take advanced math and science courses, (b) providing classroom instruction on the benefits of pursuing STEM education, and (c) improving self-efficacy through providing mentoring and small group counseling opportunities. Other suggested roles for professional school counselors in STEM counseling involve ensuring equitable gender and racial ethnic ratios in STEM classes, integrating STEM knowledge into goal setting, and involving parents and guardians in academic and career planning (Schmidt et al., 2012). Although the topic of STEM counseling within the school counseling profession is still emerging, school counselors and researchers have highlighted the importance of working with girls and underrepresented racial minorities regarding STEM pursuits (Falco & Summers, 2019; Shillingford et al., 2017).

School Counselors and STEM for Girls and Underrepresented Racial Minorities
     In order to provide equitable and anti-racist school counseling services, professional school counselors must be knowledgeable and aware of the factors perpetuating the opportunity gaps in STEM for girls and underrepresented minorities. Potential reasons for the opportunity gaps in STEM higher education include: (a) young people not being engaged in higher-level STEM coursework in high school, (b) inability to meet the financial or time commitment required by STEM programs, and (c) motivation and confidence concerns (Chen, 2013). Additionally, starting in adolescence, underrepresented students in the STEM fields also face a lack of support and encouragement and, oftentimes, direct discouragement from educators regarding enrollment in rigorous STEM coursework (Grossman & Porche, 2014).

Unfortunately, underrepresented students are less likely to expect their school counselors to share postsecondary information with them, and school counselors often miss opportunities to improve underrepresented students’ STEM outcomes (Dockery & McKelvey, 2013; Shillingford et al., 2017). Yet, emerging evidence shows that school counselors can impact STEM aspirations in students. For instance, one school counseling intervention that showed promising results in promoting STEM self-efficacy was a career group intervention with adolescent girls, half of whom identified as Latina (Falco & Summers, 2019). The school counseling intervention focused on targeting STEM self-efficacy and career decision self-efficacy. The results indicated that participants in the treatment group improved significantly on both outcomes and even increased those gains 3 months post-intervention when compared to the control group (Falco & Summers, 2019).

In another study, researchers aimed to investigate the influence that school counselors’ leadership had on STEM engagement, their collaboration between parents and students of color, and barriers that inhibited them from giving students more tools and resources to contribute to their success (Shillingford et al., 2017). The school counselors in the study aligned with a leadership style that integrated collaborative and motivational techniques and suggested other school counselors can utilize their leadership style to communicate more effectively with parents and support racially underrepresented students’ STEM aspirations (Shillingford et al., 2017). However, there are barriers surrounding these efforts, including inadequacy of education around STEM for school counselors; challenges with supporting parents, especially parents from marginalized racial identities; and having insufficient resources to benefit students (Shillingford et al., 2017). These studies show that school counselors can target STEM self-efficacy and emphasize school counselors’ roles in promoting STEM career aspirations with racially underrepresented students. However, the current context of the COVID-19 pandemic should be taken into consideration when surveying the current climate of STEM counseling with students.

COVID-19 and School Counselors
     The COVID-19 pandemic has highlighted the inequities within our education system (Aguilar, 2020). For example, there is a digital equity gap, which includes a lack of access to adequate technology or internet, which must be taken into consideration and addressed in the virtual and hybrid learning settings many school divisions have adopted (Aguilar, 2020). During the pandemic, students often come to their virtual learning environments disengaged and having experienced various traumas (Savitz-Romer et al., 2020). These considerations call for flexibility, empathy, and perseverance from educators, including school counselors.

School counselors are trained in promoting students’ social-emotional, academic, and postsecondary development and hence are key to supporting students’ readjustment, learning, and continued college and career readiness progress during this time (Savitz-Romer et al., 2020). The work of the school counselor has not halted, especially with the challenges inherent in transitioning to a new way of school counseling. These challenges during the pandemic have led to less time spent in their usual counseling about social-emotional issues, career development, or postsecondary plans; notably, 50% of school counselors reported they spent less time than usual on career planning, and 25% reported less time spent on college planning (Savitz-Romer et al., 2020). Still, school counselors are pushing forward and adapting their practices to continue their work, including STEM counseling (ASCA, 2021).

Purpose of the Current Study
     As reviewed, professional school counselors play a vital role in the development and motivation of students interested in STEM. Shillingford and colleagues (2017) called attention to the necessity of educating school counselors on how to support students of color interested in the STEM fields, as well as the influence of having a collaborative relationship between parents, students, and school counselors to assist with students’ STEM career development and exploration. Although Shillingford et al. emphasized the leadership role school counselors take in impacting the pipeline of students of color in STEM, their work (a) does not address the intersectionality of the race and gender disparities in STEM and (b) does not specifically address the critical, and perhaps last, opportunity for counseling intervention that can take place at the high school level.

Given the need for gender and racial diversity in STEM and the limited literature that emphasizes the role of school counselors in STEM counseling and education, the purpose of this transcendental phenomenological study was to increase understanding of the lived experiences of high school counselors who support girls’ and underrepresented minority students’ interests in STEM. As students begin to prepare for their next step in life, high school is the last chance school counselors have to intervene and influence students who have shown interest in STEM-related careers and minimize potential barriers that may come their way. Thus, the following research questions guided this inquiry: 1) What are the experiences of high school counselors who support girls’ and underrepresented minority students’ STEM interests and career aspirations? and 2) What contexts (including the COVID-19 pandemic) influence high school counselors’ support of girls’ and underrepresented minority students’ STEM interests and career aspirations?


     A transcendental phenomenological approach was used to develop understanding of the experiences of high school counselors who support underrepresented students’ STEM career interests and the contexts that influence their support. Transcendental phenomenology is a suitable design when the aim is to discover the essence, or the nature, of a phenomenon, experience, or concept (Moustakas, 1994). Our research team included four members. Our first author, Cabell, is a Black, cisgender female counselor educator. As the primary researcher, her role was to recruit and interview participants and to assist with coding. The research team also included two Black, cisgender female counselor education and supervision doctoral students, Livingston and Cartwright, and one White, cisgender female counselor education doctoral candidate, Brookover. Cabell, Brookover, and Cartwright hold master’s degrees in school counseling. Cabell and Brookover previously worked as high school counselors and Cartwright worked as an elementary school counselor at the time of the study. In addition, Cabell has professional experience providing career counseling to undergraduate engineering students. Livingston earned a master’s degree in college counseling and has professional experience working with diverse populations of college students.

     The recommended sample size for phenomenological qualitative research is 5–25; thus, participants were recruited with this range in mind (Creswell & Poth, 2017), using purposeful sampling. Criteria for inclusion were school counselors or school counselor interns who worked in a high school within the past 2 years. A total of nine school counselors participated in this study.

Participants were seven school counselors who worked in a high school at the time of the study, one school counselor who worked in a high school within the past 2 years, and one college counselor who worked in a high school at the time of the study. Participants were racially diverse with six identifying as Black, two identifying as White, and one identifying as Mexican American/Chicano. Regarding gender, seven identified as cisgender women and two identified as cisgender men. Participants’ ages ranged from 26 to 46. In addition, the sample included participants who worked in various states, including two each in California and Virginia; one each in Indiana, Maryland, Michigan, and Washington, D.C.; and one who worked in both Kansas and Missouri. Three participants stated that they worked at a Catholic private high school. As part of their role, all participants stated that they provided career counseling services to students on a weekly basis. Most participants (n = 5) explained that the high school where they worked was diverse with regard to students’ race and gender. Lastly, participants had 4–18 years of experience working as high school counselors. See Table 1 for participant pseudonyms and demographics.


Table 1

Participant Pseudonyms and Demographics

Pseudonym Gender Age Race State Years of Experience Role and Work Experience
Jane Female 38 Black MD 7 Counselor at a Catholic high school
Kate Female 40 Black CA 5 College counselor at a Catholic high school
Christy Female 26 Black D.C. 4 Counselor at a Catholic high school
Lauren Female 37 White KS/MO 7 Counselor who just switched from
high school to elementary school
Dawn Female 30 Black VA 4 Counselor at a public high school
Kelly Female 37 Black MI 13 Counselor at a public high school
Jo Male 46 Mexican American/Chicano CA 18 Counselor at a public high school
Tina Female 35 Black IN 4 Counselor at a public high school
Mark Male 38 White VA 6 Counselor at a public high school


Data Collection
     First, the study was approved by the university’s IRB. After approval, our first author, Cabell, sent recruitment flyers and emails to high school counselors using social media platforms (e.g., Twitter, Facebook, and LinkedIn) and state and national school counseling listservs (e.g., ASCA SCENE). Volunteers who met the eligibility criteria were encouraged to email Cabell in order to schedule a virtual interview through Zoom. Volunteers confirmed via email that they were a school counselor or school counseling intern at a high school within the past 2 years. Then, volunteers were sent the informed consent form and information on how to schedule their interview. Once scheduled, participants were emailed a Zoom link and directions on how to start their interview. Each interview lasted approximately 30–45 minutes and was audio-recorded.

At the beginning of each semi-structured interview, participants were asked demographic questions. Cabell developed interview questions based on the literature regarding (a) school counselors’ involvement in STEM education, (b) the underrepresentation of girls and racial minorities (e.g., Black, Latinx, and Native American) in STEM, and (c) the impact of COVID-19 on school counseling and K–12 education. The interview included 11 questions (see Appendix for the full list). Example interview questions included: What is your understanding of the issues of diversity in STEM? What has been your experience in promoting STEM careers to underrepresented students? What barriers do you face in promoting STEM careers to underrepresented students? and How has the COVID-19 pandemic impacted your role in supporting underrepresented students’ STEM career aspirations and interests? Following each interview, the audio recordings were transcribed using a website (Rev.com) and checked for accuracy by both Cabell and the participants. Cabell reviewed the transcripts for accuracy and made any changes due to typographical errors. She then emailed the transcripts to participants to review and make any changes. Two participants identified typographical errors in their transcript and emailed Cabell with edits.

