Unspoken Expectations: Why Military-Connected Clients Sometimes Lose Trust in Counseling
By Nicole M. Arcuri-Sanders, Ph.D., ACS, LPC-S, LCMHC-S, LPCC, LPC, BC-TMH, NCC, SAC
Counselors are trained to build rapport through empathy, curiosity, and clinical skill. Yet when working with military-connected clients, many clinicians unknowingly encounter a hidden barrier, unspoken expectations.
Service members, veterans, and military families often enter counseling assuming that me
ntal health professionals understand the systems shaping their lives (e.g., military law, documentation, confidentiality risks, and the broader culture of service). When clinicians unintentionally demonstrate unfamiliarity with these systems, trust can erode quickly.
For counselors across South Carolina and beyond, particularly those practicing in communities with strong military ties, understanding these dynamics is essential. Cultural competence with military populations requires more than awareness of values such as discipline, loyalty, or hierarchy. It also requires systems literacy.
Military Culture Is More Than Identity
Military culture is often described in terms of identity, language, and values. While these elements matter, they represent only part of the picture. Military culture is deeply embedded within bureaucratic systems, documentation processes, and legal frameworks that govern the lives of service members and their families. These systems influence where individuals live, how their careers progress, what healthcare they can access, and even what they feel safe disclosing in counseling.
For example, service members operate under the Uniform Code of Military Justice (UCMJ), a legal system that applies 24 hours a day. Certain behaviors that may not carry legal consequences in civilian contexts can have disciplinary implications under military law. As a result, service members may worry that discussing topics such as substance use, relationship conflict, or emotional distress could potentially affect their career, deployment status, or security clearance.
From the clinician’s perspective, these concerns may appear exaggerated. From the client’s perspective, however, they often represent reasonable risk management.
Why Military Clients Sometimes Seek Civilian Clinicians
Many active-duty service members and veterans intentionally seek counseling outside of military healthcare systems. Some even choose to pay out-of-pocket rather than use insurance (i.e., TRICARE). This decision is rarely about avoiding treatment. Instead, it often reflects concerns about confidentiality, documentation, and career implications.
Military clients may wonder:
Will this conversation appear in a record my command can access?
Could a diagnosis affect my deployability or promotion?
Could seeking help signal that I am unfit for duty?
Even when these fears are not fully accurate in a specific situation, the perception of risk can shape how clients approach therapy.
If clinicians dismiss these concerns, even unintentionally, it can damage the therapeutic alliance. Statements such as “That wouldn’t happen in civilian counseling” or “Mental health care won’t affect your career” may minimize the client’s lived experience. Instead, culturally responsive clinicians acknowledge the reality that military systems operate differently. A simple response such as “Many service members have questions about how counseling records work. Let’s talk through what applies here” can significantly increase trust.
Documentation Is Not Just Paperwork
One of the most overlooked aspects of military cultural competence involves documentation.
For many military-connected clients, documents are not simply administrative records. They are gateways to benefits, healthcare, and identity. Consider the DD-214, the official certificate of release or discharge from active duty. This document is required to access VA healthcare, education benefits, veteran hiring preferences, and other resources. Errors or missing information on a DD-214 can delay or block these benefits.
Other documents, such as service records, deployment orders, or Leave and Earnings Statements (LES), can affect housing allowances, disability claims, and financial stability. As a result, clients may enter counseling with intense stress related to documentation issues. If clinicians treat these concerns as minor administrative frustrations, clients may feel misunderstood.
In reality, what appears to be “paperwork stress” may represent fear about losing access to stability, identity, or care.
The Emotional Weight of Military Legal Preparation
Another area where misunderstanding can occur involves military estate planning.
Service members are frequently encouraged, or required, to complete legal documents before deployment. These may include wills, beneficiary forms, medical directives, and family care plans.
In civilian contexts, creating a will is often associated with older adulthood or serious illness. In the military, however, young service members in their late teens or twenties may be required to complete these documents early in their careers. For many individuals, this process represents their first serious confrontation with mortality. Clinicians unfamiliar with military practices may mistakenly interpret these documents as signs of suicidal thinking or psychological distress. In reality, they are often routine aspects of military readiness. Understanding this context allows counselors to explore the emotional meaning behind these experiences without pathologizing them.
