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COUNSELOR IMPAIRMENT AND WELLNESS
Counselor Impairment and Wellness
COUC 500 – Orientation to Counselor Professional Identity and Function
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COUNSELOR IMPAIRMENT AND WELLNESS
Abstract
Counselor impairment refers to a lack of wellness or a condition that prevents counselors from
functioning optimally, negatively affecting the therapeutic alliance and quality of counseling
services. The importance of this issue has led to the development of ethical standards, and the
American Counseling Association (ACA) established a task force on impaired counselors in
2003. The ACA code of ethics advises counselors to monitor themselves for any signs of
dysfunction resulting from physical, mental, or emotional issues and refrain from serving clients
when impaired. Counselor impairment can result from physical, emotional, psychological, social,
and spiritual factors, including burnout and compassion fatigue. These factors can compromise
the counselor's ability to provide competent and ethical counseling services, harming clients.
Ethical misconduct can result in disciplinary action. The most common ethical violations include
dual relationships, incompetence, professional misrepresentation, and sexual relationships with
clients. The study of trends in ethical violations reveals the importance of addressing counselor
impairment to avoid ethical misconduct. Developing and consistently implementing a wellness
plan can help counselors prevent burnout, compassion fatigue, and counselor impairment.
Keywords: Counselor impairment, prevention, wellness, misconduct, disciplinary action,
violation
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COUNSELOR IMPAIRMENT AND WELLNESS
Counselor Impairment and Wellness
Impairment is a condition where a person’s abilities or functioning are compromised or
reduced (Simmons et al., 2020). This condition can include mental, emotional, or physical
impairments that interfere with one’s ability to fulfill professional responsibilities, perform daily
tasks, or engage in social activities. In the context of counseling, impairment refers to any
condition that renders the counselor unable to provide effective and ethical service and
potentially causes harm to the client (Lawson & Venart, 2005). For this reason, the ACA code of
ethics indicates that counselors have an ethical responsibility to assess and monitor themselves
for impairment and stop providing services to clients until they have addressed what is causing
the impairment (American Counseling Association, 2014). Impairment usually develops over
time, and it is important to pay attention to warning signs leading to impairment. Factors that can
lead to impairment include substance abuse, personal crisis, physical illness, burnout, and
unaddressed mental health issues (Lawson & Venart, 2005). Impairment is not necessarily a
permanent condition, and it could be mitigated by implementing a proper self-care and wellness
plan.
Definition of Impairment
Counselor impairment is a serious issue that can significantly impact the effectiveness of
counseling services. Counselor impairment is defined as “a lack of wellness or a condition in
which the counselor is no longer functioning at their optimal capacity.” (Simmons et al., 2020, p.
295). The American Counseling Association (ACA) founded a Task Force on Impaired
Counselors in 2003 (Lawson & Venart, 2005). The task force defined counselor impairment as
“Therapeutic impairment occurs when there is a significant negative impact on a counselor’s
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COUNSELOR IMPAIRMENT AND WELLNESS
professional functioning which compromises client care or poses a potential for harm to the
client.” (Lawson & Venart, 2005). This condition can cause the counselor to fail to perform the
professional counseling obligations in a competent and ethical manner, and it could negatively
impact the therapeutic alliance and cause harm to the clients served. Due to the significance of
this issue, the ACA Code of Ethics stated in section C.2.g. that counselors should “monitor
themselves for signs of impairment from their own physical, mental, or emotional problems and
refrain from offering or providing professional services when impaired.” (ACA, 2014, p.9).
Counselors can become impaired for various reasons related to a lack of wellness in any
area of life, including physical, emotional, psychological, social, and spiritual (Simmons et al.,
2020). Practicing counseling in and of itself could contribute to impairment as counselors work
directly with clients with emotional and mental struggles such as depression and grief (Hunter,
2016). Dealing with those issues and the level of empathy and sympathy it takes to counsel those
challenges regularly has a residual impact on the counselor’s emotional and mental well-being
(Hunter, 2016). If counselors are unaware of or fail to address early signs of impairment, it could
lead to burnout, compassion fatigue, and even depression.
Burnout is a condition of exhaustion that drains a person’s physical, mental, or emotional
energy. The term burnout is usually associated with professional exhaustion that leads to
dissatisfaction and disappointment in one’s professional accomplishment (Simmons et al., 2020
& Maslach & Jackson, 1981). According to Maslach and Jackson (1981), burnout frequently
occurs among individuals who work in the helping profession (Maslach & Jackson, 1981). Some
aspects of burnout include emotional exhaustion, the development of negative, cynical thoughts
and feelings about the clients, and the negative evaluation of oneself and accomplishment
(Maslach & Jackson, 1981). Burnout can develop gradually due to unmanaged stress and heavy
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COUNSELOR IMPAIRMENT AND WELLNESS
work overload. One of the main reasons for counselor burnout is their lack of awareness of the
symptoms in themselves (Hunter, 2016).
Compassion fatigue also indicates signs of impairment (Simmons et al., 2020). It is the
stage a counselor can reach after burnout if not addressed (Hunter, 2016). Compassion fatigue
could be explained as burnout plus the buildup of stress caused by long-term continued
empathizing with clients (Sabo, 2006). Unlike burnout, compassion fatigue can unexpectedly
occur quickly (Hunter, 2016). This condition also can stem from a lack of self-awareness and
neglect of self-care. Among the reasons counselors ignore their need for self-care is the lack of
proper boundaries, unrealistic expectations, and high standards (Hunter, 2016). However, if the
counselor can recognize early signs of burnout and compassion fatigue and prioritize self-care,
the symptoms could be minimized (Hunter, 2016).