Data Analysis
     Data from the interview transcripts were analyzed. First, the raw data from the transcripts were examined to note significant quotes (i.e., horizontalization). Each transcript was reviewed individually by Cabell and Cartwright for exemplary quotes related to the research questions. Then, clusters of meaning were developed from these quotes and compiled into themes. These themes were used to develop descriptions of the participants’ experiences and explain how contextual factors influenced their support of underrepresented students’ STEM career interests and aspirations. 

Trustworthiness is critical to establishing the validity of qualitative research; thus, several measures were implemented (Maxwell, 2005). First, in order to set aside personal biases, experiences, and feelings regarding the purpose of the research, all members of our research team engaged in bracketing our own experiences (i.e., epoché) before beginning this research (Creswell & Poth, 2017; Moustakas, 1994). Bracketing was completed in the form of concept maps and journaling. We individually bracketed our potential biases and then discussed our process with the team. Potential biases that were discussed included: (a) the impact of our first author’s experience providing career counseling to engineering undergraduate students, (b) our race and gender, and (c) our prior school counseling experience with underrepresented minorities.

In addition, throughout each semi-structured interview, Cabell completed check-ins to ensure understanding of the participant’s experience and perspective. Also, after each interview was transcribed, participants were sent their transcripts for member checking. Any inaccuracies in the transcript were changed based on the participant’s responses. Only transcripts that were reviewed by the participant were analyzed. Next, Cabell and Cartwright independently coded each transcript. Then, we established group consensus for all themes and exemplary quotes. Lastly, after the codebook was developed with themes and participant quotes, we sent the codebook to two counseling graduate students, who served as external auditors after being trained by Cabell on qualitative research and auditing. They reviewed the codebook to identify any discrepancies and ensure the significant quotes, themes, and codes aligned.


We sought to (a) highlight the experiences of high school counselors who support the STEM interests of girls and underrepresented minority students and (b) identify the contexts that impact their ability to support these students, particularly taking into account the COVID-19 pandemic. Specifically, participants reflected on supporting girls; Black, Latinx, and Native American students; and those students at the intersections of both identities (e.g., Black girls, Latinx girls). We identified four themes in the analysis of the high school counselors’ experiences: 1) professional knowledge of issues of diversity in STEM; 2) training related to the needs of underrepresented students in STEM; 3) active engagement or taking an active role in supporting underrepresented students’ STEM career interests; and 4) barriers related to supporting underrepresented students’ STEM interests, including COVID-19, school, administration, students’ self-efficacy, and language.

Theme 1: Professional Knowledge
     The first theme of professional knowledge of issues of diversity in STEM encompassed participants’ knowledge of the issues of gender and racial disparities in STEM fields nationally (i.e., representation in STEM occupations) and issues of diversity in STEM at their school (i.e., STEM courses). All participants were aware of the lack of racial and gender diversity in STEM nationally. Jane explained:

People of color, especially Black students, people who identify as female or women are vastly underrepresented in many of the STEM fields. . . . I know that there are many initiatives in K–12 [and] higher education to bring in or recruit or encourage students of color in particular and female students of color to explore STEM.

Similarly, Kate discussed that the STEM fields overall are “moving in a more diverse direction” yet are still dominated by men. She noticed that the majority of the students at her high school who are interested in STEM “are not Black or Brown students, they’re usually everything else.” According to Christy, “there’s a huge gap with our minorities. They don’t have the access to the education of the different jobs in STEM, and how to even reach those positions. . . . It ends up being a cyclical effect.”

Further, Dawn reflected on the lack of representation in STEM fields and the initiatives that she knows aim to diversify the images of STEM professionals. For example, Dawn discussed a social media campaign and stated:

There’s been a cool campaign, like what a scientist looks like. And it’s all of these cool Black women in lab coats. . . . So I’m pretty sure it’s just fighting against stereotypes of who should be in STEM, and what kind of person.

Kelly also spoke to the lack of diversity in STEM, not only as a national issue but also in her high school. Kelly mentioned the STEM opportunity gap: “If students are in STEM programs and they are of color, they don’t really see a lot of support, and they definitely don’t see teachers and staff that look like them.” Likewise, Jo explained that girls in particular “sometimes doubt their ability even though they’re within our top 5% of our school.” Tina acknowledged that there is a need for more girls in STEM and girls of color in STEM nationally, so she explained, “I’ve definitely been pushing my girls, especially my girls of color, my Latinx and my Black girls to definitely go out” and “I often tell them ‘paint engineering with your red lipstick,’ because I think that’s what we need to see is more women out there.”

Theme 2: Training
     The second theme of training related to the needs of underrepresented students in STEM was identified through participants’ reflections on formal and informal training opportunities they completed to effectively meet their students’ needs. Some of the participants received informal training with regard to STEM counseling and education. For example, Jane explained that when she first became a school counselor, she “became friends with a few school counselors who were also women of color. And they were . . . fierce advocates for girls of color in the computer science field specifically.” The informal professional development that this group of school counseling peers provided her then led to more formal training on “some of the various tools that are out there, programs that are available, ways in which you can target girls of color and just some of the roadblocks that we as school counselors might run into.” Though Jane received both formal and informal training, she explained, “I’m still learning . . . ways in which we can do better in terms of exposing students, building it into our program, collecting data around it.” Similar to Jane, Mark also had the opportunity to attend both formal and informal training. Mark stated, “I’ve attended the occasional webinar here and there that focuses specifically on that particular demographic.” He also added that he had conversations with “some of the professors and the advisors [at neighboring colleges] within those STEM programs that really helped develop a broader understanding.”

In contrast, many participants (n = 7) could not discuss informal or formal training opportunities with regard to STEM and supporting underrepresented students. Kate explained that she received “nothing in the formal sense” with regard to STEM counseling or education training. Similarly, Christy stated, “I would say formally none, nothing professional regarding development, or seminars, workshops, or anything like that.” However, she did have some informal training because supporting underrepresented students’ STEM interests has been “a conversation that we have had with our counseling department of how to bring different types of professionals into the school and bringing them into the career days.” Dawn expressed that “STEM is such a big field. I still need help learning and understanding everything that STEM offers.” Sharing a similar sentiment in needing to know more, Tina explained, “I wish I knew more. . . . It’s just, I want to know more. I want to be able to support them. My goodness.”

Theme 3: Active Engagement
     The third theme of active engagement in supporting underrepresented students’ STEM career interests emphasized the roles the high school counselors took to support students with STEM career interests. Many participants recognized their role as high school counselors in providing students with exposure to STEM career fields and supporting students’ prior knowledge of STEM. Embedded into the interviews with participants was the role of the school counselor and STEM. Christy stated, “It’s really our role to bridge that gap and make the connections that may not have been made previously, or the students might not have had access to before.” Mark shared his role in optimizing students’ strengths:

“Every student is going to present his or her own set of talents and abilities. . . . it’s my job to make sure that I can help them recognize what those talents and abilities are and help them cultivate a passion.”

Participants also took pride in building relationships with students early in their high school experience to assist them in discovering STEM careers. Kelly stated, “We definitely talk about it when students come to our offices. When we meet with our eighth graders coming into high school, we definitely let them know, here are your options.”

A method of bridging the gap for underrepresented students is by providing access to academic and postsecondary STEM opportunities. Christy spoke to her experience of supporting underrepresented students by providing that access:

We introduced that summer bridge class for the students. So, this will be the first year that we will potentially see the benefit of that. And hopefully seeing stronger grades in those students, especially students coming from public schools, minority students who are just now having access to the private school resources.

Similarly, Jane found value in encouraging her underrepresented students with passions in STEM to take advantage of all opportunities. Jane spoke of an encounter with a previous student. She recalled, “Last year I had a Black female student who said that she had started coding classes in middle school. . . . She really liked it, so I was like, ‘Great. We’re going to do all of them.’” In increasing access for students, the participants were intentional to ensure underrepresented students have opportunities. Kate stated, “I keep a lookout for virtual fly-in opportunities, especially when I know I have a student that’s interested in STEM and they are of a minority group, I always nominate them for those fly-ins.”

Jane summarized her role in supporting underrepresented students’ interests in STEM by saying:

“The school counselor has a huge role in not only exposing students to the possibilities of STEM careers but really targeting and explicitly encouraging Black students, Latino students to participate in and learn more about the STEM field.”

Further, regarding taking an active role in encouraging underrepresented students to pursue STEM, one participant, Kate, reflected on how her own racial identity motivates her to encourage students of color:

Me being a woman of color, I can’t help but feel like I’m rooting for everybody Black. . . . That’s not to say that I don’t encourage my non-students of color to also pursue STEM. . . . I feel like I have to really look out for my students of color, in my counseling department, I’m the only Black counselor. So, I do feel more pressure to really look out for them because I know, prior to me getting there, they weren’t inviting Historical Black Colleges and Universities [HBCUs] to come out. There was no HBCU session at our college fairs and so forth. No one was sending out information about the multicultural fly-ins. . . . Now I’m doing it and I forward it to my coworkers.

Lauren discussed how she actively identifies underrepresented students for STEM-related opportunities. Communication is key, she said: “Good communication with my teachers, so of course, math and science teachers, if they’re in tune with their students, that’s really helpful, identify the students and let me know.” In addition to communication with teachers, Lauren found value in using college and career cluster surveys with students. Lauren said the most impact her role has with students with regard to STEM is during career assessments “when they’re identifying that their talents or their personality matches up with any of the STEM fields.” She noted, “I think that’s brought in the most numbers of kids.” Other participants also used more formal career development tools. Christy stated, “We use Naviance at our school for college planning,” and Jo stated, “Our school uses Xello. It does a lot of interest surveys and gets students to see where they’re at, their personality, their interests and then matches it to careers.”

