Monthly Archives: December 2018

From the President: Fostering resiliency

Simone Lambert December 31, 2018

Simone Lambert, ACA’s 67th president

Happy New Year! According to Oxford Dictionaries, the word of the year for 2018 was toxic. What would it take for the word of the year in 2019 to be resilience? The Oxford Dictionaries define resilience as “the capacity to recover quickly from difficulties; toughness.” How do we, as counselors, help clients and communities transform toxicity and trauma into resilience?

In a time when mass gun violence has become normalized, severe weather patterns threaten livelihoods and force migration from communities, and sociocultural and political climates are tense, the need for resilience has never been greater. On Nov. 26, the American Counseling Association Governing Council passed two statements developed by our Human Rights Committee to address the public health concerns related to gun violence and climate change. There is much we can do as a profession to advocate for preventive and mental health treatment services in schools and communities to foster resiliency related to such tragedies.

Resilience may look very different for each individual, and that’s OK. For instance, some people in recovery demonstrate resilience by serving as peer supports for others who are in the early stages of recovery. Others may decide to give back to their communities by fundraising or organizing community awareness walks that focus on particular issues. For some people, getting out of bed every day is a sign of resiliency. Choosing to not give up and to make it through the day is the ultimate indicator of resiliency for those who are in severe emotional pain.

Maya Angelou said, “I can be changed by what happens to me. But I refuse to be reduced by it.” How do we as a profession assist clients and communities in shifting potentially maladaptive reactions to negative events into reactions that can lead to posttraumatic growth? We do this work with students in the schools and clients in the community all the time. If our goal is to make resilience the word of the year, we will need to advocate for systemic changes to help communities heal and become stronger through healthy interconnections, cultural dialogues and access to mental health counseling. 

Of course, counselors aren’t immune to personal challenges, natural disasters, systemic barriers or other hardships. Life continues to happen to us even as we serve others. We have a responsibility to seek renewal and foster personal resilience because we are the primary tool through which we help others. Thus, my hope is that all counselors will include self-care as a New Year’s resolution for 2019.

Yes, self-care includes a good diet and regular exercise — those typical New Year’s resolutions. But for counselors, self-care of the mind, body and soul is critical. What fills your cup and brings you joy, both in your personal and your professional life? What would help you become more resilient as a counselor?

Gaining knowledge for complex client cases, recovering from a client’s death by suicide, securing an internship placement, obtaining licensure as a professional counselor, finding a job, relocating and finding another job … these are some of the professional challenges that counselors face throughout their careers. ACA has traditionally been a source of renewal for counselors who fill their cups by attending conferences, networking with colleagues and taking advantage of clinical resources. Also be sure to check out ACA’s more robust Career Center (, which, among other offerings, assists students and new professionals in finding internship placements. Plus, see new online learning opportunities for counselors across settings (see In the year ahead, take advantage of all that ACA has to offer, including connecting with other counselors who share a passion for advocacy, ethical and culturally sensitive practice, and the promotion of resiliency.





Follow Simone on Twitter: @drsimonelambert 

CEO’s Message: Upping our game

Richard Yep

Richard Yep, ACA CEO

Each day it seems that the world becomes smaller thanks to the advent of technology, allowing us to more easily travel, communicate, interact and learn about others. From my perspective, this means we can also learn more about diverse cultures, customs, perspectives and motivations that we may not inherently understand.

I’m not speaking here about only the internet and our ability to Google or ask Siri about any topic imaginable. Long-distance travel has also improved, and although security takes a bit more planning, it is now easier to reach many destinations around the world. In addition, communications technology allows us to actually see someone living on the other side of the country or the globe when we talk via platforms such as Skype and Zoom.

In December, I was fortunate to attend the World League for Freedom and Democracy conference in Taiwan. The American Counseling Association was invited based on its work as a recognized nongovernmental organization with the United Nations. The event brought together elected officials, policy experts and key stakeholder groups to discuss opportunities with and threats to liberal democracies that support the rights of people to live in open and free societies. My presentation asked attendees to understand the impact, and challenges, to liberal democracies when mental health issues brought on by issues such as trauma, tragedy, discrimination and oppression are disregarded.

