Happy to be a Lunk

Lunk. Meathead. Brute. Neanderthal. Vain. Dumb. 

These are all words I have heard associated with bodybuilding and weightlifting, from “outsiders.” This irks me dearly. Just the other day, a coworker had stated that, “Bodybuilders are just people who were teased a lot as a kid. There is something wrong with them.” Of course, this was coming from someone who doesn’t know what it’s like to lift until fatigue sets in, manipulating macros in order to effectively fuel the body, the inching into a tub of hot water and Epsom salt in order to soothe muscles, nor the deliciousness of not-so-delayed onset muscle soreness…the lovely DOMS we chase with fervor. 

Granted, I am not pursuing a bronze statue, but still…it seems rather hurtful to hear these words when they are associated with something I enjoy, admire, and pursue learning with a hunger that is unquenched. Why are certain passions embraced by mainstream society, whereas others are looked down upon? Perhaps it stems from the perceived notion that those who work on their physical bodies are lacking in the mental capacity, as they spend their lives in the gym. Or does it stem from the idea that they are vain and only care about their outside appearance? Granted, there are some dim bodybuilders who follow bad technique and advice, but the same can be said about those choose more mainstream hobbies and careers. There is even prejudice between "fitness" centers, in which one hosts weekly pizza events and prohibits grunting when lifting. Even employing a "Lunk Alarm" and shuns bodybuilders from using their equipment. 

If I had my way, I would do nothing but lift…and lift HEAVY. However, my personal goals include the need for the dreaded cardio, so I compromise and do both. Aside from the changes I have seen in my body, the wealth of knowledge I have gained by researching certain techniques and trying new recipes keeps me motivated, as I thrive on learning. When people learn that I do food prep for the whole week, weighing and measuring each serving prior to storing…they say they would get bored and that I have a problem. Perhaps. Nevertheless, why is eating at fast food “restaurants” and playing video games accepted more readily in society, and the pursuit of healthful goals are berated? 

I will gladly remain an outlier of society. 

Antwone Fisher: An examination of personality through two lenses

Who is Antwone Fisher?

            The 2002 film, Antwone Fisher highlights the plight of a U.S. Navy enlisted sailor who is at risk of receiving a dishonorable discharge due to his behavior and unsuitability to serve in the military. With the help of a Navy psychiatrist, which was part of the Court Martial ruling, a reluctant Antwone is able to start opening up and sharing the secrets he has kept inside for the majority of his life.

            Antwone discloses that he was born behind bars, to a mother who never claimed him after her release, and his father was killed two months before he was born. Antwone grew up in the foster care system, where he witnessed his foster brothers being physically abused by their foster father. Antwone also experienced abuse as well, but from his foster mom as well as sexual abuse by another female figure in the house by the age of six years.

            The lashing out and excessive physical aggression, combined with running away from issues has been Antwone’s motive operandi in the past. These coping mechanisms may have evolved from childhood experiences and may have been instrumental to his survival during traumatic experiences; however, they prove to be problematic as an adult.

Trait theory evaluation of Antwone

            A common evaluative tool used among trait theorists is the Five-Factor Model, developed by Robert McCrae and Paul Costa, which include neuroticism, extraversion, openness, agreeableness, and conscientiousness (Schultz & Schultz, 2009). According to the model, Antwone would score high in neuroticism due to his aggressive displays when receiving a perceived threat, however, he would also score relatively high in openness, as he took it upon himself to learn Japanese and hone his drawing abilities, indicating a level of creativeness within his tough outer shell he shows to those in his life. Trait theorists posit that people who score high on a trait are able to manifest the trait-related behavior with little situational stimulation (Marshall & Brown, 2006). Such a belief would support the placement of Antwone in the neuroticism category, as the smallest perceived slight by another would be enough to elicit an aggressive response.

            A contributing factor to Antwone’s maladaptive behavior may lay in trait aggressiveness, which refers to a disposition to behave aggressively across various situations, with the latter being key, as trait theorist suggest that one’s personality is relatively stable and life-long. Aggressiveness has been evaluated with the use of a questionnaire (Young Schema-Short Form), and addresses 15 different aspects of life, with five relating in particular to the behaviors exhibited by Antwone. These categories include abandonment/instability (the perception of instability or unreliability of significant others for providing support and concern), mistrust/abuse (the expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate or take advantage and the perception that the harm is intentional or due to negligence), emotional deprivation (the expectation that emotional support in the form of nurturance, empathy, and protection will not be provided by others), defectiveness/shame (the feeling that one is defective, bad, unwanted, inferior, or invalid or unlovable to significant others if exposed), and insufficient self-control/self-discipline (difficulty or refusal to exercise self-control, frustration tolerance, and excessive expression of emotions and impulses).

The analysis of the data provided by the questionnaires revealed that mistrust was significantly related to aggression (Tremblay & Dozois, 2009), which would also be applicable to Antwone’s case, considering the events of his childhood in which he was unable to trust those who were supposed to care for him.

Aside from Antwone’s aggressive outbursts, he also experiences insecure attachments to those in his life, both personal and professional. He has a small group of peers with which he surrounds himself with, which is reminiscent of his childhood years, in which he made friends with peers in order to guarantee his physical safety. The abandonment by his mother, abuse by his foster parents, and sexual abuse by a female caregiver may have contributed to his insecure attachment. Some researchers have suggested that such an attachment style is also related to a high level of neuroticism (Neustadt, Chamorro-Premuzic, & Furnham, 2006).

A social-cognitive examination of Antwone

            One of the main tenants of the social-cognitive theory is that most behavior is learned through both direct experience or through observing others, or vicarious reinforcement. While Antwon’s developmental years were full of abuse (physical, emotional, and sexual), he was able to resist modeling those specific behaviors later in life. Instead, he avoided the development of intimate relationships, preventing others from learning the horrors of his past. Such self-isolation may have led to the development of ineffective coping skills and while technically not a virgin due to the sexual abuse he experienced, Antwone was an intimate virgin, therefore, he did not experience adolescence the way his peers may have, including healthy sexual relationships (Schultz & Schultz, 2009).

            With the assistance of the psychiatrist, Antwone is able to realize that he does not have to relive the past, but instead he can become an active part in his future. While childhood experiences may shape an individual more than those that one experiences as an adult, they can be unlearned later in life (Schultz & Schultz, 2009). With the tools gained through his meetings with his psychiatrist, Antwone may be able to break the cycle of social-cognitive transference, which would prevent Antwone from basing future relationships on assumptions and experiences that occurred in past relationships. Success in the realm of relationships may help Antwone greatly, as significant others play a large role in the lives of others, including the shaping of one’s personality and concept of self (Andersen & Chen, 2002).