Theme 4: Barriers
     Barriers related to supporting underrepresented students’ STEM interests emerged as the fourth theme, with participants reflecting on hindrances to their ability to support underrepresented students’ STEM careers and opportunities. These barriers included: COVID-19, school, administration, students’ self-efficacy, and language.

     COVID-19 is a barrier that was presented in most of the participants’ interviews (n = 8). It was primarily identified as a context impacting students negatively and also one that resulted in changes to school counselors’ roles and day-to-day practice. When reflecting on the beginning of the pandemic, Lauren expressed, “All I did from March through May was call, email, and bother parents and seniors about graduation and making sure they were alive. That completely impacted my role for minority students pursuing STEM. . . . We were down to basic needs.” Christy also reflected on COVID-19 and said, “It’s really been bad. I would say that minorities in general, that’s probably the hardest group to get to virtually” with regard to communicating with students as a result of virtual schooling. Jo echoed Christy’s sentiments and stated, “I think the biggest challenge has been the distance, like not being able to meet them one-on-one.” Jo further explained, “Some of our students do not have all the technology they need, so they can’t jump on a Zoom, or maybe they do and the Wi-Fi is really bad.”

     Participants also highlighted requirements at the school level that hinder students from accessing STEM careers and opportunities. Jo stated, “A student could do everything they need to graduate high school but not necessarily be ready for the university.” Jo was referring to the lack of college readiness and opportunity his school provides. Moreover, Kelly stated, “So they’re interested in that…the medical or the engineering. But when they find out, ‘I can get more credit in an AP,’ it kind of turns them off a little bit.” AP courses can help students with a weighted GPA, bring students closer to meeting graduation requirements, and give them college credits. In Kelly’s experience, her students are interested in STEM fields; however, it is hard to combat the course credit hours linked to an AP course versus a STEM course. Furthermore, in relation to school barriers, Kate mentioned the importance of anti-racist school practices:

I would probably even go as far as to say, knowing that all of our STEM teachers and faculty are anti-racist and I don’t know that all of them are. And the reason why I think that that’s important is because it’s possible that they receive opportunities for students, and are they aggressively sending or communicating those opportunities out to students of color? 

     In addition to COVID-19 and school barriers, participants also highlighted the lack of time and some administrative issues as barriers to supporting underrepresented students who are interested in STEM. For example, Jane discussed that high school is late in a student’s educational experience to only just begin discussing STEM:

I think the primary barrier is getting them so late. I mean, high school is late. It’s not too late, of course. It’s never too late. Students can always find their interest and their passion. But it’s not like the super early stages.

Jane further emphasized that by the time students of color are in high school, they may already lack the necessary exposure to STEM coursework:

I don’t know if any of my Black students are coming into ninth grade with that previous exposure. . . . I know that some of them are not. And so, I think that is a huge barrier. Not having them already exposed to a lot of what the STEM fields can offer.

Another challenge that participants highlighted was not having enough time to meet with students individually because of their caseload or administrative tasks. For example, Christy mentioned, “Another barrier is just time. Even with my caseload this year, I have 350 students.” Similarly, Lauren discussed “the lack of time, and the bulk of so many other responsibilities being given to counselors by administrators” as an impediment.

She further explained that the wide list of administrative duties at the high school level not only impeded her ability to meet students’ needs but also prompted her to leave high school and work at the elementary school level. Likewise, Kelly also explained how administrative tasks hinder her ability to have “meaningful conversations in a smaller school setting” because instead of meeting with students individually, she highlighted that she has “19 other things to do . . . because of the makeup of my job.”

Students’ Self-Efficacy
     Participants also identified barriers regarding underrepresented students’ beliefs about STEM and their STEM abilities. Mark explained that one of the biggest issues he faces in supporting students from diverse backgrounds who are interested in STEM “is that they struggle with some of the challenging courses.” Similarly, Jane expressed that students may have struggled in STEM coursework during elementary and middle school, resulting in negative self-efficacy beliefs like “I’m not a math person or I’m not good at math.” In a similar vein, Jo explained that some of his underrepresented students do have the academic foundation; however, they “sometimes don’t feel as confident” about their STEM abilities. He stated, “I think a lot of my students, when they’re looking at these careers, sometimes they don’t see themselves in those careers and so that steers them away. . . . They just don’t feel it’s a possibility.”

     Lastly, some participants recognized the prevalence of barriers specific to the Latinx community. Tina mentioned the role of a counselor when helping students make the connections to various career options:

Working with Latinx and some undocumented or DACA students, the students of color, and even first-generation students . . . our role is very influential. In certain situations, especially for my kiddos whose parents don’t speak English, we are the adult, we are the person that’s helping them make those important decisions.

Some families Jo worked with did not always understand the materials about a STEM opportunity because of language barriers. He emphasized the importance of having materials in languages all families can understand:

We can sometimes talk about opportunities, but if it’s not getting into the hands of the families and if they’re not understanding what the opportunity is, they may not be as willing to allow their kid to attend maybe a 6-week program or a college program.


     STEM fields are growing in demand and are in need of talented and diverse individuals from varying gender identities and racial backgrounds (BLS, 2020; NCES, 2019). High school is the last opportunity in the K–12 system to promote and increase the pipeline of underrepresented students pursuing STEM careers. This study sought to support and extend the literature on the role of school counselors in supporting underrepresented students’ STEM career interests while also exploring the impact of context, including the COVID-19 pandemic, on STEM counseling. The findings emphasize the importance of high school counselors in promoting, encouraging, and supporting girls, racial minorities, and students at the intersections of both identities who are interested in STEM careers.

The results of this study aligned with the findings of Shillingford and colleagues (2017) that knowledge and training related to STEM professions was lacking for school counselors. Similarly, in the present study, some participants were able to identify concrete formal and informal training that they received in regard to STEM careers and diversity issues, but many of the participants in this study stated that they either received no training or were in need of more information and training related to STEM careers and diversity concerns. Further, time was similarly identified as a barrier. In both studies, school counselors explained that there is not enough time in the day to dedicate to discussing STEM career pathways with students individually.

Our findings have added a more nuanced understanding of time as a barrier for students and school counselors given its emphasis on high school. School counselors (n = 3) discussed how lack of prior STEM academic experiences can have negative consequences for high school students’ interest in STEM. For example, if a student is missing the foundational academic understanding of STEM before they get to high school, then they can fall further behind in the academic work even though they may express an interest in STEM careers. In addition, although high school is not too late to intervene and support students’ STEM interests, it is late in the academic journey to both (a) supplement academic understanding and (b) combat the internalized beliefs that students may have because of their prior educational experiences with STEM.

Similar to the work of Falco and Summers (2019), the importance of self-efficacy was explained by the participants in this study. For example, both Jo and Jane explained how Black and Latinx girls may lack confidence in themselves and not see themselves as being capable of pursuing and excelling in STEM careers. In interviews, they both observed how students either struggling in STEM coursework previously or not seeing themselves represented in STEM careers experienced diminished self-confidence regarding STEM. Although none of the participants explicitly discussed the term self-efficacy, they explained that Black and Brown students and girls may have low STEM-related self-efficacy and school counselors can play a role in increasing students’ exposure to STEM. The role high school counselors play in exposing students to diversity in STEM and diverse STEM careers is integral to challenging students’ distorted STEM self-efficacy beliefs. Moreover, Christy discussed her role in supporting students with STEM bridge courses—school counselors’ participation in these programs can help students develop STEM skills and self-efficacy.

Furthermore, in alignment with ASCA’s (2021) emphasis on school counselors’ role in supporting the social-emotional learning and career development of students, the findings in this study also revealed the importance of career development assessments in high school counselors’ ability to support students. Career assessment tools and platforms such as Naviance, Xello, CollegeBoard, etc., provided participants in this study with the tools to 1) identify students who may be interested in STEM careers and 2) help students connect their interests and abilities to STEM careers. Though school counselors might be pressed for time, utilizing career assessments can help structure individual meetings with students and open the door to follow-up conversations and programming surrounding careers in STEM.

In addition, the findings also revealed the importance of making community connections and utilizing social media to further support underrepresented students as they pursue STEM careers. Participants mentioned the importance of connecting students with HBCUs or other colleges in the area in order to help underrepresented students explore postsecondary options in STEM. Moreover, to increase students’ access to representation, as Dawn mentioned, high school counselors can expose students to social media campaigns that emphasize the representation of Black women in STEM, Latinx women in STEM, Native American men in STEM, and more. Increasing students’ access to more diverse images and professionals in STEM can help students to think about what being in STEM can look like after high school and, therefore, begin to see themselves in those STEM positions.

With the current emphasis on anti-racist educational processes in mind, the findings revealed the importance of communication. Participants explained that specifically, communication with math and science teachers is critical to identifying and supporting underrepresented students who are exhibiting strong potential in STEM. Additionally, Kate pointed out the importance of knowing that everyone in the school, including teachers and school counselors, are engaging in anti-racist practices in order to communicate with underrepresented students surrounding opportunities that increase access to STEM. Schmidt and colleagues (2012) also emphasized the importance of school counselors encouraging teachers to remove systemic barriers to students’ educational success. Moreover, Jo and Tina highlighted the importance of having materials for students and parents in various languages in order to communicate STEM possibilities. In engaging in anti-racist practices, it is important for school counselors to collaborate with school administrators to reduce barriers in communication, particularly surrounding the languages used to share STEM opportunities targeted to underrepresented students.

