Broaching Race, Ethnicity, and Culture: Examining Counselor Trainees’ Growth Through Experiential Training

This pilot study examined social justice identity development for first- and second-year clinical and school counseling master’s students enrolled in a one-semester multicultural and social justice counseling (MCSJC) course. Counselor educators can incorporate social justice pedagogy in their courses to better equip counselors-in-training with the knowledge and skills necessary to act (Odegard & Vereen, 2010), which can foster the development of their social justice identities (Miller et al., 2009). Students enrolled in the MCSJC course reported their social justice identity at the beginning and end of the semester to determine identity development over time. In addition, pedagogical strategies were evaluated for their impact on identity development. Significant increases in social justice identity domains were found, with group differences based on year and track in the program. This study identified pedagogical strategies, such as cultural immersion activities, small group discussion, and guest speakers, that fostered students’ social justice identity development. What is the public significance of this article? This study suggests that social justice identity can be developed during a semester long, masters-level multicultural and social justice counseling course. Counselor educators can consider effective and intentional ways to incorporate various pedagogical strategies in their curriculum to foster the growth of students’ social justice efficacy and engagement, and the present study offers empirically-based evidence of such effective pedagogy.

This study examined the relationship between enrollment in online counseling courses and students' counseling self-efficacy beliefs. Results indicate that students enrolled in online courses report statistically significant higher self-efficacy beliefs than students in traditional FTF courses. Implications for research and training instruction are discussed.In recent years, the increasing popularity of online instruction has dramatically changed the delivery of college curricula nationwide (Artino & McCoach, 2008). The growing popularity of this medium has led some (Keeton, 2004; Tallent-Runnels et al., 2006) to project that online education will soon become the largest source of higher education in America. According to a recent study conducted at over 2,500 colleges and universities nationwide, approximately 5.6 million students were enrolled in at least one online course during the 2009 fall semester (Allen & Seaman, 2010). This figure, as noted by Allen and Seaman, represents a 21 percent increase over the number reported the previous year, the largest ever year-to-year increase in the number of students studying online. The increased student interest in online course delivery has led more and more institutions to look into adopting online instruction as the next logical step in educational delivery systems (Bejerano, 2008; O'Malley & McCraw, 1999). Highlighting this trend, 66 percent of the 4,160 degree granting postsecondary institutions in the nation offered college-level courses via online instruction during the 2006-07 academic year (National Center for Education Statistics, 2008). Only recently has this trend carried over to the field of counseling and counselor training (Albrecht & Jones, 2001; Benshoff & Gibbons, 2011; Chester & Glass, 2006).Despite the growing interest from students in online course delivery, counselor educators traditionally have been hesitant to incorporate online learning into the counselor education curriculum (Greenidge & Daire, 2005; Karper, Robinson, & Casado, 2005). Both best practice considerations and the questionable research supporting the effectiveness of online instruction have played a role in explaining the hesitancy to apply components of online learning in counseling education and practice (Granello, 2000; Krieger & Stockton, 2004). According to Murphy, MacFadden, and Mitchell (2008), several educators have questioned whether online education is appropriate for the clinical professions where the development of basic relationship-building skills is a key curricular component. One of the common concerns often voiced has been whether or not skills-based or techniques courses could be offered sufficiently online (Wantz et al., 2003). The fundamental argument of these counselor educators is that the personal, high touch nature of counseling cannot adequately be simulated at a distance. However, this perspective appears to be changing slightly. While most counselor education programs have long espoused traditional, face-to-face (FTF) didactic instruction, Quinn, Hohenshil, and Fortune (2002) noted that a growing number have come to realize that the integration of technology and online instruction into their curriculum is essential in order to remain competitive.As a result of this shift in thinking, there is now a growing interest in the use and practicality of online instructional approaches in graduate counselor training programs (Benshoff & Gibbons, 201 1; Clark & Stone, 2002; Hayes & Robinson, 2000; Patrick, 2005). Several authors describing the effective implementation of online education have begun publishing their work in the counselor training literature. Translating theory into practice, complete online accredited programs have begun emerging nationwide. A review of the Council for the Accreditation of Counseling and Related Programs (CACREP) website indicates online accredited programs existing in a variety of programs including clinical mental health counseling (Adams State University, Capella University, Wake Forest University, Waiden University); community counseling (Regent University); school counseling (Adams State University, Capella University, Regent University, Wake Forest University); marriage, couple, and family counseling (Capella University); and counselor education and supervision (Regent University). …

