How to dress well (as a therapist)
December 23, 2017 1:06 AM   Subscribe

I recently started working as a therapist and am wondering: How would you like your therapist to dress?

I recently started working as a therapist at a large psychiatric inpatient facility. We are not provided work attire and are free to dress however we please (except for the usual stuff not too revealing etc.). I usually wear black and rather fashionable minimalist clothing and enjoy wearing large jewelry pieces (not large in the of worth but more like cheap statement pieces). I usually view clothing as a form of personal expression and have recently started wondering: Is it appropriate to express myself in that way with my patients? while I am aware that I will always show up “as myself” in my work in some way I am wondering if I should make a conscious effort to dial my look back to create more of a blank space for my patients to express themselves.
Thank you all very much in advance!
posted by zinnia_ to Clothing, Beauty, & Fashion (28 answers total) 3 users marked this as a favorite
As someone who sees a therapist, I want you to:

a) above all else, be comfortable. I don't want you to be distracted from listening to me by tight clothes, or seams that dig in, or clothes that don't breathe etc etc. I'm here for your brain, not your appearance.

b) not be so dressed-up that I feel shabby and self conscious. So no expensive jewellery or ultra fancy makeup.

c) not be so dressed-down that I think "just rolled out of bed", "alcohol/drug problem." So, nothing stained, ripped, torn, faded, threadbare.

Wear what you'd wear to a parent-teacher conference, maybe?

Or what you'd wear to lunch with a close friend to a cafe/casual restaurant?
posted by Murderbot at 1:18 AM on December 23, 2017 [10 favorites]

Tough question. I would be cautious about wearing anything sexually suggestive. That can really throw your patients off. For me I prefer my therapist to be dressed casually as it keeps me more relaxed. But you need to feel comfortable with your cloths. Gotta find that happy compromise.
posted by ljs30 at 1:18 AM on December 23, 2017

How would you like your therapist to dress?

In comfortable cottons with no perfume. No perfumed deodorants, body sprays, hair product, colognes or aftershaves.
posted by flabdablet at 1:40 AM on December 23, 2017 [15 favorites]

To me, the clothes you describe would be just fine. Are you comfortable? Put together? Don’t look ostentatiously wealthy? I’d say you’re good to go.
posted by ocherdraco at 2:08 AM on December 23, 2017 [4 favorites]

The therapist I see dresses in a slightly understated way but wears scarves or art jewelry and printed fabrics. I find myself enjoying the look of these things. They're not in-your-face, but they feel as if they're about joy and happiness.
posted by Grunyon at 2:13 AM on December 23, 2017 [16 favorites]

no perfume. No perfumed deodorants, body sprays, hair product, colognes or aftershaves.

Yes, this!

Fragrance gives me migraines that can last for up to 10 days!

Lots of people get migraines from fragrance!
posted by Murderbot at 2:33 AM on December 23, 2017 [8 favorites]

I think you meeting your patients in an inpatient psychiatric facility makes things a little different. There is more of a power imbalance right there. I think if I were being treated as an inpatient and feeling that bit more vulnerable, I'd be less willing to open up if the therapist was wearing designer/obviously expensive clothes or even just fashionable/statement pieces. What are the patients usually wearing? Can they wear whatever they want or are there any limitations?

I think I'd go fo something that signals warmth and joy more than fashion awareness.

Also, seconding no perfume. I work with patients and if a patient comes in wearing perfume I keep sneezing and my eyes keep watering throughout the entire appointment.

Whatever you decide I think it's great that you are being thoughtful about this.
posted by M. at 2:34 AM on December 23, 2017 [13 favorites]

not kidding--do those large statement pieces have sharp edges and can they be used as a weapon?
posted by Morpeth at 3:38 AM on December 23, 2017 [2 favorites]

The one time I noticed what my therapist was wearing was because she had a very deliberate purple aesthetic (not just her outfit but also her office). She was upfront about it and I got used to it very quickly. But I’m an artsy weirdo so it wouldn’t have mattered really.

All the therapists I’ve had tend to dress smart casual or slightly-more-interesting businessy wear.
posted by divabat at 4:03 AM on December 23, 2017

(I think I’d probably notice more if you were looking like a White Hippie Culturally Appropriative Woman because that would set off some alarm bells, but that’s probably the only thing that’d make me question you.)
posted by divabat at 4:04 AM on December 23, 2017 [1 favorite]

Also can the jewelry be grabbed as a way to choke you or confine you?

