How We Practice

Outpatient Care Designed for Clinical Complexity

At Side Quest Psychotherapy, how we practice is inseparable from what we believe. We are committed to neuroaffirming, consent-centered care that is explicitly anti-carceral, HAES®-aligned, and grounded in harm reduction. We believe that ethical therapy must protect autonomy, honor the full complexity of identity, and reckon honestly with the systems — ableism, diet culture, carceral psychiatry, and white supremacy in mental health — that shape distress in the first place.

We specialize in outpatient care for those whose needs are often misunderstood, misdiagnosed, or flattened by rigid treatment models. Many of our clients are autistic, have ADHD or PDA profiles, live with chronic illness, PANS/PANDAS, medical trauma, or identity-related stress — factors that meaningfully shape capacity, access, and safety, yet are frequently misread as “noncompliance” or “treatment resistance.”

Weight-centric medicine, compliance-based therapy, and diagnostic gatekeeping have caused real harm to neurodivergent and fat people. We name that directly — and we practice differently.

Our goal is to do as much as possible at the outpatient level of care — safely, ethically, collaboratively — so escalation is never the default response to complexity. Some people come to us to prevent unnecessary step-ups. Others come after higher levels of care and need support that translates gains into real life without recreating surveillance, pressure, or loss of autonomy.

What this Looks Like in Practice

Healing doesn’t happen in a straight line — it unfolds in real time, in ways that are often messy, unpredictable, and unique to you.

At Side Quest Psychotherapy, therapy is designed around this reality:

Neuroaffirming and anti-pathologizing — grounded in the social model of disability and informed by lived experience of neurodivergence.
Collaborative and autonomy-supportive — shared decision-making and consent guide the pace, focus, and direction of care.
Relational rather than hierarchical — partnership over authority, always.
Harm-reduction oriented — prioritizing safety and sustainability over abstinence or forced recovery.
HAES®-aligned — intentional weight loss is never a treatment goal; complex body experiences are held without shame or coercion.
Flexible and sensory-aware — creating space for movement, stimming, quiet, food, pets, creative play, or parallel activities.
Direct, transparent, and real — no pressure to perform wellness or follow a prescribed timeline.

Sessions may be structured or unstructured, conversational or quiet, insight-oriented or practical. Co-regulation can take many forms — sometimes we talk, sometimes we build with LEGO, share special interests, or simply exist together in a regulated space.

These moments aren’t distractions from healing—they are the healing itself. They build the relational safety that allows deeper, harder work to happen.

Clinical Care Standards

We understand that many people seeking care have had experiences where therapy felt unsafe or even harmful. We recognize that clinical complexity can bring serious risks — including suicide, medical complications, or other crises — and we take these concerns very seriously. Our care is grounded in anti-carceral principles, prioritizing your safety, autonomy, and dignity.

Below are our clinical standards for navigating these situations. Transparency and clear limits are central to building trust, and the following policies reflect how we hold safety while keeping you in control of your care:

Crisis support

Suicide Intervention

Our approach is grounded in the CAMS Framework® and rooted in compassion, autonomy, and anti-carceral care. If you're moving through suicidal thoughts, you will be met with understanding — not judgment, not automatic involvement of law enforcement or emergency services.

Hospitalization and emergency services are never our default. They are considered only as a last resort, and only after all other paths have been thoughtfully explored — with you included in every step of that conversation. Our priority is to stay in relationship, to support you, and to avoid escalation whenever safely possible.

Eating disorder care

Medical Risk Management

We follow guidelines from the Academy for Eating Disorders' Medical Care Standards Committee and Safe Exercise At Every Stage (SEES). A HAES®-aligned PCP and Registered Dietitian are essential parts of outpatient eating disorder care being the right fit.

If you’re medically unstable and outpatient care isn’t enough, we may recommend a higher level of care (HLOC). This step can feel both necessary and difficult—it can offer safety and support, but also disruption and stress. We help you prepare, plan how to communicate your needs to staff, and stay connected throughout. When you return, we’re here to continue supporting your healing, centered on your safety, autonomy, and long-term well-being.

Substance Use

Harm-Reduction Approach

We take a nonjudgmental, harm-reduction approach to substance use — including being 420-friendly. If substances are part of your life, we can explore their role together. There's no agenda, and no assumption that abstinence is the answer.

We don't provide specialized substance use disorder treatment, but we can support reflective, harm-reduction-informed conversations and refer to specialized care if deeper treatment is needed.

If You're Wondering Whether We Could Support You...

You retain agency throughout the process — including the freedom to set limits, ask questions, and shape what support looks like for you. If something we say or do misses the mark, bring it into the room. Repair is an essential part of relational work.