Finding A ‘Good Enough’ Therapist, Counsellor or Psychotherapist

Active wheelchair woman

(If you can’t afford therapy, read the last paragraph)

How do you go about this? I hear stories of people who by chance seem to stumble across a nondisabled therapist who understands disability, or is truly willing to step into their shoes. And sometimes if the person wants a disabled therapist, they manage to find this too (there are fewer disabled therapists due to access difficulties becoming trained).

Before COVID, many people who called us up said they just had to go with the only therapist local to them who was accessible, even if they felt the relationship wasn’t quite right. Hardly choice there!

COVID has pushed most therapy online and though many people still prefer to meet their therapist in person (isolation is a key issue for many of us living with/near disability and there’s just something about ‘presence’ that doesn’t quite translate online), it has opened up the field to find a therapist whose office isn’t just accessible, but their service also disability affirming.

What does ‘affirming’ actually mean? Why would I want that?

Well, let’s start with what it isn’t. Poor therapy experiences are usually around therapists being ignorant of disability: assuming your issues are all down to your impairment, having no knowledge of the daily grind of disability…the involvement of services, the assessments, the time it takes to get up, the preparation getting transport or going to venues etc. It’s also about therapists assuming that your anger means you haven’t ’accepted’ your impairment instead of exploring whether some of your anger is valid because of how you are often treated. Therapists who are overwhelmed by your story, patronise, treat you like a child, try to fix the unfixable and rescue or alternatively distance themselves…therapists who don’t own their own fears of disability which have been triggered by you contacting them…therapists who put your lack of progress (even if you are overwhelmed, in pain or fatigued) down as you being ‘resistant to change’.

Affirming is the opposite of all that.

Affirming means to look at the WHOLE picture of what it means to be disabled. It means to recognise that there may be sadness and loss and anger and fear, but there are also opportunities for identifying strengths and resources, for helping identify what’s yours and what’s society’s and helping you learn skills to better deal with society’s and others’ negative messages. It’s means working flexibly and holistically with what your daily grind is like, understanding there can be disability-caused hurdles making positive changes tricker and working with and around them. It also means sharing some of their own stories as a therapist to reduce the power that disabled people are often used to experiencing from ‘experts’.

The key difference is that poor therapy leaves you feeling the therapist is sorry for you (‘poor suffering disabled person’), is pushing you to minimise your experiences (wanting you to be the ‘Supercrip’ who overcomes), thinks it’s your fault you’re not moving on or doesn’t understand how you are still living. (A lot of this is usually unconscious on the therapists part.) That is NOT helpful.

With an affirming therapist you will get the feeling that they believe that your life could actually improve and that has to be jolly good news! 

So, if you’re considering therapy, what questions can you ask? Here are some ideas to help you decide if someone is right for you:

1.              Are you qualified? How much training have you had in talking therapy?

(We suggest you check here below or on other registers how listed therapists are vetted to ensure that someone is properly qualified. You can call yourself a counsellor after completing a 10-week online training course! To be qualified they must have completed 450 hours of training and 150 hours of client work. At BACP (British Association for Counselling and Psychotherapy) therapists have to pass a basic level test to become a member and advertise their services:

There are many therapy directories online and therapists can tick ‘disability’ as one of many interest options. In our experience this rarely means they have done any self-reflection or training in this area and therefore proves a pointless online search category as there is no way to know if they are disability affirming. We have a small directory of other therapists we know with various levels of disability experience here

There is also a Facebook group ‘Disability Counsellors Group’ and you could post on there if you are seeking someone.)

2.              Do you have personal therapy?

(a good therapist has had a few years of their own therapy. Working on their own issues minimizes them being projected onto you!)

3.              How do you work? What approach do you have?

(There are lots of different therapy trainings. Some common ones are psychotherapy, integrative counselling, gestalt therapy, person-centred therapy, CBT (Cognitive Behavioural Therapy). Read around and see what suits you best. We use an integrative approach here at Spokz People.)

4.              Have you worked with many disabled clients?

 5.              Do you have any personal experience of disability?

(it’s really totally OK to ask this question! Would you take your car to a mechanic who has only just started training at college?)

 6.              Do you understand the social model of disability and internalised oppression?

(That being disabled is not just about the individual impairment but about how other people, government systems and society treat me and how these messages can affect my esteem?)

 7.              How much training or reading have you done on disability?

(current 4-year courses only spend a few hours-a few days max. on disability!)

 8.              Have you had any post-graduate training in issues like online working, pain management, trauma (things like EMDR, Rewind techniques) or fatigue?

(These are very useful skills to have alongside talking therapy, especially as they are so common for many disabled people. They are NOT part of generic undergraduate therapy training.)

 9.              Do you know where to get disability-specific supervision?

(All qualified therapists have to have a minimum of 90 minutes a month supervision with a more experienced therapist. If the supervisor has zero disability awareness this could hinder your progress. We do offer this, and there are others who you can suggest – check out our directory)

 10.          Have you read BACP’s open access guide on Working with Disability?

(see below, you can send it to them if they haven’t)

 11.          If you have involvement from family members or PAs: Do you have any experience with involving these parties (if necessary for you to get the right support)?

Resources to send to your (potential) therapist:

Tired of being a disability ‘ambassador’?

Sometimes we all get tired of having to be our own ambassador for disability to get the support we need. Hopefully this blog makes this issue a bit lighter, knowing what questions to ask and where to find support.

A ‘good enough’ therapist?

Sometimes it might seem impossible to find the right therapist to support you. No one can completely understand the other person, and therapists are the same. We will slip up, make mistakes, say things sometimes that annoy you or upset you. We are all human. What’s important is that your relationship with your therapist is good enough so you can go back and talk about the slip up. Often this leads to a great deepening in the relationship and personal growth for you and them.

We talk about ‘good enough’ parenting when we say that a parent tries to look after their child’s needs, but will fail regularly because they are busy, distracted, ill or just not in tune in that moment. ‘Good enough’ parenting is about a parent doing the best thing for their child 70% of the time.

This is perhaps a good gauge for therapy too….do you feel listened too and heard 70% of the time? Does your therapist ‘get it’ 70% of the time?

Or do you hold back, feel silenced, feel they are adding to your own not-good-enough feelings? If so, it’s time to change. Relationships are for ‘a season, a reason or a lifetime’. In America they are used to having therapists for life, not so much here in the UK. It helps to have a long-term therapist because you can dip in and out as life changes when you need it and you don’t need to start again. At the same time sometimes changing therapists can be useful, it can throw up new insights, challenge you in new ways so you can gain new personal growth.

Can’t afford therapy?

Check out our Wellbeing Community & Programme here

Good luck to everyone out there looking.

Best wishes, Mel

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