This is a summary/reflection on my reading from the Duffey & Haberstroh (2020) text: Introduction to Crisis and Trauma Counseling. Full reference list provided below.

Chapter 1 in our text (Duffey & Haberstroh, 2020) was a good summary of the information to come. It provided a general background on what a crisis is, as well as what trauma is, and how the two differ in nature. Just because a person experiences a crisis does not mean that they will go on to experience trauma. The behavioral sciences have learned a lot about trauma in the past 15 years, and generally have found that using an RCT (relational) approach, focused on responding directly to the individual, is far more effective than a standardized and prescriptive approach. This approach tends to value processes that are “holistic, mutual, intuitive, compassionate, personal, and contextual.” There are a number of emerging technologies in the field of trauma work, such as the use of VR, neurofeedback devices featuring electrode stimulation, protocols such as accelerated response therapy (ART), written exposure therapy (WET), mind-body interventions such as acupuncture, eye movement desensitization and reprocessing (EMDR), emotional freedom technique (EFT), mantra and meditation, and yoga. Vicarious trauma is a huge consideration for clinicians working in the field, and the authors claim that counselors focusing on their own wellness (the integration of body mind and spirit in connection to a larger community) is imperative. According to research by Myers & Sweeney (2008), counselors in training have a higher level of wellness when they participate in a wellness class as a part of their curriculum.

Chapter 2 (Duffey & Haberstroh, 2020) focuses deeply on the power of relationships on individual health and wellness. RCT (relational-cultural theory) as a modality focuses on the therapeutic container being the true key to transformation. At the counselor is able to show up in authenticity, responding to their client’s self-protective methods of disconnection (strategies of disconnection/survival) in a mindful, empathic, and collaborative way, they are literally requiring their client’s brain into safer and more supportive patterns. Validation and meaning making are two huge facets of this kind of relationship, and RCT identifies the “5 good things” integral to growth (Miller & Stiver, 1997) as clarity, zest, a sense of worth, productivity, and desire for more good relational connection. This therapeutic experience can only exist in genuine mutuality— showing up with another person outside of pretense. Self disclosure is necessary: not disclosure to the client about personal matter that bring the focus away from the client, but disclosure about the mutuality of impact, and how the counselor is also benefitted through connection with the client. Despite the over 35 years that RCT has been in practice, it was only within the last 10-15 years that neuroscience has affirmed the principles as biological science. Building connection lends to good vagal toning, and that type of vagal toning goes on to build comfort and safety in more relationships (Porges, 2011). There is a lot to be said about the self work needed by a counselor in order to hold therapeutic space in the face of shame and vulnerability. Being receptive to client feedback, remaining empathic, cohesive, and sustaining alliances are necessary qualities in order to generate effective client outcomes and counseling success (Norcross & Wampold, 2011).

Chapter three (Duffey & Haberstroh, 2020)  talked about lot about how important it is for the counselor to understand their own biases, learn about diverse cultural approaches to healing (especially those in the background of active clientele), practicing cultural competence, and acknowledging both culture and context as necessary factors for effective crisis work. The ecological-social model of crisis and trauma work is designed to look at the many layered and interwoven social systems that play mutual influence. A few facets of culture that can vary are individualism versus collectivism, the perception of power and distance from influence in hierarchical systems, a person’s ability to sit with uncertainty or lean into avoidance, attachments to indulgence versus restraint, and short versus long term orientations in which traditions or future planning hold more weight. Lack of cultural awareness or cultural humility on the part of the counselor can cause significant harm in situations where there is a cultural mismatch, however when a counselor is able to recognize their power and privilege then they are able to actively empower those with less power and resources. Because empathic failures can happen even by the most adept counselor, it is imperative to focus on responding in ways that help the client feel understood— this can even teach the counselor more about their own personal biases and how to grow through them. Taking a power-over role, in which the counselor retains an “expert” status, perpetuates the cycles of harm that can be found in traditional counseling: microassaults, microinsults, and microinvalidations. In our global culture with so many people being impacted by trauma from a collective, cultural, or historical context, counselors are being called to mobilize through social justice efforts, and affirm human dignity by routinely calling out abuses of power. The therapeutic relationship is the primary container for growth to take place, no matter what the therapeutic background. 

