Monthly Archives: December 2019

The impact of internet self-disclosure on the counseling relationship

By Laurel Shaler December 16, 2019

It was only our third session, but “Anne” and I seemed to be connecting well. She was thrilled to finally have time for counseling, given her busy life as a stay-at-home mom to three young boys and with a husband who traveled extensively. Over time, Anne began to relax and feel more comfortable opening up about some of her painful past experiences. She started sharing that one of the particularly challenging times in her life involved her and her husband’s struggle to conceive.

As soon as the words were out of her mouth, however, I could almost see her wrestle to pull them back in. She stumbled to recover but seemed to be saying that she had no right to complain about their journey to parenthood because “at least” they had been able to have children. As my mind began to process what was happening, it hit me: She has seen my website.

Anne was one of my first clients after I opened a small solo practice. After leaving my previous clinical position and moving into counselor education, I had created a website on which I posted blogs and links to online articles I had written, listed speaking topics, provided links to videos as well as radio and podcast interviews, and shared about my books. Anyone who reviewed my website and read about me would learn that a part of my journey had been through infertility.

There was always a risk that students would search my name on the internet and come across my website, but that was a risk I was willing to take because I felt called to reach out to the community at large regarding topics related mostly to emotional well-being. Along the way, I shared a bit of my story.

When I opened my counseling office, I included the information about my practice on my website, but it did not occur to me that clients would review the website and bring what they found into the sessions with them. I knew that I would never be “friends” with clients on social media, nor would I search for my clients on the internet, and I included that information in my informed consent. But Anne’s reaction to her own vulnerability helped me realize that my internet self-disclosure was having a negative impact in the counseling room and that it might impact future clients as well.

Soon after my interaction with Anne, I consulted with another counselor regarding next steps. I did not want to shut down my website or stop speaking and writing, but I also did not want to cultivate an environment where my clients were so concerned about me that they filtered what they were saying so as not to hurt me (based on their own ideas regarding what would hurt me, that is). The counselor with whom I consulted had one suggestion: Separate my one website into two, with one being a personal website and the other a practice website.

I saw numerous flaws with this solution. First, I could not manage (or hire someone to maintain) two websites, especially with my private practice being very small. Second, a client could still easily locate my personal website by performing a simple internet search. (After all, the name “Laurel Shaler” is not a common one.) I thought there had to be another option for addressing this dilemma. I began to realize I could do several things to mitigate the effects reading my website might have on my clients, but at the same time, there were certain things I could not control. The same is true for any of us who self-disclose on the internet.

I cannot control a client searching for my information online, for instance. Because I have something of a public presence given my public social media accounts, trade books, and blogs/articles on the internet, clients are likely to run across some information about me that goes beyond the scope of my private practice. I have to be OK with that to maintain both an online presence and a clinical practice. Likewise, my clients need to be aware of the pros and cons of learning more about me over the internet.

What it will really come down to is the same factor that affects every counselor-client relationship: therapeutic rapport. If my client and I can establish safety and trust, as well as appropriate boundaries, and can communicate effectively, then we can more than likely work through whatever may arise as a result of the internet self-disclosure.

Through a self-supervision process, I have come to realize that Anne may have overidentified with me. In other words, in the same way she might not want to hurt the feelings of a friend, she did not want to hurt my feelings. She assumed that because I had been through an infertility journey that did not result in biological children, that sharing her journey that did result in biological children would upset me. Although I did not address the issue head-on at the time, if given a second chance, this is what the communication might have sounded like:

Anne: I shouldn’t complain because I know not everyone can have children, and I am really lucky and fortunate and blessed to have children even though I did go through infertility. I know it’s not the worst thing in the world, and others have a much harder time than we did. I shouldn’t have said anything about it.

Laurel: It sounds like even though you are grateful that your infertility journey ended by having children, that you had a hard time going through that experience. Can you help me understand why you think you should not say anything about your infertility?

Anne: Well, to be honest, I read on your website about your infertility journey, and I am so, so sorry for what you went through. I don’t want to compare my story to yours, in particular since I was able to have children and you weren’t.

Laurel: Your sensitivity to me says a lot about who you are as a caring and compassionate person. At the same time, I want this to be a safe space for you to feel free to openly share about your entire story. I want to encourage you to hold nothing back on account of me. You are welcome to read what I post — keeping in mind what you read may impact your view of me or our counseling relationship.

