19 Oct Revolution from the Couch: Integrating Social Justice into Therapy Practices
Therapy is envisioned as a safe, unbiased space. In the therapy office, clients are free to explore their past and future, free from judgement or contempt. Clients expect their therapists to provide impartial, supportive advice, without fear that their therapist will discriminate against them in any form. This is an important cornerstone of the practice of therapy.
However, this concept can also be misconstrued to mean that therapy is an apolitical practice. Therapists are thought of as neutral actors, who remove themselves from politics in the therapy room.
While this may be the case for some therapists, therapy as a whole is deeply involved in politics and social justice advocacy. Many of the early developers of therapy as we know it were involved in politics and justice, such as those involved in the settlement housing movement. Therapists today deal with oppressive structures first hand – either through themselves or through their clients.
This is not to say that therapy has always been on the side of social justice. Practices like conversion therapy have caused damage to LGBTQ+ folks, setting back progress decades.
So, how are therapy and social justice intertwined? Can therapy truly be apolitical, or is neutrality no longer an option? And how can therapists use their practice to further social justice, while honouring the needs of their clients?
De-Centre the Self, Understand the Structure
It is a well-known fact among clinicians that poverty is linked with higher rates of depression and other mental illnesses. Those with mental illness can face barriers in education and employment that can push them into poverty; while those living in chronic poverty are more likely to develop a mental illness. A lack of access to resources and support can worsen mental health outcomes for those living in poverty.
Oppression also contributes to mental health conditions. Experiencing racism, for example, increases stress and affects mental health conditions such as PTSD, depression, and anxiety. Even just the fear of racism can heighten stress levels, according to multiple studies.
So where do therapists fit in? Therapy is often recommended as the first line of treatment for mental health conditions like depression and anxiety. Therapy often focuses on an exploration of the self to facilitate healing. However, for those who are oppressed, discriminated against, or living in adverse conditions, healing may be inhibited by structural issues like poverty. Without an acknowledgement or understanding of how certain conditions or societal issues can impact mental health, therapy cannot be truly effective.
If a therapist is unfamiliar with issues such as poverty, racism, dis/ableism, sexism, or capitalism, it is encouraged that they do research to understand the realities of these issues. Many clients who take part in therapy will have first hand experience with these issues, and may require support in that area.
Therapist practices can offer support groups directly related to structural issues such as racism or poverty, to ensure that the needs of their clientele are being met. They can also host workshops for their therapists to fill in gaps in knowledge.
Support Marginalized Voices, Professionally and Individually
Another way therapy practices can pave the way for social change is by opening up opportunities for marginalized folks. Marginalized groups face barriers accessing care, often due to cost or proximity. Providing sliding scales is one way therapists can make space for marginalized folks.
Accessibility is key to providing holistic care. There are many barriers to therapy – financial, physical, or logistical. Sliding scales and accessible features are one way practices can make their care more accessible. Hiring therapists who speak other languages can also provide a wider scope of care, as mental health care is in high demand for non-English speakers.
Marginalized individuals also face barriers to employment; hence, making the active choice to hire individuals from marginalized backgrounds is a concrete way to affect change. Marginalized voices have historically been excluded from health discourse, but they are essential for providing comprehensive care. Many employers create a statement to hire BIPOC (Black, Indigenous, and People of Colour) clinicians, which – when committed to – can make a difference in increasing diversity.
Uplifting marginalized voices is also key within the therapy room. A principal concept of client-centred care is that humans are autonomous and have the right to determine their own path. This ensures that recovery in the therapy room is partly, or completely directed by the client, so that they can meet their needs. For marginalized folks, this may be difficult, as biases or blindspots in the therapist may impede their ability to self-direct. Non-BIPOC therapists must be mindful and allow clients to describe their experience of oppression in their own words. Their job is not to minimize oppression, but to understand it and help the client move towards healing.
Giving marginalized voices a microphone, both in their healing and in their professional journey, contributes to the fight for social justice. It is just as important to listen to marginalized voices, as it is to speak up on their behalf.
Go Beyond the Couch
Care is not just about the individual, but also about the community. As we have discussed, many of the issues facing clients are structural – income inequality, discrimination, lack of affordable housing, etc. Some of these issues can’t be addressed in a therapy office, and must be taken to the streets.
Some folks feel they cannot contribute to social change because they do not possess the required skills. The truth is that there are many ways to contribute to social justice. Perhaps you show up through protest or sign making; perhaps you write letters to political leaders or write social policy; perhaps you sell your crafts to fundraise for an issue close to your heart; or perhaps you provide home-cooked meals for those in need. Regardless, there are infinite ways to contribute to social change – and infinite reasons why.
If you are a therapist, consider participating in community organizing. You will have a good idea of what issues are close to your clients’ hearts. Is it housing issues? Poverty? Hunger? Once you know, see how you can contribute to changing these issues. Showing up for your clients outside of the office is just as important as showing up for them in session.
Justice = Mental Health Care
Therapy is as much about changing an individual’s life as it is about changing the world. After all, creating self-reflexive, eternally curious individuals impacts the world in a positive way. However, therapists must go beyond the couch to provide authentic, socially just care. Show up for marginalized folks, professionally and individually. Uplift marginalized voices in your own life, in your community, and in your practice. Above all, keep in mind that social justice is more than a political movement; it is mental health care.
Written by: Catiyana Adam
Catiyana, a music enthusiast, and avid writer. She has a keen interest in mental health, illness, and treatment, and is aspiring to be a therapist. Catiyana graduated from McMaster University in 2021 with a Honours Bachelor of Arts in Sociology. She focused on courses in health and illness, as well as families and feminist studies. She hopes to pursue a Master of Social Work at Wilfrid Laurier University next year.