Do No Harm

Johns Hopkins University’s graduate program in clinical mental health counseling is facing allegations that it discriminated against a group of students on the basis of mental health disability status, race, or both, by denying the accommodations or level of consideration that would have allowed them to graduate.

All say they were kicked out of the program, for academic reasons, since 2020. They're planning an on-campus protest in May, and asking supporters to wear black to bring awareness to what they describe as the university's ableism. 

Johns Hopkins challenged the notion that it discriminated against or has been otherwise unfair to students. It shared policy changes and data suggesting that the School of Education, where the clinical counseling program is housed, actually relaxed its standards somewhat during the pandemic to better accommodate all students. According to the university, roughly 4 percent of School of Education students were dismissed for academic standing or general conduct issues in 2017–18 academic year, compared to 2 percent in 2021–22.

“The safety, success and well-being of our students are of the utmost importance to all faculty and staff at Johns Hopkins,” the university said in a statement. “We are committed to providing academic programs, support services and facilities that are accessible and welcoming to all.”

Johns Hopkins said all disability-accommodation requests are taken seriously, that all reports of discrimination are investigated and that “as far back as we have records, there has been no finding of disability discrimination against any faculty member within the School of Education’s counseling program.”

Accounts Surface

Allegations of discrimination first came to light for many within clinical counseling last fall, when three dismissed students reached out to former peers via email to share their stories and possibly connect with others like them.

In March, four students shared their accounts of being dismissed from the program with Johns Hopkins’ student newspaper, mostly under pseudonyms. All said that because they were already on an academic improvement plan for a failing or close-to-failing grade, Johns Hopkins showed them no flexibility when a second academic concern arose, despite their mental health diagnoses and other extenuating circumstances.

Among other factors, two failing grades can trigger dismissal from the graduate program. Students may appeal poor grades but not dismissals.

According to the student newspaper article, one former clinical counseling student said that an internship site evaluator’s positive—but late—review led to her dismissal. Another said a poor relationship with her internship site supervisor thwarted her success in the program. One male student said he left an internship site after clients were sexually inappropriate with him and that the counseling program didn’t offer him enough support getting back on track. Another former student, who was not yet in the internship phase of the program at the time of her dismissal, said she didn’t fully understand the program’s grading policies before she was kicked out. Three of the four students are not white. 

Inside Higher Ed could not corroborate all these accounts, either because the former students did not make themselves available for full interviews or because they did not provide documentation to support aspects of their claims when asked (one dismissed student said this was because Johns Hopkins cut off access to her email account when she and others began contacting current students about their concerns).

An Internship Turns Sour

Inside Higher Ed did speak at length with and review numerous documents from the student who said she failed her internship due to problems with her supervisor. That student, who is an Asian woman with a mental health diagnosis, entered Johns Hopkins in fall 2019. In August 2020, she received a notice from Johns Hopkins confirming that she was making “satisfactory progress toward the completion of the program.”

That fall, the student got a B-minus in a class on research and counseling evaluation, and she was put on an academic improvement plan. Areas of concern for the course, according to improvement plan, were “poor participation” in small groups and lack of “skills in communication and awareness.” The student said that the description of her not talking enough in class raised some red flags for her about whether she was being stereotyped as an Asian woman. Yet she promised to increase her participation going forward—even as she privately felt the program in general asked students to walk a fine, often uncomfortable line between openly sharing their personal experiences with trauma and appearing professional at all times.

Prior to that semester, the student’s grade point average had been 3.8 or higher each term. The semester after she got a B-minus, her GPA was 4.0. This included a preinternship practicum in clinical mental health counseling, for which she received an A.

The student’s time at Johns Hopkins ended in summer 2021, however, just a few weeks into her internship period—after she’d asked Johns Hopkins multiple times for help dealing with her internship site supervisor, with whom she did not get along. (The site supervisor was not affiliated with Johns Hopkins and has since left the internship site.)