Anne: Yeah, I like what you write but did not want to offend or upset you.

Laurel: Thank you, Anne. I do not believe I will be offended or upset. However, if I am, that is my own issue that I need to work through with a counselor or supervisor. It would not be your fault. Are you open to exploring the infertility issue and the turmoil that brought to your life and marriage?

Anne: Yes, because it really messed me up for a while and my relationship with my husband too.

Laurel: OK, please start wherever you would like.

Anne: It all started …

Obviously, this fictional dialogue could go many different directions. This is a good-faith guesstimate of how the conversation might have unfolded based on the relationship I had with the client at the time.

In reality, even though I was a bit flustered internally and did not address head-on the client learning about me online, we were able to move forward with our therapeutic relationship. Anne came regularly to see me for about six months before she and her husband decided to pursue marriage counseling, at which time she needed to pause individual counseling.

My personal takeaways from this experience were twofold:

1) Counselors must think thoroughly and carefully about how having an online presence might impact their counseling practice and the clients they are serving. Counselors have to decide whether the two are compatible and if they can still be effective counselors. Is there controversial content that may lead a client to feel uncomfortable with the counselor? Is the counselor something of a “celebrity,” leading clients to be a bit star-struck and concerned about disappointing the counselor? Numerous aspects of internet self-disclosure need to be considered. Additionally, counselors must decide how to navigate the two or more hats that they wear. For example, counselors must decide whether to have two separate websites or one website that incorporates both a personal/commercial side and a counseling practice side.

2) If counselors have an online presence, this should be addressed early on in the counseling relationship. This can be part of a written informed consent, along with other information regarding the counselor not searching for clients online, not accepting or sending friend requests on social media, etc. This can also be addressed verbally in session, wherein counselors discuss their online presence and talk through how a client’s review of the counselor’s internet information might affect the counseling environment. Counselors must be aware that disclosing their online presence is, in and of itself, self-disclosure. Therefore, as with all self-disclosure, this must be addressed solely for the benefit of the client.

There is absolutely a way to have both an online presence and a successful counseling practice. Many counselors have done so beautifully. My personal experience taught me a valuable lesson about how these two can work in tandem rather than against each other. Anne — like all clients — deserved to have an authentic counselor with whom she could truly be transparent, without filtering herself based on information she knew about the counselor.

Although I believe knowing less about the counselor can be beneficial to clients, I am well aware that in our internet-driven and instant-knowledge society, many clients will desire to learn all they can about us before, during and after the counseling process. Getting out ahead of potential problems that could arise as a result may prove helpful for clients. Because my online presence is not going anywhere, this is an ever-evolving process that I must pursue for the sake of my clients.



Laurel Shaler is a licensed professional counselor, national certified counselor, and licensed social worker. She is an associate professor in the Department of Counselor Education and Family Studies at Liberty University. Contact her through her website,


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.

Q+A: Helping clients affected by dementia

Compiled by Bethany Bray December 13, 2019

The Alzheimer’s Association estimates that 14% of people ages 71 and older in the United States have some form of dementia. Alzheimer’s disease, the cause of the most common form of dementia, is the sixth-leading cause of death in the United States.

Each dementia diagnosis will affect not only the individual but also his or her entire care network – emotionally, relationally, financially and in myriad other ways, says Ruth Drew, a licensed professional counselor and director of information and support services at the Alzheimer’s Association.

The most important message a counselor can give these clients – whether that be an individual with dementia or the family or caregivers of someone with dementia – is that they are not alone, says Drew, who oversees the Alzheimer’s Association’s 24-hour helpline.


Counseling Today sent Drew some questions via email to get her perspective.

[Note: Some responses have been edited slightly for purposes of length or clarity.]


What do you want counselors to know about some of the common fears, challenges and questions that come with dementia and how they can support clients through these challenges in counseling sessions?

Alzheimer’s disease is a progressive brain disease that worsens over time. Currently, there is no medication that can cure, prevent or slow down the disease — only medications that help with symptoms. Receiving an Alzheimer’s diagnosis is life-changing, and it impacts the entire family. Along with the diagnosis and disease journey comes a wide range of emotions — fear, resentment, despair, anger, denial, relief. As a result, many families often feel lost and isolated after the diagnosis. This isolation can increase throughout the journey as caregiving demands intensify — especially if they don’t know where to turn to for help.

