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Masters and doctoral level training for Counselor Educators, Counseling Psychologists, and other students of counseling is deeply committed to the development of the skills necessary for the ethical and effective delivery of services to individuals seeking counseling. Consequently, students are exposed to the intricacies of theory and rigors of supervision as they identify and then practice these counseling skills. A necessary adjunct of this professional development is an appreciation for the written case note. Add to this the required documentation of in-take summaries, assessment reports, and written professional communication, and we begin to realize the importance of writing skills for the effective counselor.
As obvious as this need for writing skills may be, little attention is focused on their development in the graduate training of Counselor Educators, Counseling Psychologists, and other purveyors of professional counseling services. This article will explore the importance of addressing this oversight and suggest several vehicles for honing these skills in a graduate educational setting.
Developing Writing Skills in the
Counseling Graduate Student
Numerous working definitions of counseling have been suggested by practitioners and academics alike. In its vision statement, The American Counseling Association (1995) describes counselors as professionals who "...recognize that all people routinely need help dealing with the personal, social, and career concerns they face as part of their development. By focusing on the goals their clients want to achieve, professional counselors assist people in making decisions, solving problems, and adjusting to change. Professional counselors assist in empowering their clients to make positive decisions regarding their future" (ACA, 1995). Corey (1991) suggests that counselors assist individuals by providing the opportunity to address problems and concerns. In essence, most working definitions of counseling suggests to some extent that counselors intentionally involve themselves in the individual lives of one or more clients in order to facilitate a mutually agreed upon, positive change, regarding a personal problem being experienced by the client(s).
Whatever the definition of counseling one might employ, it is likely to acknowledge the fact that counseling is something that we do with our clients as opposed to something we do to them. To ask students of counseling what competencies are of greatest importance as they prepare to engage in such activities, will likely result in an impressive list of interpersonal skills which they equate with `good counseling.' Communications skills such as listening, attending, extending empathy, and demonstrating genuineness are all likely candidates for the entering graduate student's list of sought after proficiencies. In some cases, developing competence in these specific skills may well be what leads the student to seek an advanced degree in counseling.
Most students acknowledge the importance of a conceptual presentation of counseling technique and personality theory in their course work. Because graduate students tend to view the practice of counseling as conducted entirely via the spoken word and the evaluation of their proficiency the exclusive domain of the counseling lab instructor or clinical supervisor at their internship who observes their delivery of these skills, writing is rarely seen as more than an unimportant vehicle of communication, much less a valued counseling skill. Graduate students, as possibly suggested by the quality of research papers and other samples of writing produced in class -- appear unaware of the importance of writing as an essential, if not clinical, skill for counselors to master.
Not to minimize the importance of a student's technique and the role of practical skills in the molding of a competent counselor, it is important for Counselor Educators to recognize that much of the evidence of clinical proficiency rests upon the written documentation related to the individual counseling session. As counselors, we are not only expected to be skilled in the "delivery" of counseling services, but are responsible for a plethora of written documentation which records our interaction with a client. Simply stated, if the service a counselor provided is not documented in writing, it never took place (Anderson, 1996).
Counselors are expected to document their counseling sessions "in writing." The ACA Code of Ethics (1995) specifically states, (counselors) maintain records necessary for rendering professional services to their clients and as required by law, regulations, or agency or institution procedures"(B.4.a.). Counselors routinely produce written correspondence to communicate with each other regarding a case. Psychosocial evaluations, treatment plans, intake and discharge summaries, and assessment reports are all recorded in writing. Should the counselor become involved in criminal or civil litigation, it is the written word that is subpoenaed with the counselor's spoken testimony frequently linked to those facts recorded in writing (Anderson, 1996).