In one email to her faculty supervisor back on campus, for instance, the student wrote, “Differing approaches and styles is OK, but my problem [with my internship site supervisor] is I am given no autonomy for anything, my voice and input is not valued, the knowledge I bring to the table is not valued and I am frequently spoken to in a way that makes me feel offended and patronized. My supervisor tells me I’m not ready for seeing clients solo, but I already spend significant portions of my sessions solo with clients because she shows up late to most sessions.”

Beyond these concerns, the student also said she worried her supervisor was giving her conflicting information about her progress and using clients’ real first names in text messages about them, in possible violation of their privacy.

According to emails shared with Inside Higher Ed, the Johns Hopkins professor responded that he planned on “collaborating with your [site] supervisor to find a way for us to navigate some of the current challenges and I will let you know how we can proceed following our meeting.” The student responded that she appreciated the professor’s help and that she was also researching other internship site opportunities for a possible transfer, if permitted.

The professor responded by saying that site transfers were generally reserved for those students who couldn’t meet internship hour requirements at their original sites.

Just a few days later, the student learned that the internship supervisor she’d complained about hadn’t given her a successful interim evaluation, and that she’d been terminated from the internship site.

On her own, the student found another internship location willing to consider her for transfer. She informed Johns Hopkins of that option, but was soon dismissed from the clinical counseling program entirely.

A dismissal letter from Johns Hopkins quotes counseling program guidelines, saying that “Students who fail the internship field experience will be dismissed from the program. Academic probation is not an option for the field experience.”

The student appealed this effective F grade, saying that it had been based on her site supervisor’s “biased” interim evaluation, after just 10 percent of the internship’s total direct hours.

She also wrote to her new department chair, in whose course she’d previously received an A, and asked for help. The chair responded that while “you performed very well in my course,” intervening in the matter would be “inappropriate,” given her new position as head of the department.

A faculty committee denied the student’s grade appeal. The dismissal stands. She estimated she spent $60,000 on tuition, and tens of thousands more when considering rent and moving expenses, on a degree she didn’t get.

“I basically flushed away a lot of money,” she said.

Questions About Gatekeeping

Beyond wasted resources, the student said her experiences at Johns Hopkins have caused her to reflect on the concept of “gatekeeping” in counseling, which the American Counseling Association’s Code of Ethics defines as “the initial and ongoing academic, skill, and dispositional assessment of students’ competency for professional practice, including remediation and termination as appropriate.”

And while the profession runs first and foremost on the principle of avoiding harm, the student said that gatekeeping is inherently subjective—and therefore potentially harmful, to students most of all.

“The ACA code of ethics regarding gatekeeping mainly applies to supervisor-supervisee relations,” the same former student said. “There is so much emphasis on students being open to feedback from superiors. Which begs the question, what if the superior is flawed? The system never accounts for that.”

S. Kent Butler, president of the ACA, said that he couldn’t speak to the situation at Johns Hopkins because he wasn’t familiar with the details, but that “any program that’s trying to be effective is doing its best to make sure that they send no one out there into the counseling community that could cause harm.” This does include a certain level of “gatekeeping,” he said, from criminal record checks and interviews with applicants to expectations of success in classroom and field experiences.

At the same time, Butler said, in any effective program, “if you truly feel as though you are not getting the best experience—from your supervisor or from your faculty adviser or a faculty instructor—if you use the right channels, those things can be changed and won’t disrupt your career path. They won’t disrupt you being able to get through your program.” He said he's intervened as a faculty member before to help students navigate difficult relationships with instructors or supervisors, for example.

Effective counselor training programs, which last two to three years, also understand that they’re preparing “lifelong learners,” Butler said. “The courses that you take only teach you so much. So we are sending students out with the promise that they’re going to continue to grow into people who thrive as counselors, because they’re going to be doing that extra work that goes into it—going to conferences or doing continuing-education work, or specializing in certain areas. Those things don’t happen by going to one counselor ed program, right? We start them off, and hopefully they are able to blossom into the counselors, the great counselors, that they can be.”

Counseling as a field benefits from diversity and inclusion, he also said, and some counselors are drawn to the profession by their own experiences with mental health issues.