Impairment can also lead to secondary and/or vicarious trauma (Hunter, 2016). This form
of trauma happens when the counselor hears the clients' traumatic experiences regularly rather
than experiencing the trauma directly (Hunter, 2016). Secondary trauma is defined as “the
emotional duress that occurs from hearing first-hand accounts of traumatic experiences,” while
vicarious trauma is “the gradual building of emotional residue due to ongoing exposure to
accounts of traumatic experiences.” (Simmons et al., 2020). Vicarious trauma can lead to
symptoms similar to those experienced by clients who have directly experienced trauma.
According to Hunter (2016), impairment could also result in what he named “secondhand
depression.” Secondhand depression is defined by Hunter (2016) as “clinical depression resulting
from counseling the depressed over time.”
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Implications of Impairment
As discussed, impairment could compromise counselors' ability to provide effective and
ethical services to their clients. Thus, it has many implications that negatively impact the
counselor, the client, and the therapeutic alliance. Simmons et al. (2020) define ethics as “a set of
standards that outline what is acceptable and unacceptable human behavior in all situations.” The
counseling profession in the United States of America (U.S.) has its own set of ethical standards
that are enforced and governed by each state's licensing and certification boards and by
counseling associations like the ACA (Simmons et al., 2020). Violations of ethical standards
leading to misconduct can lead to disciplinary actions.
Ethical misconduct is any behavior that violates the counseling profession standards,
code of ethics, and state licensure laws and regulations (Even & Chester, 2013). A five-year
analysis of the most common legal and ethical issues related to disciplinary actions in 28 states
found that the most common ethical violations are dual relationships, incompetence, professional
misrepresentation, and sexual relationships with clients (Ahia & Boccone, 2017). Additionally,
the analysis indicated that the most frequently occurring violation was the failure to meet
continuing education (CE) requirements, followed by violations related to dual relationships and
unprofessional conduct (Ahia & Boccone, 2017). A study of trends in ethical violations and
resulting disciplinary actions by the Virginia Board of Counseling between 1999 and 2019 found
that the most common ethical violation committed was having sexual and romantic relationships
with clients, followed by failure to complete continuing education and legal arrest (Cowan,
2021). Dual relationships and professional impairment were also among the most common
violations in Virginia. (Cowan, 2021). The information provided through this study and/or more
recent information is not readily available on Virginia’s board of counseling website.
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Impairment Prevention
The example of flight attendants’ instructions to passengers to put on their own oxygen
masks before helping others is the best model for counselors to follow (Hunter, 2016). It is
pivotal for counselors to attend to their own well-being first to be able to help their clients. The
ACA is committed to developing intervention strategies and resources to prevent counselor
impairment and help impaired counselors through prevention and resiliency education, resources
and treatments for impaired counselors, and advocacy (Lawson & Venart, 2005).
Regular self-monitoring and self-care are among the most essential practices a counselor
should maintain (Lawson & Venart, 2005). Self-monitoring is a fundamental part of self-care
and wellness. The American Psychological Association (APA) defines wellness as a “dynamic
state of physical, mental, and social well-being.” (APA Dictionary of Psychology, 2023).
Norcross and VendenBos (2018) created a self-care checklist that included the following self-
care strategies, adhere to the ethical obligation of engaging in self-care, internalize the relational
core of the work, take a mindful moment to identify existing self-care activities desired,
prioritize self-care by schedule time for activities, develop self-empathy and self-compassion,
integrate a mix of self-care strategies, track personal renewal by maintaining a journal and
schedule consequential self-care activities every month.
Wellness Reflection and Plan
The Wheel of Wellness assessment provided me with good insight into the different
dimensions of wellness in my life. The findings indicate that my overall well-being in all six
domains of life is almost equal. All domains of life have room for improvement, especially
physical well-being. My spiritual well-being was the highest among all other domains. After
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assessing my current state of wellness and identifying the physical area as the area that needs the
most improvement, I intend to make some changes in my daily routine that promotes better
physical and mental health.
To improve my physical well-being, I will focus on increasing activities that promote
movement, nourishment of the body, and managing stress levels. My starting point is to increase
my physical activity by walking for 20 minutes at least three times weekly. The results of the
Self-Care Assessment Worksheet made me realize that I need to incorporate exercise more into
my lifestyle. One of the strategies on this assessment I would like to focus on is incorporating
dancing, swimming, and other fun physical activities into my routine. I tend to do more of those
activities in the summer than in winter, contributing to my mild seasonal depression. I will also
pay closer attention to my food choices and opt for a balanced diet that includes more fruits and
vegetables and limits processed foods, sugar, and food high in saturated and trans fats. As for
managing stress levels, I will start implementing activities like meditation, mindfulness, and
breathing exercises.
Most importantly, I need to balance better working, studying, house obligations, and self-
care time. Usually, self-care is the least of my priorities. I now realize that I need to build healthy
self-care practices starting immediately to prevent burnout and other negative implications of
stress in the future.
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COUNSELOR IMPAIRMENT AND WELLNESS
Conclusion
Counselor impairment is a serious issue that poses a potential risk to the therapeutic
alliance between counselors and clients. Identifying and addressing the factors contributing to
counselor impairment is essential to prevent ethical misconduct and promote the well-being of
counselors and their clients. Counselors must prioritize self-care, continuously monitor
themselves for signs of impairment from their physical, mental, or emotional problems, and
refrain from providing professional services when impaired. The ACA code of ethics is a
valuable guide for ensuring counselors provide competent and ethical services to their clients.
Professional counseling associations and state licensing and certification boards work together to
address counselor impairment and promote ethical conduct in the counseling profession.
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