Monthly Archives: May 2022

Mental gymnastics: Navigating challenging relationships

By Grace Hipona May 13, 2022

“I am not sure how they are feeling and what they are thinking. I am confused. I feel like I am going crazy. I question everything, and I don’t know if I can trust what I am feeling and thinking.”

Relationship issues are one of the more difficult problems to help clients manage. When clients make any of the statements above, especially in relation to someone else, I talk with them about what I have coined as “mental gymnastics.” Mental gymnastics can start with unsettling statements and questions but also can lead to impacting other areas of a person’s life. In this article, I discuss how clients can be affected and strategies professional counselors can use to help them navigate these challenges.

Direct communication

When a client is experiencing mental gymnastics, they may commonly ask, “Why is this so hard? Why can’t I make this work? Why is this so exhausting?”

Direct communication, including asking questions, is the best strategy for clients to navigate mental gymnastics. However, if direct questions are asked and the other party does not respond with an honest or genuine answer, then it becomes more complicated. Sometimes, there is a discrepancy between what a person says and how they act. Sometimes, they may not even have this awareness, especially if they are confused themselves.

Unfortunately, it may feel purposeful or malicious when others do not communicate directly, lie through omission or engage in other forms of dishonesty. A classic example is when a person asks, “How are you?” and the other person responds with “I am fine.” However, their body language and tone of voice indicate that they are not actually “fine” but are instead upset or angry. Another common exchange is one person asking, “Do you need anything?” and the other person responding with “no,” even though they need help.

When discrepancies between what clients say and how they act arise, it is natural for clients to question their own inclinations. “Can I trust how I feel or what I think?”

Adding to the internal conflict, the other person can potentially invalidate how the client feels or completely deny their reality. Therefore, as professional counselors, it is important to specifically ask clients their feelings about the relationship in question. This clarity can increase clients’ self-awareness. Clients will find it easier to navigate relationships when they are aware of their reality and have confidence in it.

Good vs. bad anxiety and needs vs. wants

One common example of mental gymnastics that I’ve encountered is when a client has begun getting to know someone (whether a budding friendship or a romantic relationship) and they experience anxiety that is more constant and intense than typically associated with relationship building. This is when clients may begin having unsettling questions and statements: “Why can’t I tell if they like me? I can’t seem to get a straightforward answer. I don’t know what they want.”

When this occurs, I help clients differentiate “good” versus “bad” anxiety. In other words, I provide a space for them to process how they perceive the adrenaline associated with their experiences. A person should experience levels of anxiety when meeting someone new and getting to know them. This could be perceived as “good” anxiety or excitement. Clients may feel butterflies in their stomach, brighter in their affect, and hopeful. With good anxiety, clients may have thoughts and questions such as, “Do they like me?”; “Did I make a good impression?”; and “I can’t wait to see them again.”

If clients experience “bad” anxiety, such as excessive worry, irritability, dread and the triggering of the “fight, flight or freeze” response, this may be a red flag. They may have thoughts such as, “I don’t know what to do”; “I can’t seem to say anything right”; and “What can I say or do so that they will like me more?”

In helping clients assess whether they are experiencing “good” versus “bad” anxiety, I ask them if in general they feel more positive emotions than negative ones. For example, “Do you feel happier more than 50 percent of the time?”

I also help clients determine their needs and wants. I describe needs as things that are non-negotiable to them, such as respect, trust, honesty, marriage, children, and religious or spiritual beliefs. Hard boundaries need to be set around these needs.

Wants are negotiable or flexible. Examples include physical appearance, financial status, educational background and geographic origin. When it comes to positive and healthy relationships, clients should have their needs met, and the relationship should feel like it is a “want” or a choice.


Minimizing and denying

The answers to the assessment questions in the previous section can be interrelated and could lead to more confusion. For example, clients could determine that they feel happy most of the time with their relationship but that most of their needs are not being met. This discrepancy can cause clients to question their feelings, and this could lead to an increase in anxiety.

Another potential cause of internal conflict is receiving information from the other person that minimizes or denies the client’s experience. For example, the client may be questioning their own reality because the other person is directly challenging it: “Oh, you shouldn’t feel that way. Are you sure?”

The other person could be completely denying the client’s reality: “That didn’t happen. I know what you’re feeling. You’re not really mad.”

Some may even define this as “gaslighting” (questioning their internal reality or “sanity” based on external pressure and manipulation).

Another example that can cause internal conflict is when the client brings a concern or stressor to the other person, and that person minimizes the client’s experience. The other person might respond with, “You’re making a big deal out of nothing, and you shouldn’t feel that way.” The other person may shift the focus to themselves while minimizing the client’s experience, “You think you’re upset? I’ve felt so much worse. You don’t know what suffering is really like.”

In any of these scenarios, the attention has turned toward the other person, and the client’s thoughts and feelings have been dismissed. In other words, the client is then reactively directing their energy toward the other person, and the client has lost sight of their inner experience. The client could be more likely to “lose themselves” in the relationship and, therefore, not get their needs and wants met.

Like the sport, mental gymnastics requires a person to use energy and effort. However, unlike the sport, mental gymnastics unnecessarily uses a person’s energy. One indicator that clients are engaging in mental gymnastics is that they feel tired and their mood is generally lower than usual. Clients may describe feeling “drained” even though they are not actively and purposefully using their energy. They may feel the need to use certain strategies or efforts to engage with a particular person. Clients may feel the need to “perform” a certain way; otherwise, they may feel judged, criticized and denied any love, support, care or validation from the other person. Clients may feel dueling inclinations of needing to spend time with the other person but also wanting to avoid that person.

Another reason clients may unnecessarily use energy to engage with another person is that even when trying to support this person, clients feel like they “can’t win.” In other words, the intention and effort may be there, but the other person still feels “it is not good enough.” Even if conditions are met, the other person may find something wrong with what has happened. That person may say, “That was a nice try, but I would have liked this instead.”

Aside from helping my clients gain clarity over their needs versus their wants and insight into their internal experience in general, I believe it is important to help clients reality test. Writing a “pro/con” list or something similar can be useful, especially for clients who tend to be visual in nature. Asking the following questions can support development of this list:

  • How do you benefit from this relationship?
  • How does this person meet your needs and wants?
  • How do you feel about them?
  • How do you feel about the relationship?
  • How is your life impacted by this person?
  • How do they challenge you to be the best version of yourself?
  • What do you like about this person?
  • What do you dislike about this person?
  • What do your friends and family think about this person. 

Active and reactive decision-making

After time, effort and space have been given to the questions mentioned in the previous sections and clients continue to move forward in a relationship where mental gymnastics is present, I encourage clients to think about the consequences of this choice. At this point, clients can take ownership and feel empowered by their decision-making.

When I work with clients, I focus on strategies to help them make ACTIVE decisions rather than reactive ones. Once there is a level of insight into decision-making, they can make informed decisions. This awareness can lead to active decisions where the clients feel they have a choice. Without any awareness, clients may not feel like they have a choice. They may feel compelled to do something but not know why.

An example of a reactive decision is when a client chooses not to end a relationship even though there is evidence that the relationship is unhealthy. A client may say, “I don’t want to break up with him because I love him.”

As the client’s counselor, I would ask, “Why do you love him?”

The client may respond with, “I just do” or “I am not sure, but this is how I feel.”

If clients continue making reactive or passive decisions, this can perpetuate or exacerbate negative anxiety. Counselors can assist in exploring the client’s decision-making process so the client can answer the question “why?”

I believe when clients experience anxiety, it is not just their fear of the unknown and the byproduct of internal conflict, but also a result of them not feeling empowered in their own lives. For clients to feel empowered, they need to be an active participant in their own decision-making process. Counselors can help clients manage this anxiety by helping them focus on their locus of control.

Clients can examine what they say and how they act toward the other person. They can focus on their self-care and on other important aspects of their identity. Clients can also concentrate on purposefully coping with their anxiety in healthy ways. These strategies can lead to feeling confident in navigating potential mental gymnastics.



Grace Hipona is a licensed professional counselor for NeuroPsych Wellness Center PC and holds a doctorate in counselor Education and supervision. Her dissertation focus was on disaster mental health, specifically sheltering-in-place. She is also a certified substance abuse counselor and approved clinical supervisor. Her experiences over the past 15 years include working in private practice, managing behavioral health programs, teaching graduate students, and providing supervision for master’s-level counseling students and counselors-in-residence. Contact her 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.