Overall, the findings of this study revealed that COVID-19 has resulted in additional barriers to supporting underrepresented high school students’ STEM career interests. In alignment with the emerging literature surrounding COVID-19 and its impact on the educational system, participants explained the technology gap is even wider for their Black and Brown students (Aguilar, 2020). Students’ inadequate access to technology has made it difficult for school counselors even to check in with students, much less discuss students’ STEM career aspirations. As Lauren mentioned, many school counselors have been addressing students’ basic needs during the pandemic. Although many STEM companies are still hiring during the pandemic and STEM careers are still projected to grow even after the pandemic, school counselors’ conversations with underrepresented students regarding STEM may be stalled at this time.


     The present study has implications for school counseling practice, counselor education, and school administration. As expressed in the participants’ interviews, high school counselors care deeply about supporting underrepresented students’ STEM interests, despite the barriers. At the same time, high school counselors may be limited in their own training and their knowledge of STEM opportunities. Furthermore, COVID-19 has resulted in additional barriers for school counselors who may already be confronted with limited time and resources.

School Counseling
     Students may benefit from school counselors sharing more STEM postsecondary options. For example, when discussing postsecondary options related to STEM, none of the participants discussed students participating in apprenticeships. Most participants reflected on connecting students to universities, including HBCUs. However, apprenticeships are paid industry-driven experiences in which students can receive specialized training with a company (U.S. Department of Labor, n.d.). Many apprenticeship programs are related to STEM. For example, there are apprenticeships for information technology specialists, medical laboratory specialists, and pharmacy technicians. In addition, a main benefit of completing an apprenticeship program in a STEM industry after high school is that after the completion of their apprenticeship, over 90% of employers retain their apprentices for full-time employment.

Moreover, although COVID-19 has shifted many schools to virtual formats, there are still opportunities for school counselors to help underrepresented students. For example, many STEM companies, such as Boeing, AT&T, Abbott, and more, are offering students virtual internship experiences. Websites such as Vault.com have offered virtual internship job search tools during the pandemic. In addition, online tools such as LinkedIn Learning can provide students ages 16 and above with access to training opportunities related to coding, math, and science concepts. School counselors increasing their knowledge about practical virtual STEM resources can help increase underrepresented students’ access to STEM careers during the pandemic. Through connecting with local university and community college career services departments, school counselors can learn more about STEM resources to share with students. In addition, there are several STEM-focused social media groups that school counselors can join in order to learn more about STEM. School counselors with an interest in STEM can develop more state or regional interest networks within their school counseling organizations in order to share resources and information with each other.

Counselor Education
     This study also has several implications for counselor educators who will train the next generation of school counselors. Several participants highlighted that they had limited or no training on STEM career opportunities. In order to help increase school counselors’ knowledge regarding the need for STEM professionals and the ways that they can support underrepresented students, counselor educators can incorporate this learning into career counseling coursework. For instance, as an assignment, counselor educators can help school counseling graduate students utilize career counseling theory to develop a program aimed at promoting STEM to underrepresented high school students. Utilizing career counseling coursework to encourage students to find creative solutions to career-related issues can help make this course more meaningful and practically significant for future school counselors.

In addition, counselor educators can engage in research endeavors to build the literature connecting school counseling and STEM education. In doing so, counselor educators can host webinars, present at conferences, and disseminate information in both school counseling newsletters and professional journals in order to help increase school counselors’ knowledge on the needs of underrepresented students who may be interested in STEM. Additionally, counselor educators can collaborate with ASCA to conduct professional development opportunities for school counselors that explain relevant literature on STEM and how school counselors help develop students’ STEM career aspirations.

School Administration
     Similarly, school administrators can support and encourage school counselors to attend professional development opportunities regarding STEM. This support can entail sharing STEM-related professional development opportunities with school counselors and giving school counselors the time to attend these professional development opportunities. Additionally, school administrators could benefit from listening to school counselors’ recommendations for how schools can better support underrepresented students and ensure equitable access to STEM coursework. Further, school administrators can review policies to incorporate anti-racist practices that promote STEM to diverse populations of students. These practices can include: (a) reviewing the racial and gender makeup of STEM courses to ensure equitable representation of students in STEM courses; (b) building connections with community organizations and stakeholders that provide resources to underrepresented students who are interested in STEM; and (c) ensuring that school counselors have access to documents regarding STEM opportunities to share with students and their parents in multiple languages, including both English and Spanish. Moreover, school administrators can work to ensure that the duties assigned to school counselors align with the ASCA National Model (2012) and allow school counselors to focus on STEM-related career development interventions for students.

Limitations and Future Research 

     There are several limitations to this study that warrant discussion. First, many of the participants in this study were counselors of color. Thus, there may be an element of self-selection bias wherein participants (school counselors of color) were more inclined to value the purpose of the study and be more connected to the experiences of underrepresented students. Hence, future research can emphasize the importance of all school counselors, regardless of race, addressing the needs of underrepresented students in STEM. Similarly, all the counselors in this study were several years removed from their graduate school experience. School counselors who have graduated recently may have more training and awareness of the disparities in STEM; thus, future studies can explore beginning counselors’ knowledge of STEM issues and support of underrepresented students.

In addition, all interviews were conducted virtually, which can increase the likelihood of response inhibition, wherein participants were uncomfortable with confidentiality and privacy when speaking across the internet (Janghorban et al., 2014). Future studies that are not limited by a pandemic or geography may benefit from doing in-person interviews in participants’ schools or an environment where the participants feel more comfortable. Although validity practices such as journaling, external auditing, and check-ins were utilized by our lead researcher, her closeness to the topic as both a professional and a Black woman may have impacted the objectivity of the study. The sample size was in accordance with phenomenological research; however, an increased sample size that is even more representative of school counselors from high schools across the nation could help increase this study’s generalizability.

Future research studies can explore the educational experiences of underrepresented professionals (e.g., Black women) in STEM in order to better understand what makes students pursue and stay in STEM fields as well as the role of the school counselor in their future success in STEM. In addition, future studies can explore how school counselors can collaborate with career advisors at local colleges in order to increase diversity in the STEM pipeline. In a similar vein, future studies can explore the experiences of underrepresented high school students who received STEM-related support from their school counselors and transitioned to college to pursue a major in STEM. Also, very few of the participants in this study explicitly spoke to their experience supporting Native American and Indigenous students. Given the lack of Indigenous and Native American professionals in STEM, future studies can specifically focus on their needs with regard to STEM education.


In sum, school counselors play a vital role in supporting the academic and career success of all students. For students who may find themselves underrepresented in STEM, high school counselors can make the difference by exposing them to possibilities and opportunities in STEM. High school might be some students’ last opportunity to (a) explore and discover varying career paths, (b) complete the preparation needed for a smooth transition to college, and/or (c) access resources to support diversity in STEM. In spite of barriers and limitations, school counselors ensure that students, regardless of gender or race, do not fall through the cracks and are encouraged to pursue any profession they desire, including a career in STEM.


Conflict of Interest and Funding Disclosure
This study was made possible by a grant from
the Virginia Counseling Association Foundation.
The authors reported no conflict of interest
for the development of this manuscript.



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Interview Questions

What is your understanding of the issues of diversity in STEM?

What training did you receive regarding the needs of underrepresented students who are interested in STEM?

What do you believe is the role of a school counselor in supporting underrepresented students’ interest in STEM careers?

What is your role in supporting STEM academic and career opportunities for underrepresented students?

What has been your experience in promoting STEM careers to underrepresented students?

How do you identify underrepresented students who may have potential or interest in STEM careers?

What barriers do you face in promoting STEM careers to underrepresented students?

What school and community factors influence your ability to support underrepresented students’ STEM career aspirations and interests?

How do you prepare underrepresented students for postsecondary opportunities in STEM?

What do you wish was different about how you support underrepresented students’ STEM career interests and aspirations?

How has the COVID-19 pandemic impacted your role in supporting underrepresented students’ STEM career aspirations and interests?


The authors would like to thank and acknowledge the Virginia Counseling Association Foundation; and Lexi Caliendo and Kirsten Nozime for their feedback, which improved the quality of this study. Autumn L. Cabell, PhD, NCC, LPC, CCC, CCTP, is an assistant professor at DePaul University. Dana Brookover, PhD, NCC, is an assistant professor at the University of Scranton. Amber Livingston, MEd, is a doctoral student at Virginia Commonwealth University. Ila Cartwright, MEd, is a doctoral student at Virginia Commonwealth University. Correspondence may be addressed to Autumn L. Cabell, DePaul University, 2247 N Halsted St., Rm. 246, Chicago, IL 60614, acabell@depaul.edu.

Resilience and Coping as Moderators of Stress-Related Growth in Asians and AAPIs During COVID-19

Stacey Diane Arañez Litam, Seungbin Oh, Catherine Chang


This exploratory study examined the extent to which coping, resilience, experiences of subtle and blatant racism, and ethnic identity predicted stress-related growth in a national convenience sample of Asians and Asian Americans and Pacific Islanders (AAPIs; N = 326) who experienced COVID-19–related racial discrimination. Our analysis indicated participants with higher levels of coping, resilience, experiences of subtle and blatant racism, and ethnic identity were significantly more likely to cultivate higher levels of stress-related growth. Coping strategies such as self-blame, religion, humor, venting, substance use, denial, and behavioral disengagement significantly moderated the relationship between experiences of racism and stress-related growth. Notably, participants in the study who used mental health services following COVID-19 reported significantly higher levels of racial discrimination, resilience, coping, and stress-related growth compared to Asians and AAPIs who did not use professional mental health services. Mental health professionals are called to utilize culturally sensitive treatment modalities and challenge traditional Western notions that frame coping responses from an individualistic worldview.