The neurobiology of trauma is a pretty recent study, with a lot of the information coming from the last ten to fifteen years of clinical research. The neuroscience of relationality has been studied under a number of different names (such as social neuroscience and interpersonal neurobiology), however chapter four (Duffey & Haberstroh, 2020) focuses primarily on relational neuroscience, as coined by researcher Amy Banks (2016). Although researchers at Wellesley College realized that authentic and mutually empathic connections are the core of human wellbeing as far back as the 1970’s, locating the mirror neurons that fully demonstrated the social responsiveness of the human brain didn’t happen until the mid-1990’s (Gallese, Fadiga, Fogassi, & Rizzolatti, 1996), and purely by accident. The mirror neurons give humans a pathway to truly feel another person’s active perceptual/emotional experience, and more modern research has gone on to show that the vagus nerve picks up on even the most subtle facial cues which can trigger the nervous system to settle or alert based on the stimulus (Siegel, 2015). This phenomenon is called neuroception, and there are seven forms of nonverbal communication that can be picked up by the human brain: eye contact, body position, silence, vocal tone, facial expressions or gestures, physical distance, and touch (Gladstein, 1974). These nonverbal forms of communication are considered part of right-hemisphere brain processing, and by building right hemisphere forms of connection a person can transition from a detached and dissociated state to one of inspiration and creativity (Jordan, 2017). The use of metaphor and imagery are also considered part of the right brain, which can then translate across into the more logical left-brain states of processing. Often times when there is a discrepancy between the left and right brain sources of input (a person saying one thing but presenting in an opposing manner) people tend to believe the right-brain content first (Burgoon et al., 2016). There is now a lot of research about the neurobiology of post traumatic stress disorder (PTSD), and numerous studies have confirmed that heart rate and blood pressure function at an elevated baseline for many people with that clinical diagnosis (Zoladz & Diamond, 2016). Researcher Stephen Porges (2014) has explored how the vagus nerve can be toned through mind-body practices in order to alleviate symptoms of hyperarousal. The evidence for mindfulness meditation and trauma-sensitive yoga as a tool for interoception— the perception of our own internal states— and alleviation of PTSD symptoms is abundant. A counselor must be attuned to their own internal states as well, using their own finely tuned interoception to pick up on subtle changes in client affect, allowing for places of discomfort to exist with awareness that growth is also happening in that space, and without trying to interpret or use logic to define the experience. This relational presence can create substantial growth for a client with PTSD, many times restoring much of what was lost in terms of self-regulation, no matter at what age the trauma occurred (Banks, 2016). 

Chapters 5 and 6 (Duffey & Haberstroh, 2020) talked about the fundamental skills for crisis and trauma counseling. A crisis situation does not necessarily denote a trauma— while they are similar in being an intolerably difficult experience exceeding the person’s current coping abilities or resources, trauma specifically has to do with lasting psychological symptoms that linger after the experience. Dealing with a crisis situation skillfully can minimize the experience of trauma. There are a number of different psychotherapeutic models when it comes to dealing with both crisis and trauma situations, and CBT is one of the most widely researched and developed on. Brock et al. defined a PREPaRE model of crisis prevention and intervention for school systems, including “developing and training response teams, crafting policies, outlining chain of command activities, creating annexes, training staff and students in procedures, and establishing communication protocols” (2016). Clearly a huge part of crisis management is preparation— assessing resources, safety planning, and asking for support. Based on an individual’s response to the crisis, the incoming supports may need to be more directive, however working in collaboration is beneficial whenever possible. Suicide prevention and intervention are a huge aspect of crisis counseling, and there are many resources out there, such as DARNCAT (Desire, Ability, Reasons, Need, Commitment, Activation, and Taking steps) to help a counselor assess for safety and identify client willingness to engage with change (Miller & Rollnick, 2013). Experience of trauma can arise in people who have been peripherally impacted by crisis as well: aside from primary trauma (a person immediately impacted by crisis), clinicians have also named secondary trauma (first responders who directly witness a trauma situation) and vicarious trauma (support systems who become impacted by the stories of traumatized persons). Shared trauma takes place when a person acts as a trauma support during a time that they are also being immediately impacted by the trauma, such as a natural disaster or a mass shooting in a community. Acute Stress Disorder is the diagnostic condition for trauma that manifests symptoms for one month or less, and Post Traumatic Stress Disorder is the diagnostic condition for trauma experiences lasting longer. There are also some minor differences in symptomology, most specifically the shifting of belief patterns due to the traumatic event, or flashbacks to the event, which lengthen the traumatic response necessitating the PTSD diagnosis. Impacted of trauma can be seen in many layers: cognitive, affective, behavioral, and relational. There are numerous tools for assessing trauma, and a standard biopsychosocial evaluation includes assessing the most immediate or pressing concerns, current capacity to function, assessment of risk for suicide, homicide, substance use or psychological impairment, available social supports, and both past and active coping skills. Bilateral stimulation has demonstrated great effect in relieving the symptoms of trauma and allowing for processing— a necessary component in the resolution of trauma. Complex post traumatic stress disorder, in which there are repeated and ongoing trauma events, can be really challenging to resolve. Creative methods of therapy, such as art and play therapy, and sand gray work, along with meditation and mindfulness, can be really helpful in processing through or learning to cope with trauma. 