            The importance of self-regulation in the social-cognitive theory would apply to Antwone’s anger and aggression, which is another skill that can mastered through effective practice. According to Bandura, the founder of social-cognitive theory, the development of a “self-system” is the result of self-regulation in one’s environment and interaction with peers, which allows for individuation of self-control based on the experience and outcome of such interactions (Funder, 2001).

Trait theory: A brief overview

            Personality traits allow one to categorize individuals based on little information, leading to conclusions that may or may not be true. Traits are thought to be enduring behaviors that are constant across a variety of experiences and environments. One of the early pioneers in the field of trait theory was Gordon Allport, who suggested that traits actually trigger behavior and serve as a motivator to guide one to achieve their desired goals (Schultz & Schultz, 2009). The belief that an individual will react in similar fashion in one situation as they had reacted in a past event, is a central tenant to the trait theory. While the past does not necessarily always predict the future, researchers have discovered that there is a moderate to strong positive relationship (r = .40) in determining future behaviors based on those exhibited in the past (Funder & Colvin, 1991).

            The Big Five categorization tool of personality traits, developed by Robert McCrae and Paul Costa, is often useful when describing behavior and motivation, and is comprised of extraversion, neuroticism, conscientiousness, agreeableness, and openness to experience (Funder, 2001). Each category is subject to influence from outside sources, such as biological, environmental, and cultural or societal norms. Certain traits, such as conscientiousness, are considered more desirable in Eastern cultures, whereas extraversion is more common in Western cultures (Allik & McCrae, 2004). Barring a geographical or cultural shift in one’s life, it is believed that the personality traits associated with the Big Five categories are quite stable, lasting for much of the duration of one’s life (Hampson & Goldberg, 2006).

Trait theory applied to Antwone Fisher

            According to trait theory, Antwone Fisher should have maintained his personality, which was influenced by his physical, sexual, and emotional abuse experiences as a child. However, as both advancing research and the evolution of Antwone Fisher’s personality suggest, such traits continue to change over the span of one’s life. Upon conducting a longitudinal study, researchers discovered that there was a statistically significant change in 75% of personality traits in middle age (40-60) and old age (60+), thus providing supporting evidence of a change in the once thought stability of traits (Roberts & Mroczek, 2008). Antwone Fisher lands in the age range (early adulthood), in which it is thought to be the most important time for personality development and trait change, which is evident in the comparison of his behavior prior to obtaining counseling, and after meeting with his biological family.

Trait theory and attachment

            A contributing factor to personality trait development can be traced back to Antwone’s attachment to his foster parents, where he experienced a problematic attachment style, as indicted by the abuse and lack of supportive atmosphere. Such an attachment style with an adult figure has been linked to high levels of neuroticism later in life (Robinson, Wright, & Kendall, 2011). Antwone’s adult attachment is indicative of the events he experienced as a child, which is characterized by being fearful of intimacy and social avoidance (Bartholomew & Horowitz, 1991). The sexual abuse that occurred in his past may have led Antwone to being weary and/or fearful of pursuing a romantic relationship.

            The attachment style experienced as a youth can also influence emotions as an adult. Antwone adult attachment style can be defined as an anxious-ambivalent style, which consists of insecurity regarding the actions of others, along with a high fear of rejection (Mikulincer, 1998). Based on this hypothesis,  Antwone’s anger may be an attempt at pushing others away before they have a chance to reject. The anxious-ambivalent attachment style can also contribute to the expression of anger, as persons in the category often exhibit higher anger-proneness, when compared to a more secure attachment style. A high degree of proneness to anger is associated with the perception of more situations as anger eliciting and displaying of anger in dysfunctional ways, including a lack of anger control and a high level of rumination over anger feelings (Mikulincer, 1998). Antwone’s explosive anger is an example of how his dysfunctional anger expression affects both his military and civilian areas of his life.

Trait Aggressiveness

            Similarly to anger, aggression is considered a trait-related behavior, and can be influenced from outside sources. However, among those who score high in aggression are often prone to displays of a behavior (associated with aggression) with little influence from situational factors (Marshall & Brown, 2006). Similarly to the traditional trait theories, aggressive behavior can be predicted by examining experiences, with situations that provide just enough provocation to trigger the trait-related response. It is also believed that the disposition to react aggressively is constant across various situations and stable over time (Tremblay & Dozois, 2009).

            Triggers for those who score high in aggressiveness include observing media violence, hot temperatures, pain, and provocation. The last item is the most varied among individuals, as some require a vast quantity of provocation to become aggressive, whereas those who score high in the specific trait will exhibit aggressive behavior with the slightest amount of perceived situational provocation (Marshall & Brown, 2006).

            The development of maladaptive schemas in association with trait aggressiveness is evident in Antwone’s behavior and exhibition of dysfunctional anger mechanisms. Measurement of the maladaptive schemas is often conducted using a Young Schema Questionnaire, which consists of 15 different scales, which based upon Antwone’s actions, would score high in at least five key categories including abandonment/instability (the perception of instability or unreliability of significant others for providing support and connection), mistrust/abuse (the expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate or take advantage and the perception that the harm is intentional or due to negligence), emotional deprivation (the expectation that emotional support in the form of nurturance, empathy and protection will not be provided by others), defectiveness/shame (the feeling that one is defective, bad, unwanted, inferior, or invalid or unlovable to significant others if exposed), and insufficient self-control/self-discipline (difficulty or refusal to exercise self-control, frustration tolerance, and excessive expression of emotions and impulses), if he were to answer the questionnaire truthfully (Tremblay & Dozois, 2009).

            However, while Antwone would score highly on the Young Schema Questionnaire, through effective therapeutic intervention methods, which placed much of the responsibility upon Antwone, as opposed to other methods that use a more direct approach, Antwone is able to overcome what trait theorists once believed to be a doomed future.

Social cognitive theory overview

            Influenced greatly by Albert Bandura, the social cognitive theory consists of three defining principles, including the idea that individuals interact with their environments as opposed to living in a sterile lab environment, personality is developed through these experiences, and personality is a complex and changing system, as it reacts to changes in the environment (Cervone, Shadel, & Jencius, 2001). Learning through one’s environment, either through modeling, vicarious reinforcement, or experiencing an event personally, the way one’s environment can influence behavior and personality can lead to changes in the future.

