Tag Archives: Counselor Wellness

Counselor Wellness

Recognizing burnout and compassion fatigue among counselors

By Madhuri Govindu April 6, 2023

A green sign saying "balanced" with an arrow pointing to the right and a red sign saying "burnout" with an arrow pointing to the left


When I was younger, I had a deep desire to be a crucial part of others’ lives, to help people unpack their emotions and difficult memories. I wanted to hold a sacred space for individuals to open up and share their traumatic experiences. As a result, when I was a teenager, I constantly pondered why a part of other people’s pain stayed with me. Why did I feel their pain, and what could I do to help them?

Early on in my counseling career, I realized that burnout and compassion fatigue are real issues that affect many counselors globally. While counselors help to heal clients’ diverse mental health issues, our own lives can be filled with unexpected ups and downs. Recognizing burnout and compassion fatigue before they set in has served as a saving grace for me while facing the harsh moments of our current realities.

Burnout vs. compassion fatigue

As mental health counselors, we have a professional responsibility to ensure that our clients are safe. At the same time, we have a personal responsibility to look after our own mental health. Burnout can occur easily when these two aspects get out of balance, and sometimes we tend to ignore the early symptoms, which include the following:

  • Anger
  • Frustration
  • Negativity
  • Withdrawal
  • Fatigue
  • Cynicism

Burnout stems from deep exhaustion and a lack of motivation due to overexertion. Compassion fatigue, however, comes from the fatigue caused by dealing with others’ trauma and sufferings, and it is common in any type of profession that focuses on helping others. Here are some of the warning signs of compassion fatigue:

  • Avoidance
  • Addiction
  • Detachment
  • Sadness
  • Grief
  • Lack of intimacy

It can be difficult to determine if you are experiencing burnout or compassion fatigue. As a counselor, you will experience compassion fatigue when you are overwhelmed from focusing too much on others’ well-being and unable to manage their stress. If you have constant headaches, distressed feelings, unwanted thoughts and increased irritability that are affecting your overall life, you are likely experiencing compassion fatigue.

If you feel hopeless about the nature of your work and feel it has little positive impact on your life, however, you are probably experiencing burnout and are overworked. Burnout often occurs if you work long hours, are undercompensated for your workload and are short of some quintessential tools. These factors place you under extreme stress.

Tips to prevent burnout

As counselors, it is vital to understand that our lives can’t be free of stress. Instead, we can notice repetitive patterns caused by our compulsive habits that can lead to burnout. The key is to recognize unhealthy patterns and habits early on before they exert a stronger grip on us.

Here are some tips to prevent burnout:

  • Engage in your own personal therapy if needed.
  • Maintain a strong support system of friends, family members and fellow therapists. Also, let your supervisor know if you are experiencing any signs or symptoms of burnout; they can help you delegate your responsibilities and ensure you are taking time for self-care.
  • Partake in regular physical exercise, long walks, meditation and yoga, and invest in your morning and bedtime routine.
  • Spend time journaling and subscribe to a health care model that offers 360-degree attention to spiritual, emotional, mental, physical and vocational aspects of individual wellness.
  • Create work-life balance by ensuring the number of hours spent at work is closely equivalent to the number of hours invested in a conscious, meaningful and relaxing self-care activity.
  • Get outdoors, take a mental health day for self-care, work closely with a mental professional to engage in self-care, and get together with your fellow counselors for a counseling retreat or in-person/virtual groups.
  • Find a buddy who can help identify and alert you when your stress meter has gone up. This tip is important because often as counselors, we carry stressful work situations or unsatisfactory client encounters with us in our minds. We repeatedly replay them in our heads to analyze and dissect how they could have gone better. This stress and feelings of resentment can spill into our personal space and affect the time we spend with family members and friends.
  • Join professional associations such as the American Counseling Association that can help counselors become part of the wider community and stay on track with their healing.

Tips to combat compassion fatigue

Counseling involves welcoming clients from diverse cultural backgrounds and helping them hold their inner peace. As counselors, we show compassion, and in this process sometimes we over-empathize, which can lead to compassion fatigue. Compassion fatigue often sneaks up on us, and if we are unaware or not vigilant, it can leave us feeling physically exhausted, numb, sad, stuck and withdrawn. To avoid compassion fatigue, counselors need to adopt some healthy practices such as:

  • Establish healthy habits such as getting adequate sleep, eating nutritious food and engaging in grounding activities (e.g., meditation, yoga).
  • Establish and maintain purposeful connections with friends, family members and fellow therapists. These relationships can serve as a great reminder of your authentic self.
  • Create meaningful boundaries with fellow counselors, clients and family members. This is especially important in the helping professions where everyone expects you to lend them a compassionate ear.
  • Find a way to disconnect from our clients’ stories. Sometimes clients’ stories stay with us even after we leave the session, and we may unconsciously project our own thoughts, feelings or biases onto clients. To avoid this, engage in a short mediation for about 10 minutes before and after each session, which can help counselors disconnect and prepare for the next session.
  • Develop a consistent meditation practice. I am a meditation teacher, and I have received several emails from therapists and healers expressing gratitude for my daily online guided meditation sessions.
  • Work toward becoming more mindful. Mindfulness in daily life keeps the mind alert and focused and ready to absorb more. It also protects the mind from being affected by traumatic stories.
  • Practice self-care. You cannot pour from an empty cup. Some ways we can take care of ourselves include engaging in relaxation techniques, healthy friendships, enjoyable hobbies and healthy stress outlets.
  • Maintain a healthy work-life balance. It is important to establish a manageable work schedule; know what kind of clients trigger you deeply and take precautions beforehand.
  • Engage in personal counseling. Talking to a therapist about your triggers and instances from the past when you have experienced compassion fatigue can help immensely.
  • Establish emotional boundaries. There is a common tendency among mental health professionals to slip into over-involvement and to forget to create emotional boundaries with others. But these boundaries are important because they help us to value our space, which is necessary for our recovery.
  • Commit to staying educated. It is important to learn about compassion fatigue and to stay abreast of its symptoms and remedies.

