Author: Tuason, Ma Teresa G
Date published: July 1, 2012
The Philippines, an archipelago that is 300,000 square kilometers, comprises 7,107 islands in southeast Asia (Central Intelligence Agency [CIA], 2011). Patterned after the United States, its base is capitalism, and it is a democracy. The predominant religion is Catholicism. It is the 12th most populous country in the world, home to an estimated 101 million people (CIA, 201 1 ). The poverty rate was estimated at 32.9% in 2006 (National Statistics Office [NSO], 2010) using the World Bank's definition of "living on less than $1 a day"; that estimate is 61% if poverty is defined as living on less than $2 a day, with powerfully high food insecurity (NSO, 2010). The country has had a long history of cultural influences: the indigenous Indo-Malay, Chinese, and Islamic, due to trade, marriage, and immigration; and Spanish, American, and Japanese, due to colonization (Roces & Roces, 1985). All contributed to the Filipino phenotype and rich diversity in culture and tradition, evident in the number of dialects (about 80, 11 of which are languages). In general, Filipinos are bilingual, speaking Tagalog, the national language, and English.
Much like its inherent multiculturalism, counseling in the Philippines has evolved from multiple influences. Counseling encompasses a broad spectrum of disciplines (e.g., guidance and counseling, counseling/clinical psychology) and an acknowledgment of the societal context in which it occurs (e.g., poverty, physical disasters, overseas working, graft and corruption, and economic and political instability). Counselors must navigate societal stigmas regarding the need for mental health assistance and widespread ignorance of the field; they also advocate for mental health and resilience in difficult life circumstances.
History of Counseling in the Philippines
Pre-Colonial Philippines was much like neighboring Indonesia and Malaysia, and counseling still shows vestiges of indigenous help-seeking through (a) superstition; (b) reliance on elders, faith healers, and fortune tellers; and (c) belief in the supernatural (Bulatao, 1 992). In 1 52 1 , the Philippines was rediscovered by Ferdinand Magellan, which began the Spanish colonization, resulting mainly in religious conquest: 80% of Filipinos are Roman Catholics (CIA, 201 1). The American occupation, from 1898 to 1941 (and military bases into the 1990s) followed Spanish colonization. From public school to government, the United States has had a strong influence on the country (NSO, 2010). The language of instruction in the country is English, and greater respect is given to anything American over anything Filipino. The United States has even had a significant impact on counseling because Filipino counselors and psychologists often trained there (SalazarClemeña, 2002).
Counseling, as conceived in the United States, began in the Philippines with two colleges in Manila providing guidance services geared toward identifying professions and employment opportunities and establishing the first psychological clinic at the University of the Philippines (Salazar-Clemeña, 2002). The growth of guidance and counseling was interrupted by the Japanese occupation from 1941 to 1944. From the 1940s to the 1960s was a period of counselor training (Salazar-Clemeña, 2002), as Filipinos obtained training and degrees in the United States and established academic counseling programs when they returned to the country. The birth of the two associations most instrumental in the regulation of the profession - the Psychological Association of the Philippines and the Philippine Guidance and Counseling Association - happened at this time. From the 1970s to the 1990s, the movement in counseling was primarily indigenization (e.g., Bulatao, 1992; Enriquez, 1977) of assessments, constructs, and theories, focusing on the differences between the counseling models learned in the United States within the context of Philippine culture and the realities of its social issues. The organizations established then were the Philippine Association for Counselor Education, Research, and Supervision and the Career Development Association of the Philippines.
There was monumental growth in counseling following the American occupation as the country struggled through political movements, military coups, and citizen-led revolutions to become an independent republic. The volatile shifts in governance have contributed to the country's economic and socio-political structure and its instability and oppression; but these shifts have also demonstrated the power of the people, for example, when thousands of Filipinos demonstrated peacefully against dictatorship, graft, and corruption. These circumstances continue to shape the field of counseling in the Philippines, with the necessity for advocacy and a social justice agenda (Tuason, 2008).
