Silent No More: Exploring the Effects of Mindfulness-Based Strengths Practice on Relationship Satisfaction, Mindfulness, and Well-Being in Female Survivors of Military Sexual Trauma

Crystal M. Morris, Priscilla Rose Prasath

This study explored the effects of the 8-week Mindfulness-Based Strengths Practice program on relationship satisfaction, mindfulness traits, and overall well-being in female survivors of military sexual trauma. Conducted via Zoom with 24 participants organized into three groups, the quasi-experimental design included pre- and post-intervention assessments. Although no statistically significant differences were found in relationship satisfaction, dispositional mindfulness, or overall well-being, a notable positive correlation emerged between gains in relationship satisfaction and mindfulness, as well as between well-being and relationship satisfaction during the intervention. The study suggests practical insights for trauma treatment using a non-pathological counseling approach, emphasizing the need for further research and offering implications for clinical application, group practice, counselor education, and future studies in the field.

Keywords: mindfulness, military sexual trauma, Mindfulness-Based Strengths Practice, relationship satisfaction, well-being

     The global spotlight on violence against women, particularly sexual assault and harassment, has garnered substantial attention in recent years. The World Health Organization found sexual violence to be a major public health problem and a violation of women’s human rights (WHO; 2021). WHO estimated that 27% of women aged 15–49 years worldwide have reported being subjected to some form of sexual violence.

When trauma is prevalent among women such as female service members, particularly in the context of military sexual trauma (MST), it can often hinder the development of meaningful relationships (Department of Veterans Affairs, 2021; Wilson, 2018). The #IamVanessaGuillen movement, which gained traction in 2020, further underscored the problem. Guillen’s death was connected to sexual harassment and assault while she served in the military, sparking numerous accounts from veterans and active-duty service members who faced similar experiences (Meinert & Wentz, 2024). Despite the Department of Veterans Affairs mandating MST screening, 67% of female survivors do not report their traumatic experiences (Wilson, 2018).

Military culture, marked by language, norms, and beliefs, presents challenges in seeking mental health treatment despite the recognition of heightened risks for MST survivors (Burek, 2018; Litz, 2014). Understanding the interplay between military culture and mental health treatment is crucial, especially for female veterans facing barriers to care-seeking (Kintzle et al., 2015). MST has garnered attention, with the Veterans Health Administration providing counseling services since 1992. However, research indicates that women in the military experience higher rates of sexual assault than men in the military, emphasizing the need for multi-level interventions (Blais, 2019; Brownstone et al., 2018). Brownstone et al. (2018) underscored the factors contributing to MST and advocated for supportive and validating responses to survivors.

MST survivors face heightened risks of psychological, social, physical, and employment-related difficulties (Costello, 2022). Female MST survivors commonly experience issues such as declining sexual functioning, social support challenges, maladaptive coping mechanisms, post-traumatic stress disorder (PTSD) symptoms, and reduced relationship satisfaction (Blais, 2020; Georgia et al., 2018). Psychological trauma, triggered by such distressing events, can lead to fear, nightmares, helplessness, and difficulties in relationships (American Psychiatric Association, 2013). PTSD, a challenging diagnosis for trauma survivors, involves exposure to traumatic events and intrusive symptoms impacting intimate relationships (Campbell & Renshaw, 2018). Women who experience trauma are more susceptible to PTSD and may require exploration of the ramifications of PTSD on their relationships (W. J. Brown et al., 2021).

Relationship satisfaction is a critical outcome for trauma survivors, with positive psychology interventions addressing disparities in social functioning for survivors of MST as an option (Morris, 2022; Blais, 2020). Positive psychology has foundations rooted in ancient traditions. Concepts of human flourishing, character strengths, virtue, and well-being have shaped spiritual and philosophical thought across cultures (Peterson & Seligman, 2004; Seligman & Csikszentmihalyi, 2000). It is built on the idea that, rather than solely focusing on pathology or mental illness, psychology should explore and promote aspects of human life that contribute to happiness, fulfillment, and meaning (Peterson & Seligman, 2004; Seligman & Csikszentmihalyi, 2000). The five elements of Seligman’s PERMA model (positive emotion, engagement, relationships, meaning, and accomplishments) and character strengths, including wisdom, courage, humanity, justice, temperance, and transcendence, play a pivotal role in enhancing well-being (Seligman, 2012; VIA Institute on Character, 2019; Wagner et al., 2020). A non-pathological wellness approach, incorporating positive psychology interventions like the VIA Character Strengths (Niemiec, 2013, 2014) and mindfulness practices, have emerged as a promising intervention for trauma survivors (Carrola & Corbin-Burdick, 2015; Cebolla et al., 2017; Niemiec, 2014; Seligman & Csikszentmihalyi, 2000; Wingert et al., 2022).

Mindfulness, which has proven effective in reducing PTSD symptoms, is integrated with character strengths in the Mindfulness-Based Strengths Practice (MBSP) program (Niemiec, 2014; Zhu et al., 2019). The 8-week program combining mindfulness and character strengths practices has shown positive effects on well-being and relationship satisfaction (Ivtzan et al., 2016; Pang & Ruch, 2019). Exploring the potential of MBSP in addressing relationship satisfaction, mindfulness practices, and overall well-being for MST survivors is crucial.

Theory of Well-Being—PERMA Model
     Seligman’s PERMA model and theory of well-being incorporates the hedonic (i.e., connecting with feelings of pleasure) and eudaimonic (i.e., experiences of meaning and purpose) perspectives of well-being and poses that these two components are necessary for optimal well-being (Seligman, 2012). Seligman’s PERMA model measures each element, utilizing a subjective and objective approach in the form of positive psychology interventions (Goodman et al., 2018). Furthermore, Thompson et al. (2016) reported that using both subjective and objective well-being constructs with veterans may be appropriate. The PERMA-Profiler (Butler & Kern, 2016), a multidimensional scale that assesses the five pillars of well-being, has good reliability and acceptable levels of convergent, divergent, and criterion-related validity with student veterans (Umucu et al., 2020). The PERMA-Profiler may help researchers and counselors assess the well-being of individuals, including veterans, by providing an alternative path to conceptualizing psychological interventions (Umucu et al., 2020).

Aim of the Study and Research Questions

The primary objective of the present investigation was to assess the efficacy of the MBSP program concerning its impact on the levels of relationship satisfaction, mindfulness, and overall well-being among female survivors of MST. Simultaneously, this study sought to furnish valuable insights into the implementation of practical techniques rooted in mindfulness and character strengths that can facilitate the cultivation of robust and healthy relationships in this specific population. The research questions and hypotheses that guided the study were:

RQ1.  Is there a positive relationship between the use of the MBSP program and relationship satisfaction in females who experienced MST as measured by the Relationship Assessment Scale (RAS)?
H1:    There will be a positive effect on relationship satisfaction of female survivors of MST after completing the MBSP program.

RQ2. Will the MBSP program improve dispositional (trait) mindfulness as measured by the Mindful Attention Awareness Scale (MAAS) in female survivors of MST?
H2:    The MBSP program will improve dispositional (trait) mindfulness in female survivors of MST.

RQ3.  What is the effect of the MBSP program on overall well-being in female survivors of MST  as measured by the PERMA-Profiler?
H3:    The MBSP program will improve overall well-being in female survivors of MST.

Method

Recruitment and Screening Procedures
     In this research, a multifaceted recruitment strategy was employed, encompassing recruitment flyers, letters, referrals, and social media channels. Targeted areas included military behavioral clinics, the U.S. Department of Veterans Affairs, the Steven A. Cohen Military Family Clinic, private practices, and social media counseling groups. Word-of-mouth referrals were also completed. A pre-screening phase, conducted by phone or online, featured two questions related to MST experiences, aligning with VA-MST criteria. Upon meeting the inclusion criteria (i.e., female, 18 years of age or older, veteran or active-duty service member, has experienced sexual harassment or sexual assault while serving in the U.S. military), participants then submitted demographic information online. A counselor-in-training (CIT) and Crystal M. Morris (first author and researcher) managed the pre-screening. Qualified individuals underwent a comprehensive trauma history and psychosocial interview led by Morris and the CIT as part of the screening process.

Participants
     Several studies employing the MBSP program as an intervention within the general population reported individual sample sizes ranging from 20 to 126 (Hofmann et al., 2020; Ivtzan et al., 2016; Pang & Ruch, 2019; Whelan-Berry & Niemiec, 2021; Wingert et al., 2022). The sample size for the study was determined using G-Power software, adhering to Cohen’s (1998) conventions, with a medium effect size of .5, error probability of .05, and a power of .8. A priori statistical power analyses (Faul et al., 2007) indicated a sample size of 15 participants, ensuring adequate statistical power throughout the study.

A total of 24 female survivors of MST from various military branches (i.e., Army, Navy, and Air Force), both enlisted members and officers, participated in the study. After cleaning the data, participants who had greater than 20% missing data on the scale items were removed from the study (Hair et al., 2018). For the remaining participants with missing data, mean substitution was used for the Likert scale items (Hair et al., 2018). Of the 24 participants, 41.7% (n = 10) identified as Black/African American, 45.8% (n = 11) identified as White/Caucasian, and 12.5% (n = 3) identified as Latina/Hispanic. Participants were between the ages of 22 and 63, with a mean age of 43.38%. Of the participants, 54.2% served in the Army, 33.3% in the Air Force, and 12.5% in the Navy. The majority (78.3%) had an enlisted military rank and 21.7% were officers. Of the participants, 91.67% received unwanted, threatening, or repeated sexual attention while in the military; 41.67% had prior mindfulness practice experience; 79.17% received prior treatment for PTSD/trauma in therapeutic counseling; 83.33% reported no diagnosis of bipolar, schizophrenia, borderline personality disorder, or dissociative identity disorder; and 66.67% reported never being a client for PTSD/trauma with Morris.

Research Design
     This study employed a quantitative quasi-experimental design, collecting data pre- and post-intervention, utilizing one-way repeated measures ANOVA, the Friedman test, and the Pearson product coefficient for analysis. The dependent variables include relationship satisfaction, mindfulness, and well-being, assessed at three time points. The independent variable was the MBSP intervention, conducted online because of COVID-19. The Relationship Assessments Scale (RAS), PERMA-Profiler, and Mindful Attention Awareness Scale (MAAS) were used as assessments. Table 1 outlines the 8-week MBSP program.

Data Collection Procedures
     Data collection for this study occurred online from May 2022 to August 2022, with the approval of the University of Texas at San Antonio Institutional Review Board. All participants were provided with an IRB-approved consent form before joining the study. The research involved a pre-screening process, demographic data collection, trauma history interviews, and pretest and posttest assessments conducted at different stages (i.e., baseline, Week 4, and Week 8) of the MBSP program. Participant information was securely stored on Qualtrics. Instruments used in the study included the VA-MST screening questions (2 items), the RAS (Hendrick et al., 1998), the MAAS (Bishop et al., 2004), and the PERMA-Profiler (Butler & Kern, 2016). Those who completed the study received a $50 Amazon gift card as compensation. The MBSP sessions were conducted virtually via Zoom, with Morris, a licensed professional counselor, as the facilitator and a CIT as process observer.

Table 1

Standard Structure of MBSP Sessions and Program (Niemiec, 2014)

Session Core Topic Mindfulness Practice Description Session Description Overall

Internal Session Structure of MBSP

1 Mindfulness and Autopilot Raisin exercise
(Kabat-Zinn, 1990)
The autopilot mind is pervasive; insights and change opportunities start with mindful attention. I. Opening meditation
2 Your Signature Strengths You at your best (includes strength-spotting; Niemiec, 2014) Identify what is best in you; this can unlock potential to engage more in work and relationships and reach higher personal potential. II. Dyads or group discussion
3 Obstacles are Opportunities Statue meditation
(Niemiec, 2014)
The practice of mindfulness and strengths exploration leads immediately to two things—obstacles/barriers to the practice and a wider appreciation for the little things in life. III. Introduction to new material
4 Strengthening Mindfulness in Everyday Life (Strong Mindfulness) Mindful walking Mindfulness helps us attend to and nourish the best, innermost qualities in everyday life in ourselves and others while reducing negative judgements of self and others; conscious use of strengths can help us deepen and maintain mindfulness practices. IV. Experiential–mindfulness/character strengths experience
5 Valuing Your Relationships Loving-kindness/strength-exploration meditation

(Neff, 2011; Salzberg, 1995)

Mindful attending can nourish two types of relationships: relationships with others and our relationship with ourselves. Our relationship with ourselves contributes to self-growth and can have an immediate impact on our connection with others. V. Debriefing or Virtue circle
6 Mindfulness of the Golden Mean (Mindful Strengths Use) Character strengths 360 review and fresh start meditation Mindfulness helps to focus on problems directly, and character strengths help to reframe and offer different perspectives not immediately apparent. VI. Suggested homework exercises for next session
7 Authenticity and Goodness Best possible self exercise It takes character (e.g., courage) to be a more authentic “you” and it takes character (e.g., hope) to create a strong future that benefits both oneself and others. Set mindfulness and character strengths goals with authenticity and goodness in the forefront of the mind. VII. Closing meditation (strengths Gatha)—mindfully transitioning to the next day
8 Your Engagement with Life Golden nuggets exercise Stick with those practices that have been working well and watch for the mind’s tendency to revert to automatic habits that are deficit-based, unproductive, or that prioritize what’s wrong in you and others. Engage in an approach that fosters awareness and celebration of what is strongest in you and others. VIII. Reflect, assessments, close

Note. Source: Adapted from Mindfulness-Based Strengths Practice (MBSP) Group Intervention: A Systematic Review (Prasath et al., 2021).

MBSP Program Group Intervention
     In this study, the MBSP intervention was implemented using a structured curriculum from Niemiec (2014) aimed at enhancing treatment fidelity. The curriculum encompassed three main sections: an introductory portion outlining the foundational assumptions and change process in MBSP; essential information for conducting MBSP groups, including format and timing; and key reminders. The core of MBSP group sessions involved typical group dynamics, including participant interactions with themselves, fellow group members, and the group leader. Notably, the MBSP program comprises eight sessions, usually lasting 2 hours, though the duration can be adjusted based on the setting; for this study, sessions ran for 90 minutes. The MBSP program was selected for this study because it emphasizes discovering individuals’ strengths and fostering what is right within them, in contrast to focusing on deficiencies. MBSP integrates mindfulness and character strengths practices to enhance participants’ relationship satisfaction, mindfulness skills, and overall well-being (Niemiec, 2014). Morris conducted two groups per week, each accommodating 4–10 participants, over an 8-week period, with an additional group added to account for attrition, and following the standard structure outlined in Table 1.

Group Leadership
     Morris has previous training in MBSP, a certification in mindfulness meditation, commitment to group work and leadership through the Association for Specialists in Group Work Leadership Institute in 2024, experience with multicultural populations, and experience living in a diverse military community, all of which equipped her for leading the MBSP program and study. Through her training to become an effective group leader, she learned to consider intersectionality, group dynamics, fostering a positive environment, promoting awareness, group cohesion, and compassion among participants sharing personal information (Corey et al., 2018).

Instruments
Demographic Questionnaire
     Demographic questionnaires were given to all participants for screening purposes reporting age, ethnicity, gender, race, level of education, and military experience. Participants who met the criteria for the group (i.e., female, 18 years and older, military veteran/active-duty service member, and have experienced sexual assault or harassment while serving in the military) were assessed with a trauma history psychosocial interview.

VA-MST Screening Items
     Thirty-one female veterans or service members were screened for MST with the following questions using two trichotomously scored (i.e., yes, no, decline to answer) questions: “When you were in the military: (a) Did you receive uninvited and unwanted sexual attention, such as touching, cornering, pressure for sexual favors, or verbal remarks? and (b) Did someone ever use force or threat of force to have sexual contact with you against your will?” The items may be referred to as “harassment-only MST” and “assault MST,” independently (Gibson et al., 2016). After screening, 31 participants met the criteria for the study, however, 24 completed the entire study due to attrition.

PERMA-Profiler
     The PERMA-Profiler scale, developed by Butler and Kern (2016), assesses the five pillars of well-being: positive emotion, engagement, relationships, meaning, and accomplishment. Comprising 23 items, with 15 items dedicated to PERMA elements and eight fillers, each domain is measured using three items on an 11-point scale, ranging from 0 (never) to 10 (always), or 0 (not at all) to 10 (completely). Butler and Kern reported Cronbach’s alpha values ranging from .71 to .89 for positive emotion, .60 to .81 for engagement, .75 to .85 for relationships, .85 to .92 for meaning, and .70 to .86 for accomplishment. Mahamid et al. (2023) validated the PERMA-Profiler in diverse populations, reporting a 5-factor solution with 85.49% cumulative variance. Their study showed a high Cronbach’s alpha (α = .93), confirming internal consistency. Ryan et al. (2019) found acceptable internal consistency (α = .80 to .93) in Australian adults and established moderate convergent validity with health outcomes (r = 0.46 to 0.68). Umucu et al. (2020) validated the instrument utilizing Pearson correlation coefficients and the Kruskal-Wallis test among student veterans, demonstrating satisfactory reliability, convergent and divergent validity, and criterion-related aspects. The current study reported well-being domain Cronbach alphas of .96 and .94 with 95% CIs [.93, .98], [.89, 97], and [.89, .97] across data collection periods, confirming the PERMA-Profiler’s robustness and effectiveness in assessing the dimensions of well-being. The omega coefficients for well-being for this study were .96 and .94 with 95% CIs [.93, .98], [.89, .97], and [.89, .97].

Relationship Assessment Scale
     The RAS (Hendrick et al., 1998) is a 7-item self-report scale, designed to measure general relationship satisfaction. The RAS can be used for anyone in a relationship, whether romantic or non-romantic (Hayden et al., 1998). The brevity of the scale makes it applicable in clinical settings and for online administration (Hendrick, 1988). The estimated time of completion is 5 minutes. Furthermore, the RAS uses a Likert-type scale with 1 representing low and 5 representing high. The scores for each item are added, totaled, and then divided by 7 to produce a mean score. Higher scores indicate higher levels of relationship satisfaction. The RAS is favored, as it is concise and useful in measuring satisfaction in relationships, including non-romantic relationships. Sample items ask the respondents to “rate their level of problems in the relationship” and “the extent to which their expectations had been met.” The RAS has generated good test–retest reliability, internal consistency, item reliabilities, and validity (Fallahchai et al. 2019; Maroufizadeh et al., 2020). Emergent data also support its convergent and predictive ability (Topkaya et al., 2023).

Hendrick et al. (1998) endorsed the RAS for several settings and populations. The RAS revealed significant connections to commitment, love, sexual attraction, self-disclosure, and relationship investment. Furthermore, Hendrick (1988) also discovered an inter-item correlation of .49 and internal consistency of α = .86 in her assessment of reliability. In this study, the Cronbach alphas for the relationship satisfaction at each data collection period were .86, .92, and .96 with 95% CIs [.66, .91], [.86, .96], and [.92, .98], showing good internal consistency and reliability. The omega coefficients for relationship satisfaction for this study were .81, .92, and .96 with 95% CIs [.66, .91], [.86, .96], and [.92, .98].

Mindful Attention Awareness Scale
     The MAAS (Bishop et al., 2004) is a 15-item self-report instrument assessing dispositional mindfulness. Participants rate items on a 6-point scale, measuring how frequently they experience mindfulness-related behaviors. Higher scores indicate greater dispositional mindfulness. The MAAS does not have subscales. High scores on the MAAS correlate positively with self-consciousness, positive affect, self-esteem, and optimism and correlate negatively with anxiety, depression, and negative affect (Phang et al., 2016). Dispositional mindfulness, as measured by the MAAS, reflects a general tendency to be more aware and attentive in everyday life (Bishop et al., 2004). Examples of items include “I find myself preoccupied with the future or the past” and “I find myself doing things without paying attention.” The instrument yields a mean score by averaging responses across all items. Internal consistency estimates (Cronbach’s alpha) for the MAAS in adult samples consistently exceed .80 (K. W. Brown & Ryan, 2003). Additionally, Duffy et al. (2022) demonstrated the MAAS’s reliability and validity in measuring mindfulness in veterans with PTSD. Cronbach’s alphas for the mindfulness trait in this study were .89, .84, and .90 with 95% CIs [.81, .95], [.73, .92], and [.84, .95] across data collection periods, indicating strong internal consistency. The omega coefficients for mindfulness for this study were .89, .84, and .90 with 95% CIs [.81, .95], [.73, .92], and [.84, .95].

Data Analysis Procedure
     Morris used the IBM SPSS Version 28 software package to analyze the data for this study. To examine if the MBSP group intervention (i.e., treatment condition) had any effect on the three dependent variables (i.e., relationship satisfaction, dispositional [trait] mindfulness, and well-being) over time, Morris analyzed the data using repeated measures analysis of variance (RM-ANOVA). Data was entered on an Excel spreadsheet from Qualtrics and exported to SPSS for a series of repeated measures analysis of variance (RM-ANOVA) models to include non-parametric tests such as the Friedman test. The Pearson product moment correlation coefficients were calculated to examine the relationships between the gain scores for relationship satisfaction, mindfulness, and overall well-being. The researcher checked for RM-ANOVA assumptions including (a) multivariate and univariate normality, (b) linearity, (c) multicollinearity, and (d) adequate sample size (Hahs-Vaughn & Lomax, 2020).

