Interview: Dr. Regina Moro

Dr. Regina Moro wears many hats at Palo Alto University, and I have had the privilege of seeing several of them up close. She is licensed as a Mental Health Counselor in Washington, a Clinical Professional Counselor in Idaho, and a Clinical Addiction Specialist in North Carolina. As an educator, her passion is helping counseling students learn strong interpersonal skills and facilitating a robust understanding of addiction so counselors can respond when it emerges in their work. Clinically, she has worked in a variety of settings, most recently in her own private practice providing telehealth services for a range of presenting issues.

She is also my academic advisor in the Counseling program. We meet regularly, and her thoughtful guidance, honesty, and support have helped me navigate this new professional path with more clarity and confidence.

This past Winter, I took Dr. Moro’s Addiction Counseling course, where her clinical insight and deep commitment to clients affected by addiction were unmistakable. Beyond the classroom and advising, we also connect through our university chapter of Chi Sigma Iota, where she serves as the faculty advisor and I serve as Member at Large for the local chapter. These multiple touchpoints have allowed me to see Dr. Moro as a mentor who consistently models compassion. I am grateful she agreed to share her perspective in this interview.

RN: How do you approach your role as an academic advisor, and what do you see as the most important part of that relationship?

Dr. Moro: As an advisor, I sometimes feel like a triage nurse in a hospital. This response may be because I just finished watching the new medical drama, The Pitt, last night but I’ll lean into this as it feels like an appropriate metaphor! These nurses work quickly to listen patients’ concerns, quickly determine what type of care they need, and then help facilitate a referral to the appropriate service. In the early stages of advising relationships, I find it important to take the time to learn about who my advisees are outside of their role as a graduate student. Then as our relationship progresses, I might work more like a triage nurse, see what’s emerging at this moment and consider what supports they need that I can help facilitate. I do always like to check-in before getting to business though, just a simple “How are you?” with a clear invitation to reply with more depth than “ok” or “fine” or following up on something I know was happening in their life from a previous conversation. Having that space is important. Another important part of this work is understanding my own role, that I am not a clinical supervisor, or their counselor when I’m operating in the role of an advisor. I can certainly use the interpersonal skills I’ve been trained in to facilitate meaningful conversations though. I also can help provide access to resources that might help in whichever area they need additional support. If it is a personal struggle, asking about their own counseling or referring to our mental health provider at the university, or if it’s an academic issue then directing them to their course instructor (or offering to meeting with them as a support person) or maybe referring them to the Office of Accessible Education if accommodations are a consideration. Possibly our discussion is highlighting that they want to learn more about a specific topic so I might offer readings or podcasts that I know about. And then, beyond helping students access resources, I do find that another big part of advising is about helping foster students’ emerging professional identities as counselors. This is sharing some of my own professional experiences, or about professional organizations I am a part of. I feel fortunate to have been trained by faculty members and have colleagues who are deeply integrated into the profession, and that has helped me gain a deep understanding of the profession which I can share with advisees. Ultimately, to go back to your question, the most important part of the relationship for me is that I listen to the person sitting across from me.

RN: Many students, myself included, experience moments of doubt or overwhelm during the program. How do you aim to support students through those moments?

Dr. Moro: It is in these moments I am so thankful to have training as a counselor! Not that I am providing counseling to advisees, but I know how to use interpersonal skills in intentional ways that allows me to truly listen to the student and that’s where I want to start- listen to their unique experience. The systems theory term of “equifinality” sticks out to me here- it is the idea that people can end up at the same final point (like the shared feeling of doubt or overwhelm) but start from different beginnings. I think that is important to be curious about the student’s unique experience of doubt/overwhelm. Then, after I learn from them I will consider what the student needs from me in that moment, and that is a question I will often ask them directly. Sometimes they really just need support and validation, and for this to be normalized that this is not something unique to them and something many students go through. But, they also might need further support- possibly to connect with an affinity group or local organization in their area. I want to be mindful of my own identities and the reasons that I experienced doubt or overwhelm are just that- my own, and I need to center the student sitting across from me and be curious about how their unique compilation of identities might contribute to these feelings. One thing I do not want to do is ignore this doubt or overwhelm and encourage the student to just push through. Ultimately it is about honoring their experience and connecting them with resources that can further support them.

RN: What do you think makes for a meaningful and productive advising relationship?

Dr. Moro: I think there are a variety of things that are impactful. For me, I think this all starts with a sense of compassion. I like to start by trying to remember that the students I am working with are human beings with a wide variety of roles, and being a student is just one of those. I do think it is important for the graduate student role to be prioritized, but it is not realistic for me to think that this is consistently the most important role in their life (especially for the years required to earn the degree). I also consistently try to remind myself that being a student now is drastically different from when I earned my Masters degree. In a simplistic way that has to do with the credit hours required for the degree. I graduated with my MS in Community Counseling in 2009 right before CACREP transitioned from a 48-hour credit requirement to a 60-hour credit requirement, and those 12 credit hours are a big difference- about 180 classroom hours per the Carnegie rule! I also did not attend an online program, and that comes with unique challenges.

RN: What drew you to specialize in addiction counseling, and how has that shaped your work as a counselor educator?