Survey of AuD students confirms need for counseling as part of audiologistʼs training

Even the best amplification technology is rendered useless when patients do not accept their hearing loss or when they resist improving their situation. Audiologists are ideally positioned to provide the psychological and emotional support that patients need as they progress through the help-seeking process. However, most audiologists have not received training in counseling. Because of the impact that hearing loss has on self-concept and interpersonal relationships, audiologists are generally aware that they must attend to each patient's psychological and emotional states.1–3 They know they must ask questions such as, is the patient uncomfortable asking for help? Is he self-conscious about his body image? Does she prefer the status quo to the discomfort involved with change? Is he experiencing family or occupational stress because of hearing loss? Is she angry, upset, withdrawn, overwhelmed, or depressed because hearing loss has adversely affected her life? Audiologists must not only note these reactions in patients, but also respond to them. The appropriate re-sponse will help patients address their fears, work through self-imposed barriers, and “choose growth.”4 Ineffective responses, of course, will leave the patient even more upset, more angry, and more determined to reject help. The process of recognizing and responding to these reactions in a supportive manner is the essence of “audiologic counseling.”5 Counseling is an acknowledged part of the audiologist's scope of practice.6 However, master's level training programs in audiology have usually not addressed the development of counseling skills. In 1986, McCarthy, Culpepper, and Lucks found that only 12% of audiology programs reported requiring counseling coursework.7 Little change was noted in follow-up studies in 1994 and 1997.8,9 Yet, when students were required to take a counseling course, most of them indicated receiving a moderate to major improvement in their counseling ability.10,11 In the last few years, the number of doctor of audiology (AuD) programs has increased dramatically. The purpose of this study was to answer two questions: (1) How many AuD programs include audiologic counseling in their curricula, and (2) what are the learning objectives of the courses offered? The latter question was posed to describe overall trends in course instruction. METHODS Our project consisted of two phases. Phase1: A review of web sites We first reviewed a web site (www.asha.org/gradguide) that lists all programs accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). At that time (September 2004), the web site listed 56 universities offering the AuD degree. We excluded programs with “candidate” status from the review. We then examined these 56 universities' web sites to determine if a counseling course was required in their AuD program. Because web site information can be incomplete or out of date, we also telephoned all the programs whose site did not mention a counseling course to confirm that none was offered. Although we made several attempts, we were unable to obtain information from five programs. The results are represented in Figure 1: Of the 56 AuD programs operating at the time, 40 (71%) indicated that they required a counseling course. In addition, eight programs (14%) reported that, although they did not require a specific counseling course, they had actively integrated counseling into other courses (e.g., aural rehabilitation or educational audiology). Two programs (4%) did not require a course, but recommended it as an elective. One program (2%) required no course, had not actively integrated counseling into other courses, and had not recommended a course as an elective. As mentioned above, no information could be obtained from five programs (9%).Figure 1: How counseling is taught in 56 AuD programs.To summarize, 85% of the AuD programs either required a class in counseling or incorporated counseling content into other courses. This represented a marked increase in counseling classes from earlier reports. It appears that the shortcomings in counseling training reported by Culpepper et al.8 and others are being addressed. Phase 2: A survey of instructors During September-November 2004, we e-mailed or called the 40 programs that reported requiring a counseling course to obtain the name of the course instructor. We then contacted instructors by e-mail with a request to send their stated learning objectives from course syllabi. We sent one follow-up request to non-responding departments or instructors. Twenty-one instructors (52%) responded. Seven instructors indicated that their course, although “on the books,” had not yet been taught, and therefore learning objectives had not been developed. One instructor submitted a syllabus that did not include learning objectives. The remaining 13 instructors provided a total of 82 learning objectives. We analyzed these learning objectives as qualitative data, using the “grounded theory method” as described by Have.12 The grounded theory method uses concurrent sampling and analysis, constant comparisons, and theoretical sampling. Constant comparisons are