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Article Excerpt
WHEREAS, optimum physical, intellectual, social, occupational, emotional, and spiritual development are worthy goals for all individuals within our society; and
WHEREAS, research in virtually every discipline concerned with human development supports the benefits of wellness for both longevity and quality of life over the life span; and
WHEREAS, the AACD [ACA] membership subscribe to values which promote optimum health and wellness;
THEREFORE BE IT RESOLVED that the Governing Council of AACD [ACA] declare a position for the profession as advocates for policies and programs in all segments of our society which promote and support optimum health and wellness; and
BE IT FURTHER RESOLVED that AACD [ACA] support the counseling ... professions' position as an advocate toward a goal of optimum health and wellness within our society.
--Resolution of the Governing Council of the American Association for Counseling and Development (AACD), now the American Counseling Association (ACA)
This resolution, titled The Counseling Profession as Advocates for Optimum Health and Wellness, was adopted by the Governing Council of the American Association for Counseling and Development (AACD), now the American Counseling Association (ACA), July 13, 1989. Rather than being a radical departure from prior goals, the resolution represented a renewed commitment to the history and philosophical foundations of the counseling profession as a whole. Sweeney (1995, 2001) reviewed the evolution of counseling as a profession and underscored its roots in a developmental guidance approach. These roots go back almost a century to seminal writings such as those of Jones (1934), who stated that "guidance is based upon the fact that human beings need help ... in order that decisions may be made wisely" (p. 3). Today, concern in the profession for helping people make wise decisions is reflected in a philosophy variously defined in terms such as prevention (Derzon, 2006), development (American School Counselor Association [ASCA], 2003), and wellness (Myers & Sweeney, 2005a), terms that share common tenets and, as a consequence, are often used interchangeably (Myers, 1992).
In contrast to counseling, the roots of wellness go back almost 2,000 years. The Greek philosopher Aristotle, writing in the 5th century B.C., was perhaps the first person to write about wellness. His goal in doing so was to offer a scientific explanation for health and illness and to define a model of good health in which one seeks for "nothing in excess." During the Middle Ages, Descartes and others who defined the scientific revolution proposed a duality of mind and body that resulted in a fragmented approach to interpreting human functioning. Only within the latter half of the 20th century has a new paradigm in medicine emerged in which body, mind, and spirit are seen as integral to understanding both health and wellness (Larson, 1999). This new paradigm is consistent with the World Health Organization's (WHO) definition of health as "physical, mental, and social well-being, not merely the absence of disease" (1958, p. 1). Health in this context is a neutral concept, with wellness defined as a positive state of well-being on a continuum that ranges from illness at one extreme, through health in the middle, to high-level wellness at the other extreme (Travis & Ryan, 1988).
Professional counselors seek to encourage wellness, a positive state of well-being, through developmental, preventive, and wellness-enhancing interventions. Although these interventions are based in a philosophy of care, ethical practice requires the use of evidence-based techniques. In fact, the ACA Code of Ethics (ACA, 2005) states clearly that "counselors have a responsibility to the public to engage in counseling practices that are based on rigorous research methodologies" (p. 9). Following a review of research in the counseling field, Sexton (2001) noted the urgent need for evidence-based models to inform clinical practice and remarked that "moving toward evidence-based counseling practice ... has been, and continues to be, a struggle within counseling" (p. 499). The purpose of this article was to address that struggle in a positive manner, by presenting both wellness models based in counseling and a review of the evidence underlying those models.
Although several models of wellness have been proposed in the counseling literature (e.g., Chandler, Holden, & Kolander, 1992), in our search, we were able to locate empirical studies in support of only two counseling-based wellness models, the Wheel of Wellness (Myers, Sweeney, & Witmer, 2000; Sweeney & Witmer, 1991; Witmer & Sweeney, 1992) and the Indivisible Self (Myers & Sweeney, 2005a, 2005e). The sources reviewed included 29 completed doctoral dissertations, several dissertations currently in progress, 19 published studies that were not based on dissertation research, and several additional studies in print or in press in counseling journals. Studies using other models and related assessment instruments (e.g., The Lifestyle Assessment Questionnaire and Testwell, both National Wellness Institute [1983] instruments based in Hettler's [1984] hexagon model) were excluded from this review because of their academic base in disciplines other than counseling. Implications for research needed to inform clinical practice in counseling with the goal of enhancing wellness and advocacy for greater wellness in various client populations are discussed.
* The Wheel of Wellness: A Theoretical Model
The first wellness model was developed by Hettler, who is widely viewed as "the father" of the modern wellness movement. Although models such as Healer's (1984) hexagon were presented as holistic, in practical use their emphasis was primarily on physical health. In addition, the concept of life span development was not included in these early models (B. Healer, personal communication, December 1992). In a move away from the predominant models that were based in physical health sciences, Sweeney and Witmer (1991) and Witmer and Sweeney (1992) developed the first model of wellness that is based in counseling.
Myers et al. (2000) defined wellness as
a way of life oriented toward optimal health and well-being, in which body, mind, and spirit are integrated by the individual to live life more fully within the human and natural community. Ideally, it is the optimum state of health and well-being that each individual is capable of achieving. (p. 252)
This definition is the basis for the Wheel of Wellness (Sweeney & Witmer, 1991; Witmer & Sweeney, 1992), a theoretical model that emerged from reviews of cross-disciplinary studies in which we sought to identify correlates of health, quality of life, and longevity. Using Adlerian Individual Psychology (Adler, 1927/1954; Ansbacher & Ansbacher, 1967; Sweeney, 1998) as an organizing principle, Myers et al. (2000) proposed relationships among 12 components of wellness depicted graphically in a wheel. Following early research with this model, it was expanded and refined, with 17 components depicted in the final version of the Wheel of Wellness (see Figure 1; Myers et al., 2000) that interact with contextual and global forces to influence holistic well-being.
As shown in Figure 1, spirituality is depicted as the center of the wheel and the most important characteristic of well-being. The components of spirituality include having a sense of meaning in life in addition to religious or spiritual beliefs and practices. Radiating from the center of the Wheel of Wellness is a series of 12 spokes in the life task of self-direction: sense of worth, sense of control, realistic beliefs, emotional awareness and coping, sense of humor, nutrition, exercise, self-care, stress management, gender identity, and cultural identity. These spokes help to regulate or direct the self as a person responds to the Adlerian life tasks of work and leisure, friendship, and love. The model is proposed as an ecological one in that life forces, such as the media and the government, are shown as affecting the wellness of individuals. In addition, we hypothesized that all of the components of wellness are interactive and that change in one area causes or contributes to changes in other areas of the model as well.
The Wheel of Wellness is the basis of an assessment instrument, the Wellness Evaluation of Lifestyle (WEL; Myers, Sweeney, & Witmer, 1998), and has been widely used in workshops, seminars, and empirical studies. The Wheel of Wellness remains a useful tool for professional counselors as a guide for both formal and informal assessment and for wellness-oriented counseling. Feedback we have received from professional counselors in the United States and other countries suggests that the placement of spirituality as the core characteristic of a well person has an intuitive and almost universal appeal. However, after years of study using the Wheel of Wellness model and the WEL, statistical analyses failed to support the hypothesized circumplex structure and the centrality of spirituality relative to other components of wellness.
[FIGURE 1 OMITTED]
* The Indivisible Self: An Evidence-Based Model of Wellness
Hattie, Myers, and Sweeney (2004) analyzed the database of 5,380 persons that was developed during 7 years using the WEL inventory. Through structural equation modeling, they determined a three-level factor structure that included a single higher order wellness factor that...
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