Stigma and Help-Seeking in Military Communities
Research consistently shows that stigma remains a barrier to mental health care within military populations. Military training emphasizes resilience, endurance, and mission readiness. These values serve important purposes within operational environments but can also contribute to a perception that seeking help signals weakness.
Service members may fear:
Being perceived as unreliable
Losing security clearances
Being removed from leadership roles
Being deemed unfit for duty
These concerns can lead individuals to delay treatment, minimize symptoms, or terminate counseling prematurely. Understanding these dynamics helps clinicians interpret guardedness not as resistance, but as adaptive behavior shaped by military culture.
Avoiding Common Clinical Missteps
Even well-intentioned clinicians can unintentionally undermine trust. Several common statements frequently create barriers in military counseling contexts.
Examples include:
“Your command won’t care if you’re just anxious.”
“Mental health treatment can’t affect your career.”
“You’re being overly cautious.”
“Why don’t you just use your insurance?”
Although these responses may aim to reassure clients, they can inadvertently signal that the clinician does not understand military systems.
More helpful responses emphasize transparency and respect:
“Your caution makes sense given the system you work within.”
“I want to explain confidentiality and documentation so you can decide what feels safest.”
“Many active-duty clients have similar concerns. Let’s talk through them.”
These statements validate the client’s reality while maintaining ethical clarity.
Ethical Implications for Counselors
Working effectively with military-connected clients is not simply a matter of cultural curiosity, it is an ethical responsibility. The ACA Code of Ethics emphasizes several principles relevant to military populations, including informed consent, cultural responsiveness, and respect for confidentiality. When clinicians fail to understand the systems influencing their clients’ lives, they may unintentionally violate these principles. Ethical practice requires more than interpersonal skill; it requires awareness of the broader contexts shaping client experiences.
For counselors who are unfamiliar with military systems, humility and consultation are critical. Clinicians do not need to become experts in military law or benefits administration. However, recognizing when these systems influence counseling and knowing where to refer clients for additional support can strengthen ethical practice.
Moving Toward Military Cultural Competence
Across the United States, communities continue to face shortages of mental health professionals with training in military cultural competence. As a result, many military-connected clients struggle to find clinicians who understand their experiences. Counselors can help address this gap through education, collaboration, and advocacy. Resources such as the military counseling competencies provide helpful guidance for clinicians seeking to expand their knowledge.
Ultimately, cultural competence in military counseling involves three key principles:
Respect the systems shaping clients’ lives
Recognize that caution is often rational, not resistance
Practice transparency around confidentiality and documentation
When counselors integrate these practices, they create safer therapeutic environments for military-connected clients and their families.
A Final Reflection
Many military-connected clients enter counseling carrying invisible questions:
Does this clinician understand the world I live in? When counselors demonstrate cultural humility and systems awareness, they answer that question without needing to say a word.
Trust grows when clinicians acknowledge the realities of military life: its structures, its pressures, and the profound responsibilities carried by those who serve. By expanding our understanding of military systems and experiences, counselors can better support the individuals and families who have served our nation.
Author Biography
Dr. Nicole Arcuri-Sanders, Ph.D., ACS, LPC-S, LCMHC-S, LPCC, BC-TMH, NCC, SAC, is an Associate Professor of Counseling and Program Coordinator for the Counselor Education Program at Coastal Carolina University. A licensed clinician, supervisor, and board-certified telemental health provider, she has extensive experience providing counseling and supervision across diverse clinical settings.
Dr. Arcuri-Sanders has developed a focused area of expertise in working with military-connected populations, including service members, veterans, and their families. Her work examines the intersection of military culture, systems awareness, and counselor preparation, with an emphasis on improving access to culturally responsive mental health care for this population. She has conducted research, published peer-reviewed scholarship, presented nationally and regionally, and contributed to advocacy efforts aimed at strengthening counselor education and training related to military populations.
In addition to her clinical and scholarly work, Dr. Arcuri-Sanders has contributed to curriculum development, counselor training initiatives, and program development focused on military cultural competence, helping prepare counselors to ethically and effectively serve military-connected clients in community, clinical, and educational settings.
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