Developing competence to address undue police violence

By Darius Green May 10, 2022

In the summer of 2020, many of us were reminded about the tense relationship between law enforcement and those who are Black, Indigenous and people of color (BIPOC), particularly Black Americans. Just a few months prior to the breaking news of the murder of George Floyd, the killing of Breonna Taylor and several others whose deaths came to the national spotlight, I had successfully defended my dissertation that investigated undue police violence and counselor preparation. In the recently published article from my dissertation, “Undue police violence toward African Americans: An analysis of professional counselors’ training and perceptions” (October 2021 Journal of Counseling & Development), I defined undue police violence as the unwarranted and excessive uses of law enforcement officers’ (LEO) inherently violent force that results in physical, emotional and psychological harm to those who directly or vicariously experience it.

While I am hopeful that the spotlight on racism and undue police violence has conjured lasting motivation and action toward change among some counselors, I find myself skeptical about the enduring nature of many of the anti-racist commitments and promises for change from within our profession. My skepticism is rooted in the following. 

  1. Undue police violence is not a new phenomenon. It has occurred throughout the history of the United States in the form of slave patrols, during the Civil Rights movement and in modern institutions of law enforcement (e.g., local, state, federal and immigration officers). 
  2. Racism tends to be adapted and perpetuated even as the status quo is challenged. We see this in the social and political rhetoric of disinformation toward critical race theory and approaches that work against racism. 
  3. Findings from my dissertation suggest that there is considerable room for growth in competence among professional counselors regarding undue police violence. For example, despite 68.2% of the 112 participants indicating having worked with clients who experienced undue police violence, only 17% had clinical training in identifying its impact and only 22.5% had training in advocating against it. 

I am writing this article to build off findings from my study by offering reflective points and practical suggestions for professional counselors seeking to enhance their competence regarding the topic of undue police violence. These reflective points and practical suggestions are grounded in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework.

Reshaping our attitudes

According to the MSJCC, we can start developing and enhancing our competency to address undue police violence by examining and altering our current attitudes and beliefs regarding law enforcement, criminality and racially marginalized populations. Many of us may hold positive beliefs towards LEOs, informed by personal experiences, media representation and the attitudes of those we trust. For example, we may believe that LEOs promote security in society through their roles as first responders and that their use of force toward those deemed to be “bad people” and “criminals” is typically legitimate. Alternatively, when individuals such as Derek Chauvin are highlighted in national media for negligent and violent policing, we may be inclined to believe that the harm they have inflicted is the result of individual bad behavior. When we unquestioningly hold on to these adopted beliefs, we may be hindered from critically reflecting upon and acknowledging the ways in which law enforcement systems perpetuate harm. 

A deconstruction of our belief systems entails a critical questioning and analysis of our current beliefs, the beliefs of others and how these beliefs have been shaped and developed within our social context. While LEOs can certainly function in ways that appear to promote security for some populations, we need to critically analyze instances when our attitudes and beliefs are not held up to be true. We might begin by asking ourselves: What are the purposes and functions of law enforcement? What has influenced my beliefs about LEOs across my life span? What differing beliefs do people hold toward LEOs and why? What impact have LEOs had on me and others in my community? Which members of my community have had experiences that diverge from my own regarding LEOs? What alternatives to policing exist to foster safety and security? 

Deconstruction of our current beliefs is an essential step because many populations do not live in a world in which LEOs are experienced as safe, protective and trustworthy. In fact, my fellow Black Americans and I often feel that we are seen as threatening and criminalizable by LEOs. Native and Indigenous Americans may hold beliefs parallel to those of Black American experiences of LEOs. Women of color, particularly Black women, may experience LEOs as negligent and even perpetrators of sexual violence. 

As we engage in a critical deconstruction of our beliefs and attitudes, it is important for us as counselors to empathize with the experiences of those who are marginalized in ways that often diverge from beliefs that center white, cisgender, male, abled, and middle and upper socioeconomic status experiences.

Building knowledge

Deconstructing our current attitudes to develop more critical ones toward the relationship between marginalized groups and LEOs can be a difficult task in isolation. We often need something outside of our current awareness to challenge our current beliefs. Making use of existing expert knowledge can be a great tool to support an ongoing reshaping of our beliefs about LEOs. Rather than re-creating the wheel, counselors may benefit from drawing upon knowledge from abolitionist authors who have written extensively about law enforcement and the broader criminal justice system in the United States. 

I make this recommendation because the counseling profession is often entangled with the criminal justice system. For example, we may be inclined to rely on law enforcement for emergencies or situations regarding a client’s imminent harm to others. Additionally, many counselors are referred to or work with clients who have direct and frequent contact with LEOs and the broader criminal justice system. Abolitionist writing on undue police violence can provide critical knowledge about the system of violent policing, its sociopolitical history and collective struggles against it. The following list of recently published books serves as a useful starting point for counselors:

  • We Do This ‘Til We Free Us by Mariame Kaba
  • Invisible No More: Police Violence Against Black Women and Women of Color by Andrea Ritchie
  • We Still Here: Pandemic, Policing, Protest and Possibility by Marc Lamont Hill
  • Abolition for the People: The Movement for a Future Without Policing and Prisons edited by Colin Kaepernick

In addition to texts that focus on violent policing and abolition, readings specifically geared toward policing and race-based traumatic stress may be useful for counselors seeking to integrate this knowledge into their practice of counseling and advocacy. As a starting point, it is essential for counselors to know that LEOs’ use of force, whether a mere intimidating presence, physical force or use of a weapon, is inherently violent. This simply means that using force to enforce rules relies on behavior that is violent in any other context. As many of us are aware, violence often begets trauma. 

When undue police violence intersects with racism, beliefs of racial inferiority are communicated from LEOs to those who are BIPOC. A message of racial inferiority is also communicated when institutions within the criminal justice system function to permit these practices without accountability. Moreover, these beliefs are further internalized when helping professionals negate, downplay or are simply oblivious to the impact of these experiences. BIPOC clients may exhibit the weight of racialized violence from LEOs in their developed worldview and identity, social and emotional processes, and neurological and behavioral functioning. The following books and articles may be helpful resources for advancing counselors’ knowledge about race-based trauma and violent policing:

  • My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies by Resmaa Manakem
  • “The trauma lens of police violence against racial and ethnic minorities” by Thema Bryant-Davis and colleagues, Journal of Social Issues (December 2017)
  • “The experiences of African American mothers raising sons in the context of #BlackLives Matter” by J. Richelle Joe and colleagues, The Professional Counselor (March 2019)

Developing skill and taking action

The purpose of the MSJCC is not to simply hoard knowledge and privately reshape our attitudes. Developing competency in multiculturalism and social justice requires us to export our cultivated knowledge and beliefs to support change as accomplices with the individuals, communities and populations that we serve. Without this accompliceship, we risk portraying ourselves and the broader counseling profession as performative and inauthentic. 

In the remainder of this article, I will emphasize four specific areas where counselors can take action.

1) Assessing for undue police violence and its impact. One way for counselors to begin to address the potential traumatic impact of undue police violence is to conduct an ongoing assessment of such occurrences. According to national databases on police violence such as Mapping Police Violence ( and The Washington Post’s Fatal Force database, Black and Hispanic Americans and individuals who experience mental illness are overrepresented in fatal encounters with LEOs. While less often acknowledged, Native and Indigenous Americans also experience police violence at disproportionately higher rates than do their white counterparts. 

Similarly, women of color and transgender and nonbinary people have experienced increased odds of violent encounters with LEOs that may overlap with sexual violence and aggression. Additionally, those who engage in resistance through protests have a heightened risk of experiencing undue police violence. Other populations, such as those who use substances, people without housing, domestic violence survivors and offenders, incarcerated individuals, and the loved ones of these individuals, also warrant the attention of counselors. 

When we know or suspect that our clients have had encounters with LEOs, we need to provide space for clients to share what happened, how they were impacted and what they are doing to cope and heal.