            One key aspect to the social cognitive theory is the occasional discrepancies between relational schemas, or the comparison between who an individual thinks they are and who they believe they should be in life. When the two schemas clash in a disharmonious manner, a plethora of emotions occurs, including a perceived failure, anxiety, and fear. Such an imbalance between schemas may be associated with changes in emotional reactivity, retrieval of memories, and reaction time (Funder, 2001).

            In addition to schemas, another important aspect to the social cognitive theory includes the existence of a self-system, which according to Bandura, occurs because of the interaction between an individual and their environment. The self-system is thought to include self-reward and self-punishment behavior, which suggests a possible model of moral development (Funder, 2001). Through the establishment of individual moral constructs, standards are erected that one holds themselves, and others at times, for their conduct (Bandura, 2002). Self-efficacy is also an important aspect to the social cognitive theory, as a perceived level of control and mastery can lead to a change in their perceived self-system, with self-efficacy playing a key role in a variety of personality realms, including phobias and depression (Schultz & Schultz, 2009).

Social cognitive theory applied to Antwone Fisher

            Antwone’s childhood environment provided a unique learning experience, where he often observed his foster brothers being physically abused, which he then experienced himself. He often had a clash of schemas, as he was constantly told that he was useless, a failure, and a social reject, which conflicted with his own self-schema. However, instead of developing depression or phobias, which are often associated with such staunch differences, Antwone held true to his self-schema, eventually developing a healthy self-system. The ability for one to emerge with a positive self-image from such an unhealthy environment is commendable. While Antwone did not escape his childhood without scars, his explosive anger, aggression, and fear of intimacy, and eventual changes in these areas, are a testament to the human desire to change.

Social cognitive theory and self-efficacy

            The belief in one’s capabilities and likelihood to achieve success is a benchmark in Bandura’s self-efficacy theory, and one that touches several areas of life, including health, anxiety, phobias, depression, drug abuse, and even physical activity.  The higher the perceived level of self-efficacy, the higher the motivation to achieve the desired goal, regardless of setbacks and delays in achievement (Bandura, 1997). Antwone’s self-efficacy is evident in his graduating from high school without experimenting with drugs and his mastery of the Japanese language.

            Antwone’s self-efficacy prior to joining the military, despite the traumatic experiences of his youth may have served as a protective mechanism. Individuals who report a high level of self-efficacy in an abusive relationship are often more likely to leave the environment in which the abuse is taking place (Benight & Bandura, 2004), just like Antwone did when he fled to his friend’s house after he was sexually assaulted. A high level of self-efficacy is also associated with an increased likelihood of recovery after a traumatic experience.

            Prior to obtaining treatment from the psychiatrist, Antwone displayed low self-efficacy in the domain of emotional regulation, as he did not desire to change or master his outbursts, and had even stated during his Court Martial that he would not mind being discharged. Upon receiving treatment, Antwone changed his outlook, and was motivated to master his emotional regulation, and with support from his psychiatrist, girlfriend, and newly reacquainted family members, he believed that he would be able to attain his goals.

Social cognitive theory in a cultural context

            Antwone is surrounded by a vast array of cultural influences, ranging from his ethnicity and growing up in the foster care system, to the strict world of the military, with each playing a role in the development of Antwone’s personality. One does not exist separate from their environment nor culture, but are rather enmeshed and influenced by what surrounds them. Diversity amongst individuals leads to unique learning opportunities, which is evident in the examination of Antwone’s personality. Growing up in the foster system offered a transient and unstable environment, one in which Antwone was exposed to a variety of individuals, including a family that was both extremely religious and physically and emotionally abusive at the same time, an unlikely dichotomy.

            The military offers another unique culture, in which Antwone doesn’t experience a sense of belonging, as his anger and aggression cause negative outcomes when interacting with his fellow shipmates. Antwone is considered to be part of the outgroup, cast aside by the ingroup due to his behavior in social settings (Bandura, 2002), which is undesirable in a collectivist culture such as the military. The outgroup phenomenon is strengthened by the idea that a collectivist culture cannot achieve their goals with members who are experience self-doubt or report low levels of self-efficacy (Bandura, 2002).

Conclusion

Although there are some overlapping areas between the trait and social-cognitive theory schools of thought, there are some stark differences. Personality is less concrete and more open to change in the social-cognitive theory, whereas trait theorists posit that such change is difficult to bring about in an individual, as personality is constant, long lasting, and permeates every facet of one’s life.       

While trait theorists may regard personality as permanent, a growing number is starting to reconsider such a staunch view, allowing for a little plasticity in the development of personality. Social cognitive theory allows for the influence of one’s environment to be taken into consideration, along with biology and culture, into the fluid development of personality. Antwone Fisher can be effectively viewed through these contrasting views, as they do have some commonalities, and with further broadening of the breadth of research into these two theories, they are becoming more similar than they are different. Change is possible, regardless of theory.

Antwone’s counseling, which was a result of his inappropriate behavior in the military, may have been able to help him even more if he sought help during his adolescent years, shortly after experiencing the trauma. However, by utilizing the skills and techniques provided by his psychiatrist, Antwone was able to grow and change. The counseling style, a combination of both traditional talk therapy, along with some rather untraditional methods (which at times could be considered to be in the grey area of the doctor-patient relationship), is a reminder that therapeutic interventions work best when they are individualized for the client.

**References available upon request**

Easy No-Bake Protein Bars

So, in the midst of what was supposed to be my prime final paper writing time, I found my mind wandering (go figure). The last couple of weeks have royally sucked as far as my food intake has gone. Too busy balancing work and school. But there is no excuse. Time to get back to business, as I have 189 days before my next event...gotta step up training, which means I have to fuel my body in order to make it do what I want and NEED it to do. My brain too.

I found a recipe, doctored it a little and...it's pretty gosh darn good. Try it and let me know what you think, as well as what changes you would make.