Results

Examining the effectiveness of the MBSP program on relationship satisfaction, dispositional trait mindfulness, and well-being, an analysis was conducted and revealed there was a positive relationship between relationship satisfaction, mindfulness, and well-being.  Further analysis was provided through a one-way ANOVA repeated measure, and a Friedman test (a non-parametric) for the identified variables and assessment scores. A Pearson product-moment correlation coefficient was computed to examine gain scores between dependent variables. Table 2 provides descriptive results over each time point measured at Week 1 (baseline), Week 4, and Week 8 for relationship satisfaction, mindfulness, and overall well-being.

Table 2
Pearson Correlation Among Relationship Satisfaction, Mindfulness, and Well-Being at Baseline, Week 4, and Week 8

Variables 1 2 3 4 5 6 7 8 9
1. Relationship Satisfaction
2. Mindfulness  0.15
3. Well-Being    .71* .53*
4. Relationship Satisfaction (Wk. 4)
5. Mindfulness (Wk. 4) .09
6. Well-Being (Wk. 4)    .61* .27     —
7. Relationship Satisfaction (Wk. 8)
8. Mindfulness (Wk. 8) .52*
9. Well-Being (Wk. 8) .84* .59*

*p < .01.

Research Question 1
     In answering RQ1, a one-way RM-ANOVA examined if there were significant changes in participants’ relationship satisfaction throughout the MBSP intervention program. The independence assumption was met because the study design measured each participant’s response only once at the time of the study. The normality assumption was shown to be violated, as the p-value for the Shapiro-Wilk normality test at Week 4 was statistically significant (Shapiro-Wilk = .88, p < .001). The sphericity assumption was met because Mauchly’s test of sphericity was not found to be statistically significant, 𝜒2 (2, N = 24) = 4.39, 𝑝 = .111. No significant change over time was found, F(2, 46) = 1.74, p = .187. Therefore, H1 was rejected, as data analysis failed to demonstrate a statistically significant change in pre- and post-intervention of the MBSP group intervention on relationship satisfaction. See Table 3.

Table 3
One-Way Repeated Measures ANOVA for Changes of Relationship Satisfaction Scores Over Time (RQ1)

Source Measure SS df MS F p Partial Eta Squared
Time Sphericity Assumed   52.78   2.00 26.39 1.74 0.19 0.07
Greenhouse-Geisser   52.78   1.69 31.16 1.74 0.19 0.07
Huynh-Feldt   52.78   1.81 29.10 1.74 0.19 0.07
Lower-bound   52.78   1.00 52.78 1.74 0.20 0.07
Error Sphericity Assumed 697.89 46.00 15.17
Greenhouse-Geisser 697.89 38.96 17.92
Huynh-Feldt 697.89 41.72 16.73
Lower-bound 697.89 23.00 30.34

 

Research Question 2
     In answering RQ2, a one-way RM-ANOVA examined whether participants’ mindfulness scores significantly changed throughout the MBSP intervention program. The normality assumption was shown to be violated because the p-value for the Shapiro-Wilk normality test at week 8 was statistically significant (Shapiro-Wilk = .82, p < .001). The sphericity assumption was found to be met because the sphericity statistic was not found to be statistically significant, 𝜒 2 (2, N = 24) = .78, 𝑝 = .676. Because of the non-normal data, a Friedman test (a non-parametric version of a one-way ANOVA) was implemented. The Friedman test results showed no significant change in mindfulness scores 𝜒 2 (2, N = 24) = 5.32, 𝑝 = .069. Therefore, H2 was rejected, as data analysis failed to demonstrate a statistically significant change in pre- and post-intervention of the MBSP group intervention on mindfulness (traits).

Research Question 3
     In answering RQ3, a one-way RM-ANOVA examined whether participants’ overall well-being scores significantly changed throughout the MBSP intervention program. The normality assumption was met because the p-values for overall well-being scores for each time period were greater than .05. The sphericity assumption was found to be met because the sphericity statistic was found to be statistically significant 𝜒 2 (2, N =24) = 6.41, 𝑝 = .041. The Greenhouse-Geisser correction was implemented due to the sphericity assumption violation. The one-way ANOVA results found no significant change over time, 𝐹(1.60, 36.72) = 2.63, 𝑝 = .096. Therefore, H3 was rejected, as data analysis failed to demonstrate a statistically significant change in pre- and post-intervention of the MBSP program for overall well-being. See Table 4.

Table 4
One-Way Repeated Measures ANOVA for Changes of Overall Well-Being Scores Over Time (RQ3)

Source Measure SS df MS F p Partial Eta Squared
Time Sphericity Assumed   3.05   2.00 1.52 2.63 0.08 0.10
Greenhouse-Geisser   3.05   1.60 1.91 2.63 0.10 0.10
Huynh-Feldt   3.05   1.70 1.80 2.63 0.09 0.10
Lower-bound   3.05   1.00 3.05 2.63 0.12 0.10
Error Sphericity Assumed 26.68 46.00 0.58
Greenhouse-Geisser 26.68 36.72 0.73
Huynh-Feldt 26.68 39.02 0.68
Lower-bound 26.68 23.00 1.16

 

A Pearson’s correlation coefficient was calculated to assess the bivariate relationships between relationship satisfaction, mindfulness, and well-being. Well-being was shown to be positively associated with relationship satisfaction (r (22) =.71, p < .001) and mindfulness (r (22) = .53, p = .007). At Week 4 of the intervention, well-being was positively associated with relationship satisfaction (r (22) =.61, p =.002). At Week 8 of the intervention, well-being was shown to be positively associated with relationship satisfaction (r (22) =.84, p < .001) and mindfulness (r (22) = .59, p =.003). Mindfulness was positively associated with relationship satisfaction (r (22) = .52, p = .009). See Table 2.

Process Observation Results
     The function of process observation, as described by Yalom and Leszcz (2020), is carried out by one of the group facilitators, referred to as the process observer (i.e., CIT). The process observer’s role is to observe the interaction and behaviors of the group (Yalom & Leszcz, 2020). Because the group was online, it was recommended to have a process observer, as it can help gain insight into the interpersonal interactions of group members (Prasath et al., 2023). In this study the process observer (CIT) took notes during the MBSP group and noted processes, behaviors of members, and group dynamics. In summary, they noted that most participants shared experiences and engaged in mindfulness and strengths activities, whether meditations or character strengths exercises. Additionally, the process observer noticed that the participants started to be less distracted during the mindfulness exercises after Week 4 of the MBSP group.

Discussion

The current study investigated MBSP program effectiveness with adult female survivors of MST, examining changes in relationship satisfaction, mindfulness, and well-being. In determining the efficacy of the MBSP program on female survivors of MST, Morris made several assumptions. Some assumptions were validated, and others were not. There was some congruence between previous literature and the current study. Findings are discussed based on the hypotheses in three areas: positive relationship between relationship satisfaction and the MBSP program, improvement in mindfulness practice, and improvement in well-being because of the MBSP program.

Positive Relationship Between Relationship Satisfaction and the MBSP Program
     In line with previous studies, results reveal a similar positive change in mindfulness, showing that as mindfulness practice increased, so did relationship satisfaction and well-being, as reported by the participants during some part of the group intervention. It is not surprising that participants of this study reported some increase in mindfulness as a dispositional trait at the end of the intervention, because the MBSP program regularly incorporates several mindfulness practices, particularly meditative practices (i.e., mindful listening, walking, eating, breathing, listening, speaking, and self-compassion), during the session and for homework. This is not unusual, as there is abundant literature on mindfulness practices indicating benefits for trauma survivors (Hofmann et al., 2020; Zhu et al., 2019). Mindfulness practices with individuals impacted by trauma have revealed an improvement in self-regulation of emotions, PTSD symptoms, interpersonal relationships, and overall well-being (Hofmann et al., 2020; Shankland et al., 2021; Zhu et al., 2019).

Improvement in Well-Being Because of the MBSP Program
     Consistent with previous studies, the MBSP program shows positive influence on well-being (Pang & Ruch, 2019; Whelan-Berry & Niemiec, 2021; Wingert et al., 2022). In the current study, well-being was shown to be positively associated with relationship satisfaction; as one increased, so did the other. From Week 1 to Week 4, well-being increased but did not hold statistical significance throughout the study. Results also reveal that participants struggled with completing homework tasks such as strength activities because of outside priorities, which has been mentioned in a previous study (Whelan-Berry & Niemiec, 2021). Thus, the results may have been affected, with no positive outcome at the end of the intervention for well-being.

Additional Significant Results
     In the context of the MBSP program, the study reveals a slight increase in participants’ relationship satisfaction, well-being, and mindfulness from baseline to 4 weeks, followed by a plateau from Week 4 to Week 8. This apparent plateau may be attributed to a ceiling effect, in which the MBSP program’s influence on these dependent variables reached a saturation point (Chyung et al., 2020). Notably, the COVID-19 pandemic introduced a unique external factor impacting the study’s results, as previous MBSP studies occurred pre-pandemic. This study was conducted online, mirroring a broader shift toward virtual counseling services (e.g., Zoom) during the pandemic, potentially influencing participant experiences and outcomes (Kadafi et al., 2021).

Implications for Counselors

In the Council for the Accreditation of Counseling and Related Educational Programs 2016 standards (CACREP; 2015), there’s a notable gap, as few programs teach non-trauma modalities like positive psychology and mindfulness-based practices to address trauma survivor symptoms. The lack of CACREP guidance on crisis, trauma, and disaster counseling has necessitated creative pedagogical approaches to present realistic clinical challenges to CITs in a supportive and safe learning environment (Greene et al., 2016). This could help counselor educators develop innovative wellness tools and support for clients seeking non-pathology–based treatment. Therefore, it is recommended that CACREP establish standards to incorporate these alternative modalities, as the current CACREP standards focus on crisis intervention, trauma-informed, community-based, and disaster mental health strategies. Additionally, counselor educators can teach the MBSP intervention to students, which incorporates mindfulness and the VIA Character Strengths, which have been shown to build strengths, help with anxiety, and increase confidence; likewise, mindfulness can be beneficial during supervision (Evans et al., 2024, Niemiec, 2014). The VIA Character Strengths survey can aid educators in guiding students toward self-awareness of emotions, identifying strength, and identifying theoretical orientations aligning with their values (Sharp & Rhinehart, 2018).

The study reveals a positive correlation between relationship satisfaction, mindfulness, and well-being scores during the intervention. Adapting the MBSP program to a shorter duration for trauma survivors may be beneficial in future interventions. Existing literature on veterans with PTSD symptoms recommends incorporating wellness-based models like positive psychology in rehabilitation, with consideration for the timing and severity of trauma experiences (Carrola & Corbin-Burdick, 2015). For participants with varying recency and types of traumas, the MBSP program’s impact varied, indicating the importance of trauma processing before non-pathological treatments. Despite statistically insignificant outcomes, the study provides valuable mindfulness skills and character strength utilization for participants, offering practical tools for improving relationships for both clients and counselors. This research contributes insights into tailoring interventions for interpersonal traumas, enabling the development of non-pathological, preventive approaches utilizing positive psychology and mindfulness techniques to enhance the well-being of trauma survivors.

Limitations and Directions for Future Research

The research study has several limitations, including the use of a quasi-experimental design that posed threats to internal and external validity. The absence of a control group and issues with the relationship satisfaction scale’s design could have impacted the study’s results. Self-report and social desirability biases may have been present, especially among the 33% of respondents who were previous clients of the researcher and first author. The small sample size due to convenience sampling (N = 24) raises concerns about generalizability and the risk of Type II errors. Participant attrition further reduced the sample size and validity. Additionally, the COVID-19 pandemic introduced confounding factors, as previous studies on the intervention were conducted under different conditions. Zoom fatigue, resulting from increased online counseling services, also may have influenced participant experiences. Despite these limitations, a slight improvement in relationship satisfaction, well-being, and mindfulness was observed, possibly due to a ceiling effect. Although addressing these limitations is crucial, the study’s findings hold potential for enhancing counseling practice and research in the field.

Miller and Le Borgne (2020) suggested that further research is needed to evaluate the MBSP program’s effectiveness for enhancing the well-being and relationship satisfaction of MST survivors. This could involve larger sample sizes, addressing social desirability biases, and extending program exposure. A tailored relationship satisfaction assessment for trauma survivors should be developed, and qualitative investigations into post-MBSP program experiences are recommended. The program’s impact on symptoms like anxiety, depression, insomnia, and PTSD should be explored, not only for MST survivors but also for those with different trauma experiences. Couple satisfaction within the program context should be studied, and alternative program formats, such as shorter, intensive sessions or in-person delivery, should be considered. Changing the clinical environment and conducting long-term follow-up assessments are also suggested to enhance the study’s validity. These steps can improve the applicability of the MBSP program for supporting the well-being and relationships of trauma survivors.

Conclusion

This study investigated the impact of the MBSP program on female survivors of MST, examining their relationship satisfaction, dispositional mindfulness, and overall well-being. A total of 31 participants were initially recruited, with 24 completing all study requirements. Data analysis involved various statistical tests. Although statistical significance was not consistently demonstrated, a significant positive correlation was found between relationship satisfaction and mindfulness, and well-being and relationship satisfaction. These findings raise questions about the suitability of the MBSP program for trauma survivors, necessitating further exploration of relevant factors in this context.

Conflict of Interest and Funding Disclosure
Data collected and content shared in this article
were part of a dissertation study, which was
awarded the 2023 Dissertation Excellence Award
in Quantitative Research by The Professional Counselor
and the National Board for Certified Counselors.

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Crystal M. Morris, PhD, NCC, CSC, LPC-S, is an assistant professor at St. Mary’s University. Priscilla Rose Prasath, PhD, MBA, LPC, GCSC, is an associate professor at The University of Texas at San Antonio. Correspondence may be addressed to Crystal M. Morris, St. Mary’s University, One Camino Santa Maria, San Antonio, TX 78228, cmorris4@stmarytx.edu.

Perceptions and Experiences of School Counselor Trainees on Self-Care Grounded in Mindfulness and Social–Emotional Learning

Kyoung Mi Choi, Jung H. Hyun

This study, using a transcendental phenomenological approach, explored the perceptions and experiences of school counselor trainees participating in a self-care course grounded in mindfulness and social–emotional learning. Seven students who enrolled in a master’s-level school counseling program and completed a summer self-care course shared their experiences, leading to the identification of five key themes: (a) recognizing the importance and need for self-care, (b) cultivating a nonjudgmental mindset toward challenging emotions, (c) integrating self-care into both personal and professional settings, (d) an increase in compassion and empowerment, and (e) a commitment to ongoing learning and advocacy. The school counselor trainees’ narratives highlight the importance of self-care as a way to reclaim power within themselves and become change agents in their school communities.

Keywords: school counselor trainees, self-care, mindfulness, social–emotional learning, advocacy

The COVID-19 pandemic has dramatically changed the way we live, work, learn, and interact on a daily basis, making self-care a crucial topic of discussion in both schools and workplaces (Harrichand et al., 2021; Norcross & Phillips, 2020). Many K–12 students are facing increased emotional distress and mental health issues, such as high levels of anxiety, depression, and post-traumatic symptoms (Chen et al., 2020; Marques de Miranda et al., 2020; Prime et al., 2020). At the same time, school counselors are also struggling with issues such as fatigue, burnout, and even vicarious trauma (Parker & Henfield, 2012), along with other challenges like high workloads, uncertainty about their role, and a lack of perceived support and professional development opportunities (Savitz-Romer et al., 2021). This makes self-care for school counselors and trainees more critical now than ever before (Harrichand et al., 2021).

Self-care refers to engaging in activities or behaviors that promote one’s overall wellness and prevent burnout (Christopher et al., 2016). This concept can also be expanded to include a larger sense of self-care that encompasses embracing one’s humanity; increasing awareness of internalized negative cultural messages; and fostering a positive cultural identity that embraces one’s heritage and community strengths, assets, traditions, and legacy (Duncan-Andrade & Morrell, 2008). Some scholars view self-care as the start of personal power (hooks, 1994) and a process of humanization in education that is reciprocal, anti-oppressive, and supportive of collective well-being (Paris & Winn, 2013). Additionally, many educators and scholars believe that dismantling oppressive ideologies and power structures is an important objective in the transformative process of self-care, which involves critical self-reflection, recognition of dehumanization, and reclaiming agency (Berila, 2016; Freire, 1970/2000; hooks, 1994; Litam & Hipolito-Delgado, 2021).

The significance of self-care has led to it being viewed not just as an individual responsibility, but also a professional one. Leading counseling organizations, such as the American Counseling Association (ACA) and the Council for the Accreditation of Counseling and Related Educational Programs (CACREP), consider self-care to be a crucial aspect of a mental health professional’s duties. The ACA Code of Ethics (2014) states that “counselors engage in self-care activities to maintain and promote their own emotional, physical, mental, and spiritual well-being to best meet their professional responsibilities” (p. 8). The CACREP (2015) standards, under the Professional Counseling Identity section, include standards for counselor education programs that emphasize self-care strategies appropriate to the counselor role (Section 2.F.1.i). The American School Counselor Association (ASCA; 2019) promotes the monitoring of “emotional and physical health and practice wellness to ensure optimal professional effectiveness” for school counselors (p. 7).

However, despite the recognition of self-care as an ethical responsibility, most counseling training programs do not incorporate it as part of their curriculum (Chen et al., 2020; Christopher & Maris, 2010; Shapiro et al., 2007). Lack of time, academic pressure, and the absence of guidance and faculty role models are cited as barriers (Campbell & Christopher, 2012; Christopher & Maris, 2010; Nelson et al., 2018). Nevertheless, there is a pressing need for self-care strategies to be included in counselor training and curriculum (Mitchell & Binkley, 2021). This study utilized transcendental phenomenology to investigate the essence of self-care experiences among school counseling trainees who participated in a 10-session seminar course that focused on mindfulness and social–emotional learning (SEL).

Literature Review

Mindfulness as Humanizing Process in Self-Care
     The integration of mindfulness as a self-care practice into counseling training and programs has been widely adopted over the past three decades (Bohecker & Horn, 2016; Bohecker et al., 2016; Campbell & Christopher, 2012; Christopher & Maris, 2010; Shapiro et al., 2007). Research has shown that mindfulness can lead to numerous benefits, including reduced levels of anxiety and depression, enhanced life satisfaction, increased social connection, optimism, tolerance, empathy, and self-efficacy (Bohecker & Horn, 2016; Bohecker et al., 2016; Brown & Ryan, 2003). Christopher and Maris (2010) asserted that incorporating mindfulness practices into counselor training programs could help reduce burnout, compassion fatigue, and other stress-related physical and psychological symptoms by providing education in self-care and stress management. Furthermore, Shapiro and his team (2007) found that Mindfulness-Based Stress Reduction training had a significant impact, decreasing stress levels, negative affect, rumination, and anxiety, and boosting positive affect and self-compassion.

Moreover, mindfulness is more than just a form of relaxation, but a transformative and proactive approach to self-care. It involves increased awareness of internalized negative cultural messages and the cultivation of a positive cultural identity (Duncan-Andrade & Morrell, 2008). The practice of mindfulness can lead to critical self-reflection and bring to the surface issues of power and privilege, and through deep reflection and honest dialogue, can support the process of humanization and the dismantling of oppressive ideologies (Berila, 2016; del Carmen Salazar, 2013).

Given the high levels of stress and burnout that school counselors commonly experience, prioritizing self-care practices is crucial for maintaining their personal and professional well-being. Mindfulness-based self-care has emerged as a promising approach for addressing these challenges and provides a unique opportunity for school counselors to reflect on their identities within societal and cultural contexts. Additionally, the SEL framework can be helpful in self-care training by outlining specific skills essential for managing stress, fostering well-being, and developing advocacy in both personal and professional contexts.

Social–Emotional Learning
     SEL is defined as “the process in which children enhance their ability to integrate thinking, feelings, and behaving to achieve important life tasks” (Zins et al., 2007, p. 194). The Collaborative for Academic, Social, and Emotional Learning (CASEL) outlines five core competencies of SEL: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making (CASEL, 2023a). CASEL’s mission is to make SEL a fundamental aspect of every child’s education through offering training and educational opportunities to advance scientific research, assessment, and implementation of effective SEL practices in schools (CASEL, 2023b). Numerous studies have demonstrated the positive impact of SEL programs on students’ growth (Carrell & Carrell, 2006; Durlak & DuPre, 2008; Lapan & Harrington, 2009).