Current Status of Counseling in the Philippines
The family is the main unit of Philippine society, and Filipinos value family belongingness (pagkapamilya; Enriquez, 1977). This family orientation is very much a part of counseling because Filipinos would rather go to family members than trust strangers to help them solve their problems. Counseling practices that work best involve the family, and family systems therapies are predominant, along with expressive therapies in different modalities (Catipon, Dey, Garcia, & Tarroja, 20 1 1 ) such as play (Carandang, 2009), art, and music for children. Because pioneers of counseling in the Philippines were trained in the United States during the 1960s and 1970s and because of the cultural environment, another predominant model in counseling is client-centered Rogerian therapy, with elements of spirituality. Competent counselors are sensitive to the extent of people's religiosity and respectfully include spirituality in counseling. The establishment in 2008 of the Family and Pastoral Counseling Association of the Philippines reflects counselors' responsiveness to the needs of Filipinos by tapping into the valuable resource available in people's faith and spirituality. Given Filipinos' transpersonal worldview, other forms of therapy may include placing the client in an altered state of consciousness (e.g., hypnosis, astral travel; Bulatao, 1992). What has evolved is an integrated approach to counseling that is unique to the Philippines (see Tanalega, 2004).
Access to a counselor and the openness to seek help is best mediated by family or friends who have experienced the benefits of the counseling process, unlike in the United States, where counselors can be found by using the Internet or the telephone book. In the United States, a counseling session usually lasts an hour and costs about $100; in the Philippines, although a session is prescribed as an hour and can range widely in cost between 500 and 2,000 Philippine pesos (U.S. $ 1 2-$50), it usually lasts longer because Filipinos are not overly concerned with punctuality (Roces & Roces, 1985). It is also common for clients to miss sessions and not be billed for them. Because of the cost of counseling and the absence of the luxury of time, it is usually middle- to upperclass people who can afford counseling. The impoverished do not usually seek counseling services, or if they do, it is often from a religious person or a barangay captain (i.e., leader of the village). Fortunately, nongovernmental organizations and funded research may also provide counseling to the poor (e.g., Carandang, 1996).
Guidance and Counseling Act of 2004
The most significant development in Philippine counseling is the Guidance and Counseling Act of 2004 (Republic Act No. 9258). The Act was intended to professionalize the practice of guidance and counseling and to create the Professional Regulatory Board of Guidance and Counseling, which is under the administrative control and supervision of the Professional Regulatory Commission. Prior to 2004, mental health workers did not need a license to practice nor was there a regulatory board to ensure adequate training and ethical practice.
Guidance counselors pioneered regulation for counseling, and psychologists are following suit through the Philippine Psychology Act of 2009 (Republic Act No. 10029), which will regulate psychology and create a professional regulatory board for licensing psychologists (Kabiling, 2010). Although mental health providers have the same mission, hierarchy dictates that a doctoral-level counselor or psychologist has the highest rank, followed by the master's-level counselor. Other levels within this hierarchy are determined by where the individual earned her or his degree: A U.S.-trained counselor has more credibility than a Philippines-trained practitioner, although this view is slowly changing (Republic Act No. 10029, Foreign Reciprocity).
According to the Guidance and Counseling Act of 2004, counseling in the Philippines, similar to how it is defined in the United States, is a "profession that involves the use of an integrated approach to the development of a well-functioning individual primarily by helping him/her to utilize his/her potentials to the fullest and plan his/her present and future in accordance with his/her abilities, interests, and needs" (2004). The functions of a guidance counselor enumerated in this law are counseling, psychological testing, learning and study orientation, research, placement, referral and group processes, and teaching guidance and counseling courses.