• 8 scoops protein powder (I used chocolate whey)
• 1 cup old fashioned oats (I buy it at Costco, as I use them daily)
• 3 Tbsp flax seeds (I used the flax seed meal, ground style)
• 3 Tbsp peanut butter (Natural is the best, no added sugar, salt, crap...)
• 3 Tbsp honey (Squeeze the bear!)
• 1/2-3/4 cup almond milk (Or you can use soy, skim or 1%)

Mix all ingredients. It will be a bit of a sticky, flaky mess, and look as if it won't come together. But give it time, love, and patience. Pat into a sprayed baking pan (I used an 8"x10" I think), using some force and determination to make it dense. Chill in the refrigerator for an hour or so, cut into squares (I ended up with 9 squares), and wrap individually in wax paper or foil, and store in the refrigerator. 

And voila! Tasty, clean, and cheap protein bars!

It's a Bird! It's a Plane! It's Swole Girl!

Some workouts make me feel like a puddle of primordial ooze, while others leave me feeling like a super hero. I can do the same workout and have both of those reactions, so it is not so much what I do, but rather why and what I have in my head during the time…I think. The luxury of building a gym in one’s living room is that it affords the time, convenience, and doesn’t really require “appropriate” attire. While I know that not all 30-somethings have a smith machine, over 300 pounds in plates, dumbbells that go up to over 55 pounds each, kettlebells, medicine balls, a pull-up station and various other accoutrements, I do…and I love it.

With my schedule, it is challenging at times to juggle work, school and training, but when something is important to you…you find a way. Yes, recurring 12+ hour shifts does take a drain on the psyche, but I find that my friend iron assists in recharging my sanity. I had a couple of weeks (after my Tough Mudder) where I had to focus on allowing my body to heal after taxing it greatly, which I found fucked with my head (for lack of a better term). Taking on new responsibilities at work also depleted my sanity, which is not good for anyone…my clients nor myself.

My boss recognized that I was a little stressed (no duh…) and was able to adjust the schedule so I wasn’t working 6-7 days in a row. A day off or two is all I really need per week, but sometimes it’s a challenge to make that happen. Heck, even if I do have a day off, it is usually filled with trying to cram as much into it as possible (all my assignments for the entire week, cooking, cleaning, laundry, etc), so it isn’t much of a relaxing time. That of course implies that I know what it is like to relax, which I don’t. I do believe I was born without said gene.

So, chicken is thawing so I can brine and bake, veggies are portioned and ready to go, protein bars are cooked, and supplements are stacked. Getting back on track, so I can succeed in all aspects of my life.

I snagged the following 4-minute workout from @FitnessLeak. I use an interval timing app (Interval Timer AD) on my phone that assists greatly:

• Burpees (20 seconds)
• Rest (10 seconds)
• Mountain Climbers (20 seconds)
• Rest (10 seconds)
• High Knees (20 seconds)
• Rest (10 seconds)
• Jumping Jacks (20 seconds)
• Rest (10 seconds)
• Repeat

The upper body workout that followed consisted of (each for 3 sets of 8 reps at max weight with good form):

• Bench press
• Lawn Mowers
• Skull Crushers
• Chest Fly
• Tricep Kickbacks
• Bicep Curl (with a pinky twist at the apex)
• Pull-up (varying hand positions each set)

I can feel myself getting stronger, but I know there is room for improvement. I push myself so I can accomplish my goals and lose myself in PASSION! 

Fear: False Evidence Appearing Real

That is my favorite definition of fear, as it is quite accurate. Sure, there are some fears that are irrational and not quelled by seeking information, for I know firsthand the entanglement of irrationality. Some of the more common fears include: the dark, dying, being alone, heights, spiders, etc. However, my biggest fear is not amongst these, as I see best in the dark, know that everyone dies, thrive on being alone, remain calm when my feet are far from the ground and well, spiders are cool if they stay outside.

As I sit here in a hotel room, awaiting an event I have trained for over the past year, I am full of reflection, anxiety, nervousness, excitement…oh, and fear too. Not that many years ago, I sat alone in a hotel room, but that experience was quite different, yet the same descriptions of feelings were present. Then, I had attempted to overdose (on purpose), with a note in my pocket for whoever was the person unlucky enough to find my body. Clearly, my attempt was unsuccessful. A fact for which I am grateful.

Fast-forward a couple of years, to where I am now…in a hotel room, clothes hung up for the events of the following day, a mini-fridge full of Greek yogurt, skim milk, cottage cheese, G2 and Superfood with spirulina. Oh, and some bananas, a couple gallons of water and some gummy bears that just jumped in my bag (sneaky little guys).

Both of these events involved a possibility of death; the overdose attempt and the “death waiver” I had to sign to participate in tomorrow’s event. I find it interesting that two events, on the polar opposite sides of the spectrum, have so much in common. Tonight’s reflection is focused on how far I have come (and how far I still have left to go), the changes I have made in my life and things I can focus on changing in the future. I can feel the heart palpitations associated with anxiety, for the events of tomorrow are like nothing I have ever attempted in the past.

Most of all…I am scared. Scared of failing; failing myself and my team. We shall see.

And, just in case there are some readers who don't know what event I will be participating in tomorrow... here is the website

Never Forget (As If I Could)

      That morning. The sun was out, shining over the harbor. Planes were taking off from Logan and passing over Boston’s North End. I donned my blue uniform, as I had done all those years, not knowing what was set to happen later that day. While working in Aux I of a 270’ cutter, one of my shipmates had lowered down the watertight hatch, dogging all the corners, the change in atmospheric pressure danced upon my eardrums. Wondering what was happening, I opened the center of the hatch, poking my head through. I walked out to the messdeck, where there was an image, one of which I will never forget, playing on the television. The whole ship seemed silent, without the usual banter between shipmates. 

      My crew was ordered to return to our shop on base where many had tried to call family members, only to find the cell phone towers were overwhelmed. The look upon the faces of those who surrounded me was one of disbelief. There wasn’t anything that covered this in our Bluejacket manual. On the walk back to our shop, I decided I would tell my chief that if they needed anyone, to please send me. I didn’t care where, when or for how long, I wanted to go. Knowing that one of the planes had flown right over our base seemed to irk and rile me, fueling my desire to do something.

      The next day I was in New York. There was still an enormous amount of confusion as to what happened, who was responsible and what needed to be done. We had a makeshift base set up, the Red Cross was dispatched to provide food (in addition to tasty MRE packs) and we had brought our portable tool shop. We were ready…for what, we didn’t know, but we were ready.

      What followed was a month of long nights, seeing things that I didn’t want to see and a massive intake of alcohol to numb the feelings. That event changed our lives. When I was stationed on the East Coast, I would make a trip to NY for each anniversary. When I transferred, I would still watch the coverage on television, however, a couple years ago I found myself getting mad and crying, so I stopped watching. 

