We were lucky to catch up with Steph Fowler recently and have shared our conversation below.

Steph, thanks for joining us, excited to have you contributing your stories and insights. Have you ever experienced a times when your entire field felt like it was taking a U-Turn?

The pandemic has forever changed the landscape of mental health care, at least for some of us. Telehealth has been a game changer, not only to make therapy more easy to access, but it also enables a different type of relationship to develop when you get to see clients in their homes and they get a glimpse into yours. It allows us to do different types of work focused on or activated by the home environment, which wasn’t possible before. Sometimes people feel more comfortable being vulnerable when in the familiarity of their home, or when their pets can join them. It’s reassuring that studies have found virtual therapy to be as effective as in-person therapy – and extra beneficial when it removes some of the barriers of accessing the support.

While I know that many were quick to return to normal as soon as possible, some of us recognized that “normal” wasn’t actually working well for everyone and have been eager to integrate the lessons and adaptations from the pandemic instead of forget them. Although the abrupt shift to telehealth wasn’t a fun transition to make so quickly when COVID hit, it’s been a welcome change over time, and I hope it’s here to stay. It’s the only way I’m able to continue working with Long COVID.

Steph, before we move on to more of these sorts of questions, can you take some time to bring our readers up to speed on you and what you do?

You might say I struggled to know where I fit much of my life, and my career was no exception. I came into the mental health field after a team-building exercise/personality test suggested I might enjoy being a counselor. With some time, I was inspired to change paths and got my Master’s degree in 2010. Initially, I bounced around between positions to get exposure to all different levels of treatment and learn how to work well with multiple types of clients. While these were valuable experiences that have made me a better therapist, I again had trouble finding somewhere that felt like a good fit for me.

In 2017, I somewhat accidentally opened a therapy private practice when my other employment plans fell through. It turns out working for myself was the best decision I could have made. As I integrated all of my professional experience and embraced my personal healing work, I found myself attracting – and really enjoying working with – clients who were fellow black sheep, rebels, cycle-breakers, and other “weirdos” (my deepest term of endearment). When the pandemic hit and I became disabled from Long COVID in 2020, my challenges within healthcare and wisdom from the chronic illness community shifted my perspectives and priorities. In 2024, I rebranded my business and refocused my work to support and elevate the needs of new types of non-conformers: those in the Long COVID, chronically ill, dynamically disabled, neurodivergent, and COVID Conscious communities.

I now help fellow misfits reclaim their identities, stories, and power. In addition to psychotherapy, I provide training and consultation to assist other professionals in adapting their work to better serve these groups, or to make their own entrepreneurial efforts more sustainable if they belong to these groups themselves. I can also be found over on Substack writing the Misfit Mental Health newsletter where my focus is depathologizing non-conformity and deconstructing social norms and narratives that impact our collective mental health and wellbeing.

It has been a challenging transition because of how limiting Long COVID is for me, even 5 years later. Trying to balance running a business while managing my health needs and limitations has been a struggle. However, I honestly believe that the flexibility I have working for myself and being able to adapt to my symptom flares is the only reason I’m still able to work at all. Despite the difficulties, I’m proud of what I’ve been able to accomplish. I was recently interviewed for a piece in the February 24, 2025 issue of TIME Magazine called “5 ways to stand up for yourself at doctor’s visits”, and it’s available online under the title “What to Do If Your Doctor Doesn’t Take Your Symptoms Seriously”. I hope this will be one of many ways I can help people feel validated and better able to navigate a world that isn’t designed for all of us.

Other than training/knowledge, what do you think is most helpful for succeeding in your field?

Curiosity, complexity, and collaboration. (And honestly I think this applies to most helping professions.) Much of the culture and education within the mental health field tries to position therapists as experts in a hierarchical way, and I believe this is often a disservice to both therapists and clients. Rather than approaching competency as something that is attained with certifications in a one-size-fits-all approach, learning to have more nuance and flexibility significantly increases effectiveness.