Keywords: Asian, Asian American, COVID-19, racial discrimination, stress-related growth


Asians and Asian Americans and Pacific Islanders (AAPIs) represent vulnerable ethnic groups that may present with higher rates of mental health distress during COVID-19. Following the global outbreak, rates of discrimination, harassment, and violence toward Asians and AAPIs have substantially increased (Congressional Asian Pacific American Caucus, 2020; Jeung & Nham, 2020). The rise of COVID-19–fueled racism directed toward Asians and AAPI groups, especially individuals who phenotypically appear East Asian, has deleterious effects on their mental health and wellness (Litam, 2020; Litam & Oh, in press, 2020; Wen et al., 2020).

Although Asians who reside in the United States and AAPI groups are both affected by COVID-19–related racial discrimination, mental health professionals must recognize the important distinctions and challenges that exist between Asian internationals and Asian Americans (Anandavalli et al., 2020; Sue et al., 2019). Professional counselors must also consider the vast heterogeneity that characterizes Asian and AAPI ethnic subgroups (Budiman & Ruiz, 2021; Chan & Litam, 2021). Although an extensive overview of the differences between Asians and AAPI ethnic subgroups was beyond the purview of this study, mental health professionals are called to examine how the intersection of client identities (e.g., international status, nationality, ethnic identity, acculturative status, colonization history) may influence the ways in which COVID-19 racial discrimination affects Asian and AAPI clients (Chan & Litam, 2021; Litam, 2020). For the purpose of contributing to the scant literature on the effects of COVID-19 on Asian and AAPI communities, the current study assesses a national convenience sample of Asians and AAPI groups who reported discrimination experiences following the pandemic. Aggregating these distinct populations was not intended to overlook the vast heterogeneity that exists across ethnic subgroups nor to invalidate the unique challenges faced by Asian and AAPI individuals who reside in the United States. Rather, the present study combined Asian and AAPI populations to ascertain a more collective understanding of the ways in which the greater community may be affected by COVID-19–related racial discrimination.

Effects of Racial Discrimination on Asian and AAPI Mental Health
     Extant research illuminated how perceived racial discrimination among Asian and AAPI communities has adverse effects on overall mental health, coping responses, and wellness. Asians and AAPIs who faced race-based discrimination reported higher levels of psychological distress, substance use, anxiety, depression, and suicidal ideation (Choi et al., 2020; Gee et al., 2007; Hwang & Goto, 2008; Le & Ahn, 2011; Leong et al., 2013). Experiences of race-related stress in Asians and AAPIs were also associated with negative outcomes related to well-being (Iwamoto & Liu, 2010; Mossakowski, 2003), self-esteem (Liang & Fassinger, 2008), and social connectedness (Wei et al., 2012). Although the importance of understanding the effects of COVID-19–related racial discrimination on the mental health of Asians and AAPIs has been established (Asmundson & Taylor, 2020; Chan & Litam, 2021; Litam, 2020), a paucity of empirical investigations examines the mental health effects of pandemic-related discrimination among Asians and AAPIs across the life span (Litam & Oh, in press).

Ethnic Identity
     Ethnic identity is the quality of an individual’s affiliation with their ethnic group and includes a sense of belongingness, self-identification, and attitudes toward one’s group (Phinney, 1990). Phinney (1992) outlined four developmental stages based on high and low levels of exploration and commitment. Whereas exploration includes activities and behaviors undertaken to understand the role of one’s ethnicity or race in one’s identity, commitment refers to the affirmation, sense of connection, and clarity about how one’s ethnic or racial identity fits into one’s life and self-concept (Phinney, 1992). Taken together, the two dimensions of exploration and commitment form four statuses of ethnic and/or racial identity development: diffused (low exploration, low commitment), foreclosed (low exploration, high commitment), moratorium (high exploration, low commitment), and achieved (high exploration, high commitment; Erikson, 1968).

The mixed effect of ethnic identity in the relationship between racial discrimination experiences and well-being has been noted across earlier studies. On one hand, existing research has noted that Asians and AAPIs who cultivated strong ethnic identities were more likely to maintain a positive sense of psychological well-being, reported a greater sense of belongingness to their ethnic communities, and responded with greater resilience when racial discrimination occurred (Lee, 2003; Lee & Davis, 2000; Lee & Yoo, 2004; Litam & Oh, in press; Phinney, 2003; Yip & Fuligni, 2002). In the United States, AAPIs with a strong sense of ethnic identity reported a better quality of life and greater levels of spousal support and harmony (Lieber et al., 2001). In one study with 187 Chinese and Chinese Americans, strong ethnic identity moderated the relationship between experiences of COVID-19 discrimination and levels of depression (Litam & Oh, 2020). Levels of exploration and commitment may additionally influence whether ethnic identity buffers or exacerbates well-being among Asians and AAPIs who experience racial discrimination. According to a meta-analysis of 51 studies, Yip and colleagues (2019) asserted that individuals high in exploration reported more negative mental health and riskier health behavior outcomes following experiences of racial discrimination. Conversely, ethnic identity was a protective factor for individuals with high levels of commitment following racial discrimination (Yip et al., 2019).

The moderating effects of ethnic identity on Asian and AAPI mental health may be framed within the context of social identity theory (Tajfel & Turner, 1979) and self-categorization theory (Turner et al., 1987). According to social identity theory (Tajfel & Turner, 1979), individuals are members of many social groups with whom they may identify (e.g., religion, race, ethnicity, gender). Once individuals have determined their social identities, they become invested in maintaining and enhancing their self-concept (Tajfel & Turner, 1979). Social identity theory therefore predicts that individuals who center their identities are better equipped to cope with identity threats to protect their overall self-concept (Tajfel & Turner, 1979). Through the lens of this theory, individuals who strongly identify with their Asian or AAPI identities may be better positioned to engage in coping strategies that buffer the harmful impact of ethnic or racial discrimination.

Self-categorization theory builds on social identity theory by recognizing that individuals can identify with several social groups simultaneously and that some social identities become more psychologically salient than others (Turner et al., 1987). When ethnic identity becomes salient and represents an important component of one’s identity, self-categorization theory predicts that ethnic and racial discrimination will have a stronger negative impact on mental health and wellness outcomes (Turner et al., 1987). Taken together, social categorization theory predicts that positive feelings toward one’s ethnic group may heighten awareness to ethnic discrimination, which may exacerbate the harmful effects of ethnic or racial discrimination (Lee, 2005), whereas social identity theory posits that high regard for one’s ethnic identity may result in a buffering effect to the deleterious effects of racial discrimination (Yip et al., 2019).

     Resilience refers to the “personal qualities that enable one to thrive in the face of adversity” (Connor & Davidson, 2003, p. 76). Although responding with resilience in times of stress has been reported across diverse AAPI subgroups, various ethnic groups may conceptualize resilience in unique ways. As a coping strategy, resilience is not limited to how one responds to challenges but also encompasses strategies for goal achievement. For example, Hmong women demonstrated resilience in career development by adopting positive perspectives, focusing on goal achievement, and reflecting on ways to continue improving (Yang, 2014). In another study, Chinese immigrants demonstrated fortitude through the immigration process and continued to thrive in the United States despite living in poverty in a California Chinatown community (Cheng, 2013). Resilience, therefore, consists of a stress response and an enduring phenomenon. Resilience may be fostered through the presence of social support, especially among family members (Lim & Ashing-Giwa, 2013), through the promotion of cultural understanding (i.e., cultivating ethnic identity), engaging in meaningful activities, and developing mental toughness (i.e., resilience; Kim & Kim, 2013).

Coping and Stress Responses
     Individuals evaluate racial discrimination experiences and cope with stressors differently based on their cultural values and beliefs (Lazarus & Folkman, 1984; Tweed & Conway, 2006). Asians and AAPIs who endorse higher levels of ethnic identity may be more likely to employ coping strategies that align with culturally embedded values (Miller & Kaiser, 2001; Miller & Major, 2000). These cultural values may assert the importance of adjusting one’s feelings to fit their environment, accepting rather than confronting problems, preserving social harmony, avoiding problem disclosure (Inman & Yeh, 2007; Tweed & Conway, 2006; Yeh et al., 2006), and evading conflict to preserve interpersonal relationships (Noh & Kaspar, 2003). These passive forms of coping may be problematic, as avoidant and emotion-focused responses may contribute to poorer mental health outcomes in AAPIs.

Other culturally congruent coping responses such as social isolation, which protects the user by avoiding the stressor (Edwards & Romero, 2008); self-blame or criticizing oneself, which maintains interpersonal harmony (Wei et al., 2010); and substance use (Pokhrel & Herzog, 2014), which momentarily helps one evade problems or adjust one’s feelings to the environment, may also be preferred by Asians and AAPIs. Following stressful events, social isolation has been strongly linked to increased symptoms of depression and anxiety, decreased feelings of self-worth, and lower levels of life satisfaction (Cacioppo & Hawkley, 2003; Cacioppo et al., 2002).

Stress-Related Growth
     Individuals may respond to stressful life events, transitions, and traumatic experiences with positive psychological changes (Park et al., 1996; Tedeschi & Calhoun, 2004). Researchers posit that coping strategies (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004), higher levels of self-esteem, positive spiritual changes, and increased social support (Linley & Joseph, 2004; Tedeschi & Calhoun, 1995, 2004) may arise following experiences of stress. According to Tedeschi and Calhoun (1996, 2004), examples of stress-related growth may include pursuing new possibilities, having a greater appreciation for life, cultivating meaningful relationships, enhancing spiritual growth, and developing personal strengths. A meta-analysis of 103 studies identified the presence of coping strategies, cognitive reappraisal, religion, optimism, and social support as significant predictors for stress-related growth (Prati & Pietrantoni, 2009). A qualitative study with Korean immigrants indicated the use of coping strategies was a predictor for stress-related growth (Kim & Kim, 2013).

