Getting into the room is the first hurdle
BACP blogs

I’ve been turned down by over 100 therapists. Although some turned me down due to lack of availability, a significant number said their venue wasn’t accessible to me as a wheelchair user. Almost one in five people in the UK are disabled (ONS, 2015)¹. Disabled people are more likely to experience mental distress than non-disabled people, yet are significantly disadvantaged when accessing support (Cree et al. 2020)².

Growing up, I accepted I couldn't access certain places because I couldn’t walk. My life changed when I was introduced to the social model. Suddenly, I felt rightful anger whenever a design oversight disabled me, through no fault of my own. To use the term disabled people is a political statement, illustrating that we are disabled by society rather than our bodies and minds.

Disabled people are expected to feel grateful for any form of access, as if the ableist world we live in is doing us a favour by facilitating access despite how dehumanising this might be. I’m expected to be grateful I can be in a building even if I enter through dark corridors, past the kitchen and the clutter rather than through the well-maintained front door like everyone else. This makes me question the value society places on me. I can never take access as a given but when it came to looking for a therapist, I wasn’t expecting the fight for inclusion I had.

Despite online therapy often being seen as a one-size-fits-all solution for disabled people, I struggle to feel someone’s presence, so when I recently needed a new therapist, I combed through directories for someone to see face to face. I quickly received replies saying the therapist’s venue wasn’t accessible. Many were apologetic, but those who displayed no remorse for being inaccessible frustrated me the most. Would it be acceptable to prevent any other minority group from accessing therapy? Some were willing to try alternative rooms such as community centres. These were often noisy, cluttered and generally not conducive to therapy. For some, I spent time working out how to get into inaccessible spaces by walking which brought into painful realisation how much my condition had deteriorated in recent years, giving me more difficult feelings to eventually take to therapy. Home visits may solve access issues for some disabled people, although many therapists I contacted were reluctant due to feeling like it overstepped boundaries. For myself, I highly value the container an external room provides and was unsure about wanting such difficult things being explored and left in my home. However, enforced gratitude meant I felt I had no right to be picky.

I certainly couldn’t be picky when it came to therapists. The simple test of being able to get through their door ruled many out before I got around to assessing our compatibility, their skillset or any of the other qualities people use when choosing a therapist. A directory search for local face-to-face therapists generated 505 therapists but when I filtered for wheelchair accessible therapists, just 141 remained, less than 30%. In fact, most directories didn’t have wheelchair access in their filters.

My experience isn’t unique. I know one wheelchair user whose search result threw up just four accessible therapists. A physically disabled friend was told to go back to the inaccessible therapist when she was better. Ashley Cox (2019)³ made national news when he was rejected by eight therapists for being visually impaired.

Even when I found accessible therapists, I discovered many didn’t understand my lived reality as a disabled woman and the barriers I face. Instead, they focused on my impairment. When I asked therapists how they would work with my disability experience, many individualised it and explained how they would help me change my thinking to overcome my difficulties. This won’t change the reality that inaccessibility and ableism is everywhere. I want someone to hear my anger that so often gets silenced and sit alongside me in the injustice. Reeve (2004)⁴ urges therapists to broaden their understanding of social constructions of disability and in doing so, stop pathologising disabled people’s understandable emotional reactions to oppression and ableism.

I'm very used to counteracting ableist attitudes. However, I was seeking therapy for deeply personal things. I didn’t have the emotional energy to teach nor did I want to use the sessions I was paying for to do this. In addition, like many disabled people, I have internalised ableism – how would a therapist challenge me on this when they hadn’t challenged their own ableist thoughts?

There are many laws and policies in place ensuring services are accessible to disabled people. As my experience has shown, these don’t stand up in practice. In no way do I think those therapists purposely excluded me from their services but by setting their practice in inaccessible spaces this was the result. I wonder what could have come from those connections had I been able to get through the door.

The BACP resource, Working with disability across the counselling professions GPaCP 007 aims to give an overview of common themes and ideas to encourage affirmative practice.

References

1 ONS. (2015) ‘Nearly one in five people had some form of disability in England and Wales’. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/articles/nearlyoneinfive
peoplehadsomeformofdisabilityinenglandandwales/2015-07-13
2 Cree, R.A., Okoro, C.A., Zack, M.M., Carbone, E. (2020). Frequent Mental Distress Among Adults by Disability Status, Disability Type, and Selected Characteristics. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499832/
3 Cox, A. (2019) ‘I needed mental health support but eight therapists rejected me for being blind’, Metro, 30 June. Available at:
https://metro.co.uk/2019/06/30/i-needed-mental-health-support-but-eight-therapists-rejected-me-for-being-blind-9698621/
4 Reeve, D. (2004) 'Counselling and disabled people: Help or hindrance?' in Swain,J. et al. (eds.) Disabling Barriers - Enabling Environments. 2nd Edition, London: Sage Publications, pp. 233-238.