By Zufan Bazzano and Hannah Fleischman
How hard could it possibly be to find a good therapist?
You could go to PsychologyToday.com and type in your zip code and your insurance provider and they will list over four pages of verified clinicians.
But what if you’re looking for a therapist who specializes in specific types of issues — attachment, grief/loss, adoption, domestic violence, LGBTQ, etc? What if your lived experience intersects with multiple identities? How about if you’re looking specifically for Black and Latino therapists?
At the beginning of the COVID pandemic, there was a staggering increase in the need for mental health counseling from the general public. The psychological stressors the pandemic created exacerbated the mental health field, leaving many clinicians overbooked and unable to accept new clients.
According to the federal government's mental health and substance abuse referral hotline, the referral hotline rose from 833,598 calls in 2020 to 1.02 million in 2021. Fast forward to 2022 and these demands still haven’t been adequately met.
But are these services beneficial for everyone?
Searching for a culturally competent clinician is essential for anyone who wants to take the step toward prioritizing their mental health. But for marginalized groups, finding a culturally competent clinician can be a challenging process. Ostensibly, therapy is for everyone yet, only some people have to consider cultural competence while searching for a therapist. Cultural identity is rooted in gender, race, class, and ability, but of course, the list goes on. Marginalized groups hold identities that don’t hold much social power as privileged groups. As a result, these groups are more likely to struggle to connect with an adequate psychiatrist.
Cultural competence should be taught through a social justice lens that utilizes the clinicians' lived experience as a learning opportunity. Take the words of Shamyra Howard-Blackburn, LCSW who believes that
“Trust in a therapist isn't granted because that therapist attended a three-hour workshop on cultural competence, led by someone who isn’t a person of color. We need therapists who are willing to do deep anti-racism work, who present with cultural humility.”
Finding a therapist that's culturally competent means different things for different people because we all hold different identities, however, the bottom line is that a therapist should be able to provide mental health service to their client that is non-stigmatizing, non-traumatic, and social justice-based.
Modern talk therapy practices were developed largely by and for a white, middle-class demographic. The effects of this still reverberate in therapeutic spaces today. Therapists are rarely equipped to holistically address the trauma that invariably accompanies experiences of discrimination.
Searching for someone who's both accessible (physically and/or financially), as well as able to understand one's experiences/identities while navigating mental health stigma is challenging enough. Add in fearing a potential microaggression from a clinician and for many, that’s enough of a deterrent to stay away from therapy entirely. How many people want to be retraumatized in the process of seeking help?
Finding a therapist with a shared cultural background or understanding shouldn’t require medical expertise. Currently, though, it often does. One of the reasons for this is how overwhelmingly white therapeutic spaces remain. According to a 2021 Census Bureau report, about 18% of people in the United States identify as Hispanic and 13% as Black, but an American Psychological Association report found that a mere 5% of psychologists are Hispanic and only 4% are Black. Or, in other words, a staggering 86% of therapists are white.
Of course, sharing similar cultural roots does not necessarily guarantee a better therapeutic outcome, but a workforce should at least slightly mirror the populations they serve. The demographic imbalance in therapist offering betrays a deeper issue in psychology.
While the American Psychological Association requires programs to cover cultural competence, and some states have begun to require such training for licensure, many psychology programs tack cultural competence training on as an afterthought. What would comprehensive, intentional cultural training look like?
For starters, it would last longer than a single unit, or even a single semester long course. It would emphasize being mindful of verbal and non-verbal interactions, and the importance of life-long learning. Cultural competence cannot be a peripheral component of psychological training, but must be fundamentally integrated.
Therapists cannot sufficiently provide mental and emotional support when they expect their clients to share the same context. When counselors assume their clients should experience their emotions and behavior in accordance with dominant cultural attitudes they can cause harm.
Still, why is it so difficult to connect to culturally competent therapists? Sure, resources like Psychology Today do provide an option to filter therapists by specific issue, but in the process, it often advances the notion that cultural competence is optional. We need service providers that center cultural competence. Taking care of one’s mental health during a pandemic is overwhelmingly enough, no one should endure microaggressions while seeking help.
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