Self-care as second nature

No one is immune to suffering in this world, not even counselors. In navigating from one client to another — and often helping clients deal with a lot of suffering — we can carry residual energies from previous sessions. Hence, cleansing ourselves becomes crucial so that we are not affected in the long run.

We are often busy as counselors helping others, seemingly leaving us very little time for our own recovery and self-care. But it is equally important for us to indulge in self-inquiry and ask ourselves: “How often am I sitting with my discomfort? If I am not doing this, then why not?” Do we find it challenging to “heal” ourselves or is it that we often get so focused on helping others that we forget to take care of yourselves? Do we tend to put others first (before ourselves)?

After engaging in this self-reflection, counselors may discover that self-care does not come naturally to them. Because they have a natural inclination toward helping others, caring for the self can feel like an additional task. Being fully aware of this attitude may help counselors build a deeper relationship with themselves and release the notion that they cannot seek help themselves. Here are some questions to you become more aware of your self-care practice and areas you need to work on to change how you approach self-care in your life:

  • How often have you found yourself comfortable in your discomfort?
  • While you are trying your best to heal others, who is helping you?
  • Who is listening to you?
  • Is your mental health a priority or has it taken a backseat?
  • Who is devoted to you when you are devoted to everyone else around you?

There is often a gap between how we are visualizing our ideal life in our heads versus how we are living life in reality. The power of self-care is often underestimated, and it is time for us to change this attitude as counselors.

Listening to ourselves

As counselors, we invest a lot of our time, energy and emotions in working with others. Deeply listening to others and helping others untangle their wired thoughts is an art. We bring the best out in others as we remind them of their positivity, strengths and resilience. But amid this process of healing others, we mustn’t forget to listen to our needs as well.

Flight attendants always advise airplane passengers that in case of emergency, each person should put on their own oxygen mask before trying to help others. This approach is equally applicable to us in the helping professions, where the goal is to help those in distress.

Being emotionally attuned and available to ourselves as counselors is of vital importance. We must respect our boundaries, nurture our health first and continuously monitor ourselves for any early signs of stress. Because we are instrumental in healing others, we carry a great responsibility to stay attuned to our authentic selves and prioritize our needs.

After all, if your cup is empty, how can you truly hope to help and support others? Hence, it is crucial to refill your cup as soon as you feel you are verging closer to burnout or compassion fatigue. Don’t wait for your inner batteries to die down completely before taking steps to recharge them.

Counselors can find support from other mental health professionals. In 2018, I built a virtual platform called Soulful Conversations, which allows counselors to have heart-to-heart conversations and helps them to better cope with burnout, compassion fatigue and mental unrest. This provides mental health professionals with a space to share their advice, best practices, life-changing experiences expertise on dealing with burnout and compassion fatigue. These videos are available on my YouTube channel, Soulful Conversations With Madhuri Govindu.

As I said in one of the Soulful Conversation sessions, “If you cannot nourish your soul, you cannot ignite the well-being of others.” Before trying to heal others, we must first ensure that we are healed and nourished within ourselves.


Madhuri Govindu is a counseling psychology graduate student at Pennsylvania Western University at Edinboro. She is also a meditation teacher, yoga enthusiast and influencer. Her work was featured in The New Indian Express in 2018 when she began to invite individuals from all walks of life to embrace the present moment through her open social change platform titled Soulful Conversations. Contact her at madhurigovindu23@gmail.com.

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 Psychotherapy.net 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 lphillips@counseling.org.


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.

Other people’s monsters: A personal account of vicarious traumatization

By James M. Smith March 9, 2022

Last year, I was fortunate to have a piece published in Counseling Today with my co-author, Adrian Warren. The article, which appeared in the June 2021 issue, encapsulated our research on adult male survivors’ lived experiences of disclosing child sexual abuse. 

Necessary to this research was the interview process in which I listened to the stories of men who had experienced horrific child sexual abuse, some by multiple perpetrators. These interviews took place over the course of about six weeks. I was bombarded with horror stories of emotional betrayal and sexual violence.

Then the nightmares started.

I can’t recall the exact date of my first nightmare, but I remember waking up angry and in a cold sweat after having dreamed that my youngest, 8 years old at the time, had been molested by a friend’s father. A few nights later, I dreamed I was beside my oldest son’s hospital bed after he was found beaten on a playground at school. In my dream, he was too ashamed to tell us who the perpetrator was or what exactly had happened. I woke up again in a cold sweat with a deep feeling of guilt that my son had been victimized. It took a minute for me to realize it was just a dream.

A few weeks after the nightmares started, my daughter, our middle child, announced she was planning to go to a sleepover at a friend’s house that weekend. “No, you’re not,” I blurted out without thinking. 

My wife gave me an inquisitive look and asked, “Why not? We don’t have anything planned this weekend, do we?” 

I couldn’t respond. I honestly didn’t know why I had suddenly become defensive, maybe even a little angry, about the thought of my daughter spending the night at a friend’s house. She had done it before many times, and we knew the family she would be staying with. My wife and I had been friends with this family since before our children were born. Why did I suddenly feel sick to my stomach at the thought of our daughter going to their home?