According to Philippine Labor and Employment Secretary Rosalinda D. Baldoz, there are 49 guidance counselor networks with 1 ,739 members (Department of Labor and Employment, 2011). Twenty-three universities and colleges offer graduate studies in guidance and counseling, counseling/ clinical psychology, and counselor education, and a handful of institutes offer degrees in pastoral counseling. Most programs offer master's degrees and a few offer doctoral degrees, most of which follow the practitioner-scientist model. Curricula are determined by individual programs and are often patterned after courses in the United States, although courses are taught with extensive applications to the Philippines to make these counseling models and theories relevant to the Philippine population, as evidenced by applied research in theses and dissertations (e.g., Nísperos, 1994; Trivino, 2000). The two main differences between training programs in the Philippines and the United States are the field experiences and supervision. In the Philippines, because few field placements are available, 100 practicum hours are required for the master's degree and two semesters of internship for the doctoral degree, much less than the 1 ,000 hours required for a master's degree in the United States. Moreover, regular weekly individual supervision is not provided in the Philippines.
Unique Characteristics of Counseling in the Philippines
Although counseling shares the important aspects of advocacy, professional standards, public policy, and research, as it does in the United States, there are unique characteristics to counseling in the Philippines. Advocacy is directed toward societal issues and includes a social justice agenda given the prevalent poverty, the intersection of poverty with crime and trauma, the necessity of overseas working in families, the presence of street children, and child laborers. Certain issues create the context of the Filipino's environment, and importantly, set the parameters for how change happens. Of these, the most significant are poverty, overseas working, and unstable political and economic conditions. Social issues become counseling issues at the individual level. Hazards and disasters in the Philippines exacerbate the impact of poverty; the country is affected by typhoons, volcanoes, landslides, earthquakes, and tsunamis (CIA, 2011).
Poverty coexists with high crime rates, overpopulation, and illiteracy, which all impede an individual's ability to advance economically (Tuason, 2008). Career counseling requires consideration of what career choice might yield possibilities for economic mobility (Salazar-Clemeña, 2002). Overseas working has become the nation's response to high rates of poverty, overpopulation, unemployment. According to NSO (2010), unemployment and underemployment were 7.1% and 1 9.4%, respectively, in 2009; unofficial reports may be higher. Ten million Filipino people, 11 % of the country's total population, leave the Philippines and work in approximately 194 countries and territories around the globe (Go, 1998). Given the importance of family, separation issues resulting from overseas work are central concerns in counseling because family roles are altered, forcing children to substitute for a missing parent for their younger siblings (Taylor & Tuason, 2008). Because nearly as many women as men work overseas, there is evidence of the changing role of the father as the sole parent in the home (Garabiles, 2010). Telephone counseling for overseas Filipino workers who are employed as domestic helpers in Hong Kong found that the problems of these workers mainly had to do with the pain of separation from children, the inability to take care of them, philandering husbands, fathers sexually abusing their daughters, loneliness, and maltreatment by employers.
Sociopolitical crises due to unstable political leadership and extreme socioeconomic inequities stress Filipino families (Carandang, 1989). Furthermore, because of rampant graft and corruption in government offices and dishonesty in the media, a collective and personal sense of volition is difficult to achieve. One problem is that the absence of consequences makes it hard for people to be accountable and realize the consequences of their actions. Another is that people feel helpless in the face of power inequality and inequity of rights and duties (de Guzman, 2009). Hence, the sense of control is lacking, which is a necessary variable for change in counseling.
Counseling in the Philippines has evolved to address the substantial influence of social illnesses. On the other hand, the country is rich in resources that play a significant role in the counseling process. These resources, which strongly contribute to healing and flourishing, include religiousness and spirituality (Dy-Liacco, Piedmont, Murray-Swank, Rodgerson, & Sherman, 2009); engagement of family members and friends (Grimm, Church, Katigbak, & Reyes, 1999); and a strong drive for survival, hopefulness, and hardiness (Tuason, 2008).
Future of Counseling in the Philippines
Counseling will continue to develop through increased professionalization. As evidenced by the Guidance and Counseling Act of 2004 and the Philippine Psychology Act of 2009, the Psychological Association of the Philippines, the Philippine Guidance and Counseling Association, and other related agencies and institutions collaborated to create guidelines and policies that not only regulate the profession of counseling but also pave the way for the distinction between counselors and psychologists. Licensing and certification will also help maintain the level of expertise within the profession through laws that require continuing education and research.
