Mental Health Counseling: Navigating Life's Challenges

0:00:01 - Announcer

You are listening to the National University Podcast.

0:00:10 - Kimberly King

Hello, I'm Kimberly King. Welcome to the National University Podcast, where we offer a holistic approach to student support, well-being and success- the whole human education. We put passion into practice by offering accessible, achievable higher education to lifelong learners. Today we are talking about a new trend- clinical mental health counseling. It's so relevant in today's world and a really interesting interview coming up.

But according to a recent article in very well health publication, mental health counseling aims to diagnose and help improve emotional and behavioral well-being. It also may serve as an alternative to medicine or be used with medications or other mental health treatments. It's a really interesting conversation coming up on today's show. On today's episode we're discussing clinical mental health counseling and joining us is National University's distinguished emeritus professor, Dr. Joshua Gold, and Dr Gold has 32 years as a faculty member in counselor education and has also been a counselor since 1984. He is the program director of the clinical mental health program at National University and he's received several awards over the years, most recently given the UTC CHEPS Outstanding Clinical Faculty Award in 2023. Congratulations and we welcome Doctor to the podcast. How are you?

0:01:38 - Doctor Joshua Gold

We're doing fine. I hope you all are. Thank you for the invite.

0:01:41 - Kimberly King

Absolutely Love having you on with us, and why don't you fill our audience in a little bit on your mission and your work before we get to today's show topic?

0:01:50 - Doctor Joshua Gold

Okay. Most of us started off as clinicians because sometime in our growing up experience we found an issue or a population who could use our support. Some of us and I guess I would count myself among them decided that we could have a greater impact, not by delivering clinical service, but by training the next generations of clinicians, and that's what prompted the trip through the PhD program and then my entire career.

My legacy, my assumption is nobody's going to name a street nor a football stadium after me. But if I had sent out sufficient numbers of well-trained clinicians on a societal level, that's where the impact will be.

0:02:36 - Kimberly King

I love that, and boy, what a legacy. I think that's much more important. So today we are talking about clinical mental health counseling and we have the right guest on to discuss. So, Dr. Gold, what is clinical mental health counseling, CMHC?

0:02:52 - Doctor Joshua Gold

CMHC, it is. I'm going to start with a history lesson, because I used to be a history professor, and when this gets way too old you're just going to cut me down. Counseling, as distinct from psychology, is found in the field of education. The original counselors, known as vocational guidance personnel, came into being around the same time as people mandated public school education. Their job was to help children at that point see a connection between what they learned in school and a future career.

From that start, counseling spread with a couple of unique characteristics. One, it is for everyone, not just for those mentally ill. Two, it deals with predictable life transitions and helping individuals to navigate those transitions. Out of the school counseling focus there then became a split off bunch that wanted to work in non-schools and it was originally called, believe it or not, community counseling, and the training was similar. Obviously, the clinical placements were different. Clinical mental health counseling, I think, reflects a societal focus on better diagnosis of mental illness, more considerate effort to legitimize mental health issues among the general population and, I think, a greater acceptance of the field of psychology in general.

0:04:23 - Kimberly King

Wow, that is, I think, really hitting all the high marks, and again, we talked a little bit about how relevant this is in today's society, and so I hope that you inspire more people to get involved. How is CMHC different than psychology, social work, marriage and family therapy?

0:04:46 - Doctor Joshua Gold

I should have a PowerPoint with this and I don't. Luckily it's just audio so it wouldn't show up very well. [Laughter.] We train folk. A lot of the skills are the same. It's really an orientation towards your client. Counseling, generically, I think, is founded in what we call a humanistic tradition. By that I mean, if I sit with a client and I ask the right question at the right time in the right atmosphere, I trust the client will find his or her own personally relevant answer. The question then becomes not, do clients need answers? But they don't have the questions they need. My job is to provide those questions.

0:05:33 - Kimberly King

So, going backward, right, you do the answers and then the questions. That's interesting.

0:05:38 - Doctor Joshua Gold

Well, there's an assumption, I think, among counselors, men, that we are all alike on our human journey. Because of that, while we may not share gender or ethnicity or common life experience, we've had similar life experience. Most of us and I have yet to find a student to attest to this grew up in some kind of family. I asked many students, any of you raised by wolves? And nobody said yes.

0:06:08 - Kimberly King

[Laughs.] You just had to throw it out there first to find out right.

