Cutting right to the chase, therapists need to be culturally competent — but what does that mean exactly? Veronica Johnson [1], PhD, assistant professor of psychology at John Jay College of Criminal Justice, told POPSUGAR that "in a nutshell, a culturally competent therapist is a therapist who has the ability to both recognise and mindfully navigate cultural differences and similarities in the psychotherapeutic relationship." It means they are aware of and feel comfortable talking about culture, race, gender, etc. in sessions.
This is one of Dr. Johnson's areas of research [2]. She aims to examine the difference between working with a culturally competent therapist vs. working with one who is not considered to be culturally competent. "My goal is to really understand how specific interventions used by the therapist have an impact on minority clients', specifically Black clients', ability to feel connected to the therapist," she explained.
It's common that people seek out therapy from professionals who share their identity, Dr. Johnson said. For instance, Black people typically prefer to see Black therapists, but they only make up a small portion of mental health professionals. Take psychology in particular: it was reported in 2015 that while 86 percent of working psychologists in the US were white, four percent identified as Black or African American [3]. "So often, Black clients are in a position where they need psychotherapy, but there are only non-Black therapists available," Dr. Johnson noted.
"By having a Latina therapist, I don't feel like I am approaching an outsider. It's like having somebody in my circle and in my corner."
Wandy Felicita Ortiz, 25, began therapy in 2016 through her university after the death of her grandfather, and the therapist, by chance, was Latinx — Ortiz is also Latinx. "When I spoke to her about Latinx attitudes towards death, she understood what I was saying from a cultural and personal perspective. That, I really liked and valued," Ortiz told POPSUGAR. "It made me feel like I was not alone in my experience." It was only when she left college and switched to a therapist who was not Latinx that she realised the value of working with someone "who is culturally compatible with your lived experience." Lived experiences, she added, you can't learn through a textbook.
To Dr. Johnson's point that people initially assume those "who are racially the same, ethnically the same, and the same gender are similar to them," Ortiz has found that similarities in identity have caused her to open up more in therapy. Her current therapist is a Puerto Rican woman from New York — and Ortiz, incidentally, is also a Puerto Rican woman from New York. "By having a Latina therapist, I don't feel like I am approaching an outsider," she said. "It's like having somebody in my circle and in my corner."
Yes, there are registries such as Therapy For Black Girls [5] and Therapy For Latinx [6], which Dr. Johnson said are doing great things for helping a more diverse group of people feel increasingly comfortable with therapy, but oftentimes, clients delay treatment because therapists from those registries are fully booked. And while there needs to be more open doors for nonwhite mental health professionals, the fact of the matter is all therapists need to be versed in how to become more culturally aware.
Dr. Johnson's ongoing research is about "trying to enhance the training and understanding of cultural competence for therapists of all backgrounds, so that people of colour, Black women, Latinx populations don't have to delay their treatment for two years waiting for a therapist that looks like them."
Being culturally competent as a therapist has to do with your understanding of differences based on socioeconomic status and physical and mental ability as well. Licensed social worker and disability consultant [7] Vilissa Thompson, LMSW, told POPSUGAR that she began writing her blog, Ramp Your Voice! [8], due to the gaps in what social workers are taught. "And that continues with other practitioners like psychologists, psychiatrists, licensed counsellors, so on and so forth," she said. "What they understand about disability, which includes mental health, is very outdated when it comes to the language and is very ableist in the way that we discuss it."
"We need to understand how being a Latina is different from being a trans Latinx woman."
Plus, Thompson said, the mental health field does not have enough disabled professionals [9]. "There's a gap within the profession itself," she stated, adding, "If therapists, particularly white therapists and even some people of colour, are not in tune with how racism looks, or how anti-Blackness looks, then how can we expect them to understand disability, which is an identity, a culture, an experience?"
Due to this, Dr. Johnson explained that every mental health training program has to address cultural competency [10]. "It's part of their ethical guidelines," she said. But the depth of those trainings and coursework can vary. That means mental health professionals will have to do the work outside of those programs themselves. Dr. Johnson, for starters, offers some trainings [11], and she also said literature can go a long way (she suggests looking into editions of Counselling the Culturally Diverse [12] by Derald Wing Sue and David Sue).
The thing to understand about cultural competency is that "you have to know yourself first," Dr. Johnson said. "What I recommend for white, non-Black, and Black counsellors alike is to understand your own biases, blind spots, and assumptions." That work can be very difficult, she noted, but reflection is of utmost importance. And every therapist, no matter who they are, should put in the work, she said. "I recommend that everyone do critical self-reflection on how they understand their own race and how they understand other people's races, ethnic groups, gender, sexual orientation, ability, status, all of it."
It's about intersectionality, Dr. Johnson concluded, echoing Thompson's comments. "We need to understand how being a Black person in a wheelchair is different from being a Black able-bodied person," she said. "We need to understand how being a Latina is different from being a trans Latinx woman." It's complex, sure, but it's absolutely necessary to create better client-therapist relationships.