The aforementioned legislation makes it possible for the counseling profession to become more visible and accessible to Filipinos. The laws and the boards they created demonstrate that Philippine society recognizes the relevance of the counseling profession and that the counselor has power, status, and responsibility in Philippine society. Counseling organizations will become more institutionalized, gaining recognition not only from constituents but also from the public and the government, and they will be more accessible and responsive to the issues in Philippine society. Oversight boards ensure that the profession will be more regulated and that only licensed practitioners will provide services, thus making the profession more credible. With appropriate advocacy, communication, and collaboration with allied professionals and the general public, using counseling services will become less stigmatized. Moreover, continued research studies on the efficacy of counseling will provide the public with evidence that counseling is indeed needed for nation-building and healing.
Counseling Where it Matters
The counseling field will continue to develop services for the poor primarily as nongovernment entities but will also pave the way for counseling services to be provided for street children, the sexually abused, the impoverished, and victims of unsolved crimes and human and natural disasters. Although these services are already available, the future holds hope for more services to be offered to more people, particularly through the venue of funded research. In the future, counseling services will be provided in conjunction with advocacy to alleviate poverty, primarily through prevention; we are hopeful that these services will be made available with participation from government agencies and affluent professionals and support from outside sources, such as UNICEF or other countries.
Much of the future focus in counseling needs to be on healing the nation. Because of the deep conflicts perpetrated by long-standing graft and corruption, bribery, and injustices toward the citizens, the protracted conflict between Christians and Muslims (Ebal, 2006), exacerbated by intractable poverty, counseling practices and research, training, and supervision of future counselors will need to focus on restructuring societal systems to be more reliable and just. At the individual level, counselors will need to focus on redefining themselves within the context of the system to be empowered and create changes within their spheres of influence.
Counseling models and theories will develop that are indigenous and more applicable to the field as counseling applications become more far-reaching. The indigenization of theories that started with Filipino psychology by Enriquez (1977) and phenomena of religion, consciousness, and culture by Bulatao (1992) will continue in the future, specifically identifying, labeling, and using counseling models borne in Philippine society (e.g., Ramos, 2010; Tanalega, 2004). Counseling models that acknowledge the changing identity of the Filipino living with both Western and traditional influences (Carandang & Lee-Chua, 2008) and the growing diversity of Filipino family types (Tarroja, 2010) will also be helpful. Additionally, the counseling field will benefit from a more structured and intentional avenue for supervision through field training and curricula, guiding counselors' professional and personal growth. Although the field of counseling began in the Philippines by drawing from the U.S. model as a guide, it will come into its own, respecting the depth of its context and problems, using the resources that are intrinsic to the Filipino soul, and having an impact on the Filipinos who need counseling services the most.
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Ma. Teresa G. Tuason, Clinical Mental Health Counseling Program, Department of Public Health, University of North Florida; Karina Theresa Galang Fernandez, Department of Psychology, and Maria Aurora D. P. Catipon, Office of Guidance and Counseling, Ateneo de Manila University, Quezon City, Philippines; Louise Trivino-Dey, In Touch Community Services, Makati City, Philippines; Ma. Lourdes Arellano-Carandang, Department of Psychology, University of the Philippines, Quezon City, and MLAC Institute for Children and Families, Pasig City, Philippines. The authors thank James Solari, Patrick OngAnte, and Shannon McLeish for their thoughtful comments on earlier versions of this article. They also express their gratitude to the people who have championed the development of counseling in the Philippines. Correspondence concerning this article should be addressed to Ma.Teresa G. Tuason, Clinical Mental Health Counseling Program, Department of Public Health, University of North Florida, #1 UNF Drive, Jacksonville, FL 32224 (e-mail: email@example.com).