0:06:11 - Doctor Joshua Gold

Yet, family does the same thing differently, so catch code with a different sense of normalcy and unfortunately, from what we have learned, family crazy is normal to a lot of people.

0:06:28 - Kimberly King

That is a good point too. It's that people don't always post it on social media, but you do know that that's a very common theme. We all come from a little bit of crazy, don't we?

0:06:38 - Doctor Joshua Gold

Yeah, we do, and everybody learns the same life lessons differently. I think that the most telling indication of a successful marriage for newly engaged people would be whether or not they could survive a trip to the grocery store together, or they could go to the laundry detergent aisle, but whether one needs Tide pods or some other kinds of detergent.

0:07:00 - Kimberly King

Good point, good point. That's a good test. I love it. So talk to me a little bit about how do CHMC view client issues.

0:07:14 - Doctor Joshua Gold

Well, that's a really short question to which I would have to take a long answer.

0:07:20 - Kimberly King

OK, you got the floor.

0:07:22 - Doctor Joshua Gold

Yeah, there are multiple approaches to working with clients based on how much history clients want to know about their issue or whether they don't want any history. Based on whether or not clients prefer to approach the world in a feeling model or a thinking model. Based on how much clients understand their culture and how their particular cultures influence the meaning that they make in the world. I think counseling generically suggests the event itself has no implicit meaning. We create meaning out of every event in our life and because of that we can recreate meaning.

0:08:04 - Kimberly King

Hmm, I Really like that. Can you expand on that a little bit? I think that's such an interesting point that so it's created, but then you recreate it too For the purposes of your memories or dealing, or is that kind of what you're saying?

0:08:20 - Doctor Joshua Gold

Both. I'm gonna give very quick example. Man from teaching school, I can give children in school a Paperback worth exactly the same grade One is elated because this child was tended to be a C student who got a B. Okay one is in tears Because that student was an A student in gotta be. Hmm the response is not in the grade. The grade is exactly the same, but in the meaning that each child attaches to that grade.

0:08:48 - Kimberly King

Oh yeah.

0:08:50 - Doctor Joshua Gold

Most people unfortunately generate a meaning schema as children and never explored or re-authored that schema.

0:09:02 - Kimberly King

Okay, wow, I'm really fascinated by this and I love that. So that's the part of going back and looking at it to change the, the, I guess the processing we've been told ourselves or telling ourselves or through that history that's something, is some way. But then it's revisiting that and learning, just kind of flipping the script a little bit.

0:09:24 - Doctor Joshua Gold

Is that not the mission of social justice? And the eradication of all prejudice.

0:09:29 - Kimberly King

Right, good point. Yeah, wow, interesting, I Like it. How do CMHC work with clients then? Specifically, Okay.

0:09:40 - Doctor Joshua Gold

Counseling tends to be much more issue focused than some of the other disciplines. It really is based in a notion that if we can sit with clients no, I don't want to make this too complex and help them, in a really safe environment, discover what it is that they truly want, in this situation, all things become clear.

Hmm from a peculiar Issue and I will offer this from my stance only. I've worked with substance abuse folk an awful lot, yeah, and people always say how do you do substance abuse counseling? And I say it's a waste of my time. Hmm, and the reason I suggest that, man, is I see substance abuse use as a failed attempted solution to deal with a life pain.

I can do it kinds of rehab stuff with folk. The recidivism rate, as y'all know it is enormous. Until we can readdress that initial pain, the people are gonna have to continue to protect themselves from it. My job is not to save a client from their life pain, but sitting with me to help them know that they can deal with it.

0:10:51 - Kimberly King

And so it is interesting and I can understand you know where you see those clients. But I would imagine, especially since we've come through COVID and you know, with the kids that are now you know they were in front of their screens and then trying to come back in as a social- Do you work with a lot of kids or teenagers as well that that may be having these issues?

0:11:12 - Doctor Joshua Gold

We do. I'm currently doing some work at the University of Tennessee in Chattanooga dealing with- in their school psychology program- and that's exactly what you're seeing is kids coming to school lacking basic social skills because for the last four or five years they've been interacting with the screen.

0:11:31 - Kimberly King

Yeah, well, good for you-

0:11:35 - Doctor Joshua Gold

The teachers have discovered that these are not the same kids that went out.

0:11:39 - Kimberly King

Which is so unfortunate that we had that pause, you know, in our world and our lifetimes, but for thank goodness for somebody like yourself and that you are teaching the next generation to you know how to really, I think if you don't have those social skills and can't have a conversation, and just it's just, it's really tragic.

