Although the problem of impaired professionals has been with us for as long as professionals have been so designated, this article considers potential harm to clients and the profession's obligation to monitor its members and provide appropriate rehabilitation. Definitions of distress and professional impairment are discussed, as are the indicators of impairment.

This study examined the relationship between client presession level of distress and client rating of the effectiveness of individual counseling sessions. Results of this investigation suggest a need for caution when interpreting client ratings of the effectiveness of counseling services. Preexisting client conditions may significantly influence the client ratings, independent of the effectiveness of the counselor.

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