Writing in all professions plays an important role, and counseling is no exception. As Soven (1996) suggests in her guide to writing across the curriculum;
"As educated adults we readily acknowledge the significance of writing in our own lives. We not only write letters of inquiry and complaint and messages of warmth and cheer, but we write to participate in the community of discourse of our disciplines. Perhaps even more important, when we are puzzled, we write to clarify our thoughts, we take notes, we write notes to ourselves. We write to solve problems. We write for professional, practical, and personal reasons and know that the ability to write gives us a sense of power in each of these domains. We write, in other words, to learn as well as to communicate what we have learned. We believe it is important to transmit these skills to our students and struggle to find methods for encouraging students to write in purposeful ways in our classes, hoping that they too will learn to use writing in their personal and professional lives." (p.1)
To state this quite simply, professionals, including counselors, are what they write. If there is any truth to this statement, then it is incumbent upon Counselor Educators as academics and practitioners to address the importance of writing as a necessary skill in counseling and demand proficiency.
Soven's (1996) analysis of the literature on writing demonstrates the connection between writing and learning. As such, writing is a pedagogical tool that can be employed in counselor training to enhance the learning process. The use of such assignments in the preparation of counselors compels students to organize information accurately and communicate it succinctly. These are skills that practicing counselors rely on daily in the preparation of case notes and professional summaries, documents which help the counselor understand the client's issues and provide quality care. Through the written case note, a counselor can focus attention on the prominent issues in the session, hypothesize strategy for effectively addressing these issues, and chart progress. With a clinical summary, the counselor is able to organize the salient issues that have been documented in a particular case and comment on the client's overall treatment to date.
But writing not only enables a counselor to organize what has been learned and is hypothesized about a client's treatment needs, it also enables these thoughts to be shared, realizing the necessity of informed consent, with colleagues and allied professionals. Considering this dimension of counseling, the professional with whom the counselor communicates via the written word is as likely to formulate an opinion about the counselor's as would the professor who critiques the student's written assignments. A poorly crafted missive or professional document speaks to the counselor's proficiency and may cast doubt on the diagnosis provided or treatment recommendations offered. In short, first impressions do count and a poorly written document can affect credibility.
To this point, it has been argued that writing assignments are a valuable pedagogical tool that should be used in the training of counselors. It is likely that the reader who is also a counselor will likely accept, to some extent, this premise for the simple reason that the demands of the profession have dictated that counselors develop good writing skills. But how are these skills cultivated? By what path do counselors arrive at their current level of writing proficiency? And more importantly, how do Counselor Educators and other academics cultivate these skills in the students accepted into graduate programs in counseling? These are questions too often over looked by academics and clinicians alike.
All too frequently, Counselor Educators are often appalled by the lack of writing skills in the graduate population whom they find seated in their classes. Following a student's initial writing assignment, the professor may well come to the realization that a student's ability to intelligently discuss a concept in class is no guarantee that she/he will be able to present an equally cogent and articulate argument in writing. In essence, verbal and written expression involve different sets of skills. Emig (1977) asserts this as she teases out the contrasts in these two distinct and uniquely different skills.
For most who speak well, talking is so natural as to be all but an irrepressible behavior. To write, on the other hand, is a skill that must be intentionally learned. Unlike speech, if reading and writing are not taught, these skills will not develop. To this end, writing is an "artificial process" (Emig, 1977; p. 36) while speaking is entirely natural. To pursue this distinction further, writing is a "technological device" (p. 36). While it can be argued that writing is an invention developed to enhance the exchange of ideas, and we can approximate its arrival on the time line of human development, it is likely that the spoken word has been a method of communication since the first bipedal humans evolved the physical competence to utter sound and the cognitive ability to assign meaning to the auditory symbols we now call language.
Developing Writing Skills
Graduate training in counseling may incorporate many pedagogical tools in the process of preparing a student for a career in counseling. Excellent examples of such training devices are the master's level practicum and doctoral level internships which provide the "hands on," supervised experience which enables the student to apply the theory and technique learned in the classroom. The hall mark of these training experiences is the supervision and feedback the student receives regarding his/her actual interaction with a client. It is the recognition of the specific counseling techniques employed successfully and highlighting of mistakes made or opportunities missed which allow students to increase their proficiency as counselors and enhance their standing as professionals. Yet short of the formal research paper or master's thesis/doctoral dissertation, little opportunity exists for students to receive the same quantity and quality of feedback on their use of the written word.
To facilitate the development of writing skills as a component of a graduate education in counseling, there are a number of techniques which will require the student to think and act as a counselor when writing as well as when speaking. These techniques, both formal and informal, present the student with the opportunity to recognize that writing is an important skill which will factor in to their academic success as well as their professional development.
