Making a therapy service
accessible.
Accessible on paper isn’t always accessible in use.
A stage-by-stage checklist for managers and staff of counselling and psychotherapy services.
What this is: a checklist covering the whole pathway, from finding you to complaints.
Why it matters: ordinary policies often create the biggest barriers.
The sharpest reframe: a missed session is a question, not a verdict.
One thing to take away: fix policies first, and publish what you offer.
The short version
Whether disabled people can use a therapy service depends on the whole pathway, not just the therapy room: how people find you, refer, wait, get letters, arrive, take part, miss sessions, end and complain. This checklist walks through each stage. The biggest barriers are often ordinary policies, like discharging people after two missed appointments, which fall hardest on people with fluctuating conditions. Use it to review your service, decide what to change first, and be honest with people about what you can’t yet offer.
Who this is for
Managers and staff of counselling and psychotherapy services: in health services, voluntary organisations, universities, workplaces and group practices. For individual therapists, the ten-point self-audit covers practice-level access.
The pathway, stage by stage
Our frameworkFinding you
- Your website works with screen readers, keyboard-only use and zoom, following current web accessibility guidance (WCAG).
- It says plainly what access you offer: step-free access, online sessions, interpreters, session lengths.
- There’s more than one way to make contact: phone, email, text or a form.
Referral and intake
- Referral and intake forms ask about access needs, and say why.
- Forms come in accessible formats, and can be completed with support or by conversation.
- Assessment allows extra time for communication aids, interpreters or processing.
Waiting
- People can say how they want updates: letter, email, text, phone.
- Access needs recorded at intake are passed to the therapist, so the person doesn’t have to explain again.
Getting there, or getting online
- The building, toilets, parking and route from transport are step-free and checked in practice, not just on paper.
- Waiting areas consider noise, lighting and seating.
- Online sessions are offered as a real option, with captions or interpreters available.
Sessions
- Session length, time of day and breaks can be adjusted.
- Interpreters and communication support are booked and paid for by the service.
- Therapists have had training on disability, including diagnostic overshadowing.
Missed and cancelled sessions
- Policies on missed sessions take account of fluctuating conditions, flares, hospital appointments and unreliable accessible transport.
- Before discharge, someone asks why sessions were missed.
- Switching to online or a shorter session is offered as an alternative to cancelling.
Endings and discharge
- Endings are planned with the person, not triggered automatically.
- Letters about discharge are in the person’s preferred format, and say how to come back.
Feedback and complaints
- Feedback and complaints can be made in several formats, including with support.
- Feedback leads to changes, and people are told what changed.
- The service records who asked for which adjustments, so it can see what’s needed.
Deirbhile manages a small community counselling service. The service discharged anyone who missed two sessions without notice. Reviewing six months of discharges, she found that over a third were people with chronic illnesses or who relied on accessible taxis. The service changed the rule: after a missed session, a counsellor now phones or texts to ask what happened, offers an online session, and only discharges after a conversation. Attendance didn’t change much, but fewer people had to be re-referred.
Deirbhile is a fictional teaching example, not a real person.
Be honest about limits
Our frameworkNo service can offer everything. If you can’t provide home visits, a particular language or a step-free room yet, say so clearly on your website and at first contact, and help people find somewhere that can. People lose time and energy finding out at the door.
Where to start
- Pick one stage and walk through it as a disabled person would, ideally with disabled people who use, or have tried to use, your service.
- Fix the policies first. A missed-session rule or a form often costs less to change than a building.
- Publish what you offer, and what you don’t yet.
- Review again in six months.
Evidence & sources
Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.
United Nations (2006), Convention on the Rights of Persons with Disabilities, Article 9 (Accessibility) and Article 25 (Health).
World Wide Web Consortium (W3C), Web Content Accessibility Guidelines (WCAG) 2.2 (2023).
The pathway stages, the checklist and the guidance on missed-session policies are this site’s synthesis, drawing on Access Is Part of the Therapy and Not Repeating Harm in Services.
Deirbhile, her service and its figures are constructed for learning. They are not real.
Our targeted searches did not find studies of how missed-appointment policies affect disabled clients of therapy services.
How to cite this page: Donaghey, C. (2026). Making a Therapy Service Accessible. Disability in Psychotherapy. Available at: https://disabilityinpsychotherapy.online/for-referrers-and-services/making-a-therapy-service-accessible/ (Accessed: [date]).
Shared under CC BY-NC 4.0: you can share, adapt and teach from this page, including on fee-paying courses, with credit. See Reusing This Material.