Nine Dilemmas Counselors Face
Judgment calls can make a difference.
Posted Aug 06, 2019
A counselor’s effectiveness depends significantly on the ability to make good judgment calls. I’ve found these dilemmas to be especially important and common:
Should you work with this client?
Even if you’re working in an organization rather than in private practice, you should retain some discretion over whether you should accept a client. Even if you’re desperate for clients, do remember that a life hangs in the balance, and from a more pragmatic perspective, a client who is deeply dissatisfied with you can cause you more trouble than they're worth.
Just ask yourself, “Do I believe I have a reasonable chance of helping this client, enough to justify his or her time and perhaps money?”
Also, ask yourself that before you decide whether to invite the client to have another session. Your suggestion could range from, “We’re doing well. Want to make another appointment?” to “I’m not sure we’re a good fit. Why don’t you go home and think about whether you’d do better with someone else?”
Speed vs. thoroughness
The effective counselor recognizes that one approach does not fit all. Within the bounds of what you think will be helpful, consider whether or not a client would end up most satisfied with a quick, action-oriented approach, as is common in cognitive-behavioral therapy. Or would the client be better off with a thorough exploration of what has made the client who they are today as preliminary to working on action steps?
How directive to be?
You’ll want to spend much of the session time in listener/facilitator mode with certain types of clients.
- Ideationally fluent—that is, they readily come up with solutions to their problems.
- Defensive, likely to "yes, but," and feel antipathic to your suggestions.
- When you have limited domain expertise compared with the client: for example, your career counseling client is a data scientist.
- When clients explicitly or implicitly make clear that they want you primarily as a sounding board.
You may want to be more directive with other clients, notably:
- Those who aren’t ideationally fluent.
- Those who not only ask, but you sense really want your suggestions. Of course, offer suggestions tentatively and tactfully, for example, “I’m wondering if X might work. What do you think?”
- When you have more expertise regarding the client’s problem than they do.
Should you interrupt?
Clients vary in their desire and tolerance for being interrupted. For example, long-winded, discursive clients may welcome you reining them in and getting them back on topic. Other clients should rarely be interrupted; for example, those you sense are developing their thoughts as they speak.
Also, there are cultural considerations. In some cultures (New York and Israeli Jews come to mind), interrupting is not only accepted but appreciated as core to an efficient, dynamic conversation. In most other cultures, however, interrupting is seen as rude. That said, even in such a culture, you may decide, in a given situation, that the benefit of interrupting is worth it. As I said, these are judgment calls.
When a client wants to revisit past trauma
It’s sometimes helpful to revisit even well-trod territory regarding a person’s traumas, from an abusive parent to a firing that the client perceives as unfair. But a client may believe they're ready to take steps forward. The counselor can decide whether to revisit simply by asking the client, for example, “Do you think it will be more helpful for us to revisit that past trauma, or do you feel ready to identify and then take baby steps forward?”
How much should you deviate from probabilistic thinking?
Everyone, even end-stage cancer patients, wants hope. So, usually, it's wise for the counselor to err modestly toward optimism. Of course, that doesn’t mean encouraging long-shot dreams (like a lackluster person who wants to try to get rich by becoming the next Oprah) without a discussion of the probability of even partial success relative to the opportunity cost: what the client could have been doing with the time and money.
But occasionally, the counselor would be wise to lead a clear-eyed discussion of the probabilities. That’s especially true when the liabilities of pursuing a goal are great. I recall a client who, at 49, quit a job he liked as a professor so he could become an orthodox rabbi. With the job market poor for rabbis and the required training being six expensive years, I felt that encouraging probabilistic thinking was the right approach. (In fact, however, he ignored the probabilities and is in rabbinical school.)
How enthusiastic should you be?
I posit an unproven theory that there’s a relatively fixed amount of energy in the dyad when discussing an idea. The more enthusiasm displayed by the counselor, the less that’s left for the client—It makes the client feel less ownership of the idea. So normally, I default to neutrality or mild enthusiasm. On the other hand, if a client is despondent, an extra dollop of enthusiasm might be needed to give the client the aforementioned important hope.
Confrontation is generally the nuclear option—It risks destroying the client’s self-esteem and trust in you. Yet confrontation should remain in the advanced practitioner's toolkit. There are instances with some clients in which “support” and non-judgmental listening have yielded only reinforcement of undue complacency and self-absorption.
A common example is a client who blames everything on external factors and takes little or no responsibility for their failures. It can be especially ticklish if they blame their failures on today’s hot-button factors: race, ethnicity, and gender.
One way to mitigate at least some of the risk is to say something like, “Are you willing to try a little game?”
They usually agree, at which point, I’ve said something like, “Instead of being your mild-mannered career counselor, I’m going to turn into a dictator. No nicey-nicey counselor talk. Straight talk. OK?”
If they say yes, I confront them with what I think they need to hear, straight-up. I do so in a completely different tone—aggressive. After I’ve said it, I revert back to my counselor's voice and say, “Of course, that wasn’t really me. What would you say to the dictator?”
Usually, the client says that the dictator is right, and that moves us into a fairer-minded discussion of what the next steps should be.
Shake hands, hug, wave, or just say good-bye.
It’s generally safest to shake hands, wave, or just say good-bye unless the client says, “Can I give you a hug?” or at least extends arms, when it’s probably safe to give a two-second hug in which only shoulders touch, no breasts, no pelvis. While this is probably true across genders, in today’s #MeToo era, it may be especially true for a male counselor and female client.
That said, there is the rare situation, usually after multiple sessions, by which time trust has been established when especially after a challenging or unusually rewarding session, even a man might initiate said brief, clearly non-sexual hug.
Of course, different counselors in different situations may well make different decisions or identify different key dilemmas. But these are some dilemmas I try to stay conscious of that I believe help make me more effective.
I read this aloud on YouTube.
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