The Journal
To teach students how to chronicle their thoughts, observations, and questions related to a specific course is an excellent way to instill a recognition of the importance of writing as a way of structuring their thinking and tracking progress. This technique is as effective in a didactic presentation of personality or counseling theory as it is in a counseling laboratory where students are beginning to establish a personal approach to employing theory.
To ask students to keep personal journals as if they were clinical notes on a client being seen is a useful practical exercise. Frequently, this involves instructing the students in a particular format to be used in recording case notes such as the D.A.P. -- Data, Assessment, Progress/Plan -- or other like outline. Having students record their observations on class discussions and assigned readings, as well as questions which occur out of class, encourages them to "react independently to required readings before coming to class...and structure the reading of related course materials" (Soven, 1996; p.22).
While journals should never be "graded" per se, they can be a required assignment. Feedback can be provided in the form of "post 'em" notes which are affixed to individual pages with feedback on everything from handwriting legibility to the clarity of comments and observations. Students can be encouraged to keep their journals on their word processors and offered the option of submitting such for review via floppy disk, email, or hard copy, with feedback on electronic journals presented parenthetically and in CAPS.
Students often report that this assignment enhances their preparation for participating in classroom discussions and offers a quick way to review materials covered in the course. As an aside, when coupled with appropriate outlines of different courses and theories, the journals become useful tools in preparing for qualifying and comprehensive examinations.
Discussion Questions
To facilitate student participation in class discussions and prepare for eventual participation in case conferences, require students to pose written questions related to assigned readings, case presentations, or other class activities. This technique serves to assist students in both organizing their thoughts about a particular topic as well as conceptualizing and articulating questions which elicit desired information. While these questions can be considered as "class participation" and factored in to a student's grade, whether graded or not this technique helps students pose questions with an eye to clarity and brevity.
Feedback with this technique is immediate and often quite enlightening. Once a question has been read, the response it elicits from the class can be very telling with regards to the questions clarity. A prompt response from peers tends to reinforce the way the question was crafted; requests for clarification or comments suggesting confusion suggest the opposite. With this exercise, the importance of the written word is practically demonstrated. Additional reinforcement for well crafted questions can be delivered by inclusion in subsequent examinations.
Written Feedback
Written feedback on in-class presentations serves the dual purpose of developing writing skills for the student providing the feedback as well as a more meaningful critique for the presenter. Requiring students to follow their spoken feedback with a written version will further enhance the development of writing skills. Such written comments serve to instruct the student who receives the feedback as well as the student who authored it. By differentiating between the easily understood and clearly phrased rejoinder and that which is poorly crafted, the student will recognize first-hand the importance of writing as a professional skill in counseling.
It is important to remember that writing, like any skill being learned, is strengthened with practice. To require informal as well as formal writing in a graduate course in counseling only serves to provide the practice which will assist in the development of this important counseling skill.
Formal Written Counseling Assignments While the written essay exam, research paper, and critical book review are all but ubiquitous methods academics employ to evaluate graduate students, these are but a small sample of how writing can be formally introduced into a graduate curriculum. Soven (1996) suggests that professors create special assignments designed to enhance a student's writing skills while at the same time pursuing the topical material outlined in the course syllabus. One such example is the written summary of a required reading assignment.
The summary is a particularly useful assignment for students of counseling as it enables them to develop specific skills in order to "target" a distinct audience. With this assignment, the student must learn to interpret the information being presented by the author and then report on it in the summary, using her or his own words. This helps the counselor develop the ability to both organize the information to be presented while at the same time clearly and concisely reporting the facts. This is especially useful in helping the student to prepare case summaries for clinical conferences or learning how to write intake and discharge summaries. These clinical documents are among the more important documents in a well managed case and often represent the first line of contact between the counselor and the allied professional to whom the counselor may be making a referral.