The American Association of Suicidology reports that for every person who dies by suicide, there is a peripheral ripple through the community that impacts an average of 147 people, with at least 18 of those people experiencing significant life disruptions (2014).  With suicide now listed as the second leading cause of death in the United States for individuals 1-44 years old (CDC, 2024), those ripple effects are astronomical, causing suicide contagion and secondary trauma for a significant number of people that could perpetuate the cycle of harm if not met with the proper intervention. Being well informed about how to notice the warning signs of suicide, as well as having the courage to discuss suicidal behaviors directly is integral to combating this mental health crisis of epidemic proportion. 

There is a lot of statistical data about the populations who are at higher risk for death by suicide. Included in those statistics are Native Americans, individuals identifying as a member of the LGBTQAI community, current and former military, and men in midlife and beyond (Duffey & Haberstroh, 2020). The pneumonic IS PATH WARM can be used to help clinicians remember how to assess for the warning signs: Ideation, Substance use, Purposelessness, Anxiety, feeling Trapped, Hopelessness, Withdrawal from communities and activities, Anger, Recklessness, and Mood changes (Juhnke, Granello, & Lebrón-Striker, 2007). 

The most important tool for the counselor is arguably the ability to speak in a direct and nonjudgmental manner about these topics. Asking questions such as “are you thinking about killing yourself?” or “what would you use to end your life?” can be the only ways to accurately assess a person’s potential risk. Determining whether the client has suicidal ideation, their prospective means and access to that means, and their timeline, can assist in determining risk of lethality and recommended level of intervention (Duffey & Haberstroh, 2020). Assessing buffers to suicidal behaviors can also be really helpful: future plans, social supports, immediate access to resources and supports, willingness to engage with supports, any sense of purpose or core beliefs that would impact suicidal behaviors, or views on living and dying can all be helpful when assessing for risk (Joiner et al., 2007). Stanley and Brown (2012) standardized a safety planning intervention that could be used in instances where there is any hope present for the client. Warning signs, internal coping strategies, utilizing contacts as a means of distraction, accessing personal supports, accessing professional supports, and reducing potential access to lethal means comprise the outline of their plan (Stanley & Brown, 2012). 
 

Arguably, understanding Suicidology, and how to respond in a time of suicidal crisis takes much more than reading a chapter in a book, or even a semester of lecture and practice. Clinicians must be willing to assess their own biases, develop the ability to have direct and shameless dialogues on the topic, and be able to listen for glimmers of hope without pushing a personal agenda. It is the responsibility of the clinician to advocate for prevention at all levels— universal access to resources and supports, selective care for members of highly impacted communities, and individually indicated warning signs— until the stigma has been successfully transformed on a cultural level and suicidal behaviors no longer exist at epidemic proportion. 