Despite the positive effects of SEL in education, its traditional definition has faced numerous criticisms for its inadequacy in addressing equity and justice issues in classrooms and the educational system in light of recent racial and gender awareness. Higheagle Strong and McMain (2020) argued that the traditional SEL approach reinforces oppressive ideologies by valuing White, middle-class knowledge systems above others, portraying marginalized students as troubled and incompetent, and perpetuating injustice. With a growing emphasis on cultural responsiveness in the SEL definition (Higheagle Strong & McMain, 2020; Jagers et al., 2019), a critical question arises: “Are we teaching individual students to manage their emotions and behaviors simply for the sake of upward mobility or recognize and reclaim their emotions and relationships as fuel for social and cultural healing and transformation?” (Camangian & Cariaga, 2021, p. 16).

CASEL subsequently revised their definition of SEL and introduced a new concept of transformative SEL, defined as “a process whereby students and teachers build strong, respectful relationships founded on an appreciation of similarities and differences; learn to critically examine root causes of inequity; and develop collaborative solutions to community and social problems” (Jagers et al., 2018, p. 2). This updated definition acknowledges existing educational disparities and places an emphasis on authentic partnerships between schools, families, and communities. It also calls for a re-examination of the curriculum, instructional methods, and evaluation systems. Educators are encouraged to adopt an equity-focused lens when assessing the five core SEL competencies, asking questions such as “What are the social dynamics among students from different backgrounds in your class? Do you view these differences as a liability or an asset?”, “How do you create an inclusive and safe learning environment for all your students?”, and “Are there policies or practices in your school that prevent your students from receiving the quality education they deserve?”

Overall, the principles of SEL are closely aligned with the goals of school counseling, particularly in developing the skills necessary for promoting the social, emotional, and cognitive development of their students and promoting equity, social justice, and cultural competence necessary for supporting diverse student populations. School counselors can leverage SEL strategies to create a welcoming and inclusive environment that fosters learning, resilience, and well-being among students. Van Velsor (2009) emphasized the role of school counselors as SEL consultants, empowering students to achieve their personal goals and promoting prosocial behaviors, with the ultimate aim of improving the well-being of both the school and society.

Self-care has been integrated into the ethical standards of school counselor preparation programs (Christopher et al., 2016; Nelson et al., 2018), and mindfulness is often taught and studied in these programs (Campbell & Christopher, 2012; Christopher & Maris, 2010). However, there has been a lack of research investigating the experiences of school counselor trainees when learning and practicing self-care alongside mindfulness and SEL competencies in counselor education. In this study, we created and implemented a self-care curriculum for school counseling trainees and examined how this curriculum impacted their personal and professional lives through the use of transcendental phenomenology. The goal was to delve into the experiences of master’s students who took part in a summer course on self-care that was grounded in both mindfulness and SEL.

Methodology

The transcendental phenomenological investigation is often used in research to explore individuals’ subjective experiences and perceptions of a particular phenomenon (Giorgi, 2009; Moustakas, 1994). Using this approach, we aimed to explore the school counseling trainees’ thoughts, feelings, and behaviors of the personal and professional changes in the areas of self-awareness, self-management, social awareness, relationship skills, and responsible decision-making. The umbrella research question that guided this study was “What is the essence of the lived experiences of self-care of school counseling trainees who took 10 seminar sessions grounded in mindfulness and SEL in a master’s-level counseling program over a 5-week period?” Semi-structured interview questions were used to explore the participants’ experiences in their own words, which are detailed in Appendix A. After the approval from the IRB, we invited counseling trainees to participate in the study and followed the three steps of Moustakas’s (1994) transcendental approach: (a) the epoche, (b) the eidetic reduction, and (c) the transcendental reduction in data analysis.

Participants
     The purposive sampling method outlined by Glesne (2011) was utilized to select participants for the study. Invitations were extended to all 15 students who had completed the EDCO 298 Seminar in Professional Counseling during the summer course. Based on the guidelines set by Polkinghorne (1989), a sample size of 5–25 individuals is recommended for a phenomenological study. Seven participants, who were female graduate students in the counselor education program, agreed to take part in the study through in-depth interviews. The participants were between the ages of 21 and 45 and attended a single, midsized, public university designated as a Hispanic-Serving Institution in Northern California, United States. Five of the participants identified as Hispanic, Mexican, or Latinx, while two identified as White.

Data Collection
     The data for this study was collected through qualitative interviews with individuals who had completed a summer course, EDCO 298 Seminar in Professional Counseling, taught by Kyoung Mi Choi. To ensure impartiality and minimize the impact of the professor’s influence, three precautions were taken: (a) participants were contacted at least 14 days after the course had ended and their grades were posted, (b) they were informed that participation in the study was voluntary, and (c) all interviews were conducted by Jung Hee Hyun, who had no association with the program and held no power over the students’ grades.

Description of the Course
     In summer 2020, Choi created an online 5-week course called EDCO 298 Seminar in Professional Counseling, which is detailed in Appendix B. The focus of the course was on self-care, combining six mindfulness core values (such as presence, gratitude, and compassion) and the five SEL competencies framework (self-awareness, self-management, social awareness, relationship skills, and responsible decision-making). The course was attended by 15 master’s-level school counseling students. The aim of the class was to encourage and inspire the students to make a deeper connection with their thoughts, emotions, and physical well-being.

The objectives of the course were to (a) explore the five SEL competencies, (b) explore the mindfulness-based self-care and SEL interventions for counseling and personal growth, (c) understand the effectiveness of the SEL tools and practice mindfulness in daily life, and (d) create a workshop that serves the community the student hopes to serve. The instructor’s role was to create a supportive and safe environment in which students could share their personal narratives and experiences, including their strengths, cultural assets, resilience, privilege, discrimination, and oppression. Throughout the course, various mindfulness practices were utilized, such as collective breathing, body scan, mindful walking, mindful eating, mindful speaking, journaling, storytelling, visualization, and meditation.

Individual Interviews
     After the summer session was over, Choi’s counselor education department gave permission to announce the research project via email. Those who showed interest in participating were given a research packet containing details of the study, informed consent, and a demographic sheet, as well as contact information for further inquiries. At every stage of the recruitment and research process, it was emphasized that participation or non-participation in the study would not affect the participants’ course credit or final grade. To be eligible for the study, participants had to meet the following criteria: (a) enrolled in the counselor education program, (b) completed the summer seminar, (c) successfully finished the entire course, and (d) willing to participate in a voluntary lengthy interview.

Once students agreed to participate in the study and submitted their informed consent, contact information, and demographic questionnaire (including a pseudonym, gender, age, self-identified ethnicity, and specialization), they were individually interviewed by Hyun through Zoom. The interviews lasted for approximately an hour and followed a semi-structured format consisting of 16 open-ended questions asked in a consistent order (see Appendix A). The interviews were recorded in their entirety and then transcribed by a graduate student who was not affiliated with the study. After being reviewed by the participants and analyzed by the researchers, the audio recordings were deleted. To maintain the confidentiality of the participants, only pseudonyms were used in all written materials.

Data Analysis
     The research methodology employed by the team was transcendental phenomenology (Moustakas, 1994), aimed at uncovering the fundamental nature of human experience (Moerer-Urdahl & Creswell, 2004). NVivo12, a qualitative data analysis software by QSR International (2018), was utilized for data storage, coding, and retrieval. To analyze the data, we followed Moustakas’s (1994) steps for data analysis, which involved the following process: (a) the researchers reflected on and recorded their own experiences of self-care, mindfulness, and critical consciousness before, during, and after data collection; (b) the transcripts were imported into NVivo12, and key statements that provided insight into the participants’ experiences of self-care were highlighted (horizontalization); (c) themes were formed by summarizing these significant statements (cluster of meanings); (d) the significant statements and themes were used to describe the participants’ experiences as a collective whole (textural description); (e) the context that influenced the participants’ experiences of self-care was described using the significant statements and themes (imaginative variation/structural description); and (f) a synthesis of the meanings and essence of the experience was provided by integrating all of the textual and structural descriptions into a universal description.

Reflexivity Statement
     Choi is a professor and holds a master’s degree in school counseling and international relations, as well as a doctorate in counselor education and supervision. She has been teaching at the master’s level for over a decade and has received extensive training in mindfulness, yoga, and SEL. Hyun is an associate professor specializing in school counseling and holds a master’s degree in school counseling and a doctorate in counselor education. She provides counseling and consultation to children and parents using play therapy and multicultural counseling interventions. Choi taught the course that the study is based on, while Hyun conducted the participant interviews. Both Choi and Hyun have prior experience in qualitative research and are dedicated to promoting multiculturalism and social justice in counselor education.

In our research, we utilized the epoche technique, which involves temporarily setting aside our preconceived beliefs and assumptions about self-care to approach the research with an open mindset. Throughout the research process, we made a conscious effort to examine and clarify our assumptions to avoid potential biases. We also practiced reflexivity by reflecting on our own positionality and how it could affect our assumptions and interpretations of the data. This approach helped us to ensure that our findings were based on the actual experiences and perspectives of the participants, rather than on our own assumptions. Our assumptions about self-care included the following: (a) the importance for counselors to be responsible about self-care; (b) the impact of self-care practice on both personal and professional life; (c) the necessity for counseling programs to provide specific tools and strategies to support students in developing the knowledge and skills for self-care; (d) the holistic approach of self-care, encompassing cognitive, emotional, physical, interpersonal, and spiritual well-being; (e) the gradual development and continual practice required for self-care ability; (f) the possibility of self-care looking different based on individual and cultural backgrounds; and (g) the transformation process of self-care, facilitating the humanization process, increasing awareness of internalized oppressive messages and cultural identities and leading to individual and collective liberation.

Establishing Trustworthiness
     In order to enhance the reliability and validity of the study, we employed the use of an external auditor and member checking (Glesne, 2011; Hays & Wood, 2011; Lincoln & Guba, 1985). The external auditor, a research assistant with previous experience in phenomenological approaches but no prior knowledge of self-care or mindfulness research, was appointed to assist in increasing the credibility of the study. The external auditor reviewed the research process, examined the interview process for potential biases, and verified the interpretations of the data. Additionally, we utilized member checking, in which we presented emergent themes and interview content to the participants to ensure their agreement with the written comments and to check for any additional information or edits.

Findings

We identified five themes that reflect the perceptions and experiences of school counseling trainees regarding self-care grounded on mindfulness and SEL: (a) recognizing the importance and need for self-care, (b) cultivating a nonjudgmental mindset toward challenging emotions, (c) integrating self-care into both personal and professional settings, (d) an increase in compassion and empowerment, and (e) a commitment to ongoing learning and advocacy. These themes, which capture the essence of the participants’ experiences, are contextualized as follows.

Theme One: Recognizing the Importance and Need for Self-Care
     Participants in a summer course focused on self-care were aware of their motivations and inspiration for registering for the course. They reported their experiences of struggle and challenges in their lives, particularly during the COVID-19 pandemic. Elizabeth stated, “I was facing personal challenges. This course arrived just when I needed it the most.” Sophia added, “I was struggling with intense emotions during the lockdown period and had doubts about myself. But after taking the first class, I felt that it was meant for me.”

     Despite the eagerness of all participants to gain knowledge on self-care, they lacked a clear understanding of the concept. The term “self-care” had been mentioned in other classes within the counseling program, but the application of self-care through mindfulness and SEL was unfamiliar to most of them. Daisy expressed:

I never truly comprehended the meaning of connecting with oneself, which requires dedicating time for personal reflection within daily activities and establishing a connection with one’s body and emotions. This was a new idea for me, as I had not previously implemented or even recognized its significance before participating in the course.

     The participants were amazed to discover the relationship between their body, mind, emotions, and nature when they made time for self-reflection and self-care. Stacy expressed, “I never considered the idea of self-care before. This class has shown me that some of the things I already do actually fall under the category of self-care.” Sophia also said, “Self-compassion, I did hear about it or read about it, but I never truly dedicated myself to practicing it.” Furthermore, Stacy added, “I never realized the importance of having a complete connection between the body and nature.”

Theme Two: Cultivating a Nonjudgmental Mindset Toward Challenging Emotions
     The participants shared their difficulties in managing emotions such as anxiety, depression, anger, disappointment, uncertainty, and shame. They found learning practical mindfulness strategies to recognize and process these emotions without judgment to be helpful. Elizabeth shared how she connected with her body and was able to understand the physical and emotional cues signaling her needs through increased self-awareness:

I have always been constantly on the move and never took the time to acknowledge my physical and emotional well-being. This class taught me the importance of paying attention to my body’s signals, both physical and mental, signaling the need to slow down. I learned to recognize signs, such as backaches, sore muscles, and headaches, and to listen to what they are trying to tell me about my overall well-being.

Sara echoed, saying, “Self-awareness is about embracing and loving myself.” Veronica, who identified as an immigrant, shared her insight on the impact of self-compassion and a shift in perspective:

As an English learner, I often get nervous during public speaking or classroom presentations because I self-doubt. That’s where self-compassion has played a crucial role for me. Instead of viewing myself as someone who doesn’t speak perfect English, I see myself as someone who has accomplished much despite being an immigrant. I used to struggle with low self-confidence, but after being introduced to self-compassion, it has opened my eyes to see everything as a growth opportunity rather than a potential failure. It’s about focusing on what you have, rather than what you lack, and viewing yourself as a human being like any other. This shift in perspective has been healing.

     Carol explained how the class aided her in processing challenging emotions, saying “I learned to create space between myself and my emotions, have more control over impulsive emotions, and take breaks to have fun or engage in self-care.” Daisy summarized her approach to dealing with challenging emotions by saying, “The course taught me that it’s okay to accept my feelings, allowing myself to experience them without judgment. I understand that they are temporary and by processing them, I am able to let them go.”

Theme Three: Integrating Self-Care Into Both Personal and Professional Settings
     A strong connection between understanding the importance of self-care and its practical application in daily life was evident in the narratives of all participants. They explored, experimented with, and reinforced a variety of self-care strategies both in and outside of class. Sophia stated, “The class helped me to become more patient, and I now practice those techniques daily.” Elizabeth also spoke of the impact of the class and her daily self-care practices:

I realized the enormous benefits of taking time for myself, both in the morning to start my day and in the evening to relax. Practicing mindfulness and self-care, such as staying aware of my body’s signals through yoga, stretching, and breathing, has been incredibly helpful. My physical healing has become a path to emotional healing. I’m making a conscious effort to care for myself. The class was the perfect introduction to this.

Veronica echoed similar experiences in implementing what she learned from the course.

I feel like I gained a lot from this course because we were able to put what we learned into practice. This class provided a deeper understanding of the subject through reading and trying different practices such as meditation and deep breathing. I’ve made a conscious effort to practice mindfulness daily, instead of only when I felt the need. Currently, I’ve been more consistent and practice it at least five times a week.

     Positive and affirmative perspectives toward oneself transformed the participants’ relationship with themselves. Sophia described this transformation by saying, “Since taking the class, I have become a different person. By different, I mean that I approach things differently and I don’t feel stressed out as much. I am able to identify and process my emotions, and accept them.” She explained how her 5-minute mindfulness practice changed her challenging relationship:

Mindfulness allows me to connect with myself, to disconnect from external distractions. I only need 5 minutes of silent meditation to feel that inner connection. If I have an issue or conflict with someone in my family, I take those 5 minutes to disconnect from the story, reflect, and become more relaxed.

Theme Four: An Increase in Compassion and Empowerment
     The participants, who exuded confidence and a newfound sense of self-care, expressed their eagerness to assist others in their own self-care journeys. They saw their role as school counselors as being further strengthened, and they showed a keen interest in exploring effective mindfulness and self-care techniques. Veronica stated, “I am confident that offering emotional support online will be just as impactful as in person. I now have a wider range of tools and activities to support my students.” Sophia also shared how her newfound sense of empowerment has made her more compassionate toward her students, saying:

I have changed. Our learning has taught me that my students are the most important individuals sitting in front of me in my counseling offices . . . my goal in supporting them is to acknowledge their opinions, feelings, and emotions. I care about all that they are experiencing, not just their issues but also their emotions. I have gained more empathy for them and strive to provide them with the best support I can.

     Elizabeth stated, “As a future school counselor, I am confident that incorporating mindfulness practices into my work will have a positive impact on my interactions with students, staff, and teachers. I have learned these techniques in class and am eager to put them into practice.” Daisy shared her engagement with her students, saying:

At times, I can feel overwhelmed by the volume of students I see in a day and the diverse range of topics discussed. However, by taking the time to connect with myself and acknowledge my emotions, I find that I am more grounded after a workday. This has also helped me form stronger connections with my students.

Carol also expressed that mindfulness can rejuvenate one’s energy and foster positive relationships with oneself and others:

When you have a student who requires a lot of your energy, and you find yourself feeling depleted afterwards, it can be challenging to give your best to the next student. I think it’s important to learn how to recharge quickly so that each student receives the best version of you. With the pandemic, it’s even more crucial to meet the students’ needs academically, emotionally, and for career and college planning. What I have found is that students especially need emotional support because of the stress caused by COVID-19.

Theme Five: A Commitment to Ongoing Learning and Advocacy
     The participants recognized the significance of self-care and appreciated their capacity to support others with openness, curiosity, and empathy without any judgments. They viewed self-care and mindfulness as a never-ending journey of learning and personal growth. They expressed their determination to continue their mindfulness-based self-care journey. Elizabeth described the process of healing as like a domino effect, in which one positive change can lead to a chain of similar changes in other areas of life: “Healing one aspect of my life has a positive impact on other parts as well. I’m excited to attend workshops and read more to further my mindfulness journey.” Daisy spoke of her strengthened connection with her students, saying “I feel like I am able to better communicate with my students. I strive to offer them a warm and caring presence, and I am being transparent and accepting of their diverse cultural backgrounds.”

Sara explained her practice with her family, saying, “I have been continuing to study and practice throughout the summer and have been sharing and discussing with my family members. This has been a really healing experience for our family.” Sophia also emphasized the importance of continuing her practice, stating:

Healing is a process, and it doesn’t happen overnight. However, it does help us become better people, improve our connections with others, become better listeners, judge less, and listen more to ourselves. This class has had a truly positive impact on me, and I plan to continue my mindfulness practices.

     Advocacy is seen as a natural progression. Stacy also expressed her commitment to practicing alongside her students, saying, “It’s important to understand the importance of congruence in both teaching and life. If I just tell my students what to do, they won’t listen. But if I practice alongside them, it’s more effective.” Sophia spoke about the power of sharing mindfulness practices and their impacts with others, stating,

As a counselor and advocate for these techniques, I want to bring them into the K–12 education system at an early age. I hope to introduce these practices wherever I go and to our students, as I believe everyone can benefit from them.

Discussion 

The five themes embody the significance and definition of self-care grounded in mindfulness and SEL for graduate students in counseling who took a summer self-care course. Participants reported a new experience in self-discovery through the practice. Despite the difficulties brought by the COVID-19 pandemic and the shift to online education, learning about self-care helped them cope with daily stress. By participating in a group, they discovered their personal and professional understanding of self-care. They learned how to connect with their emotions, physical sensations, thoughts, and others in their relationships. Particularly, they emphasized the importance of embracing difficult emotions. The self-care grounded in mindfulness and SEL taught in the course enabled them to face emotions such as anger, disappointment, anxiety, uncertainty, and shame with nonjudgment and acceptance. The students connected their understanding of self-care with their daily practices both in and outside of the class. The consistent and dedicated practice demonstrated a true embodiment of self-care among the participants.

Along with displaying great confidence in themselves and their self-care practices, the participants strongly expressed their desire to help others in their communities. Their professional identity as school counselors was enhanced, and the participants developed agency to empower underserved students and communities by introducing self-care strategies and mindfulness practices. After completing the course, the participants expressed their intention to continue the practice and viewed self-care and mindfulness as a lifelong journey.

These findings align with previous qualitative studies (Baker, 2016; Bohecker & Horn, 2016; Campbell & Christopher, 2012; Christopher et al., 2011, 2016; Christopher & Maris, 2010) on the experiences of master’s-level students in mindfulness self-care courses. Across these studies, a common theme is that students reported substantial changes in both their personal and professional lives. This included increased confidence in their professional and interpersonal relationships, a greater appreciation for their physical well-being, healthier lifestyle choices, and the ability to handle challenging situations more effectively.

Furthermore, the significance of the current study is to confirm that self-care is imperative for counselor training. As the participants expressed their sense of empowerment and desire to engage in creating and providing workshops for their families, schools, and communities, they demonstrated self-care as part of social and cultural advocacy. There was a clear shift from a deficit- to a strengths-based self-identity regarding linguistic ability, emotional availability, and a healing-focused process. This is consistent with the role of school counselors, as system change agents need to critically examine dominant culture and its impact on their own racial identity development, power, privilege, and oppression in educational settings (Mitchell & Binkley, 2021). Before disrupting and dismantling the oppression and power in the system, school counselors will need to embrace themselves wholly and consider using themselves as a tool in advocating for those in need. When serving diverse students and communities, self-care goes beyond relaxation and self-awareness of one’s own thoughts and emotions. It also involves reclaiming power within oneself—physically, emotionally, spiritually, and culturally.