Soven (1996) suggests an eight item "check-list" for evaluating and providing feedback on the written summary. Her recommendations can be effectively adapted to case summaries prepared by counselors in their field placements:
"1. Has the document been identified appropriately? (title, author, publication information." When writing the case summary, it is important that students include their name and other pertinent information needed by the professor/supervisor, e.g., date and time, location, etc. However, because of reasons of confidentiality, it may well be important to use either a case number or other non-specific way of identifying the client.
"2. Are the main ideas of the original document clearly stated?" An accurate summary of the objective facts is an important portion of any summary or case note. Has the student captured the salient facts about the case/session? Have the objective data been separated from the student's interpretation of them?
"3. Are the relationships between the main ideas clearly indicated?" Are these key facts reported in accurate and chronological order? Whether it is a case summary which chronicles a counselor's involvement with a client over an extended period or a simple case note designed to document an individual counseling session, the relationship between the reported facts is an integral part of a well written summary. Without such integration, the student's assessment of the situation and the approach to clinical intervention taken may not be clearly evident.
"4. Are important examples and explanations included?" This is especially important when preparing a case summary. As the student outlines her/his clinical impressions of the client's diagnosis and proposed treatment, examples illustrating the problem as well as the client's progress in treatment are crucial to a well written summary.
"5. Is all essential information (names, costs, places dates, etc.) included?" This suggestion is self-evident for a well written clinical case note or summary.
"6. Is the length of the summary appropriate, in view of the purpose of the summary and the complexity of the material?"
"7. (Has the student) avoided injecting (his/her) own opinion or additional information?" For the counseling student, "injecting" one's opinion is an important part of the summary. What is important here, is determining if opinion, i.e., clinical assessment, is clearly noted as such and located in the appropriate section of the summary.
"8. Are mechanics correct?" As has been the focus throughout this essay, it is important for the counselor to write well. Mechanics are an integral part of recognizing writing as a counseling skill (p.43).
Related to the written summary and of equal value in training students of counseling to view writing as an important skill, is the short analysis essay. An assignment to analyze an essay, journal article, or book chapter is another approach that can be helpful in impressing upon students that writing is a skill that will be used frequently as a counselor. Assigning students to prepare critical essays, assists them in going beyond providing a simple overview of the article. Done well, the critique allows the student to contribute some explanation or interpretation of the individual elements of the considered essay or article. <P>
For the graduate student in counseling, this assignment requires that he/she not only think about what the author has written, but draw upon his/her previous courses and training in order to offer an interpretation of what has been read. The confluence of reading an article, understanding its author's intent, and interpreting this to the counseling field with the ability to accurately and effectively communicate this information in writing is significant in a counselors professional development. If a written summary, as outlined above, enables the counseling student to organize and accurately report information, then the short analysis essay provides the opportunity to develop one's ability as a critical thinker and craft an accurate written representation of these observations. This will further enhance the student's ability to accurately report on individual treatment sessions as well as prepare succinct yet thorough case summaries.<P>
Concluding Remarks
Counselor Educators and Clinical and Counseling Psychologists tend to be, by their training and experience, practitioners. Consequently, their teaching attention is focused on theory and the development of direct service skills. This essay has not so much targeted this approach to graduate training for question, as to argue that the clinical responsibilities of the practicing counselor are heavily steeped in the written word. With this as a basic assumption, ways of illustrating this point and approaches to developing writing skills for counselors in training have been presented.
It is easy to assume that the student who has graduated from an accredited college or university with an undergraduate bachelors degree has mastered the art and craft of writing. This assumption coupled with a proclivity to over look the importance of the written word in the delivery of competent counseling services, may well create an atmosphere conducive to producing graduates who are well prepared clinically to deliver counseling services, but without the requisite knowledge or skill to record their activities.
While but a portion of those who function as counselors will choose to write for publication, all counselors are required to record their case notes, communicate with each other and allied health care professionals, provide formal documentation of services delivered, and engage in case management activities of some description. Each of these responsibilities requires proficiency with the written word.
While the suggestions outlined in this article may represent steps already employed in the classroom, to underscore their significance as pedagogy in the development of writing skills alerts the student to the importance of writing well as a counselor. Perhaps as educators who have assumed the responsibility to train counselors in both the art and craft of counseling, we likewise have a responsibility to consider this all to often overlooked facet of professional counseling, the written word.
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