Violence, abuse, and neglect can have profound impacts, whether occurring in childhood, adolescence, or adulthood. There have been numerous studies in the past two decades into the phenomenon of ACEs (adverse childhood experiences) and their impact on long term mental and physical health. The ten domains of ACEs include: physical abuse, sexual abuse, having a family member incarcerated, drug use or a serious mental health issues on the family home, parental separation or divorce, domestic violence, and food insecurity or nutritional deficiency (CDC, 2019), however bullying, racism, witnessing interpersonal violence, accidents or traumatic injuries, and many forms of grief and loss can also create effects similar to those of the CDC-defined ACEs (Duffey & Haberstroh, 2020). Because we are aware of the significant impact that trauma can have on the developing mind, and the tendency for children and adolescents impacted by that trauma to be given a range of diagnostic conditions, in 2009 the National Child Traumatic Stress Network advocated for a new diagnostic category that would adequately define the symptomology of complex trauma and its impact: Developmental Trauma Disorder (van der Kolk et al., 2009). Especially noteworthy, exposure to childhood physical abuse, childhood sexual abuse, and childhood emotional abuse and neglect can create powerful relational and controlling images that keep people from connecting authentically, building expectations for social and cultural oppression (controlling images), or expectations around how others will treat or behave towards them (relational images). Despite this focus on adverse childhood experiences, neglect and abuse is a huge issue in the population of aging adults, with self neglect— the ability or unwillingness to provide for oneself the goods or services needed in order to ensure adequate health and care (Lee, Burnett, Xia, Smith, & Dyer, 2018)— being a significant risk, especially in aging populations impacted by cognitive impairment, decreased physical and emotional functioning, medical disorders such as dementia or depression, and general refusal of care or support (Dong, Simon, & Evans, 2012). 
 

Another significant trauma that impacts humans across age groups is sexual assault. American culture is a rape culture— defined as an environment in which rape is prevalent and in which sexual violence is normalized and excused in media and popular culture (Marshall University Women’s Center, n.d.). This can be seen in commonplace misogynistic language, the celebrated objectification of women’s’ bodies, the glamorization of aggressive sexual behaviors and sexual violence, and even the refusal to honor women’s’ reproductive rights. This history of rape culture is longstanding, with domestic violence considered a healthy expression of sexuality and a cathartic experience that benefitted both partners as recently as the 1960’s (Snell, Rosenwald, & Robey, 1964). There is now a significant amount of information about how to respond after a sexual assault, including a 5-step protocol developed by Chakaryan (2018). Ultimately, connecting with even one empathic person can create a powerful trajectory towards healing, as neuroplasticity and social connection can help to mitigate even severe effects of trauma. Child-parent psychotherapy, the Attachment, Self-Regulation, and Competency model, and the Intergenerational Trauma Treatment model are all family-oriented practices that can help bridge into repair when trauma is impacting one or more members of a family (Duffey & Haberstroh, 2020).

Chapter 9 (Duffey & Haberstroh, 2020) acknowledged that there are many developmental milestones throughout a lifetime that do not go on to a PTSD diagnosis, but which can be deeply distressing and uprooting nonetheless. With support and reframing a crisis can be seen as an opportunity for reflection and personal growth. In fact, a counseling relationship is often a mirror, providing reflective distance in much the same way as a mediator (paint brush, carving tool) in an art therapy practice— allowing the client to pull back from their fingers-in-the-muck in order to navigate the medium (their life) with increased skill. Awareness that a person’s suffering always makes sense in their current context, and microinvalidations or lack of empathy can further that suffering, is integral to being a proper mediator in a counseling relationship. The dual process model (Stroebe & Schut, 2010) acknowledges and validates the “untidiness of change” by normalizing how an emotional response may include a myriad of sudden and seemingly-opposite extremes. Supporting a client in recognizing and labeling distress caused by oppressive systemic forces can also help the client to build resilience (Ching et al., 2018). Developmental trauma disorder (not currently in the DSM-V) and deviations from an expected developmental pattern can be challenging for both parents and children. Sexual harassment, job loss, chronic illness, marital stresses and periods of empty nesting, or even retirement can all be periods of crisis for an individual.