0:12:01 - Doctor Joshua Gold

But I think the other thing that distinguishes counseling from my perception is if you look at diagnostic criteria, it says that the behaviors you're seeing must be outside the developmental norm for individuals of that age and culture. So it's not a behavior checklist that a parent can you know, check boxes, but if I don't know what's normal development, how do I know what's abnormal?

0:12:28 - Kimberly King

Good point.

0:12:29 - Doctor Joshua Gold

So a lot of what we do, and a lot of counselors in different perceptions do, is help folks understand. What you're dealing with is a normative life transition experience. I had the opportunity, if I can go back a couple of years at the University of South Carolina to become involved working with a gentleman by the name of John Gardner and John Gardner might not be a name used to your folks, but what he created did way back in the when he was talking to the provost of Carolina. They were worried about first year students disappearing. They would leave at Christmas and not come back to campus, and it wasn't for academic reasons.

My memory of the story is Dr. Gardner said to the provost, will you find one little section? I got an idea that we're going to try to do with first year, first semester students to see if we can address the non-academic transition issues to college. Provost said oh yeah, we'll give you some money for that and see where it goes. That became something called University 101. That exists on every college campus, ma’am. They have a version of that saying we know, as a first year student, what you're facing coming in and rather than you pathologizing that and internalizing it, we're going to create program to normalize it.

0:13:57 - Kimberly King

I love that. You know I talked about this so many times recently. My son is a police officer and in his training he has to go through scenarios which are very life or death scenarios. But if they didn't go through those they wouldn't know how to respond or to react. But I think we need those real life scenarios in life. It's not going to be easy and it is normal to hurt and to go through things. But I think we tend to just really try to find the easy way out or make it look like it's all a bed of roses. Life normally is not always a bed of roses.

0:14:34 - Doctor Joshua Gold

I hope that makes sense. I wish it could be and I know homework wishes it could be, but being able to cope with life teaches one a sense of ego strength, resilience, of perseverance, of patience, of self-understanding and of optimism. And it became like do that as adults? How do we teach that to our children?

0:14:58 - Kimberly King

Good point, yeah, I yep. And I don't think social media is helping when you only see the good things there too.

0:15:02 - Doctor Joshua Gold

So yeah, I think media is confusing because folks confuse opinion for fact, right, right, and you know I have no social media presence. Nor do I wish one. You're an anomaly? Well, probably am. I've been called other names but I don't know if I'm okay. You know, and I love your opinion, you're entitled to it. I'm just not interested in it.

0:15:36 - Kimberly King

Exactly, I 100% agree with that. So how do you CMHC view clinical success? Is that easy? Yeah. So how do you CMHC view clinical success? Is that easy or how? How do you measure that?

0:15:46 - Doctor Joshua Gold

Well, it's not measured. No, I think my measurement tape is inclined satisfaction. Are you getting what you want out of this in terms of resolving the issue you brought? And, on a deeper level, have I helped you to consider a different way of making sense of your life struggles? If I've done that, then our time together is generalizable. Beyond working through this one issue that brought you, I'm also providing them, I think, with an experience of how you interact with other people in a respectful, gentle, listening way. Talk with people. I don't talk at them.

0:16:30 - Kimberly King

Yeah, yeah, and that's a lost art, by the way. So I'm glad you are that is at the top of your list and you're teaching, because I think people have an opinion like you had mentioned, and they come in with that, with shutting their ears down, without that ability to listen these days.

0:16:48 - Doctor Joshua Gold

Well, my grandfather said to me once when I was much younger. He said look in the mirror, boy. And he said what you see? And I told him what I saw because I was very polite and I mentioned that I had one mouth and two ears. He said well, that means you should be listening twice as much as you're talking.

0:17:06 - Kimberly King

]Laughter.] That should be the title of your book. Next one yes, wow. Well, I could talk to you all day, or listen to you, I should say. But this is interesting information and right now we need to just take a quick break. But stay with us and we will be right back. And now back to our interview with National University's distinguished emeritus professor, Dr. Joshua Gold. We are talking about clinical mental health counseling, CMHC, and so, Doctor, fascinating information. This is great. How can you answer? How are CMHC trained?

