Sneha Raj, PsyD, LP

Approach to care

• What does it look like for you to provide care to patients in larger bodies? How is, or isn’t, your approach different from how you care for patients in smaller bodies? If you work with children, how is or isn’t your approach different when working with children?

  I have a background in health paychology and practice therapy from a Health at Every Size/Acceptance and Commitment/Cognitive Behavioral perspective. I believe that each client is an expert in their own lives and my role, as a therapist, is to be a consultant on their personal journey of personal well-being. Throughout my professional, clinical experiences, I have learned that no two people are alike, in their lived experiences and in their own bodies, and there is no one-size-fits-all route to well-being. My clients and I explore, together, the unique biological, psychological, and physical factors that create a unique quality of life, and we work to uncover the important values that contribute to a meaningful life. When we focus on a client's unique values, we always uncover creative solutions for managing distress and enhancing wellbeing that is tailored to the unique needs of a client.

• What is your perspective on how weight is or is not related to health?

  My clinical experiences in working with individuals who are managing chronic pain and illness has taught me that weight is only one of many factors - to be considered when exploring a client's therapeutic needs. Weight is a whole number that does not specify how much is fat, bone, organs, water, or waste. And that number definitely does NOT indicate how loved, wanted, valued, needed, and important a person is in this world.

• Finish this sentence: “Fat people are…” 

  some of the most intuitive and empathetic individuals I have had the privilege of working with and knowing in my life.

• How do you, your clinic, and the healthcare system you work in use BMI (i.e BMI cutoffs for accessing certain services, BMI on charts and printouts, etc)? Is this flexible?

  I do not use BMI cut offs in my clinical work and do not bring attention to it unless the client verbalizes that this as a specific focus of therapy.

• If a patient declines to be weighed, how do you and/or your staff proceed?

  I will never ask to weigh a client or discuss their weight, unless they verbalize this as specific focus of therapy.

• If a patient declines to discuss weight loss, nutrition, and/or exercise, how do you proceed?

  When a client does not want to talking about any subject, I end that particular line of questioning immediately. I try to ask open ended questions that let the client inform me of what is important to them and what they want to talk about. I believe that respecting the client's right to consent is vital to creating a safe space for self-exploration.

• What does the physical accessibility of your office space look like? What kinds of accommodations are present for people in larger bodies? Are there things you wish were in place that are currently not? 

  I am a telehealth clinician and only offer therapeutic services online. This allows my clients to engage therapy from their own spaces of comfort and also informs me of their unique needs for accessibility.

• What do you do to allow fat people to feel comfortable and welcome in your office? 

  I remind my clients that it is their right to not consent - and change their minds on consent - to anything that feels uncomfortable or unsafe. I always engage my clients in a discussion on what they need, in their space, to feel comfortable and safe in order to engage therapy.

• If you’d like to use this space to talk about any identities (gender, race, size, sexuality, etc.) you hold and how this relates to your care, please do so. 

  I am a South Asian-American female who, like many individuals, has been on a life long journey to not only to unlearn toxic, societal messages about what my body should look like, how it should function, or be pleasing to others, but to also remember how to listen to listen to my body and intuition. As a therapist, I want to support others in exploring their unique values and how to listen to their sense of healthy intuition, that allows them to create an authentic and meaningful life for themselves.