Background

Due to the stigma of sex work, sex workers can be vulnerable to microaggressions and minority stres​s and can experience​         discrimination when they access basic services, like healthcare or therapy.  As such, this guide is intended to help people with sex work experience in finding a mental health professional that approaches sex work from a harm-reduction, workers-rights perspective.

Many therapists are unfortunately not trained in sex worker-specific issues, conflate sex work with sex trafficking, use language describing sex work that is inappropriate/offensive, and assume sex work is pathological. This criteria are intended to be used by sex workers in their search for a mental health professional.

What are the criteria for sex worker-affirmative therapists?

• A therapist who is sex worker-affirmative recognizes that sex work can be a normal part of the sexual spectrum of behavior and is able to distinguish sex work from non consensual sexual exploitation.
• The therapist has educated themselves about sex work via books, articles, websites, discussion groups, and by talking to sex workers about their experiences.
• The therapist is aware of what constitutes safer and less safe types of sex work (acknowledging that different people may have different standards for this).
• The therapist is aware of different types of sex work and expectations/definitions of said work that are commonly encountered in the sex work community.
• The therapist understand the minority stress that sex workers may experience in keeping their work a secret/concealing it from their friends, family, partners, etc.
• The therapist has worked with a number of clients from the sex work community, and are explicitly welcoming of such therapy clients in their advertising materials.
• Finally, the therapist is aware that for many sex workers, sex work might not have anything to do with the reason that the client is coming in for therapy. Often, sex work is just another facet of someone’s life, like their vegetarianism or their hobby of knitting.
• In smaller towns, it may be more difficult to find a therapist who meets all of the above criteria. The next best option may be to find a therapist who, while not necessarily sex worker-affirmative, is sex work-aware. Such a therapist may not be explicitly trained or experienced in working with sex workers and needs of people in the industry, but they would be willing to maintain an open mind, and can commit to not being judgmental towards their therapy client. Some therapist are also offering online therapy (“distance-counseling”), which can be a good option for people living in smaller, more rural areas.
• The therapist will welcome your suggestions about books and other resources that they can use to expand their awareness about sex work. Often this type of therapist has worked with other sexual minority clients, like members of the lesbian, gay, bisexual and transgender communities and kink and/or polyamorous folks.

How do I actually find a therapist?

• There are many online directories that are useful and can search for local therapists. Psychology Today is a good place to​  start.
• The American Association of Sex Educators, Counselors and Therapists director​y
• The American Association of Sex Educators, Counselors and Therapists director​y
• The National Coalition for Sexual Freedom kink-aware professionals director​y
• Ask your local SWOP chapte​r if members have recommendations for local therapists who are competent in working with sex​
• When searching these directories, look for therapists who mention sex positivity, offer LGBTQIA+ affirmative care, and specialize in sexual health issues – this does not guarantee they are sex worker-affirmative, but they may have more knowledge about sex work in general and be more open to learning.
• If you have questions, reach out and ask the therapist! Some good questions for therapists could be:
• Have you worked therapeutically with sex workers before?
• What is your therapeutic style?
• Do you use harm-reduction practices?
• Are you familiar with the sex workers outreach project?
• Do you view sex work from a labor-perspective? Have you done any abstinence-based work in the past (regarding drugs/alcohol)?

In conclusion, it is important to find a mental health professional who is understanding , empathic, and supportive of your work and respects your decisions. Sex work is not in and of itself pathological and is something that can be a very healthy part of your life and identity. You deserve to find a therapist who has information about sexual diversity and range of sexual expression, including sex work.

There may come a time when one of your parents needs advanced nursing care while the other is still capable of independent living. In this scenario, it’s important to help them assess their options. This can be based on their financial situation, their independent needs, and their personal preferences. Rainbow Counseling can help you and your loved ones traverse this sometimes difficult time of life in an open and loving way.

Downsizing Options

When one parent needs a level of care the other doesn’t, there are a couple of different approaches to consider. They can continue living in their own home together, with the assistance of supplemental nursing care, or they could move in with you or another loved one. Alternatively, the more able parent could downsize to a more manageable home, while the parent with the advanced needs moves into assisted living. A third option is a tiered facility that offers living accommodations for both needs – independent living and skilled nursing, all in the same facility. While this is the more expensive option, it allows your parents to stay together while ensuring their health and wellbeing.

Assisted Living

There are a variety of different options available when it comes to assisted nursing care or assisted living facilities. Some facilities specialize and may cater to veterans, or those who need memory care or rehabilitation following surgery or illness. Research the various facilities in your loved one’s price range to ensure you find a location that offers the best fit in terms of their health needs. According to A Place for Mom, you may need to tour a number of facilities to find one that feels like a match. You’ll also want to ask about the caregiver-to-patient ratio, socialization opportunities, and the potential for increasing levels of care as your loved one ages.

Smaller Home

Of course, if one parent needs to go into assisted living, the other will likely want to be nearby. According to Senior Living, look for low-maintenance housing options like a condo, townhouse, or apartment that fits their needs. Professional movers can be a great help when it comes to downsizing and relocation. Your loved ones may opt to sell, donate, or even store furniture and personal belongings, or have them transported to a new home or residential facility. Look for local movers who have top-ranked reviews to ensure you find a reputable company. You’ll want to ask for an in-home evaluation and a written estimate before choosing a service provider.

Funding Their Needs

While some people have excellent long-term care insurance, savings, or the ability to get some degree of funding through Medicaid or Medicare, many older adults face financial struggles when it comes to funding their later years. If this is the case, you may need to help your parents free up some cash to help with relocation or assisted living costs. Sometimes selling the family home is the best option. They can calculate their home equity by subtracting the amount of money still owed on the mortgage from the current market value. This will give them an idea of how much money there is to work with when making long-term care and housing decisions.

It can be very difficult for older loved ones to face the fact that they can no longer live completely independently or care for one another without assistance. Exercise compassion, and consider looking at counseling options to help your loved ones cope with these big life changes. Offer support, listen to concerns, and do all you can to make the transition as low-stress and anxiety-free as possible. Remind your loved ones that your objective is to ensure they are safe, well-cared for, and happy.

Rainbow Counseling uses techniques including mindfulness, differentiation, and socio-cultural-based therapies to create a holistic approach to treatment that empowers clients to build self-acceptance and emotional resilience. Reach out today for an in-person or online appointment.