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Chapter 7: Special Considerations

The issues addressed in this chapter don’t fit neatly into any other category, but you may consider them the most important of all. They deal with the fit between you and your therapist, which is a big part of how therapy works.

In most situations, you’d be sued for making a hiring decision based on gender, ethnicity, religious outlook, or sexual orientation. When hiring a therapist, however, these may be acceptable considerations.


Most male and female therapists can work well with clients of either gender, so you’re in good shape if you don’t have a strong preference either way. If you do have a preference, however, you need to consider where it comes from.

You may feel that you can relate better to a therapist of the same gender; or you may prefer a therapist of the opposite gender to gain a new perspective.

You could have strong feelings about this topic if you were the victim of abuse. If you were sexually abused by a man, for example, you may not be comfortable working with a male therapist. On the other hand, you may actually seek out a male therapist as a way of helping you regain some of your trust in men.

Marital therapists are attuned to different communication styles and are particularly skilled at working with clients of both genders. If you’re still concerned about fairness and balance, however, you can seek out a co-therapy team in which a male and female therapist work together with you and your spouse.

Single-sex men’s groups and women’s groups are also available. These groups may deal with gender-specific or general issues, and are built around the assumption that people are more willing to be open with people of their own gender than they would in a mixed-sex group. If this point of view makes sense to you, a single-sex group might be the way to go.

Sexual Orientation

If you’re gay or bisexual, you’re probably concerned with finding a therapist who will understand and respect your lifestyle. Most therapists are comfortable working with clients of any sexual orientation, and some specialize in working with gay and bisexual clients. Some therapists have personal or religious objections to homosexuality, though, so it’s best to ask about this up front.

You can also find specialists that help clients deal with issues of sexual or gender confusion. Others focus on working with transsexual and transgendered clients.

Race, Ethnicity, and Culture

Most therapists can work successfully with people of different backgrounds. Choosing a therapist of a different race, ethnicity, or culture can be a great way to break stereotypes and gain new perspectives.

Your therapist may not be an expert on your background, however, so be prepared to explain aspects of your experience that are relevant to your therapy. Most therapists are eager to learn and will appreciate your efforts.

If you’ve been the victim of racism or discrimination, you may have a difficult time working with a therapist of a different background.
The important thing is to find a counselor you can trust. Unless you feel comfortable enough to open up, therapy isn’t going to help much.

Religion and Spirituality

If religion or spirituality is an important part of your life, then you know that your faith goes beyond your belief in the supernatural; it profoundly influences your perspective and just about every aspect of your life.

Obviously, you want to find a therapist who respects andunderstands your beliefs, but it’s important to know that a therapist doesn’t necessarily need to share those beliefs in order to work with you successfully.

In secular counseling, you are the authority on your own beliefs, and you should be prepared to share those elements of your faith that are relevant to your therapy.

It’s important to understand the distinction between this kind of therapy and religious-based counseling.

In religious-based counseling, you look to your therapist to provide faith-based expertise. Religious texts and teachings form the basis of the work your therapist does with you, and very often, mutual prayer will be an important part of your treatment.

Religious counselors may or may not be officially associated with a church, temple, synagogue, or mosque. Some rely almost exclusively on religious material, while others combine religious and spiritual teachings with mainstream psychological approaches. Most wil be happy to explain their philosophy if you ask.

Religious counselors may be licensed professionals, but this is not a requirement, so you’ll want to ask questions about experience, education, and qualifications.


As mentioned earlier, age is not always a good indicator of professional experience, but you may still have a preference in this area.

Be aware that there are exceptions to every stereotype. It’s very common to find older therapists with lots of enthusiasm and openness to new approaches. You may also discover younger therapists with more life experience than you’d expect.

Activity 7

At the top of an index card or small piece of paper, write Special Considerations. Below that, make a note of your preferences about these special considerations.

Chapter 7: Special Considerations

Ben Butina

Ben Butina is a therapist and trainer. He is the executive director of Westmoreland Marriage, Inc. and lives with his wife and two children in Latrobe, Pennsylvania. This book is reproduced here with permission and is copyrighted © Ben Butina. All rights reserved.

APA Reference
Butina, B. (2009). Chapter 7: Special Considerations. Psych Central. Retrieved on August 9, 2020, from


Scientifically Reviewed
Last updated: 27 Sep 2009
Last reviewed: By John M. Grohol, Psy.D. on 27 Sep 2009
Published on All rights reserved.