Tedeschi and Calhoun (1996, 2004) conceptualized stress-related growth as both a long-term outcome and a process. For instance, stress-related growth has been conceptualized as a coping strategy following traumatic events (Nolen-Hoeksema & Davis, 2004) and may occur as the result of ongoing medical conditions such as cancer (Cordova et al., 2017) and chronic pain (Rzeszutek & Gruszczyńska, 2018), wherein traumatic experiences are not time-limited. Thus, stress-related growth may result from the ongoing process of awareness, adaptation, and concern related to medical, psychological, and social consequences associated with the conditions of living (Edmondson et al., 2011). Given the precedence of emerging research that measures stress-related growth during COVID-19 (Vasquez et al., 2021), stress-related growth was included as an outcome variable in our study. This variable was of particular interest because research remains forthcoming on the contributing factors to stress-related growth among Asians and AAPIs following experiences of stress related to COVID-19.

The call to identify moderators of mental health in Asian and AAPI communities following racial discrimination has been established (Litam, 2020; Litam & Oh, in press; Nadal et al., 2015; Wong et al., 2014). It is of paramount importance to identify race-related response strategies to develop culturally sensitive and effective counseling interventions (Chan & Litam, 2021; Frazier et al., 2004; Litam & Hipolito-Delgado, 2021). The relationship between COVID-19–fueled racial discrimination, ethnic identity, resilience, and coping responses in Asian and AAPI populations remains to be seen and necessitates special consideration for mental health professionals. Understanding this relationship is crucial when considering how Asians and AAPIs tend to avoid health care services (DeVitre & Pan, 2020; Sue et al., 2019). To address this paucity of literature, this study was undertaken to examine the following research questions:

  1. To what extent do coping, resilience, experience of racism, and ethnic identity predict stress-related growth following COVID-19?
  2. To what extent does coping moderate experiences of COVID-19–related racism and stress-related growth?
  3. To what extent does resilience moderate experiences of COVID-19–related racism and stress-related growth?


     Data was collected from June to July 2020. A total of 409 Asian and AAPI individuals were recruited through AAPI listservs and community organizations (n = 10) and Amazon MTurk (n = 399). Sixty-eight respondents from Amazon MTurk completed less than 50% of the survey items, so their associated surveys were removed from the data. An additional 11 respondents from Amazon MTurk endorsed all survey items with the same response or incorrectly answered validity items, and their surveys were also eliminated from the data. Lastly, four multivariate outliers were removed (i.e., Mahalanobis distance value > 20.515 at a = .001), resulting in a final sample of 326 cases (79.7% useable response rate). The final sample (N = 326) met sufficient sample size for hierarchical multiple regression (N > 94) and a path analysis (N > 134; O’Rourke & Hatcher, 2013) at a = .01 to identify medium effect size.


Table 1

Descriptive Characteristics and Correlations

Characteristic Frequency %
Male 225 69.0%
Female 101 31.0%
Education Level
High School Diploma or the equivalent 6 1.8%
Associate Degree 6 1.8%
Bachelor’s Degree 205 62.9%
Master’s Degree 95 29.1%
Doctorate Degree 14 4.3%
Sexual Identity
Heterosexual 220 67.5%
Gay or Lesbian 9 2.8%
Bisexual, Pansexual, or Non-Monosexual 91 27.9%
Other 6 1.8%
Seeking Mental Health Service Since COVID-19
Yes 153 46.9%
No 149 45.7%
No, but I have considered it 24 7.4%
Variable a M SD 1 2 3 4 5
SBRS .91 27.48 7.28
SRGS .95 77.05 15.09 .510**
MEIM .61 22.56 3.20 .437** .429**
Resilience .95 134.92 20.97 .301** .703** .436**
Coping .92 79.05 13.10 .662** .699** .521** .518**

 Note. SBRS = Subtle and Blatant Racism Scale; SRG = Stress-Related Growth Scale; MEIM = Multigroup
Ethnic Identity Measure.
**p < .01


Table 1 presents details regarding descriptive characteristics of participants in this study. The average age of Asian and AAPI participants was 33.79 years (SD = 9.19), ranging from 18 to 72 years. The majority of participants identified as male (69.0%, n = 225), and a smaller group identified as female (31%; n = 101). Most participants reported having an international status (72.7%, n = 237), whereas 27.3% of participants (n = 89) identified as an American citizen or permanent U.S. resident. For one item, “Have you sought professional mental health counseling services since COVID-19?” approximately half of the participants (46.9%, n = 153) selected “Yes,” a total of 150 participants (45.7%) selected “No,” and a total of 24 participants (7.4%) indicated “No, but I’ve considered it.”

     IRB approval from relevant universities was obtained prior to data collection. Potential participants were recruited using non-probability convenience sampling with inclusion criteria. Participants who (a) self-identified as Asian or Asian American, (b) resided in the United States, and (c) had either directly or indirectly experienced COVID-19–related racism were able to participate in the study. Participants from the MTurk obtained $0.50 as an incentive for their completion of the survey. To ensure the quality of data, the survey included two validity items that asked participants to choose specific response options. Participants who chose incorrect responses were automatically excluded from participation in the survey. 

Demographics and Background Form
     A demographics/background information form was created to gather information regarding participants’ age, gender, highest level of education, race/ethnicity, sexual identity, income level, occupation, international status, religion, and generational status. Additional survey items assessed English proficiency and how rates of discrimination evidenced through verbal, covert, online, and physical harassment may have changed following COVID-19. Participants were provided with the option to input text describing additional forms of racial discrimination experienced since COVID-19.

Multigroup Ethnic Identity Measure – Revised (MEIM-R)
     The Multigroup Ethnic Identity Measure (MEIM; Phinney, 1992) is a 14-item scale that assesses three aspects of ethnic identity: positive ethnic attitudes and a sense of belonging (five items), ethnic identity achievement (seven items), and ethnic behaviors or practices (two items). The measure is scored by reversing negatively worded items, summing the scores across each item, and obtaining the mean. Scores range from 4 (high ethnic identity) to 1 (low ethnic identity). Overall reliability was .90 in a college sample, and the results of a principal axis factor analysis using squared multiple correlations supported the presence of two factors, ethnic identity and other-group group orientation, accounting for 30.8% and 11.4% in college samples, respectively (Phinney, 1992). The MEIM was shortened into a six-item scale that measures two subscales, Identity Exploration and Identity Commitment (MEIM-R; Brown et al., 2014). Example items include “I have spent time trying to find out more about my own ethnic group, such as its history, traditions, and customs” and “I think a lot about how my life will be affected by my ethnic group membership.” The MEIM-R demonstrated adequate internal consistency for the overall scale and two subscales with all Cronbach alpha values near or above .70 (Brown et al., 2014). Based on the results of multiple-groups confirmatory factor analyses, the MEIM-R demonstrated evidence of measurement invariance, had good psychometric properties, and is an appropriate measure of ethnic identity across diverse Asian subgroups (Brown et al., 2014).

Resilience Scale (RS)
     The Resilience Scale (RS; Wagnild & Young, 1993) is a 25-item measure that uses a 7-point Likert-type scale from 1 (strongly disagree) to 7 (strongly agree). Example items include “I usually manage one way or another” and “I feel that I can handle many things at a time.” The RS demonstrated a coefficient alpha of .91 with item-to-total correlations ranging from .37 to .75. The concurrent validity of the RS was also robust and was strongly associated with measures of life satisfaction, morale, and depression. The results of a factor analysis indicated the RS is a reliable measure that demonstrated good internal consistency reliability, concurrent validity, and preliminary construct validity (Wagnild & Young, 1993). 

Subtle and Blatant Racism Scale for Asian Americans Revised (SABRA-A2)
The Subtle and Blatant Racism Scale for Asian Americans Revised (SABRA-A2; Yoo et al., 2010) is an 8-item measure that uses a 5-point Likert-type scale from 1 (almost never) to 5 (almost always) to assess the presence of subtle and blatant forms of racial discrimination. The total score is obtained by summing the responses across each of the items, with higher scores indicating greater perceived racism. Example items include “In America, I am faced with barriers in society because I’m Asian” and “In America, I have been physically assaulted because I’m Asian.” Support for the two-subscale structure was confirmed through an exploratory and confirmatory factor analysis with evidence of good internal reliability and stability over 2 weeks (Yoo et al., 2010). The SABRA-A2 also demonstrated good discriminant validity as evidenced by no correlations with color-blind racial attitudes (Yoo et al., 2010).

Brief COPE
     The Brief COPE (Carver, 1997) is a 28-item measure and uses a 4-item Likert-type scale to measure the extent to which participants report using various coping strategies. The measurement has 14 subscales that include two items each. Available responses are 1 (I haven’t been doing this at all), 2 (I’ve been doing this a little bit), 3 (I’ve been doing this a medium amount), and 4 (I’ve been doing this a lot). Example items include “I’ve been concentrating my efforts on doing something about the situation I’m in” and “I’ve been criticizing myself.” The Brief COPE has demonstrated acceptable psychometric properties and has been used with Asian populations (Sue et al., 2019). Cronbach’s alpha for the entire scale is .92 in the current study. Cronbach’s alpha for each of the 14 subscales ranged from .34 to .65. Given the poor reliability for the subscales, the present study utilized the total score for the entire scale.