Instead of watching, I plan on doing. 

      Later on this month, I am participating in a Tough Mudder (http://toughmudder.com), an event I have been training for over the course of the past year. Proceeds from the event go towards an awesome cause that brings tears to my eyes…The Wounded Warrior Project (http://www.woundedwarriorproject.org). I also have completed my BS degree and have started on my MS in Counseling so I can continue to help those who have been affected by some of the events that also affect myself. 

My cause, my mission, my passion…

From hopeless to hopeful: Assisting veterans in housing, medical and mental health needs

Abstract

With the changing economy, more individuals are finding themselves unable to make ends meet, on the brink of becoming homeless. The United States Veterans Affairs (VA) have identified homelessness amongst veterans as a growing problem, often compounded by the presence of substance abuse and/or mental health disorders, creating a comorbidity factor, which requires special attention. The VA, in partnership with the current government administration, aims to end veteran homelessness by 2015, which is quite a lofty goal. Since the Homeless Veterans Initiative came to fruition in 2009, over $60 million has gone towards assisting 22,000 veterans and family members (http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2355). 


      By adhering to The Soldier’s Motto, “I will never leave a fallen comrade” the homeless veteran population may be something to add to the history books. The program proposed in the following paper will attempt to address the unique needs of homeless veterans, including mental health, substance abuse, vocational training and an evaluation of individual’s benefits in partnership with the VA. 

Community needs

Addressing the unique needs of a community requires a thorough understanding of the culture involved, the strengths and shortcomings of programs that are already in place, and how to provide mental health counseling in a manner that is both cost and time effective. Much can be gleaned by observation, surveys, and interviewing both providers and those who use the services. Finding a right fit for the community is essential to increase the likelihood of individuals actually seeking out and using a new program. 

A survey conducted on a cold night in January in 2011 revealed that there were 67,495 homeless veterans on the street, with almost 150,000 who had spent at least one night in an emergency shelter program during the previous year. The state of Oregon has a large homeless population, with 1,425 (or 8%) comprised of veterans (http://cms.oregon.gov/odva/info/Pages/stats.aspx). 

      Homelessness, defined as a lack of a fixed and regular nighttime residence, is associated with a higher incidence of both poor mental and physical health (Gordon, Haas, Luther, Hilton and Goldstein, 2010). There are current programs in place that aim to address the homeless veteran problem, but with the assistance of grants from the VA, more programs can be implemented that can better address the needs of this unique population. 

Services needed

Comorbidity of psychiatric and medical disorders amongst the veteran community is a common occurrence, with addiction and generalized illness (comprised of eye problems, hypertension, COPD, liver disease and gastrointestinal problems) indicating the highest correlation (Goldstein, Luther, Haas, Gordon and Appelt, 2009). Thus, a treatment program that addresses substance abuse and mental health counseling, in conjunction with medication management, housing and vocational training may prove beneficial to the individual seeking assistance. Grants from the government, which go towards helping non-profit organizations in providing services for low income veterans can help to offset housing and operating costs, thus reducing the monetary burden. 

Currently a couple of initiatives address the need to connect homeless veterans with needed psychiatric services, including domiciliary care for homeless veterans (DCHV) and homeless chronically mentally ill (HCMI). However, those who have a need for such services already outweigh the resources available, making alternatives a necessity (Stovall, Flaherty, Bowden and Schoeny, 1997). 

Goals and objectives

Measurable goals, both terminal and ultimate are important in considering the implementation of a new program. Ensuring the goals are feasible, viable and pragmatic are essential to creating realistic benchmarks (Milstein and Wetterhall, 2000). Focusing on evidence-based practices may shorten the evaluation period due to the proven record of accomplishment during prior therapeutic interventions (Calley, 2009). The initial goals for the proposed program are to address acute health and mental health problems, resource-related problems (housing, employment and hygiene), and public perception problems (rejection, dehumanization and community fear of veterans), which were identified as the main contributing factors to the problems experienced by homeless veterans (Applewhite, 1997). Long-term goals of the program include treating any substance abuse or other issues documented during the initial intake, vocational training and employment opportunities, which can help to facilitate self-sufficiency. 

The proposed program aims to coincide with the Six Pillars of the Homeless Initiative, as set forth by the VA, which include community partnership, income and benefit analysis, housing and support services, outreach and education, prevention of becoming homeless and treatment of medical and psychiatric needs (http://www.va.gov/HOMELESS/about_the_initiative.asp). By blending programs it will be easier to implement tactics used successfully in the past, thus reducing the amount of time needed for program research.

Program design

Prior to acceptance into the program, clients would be screened by mental health counselors regarding their present level of assistance required, the presence of any comorbidity factors (primarily those involving drug and/or alcohol abuse) and their current living situation (threat of becoming homeless, homeless, living with friends, etc.). The screening is an important aspect, as certain comorbidity relationships have an impact on behavior and functioning (Goldstein, Luther, Jacoby, Haas and Gordon, 2008), which may affect the other residents in the program. Another consideration to keep in mind during screening is that the facility will be a clean and sober living situation, which residents will have to agree to and abide by in order to remain in the program.

The ideal facility would be one of many vacant apartment buildings located within the county, purchased with funds provided by government grants. If the units are 1-2 bedrooms, there should be at least 10-12, more if they are studio apartments. Some considerations regarding facility amenities would include handicap access and proximity to loud noise generators, which may cause undue stress upon residents. 

      One unit would be staffed 24-hours a day and designated for treatment, including counseling, group meetings and medication management. Vocational programs may supplement staffing needs by training residents to fill the needs of the program, thus not only help to lower the operating costs, but also promote a positive self-image and foster resiliency within the clients. However, a licensed counselor and direct care providers would still be required onsite, as these positions would be solely support and clerical services.

      Counselors working within the program should be familiar with the unique needs of both the military and homeless communities, and use a holistic approach when interacting with clients. A bio-psycho-social-spiritual approach is often effective in drug and alcohol rehabilitation settings, as it allows for more flexibility in therapeutic interventions. The use of motivational interviewing, which is a client centered approach with a focus on strengthening intrinsic motivation has also shown to be beneficial in improving program interaction, retention and a reduction in relapse incidents (Wain, Wilbourne, Harris, Pierson, Teleki, Burling and Lovett, 2011). A focus on psychosocial rehabilitation would also prove beneficial, as the main philosophy includes some commonalities to the Six Pillars highlighted earlier, consisting of an emphasis on teaching essential skills of community living: vocational, social/recreational, residential and educational (Juvva and Newhill, 2011).

