In six different graduate programs, I have taught students who were training to become either clinical mental health counselors or school counselors. During my first years in counselor education, students practiced their counseling skills by recording themselves as therapists with acquaintances of friends who served as clients. These sessions occurred outside of class. The students’ recordings were then brought to class, and we would listen to the most important parts of the sessions. Together, we critiqued what we heard. This continued for eight sessions and seemed to work quite well.

As time passed, however, and the programs where I taught changed, situations became more complicated. My students had increasing difficulty finding practice clients. Finding someone to volunteer became challenging and potentially risky. Random advertising to recruit volunteer clients on Craigslist or other sites would not work. I placed a stipulation on students that their volunteer clients were not to be in ongoing therapy or on psychiatric medication. To minimize issues, I also said that client problems needed to be related to work or relationships.

Allowing these counselors-in-training to rely on their fellow classmates as clients was a poor alternative. Either a student client would disclose too much information and leave the student therapist overwhelmed, or the student client was closely guarded and would not share enough. Student clients who were already in therapy were having issues for obvious reasons, and this raised other hurdles. First, clients do not see two therapists concurrently and, second, the student therapists were not equipped to handle real psychological problems because they did not yet have the proper skills.

This was not a productive learning situation. How far could a vulnerable student be pushed before disaster happened? My concern has always been for the safety and mental health of all students. I needed a new technique that would allow graduate students to acquire and practice counseling skills without being encumbered by their own personal issues or those of their classmates who were serving as practice clients.

My method

Essentially, the task remains the same: Record eight or more practice sessions throughout a semester. However, I now ask graduate counseling students to serve as both the client and the therapist for a fellow classmate.

Each week, the client and the therapist work on an issue that is stated as the presenting problem during the first session. At a designated time — using approximately 30- to 45-minute sessions — the roles are reversed. (My preference is for a longer amount of time, 45 minutes, but that depends on whether recording is being done during a three-hour class session or outside of class). As follow-up assignments, the therapist submits DAP (data, assessment and plan) notes after the session, and the client submits a reaction statement. During class time, we discuss approaches the therapist can take as we dissect the client’s responses.

I assume that each graduate student possesses some familiarity with various forms of psychological problems and mental illnesses. I first ask directed questions to initiate the process of creating a persona. This is a learning opportunity. For example, are they apprehensive about working with a specific population, such as:

• A client who is elderly
• A client who is suicidal
• A client who just lost a job
• A client who is transitioning gender
• A client who has a substance abuse problem
• A client who has an eating disorder
• A client who is suffering from schizophrenia

This enables students to select a persona that they might want to adopt for their recording sessions.

The next step is to thoughtfully create a profile of an individual: Adopt a name, a gender, an age, a race, a profession and an education level. I also ask students to consider whether the support of specific family members and friends might have contributed to their character being more or less resilient. In other words, I guide them to create a character with a history, a family and a social constellation. Finally, as their new persona, I ask them to state their problem: Why do they want counseling at this time?

To adopt their persona, students need to know more about their character and the character’s problem. The students research various aspects of their persona so they can become a credible client in therapy. They develop their persona from journal articles, book chapters and additional media sources (as noted in the bibliography of their final paper).

The final paper for this assignment summarizes the experience. I require students to provide answers to specific topics:

1) Biopsychosocial information

2) Reason for selecting the persona

3) Effect of therapy

4) Specific techniques that may assist in the future

5) What they gained from this experience

6) Critique of the experience

In some situations, students are working at practicum sites, so another point is to share “application to practicum experience.”

In one final paper, a student wrote that she chose her persona because she wanted to experience a reality so far from her own that it would be a complex, yet interesting, challenge. In another situation, a student based her persona on a character from the film Prayers for Bobby, which involved the suicide of a younger sibling who was struggling with gender identification. Other students simply created their own persona. For example, a female student created a biracial, Hispanic and black 16-year-old male who was dealing with issues about his sexuality. The research enabled the student to learn more about specific issues, including being biracial, being a male, the acceptance of homosexuality in Latino and black cultures, and problems dealing with parents’ reactions to coming out.

Another student shared her objective of getting a deeper emotional understanding of what it means to be gay and discovering the challenges that these clients face. Her research and the creation of her persona helped her acquire that knowledge. “I found the process of creating and developing this character to be extremely useful for my professional and academic growth.” (Ellen)

A male student decided to be a female persona with marital issues. She was struggling with her husband’s domineering role in their marriage. She was also wrestling with notions of divorce, all from a female perspective.

Discussion

The results of this method were consistently favorable. The students not only learned about specific populations and disorders but also gained insights into mental health problems. They practiced skills and became aware of which skills seemed more effective under various circumstances. The students reported that open class discussion reduced their tension levels and feelings of stress about serving as therapists. They freely critiqued one another and offered suggestions about how to best proceed with specific clients.

“The sessions helped me raise valuable questions about how I would choose techniques to help my clients. This experience also helped me become more aware of how I listen to clients and gather information. I found this experience to be valuable because it made me think about how I would respond to certain comments and questions from a client. It has also made me think about the research I would like to do on techniques to help clients.” (Sabrina)

Another student wrote that she believed helping clients learn to face their problems in positive ways would be extremely important in their recovery. “Overall, I found this experience to be beneficial in many ways. The most important part of these sessions though was when we were able to discuss them in class and learn from each other’s experiences. The in-class discussions greatly helped me when dealing with my own client, as well as giving me tips in how to think out of the box when it came to being the client myself. There were multiple types of therapy methods discussed, which were a great help when it comes to what type of things I may face in my future prospects as a counselor. It was also great that we were able to pick our own characters, which gave promise to there being a very diverse population of clients and proceeding mental health issues. I really enjoyed and learned a lot from this assignment.” (Kaleigh)

Chris shared that the counselor didn’t always need to have all the answers. He acknowledged that having an empathic listener lessened the stress he had placed on himself. He reported that he was able to relax more and allow conversations to come naturally.

I firmly believe the didactic implementation of creating a persona for recording practice counseling sessions uses counseling skills while raising awareness of students’ potential as counselors. Having students research and develop a persona expands their knowledge base while helping them to acquire empathy. It’s one thing to hear about a problem; it’s another to adopt that issue as your own and seek counseling to help resolve issues.

I strongly believe my method works for all students on several levels. As students learn basic counseling skills, using those skills in sessions with practice clients is essential. One advantage of my method is that each student gains knowledge and no students suffer. Most important, this method psychologically protects the individual student while enhancing fundamental skills practice, broadening knowledge and influencing future mental health counselors.

As educators, we want to prepare confident and effective mental health professionals.

 

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Helen M. Garinger is a licensed professional counselor, a licensed mental health counselor and a national certified counselor. After 13 years as a full-time professor, she is currently an adjunct professor at New York University, University of Connecticut and Norwalk Community College. She wishes to thank her graduate students for their great work and contributions. Contact her at hmg3@nyu.edu.

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