Clinician’s Corner: Understanding Culture and Therapy Use

5 Strategies for Engaging African Americans in Therapy

Posted Jan 31, 2017

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As a psychologist of color, I have first-hand knowledge of the importance of valuing someone’s culture and background. As a requirement to practice, psychologists and mental health providers have an ethical responsibility to self-reflect and take steps to improve their competence with working with individuals from diverse backgrounds. In a recent article, my co-authors and I described how numerous factors contribute to whether individuals from diverse background, such as African Americans, pursue or engage in therapy (see Turner, Cheng, Llamas, Tran, Hill, Fretts, & Mercado, 2016). Research consistently note that many African Americans may be reluctant to seek therapy because they perceive that their provider may come to the session with biases towards them. Therefore, it is important that providers understand how they can engage clients from diverse backgrounds to prevent their biases from negatively impacting rapport. For those who are interesting in continuing education or learning more about specifically working with African American clients, you can consider this webinar offered through Vyne Education, LLC. 

Below are 5 strategies for engaging African Americans in therapy

1. Psychologists must become aware of their own values, beliefs, and stereotypes. Additionally, they should be aware of how clients may react to their own personal characteristics (e.g., gender, age, ethnicity, etc). With regards to working with African American clients, it is important for practitioners to recognize the impact of their race and education on the perceptions of their African American clients. At the same time, it is important to not let your own stereotypical views of African Americans influence your attitude towards your client.

2. Psychologists need to understand their clients’ background and characteristics such as family structure, social class, and culture. It is important to not assume that all African Americans have encountered the same experiences. There is great diversity and heterogeneity within ethnic minority groups. It is paramount that clinicians explore individual experiences of family interactions, traditions, and social injustices.

3. Consider providing a pre-therapy intervention. During your initial session with African American clients, it may be helpful to discuss the following:

  • What is psychotherapy? How can psychotherapy help? Describe what will be required during the course of treatment.

4. African Americans may avoid psychotherapy because they see little value in the service. It may be important to establish credibility early in the process. This does not involve pointing out the number of degrees you have on your wall. For many clients from ethnic minority groups, credibility involves showing them that you can help improve their problem. By helping clients decrease their symptoms and/or provide them with a sense of understanding of their situation, you can establish yourself as a credible practitioner. This can improve the therapeutic alliance and prevent premature termination.

5. When working with clients from dissimilar cultural backgrounds, be attentive to your discomfort and resistance. It is not uncommon for psychologists to have difficulties dealing with their own feelings of discomfort or uncertainty when working with culturally diverse clients. African American clients may challenge your recommendations directly or indirectly, may have inconsistent session attendance, or may have religious beliefs that may make the treatment process difficult. It is importance to recognize these frustrations and learn how to use these moments to better understand yourself in an effort to help your client.

Additional Sources:

The importance of ethnic identity and religion among African Americans 

Working with African American families

Copyright 2017 Erlanger A. Turner, Ph.D.

More About the Author

Dr. Turner specializes in child and adolescent psychological disorders, parenting, and psychological assessment. His research interests focus on psychotherapy use, mental health equity, and access to behavioral health services among diverse individuals. Visit for more information.

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Turner, E.A., Cheng, H., Llamas, J., Tran, A., Hill, K., Fretts, J., & Mercado, A. (2016). Factors impacting the current trends in the use of outpatient psychiatric treatment among diverse ethnic groups. Current Psychiatry Reviews, 12(2), 199-220.