For too long, governments worldwide have failed to provide appropriate support to efforts that address behavioral health needs. Each of you does outstanding work to advocate on behalf of your clients, students and communities. Therefore, you expect a professional association that will represent your interests to those with the authority (and responsibility) to adopt and fund services and programs that impact the counseling profession and those you serve.

As we begin 2019, here is more than just a New Year’s resolution. The ACA Governing Council has been deliberate over the past 12 months in creating a vision and a strategy — supported by an actual budget — that seeks to do much more than create taglines designed to make members feel good. Although we still want you to feel good about ACA in 2019, we are doubling down on our public policy efforts as we engage with the new Congress and policymakers, as well as those serving at the state level. While the bulk of our efforts will be focused on actions in the United States, we will continue to build on our role within the U.N. and the establishment of relationships with your counterparts in Asia, Europe and other parts of the Americas.

Our Government Affairs Department and our Public Policy and Legislation Committee have done a great job positioning ACA more prominently in the public policy arena. This year, we will be bringing on more staff, and our efforts will be part of organizational collaboration across all ACA departments. We will also use technology wisely to raise awareness among public policymakers about what counselors are doing. I hope that you will join in our efforts when asked to share your opinions with public policy officials.

Shame on us if we don’t use technology, staff resources and the latest communications techniques to carry out the directive of your elected representatives on the ACA Governing Council.

With all of the divisiveness we see occurring in society, my hope in 2019 is that the counseling profession will be able to communicate a message to those in government that the rhetoric, false information and lack of financial support must end. Our top priorities this year include enhancing your practice, providing resources for the work you do and effecting real change.

The ACA staff and I wish you the best this year and want you to know how incredibly thankful we are for the work you do.

As always, I look forward to your comments, questions and thoughts. Feel free to call me at 800-347-6647 ext. 231 or email me at You can also follow me on Twitter: @Richyep.

Be well. v

Building client and counselor resilience

By Laurie Meyers December 26, 2018

Merriam-Webster offers two definitions for resilience. One is literal and drawn from physics: the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress. The second definition is a symbolic mirror of the first: an ability to recover from or adjust easily to misfortune or change.

In the past, many experts ascribed this ability to an innate quality that certain people possessed but others did not. More recently, however, researchers and mental health experts have concluded that resilience is multifaceted — something that is influenced by genetics, yes, but also something that can be built and enhanced over a lifetime (see sidebar, below).

“I believe we all have the capacity for [resilience],” says licensed professional counselor (LPC) Cara McCarty, “but it’s not something that’s earned or received without work. It’s not something that we just get for free. It’s something that you fight for, you have to work for, you have to earn.”

McCarty says that in the counseling profession, the idea of developing resilience — at its essence, the ability to rebound, bounce back and overcome — has most often been linked to trauma work. However, she believes it is something that counselors should be trying to nurture in all of their clients. Indeed, resilience is so central to McCarty’s counseling philosophy that she named her Oklahoma City practice Resilience Counseling.

McCarty says it was her initial work as a counseling intern with transgender clients that opened the door for her to see what she calls the “incredible power” of resilience. As she points out, transgender people are a minority even within the LGBTQ community, are marginalized by society and live every day in bodies that they don’t feel are their own. They often have co-occurring depression and anxiety and are pursuing a goal that often feels out of reach to them — to live fully as the gender with which they identify. Despite all of these challenges, they choose to keep going and pursue being themselves. This ability to endure in the face of existential obstacles led McCarty, who continues to work with transgender clients, to believe that resilience is the key to navigating all of life’s challenges.

LPC Karl Memmer has also based his practice on resilience. “I believe the concept of resilience captures the balance between the acceptance of the negative in our lives and the acknowledgment that we can all develop the skills necessary to overcome the adversities we all face,” he says. “Building resilience empowers individuals to take more control of their own lives, take responsibility for what they can and cannot control, and develop a greater sense of confidence in overcoming challenges. … I feel it is central to the practice of counseling as, ultimately, our jobs are not to take away the burdens of others but to help them organize the chaos in their own lives by listening objectively and helping them develop or enhance skills to more effectively take action and responsibility.”

