Because mental health is largely misunderstood, people often believe their problems aren’t severe enough to require therapy. But the truth is everyone can benefit from talk therapy at some point in their life—and that includes me, even though I’m a therapist myself. But it was not until I had a subpar experience with a white therapist that I realized the importance of cultural background in the client/therapist relationship.
As a professional in the field, I have read countless studies and have been a part of numerous conversations about how a shared racial background between client and therapist can lead to better outcomes. However, when I transitioned from being a therapist into the role of a client, I truly began to understand, firsthand, the benefit of working with someone who looked like myself.
This is not to say that non-BIPOC (Black, Indigenous, and people of color) therapists cannot provide effective therapy to Black clients—because they most certainly can. However, it’s of crucial importance for both therapists and people seeking therapy to understand that cultural background can play a role in the effectiveness of therapeutic outcomes and why. Especially considering that less than two percent of American Psychological Association members are Black and only 19 percent of counselors are Black; more than 60 percent are white. (Can’t leave home for therapy? Here’s how to find an online therapist or counselor.)
Why I left my white therapist
Anxiety over my on-again-off-again devotion to people-pleasing and ending a six-year-long relationship led me to seek therapy. After only three sessions with my white therapist, I quickly realized that she wasn’t a good fit. She was extremely timid and reluctant to challenge me. At first, I attributed it to the normal early phases of therapy.
Because I wanted to be fair and give both myself and my therapist adequate time to become more comfortable with one another, I didn’t decide to stop seeing her until four months into counseling; even then, it was a difficult decision to make. Overall, I liked her as a person. I knew that she meant well, but it was clear that although she wanted to be helpful, she was not willing to do the work to better understand my lived experiences as a Black woman if it resulted in her discomfort. Even more frustrating, she was unwilling to incorporate my feedback into our sessions, which overtime felt like a slap in the face.
When I would share my experiences with racism, she would quickly respond with her self-espoused “colorblind” ideology as if to defend herself from similar accusations, but this had the effect of minimizing or altogether dismissing my experiences and feelings. Over time, I found myself leading sessions and not authentically expressing my needs or my true feelings for fear of adding to her discomfort. Often, I left our sessions exhausted and angry for allowing myself to be silenced. By month four, it was time to move on, but moving on wasn’t so easy. (Here are 14 places to donate to fight racism and injustice.)
The challenges of finding a Black therapist
Once I decided to jump ship from my former counselor, what I was worried about came to pass: It was virtually impossible to find a Black therapist. At the time I lived in Los Angeles, and when I first began looking for a Black therapist, either they weren’t taking clients or their contact information was out of date. On the rare occasion that I found a Black therapist who was taking clients, the projected wait time before I could begin therapy was months out. Eventually, my frustration led me to put my quest for a suitable counselor on hold.
Three years drifted by without me restarting my search. Then, my father suddenly passed away. My sadness drove me to make a change, and I moved to the Midwest to start a doctoral program. Shortly after, grief caught up with me and I knew that it was time to resume my search for a Black therapist. Luckily, in the three short years since my last search, the profession had made modest but impactful strides in improving access to Black clients and the visibility of Black therapists.
I discovered black therapist directories that were like gold: Therapy for Black Girls, Black Female Therapists, Therapy for Black Men, Black Girl in Om, BEAM, and more. Even landmark mental health publications such as Psychology Today began to feature more Black therapists in their directories. Don’t get me wrong—it still took some time to find a Black therapist, but it was much easier since previous unsuccessful search.
Feeling an underlying sense of comfort
Finding my new therapist was like winning the lottery. There were still moments of awkwardness. Especially, when we first began meeting. However, I felt an immediate underlying sense of comfort after our first session. Unlike my prior counselor, she openly challenged me and held me accountable, which I appreciated and needed at the time. She didn’t shrink herself as a means to relinquish her responsibility as a therapist, and I didn’t feel like I had to lead our sessions.
Just because we were both Black women didn’t mean that we shared completely parallel experiences, but unlike my prior therapist, I didn’t find myself feeling like I had to defend my perception of experienced racism. Simply put, she believed me, which in turn, strengthened my trust in her and allowed me to be vulnerable and open. This was perhaps the most significant difference between my two experiences, and it is why my counseling experience was successful the second time around. (Here are the little habits that can boost mental health.)
Mental health in the Black community
About one in six Blacks report having a mental illness, according to a 2018 survey by the Substance Abuse and Mental Health Services Administration. And 22 percent of that group report serious mental health issues. Numbers from Centers for Disease Control and Prevention suggest that more than half of Blacks between the ages of 18 and 49 didn’t get treatment despite having a serious mental illness.
Making matters worse, Blacks disproportionately experience systemic racism and bias which places them at an increased risk of experiencing mental health challenges. A 2017 study published in Race Ethnicity and Education suggests that both exposure to racism and the anticipation of being exposed to racism has been linked to an increased risk of experiencing challenges with anxiety, depression, and racial battle fatigue. Financial stress and economic disparities also make some members of the Black community more likely to be diagnosed with mental illness, which is concerning considering that 22 percent of Blacks live at or below poverty in the U.S. (Here’s why Covid-19 hits people of color harder—racism plays a role.)
Given the apparent need for mental health care in the Black community, this begs the question: why are some Blacks less likely to seek and/or receive mental health treatment? Experts suggest that there are several factors that prevent members of the Black community from seeking counseling services:
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Mistrust of health professionals based on frequent misdiagnosis, the historically higher-than-average institutionalization of Blacks with mental illness, and on previous mistreatments, such as the Tuskegee Experiment.
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Cultural barriers between therapist and their clients.
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Focus on family and religion, instead of mental health treatment during times of emotional or mental distress.
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Racism and racial bias in healthcare.
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Socioeconomic factors that limit access to medical and mental health care.
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Stigma about mental illness and/or lack of information about mental health and wellness.
How to find the best therapist for you
Although the number of Black therapists remains low and the need for mental health care in the Black community remains high, there’s good news for both Black clients and for non-BIPOC therapists who wish to provide quality care to their Black clients. Therapists don’t have to be Black to effectively work with members of the Black community. As I mentioned, sharing a similar ethnic or racial background alone doesn’t guarantee a good client/therapist fit. Being a therapist is hard work for everyone.
That said, it’s important for members of the Black community who are seeking therapy to keep in mind that they’re doing so to improve their mental and emotional wellness, not to affirm, validate, or nurture their therapist’s feelings or ego. I made that mistake with my first therapist. Don’t fall into that same trap. Instead, feel empowered to interview prospective white therapists before scheduling an appointment. Some insightful questions include:
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What is your approach to treatment and your experience working with my specific [depression/anxiety/other] emotional issues?
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Can you describe your experience working with Black clients?
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What are your perspectives on institutional racism, racial bias, white supremacy, and their impact on the mental health of Blacks?
A word of advice for white therapists
As for white therapists—be clear and honest with your answers. Ethically, therapists are mandated to not only possess a cultural awareness and acceptanceof racial minorities, but also an awareness of themselves and their intersecting cultural identities. This is a crucial first step in better understanding concepts such as privilege and oppression and how both might impact your BIPOC clients and the therapeutic relationship.
Developing a deeper cultural understanding also helps white therapists work through any feelings of guilt, shame, and frustration that might present when conversations about race and racism are discussed with clients. Most importantly, remember why you decided to become a therapist and that everyone deserves access to quality, effective, and empathetic therapy services. (Next, read about how racism targets Black doctors.)
How to Find a Black Therapist
Black Therapists and Racial Trauma
Giving Birth As a Black Woman
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