We want everyone to know that no one should face this disease alone, and no one has to. There is so much information and support available round the clock, and it is only a phone call or mouse click away through the Alzheimer’s Association Helpline (800-272-3900) and website at

Counselors can help people facing dementia by acknowledging that it is normal to experience a wide range of emotions. Getting information and support is an empowering first step in coping with the challenges ahead.


What kind of help does the Alzheimer’s Association Helpline offer?

Our free, 24/7 Helpline receives more than 300,000 calls a year, answered by specialists and master’s-level clinicians who provide disease information, caregiving strategies, local community programs and resources, crisis assistance and emotional support.

Ruth Drew, LPC, director of information and support services at the Alzheimer’s Association.

If a caller is worried about signs of memory loss, we provide information on the warning signs of the disease, how to approach the conversation with the person [showing signs of memory loss] and how to seek a diagnosis. If a person recently received a diagnosis, we can answer their questions and provide a safe place to process their feelings and learn about the peer support that is available. If a caregiver is exhausted, grieving and feeling burned out, we can listen, normalize their experience, and help them find the support and resources they need for themselves and the person they are caring for.

We advocate for a person-centered caregiving approach and help families figure out how to navigate Alzheimer’s based on their unique set of circumstances. That can include connecting people with local Alzheimer’s Association education programs, support groups and early stage engagement programs offered by our chapters across the country.


In addition to counseling, what resources do you recommend for people with dementia and their caregivers and families?

Alzheimer’s can go on for many years, so people need different resources and levels of support as the disease progresses. Whether you are the person living with the disease or [whether you are] a family member, the first step is to educate yourself about the disease, care strategies and available resources. The second step is to have open conversations with the people who are important in your life and make plans for the future.

Getting support from the people you care about and making plans for the future are empowering steps that can help families make the most of their time now and avoid a crisis later. The Alzheimer’s Association offers a number of education programs in local communities across the country that can help people understand what to expect so they can be prepared to meet the changes and challenges ahead and live well for as long as possible. We also provide free online education courses, from understanding the disease to planning for the future.

Whenever facing difficult times, having a good support network [they] can turn to for advice and encouragement can help individuals feel socially connected and give them a sense of belonging and purpose. Connecting with others going through the same situation — whether they are living with the disease or a caregiver — can help put their own experiences with the disease in perspective and provide them with the support and encouragement they need. The Alzheimer’s Association also offers local face-to-face support groups and an online support community.


What would you like to highlight for counselors to recommend for their clients? Is there anything that comes to mind that they might not be aware of?

One thing we always want people to be aware of is the Alzheimer’s Association free 24/7 Helpline (800-272-3900). It’s available 365 days a year, in over 200 languages, for anyone in need of information, advice and support — whether it is a person living with the disease, their caregivers, professionals, academia or the general public. Trained staff are ready to listen and equipped with information to provide referrals to local community programs and services, disease education, crisis assistance and emotional support.


Are there any assumptions or misconceptions that counselors might have about dementia and Alzheimer’s that you’d like to clear up?

Sometimes when people picture a person with Alzheimer’s, they envision a person in the late stage of the disease. Alzheimer’s often progresses very slowly, and people may live four, eight or even 20 years after the onset of symptoms. The range and variety of symptoms is enormous, and many people can stay very engaged with family and activities of living for a long time in a supportive environment.

Often, caregivers tell me that everyone asks about the person with the disease, but no one asks them how they are doing. The data show that caring for someone with Alzheimer’s is much more arduous physically and emotionally than other types of caregiving, so it is crucial to ensure the caregiver is well supported.

Family members often deal with grief and loss throughout the time they care for someone with the disease. They grieve each loss of ability and memory, as well as anticipating the losses to come. Symptoms of stress, depression and anxiety may be connected to this ongoing loss.


Our readers are professional counselors of all types and specialties (including graduate students). Are there any main takeaways you’d like to share?

People impacted by dementia need understanding, information and support. While each situation is unique, the more you know about the disease, the better able you will be to connect with each person and provide a therapeutic setting where they can get the help they need.