My wife made the arrangements. My daughter would go straight from school on Friday to her friend’s house with her friend’s parents, and we would pick her up around lunchtime on Saturday. 

Friday loomed. The knot in the pit of my stomach grew heavier. Friday morning, I woke up in a cold sweat. Before getting in the car to take our daughter to school, I made sure she had her cell phone, a portable charger and her charging cable. I went over with her what numbers to call “if anything happened” and she needed us. I harped on it.

“Dad, chill out,” she said that morning. “You’re freaking me out a little.”

I was freaking myself out a lot. I checked my phone about every two minutes to see if she had called. When 9:30 p.m. rolled around, I called her. She didn’t answer. I was over the edge. I texted her and asked what she was doing. “Hanging out,” came the reply. She had just finished watching a movie, and they were getting ready to play some games. I spent that night in a state of near panic. I slept for maybe an hour and made sure my phone was on full volume and by my side the whole time.

Saturday morning came, and I couldn’t wait to go get our daughter. I was crawling out of my skin waiting. I almost called her at 6:30 a.m. to make sure she was OK. I sat that morning in a state of uncontrolled fear until we picked her up and she was safe with me again.

Mindfulness in action

The next day, as I nursed my cup of coffee, I realized I had not spent time in my mindfulness exercises all week. I have practiced mindfulness for more than 20 years. It was first introduced to me by Benedictine monks at a college I attended. Mindfulness exercises helped me manage depression and anxiety. When I became a counselor, I started integrating mindfulness into my own work with clients.

I put my coffee aside and went to my meditation chair. I have a specific place where I practice mindfulness exercises. The chair is comfortable but not so much that I fall asleep. It helps me sit up straight. I can put my feet on the floor or cross them underneath me depending on what is most comfortable on any given day. I went to my chair and began a mindfulness body scan.

I could feel how my feet rested on the floor with my ankles crossed. I could feel the bend of my knees and how my legs felt as I focused on each part of them. I could feel the pressure of my forearms resting on my thighs as my hands were placed in my lap, cupped in each other. 

Yupa Watchanakit/Shutterstock.com

My attention moved up my hips and to my abdomen. Fear. There it was. Intense fear. The fear filled my stomach and rose up my chest like I was gagging on it. As I got in touch with that fear, I could feel my heart pounding and the tension in my shoulders, arms and neck. I noticed for the first time the stutter of my breath as I exhaled. I sat with this fear, recognizing the emotion of it. I accepted that I was afraid of something. I noted the physical sensations of fear and moved on with my body scan.

I spent the rest of the day paying attention to those physical cues of fear. I noticed how they intensified as my children talked about their activities. Every time my children mentioned their experiences of spending the night at a friend’s house or participating in some extracurricular activity, my stomach would knot up and my breath would quicken. 

As I reflected on that fear in the coming days, I kept coming back to the same question: “What am I afraid of?” 

“They’re going to hurt your children.” The voice was clear inside of me, although it felt a little alien.

“Who’s going to hurt my children?”

“Your friends. Your family. The abusers and manipulators. And you won’t know who they are until it’s too late.”

I had heard of vicarious traumatization in my academic studies, and it had always been an academic exercise: Identify the symptoms, prescribe intervention, promote prevention. I thought my academic understanding would be enough to insulate me from the threat. 

Here I was though — nightmares, hypervigilance, intrusive thoughts, all underneath an anger that I didn’t understand. The worst part was the constant suspicion of everyone, even family members. As a counselor, I knew what these symptoms indicated. As a person, I wasn’t ready for the emotional toll they would take.

Support and self-care

I have always made it a point in my professional career to maintain a close-knit support group with other clinicians. Sometimes, I’ve been able to do this with co-workers in the same treatment organization. Other times, I’ve worked diligently to create my own professional support network. The iteration of my professional support network during this season of my life was a small group of three other counselors who met about every other week to talk and drink coffee. They were mindfulness practitioners too.

We visited with each other, and I let them know what was going on with me. Their response was more of a “Well, duh!” support than the kind of empathy that Brené Brown has spoken elegantly about, but that’s the kind of relationship we have. I told them I was kind of at a loss, and they helped me put together a plan and a series of exercises. They reminded me of the fundamental mindfulness concepts: radical acceptance, nonjudgment, compassion, patience, here-and-now focus. They reminded me to remain attuned to what I was paying attention to in my thoughts, to my emotions and to my body. They reminded me that the time to practice mindfulness is not when I’m in the grip of a vicarious trauma reaction or panic episode and most need to be mindful, but rather when I’m more relaxed. 

Together, my support network and I worked out a plan of practice to address the experiences I was having. The first step was acceptance. I worked on accepting that the fears I was experiencing were not from my own lived experiences. 

I found an image once of a woman walking down a darkened street. Her shadow was visible from a nearby street lamp, but behind her were the shadows of monsters clearly coming from a different source. This image summed up my understanding of vicarious trauma. Those of us in the helping professions can be haunted by the monsters that other people have faced. 

We as counselors have many protective factors, including our knowledge, a developed self-awareness and strong support networks. While these protective factors may help us gain insight, they do not insulate us entirely from the vulnerabilities of our profession. Sometimes, we must accept the truth that we are not doing very well ourselves. The fear, nightmares, hypervigilance, suspicion and anger followed me but did not originate from my own experiences. Accepting that I was having these experiences was key to dismantling them.

The second step was to make sure I was engaging in my daily mindfulness practices. It has always been very easy for me to get busy and forget about the things that keep me well. I mentioned that I had not engaged in mindfulness practices the week prior to my daughter’s sleepover. That wasn’t because I deliberately chose to put these things on the back burner or to ignore my own needs. I just got busy. 