Stress-Related Growth Scale Revised (SRGS-R)
     The Stress-Related Growth Scale Revised (SRGS-R; Boals & Schuler, 2018), is a 15-item measure that assesses the extent to which participants experience change following a negative event. The scale uses a bipolar 7-point Likert-type scale from −3 (a very negative change) to +3 (a very positive change), and example items include “I experienced a change in the extent to which I listen when others talk to me” and “I experienced a change in my belief that I have something of value to teach others about life.” The SRGS-R demonstrated acceptable measures of convergent validity and stronger associations with outcome measures of mental health, including depression, anxiety, global distress, and post-traumatic symptoms (Boals & Schuler, 2018). Compared to other measures, the SRGS-R may be a more accurate measure for human resiliency as evidenced by the neutral wording of each item and the inclusion of items that avoid measuring illusory growth (Boals & Schuler, 2018).

Data Diagnostics
     Examining the proportion of missing data indicated that 88% of participants reported no missing values, and 83% of the items were not missing data for any case. The proportion of missing data for the rest of the 17% of the items ranged from 2.7% to 16.8%. The degree and pattern of missing data were examined to determine whether data were missing at random. A matrix of the estimated means with each pattern yielded no particular patterns nor severe degree of missing data, which supported evidence for proceeding with missing data replacement techniques. Missing data points were populated using multiple imputation (MI), a method to allocate missing data without causing inflated bias even when there is a large portion of missingness in the data (Osborn, 2013).

     Next, the assumptions of normality, linearity, homoscedasticity, and multicollinearity were tested. The residuals were linear and did not deviate from normality as evidenced by the residuals lying reasonably in a straight, diagonal line. The assumption of homoscedasticity was also supported, as most of the residuals were concentrated along the zero point. All variance inflation factor (VIF) values were less than 10 and tolerance values were greater than .1, indicating absence of multicollinearity (Tabachnick & Fidell, 2019). Therefore, the data were deemed appropriate for hierarchical regression and path analysis (Tabachnick & Fidell, 2019).

Analytic Strategy
     Hierarchical regression models of stress-related growth were employed using SPSS version 27. First, gender, age, education status, sexual identity, and help-seeking experience were entered in Model 1 as the control variables. In Model 2, the first independent variable of subtle and blatant racism was added. In Model 3, the second independent variable of ethnic identity was entered. Finally, the remaining two independent variables of resilience and coping strategy were added as key predictors that may function as potential moderators in Model 4.

To examine potential moderating roles of resilience and coping strategy in the relationship between racism and stress-related growth, Hayes’ (2018) PROCESS macro version 3.5 was conducted. Specifically, 10,000 bootstrapping resampling was conducted to produce 95% percentile confidence intervals (CIs) for the moderating effect. If the CIs excluded zero, moderating effect was considered to be significant. Furthermore, the moderating effects were examined utilizing three conditional values of moderators (Hayes, 2018; Preacher et al., 2017), which included low (the mean score of the moderator −1 SD), moderate (the mean score), and high values (the mean score of the moderator +1 SD). Bodner’s (2017) formula was used to calculate effect size across moderator values. All predictors and moderators were mean-centered for more meaningful interpretation of moderating effect (Hayes, 2018).


Preliminary Analyses
     Descriptive characteristics are found in Table 1. Male and female participants reported similar mean scores on all measurements, except the SABRA-A2. Female participants reported experiencing significantly higher levels of racism (M = 29.10, SD = 6.25) than their male counterparts (M = 26.75, SD = 7.59), with a small effect size (d = 0.34; Cohen, 1998). Participants who had sought mental health services since COVID-19 reported significantly higher resilience scores (M = 138.78, SD = 20.59), experiences of subtle and blatant racism (M = 29.99, SD = 6.38), coping strategy (M = 84.34, SD = 12.61), and stress-related growth (M = 81.13, SD = 14.25) than participants who either did not seek professional mental health services or who considered seeking services, but had not used them.

     Correlational analyses among all study variables were conducted. Table 1 presents the correlations among the predictive and outcome variables assessed in the study as well as the mean and standard deviations for each variable and internal reliability for each measurement. As expected, ethnic identity, resilience, coping strategy, and stress-related growth were positively and moderately correlated with each other. Interestingly, subtle and blatant racism were also positively related to ethic identity, resilience, coping, and stress-related growth.

Hierarchical Regression Analyses
     Results from the hierarchical regression analyses are provided in Table 2. The control variables of gender, age, education status, sexual identity, and help-seeking experience were examined in Model 1. Among the control variables, education status, sexual identity, and help-seeking experiences were significantly associated with stress-related growth for Asians and AAPIs. Specifically, participants who had earned a master’s degree or higher and identified as heterosexual had significantly lower scores of stress-related growth compared to those who did not identify as heterosexual. Moreover, participants who sought mental health services following the COVID-19 outbreak reported significantly higher scores of overall stress-related growth compared to those who did not use professional mental health services. Model 1 accounted for 11.6% of the variance in stress-related growth.

The direct effects of subtle and blatant racism on stress-related growth were examined in Model 2. Subtle and blatant racism had a significantly positive relationship with stress-related growth among Asians and AAPIs (β = .456, p < .001) after controlling for gender, age, education, sexual identity, and help-seeking experience. Thus, higher levels of subtle and blatant racism were correlated with higher levels of stress-related growth. Among the control variables, only education status was found to be significantly associated with stress-related growth. Model 2 explained 28.8% of the variance in stress-related growth. The addition of subtle and blatant racism accounted for a 17.2% increase in the explained variance in stress-related growth, which was deemed a medium effect size (Cohen, 1998).

Ethnic identity was added in Model 3. Results indicated that ethnic identity was significantly positively associated with stress-related growth for Asians and AAPIs (β = .244, p < .001) after controlling for gender, age, education, sexual identity, and help-seeking experience. Based on these results, participants in the study who endorsed stronger levels of ethnic identity were more likely to cultivate higher levels of stress-related growth. Model 3 accounted for 33.5% of the variance in stress-related growth. The addition of ethnic identity explained 4.7% of increase in the variance of stress-related growth.

Resilience and coping strategy were added and analyzed in Model 4. Both resilience and coping strategy had significantly positive associations with stress-related growth for Asians and AAPIs after controlling for gender, age, education, sexual identity, and help-seeking experience. Specifically, Asians and AAPIs who had higher levels of resilience and higher levels of coping strategy were more likely to develop higher levels of stress-related growth. Model 4 explained 66.2% of the variance in stress-related growth. The addition of resilience and coping strategy accounted for a 32.7% increase in the explained variance in stress-related growth, which represented a large effect size (Cohen, 1998).

Moderating Effect of Resilience and Coping Strategy
     To examine the moderating effect of resilience and coping strategy, Hayes’ (2018) PROCESS macro (Model 1) was employed using 10,000 bootstrapping resamples. As shown in Table 3, coping strategy was significantly positively related to the slope of subtle and blatant racism on stress-related growth
(β = .017, p < .001). Based on these results, coping strategy significantly moderated (i.e., strengthened) the positive link between racism and stress-related growth. As the moderator, coping strategy explained 1.4% of the total variance (51.2%) in stress-related growth, yielding a small effect size (Cohen, 1998). The nature of the moderating effect is presented in the simple slope analyses (Figure 1). Subtle and blatant racism had a significant effect on the development of stress-related growth for Asians and AAPIs with higher levels of coping strategy (+1 SD; b = .468, 95% CI [.169, .767]), but the significant effect did not hold for those with lower levels of coping strategy (−1 SD; b = .017, 95% CI [−.224, .257]). A +2 SD increase in resilience yielded less than .001 change in the conditional effect on stress-related growth, which was small in magnitude (Bodner, 2017). Thus, resilience did not significantly moderate the link between racism and stress-related growth.


Table 2

Results From Hierarchical Multiple Regression and Moderated Path Analysis

Model 1 Model 2 Model 3 Model 4
Variables Β (S.E.) β Β (S.E.) β Β (S.E.) β Β (S.E.) β

Female (ref)

   Male −1.668


−.051 .187


.006 −.036


−.001 −1.831



> 34 (ref)

  ≤ 34 −1.205
−.039 −2.059


−.067 −2.287


−.074 .397



≤ Bachelor (ref)

≥ Master −5.017


−.157** −3.470


−.109* −2.249


−.070 .320


Sexual Identity

Non-hetero (ref)

   Heterosexuality −4.479


−.139** −1.721


−.109 −1.621


−.050 −1.512



No (ref)

   Yes 6.796


.225*** 2.691


.089 2.880


.095 .452


SBRS .947


.456*** .734


.354*** .220


MEIM 1.152


.244*** −.172


Resilience .357


Coping .433


R2 .116 .288 .335 .662
∆ R2 .172 .047 .327

 Note. Β = unstandardized regression coefficients; S.E. = standard errors; β = standardized coefficients; SBRS = Subtle and Blatant Racism Scale; MEIM = Multigroup Ethnic Identity Measure; ref = reference group.
*p < .05. **p < .01. ***p < .001


Table 3

Results From Moderation Path Analysis

Variable β SE LLCI ULCI
SBRS 0.242* 0.115 0.015 0.469
Coping 0.718*** 0.062 0.596 0.841
SBRS × Coping 0.017** 0.006 0.006 0.029
Controlled Variables
    Age −1.420 1.215 −3.811 0.971
    Gender −0.681 1.297 −3.232 1.871
    Education −1.409 1.287 −3.942 1.124
    Sexual Identity 0.185 1.304 −2.380 2.750
    Help-Seeking 0.070 1.282 −2.452 2.592
SBRS 0.577*** 0.089 0.403 0.751
Resilience 0.443*** 0.029 0.387 0.499
SBRS × Resilience 0.001 0.004 −0.006 0.009
Controlled Variables
    Age 0.472 1.109 −1.709 2.654
    Gender −1.704 1.175 −4.015 0.607
    Education -0.084 1.174 −2.227 2.395
    Sexual Identity −2.569* 1.184 −4.899 −0.239
    Help-Seeking 1.542 1.138 −0.696 3.781

Note. SBRS = Subtle and Blatant Racism Scale; LLCI = lower limit of confidence interval; ULCI = upper limit
of confidence interval.
*p < .05. **p < .01. ***p < .001.


