Social advocacy has been described by some counseling theorists as a "fifth force" paradigm that should be considered to rival if not replace other major counseling psychology paradigms regarding behavior and mental illness (Ratts, 2009). This paper briefly discusses what social justice/advocacy is, the debate regarding its status as a paradigm in counseling psychology, and how social advocacy can enhance both the client's experience and life and the professional counselor's personal, professional, and ethical obligations to helping others.
Social justice is fairness or impartiality exercised in society, specifically as it is implemented by and within different levels of social classes of a society. A truly socially just populace would be based on the principles of solidarity and equality, would consider and maintain values, human rights, and the dignity of every person in the society (Bell, 1997). Social justice/advocacy theories have in recent years been presented as valid psychological paradigms for counseling psychology.
Social Advocacy as a "Fifth Force" in Counseling Psychology
According to Ratts, D'Andrea, and Arredondo (2004) the profession of counseling is being influenced by a growing movement directing professional counselors to incorporate a social justice perspective into counseling theories, paradigms, and practices. A counseling perspective incorporating social justice would consider issues surrounding the imbalance of power and oppression and would focus on activism and social advocacy as a method to speak to the inequitable conditions in a society that hinder the personal development, academic attainment, and career objectives of marginalized groups (Ratts, 2009). Ratts (2009) also claims that social advocacy as a means to address issues of societal inequity is in union with the American Counseling Association's Code of Ethics (American Counseling Association [ACA], 2005). Ratts (2009) points out that in Section A.6.a. Of the code this mission is clearly stated: "when appropriate, counselors advocate at the individual, group, institutional, and societal levels to examine potential barriers and obstacles that inhibit access and/or the growth and development of clients" (ACA, 2005; p. 5).
The relationship of social justice/social advocacy to counseling should go beyond simple partisan political affiliations or beliefs according to Ratts and associates. For example, Ratts et al. (2004) make the case that social justice counseling as a "fifth force" in the field following the paradigms of the psychodynamic, cognitive behavioral, existential-humanistic, and multicultural counseling paradigms that have been the backbone of theory and intervention in counseling. Other theorists have followed suit (e.g., Fouad, Gerstein, & Toporek, 2006; Lee, 2007). In more recent pleas for the infusion of social advocacy/justice as a counseling psychology paradigm Ratts et al. (2009) claim that the intentions of the counseling field are not effectively drawing the connection between oppression in marginalized groups and issues surrounding mental health. The issue for social justice advocates is that they believe that the prominent counseling paradigms, whose focus tends to be on the individual without taking into account environmental factors, is limiting in its explanation of mental health. This notion has led Ratts and others to the request to expand the counselor role as to include the notion of social justice advocacy (Ratts, 2009). Indeed several other authors have followed this call with the justification that social justice counseling is a resurfacing paradigm that is consistent in understanding broader explanations of human behavior and the methods by which the practice of counseling is currently being shaped (e.g., Greenleaf & Williams, 2009; Lee, 2007). In essence, this is an ethical cry to adopt a political, social, or philosophical point-of-view as a psychological paradigm. Moreover, this "paradigm" has been rediscovered many times. The fundamental foundation of this ethical command is that long-established counseling paradigms in the form of individual, family or other psychotherapeutic interventions have at times not been able to assist therapeutic clients to maximize their wellness and personal development. So these researchers claim that newly discovered links between systemic oppression and mental health issues indicate that many of the clients' problems and issues are environmentally-based (Greenleaf & Williams, 2009). This writer finds this last claim almost comical and wonders if these individuals ever read the works of Freud, Watson, Skinner, Lewin, Rogers, Allport, and a host of other classic psychological theorists who described environmentally-based factors that shape human behavior.
