By Jill Kiely and Jonathan Ohrt

Advocacy = Changes are driven by an awareness of inequities with an intent to move humanity toward an
“enlightened world society”.
Advocate a person who acts on someone else’s behalf
Counselor
Family
Member
Neighbor

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Promoting equity for clients:
Teaching clients assertiveness skills
Coaching clients on writing letters to newspapers or politicians
Intervening with clients on their own behalf with members of the community such as landlords or employers

As counselors we know the point of counseling is to help the client to acquire coping skills and resources to not need us. The same principle is applied to advocacy.
An Old Fable:
“When a man is hungry, you can catch him a fish to feed to his family, but, if you teach him how to fish, he can feed the whole village”.

(Kieffer, 1983)
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Entry: The person first begins to get involved and become aware of the need for advocacy efforts.
Advancement: A person becomes increasingly involved in organizational activity.
Incorporation: The person develops a sense of mastery over and competence in the advocacy activities.
Commitment: The person develops a further sense of mastery and participatory competence.

Multisystems Perspective
Counselors must advocate for clients at the individual, group, and organizational level
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Individual (educating and empowering the client)
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Group (educate groups that effect the clients, e.g. family)
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Organizational (serve as a mediator between a client and institutions, negotiate with agencies to provide better services)
(Kiselica & Robinson, 2001)

Necessary Counselor Skills and Attributes for
Advocacy
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Commitment (willingness to address the issues)
Appreciation for human suffering (empathy)
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Nonverbal and Verbal communication skills (with clients, those in power)
Multisystems perspective
Knowledge and Use of the media and technology
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Research Skills
(Kiselica & Robinson, 2001)
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Knowledge of current laws and rights of clients
Ability to access resources

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Gaining recognition among the general public for the profession of counseling:
Public service messages
Speaking at local PTA meetings

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Gaining recognition of counseling as a discipline among other therapeutic professionals:
Becoming involved in professional organizations to develop standards of care
Attempting to exert influence over who is assigned to state board for counselors

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Membership in state and national counseling associations: ACA, ASCA, FCA,
FSCA, etc.
Before a state law is passed there are usually opportunities for public hearing.
Maintain a visible profile in the community, ex.: find an area of expertise to speak on

Organizations
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Chi Sigma Iota: advocacy projects www.csinet.org
American Counseling Association: links to state lawmakers and current issues www.counseling.org
Florida Counseling Association: legislative days, information on current issues www.flacounseling.org
American Mental Health Counselors Association: links to legislators www.amhca.org

Other Ways to Advocate
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Speaking publicly about an issue
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Writing newspaper or journal articles both professional and public
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Writing to legislature
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Recruiting powerful voices to help advocate
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Joining or creating an organization that advocates for specific populations

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Helen Keller: Helped found the Civil Liberties
Union to advocate free speech, member of
Industrial Workers of the World, & social advocate for American Foundation for the Blind
Mothers Against Drunk Driving: Established by the mother of a child killed by a drunk driver
Magic Johnson: Contracted HIV and now advocates for safe sex
The National Alliance for the Mentally Ill:
Established by consumers and families of consumers.

Activity
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Think of a group that may be oppressed, underserved, or may lack the ability to advocate for themselves. Devise an activity to raise social awareness regarding the groups’ hardships and what can be done to help alleviate the problems.

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Perception of job description: “It’s the case managers job to advocate, my job is to provide therapeutic services.”
Time: “Advocating is a full time job, often unpaid, and I can only do volunteer work after all my other responsibilities are met.”
Expenses: “To provide testimony at a state hearing requires traveling and lodging costs, plus missed time at work.”
Emotion: “When I did start talking about the issue at hand my efforts were met with anger from those around me and it was very intimidating and challenging.”

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Research is funded by external sources (private foundations or state and federal funding)
Projects funded based on pressing or relevant issues
When it is decided that an issue is “pressing” researchers and practitioners are advocating for a cause
Advocates depend on data generated by research
Research
Advocacy
Funding

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Therapists are being increasingly asked to demonstrate that treatment results in positive outcomes.
There is lack of agreement as to what “treatment outcome” is, however Kazdin (1994) stated the goals of psychotherapy research as being:
Understanding the alternative forms of treatment for a particular disorder.
Understanding the mechanisms and processes through which treatment operates.
Understanding the impact of treatment and other moderating influences on adaptive and maladaptive behavior

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Counseling is a soft science.
The types of variables are rarely concrete, observable or measurable.
When dealing with variables related to human behavior, it is not possible to control every variable.
Ethical problems are created when controlling variables results in negative outcomes for the client.

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When evaluating quantitative research:
How generalizable are the results?
Can the results be replicated by another, uninvolved researcher?
Are the key variables operationally defined?
Are there ways to explain the results?
How much do the studies contribute to the body of knowledge about theory and research?

