Gaining universal clarity on what is meant by the term "impaired" is essential. The task force on impaired counselors has developed the following working definition of counselor impairment to guide our work:
"Therapeutic impairment occurs when there is a significant negative impact on a counselor's professional functioning which compromises client care or poses the potential for harm to the client. Impairment may be due to:
- Substance abuse or chemical dependency
- Mental illness
- Personal crisis (traumatic events or vicarious trauma, burnout, life crisis)
- Physical illness or debilitation
Impairment in and of itself does not imply unethical behavior. Such behavior may occur as a symptom of impairment, or may occur in counselors who are not impaired.
Counselors who are impaired are distinguished from stressed or distressed counselors who are experiencing significant stressors, but whose work is not significantly impacted. Similarly, it is assumed that an impaired counselor has at some point had a sufficient level of clinical competence, which has become diminished as described above."
This definition highlights the reasoning behind the development of wellness education. By definition all counselors are on the spectrum from "well" to "impaired" at any point in time. Estimates of the prevalence of mental and emotional disorders in the American population cluster around 21% (US Surgeon General, 1999) and it is believed that counselors may in fact be more vulnerable for a number of reasons (Figley, 1995; Grosch & Olsen, 1994). As such, it would be useful for counselors to know what places them at risk for progressing along the spectrum and to better equip them with activities and strategies that promote health.
Other Relevant Definitions
Compassion fatigue:"A feeling of deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the pain or remove its cause." It is described as the "emotional residue of exposure to working with the suffering" (Figley 1995).
Vicarious traumatization:A cumulative process of change in the helpers' inner experience that happens through empathic connection with clients. The concept is applicable even when clients are not disclosing personal histories of trauma; in the process of connecting with clients, we are connecting with their pain, and our empathy with that pain has an impact. (Saakvitne, Pearlman & Staff of TSI/CAAP, 1996).
Burn-out:"A state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding situations." (Figley 1995). Current literature typically attributes burnout to the work environment, context or job choice. It is seen as cumulative, and, frequently, a vacation or job change helps considerably.