Our practices for self-care are training for a marathon — training that needs to happen before the day of the race. We learn coping skills, just as our clients do, to make sure that we can manage our experiences as helpers. So many of the clients I have worked with through the years believe that they need to use the coping skills we review only when they are in the midst of dysregulation, be it panic, anger or addiction. We as counselors know that if a coping skill is not practiced before it is needed, it is not as effective as it could be when the time comes to use it. 

The same is true of our own self-care. If the only time we engage in self-care is when we are on the edge of burnout, compassion fatigue or vicarious trauma, our self-care might stave off a crisis, but it won’t be very effective at keeping us well. So, I pledged to my support group that I would return to the daily practices that had helped me in the past. I made a commitment to them to practice mindfulness skills in meditation at least 30 minutes every morning, to exercise several times a week and to spend more time with my spouse and children. I committed to being mindful.

Finally, I used my support network. I have been to counseling in the past. It helped me immeasurably and put me on the path of becoming one myself. I am not opposed to seeing a counselor for my own individual therapy. Just as I encourage my clients, however, I decided to use my natural support network first. 

These are friends in the profession with whom I have bonded. We meet regularly and speak openly to one another about our personal challenges. Sometimes we complain about our employers. Sometimes we complain about our employees. Most of the time we challenge one another to make sure we are taking care of ourselves, our families and our clients. I knew that I could sit down with them and say, “I think I’m having a vicarious trauma reaction.” I knew that they would hear me and help me recenter and get through it. Each time that we met afterward, I shared with them how I was doing on my plan to address these experiences. 

Having this professional support is invaluable to me. We gather often to challenge, support and educate one another. This small group of clinicians is an important element of my self-care and ongoing professional competence.

Along with this professional network of support, I have natural supports in my life. I belong to a group of men that meets every Saturday morning for breakfast to share our stories of personal faith and to hold one another accountable as spouses and fathers. I shared with this group what was happening. They expressed understanding. 

I also told my wife what was going on. She asked me if I wanted to stop letting our kids spend the night with friends for a while. I said just the opposite. I felt we needed to proceed as normal with our children’s activities, and I needed her to remind me that it would be OK. 

This sharing of my experiences with my natural supports helped in the acceptance process. Talking about it with them and having to explain it at times helped me accept that it was happening. 

Working through

I wish I could say that the nightmares, discomfort and anxiety stopped after a period of time. Word spread through my professional network that I had expertise in working with men who were survivors of child sexual abuse. This led to me getting more referrals of this particular client population than I had before. I have heard many more stories of abuse and betrayal since then. So, I continue with the regimen I established:

  • Regular meetings with my professional support network
  • Daily training in mindfulness practices that prepare me for the moments of panic I sometimes feel
  • Honesty with my natural supports in life, which helps with the acceptance that I have this vulnerability

The symptoms of vicarious trauma have not gone away, but I am managing better. I still wake up occasionally from a nightmare, but the nightmares are less intense. I still experience bouts of anxiety when my children attend sleepovers and other activities. I was out of my mind this past summer when my kids went to a swim party at a friend’s house. I practice deliberately shifting my attention to other things until they are home and remind myself constantly that my wife and I have done our due diligence regarding who our children are spending time with. 

I caution counselors-in-training against acting as their own counselors. In this spirit, I continue contact with my support network of other counselors. I am radically honest with them about my self-care. These supportive colleagues helped me create a list of things I need to watch for as indicators that I should seek individual counseling myself.

In the final analysis, my experience of vicarious trauma did not affect my work with clients. Based on the feedback I receive from them, they continue to feel that I am present and empathic, compassionate and helpful. 

No, this experience primarily affected my life at home and my relationship with my children. It wasn’t just that I wanted to crawl into a hole but rather that I also wanted to put my kids in a hole where I thought they would be safe. My fear was closing in around my children, making me want to shrink their world and experiences. It threatened their well-being as they continue developing into their outstanding selves. 

Through this experience, I have learned that self-care for me means that I wrestle with other people’s monsters so that my children, wife and friends don’t have to wrestle with mine.



James M. Smith is a licensed professional counselor, national certified counselor, approved clinical supervisor and board certified telemental health provider. In addition, he is a contributing faculty member with Walden University, a husband, a father, and a friend to a golden retriever. To contact him, email james.smith@mail.waldenu.edu.


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 ct.counseling.org/feedback.


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.

Counselor burnout during COVID-19

By Carrie L. Elder, Elizabeth K. Norris and Leann M. Morgan March 8, 2022

As professors of counselor education at three separate universities, we share a vested and common interest in counselor wellness. When COVID-19 hit, we began researching burnout in counselors. There is a consensus in the profession that burnout is the gradual onset of emotional, cognitive and physical exhaustion related to work. Often there is a sense of dread and avoidance with completing work-related tasks.

Our thinking was that due to the demands on counselors and the heightened health scare during COVID-19, counselors would begin to burn out. We wanted to understand the relationship between the new pandemic and counselors’ levels of stress, burnout, resilience and self-compassion during this time. We asked ourselves how we could better understand this unprecedented phenomenon so that we could better support our students, our supervisees, our colleagues and ourselves. 

After conducting three independent research studies over the past year, we discovered some surprising results that could help us define — and rule out — what issues counselors may be facing and what can help keep us well during our parallel experiences with clients during the continued evolution of COVID-19.