  • The Alzheimer’s Association has a wealth of information on dementia and Alzheimer’s disease, including nuances of the diagnoses and resources for living with or caring for a person who has been diagnosed. Call the association’s 24/7 Helpline at 800-272-3900 or visit


  • See Counseling Today’s January cover article, “Dealing with the realities of dementia,” for an in-depth look at helping clients with dementia, as well as their families and caregivers.




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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.


Positive actions to prevent the holiday blues

By Esther De La Rosa Scott December 11, 2019

‘Tis the season to be jolly! The season for candlelight, friends, gatherings and warmly lit fireplaces. Although the holiday season is a time full of parties and family gatherings, for many people it is also a time of self-evaluation, loneliness, reflection on past “failures,” and anxiety about an uncertain future. It is the season for the holiday blues. The National Alliance on Mental Illness defines the holiday blues as temporary feelings of anxiety or depression during the holidays that can be associated with extra stress.

There is much connected to our holiday festivities that can cause us stress. What to wear? What food to bring? What gifts to get? For some people though, the more pressing question is, “How will I get through the holiday stress and the memories that accompany the season?”

This is also the season, with the days getting shorter and shorter, when we spend a significant amount of time inside and in the dark. Waking up in the dark, going to work in the dark, and leaving work in the dark can be tough for many of us, putting us at risk for seasonal affective disorder (SAD) in the wintertime.


What causes the holiday blues?

Researchers have yet to uncover the specific cause for SAD, which is also referred to as the holiday blues. However, they do acknowledge that several factors are at play.

The reduction in sunlight in winter can throw our biological clocks out of whack and reduce our levels of serotonin (a brain chemical that regulates our mood) and melatonin (a chemical that regulates sleep and mood).

The holiday or winter blues can be triggered by other factors that include unrealistic expectations, overcommercialization, or the inability to be with our families and loved ones. The increased demands of shopping, parties, family reunions, and houseguests also can contribute to these feelings of tension. Even people who do not become depressed can develop other stress reactions such as headaches, excessive drinking, overeating, and difficulty sleeping during the holidays.


When to seek help

Recent studies have shown that environmental factors — namely fewer hours of sunlight — can contribute to feelings of depression around the holidays. SAD is considered a category of depression that emerges in particular seasons of the year. Most people notice SAD symptoms starting in the fall and increasing throughout the winter months. If you are experiencing SAD symptoms (e.g., changes in sleep and appetite, a loss of pleasure in activities you once loved, depressed mood, feelings of hopelessness, a lack of energy, difficulty concentrating, reduced sexual interest, unhappiness, thoughts of death or suicide) make an appointment with a mental health provider.

We all have days when we feel unmotivated, but if your symptoms are causing disruptions in your life, it is time to reach out for assistance. A mental health professional can help you figure out the things in your life that are stressing you out and help you make a plan to manage or minimize their impact on your emotional health. In addition to seeking help from a mental health professional and avoiding specific unhealthy habits, implementing the positive actions described in this article can help improve your symptoms.

During the holidays, there are many obligations — from attending parties to wrapping gifts to baking treats — that can cause us stress. We can easily get caught up in fulfilling these obligations rather than spending time doing the things that would actually bring us joy. Rather than letting the season take a toll on us, we can take positive actions to emotionally prepare ourselves for winter and the holiday blues. After all, the holidays are supposed to be a time for us to recharge and restore our energy for the year ahead.


Positive actions

Here is a partial list of positive actions that can help prevent the holiday blues.

1) Get organized. The brain functions better when structure is provided. Take time to go through your closet and put away any clothes you won’t be using during the winter months. Move the key pieces you will be reaching for during the cold months to the front of your closet. This will give you a feeling that you are in control.

2) Get festive. Decorate for the holidays to make your space feel a little less monotonous. Put on some appropriate tunes while you are decorating. This will help you feel included and as so many others are celebrating in their own unique ways. Remember that holiday cheer does not automatically banish reasons for feeling sad or lonely. There is room for these feelings to be present, but a little holiday spirit can help you better manage your emotions.