As for whether gatekeeping may introduce harmful levels of subjectivity into a counseling program, Butler said this: “We spend a lot of time with our students. We get to know them very well. And so we can really look at them because we have objective measures. And then the subjective piece is just how we mentor them into the process—how we speak with them, how we help calm them if they are upset or how we work with them to help them become better counselors. So the purpose of all counseling is to go out and do no harm.”

Notes on Empathy

In response to the student newspaper story, Christopher Morphew, dean of education, wrote a letter to the editor requesting an immediate retraction (which has not been granted). Morphew argued that the article “featured first-person accounts from former students but did not include corroborating evidence to support claims of discriminatory behavior—even while identifying individual faculty members. This decision to name faculty members while providing anonymity to former students was irresponsible and unfairly puts the professional reputations of our scholars at risk.”

Morphew wrote that all programs within the School of Education “strive to treat all students fairly and without regard their race, gender, disability status, sexual orientation or any other protected class” and that publishing “unfounded allegations has significant consequences and can cause real harm for real people.”

This full-throated defense of the program's faculty upset some current program students, who already had questions about what really had happened to their former cohorts.

One current student, who did not want to be identified by name to avoid possible negative consequences, said of Morphew’s letter, “To me, the dean’s letter felt like a warning to other students. Dean Morphew’s emphasis on his personal regard for these professors and Hopkins not having found these professors responsible for disability discrimination in the past seems intended to dissuade students from reporting professors who engage in discriminatory or abusive behavior.”

The dean’s message “is completely at odds with what we’re taught in classes about promoting institutional accountability, equity and transparency," the current student also said. "It is baffling to me that the leader of a school of education would want to send such a message to its students and would want those students to carry such a message into their careers.”

Beyond speaking out internally and via the student newspaper, the former counseling students have filed complaints with groups including the clinical counseling program’s accreditor, the Council for the Accreditation of Counseling and Related Educational Programs, or CACREP. The Hopkins program temporarily lost specialized CACREP accreditation in 2019 for having too few core faculty members teaching classes.

The clinical counseling program "shows a consistent lack of effort in retaining a diverse group of students and in creating and supporting an inclusive learning community," four former students told CACREP, writing that they were aware of two other students dismissed since mid-2020, with four of the six total students having documented disabilities and five being racial minorities (four were Asian). Professors within the program exercised grading leniency with some students and not others, and some they felt as if they were being retaliated against for requiring accommodations at all, making for an inequitable learning environment, the complaint says.

CACREP said Friday that it had “received and processed the complaint” per its procedures but provided no follow-up information when asked.

Johns Hopkins said that COVID-19 led to increased disability accommodation requests across the university, and that the School of Education has seen significant increases in requests granted, from 46 in 2017 to 88 in 2020 to 130 so far this year.

Morphew said in a brief statement to Inside Higher Ed, “We always appreciate feedback from our students, whether positive or negative, and we welcome the opportunity to work with them to address any concerns they may have so that we can foster positive learning environments for all students."

Rohan Arcot, a 2020 alum of clinical mental health counseling at Johns Hopkins and a current teaching assistant and lab manager for the program, who was introduced to Inside Higher Ed by the university, said he had “empathy” for all involved, from the dismissed and current students to the faculty members he now works alongside and understands and respects in new ways.

“It’s saddening, honestly, and the main impact I’ve seen of it in my specific role and experience is that it’s made it more challenging for students and faculty in the program to meet our mission of educating future counselors,” he said of the dismissals. “It’s been a significant issue this year and, yeah, there have been a lot of conversations around it. And I’ve been part of conversations where students have asked questions and felt they haven’t gotten the answers that they’re hoping for.”

Such conversations have perhaps been especially challenging, given that “we’re coming off the heels of the CACREP reaccreditation,” Arcot added. “I think we were all hoping that we would be able to move forward from that, and it feels like that issue has made it difficult to do that.”

Asked whether counseling as a field is hospitable, or not, to those with mental health diagnoses, Arcot said that counseling programs “are challenging both academically and personally in that they require a lot of you, for you to gain the skills and knowledge that you need, that we know counselors need.”

And "it's absolutely essential to remember that counseling students are humans and that we’re asking a ton of our students," he added. "It’s important to have that empathy that we have for clients with our students, as well.”