0:17:44 - Doctor Joshua Gold

The training for a counselor is a graduate degree program only. The standards for that training are prepared by the council for the accreditation of counseling related educational programs. That's a very long title, it would take two t-shirts [laughter]. It is the counseling equivalent of APA or AMA, like the American Medical Association. It says students need 60 graduate credits. They're in eight core professional training areas and students must complete a practicum and an internship in order to qualify for state licensure.

0:18:29 - Kimberly King

Okay, wow, that is. But yeah, you've earned that accreditation, so let's talk a little bit about that. How important is program accreditation in CMHC?

0:18:40 - Doctor Joshua Gold

I think it is critical and the program at National University is moving as quickly as they can towards qualifying for that accreditation. It is an assurance to a student of the quality of the program and a fit between the program's curriculum and licensure requirements in each state.

0:19:01 - Kimberly King

So that leads me to my next question how is accreditation status linked to state licensure for CMAHC?

0:19:08 - Doctor Joshua Gold

Okay, they are identical.

0:19:11 - Kimberly King

Oh, okay, that's easy.

0:19:13 - Doctor Joshua Gold

It really is. The counseling profession has fought for years because they are licensed, as you know, on a master's level, state to state and for many years each state had their own kind of different licensing. And over the years, the counseling profession, the American Counseling Association, has advocated for equivalence between the states, which also then leads to license portability between states.

0:19:41 - Kimberly King

Okay, okay, interesting. So how portable is a state license as a licensed professional counselor, an LPC?

0:19:50 - Doctor Joshua Gold

Okay, there is an interim step between graduating from a graduate program and earning an LPC. Each state awards what they would call a provisional license or an associate's license, kind of like a driver's permit. In each state there are a specific number of clinical hours one must accrue and to be guided by a supervisor. Once a state license is earned a full LPC- to the best of my understanding, you can take that anywhere in the country and swap it off for a local one.

0:20:27 - Kimberly King

If I'm not mistaken, isn't that sort of like when you get your nursing degree as well, can you go state to state with a nursing degree? Different than an adventure?

0:20:35 - Doctor Joshua Gold

I cannot speak to that ma'am. I don't know enough about nurses.

0:20:39 - Kimberly King

Okay. Well, let me ask you this then- After the masters, students need to do clinical hours, but are those standardized across the states? Do you know that?

0:20:49 - Doctor Joshua Gold

I do know, and unfortunately they are not, and I have yet to get any kind of explanation from any state about how they picked that number. You know, some states say you need 1,000 hours, some states can say you need 3,000 hours. What is critical for students to know is that once you get your degree and your associate's license, you are employable as a licensed counselor. So it's not a question that you're trying to get these hours around another job.

0:21:16 - Kimberly King

Okay, Interesting. What about national organizations? State organizations? Do they exist for the advocacy of CMHC?

0:21:26 - Doctor Joshua Gold

Yes, ma'am, they do. Nationally as the American Counseling Association. If you all are going to be down in New Orleans this spring, the National Convention is there. That is the largest national body for counselors. Each state has a professional counseling association. And when they're becoming strongly- to each of the students at national that they become involved in that national organization.

0:21:53 - Kimberly King

Well, that's good, that's something that so, if you're interested, as you're a student, you know looking for those national organizations. But also, what advice would you give to a new counselor just starting out?

0:22:06 - Doctor Joshua Gold

Yeah, as a student, ma'am, or as a practitioner? As a student, I would say, be humble.

0:22:15 - Kimberly King

I like that.

0:22:16 - Doctor Joshua Gold

I would say be patient with yourself. You know, I use the analogy about folk who have learned to play a musical instrument and when they sat down it looked easy, but it had notes and they had to do things with their fingers and it took a lot of time and some diligence and a bunch of practice.

And the same analogy could be played to becoming a professional counselor. Unlike notes, the only tool we have are words, and we must be judicious and wise in how we choose them and use them to have the help we hope to have with our particular clients.

0:22:56 - Kimberly King

Wow, it's really interesting. I really appreciate you taking the time to really open up a whole new window, a whole new area where I think people would succeed in the world that we live in today, and so I think I appreciate you making a difference in these students' lives and counselors, your CMHC counselors. So, thank you for sharing your knowledge and if you want more information, you can visit National University's website at nu.edu. And again, doctor, thank you so much for your time today.

0:23:30 - Doctor Joshua Gold

Thank you for having me.

0:23:34 - Kimberly King

You've been listening to the National University Podcast. For updates on future or past guests, visit us at nu.edu. You can also follow us on social media. Thanks for listening.