Dr. Moro: It was really my clients who led me to this specialization, as it was not something imagined I would be doing when I considered my future as a counselor. I originally entered the profession because I was interested in working with families experiencing divorce and the process of blending families, largely because of my own personal experiences as a child. But then I started working with clients. I did my Masters practicum at a college counseling center, and I did my internship at a family medicine residency program where I worked with the patients of the medical practice. In both settings I kept interacting with clients who were using substances (mostly alcohol) in risky ways. I also did not take a class on addiction counseling in my masters program! I graduated before CACREP required this education for all students so I felt very ill-equipped working with these clients. I was fortunate to have an amazing clinical supervisor and peers who helped me navigate this work but it was these clients that helped me know I needed to learn more about addiction. I chose a PhD program that also had an option where I could earn a graduate certificate in addiction counseling. I learned a profound amount in this program, in my classes, interactions with my professors, my clinical training and during clinical supervision. These experiences really fueled my passion for helping all counselors learn about addiction so they can respond when it emerges in their clinical work. You’ll notice I am not saying “if” here. My early clinical experiences helped me see that it doesn’t matter if you work in an addiction treatment facility or not, if you are working with people, you are going to encounter addiction. This might be the person struggling with addiction themselves, or maybe it is through your role as a school counselor working with a fifth grader whose parent has been gone in treatment for the past month, and they are having trouble focusing on their homework. I want everyone to be prepared to hold space for when it emerges and that largely informs how I approach my work as a counselor educator.

RN: I took your class last Winter Quarter, and the 12-step meeting assignment had a big impact on me. What do you hope students take away from that experience?

Dr. Moro: I do want to clarify that this assignment was for you all to go to an open peer-support group meeting, which includes other organizations that are not just based in the 12 steps. It’s an important distinction because there are many misconceptions about the peer recovery process, one that all peer support groups are 12-step groups. There are many people who are indebted to 12-step programs for supporting their recovery, and at the same time they are not the only option, which is important for everyone to know! This is a very important assignment with quite a few intended learning outcomes. One of these is for students to gain an understanding of the organizations and the format and flow of meetings. Another is to have the actual experience of going to the meeting. If going in-person that means figuring out how to get there, experiencing the commute, finding the door, entering the space, and all of those logistics. If going to a virtual meeting- finding the weblink, logging in, making decision about whether to be on mute or not or if to have their camera on. These are all considerations that someone going to a meeting for the first time is going to experience, and for students to have those experiences can be helpful when talking with clients. Another learning outcome is to experience sitting in these meetings to learn from the lens of being a counselor-in-training. Most of us enter this work with our own experiences of addiction, maybe we are in recovery, or we have a family member or friend who has struggled with addiction, or we have been influenced in some other way. I hope that this assignment helps students re-orient to a professional role and consider what might interfere in their ability to do so. That can provide helpful information of areas that students might need to do some of their own work on. Another big learning outcome happens during the course and the small group debrief process. Students are asked to share about their experiences with the meeting (never disclosing details about who was there to honor the anonymity) but focusing on what it was like for them. In these conversations I hope that students take away that there are some commonalities that all peer-support meetings have, and at the same time there are some large differences in meetings, not just across organizations but within. I emphasize this when we come back to the large debrief. And I’d say one of the last learning outcomes that I hope for students here is for them to learn that these organizations are distinct from clinical counseling that they will be involved in, and to honor how each offers clients support in unique ways.

RN: In your view, what are some of the biggest misconceptions counseling students have about working with clients who experience addiction?

Dr. Moro: My brain just went in about 5 different directions! I think there are so many misconceptions but the one that comes up in almost every class that I teach is the misconception that all clients struggling with addiction are resistant to change. I have heard this from students, and from counselors with decades of experience. Whenever I hear the word “resistant” I like to highlight that resistance is a defense mechanism. We know that defense mechanisms emerge when someone is feeling like they need to protect themselves (which often happens without our awareness). Instead of a dismissive statement like, “That client is just resistant” I invite the student or counselor to reflect on the following: “That client is demonstrating resistance- I wonder what is contributing to them feeling unsafe that they need to use this protective strategy?” Then reflect on what those contributing factors might be, including looking at themselves, the environment, the relationship, etc. I find this incredibly important to keep the counselors engaged in the relationship. That is probably the misconception that makes me stand on my soapbox the most often in class!

RN: What advice would you offer to students who are still figuring out their professional focus or theoretical orientation?

Dr. Moro: Trust the process and trust yourself! Yes, I know, the fist is the most cliché response. But I can attest to this for my own professional identity process! Your clients or specialization will find you, just remain open to the idea that it will happen. It might not be right away in your Practicum, maybe it will be after you graduate or even a little later after you have a few different experiences. And this might shift and evolve throughout your career. That is one of the beautiful things about our Masters degree is how versatile it is. I also say trust yourself here too because I have worked with quite a few students through the years who try to force a certain theoretical orientation onto themselves that really isn’t a great fit for them. There are many theoretical orientations that have empirical evidence so if we are using one that is scientifically grounded (as required by our ethics code), the counselor needs to be able to use the theory in their work. It needs to deeply resonate. For students struggling to identify their theoretical orientation I like to ask them to reflect on the this: “In simplistic terms, not trying to be a graduate student or use counseling language- why do you think people struggle in the world?” The answer to that question often points to elements which highlight their foundational theory! If you are one of those people reading this struggling with your own theory, I might invite you to reflect on that question and perhaps bring that to your academic advisor to explore more!

RN: We thank you, Dr. Moro, for this interview!

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I will see you next week.