2) Broaching. Broaching — the intentional invitation to discuss matters of race and culture in counseling — can be a useful tool to initiate conversation and meaning making around undue police violence. We broach by acknowledging the connections between our clients’ cultural identities, sociopolitical history and context, and their wellness. We then invite our clients to share and expand on their experiences in a safe relationship with us. 

Care and attention must be given toward how we broach to avoid causing harm. We want to avoid robotic, scripted or inauthentic invitations. We also want to avoid tokenizing or burdening our clients by asking them to educate us on things that we can easily educate ourselves on. For example, it might not be wise to prompt a Black client out of the blue or simply because we are curious to tell us “what it is like to be a Black person in light of the Black Lives Matter movement.” While such a response acknowledges race, it misses out on communicating the ways in which we are attuned to our clients’ specific experience. 

When teaching about crisis and trauma, I often encourage my students to explicitly share their observations of a client’s emotions, behaviors and thoughts as opposed to offering hollow or cliché comments to acknowledge evident distress and pain. When applied to broaching undue police violence and its impact, we want to let clients know that we can see the weight of their experiences, we understand and believe their experience to be valid, and we value their trust in us to share their narrative. 

When we notice that encounters with LEOs, whether directly or vicariously experienced, impact our clients’ wellness, we might respond by first describing our observations and their relationship to culture and race. From there, we can invite clients to respond to the observations that we have brought forth. Throughout the client’s narrative, we want to communicate our attunement to their past and present emotional experiences through active listening techniques. I often encourage students to honor what is authentically present rather than attempting to “fix” clients or evoke the depths of their suffering. Lastly, we want to acknowledge our clients’ willingness to entrust us with their narrative, especially given the likelihood that their experiences have previously been met with skepticism, arguments or invalidation.

When broaching experiences of undue police violence, it is essential that we avoid interrogating, doubting or attempting to offer a “neutral” or “balanced” perspective for our clients. These behaviors are likely to be perceived as invalidating or antagonizing to clients. We also want to avoid placing our clients in stereotypical boxes. For example, not all Black people will experience undue police violence or, as a function of racial identity development, even share the same beliefs about LEOs. 

These sorts of responses run the risk of creating relational ruptures, poking existing traumatic wounds and further stigmatizing clients’ experiences. Instead, we need to trust that our clients are knowledgeable and truthful in how they describe their experiences. Broaching is less about an extraction of information from our clients or investigating claims around their experiences. It is more about creating a relationship in which clients can share their racial and cultural experiences while being met with a nonjudgmental, attuned, affirming and validating presence from a professional. In doing so, we can cultivate spaces that help our clients cope with, integrate and heal from their distressing encounters with LEOs. 

3) Coping and healing. After inviting experiences associated with undue police violence into the counseling room, we need to consider what coping and healing approaches look like. I have found the article “Toward a psychological framework of radical healing in communities of color” by Bryana French and colleagues in The Counseling Psychologist (January 2020) helpful in distinguishing between these two terms. 

French and colleagues describe coping as surviving the experiences of injustice and oppression that inhibit optimal wellness. Coping entails supporting others in getting by and resuming functioning despite the distress from direct and vicarious exposure to undue police violence. Examples of coping might entail developing skill in affect regulation after exposure, altering one’s cognition to minimize distress associated with LEOs, enhancing connectedness to one’s social support systems or setting boundaries around social media usage following the viral sharing of a killing by an LEO. 

While coping is essential, it is often more of a Band-Aid and does not address common roots of the distress from undue police violence: racism and systemically violent policing. French and colleagues’ article describes healing as fostering the collective critical consciousness and resistance against systemic suffering. On an individual level, healing might entail supporting a client’s growth in their critical consciousness around law enforcement and their advancement in racial identity development. On a collective level, healing may look like bringing community members together to foster hope and collective strength using support groups and healing circles. Healing may also include supporting a client’s engagement in various forms of resistance in their community to advocate for changes in laws, policies and norms that promote racist and violent policing practices. 

As professional counselors, we can and should also be collaborating with our clients outside of the counseling room to enact tangible changes in communities where we operate. This might include active participation in organizing protests, demonstrations and calls for action as a complement to the work that we are traditionally trained to do.

4) Engaging in advocacy. It is essential that we address undue police violence in ways that do not solely reflect individual responsibility for experiencing or being impacted by police violence. Being engaged in our communities and society at large through advocacy is one way to achieve this. The following is a nonexhaustive list of actions that counselors can take and support alongside their clients and communities:

  • Share credible educational resources on police violence.
  • Contribute to public education efforts regarding the intersection of undue police violence and race-based traumatic stress.
  • In moments of community unrest associated with undue police violence, organize with other counselors to open our doors for pro bono crisis counseling.
  • Volunteer to support community efforts toward accountability of local law enforcement.
  • Strategize a long-term plan of action with community leaders to minimize contact between LEOs and the public, particularly those who are BIPOC.
  • Organize and advocate alongside clients to call for a divestment in law enforcement while simultaneously investing in public health and wellness initiatives that would foster community safety.
  • Participate in public demonstrations against undue police violence. Specifically, counselors can collaborate with organizers to infuse culturally authentic wellness practices and strategies for maintaining safety.
  • Conduct research on undue police violence, its impact and strategies toward change.
  • Identify and contribute to resources for mutual aid to establish holistic care for clients in need.
  • Integrate information about undue police violence into the classroom and supervision to better prepare counselors-in-training when working with vulnerable populations.
  • Regarding substance use, advocate with local officials of the criminal justice system to allow for approaches that value harm reduction over punishment (e.g., incarceration) following relapse.
  • In schools, advocate for the removal of school resource officers. When this is not achievable, advocate for a systemic restructuring of the roles of school resource officers to minimize contact with students, particularly those most vulnerable to undue police violence.
  • Support or challenge candidates for local, state and national elected positions to make policy changes that minimize contact between LEOs and members of the public, especially those vulnerable to undue police violence.

Pursuing change in community

While we can build competence in isolation, it may be most effective and efficient to initiate this progress in community with others. When working alone, we may find ourselves avoiding blind spots or struggling to sustain our motivation to undergo change.


To tie the contents of this article together, I strongly encourage counselors to form action-focused reading groups around undue police violence. These groups should be different from traditional book clubs that function to gain new wisdom. Instead, these action-focused reading groups should be centered on making change and acting. To be effective in this goal, we may consider defining specific and actionable goals toward change before participating in these groups. Additionally, we can embed time for collective brainstorming, collaboration and reflection over action taken toward any identified goals.

Although the demands of the task are complex and politically charged, we have a responsibility as counselors to address undue police violence in support of the wellness of the client populations we serve. We should expect resistance, defensiveness and other forms of pushing back as we dig into making such important changes. Nevertheless, addressing and minimizing undue police violence is imperative. With the MSJCC as a guiding framework and with collective support from colleagues, counselors can make substantial gains in developing our competence before the next George Floyd-like tragedy inevitably occurs.



Darius Green is an adjunct professor and counselor educator. He earned his doctorate in counselor education from James Madison University in Harrisonburg, Virginia. Contact him at and follow him on Twitter @dariusagreen.


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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.

How to elicit and implement group feedback

By Ashley E. Wadsworth May 9, 2022

Remember when we were all eager-minded counseling students? We were delighted with the pursuit of self-improvement and strove to be the best versions of new counseling professionals. To that end, we feverishly sought the feedback of our faculty and peers to enhance our basic counseling skills. 

So, what happened? Where did that drive go? According to an article by Cheri L. Marmarosh that appeared in the journal Psychotherapy in 2018, eliciting feedback in group settings is not a common practice among therapists. This lapse may be because most group therapy courses do not emphasize the importance of eliciting feedback in group settings. Where does that leave us as practicing clinicians? 

Without external sources of feedback, counselors are left with only their clinical judgments for assessing clients’ perceptions of treatment efficacy and satisfaction. Unfortunately, even for experienced practitioners, these judgments may be inaccurate. A counselor’s ability to make accurate judgments may be influenced by several factors, including heuristics, bias and, regrettably, hubris. Some of the more salient factors that influence therapists’ judgment include:

  • Availability heuristics
  • Representative heuristics
  • Fundamental attribution bias
  • Confirmation bias
  • Leniency bias
  • Severity bias
  • Illusory correlation
  • Primary effects
  • Sunk costs
  • Overconfidence

Considering the multitude of variables that influence counselors’ judgment, it is easy to understand why their judgments about clients’ perceptions may be imprecise. If clinical judgments are an unreliable gauge of clients’ perceptions, how might a counselor calculate clients’ respective attitudes toward treatment? Asking directly about clients’ perceptions may be a prudent step in the right direction. In other words, to address the potential shortfall of eliciting feedback from group counseling experiences, it may help to go back to the basics.