Implications

The study’s results have significant implications for counselor educators. First, student readiness is crucial for the maximum impact of self-care courses. What is noticeable in the findings is that the students were ready to change as they chose the course and had a strong desire to learn more about self-care. When students are prepared, the impact can be powerful. Additionally, students who accepted themselves, both strengths and weaknesses, and experienced the mind–body–spirit connection had a greater awareness of themselves and felt more prepared to serve others. The study suggests that self-reflection is essential to maintaining an ethical practice when working with people of different identities, values, and cultures. The participants in this study emphasized their humanity by accepting their identities, processing challenging feelings, practicing self-compassion, and sharing their experiences and knowledge to empower others.

Second, the study recommends that counselor education programs incorporate a self-care course or workshop into their curriculum, as it has been shown to have a positive impact on pre-service counselors (Harrichand et al., 2021). Students’ strong desire to learn more about mindfulness and self-care is consistent with the literature (Baker, 2016) and shows the urgency of incorporating mindfulness practice, SEL, and self-care practice in the school counseling curriculum. The participants recommended offering the course every year and an advanced level later in the program. Because of logistical difficulties, it may be more practical to integrate self-care knowledge and practice into existing coursework and programs rather than adding an extra course.

Lastly, many studies on mindfulness, SEL, or self-care do not give enough importance to humanization, agency, inclusion, and equity in the individual and collective self-care process (Mitchell & Binkley, 2021). This study suggests that it is essential to include mindfulness in personal as well as social and cultural transformative processes. Participants expressed increased agency and advocacy during and after learning and practicing self-care. The self-care course can cultivate and strengthen the capacity to imagine a world beyond the current social conditions with confidence in the ability to bring change through individual and collective efforts (Pyles, 2020).

Limitations and Future Research
     The authors of the study acknowledge that self-selection may have contributed to biases in the findings, as participants who enrolled voluntarily in the summer elective course showed strong interest in the research topic (Lavrakas, 2008). They also volunteered to share their experiences, which could have resulted in them focusing on positive and socially desirable narratives. The authors of the study also acknowledge that factors such as the class format, selected activities, and instructor’s teaching styles may have contributed to the participants’ experiences, which may not be generalizable to other school counseling trainees and programs. For future research, a study exploring how master’s students with different placements (i.e., pre/post-practicum, internship) or cultural identities (ethnicity, sexual and gender identity, religion, generation) experience and practice self-care could provide valuable insights to counselor educators. Additionally, a quantitative study using pre- and post-surveys to assess progress in the five SEL competencies can provide useful data for counselor educators and researchers to understand students’ social–emotional development.

Conclusion

This study examined the experiences of school counselor trainees in a self-care course based on mindfulness and SEL, consisting of 10 seminar sessions over 5 weeks. The findings revealed information about the transformation process, the importance of self-care in counseling preparation programs, and the empowering effects on graduate students becoming agents of change. Participants experienced a transformation leading to a change in their relationship with their mind, body, and emotions, and this transformation extended to their relationships with family, friends, students, and colleagues, empowering them to be more engaged with their communities and society. They embodied Carl Rogers’s (1980) core conditions for change, including unconditional positive regard, genuineness, and empathy (Campbell & Christopher, 2012), both personally and professionally, describing the experience as encountering a new self through fresh eyes.

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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Appendix A
Semi-Structured Interview Protocol

Title of the Study: School Counselor Trainees’ Perceptions and Experiences on Self-Care Grounded in Mindfulness and Social–Emotional Learning (SEL)

To be consistent with the goal of qualitative research, all participants will be described through their own viewpoints and in their own words. All questions are open-ended, and these semi-structured interview protocols will guide the researcher throughout the interviews. However, it is not expected that the remaining questions will be asked sequentially, that all questions will be asked of all participants, or that the list of provided questions is exhaustive. Rather, we offer the questions below as representing possible directions in which we anticipate the interviews may proceed.

Introduction

We want to thank you for your willingness to participate in this study. Recently, you completed the course EDCO 298-01 Seminar in Professional Counseling. Today, we would like to take some time to collect information on your perceptions, thoughts, reactions, and follow-up response to your mindfulness-based self-care and SEL practice. If at any time you feel uncomfortable or do not desire to answer a question, please let me know.

Semi-Structured Interview Questions

  1. What are the most important things you learned regarding mindfulness-based self-care and SEL?
  2. How have your knowledge and practice of SEL affected your personal and professional life in the area of self-awareness, self-management, responsible decision-making, relationship skills, and social awareness?
    • Do you attribute these changes to the class?
    • Have these changes stayed with you since you took the class? What has changed?
  1. Describe the history of your self-care practices.
    • What self-care practices do you currently practice? How often for each?
    • How did the class influence these practices?
  2. Describe how your mindfulness-based self-care affects your personal and professional life.
    • In what ways do your own practice of mindfulness and self-care change how you think about students’ or clients’ issues or problems? How have your ideas about what is therapeutic, or healing, changed since taking the class? Do you see mindfulness techniques as healing? How?
    • Have the mindfulness practices influenced who you are as a counselor, advisor, educator, or therapist or what it’s like for you to be in the role of the counselor, advisor, educator, or therapist? How?
    • Have you tried to introduce mindfulness concepts/techniques with a client/student? Which techniques? What was your level of comfort with introducing the mindfulness techniques?
  3. What are consequences/outcomes from mindfulness-based self-care practices? (elaborate)

General Questions & Feedback

Is there anything you would like to say about your experiences in relation to the course that we have overlooked? What suggestions do you have to make this course a better experience?

Ending

We want to thank you for your participation in this project.

Appendix B
Course Content and Activities

Week Module Mindful Theme SEL Competencies Class Activities
One 1 Presence Self-Awareness Course Overview: Review syllabus, expectations, course
requirements, and online resourcesWhat’s Social and Emotional Learning (SEL)?

Three Collective Breaths

Why Aren’t We Teaching Mindfulness: TED Video

Pre-Training Survey

Small Group with Accountability and Support

2 Self-Connection Practice

Mindful Listening and Speaking

Brave Zone

Trauma-Informed Practice: Grounding, Orienting, and Centering

“Seven Up” Film

My Seven Up Writing

Body Scan

Weekly Journal Entry

Two 3 Gratitude Self-Management Setting Intentions

Mind–Body Connection

Non-Violent Communication

Empathy Practice

Appreciation Circle

4 Non-Violent Communication Tools: Mourn/Celebrate/Learn (MCL)

Exploring Identities: “I Am”

Thankful Thoughts

Negative Bias

Weekly Journal Entry

Three 5 Creativity Relationship Skills Play Therapy: Foundations and Techniques (1)

Creative Arts

Additional Readings

6 Play Therapy: Foundations and Techniques (2)

My Relationships

Community Circle: Appreciation Practice

Weekly Journal Entry

Four 7 Compassion Social Awareness Check-In: Daily Practice

Compassionate Self-Talk

Neuroplasticity

“Into Light” Video

My Life and Vision: Milestones

8 Courageous Conversations

Mindful Eating

Sound Healing

Capstone Preparation

Weekly Journal Entry

Five 9 Equity & Inclusion Responsible Decision-Making Giving and Receiving Loving-Kindness

Transformative SEL: Advocacy

Gender Identities and Pronouns

Mindful Breathing

Silent Mindfulness Practice

Yoga and Mindfulness

10 Capstone Presentations

Celebration: A Closing Ceremony

Post-Training Survey

Final Journal Entry

 

Kyoung Mi Choi, PhD, NCC, is a professor at San José State University. Jung H. Hyun, PhD, NCC, is an associate professor at Nova Southeastern University. Correspondence may be addressed to Kyoung Mi Choi, One Washington Square, San José, CA 95192, kyoungmi.choi@sjsu.edu.

Addressing Anxiety: Practitioners’ Examination of Mindfulness in Constructivist Supervision

Jennifer Scaturo Watkinson, Gayle Cicero, Elizabeth Burton

 

It is widely documented that practicum students experience anxiety as a natural part of their counselor development. Within constructivist supervision, mindfulness exercises are used to help counselors-in-training (CITs) work with their anxiety by having them focus on their internal experiences. To inform and strengthen our practice, we engaged in a practitioner inquiry study to understand how practicum students experienced mindfulness as a central part of supervision. We analyzed 25 sandtray reflections and compared them to transcripts from two focus groups to uncover three major themes related to the student experience: (a) openness to the process, (b) reflection and self-care, and (c) attention to the doing. One key lesson learned was the importance of balancing mindfulness exercises to highlight the internal experiences related to anxiety while providing adequate opportunities for CITs to share stories and hear from peers during group supervision. 

Keywords: supervision, mindfulness, counselors-in-training, anxiety, practitioner inquiry

 

It is widely documented that counselors-in-training (CITs) experience anxiety as part of the developmental process (Auxier et al., 2003; Kuo et al., 2016; Moss et al., 2014). Reasons for anxiety include CITs’ doubts about their ability to perform competently within their professional role (Moss et al., 2014) coupled with perfectionism (Kuo et al., 2016). Additionally, Auxier et al. (2003) noted that CITs’ anxiety also stems from the pressure associated with external evaluation provided by supervisors. Wagner and Hill (2015) added that CITs’ need for external validation from their supervisors, coupled with the belief that there is only one right way to counsel clients, also generates anxiety. This need for external validation creates an overreliance on a supervisor’s judgment that could render a CIT helpless (Wagner & Hill, 2015). Although a moderate amount of anxiety may increase a person’s focus and positively impact productivity, too much anxiety impedes learning and growth (Kuo et al., 2016). Hence, there is a need for supervisors to address anxiety early in a CIT’s development to foster self-reliance and professional growth (Ellis et al., 2015; Mehr et al., 2015).

The two lead authors of this article, Jennifer Scaturo Watkinson and Gayle Cicero, are counselor educators who supervised school counseling practicum students and ascribed to a constructivist approach to supervision. While discussing supervision pedagogy, we shared our observations on how anxious our practicum students were to be evaluated and our belief that their anxiety often limited their professional growth and development as counselors. Within constructivist supervision, mindfulness exercises are used to help CITs work with their anxiety by having them focus on their internal experiences of discomfort (Guiffrida, 2015). Thus, we utilized mindfulness as a central approach to helping our students work with their anxiety associated with the counselor developmental process.

To assist in our planning, we reviewed the supervision literature and found that discussions on mindfulness were largely conceptual (Guiffrida, 2015; Johnson et al., 2020; Schauss et al., 2017; Sturm et al., 2012) or outcome-based (Bohecker et al., 2016; Campbell & Christopher, 2012; Carson & Langer, 2006; Daniel et al., 2015; Dong et al., 2017), with limited focus on supervision pedagogy to guide supervisors on how to integrate mindfulness into their practicum seminars, particularly from the perspective of the practitioner. Further, Barrio Minton et al. (2014) and Brackette (2014) confirmed that there was a scarcity of counselor education literature that focused on teaching pedagogy and argued that more research in this area was needed to improve counselor preparation. To add to the current literature on supervision pedagogy and inform our practice, we engaged in a practitioner inquiry study (Cochran-Smith & Lytle, 2009) and formed a professional learning community to investigate how utilizing mindfulness within our supervision could help school counseling practicum students work with their anxiety.

Literature Review

Constructive Supervision
     Supervisors who utilize constructivist principles help CITs make meaning of their experience by examining how their approach benefits their clients (Guiffrida, 2015). Constructivism is built upon the belief that knowledge is not derived from absolute realities but rather localized to specific contexts and personal experiences. McAuliffe (2011) argued that knowledge is “continually being created through conversations” and is not given to the learner through a one-sided expert account. Constructivists believe that learning is “reflexive and includes a tolerance for ambiguity” (McAuliffe, 2011, p. 4). Constructivist supervisors prioritize CITs’ experiences, encouraging them to examine the intent behind their approach and reach their own conclusions. Hence, constructive supervisors help supervisees deconstruct experiences that have multiple “right” approaches to client care while normalizing the anxiety associated with professional growth. Within a constructivist supervision framework, moderate amounts of anxiety are not viewed as problematic but rather are seen as a catalyst for change (Guiffrida, 2015) and part of the learning process (McAuliffe, 2011). Guiffrida (2015) asserted that the aim of supervision in the early stages of counselor development is not to remove feelings of anxiety but rather to help the CIT acknowledge and live with the anxiety. Utilizing mindfulness, supervisors acknowledge CITs’ internal experiences and guide them through intentional mindfulness practices to generate personal and professional reflection and meaning making.

Within constructivist supervision, mindfulness is a central approach to helping CITs work with their anxiety (Guiffrida, 2015). Kabat-Zinn (2016) defined mindfulness as “paying attention in a sustained and particular way: on purpose, in the present moment and nonjudgmentally” (p. 1). Constructive supervisors facilitate learning experiences that promote introspection and intentionally direct CITs to examine their internal experience, without judgment, during times of disequilibrium. Rather than helping a CIT rid themselves of anxiety, the constructivist supervisor acknowledges that anxiety is a normal response to the uncertainty of doing something for the first time (Guiffrida, 2015). Mindfulness provides a platform for a supervisor to normalize anxiety within the supervisory relationship (Sturm et al., 2012). Hence, supervisors can utilize mindfulness to prioritize the CITs’ internal experiences (e.g., doubt, uncertainty, fear) and foster self-reliance.

Mindfulness as an Approach
     Mindfulness practices are linked to the personal and professional growth of CITs (Bohecker et al., 2016; Campbell & Christopher, 2012). Campbell and Christopher (2012) compared counseling students who participated in a mindfulness-based stress reduction (MBSR) program to a control group and found that those who participated in MBSR reported significant decreases in stress, negative affect, rumination, and state and trait anxiety while noting a significant increase in positive affect and self-compassion when compared to participants in the control group. Additionally, Christopher and Maris (2010) reported that supervisees who were exposed to mindfulness were “more open, aware, self-accepting, and less defensive in supervision” (p. 123). Similarly, Bohecker et al. (2016) discovered that CITs who participated in a mindfulness experiential small group saw the benefits of attending to their emotions (e.g., internal experiences) and acknowledged that mindfulness increased self-awareness and promoted objectivity when attending to their thoughts. Having objectivity allowed them to be in the present, which positively affected their behavioral responses (Bohecker et al., 2016).

CITs also experienced benefits to having mindfulness incorporated into their practicum and internship seminar classes. Dong et al. (2017) examined CITs’ response to mindfulness-based activities and discussions during internship seminar. Results suggested that CITs who engaged in mindfulness practices were more focused on the moment and responded to stressors with acceptance and nonjudgment. As a result, CITs were more likely to be “okay with not being okay” when faced with challenging situations (Dong et al., 2017, p. 311). Additionally, Dong and his colleagues noted that participants were able to validate themselves when they made mistakes and were more accepting of their rough edges. Carson and Langer (2006) agreed and added that CITs who received mindfulness as part of their supervision were better able to examine the thoughts that contributed to their anxiety and were more open to accepting their mistakes as learning opportunities. As a result, CITs minimized the focus they put on self-criticism and were less vulnerable when they made mistakes (Carson & Langer, 2006). These studies highlight how CITs benefited from integrating mindfulness into group supervision, yet there is limited research on how counselor educators might structure their practicum seminars to include mindfulness as an integrated approach to supervision.

Purpose of the Present Study
     The purpose of this practitioner inquiry was to inform Watkinson and Cicero’s practice as supervisors of practicum school counseling students within a CACREP-accredited program. We utilized mindfulness as a central approach to group supervision during practicum seminar and wanted to understand how intentional mindfulness exercises that prioritized the CITs’ internal experiences (e.g., uncertainty, doubt, fear) were perceived by our students. By understanding the student experience, we could make informed decisions about how we might improve upon the way we integrate mindfulness into future seminar meetings. Specifically, we were guided by this research question: How are CITs experiencing mindfulness as part of group supervision provided during practicum seminar?

Method

We engaged in a practitioner inquiry study (Cochran-Smith & Lytle, 2009) to examine the application of mindfulness within the context of our practice. Cochran-Smith and Lytle (2009) argued that the examination of one’s practice privileges practitioner knowledge and adds to the overall discourse on teaching pedagogy, as “deep and significant changes in practice can only be brought about by those closest to the day-to-day work of teaching and learning” (p. 6). Although not intended to generalize knowledge, practitioner inquiry positions the researcher as a participant to uncover tensions and challenges that come from applying theory to practice while enhancing the knowledge of the practitioner doing the investigation (Cochran-Smith & Lytle, 2009). Thus, we intended to reflect upon how we integrated mindfulness into supervision by understanding the experiences of our practicum students.

Participants
     We gained approval from our university’s IRB to conduct the study and invited all 33 CITs enrolled in our practicum sections to participate. Twenty-five (76%) CITs agreed to participate. Of the 25 participants, 24 identified as female (96%) and one identified as male (4%). Sixteen students (64%) self-identified as White/Caucasian, five (20%) as African American, three (12%) as Hispanic, and one (4%) as other. Eighty-four percent of participants were full-time students and 16% identified as part-time. Students were told they could withdraw their participation at any time. All practicum students completed their field experience in public schools.

To safeguard participants from believing they were required to join the study, Watkinson and Cicero were not aware of which students agreed to participate until the end of the semester, when grades were submitted. To protect participant identity until after the semester, we took the following steps: 1) the third author, Elizabeth Burton, was the only one who knew the identity of the participants; 2) Burton recruited participants, stored data (erasing identifying information), and communicated with the participants; 3) the data source labeled sandtray reflections included activities that all CITs completed as part of a required seminar experience; 4) a focus group was held after the semester concluded and grades were submitted; and 5) during data collection, Watkinson and Cicero never discussed the study with any of the CITs enrolled in practicum.

Seminar Context
     The practicum course is the first field experience for CITs enrolled in the school counseling master’s program. As per the CACREP 2016 Standards, the practicum experience is a 100-hour experience in which 40% of those hours are in direct service. In addition to meeting those direct hours by working with several individual clients, practicum students are also required to design and run a small counseling group and deliver several classroom lessons within schools. Further, CACREP-accredited programs must provide practicum students with 1.5 hours on average of group supervision per week throughout the duration of the semester. Thus, our practicum seminars were designed to provide CITs with the required group supervision.

All practicum seminar sessions met in person except for one, which was held synchronously through Zoom, a web conferencing platform. There were three sections of practicum, two taught by Cicero and one taught by Watkinson. Watkinson and Cicero drew upon constructive supervision principles and mindfulness core concepts (e.g., self-compassion, present moment, and nonjudgment) to guide the planning of the practicum seminars. We maintained similar course structures, objectives, and learning outcomes utilizing similar room arrangements, mindfulness exercises, and structured learning experiences. Mindfulness exercises were central to the practicum seminar and were focused on the practicum students’ internal experiences. The 15 weekly practicum seminars were 90 minutes in length, and student-to-faculty ratios were 9:1 for two of the practicum sections and 6:1 for the third. The room arrangement consisted of a circle of chairs for students to use during the opening and closing of the seminar, along with a designated workspace for students to sit at tables to take notes or complete reflective class experiences. Soft meditation music played as students entered the room and was turned off to signal the beginning of class.

Watkinson and Cicero engaged in weekly collaborative planning meetings throughout the 15-week semester to plan their seminar meetings and share insights related to student learning. The instructional design was experiential and incorporated mindfulness exercises during the opening of the seminar to bring attention to the “here and now,” breath, nonjudgment, and self-compassion. Cicero was previously trained in mindfulness and exercises were selected based upon her training; Cicero taught Watkinson how to implement those mindfulness exercises during their weekly meetings. Many of the opening mindfulness exercises can be found through internet searches.

Structure of Seminar Meetings
     The structure and room arrangement for each practicum seminar were consistent across the three sections. Fourteen of the 15 seminar meetings began with the CITs participating in a 5-minute mindfulness opening that transitioned into structured learning experiences and ended with a sharing circle. Seminar Meeting 11 was entirely dedicated to mindfulness, engaging practicum students in several mindfulness activities for the purpose of drawing their attention to breath and reflection.

Mindfulness Openings
     The 5-minute mindfulness openings were scripted and consisted of either a guided meditation (e.g., Calm Still Lake, A River Runs Through It), intentional breathing exercises (e.g., Balloon Breath, Meditative Chimes) or chair yoga (e.g., Mountain Pose, Warrior 2). Each mindfulness opening concluded with reflective questions to increase awareness of the present moment (e.g., What was this experience like for you?). The meditation exercises were varied to introduce CITs to different approaches they might want to try outside of seminar for personal use or in their own practice with K–12 students.

Structured Learning Experiences
     After the mindfulness opening, CITs participated in structured learning experiences that focused on either counselor development, case conceptualization, group counseling leadership, evidence-based planning, or classroom curriculum development and instruction. Guided by constructivist supervision principles, two of the structured learning experiences implemented were metaphorical case drawing (Guiffrida, 2015) and sandtray (Guiffrida, 2015; Saltis et al., 2019).

