Common forms it takes

• Treating disability as the presenting problem — assuming that’s what brought the client in, before they’ve said so
• Diagnostic overshadowing — attributing a new symptom to an existing diagnosis without investigating it on its own terms
• Pathologising adaptation — reading a coping strategy that disability requires as avoidance, resistance, or dysfunction
• Cure assumptions — quietly equating “improvement” with becoming less disabled
• Inspiration framing — praising ordinary coping as extraordinary resilience
• Identity erasure — reducing distress by asking someone to suppress disability or neurodivergence, without weighing what that suppression costs

Why it’s easy to miss

Most clinical ableism isn’t hostile — it’s structural. It’s built into training that never covered disability, assessment tools normed on non-disabled populations, and a professional culture where “normal functioning” quietly means non-disabled functioning. A well-meaning therapist can practise clinical ableism fluently without ever intending harm, which is exactly why it needs to be looked for rather than assumed absent.

A quick self-check

Before treating a client behaviour as psychologically significant, ask: would I read this the same way if the client weren’t disabled? If a non-disabled client cancelling for the same reason wouldn’t raise a clinical flag, be cautious about raising one here.