Why feedback is important

Facilitating group therapy involves a lot of moving parts. Having more than one client in a clinical space increases the demands on counselors exponentially. Because of that, therapists must be even more diligent and mindful of the treatment they provide and the environment they create in conducting group therapy. Eliciting group feedback can greatly assist therapists in that capacity. 

Group feedback can improve treatment outcomes, which may increase the ability of clients to reach their treatment goals. In addition, group feedback contributes to measurable returns by making it easier for therapists to track the efficacy of treatment interventions. Knowing clients’ perceptions provides therapists with concrete data to assess which treatment interventions are working and which are not. Additionally, group feedback provides context as to why certain interventions fail to meet expectations. 

Furthermore, owing to the complex variables at play in group settings, attrition rates continue to be an issue throughout the life span of a group. Although estimates in the literature vary, some suggest that group attrition rates are as high as 40% to 60%, with the early stages of a group being the most vulnerable to this phenomenon. Eliciting group feedback allows therapists to curtail client exodus by identifying group members who may be at risk. In addition, by capturing the factors that influence potential dropouts, therapists are given actionable information that can be used to quickly course-correct and ameliorate those clients’ concerns. 

A pleasant byproduct of actuating a client’s feedback is strengthening the therapeutic relationship. When clients see that their feedback has value and their concerns are real and valid, they may be more apt to trust their therapist and feel less stress in the therapeutic environment. That experience decreases dropout rates and increases group cohesion. 

Allow clients to do the heavy lifting by supplying the pragmatic insights needed to improve the treatment being provided and enhance the therapeutic environment. While soliciting client feedback requires applied effort on the part of counselors, asking for feedback requires minimal exertion. Furthermore, while this should go without saying, the benefits of group feedback remain absent to therapists who do not ask for their clients’ input.

Eliciting feedback

While the word feedback often evokes a visceral response in the person receiving that feedback, it is critical that counselors provide effective treatment to clients in group settings. Even more difficult can be the solicitation of the feedback itself. 

According to a research study published in the Journal of Applied Psychology by Elad N. Sherf and Elizabeth W. Morrison in 2020, individuals with high self-efficacy tend to underestimate their need for feedback. Sherf and Morrison also argued that individuals who were unable to consider the perspectives of others were less likely to elicit feedback. These findings do not bode well for experienced counselors. 

Factoring in the influence that power differentials have on self-efficacy and perspective-taking (the ability to consider others’ perspectives), Sherf and Morrison contended that individuals in high-power positions and with increased self-efficacy were less likely to consider the perspectives of others. While this research study did not relate specifically to the counseling profession, the results are no less dispiriting. Sherf and Morrison’s study helps to demonstrate the importance of self-awareness, the intentionality required for effective group leadership, how vital perspective-taking can be, and the detrimental impacts of hubris.

Client self-evaluation

Asking clients to evaluate their progress in treatment is a crucial element of group feedback. Because counselors’ views of group clients are usually relegated to a 60- to 90-minute weekly snapshot, the ability to evaluate the minutiae of clients’ daily lives and their interpersonal interactions is significantly limited. Client self-evaluation forms allow group clients to provide a more detailed account of their perceptions of progress toward treatment goals as well as any cognitive, behavioral and social changes. Furthermore, self-evaluation provides group clients with a) an element of personal responsibility for their own treatment, b) the opportunity to practice self-reflection skills, c) a simplified way to identify strengths and areas for growth and d) the ability to visualize their progress. 

Group client self-evaluation may contain some of the following elements:

  • Attendance/punctuality
  • Participation
  • Communication
  • Behavior changes
  • Cognitive changes
  • Social/interpersonal changes
  • Self-awareness/impact on others
  • Identification of strengths
  • Identification of areas needing improvement

Group facilitator evaluation

Being a group facilitator is a weighty responsibility. As is the case with all client-counselor relationships, an inherent power differential divides the therapeutic space, no matter how egalitarian the therapist’s views. Within the context of group therapy, the disparity in power dynamics is seemingly magnified by the proportion of clients present. Therefore, responsible group therapists might engender meaningful and transparent ways to facilitate accountability to their clients. Eliciting group feedback about their performance as a group therapist is one way to fulfill that objective. 

Group facilitator evaluations might include some of the following items:

  • Timeliness
  • Level of preparation
  • Disposition
  • Professionalism
  • Ability to provide relevant information
  • Ability to support/challenge clients
  • Ability to address conflicts/disputes/inappropriate behavior
  • Ability to enforce group rules
  • Overall client satisfaction of facilitator’s performance
  • Ideas for improvement 

Group culture and environment evaluation

In many respects, group dynamics can make or break the success of a group. Group cohesion is the most crucial factor contributing to effective outcomes in group settings. Group cohesion depends on clients’ abilities to connect and be vulnerable with the facilitator and other group members. The development of group cohesion is a process that the facilitator must intentionally and conscientiously nurture. Part and parcel of the initiation of group cohesion is the group culture and group environment. 

Group culture refers to the behavioral norms, attitudes, values and interactions of the members. While group culture is mainly reliant on the makeup of the individuals within a group, the facilitator can guide group norms. Eliciting client feedback about the group culture allows therapists to be informed of perceived issues within the group dynamic that may have a negative impact on group cohesion. 

The physical environment where the group is conducted is also consequential to the formation of group cohesion. Clients are more apt to be open and at ease when they feel safe and unagitated. Because individuals’ preferences vary and what engenders feelings of safety is different from one person to the next, feedback can contribute to a counseling environment that is suitable to most and mitigates situations or irritants that may hinder group cohesion. 

While descriptions of effective group settings are outside the purview of this article, Chapter 6 of Scott Simon Fehr’s 2019 text, Introduction to Group Therapy: A Practical Guide, serves as a suitable primer. Group culture and environment evaluations may incorporate some of the following contents:

  • Physical environment
  • Security and privacy
  • Noise contamination/distractions
  • Group members’ behavior (e.g., participation, active listening, respect for others’ views, openness to giving/receiving feedback, allowing equal space to share/dominating the conversation, adherence to rules)
  • Ideas to improve group environment or group culture

Receiving feedback

Receiving feedback is truly an exercise of intentionality and self-awareness. Therapists must be open to receiving feedback with a clear mind and thoughtful consideration of the client’s perspective. Once received, feedback should be acknowledged and the client’s perspective validated. The therapist should focus on what was said and not feel the need to respond immediately or take a defensive posture. 

Asking open-ended questions can help ensure clarity; once attained, the therapist should convey their understanding to the client. Next, initiate a dialogue with the client to ascertain their perspective on a possible solution or how they may view a practical improvement to their concern. Finally, thank the client for their openness and vulnerability in providing feedback, effectively reinforcing the behavior. Unguarded gratitude also serves to maintain a supportive group environment and provides a foothold to engender group cohesion. 

In discussing the importance of feedback in group settings, it would be negligent not to mention the roadblocks that fragile egos can create. As previously identified, feedback can elicit a rather visceral response on the part of the person receiving feedback. Fragile egos add a complexity that can exacerbate that reaction, acting as a catalyst that can transform a well-intended suggestion into a perceived character assassination. 

As the recipient of feedback from group clients, counselors may find themselves struggling to hear and embrace that feedback and should stop to consider the why behind their response. Considering the origin of that resistance may elucidate some unresolved personal challenges on the therapist’s part, which may need individual therapy and supervision to address adequately. 

Implementing feedback

The most important aspect of receiving feedback is what you choose to do with it. Feedback is meaningless unless it is put into action. The 2014 ACA Code of Ethics states that counselors must refrain from causing harm to their clients. One could then posit that counselors are duty-bound to consider and execute relevant client feedback. 

