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When Camila Pulgar Guzmán was a 16-year-old growing up in Santiago, Chile, her parents moved the family to Winston-Salem, North Carolina—a place she had never heard of—after her father’s job was transferred. It was a difficult transition for her and her three younger brothers, none of whom could speak English.
She knew at an early age that she wanted to work in a helping profession, she says.
“Growing up in the Latinx community, there’s always this sense that the oldest daughter is responsible for everything and everyone,” she says. “I had family members who were struggling silently with depression and anxiety, and they always approached me to tell me about what they were feeling. Although I didn’t always know how to help because I wasn’t trained, I’ve always been comfortable sitting in that space and listening to people.”
Understanding the educational system and adjusting to life in the United States brought many challenges that solidified her desire to help others by becoming a counselor.
“My parents did their best to help us navigate all of that,” she says. “I took psychology classes at R.J. Reynolds High School, and that made it very obvious to me that I wanted to continue in the psychology field.”
She next studied psychology at the University of North Carolina at Greensboro (UNCG) where she met a Latina faculty member who mentored her.
“At that time, she was studying depression in the Latinx community, so that’s when I first started having some exposure to the mental health disparities that we have.”
After receiving her bachelor’s degree in psychology, Dr. Pulgar Guzmán earned a master’s degree in mental health counseling from North Carolina A&T State University in Greensboro. During that time, she worked as a Licensed Professional Counselor Associate (LPCA) at a clinic in Winston-Salem where she counseled families and children. Her work there earned her a Beginning Child and Adolescent Counselor Award from the Association for Child and Adolescent Counseling (ACACNC) in 2016. She was named a 2019–2020 National Board for Certified Counselors Minority Fellow, and earlier this year, she earned her PhD in counselor education/school counseling and guidance services from UNCG.
Currently, she is the only bilingual counselor at CareNet, an affiliate of Atrium Health Wake Forest Baptist in Winston-Salem, where she sees Spanish-speaking immigrants who have depression and have experienced trauma, most of which results from the difficulties that come with adjusting to their new lives, she says. She also recently started a part-time practice, Salud Mental Health, to increase awareness of mental health needs in the Latinx community.
“The immigration process is really unique, and it’s something you don’t understand until you experience it. For me, I’m able to have compassion and understand that experience on a personal level because my family and I immigrated here.”
Though she speaks English and Spanish, she says that language barriers and cultural differences are always concerns.
“In Chile, where I grew up, like all countries in Latin America, not everyone speaks the same type of Spanish,” she says. “There are different words for different things, and even the emotional language is different. That’s where the relationships with my clients come into play now. I want to know their backgrounds along with their stories, so I can use words and phrases that make sense to both of us. Just because I speak Spanish does not necessarily mean I’m going to be able to relate to everyone who comes into my office. I think it’s important for all of us to have that cultural humility and ask those questions to better understand our clients and their need for culturally appropriate services.”
There is a long-held stigma within the Latinx community associated with seeking mental health services, Dr. Pulgar Guzmán says.
“For many of us, myself included, it dates back to childhood,” she says. “I grew up in a very male-centered and male-driven culture, and the ‘macho man’ figure was something that we all had to follow; no one could speak of their feelings or cry, or show weakness, per se. When we move to another country, we don’t leave those values behind. They are always with us, and they accumulate on top of having made the sacrifice to move your entire family to another country. Once you’re here, you’re supposed to do whatever it takes to succeed, and that often means just putting your head down and doing your work without taking care of your mental health and seeking help when you need it. That’s why we see a lot of substance use spiking in our community, and suicide rates as well.”
After one of her brothers survived a suicide attempt, Dr. Pulgar Guzmán became motivated to focus on suicide prevention within the Latinx community.
“It happened at a very critical time in my family’s acculturation process,” she says, “and seeing my family navigate the mental health system in a different language, with few resources, in a strange and foreign place, that really opened my eyes. On top of the fear of losing my brother, I really wanted to help other families who have members who struggle with suicidality and suicidal behaviors, so they wouldn’t have to face that alone. It’s hard to talk about suicide, period. But it’s even harder in a community where you’re expected to not show your feelings and not reach out for help. People really struggle alone, and that is something that I’m always striving to change.”
Her work can be challenging at times, she says.
“One of the things that I’ve struggled with over the years is that all of our training is in English and is from more of a Western perspective. In school, we may learn about Latinx culture from a few chapters in a book, but it is a more complex process, and it’s something that all immigrants and their families struggle with when trying to find their way into a new life. For me, as a professional, I’ve had to do extra work to be able to be trained and to serve my community.”
Burnout and a lack of funding can further complicate matters.
“I’ve always been in organizations and groups where I’m the only one who speaks Spanish, and a lot of that responsibility and the assumption that I’ll be the voice for everyone from the Latinx community, it comes with a degree of burnout,” she says. “Also, in our community there are a lot of undocumented folks, and that means that they don’t have health insurance, so I often must find my own grants and other resources to fund my time, because I also have to make a living. I believe we can do a better job of supporting those clients who don’t have insurance.”
Because churches are one of the first places that many people turn to for help, Dr. Pulgar Guzmán has forged relationships with local religious leaders to provide information to their congregations and help remove the stigma associated with seeking mental health services.
“That’s why I think doing the groundwork and that communication with leaders in our community is so important,” she says. “As counselors for Latinx clients, we need to be involved in church communities regardless of their denomination. Everyone struggles with mental health, so for years I’ve made those connections, and pastors have invited me to give talks and offer resources, because that way we can make a better effort to remove that stigma together.”
Dr. Pulgar Guzmán believes that changes beginning at the university level could foster stronger counseling programs and counselors who are better prepared to work with the Latinx community.
“Counselor educator programs need to represent the folks that we serve,” she says. “Making sure that these students can see themselves in faculties across the country and in our counseling programs is important. This will trickle down to developing providers who are well-trained, not only because they speak Spanish, but also because they are competent and have had training that wasn’t just translated to English but was created with our community in mind. I’d like to see programs that train students how to work with the Latinx community and Spanish-speaking people clinically as well as socially.”
She also believes the counseling profession could do more to help undocumented and uninsured clients receive treatment and to better understand the resources available to them.
“It really pains me that I have to think about how I’m going to treat these clients if they don’t have insurance. Even sometimes a sliding fee scale is not something that they can afford,” she says. “Therapists should be supported and paid a salary that doesn’t cause them to worry about how they’re going to do the work. I’d also like to see more information provided in both English and Spanish. There are newsletters and websites with a lot of good information, but they don’t have a Spanish option. I think overall the counseling field could do a better job with that.”
She encourages those with specific interests in the counseling profession to find a mentor and ask plenty of questions.
“Therapists in general are usually very approachable people,” she says. “Find someone who has been working in the field for a while who can help. I love talking to others who are thinking about doing this type of work. We need more diverse voices, people who have had life experiences and are open to being trained. You can always reach out to organizations such as NBCC and the American Counseling Association (ACA) and ask questions as well.”
When she’s not working, Dr. Pulgar Guzmán enjoys spending time with her husband and their families, walking her dog, Luna, and hosting salsa dancing parties in her living room.
Earning her PhD was an important milestone and her crowning achievement thus far, she says.
“I’m the first woman in my family to attain that level of education, and when I received the diploma in my mailbox, I just sobbed,” she says. “It’s a huge commitment and a lot of work, but when people ask me, I tell them that I’d do it all over again.”
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