Assessing and building resilience

What does resilience look like? McCarty says that in her experience, people with high levels of resilience are more “flexible,” meaning they are more easily able to adapt and adjust to life’s happenings as needed. This applies to everything from being inconvenienced by a simple mix-up in plans to being diagnosed with a serious medical condition or experiencing the sudden death of a loved one. People with high levels of resilience take in what has happened to them and ask, “What next?” she explains. Other people, such as those who struggle with anxiety, are less flexible, so they have to work harder at building their resilience.

McCarty isn’t aware of a scale or assessment tool to measure a person’s resilience. Rather, she says that she begins introducing the concept at intake. In her paperwork, she asks clients to describe past difficulties that they have overcome. “It gives me a window on how they view themselves,” McCarty says.

Clients sometimes leave this question blank because they don’t view their own challenges as serious or particularly difficult. In other instances, clients may perceive that they have failed to address the challenges in their lives. In either case, the responses give McCarty an opportunity to explain resilience to her clients, point out the ways in which they have already been resilient and discuss ways to continue building on that resilience.

“I think everything counts as a chance to be resilient, [such as] changing jobs or moving neighborhoods. It’s not just for major life events but for things that happen all the time,” she says.

McCarty’s aim is to help clients recognize that they are already using their personal strengths and attributes — such as grit, toughness and persistence — every day to do hard things on a smaller scale.

“For example, let’s say my client has been working on social anxiety and we’ve made a goal of attempting low-pressure conversation three times this week. My client reports they spoke to someone in the break room at work, they made small talk with their cashier and they interacted with someone while pumping gas,” McCarty says. “I might ask them how successful each of these were. Let’s say two out of three were positive. I might ask my client if they noticed a change in their anxiety with each interaction and if they felt the interactions got easier or harder. Assuming their anxiety was lower with each interaction and they felt more comfortable as a result, I would point out how their grit and persistence kept them moving forward.”

“In this example,” she continues, “even if the interactions were negative, the fact that the client kept trying shows grit and persistence and helps the client understand that it’s not about the result of the interaction, it’s about the attempt. The more attempts we make, the easier it is to keep going regardless of the result or outcome. Resilience is the culmination of this practice and work.”

Andrea Cooper, an LPC and licensed clinical professional counselor who works with Memmer at Resilience Counseling and Social Skills Center in the Richmond, Virginia, area, says that building resilience often begins with shoring up clients’ self-esteem. She asks clients to keep a thought record, which helps them monitor what they are feeling and how they are reacting to situations that they find difficult or unsettling. The goal is to uncover automatic thoughts tied to negative

“Someone who has ideas about contributing to a business meeting but doesn’t speak up may be listening to their own automatic thoughts,” Cooper says, “such as ‘No one will care. They will not think this is a very good idea. Who am I to speak up?’”

She explains that these negative self-messages are often an indication of false core beliefs, such as “I have nothing of value to contribute” or “I’m not smart enough.”

“Developing an awareness of that automatic thought trail gives the person an opportunity to interrupt their habitual response — not contributing — by choosing alternative statements to tell themselves, such as ‘I feel uncomfortable speaking up, and that’s an old habit. I have an idea worth sharing,’” Cooper continues.

The process may sound simple on paper, but disrupting negative automatic thoughts takes practice. “We generally start practicing with low-risk situations — such as contributing to a social encounter in the break room — so the client gains a sense of success with their new behavior,” Cooper says.

Memmer chips away at self-esteem issues that can hamper resilience by teaching clients to distinguish between thoughts, feelings and actions. One tool he uses to do this is a “thought pyramid.” He and the client start by drawing a pyramid on a piece of paper. The pyramid is divided into three sections: Thoughts are at the top, feelings are in the bottom left-hand side, and actions are assigned to the bottom right.

Memmer then asks clients for examples of thoughts — typically negative — that frequently pop up in their daily lives. Those thoughts — for example, “I’m a loser” — are recorded at the top of the pyramid. Next, emotions such as anxiety, sadness and hopelessness that accompany those thoughts are recorded in the bottom left space. Finally, Memmer and the client move to the bottom right-hand corner: actions.

Memmer asks clients what they typically do when they feel these negative emotions. They might respond by saying that they isolate themselves from their friends. Memmer then demonstrates how those actions are contributing to a negative feedback loop by asking clients how they feel when they isolate themselves. The answer (for example, “Like an undesirable loser”) lands them back at the top of the pyramid: their thoughts.