Consider the following as potential processes for implementing feedback:

1. Develop a plan

  • Define the goal
  • Outline steps to achieve the goal
  • Determine a timeline
  • Consult with peers
  • Seek supervision

2. Execute the plan

  • Identify a time frame to implement
    the plan
  • Stay on task
  • Practice intentionally
  • Trust the process

 3. Evaluate

  • Elicit group feedback
  • Consult with peers
  • Seek supervision

4. Reflect on the feedback received

  • Identify, acknowledge and confront emotions/bias
  • Make a note of impacts to self and others
  • Consider what was helpful
  • Consider what was not helpful
  • Take responsibility

5. Seek individual therapy as needed

6. Repeat

One of the most vital roles that a counselor facilitates within the therapeutic space is modeling behavior for clients. Within a group setting, counselors must model the appropriate response for receiving feedback. Additionally, implementing feedback openly and transparently, in plain view of group clients, completes a healthy demonstration of receiving feedback. It models not only the behavior but also the intentionality and effort behind the actions.

Make it actionable

As stated at the beginning of this article, the benefits of group feedback remain absent to therapists who do not ask for their clients’ input. Even counselors with the best intentions can feel bogged down by the cumbersome process of creating new systems to implement change. 

To ease the transition, ready-to-use group feedback forms are provided to help group counselors implement a new framework for facilitating group feedback. (Scan the quick response [QR] code on the left to access the forms.) These forms can be used as-is or may serve as a helpful starting point to build more bespoke forms better suited to your practice. Each of the dedicated feedback forms reflects the above-described categories: client self-evaluation, group facilitator evaluation, and group culture and environment evaluation. 

Concluding thoughts

In summation, counselors practicing in group settings limit their success as effective clinicians by failing to elicit and implement group feedback. The sole reliance on clinical judgments to measure client satisfaction in group settings renders counselors vulnerable to myopic interpretations. This article delivers the framework for a conversational agenda among practicing group counselors to address client concerns that may have otherwise been minimized or overlooked. 

All counselors have an obligation to commit to excellence in practice. An integral part of that is identifying, validating and actively addressing the needs and concerns of our clients. The therapeutic space is a shared environment. As such, the clients sharing that space should have a voice pertaining to the conservation of the reparative atmosphere. As counselors, it is incumbent upon us to translate that feedback into actionable change to model healthy behaviors and reinforce assertive communication among our clients.

pixelheadphoto digitalskillet/


Ashley E. Wadsworth recently completed her doctorate in counselor education and supervision from Capella University. She is a licensed clinical mental health counselor, a licensed clinical addictions specialist associate and a national certified counselor. Having received the President’s Volunteer Service Award in 2017, she is committed to promoting advocacy for the counseling profession and the military community. Contact her at


Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit


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.

Counseling girls and women in the current cultural climate

By Tracy Peed, Crissa Allen, Mary A. Hermann, J. Richelle Joe and Anna M. Viviani May 5, 2022

This piece is the second of a three-part series for CT Online. It is the result of the work of ACA President S. Kent Butler’s Gender Equity Task Force. The first article, “Breaking the binary: Transgender and gender expansive equality,” was published on April 4 and the third article “The effects of gender socialization on boys and men,” was published on June 15.

In this article, we highlight gender equity issues that impact girls and women and provide recommendations for counselors who work with this population.

Complex realities of girls and women

Girls and women experience complex realities. Despite their increased opportunities in the past several decades, they face pervasive limiting gender norms. For example, girls and women are still dissuaded from entering STEM fields and encounter a “chilly climate” in STEM classrooms, resulting in significant underrepresentation in STEM fields. Furthermore, girls and women with additional marginalized identities experience heightened challenges.

The supergirl and superwoman ideals permeate popular culture and media. Selective, digitally altered social media posts send the message that the superwoman ideal is achievable, and even easily accessible. The narrow construct of feminine beauty further complicates these messages. Girls’ and women’s socialization to “have it all” has become more difficult, with work hours continuing to increase in many professions as technology creates new norms related to worker availability.

In addition, women engage in the invisible work of navigating the gender bias that remains prevalent in the workplace. Women still earn significantly less than men for the same work, and this reality is compounded by racism. For example, white, non-Hispanic women who work full time earn 79% of what white, non-Hispanic men earn, whereas African American women earn approximately 64% and Hispanic women earn 57% of what white, non-Hispanic men earn. Adding to this challenge, negotiating a higher salary is more complicated for women because it defies social stereotypes.

Women who are mothers have experienced heightened parenting expectations in recent decades. They engage in more child-centered activities than mothers did in the 1960s, a time when most mothers of young children did not work outside of the home. Yet, prior to the COVID-19 pandemic, almost 75% of mothers of young children worked outside of the home.

Working mothers in the United States attempt to meet societal motherhood expectations while maintaining employment without the supportive infrastructure found in almost all other industrialized countries. The cost of child care often exceeds the cost of rent. Paid family leave is not available in many work settings, driving 25% of mothers back on the job within two weeks of giving birth. And despite the lack of paid family leave, the promotion of breastfeeding as imperative is a message new mothers receive from almost everyone today, including medical professionals — a puzzling phenomenon in light of contradictory studies on the benefits of breastfeeding. Even women who adopt their babies experience pressure to breastfeed. Women experience judgment and shame if they are not in a position or choose not to breastfeed, which can lead to negative mental health outcomes.

Why now: Refocusing on the needs of girls and women

Although men have increased their participation in household activities in the past few generations, the second shift still falls primarily on women. Furthermore, expectations related to second-shift activities have continued to rise in what Susan Douglas and Meredith Michaels call the “Martha Stewartization of America,” where women are judged on their parenting and the appearance of their homes under these elevated standards while men are not. In fact, men are often glorified for participating in basic parenting activities, which Anne-Marie Slaughter called the “halo dad syndrome.”

Intersectional identities add new layers to these challenges. For example, girls and women who identify as part of the LGBTQ+ communities are vulnerable to increased risk of depression, anxiety and suicide as a result of discrimination. Although the need for mental health services is high, members of these communities often experience a disproportionate lack of access to these resources.

According to the cultural narrative, women are expected to navigate discrimination, harassment, rising work hours, increased motherhood expectations, heightened second-shift cultural standards and current unattainable beauty ideals without ever asking for help. Many women blame themselves when they believe they are failing to meet societal standards, but in reality, the cultural system is failing them.

Similarly, girls and women encounter sexism, bullying, sexual harassment and toxic body image messages. They are encouraged to take advantage of all opportunities and to strive to be perfect at everything. Thus, they are socialized to reach for impossible standards of success. Social media often intensifies these messages.

Yet benefits of social media exist as well. Some girls and women have found supportive communities through social media, which have provided them new channels toward justice and change. Since its inception in 2006 by Tarana Burke, the #MeToo movement has promoted empowerment and support for girls and women who have experienced sexual violence. The social media hashtag has evolved into real-world measures of accountability for aggressors, notably in the entertainment industry. Use of social media for revealing information on sexual abuse does, however, have repercussions. Girls and women have cited instances of harassment, stalking and bullying on the web after posting the hashtag, leading to increased isolation, grief and retraumatization.

The COVID-19 pandemic has exacerbated many of the challenges girls and women encounter. Gender inequities in the United States are further exposed during the crisis. For example, mothers experience a higher burden in managing family life during the pandemic. In the early days of the pandemic, most working mothers lost their access to child care and other support systems. Even two years into the pandemic, isolation and quarantine mandates continue to disrupt the availability of child care on a regular basis, including the child supervision provided by schools.

The pandemic-related challenges have lingered far longer than expected, often resulting in significant mental, physical and emotional fatigue. Not surprisingly, the pandemic negatively affected women’s workforce participation. In 2019, women accounted for approximately 50% of the U.S. labor force; by the end of 2020, there were 2.1 million fewer women working.

As women were leaving the workforce at alarming rates, men’s workforce participation increased. Systemic racism exacerbated these gender inequities. African American women experienced an unemployment rate of approximately 41%, and Latinx women experienced an unemployment rate of over 38%. While the economy improved in 2021, less than 50% of these women returned to the workforce. For many workers who remained employed, on-the-job hours increased as staffing shortages grew.

Culturally responsive counseling with girls and women

Although it is important to understand the various challenges that girls and women may experience, it is also critical to avoid assumptions and stereotypes related to gender when counseling girls and women.

