Guest Post: Counseling: Will My Therapist Even Know What Disability Means? by Lauren Presutti

Post Comment

You’re sitting in your first counseling session. You told the receptionist over the phone that you use a wheelchair – after all, you had to make sure the building was accessible – but you’re wondering if that message was relayed to your therapist. A stranger. Someone you have never met. And, like most new encounters go, you’re wondering if your therapist was surprised to see that you use a wheelchair upon greeting you. And as you make yourself comfortable in the small room – not on his couch, but from the seat of your chair – you can’t help but wonder, has this guy ever met someone in a wheelchair before? Will he assume I’m only here because of my disability? Will he ask why I can’t walk in the first five minutes?

If you have ever experienced – or imagined – these thoughts, you are not alone. Most wheelchair-users commonly experience similar thoughts when meeting able-bodied strangers. Understandably, these types of thoughts can be become louder and more bothersome when a person applies them to the context of meeting someone new who is about to become your therapist, asking all sorts of intimate questions and expecting you to open up about your feelings.

The nuances of counseling – or psychotherapy – whatever you call it – can make anybody sweat, but adding a wheelchair into the equation can cause a whole new level of anxiety. Although well-intended curriculum in training programs may touch on “how to be a counselor for people with disabilities,” the reality is that most therapists enter the field without much knowledge about this population. The outcome, unfortunately, means that even mental health professionals are not exempt from internal biases and misconceptions of disability.

This is what ultimately inspired me to become a psychotherapist specialized in working with people and families affected by disabilities. Born with muscular dystrophy and using a wheelchair through my entire life, I realized early on that we need more training programs that prepare mental health professionals to work effectively with this population, offering true empathy and understanding, and not leaving it up to the client to educate the therapist about what disability really means.

Wheelchair-users – especially those with spinal cord injuries – are often asked questions about their disability from the general public. If you have ever been asked why your legs don’t work from a child at the mall, you know what I mean. The counseling environment should be one where you don’t need to worry about answering those questions. It should be a safe, genuinely supportive environment where you can focus entirely on the reasons that you are seeking help.

Maybe you are seeking counseling for help with something related to your spinal cord injury. Or maybe you’re looking for help with something that has nothing to do with your spinal cord injury. Either way – you should be able to access mental health counseling without feeling like your therapist is clueless about life with a disability.

If you’re interested in counseling but worried about your therapist not understanding disability-related ideas, do your research ahead of time before setting up an appointment. Seek out community resources and ask people over the phone if your therapist has any experience working with people affected by disabilities. Although some therapists may not specifically advertise working with people with spinal cord injuries, some may advertise working with people affected by chronic illnesses.

Chronic illness doesn’t equate to a spinal cord injury, but it may be a good filter to use when scrolling through potential therapist options. If possible, give them a call to see if a free consultation might be offered. Be open to the experience, express whatever concerns you have, and remember that you don’t have to stick to the first therapist you see if you don’t feel like it’s a good fit for you.

Your mental health matters. You matter. Your wheelchair shouldn’t serve as a barrier to getting mental health treatment. Contact me if I can be helpful to you as you navigate options and make decisions to care for your mental health.

Be well,
Lauren Presutti

To learn more about Presutti Counseling, visit or follow Presutti Counseling on social media.


Leave a Reply


Spinal Cord Injury
8315 N Brook Ln Apt 906,
Bethesda MD  20814
Phone Number: +1 703-795-5711