      Even the well-educated and seasoned counselor may find himself or herself amongst unfamiliar territory, as clients are individuals, and that brings a collection of unique experiences. Having an effective consultation and referral program is essential to success, for both the client and counselor alike. Some resources to consider include VA trained staff, religious or clergy members, parole or probation department specialists and those familiar with evaluating military benefits including disability payments.

      Working with local agencies would also provide a way for the clients to engage in their recovery and reintegration as productive members of society. Creating a partnership between the program and vocational training centers, such as Goodwill, Salvation Army and Habitat for Humanity will assist the clients in earning both monetary compensation and employment skills that they can use after graduation from the program. 

Evaluation 

      An important part of any program is a reevaluation after a period, to analyze the strengths and weaknesses present and to address such findings. The key aspects to evaluate would be cost-effectiveness, relapse rate, program retention, improvement (or decline) in mental health conditions and positive contributions to the program and the surrounding community by the clients. A way to address a possible cost issue is to apply the disability or SSI payments of the residents to the rent, recruit graduate students for the direct care staff, conduct fundraisers or apply for additional grants.

      Allowing for flexibility in treatment delivery approaches to fit the client may assist in increased sobriety and program retention; however, if it becomes troublesome or ineffective, a reevaluation of methods is warranted. An examination of program length is important, as some clients may be staying after they have completed treatment, thus taking a spot that could be filled by another homeless veteran. However, keeping with the mission statement of “I will never leave a fallen comrade,” the program will not abandon clients, but rather refer them to other programs that will better suit the needs of the veteran.

Reporting outcomes

Public disclosure, transparency and informing the stakeholders of the strengths and weaknesses of programs can help to ensure accurate information is disseminated, rather than speculation. Such avenues include town hall forums, VA meetings, ballot measures, articles published in peer-reviewed journals and letting the positive results speak for themselves.

Conclusion

While veterans are the minority amongst the homeless population in Oregon, the fact that there is even one without consistent shelter is a concern. The influx of returning soldiers from wars and conflicts overseas may contribute to a growing need of the services proposed by the aforementioned program. By offering a one-stop veteran assistance program, combining shelter, mental health, substance abuse and veteran benefit analysis, the incidence of homeless veterans may decrease, thus showing the respect these men and women deserve.

*References available upon request

Roles and approaches within clinical mental health counseling

Abstract

The definition of supervision varies within the context in which it is applied, however, within the counseling profession, one seems to stand out as the most widely accepted. According to Bernard and Goodyear (2004), supervision is, “…an intervention provided by a more senior member of a profession to a more junior member or members of that same profession. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s), monitoring the quality of professional services offered to the clients, she, he or they see, and serving as a gatekeeper for those who are to enter the particular profession.”



While the presented definition does appear to be applicable, it is just the groundwork for what supervision entails, as it is multifaceted, needs to be tailored to the situation and personnel involved, including the client, supervisee and the supervisor. The definition also does not address the different models, theories and methods involved, allowing much to be interpreted by those involved in such a relationship. The following paper will provide a brief overview of supervision, models and theories used within clinical mental health counseling. 

Roles and functions

     Supervision within the counseling is one of the more important and prominent part of one’s position as a member of the mental health community. However, although supervision is conducted by at least two thirds of counseling psychologists, few have received thorough training in the application of effective supervisory skills (Milne and Oliver, 2000). By requiring supervision but not providing training, the experience is unique as it is influenced by the one providing the guidance, which is influenced those who had supervised them early in their careers. 

     However, the American Psychological Association’s (APA) Office of Accreditation observed such a gap and in 1996, added supervision as one of the skills to be included in accredited programs at the doctoral and internship levels, thus addressing the need to have formal education in supervision (Peake, Nussbaum and Tindell, 2002). According to the APA, supervision covers a vast and diverse collection of responsibilities, including but not limited to: monitoring, evaluating, instructing, advising, modeling, consulting, supporting, foster autonomy within the supervisee and a responsibility to the patient, profession, system and society. Supervision also addresses legal and ethical issues that may arise, thus further emphasizing the importance of effective training within the mental health profession (www.apa.org). 

     Supervision is not complete at the end of one’s internship, as an interaction between junior and senior counselors can help to provide insight on new therapeutic interventions, different perspectives on a situation and work as a supportive environment in which to voice concerns that may arise. Supervision isn’t just a requirement among American counselors, as members of the Humanistic and Integrative section of the UK Council of Psychotherapy have to apply for membership every five years and state what style and source of supervision they are currently engaged in within their practice (www.hipcollege.co.uk). 

Models within supervision

There are several different models of supervision found within the field of counseling, including individual, group and triadic. Each has their strengths and weaknesses, including within the application and reception by the supervisee. Individual, one-on-one supervision is the most costly in resources, as time is available in limited quantities when there are several students that require supervision and only a few senior counselors to provide the needed individual interaction. However, the approach is more effective when providing feedback regarding casework and planning for future sessions (Milne and Oliver, 2000). Group supervision usually involves a small number of supervisees, which may help to foster a cohort effect, thus the students are able to teach each other through their experiences, with a senior member overlooking and guiding the process.

     The Council for Accreditation of Counseling and Related Educational Programs (CACREP) approved a third method of supervision in 2001, which is the triadic method. The premise behind the triadic approach is a working tutorial relationship between a supervisor and two counseling students, involving all three members in an open and supportive communication atmosphere (Lawson, Hein and Getz, 2009).


     Within the different models, there are is a plethora of methods used to help to facilitate effective supervision. Both audio and visual recordings of sessions conducted by the student can serve as an accurate measure of providing feedback, as the supervisor is able to see and hear what occurred within the session. Having the video of the session may also provide insight to the importance of non-verbal communication between the client and the student. However, knowing that one is being recorded may alter the behavior, of both student and client. 

     Another less obtrusive method of supervision is the bug-in-the-ear or eye, which is a method approved by CACREP, involves either a small receiver to be placed inside the supervisee’s ear in which the supervisor provides support and feedback during a session. With the bug-in-the-eye technique, the supervisor monitors the session and provides written guidance via a monitor that is behind the client. Both of these methods are effective, as they allow the supervisor to provide real-time feedback, assisting when the student may run into a challenging moment. However, they also serve as a possible distraction and added source of stress for the supervisee. Methods are more likely to be effective and well received when tailored to the individuals involved in the therapeutic relationship, which includes the supervisor, supervisee and the client.