Identifying as a girl or woman is just one aspect of an individual’s multifaceted identity. The combination of various intersectional identities coupled with one’s environment ensures that individuals have vastly different life experiences. Furthermore, one’s identities may result in more collective privileges, compounded marginalization or a mix of both.

Therefore, it is important to understand not only a client’s gender identity but also their other social and ethnic group identities and how these various identities intersect and influence aspects of a client’s life. It would be unjust to assume that a white, upper-class, heterosexual, cisgender woman has had the same lived experiences as a Latinx, working-class, pansexual, transgender woman. As counselors, we need to be mindful of and provide an accepting space for women to explore the development of their multiple identities in counseling.

When working with girls and women, counselors need to consider several salient concerns regarding career interests, such as career choice alignment with familial and cultural expectations, traditional versus nontraditional career choice, as well as navigating harassment, bias, the glass ceiling and the gender pay gap. Tread carefully in this work, and remember that people put limits on themselves in the career domain based on their self-concept and their belief that they are a fit for or could do a particular job.

Girls and women are likely to engage in circumscription, eliminating careers that appear too masculine in the eyes of society or seem unsuitable or out of reach of their capabilities. Or girls and women compromise, selecting or short-listing careers that they see women within their social environment pursuing. Counselors must strive to monitor girls’ and women’s reactions and responses to and support of career-related endeavors, recognizing that they may be trimming their options based on the counselor’s response.

It is important to use gender-neutral language and present a wide array of potential options when introducing and exploring jobs/careers. Being a girl or a woman can come with a multitude of career expectations, relationships and society. Counselors provide women with an environment to process their numerous roles, determine if role strain or role conflict exists, and work together to navigate role-related issues based on the client’s authentic choices.

Counselors must consider how to be more gender aware, attuned and affirming in their approaches and interventions. Many postmodern approaches and theories lend themselves to this aim. The following are a few to consider alongside your current approaches. Keep in mind that this list is not exhaustive; a search of multicultural and social justice-oriented theories will provide a more extensive list.

  • Multicultural counseling and therapy acknowledges all individuals as cultural beings and, as such, their various cultural identities, values and biases are an important part of the counseling process.
  • The Multicultural and Social Justice Counseling Competencies provide additional support for working with a diverse clientele.
  • Feminist therapy allows counselors to view clients and their concerns through a lens that incorporates concepts of gender, power, privilege and oppression.
  • Relational-cultural theory focuses on finding identity through relationships and culture as a powerful influence on these relationships.

By shifting their approach, counselors create culturally responsive ways to meet the growing needs of girls and women.

Advocacy interventions with girls and women

In addition to counseling individuals and groups, advocating for clients is a vital and necessary part of our practice. Advocacy can occur on multiple levels, ranging from micro to macro. A counselor can engage on behalf of the client or with the client/group, with an overall goal of empowerment and eliminating individual and systemic barriers and oppression.

At the individual level (microlevel advocacy), the focus is on empowerment interventions with or on behalf of individual clients. Advocacy might include activities such as negotiating inequitable child care and second-shift expectations in a relationship. Counselors can navigate these actions using theoretical approaches and interventions that allow for identity development, are strength-based and are focused on empowerment.

Counselors may observe girls and women struggling with similar issues. Although counselors will likely work on individual empowerment, larger scale intervention may be needed to address more pervasive systemic issues. In this midlevel advocacy, counselors would advocate for community change with and on behalf of girls and women. Examples of community-level advocacy include advocating in schools against unfair dress code policies that marginalize girls, advocating at the local school board for curriculum to support girls and young women in mathematics and science, and advocating to local employers to support women’s needs from health care to child care in the workforce.

Although not all counselors feel comfortable or ready to advocate on a systems level, they are strongly encouraged to note their clients’ needs and get involved. Even a small advocacy endeavor has a ripple effect.

It is therefore important to know and understand the issues facing girls and women, not only in your community but also at the state, national and international level. We can all advocate for just social policies and strive to dismantle systemic inequities experienced by girls and women, such as lack of affordable access to quality health care and child care, the minimal amount of paid family leave and support for working mothers, pay inequities and work/career barriers.

For more help with advocacy initiatives, consult the ACA Advocacy Competencies for guidance.




Find out more about ACA’s Gender Equity Task Force at



Tracy Peed is a licensed professional school counselor in Illinois and Minnesota, an assistant professor and doctoral coordinator in the Department of Counseling and Student Personnel at Minnesota State University, Mankato, and a member of the ACA Gender Equity Task Force. Contact her at

Crissa Allen is a doctoral student at East Carolina University and a licensed clinical addictions specialist associate. Contact her at

Mary A. Hermann is a licensed professional counselor, a certified school counselor, an associate professor in the Department of Counseling and Special Education, and affiliate faculty in the Institute of Women’s Health at Virginia Commonwealth University. She is the co-chair of the ACA Gender Equity Task Force and founder and director of the Women’s Lifespan Development Research Lab. Contact her at

Richelle Joe is an associate professor in the Department of Counselor Education and School Psychology at the University of Central Florida. Contact her at

Anna M. Viviani is an associate professor at Indiana State University, a licensed professional counselor in Indiana and Illinois, an approved clinical supervisor and a member of the ACA Gender Equity Taskforce. Contact her 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.

Getting triggered as a counselor

By Lindsey Phillips May 3, 2022

The term countertransference has been discussed and debated since Sigmund Freud first argued that it was something taboo — a personal obstacle that would harm the therapeutic relationship. Today, counselors acknowledge that countertransference is inevitable. They are human and prone to having their own issues emerge, often without them even realizing it. Sessions can trigger past experiences, unresolved issues, implicit beliefs and an array of emotions. 

“There’s no way counselors can really extricate themselves and their personality from the [therapeutic] process,” says Peter Allen, a licensed professional counselor (LPC) and integrated care supervisor at Brightways Counseling Group in Madras, Oregon. “That doesn’t mean we’re always talking about ‘me’ [in session]. But it means that I’m acknowledging that I’m coming in with a lot of baggage and perceptions about things that have to be managed.”

Jessie Guest, a licensed clinical mental health counselor and supervisor in North Carolina, views countertransference through Charles Gelso and Jeffrey Hayes’ definition, which she summarizes as an “inevitable, unresolved conflict that leads to misdirected feelings toward a client that can be triggered by the content of the session [or] the client’s personality or appearance.”

Although countertransference is more widely acknowledged today, counselors, especially those early in their careers, often struggle to disclose it, Guest says, because they are either unaware of it or they fear it will make them appear incompetent to others in the profession. Having negative feelings about a client can also make counselors question themselves — both as people and professionals — because they believe that as helpers, they should always be happy and nice, adds Guest, an American Counseling Association member whose specialties include play therapy, trauma and countertransference.

When she was a new professional, Guest worked in a play therapy room with a young child who yelled, kicked and threw objects throughout the session. This behavior triggered something in Guest, who says she is not a “yeller” herself. She felt her body tense every time the child lashed out, and she could sense her anxiety increasing. She worried that the other counselors in the building would hear the child screaming and think that Guest was a “bad” counselor who didn’t know what she was doing. 

After the session ended, Guest reflected with her supervisor on what had happened and realized that her anxiety stemmed from her own discomfort with yelling and her insecurities of being a new counselor. It wasn’t really about the client.

How counselors handle their countertransference “can either be helpful or hinder the therapeutic relationship,” says Guest, who is a registered play therapist and supervisor. “We all have experiences, and people are going to poke those experiences. … But it’s our job to be aware of it and take the time to reflect on those things so it can be helpful instead of harmful for our clients.” 

Recognizing when you’re charged 

Even if counselors realize that countertransference is inevitable, it can still be challenging to recognize when it is happening in session. From her research, Guest, a clinical assistant professor of counselor education at the University of South Carolina, found that counselors who work with children with challenging behaviors often struggled with unrecognized countertransference. 

The clients’ anger and emotional outbursts frequently caused counselors to become charged and engage in unhealthy therapeutic behaviors themselves, she says. Some counselors scheduled certain clients less frequently or ended sessions early. Others would walk out of session when they became too triggered and leave the child alone. Counselors also recalled talking more flippantly with colleagues about certain challenging clients. Guest has published and presented on countertransference, including at the 2021 ACA Virtual Conference Experience. 

