Imagine that a woman wants to see a gynecologist. Preferably a woman gynecologist. She goes to a medical clinic and sees a male doctor. But he is not a gynecologist. None of the other doctors in the clinic is a gynecologist or a woman. But the male doctor tries to reassure the woman. He tells her that his medical training has made him well-prepared to work with women.
People of color have similar experiences in mental health clinics. A new survey of the psychologists indicates that the typical psychologist is a 50-year-old White woman. Although people of color are nearly 40 percent of the United States population, they are only 16 percent of psychologists. This percentage of psychologists of color has changed little in the past decade. Most of the time, people of color will not find a psychologist who looks like them.
How important is it for people of color to have a psychologist who looks like them? A summary of psychotherapy research indicates similar improvement for clients when psychologists are and are not of their same ethnicity. This may be because a psychologist’s skill is more important than their ethnicity. But for some people of color, knowing that there are psychologists like themselves may get them to seek help. And having a psychologist of the same ethnicity may prevent dropping out of therapy before it is finished.
The male doctor felt well-prepared to work with women. Similarly, the survey indicated that most psychologists feel well-prepared to work with people of color. However, feeling well-prepared does not mean that one is effective. A summary of studies indicates psychologists’ feelings of being culturally competent are not associated with clients’ therapy experiences.
So, can psychologists help people of color? The summary of psychotherapy research indicates that culturally-relevant psychotherapy can be particularly helpful to people of color. Cultural relevance involves changing psychotherapy to fit the client’s cultural context. For example, if a client speaks Spanish, the psychologist communicates in Spanish. Some clients’ cultures emphasize relationships over the self. Then the psychologist focuses on the self in the context of relationships. Some cultural groups tend to express distress physically, such as in sleep problems. Then the psychologist focuses on physical problems before working on other issues, such as emotional problems.
A person of color can do the following to increase the effectiveness of mental health services:
Psychology has a long way to go before its workforce “looks like America”. But psychologists of any background can be trained to make therapy culturally-relevant.
American Psychological Association (2017). Demographics of U.S. psychology workforce. Retrieved from http://www.apa.org/workforce/data-tools/demographics.aspx
Hall, G. C. N., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (2016). A meta-analysis of cultural adaptations of psychological interventions. Behavior Therapy, 47, 993-1014. doi: 10.1016/j.beth.2016.09.005
Ibaraki, A. Y., & Hall, G. C. N. (2014). The components of cultural match in psychotherapy. Journal of Social and Clinical Psychology, 33, 936–953. doi: 10.1521/jscp.2014.33.10.936
Smith, T. B., & Trimble, J. E. (2016). Foundations of multicultural psychology: Research to inform effective practice. Washington, DC: American Psychological Association. doi: 10.1037/14733-000