Face Negotiation

Counselor Interview

Ursuline Bankhead is a doctoral student in the field of Counseling Psychology. She is currently working in the Veterans Administration Hospital doing a rotation in the Geriatric division. She works forty hours a week and it is a paid internship. She prefers to work with clientele ranging from adolescents to geriatrics.

How does she like the profession so far? At her present internship, it's challenging but it's great and it's needed with the population getting older. I asked her how she works with patients who have dementia and she told me that she first tests them to look at their level of functioning There's a series of mental status tests that she gives them to see where their memory is and what they can and cannot do and also administers mental status tests. She does counseling with some of them and their families about changes that are happening for them and how they can adjust to them and she works with caregivers on how to adjust emotionally and practically to the changes that are happening to the patient with dementia. These patients are outpatients so they come in to see her or they are a part of the Adult Day Care at the hospital. She does see some patients who are inpatients that are getting rehabilitation after a stroke or may be having other difficulties. She sees a variety of people for a variety of reasons.

In answer to my question about how she communicates with a patient who has a stroke, she told me that she communicates with a patient with a stroke and it depends on the severity. If severe, she has them communicate with an eye blink for yes or two blinks for no. She has to be creative in communicating. She has some clients who have tracheotomy tubes in which there is no larynx so she uses mechanical devices or whatever she can do to help them communicate with her.

As far as education is concerned, of course an undergraduate degree is needed so that you can understand the basic fundamentals of psychology.

Then you will need at least 5 years of graduate school and dissertations must be done to receive your doctorate degree. The whole time you are in school you are seeing clients in a variety of settings such as counseling centers, community agencies and hospitals. She worked at the Holding Center for a year and a correctional facility as well. Along with coursework, you work 15-20 hours of time a week working with clients. Your last year, 5th year, which is the year she is working in, involves a year working full-time at a site and you have to compete to get it. It's not guaranteed.

I asked her if after she receives her Ph.D. whether she will move to another state. She plans to practice her profession here in Buffalo because she's married and she has a 7 year old child.

I asked her why she chose the counseling profession and her response was when she was 22 years old, she was living in Oregon and she needed a job very badly and randomly got a job working with teen mothers who were involved in gangs and she really loved it. She just loves working with people and interacting with them and seeing how people change and realizing that to help people who want to change you have to be creative and flexible. It's challenging and if you're good at psychology, you are always challenging yourself so that you can help each individual or each family. She challenges herself by looking at assumptions and biases she may have. She realizes that if she is working with a patient or a client and she is bored, then she is probably also boring the crap out of the client too so she understands that she needs to do something different so instead of just doing talk therapy she may use art or music or teach them relaxation or anything that will work so that they can be expressive. The counselor must go beyond just saying to them things like "How are you feeling"? Sometimes you have to ask them hard questions such as: asking an 80 year old man if they are having sex and if not, what is it like for him to not be able to have sex. She had to learn to get over being shy. Ursuline told me, "If you're going to be a good therapist you are going to be challenged". In the geriatric rotation she's in, she has to deal with issues of death and dying and not only looking at her beliefs but her patients' beliefs about death and what it means. It's challenging for her. She's constantly growing because if she stops then she feels she's not going to be any good to her clientele at all. She loves the challenges and would not think of ever changing her profession.

Most of her patients Ursuline works with are about 75 years of age and older and she works mainly with patients who have dementia and enjoys it immensely. She also does evaluations for Transplant Services in the kidney and liver division and capacity hearings which involve seeing if patients are able to make decisions about their health care and their finances. This rotation is for 6 months and for another 6 months she will be doing Behavioral Medicine. And she probably will be doing in the near future a substance abuse rotation.

The theoretical model Ursuline has adopted in her counseling is called Family Systems. It's not real popular in psychology but it's a belief that if she were to work with an individual, she would have to also look at their background and their relationships with their family members. For instance, if she was working with me and I am coming in with depression, she's looking at not only my family history of depression but also how does my family cope with stress and what messages have I learned about stress and about depression and about myself. She will also look at how I interact in my environment and what role do I play in my family. Am I the good kid or the bad kid? Am I the one that's ignored? So it's looking a lot at family relationships and how those relationships influence how you interact in other aspects of your life like work or in romantic relationships or even with your friends. It's not just past-oriented but present-oriented. We carry our family and our heritage with us and how our family deals with things or has taught us to deal with things never leaves us and it influences us. There are some things we may need to learn how to adjust to so we can function better so it's both historical and present. She is aware of cultural differences and for her it's important to address multicultural issues. To her, each family has its own unique culture aside from the culture of the larger group. Individuals of color very often look to the family as for the reasons they do what they do. She has to work within that framework and if she doesn't understand the culture, then