Surprising Evidence of low burnout rates 

In the past year, we have been inundated with anecdotal information from online sources and peer-reviewed manuscripts that communicate how counselors are experiencing high rates of burnout while seeing clients during the pandemic. This is a fair and seemingly clinically sound assumption, except that our current research isn’t supporting this claim. Three independent research studies that gathered data from counselors across the country in 2020 and 2021 indicate that burnout rates in counselors remain low, which is consistent with reports prior to the pandemic.

Three months into the pandemic, we sampled 211 counselors and found an average burnout rate of 20.85, which fits in the “low” category. According to Henry E. Stamm, developer of the Professional Quality of Life Scale, a score of 22 or less indicates low levels of burnout; a “moderate” score ranges from 23 to 41. Most participants in our first study scored low on burnout (67%), with the remainder displaying moderate levels (33%). No participants reported high levels of burnout. In this first study, we found self-compassion and resilience predictive of lower levels of burnout.

Eight months into the pandemic, we conducted two additional independent studies looking at other predictors of burnout. In the second study, 252 counselors reported an average burnout level of 20.99, again in the “low” category. This study found compassion for self and others predictive of resilience, whereas empathy was predictive of burnout. 

The third study surveyed a national sample of 125 counselors who reported an average burnout level of 22.09, which again is consistent with that of the “low” burnout category. This study found that counselors’ negative perceptions of their working conditions, maladaptive coping styles, decreased levels of compassion satisfaction, higher caseload volumes of clients with trauma-related concerns, and lower levels of resilience were predictive of burnout. 

Low burnout rates are surprising and, again, seem counterintuitive, even when we take our own experiences into consideration. This isn’t to say that counselors aren’t experiencing burnout, however, because they are. They just don’t seem to be experiencing it any more than they did before the COVID-19 pandemic. 

Admittedly, it is hard to define an experience when it is one the current generation of counselors has yet to practice and live through completely. The trajectory of COVID-19 variants is still unknown, so further defining the struggle that counselors may be facing can be beneficial in increasing our ability to maintain personal wellness.

So, what is preventing counselors from experiencing higher burnout rates given the added stressors we have all faced this past year-plus, both at home and at work? Our research indicates that counselor resilience during the pandemic is moderately high. These findings suggest that counselors may be uniquely suited to cope with the additional pressures of a pandemic. By utilizing skills taught in counselor training programs and supervision — including maintaining adequate self-care, maintaining healthy boundaries, practicing ethical decision-making and responding to crises — counselors seem to be able to maintain enough resilience to keep burnout levels low.

Pandemic fatigue

If we aren’t experiencing burnout, then what are we experiencing? Here’s what we think: The phenomenon of providing counseling during a pandemic has produced an outcome unique to COVID-19 — pandemic fatigue. It is time that we talk about what this means for counselors. 

The World Health Organization defines pandemic fatigue as “a reaction to sustained and unresolved adversity which may lead to complacency, alienation and hopelessness, emerging gradually over time and affected by a number of emotions, experiences and perceptions.” Pandemic fatigue is dissimilar to burnout in that the exhaustion being experienced isn’t related only to our work as counselors but is woven throughout the tapestry of our lives as a whole.

To us, this makes good sense. Counseling during a pandemic means that we cannot leave all of our clients’ material at the office. Because we are all experiencing the pandemic — clients and counselors alike — we, as counselors, carry our own experiences of the pandemic home with us. Often, we are transitioning from holding space for our clients’ concerns related to the pandemic to going home and doing the same for ourselves and our families. In this context, we can start to see that it’s not necessarily the tasks related to counseling that are increasing burnout but rather the increasing demands on our personal lives that are leading to pandemic fatigue.  

Fortunately, counselors are trained to respond in crisis situations. When the pandemic hit, we continued to provide care to the growing numbers and needs of clients, most likely by shifting to a new telehealth business model to safeguard our health and the health of our clients. We prepared for a sprint instead of pacing ourselves for a marathon. Although access to vaccinations has provided some health care workers an increase in psychological resilience, counselors are still in the race with no known finish line in sight for themselves or their clients. 

When humans are confronted with a crisis, they draw on short-term survival instincts and systems. When circumstances drag on, new coping strategies need to be implemented to prevent or reduce behaviors that cause fatigue and demotivation. 

Pacing ourselves

So, what can counselors do to pace themselves for the marathon we find ourselves in? Here are three suggestions:

1) Utilize parallel processes in supervision. Counselors shouldn’t be afraid to discuss fatigue, lack of motivation or other symptoms of pandemic fatigue with a clinical supervisor or colleague. Regardless of years of experience, talking about the exhaustion of providing care during the ongoing pandemic can have a dual benefit. 

First, counselors can work with their supervisors to identify and discuss any guilt, demotivation, and lack of energy with clients, and ways of improving resilience in these areas. In doing so, the counselor participates in a parallel process that may trickle down to how the counselor identifies and treats pandemic fatigue in clients. Using the parallel process may increase new coping strategies and resilience in both counselor and client.

2) Practice compassion more and empathy less. According to neuroscientists Olga Klimecki and Tania Singer, empathy activates the pain network within the brain. In contrast, compassion activates nonoverlapping brain regions. In a subsequent study of counselors, increases in compassion (compared to increases in empathy) were associated with increases in counselor resilience. This means that counselors may benefit from practicing compassion to self and others. It also means identifying causes of suffering and working to alleviate them. 

This contrasts with our practice of empathy. Empathy requires the counselor to take the perspective of the client by “trying on” their pain. When we practice empathy by putting ourselves in our clients’ shoes, our brains have difficulty distinguishing what is “ours” and what is “theirs.” Taking the client perspective requires an additional process of emotional regulation to distinguish others’ suffering from our own, which may add to counselor fatigue. 