By using this exercise, Memmer is also highlighting that clients cannot change negative thought patterns just by “deciding” to feel or act differently. Rather, they must disrupt the cycle through identifying and reframing the negative thoughts.

As clients begin changing their negative beliefs, they often come to the realization that they cannot always control their daily stress and strife, but they can control how they react. This awareness allows them to feel more capable and empowered — more resilient, Memmer says.

Because Cooper believes that cultivating emotional and physical wellness enhances resilience, she encourages clients to take time between sessions to focus on mindfulness techniques such as guided meditation. Rather than asking clients to sit down and aim for 30 minutes of meditation on their own, she recommends that they use an app such as Headspace, which offers numerous guided meditations that focus on stress, anger, anxiety and other issues. Other meditations are geared toward helping listeners sleep better or develop stronger focus.

The important things in life

Cooper also believes that helping clients identify their values — what is most important to them — and evaluating how closely their lives conform to those core principles enhances resilience. She does this by listening to clients’ stories.

For example, a client might talk about being unhappy at work because he or she is supervised very closely by a manager and expected to provide continual incremental updates. This tells Cooper that the client is feeling smothered and values autonomy at work. The client can then work to change or improve the situation by setting boundaries in the current job or perhaps looking for a different position that offers more autonomy.

Cooper has also worked with numerous teachers who feel they are never really off the clock. Responding to parent phone calls and email inquiries extends their workdays well into the evening, leaving them little time to spend with their spouse, partner or children. When these clients identify family time as one of their primary values, Cooper helps them explore whether they can engage in more family activities on the weekends or whether they might benefit from improving their time-management skills.

“Once we can name [our] values, we’re more apt to seek them out and improve our quality of life,” she says.

Cooper asserts that being connected to others is also essential to building and maintaining resilience. “Connectedness is important [because] we are social beings and need some meaningful relationship to others,” she says. She adds that depression, isolation and loneliness often accompany each other.

Cooper points out that life phase changes are one common cause for social disconnectedness. Relocating for a new job or graduating from college or high school may be exciting life events, but they often result in the dissolution of previously established social circles. “We have to learn how to connect with new people,” she says.

One way that counselors can assist clients in building resilience is to help them find ways of establishing new connections. This might involve encouraging clients to explore their interests and engage in activities. “Do what you love and you are likely to encounter others who are like-minded,” Cooper advises. She adds that religious or spiritual connections and volunteer work can also lead to rewarding social contact.

In fact, resilience is not limited to the personal level. It is also manifested at the relationship level and the community level, says American Counseling Association member Matthew Fullen, an assistant professor at Virginia Tech who studies resilience in aging adults.

He explains that the counseling relationship itself can be a source of resilience for clients because of its supportive nature. It also helps demonstrate that resilience is developed with the help of relationships that lift people up and support them. Likewise, communities such as cultural or faith-based groups not only surround people with support but derive resilience
from their shared histories, traditions and experiences.

Fullen, a licensed professional clinical counselor in Ohio, believes that group therapy is particularly effective for building resilience precisely because of this community effect. As part of a study, Fullen ran a program at a day facility that offered support and rehabilitation for people 55 and older with disabilities that severely curtailed their functioning. The group spent a substantial amount of its time discussing resilience. Members not only shared times when they had been personally resilient but also pointed out examples of resiliency demonstrated by other group members.

“I remember someone saying, ‘Every day I have this physical therapy. It’s excruciating and it’s really hard, and there are times when I feel like I can’t take one more step. When that happens, I think about this group,’” Fullen recounts. He points out that the group member was able to call on the collective resilience of the group as a source of support and inspiration that increased the group member’s personal level of resilience.

Another incident had a particularly profound effect on the group, according to Fullen. One day, he asked group members to name someone who exemplified resilience to them. Fullen was expecting people to name family members or celebrities. Instead, a soft-spoken group member shyly raised her hand and said, “Judy. Judy is who I think of,” pointing to one of the people in the room. The woman explained that Judy came in daily for difficult physical therapy and never complained.

“I know she has a lot going on at home,” the woman continued. “Her kids are having problems, and it weighs on her, but she is still able to come in and be nice and helpful.”