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When evaluating a qualitative study:
How clear are the research procedures?
Does the study generate knowledge that is specific to time and place?
Does the research help to develop theory and interpretive frameworks for organizing knowledge?

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Self report inventories
Client satisfaction questionnaires
Ratings of target symptoms, either by client or clinician
Behavioral measures
Structured interviews by expert clinicians
Ratings by significant others
Ratings by therapists
Cost –benefit analysis

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In the past a therapists choice of how to proceed with a client may have been based mainly on their theoretical orientation. However, with managed care there is emphasis on the maximum therapeutic gain within the least amount of time.
Be well versed in the treatment strategies that are indicated for particular disorders.
Be able to cite references that justify your treatment approach.
This increases the likelihood that you are providing the best possible treatment you can.

Empirical evidence versus Intuitive Knowledge
Using Empirical Evidence
For Best Possible Treatment
Clinical or Intuitive Knowledge
Of What Works With Client’s

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Process: The mechanisms and conditions under which clients make emotional, behavioral, and cognitive changes through the course of therapy.
Outcome: What happens at the conclusion of treatment. This includes clients whose concerns were successfully addressed, as well as those who drop out of counseling, or decide counseling is not meeting their needs.

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A large number of client variables that can potentially influence outcome
Variability in level of therapist expertise
Variability in severity of the disorders being treated
Participant and observer bias
Questionable ethics of establishing true treatment and placebo groups
Difficulty in assessing how much progress has been made

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(Perry, Francis, and Clarkin, 1985)
Establishing and maintaining a therapeutic relationship; unconditional positive regard with the clients best interest in mind
Providing support through reality testing, suggestions, confirmation, and acceptance
Providing education and information
Decreasing or eliminating painful feelings and/or maladaptive behaviors
Modifying specific misinterpretations of stimuli
Helping clients put concerns in meaningful context
Expanding emotional awareness
Enhancing interpersonal effectiveness

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according to Orlinksy, Grawe, & Parks (1994)
The therapeutic contract: goals and conditions under which the client and counselor work together
Therapeutic operations: specific, technical, clinical procedures that counselors and client’s perform within the parameters of the contract
Self-relatedness: self-awareness
In session impact: client’s experience during the session
Sequential flow: the sequence of counseling, both within a session and across the whole process

Prochaska & Di Clemente (1982)
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Precontemplation: Unaware or underaware a problem exists and no plans for change
Contemplation: Beginning to be aware a problem exists, but minimal commitment to take action to change “I’ll quit tomorrow, so give me a double today.”
Preparation: Intending to make the behavior change
Action: The person modifies their behavior, experiences or environment to overcome their problem (joining AA, completely abstaining from alcohol)
Maintenance: The person works to maintain the behavioral changes achieved in the action stage

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Precontemplation
Consciousness Raising: Develop awareness of the problem and how it affects oneself
Dramatic Relief: Experiencing and expressing feelings about one’s problems and solutions; psychodrama, grieving losses, role-playing
Environmental reevaluation: Evaluating how one’s problems have an impact oh the physical environment

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Contemplation
Self-reevaluation: Assessing one’s feelings and thoughts about oneself in the context of the problem; value clarification, imagery
Preparation
Self-liberation: Accepting responsibility for making changes; decision making therapy

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Maintenance
Reinforcement Management: Rewarding oneself or having others administer a reward for making and sustaining changes; contingency contracts
Helping Relationships: developing a warm supportive interpersonal relationship
Counterconditioning: Replacing maladaptive behaviors with adaptive ones; relaxation, desensitization, assertiveness training
Stimulus Control: Removing or avoiding stimuli that stimulate maladaptive behaviors; removing alcohol or fattening food, avoiding high-risk cues

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Advocacy and research are central to delivering competent services
The importance of teaching client’s to advocate for themselves
Knowing how to identify effective treatment techniques
The need to cite relevant data that support the course of action chosen

References
American Counseling Association website www.aca.org
viewed on
7/5/06
Arredondo, P., & Perez, P. (2003). Expanding multicultural competence through social justice leadership. The Counseling Psychologist, 31
(3), 282-289 .
Chi Sigma Iota Website www.csi-net.org
documents retrieved on
7/5/2006
Florida Counseling Association website www.flacounseling.org
viewed on 7/5/2006
Kiselica, M. S., & Robinson, M. (2001). Bringing advocacy counseling to life: The history, issues, and human dramas of social justice work in counseling. Journal of Counseling and Development, 79, 387-397
MacCluskie, K. C., & Ingersoll, R. E. (2001) Becoming a 21 st Century
Agency Counselor. Belmont, CA: Wadsworth/Thomson (ISBN:
0534356052)