Etiology of Client Distress in Counseling Psychology

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In my attempt to come to terms with the client’s worldview, especially in the extreme resistant scenario, I usually try to roll out with the behavior. I am convinced that there are several causes of clients’ distress that in most cases result in poor counseling outcomes. In most cases, it is relatively difficult to build a proper relationship that result in effectiveness in psychotherapy in an environment characterized by client distress (Chui et al., 2016). Since clients have the potential to change, understanding the nature of the change process is equally a critical aspect of psychotherapy. My encounter in counseling psychology has enabled me to understand the etiology of client distress and the nature of the change process especially whenever there are positive outcomes.

Whenever I am handling adolescents who are undoubtedly furious and highly resistant, I always try to accept the violent reactions without showing any form of fear or anger. In most cases, I assume that their social environment may have fostered distrust toward helpers which is the leading cause of distress. However, in the instances that I have been thrown off balance, I recall they resulted from the internal reactions that are counter transference. In cases when client’s behavior results in negative moods, they interfere with my emotional well-being, which is a prerequisite to effectiveness in counseling. In one instance, when I came out of a session, in which the client demonstrated a complete resistance, the second client pointed out that he had had enough of counseling. I was already aware of my affective state of anxiety that enabled me to validate and empower John to open up despite his experience with psychotherapists.

Meanwhile, lack of self-awareness can be a significant cause of client distress among counselors (Chui et al., 2016). Generally, client distress will result from events, which may be traumatic, for instance, loss of loved ones or physical abuse. In some cases, after giving clients room to come to terms with my presence, they open up, and immediately I realize that they are victims of interpersonal relationships. External factors, such as divorce and cultural aspects, are also common causes of client distress. In my numerous breakthroughs in understanding the origins of client distress, there are some instances when I failed to understand the client’s worldview. However, the etiology of their distress remains to be external or internal.

Clients’ experience change is a movement from one state of wellbeing to another in which they gain adequate control of themselves and the sources of distress. The change process can tend to occur in stages. In my experience, the typical change process begins in the first visit whereby the counselor-client interaction results in the discharge of distress. For instance, they may cry, shiver or yawn during the session. It is a reflection of a self-generated change, which indicates that client is the primary source of change that is experienced in the counseling sessions. In most cases, counselors allow clients to determine what best suits them, which is the basis of discussion on the appropriate paths toward their life journey (Bohart & Tallman, 2010). The change process can also be spontaneous, whereby recovery occurs without professional interventions.

In conclusion, the etiology of client distress can be categorized as internal and external while the nature of change process is self-determining as well as spontaneous. I have always tried to build a shared worldview in my counseling session to develop a relationship with the client, understand their causes of distress and instigate a relevant change process.


Bohart, A.C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. In B. Duncan, S. Miller, B. Wampold, & M. Hubble (eds.), The Heart and Soul of change: Delivering What Works in Therapy (pp. 83-111). Washington, DC: American Psychological Association.

Chui, H., Hill, C.E., Kline, K., Kuo, P., & Mohr, J.J. (2016). Are you in the mood? Therapist affect and psychotherapy process. Journal of Counseling Psychology, 63(4), 405-418.

January 19, 2024

Life Psychology


Emotions Experience

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