It was a moment of revelation for everyone in the room, Fullen says, because it drove home the point that resilience isn’t something possessed only by people who are outwardly “successful.” It can also be embodied by those who are marginalized. In fact, participants in the group showed significantly increased levels of resilience at the end of Fullen’s study.

Counselor, heal thyself

As counselors attend to clients’ resilience, they must also make sure to build and maintain their own. “What we do as clinicians impacts others,” says ACA member Robert J. Wicks, an expert on secondary stress in clinicians and the author of books such as The Resilient Clinician, Bounce: Living the Resilient Life and Night Call: Embracing Compassion and Hope in a Troubled World.

“There is a Chinese proverb that says, ‘When the tide rises, the boats in the water do as well,’” he continues. “I think this is true, but as clinicians, that doesn’t mean that raising the psychological tide is easy.”

The primary risk to counselors’ resilience is bound up in an essential paradox: The seeds of therapeutic compassion and the seeds of secondary stress are the same. Therapy is performed through reaching out to others, but the pressure caused by the therapeutic connection puts practitioners at risk for compassion fatigue, Wicks explains.

Those in the helping professions need to recognize that no matter how prepared they are, the pain of those they serve is so omnipresent that it can catch practitioners off guard and drain them, he continues.

When working with physicians and nurses, Wicks gives them a reminder of their epidemiology studies: For every case of poisoning, there are at least a dozen cases of subclinical toxicity. The parallel to counseling? He believes that for every impaired clinician, there are a least a dozen cases of practitioners who are on the edge of compassion fatigue.

“The reality is that — and this is important — clinician impairment is most often a developmental process … not a cataclysmic event,” he asserts. He adds that clinicians must learn to recognize, and lean back, when their stress is high.

Wicks says that counselors can build and maintain their resiliency by:

  • Gaining skills in regulation of emotions
  • Decreasing maladaptive behavior patterns that result from poor self-awareness
  • Improving their ability to balance their personal and professional lives
  • Developing a willingness to honestly assess their own coping patterns
  • Taking responsibility for managing personality-based coping tendencies and attitudes that drive them
  • Uncovering disruptive maladaptive coping habits, including workaholism and other compulsions
  • Treating their body/mind/spirit with respect
  • Counteracting toxic emotions
  • Learning to self-nurture with healthy pleasures
  • Using positive interpersonal skills such as assertiveness, anger management and principled conflict negotiation
  • Employing realistic work and family balancing strategies

Wicks also stresses the importance of counselors regularly setting aside time to be alone and reflect. Practitioners may be able to give themselves this necessary breathing room by modifying their habits and practice style. For instance, Wicks suggests that practitioners make it a habit of arriving early to their offices so they have time to center themselves rather than rushing in with only minutes to spare. He also advises against counselors putting client sessions back-to-back, which can cause client issues and details to run together.

Setting aside this time can assist counselors in recognizing their own foibles, protecting their “inner fire” and accepting change and loss. “We all need time to adjust and grieve,” Wicks says.

Rodney Dieser, a professor of health, recreation and community services and affiliated faculty member in the Department of Clinical Mental Health Counseling at the University of Northern Iowa, has centered his research, practice and teaching on the importance of leisure to overall well-being. He is a proponent of sociologist Robert Stebbins’ “serious leisure perspective.” Dieser, a licensed mental health counselor, believes that leisure is an essential component of maintaining counselor resilience by helping to prevent burnout.

Summarizing Stebbins’ research, Dieser explains that leisure has three categories:

1) Serious leisure involves spending a large amount of time mastering certain skills as a hobby. An example would be learning to play an instrument over time and participating in the community orchestra.

2) Casual leisure is what most people think of as leisure. It requires little in the way of special training to enjoy. Examples include relaxing, going to a restaurant, reading, engaging in social conversations, resting on a hammock or going to the beach.

3) Project-based leisure involves taking on a project that is somewhat complicated but that doesn’t involve more “serious skills.” Examples include planning a family vacation, engaging in fundraising for a local community project or participating in other kinds of volunteer efforts.

Research has shown that leisure can relieve stress, provide healthy coping methods and offer protection from the negative health effects of extreme and prolonged stress, says Dieser, a member of ACA. With that in mind, Dieser has students in his introductory counseling classes design self-care plans that include one serious leisure, one casual leisure and one project-based leisure activity. 

