Scarleteen

Hello!

I am beginning to research therapists in the areas I'll end up interviewing for a job. Something that is important to me is that the therapist is queer affirming. I'd like to be able to talk about some of my experiences as a queer person even if it isn't the focus of my sessions as well as explore what relationships mean to me given my asexuality and potential aromanticism.

I'm excited to start what will hopefully be a (long over due) healing experience. However, I've had some poor interactions with mental health care professionals in the past. Most recently was a person who said that they were LGBT friendly but only had "male" and "female" options on the intake form and didn't ask about pronouns. The only sort of affirming thing she did was tell me that "If I ever have a boyfriend or girlfriend, they would want you to be more in touch with your feelings."

Does anyone know of any "green" or "red" flags that might signal whether or not someone is truly accepting? I wish I could say that I'd be able to move on and try again right after a not affirming experience, but I really have very low trust in the mental health care field. I worry that a few more negative experiences might make me not want to try at all and prolong my mental health struggles.

As a side question, is Thriveworks legit? I've been researching affordable options for me, and their pricing seems too good to be true. Sorry, y'all, I'm super new at this.

Hi Raffles,

Oof, yeah, I've noticed that some therapists will use "LGBT friendly" to mean "I won't tell you you're going to hell" and not much else. But, there are definitely some great Queer affirming therapists out there for you to find!

One tip I have for looking for affirming therapists in an area is to look and see if there are any LGBT resource lists or a resource center in the area (if there isn't, sometimes the one in the nearest large city will have resources for the surrounding towns). Those places often compile lists or directories of queer friendly service providers, so they might be able to point you towards therapists.

When you're searching yourself, if the therapist's bio or work history is listed, you can check it for green flags (like working with queer resources or projects, or even just listing that they're queer or trans themselves, which some might do). I also think you're well within your rights to contact a potential therapist ahead of time and ask them what LGBT friendly practice means or looks like to them.

Looking at it, ThriveWorks seems about as legit as things like Pride Counseling or other online therapy platforms, so of they're a good option for you budget-wise, that's for sure something to explore.

Those are solid tips! I found one person who is on a list of affirming therapists, identifies as queer, and even studied women, gender, and sexuality studies. That feels like a relatively safe bet for me.

I've got a few follow-up questions (not related, so there's no pressure to respond because it really doesn't relate to the work that scarleteen does).

I've noticed that some therapists say that they are "trauma informed" and provide "trauma informed care." This might be a dumb question, but shouldn't all therapists be trauma informed? If not, what are the differences in care between a provide who is and isn't trauma informed?

Also, I've noticed something that is very difficult for me in first sessions (and why I haven't really ever been able to progress past a first session) is that you're often required to disclose major issues and trauma in a first appointment. I find that I'm generally unable to do this because I don't know the person and don't trust them and that sort of dynamic is really hard to me to function in. Is it reasonable to tell a therapist that there are simply things that you aren't ready to share yet and instead start with a smaller issue?

That does sound like a promising lead!

That's a good question about trauma informed care! So, yes, in theory all therapy should come from a trauma informed approach. But for a long time, a lot of therapeutic practices on both an individual and institutional level didn't really structure themselves that way; not in the sense that they were trying to re-traumatize clients or that they ignored or disbelieved their trauma (though that certainly still happened), but more in that they didn't look at all the ways trauma could be re-triggered. For instance, a lot of therapy used to be very one directional; the therapist is the expert, they tell the client what to do, and might even penalize them in some way for being "non-compliant." A trauma informed approach acknowledges that clients who have survived trauma need to have power in the interaction and be treated as the experts on their lives. I think this offers a good break down of what the term is meant to cover: http://socialwork.buffalo.edu/social-re ... -care.html.

I will say that trauma informed is also considered a standard of care now, bordering on a buzzword, so a lot of providers use it to signal "I am up to date on best practices."

