How to Find a Culturally Responsive Therapist
Therapy can help people of color cope with the stress of racism and microaggressions, but only if it’s done right
In high school, I went to see a psychiatrist to discuss options for treating my depression, anxiety, and inability to concentrate. I was nervous about going alone, but my parents assured me I had nothing to worry about.
I arrived at the small, private practice early and waited in a nondescript reception area — and waited, and waited. The doctor called patient after patient to come back to his office, but he never called me, despite the fact that I had an appointment. Maybe he saw a black teenager sitting in his waiting room and assumed I couldn’t possibly be his patient. Or maybe he just didn’t see me even when I was the only person there. I was too embarrassed to ask what was going on, so eventually, I just got up and left.
To this day, I still can’t quite wrap my head around what happened. That’s exactly what’s so insidiously slippery about microaggressions — you’re never 100% sure they actually occurred. I held it together until I got home and my dad asked me how it went. Then, I burst into tears. My father was furious — and he does not get furious — and called the psychiatrist. I remember hearing him yell, “You didn’t see her? You didn’t see her??!!”
I had experienced my first therapist who wasn’t culturally competent.
Why does culturally competent therapy matter?
I never went to that office again but, unlike many people who share my racial and ethnic background, I did return to therapy. My family did not associate therapy with a negative stigma, though many black and Latinx people do, for a couple reasons: One, the notion that “therapy is for white people” is perpetuated through mass media and cultural stereotypes. And two, institutional racism within the health care system present significant barriers to mental health care for many people of color.
But another problem may be therapists themselves. In the United States, the overwhelming majority of psychologists and psychiatrists are white, meaning a person of color looking for mental health care is likely to find it with someone who experiences the world different than they do. And in a profession that relies so heavily on empathy between practitioner and client, that disconnect can dramatically affect the quality of care. What’s more, without intentional intervention, therapists may bring their privilege and implicit bias into their practice.
“I’ve had many clients of color tell me that they terminated counseling after one session because they came out feeling worse rather than better,” says Derald Wing Sue, a professor of counseling psychology at Columbia University. “I’m not saying that therapy isn’t helpful. It’s very helpful if you are working with a culturally competent individual.”
What can culturally competent therapy do?
A culturally competent therapist will offer mental and emotional support in a way that’s relevant to the client’s social and cultural background. Most therapists tend to follow a Western paradigm of mental health counseling that’s deeply rooted in individualism, says Sue. For example, a culturally incompetent therapist might consider an Asian male who asks his parents whether or not he should take a new job, or a Latinx woman who still lives at home, as “immature or overly dependent,” even though these are normal behaviors within their respective cultures.
People of color also often have different reasons than white patients for seeking out mental health care. Therapy can help black and brown people develop healthy ways to cope with problems like exposure to racism and microaggressions, for example.
Joy Harden Bradford, a licensed psychologist in Georgia who specializes in working with black women, says that many of her clients talk to her about workplace issues, such as feeling pressure to conform to white norms of appearance and behavior, and structural racism that reduces opportunities for advancement and mentorship.
“I think it helps to give you another voice,” says Harden Bradford, referring to “culturally responsive work,” which is her preferred term. Having a therapist who understands what you’re going through “can give you insight into the fact that this is a lot of black women’s experience in the workplace, and it’s probably not you. You’re not alone in the struggle.”
How do I find a culturally competent therapist?
First, you need to do your homework. Erica Key, a licensed professional counselor and intake specialist at BJC Behavioral Health in St. Louis, Missouri, says she found her own therapist via the Psychology Today website, which allows users to filter for desired traits. “I was looking for a black woman who shared similar beliefs as mine and accepted my insurance,” she says. “So I read a lot of profiles.” Harden Bradford’s own website, Therapy for Black Girls, also has a searchable directory of black therapists, and Therapy for Black Men is another good resource.
Unfortunately, there’s no professional certification for cultural competence, says Sue, though he believes the industry is moving in that direction. In the meantime, he suggests tapping professional membership groups like the Association of Black Psychologists, National Latinx Psychological Association, and the Society of Indian Psychologists for recommendations of qualified therapists in your area. If you live in white-majority communities where options for culturally clued-in therapists are limited, Sue recommends exploring online options, such as therapists who practice via Skype.
After you’ve narrowed your search down to a few candidates, Harden Bradford recommends taking a closer look at each therapist’s website to see how they market themselves.
“See whether they speak about having a commitment to working with people from different groups,” she says. “What kind of stock images people choose on their website will tell you a lot about whether they view you as somebody who could be in their space. If all of their pictures on their website are white women, then that sends a message: This is not a place for you.”
It’s also a good idea to check if they provide an email address or offer a complimentary call before the first paid session. Whatever your initial contact, don’t be shy about asking questions. It’s totally acceptable to flat-out ask them if they’ve worked with people of color before, and how they deliver effective treatment to people with your background.
You can also get a little sneaky and ask what kind of treatment techniques they favor. This is a trick question, Sue explains: There’s no one therapy modality that’s better for nonwhite clients. The point isn’t that, say, Gestalt is any better for nonwhite patients than psychodynamic or cognitive behavioral therapy. It’s that the ideal therapist for diverse clients is “eclectic in orientation,” he says, and able to use different approaches to meet the needs of each client.
With all that said, it’s important to remember that traditional western therapy is not a psychological panacea. You should also consider plugging into communities of faith, membership clubs, or supportive online communities with like-minded members. The important thing is finding a space for “validation, support, encouragement, and people who really understand the issues that you’re going through,” says Sue. Ultimately, it’s about being seen, in all senses of the word.