Key considerations for those of us working to support others.

Because it has been considered that therapy is unlikely to cause harm, the field of counselling psychology has lagged in some of the oversight, regulation, and best practices that could raise the bar for our field.

The aphorism, ‘first do no harm’ is familiar in medicine, but counselling and psychotherapy is only belatedly treating harm as a real possibility. A 2019 meta-synthesis of client experience found that although a small proportion of clients (5-8 %) report worse outcomes, the field had done ‘little quantitative research’ into adverse outcomes.

In short: oversight frameworks that guide other health-professions (statutory regulation, mandatory supervision, adverse-event monitoring) remain underdeveloped in counselling and psychotherapy at the moment. This regulatory lag leaves gaps in safeguards that could protect clients and points to the need for more systematic attention to harm, accountability and best practices. Fortunately, the BC Association of Clinical Counsellors (BCACC)  is pursuing regulatory processes as we speak.

Though counsellors don’t wield a scalpel or provide pills (heaven-forbid!), any of you who’ve had the experience of missed attunement, or non-belonging, or felt yourself drop catastrophically to the floor when not caught in an emotional trust fall will know: it is not true that counsellors cannot do harm. In fact, the psychological wounding that can occur when we feel alone in our vulnerability is exactly what compels most of us to seek support from a counsellor in the first place. I spend much of my time as a Registered Clinical Counsellor (RCC) helping my clients heal not from the scarring of physical wounds, but from exactly this type of pain: the all-too common human experience of feeling alone in our pain.

I learned the hard way how wrong this can all go. Get ready for this irony:  I was harmed as a student in counselling school—in my group therapy class, with my instructors looking on. From the outside, it wouldn’t have looked like much. I shared something vulnerable with the group in response to the instructors’ prompt.

“I’m afraid I might have made a huge mistake. I’m not sure I belong here,” I disclosed.

The woman next to me dove in, 

“Well, I feel great here!”

No big deal. She just didn’t feel the same way I did. Except nobody else spoke to what I had shared. And that left me feeling naked in the group, alone, overwhelmed, and abandoned in my pain and in my sharing. And that feeling shot me straight back into the bathroom stall I’d had to hide in when I’d felt so belittled by the bullies who targeted me at age 13. The thing is, this moment, or the mechanism of injury (if I were to bring in my training from first aid) would likely be invisible to the untrained eye. In fact, it was missed by several professionals in the room whose job it was to prevent things like this from happening. It wasn’t just what happened at that moment. It was what didn’t happen. In my moment of exposure and vulnerability, nobody stepped forward to say, “I’m here, I see you, and you’re not alone in your experience. Let’s talk.” And so, I was left standing alone in the circle, reliving an already painfully familiar experience of missed connection and non-belonging in a group. This, and other experiences of moments like this going wrong in groups has guided my practice.

Side note: our nervous systems interpret this experience of non-belonging as a threat to life. In our ancient past, being left behind by a group would mean certain death. Our hardware has yet to evolve beyond this.

To illustrate my point, I’ll use the metaphor of trust falls. This is a standard group trust-building activity used often in outdoor settings, in which the group follows a series of increasingly risky progressions, building up to having an individual stand on a raised platform and lean back, arms folded across their chest, falling into the hands of their waiting peers. You can imagine what happens if the group isn’t ready to catch the person, can’t you? The individual could crash to the ground, facing injury, and also learn, or reinforce an existing belief or fear, that others are not to be trusted: the exact opposite of your intent as a facilitator. 

When done well, slowly, and with gently and gradually increasing intensity however, an activity like this can go a long way towards increasing the level of trust, cohesion and safety within a group and its individual members. You see where I’m going with this? This example, drawn from my time in outdoor leadership and as an adventure guide, highlights quite simply why we as leaders, must not engage in trust exercises and inviting vulnerable openings, unless we are nearly positive that both we, and the group we’re working with, have the capacity, resources and strength necessary to catch any participant who leans into the arms of the group. We have to both train the group to catch one another, and to be ready when they miss. This is our job.

So despite the fact that my degree was in Wilderness Therapy, led by therapists and outdoor guides who should know better, when I shared my fears in our circle, they all missed a critical moment in my trust fall. Nobody caught me, and I crashed to the ground. 

Again, this sounds small. But it’s not. I spent years healing from and renegotiating the above experience. Not because of that moment, but because it reopened a wound that was already there. And look, I’m a straight, cis, White woman with a lot of privilege. Just imagine how a missed trust fall like that would have (and did) go for my queer Black classmates. 

With great power comes great responsibility.

