Affirming-Care 101

At Gather & Grow we believe in that everyone deserves Affirming Care.

For us as a group practice and as individual clinicians this means understanding who we are competent to serve and communicating this clearly to potential clients. We don't believe in being generalists or that being "friendly" is enough -- especially to our most marginalized communities.

It can be important to consider the following reminders:

  • Oppression is systemic and institutional -- it gets normalized through common discourse and pushing back can end up being coded as deviance.

  • Classism, ableism, sexism, sizeism, heterosexism, ageism, etc are implicit in our mental healthcare system. Similar to concepts of anti-racism, if you're not actively working against these structures, you are a part of them.

  • Coping skills developed over time for survival may look like challenging behaviors.

  • Naming the In|Validation that happens around intersectional identities needs to be centralized in healing to be affirming care. This is part of the direct and indirect support offered through our practices.

The first step in being an affirming practice is to be able to discern between levels of care. While there is nothing wrong with "friendly" it's important to consider what this communicates to populations who have long been pathologized and dismissed by the mental health industry and society at large. We are indirectly indicating they should feel "grateful" for being tolerated rather nurturing their internal since of being deserving of accurate and competent care.

This is complicated by the fact that there are very real barriers to accessing mental health support and that there is not nearly enough diversity in providers. Sometimes our clients will have to make choices about who is the "best" fit and we will end up serving folks who have some intersectional identities we are familiar with while also having some that we are not. In these cases the most empowering thing we can do is be accurate in how we present ourselves to our clients so that they can make an informed decision about who is the best fit for their journey.

Our goal at Gather & Grow is to serve clients who fall into areas we feel affirming and knowledgeable in. When we serve clients outside of our scope we risk the following:

  • Poor Outcomes: Care that is not affirming can create higher turnover, lower retention, and poor efficacy.

  • Imbalanced Labor: Care that is not affirming can place the labor of education on our clients to teach us about who they are.

  • Trust Ruptures: Care that is not affirming can create damaging ruptures in trust if clients experience the therapy relationship as unsafe.

  • Re-traumatization: At worst, care that is not affirming can mimic traumatic situations clients have faced in past therapeutic situations or out in the world where they felt rejected, not held, and harmed.

The 4-L's of Affirming Can be utilized as a simple checklist when working with diverse communities.

  • Label: Name inequity when you see it along with your capacity, education, and experience as a provider. You can do this directly through compassionate inquiry and accountability statements and indirectly through examples and anecdotes. Potential clients should feel seen accurately in all parts of the therapeutic process and feel safe to speak up when they feel misunderstood.

  • Listen: Honor your clients' narratives about themselves. Honor the ways your clients have survived and shown resiliency even if in the present it looks like a "defense mechanism" they may want to release. Help your clients find and name this balance of gratitude and desire for evolution for themselves.

  • Learn: There will always be something we can learn from our clients but we should also be educating ourselves. Be an intentional and conscious consumer of information so our clients don't need to utilize their session time to educate us, a labor that is often put on non-normative folks in the world at large.

  • Let Go: Your client will always be the expert in their own life. You may also need to release attachment that a client may not feel safe no matter how safe you experience yourself to be. Identifying activation can be a helpful process tool but your client is not obligated to explain why they may need to take space. Fragility is for you to process, not your client to salve. You may also need to release attachment around the timeline of therapy. Your client needs to process at the pace that feels right to them.

We love this ARTICLE from Healthline about how important (and healing!) it can be challenging to find a therapist that reflects you. We can't always find the perfect identity reflection, but it's important to remind potential clients that they have the right to advocate for themselves in this way!

**PROCESS QUESTION**

(Answer via email to info@gatherandgrowoc.com)

The following are some communities that Gather & Grow serves. Pick one, identify your current level of care, and describe why you are affirming/knowledgeable and/or how you could move towards affirming/knowledgeable.

  • Lesbian/Gay

  • Bisexual

  • Trans

  • Non-Binary

  • Asexual

  • Polyamorous

  • Kinky

  • Sex Workers

  • Black/Indigenous Queer

  • Neurodivergent

  • Partnerships Opening Their Relationship

  • Non-Romantic Partners

  • Survivors of Religious Trauma

  • Survivors of Childhood Sexual Abuse

  • Agender

  • Intergenerational Trauma

  • Complex Trauma