If therapists shift from an expert stance into a collaborative stance with humility, it can encourage the client to tap into their autonomy, reattune to their own voice, and build on existing strengths. It creates a very different dynamic when therapists work more as a guide or consultant with ideas and strategies that may help clients, but then let the clients decide what to try and whether it’s effective. It also relieves some pressure on therapists to “get it right” and makes space for messing up and course-correcting when needed. When clients have identities or experiences that the therapist doesn’t hold or have, this also fosters an environment for therapists to be in a learning role and lets the client’s expertise guide the work.

Cultivating a perspective of complexity encourages recognition of the different identities someone has or the many dimensions of their life. Oversimplifying people or their problems can cause significant harm in therapeutic relationships. Similarly, having a singular approach for every client risks alienating or pathologizing someone if it is not effective for them. Instead, I’ve found significant value in having multiple modalities to draw from, and viewing a case more in terms of, “how much might X help which symptoms, and what other approaches might address the rest?” I strongly believe this framework is more accurate and effective across the board, but especially when working with chronic illness and disabilities.

Lastly, I think curiosity helps foster both collaboration and complexity. Learning to acknowledge one’s own assumptions and ask better questions didn’t come from grad school. I had to unlearn/relearn how to be more curious and think less in simplistic absolutes by taking a year-long training in narrative therapy. I don’t think this modality gets much traction in the Western world because much of it runs contrary to our culture and our medical model of healthcare. I can’t help but think about how more curiosity, complexity, and collaboration across the board might positively impact many of our problems – both individually and systemically.

We often hear about learning lessons – but just as important is unlearning lessons. Have you ever had to unlearn a lesson?

Not everything can be fixed. It might seem obvious or simple, but this actually contradicts a lot of assumptions and expectations in our culture. I realized early in my career that sometimes problems or feelings don’t fully change or go away, and instead therapy helps reduce the frequency or intensity, recognize when these old feelings or patterns get activated, and manage it better when that happens.

While I learned that relatively quickly, it was only more recently that I reckoned with this also applying to physical health. Even though I never would have said, “if someone gets sick and doesn’t get better, it must be their fault”, I discovered I had internalized a lot of ideas that imply this. The model we tend to see most often is that health is simple – if someone gets sick or injured, all they have to do is just go to the doctor who will figure out what’s wrong and what medical care will restore their health. There are a lot of perpetuated beliefs that if this doesn’t happen, the suffering person isn’t trying hard enough, is doing the wrong thing, is faking it, or must be exaggerating.

Unlearning this didn’t come from a book but instead came from a crash course provided by Long COVID. I spent years with odd debilitating symptoms, some constant and others intermittent. I exhausted myself trying to find knowledgeable doctors, waiting for months each time, then spending tens of thousands of dollars on imaging, tests, medications, therapies, rehabilitation, and alternative treatments. Even though I found providers who believe and want to help me, nothing in 5 years has really helped, and I only have roughly 30-40% of my previous capacity. I had to learn the hard way that good health and physical ability are fragile and temporary in nature, and you cannot always regain what’s lost. Some of us just don’t fit inside the boxes that exist, but it’s the boxes that need to be expanded.

Throughout my process and in hearing from others I’ve met along the way, it became clear that very few professionals understood these realities or how they can impact every facet of someone’s life, identity, and psyche. It’s been a tough learning curve, but I feel fortunate that I can use this hard won knowledge to support others as they adjust to their changing bodies and abilities. It’s also satisfying to educate other professionals and help them to unlearn these ideas and practice better ways to support the people whose experiences don’t mirror traditional models and expectations of recovery.

Contact Info:

• Website: https://www.misfitmentalhealth.com
• Instagram: https://www.instagram.com/misfit.mental.health
• Linkedin: https://www.linkedin.com/in/stephfowler/
• Other: https://linktr.ee/misfit.mental.health
  https://bsky.app/profile/misfitmh.bsky.social
  https://misfitmentalhealth.substack.com

Image Credits

Photo 1: Kyle Bice