done by comparing data from different subjects, comparing data with an emerging category, and comparing a specific category with other categories. Comparisons are made until saturation occurs and recurring themes are identified. We analyzed course objectives using a file-card system. Each objective was written on individual file cards and reviewed to identify recurring themes, which were used as coding strategies. We organized the file cards by coding categories in order to identify the most prevalent objectives in counseling courses. We independently analyzed data to identify recurring themes, and then compared results in order to achieve joint agreement concerning emerging themes. This last process, called “triangulation,” provides a method of validating information by having multiple data sources, methods, investigators, or theories.13 RESULTS This qualitative analysis of 82 learning objectives indicated a strong consensus among instructors regarding course content. We discarded four learning objectives as lacking a strict application to personal adjustment counseling (e.g., conducting an aural rehabilitation assessment). From the remaining 78 learning objectives, four themes emerged: (1) the pyscho-emotional effects of hearing loss, (2) counseling theories, (3) counseling skills, and (4) the role of the audiologist in counseling. Additionally, one minor theme (less frequently reported, but not rare enough to be considered an outlier) also emerged: understanding a culturally diverse population with respect to disability, the role of the health professional, and interpersonal communication behaviors. The five themes are developed below with composite learning objectives: (1) Students will describe the psychological, emotional, and social effects of living with impaired hearing. Concepts include: denial, grief and loss, self-concept, impact on family, life-span concerns, locus of control, social isolation, defense mechanisms, coping mechanisms, empathy. (2) Students will compare and contrast current counseling theories, provide historical perspectives, and apply these theories to audiologic practice. Concepts include: behavioral therapy, person-centered (humanist) therapy, rational-emotive behavioral therapy, narrative therapy, Erickson's theory of cognitive-emotional development, existentialist therapy, family systems therapy, Kubler-Ross's theory of the grief cycle, the help-seeking process. (3) Students will demonstrate a set of effective counseling skills via role-playing, self-reflective journaling, video self-monitoring, and/or peer or instructor evaluation in simulated or actual clinical situations. Skills include: recognizing patient reactions and responding with affirmations, reflective or active listening, paraphrasing, or clinical silence; effective interviewing (when to use different types of questions); group counseling; promoting acceptance and growth; conveying difficult news; identifying and avoiding communication mismatch; recognizing crisis; developing awareness of one's own reactions and responses; using appropriate and inappropriate reassurance; using self-assessments as counseling tools. (4) Students will define the role of the audiologist in counseling. Concepts include: patient-practitioner dynamics, ethics, the role of helper, professional boundaries, knowing when to refer to professional counselors, referring for genetic counseling, recognizing one's own stress responses, professional burnout, the difference between professional and non-professional counseling. (5) Students will describe differences observed among Western and non-Western cultures, and describe how audiologic counseling should be modified accordingly. Concepts include: non-Western cultures' perceptions of disability, the role of the healthcare professional, family roles, etc.; non-Western cultures' communication styles and their impact on counseling efforts; developing relationships among members of the cultures served to ask for information on how best to be of help. SUMMARY By the end of 2004, most audiology doctorate programs had incorporated counseling training into their curricula either by requiring a course specializing in this content or by integrating counseling content into existing courses. This represents a substantial change from the days when few master's degree programs in audiology provided any preparation in counseling. A review of the learning objectives generously shared by course instructors indicates a strong consensus about course content and expected student outcomes. Although these learning objectives represent only one-third of programs requiring counseling courses, this level of consensus is noteworthy since it evolved in something of a vacuum, that is, without formal discussion among instructors or published standards for desired student outcomes. Still to be determined is the student perspective. What are the concerns of AuD students about interacting with, communicating with, and counseling patients and their families? Is there a possible mismatch between student needs and instructional goals? To find out, a follow-up study is being conducted to determine students' learning objectives in the area of audiologic counseling.

