Understanding Backwards: Counseling Approaches for Advising Pre-Health Students

Introduction

Pre-health students face numerous challenges when pursuing careers in health care (Zhang et al., 2020). Some students are unaware of the demands of daily medical practice (Lin et al., 2013). Some students may be unprepared for the academic rigor of college-level science courses due to social, racial, or structural inequalities in our broader society (Verrier et al., 2015; Zhang et al., 2020). On the other hand, high-achieving students from underrepresented groups may experience stereotype threat due to inaccurate perceptions they are “unprepared” for college-level science courses (Inzlicht & Schmader, 2012; Murphy & Taylor, 2012; Murphy et al. 2007). Stereotype threat happens in academic environments when students perceive they are being judged by negative stereotypes of their group rather than by individual achievement (Inzlicht & Schmader, 2012). Research studies have shown stereotype threat leads to low academic performance among members of underrepresented groups (Murphy & Taylor, 2012). Finally, pre-health advisors may spend a significant amount of time helping students cope with disappointment when not making adequate progress in a pre-health program (Nelson, 2015; Verrier et al., 2015). Counseling approaches provide a framework to address these and other concerns.

This chapter focuses on the value of counseling approaches in pre-health advising practice. Professional counselors assist and guide people in facing personal challenges. Counselors use their professional skills to help people move toward meaningful goals and make significant life changes based on evidence-based practices (Cormier et al., 2016; Hayes et al., 2012). Counseling theories and models serve as the basis of counselor education, yet one need not earn a degree in counseling to apply counseling approaches to advising practice. On the contrary, as has been noted by Musser and Yoder (2013), theories from outside the field of academic advising may suggest ways advisers can guide students.

This chapter reviews three counseling approaches that are effective in advising pre-health students: Acceptance and Commitment Therapy (ACT), Motivational Interviewing (MI), and Multicultural Counseling (MC). These counseling theories were chosen for discussion because they effectively address three distinct challenges which often emerge in pre-health advising.

The first challenge is that the outcome—i.e., being admitted to a medical school or other professional health graduate program—remains open-ended and unknown throughout students’ undergraduate experience. Pre-health programs are not degree-granting; instead, pre-health is a process, or future intention, to be planned for but may or may not lead to admission to professional school. Nevertheless, students invest a significant amount of time as undergraduates working toward an uncertain goal while volunteering in hospitals, taking challenging advanced science courses, working in science labs, and doing community service without knowing the outcome of their efforts. Uncertainty about the eventual outcome is an ever-present theme of pre-health advising.

The second challenge inherent in pre-health advising is motivation. Some students feel discouraged by advanced university science courses that demand a significant commitment of time and effort. Students may have enjoyed science in high school because they liked the teacher or succeeded in high school science courses with minimal work. Advisors need a strategy to help pre-health students awaken the internal motivation necessary to develop practical study skills, utilize academic resources, resolve feelings of ambiguity about changing unproductive behaviors, and remain persistent in a pre-health program.