Reader,

What happens when our definition of accountability becomes so narrow that it only flows upward?

As clinicians, we spend years learning how to be accountable to institutions:

• Ethics boards.
• Licensing bodies.
• Agency policies.
• Insurance companies.
• Employers.

And yes, we need to keep these systems in mind, especially if we're not thinking of divesting from licensure (or can't do it yet.)

But accountability that only moves upward can create a strange dynamic: clinicians become highly skilled at protecting institutions while remaining disconnected from the communities we are meant to serve.

A liberatory practice asks a different question:
​Who else are we accountable to?

Or even better:
​Who should we truly be accountable to?

After all, accountability Is not the same as compliance.
​Many of us were trained to equate accountability with:

• following rules
• avoiding complaints
• minimizing liability
• documenting correctly

But accountability is relational.
It requires listening, reflection, repair, responsibility.

Clinician can be fully compliant and still cause harm.
Clinicians can follow every policy and still fail to meet the needs of the people in front of them.

So I propose that we move towards Interdependent Self-Governance.
​I know though... many people hear “self-governance” and imagine chaos.

No rules. No accountability… Everyone doing whatever they want.
But interdependent self-governance asks for more responsibility, not less.

It asks us to move away from authority concentrated at the top and toward responsibility distributed throughout relationships and communities.

In other words, it's about learning from communities, not just assessing them.
​And don’t get me wrong, being trained to observe, assess, diagnose, conceptualize… it’s an integral part of what we do…

But what happens when our expertise becomes more valued than a community’s own knowledge about itself?

We risk losing sight of:

• practicing cultural responsiveness
• acknowledging community wisdom
• learning before labeling
• curiosity before certainty

Or what if therapy is not always the answer?
​Sometimes the thing someone needs most is:

• housing
• community
• rest
• disability accommodations
• political organizing
• friendship
• cultural reconnection
• spiritual care
• economic stability

Because therapy can support healing. It should not be expected to replace everything else healing requires.

Liberatory practice is not about becoming less accountable.​
It is about becoming accountable in more directions.

Upward to institutions when necessary.

But also outward and sideways to communities.
Across to colleagues.
Toward clients.
Toward future generations.
Toward the collective conditions that shape whether healing is possible in the first place.

And perhaps one of the most liberatory questions we can ask ourselves is:

With liberatory care,

Silvana

​​Liberatory Letters | The Practice of Liberation | Decolonize Your Practice​

PS.
​If today's letter on true accountability resonates with you, you will enjoy my workshop “Start Here: A 4-Step Framework To Begin Decolonizing Your Practice”, my upcoming live 90-minute workshop on decolonizing your practice.

One of the things we'll explore is how accountability shows up inside our day-to-day clinical work—not only as a professional obligation, but as a relational practice.

We'll look at how our identities shape our clinical lens, where change is possible within our practices, what gets in the way, and how to begin making liberatory shifts that are grounded in your actual capacity.

Because knowing that something needs to change is one thing.
Knowing where to begin is another.

​Sign up here​

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⬆️ Let's connect!