Practicing self-compassion may also aid in identifying and decreasing guilt associated with the counselor’s inability to treat as many people in need as possible throughout the pandemic. Recent literature has captured the moral challenges of counselors when they are unable to provide more services to the increasing numbers (and overwhelming needs) of clients. When we practice self-compassion, we address our desire to help others and the guilt that arises when we cannot do so, while offering lovingkindness toward ourselves in the midst of that guilt. 

By engaging in this self-compassionate process, counselors are better able to extend the same care and consideration to their clients. After all, we cannot effectively lead our clients to a place we have yet to discover or experience ourselves. 

3) Define personal space and time. Remember, slow and steady wins the race. It looks like we are in a fluctuating pandemic that has the potential to affect us and our clients for some time to come. Intentionally carving out time and space to come back to center so that we can choose what we do with our time (instead of ceaselessly dedicating it to work) can provide balance. 

No, this doesn’t necessarily mean taking a spa day, getting our nails done or binge-watching reruns. Those coping strategies are good only in the short term to distract from stress. They might have been effective coping strategies during the first months of COVID-19, but they can quickly turn into maladaptive behaviors that prevent us from being in our feelings and really assessing what we truly need. Instead, we are asking counselors to pay attention to their thoughts, bodies and feelings and prescribe leisure time (and purposeful aloneness) accordingly. Healthier coping strategies may enable us to remain resilient for the long haul.


Why is this important? Yes, we have available vaccinations and boosters, businesses are back up and running for the most part, many children and adolescents have returned to school for in-person learning, and more counselors are seeing clients face-to-face. Even so, we have such little information about how professional counselors remained well during pandemics and crises prior to COVID-19. Because little can be gleaned from the past, we hope to provide additional context centered on counselors’ experiences during global crises. Based on our research, we have a better understanding of what is keeping us well and what we may need to do to maintain that level of wellness. 

As a profession, it is easy to focus on the needs of clients and not to focus on our own needs. The truth is that by keeping ourselves well, we are better positioned to help our clients reach and maintain their own wellness. Additionally, when we are well, we are more likely to make ethical decisions. 

Our mental health is not separate from that of our clients. When they are suffering more, we are more likely to feel its effects, much like a shared experience. Conversely, when we are suffering more, our clients too are more likely to feel it. During the pandemic, when both counselors and clients are experiencing the same challenging phenomena, our symbiotic relationship needs to be addressed.

Given the ongoing nature of COVID-19, the unpredictability of its variants and an undetermined end point for the pandemic, understanding counselor wellness during this time is imperative. Counselors have described feeling burned out, and this is mirrored in current literature. When tested, however, we did not find counselors to have higher rates of burnout than before the pandemic. Instead, counselors may be experiencing pandemic fatigue marked by chronic stress that impacts perceptions of events, increased exhaustion and decreased motivation. 

To mitigate these symptoms, counselors can use parallel processes in supervision to reinvigorate both the counselor and the client, practice compassion toward self and others, and carve out time for intentionally addressing needs. Using new coping strategies may help counselors to pace themselves during the COVID-19 marathon and mitigate pandemic fatigue.

Considering the gradual onset of burnout, it is plausible that counselor burnout rates will climb as the pandemic continues. However, many of the coping strategies we recommend using to reduce pandemic fatigue should also help prevent increases in burnout.



Carrie L. Elder is a visiting assistant professor and clinical coordinator at Mercer University in Atlanta. She is a licensed professional counselor (LPC), national certified counselor (NCC), certified professional counselor supervisor and registered art therapist. Contact her at elder_cl@mercer.edu.

Elizabeth K. Norris is an assistant professor of counseling at Denver Seminary in Littleton, Colorado. She is an LPC, NCC and board certified telemental health provider (BC-TMH). Contact her at elizabeth.norris@denverseminary.edu.

Leann M. Morgan is core faculty in the School of Counseling at Walden University. She is an LPC, BC-TMH and certified career counselor educator. Contact her at leann.morgan@mail.waldenu.edu.


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 ct.counseling.org/feedback.


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.

Why your own therapy is so important as a counselor

By Scott Gleeson February 28, 2022

One stigma Francesca Giordano would like to vanquish in the mental health professions is the notion that therapists do not need their own therapy. Giordano, a retired counselor educator and the principal partner of Veduta Consulting in downtown Chicago, says there may be no greater resource for a clinician — including supervision and personalized self-care — than regularly meeting with a therapist. And yet, clinicians’ perceptions of themselves in the opposite chair remain a blockade.

“I think in the history of our profession, there’s sometimes been a negative association with the idea of being a wounded healer, that by going to our own therapy, we are perceived to be too damaged to help,” Giordano says. “That label gets in the way instead of being able to see a clinician going to a therapist and doing their own continual work as a strength.”

Giordano’s sentiments echo a call to action in the counseling profession that has often been stampeded over by a multitude of available workshops and seminars that focus on clients’ needs first. 

“Counselors are inclined to put clients’ interests before everything else,” says Stephanie Burns, an associate professor and coordinator of the clinical mental health counseling program at Western Michigan University. “The problem is that counselors can often put themselves last and overlook self-care for themselves. Much like with clients, counselors can avoid help-seeking behavior like therapy because of fear of feeling incompetent and ashamed. It becomes, ‘I’m a counselor, so I should be able to handle all of this.’ That type of self-sacrifice mindset can ultimately lead to depression and burnout.” 

Stephannee Standefer, the associate program director of Northwestern University’s online master’s in counseling program, says a clinician can be masqueraded by their own shame in taking a no-counseling approach. “When I hear from students or counselors, ‘I don’t need therapy,’ I actually hear them saying they want to distance themselves from their woundedness or pretend it doesn’t exist,” Standefer says. “But if you don’t face your own pain regularly, it limits your ability to be an effective counselor.” 

