It is natural and normal for a person seeking mental health help to want their therapist to understand them. It is difficult now for people to find a therapist, but people of color who want a therapist who understands their experience are having an especially hard time of it. That’s a problem.
In an ideal world, the race of a person’s therapist shouldn’t matter. But anyone who is paying attention knows this is not an ideal world. Race plays a role in most human interactions, and there are few interactions more human than therapy. Race is a factor for all of us in how we see and measure ourselves, and it’s a factor in how we see each other. Denying that closes off the therapeutic relationship before it can even get started.
Most therapists are White – 73 percent of them. Only 8 percent are Latinx, even though Latinx people make up 18.9 percent of the population. Only 4 percent are Black, even though Black people are 12.6 percent of the population. Clients who speak only Spanish, Cantonese or Mandarin — the three most popular non-English languages in this country — have even fewer options.
For clients of color, comfort and fluency in issues related to race are foundational to whether therapy is going to succeed. Clients of color want a therapist who can really understand them, without having to explain what their experiences mean. Having to do so feels like a questioning of their culture, having to educate White s about race-tinged issues they encounter in their lives.
It is more galling when clients realize that when they do that, they are paying to educate their therapist. Clients want the therapist to have the cultural knowledge and smarts to bring this up on their own. When therapists fail to ask about race, it’s problematic.
I once interviewed White therapists about how they deal with race. In many cases, they don’t. They duck the issue, shortchanging the client. One told me, “I don’t want to feel bad about myself as a White therapist, so I don’t bring up race.” Another said, “I am not going to bring it up, because I’m not going to let them question who I am.” How does that serve the client?
This dynamic is just as true with therapists of color and White clients. As a Black therapist, if I have a White racist client, I have to figure out a way to work with that client and understand who they are. Even though White people are the “norm” in this country, that can create race-related issues for them as well. For example, what might be behind why they feel they don’t measure up to expectations? A Black therapist needs to dig into a White client’s identity. You have to understand the client in their full identity, and race is a part of everyone’s identity.
If therapy does not address race and explore its role, it fails to see the client, and to really know the client.
No one has the goal of making White children uncomfortable with race, but children of color deal with it every day.
The paucity of therapists of color is a call to train more of them and to welcome them into the field. There is a need that they can fill.
Even so, I am not advocating that people should see only therapists of their own race. Instead, I am advocating that all therapists should be able to acknowledge, talk about and investigate issues that stem from race. We have to be unafraid and undeterred to ask questions. We should be trained to do our own work.
This is why we focus on the “self of the therapist” at the Ackerman Institute for the Family, the organization where I am director of training. We help future family therapists uncover their unconscious biases. We ask that they think of how they feel about their own racial identity, whatever it may be.
This is not easy work. We had a White student who left Ackerman, saying she just was not going to look at race. This was a psychologist with a doctorate degree. I can only imagine how her clients of color must suffer now.
Clients have their own responsibilities in helping themselves. They must advocate for themselves. They should try to select a therapist they’re comfortable with, but they must understand it is not always possible. They should ask about treatment philosophies at private practices. The success of the therapeutic relationship depends on the client, too.
Over the years, it has become more critical to talk about issues related to race, particularly in family therapy. We have tried as a society to act like race doesn’t matter. It was only after George Floyd’s death that we began to talk about systemic racism.
This is why we need to train more therapists of color, and train all therapists more fully. Therapists need to do their own work, and learn how they come across to clients. If they can be honest and courageous with themselves, they will better serve their clients.
This commentary was originally published by Word in Black.
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