Dreams of Flight: A Journey to Private Practice

“I got into private practice because I was tired of having to prove over and over again to sighted employers that I’m competent and educated,” Darian Slayton Fleming, a social worker in Portland, Oregon, tells me. “It can be really tough in the job market for people who are visually impaired, and I finally decided I was done convincing people of my worth. So I started my own practice.” 

Fleming describes herself as “a survivor with a fighting spirit,” and in talking to her, I can see that’s true—both in her career as a licensed clinical social worker and certified rehabilitation counselor, and also in her personal life. When Fleming was a young child, she became ill with laryngeal tracheal bronchitis, an illness that left her with legal blindness and acquired cerebral palsy. 

This experience, she says, is one of the reasons she chose to specialize in vocational counseling and helping clients with disabilities or chronic health conditions and their families. Although Fleming is quite open and frank about the challenges she’s faced to reach where she is now, she sounds positive. All of her life experiences weave into her evaluation of the journey her practice has taken to get where it is today, and where she might go in the future. 

Building the Foundation

Fleming got her masters in social work in 1983, and has been in the social work arena since the seventies. Despite that experience, she didn’t get into private practice until much later in her career. “I’ve worked in the public sector all my life,” she says. “I was always working for other agencies, and I just finally got to the point where it wasn’t working for me.”

Her agency work, Fleming goes on to say, was challenging for her—not necessarily because of the work itself, but because of the environment and expectations. She finally decided she didn’t want to deal with it anymore. Once she got her license as a clinical social worker, her options opened up. “That’s when I decided to get serious about my private practice,” she says. 

Today, Fleming has a thriving practice where she works with her clients on what she calls “disability management across the lifecycle.” But it took her a little while to get here. 

The Path So Far

Like many private practitioners, Fleming didn’t experience a straight line from wanting to start a practice to officially opening her doors—there were some obstacles to overcome in the early days. 

When she started her practice in 2010, it started out small, in part because she was having difficulty enrolling on insurance panels. “That quickly became an access issue for me,” she explains. “For the most part, websites on the internet aren’t user-friendly to people who use screen-readers.” 

There are resources online that companies can use to make sure their websites are more accessible, but Fleming says since it’s not mandated by any legislation, a lot of web developers don’t use them. “A lot of companies think it’s a hardship, or that it’s going to be costly, but it’s really not,” she says. “It just requires some knowledge, and a willingness to learn how to do new things.” 

Despite the access issue, Fleming still wanted to be paneled with insurance companies—but without a steady clientele, it was a slow process. She explains that she needed to pay someone to enroll her on insurance panels, and could only afford so much at a time, which slowed her down. But in December of 2015, she found someone who’s entire business was enrolling people on insurance panels. Once they started working together, Fleming says, the referrals started rolling in. 

Finding Stability

“At the beginning, that EAP-work was my bread and butter,” she tells me. “I had so many referrals that I couldn’t take them all. That really helped me get my practice started. It helped me build up my client list and get a regular income.” 

Now, five years down the road, Fleming has started to establish herself and build relationships with her clients, so that they keep coming back. “I’ve realized recently I have a bit of a following,” she says with a small laugh. “I have clients who initially came to me for their EAP sessions, but once those are done, they ask to come back.”

Although it took her some time to get her practice on the road, Fleming is proud of the work she’s done, and excited for the future. Because of her recurring clients, she says that she’s “starting to get to a point where I might not need to rely so much on EAP referrals anymore, which is pretty exciting. My income is now supporting me, not just my office. It feels really good to be here.” 

Developing a Niche

Despite all the progress she’s made in developing her client base, Fleming still considers herself a bit of a generalist. “I haven’t developed enough of a clientele in the disability arena to fully support  myself that way—yet!” she says. “So I work with a lot of anxiety and depression, as well as some adjustment to disability.” 

Fleming’s personal background and education make her a good fit for many disabled clients, but she’s found that not everyone who comes to her necessarily identifies as disabled. “A lot of my clients have chronic health conditions, or concerns about their body and physical limitations as they age,” she tells me, “My background has been really helpful to serve those populations.” 

Focusing on Forgiveness

Another thing Fleming noticed as her client base grew was that many of her clients were coming to her with feelings of anger. But when she researched anger management groups in her area, they weren’t necessarily good fits for her clients—so she decided to start her own. 

“In my group we talk about stress management, communication, and how we handle our self-talk. And we also spend a lot of time talking about forgiveness,” she says. She goes on to explain that when she was researching groups, forgiveness wasn’t as much of a focus as she wanted it to be for her clients. 

“For me, it’s not only about learning how to manage our anger so other people will respond to us better,” she says. “It’s also about how we talk to ourselves, and how we learn to accept who we are. We have to learn how to work with what we have, instead of trying to avoid who we are.”

Fleming says it was her own personal experience and study of forgiveness that led her to have this as a focus in her group. As she’s continued to study it, she feels more sure that forgiveness is a key pillar of her technique as a therapist in addition to her anger management group. “Everybody has strengths. If we can build on those, and be forgiving about our limitations, then we can begin to understand what our barriers are to being able to manage our emotions effectively, and what we can work on to overcome that,” she says.  

Living with Intention 

Aside from her focus on forgiveness, Fleming also places a lot of emphasis on intention. “I’m really passionate about helping people learn to be intentional about the person that makes a difference in their own lives,” she explains. “Because at the end of the day, even though we need support from other people sometimes, we have to be ready to be the ones to make that change. So that’s why I try to help my clients do.” 

I ask Fleming if she thinks this approach is why she connects so well with her clients. Partly yes, she says. But she also thinks that certain qualities of her personality—such as being a good listener and practicing empathy—makes a big difference. 

“I think it helps that my clients see me as human. They see me as approachable because I appear to them as someone who also has challenges,” she tells me.  “I think those challenges are part of what makes me a good counselor—I’m resourceful and I try to find ways to overcome barriers, and that’s what I try to do with my clients as well.” 

Looking to the Future 

Ultimately, Fleming says, her approach is working for her practice for the state it’s in now. She has returning clients, and hears positive feedback from her long-term clients, which encourages her that she’s moving in the right direction with her practice. Even with this success though, she says she’s always looking to grow. 

“I’m always looking to develop, maybe start doing some more group therapy,” she tells me. “I also want to start doing some motivational speaking, and part of that is I’m working on a documentary about my late husband.” 

She tells me the premise of the documentary. It’s about her husband, affectionately called Blind John, who was a blind, solo skydiver. The documentary is about his life, and his skydiving—which he continued to do even after he lost his vision. 

John learned to skydive while in the Air Force, but when his vision started deteriorating, Fleming says, he didn’t want to give up skydiving like he had given up so much else. So he and his diving buddies developed safe methods that John could use to continue to skydive on his own. 

“When it’s done, I’m hoping to use this film to really talk to the sighted public about working with and employing people with disabilities,” Fleming explains. “And I also want to use it to talk to the disabled community about pursuing your dreams.

“Because that really was his message. He thought you could do just about anything that you want to do. You might have to get creative, and do some outside-the-box thinking, to find the ways to do it. You’ll need determination and willingness to seek support—but you can find ways to do the things that matter to you.”