Disabled therapists
and attachment.

Being reliable, honestly

A secure base doesn’t require constant availability. It requires predictability and honesty. For a disabled therapist, that might mean being clear about working days, having a plan for short-notice cancellation, offering online sessions when travel isn’t possible, and not over-promising to compensate. Proving competence by ignoring fatigue tends to make reliability worse, not better.

Planning for absence

• Tell clients at the start how cancellations by you will be handled.
• Have a colleague clients can contact if you are unexpectedly away.
• Agree with your supervisor what happens if you are unwell for longer.
• Treat your own absence as part of the therapy, to be talked about, not hidden. See Rupture, Repair, Breaks and Endings.

Clients’ responses to your disability

Clients may respond to a therapist’s visible or disclosed disability with worry, protectiveness, curiosity, relief or discomfort. Some may hold back their own distress to avoid burdening you, or start looking after you. From an attachment perspective, this is worth noticing gently: does the client feel responsible for your wellbeing? Can they still bring their need to you? Sometimes shared experience helps; sometimes it leads both people to assume more similarity than exists.

Disclosure

Whether, when and how to disclose a disability is a clinical and personal decision. The useful question is what disclosure serves in this particular relationship: the client’s work, practical arrangements, or the therapist’s own need. See Therapist Disability Disclosure.

Supervision prompts

These are prompts for supervision, not evidence that disabled therapists are unusually insecure or clinically problematic.

• Am I assuming shared experience means shared meaning?
• Am I proving competence instead of noticing fatigue?
• Does my wish to be dependable make limits difficult?
• Does the client feel responsible for my wellbeing?
• How do we discuss changes in my access or availability?
• What does disclosure serve in this particular relationship?
• Do I get the support I need to do this work well?

Your own secure base

Therapists need secure bases too: supervision, peers, and, for disabled therapists, access arrangements at work and in training. Supervision that treats your disability as a problem to manage, rather than a part of your practice, is worth noticing and, where possible, changing. See The Disabled Therapist and Training Institutions and Disability.

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.