With regards the issue of race and therapy, the overwhelming focus within the industry remains on how to mitigate the issues that arise in the context of racialized clients and White therapists. Here the multicultural competence literature indicates that matching the cultural characteristics of the treatment with those of the client increases treatment effectiveness (Interian & Díaz-Martínez, 2007; La Roche & Lustig, 2013). But this remains a foggy and under researched task, and it is increasingly being shown that matching the cultural characteristics of the therapist themselves to the client also increases treatment effectiveness – due in large part to a greater consequent understanding of the intersections of the client’s complex individual identity (Collins et al., 2010; Ecklund, 2012). There is significant evidence to support this, with clients whose therapists were ethnically similar and/or spoke their native language dropping out of treatment less, staying in treatment longer, and experiencing better treatment outcomes (Wilson & Stith, 1991; Interian & Díaz-Martínez, 2007; Awosan et al., 2011; Hall & Sandberg, 2012; Presely & Day, 2019), highlighting the value of cultural knowledge exercised by ethnically similar therapists. Furthermore, there is strong evidence indicating that this is also the clear preference of racialized clients themselves (Chang & Yoon, 2011; Mofrad & Webster, 2012).
The message here is that racialized therapists are uniquely positioned to serve racialized populations by helping them to recognize their individual and collective strengths; by helping them to define themselves as individuals with unique qualities that can help them overcome individual difficulties; and by being comfortable with and empathic about the impact of skin color differences and associated projections on our lives. (Chen et al., 2008; Chang & Yoon, 2011; Zaharopoulos & Chen, 2018; Sawrik, 2020).
A racialized therapist can provide a unique opportunity for racially marginalized folks to better understand their own selves – an opportunity to better learn how to manage the stressors unique to their marginalized status alongside someone who shares the experience of otherness and who can work together with them to understand and shape their experience while highlighting their own agency in doing so (Jones & Pritchett-Johnson, 2018). This opportunity comes at less risk of further traumatization – not at zero risk, as aforementioned, because intersecting and often invisible aspects of identity can still collide – but one that can provide a worthwhile mitigation of a pressure racialized folks otherwise experience every day of their lives.
Awosan, C. I., Sandberg, J. G. & Hall, C. A. (2011). Understanding the experience of black clients in marriage and family therapy. Journal of Marital and Family Therapy, 37 (2), pp. 153-168. doi: 10.1111/j.1752-0606.2009.00166.x
Chang, D. F. & Yoon, P. (2011). Ethnic minority clients’ perceptions of the significance of race in cross-racial therapy relationships. Psychotherapy Research, 21 (5), pp. 567-582. DOI: 10.1080/10503307.2011.592549
Chen, E. C., Kakkad, D. & Balzan, J. (2008). Multicultural Competence and Evidence-Based Practice in Group Therapy. Journal of Clinical Psychology: In Session, 64 (11), 1261-1278. DOI: 10.1002/jclp.20533
Collins, S., Arthur, N. & Wong-Wylie, G. (2010). Enhancing Reflective Practice in Multicultural Counseling Through Cultural Auditing. Journal of Counseling & Development, 88, pp. 340-347.
Ecklund, K. (2012). Intersectionality of Identity in Children: A Case Study. Professional Psychology: Research and Practice, 43 (3), 256–264. DOI: 10.1037/a0028654
Hall, C. A. & Sandberg, J. G. (2012). “We Shall Overcome”: A Qualitative Exploratory Study of the Experiences of African Americans Who Overcame Barriers to Engage in Family Therapy. The American Journal of Family Therapy, 40:445–458. DOI: 10.1080/01926187.2011.637486
Interian, A. & Díaz-Martínez, A. M. (2007). Considerations for Culturally Competent Cognitive-Behavioral Therapy for Depression With Hispanic Patients. Cognitive and Behavioral Practice, 14, pp. 84--97
Jones, M. K. & Pritchett-Johnson, B. (2018). “Invincible Black Women”: Group Therapy for Black College Women. The Journal for Specialists in Group Work, 43 (4), 348-375. DOI: https://doi.org/10.1080/01933922.2018.1484536
La Roche, M. & Lustig, K. (2013). Being Mindful About the Assessment of Culture: A Cultural Analysis of Culturally Adapted Acceptance-Based Behavior Therapy Approaches. Cognitive and Behavioral Practice, 20, pp. 60-63
Mofrad, L. & Webster, L. A. D. (2012). The treatment of depression and simple phobia through an interpreter in the North East of England: a case study. The Cognitive Behaviour Therapist, 5, pp. 102–111. doi:10.1017/S1754470X13000044
Presley, S. & Day, S. X. (2019). Counseling Dropout, Retention, and Ethnic/Language Match for Asian Americans. Psychological Services, 16 (3), pp. 491–497. http://dx.doi.org/10.1037/ser0000223
Sawrik, P. (2020). Service providers’ cultural self-awareness and responsible use of racial power when working with ethnic minority victims/survivors of child sexual abuse: Results from a program evaluation study in Australia. Children and Youth Services Review, 119 (10). https://doi.org/10.1016/j.childyouth.2020.105641
Wilson, L. L. & Stith, S. M. (1991). Culturally Sensitive Therapy With Black Clients. Journal of Multicultural Counseling & Development, Vol. 19, Issue 1, p32-43. DOI: 10.1002/j.2161-1912.1991.tb00455.x.
Zaharopoulos, M. & Chen, E. C. (2018). Racial-Cultural Events in Group Therapy as Perceived by Group Therapists. International Journal of Group Psychotherapy, 68:4, 629-653, DOI: 10.1080/00207284.2018.1470899.
Thoughts on Therapy and Mental Health