“Leisure programs can minimize the impact of stress through enjoyable distractions that create psychological breathers or regrouping,” he explains. “Leisure pursuits serve as a source of protection against stress because they enable coping through social support and the application of self-determination. During a stressful event, groups of similar people or acquaintances, including [those based on leisure activities], can provide a source of relief, instill hope, serve as a catharsis in expressing feelings and help a person not to feel alone. Application of self-determination through leisure allows a person to feel they have some control in their lives when other parts of their lives are out of control. … [Finally], leisure experiences can create or restore a sense of optimism through pleasant experiences in the face of intense stress.”

Cooper reminds counselors that they are their own best instrument of practice when it comes to resilience. “Practice some of the things you try to teach clients,” she urges. “Take care of your physical health, take time for yourself [and] get enough sleep.”




The science of resilience

The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” According to the October 2012 Science article “The science of resilience: Implications for the prevention and treatment of depression,” genetics play an important part in people’s responses to stress and trauma, but there are also important psychosocial factors that contribute to resilience. These factors include:

  • Positive emotion and optimism
  • Loving caretakers and solid role models
  • A history of mastering challenges
  • Cognitive flexibility, including the ability to reframe adversity in a more positive light
  • The ability to regulate emotions
  • High coping self-efficacy
  • Strong social support
  • Disciplined focus on skill development
  • Altruism
  • Commitment to a valued cause or purpose
  • The capacity to extract meaning from adverse situations
  • Support from religion and spirituality
  • Attention to health and good cardiovascular fitness
  • The capacity to rapidly recover from stress




Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (

Books (

  • Neurocounseling: Brain-Based Clinical Approaches, edited by Thomas A. Field, Laura K. Jones and Lori A. Russell-Chapin
  • Counselor Self-Care by Gerald Corey, Michelle Muratori, Jude T. Austin II and Julius A. Austin

ACA Mental Health Resources (

  • Self-care Resources for Professional Counselors




Laurie Meyers is the senior writer for Counseling Today. Contact her at

Letters to the




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Our most-read articles of 2018

Counseling Today

What were counselors reading in 2018?

This year saw the explosion of the #MeToo movement, so it’s no surprise that a piece on supporting clients through sexual assault response was among the top five articles that received the most views at Counseling Today’s website,

Readers were also interested in pieces on navigating and preventing professional burnout, as well as helping clients with workplace stress, chronic pain, eating disorders, parenting issues, trauma and a variety of other topics.

Interestingly, the top search terms that brought readers to in 2018 included “polyvagal theory,” “dual relationships in counseling,” “working with client lies and concealment,” “self-care for counselors” and “how to deal with countertransference.”

Close to 150 articles, both online-exclusive pieces and articles that also appeared in Counseling Today’s print magazine, were posted at in 2018.


Most-viewed articles posted in 2018 at

  1. The hurting counselor” (Member Insights on practitioner burnout, August magazine)
  2. The battle against burnout” (Cover story, April magazine)
  3. Parenting in the 21st century” (Cover story, March magazine)
  4. Effective ways to approach sexual assault response,” (Member Insights, July magazine)
  5. The therapy behind play therapy” (Cover story, September magazine)
  6. Understanding and treating survivors of incest” (Knowledge Share, March magazine)
  7. Could toxic workplaces be killing your clients?” (Feature, October magazine)
  8. Why do cops avoid counseling? Eight myths about law enforcement officers and mental health treatment” (Online exclusive, January)
  9. Talking through the pain” (Feature on helping clients with chronic pain, February magazine)
  10. Food for thought” (Cover story on disordered eating, February magazine)
  11. Past trauma in counselors-in-training: Help or hindrance?” (Online exclusive, May)
  12. When panic attacks” (Feature, August magazine)
  13. When help isn’t helpful: Overfunctioning for clients” (Online exclusive, March)
  14. Moving through trauma” (Member Insights on healing through yoga, breathwork and meditation, November magazine)
  15. The opioid crisis and a wounded counselor’s heart” (Online exclusive, May)
  16. Counseling people who stutter” (Member Insights, April magazine)
  17. Standing in the shadow of addiction” (Feature on supporting the adult children of parents with alcohol use disorders, November magazine)
  18. Five strategies to develop mental health models in schools” (Member Insights, March magazine)
  19. When bias turns into bullying” (Feature, July magazine)
  20. The social justice of adoption” (Online exclusive, June)






What was your favorite article of 2018? What would you like to see Counseling Today and CT Online cover in 2019?