     Metaphorical Case Drawing. Guiffrida’s (2015) metaphorical case drawing was used to assist CITs in the development of their case conceptualization skills. In Guiffrida’s work, a metaphorical case drawing has three steps. First, CITs reflect upon six items that highlight their internal experiences and perspectives specific to an individual counseling session with one of their clients: 1) identification of the client’s primary concern, 2) description of the client and CIT interaction, 3) CIT’s intention for the session, 4) CIT’s description of how they viewed their performance as a counselor during the session, 5) general assessment of how the session went, and 6) statement on what the CIT thought the client gained from the session. Second, CITs use images and/or metaphors to respond to three of the six items above to create a case drawing. Lastly, utilizing their case drawings, CITs share their cases with the supervisor and other supervisees. Through the presentation of their case, the CITs interpreted their work while the supervisor and other supervisees listened and asked questions to facilitate deeper insight by offering alternative perspectives.

     Sandtray. Although sandtray is typically used in supervision to help CITs develop their case conceptualization skills (Anekstein et al., 2014; Guiffrida, 2015; Guiffrida et al., 2007), we modified our use of sandtray to focus the CITs on their developmental journey as counselors. Like the metaphorical case drawing, the sandtray facilitates an internal examination where CITs get to interpret their own experience (Guiffrida et al., 2007). The sandtray was used in Seminar Meetings 6 and 13 to document how CITs were encountering practicum at two different times in the semester. The written reflections that followed the sandtray were used as a data source for this study and are therefore described in further detail.

Prior to creating an image in the sandtray, CITs were asked to journal about their experience as a practicum student. The prompt was left open so that CITs would have the freedom to focus on the most salient part of their experience. Next, CITs were partnered to create a sandtray image and each pair were given a large box that contained sand and a small baggie filled with a variety of miniature objects. CITs had 5 minutes to create an image in response to this prompt: Create an image that represents your practicum experience thus far. At the conclusion of the 5 minutes, CITs shared their stories with their partners. After everyone created a sandtray image and shared, CITs wrote a reflection in response to this prompt: Drawing from the sandtray exercise and sharing, describe your experience in practicum thus far. Identify and describe the thoughts and feelings you have as you begin your work with students. These written reflections were submitted to the professor at the conclusion of the seminar meeting.

At Seminar Meeting 13, CITs created and shared their sandtray images. Following the same procedure as identified in Seminar Meeting 6, CITs engaged in the sandtray activity again to create a new image in response to a new prompt: Create an image that described your overall experience in practicum. After creating and sharing of their image with a partner, students reflected and responded in writing to a final prompt: Drawing from the sandtray exercise, describe your experience in practicum. Identify and describe your thoughts and feelings now that practicum has come to an end. What have you learned about yourself? Written reflections were completed during the seminar meeting and submitted to the professor when class ended.

Sharing Circle
     After the structured learning experience, each seminar concluded with a 5–10 minute sharing circle where students summarized new insights and identified actions to implement at their practicum site. The sharing circle was guided by two questions: What are some key takeaways from today’s seminar? and How might we use what we have learned today within our own practice?

Structure of Mindfulness Seminar Meeting
     Seminar Meeting 11 was fully dedicated to the practice of mindfulness and did not follow the above seminar format and structure. During this one 90-minute class, CITs identified an intention, created a mindfulness jar, journaled, and walked a labyrinth. Johnson et al. (2020) argued that CITs who receive mindfulness as part of their supervision should start or maintain a mindfulness practice of their own. Yet there is nothing in the research that identifies specific mindfulness exercises as being essential to that practice, only that CITs should be exposed to mindfulness as part of the classroom experience (Johnson et al., 2020). Thus, our intent for this seminar meeting was to engage CITs in mindfulness exercises that would encourage meditation and reflection. For this class we requested a large room to accommodate a small circle arrangement of 10 chairs and three stations: a labyrinth, creating a mindfulness jar, and journaling. During this seminar meeting, the CITs were instructed to visit the three stations at their own pace and to self-select the order in which they participated in those stations. Class opened with a mindfulness exercise that focused on breath and ended with a sharing circle to debrief. An example of a closing question posed by the professors during the sharing circle is: What insights would you like to share about your experience in seminar today?

     Labyrinth. CITs were given a brief description of a labyrinth along with written instructions on how to set an intention and walk the labyrinth. We created a floor labyrinth for use during the seminar. CITs set their intention prior to walking the labyrinth. Some examples of intentions were to be open to the process or to demonstrate self-compassion. Once inside the labyrinth, CITs would follow the path and could walk the labyrinth as many times as they desired.

     Creating Mindfulness Jars. CITs created a mindfulness jar from an empty 8-ounce bottle, fine glitter, clear hand soap, confetti, and water. Directions on how to create a mindfulness jar were provided at the station. CITs were encouraged to use the mindfulness jar during the 90-minute seminar as a focal point to guide their breath during reflection time.

     Journaling. CITs were provided paper, pens, markers, and crayons for journaling at the beginning of the seminar. CITs were provided minimal directions on what they were to journal, outside of selecting a quiet place in the room to write and reflect upon their experience during the session. Journals were private and CITs were not asked to share what they wrote with the professors or other CITs.

Data Sources and Collection
     We used three data sources to understand CITs’ experience with mindfulness as part of supervision: supervisor observations, sandtray reflections from weeks 6 and 13, and focus group transcripts. Watkinson and Cicero captured supervisor observations in their meeting minutes, which also included specific plans for each seminar session along with assumptions and observations about CIT learning. The written sandtray reflections captured CITs’ overall experience in practicum at two different points in the semester. Using a multi-step process, the sandtray served as a structured learning experience completed and collected during the seminar meetings. Data from sandtray reflections taken at the end of the semester (week 13) were analyzed to examine how CITs reflected on their overall practicum experience at the completion of the semester.

All 25 participating CITs were invited to participate in a focus group. Of the 25, nine (36%) attended and two different focus groups were held to accommodate their schedules. Each focus group was held virtually on Zoom, recorded, and transcribed, and took place at the end of the academic semester after grades were issued. Focus groups lasted 60 minutes, were co-led by Watkinson and Cicero, and served as a type of member checking. Guiding questions/prompts were: Describe your experience in practicum this semester, Describe your feelings throughout the semester, and What was it like for you to engage in mindfulness as part of your development as a counselor?

Trustworthiness
     Watkinson and Cicero are both counselor educators at a university located within the Mid-Atlantic region of the United States. Watkinson is a Caucasian middle-aged female with 14 years of experience as a school counselor and over 10 years of experience as a counselor educator. Cicero is a Caucasian middle-aged female with 30 years of experience in a large public school district as a teacher, school counselor, and a district-level administrator of school counseling and student service programs, as well as 3 years of experience as a counselor educator. Watkinson and Cicero are licensed professional counselors, board approved certified supervisors, and certified school counselors. Burton was a first-semester school counseling student and served as Watkinson’s graduate assistant. She is a Caucasian female with no prior experience in schools or as a counselor. At the time of data analysis, she had finished her first year of coursework and offered an additional perspective on how the data could be interpreted.

Watkinson and Cicero held certain biases and assumptions about how mindfulness might be experienced by CITs in their practicum sections. We assumed that mindfulness was beneficial to CIT counselor development yet had no preconceived ideas as to the type of benefit it would have on their professional growth outside of our assumption that mindfulness could help CITs work with their anxiety. Additionally, we found that CITs, particularly at the practicum level, were anxious and worried about their performance and believed that supervision was needed to attend to that anxiety. Lastly, we shared a strong desire to better understand our own practice and were therefore open and expected feedback to strengthen that practice.

Trustworthiness was addressed in a variety of ways. In practitioner research, validation is obtained through a form of peer review, where practitioner researchers collaborate to discuss and reflect upon their experiences through peer feedback (Anderson & Herr, 1999; Cochran-Smith & Lytle, 2009). Thus, Watkinson and Cicero met weekly during the 15-week semester to share observations and obtain feedback related to their own practice. Further, during these meetings we engaged in critical dialogue to disrupt previously held assumptions and biases. For example, we challenged each other to share evidence to support the interpretations we made about how students were experiencing the course, asking the question, How do you know? Observations that included peer feedback were recorded in our meeting minutes.

Second, we engaged in prolonged observation of participants as we worked alongside CITs, acting in the role of both inside and outside observers during the 15-week semester. As Creswell (2013) asserted, validation of findings comes from prolonged engagement and persistent observation of participants. Third, we triangulated data, comparing Seminar Meeting 13 sandtray reflection data across the three practicum sections to the focus group transcripts (Merriam, 2009). Fourth, the focus groups served as a type of member checking (Merriam, 2009) to validate and refine our analysis of the final sandtray reflections to the perceptions that were shared by students in the focus groups.

Data Analysis
     We formed a research team and regularly met to debate and discuss the data during the analysis process. Data from the sandtray reflections taken during Seminar Meeting 13 were organized into a table for analysis so that we could track individual responses and practicum sections. Drawing from Creswell’s (2013) process for analyzing data, we each familiarized ourselves with the data by independently engaging in multiple readings of the final sandtray reflections and focus group transcripts, including memoing to capture initial impressions and key concepts. After familiarizing ourselves with the data, we met as a research team to share initial insights and bracket assumptions. Next, we reviewed each line of the final sandtray reflection data independently to identify initial codes. As a research team, we shared our codes, discussed discrepancies, and reviewed units of data until consensus was reached and a codebook was created. Next, codes from the final sandtray reflections were compared to the focus group transcripts and refined. Lastly, we looked for patterns in the data and organized them into themes.

Findings

To examine our supervision practice, we sought to understand how CITs experienced mindfulness as a supervision approach. Prioritizing mindfulness within our practicum seminar meetings focused our students on the examination and understanding of their internal experiences and meeting uncertainty with nonjudgment and self-compassion. After analyzing the data, three major themes emerged: openness to the process of becoming, reflection and self-care, and attention to the doing.

Openness to the Process of Becoming
     Although CITs acknowledged the challenges associated with their experience, they also expressed an openness to becoming a counselor who generated personal insight, self-compassion, and wisdom. As one participant stated, “It’s natural to feel uncertain when learning new concepts. However, uncertainty should not consume you and cause your thoughts to become negative. Give yourself permission to grow.” Another wrote, “The biggest growth I’ve seen in myself is self-awareness. Regardless of my weaknesses and shortcomings, I am good enough!! The greatest gift I can give to students is to be myself.”

CITs felt hopeful and purposeful in their development as counselors and expressed excitement about their professional growth. As one participant remarked, “In the beginning everything seemed new and scary, but when I look at the end, I see so much growth. I will continue to grow and expand. I look forward to my career.” Another wrote:

At the beginning of practicum, I felt awkward and unsure of myself. I felt self-conscious. At the end of practicum, I can feel the growth I’ve made. I no longer feel awkward or self-conscious. I know who I am and what kind of counselor I am.

     Acknowledging the emotional challenges of their professional journey, CITs highlighted the emotional discomfort they felt at the start of practicum. One student stated: “Anxiety from the beginning—feeling of anxiety and not knowing what to expect.” Another mentioned in her reflection, “I definitely had feelings of inadequacy. I just didn’t think that I was doing what I needed to do.” Some students expressed this discomfort as cyclical:

Understanding everything that was going to be happening and everything that was expected and what it all entails, I definitely started to get more anxious and got comfortable and then getting [anxious] again. So, kind of like back and forth a lot.

Students compared this back and forth feeling to that of a rollercoaster: “I feel like some weeks I’d be on fire, like, yeah, I did really good . . . there would be other days where it’s like my timing is off and I’m uncomfortable in the classrooms . . . it was definitely a rollercoaster feeling.”

Another student agreed, sharing that they “would definitely second the rollercoaster. The beginning was very overwhelming for sure . . . that rollercoaster of like the expectation of learning . . . feeling like you’re doing really bad and then learning what is good.”

There was also a sense of wisdom in how the participants described what they gained from this experience of becoming. One participant mentioned “feeling depressed and anxious. . . . Fast forward 2 months and I had grown so much. I can’t believe in only 60 days my attitude toward practicum changed so dramatically. . . . change and growth take time, but it does happen.” Another CIT stated:

In my first reflection, there seemed to be a lot of low points, but I was hopeful things would get better. In my second reflection, I realized that the things I have done have made an impact and the highs and lows both got me to this point.

     CITs expressed recognition of the highs and lows experienced and within that recognition focused on a greater purpose. As one wrote,

I started out being very unaware and doubtful of myself. I was overwhelmed and wasn’t seeing the beauty in the process of learning who I am as a counselor. I began to see the small and big impacts that I had with my students in 15 weeks. I saw the power that comes with being a counselor and am more mindful of the impact I have and will make.

Another reflected:

The biggest growth I’ve seen in myself is self-awareness. Awareness of my strengths and weaknesses so that I can be mindful of how to be the best I can be for all students. So that I can strive to have a positive impact on others.

Another mentioned:

At this point in the journey, I finally met my passion. I always wanted to have an impact not because I taught a great lesson, but because I helped a student and showed I cared. I grew by knowing how to use my tools to make a difference while finding my style of counseling in the process. The growth hasn’t stopped and needs refinement, but I want each day to be better for myself and the students.

     Additionally, CITs perceived feedback to be essential to their growth process. One CIT reflected that they “learned to be open to change . . . accepting feedback and letting it help me make positive changes throughout this journey. There is always a need for continued growth and development.” Another remarked:

I’ve realized that in order for me to learn and grow I have to be more open [to feedback]. Being closed off means that I am only working with what I know, which is not helpful to me personally, but also what we tell students not to do. Being open has forced me to become a more active participant in my learning and take more risks . . . it will all be worth it in the end.

Another practicum student focused on gratitude:

Feedback and supervision helped to change my perspective and boost my confidence. Things about myself that I thought had nothing to do with being a counselor were highlighted and the areas for improvement were spoken of and tended to with genuine care. I’m grateful to have had the experience of becoming so reflective. I’m grateful for the lows and the moments where I felt as though I was at a standstill. I’m grateful for falling so hard that my only option was to reach out and ask for help. I’m grateful for the hurdles . . . and I’m grateful for the ever-flowing river. I’m grateful for the art and the science of counseling. I’m grateful for who I’m becoming in the process of becoming. I’m grateful for grace and for the realization of how necessary it is. I’m grateful for family and adopted big sisters in the program. I’m grateful to have had the chance to say “I don’t know” and keep learning.

     The theme of openness to the journey was also highlighted in the acknowledgement of not being in control. There was an openness to embracing the unknown and the chaos associated with not having everything figured out, as one CIT concluded:

In the beginning, I was working really hard to try to figure everything out. I saw obstacles everywhere. As I moved on, I started to focus on counseling in a way that didn’t put pressure on me to do all of the right things. I started to grasp the essence of counseling and what makes the profession unique.

Another noted:

One major insight is that it was a chaotic journey. It’s not straightforward, and I don’t always know the path I’ll take, but I am continuously growing and learning about myself as a person and as a school counselor. . . . I am enjoying the unknown. I like what I am doing, and I like moving forward, even if I am unsure at times.

Reflection and Self-Care
     CITs reported that the seminar was very reflective, which gave them a sense of calm and a new appreciation for self-care. As one student commented, “I did, like everyone else, find [the seminar class] to be calming, enjoyable, and reflective.” Reflection generated by the mindfulness exercises gave CITs an opportunity to get to know themselves:

It was definitely a positive experience for sure. I would agree it was very calming and super reflective. I felt like I understood myself as a counselor and also just like as a person on my own personal journey. Even aside from that I felt like I learned a lot.

Further, CITs expressed the importance of reflection and giving themselves the space to be in the present moment as a means of self-care:

I am so wrapped up in everything that is going on in my life and getting everything done. And school takes a lot of everything I’ve got . . . to be reminded and practice [mindfulness] on a regular basis . . . but doing it each week in class, helped me to do it at home. So that was giving me that practice and repetition and it really made a huge difference.

Another mentioned, “There’s just so many things going on in your life . . . to be reflective and just calm my inner self and learn how to breathe . . . this was a life skill class for me,” and a different student elaborated, “I was so grateful for it because I realized how much self-reflection I have to do . . . that I need to keep doing it and making it a priority.”

Attention to the Doing
     Although students valued the priority that we placed upon mindfulness to better understand their internal experiences, some wished that we had provided more time for them to share stories about their practicum sites. As one CIT stated, “I would have liked to have had time each week for all of us to share what was going on and to learn from each other’s situations and to support each other in those situations.” Additionally, CITs desired to know more about what was happening at different practicum sites because of the belief that they were missing an experience. As one CIT explained, “I didn’t have a role model so it was nice to hear everyone else’s role models . . . so I could just learn from pieces I wasn’t getting [at my site].” Another CIT agreed: “I think it definitely would have helped to hear more about other people’s sites just because I wasn’t really getting a ton out of my site. Or I did get things, but differently.” Another mentioned, “I wanted to hear other people’s experiences because I felt like everyone was at such different schools and different levels . . . we’re all experiencing different things.”

Discussion

We sought to understand how practicum students experienced mindfulness exercises within supervision to improve our own practice. To help practicum students work with their anxiety, mindfulness exercises were heavily integrated into the course structure to engage all CITs in weekly reflective exercises that directed their attention toward their internal experiences. Practicum students were invited to acknowledge their anxiety and respond to it with nonjudgment and self-compassion. Mindfulness core concepts (e.g., being present, nonjudgment, self-compassion) served as a framework for how practicum students made meaning of their internal experiences. Although our focus was not to determine the impact mindfulness had on our practicum students, to inform our practice we did seek to gain a descriptive understanding of how our students experienced mindfulness as part of their group supervision.

Open to the Process of Becoming
     Our CITs reported being open to the process of becoming a counselor that included acceptance of where they were in the developmental process. Through acceptance, CITs reported being aware of the uncertainty associated with learning a new skill and leaned into that anxiety with self-compassion and nonjudgment. Further, they were able to acknowledge the ambiguity (e.g., “rollercoaster”) associated with learning something new and the tension that comes with being uncomfortable. Bohecker et al. (2016) found similar results in their qualitative study, acknowledging that CITs who integrated mindfulness practices into their daily lives were better able to handle the ambiguity associated with counselor development. As part of her correlational study, Fulton (2016) found that self-compassion, a core principle of mindfulness, was predictive of a CIT’s tolerance to handle ambiguity. Thus, our findings support and add to the current literature by describing qualitatively how practicum students made meaning of that uncertainty to normalize the tension that was associated with it.

Self-Care
     Participants saw reflection as a form of self-care, finding meditation to be relaxing, and they acknowledged that meditating each week during seminar allowed them to stay in the present moment. Similarly, Duffy and colleagues (2017) found that CITs in their qualitative study who participated in weekly mindfulness exercises as part of a core class described mindfulness as reflective, providing them with a sense of calm and ability to stay within the present. Banker and Goldenson (2021) noted that CITs within their qualitative study also reported personal benefits to utilizing mindfulness within their practicum seminar, including being able to better transition to the present moment. Thus, the experiences our practicum students had connecting reflection as a form of self-care are similar to the experiences of other CITs who practiced regular meditation.

Attention to the Doing
     Although CITs saw value in participating in group supervision that integrated mindfulness as a central approach within their practicum seminars, some CITs wanted more focus on learning about the experiences other practicum students had at their school sites. Specifically, CITs desired to know more about school counselor practice by sharing stories of what their peers were doing, as well as the work being done by the practicing school counselor. Participants sought more understanding on school counselor practice either because of a lack of modeling at their own schools or professional curiosity. Similarly, Watkinson et al. (2018) noted that counselor educators reported discrepancies between how school counseling CITs were being prepared versus what they experienced in the field. For example, counselor educators shared that they often taught content (e.g., implementing a comprehensive school counseling program) that their school counseling CITs did not see modeled at their schools. Thus, it would seem logical that CITs at the practicum level would want to have more exposure to activities that school counselors were doing at other sites, especially if what they were observing was not aligned with their training.

Reflecting on Our Own Practice: Lessons Learned
     Through this practitioner inquiry, we gained some valuable insight into how CITs experienced mindfulness that has informed our practice. First, by analyzing our CITs’ experiences in practicum, we believed that they benefited from the mindfulness exercises as a way to work with their anxiety. Specifically, we were encouraged that practicum students expressed an openness to the process of becoming a counselor, which included self-acceptance. CITs stated they were more open to feedback and less critical of themselves, recognizing they still had much to learn. Second, we learned that although the integration of mindfulness as a central approach to our supervision could be helpful to practicum students, CITs also expressed a desire to have more time dedicated to hearing about the work their peers and other practicing school counselors were doing within schools. This was particularly important if the CIT believed their site was lacking. Hence, as supervisors we needed to create a balance between engaging our CITs in mindfulness practices and the need that our CITs had to share work stories and gain some practical insight into the work of school counselors.