As for your second question, that is absolutely a reasonable thing to tell a therapist. In fact, it can be really helpful information for them to have, because they know that a) you have some bigger stuff you'd like to discuss down the line and b) what you're comfortable bringing up as you build a therapeutic relationship with them. I also think it serves as a good "test" of that therapist; if they react poorly to you setting a needed boundary, that's a sign they're not a good fit.

Thanks for the resources! It explained a lot, and the recent article with Kimberly Dark had a lot of things that I needed to hear/read.

I've got a few more questions now that I'm thinking through more specifics and doing my research.

The first is related to something already mentioned. I've noticed that intake forms often have really personal questions, so of which I'm just not willing to answer the first time I meet someone. However, will this result in a refusal of treatment? Like will a therapist refuse to take me on as a patient because I won't answer some of the questions? For example, my family, gender, and coping strategies aren't something I think I could share right off the bat. In the past, I've sort of just lied about my answers, but they were short term situations and I don't want to do that if there's a possibility that I will work with a therapist for a longer duration of time.

Related to that, I've struggled with the concept of an emergency contact. When I start, it will probably be after I get a job, and that will likely be in a new place where I don't know anyone. Even if it were close to where I live currently/have lived previously, there really isn't anyone that I'd feel comfortable asking to be my emergency contact for a mental health crisis. Does anyone have any suggestions about how to handle that? I don't want that to be a barrier to treatment either.

Hi Raffles,

I'm glad my answers and Kimberly's interview were helpful!

With the intake forms, it should be fine to answer with some variation of "this is a loaded topic for me and I need time to be able to talk about it." That shouldn't disqualify you from treatment, and honestly it's still gives the therapist the information they're looking for, which is that there are issues attached to those topics that are tied, in some way, to why you're seeking support.

I might bring up the emergency contact thing with the therapist when you start seeing them (you could just list "none" on the form). It shouldn't be a barrier to treatment, since most therapists are aware that not everyone will have the social circle or family where they're safe and able to assign someone that role. But the two of you can also brainstorm if there's an option that fits what they need that information for that you're comfortable having listed.

Hi! I'm reopening this thread to ask advice on an adjacent issue.

I plan on going to get some mental evaluations done for my reading issues. Something the psychologist mentioned in my consultation is that it might be due to social emotional issues. Now, I am painfully aware that I have some social emotional issues, but my reading issues are the main concern right now and significantly predate my other mental health problems.

If/when I go to be evaluated, I want to be honest because I know that that is the best way for me to get reliable results. However, there are two major problems.

The first is the trust issue. Because it's a one and done sort of thing, there isn't time to build that trust, so I'm assuming I just have to go for it, right? All or nothing?

The second issue is that I don't want the psychologist to focus on the social emotional issues. I am going there to figure out my reading problems. I worry that once I disclose some aspects of the social emotional stuff, it will derail the conversation about my reading. My reading issues have been a thing for at least 4-5 more years before anything else happened, so it is unlikely that the social emotional stuff is the cause. Is there a way I can communicate this to her and actually be believed?

I also already kind of lied to her in my consultation. She asked me if I have any concerns about anxiety or depression and I said no, but that's not really true. What I meant was no, I don't think that those are what's affecting my reading. It feels like my options are to continue selling the lie or be honest and risk her over valuing the social emotional stuff as the cause and not actually getting to the bottom of it.

Hey there, Raffles.

Rather than kind of trying to game this second issue, what I would suggest is that you tell the psychologist what you have told us here. I would tell them about your concerns in terms of the focus, and let them speak to their ability to focus on your reading. You then will get to decide whether to see it through with them or not. You can ask to do that in a phone consult before an appointment, too: you would just say you have some concerns ahead of your appointment you want to address.

In terms of trust, yes, with someone you are only seeing for an evaluation, just going for it is most of how it has to be. But again, at the very least, if you can have even a brief advance conversation about your concerns ahead of time, that should help a bit with trust.