Working with couples and families, as discussed in chapter 10 (Duffey & Haberstroh, 2020) can put counselors into contact with topics such as addiction, divorce, domestic violence, incest, infidelity, suicide, and more. There are no “tidy” solutions to these problems—showing up in a relational context to support the clients with cultural humility and access to resources is perhaps the one ongoing practice that transcends subject matter. Intimate partner violence (IPV), often involving acts of power and control and aggressive behaviors such as name calling, hitting people or objects, chastising, and sexual coercion, is incredibly common, and some demographics are at a statistically increased risk for these experiences. Individual counseling is the safest way to approach IPV treatment due to the risk of increased violence following couples’ sessions and the potential for victim shaming (Rowe et al., 2011). Incest is particularly challenging to address due to potential lack of support or belief by the caregiver(s) and the need for secrecy and denial, both to protect against public scrutiny and in order to sustain active family systems. Grooming for incest can be a long process involving years of building trust and building a special bond with a child, and at times that bond can even place the child at defense of the perpetrator. Working with family members to address their own vicarious trauma it’s important, as is acknowledging the multigenerational patterns of abuse that led to the incident(s). Often incest is not a one-off experience, but sustained repeatedly through time. Infidelity, divorce, and custody battles all have uniquely destabilizing challenges, and the culturally appropriate way through is client-led. Death by suicide in a family can be especially isolating, since often children will worry about protecting their parents from the burden of their emotions. In situations of chronic illness, anticipatory grief (AlGamal & Long, 2010) in which the worst case scenario is seen as the most likely outcome, can be common. Through all of this it is integral for the counselor to refer to codes of ethics in order to protect the client from potential dual relationship, ensure standards of care, and adhere to the foundational principle to do no harm. 

Chapter 11 (Duffey & Haberstroh, 2020) introduced a number of core principles for supporting communities recovering from violent or traumatic experiences. Whether a natural disaster, a sudden tragedy such as a school shooting, or a refugee population fleeing from an ongoing genocide, there can be a sense of trauma bonding that pervades a community. Despite this initial sense of connection-through-experience, the subtle differences in experience and impact and the differences in approach to processing (reflection versus avoidance and the desire to move forward, for example) can fragment a community and lead to an all too common sense of isolation and disconnection that perpetuates the traumatic response in the body. Initial symptoms may include difficulties in concentration, sleep, and motivation, and complicated grief can arise when symptoms have felt overwhelming and disruptive to daily functioning for an extended period of time. Communally, the grief may also be prolonged through the process of neuroception— in which subtle facial cues of distress are mirrored, further perpetuating a sense of social vulnerability and triggered responses. Counselors themselves may experience primary trauma, sharing in the pain and loss of the community as an impacted person, or existential trauma by struggling to find meaning and purpose in something we witness significantly altering the structure of community. It is imperative that counselors are doing the work themselves— working through trauma with peets, counselors and supervisors while remaining rooted in our own humanity and need for personal wellness. We must also remain committed to our skills and training, and actively lean into connection in order to avoid the isolation so prevalent in times of trauma. There is a lot of information available to counselors working in a disaster zone, such as FEMA’s Community Recovery Management Toolkit (FEMA, 2023), and working to create safe physical environments including culturally representative decorations, child-friendly spaces, private entryways, handicapped access throughout, privacy considerations such as white noise machines and soundproofing, ample lighting, and lockable doors and files are recommended. There is a great need for community education around trauma, and multiple forms of communication such as media alerts, phone and text banking, and collaboration with community centers and religious leaders can assure that the information reaches those who need it. Access to resources are just as important as access to information around common trauma responses and the path towards healing. Providing this information early on is important, but it must also be provided repeatedly, since trauma can impact the processing and attention needed for retention. While specialized professional support is often required (such as EMDR, brain spotting, biofeedback, somatic experiencing, or EFT) in order to adequately begin the process of reintegration through trauma, ongoing interventions such as trauma informed yoga, expressive art therapies, and mindfulness/meditation classes must remain available even when the immediate disaster response has ceased and the intermediate phase of recovery has begun.

Military culture, although often stereotyped as a culture centered around individual strength, is actually deeply rooted in principles of interconnected relationship and trust (Burk, 2008), with many military personnel being placed in situations that necessitate a team-oriented bond that supersedes all other relationships, even that of romantic and familial nature (Tick, 2005). In order for a counselor to effectively work with this population, it is necessary to be familiar with the many facets of military life, including deployment structures (predeployment, deployment, sustainment, redeployment, and postdeployment), military-specific rituals and hierarchies, and the processes and situations in which a person comes to separate from the military (voluntary separation, involuntary separation, and retirement).