Cochran-Smith and Lytle (2009) highlighted that a benefit to practitioner inquiry was the uncovering of professional dilemmas that naturally occur when you apply a concept to practice. For us, seeking balance challenged us to consider what specific mindfulness exercises were critical to maintain. Watkinson et al. (2018) also found that counselor educators struggled with balancing the amount of content that needs to be covered in a course versus the depth of understanding that is needed for CITs to apply the content learned. Thus, we too needed to decide on depth versus breadth, which boiled down to identifying the frequency with which we had our practicum students participate in mindfulness exercises in each seminar meeting to gain benefit.

Because the recent literature suggested that exposure to weekly mindfulness exercises within core courses and clinical seminars benefited CITs (Campbell & Christopher, 2012; Dong et al., 2017; Fulton, 2016), we decided to keep the opening mindfulness meditative exercises and remove the one seminar session we had dedicated to mindfulness. Further, we increased the time CITs spent in sharing circles to include space for CITs to talk about the work being done by school counselors (or themselves) at practicum sites. Lastly, we looked for opportunities to highlight mindfulness principles in case conceptualization.

To integrate mindfulness principles into case conceptualization, Sturm and colleagues (2012) proposed using metaphors (i.e., Earth, Air, Water, Space and Fire) that represent ancient Buddhist principles when conceptualizing cases. For instance, the Earth metaphor symbolizes grounding, and when applied to case conceptualization enables CITs to consider what grounds them personally and theoretically when treating a client (Sturm et al., 2012). Another example of integrating core mindfulness principles into supervision is through free association (Schauss et al., 2017). Schauss et al. (2017) used free association to help CITs attend to the present by asking questions that focused CITs on the here and now (Schauss et al., 2017). Sample questions include: What are you feeling in this moment? When and in what ways has this feeling surfaced during your counseling experiences at your school site? How does your body respond to this type of feeling and what is the impact on your counseling experiences? By integrating mindfulness principles into skill development (e.g., case conceptualization), our practicum students would be further exposed to core mindfulness principles.

Limitations and Future Research

Our intention of sharing the findings from this study was to offer a practitioner’s perspective on how CITs experienced mindfulness within supervision to contribute to the broader discussions on counselor education pedagogy. Generalization was not the objective, and findings need to be interpreted within the context of practice. Further, this study did not examine the impact that mindfulness had on CIT anxiety, and we are not able to infer such causal relationships. To strengthen our understanding of counselor education pedagogy, future studies could build upon our findings to identify which mindfulness exercises had the greatest impact on helping CITs work with their anxiety. Understanding which mindfulness exercises impact anxiety, counselor educators could be more intentional with the exercises they include, thus making room for other supervision priorities (e.g., CITs hearing about the work of practicing school counselors).

Future research could also investigate how supervisors’ modeling of core mindfulness principles could impact counselor development and the supervisory alliance. Daniel et al. (2015) have called upon researchers to increase understanding of how supervisors’ mindfulness behaviors impact the supervisory relationship. Future research could attend to this deficiency within the literature by looking at the relationship between a supervisor’s mindfulness behaviors and the supervisory relationship through a practitioner lens.

Conclusion

By incorporating a mindfulness approach into supervision, we learned that CITs were open to working with the anxiety associated with becoming a counselor. This openness or self-acceptance gave them the perspective to appreciate the impact this experience had on them and others while also valuing the benefits of reflection through meditation. The intent of this study was not to generalize the experience of these CITs to others; rather, it was to generate conversation and an understanding of how CITs experienced mindfulness to better our practice as supervisors. Although CITs saw benefits of mindfulness within supervision, they also desired more conversations on counselor practice to better their understanding of the role school counselors have in schools. As supervisors, we understand mindfulness should be balanced with the need for CITs to learn about the work of the school counselor through the sharing of experiences at their practicum sites. Beginning each session with a mindfulness exercise and infusing mindfulness core principles into case conceptualization could be a means to achieve such balance.

 

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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Jennifer Scaturo Watkinson, PhD, LCPC, is a certified school counselor and serves as an associate professor and the School Counseling Program Director at Loyola University Maryland. Gayle Cicero, EdD, LCPC, is a certified school counselor and serves as an assistant clinical professor at Loyola University Maryland. Elizabeth Burton is a certified professional school counselor for Baltimore County Public Schools. Correspondence may be addressed to Jennifer Watkinson, Timonium Graduate Center, 2034 Greenspring Dr., Lutherville-Timonium, MD 21093, jswatkinson@loyola.edu.

Examining the Facilitating Role of Mindfulness on Professional Identity Development Among Counselors-in-Training: A Qualitative Approach

Shengli Dong, Amanda Campbell, Stacy Vance

Professional identity development is crucial for counselors-in-training, as it provides a frame of reference for understanding their chosen field and contributes to a sense of belonging within the professional community. This qualitative study examined the impact of mindfulness on professional identity development among counselors-in-training. Participants reported that mindfulness, along with experiential learning and mentoring, served as a facilitator in completing the transformational tasks in the process of professional identity development. The preliminary results from this qualitative study warrant further research to examine and validate the impact of mindfulness on professional identity development among counselors-in-training.

Keywords: mindfulness, professional identity development, transformational tasks, counselors-in-training, experiential learning

The counseling profession has emphasized the importance of developing healthy professional identity among counselors-in-training (Corey, Corey, & Callanan, 2011; Council for Accreditation of Counseling & Related Educational Programs [CACREP], 2016; Granello & Young, 2011). Gibson, Dollarhide, and Moss (2010) defined professional identity development (PID) as the “successful integration of personal attributes and professional training in the context of a professional community” (pp. 23–24). A strong sense of professional identity provides an individual with a frame of reference for understanding his or her chosen field, contributes to a sense of belonging within the professional community, and helps to develop competency and an allegiance to the profession (Elman, Illfelder-Kaye, & Robiner, 2005; Pistole & Roberts, 2002). Conversely, a lack of professional identity may have negative consequences, such as detriments to the quality of counseling services (Pistole & Roberts, 2002) and role confusion among beginning practitioners (Studer, 2006).

Moss, Gibson, and Dollarhide (2014) and Gibson et al. (2010) proposed a transformational model in describing the development of professional identity across time among counselors-in-training and counselors. Specifically, the researchers reported that counselors passed through several transformational stages, including moving from idealism to realism, burnout to rejuvenation, external validation to internal validation, and separation to integration into the professional community, as they became more advanced. Additionally, counselors developed an internalized definition of counseling over time (Moss et al., 2014).

Developing professional identity can be a daunting task. On one hand, counselors-in-training and new professionals experience a variety of challenges in the course of PID. Some of these challenges include demanding academic and clinical work (Aponte et al., 2009), contradictory or ambiguous experiences triggering self-questioning and identity reshaping (Adams, Hean, Sturgis, & Clark, 2006; Slay & Smith, 2011), and a tendency to be self-critical and evaluate oneself primarily based upon external standards (Skovholt, Grier, & Hanson, 2001). In addition, counselor trainees tend to have an unrealistic view of their roles and capacity as a counselor (Thompson, Frick, & Trice-Black, 2011). These challenges may hinder the process of PID.

On the other hand, PID is a complicated process that involves transformational aspects such as cognition, behavior, and affection. A counselor-in-training or a new counselor develops a sense of oneness with a profession while addressing difficulty in balancing personal identity with professional identity (Goltz & Smith, 2014). Additionally, intense emotional interactions with clients and supervisors, such as constant exposure to professional evaluations, require consistent broadening and review of internal boundaries and perceptions (Birnbaum, 2008). Without successfully balancing these academic and professional requirements and expectations, counselors-in-training may encounter burnout. Thus, it is important for counselor educators and supervisors to assist trainees in the development of their professional identities (Auxier, Hughes, & Kline, 2003; Brott, 2006; Levitt & Jacques, 2005).

Most current approaches to PID focus on cognitive and behavioral aspects through experiential learning, continuing training, and supervision (Limberg et al., 2013; Zakaria, Warren, & Bakar, 2017). However, the aspect of affect also is of great significance. Several researchers have identified the significant impact of an affective component in the development of professional identity (Clouder, 2005; Mayes, Dollarhide, Marshall, & Rae, 2016). For example, Clouder (2005) stressed that affect development, which is highly associated with mindfulness (Schroevers & Brandsma, 2010; Snippe, Nyklíček, Schroevers, & Bos, 2015), should be integrated into PID.

Mindfulness and PID

Mindfulness is instrumental in affective development through emotional regulation (Hill & Updegraff, 2012; Hülsheger, Alberts, Feinholdt, & Lang, 2013). Mindfulness is a complex construct with several definitions. According to Kabat-Zinn (1994), mindfulness is conceptualized as “paying attention in a particular way: on purpose in the present moment, and nonjudgmentally” (Kabat-Zinn, 1994, p.4). Similarly, Bishop et al. (2004) defined mindfulness as a two-component model, involving the “self-regulation of attention” and “a particular orientation towards one’s experiences in the present moment . . . that is characterized by curiosity, openness, and acceptance” (p. 232).

The benefits of mindfulness practices have been found in many areas, such as preventing and reducing burnout (Epstein, 2003; Rothaupt & Morgan, 2007), enhancing counseling competency (Campbell, Vance, & Dong, 2017; Greason & Cashwell, 2009), and fostering acceptance of one’s challenging thoughts and feelings as opposed to encouraging one to alter or control them (Davis & Hayes, 2011). In addition, Snippe et al. (2015) examined the temporal order of changes in mindfulness and affect and found that the changes in mindfulness seemed to predict and precede the changes in affect. The characteristics of mindfulness and its impacts on affect could potentially facilitate the transformational process in PID, which requires not only clinical and cognitive competence, but also affective and reflective capacities.

Although several studies have been conducted in the fields of social work, nursing, and psychology that have supported the relationship between mindfulness and PID (Birnbaum, 2008; Jacobowitz & Rogers, 2014; Martin, 2014), there is a lack of research exploring this relationship in the field of counseling (Beddoe & Murphy, 2004; Birnbaum, 2008; Louchakova, 2005). Furthermore, no study has focused on exploring a possible link between mindfulness and the transformational tasks in the process of PID. The purpose of this qualitative study was to explore how mindfulness may relate to the transformational tasks of PID (idealism to realism, burnout to rejuvenation, external validation to internal validation, and separation to integration) through the perspectives of mental health counselors-in-training.

Method

The qualitative approach for this study was informed by phenomenology and qualitative content analysis (Cho & Lee, 2014). Phenomenology was used as a framework to gain an understanding into participants’ experiences of PID through the potential impact of mindfulness among counselors-in-training. The qualitative content analysis offers a systematic method for identifying key themes among mindfulness and transformational tasks within the PID process among participants.

Participants

The participants in this study were master’s-level counseling students enrolled in two sections of an internship class during the last semester of their mental health counseling program (spring 2015) at a CACREP-accredited program of a Research I university in the southeastern United States. Six out of 16 students in the internship classes participated voluntarily in this study, with a participation rate of 37%. The sample included four Caucasian and two Hispanic participants, with four identified as female. The sample size of a qualitative study should be based upon goals and purpose of the study (Starks & Trinidad, 2007) and the depth of interviews—for more in-depth interviews, fewer participants are needed (Patton, 2015). Starks and Trinidad (2007) stated that the typical number of participants in a phenomenological study range from one to 10.

The participants conducted their internships in various settings, including an inpatient behavioral health center, a university counseling center, local community agencies, youth and family services, and low-income community services.

Procedures

The first author of this manuscript offered the internship course in which mindfulness-based practices and activities were discussed, demonstrated, and practiced. The mindfulness activities included meditation practices, readings regarding mindfulness, and weekly reflections on mindfulness practices for participants at their internship sites (mindfulness instructions and procedures can be obtained by contacting the first author).

The first author informed the students about the availability and voluntary nature of this study. The second and third authors (two doctoral-level students in the counseling program at the same university as the first author) came to the internship class and introduced the study, its purpose, nature and procedure, format, and the voluntary nature of participation. During that time, the course instructor (the first author) left the classroom. The students were informed that they would be invited to participate in this study via emails by the two doctoral-level investigators. Should students in the class agree to participate, the two doctoral-level investigators and the students would schedule a time to conduct interviews. All interviews were conducted by the second and third authors.

Prior to conducting the interviews, the doctoral-level investigators presented the interviewees with an informed consent form and told the interviewees that they could withdraw from the study at any time. Whether interviewees would participate or withdraw from the study would not be known to the course instructor and would not affect their grades for the class. In addition, data analysis was conducted after the end of the semester, when all the participants’ final grades had been submitted through the university’s grade submission system.

Each interview lasted about one hour and took place during the last four weeks of the spring semester of 2015. The interview included four open-ended questions, with two of these questions having additional probing questions. The semi-structured interviews served to better answer the research question. The interview began with questions regarding the participants’ professional development, including questions relating to internship site expectations, capability as an effective counselor, and the relationship between personal and professional identities. Next, the participants were asked questions pertaining to their experience in the internship class and internship sites,  including questions about in-class mindfulness activities, internship site expectations, client interactions, and changes in professional identity. In addition, participants were asked about their self-care and mindfulness activities outside of the classroom. The interview concluded with a discussion about the factors that would aid participants to reach the next stage of their PID.

The interviews were audio-recorded and transcribed by the second and third authors. The transcripts were kept in a password-protected file and accessible only to researchers of this study. All identifying information was removed prior to data analysis. The audio recordings were deleted once all of the transcripts were cross-checked by the second and third authors to ensure the accuracy of the audio recordings and transcripts.

Qualitative Content Analyses

We used a qualitative content analysis approach to identify transformational tasks in PID and explore the potential impact of mindfulness on facilitation of completing transformational tasks. According to Cho and Lee (2014), qualitative content analysis is flexible in utilizing inductive or deductive analysis: codes or themes are directly identified from the data in inductive approach, whereas deductive approach starts with preconceived codes or categories derived from prior relevant theory.

We started the coding and data analysis process after all interviews had been completed, as suggested by Seidman (2013). In order to reduce or minimize the effect of our biases and preconceived assumptions on our interpretation of the meaning of the data, we engaged in bracketing (Moustakas, 1994) by reading the transcripts multiple times with the goal of embracing the participants’ perspectives while reducing the researchers’ preconceived notions on the topic (Hycner, 1999). Both the verbal and nonverbal (e.g., fillers and silences) content of the interviews were included in the transcripts.

The content analysis approach requires the researchers to review the data to ensure a thorough and integrative analysis. First, we carefully read each transcript and made notes identifying relevant information related to the research question. Second, we read the notes and listed the types of information found, then categorized interview content and notes in a meaningful manner. Third, we identified if connections between categories could be found or themes could be observed. Finally, we compared and contrasted various major and minor categories. The same process was repeated for each transcript. After analyzing all the transcripts, we identified themes and examined each in detail and considered if they were appropriate. Once all the transcripts were carefully examined and categorized into themes or subthemes, we reviewed the data to ensure that the information was categorized and described appropriately. Finally, we reviewed the transcripts and ensured that all relevant information was examined and categorized (Neuendorf, 2016).

Triangulation is the process through which a researcher gains confidence and assurance that their findings and interpretations of the data are reflecting what is actually occurring in the data (Stake, 2006), and it provides a check on selective perception and illuminates blind spots in an interpretive analysis (Patton, 1990). Content analysis with multiple researchers in this study offered opportunities for cross-checking and analyst triangulation. We each coded the interviews independently, and compared and contrasted categories and comments under each theme. When different opinions occurred, we discussed the discrepancies and brought light to data through multiple perspectives. The first author has research and clinical experiences related to mindfulness and PID, and past experiences in qualitative content analysis. The second and third authors have relevant research experiences in mindfulness and training in qualitative research.

Results

The results section describes the tasks in the transformational model of PID and their relationship to mindfulness based upon the participants’ responses. Under each transformational task, results are presented in two categories: (1) the transformational model of PID tasks, and (2) the impact of mindfulness on the transformational tasks.

Burnout to Rejuvenation

Transformational model of PID task. According to the results of the interviews, participants described being at different points on the burnout–rejuvenation continuum. Most commonly, participants noted multiple sources of burnout that accompanied their training experiences. These sources ranged from the nature of the work itself to an inability to cope with stress and multiple demands. For example, a male participant from a low-income community agency indicated nervousness at the prospect of being adjudicated as the result of a client complaining. In contrast, participants also cited their work as a means of rejuvenation. When given the opportunity to apply the knowledge that trainees had learned in class, participants often cited their practicum experiences as sources of excitement. One female participant from youth and family services and university services stated, “I’m excited and I want to get out there and see more and do more.”

Impact of mindfulness. A common theme emerged illustrating that participants viewed mindfulness as a strategy for reducing burnout and facilitating movement toward rejuvenation while developing their professional identities. Through building awareness of their internal and external experiences, participants noted a transition in the energy that they felt for their work. Specifically, participants noted initially feeling tired, stressed, and overwhelmed by their work. However, attending to these feelings, focusing on the here-and-now, and accepting the experiences nonjudgmentally helped participants manage feelings of burnout and ultimately feel an increased energy for their work. Participants perceived mindfulness as facilitating awareness of their internal and external experiences. One female participant working with an inpatient psychiatric hospital highlighted how mindfulness served as a facilitator for awareness of internal experiences: “I try really hard to focus on myself throughout the day using mindfulness, especially when I became overwhelmed where I could feel my body reacting, and that helped professionally because I could prepare for those situations.” In addition, a female participant from youth and family services noted that mindfulness served as a facilitator for awareness of external experiences, “[being] more mindful about where I was in the situation with a client so [I would not] get attached and bring that [vicarious trauma] home with me.”

Participants also noted mindfulness as facilitating acceptance of their internal experiences when faced with external stressors. For example, one female participant working at an inpatient psychiatric hospital and prison noted, “I mean deep breathing, especially when I’m feeling anxious . . . even when you’re just . . . feeling depressed, is nice to just [say] okay, ‘this is maybe just a phase I’m going through, it’s a normal reaction to everything that is happening.’” Furthermore, bringing awareness to all aspects of the internship through mindfulness activities helped relieve burnout and increase energy for work. For example, one participant working with an inpatient psychiatric hospital stated: “Really stopping and looking at the good times and the energy . . . in (the) workplace . . . and looking at the good things that happen really changed my view.”

Idealism to Realism

Transformational model of PID task. Participant responses revealed a pattern of adopting an idealistic perspective of the counseling process or outcomes, as well as unrealistic expectations of the counseling workplace. Responses demonstrated that some novice counselor trainees believed their roles were to “fix” or “save” their clients. For example, one participant at youth and family services noted, “a lot of the kids I have seen have been raped or sexually abused, neglected, abandoned. . . . I want to save every kid and I want to take every one of them home with me because I can feed them.” Other participants demonstrated having unrealistic expectations about the counseling workplace. Among responses collected, many participants defined counseling as “sitting there and listening to people” and noted beginning their internships with an idealistic perspective. For example, a female participant working with an inpatient psychiatric hospital stated, “Before, you have this idea of a counselor, sitting in a room with books around you and asking, ‘How do you feel about that?’” Many participants began with idealistic perspectives of their clinical skills and transitioned to more realistic expectations. For example, one female participant from a youth and family agency indicated that she had not anticipated the need to develop skills in helping, communicating, and connecting with parents prior to her internship, but had developed a more realistic expectation of her role in working with the parents of her clients.

Impact of mindfulness. Participants’ openness, awareness, and acceptance of experience are instrumental in the facilitation of realism in PID. Through an openness to experience in their internships, these novice counselors began to note a transition in their conception of the profession. Specifically, participants demonstrated attention to the here-and-now while engaging in their clinical experience, thereby allowing their understanding of the profession to be malleable to their therapeutic practice. One female participant from a youth and family agency noted that attending to the moment, rather than overpreparing, allowed her to remain open and flexible in her work with clients. Additionally, the participant stated mindfulness helped her with “being okay with not being okay . . . being more aware of my own feelings, accepting [clients] more, and dealing with [clients] in a better way than I normally would have.”

Furthermore, the participants were open to and accepted their experiences as opposed to rejecting their experiences because they did not fit with their pre-existing perception. Through the acceptance of their experiences, participants were able to begin to broaden their definition of counseling to a more realistic view. For example, a male participant from a low-income community agency noted, “we integrate counseling along with some aspects of basic-level social work case management; sometimes we are doing advocacy, sometimes we are doing a multitude of other things where counseling skills are helpful, but the counseling is not your direct . . . objective.”

Separation to Integration

Transformational model of PID task. With regard to separation to integration, participants at the beginning stages of training often viewed their professional identity as a separate entity from their personal identity. Many participants reported sustained effort in keeping their professional and personal identities separate when beginning their internship. For example, one participant reported “learning that it’s [her] identity as a counselor and not who [she is] as a person,” and further reported concerns about “bringing everything back home with [her] at the end of the day.”