3) Let go of the past. Don’t be disappointed if your holidays are not like they used to be. Life brings changes. Each holiday season is different and can be enjoyed in its own way. You set yourself up for sadness if everything has to be just like the “good old days.” Instead, prepare yourself by stocking up on delicious smelling candles, or light a fire and sit down with pen and paper to write a gratitude journal, or send handwritten notes to friends and family. Don’t be afraid to try something new. Celebrate the holidays in a way you have not tried before. Try volunteering some time to help others. Dopamine (“happy juice”) is released in the brain when we perform acts of kindness.

4) Go window shopping. Go shopping without buying anything. Take advantage of holiday activities that are free of charge, such as driving around to look at Christmas decorations in your neighborhood or participating in your community tree lighting or church service tradition.

5) Spend time with people who are supportive and care about you. Do you ever find yourself staying late at work because you don’t have a reason not to? Make reasons to leave. Make plans with friends ahead of time so you can’t back out and just stick around the office.


Things to avoid

1) Do not stay inside and be alone for too long. Try going outside as often as possible; getting plenty of sunlight will lift your mood. Visit a church or gather with others. The holidays are intended to be a time to get together with people we love to express gratitude for the things in our lives that we treasure. It is a time to spread messages and acts of love to one another. Keeping sight of the true reason for the season and spirit of the holidays will help to improve your mood.

2) Do not stop your exercise routine. Exercise works like an antidepressant. It increases levels of serotonin and dopamine in the brain, boosting your mood. But for many people, the holiday season brings drastic changes in routine. They lose their sense of normalcy and stop the routines they have established that help them to feel healthy and secure. It is of great importance to maintain your usual routines — particularly your exercise routine — even throughout the holidays. Sometimes, something as simple as sticking to a routine can help you maintain a sense of control. Don’t forget to keep a reasonable sleep schedule as well.

3) Do not drink excessively or use drugs. For those who have lost someone close to them or experienced a romantic breakup, the holidays can trigger intense feelings of loss and pain. Some people fall into the trap of self-medicating with alcohol or drugs to alleviate emotional pain and other symptoms of depression. In reality, treating these problems with alcohol or other substances only makes the problem worse.

Alcohol and depression have a dangerous relationship. Although alcohol can create a sense of pleasurable feelings in the short term, it is ultimately a depressant on the central nervous system and will leave you feeling worse. In addition, alcohol lowers serotonin levels in the brain, causing a person who feels depressed to slip into an even deeper depression. Alcohol also interferes with metabolic processes and sleeping patterns, which can further worsen the person’s condition.

Instead, it is helpful to prepare for these triggers with a therapist or close friend. Then you will know what to expect and how to handle the strong emotions that you may experience. Another way to mourn the loss of a loved one around the holidays is to honor their memory through a holiday tradition that they enjoyed. Perhaps this involves baking their favorite dessert, putting up their favorite decorations, or sharing stories and special memories of the person.

Make an agreement with yourself about how many drinks you plan to have in advance, and stick to it. Seek immediate help if you are using alcohol or drugs to manage your pain and are experiencing suicidal thoughts. Call the National Suicide Prevention Lifeline at 800-273-TALK (8255).


Next step

There is nothing new under the sun, and the same is true for the ideas discussed in this article. I have not suggested any strategies that are not already known or that have not been given by somebody else. But what I have done is provide an organized list of positive actions that you can take to prevent the holiday blues.

If you anticipate that the holidays may be a challenging time for you and you could use a little extra support implementing any of the positive actions from this article, make an appointment with a mental health provider. Counseling in one of the most powerful weapons we have to protect against emotional pain, depression, the holiday blues, and even the everyday ups and downs of life. Having someone who is trained and there specifically to talk about your feelings is invaluable. Remember, asking for help is a sign of strength and movement toward a better version of yourself.

You can’t force yourself to have fun, but you can push yourself to take the positive actions necessary to protect yourself against the emotional impact of the holiday blues. Make time for leisure activities that bring you joy, whether it is painting, singing, playing the piano, working on crafts, or simply hanging out with friends. And consider how you can start implementing these positive actions today for a more meaningful, well-balanced, healthier life this season and every season.



Esther De La Rosa Scott is a licensed professional counselor. She is a solution-focused specialist and couples therapist. Her specialties include relationship counseling, grief, depression, and teaching coping skills. Contact her through her website 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.