Seeing a military family as its own microcosmic unit can be very helpful, with many family members being at risk for developing secondary traumatic stress and experiencing relational rupture due to power-over dynamics that perpetuate into the home (Jordan, 2010). Stereotyped cultural values such as hypermasculinity, aggression, hierarchy, and authoritarianism can play a huge role in harmful dynamics coming back into a military family home, and the system itself can operate in ways that protect perpetrators of violence (Kern, 2017). There is a significant lack of research and data when it comes to domestic violence between LGB military couples. The renegotiation of roles in the home pre- and post-deployment can be deeply stressful for everyone involved, and having a family member that does not return from deployment can leave family members in a state of ambiguous loss (Boss, 2016), with young children experiencing jealousy towards families who were fully reunified and adolescent reunification families leading to suicidal ideation (Kaplow et al., 2013). Furthermore, a family that had lost a service member in the line of duty may also lose access to their military identity and the supports that come along with it (Holmes, Rauch, & Cozza, 2013).

There is an elevated risk for suicidality at any part of a military member’s reintegration to the civilian world (Pease, Billera, & Gerard, 2016), and although symptoms of PTSD or TBI can be deeply debilitating, some researchers believe that moral injury may be the most pervasive force that drives criminal behavior, aggression, and suicidality among service members (Shay, 2014). While female service members are nine times more likely to develop PTSD after experiencing a sexual assault (Street & Stafford, 2014), the men who report a sexual assault while enlisted are twice as likely to complete an act of suicide (Kimerling et al., 2016). Research has found that using EMDR directly after a traumatic experience can significantly reduce symptoms of PTSD (Wesson & Gould, 2009) and combining EMDR with CBT (an often used therapeutic approach when working with military personnel due to the structured approach) can be particularly helpful for trauma processing (Foa, Davidson, Frances, & Ross, 1999). It is estimated that only one in three service members are treated effectively for their trauma, and a more modern approach uses MDMA in collaboration with therapy to dismantle traumatic memories, with most clients no longer meeting criteria for PTSD after treatment (Phillips, 2018). Sand tray therapy, which can be combined with multiple modalities, can also be extremely helpful for processing trauma, by creating reflective distance through the use of miniature scenes, replaying scenarios with alternate endings, and allowing for nonverbal processing spaces that still foster a sense of connection and understanding (Homeyer & Sweeney, 2011). Equine therapy and Neurofeedback are other therapeutic methods that have demonstrated promise but need more clinical validation (Duffey & Haberstroh, 2020). 

Ultimately, building relational resilience and creating space for connection is an integral part of working with military personnel, with so much Masking (Wertsch, 2001) taking place both professionally and personally through secrecy, stoicism, and denial. Connection is the root of effective military culture, promoting a sense of pseudo-tribalism, and there are many resources available to military personnel when enlisted as well as after separation. 

Duffey & Haberstroh (2020) focus on crisis prevention and intervention services in K-12 institutions in Chapter 13, naming bullying, school shootings, natural or accidental death of a classmate or staff member, acts of suicide, physical and sexual abuse, neglect, substance abuse, family violence, personal and social response to sexual orientation or gender identity, natural disaster, ineffective relationships, war and threats of war, as well as cultural and historical traumas as some of the primary crises faced in this demographic. Nearly one for every two children will live through an adverse childhood experience, and almost one in three people aged 12-18 are bullied in school or its adjacent activities. There are some well known health impacts that can occur in the subjects of bullying, and with over half of reported bullies also having been victims of bullying and nearly seventy percent of school shooting offenders having struggled with depression and suicidal ideation, it is integral to provide adequate supports. School guidance counselors may intervene by building a guidance curriculum, working through individualized student plans, offering responsive services, and advocating for processes and systems that support student success in both the localized and systemwide spectrum. Promoting relational resilience means encouraging youth to reach out about feelings of pain or disconnection with the understanding that everything is relevant or useful to growth, and providing group space for peer sharing in an environment that promotes relational resilience is ideal. There are many nuances around the potential disclosure of information when it comes to minors, but having the rules and policies clearly stated and shared allows for consensual engagement. 

