Most of us have a clear idea of the kind of therapist we would want to work with. Assuming a basic level of competence, we often have other specific preferences as well. Male, female, White, Black, older, younger, serious, funny, conservative, liberal—in most cases, our ideal therapist is often familiar or similar to oneself in some way. We tend to assume that therapists who share our values, upbringing, culture, even sense of humor will be more likely to understand where we are coming from. Or at the very least, be compassionate, respectful, and accepting of the darkest parts of ourselves.
It is perhaps not surprising then, that a recent meta-analysis of 52 studies found a moderately strong preference for a therapist of one’s own race/ethnicity. Across 81 studies, there was a significant tendency to perceive therapists of one’s own race/ethnicity somewhat more positively than other therapists (Cabral & Smith, 2011).
Unfortunately, trying to find an ethnic minority therapist requires the sleuthing skills of a private investigator. Using the Find a Therapist feature of the Psychology Today site, I can search for therapists by zip code, issues treated, sexuality/gender, languages spoken, religious orientation, treatment orientation, and insurance accepted, but not race or ethnicity. A search under “issues” lists over 60 different problems, including “video game addiction” and “medical detox” but not anything that might hint at the race or multicultural sensitivity of the therapist, e.g., “minority stress” or “discrimination”. Looking under “alternative languages” enabled me to find 19 (Chinese-looking) Mandarin-speaking therapists and 10 pages worth of Spanish-speaking therapists, but what if I want to find a Black therapist?
Maybe searching for French-speakers, I could find a Black therapist from Haiti or West Africa? After combing through 8 pages of hits and squinting at the often grainy and underexposed headshots, I was able to find 5 clinicians in all of New York City who might possibly be Black (not that one’s visual appearance is necessarily consistent with one’s racial identification). Come on, Psychology Today! Oddly, when I Google “Black Therapists in NYC”, the top hit is “African American Therapists in New York” on PsychologyToday.com. Clicking on the link takes me back to the very “Find a Therapist” feature that I’ve been trawling through for the past half hour. Lo-and-behold, a previously hidden search function for “Ethnicity” pops up with “African American” selected, revealing 7 pages of therapists identifying as having a client focus on African Americans (many of whom who do look Black), but still no description of the therapists’ self-designated racial/ethnic identity.
Wiping the sweat from my brow, I sit back in my chair incredulous that it should be so hard for a person of color to find a therapist that shares his/her race or ethnicity. Note that I am not arguing that race/ethnic matching is necessarily better (and indeed, numerous studies would argue otherwise). However, I do believe that patients, like all consumers of services, have the basic right to choose the service provider that is right for them. Whether it is a female OB-GYN, a pediatrician that promotes attachment parenting, or a Russian-speaking dentist, we are much more likely feel to comfortable asking questions and participate in our own care if we trust and feel positively towards our caregivers.
So, some suggestions:
To therapists: Consider including your race/ethnicity somewhere in your online biography to reach patients who may be specifically looking for a therapist of a particular group. Obviously, presenting myself as only an “Asian-American psychologist” is reductionistic and triggers a worry that some may choose not to see me because of my ethnicity. From a marketing perspective however, providing information about our identity statuses can help us reach target audiences for whom this characteristic is important.
To patients of color: If you are searching for a therapist who shares your race/ethnicity, try the trick I discovered above and sift through the results. Better yet, head to the websites of professional organizations such as the Association of Black Psychologists -- some have similar “Find a Psychologist” search tools. Consider whether you would feel comfortable working with someone from a different racial/ethnic group but who demonstrates cultural sensitivity and awareness of the impact that sociocultural factors may have on your life. If so, feel free to contact the most promising candidates on your list and screen them by phone. Ask them to tell you about their training in working with culturally diverse populations, and experience working with people who share the problems and concerns that you do, and go from there.
To PsychologyToday.com: The “Find a Therapist” feature is a great service, but using this tool to find your Black, Chinese, Latino, American Indian, Lebanese, or Vietnamese therapist soul mate is a daunting task. Given that people of color, and Black patients in particular, exhibit a clear preference for working with someone of the same background, why not include the option for therapists to self-designate their racial/ethnic identity? It’s a small thing that could have a big impact by removing one key barrier to seeking help.
Cabral, R. R., & Smith, T. B. (2011). Racial/Ethnic Matching of Clients and Therapists in Mental Health Services: A Meta-Analytic Review of Preferences, Perceptions, and Outcomes. Journal of Counseling Psychology. 58(4):537-54