Technique without soul is dead

By Peter Allen December 10, 2019

As a licensed professional counselor, I am interested in what is helpful or effective for my clients. As a client in therapy, I am equally interested in what helps me to reduce my own suffering and develop better skills for navigating the larger world in which I live. Therefore, I consider myself a student in both respects. The clinician in me studies to achieve greater skill and experience, whereas the client side of me is ever sensitive to what is helpful in everyday life. I have had many experiences as both clinician and client that inform my approach, depending on which chair I happen to be sitting in on any given day.

There is one particular experience I had in therapy that has taken me years to integrate and use toward positive ends. At the time, I had been seeing a therapist for a few weeks. I was there to work through some old resentments and anger that were bogging me down and interfering with what was an otherwise good life. A trusted colleague and friend had referred me to this particular clinician, an older man with years in the field and a positive reputation.

After a few sessions, I remember thinking that the therapist was a little aloof for my tastes and perhaps a bit too professorial. He was kind but in a detached way. I had the sense that he did not think about me or my problems after he left the office for the day. Reflecting on my experience with him, I realize it was not what he did that sticks in my memory so much as how he taught me what not to do.

I had been attempting to work through some of my aforementioned anger issues with his help but had become somewhat stuck. He gestured toward a large, cube-shaped pillow on the ground in his office, measuring roughly 3 feet on each side. I hadn’t paid this object much attention until that moment, which is strange because a large cubed pillow in any office strikes me as noticeable in hindsight. The therapist asked me to repeatedly strike the pillow while verbalizing the very things that were upsetting me. I looked at him incredulously, and I remember specifically thinking, “This is stupid.”

I voiced my reservations, telling him openly that I did not think hitting a pillow and venting my anger in this way would be of much help. He smiled at me, trying to be reassuring, and encouraged me to try the exercise despite my misgivings. And so, I did.

Not surprisingly, I felt stupid. I was a grown man standing in a quiet therapy office hitting a large, cube-shaped pillow and trying to muster real anger in hopes that it would overtake my embarrassment. It did not. It caused me instead to feel like a petulant child who was not getting his way. Later, I would in fact feel the anger that was elusive in that moment, but my anger would be directed at the therapist rather than at the other people in my life.

What went wrong?

We processed this event immediately afterward in a somewhat perfunctory way, owing to my new resentment toward the therapist. I told him that I felt stupid, and he listened without comment. He was less interested in how the exercise reflected on him and more interested in my experience of it. The session ended on an anticlimactic note. I left his office and decided not to return. I should note that I could have given him more decisive verbal feedback about my experience, or inquired further about his intentions or technique. I did neither of those things, so in a way, perhaps I cheated him out of an opportunity to learn and grow. I take some comfort in the thought that his training and development were not my responsibility.

Upon reflection, I came to see that this therapist had disregarded valuable information and feedback I had given him in session. He used an intervention with me that he had likely used countless times before with other clients, and perhaps with some success. After all, he had gone to the trouble of purchasing that strange cube-shaped pillow. He executed a technique despite my obvious resistance because he thought he knew better than I did about what might be helpful. My experience was that I felt unimportant, unheard and embarrassed.

After reflecting on this somewhat minor event, I finally came to understand some of the dynamics that had played out in that room. The therapist was applying a technique without any soul — or, in other words, without first establishing an emotional bond or connection with me. Because he had not forged such a connection with me, the intervention was an abject failure. He assumed that the technique alone was powerful enough to overcome my reservations or, as I’ve said, that he knew better and I just needed to trust him. In my attempt to be the good client, I placed my trust in him, and he showed me that he had not earned it yet.

A basic critique I have of this method is that it does not translate to my life in the world. Hitting objects when one is angry has no application in the real world. We cannot repeatedly hit the table if we become angry in the middle of a corporate board meeting. This method is not encouraging the development of further skills; rather, it is reinforcing a negative human behavioral habit.

Although it took me many years to understand what I had experienced in that therapy session, I eventually arrived at an obvious answer: I went there assuming the therapist was, in fact, an expert, but the person who instructed me to hit the pillow was simply a flawed human being using a flawed methodology. He, like me, is in the process of learning and growing, and, as such, he is still making mistakes. I accept this, and I accept him as being in process.