Debra Chatman-Finley, an LPC in private practice in Montclair, New Jersey, says she often notices her own physical reactions when she’s triggered in session with a client. Her body may tense or she may find herself squirming in her seat or tapping her foot on the floor. 

Signs such as those let the counselor know that “something is happening between you and that client other than the typical therapeutic interactions,” she says. “And that is when the onus is on the clinician to examine it because whatever that is, it’s going to come through in the form of a question, the way you phrase a question” or a nonverbal response. 

Chatman-Finley, an adjunct professor in the Silver School of Social Work at New York University, had a Black client tell her that when they mentioned they were a graduate of a prestigious university during a session with a white therapist, there was shock written all over the therapist’s face, although the therapist didn’t verbally express it. The therapist was probably well-intentioned and didn’t even realize they were responding nonverbally, Chatman-Finley adds. 

Sometimes clinicians understand countertransference only at its most noticeable level, such as becoming angry or teary-eyed in session, observes Allen, an ACA member. But avoidance, annoyance and impatience are other potential signs of countertransference, and those, he says, “are much harder to recognize in yourself in the moment and can easily go unnoticed … because they can be subtle and insidious.”

When counselors aren’t sure whether they are charged or triggered in session, they can use the PERMS technique, suggests Alex Castro Croy, an LPC and licensed addiction counselor in Denver. The acronym stands for checking in with one’s physical, emotional, relational, mental and spiritual self. 

Possible physical reactions include feeling fidgety or experiencing cold sweats or elevated blood pressure. Emotional states could involve feeling angry or numb. The relational domain refers to how counselors feel toward themselves and their clients; they may feel incompetent or second-guess themselves, for example. The mental domain is based on one’s thoughts, values and beliefs about oneself such as “I’m not a good therapist” or “I’m messing up.” With the spiritual domain, counselors may question their meaning or purpose; they may wonder if they are cut out to be a counselor and may contemplate leaving the field. 

Being overly supportive is yet another form of countertransference. A counselor might make exceptions for a client because they are fond of them, or they may verbalize to a colleague that they “like this client.” Should something happen along those lines, the counselor needs to explore it further, advises Castro Croy, the owner, director and lead clinician at Life Recovery Centers, a group practice with offices in the Denver metro area. What is it that they like about the client? Is it that the client reminds them of their brother, mother or best friend? The counselor needs to be mindful of this feeling, he says, and consider the ways that it could be productive and counterproductive for the client. 

Clinicians should also pay attention to their ability to remain objective with specific clients, Guest adds. Are they getting overly defensive about a client or finding themselves oversharing in session? Do they refrain from challenging a client (when needed therapeutically) because they overidentify with the client or because the client reminds them of someone who is close to them? 

Implicit biases and beliefs 

Countertransference is often an indicator of implicit beliefs, attitudes and biases, says Chatman-Finley, who teaches workshops on racism, microaggressions and racial trauma. It reveals “what’s going on with you unconsciously that may be in conflict with what you believe or think consciously and how [that] might be showing up in your clinical work,” she explains.

All clinicians have beliefs and biases, and those can enter the therapeutic relationship without clinicians realizing it. For example, as a Black woman, Chatman-Finley believes in Black people getting their education, but she thought she could separate this personal belief from the needs of her clients. Her strong unconscious beliefs surfaced, however, when she was working with a Black mother who wasn’t interested in attending college. Chatman-Finley recalls her body tensing up when the client mentioned this, and her therapeutic questions became skewed in the direction of the client attending college. 

She thought she was being supportive and helpful. School wasn’t a priority for the client at the time, however, so the client perceived the questions as judgmental. Chatman-Finley didn’t recognize the countertransference at first, so it negatively affected her work and caused a rupture in the therapeutic relationship to the point that the client stopped showing up for sessions. 

Chatman-Finley told her supervisor that she was struggling with this particular client and couldn’t figure out why. She assumed it was because the client just wasn’t ready to do the work. But her supervisor challenged Chatman-Finley to examine her own role and responsibility for the rupture: What was she focused on in treatment? What questions was she asking the client? What happened in session right before the client stopped coming? Although this line of questioning was uncomfortable for Chatman-Finley, it forced her to reflect on how her own beliefs and internalized thoughts on race and education were sneaking into session in subtle ways. 

Chatman-Finley reached out to the client and scheduled another session where she admitted that her own beliefs about education had gotten in the way of the work that the client needed and wanted to do. 

One strategy Chatman-Finley and Allen find helpful in identifying potential bias and countertransference is to ask themselves whether they would do the same thing with a different client. “If the answer is no,” Allen says, “then you’re probably in the terrain of unrecognized countertransference.” 

He offers an example: In couples therapy, the counselor learns that the woman had an affair, and the clinician feels judgmental. In the next session, a different couple comes in, but this time the man has been unfaithful, and the clinician thinks, “Well, he must have been lonely.”  

“That’s evidence that the counselor is off,” Allen says. “If I’m seeing the same situation in drastically different ways in different clients, that’s a sign” of countertransference.

It’s not the client, it’s me 

Chatman-Finley recalls learning in graduate school that the client’s issues were the only thing present in the room, so if something felt uncomfortable, it probably had to do with the client, not her. But later when she started seeing clients, she learned that this wasn’t true. Her own thoughts, feelings and beliefs could also enter the session and affect the therapeutic relationship. 

It’s easy for clinicians to slip into assuming that the negative energy in the room or the therapeutic rupture is because of the client, Chatman-Finley says. Counselors can find themselves thinking, “I guess that client is just not ready to do the work,” when in reality, she explains, it may have been something the clinician said or did in session that is the true source of the problem.

Allen acknowledges falling into this type of thinking when he was working with a client who had posttraumatic stress disorder. The client wasn’t applying the skills and concepts they were practicing in session. Instead, the client continued to show up and recount stories that depicted him as the hero, so Allen found himself getting annoyed and dreading sessions with the client. This frustration and annoyance spilled into the way that Allen phrased his clinical notes, writing, for example, that “the client refuses to practice interventions at home” rather than “the client displays difficulty in practicing interventions at home.” Despite the subtle signs of countertransference, Allen still thought his annoyance was being driven by the client’s lack of motivation. 


In discussing the client with his clinical consultation group, Allen eventually realized that he was annoyed with himself, not the client. His annoyance came from anxiety related to his own internal pressure to “heal” the client and his insecurities about not being competent as a counselor. His colleagues also helped him realize that the client was making progress in his own way: He trusted Allen and continued to show up for sessions.

To help counselors determine if the problem lies with them or with their client, Castro Croy recommends that they do a “chicken check-in” — a story that originates from his work helping a man who was employed in a grocery store deli. An older couple would regularly visit the store at lunchtime and ask for free samples, a distraction that led the employee to burn the chicken he was cooking on multiple occasions. The third time that he burned the chicken, he yelled and cursed at the couple, and they filed a complaint. 

Castro Croy worked with the client to put his frustrations in context: Had he lost his job because he burned the chicken? Had the grocery store reduced his work hours? Had his employer docked his pay? To all three questions, the client answered “no.” 

“Then, it’s not your chicken,” Castro Croy told him, meaning that it wasn’t worth him getting dysregulated over a chicken that didn’t belong to him. (Castro Croy discusses this story and the intersection of the professional and human selves in more detail during his recent TEDxCherryCreek talk.)

Castro Croy, an adjunct professor in the Department of Human Services at Metropolitan State University of Denver, now uses the “not my chicken” story both to remind clinicians to stop and assess the situation when they feel themselves getting charged in session and to help them set personal boundaries. If it’s not their chicken, counselors can let it go, but if it is their chicken, then they can temporarily bracket it, refocus on the client and process their own feelings after session, he says. 

Managing countertransference

The moment that counselors assume they have countertransference under control is when they are most vulnerable, Allen asserts. “There are days I’m going to miss it even if I’m looking for it,” he says. “And there are days I’m going to see it coming from way off. If I know I am seeing a challenging client at 2 p.m., I need to get centered about that.” 

