Accessing mental health treatment is hard. It requires a lot of courage and a deep willingness to look at yourself through the eyes of another. It’s not easy work by any means.
The decision of who you could or should work with can be daunting. The decision can be even harder for people who are systematically marginalized or not celebrated in mainstream culture.
My hope is that this post sheds some light on some important dynamics to consider when seeking a therapist.
Even in a city as big as New York City (where I practice), there aren’t of a lot of options when looking for a LGBTQ therapist or a therapist who is a person of color (or both!). For many who seek these identities to be more fully understood in the counseling space, finding the right fit can be downright daunting...even exhausting.
Sometimes, when you succeed in finding a clinician who who holds the same social spaces (race, gender, sexuality, heritage, etc.) as you do, other aspects become less accessible, like fee, convenience, or overlapping availability in your schedules. It’s not easy to find the right fit. A fellow MyWellbeing provider's, Raquele Williams, client shares some sentiments about what it means to work with a BIPOC provider for her. "Being a woman of color comes with its own unique life experiences. As a result, finding a therapist who could ‘get me’ had seemed nearly impossible until now."
I’ve talked with clients who have felt let down by the options for treatment due to these dynamics and opt out of treatment altogether or experience extended wait times for the right provider. This can make for troubled times in the interim as their mental health suffers.
I encourage you to find care that is accessible for you, and to practice having an open mind if the provider you connect with does not check 100% of the boxes you are looking for at first.
We all want to be able to walk into the space of therapy and feel supported and understood.
If you’re a person of color or a member of the LGBTQ communities you may feel you have to be extra careful about who you let into your mind space. Of course, you want to avoid subjecting yourself to someone who may not fully appreciate and accept your humanity, or may lack knowledge and competence to adequately support you in your journey.
You may find relief in knowing that now more than ever, many mental health providers gain competence in working with communities different than their own.
In fact, this can often be a big part of therapist training programs. And they can be quite good too!
That doesn’t mean that any provider who says they’ve worked with Black clients before, for example, is well equipped to understand your life and help you come to a new understanding. Feeling out a strong connection with your therapist will be more nuanced.
All of which is to say, while some people want (or need) to work with a provider who shares their same social identities, this isn’t always necessary.
If you are working with other limiting factors, like a limited budget or limited availability in your schedule, good support is better than no support, even if that support doesn’t look like you.
It should also be said that sometimes, for a variety of reasons, the people who look like you may also not be your best fit.
The real thing to pay attention to when searching for a therapist is competence.
Competency in counseling refers to “a set of congruent behaviors, attitudes, and policies that … enable a system, agency, or group of professionals to work effectively in cross-cultural situations” (Cross et al. 1989, p. 13).
When you are a therapy client who is exploring the option of working with someone who doesn’t hold the same identities as you, you might consider exploring:
You might see evidence of competency for a potential provider on their website and marketing materials. For example, do they show people who look like you? What language do they use? What do their public social media accounts reflect?
Every mental health provider enters this field with the intent of helping others throughout some of the toughest times of their lives. We don’t take the therapeutic relationship lightly.
You can generally trust that any provider you encounter will want to help you work through your concerns and will aim to do so with grace.
You should be able to trust that your provider has done work in understanding others different from themselves. This could be academic (journals, articles, etc.) and it could be personal or cultural (shows, music, news, cultural events).
If you are unsure, you can always ask.
At the end of the day, you need to feel safe in the therapy room and that means some conditions need to be met.
You don’t want to spend the majority of your sessions battling through your providers’ own queerphobia, sexism, ageism and racism. If you find that you spend a good amount of time educating your therapist on very basic aspects of your community then perhaps they are not as competent as you thought and it might be time to move on.
It is not your responsibility as a client to help your provider understand your cultural group. They are there to know and understand YOU.
Your therapist will likely ask plenty of questions about how your identities impact your worldview and individual choices. That is part of therapy. There is definitely a difference between the therapist asking questions about you and your experience in relationship to your identities compared to the therapist asking you to educate them or help them to understand a particular term or set of terms.
As the incomparable Mr. Fred Rogers used to say, “Look for the helpers. You can always find people who are helping.”
Sometimes those helpers will be just like you but often they may not. When it comes to managing your mental health, exploring your options is always worth it.
Jor-El Caraballo is a licensed therapist and Co-Creator of Viva Wellness. Jor-El believes that mental health and wellness should be accessible to all communities, particularly those underrepresented in traditional mental health services like people of color and LGBTQ folks. When not working, Jor-El is likely checking out a new movie, checking out a new restaurant in the city or spending time with his pet, therapy dog Nomi.
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