Cause for reflection

Being on the receiving end of this intervention gave me license to truly examine its effectiveness, or lack thereof, in my own life. This small experience also led me to reflect on how often I — and perhaps, we, as clinicians — may be deploying techniques in a mechanical and disconnected fashion, whether we learned these methods in school, from a trusted mentor, or from a celebrity therapist. I have come to believe that when we do this, we are elevating and accenting the academic concept at the expense of an interpersonal connection.

What benefits our clients is subject to debate, of course, and reasonable people can disagree about this. We learn a variety of evidence-based practices, techniques and theories in the hope that we can help reduce our clients’ pain and suffering. I have colleagues I trust and respect enormously who approach therapy from a more scientific standpoint. They have a toolkit of interventions they use for a variety of presenting problems. Presenting problem A gets intervention B and so on and so forth. I also know brilliant clinicians who use a primarily interpersonal approach, in which the central and ongoing interventions are kindness, consistency, nonjudgment and acceptance.

I would be willing to gamble and say that the majority of therapists artfully blend the scientific with the interpersonal. What is scientific in counseling is by definition methodical, detached and concerned with evidence. What is interpersonal is by definition emotional, involved and subjective. There need not be tension between these two concepts; skillful therapists braid them together.

Carl Rogers, the founder of client-centered therapy (also known as person-centered therapy), came to the conclusion that the interpersonal approach actually produces scientific, measurable results. I will not dive too deeply into discussions of duality and what the superior approach might be (in part because I don’t know), but it is incumbent on the professional counseling community to ascertain anew each day what is effective versus what is ineffective.

My conclusion was that my therapist at that time was relying on pure scientific technique, which lacked warmth. Therefore, what I experienced was his detachment from me and his failure to respond to the verbal and nonverbal feedback I was conveying to him in that moment. My bias, of course, is the golden thread in this entire experience: I lean mostly Rogerian as a counselor, and my therapist had failed to honor one of Rogers’ most important insights — namely, that I am the expert on myself. My therapist put himself in the role of expert, which was a natural result of his unique life experiences, training, upbringing, biases and blind spots.

Undoubtedly, this therapist’s approach has been helpful and effective for many people over the decades that he has been in practice. With the enormous variety of human beings on this planet, an enormous variety of styles and approaches in counseling is merited.

I have concluded from this experience that technique without soul is dead. The cold application of scientific knowledge in the therapy office lacks humanity. However, using only warmth and empathy without technique can be amorphous and ungrounded. I occasionally find myself wanting to revert to technique alone for its definitive attraction — namely, that it is an intellectual and finite concept and therefore seems easier to grasp. Conversely, when I rely too heavily on an interpersonal connection, even as a Rogerian, I find this to be limiting in a different way.

For me in my process of development now, the interpersonal connection is what builds trust, and that is what allows techniques to flourish and gain traction. When techniques are successful and helpful, and when clients experience real change from them, the interpersonal connection thrives. In this way, a skillful pairing of these approaches serves to reinforce the strength of both of them.

I have tremendous empathy for my previous therapist, despite my obvious critiques of him. It was easy for me to see, both then and now, that he meant well. I also have the benefit of being able to evaluate his approach, whereas my own approach is not subject to his scrutiny. I have an inherent advantage in this sense because nothing I have done is under the microscope. That being said, readers of this article may find fault with my analysis, and I welcome a robust debate. I am grateful to him in a noncynical way for showing me what type of therapist I do not want to be: detached, professorial, expert. I strive to become more and more who I want to be as a counselor: someone who is involved, humble, and allied with my clients. In short, I strive to become the professional whom I needed that day in his office.



Peter Allen is a licensed professional counselor at East Cascade Counseling Services in Bend, Oregon. Contact him at


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From Combat to Counseling: Veterans and the criminal justice system

By Duane France December 9, 2019

As I was preparing to retire, I was already on the path to becoming a clinical mental health counselor. I was finishing the first year of my master’s program  in clinical mental health counseling and would start my practicum and internship in about seven months. Knowing that I wanted to work with veterans as a clinician, I reached out to our local veterans treatment court to see if I could observe some of the proceedings.

I had been in court before, having served a detail as a security escort for a court martial, but that was a military court—a legal venue that operates differently than the civilian justice system. This was a real courtroom, with the judge on the bench in a robe and everything. But that’s not what caught my eye when I first walked in. The first thing I noticed was a veteran sitting to the right in an orange jumpsuit, hands and feet in shackles.