The multicultural counseling course attended by counselor trainees is expected to enrich their multicultural experience through the academic environment, as they come from different backgrounds and personal multicultural experiences. While most multicultural counseling courses focus on the three components of multicultural counseling competence, counselor trainees should be provided with more multicultural exposure and interactions during classes to develop skills to work with diverse clients. Therefore, this descriptive-correlational study explores the relationship between multicultural experiences (personal and academic) and multicultural counseling competencies (self-reported and observer-rated) among Malaysian counselor trainees. All four instruments had been adapted and translated into the Malay language before being completed by 208 randomly selected counselor trainees. This study reported that counselor trainees scored at low levels of personal multicultural experience, high levels of academic multicultural experience, moderate levels of self-perceived multicultural counseling competence, and high levels of observed multicultural counseling competence. The findings showed no significant relationships between personal and academic multicultural experience and self-perceived and observed multicultural counseling competence. In conclusion, the findings imply that there are practices of experiential pedagogy in delivering multicultural counseling courses in counselor education programs. However, more research is needed to identify the underlying variables, such as counseling self-efficacy or self-introspectiveness, which may link the study variables, as this will serve as the most critical aspect in sustaining the counselor trainees’ multicultural counseling competencies.

Purpose Counselling is one of the eight pillars of clinical practice for speech-language pathologists, but training varies across programmes and practising speech-language pathologists feel unprepared to deliver counselling in clinical practice. This study examined the perspectives of speech-language pathologists working in rehabilitation contexts within the US. Method An online survey was distributed to speech-language pathologists working in rehabilitation contexts, eliciting 93 respondents. Quantitative data were characterised using descriptive statistics. Result Only 47% of respondents had taken a counselling course as a graduate student of which 82% were within a speech-language pathology graduate program and 19% were outside of their graduate training program. Forty-two percent who had not taken a course indicated that counselling was embedded in other graduate coursework. Sixty-six percent of respondents had not taken continuing education or additional training in counselling as a practising speech-language pathologists. Across all training, 75% of respondents had no hands-on training or practise in counselling. Most respondents had no training in specific counselling techniques. Conclusion Because only half of rehabilitation speech-language pathologists report taking coursework in counselling within their graduate training, their readiness for implementing counselling in practice is suspect. Limited access to professional development training in counselling further limits this capacity. More consistent counselling training within graduate programmes and continuing education is necessary.

Counselors need to learn how to effectively and respectfully enter into communities hit by disasters and create collaborative partnerships with community members. Using critical consciousness theory, the authors describe a humanistic, culturally responsive approach to disaster response counseling for marginalized individuals and communities and discuss empowering clients through culture‐centered interventions and providing social justice advocacy.

The process of addressing ethical perplexities is challenging and there is insufficiency of clear solutions and proper resources to resolve the ethical quandaries. Thus, this study aims to identify the greatest predictor of trainee counselors’ self-efficacy in addressing ethical perplexities. The greatest predictor of self-efficacy is expected to enhance the existing counseling ethics education curriculum and pedagogy. A quantitative methodological approach was administered through questionnaires. There were 148 trainee counselors selected through simple random cluster sampling and they were all students from private universities in Malaysia. The data gathered were analyzed using correlation and multiple regression analyses. Correlation analysis recorded the highest coefficient of r value which was a substantial relationship between self-efficacy and multicultural competence. Next, multiple regression analyses indicated that the three predictors which are multicultural competence, religiosity, and spirituality were predictive of self-efficacy. However, the strength of prediction varied. Multicultural competence had the most powerful prediction on trainee counselors’ self-efficacy, followed by spirituality, and religiosity. These findings revealed the importance of the three predictors in enhancing trainee counselors’ self-efficacy, addressing ethical quandaries, and developing pedagogic counseling education. The process of preparing and developing intuitive counseling professionals is worthy of attention in the counseling training and practice, specifically in addressing ethical perplexities. Thus, the three predictors should be integrated into the counselor education curriculum and pedagogy at all levels. Cultivation of these three predictors in all trainee counselors would build their level of self-efficacy and help in their survival during counseling dilemmas, leading to successful counseling sessions.