Self-awareness over self-demolition 

Like many mental health professionals, Judith Fawell, a licensed clinical professional counselor and certified alcohol and other drug counselor, felt drawn to the field based on her own experience with therapy. The same foundational principles that she developed in her own therapy still foster self-awareness now. 

“As a therapist, more than anything I’ve learned in school or the field, I draw from my memory working with my own therapist and the wisdom I got from that. It was like having the best mentor and someone who saved my life at the same time,” says Fawell, a recipient of the 2020 Award of Excellence from the Illinois Mental Health Counselors Association.  

“I saw firsthand how one could benefit from seeing a therapist,” Fawell continues. “In essence, my therapy was part of my training too.”

Giordano, a member of the American Counseling Association, says that “training” period of counselors doing their own work before entering the profession is wholly necessary. She also thinks it is best to keep therapy ongoing while seeing clients. 

“My belief is that the relationship you have with a client is the conduit for change, and you have to do your own therapeutic work to use yourself as a vehicle,” says Giordano, a former Illinois Counseling Association president. “My philosophy is pretty strong on the importance of therapy and ongoing therapy. Not just for students and young counselors but [for] experienced practitioners. That’s super important. It’s a false dichotomy to think that we’ve already done our own work and are ‘fixed’ or finished growing.”

Standefer agrees that the self-awareness developed from therapy is key. “When I do my own work, I know where I end and where the client begins,” she says. “I become aware of my own reactions to a client’s narrative, and I can hear it in a way that’s therapeutically effective for the client. I’m able to challenge my assumptions and raise awareness to countertransference.”

Fawell says it is naïve to not expect some clients to draw out countertransference and that counselors who are in therapy themselves often have a wider container for the psychological complexities that clients bring into session. 

“As you help people, clients are going to trigger you in all kinds of ways,” she says. “They’re going to hit your nerves from the past. You have to work through those in order to be the best helper you can be. Therapy can also help you become self-aware to know whether … to refer out or not.”

Both Fawell, a member of the Illinois Professional Counselor Licensing and Disciplinary Board, and Giordano, a former vice chair on the disciplinary board, say they have noticed a correlation between clinicians who inadvertently harm their clients and clinicians who have not done their own therapy.

“I’m totally convinced that there’s a relationship to clinicians’ own stress and making poor decisions that affect clients and get them into trouble,” Giordano says. “It makes sense. When you’re not in therapy, it’s common to use defenses or block problems or even project those problems onto others. When people are in therapy, their relationship to their own problems changes. Having personal problems doesn’t have to be a bad thing, because then you have an understanding and sense of self and can integrate that into what a client is going through.”

Understanding a ‘unified phenomenon’

Burns believes counselor care and client care are a “unified phenomenon” in that they both hold equal importance to infuse the other. But too much of one form of care tends to not work in the best interest of the client. 

“It’s equally as bad if you’re focused on yourself and not caring for the client as if you’re too focused on the client and not yourself,” Burns asserts. “The more mature stance is to blend the two. That makes for a better, more therapeutic relationship with the client.”

“The best way to accomplish that balance,” Burns notes, “is through therapy. … When you’re in therapy, you’re naturally more self-aware of things like compassion fatigue and boundaries. When you’re more self-aware, you have more room for empathy because you’re giving the same thing to your clients that you just gave to yourself. Without it, then it’s easy to get disappointed in clients because of how they’re managing their life or even feel personally slighted if they don’t grow.” 

Ingo Weigold, a licensed professional counselor at Centennial Counseling Center in St. Charles, Illinois, sees his own individual therapist regularly and has been an active member in men’s groups over the years. He says he uses his own work as a way to stay humble.

“I never want a client to think I’m above them,” Weigold says. “I want them to know I’m sitting with them, exploring with them. That I’m in the passenger seat. It’d be so easy to develop a power complex in this field because people come to us at their most fragile states and are trusting. We have to treat that as a privilege, and I believe that entails us doing our own work.”

Weigold co-hosts a podcast, Drinks ‘n Shrinks, that aims in each episode to normalize mental health practices and humanize the clinician through exchanges with licensed therapists. It would be “pretty hypocritical if we were to say we’re above the therapeutic process. Just because we’re clinicians doesn’t mean we’re not human,” he says. “We go through things just as much as the next person. That’d be like a mechanic saying, ‘I don’t believe in oil changes. Those don’t work.’”

Giordano agrees that engaging in individual therapy as a counselor can help to remove any perceived hierarchy because the reflex of facing uncomfortable emotions is already in place to be modeled for the client. “When you do your own therapy, you don’t necessarily lose countertransference. You still feel it,” Giordano says. “But then you’re not afraid of it. You can use it to help the client and the therapeutic relationship instead of projecting or going to a safer place above the client out of fear.” 

Supervision and counselor friends aren’t always enough

Marina Harris, a licensed psychologist in North Carolina, meets with a group of fellow clinicians weekly to process different cases and client dynamics. “Your self-care and support can take many different forms. Every clinician has something that works for them,” she says. “Personally, I turn to my consultation group because these are clinicians I really trust. But at the same time, it’s not the same as therapy. I support every clinician using their personal intuition of when to do their own therapy.” 

Weigold admits that his own therapy can sometimes get put on the back burner, so he makes a conscious effort to supplement it with his clinical supervision sessions. 

“Supervision isn’t therapy,” Weigold admits. “It’s a weird mix of therapy processing of clients and coaching. It’s more neutral and asking the question, ‘Why am I feeling countertransference?’ But it’s not necessarily processing. We want to be self-actualized and continue growing as we’re seeing clients and going to supervision about clients.”