I knew him.

We had served together about seven years before this; I was the company operations non-commissioned officer (NCO) in his unit. He was particularly memorable to me, not only because we were in the same company, but because I was there at the gate the day that he came back in from outside the wire after seeing  his platoon sergeant wounded by a sniper. If there was a blinking red line from that incident in 2006 to him sitting in the county jail, I was at both ends of that line.

The time in between, for him, was filled with medical problems, homelessness, addiction, disrupted relationships and involvement in the criminal justice system. It was a shock for me to see someone I served with in that situation. But I understood; many of us do. Veterans are significantly affected by the extremely traumatic events they routinely witness.


Veterans treatment courts

If you’re not familiar with veteran treatment courts, then you’re not alone. Even though the number of courts across the country are increasing, they seem to be unknown to those who are not directly involved with them. Throughout the nation, there are over 300 of these specialty courts that serve veterans.

The first veteran courts in the country were established in 2008. They are what are known as “problem solving courts,” modeled after the drug courts that were established in the mid-1990s. Not all courts are the same, and the different models vary by location, but they all are designed to help veterans get treatment for the issues that led to their involvement with the criminal justice system.

The problem-solving court model is one that addresses a particular issue with similar defendants using an interdisciplinary team of professionals to address the needs of the participants. Drug court, for example, provides substance use recovery treatment while addressing other risk factors that could lead to continued involvement in the criminal justice system. Some jurisdictions have other kinds of problem solving models such as DUI/DWI or domestic violence courts.

Veterans who become involved in the justice system frequently struggle with the difficulties that these other courts address. However, they are often experiencing many of these issues at the same time—creating the need for, in essence  substance recovery courts, DUI courts, mental health courts and domestic violence courts all rolled into one. Veterans treatment courts are designed to address these and other population specific needs with a multidisciplinary team that in addition to traditional court personnel such as a judge, the prosecution and defense, includes treatment providers, law enforcement, Department of Veterans Affairs representatives and a team of volunteer veteran mentors.

Some might argue that the regular criminal justice system has been handling veterans’ cases for years — why create special courts now? In the past, the elements that drove veterans to commit crimes were usually not unique to the military population. But multiple extended campaigns like those in Afghanistan and Iraq have created a large population of military members with extended conflict experience. As a result, there are situational and systematic influences on many current  veterans’ thoughts and emotions that lead to poor choices and reckless, dangerous behavior. I’m not saying that all who are incarcerated are innocent and misunderstood victims– there are veterans who commit heinous and horrendous crimes. The majority of veterans who are currently in the criminal justice system, however, aren’t hardened criminals.

In addition, veterans are usually not repeat offenders with a history of criminal behavior. That is the challenge when working with justice-involved veterans – determining the underlying motivation and reasons behind the dysfunctional and antisocial behavior. Treating the emotional and behavioral problems that lead to criminal behavior is one of the keys to helping veterans get—and stay—out of the criminal justice system. As a society, we need to have veterans return from combat and reintegrate, to get back into the workforce, engage in the public process, go to school, and become scientists and scholars.

The challenge, however, is that there is a period of adjustment for many veterans, and the difficulties it poses are different for everyone. For some, a lack of a sense of purpose and meaning in their lives leads to a period of wandering and aimlessness, and their behavior never rises to the level of criminality. It is a very thin line, however, that separates behavior that is reckless from behavior that violates the law, and many times veterans cross that line.

The majority of veterans leave the service strong and resilient. Many, however, do not, and that is a fact. Remembering that there are veterans who face, and fail to deal with, significant challenges is just as necessary as encouraging those who meet those challenges.

For more information on the effectiveness of veteran courts, a number of published studies such as this one has shown that graduates from these programs have a lower recidivism rate than others in the criminal justice system.




Duane France, LPC

Duane France is a retired U.S. Army noncommissioned officer and combat veteran who practices as a licensed professional counselor in Colorado Springs, Colorado. He is the director of veteran service for the Family Care Center, a private outpatient mental health clinic specializing in service members, veterans and their families. He is also the executive director of the Colorado Veterans Health and Wellness Agency, a 501(c)3 nonprofit that is professionally affiliated with the Family Care Center. In addition to his clinical work, he writes and speaks about veteran mental health on his blog and podcast at 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.