People don’t come to therapy because life feels easy—they come carrying the weight of shame, self-doubt, and often a long history of trauma. Many have spent years feeling unseen, unheard, and told they needed to be "fixed." The vulnerability they bring into the therapy space is profound—a raw, aching hope that this time, someone will truly see them, not as broken, but as whole and worthy.
As a therapist, my responsibility to my clients is not to “fix”—it’s about ensuring that the lens through which I see this person in front of me does not become yet another source of harm.
I remember the first time I truly understood what it meant to offer affirming care. I had always considered myself an open, accepting therapist, someone who wanted the best for my clients. But the more I learned, the more I realized that my lens—the way I viewed my clients, their identities, their struggles—was shaped by systems that I hadn’t fully examined. And some of those systems, some of those beliefs, were not just unhelpful. They were probably also harmful.
I can’t tell you how many times I’ve seen well-meaning therapists misinterpret clear traits of autism or ADHD as personality disorders, mood disorders, or emotional instability. And I can’t tell you how many times I did the same before I truly understood what neurodivergence looks like.
Realizing that a lack of knowledge may have caused harm is a gut-wrenching experience. But I also know that much of it wasn’t intentional—it was the result of incomplete information, of training that didn’t equip us to see beyond pathology. And while it’s important to understand how we got here, dwelling on the why won’t undo the harm.
Instead of fixating on why things have been done this way, we need to ask: What do we do now? How do we shift, learn, and ensure that the clients who come to us—many already carrying the weight of misdiagnosis and misunderstanding—receive the affirming care they deserve?
Dr. Maya Angelou’s words have stuck with me ever since: "Do the best you can until you know better. Then when you know better, do better." The moment we know better, we have a choice. We can defend our past ways of thinking, insisting that our intentions were good enough. Or we can acknowledge the discomfort of realizing we may have caused harm, and choose to grow.
The Challenge of Growth as a Therapist
As therapists, we are trained to hold space for others, to help them explore the painful and difficult. But when it comes to our own growth, especially when it challenges deeply ingrained beliefs or practices, it can feel threatening. We take pride in the work we do. The idea that we may have done harm—even unintentionally—can feel unbearable.
This is especially true when it comes to working with marginalized communities. Many therapists were trained in models that did not affirm LGBTQ+ identities, neurodivergence, disability, racial identity, or trauma in the way we now understand them. If we were taught that certain identities are disorders, that certain ways of being are deficits, then we carry those biases into the room whether we mean to or not.
Recognizing this does not mean we are bad therapists. It means we are human. But ignoring it—defending outdated perspectives or dismissing the experiences of those we serve—does make us complicit in harm.
What Affirming Therapy Looks Like
Affirming therapy is not just about tolerance. It is not enough to simply “accept” a client’s identity. Affirming care means actively working to understand and validate their experiences, dismantling harmful narratives, and recognizing that our role is not to change them—but to support them in becoming who they already are.
Affirming therapy means:
Examining our biases. No matter how progressive we think we are, we all have blind spots. Doing the work means questioning where our beliefs come from and who they serve.
Listening to lived experiences. We must learn from our clients, from their communities, from those who have been harmed by non-affirming care.
Staying humble and open to change. If a client tells us something we said felt invalidating, we don’t defend ourselves—we listen, we learn, we do better.
Understanding the impact of systemic oppression. Our clients do not exist in a vacuum. Racism, homophobia, transphobia, ableism, and other oppressive forces impact mental health in real and tangible ways.
Recognizing intersectionality. No single aspect of a person’s identity exists in isolation. A Black neurodivergent client will have different lived experiences than a white neurodivergent client. A disabled queer client will have unique challenges that cannot be separated from their disability. Affirming care requires us to see the whole person.
For Clients: How to Find an Affirming Provider
If you are a client seeking therapy, finding an affirming provider is crucial. You deserve to work with someone who respects your identity and understands the unique challenges you face. Here are some things to look for:
Pay attention to language. Does the therapist use inclusive language on their website or in their paperwork? Do they seem informed about your identity and experiences?
Ask direct questions. If you’re LGBTQ+, neurodivergent, disabled, BIPOC, or from a marginalized background, ask a potential therapist about their experience working with clients like you. Their response will tell you a lot.
Trust your gut. If you feel dismissed, misunderstood, or like you have to educate your therapist on basic aspects of your identity, it may not be the right fit.
Seek therapists with specialized training. Certifications and continued education in areas of affirming care can indicate a commitment to learning.
Look for therapists who acknowledge systemic issues. A good therapist understands how racism, ableism, and other forms of oppression impact mental health and does not dismiss these experiences.
The Call to Do Better
Being a therapist requires us to be lifelong learners, not just in the clinical sense, but in the human sense. It requires humility—the ability to say, I got that wrong. I need to do better. It requires courage—to unlearn what we were taught, to stand against outdated models, to be willing to be uncomfortable.
To my fellow therapists: It is our responsibility to examine the lens through which we see our clients. And if that lens is harmful, it is our responsibility to change it. We get to learn and evolve as we gather more information (there is a reason we don’t do lobotomies anymore, just as an example). But, if we choose to dig our heels in because we are fearful of change, of how we are being perceived, or because it challenges how we’ve done things up to this point we are on a slippery slope.
To clients: You deserve care that sees you fully, that honors who you are, that does not ask you to shrink or conform. If a therapist does not offer you that, keep searching. The right therapist will meet you where you are, with a lens that affirms your worth, your identity, and your humanity.
I want to be clear - we are not the only neurodivergent affirming practice around. I do not consider myself to be the "voice of neurodivergence" despite being neurodivergent. In fact, I know I have so much to learn about being affirming every single day (as I dismantle my own internalized junk about who I am as an ND provider and who I “should be” and how that translates outside of myself). But I will absolutely continue to challenge myself and others, educate myself to the greatest extent possible and offer affirming ways for the ND community to come together and work together.
Neurodivergence is not a trend. We’ve always been here. We will always be here and we cannot continue to avoid the importance of affirming care in our offices. I might not be "the voice", but I am willing to be a voice because this matters.
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