In contrast, participants at the later stages of their training often perceived their professional and personal identity as one and the same. In this study, four of the six participants noted that their personal and professional identities are intertwined. For example, one male participant at a university counseling center stated, “I feel like I identify a lot with that [counselor] role. Sometimes it’s . . . hard to differentiate between taking off my counselor hat and keeping it on, even in some interpersonal . . . relationships.”

Impact of mindfulness. Responses from the participants also revealed that the integration process helped energize them. For example, one female participant at an inpatient psychiatric hospital stated, “Before, when I had jobs, I would separate myself. Because my career is so closely aligned with my personality, I feel like it’s the same. The way I am at my job energizes me; it makes me who I am.”

Additionally, some participants also indicated feeling comforted and integrated into the professional counseling community through accepting who they are and interacting with both peers and supervisors. For example, one female participant at youth and family services noted “knowing other resources to give clients and walking through the process of this is all that we can do with them . . . and then knowing that we did all that [we] could and that was okay.”

Similarly, there was one participant who noted that becoming integrated within the professional community helped with regard to becoming more internally validated. A female participant working in an inpatient psychiatric hospital noted that “things were finally starting to click into place where I was a part of the team . . . that was when my professional identity started to grow—when I see me as a professional instead of an intern.”

External to Internal Validation

Transformational model of PID task. Naturally, novice counselors experience doubt about their skills and capabilities in serving clients in a therapeutic capacity and often look to other more experienced professionals or resources for validation. Participant responses indicated that they were self-critical and looked toward others for validation of their experience. For example, one male participant from low-income community services indicated that when using professional manuals as an ultimate reference at the beginning of their training, “I didn’t trust myself to go off the manual . . . I was so concerned [about], okay did I cover this step, did I cover this step, did I cover this step.”

As the counselors-in-training developed their professional identity, there was a movement from external validation to being able to internally validate themselves. For example, the participant from low-income community services stated, “I am just now starting to trust myself to use the manuals as a base and then apply my own clinical judgment.”

Impact of mindfulness. One’s level of self-acceptance and tendency to not judge oneself is the key to the ability to validate oneself internally. Through nonjudgmentally accepting and evaluating oneself, participants were able to trust and internalize their own strengths and abilities. One male participant from a university counseling center stated, “I learned to accept the current level that I’m at, not being so critical on myself about what I should or shouldn’t be doing, or should and shouldn’t know . . . and that’s been helpful.”

Within this study, mindfulness appears to contribute to one’s willingness to expand the personal comfort zone and explore new and creative approaches, both of which facilitate development toward becoming an effective counselor. A male participant from the university counseling center stated, “It [mindfulness] helped me . . . step out of my comfort zone and try different things with clients, it’s been well received [and] really helpful in terms of feeling more competent [and] confident.”

Mindfulness assisted participants with accepting and trusting themselves, which develops internal confidence and validation. A male participant from low-income community services stated, “The basic concept of stopping yourself, examining in the moment, and saying okay . . . trusting myself that I could find the answer . . . if I allowed myself to relax, it made the client less agitated and less frustrated.”

Discussion

This qualitative study explored how mindfulness facilitates the transformational model of professional development (Gibson et al., 2010; Moss et al., 2014) in master’s-level counselor trainees. Although the extant literature within the field of social work has examined the role of mindfulness in PID (Birnbaum, 2008; Jacobowitz & Rogers, 2014; Martin, 2014), no research to date has examined this relationship within the counselor education field. This study employed a qualitative method, which offers contextual data on the experiences of counselor trainees’ PID. Thus, this exploratory study serves to address gaps in the literature by offering an understanding of how mindfulness may foster growth in counselor trainees’ PID.

The results of the study supported the transformational model of PID proposed by Gibson et al. (2010) and Moss et al. (2014). Indeed, participant responses supported each of the transformational tasks and seemed to hint that this process occurs as a continuum. Although participants were all master’s-level internship students at the completion of their program, each student demonstrated being in various places on the continuum on the four transformational tasks. For example, although some participants indicated a need to keep their professional identity and personal identity separated, others demonstrated beliefs that the professional and personal are intertwined, indicative of separated and integrated identities, respectively. Furthermore, participant responses alluded to change in their professional development over time, further validating the process of growth through the transformational tasks.

The emphasis of the current study was to examine how mindfulness may facilitate growth in PID through the aforementioned transformational tasks. Participant responses seemed to support that some participants found components of mindfulness assisted in their PID. The results showed that specific mindfulness facets associated with acceptance and a here-and-now orientation of internal experiences (e.g., thoughts, emotions, perception of self) and external experiences (e.g., internship experiences) contributed to more sophisticated PID perspectives.

The findings of this study support existing literature on mindfulness in counselor education. Wei, Tsai, Lannin, Du, and Tucker (2015) found that hindering self-focused attention, the antithesis of self-acceptance, led to diminished self-efficacy in counselor trainees. As this relates to the current study, many participants noted experiencing greater internal validation as a result of learning to accept their shortcomings as a counselor trainee. Similarly, participants indicated that self-acceptance yielded a greater propensity for rejuvenation. As suggested by Masicampo and Baumeister (2007), one’s acceptance of difficult thoughts and feelings allows for the development of affect tolerance. However, when counselor trainees are unable to accept their internal experiences (i.e., experiential avoidance), the negative emotional impact may be excessive and garner feelings of exhaustion and result in further manifestation of those avoided internal experiences (Hayes, Strosahl, & Wilson, 1999) or burnout. Indeed, the current research also suggests that self-acceptance played an important role in developing more realistic perspectives of their abilities and the profession. Corroborating evidence for this finding suggests that mindful acceptance and attention to the present moment allows counselor trainees to separate from the need to control themselves and their environment, thereby allowing themselves to be in the here-and-now with their clients and themselves (Christopher & Maris, 2010). In doing so, it is thought that individuals are able to see their abilities and profession as they are, thus developing a more realistic perspective.

In addition to mindfulness, participant responses also indicated a myriad of other experiences that contributed to their PID. Specifically, participants cited sources of growth such as experiential learning and field experiences, research, colleagues, supervisors, and coworkers. This finding is well supported in the literature on mental health counselors’ PID. Specifically, research on PID indicates that experiential learning; faculty, mentor, and supervisor relationships (Limberg et al., 2013); professional peer relationships (Murdock, Stipanovic, & Lucas, 2013); and professional organizations, such as the American Counseling Association (Reiner, Dobmeier, & Hernández, 2013), are all helpful in developing trainees’ professional identities, as they serve to validate shared experiences. Additionally, participant responses indicated that these sources of growth assisted many counselor trainees in becoming more integrated into the professional community.

An unexpected result was the various understandings and opinions regarding mindfulness expressed by participants. It was derived that some participants viewed mindfulness as a set of techniques and strategies (e.g., mindful breathing), whereas others considered mindfulness more as a state of being. For those adopting views related to the latter, responses indicated the acknowledgement of how awareness and acceptance of one’s internal and external experiences initiated progress in their PID. Although most participants adopted a positive view of mindfulness, perhaps because of their voluntary participation in a mindfulness study, a minority indicated that mindfulness was not personally beneficial to them, as they disliked using mindfulness techniques. Although there is a dearth of literature on the topic of those who do not benefit or dislike the use of mindfulness, La Roche and Lustig (2013) posited that the individual and the intervention that is being employed by the individual must match if it is to be effective. Indeed, it is possible that participants who did not find benefits from mindfulness maintain personal assumptions that are inherently distinct from, and perhaps incompatible with, basic tenets of mindfulness. In other words, the participants’ culture must be assessed and considered when attempting to employ mindfulness strategies in counselor trainees (Hyland, Lee, & Mills, 2015).

Limitations

Although this study provides a contextual understanding of how mindfulness may impact the PID of counselor trainees, it is not without limitations. The study implemented a convenience sampling procedure, recruiting counselor trainees from two sections of a course offered at one southeastern university. The final sample size was relatively small, including only six master’s-level trainees out of 16 students in the course, and was predominantly female (66%). The participants’ motivation to apply mindfulness practices and their knowledge of mindfulness could be different from that of their peers who did not attend the study. As such, the findings are limited to the sample used in the study and cannot be generalized to counselor trainees attending other universities or degree programs. Additionally, although the interviewers attempted to create a warm, nonjudgmental, welcoming environment, it is possible that participants may have felt hesitant to share their true experiences. Furthermore, all of the transformative tasks outlined in Moss et al.’s (2014) model were supported by the data; however, the use of a deductive approach may have led to confirmatory bias. Lastly, given the qualitative nature of this study, no causal inferences can be made with regards to the impact of mindfulness on PID.

Implications for Counselor Education and Further Research

The results of the current study indicate that mindfulness may contribute to the PID of counselor trainees through a variety of different mechanisms. As such, counselor educators may better assist counselor trainees in addressing barriers to PID through incorporating mindfulness-based approaches into curriculum and experiential activities. Counselor educators should work collaboratively with site supervisors to incorporate mindfulness into the supervision and field training experiences of counselor trainees, while also gathering feedback on the PID of counselor trainees over time. Furthermore, as some counselor trainees in this study demonstrated a superficial understanding of mindfulness (e.g., mindfulness as purely an intervention technique), students may benefit from the addition of a course focused on mindfulness and the PID process as a means to facilitate a deeper understanding of the philosophy and practice of mindfulness while fostering PID. Overall, counselor trainees may benefit from developing an understanding of the PID process and the benefits of mindfulness in facilitating both professional and personal growth.

Further research should incorporate larger sample sizes, varying degree programs, and multiple universities to develop a more general understanding of mindfulness and PID across counselor trainees. The impact of mindfulness on PID may be further examined using experimental and longitudinal research designs. For example, examining the impact of a mindfulness-based intervention on the PID of counselors-in-training, using pretest and posttest measures, and using a control group for comparison would add to our understanding of these phenomena. In addition, developing an understanding of mindfulness and PID may require moving beyond the self-report measure often used in social science to incorporating the feedback and observations of supervisors overseeing the work of counselor trainees within the clinical setting. Given the parallels between mindfulness and professional development (Beddoe & Murphy, 2004; Birnbaum, 2008; Louchakova, 2005) in other fields, as well as the findings of this study, deriving a mindfulness-based model of PID may prove beneficial for deepening the understanding of the connection between these two processes both in research and practical setting.

The complex and ever-evolving nature of PID is an area ripe for further exploration and discussion, particularly among counselor educators and trainees. The results of this exploratory qualitative study revealed that mindfulness facilitates engagement in the transformational tasks (i.e., burnout to rejuvenation, separation to integration, idealism to realism, and external validation to internal validation) in the process of PID for counselors-in-training. Considering the significance of PID and preliminary results in this study, further research is needed to examine and validate the impact of mindfulness on PID.

 

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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Shengli Dong, NCC, is an assistant professor at Florida State University. Amanda Campbell and Stacy Vance are doctoral students at Florida State University. Correspondence can be addressed to Shengli Dong, 114 Call Street, Tallahassee, FL 32313, sdong3@fsu.edu.

Self-Care Through Self-Compassion: A Balm for Burnout

Susannah C. Coaston

Counselors are routinely exposed to painful situations and overwhelming emotions that can, over time, result in burnout. Although counselors routinely promote self-care, many struggle to practice such wellness regularly, putting themselves at increased risk for burning out. Compassion is essential to the helper’s role, as it allows counselors to develop the therapeutic relationship vital for change; however, it is often difficult to direct this compassion inward. Developing an attitude of self-compassion and mindfulness in the context of a self-care plan can create space for an authentic, kind response to the challenges inherent in counseling. This article expands beyond the aspirational aspects of self-compassion and suggests a variety of practices for the mind, body, and spirit, with the intention of supporting the development of an individualized self-care plan for counselors.         

Keywords: self-care, self-compassion, burnout, mindfulness, wellness

Wellness, prevention, and human development compose the core of a counselor’s professional identity (Mellin, Hunt, & Nichols, 2011). This fundamental grounding is emphasized within the American Counseling Association’s (ACA) Code of Ethics (ACA, 2014), as well as by the Council for Accreditation of Counseling & Related Education Programs (CACREP; 2016). To fulfill their role in the change process, counselors depend heavily upon compassion, a key component of the therapeutic relationship that—paradoxically—counselors may seldom apply to themselves (Patsiopoulos & Buchanan, 2011). Whereas compassion means being with others in their suffering (Pollack, Pedulla, & Siegel, 2014), self-compassion can be understood as “being touched by and open to one’s own suffering, not avoiding or disconnecting from it, generating the desire to alleviate one’s suffering and to heal oneself with kindness” (Neff, 2003, p. 87). Higher levels of self-compassion can serve as a buffer against burnout (Barnard & Curry, 2011). Therefore, cultivating an attitude of self-compassion may assist counselors in employing self-care practices to refresh, rejuvenate, and recharge their bodies, minds, and souls. The purpose of this manuscript is to reimagine self-care as regular acts of self-compassion that benefit both clients and counselors.

Self-Compassion

Self-compassion, a construct from Buddhist thought, consists of self-kindness, common humanity, and mindfulness, and is characterized by gentleness with oneself when faced with a perceived sense of inadequacy or failure (Neff, 2003). Self-compassion is not based on an evaluation of the self; self-compassion becomes the path to positively relating to oneself (Neff & Costigan, 2014). The concept of self-compassion is consistent with the idea of self-acceptance in the humanistic tradition (Neff, 2003). Carl Rogers (1961) described a successful outcome of psychotherapy as an increase in positive attitudes toward self: “The client not only accepts himself . . . he actually comes to like himself. This is not a bragging or self-assertive liking; it is a rather quiet pleasure in being one’s self” (p. 87). The practice of self-compassion calls for a mindful awareness of emotions, and painful emotions are met with a sense of understanding, connection to our common humanity, and self-kindness (Neff, 2003). Neff and Costigan (2014) described self-compassion’s relationship with pain thusly: “Self-compassion does not avoid pain, but rather embraces it with kindness and goodwill that is rooted in the experience of being fully human” (p. 114). Self-compassion practices have been found to improve psychological functioning in both clinical and non-clinical settings (Neff, Kirkpatrick, & Rude, 2007; Schanche, Stiles, McCullough, Svartberg, & Nielsen, 2011).

Mindfulness is one of the core components of self-compassion and is critical for the awareness of suffering that precedes compassion (Germer & Neff, 2015). Mindfulness is the focusing on the awareness of pain in the present moment, and self-compassion becomes the act of taking that awareness and encouraging kindness toward oneself. The common humanity component of self-compassion becomes one of acknowledgment that, as humans, we are imperfect and make mistakes; recognizing our flawed condition allows for a broader perspective toward our difficulties (Neff, 2003). Adopting such a view of pain reduces the chance of over-identification or getting so wrapped up in one’s emotions that they become exaggerated (Neff & Costigan, 2014). When an individual can recognize pain as a universal occurrence, such a viewpoint then fosters a sense of connection with others who have felt suffering. Pain becomes an uncomfortable but acknowledged part of the human condition. When practicing self-compassion, the self-directed kindness is not done to change the circumstance of suffering, but done because there is suffering. The practitioner asks “What do I need now?” The individual then acts accordingly to provide comfort when experiencing the pain of inadequacy or failure (Germer & Neff, 2015). Learning self-compassion becomes a gift for both clients and the practitioner (Barnett, Baker, Elman, & Schoener, 2007). Making time for one’s self is one way counselors can practice self-care (Patsiopoulos & Buchana, 2011). That self-acceptance can prove vital for counselors, whose work often puts them at a risk for burnout (Yager & Tovar-Blank, 2007).

Counselor Burnout

Burnout is a multidimensional experience consisting of exhaustion, cynicism, and reduced professional efficacy that can result from dissatisfaction with the organizational context of the job position (Maslach, Schaufeli, & Leiter, 2001). Burnout can affect individuals in a variety of ways, with anxiety, irritability, fatigue, withdrawal, and demoralization as major examples (Schaufeli & Enzmann, 1998). Burnout can affect individuals at any point in their career and can hamper productivity and creativity, resulting in a reduction of compassion toward themselves and clients (Grosch & Olsen, 1994). “It is when counseling seems to have little effect that counselors reach despair because their raison d’être for choosing this work—to make a difference in human life—is threatened” (Skovholt, Grier, & Hanson, 2001, p. 171). Caring for others and caring for oneself becomes a difficult balance to achieve for both new and seasoned counselors alike. Carl Rogers (1980) wrote, “I have always been better at caring for and looking after others than I have in caring for myself. But in these later years, I made progress” (p. 80). Self-compassion can serve as a protective factor against such potentially debilitating effects of work-related burnout.

Historically, researchers examined the causes of burnout relating to demographic, personality, or attitudinal differences between individuals (Maslach et al., 2001). Today, burnout is viewed from an organizational standpoint and is concerned with the relationship, or fit, between the person and his or her environment, wherein mismatches can result in burnout over time (Maslach, Leiter, & Jackson, 2012). An individual’s perceptions have a reciprocal relationship with the work environment; how counselors make meaning of their work impacts their satisfaction, commitment, and performance in the workplace (Lindholm, 2003). Counselors experiencing work-related stress and burnout will construct meaning differently and require a tailored self-care plan that reflects their individual assessment of their own fit within their work environment.

Counselor Self-Care

Self-care can be defined as an activity to “refill and refuel oneself in healthy ways” (Gentry, 2002, p. 48). Self-care is vital if we are to remain effective in our role and avoid burnout; however, many counselors do not regularly implement the techniques they recommend to clients in their own lives (O’Halloran & Linton, 2000; Skovholt et al., 2001). Although self-care is widely promoted within the counseling literature, this author contends that inherent in many self-care plans and workplace improvement efforts is the idea that overwhelming work-related stress reflects an inadequacy of the individual. The message in the literature often reflects the view that a counselor’s distress hinges upon inadequate coping resources, poor health practices, or other kinds of personal failing, such as lacking assertiveness or not taking enough time off from work (Bradley, Whisenhunt, Adamson, & Kress, 2013; Killian, 2008; O’Halloran & Linton, 2000). As a result, self-care plans tend to take on the air of a New Year’s resolution, a strategy to get better. This narrow focus reflects the historical view of burnout that focused primarily on its individual dimension, without taking into consideration the organizational, interpersonal, or societal perspectives (Schaufeli & Enzmann, 1998). When self-care plans are written like self-improvement plans, the opportunities for criticism and judgment abound, particularly for new counselors who struggle with anxiety and self-doubt (Skovholt, 2012). When counselors are suffering, experiencing symptoms of burnout, struggling to maintain healthy professional boundaries (i.e., under- or over-involvement), or feeling as though they are not caring for themselves effectively, shame may cause them to be less likely to seek assistance (Graff, 2008). Some counselors may fear negative repercussions as a result of disclosure, such as being perceived as impaired or having professional competency problems (Rust, Raskin, & Hill, 2013).

Self-care is an ethical imperative (ACA, 2014), because utilizing self-care strategies reduces the likelihood of impairment (ACA, 2010). Issues in a counselor’s personal life, burnout in the workplace, mental or physical disability, or substance abuse can result in impairment (ACA, 2010). Sadly, in a survey completed in 2004, nearly two-thirds of participants knew a counselor that they would identify as impaired (ACA, 2010). Counselors who better manage their self-care needs are more likely to set appropriate boundaries with clients and less likely to use clients to meet their own personal or professional needs (Nielsen, 1988). Self-care education has been integrated into the accreditation standards for counselor training (CACREP, 2016), and there are multiple articles discussing how to incorporate the value of wellness and self-care into counselor education programs (Witmer & Young, 1996; Yager & Tovar-Blank, 2007). For counselor educators and supervisors, monitoring counselors-in-training for possible impairment is an important part of the responsibility of gatekeeping (Frame & Stevens-Smith, 1995). However, despite this attention, both students and practicing professional counselors still struggle to implement self-care (Skovholt et al., 2001; E. Thompson, Frick, & Trice-Black, 2011).

Bradley and colleagues (2013) suggested that many of the self-care suggestions in the literature are too general, focusing mainly on general health practices, such as eating healthily and getting enough sleep, or professional recommendations regarding seeking support from colleagues. A case can be made that a counselor would be better served by employing an overall approach to efforts that are based in a self-compassionate mindset. Therefore, actively seeking awareness of one’s own signs and symptoms that indicate suffering can not only help counselors recognize burnout, it also can provide clues toward the first step in soothing.

Mindfulness represents one possible means of increasing such awareness. Mindfulness allows the practitioner to be present in the moment non-judgmentally (Kabat-Zinn, 1994). To practice self-compassion, a counselor needs to be willing to attend to feelings of discomfort, pain, or suffering and acknowledge the experience without self-recrimination (Germer & Neff, 2015). Consider the experience of having a regular client stop attending sessions and returning calls or abruptly discontinuing services. Although common, the ambiguous loss of a connection with a client can be a source of stress and pain (Skovholt et al., 2001). It also can provide an opportunity. Covey (2010) shared the following quote that is often misattributed to Viktor Frankl: “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom” (p. VI). The space Covey describes is our opportunity to be mindful of the stimulus and choose to offer ourselves compassion in response. Choosing to deny, suppress, or distract to avoid these feelings may cause the counselor to miss the trigger to practice self-care. When such feelings are recognized, the counselor may act compassionately toward himself or herself by normalizing or validating the experience. Within self-compassion, the concept of common humanity becomes crucial to precluding the often-automatic tendency to become self-critical for experiencing discomfort (Neff, 2003). Thoughts such as, “I shouldn’t feel this way,” “Just snap out of it; it’s not so bad,” or “What’s wrong with me?” invalidate the sufferer and may cause the counselor to feel as though self-care is an act of indulgence rather than an essential, self-directed gift of kindness. Expressing kindness through self-care acknowledges that counseling can be both difficult and rewarding, a duality representative of the human condition.