I’m a therapist who has worked in a psychiatric ER and when I worked there I would wear comfortable, modest, and neutral clothes. For example, looser pants and a flowy sweater or a maxi skirt and a tunic top in solid colors or minimal patterns. I found comfortable shoes are a must for my own sanity. A lot of my coworkers wore danskos like the nurses, but I found a great pair of aerosoles ballet flats with good arch support.
posted by Waiting for Pierce Inverarity at 4:07 AM on December 23, 2017 [8 favorites]

I don't care too much what my therapist wears as long as it's not distracting. Most of mine have worn business casual-type wear.
posted by bunderful at 5:00 AM on December 23, 2017

There's no single way to dress that will work for every patient. Some may want to be treated by someone who looks important and powerful (i.e. an expert) while others need someone who is approachable, relaxed, informal.
posted by Obscure Reference at 6:34 AM on December 23, 2017 [2 favorites]

Coming back to it:

* Clean
* Nicely/neatly enough that I'm not concerned for your mental or financial well-being
* Fairly conservative and non-distracting - no chest hair/cleavage/belly buttons.
* Not so flashy or expensive that I wonder if I'm being over-charged, or if you're committing some kind of insurance fraud
* Easy on the cologne/perfume - preferably none

I have had a therapist who was always dressed to the nines with great hair and makeup and it made me feel a little self-conscious that I'm never as well-put-together, and also that if she valued appearance so highly she must surely be noticing my inexpensive shoes and lack of makeup, but she was a good therapist and I moved past it. I *am* generally more comfortable with therapists who have a more down-played look - minimal makeup, neat and ironed but not flashy, simple business casual look. When I leave the room I want to remember what we talked about and not what either of us was wearing.
posted by bunderful at 7:02 AM on December 23, 2017 [3 favorites]

I have a family member who spends some time in psychiatric facilities and I know he reads things into everything. From being around him for the past several years my only feedback would be that all black would read to him like death/undertaker/grim reaper, etc. Not that this is your responsibility! But depending on the type of people you work with, something that was a little more socially neutral (i.e. dark tones but ones with less social meaning potentially imbued in them) might give them a little less to fixate on. If I were a suicidal psychotic, seeing someone in all black might not be right for me.
posted by jessamyn at 7:13 AM on December 23, 2017 [5 favorites]

There's good answers above. When I did med management for psych, I developed a uniform of sorts that involved plain slacks, a patterned or plain business casual shirt, and a cardigan.

My company's id cards came on breakaway lanyards. I was involved in several occasions where med team members were assaulted with their own stethoscopes around their necks and rings were torn off. Don't wear anything more than a wedding band if applicable. Also I recommend clothing that is easy to wash.
posted by cobaltnine at 7:39 AM on December 23, 2017 [3 favorites]

I am a social worker and I've never worked in inpatient psych, but have worked in residential care for people with different levels of cognitive issues, sometimes including hallucinations, delusions, episodes of large jewelry has mostly stayed at home during the times I worked in those environments. I've had necklaces used to choke me or even just (through no malicious act) to pull me much closer than I was interested in being to the client. Large earrings are also a target--having an earring pulled is VERY painful and can actually tear your earlobe.

I still express myself through my clothing, but usually try to do so with color, layers, and pattern, and you're right, more subtly. Layers are doubly good because you are not in control of the temperature and you may be walking/on your feet a lot more than you imagine and may need to shed some layers or you may be sitting with a client at a desk and get chilly. I would avoid overly busy patterns on top as it can be stressful for people to sit and look at for a long time. Also if people are having hallucinations or visual distortions they might reach for patterns if they're on a blouse.

100% recommend comfortable shoes, whatever that means to you. I always said when I finished grad school I was going to get a pair of Danskos but I haven't done it yet!
posted by assenav at 7:53 AM on December 23, 2017 [7 favorites]

So, my husband and I are in marriage counseling right now and our therapist wears ballet flats without socks. Sometimes while she's talking/listening, she fusses with them such that the shoe is just dangling off the end of her foot and I can see most of her foot and toes and it is SO. GROSS. And very distracting. Like, I don't want to see your feet! Please stop! It's so bad that I think I'm going to anonymously send in a note about it to the office manager. So yeah, don't show me your foot? Weird. Ugh.
posted by ancient star at 8:25 AM on December 23, 2017 [1 favorite]

Therapist here! So great that you're thinking about this.

When I worked in an inpatient setting, I was very mindful of feeling comfortable and safe at all times - so no long necklaces or earrings (for reasons stated above) and comfy shoes. (mostly low booties/oxfords/loafers) Didn't wear anything too short or tight or low-cut. I generally don't wear a ton of makeup or perfume or jewelry, and I think dialing it back is good practice in general in our line of work. (for example, I looove red lipstick but I save it for the weekend.) I wear mostly neutrals (think Everlane/Oak & Fort/Madewell) and add pops of color with my shoes when I feel stuck in a rut of blacks and greys. I work in outpatient/private practice now and that's how I generally dress there too, though I throw jeans into the mix now.