Leave a reply in the comment section below, or email us at






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Voice of Experience: Avoiding boundary violations

By Gregory K. Moffatt December 17, 2018

Boundary violations happen in two general ways — a momentary bad decision or a long series of bad decisions that leads to a huge error. Here are examples of each.

A clinician friend attended a client’s graduation party. She had worked with this client for months as he dealt with the ending of his marriage, the loss of his 20-year career and the decision to go back to college to begin a new life.

The graduation party was a celebration of the long road they had traveled together as clinician and client. But the decision to attend was a mistake. It was a small party made up almost exclusively of relatives. Even though my friend stayed only a short time, the client introduced her as someone who had helped him through hard times. Subsequently, she was met with questions about her relationship with the client, whether they were dating and other awkward speculations.

Because of the way he introduced her, my friend could not clarify her relationship with the client. Her decision to attend the party was made with the best of intentions but clearly violated the client-counselor boundary. It is a mistake that she won’t make again.

The second type of boundary violation happens over time. Consider this scenario: “Bob” was a marriage and family therapist in his 40s who had been divorced for a little more than a year. His client, “Mary,” was a 40-something woman working through her own divorce.

Bob tried to ignore his subtle attraction to Mary, dismissing it as nothing that would lead to unethical behavior. She was his last client of the day and, eventually, he began allowing their sessions to run 10 or 15 minutes over the allotted time. Bob rationalized that he didn’t have to be in a hurry. After all, no other clients were waiting, and he had no place to be.

Bob also allowed the dialogue at the end of sessions to wander into questionable areas — his hobbies, movies that Mary liked, favorite restaurants. In the process, Bob discovered that he and Mary shared the same favorite restaurant.

After their first session, Bob allowed Mary to give him a “shoulder hug” at the conclusion of therapy — a behavior that became routine. Again, he rationalized this action as harmless. Mary initiated it, and he didn’t intend anything further to happen. He told himself that he had been in practice for many years and had never had an attraction to a client that he had acted on.

Then came the gross boundary violation. At the conclusion of a session, Bob and Mary lingered in the office for nearly 30 minutes, chatting like friends rather than therapist and client. Mary mentioned she was hungry and suggested that they go to their favorite restaurant and continue their conversation over dinner. Bob agreed.

At dinner, long gazes and awkward pauses made it evident that there were feelings between the two. Immediately following dinner, Bob called me, asking how to pull the reins back on their relationship.

Bob didn’t make one mistake. He made many mistakes that led to the most obvious one. Fortunately, he and Mary didn’t end up in a sexual relationship, but the boundaries of their clinical relationship had become so blurred that he chose to refer Mary to another therapist. This was a devastating setback to her. She had again been rejected by a man she cared about, even though Bob never intended that to happen.

Bob failed to recognized how his physical contact might be interpreted by his client. He ignored, rationalized and routinely failed to maintain clear time boundaries that help to clarify the therapist-client relationship. In addition, he failed to manage his attraction to Mary.

In Mary’s eyes, Bob was her friend, not her therapist, and over time, that gave her the green light to ask him to dinner. Accepting the invitation was just the last of Bob’s long series of errors.

My internship supervisor was an exceptional model of boundaries. She cared about me and wanted me to succeed, but there is no way I would ever have supposed that her concern for me was anything more than clinical. She was warm, friendly and gracious, but I laugh at the idea that I would have ever asked her to dinner. No way. She made our roles clear.

So, whether you have windows or no widows in your office door, whether you touch your clients or do not touch them, or whether you attend or refuse to attend a function such as a client’s graduation isn’t the issue. The issue is the clarity of boundaries and ethical behavior.

Our best insurance is integrity. I have worked very hard over my career to build a professional reputation that is so solid that any accusation would be met with, “You’ve got to be kidding!”

If Bob had done that, Mary would never have asked him to dinner.




Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.