Sizeism in Therapy: Fat Shaming in Supervision

The author, a doctoral student therapist, discusses her experience with a clinical supervisor who fat-shamed a client during supervision. This incident is examined within a shame framework and addresses the experience of shame, the effects of shame and shame-proneness on mental health outcomes, and why discussions about shame are often avoided in therapy by both clients and therapists. Some of the real-world considerations that can impact treatment for fat individuals, including chair size and comfort of the client, implicit bias within therapy, and goals for treatment, are also discussed.