In a religious context, sexual behaviors are interpreted by the priest in terms of venial and mortal sins, while the HIV counselor views this information in terms of safer and risky behaviors. A confessional dynamic can occur in test counseling sessions for several reasons. Expectations of admonishment often evolve from projections of a client's own anxieties and self-judgment onto the counselor. Clients may unwittingly place counselors in the role of confessor. The confessional dynamic, which involves a client's self-judgment, can make the counselor hesitant to explore the client's issues, resulting in a superficial test counseling session.
Counselors find themselves in the role of admonishing parent rather than empathic confidant.
If the counselor asks additional questions about a risky incident, he or she risks being seen as overbearing. While this strategy helps counselors provide information and advice, it does not serve as effective client-centered counseling, because too often, clients receive little new insight into their particular situations. These statements can set up a confessional dynamic that requires the counselor to absolve the client of wrongdoing. It may also make it difficult for the counselor to follow such statements with a productive discussion of risk behaviors. The following two cases illustrate how risk assessment questions can create a confessional dynamic.