You might be wondering whether this conversation is only for professional counsellors. The truth is, many people outside of counselling — such as life coaches, wellness practitioners, or other helping professionals — also work with clients who carry trauma, whether or not they realize it.

Unlike counsellors, who receive formal training in ethics, boundaries, and trauma-informed practice as part of their professional education, coaches and other practitioners may not have these safeguards built into their work. This doesn’t mean they can’t help. But it does mean that if you’re practicing in one of these fields, it’s essential to seek out specific training in trauma-informed care — or at the very least, learn to recognize the signs of traumatic activation and know when to refer a client to a licensed professional. Check out our blog post here on key differences between coaching and counselling.

For potential clients, this is also important to know: not every “helper” you encounter will be trained to respond ethically to trauma. Asking about a practitioner’s training, scope of practice, and approach can help you make an informed decision about the support you’re seeking.

While becoming better, kinder, more empathetic listeners is a critical first step towards ultimately catching one another when we fall and to decolonizing practices, like the practice of therapy (Let’s all read Jennifer Mullan’s fantastic book Decolonizing Therapy!) we also need to really know and understand the terrain we’re stepping into before we attempt to bring others there with us. When I was an outdoor guide, this meant studying the weather and the maps, planning our route and itinerary and both packing and preparing for any challenges we may encounter on trail (ie. carrying a first aid kit, inclement weather gear, bear spray, etc. Of course, I also spent years training beforehand to both create conditions for safety, and to be prepared to manage anything that might go wrong. Now that I am a wilderness therapist, I do all the same preparation for the physical journey ahead, and engage the same level of preparation and presence for the emotional landscape we will explore together. When we show up with our clients - or whenever we gather people together to do any form of emotional healing work - we are responsible for preparing, tracking, and responding to any emotional safety needs that might arise along the way.

First, those of us in positions of leadership need to recognize that we are in positions of power. Unfortunately, all too often, we don’t. For example, how many of us regularly remember each time we’re in the presence of children, that as adults, we hold the power? Our words and our actions carry weight. How many of us recognize that in the current Capitalist, colonized, patriarchal, White supremacist culture in which we’re all steeped, that if we are White, we inherently hold power? That if we hold settler-privilege, we hold power? That if we’re a man, we hold power? That if we are White, straight, or cisgender, we hold power? On and on it goes. Those identities privileged by our society have the power. My personal favourite resource on this at the moment comes from the field of Hakomi therapy and is a training called Right Use of Power. The Right Use of Power course invites participants to explore how to use personal and professional power with humility, clarity, and care—learning to navigate influence and responsibility in ways that foster trust, safety, and authentic connection.

Why does this matter for us as coaches, counsellors, teachers, medical practitioners, leaders, group facilitators, or professionals of any kind? Well, if we are the ones who have gathered a group, or have stepped into the facilitation role, we hold the power in relation to the participants. Imagine now if we are to overlay this with other intersecting identities of age, race, sex, sexuality and gender. The power dynamics in the room can become quite complex, and it is our job to understand them. This means that not only are we responsible to keep things on time and on track and to deliver upon what we’ve promised, but that it is also incumbent upon us to oversee the physical and emotional safety not only of the group, but of each individual within the group (which intersect, but are not necessarily the same thing). While it is always fair to recognize that we don’t know what we don’t know, ignorance is not an excuse, especially when there is power in the balance. So, thank you for being here, and thank you for reading on, my friends!

Coaching or counselling, which path to choose?

Personally, much of my drive to attend counselling school was that I’ve long been interested in supporting folks in finding their purpose and connecting to their calling. 

This desire guided me to seek out a few life coaches of my own over the years, who despite their best efforts, in all but one case unfortunately either went outside their scope of practice.  Numerous folks shared their opinions on medication, or the advantages of specific nutrition and exercise regimens, which not only wasn’t their area of expertise, but aligned with the part of me that felt flawed, or that I was doing something wrong and had to work harder, try harder, and pay more.

Two of the practitioners I saw breached confidentiality. In one case somebody walked into the room during my session and the coach denied that it had happened. In another, a practitioner shared that she’d been working with me with her personal network—I learned about this when somebody in her network reached out to tell me.

Other coaches missed safety and suicide assessment cues at critical moments when they should have referred me to trained healthcare practitioners.

These experiences led me to choose counselling as a field of study, such that I could build the competence, knowledge, and a backpack of skills to safely guide folks through emotional terrain, and to really understand my scope of practice, before setting out on a career as a helping professional. As it turns out, I loved counselling, so I left the idea of coaching behind and have been working as a nature-based counsellor and mentor ever since. 

