Fear of Making the Wrong Call: A Clinician’s Silent Companion

By Hanouf Alahmari, MA, LMFT

Licensed Marriage and Family Therapist in California and licensed Senior Specialist in Clinical Psychology in Saudi Arabia

Even after years in the field—sitting with clients navigating crisis, trauma, and deep emotional pain—one fear has a way of lingering, quietly, behind the scenes:

“What if I get it wrong?”

This fear doesn’t mean you’re unqualified. Often, it signals something else entirely: a deeply ethical, emotionally attuned clinician who understands the weight of human life. Especially with high-risk clients, the stakes feel enormous. And while we know healing isn’t something we can control or force, our nervous systems often don’t register that logic in the moment.

Common Scenarios That Fuel This Fear

1. The Client Who Minimizes Risk at Intake - You conduct a thorough intake. The client denies suicidality. Days later, they disclose intrusive thoughts—or a recent attempt. You replay that first session in your head, wondering what you missed.

2. The Client Who Cancels in Crisis - You sense emotional instability. Then comes a last-minute cancellation. You’re caught between respecting the client’s autonomy and sensing an unspoken urgency. Hours pass. No update. The “what-ifs” begin.

3. The Nonlinear Nature of Healing - A client who has made stable progress suddenly spirals. You find yourself questioning: “Did I miss a warning sign? Was there something in my tone? Did I push too fast?”

4. The Emergency Room Dilemma - You’ve developed a solid rapport, and the client trusts you—but today, they express active suicidal ideation but with no clear plan or intent. You sit with the heavy decision: do you initiate hospitalization and risk rupturing the relationship, or wait and risk too much?

What I Remind Myself and Others

The goal isn’t to eliminate fear. It’s to relate to it differently.

We are trained to assess, to document, to intervene—but we are not fortune-tellers. Even the most well-trained clinicians cannot predict outcomes with certainty. The mind is complex. 

Trauma is unpredictable. Suicidality ebbs and flows. And healing does not follow a manual.

Here’s what matters:

• That you showed up with presence, cultural sensitivity, and attunement.

• That your actions were grounded in ethical, legal, and trauma-informed care.

• That your documentation reflects your clinical reasoning, not just your conclusions.

• That you continue to reflect, seek feedback when needed, and stay open to growth.

Practical Approaches to Soften this Fear

Use Collaborative Language Early and Often - Move away from yes/no questions like “Are you suicidal?” and invite nuance:

• “When you feel overwhelmed, what kind of thoughts show up?”

• “What do you usually do when life feels unbearable?”

These questions help regulate shame and allow space for ambivalence—a common experience in suicidality that clients may be afraid to name.

Document Clinical Rationale, Not Just Risk Level - Risk level labels alone (e.g., low/moderate/high) don’t capture the full picture. Your notes should also include:

• Client’s protective and risk factors

• Cultural beliefs about death, coping, and meaning

• Emotional tone, body language, and shifts in affect

• Clear reasoning for your decisions (e.g., why you chose not to hospitalize)

This protects you legally, ethically, and emotionally—because it reinforces that your decisions were intentional, informed, not impulsive.

Consultation Is a Clinical Intervention

Make peer consultation a routine, not a rescue. Your brain in isolation will spiral. Supervision and team support are not just good practice—they’re an antidote to clinician fear and shame.

Separate Outcome From Responsibility

This part can feel brutal. Especially if you care deeply.

But a client’s actions—even tragic ones—do not automatically mean you failed. Your responsibility is the process: Did you provide care that was rooted in best practices, cultural humility, and trauma-attuned principles?

If the answer is yes, then you showed up with integrity.

A Personal Note to Fellow Clinicians

I’ve walked with clients through some of the most fragile, painful moments of their lives.

I’ve had cases that kept me awake at night.

I’ve questioned myself more times than I can count.

And through it all, I’ve come to believe this:

There is no such thing as perfect clinical judgment. But there is such a thing as integrity, presence, and attunement.

That’s what your clients will remember—even if they never say it.

Let your fear be your compass—not your captor. It means you care.

It means you’re connected.

And it can lead you to more compassion, not just for your clients—but also for yourself.

About the Author

Hanouf Alahmari, LMFT, is a bilingual (Arabic & English) therapist licensed in California and Saudi Arabia. She specializes in healing trauma, attachment wounds, and relational challenges, providing evidence-based, culturally attuned care to support lasting emotional well-being.

Hanouf is available for speaking engagements, podcast interviews, and panel discussions on trauma, attachment, mental health, and healing in Middle Eastern, North African (MENA), and Muslim communities.

For collaborations and inquiries, contact hello@trueselfpractice.com

هنوف الأحمري، معالجة نفسية ومعالجة أسرية وزوجية مرخصة في كاليفورنيا والمملكة العربية السعودية، تقدم علاجًا نفسيًا ثنائي اللغة (العربية والإنجليزية) يرتكز على فهم الصدمات النفسية وجروح التعلق والتحديات العاطفية. تعتمد في نهجها على أساليب علاجية قائمة على الأدلة العلمية، مع مراعاة الثقافة العربية والإسلامية، لمساعدة الأفراد على استعادة توازنهم العاطفي وبناء علاقات صحية ومتوازنة.

هنوف متاحة للمشاركة في الفعاليات كمتحدثة، وإجراء مقابلات في البودكاست، والمشاركة في حلقات نقاش حول الصدمات النفسية، والتعلق، والصحة النفسية، وطرق التشافي في مجتمعات الشرق الأوسط وشمال إفريقيا والمجتمعات المسلمة.