351 – Moral Injury in Therapy

Counselling, Class and Politics - Linking Theory to Practice In Episode 351 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly take us through this week’s three topics: Firstly, in ‘Ethical, Sustainable Practice’, they explore the concept of moral injury in therapy - how it shows up in the therapy room and how to work with it ethically and compassionately. Then in ‘Practice Matters’, Rory speaks with counselling student and writer Nell Ash, whose upcoming book addresses how class and politics influence both therapy and training. And finally, in ‘Student Services’, Rory and Ken discuss how to link theory to practice - bridging what you learn in the classroom with what happens in real-life therapy sessions. Moral Injury in Therapy [starts at 03:06 mins] Rory and Ken explore moral injury in therapy - a hidden, yet powerful emotional wound that often emerges in counselling work. Some main points: Moral injury occurs when individuals act in ways that go against their own values, often under pressure or in crisis. Recognised in the DSM as related to PTSD, but not considered a disorder in itself. It can originate from external impositions (e.g. institutional decisions) or internal choices that evoke shame or regret. Clients often don’t present moral injury directly - it may be masked by anger, withdrawal, or self-condemnation. Therapists must use patience, trauma-informed approaches, and supervision to support clients experiencing moral injury. Key interventions include validating the experience, reframing, normalising responses, and helping clients reconnect with their values. Counselling, Class and Politics [starts at 28:27 mins] In this week’s ‘Practice Matters’, Rory speaks with Nell Ash, a trainee counsellor and writer exploring class as an often-ignored factor in therapeutic work. Key points of this discussion: Nell’s forthcoming book is the first since Ann Kearney’s 1996 work to tackle class and politics in therapy. Class is often defined economically, but Nell argues it is deeply cultural and emotional - shaping how people relate, express, and seek support. She highlights how counselling models often reflect middle-class values, which can alienate working-class clients. The conversation critiques therapeutic "saviourism" and urges a move toward greater class awareness and inclusivity. Humour, family dynamics, and language use in working-class communities are often misunderstood or pathologised in therapy. Nell’s project advocates for broader training perspectives and more accurate “mirrors” for clients from diverse class backgrounds. Linking Theory to Practice [starts at 00:55:00 mins] Rory and Ken share guidance for students working to apply counselling theory in real-life client sessions. Main points for this section: Theories offer helpful frameworks, but clients won’t always present in textbook ways. True understanding of theory often deepens during and after client work - not just in the classroom. Assignments and supervision benefit from using theory as a vocabulary for reflecting on client material. Clients are not research subjects - focus on the person, not fitting them into a theoretical model. Theory should support, not override, therapeutic presence and attunement. With time and experience, theory becomes an integrated part of practice rather than a separate concept. Links and Resources Nell Ash's Instagram Class Therapy Counselling Skills Academy Advanced Certificate in Counselling Supervision Basic Counselling Skills: A Student Guide Counsellor CPD Counselling Study Resource Counselling Theory in Practice: A Student Guide Counselling Tutor Training and CPD Facebook group Website Online and Telephone Counselling: A Practitioner’s Guide Online and Telephone Counselling Course