This world is desperate for healing, and for connection. So, regardless of our titles, let’s link arms, and do this potent work as well as we possibly can, together. In this increasingly polarized world, let’s see and hold our clients and our communities in their strength. And, even as we hold them gently in their pain points, let’s honour and celebrate their resilience, their resourcefulness, and their post-traumatic growth.

I feel no greater joy and sense of support than being able to refer a client on to another practitioner I trust who can support the next leg of their journey even better than I, and to offer the same widening rings of support to my fellow healers and practitioners.

So here’s what I have to offer, having lived this both professionally and personally:

Too much too fast is where people get hurt. It NEVER hurts to decrease the pace or the intensity. But it certainly can (and often does) go wrong in the other direction. As adrienne maree brown puts it in her brilliant book Emergent Strategy, we must “move at the speed of trust”. For us as counsellors, that means we have to stay in contact with our client throughout the experience. This is a hard thing to learn, but includes tracking both verbal and non-verbal cues, which are often very subtle, and checking in regularly. In Hakomi therapy,  this is called “tracking”. In other somatic approaches, one might be trained to look for subtle cues like a shift in the prosody of the voice, difference in the gaze, or a slight colour change in the face.

What this could look like:

Before diving into a heavy topic:
“Let’s take a moment to check in—how is your body feeling right now before we continue?”

→ Why it helps: This pause invites somatic awareness and gives the client space to notice overwhelm before it escalates, helping to prevent re-traumatization.

After a client shares something intense:
“Take your time—there’s no rush. We can sit with that for a moment if you’d like.”

→ Why it helps: Slowing the pace allows emotional processing and helps the nervous system settle, reinforcing safety, presence and connection to self and the other.

Know what your scope of practice is and stay within it. If you run into something you’re not trained or qualified for, acknowledge it and bring in someone who is, you’re not alone in it out there! There’s great wisdom in acknowledging the edges of our competence. And, of course, other practitioners will always be honoured to receive our referrals.

What this could look like:

When a client brings up complex medical or diagnostic questions:
“That’s a really important issue—and it’s outside my scope as a counsellor. I’d recommend speaking with your doctor or a specialist, and I’m happy to support you in preparing for that conversation.”

→ Why it helps: This models professional boundaries and protects clients from misinformation, while still offering emotional support and validation.

Noticing personal discomfort or unfamiliar territory in a session:
“I want to be transparent that this is getting into an area that’s beyond my training. Would it be okay if we explored a referral to someone with expertise in this?”

→ Why it helps: It prioritizes ethical care, reduces the risk of harm, and affirms the client’s right to receive the best support possible—even if that means bringing someone else in.

We all make mistakes. Own your mistakes and address them as soon as you’re able to do so from a calm place, with your nervous system regulated, in service of the person who was hurt. This can take time. If you feel unsure about something that happened in a session, you could seek supervision, journal about it, and do some grounding practices to get yourself to the point where you can address things from a healthy, curious, and non-defensive stance with your client. Do you know how far it would have gone for me if one of my teachers had approached me that evening after I shared in the group that I felt I didn’t belong?

What this could look like:

After unintentionally interrupting or misattuning to a client:
“I realize I spoke over you just now—I’m sorry. What you were saying matters. Can we go back to that?”

→ Why it helps: Timely repair rebuilds trust and signals that the relationship is safe enough for honest, mutual connection—even when there are ruptures.

When a client or participant seems withdrawn or activated after something you’ve said or something that has taken place:
“I noticed a shift just now. If something I said didn’t land well, I’d really like to check in and make space for that.”

→ Why it helps: Repair acknowledges the impact of missed attunement without defensiveness, which helps the client feel seen, respected, and emotionally safe.

Thank you so much for taking the time to read my thoughts on the sacred nature of our healing work, and on doing it well. Please be in touch with further thoughts you may have on this topic and others, such that we may link arms and grow our own competence and capacities, as we raise the bar together. 

Forever curious, forever learning,

We’re building something different over here for healthcare providers who feel overextended, exhausted, or burnt out. If you want to work differently, in greater integrity with your values and your wellness, this is a space for you. We’re creating and calling in a community rooted in the wisdom of the Earth, nervous system science, right relationship and reciprocity, and radical sustainability. Our new offerings will invite slower, deeper, more honest and aligned ways of working—together. If you want to raise the bar on ethical practice in Canada, increasing joy, decolonizing practices and working in community with like-minded others, this is a space for you. Join our pre-launch list to be the first to learn about and be invited in to this countercultural space for healing, reflection, and regeneration. This is the future of practice.

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