Chapter 14 went on to discuss higher education environments, with top concerns of students reported as anxiety, depression, stress, family issues, academic performance, relationship problems, developing self-esteem, healthy adjustment, and sleep problems, along with the academic and vocational stresses that come along with sexual assault, harassment, bullying, and physical violence. Bullying can happen at all ages and in any setting, can be between individuals sharing similar amounts of power, or people clearly understood to be in a power differential. Bullying can be individual or organizational, overt or covert, direct or indirect, on the ground or cyber-based. Physical bullying involves acts of abuse, threats of harm, and coercion. Emotional or psychological bullying (sometimes called verbal bullying) involves name calling and threatening remarks or intentional actions that demean, ostracize, or minimize others, and may also include relational bullying which involves the manipulation of social status or reputation. Cyber bullying is a significant problem, which includes posting hurtful comments or rumors, threatening to harm someone or telling them to harm themself, releasing personal documents (doxing) or potentially harmful media, and even derision of personal demographics. There are significant problems with sexual assault and sexual harassment on college campuses due to the unique living environment and social pressures, and their prevention and intervention strategies are similar to that of bullying, with raising awareness and offering education one of the primary focuses. Understanding available resources, and a campus safety plan can provide additional supports in times of crisis, and building a diverse team for preparing a campus safety plan could include academic, legal, psychosocial, public health, infrastructure, transportation, and housing representation in order to outline emergency care and lockdown protocols. Awareness is essential, not only for supporting students before a crisis scenario arises, but to swiftly assess potential crises, since there is often leakage in which acts of harm and violence are premeditated. Having a close and supportive care network, from individual to institutional levels, allows for potential or potentially harms to be met swiftly with care, consistency, and compassion. 

The authors dedicated their final chapter (Duffey & Haberstroh, 2020) with a reflection on resilience. They point out how western culture is consistently sold an image of “bouncing back” from trauma, just to return to a baseline image of normalcy prior to catastrophe, however such conditioning can actually be an impediment to real, functional, and necessary social changes. In 2017, the American Psychological Association (2017a, 2017b) reported that two thirds of the American population identified with significant sources of stress about the future of the United States, with politic and personal safety as some of the most intensely pressing concerns. Relational psychiatrist J. B. Miller (1976/1986, 1983) observes that, while conflict is an unavoidable part of change, we can still practice “waging good conflict” by recognizing our differing opinions without devolving into aggression. In fact, while there are many social connections that help to build a sense of resilience, the most imperative tool to foster a resilient society is consistently, actively supporting the dignity of all people. Mutuality, authenticity, and respect are key components of relational resilience, in which the health of both people and planet are centered towards collective wellness. Humiliation, or the experience of being devalued, dehumanized, demeaned, denigrated, dismissed, disrespected and violated, is the antithesis of dignity. The role of the counselor is to consistently promote dignity, on both personal and sociocultural levels, not only supporting clients through brainstorming, reframing their perspective, and creatively approaching challenges, but by putting effort into systemic change, systems of client care, and the reform of ethical codes to promote the dignity and humanity of all persons. Ending systemic humiliation needs to be a primary focus of all counselors, actively living the work by promoting dignity in all aspects of their life and encouraging mutual growth with all personal and professional contacts. Counseling is an inherently creative practice, relying on the active co-creation between therapist and client. Some people can wear a mask of resilience while actually feeling deeply devastated and isolated, and breaking through stigma and rejection to promote connection can be the spark of creation that brings new life to a person suffering. In fact, post-traumatic growth can often lead to even deeper forms of strength and vulnerability, spirituality, value in relationship, and fulfilling life path. The authors encourage all counselors to strive for self-reflection and alliance with both peers and personal contacts in order to actively reflect upon opportunities for personal growth, and to adequately assess for any active shortcomings. The Universal Declaration of Human Rights (United Nations, 1948) states in its first article that “All human beings are born free and equal in dignity and rights.” Through counseling we are able to call ourselves and others back into this sense of humanity, for the health and wellbeing of our global community. 

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