That said, MY therapist's uniform is a button down shirt, khakis, and hiking shoes. Occasionally she looks a little sloppy but I don't care how she dresses because it's none of my business and she's wonderful.
posted by blackcatcuriouser at 9:56 AM on December 23, 2017 [3 favorites]

All wonderful advice above- especially regarding not wearing any scents/fragrances and dressing comfortably/safely.

The way you described your style of dress- black with statement jewelry- would be reassuring to me as a client/patient. It doesn't sound too visually stimulating. It also sounds like it would be consistent enough that I would be able to recognize you if I had difficulty recognizing your face/voice.
posted by dearadeline at 10:04 AM on December 23, 2017

I would avoid overly busy patterns on top as it can be stressful for people to sit and look at for a long time.


Additionally, the way you dress from week to week (or day to day if you see patients more frequently) should be relatively consistent as part of the therapeutic frame... The stability that they're looking to you for rather than changing drastically from week to week.
posted by Jahaza at 10:27 AM on December 23, 2017 [1 favorite]

I think the better question is how would you like *your* therapist to dress, knowing that clothing is one of many ways that you'll be expressing who you are. Some therapists want to reveal nothing of themselves, so dress very generically. Personally, I prefer my therapists to be quirky, so I always prefer to see people whose clothing tells me something about who they are. I'm more comfortable with someone who is themselves comfortable with who they are, so super casual is fine with me, as is super stylish. As long as I get a sense of who the person is.

Obviously, clothing is only one part of the therapist's way of expressing themselves. There's also word choice, non-verbal behavior, the sorts of things they ask about, etc.

When I've supervised therapists in training, I've always urged them to remember that who they are is the most important tool they have, and that they should try to be more of who they are, as opposed to trying to look or be like someone else.

Notes of caution - n-thing what's been said above about safety on inpatient units. People can get choked and otherwise attacked with clothing items like necklaces and ID badge lanyards. I'm surprised your employers haven't cautioned about that. Also, just notice if you find yourself dressing *for* a particular patient, like if you're thinking that such and so would like this dress or piece of jewelry. It can signal an important piece of counter-transference.
posted by jasper411 at 10:39 AM on December 23, 2017 [2 favorites]

The style you've described should be just fine. If clients start getting distracted by your jewelry or other accents, you can make a change.

The only time I've had an issue with clothes in such a situation: I went to a certain psychiatrist 3 times. Day one, she was nicely put together in shades of brown, with an a-line skirt, refined-looking blouse, and soft cardigan. The next time, she wore very tailored pants and a snug white blouse shaped like a vest in front -- quite crisp and restrained. The next time, She had on a very flowy light-weight flowery skirt and a lacy blouse, and very feminine flats. Perhaps she just likes to wear lots of different styles, but I was mystified.

Many people who go for therapy look around at the room and observe how the therapist looks and acts. It's the only way we get clues as we go into a new and anxiety-provoking situation. If they comment, you may be able to take off from their comment and use it therapeutically.
posted by wryly at 12:04 PM on December 23, 2017

I have seen a lot of therapists and my most recent and total fave is a young queer tatted Chinese-American woman who wears jeans and plainish short-sleeved shirts. She looks like who she is, which is great. But I am seeing her voluntarily, not as an inpatient, so honestly I cannot speak to that. You sound thoughtful and considerate, Which are valuable traits in a therapist and other human beings. Good luck!
posted by Bella Donna at 7:47 PM on December 23, 2017

Hard no to the statement jewelry, but everything else you're describing sounds fine.

I know multiple people working in your approximate position. Minimalist sounds like a great approach.
posted by RainyJay at 8:52 PM on December 23, 2017

Response by poster: Thank you all so very much for your thoughts! I was always very careful to look put together as a way of being respectful to my patients and never thought about it being intimidating - which totally makes sense now. The people I work with are mostly treated for affective disorders, so physical safety is less of an issue than in a psychiatric ER or on other floors of the house.

There are some things I can’t really help (I sweat like nobody’s business anyway and being a rookie in my line of work can be pretty sweat-inducing), but I will definitely reach for a more neutral outfit when I return to the clinic tomorrow.

Again, thanks a lot for your help!
posted by zinnia_ at 1:38 AM on December 25, 2017

I sweat like nobody’s business anyway

Unscented antiperspirants
are a thing.
posted by flabdablet at 2:06 AM on December 25, 2017

Also, sweat takes at least a day to make cottons smell bad, as opposed to merely human. Synthetics get festy far faster.
posted by flabdablet at 2:07 AM on December 25, 2017

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