Nonetheless, the ACA created a taskforce to present a framework to address issues of oppression so that it could assist the counseling profession conceptualize how social justice and advocacy counseling appears in clinical practice (Lewis, Arnold, House, & Toporek, 2002). These Advocacy Competencies outlined a model for counselors to follow when engaging in social justice counseling at multiple levels including counseling with the client/student and the school/community. At the client/student level this would involve empowering these individuals to advocate for themselves and advocate on behalf of others when fitting. Advocacy at the school/community level emphasizes community involvement and entails collaboration with leaders in the community or in organizations to distinguish and reduce oppressive situations and structures. Advocating at the public level focuses on making the general public aware of macro-systemic issues as the relate to human dignity as well as acting as agents of change to get rid of barriers that obstruct the development of clients and students ( Lewis et al., 2002).
According to Ratts (2009) in spite of ACA's ethical mandate for advocacy and the formation of Advocacy Competencies, there are still a large number of counselors that still fail to recognize the role of societal oppression in generating and perpetuating clients' issues and the profession is stilled filled with practitioners who exclusively adhere to an intrapsychic viewpoint in order to explain and ease the client's issues. In other words, social justice theory, according to Ratts and others trumps any other psychological explanation of a client's difficulties (see also Greenleaf & Williams, 2009).
According to Dohrenwend (2000) support for a paradigm shift in counseling can be found in the empirical research on oppression and its effects on wellness and development. The evidence indicates that oppression leads to stress, and stress has dramatic physical and mental health consequences (Dohrenwend, 2000). Chronic stress in the form of oppression can cause (associated) physiological changes to the immune system and the brain that may result in psychological distress (Carlson, 2011), substance abuse (Carlson, 2001), increased rates of suicide (Dohrenwend, 2000), and increased risk for biological disease such as coronary and infectious diseases (Carlson, 2011).
Dohrenwend (2000) also looked at the rates of physical and psychological problems related to stress and determined that the increase of adversity inherent in racial prejudice there were higher rates of depression, anxiety and other psychological problems among disadvantaged groups. Turner and Avison (2003) found that African-Americans reported higher instances of chronic stress compared with Caucasians over their lifetimes. Zyromski (2007) reported that post-traumatic stress disorder (PTSD) occurs more frequently in Hispanic and African-American and Latino than in European-American youth due to the greater exposure to violence and oppression which these minorities' experience.
Discrimination, which is a type of oppression, apparently may have consequences that can be related to depression. For example Gee (2002) discovered that there was an association with depressive symptoms in Asian-Americans and perceived discrimination as well an association of discrimination and overall poor mental health. Other researchers have found this same association of perceived discrimination is negatively associated with self-esteem, and positively associated with depressive symptoms and stress. Numerous other studies support these relationships (Ratts, 2009).
Ratts (2009) charges that the traditional intrapsychic-oriented approaches to mental health care as well as culturally biased diagnostic criteria work to propagate various forms of cultural oppressions and social injustice within the profession of counseling. Ratts (2009) further charges that other researchers have documented that that the various DSM-IV-TR diagnoses (e.g., anxiety, depression, etc.) are social indicators of the distress that is experienced by disenfranchised populations that lack power. Therefore counselors should anticipate that oppressed and underprivileged groups would demonstrate greater and more frequent symptoms of psychopathology and of stress in general. Ratts (2009) also charges that there is a correlation between marginalized populations and the misdiagnosing (under or over misdiagnoses) of psychopathology. Thus, the fifth force in counseling should be social justice advocacy counseling. Therefore, despite the acceptance of the medical model in conceptualizing mental health the intrapsychic framework it involves should conflict with legitimate counselors' core values and beliefs according to some (Greenleaf & Williams, 2009; Ratts, 2009).
Opposition to the "Fifth Force" Concept
Despite the call for social advocacy as a counseling paradigm this call to arms has not been embraced by all. For example, Smith, Reynolds, & Rovnak (2009) traced the history of the social advocacy movement and offer several criticisms of the proposed social justice/advocacy paradigm. Social advocacy purports that mental illness is the result of a societal illness and that counselors have a responsibility to right this injustice. Smith et al. (2009) see three major issues here: First, Smith et al. suggest that the social advocacy movement in counseling lacks sufficient control over its doctrine and as a result attempts to promote certain agendas (e.g., political, personal, economic, etc.) labeled as…