     Just as there are different models and methods in providing effective supervision, there are a variety of theories used in mental health settings, each with strengths and weaknesses associated with their unique approaches and views. Some are psychotherapy-based in their approach to supervision, which includes psychodynamic, person-centered, experiential, psychodrama, cognitive, cognitive behavioral, multimodal, solution-focused and narrative (Pearson, 2006). Another approach is the Littrell, Lee-Borden and Lorenz Model of supervision, characterized as a developmental approach since it focuses on the supervisor’s transitional role as the supervisee passes through four sequential stage. The stages are supervisor as teacher, establishing a relationship and setting goals; continue with scaffolding of supervisee, providing feedback in perceived skill deficits; collaborative relationship between supervisor and supervisee; and finally a graduation of the supervisor to a consultant role, allowing the supervisees to take greater responsibility (Nelson, Johnson and Thorngren, 2000).

Intern expectations of supervision

     Supervision is an important aspect in the continued learning environment, providing support, feedback and establishing a supportive atmosphere in which a new counselor can thrive. Forming a positive bond with one’s supervisor during internship and as a new clinical mental health counselor can help to facilitate effective communication, which can help to enhance the experience. The type of supervision can vary depending on the work environment, clients treated, financial resources and even the culture within the community.  

     Some individuals may not feel as comfortable in one-on-one supervision and may prefer the small group or triadic models, especially if the relationship between supervisee and supervisor is not welcoming or appears cold and impersonal. As one who desires to work within the military community as a mental health counselor, it is more likely that the type of supervision that will be present will be of the group variety, due mainly to cost constraints and the availability of supervisors. In the military setting, much of the therapy is of limited duration and would fall within the solution-focused aspect of the psychotherapy-based approach. Supervisors who have specialized training in the same field would be beneficial as well, since clients who are seeking a marriage and family counselor may differ from those who are seeking a trauma therapist.


Conclusion

     Supervision, like the field of counseling itself, is quite varied. Depending on a variety of methods, models and theories to assist in developing a well-rounded counselor, able to effectively help clients during the span of their career. Developing a supportive atmosphere that allows for fostering confidence and an open dialogue between the supervisor and supervisee is tantamount to a positive and successful outcome, which is important for all parties involved. The approach must be holistic in nature, as individuals are multifaceted and are more receptive to styles that address the whole picture, rather than just small aspects.

*References available upon request

Trauma Within The Ranks: Fighting Back Against Military Sexual Trauma (MST)

Abstract

According to the most recent statistic from the Department of Defense (DOD) dated April, 2012, females make up roughly 14% of the active duty military population, with service dating back to the Civil War. While it appears ample time has passed for the military to fully integrate and accept women as soldiers, a growing problem has surfaced, namely, military sexual trauma. The story of Molly* will demonstrate the effects of MST, highlight the lack of research that has been conducted on a relatively new diagnosis, as well as resiliency and wellness planning that is particular to such cases.

*Not her real name

Client characteristics

Molly, a 25-year old female active duty E-5 soldier appears quite young until one takes the time to look close enough to notice the early onset of Crow’s feet around her eyes, the creases around her mouth from smoking and the ruddy color around her nose due to broken blood capillaries. The yellowing fingernails have been chewed to nubs, chipping away the façade of youth and showing signs of wear in the armor she has been wearing to protect herself from the constant battle of stress.

The observable signs seen in Molly are common characteristics of an individual who has been experiencing chronic stress and trying to deal with it on their own, without sufficient coping skills. According to the Mayo Clinic, some unhealthy reactions to stress include: physical pain without an outside source of injury; overeating or undereating; explosive anger with little provocation; uncontrollable crying; depression that lasts longer than a bout of sadness; focusing on the negative aspects of life; and a marked increase in smoking or alcohol consumption.

Upon a brief discussion with Molly about her background, it is learned that she identifies as a Catholic (although admits that she has not been to mass in many years), has been serving in the military on active duty for the past six years. She reports being deployed twice to Iraq and once to Afghanistan as part of support units, sometimes being part of the lead crew, which ensures the path is clear of improvised explosive devices (IEDs), returning from her most recent deployment with her unit less than a month ago. Her family appears to be supportive of her career choice, however when it comes to her private life, they are not as supportive. Molly considers herself a lesbian and has been in a couple relationships with other women in the past, although due to the military culture, has had to hide that part of her life from her fellow soldiers. 

Counseling, ordered for Molly by her command due to a recent suicide attempt, is a common occurrence amongst both active duty and veteran military personnel. During the first 155 days of 2012, there were 154 suicides reported involving past or present military members (http://www.politico.com/news/stories/0612/77188.html), a statistic that indicates a 18% increase in suicides from the previous year. However, the difference in Molly’s case is that she is in the office, obtaining the services she needs to aid in the prevention of a successful suicide.

After gaining Molly’s trust and opening an effective therapeutic line of communication, she reveals that she was raped this past tour by a fellow soldier. The attack left Molly bruised, both mentally and physically; feeling powerless as the offender was higher ranking and threatened to keep her on lead caravans, risking her life each time, if she ever reported the incident. The rape also resulted in a pregnancy, causing an increase in mental torment since as a Catholic abortion is considered a sin. 

Molly’s increased alcohol intake and cigarette smoking were ineffective coping mechanisms, leading her to see suicide as the only other option of ending her pain. The shame and guilt associated with sexual attacks is often compounded when one has to rely on their attacker as in a military situation. In a recent study, the incidence of rape amongst female military members perpetrated by their male counterparts was discovered to be 28% (Williams and Bernstein, 2011). 

Military Sexual Trauma (MST) and Posttraumatic Stress Disorder (PTSD)

Molly’s presenting concern is primarily the sexual assault she experienced at the hands of another soldier. Military Sexual Trauma, or MST, is defined by the National Center for PTSD as, “unwelcome sexual attention including gender harassment, unwanted sexual attention, sexual coercion, sexual assault, and rape.” The DOD has reported a 16% increase in MST within military deployments to Iraq and Afghanistan, with many incidents going unreported, as in Molly’s case. The DOD has taken steps to address the growing incidents of MST, one of which was the addition of the Sexual Assault Prevention and Response (SAPR) program, which provides oversight of the DOD sexual assault policy. SAPR’s mission statement, “To enable military readiness by establishing a culture free of sexual assault,” is a good attempt at addressing the issue, but without feeling free to reach out and obtain assistance, some survivors turn to drugs, alcohol or suicide as a way to cope.