So, Allen continues, clinicians must constantly check in with themselves and ask self-reflective questions: Do I not realize countertransference is happening? Do I notice it but it’s not an issue? Is it affecting the decisions I am making in session? 

“Recognizing it doesn’t automatically make it good either,” Allen notes. “If you recognize it and don’t do anything about it, it can still be harmful.”

Castro Croy advises counselors to first do the PERMS check-in during session to recognize if they are feeling charged. If something is affecting them, after the session ends, they can delve deeper into the countertransference they experienced by doing what he calls a “functional analysis of self.” This involves carefully contemplating their reactions and any potential underlying reasons for the countertransference (i.e., reflecting on what’s “their chicken”). 

Allen agrees that checking in with his physical, emotional and mental state is helpful. Throughout sessions, he’ll notice if he’s holding tension in his body or if his thoughts are distracted. When he feels triggered, he relies on the same mindfulness techniques that he often teaches his clients. For example, if a client is yelling, he continues to listen to them, but he also focuses on his own breathing. This helps him stay in the moment with the client and avoid having his own feelings affect the session.

Research supports that emotion regulation interventions such as mindfulness can be a good management strategy for dealing with countertransference when paired with psychoeducation about the client’s disorder or mental health concern, Guest notes. Her research study for her dissertation confirmed this finding. Guest created an intervention that combined psychoeducation on child communication, especially for children who have endured trauma, with a mindfulness-based practice to reduce negative countertransference for counselors working with children who exhibit externalizing behaviors such as yelling and hitting. 

The counselors in the study discussed Erik Erikson’s stages of psychosocial development, the functions of child behavior and the theoretical tenets of child-centered play therapy developed by Garry Landreth. Guest also had the counselors use the mindfulness intervention RAIN (developed by American psychologist Tara Brach): 

  • Recognize the stress. (“The child kicked me, and I feel my blood pressure rising.”) 
  • Allow for feelings to be expressed. (“I feel frustrated, and I’m not sure how to react.”) 
  • Investigate what is happening for the counselor and the client. (“What is the worst part of this for me — the yelling or feeling insecure? What was the child trying to communicate by kicking me?”)
  • Nurture with compassion for self and client. (“I’m human, and it’s OK if I don’t know what to do in this moment. The fact that the client is exhibiting this behavior with me means they are trying to show me something.”)

Guest also asked the counselors to practice breathing exercises (such as the mindful minute, during which they count their breaths before and after each session), body scans and guided meditations daily to make them less reactive in session and allow them to be controlled in how they respond to clients. 

By doing multiple mindfulness practices, we are providing ourselves more of a space between stimulus and response. We are less reactive,” Guest says. So, she explains, instead of responding immediately to the client’s negative behavior, counselors have the space to manage and redirect their countertransference into a healthy reaction, such as considering what the child is trying to communicate by the action, rather than just ending the session quickly out of frustration. 

Taking the issue to supervision 

Successful management of countertransference involves good supervision, Chatman-Finley emphasizes. This means the supervisor normalizes countertransference as a part of the therapeutic process and challenges the supervisee to reflect on how they are feeling in session, she says. 

“Supervision can’t just be about the client,” she explains. “It has to include an examination of the therapist’s thoughts and beliefs about the client because there could be something else that’s unconsciously going on with the therapist.”

Chatman-Finley has a peer supervision group in which each member presents a case and the others in the group pose challenging questions so the counselor can consider how their own feelings, beliefs and experiences may be affecting the therapy session. Group members may ask, for example, “What is it like for you to work with that client? What are your goals in working with this client? Why did you go down that path of questioning or treatment with the client? What happens in your body while working with the client?” 

Allen notes that not all supervisors are prepared to discuss countertransference or even know how or when to bring it up. This can create problems for clinicians if they are struggling with how to manage their countertransference. If supervisors don’t handle this correctly, there is potential for them to inadvertently reinforce the message that should counselors have a reaction or feelings toward a client, it means they are bad at their job, he says. (See Allen’s article “Countertransference: How are we doing?” for more on the social solutions to countertransference, including supervision and consultation.) 

Castro Croy is aware that counselors, especially new professionals, are sometimes hesitant to broach the issue of countertransference. So, when he notices a supervisee stumbling in the way they discuss a client or if they are overly cautious when crafting a question, he’ll prompt them by saying, “OK, what’s the question underneath that one? What are you really asking?” or “OK, now ask me that question as a human in the profession, not as a counselor.” This opens the door for them to explore and discuss those times when they feel charged in session. 

Guest recalls having a supervisor who normalized countertransference without even mentioning the term. When discussing how she felt stuck with a specific client, the supervisor simply asked her, “Do you like your client?” 

She was initially surprised by this question. Of course she liked her client! But then she let the question sink in for a few moments, and she considered whether she did actually like this client, what that even meant and why she felt the need to like all of her clients. 

“It was a great question,” she says, “because it allowed me the freedom and safety to process and accept if I was having frustrations or not.” 

Guest encourages counselors to surround themselves with colleagues who are supportive, who will challenge them, who have diverse experiences and perspectives, and who “can help [them] see any blind spots.” 

Turning countertransference into a therapeutic tool 

Although countertransference is largely discussed in terms of something to be avoided, it can have benefits for both the counselor and the client. Namely, it can provide clinicians with insight to better understand the client, Guest asserts. 

For example, she says, take a counselor who is triggered by a young female client who is often defensive and not receptive to feedback in session. The client’s behavior has caused the counselor to become tense and anxious. The client has mentioned in previous sessions that she struggles with relationships and isn’t sure why. The counselor could choose to use the countertransference as a reflective tool to examine if this experience in the counseling session is also happening outside of the session for the client, Guest says. They could say, “I’m noticing some tension, and sometimes I feel like you may not hear me. I’m curious if this happens for you in your other relationships.”

Allen has used countertransference in a similar way. He once worked with a client who dominated the conversation and rarely gave him a chance to talk. Allen was aware that his own annoyance with this type of personality could result in negative countertransference, but instead he used it as a tool to better understand the client. He said, “I’ve noticed you ask me questions, but you do not give me the space to answer them, so I’m not sure if you want me to answer them or not.” 

He followed up with a few questions to learn more about why the client felt the need to dominate the conversation: “Did you come from a family where you felt like you couldn’t get a word in? Are you uncomfortable with silence?”

Sometimes countertransference even has the potential to strengthen the therapeutic relationship. Allen was doing couples therapy shortly after his own divorce. With one particular couple, he decided to meet with them individually to see if they could identify issues they might have been hesitant to share when the other partner was in the room. In an individual session, one of the partners started to cry as she said, “I don’t think we are going to make it.” 

Allen began to tear up as well. He quickly decided to allow that moment of countertransference to come through because he thought it would be helpful to the client in that moment. His instincts proved correct. The client asked him, “Have you gone through this before?” He acknowledged that he was recently divorced, and she told him that she felt seen by him. 

“If I had locked those feelings away and been professorial and distant, it would have been very disconnecting for her,” Allen says. “But I had a spontaneous reaction, and she saw it, and it was a wonderful moment in therapy.” 

However, Allen cautions counselors to carefully consider each client and situation before showing their personal feelings in session. “It might have been the exact wrong thing to do with another client on another day,” he observes. 

The gift of countertransference 

Countertransference can also provide counselors with greater self-awareness. Castro Croy once worked with a Latino child whose father was reinforcing culturally stereotypical messages at home. The instant the child shared this information in session, Castro Croy blurted out, “Excuse me?” in an appalled tone. 

This client’s experience evoked a strong reaction in Castro Croy because he had also struggled with religious and cultural oppression from his upbringing as a child. But he quickly reminded himself, “This is not my chicken,” and proceeded to focus on the client in session. 

This brief moment of countertransference made him realize that there were still residual parts of his own childhood that he had not fully processed in therapy, and he had more work to do himself. 

“When things from the unconscious show up — whether it’s good, bad or ugly — there’s room for that in the [clinical] space,” Castro Croy affirms. Counselors don’t need to “feel scared or intimidated with the humanness that shows up in the profession,” he continues. “Countertransference is a gift because it reminds us … that we are human, that we still have work to do. So, it should not be seen as something negative but as a strength — this is an area I need to work on.”



Lindsey Phillips is the senior editor for Counseling Today. Contact her at


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