Standefer expresses concern for clinicians who rely solely on supervision and for supervising clinicians who inadvertently become therapists to their supervisees. 

“Supervision has four purposes: administrative, knowledge base of cases, ethics and ensuring client well-being. Counselor well-being doesn’t fall under that list,” Standefer points out. “If we’re taking up the time in supervision doing our own therapy, all four of those parts of supervision become weakened. You lose, the supervisor loses, and the clients lose. We’re cheating ourselves if we don’t do our own work before we come to supervision.” 

“It’s very hubris[tic] and prideful for a supervisor to think that they can grossly overstate their role to be both a supervisor and a therapist to clinicians working under them,” Standefer adds. 

Giordano notes that supervision has limitations when it comes to vulnerability because clinicians can get wrapped up in protecting their self-image with colleagues. “No matter how good your supervision or consultation is, there’s always that impression management component, that piece of trying to impress a boss or colleagues,” she says. “With a therapist, you can get more real and go deeper on something a client brought up or something separate you’re going through.” 

Regardless of whether counselors turn to their own therapy or trusted confidants, it is essential for them to be in a space where they can be their authentic selves and remove any mask, Fawell says. She experienced this firsthand when suffering a personal loss. “Whatever the outlet, you’ve got to be able to be vulnerable,” she says. “When my son was killed, I spent a lot of time with someone I [could] trust.” 

Exuding therapeutic growth versus self-disclosure 

Although destigmatizing mental health is necessary in the field, Harris says self-disclosure with clients about doing individual therapy as a clinician is not always wise. 

“To me, that’s more of a case-by-case and situational basis,” she says. “We always have to ask [ourselves] with that, ‘Am I sharing this to help the client and in their best interest? Or is it for a different reason?’ One way I’ll get around that is [sharing] with my clients that skills are to be learned and there are still things I’m working on. For instance, that nobody has a perfect self-care regimen.”

Burns agrees. “We do have to be really careful with self-disclosure because it has the ability to enhance the alliance or make it problematic because a lot of the worries or concerns or judgments about therapists being in therapy come from clients who don’t know how and why that’s healthy and good for their experience. They might start probing the counselor to where you’ll have to redirect the focus back to the client. Research shows that self-disclosure is highly problematic, so it has to be in the best interest of the client.” 

Weigold says counselors’ self-disclosure of their own therapeutic work becomes unnecessary when they can “wear” it or exude it with quiet confidence and noticeable self-awareness. “Clients can feel when you’ve done your own work as compared to just reading it out of a book,” Weigold says. “Even if you don’t say anything out loud, they can feel you’ve been there or know a little bit about what they’re going through. You can show them you’ve come out on the other end or are growing in the moment. I know if I didn’t have my own therapeutic journey, I wouldn’t be able to connect with clients the way I do.” 

Fawell concurs. “When a client says to me, ‘You’re so real,’ I think that’s their way of knowing I get them. Well, I’m so real because I’ve done what they’re doing.”

Standefer says her two decades in therapy often speaks for itself through a similar form of realness. “[Carl] Jung talks about the shadow self. I feel like we can only bring out the light when we test it out in reality, dissect it and reframe it. That is not something we can teach. You have to do it yourself first, and then [clients] can feel that energy.” 

Talking about our own therapy

Standefer says that whenever she shares with students or counselors-in-training that she still sees a therapist, she experiences a “vulnerability flash.”

“Every time I say it, that I’m in counseling myself, I’m very aware of what I’m putting out there, that I’m being judged,” she says. “But I’ve come to a place where I think it’s important for the benefit of other people because it changes people’s perception of ‘she’s arrived’ to more of ‘she’s arriving.’ If I don’t express [that] I’m in therapy, then I’m subject to believing what others might project onto me. I want students to see my vulnerability in that way because it can normalize therapy in the field and encourage them to not keep their best tools in the toolkit in being their vulnerable selves.”

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Giordano says there is a macro impact when counselor leaders discuss doing their own therapy on a micro level. “It’s so important for counselor educators to talk about their own therapy,” she says. “Because not mentioning it at all then reenforces the stigma, and [students] can develop this distortion that older clinicians don’t seem to need therapy, so they can stop their own hard work while they’re being available for clients. It’s actually the opposite. Doing your own work is what empowers you to be available to clients.

“We have to get past these ideas that someone needs therapy because they’re inexperienced or having a problem. We need therapy because we’re human and this is complicated work.” 

Giordano adds that the modeling that comes from therapy has a trickle-down effect from a cultural perspective as well. “If a therapist represents a cultural group that isn’t known for going to therapy, whether that be race or gender, then the value of modeling takes on an added layer,” she explains.

Burns points out that private practices cannot necessarily mandate that clinicians do their own work, but it can be heavily implied or suggested. 

“The workplace culture matters,” she says. “Research has suggested that age isn’t a factor on whether clinicians take care of themselves with self-care. What is a predictor is working conditions in a workplace setting. That means it really does start from the top and [it] puts an emphasis on not just supervisor support but supervisor modeling and leadership with boundaries and one’s own therapy.”


Note: The author previously held professional relationships with multiple clinicians quoted in this article.



Scott Gleeson is a licensed professional counselor for DG Counseling in the Chicago suburbs, specializing in trauma and relational dynamics. He spent more than a decade writing for USA Today, where he won national writing awards from the Associated Press and NLGJA: The Association of LGBTQ Journalists. His debut contemporary novel, The Walls of Color, will be published in 2023.


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.