Military culture is fraught with power struggles, be it between ranks, warzone conflicts or genders present within the military population. Many, often resulting in more questions than answers, have examined the unique culture of the military but some have produced rather startling findings, some of which are applicable to Molly’s case. The US Air Force was investigated following a rash of sexual assaults in 2003, complete with allegations of assaults and cover-ups, which hit the media causing the ugly truth of sexual assaults within the ranks to become known to the public at large. One study suggests that the power and control concepts contribute to sexual aggression, as new recruits are often devoid of power, causing a possible need for them to seek out other ways they can have obtain control (Callahan, 2009). 

While PTSD has been studied extensively (and still is) amongst the veteran population, MST is a relatively new addition to the trauma spectrum. Rape and sexual trauma is often found to cause more psychological harm than the more common military associated contributing factors to PTSD. The combination of being deployed in a warzone while experiencing sexual trauma can negatively impact the psychological wellbeing of a soldier more than experiencing each incidence separately (Williams and Bernstein, 2011).

Soldiers exhibiting signs of PTSD often come back from deployment with a combination of symptoms, including sleeplessness, nightmares, hostility management issues, flashbacks, panic attacks and a decreased ability to cope within society in a productive manner. Those coming back who have also experienced MST often return with a loss of self-respect, feeling as if they had lost control over their lives and were at a higher risk of self-harm (Benedict, 2007). Molly’s symptoms via self-disclosure during the initial meeting fit those associated with both PTSD and MST. A 2006 study suggests that women with MST had higher rates of PTSD as compared to those who had experienced other forms of trauma (Yaeger, Himmelfarb, Cammack and Mintz, 2006).

Confounding variables and effective coping

The repeal of the Don’t Ask, Don’t Tell (DADT) policy in September of 2011, which in the past had banned openly gay individuals from serving in the military, was a step in the right direction but did not end discrimination. Molly does not feel comfortable sharing the fact that she is a lesbian with her fellow soldiers, partially in fear of retribution or experiencing further trauma at the hands of those she works amongst and relies on for career advancement. The inner turmoil Molly is experiencing as she is caught between an unwanted pregnancy that is the result of a sexual attack and the morals of her religion, which define abortion as a sin, may have compounded her experience of distress, leading her to the suicide attempt. 

As a counselor, one has to separate any personal belief systems to assist the client in gaining a more stable foundation in which they are to rebuild their focus and proceed in life with a stronger and clearer outlook. Instilling a resilience plan and providing tools for the client that are specific to them is key in obtaining a positive and desired outcome. A wellness plan for Molly would need to be holistic in approach to work best, as it would address the biological, psychological, social and spiritual aspects of her presenting concerns (Gladding and Newsome, 2010). 

Providing a safe and secure location for her to share her experience would also be of benefit. Some current therapeutic interventions for MST include cognitive processing and prolonged exposure, with both showing promise as effective measures to help one deal with the traumatic experiences (Cater and Leach, 2011). The Veterans Administration is also conducting trials on new forms of therapy, including guided imagery therapy as a therapeutic adjunct to conventional talk therapy. Sadly, even with these treatment options on the horizon, many will seek out self-medication as effective ways of treating the symptoms, with the rates being higher amongst the military population in which mental toughness is seen as a positive attribute.

Employing effective stress management skills into Molly’s therapy would be an essential step to recovery. These would include an education about the cause of her stress, recognizing the physical and emotional effects of stress, and learn to use appropriate coping mechanisms to current and future stress (Gladding and Newsome, 2010). An ecomap may assist Molly in recognizing her sources of support, outside of the military as well as within. A visual representation of those in her life and their ability to influence, positively and negatively, can serve as a reminder when challenges arise. 

Since Molly’s case is multifaceted, she may need a referral to additional support members, including a physician, drug and alcohol specialists and a counselor who may be more skilled in the Catholic faith, as that aspect combined with her unwanted pregnancy appears to add a significant amount of stress. Having a network in place for referrals helps both the client and the treating counselor.

Advocacy opportunities

Molly’s recovery process may be influenced by several factors, including personal characteristics that may hinder or assist the ability for her to achieve a positive and desired outcome. Some of these include her family not being accepting of her sexual orientation, the unique culture that is found within the military and her religious faith and beliefs. The more recent addition of alcohol use and pregnancy highlight the importance of tailoring a treatment plan specifically for an individual, rather than trying to make the individual fit the plan. 

There are several agencies, both within and outside the military and government that can assist in providing the needed guidance and support to effectively help Molly navigate her path to wellness. The first step of coming into the counselor’s office, by choice or by direct order, is a promising start. By branching out after establishing a trusting atmosphere to explore community resources, Molly will be able to obtain the needed support system that will aid her recovery. Depending on the status of the relationship between her and her immediate family, that may be an avenue to pursue. However, it should be done cautiously, as it may cause more stress to an already precarious situation. 

Upon instilling an effective treatment plan, complete with regular meetings both with Molly and her treatment team, depending on her progress, she may find additional strength in advocating for herself with the assistance of community resources. Within the military, some resources include Service Women’s Action Network, or SWAN which advocates for all military women at the local, state and federal levels to bring about change to create and support legislation that caters to the unique needs of female members of the armed forces. 

With the repeal of Don’t Ask, Don’t Tell, several military bases have started gay and lesbian advocacy groups, such as Gay, Lesbian And Supporting Sailors, or GLASS, and OutServe, which is an association of actively serving military members with 45+ chapters worldwide. Such organizations help to foster a supportive environment, helping to educate military members and spouses about the need to understand and respect others, regardless of their sexual orientation.

Conclusion

The case of Molly is far from rare, as indicated by the statistics on MST within the armed forces. Through education and advocacy, both by survivors and their support system, sexual trauma may come into the light, where it belongs. Only then can it be effectively addressed, both in legislation and in the counselor’s office. By becoming her own advocate, Molly is fostering her own resilience, as seeing a positive outcome from what was despair may help her to continue on the path of recovery. Counselors need to remember that the focus is and should be on the client and helping them to eventually help themselves, leaving any personal ethics aside that may hinder the growth of their client.

*References Available Upon Request