Supplementary Analyses
     Because the 14 coping subscales demonstrated poor reliability, we examined which types of coping strategies moderated the link between racism and stress-related growth. Among the different types of coping responses, self-blame, religion, humor, venting, substance use, denial, and behavioral disengagement had significant moderation effects on the relation between racism and stress-related growth. On the contrary, self-distraction, active coping, use of emotional support, use of instrumental support, positive reframing, planning, and acceptance did not significantly moderate the relationship between racism and stress-related growth.


Figure 1 

Coping Strategy Moderates the Effect of Subtle and Blatant Racism on Stress-Related Growth


The present study examined the extent to which coping, resilience, experiences of racism, and ethnic identity predicted stress-related growth in a national convenience sample of Asian and AAPI individuals. The results of our exploratory study provide empirical evidence for the moderating effects of coping on the relationship between racial discrimination and stress-related growth in Asians and AAPIs following the COVID-19 pandemic. In our study, ethnic identity was positively associated with stress-related growth, which further supports the current body of research linking ethnic identity to well-being (Iwamoto & Liu, 2010; Mossakowski, 2003; Yip et al., 2019). Our findings may be additionally explained through the lens of social identity theory (Tajfel & Turner, 1979), which posits that individuals who strongly identify with their social identities (i.e., ethnic and/or racial identities) are better equipped to leverage effective coping strategies that protect their overall self-concept and buffer the harmful impact of discrimination.

Participants in the study who used mental health services following COVID-19 also reported significantly higher levels of racial discrimination, resilience, coping, and stress-related growth compared to Asians and AAPIs who did not use professional mental health services. The results from our study are consistent with existing research that asserted how individuals may cultivate coping responses following traumatic experiences (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004) in ways that can strengthen the relationship between stressful experiences (i.e., racism) and stress-related growth (Park et al., 1996; Tedeschi & Calhoun, 2004). The results of our study therefore contribute to a larger body of research that establishes the relationship between stress-related growth and psychological health, optimism, positive affect, and psychological well-being (Bostock et al., 2009; Bower et al., 2009; Durkin & Joseph, 2009) while contributing nascent findings to the relationship between COVID-19 racial discrimination and stress-related growth in Asian and AAPI communities.

The results from Model 1 indicated education status, sexual identity, and help-seeking experiences were significantly associated with stress-related growth for Asians and AAPIs in the study. Specifically, participants who reported higher levels of education and identified as heterosexual or straight had lower scores of stress-related growth compared to those who did not identify as heterosexual. These findings are notable as individuals with lesbian, gay, bisexual, and other marginalized identities experience more stress and mental health issues compared to their heterosexual counterparts (Mongelli et al., 2019), resulting in greater opportunities to cultivate coping responses, build resilience, and establish meaningful social supports (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004). Participants in our study who used mental health services following the COVID-19 outbreak reported significantly higher levels of stress-related growth compared to Asians and AAPIs who did not use professional mental health services. One possible explanation for this finding may be that participants who sought mental health services already demonstrated higher levels of psychological mindedness, which may have influenced higher levels of stress-related growth following COVID-19–related racial discrimination.

In our study, the combined effects of resilience and coping explained 66.2% of the variance in Model 4, with coping strategies moderating the relationship between experiences of racism and stress-related growth. Participants in our study may have learned cognitive coping responses in the therapeutic setting that mitigated the effects of racism and cultivated stress-related growth. Our findings are consistent with the results of a meta-analysis (n = 103) that identified coping responses such as reappraisal, acceptance, and support seeking as significant predictors of stress-related growth (Prati & Pietrantoni, 2009). The specific coping responses that moderated the link between racism and stress-related growth in this study were self-blame, religion, humor, venting, substance use, denial, and disengagement. Leveraging these coping strategies in response to stressful experiences may be consistent with culturally congruent coping responses that protect Asians and AAPIs by avoiding the stressor (Edwards & Romero, 2008; Litam, 2020). Consistent with extant research on culturally congruent coping, engaging in self-blame responses may maintain interpersonal harmony (Wei et al., 2010), and humor, venting, denial, disengagement, and substance use may help one evade problems or adjust one’s feelings to the environment (Pokhrel & Herzog, 2014). The results of our study are thus consistent with research that emphasizes the influence of cultural notions on coping responses (Lazarus & Folkman, 1984; Tweed & Conway, 2006) while contributing new findings about which coping responses may contribute to stress-related growth in Asian and AAPI communities following COVID-19.

Implications for Counselors
     This study highlights how experiences of racism, ethnic identity, resilience, and coping strategies may cultivate stress-related growth among Asian and AAPI individuals who experience COVID-19–related racial discrimination. Each of these variables were found to predict stress-related growth in our study. Mental health professionals working with Asian and AAPI clients who have experienced COVID-19 racism are encouraged to consider how their clients’ ethnic identity, resilience, and coping strategies may be leveraged to promote their well-being. In this exploratory study, participants with higher levels of ethnic identity experienced greater levels of stress-related growth, so it may behoove mental health professionals to embolden Asian and AAPI clients to fortify the quality of their ethnic group affiliation by pursuing cultural practices that promote a sense of group belongingness (Phinney, 1990). For example, ethnic identity can be cultivated by fostering community connection through local Asian and AAPI organizations, embracing cultural notions, and learning more about one’s culture, background, and family history (Chan & Litam, 2021; Litam, 2020). Clients who embody strong ethnic identities may be more likely to employ coping strategies that align with culturally embedded values; therefore, it is essential that mental health counselors recognize their own cultural values while remaining respectful of their client’s cultural values (Chang & O’Hara, 2013; see MSJCC, Ratts et al., 2016).

Given the importance of coping strategies and resilience on stress-related growth, mental health professionals are encouraged to identify and amplify clients’ existing coping strategies while fostering responses that cultivate resilience. Though limited, a supplementary analysis indicated that different forms of coping, such as self-blame, religion, humor, venting, substance use, denial, and disengagement, may moderate the relationship between racism and stress-related growth among Asian and AAPI communities facing racial discrimination following COVID-19. Thus, mental health professionals working with Asian and AAPI clients must assess the intention and outcome of client coping responses and challenge individualistic assumptions that minimize the value of culturally congruent coping strategies. The importance of using culturally sensitive therapeutic interventions when supporting Asian and AAPI clients during COVID-19 has been established (Litam, 2020). For example, mental health professionals must challenge assumptions that disengagement coping strategies are inherently problematic for their Asian and AAPI clients (Wong et al., 2010). Instead, mental health professionals are encouraged to focus on the usefulness of their Asian and AAPI clients’ coping strategies without imposing their own preconceived notion of what healthy and unhealthy coping entails. Of note, substance use was identified as a coping strategy used by participants in this study. Counselors are therefore called to examine the purpose and outcomes associated with client substance use with nuance to determine the extent to which ongoing substance use may contribute to mental health sequelae.

Limitations and Future Areas of Study
     The results of the study must be interpreted within the context of methodological limitations. First, although all participants resided in the United States, the majority of participants held international statuses compared to U.S. citizens or permanent residents. Readers must be cautioned before generalizing these findings to AAPIs, who may endorse generational differences. Next, it is possible that participants recruited from MTurk may not be representative of the general Asian and AAPI population in the United States (Burnham et al., 2018). Future areas of research may consider incorporating various strategies to recruit more representative samples. Additional areas of investigation may also examine how generational identity may affect the extent to which coping, resilience, racism, and ethnic identity predict stress-related growth. Next, although a significant positive association was found between using professional mental health services and levels of resilience, racism, coping, and stress-related growth, it is unknown whether participants in the study already embodied higher levels of stress-related growth, coping, and resilience before seeking services. Future areas of study may examine whether these variables may actually predict help-seeking behaviors in Asians and AAPIs. For example, seeking professional mental health services is consistent with predictors of stress-related growth, including leveraging community support, engaging in cognitive responses, appraisal, and facilitating meaning making (Park & Fenster, 2004; Prati & Pietrantoni, 2009). Moreover, the validity of the findings from the supplementary analysis could be limited because of the low reliability of 14 subscales. Finally, Asians and AAPIs were aggregated in the study, which results in the loss of important within-group distinctions. Future studies are warranted that investigate the extent to which coping, resilience, racism, and ethnic identity predict stress-related growth in specific Asian and AAPI subgroups.


     Asians and AAPIs who employ culturally congruent coping responses may experience greater levels of stress-related growth following experiences of COVID-19–related racial discrimination. In this study, higher levels of ethnic identity, resilience, and coping responses predicted stress-related growth in a national convenience sample of Asians and AAPIs residing in the United States. Asians and AAPIs in this study who sought professional mental health services reported higher levels of racism and endorsed higher scores of resilience, coping, and stress-related growth compared to those who did not seek professional mental health services. Mental health professionals are encouraged to support Asian and AAPI clients in strengthening their ethnic identity, building resilience, and using culturally congruent coping responses to mitigate the effects of COVID-19–related racism and promote the development of stress-related growth.


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



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Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC-S, is an assistant professor at Cleveland State University. Seungbin Oh, PhD, NCC, LPC, is an assistant professor at Merrimack College. Catherine Chang, PhD, NCC, LPC, CPCS, is a professor at Georgia State University. Correspondence may be addressed to Stacey Litam, 2121 Euclid Ave., Cleveland, OH 44115, s.litam@csuohio.edu.