When counselors choose to practice self-care, they enhance themselves and their practice. One participant in a narrative inquiry on self-compassion in counseling stated: “What’s so important about self-compassion? Three words: Avoidance of burnout” (Patsiopoulos & Buchanan, 2011, p. 305). Another participant noted, “When we come from a self-compassionate place, self-care is no longer about these sporadic one-time events that you do when you feel burned out and exhausted. Self-care is something you can do all the time” (Patsiopoulos & Buchanan, 2011, p. 305). The consequence of our job as counselors is working compassionately with suffering, and in doing so we suffer (Figley, 2002).

For someone to develop genuine compassion toward others, first he or she must have a basis upon which to cultivate compassion, and that basis is the ability to connect to one’s own feelings and to care for one’s own welfare. . . . Caring for others requires caring for oneself. (Germer & Neff, 2015, p. 48) Self-care, then, is a vital part of a counselor’s responsibilities to clients and to one’s self.

It is important to remember that counseling can be emotionally demanding for counselors in different ways (O’Halloran & Linton, 2000). Self-compassion encourages remembering the shared human experience (Neff, 2003), as the experience of being a professional counselor can be quite isolating, especially for those working in more independent environments (e.g., school counselors, private practitioners; Freadling & Foss-Kelly, 2014; Matthes, 1992). Using mindfulness, counselors can maintain an objective stance that can allow the counselor to view one’s work circumstances with a non-judgmental lens (Newsome, Waldo, & Gruszka, 2012), then act kindly to intervene with a self-care practice that is revitalizing to mind, body, and spirit. Using self-compassion tenets as a guide, self-care plans can be created that are authentic and kind, connect us to the human experience, and reflect a balanced state of self-awareness.

Creating a Self-Compassion–Infused Self-Care Plan

In wellness counseling, optimal functioning of the mind, body, and spirit is the goal for holistic wellness (Myers, Sweeney, & Witmer, 2001). The physical dimension is the most common focus for wellness intervention (Carney, 2007); however, this is quite limiting in a profession that is often sedentary, with long hours and pressure to meet productivity demands (Franco, 2016; Freadling & Foss-Kelly, 2014; Ohrt, Prosek, Ener, & Lindo, 2015). Maintaining one’s health is important but may not be enough to assuage the emotional demands of a high-touch profession in which a strong professional relationship is combined with the often-conflicting pressures of reimbursement; short-term, diagnosis-focused treatment; and behaviorally based outcomes associated with managed care (Cushman & Gilford, 2000; Freadling & Foss-Kelly, 2014). Developing a collaborative treatment plan is a common practice in counseling; it allows the counselor and the client to determine the possible direction and outcomes for their work together (Kress & Paylo, 2015). In the best case, this plan is individualized, specific, and open to revision when necessary. A good self-care plan can follow the same formula.

What follows are specific suggestions regarding self-care practices that stretch beyond the “should,” the “ought to,” and the New Year’s resolution language. When reading the interventions, consider the question Linder, Miller, and Johnson (2000) suggested for clients when encouraging self-care: “How do you reassure yourself?” (p. 4). The suggestions are organized into mind, body, and spirit; however, these are artificial divisions and some interventions may satisfy in multiple ways.

Interventions for the Mind

Mindfulness is a component of self-compassion, but it can also be used intentionally as a regular practice for self-care. Mindfulness can be described as a dispositional trait, a state of being and a practice (Brown, Ryan, & Creswell, 2007). The use of mindfulness has been integrated into many facets of counseling practice (I. Thompson, Amatea, & Thompson, 2014). For those attracted to the practice of mindfulness for self-care, non-judgmental awareness can be integrated as a practice (e.g., a set time for engagement in a particular mindfulness exercise) or as a way of being during particular activities within the day. Exercises such as mindful eating, maintaining sensory awareness while washing dishes, or mindful walking can be helpful for those who are looking for brief, everyday opportunities for self-care. Researchers I. Thompson and colleagues (2014) found that higher levels of mindfulness corresponded with lower levels of burnout. Mindfulness has been suggested as a beneficial way to teach self-care in counselor training (Christopher, Christopher, Dunnagan, & Schure, 2006), and also as a way to reduce stress and increase self-compassion in students training to be in helping professions (Newsome et al., 2012). For any number of reasons, not all counselors may find benefit in mindfulness practices; therefore, some may choose methods of self-care that are more mentally invigorating.

Intellectual stimulation in any endeavor is important to maintain engagement, interest, and enjoyment, but such motivation can be particularly helpful when a work position contains routine, mundane, or downright boring tasks. To create a stimulating work life, seasoned professionals find active ways to continue their professional development, which can decrease the boredom that can lead to burnout (Skovholt et al., 2001). Activities for growth and development can include learning something new within counseling or outside the profession, such as learning a new language, or how to make sushi, write code, or play a strategy game such as the ancient board game, Go.

The role of a counselor involves exposure to circumstances of human suffering, painful emotions, and heartbreaking situations, which increases the risk of burnout due to absorption of the clients’ pain (Ruysschaert, 2009). Finding a way to keep and maintain positive memories, cards and notes, compliments or successes—what this author terms warm and fuzzies—either personally or professionally, in a box, folder, jar, or bulletin board, can be a helpful response. Bradley and colleagues (2013) suggested tracking small changes made by clients when discouraged and sharing the progress with co-workers.

Writing can be a powerful intervention in a counseling setting and can benefit both mental and physical health (Pennebaker & Seagal, 1999; Riordan, 1996). Counselors can use the medium of writing in a multitude of ways. Whether through journaling, narrative, poetry, musical lyrics, or letters, the act of writing can reduce emotional inhibition (Connolly Baker & Mazza, 2004). Creative writing can be used to access the healing benefits of writing without worry about form or audience (Warren, Morgan, Morris, & Morris, 2010).

Warren et al.’s (2010) The Writing Workout is a way to express, validate, and externalize painful emotions. This wellness approach illustrates how creative writing for self-care can cultivate compassion. Narrative writing strategies can allow the writer to change the outcome of a lived experience or reframe a life experience (Connelly Baker & Mazza, 2004). Creating a narrative of an event can help the storyteller organize details and events, reflect and process thoughts and feelings, and derive meaning from experiences (Pennebaker & Seagal, 1999). A creative, mindful writing intervention could be used to examine a clinical situation that may not have gone as the counselor had hoped, or to creatively explore life lessons derived from a clinical encounter. For some clinicians, writing gives voice to emotions too raw to easily speak aloud (Wright, 2003).

Traditional journaling can allow for self-reflection, increased self-awareness, and growth (Lent, 2009; Utley & Garza, 2011). Journal writing can be inherently self-compassionate. Linder et al. (2000) discussed the use of a non-judgmental journaling practice in which there are no wrong words and writers are encouraged to use random sentences and words that do not make sense. Through almost nonsensical form, journaling offers a sense of safety and freedom, while creating a trusting relationship with the journal. Linder et al. (2000) stated, “Journaling finds the meaning in meaninglessness and negates the emptiness through creating writing from the heart. It is an outlet to tell the truth without being judged” (p. 7).

Beyond the traditional journal, counselors may find alternative ways to use journaling for emotional expression, such as use of bullet journaling or a personal blog online. Bullet journaling uses a rapid-logging approach, or a visual code, to represents tasks, events, and notes in a physical notebook (Bullet Journal, 2017). Keeping a bullet journal is a clever way of managing multiple arenas of one’s life in a single place, and the events and notes categories can be particularly helpful in the practice of journaling for self-care. Events are to be written down briefly and objectively despite the degree of emotional content they carry (Bullet Journal, 2017), offering an opportunity to practice the non-reactive skill of mindfulness (Kabat-Zinn, 1994). Once an event has been entered, the counselor can respond mindfully to it by writing at length on the following page. The notes category for bullet journaling consists of ideas, thoughts, or observations (Bullet Journal, 2017), which could include inspirational quotes, eureka moments, or other insights worth reviewing at a later date. The author can use signifiers (i.e., symbols) to create a legend to provide additional context for an event, note, or task. The bullet journal approach for self-expression exemplifies a creative twist on an old concept to better fit the preferences of the writer. Similarly, scrapbook journaling can be used to accommodate the types of expressive media that resonate with the counselor’s personal style or interests (Bradley et al., 2013). Counselors can use photos, poems, song lyrics, and quotes to reflect their emotional state, and then reflect on the emotional patterns or themes that arise. For counselors who prefer to share their thoughts on the Internet, an online blog can be a cost-effective, accessible medium to express oneself emotionally and share thoughts, feelings, and experiences with others (Lent, 2009). Counselors should consider the risks associated with the use of the Internet and maintenance of confidentiality in an online medium in accordance with the ACA Code of Ethics (2014).

Finally, a simple self-care intervention can involve writing oneself a permission slip or prescription for something. This could be the permission to be imperfect, to take a mental health day, or to run through a sprinkler on a hot day. A writing assignment of this sort expresses kindness in providing the very thing that is needed for an emotional recharge. In some cases, this may involve taking a quiet moment to allow one’s mind to wander. This can occur during a warm bath or shower at the end of the day or while savoring a warm cup of coffee or tea in the afternoon. Although mind-wandering can be a threat to effectiveness and productivity when it occurs at inopportune times, taking time for mind-wandering can relieve boredom, stimulate creative thoughts, and facilitate future planning (Smallwood & Schooler, 2015).

Interventions for the Body

Many self-care plans begin and end with a strong concentration on physical self-care, typically involving making nutritional changes and increasing physical activity (Bradley et al., 2013; E. Thompson et al., 2011). These therapeutic lifestyle changes (TLCs) can have a huge impact on health and well-being (Walsh, 2011). Although the mental health benefits of these types of changes are well documented (Walsh, 2011), a myopic focus on physiological wellness may be limiting, and self-care should include a broader range of ways to cope (E. Thompson et al., 2011). For individuals wishing to focus specifically on such changes, using the imagery of caring for oneself as one does a plant may increase self-awareness of bodily self-care needs (Bradley et al., 2013). Considering one’s needs in this metaphorical way may help counselors increase their own self-compassion by considering their unique needs and the changes they are ready and willing to make. A counselor may indicate they require shade from the sun, which could represent reducing over-stimulating environments; good spacing from other plants, indicating healthy boundaries or alone time; and water and nutrients, which may remind the counselor to keep a pitcher of water on the desk and a bag of almonds in a drawer. Externalizing in this way can be particularly helpful when learning self-compassion because often counselors find it easier to care for others than themselves (Patsiopoulos & Buchanan, 2011).

Although exercise has clear mental health benefits (Callaghan, 2004), for some the concept of exercise may lack appeal or may prove difficult to prioritize within a daily work schedule. The use of stretching, walking, or yoga for a short amount of time may be more easily integrated into a hectic schedule. Yoga has been found to be equivalent to exercise in many mental and physical health domains, but not all types of yoga have been found to improve overall physical fitness as compared to more rigorous exercise (Ross & Thomas, 2010). The practice of yoga has been found to increase acceptance of self and others and reduce self-criticism (Valente & Marotta, 2005). Further, the regular practice of yoga can “provide therapists with a discipline capable of fostering a greater sense of self-awareness and helping to develop a lifestyle that is conducive to their own personal growth and the goals of their profession” (Valente & Marotta, 2005, p. 79).

The benefits of movement go beyond improvements in cardiac and musculoskeletal health, while serving to benefit the mind and the spirit. Dance has been used for centuries as a healing practice (Koch, Kunz, Lykou, & Cruz, 2014) and reduces stress, increases stress tolerance, and improves well-being (Bräuninger, 2012). Marich and Howell (2015) developed the practice of dancing mindfulness, which utilizes dance as the medium for practicing meditation. Dancing mindfulness participants report improvement in emotional and spiritual domains, greater acceptance of self, and an increased ability to use mindfulness in everyday life (Marich & Howell, 2015). However, caring for oneself requires more than just nutrition and movement; self-care plans should metaphorically consider the environment.

Skovholt et al. (2001; Skovholt, 2012) uses the concept of a greenhouse to describe the characteristics for a healthy work environment. Plants flourish within a nurturing greenhouse environment. Likewise, counselors thrive within a work environment that is characterized by a sense of autonomy and fairness; growth-promoting and meaningful work; reasonable expectations and remuneration; and trust, support, and respect among colleagues (Skovholt, 2012). The metaphorical work “greenhouse” contains individualized supports and resources that allow for growth and rejuvenation, but can protect the counselor from the harshness that could characterize their work. Examining and adjusting factors that may be under the counselor’s control, such as breaks between clients; scheduling of clients engaged in trauma work; number of assessments, intakes, or group sessions in one day; or other malleable elements can help create a work day that best meets the needs of the counselor. Strategic planning and focused intentionality allows the counselor to engage fully in each client encounter.

Interventions for the Spirit

Religion and spirituality are important factors within the lives of many clients (Cashwell, Bentley, & Bigbee, 2007). Within the United States, 77% of adults identify with some religious faith (Masci & Lipka, 2016). However, the United States is growing in those who identify as spiritual, with 59% of adults reporting a regular “deep sense of ‘spiritual peace and well-being’” (Masci & Lipka, 2016, para. 2). To attend appropriately and fully to clients’ religious and spiritual needs, counselors also need to care for their own spiritual selves.

Humanistic counselors engage fully with clients to create a genuine connection and are most effective as helpers in areas in which they themselves are stronger and more grounded (Baldwin, 2013). Therefore, when addressing the spiritual concerns of a client, counselors need to be aware of where they are on their own spiritual path. Otherwise, there is no assurance their own religious or spiritual concerns will not create an obstacle for their client’s growth (Sori, Biank, & Helmeke, 2006). A counselor’s spiritual concerns can influence the therapeutic alliance in many ways. Influences can include increased reactivity to the spiritual concerns of the client, decreased recognition of how the client values personal spirituality, or inattention to how the client’s spirituality may be a therapeutic resource or contributing factor to distress (Sori et al., 2006). Sori and colleagues (2006) concluded that failure to be aware of spirituality as an aspect of the human condition can create potential boundary issues, limit a counselor’s understanding of the client due to unexamined beliefs rooted in one’s own spiritual background, and result in difficulty managing the emotional uncertainty and pain of clients due to the counselor’s own struggles with faith. Therefore, engaging in reflection, exploration, or a regular spiritual practice can benefit both the counselor and the client.

Spirituality in counseling has been defined as “the capacity and tendency present in all human beings to find and construct meaning about life and existence and to move toward personal growth, responsibility, and relationship with others” (Myers & Williard, 2003, p. 149). This definition conceptualizes spirituality as a central component of wellness that shapes one’s functioning physically, psychologically, and emotionally, not as separate parts of the whole being (Myers & Williard, 2003). Valente and Marotta (2005) asserted that a healthy spiritual life can be emotionally nourishing and keep burnout at bay. Further, greater self-awareness of one’s spirituality may allow practitioners to be more present with their own suffering and that of their clients. Chandler, Miner Holden, and Kolander (1992) stated that attending to spiritual health when making personal change toward wellness will increase the likelihood of self-transformation and greater balance in life. Because there are many expressions of spirituality, individuals wishing to incorporate spirituality into their self-care plan should consider choosing activities that align with personal goals and are consistent with their values (Cashwell et al., 2007).

A spiritual self-care practice can create an inner refuge (Linder et al., 2000) that can offer sanctuary for a counselor when overwhelmed by personal or professional suffering (Sori et al., 2006). Particularly for those in the exploration phase of their own spirituality, but beneficial for all, conducting a moral inventory can assess how individuals are living in accordance with personal beliefs and values (Sori, et al., 2006). Following the moral inventory, a counselor may create a short list of principles to live by (i.e., a distilled list of values consistent with religious and spiritual ideas that are particularly personally valuable; V. Pope, personal communication, August, 2016). Individual research or joining a spiritual community can be helpful for education, support, and guidance in learning more about a particular religious or spiritual tradition (Cashwell et al., 2007). Some religious traditions, such as Seventh-Day Adventists, offer guidelines for physical and mental exercises, as well as nutritional advice that can be translated into intentional counselor self-care practices. Seventh-Day Adventists have a strong focus on wellness and advocate a vegetarian diet and avoidance of tobacco, alcohol, and mind-altering substances (General Conference of Seventh-Day Adventist World Church, 2016). Further, self-reflection may be regularly incorporated into rituals associated with an important time of year such as Lent or the Days of Awe.

For many, prayer can be a powerful practice for connecting with a higher power. Prayer is an integral part of a variety of spiritual traditions and has been associated with a variety of improvements in health and well-being (Granello, 2013). Spending time in communion with a higher power can be integrated into a regular routine for the purpose of self-care. Meditation also can be a spiritual practice and has a long history of applications and associations with health improvement (Granello, 2013). Broadly speaking, there are two types of meditation: concentration, which involves focusing attention (e.g., repeating a mantra, counting, or attending to one’s breath), and mindfulness, which non-judgmentally expands attention to thoughts, sensations, or emotions present at the time (Ivanovski & Malhi, 2007). These quiet practices can allow the participant moments of silence to achieve various ends, such as relaxation, acceptance, or centering.

Connecting with the earth or nature also can be a practice of spiritual self-care. Grounding exercises such as massage, Tai Chi, or gardening can be helpful to encourage a reconnection with the body and the earth (Chandler, et al., 1992). Furthermore, spending time in nature has been found to be rejuvenating both mentally and spiritually (Reese & Myers, 2012).

Engaging in a creative, expressive art activity for the purposes of spiritual practice and healing can be incredibly powerful to heal mind, body, and soul (Lane, 2005). Novelist John Updike has said, “What art offers is space—a certain breathing room for the spirit” (Demakis, 2012, p. 23). Art can come in many forms. Expressive arts can be a powerful tool of self-expression (Snyder, 1997; Wikström, 2005) and provide many options that can easily be used as self-care interventions. Sometimes the inner critic, need for approval, fear of failure, or a fear of the unknown can create barriers to exploring one’s creative energy (N. Rogers, 1993). Maintaining a self-compassionate attitude can allow counselors to create a safe environment to practice self-care free of judgment.

Use of dance, music, art, photography, and other media can be used intentionally for holistic healing. Through the use of clay, paint, charcoal, or other media, the creator can become in touch with feelings, gain insight, release energy, and discover alternative spiritual dimensions of the self, as well as experience another level of consciousness (N. Rogers, 1993). Music has been found to be both therapeutic and transcendental (Knight & Rickard, 2001; Lipe, 2002; Yob, 2010). There are various ways to incorporate music into a self-care plan depending on interest, access, and preference. In many cultures, music and spirituality are integrally linked (Frame & Williams, 1996). Listening to a favorite hymn, gospel music, or other type of liturgical music can be one way to revitalize the spirit during the workday. Relaxing music has been found to prevent physiological responses to stress and subjective experience of anxiety in one study of undergraduates (Knight & Rickard, 2001). Singing is another way of expressing thoughts and feelings, and for some it can provide a vehicle for self-actualization, connection to a higher power, and self-expression (Chong, 2010). After a long day, singing in the office, in the car, or while cooking dinner can be particularly cathartic.

Conclusion

Counselors are routinely exposed to painful situations, traumatic circumstances, and overwhelming emotions. Consequently, they could benefit from creating a safe place for vulnerability, especially when emotionally overwrought after a long day or a particularly difficult counseling session. To thrive as a counselor, self-care is essential, yet many struggle to care for themselves as they care for their clients. To best achieve holistic wellness, counselors must incorporate interventions for the body, mind, and spirit. Counselors can apply self-compassion principles to the creation of an individualized self-care plan, one that functions to rejuvenate flagging professional commitment and soothe potentially debilitating stress. By cultivating an attitude of self-compassion, counselors may be more attentive to their own needs, reducing the risk of developing burnout and benefitting both clients and themselves. These counselors also may be more effective in assisting clients with overcoming their own barriers to self-care. Similarly, counselors who serve as educators or supervisors can model such principles and routinely ask students and supervisees, “What do you need now?” to increase awareness and the practice of tuning in. Consequently, the self-compassionate counselor learns to create a self-care plan that becomes a balm for burnout.

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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Susannah C. Coaston is an assistant professor at Northern Kentucky University. Correspondence can be addressed to Susannah Coaston, 1 Nunn Drive, MEP 203C, Highland Heights, KY 41099, coastons1@nku.edu.