Unpacking Bias in Therapy: Helping Clinicians Recognize and Address Unconscious Bias
Therapy is meant to be a safe, affirming space for clients to explore their thoughts, emotions, and identities. But what happens when unconscious bias—even from well-intentioned therapists—creates barriers to trust, understanding, and true healing?
Bias isn’t always blatant. It doesn’t always look like discrimination or outright rejection. Often, it’s subtle—a misstep in language, an assumption about a client’s experience, or a moment where a therapist’s worldview unintentionally influences the way they interpret a client’s story.
No therapist is completely free of bias—but every therapist has a responsibility to recognize and actively address it.
What is Unconscious Bias in Therapy?
Unconscious bias refers to the automatic, unexamined assumptions we make about people based on factors like race, gender, sexuality, disability, culture, or socioeconomic status. These biases are shaped by social conditioning, media, and personal experiences, and they can show up in therapy in ways that impact client care.
Common forms of unconscious bias in therapy include:
🔹 Assumptions about gender and sexuality – Automatically assuming a client is straight or cisgender, or questioning the “validity” of queer or trans identities.
🔹 Pathologizing cultural differences – Viewing non-Western family structures, communication styles, or belief systems as dysfunctional rather than different.
🔹 Minimizing systemic oppression – Focusing on individual coping skills without acknowledging the real impact of racism, homophobia, transphobia, ableism, and classism.
🔹 Stereotyping neurodivergent clients – Assuming that autism, ADHD, or other neurodivergences lead to a lack of emotional depth or self-awareness.
🔹 Expecting disclosure or education – Expecting marginalized clients to explain their identity or educate the therapist, rather than the therapist taking responsibility for their own learning.
These biases don’t always come from a place of malice—but they can cause real harm if left unexamined.
How Bias Impacts Clients
Even small moments of bias can have a significant emotional impact on clients, including:
🚨 Feeling unseen or misunderstood – When a therapist makes assumptions instead of listening, clients may feel they can’t bring their full selves to therapy.
🚨 Distrust in the therapeutic relationship – If a client senses bias, they may withhold parts of their identity or stop seeking care altogether.
🚨 Emotional labor & burnout – Clients shouldn’t have to spend their sessions educating their therapist or justifying their experiences.
🚨 Reinforcing internalized oppression – Subtle invalidation in therapy can make clients question their own reality and worth.
When bias isn’t addressed, therapy can become another space where clients feel erased, misunderstood, or even harmed.
Steps Clinicians Can Take to Recognize and Address Bias
Becoming an affirming therapist isn’t just about wanting to be inclusive—it requires ongoing self-reflection, education, and action. Here are key ways clinicians can unpack bias and improve client care:
1. Acknowledge That Bias Exists (Even in You)
No one is completely free of bias—it’s part of being human. The key is not to deny it, but to recognize it and actively work against it.
2. Practice Deep, Active Listening
Instead of making assumptions, ask:
✅ What does this experience mean to you?
✅ How do you define your identity?
✅ What kind of support feels most helpful to you?
Let clients tell their own stories without filtering them through your lens.
3. Reflect on Your Own Identity & Privilege
Consider:
🔹 How do your own identities (race, gender, sexuality, ability, class) shape the way you see the world?
🔹 Where might your lived experiences differ from those of your clients?
🔹 Are there areas where you might unintentionally center your perspective over theirs?
Therapists should regularly engage in self-reflection and seek supervision, consultation, or peer discussions about biases they uncover.
4. Educate Yourself—Without Relying on Clients to Teach You
It’s not your LGBTQ+, BIPOC, disabled, or neurodivergent clients’ job to educate you about their experiences. Take the initiative to:
📚 Read books, research, and firsthand accounts from marginalized communities.
📺 Follow educators and activists who share lived experiences.
📢 Attend trainings, workshops, or conferences focused on anti-oppressive therapy.
5. Use Affirming Language & Avoid Microaggressions
Simple language shifts can make a huge difference:
✅ Instead of “Do you have a boyfriend/girlfriend?” → Try “Are you dating anyone?”
✅ Instead of “You don’t look nonbinary.” → Try “What does being nonbinary mean for you?”
✅ Instead of “That’s not a big deal.” → Try “I hear that this has been really difficult for you.”
Microaggressions, even when unintentional, can cause real harm. Approach every client with humility and openness.
6. Address Bias When It Happens—And Apologize If Needed
If a client calls out bias in therapy, listen without defensiveness. Acknowledge the impact, apologize if needed, and commit to doing better. A simple, sincere response like:
"I appreciate you sharing that with me. I realize I made an assumption, and I’ll be more mindful moving forward."
...can go a long way in rebuilding trust.
Making Therapy a Truly Affirming Space
Therapists have the power to create healing spaces where clients feel fully seen, heard, and validated. But that only happens when we commit to recognizing and unlearning our own biases.
Unpacking bias is not a one-time event—it’s an ongoing process of growth, learning, and accountability.
If you’re a therapist looking to deepen your understanding of LGBTQ+ affirming care, neurodiversity, racial justice, or other intersectional identities, consider engaging in LGBTQ+ Affirmative Therapy training, supervision, or self-study.
👉 Want to be a truly affirming therapist? Seek out continued education, reflect on your biases, and commit to showing up for clients in ways that honor their lived experiences.