The development of empathy in students on a short, skills based counselling course: a pilot study

This article offers suggestions and resources for infusing information about working with gay, lesbian, and bisexual clients into a counselor education curriculum or for use in one's professional development as a counselor. Information is provided for core counseling areas and clinical instruction.

This phenomenological study explores school counselors in training (SCITs’) experiences addressing social determinants of health (SDOH), the leading causes of educational and wellness inequities. Interviews with eight SCITs revealed three core themes: (1) professional identity conflict between awareness, skills, and action; (2) social justice knowledge to practice gap; and (3) recommendations for knowledge to practice gap resolution. Themes explained participant preparedness for responding to disparities. Participants were aware of challenges related to SDOH, though struggled with addressing those challenges due to lack of preparation or perceived role constraints. Participants also experienced difficulty practically applying their understanding of social justice theory to SDOH-related challenges. The researchers noted various recommendations for how SDOH may be addressed in the counselor education curriculum and in practice.

Multicultural experiences can be conceptually connected to counsellor trainees' perception of the multicultural exposure and interaction that they experienced during the multicultural counselling course. The degree of counsellor trainees multicultural experience may reflect the status and focus of the multicultural counselling course. Therefore, the objective of this study is to investigate the factor structure, reliability, and validity of the Malay version of the MCREI. There are 205 counsellor trainees from local universities who completed the questionnaire. Based on factor analysis, the four-factor structure, the same as the original version was confirmed with 12 items were retained. For reliability, internal consistency and construct reliability were evaluated and confirmed. The finding showed that the internal consistency was ? = .842 and construct reliability of .837. The convergent validity value obtained from the confirmatory factor analysis was .574. In addition, an external validity value is also provided. Overall, the factor structure, reliability, and validity of the Malay version of the MCREI were all confirmed in this study. The high reliability and proven validity imply that MCREI can successfully be used by counsellor trainees across gender and ethnicity.

The counsellor trainees’ self-efficacy is indirectly influenced by what they have experienced in their personal or academic lives, and the experience does contribute to their knowledge, beliefs, and attitudes. Nevertheless, sufficient evidence to elaborate on the reciprocal interactions in the context of counselling is still limited. Therefore, this descriptive-correlational study intends to investigate the connection between Malaysian counsellor trainees’ perceived multicultural counselling competence and self-efficacy and their personal and academic multicultural experiences. All four instruments had been adapted and translated into Malay before being completed by 208 randomly selected counsellor trainees. According to the study’s findings, counsellor trainees scored high on academic multicultural experience but low on personal multicultural experience. They also gained high scores for multicultural counselling self-efficacy and moderate perceived multicultural counselling competence. Importantly, findings revealed substantial correlations between perceived multicultural counselling competence and self-efficacy with academic multicultural experience. Overall, the finding highlights the practice of experiential pedagogy in the multicultural counselling course and encourages collaborative efforts involving faculty members and programme providers in developing and sustaining students’ or counsellor trainees’ multicultural counselling competency and self-efficacy growth.

Psychotherapy clients often hold multiple and varied cultural identities, and it is important for therapists to attend to the intersectionality of clients' cultural identities, as well as the saliency of these identities. However, to date, few studies have considered the saliency of clients' multiple identities and how this may impact clients' perceptions of cultural processes in therapy. Therefore, this study utilized polynomial regression and response surface analysis to operationalize and examine congruent and discrepant effects between the saliency of clients' multiple identities and their perceptions of their therapists' cultural humility and cultural missed opportunities. Data for this study consisted of 87 clients who received individual counseling services at either a university counseling center or training clinic at two large universities in the United States. As hypothesized, results indicated significant discrepant effects between the saliency of clients' first and second most important cultural identities and perceptions of their therapists' cultural humility and cultural missed opportunities. Specifically, clients' ratings of their therapist's cultural missed opportunities were lowest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. Similarly, clients' ratings of their therapist's cultural humility were highest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

LGBTQ cultural competence for pharmacists