How to Talk About Race With Your Therapy Clients

Among life’s most frustrating and persistent truths is this: You don’t know what you don’t know. This truth is particularly applicable to therapists, whose job is to help heal the world, one client at a time. And it can be most stark when therapists are called on to navigate the dynamics of race and systemic oppression that cast a shadow on the lives of their clients of color.

Most training programs have called for "multicultural competency" for decades. But in practice, this education is often lacking. As a Black therapist who now works extensively with clients who are Black, indigenous, and people of color (BIPOC), I distinctly remember, during my own training, a singular chapter in my textbook on culturally-sensitive therapy. I read through one paragraph teaching me how to work with African Americans, one for Asian Americans, and one for Pacific Islanders. It wasn’t nearly enough.

If you are a therapist, chances are high that, like mine, your training program addressed the intersection of race and therapy, at least in passing. But chances are equally high that it didn’t appropriately train you to work and truly connect with the BIPOC clients who enter your practice. Three paragraphs in a textbook are not sufficient to help you see your own blind spots when it comes to race. If you are white, you may not fully understand how your own privilege manifests in the therapy room. You may take a “colorblind” approach—insisting that you treat all your clients equally, regardless of their race.

And in so doing, you may be doing clients of color a vast disservice—whether by being blind to the myriad ways race influences their lived experiences or by minimizing or dismissing their race-related concerns. You may be guilty of microaggressions, which, a study published in the Journal of Counseling Psychology found, are a major source of frustration for Black clients of white therapists. You may be contributing to an environment in which BIPOC individuals—already less inclined to seek therapy in general—are more likely to be disillusioned with the experience. This is particularly true when therapists fail to mention race in sessions, research from the Journal of Community Psychology found.

Many BIPOC clients deliberately seek out therapists who share their race or culture. But that’s an imperfect solution: Because white clinicians still vastly outnumber their BIPOC counterparts, some would-be clients have few options.

White therapists who want to do right by their Black and brown clients, but struggle to bridge the topic of race, can learn to do so in more sensitive, supportive ways. Based on my own experiences—both as a clinician and as a client—there are a few things you can do engage with your clients through a more culturally-informed lens:

1. Do your own work. In order to build skills, therapists can engage in ongoing education on the practice of anti-racist, culturally sensitive therapy. This could involve gathering a group of like-minded clinicians to study best practices together, teach each other, and pay BIPOC experts to educate them on a regular basis. Similarly, you could seek out a supervisor who is well versed in culturally relevant training.
2. Invite discussions about race (before a murder demands discussion of it). When racial tension is a country-wide topic of conversation—like after the murders of George Floyd or Breonna Taylor—you may feel an urge to broach the topic but be held back by awkwardness or guilt. Making race a normal subject of conversation in your practice from the beginning can reduce such feelings and help you build a better support system for your clients. Some clients may decline your invitation to talk about race. Respect their choice. Even if a client seems uninterested in discussing it, you should still be cognizant of how systemic racism infiltrates every aspect of her life.
3. Engage in discussions about race outside the therapy room, too. Before you hurt a client with an insensitive remark, practice having conversations about race with your friends, family, and peers. Talking about race makes many white people uncomfortable; learn how to sit with the discomfort.
4. Accept that you will make mistakes. If a client calls you out for making a culturally insensitive comment, say, “Thank you. I’m sorry.” The correction is a gift—one that your client had no obligation to give. Learning how to repair the relationship after you make a mistake—and you will—is as important as learning how to avoid one in the first place. After you’ve apologized, it may be helpful to process together what happened and how it was painful for your client. Your relationship may become stronger because of it. However, you may have caused too much harm for him to continue and he may leave your practice entirely. This, too, is a learning opportunity. Process your feelings with your own therapist, your supervisor, and your peer education group.
5. Offer concrete help, not a vague focus on “healing.” Help clients develop the stamina to navigate the systems that oppress them. But you must recognize that you’ll have to do a lot of work in your own systems—in yourself and with those around you—before any true healing can be complete. Don’t view your BIPOC clients as victims; think, instead, of how they have faced great injustices and continue to survive.

We must rethink what it means to be “culturally competent.” Being “competent” to work with someone of a different culture should be the bare minimum, the starting point from which you begin the journey to do no harm. Engaging fully with your clients means being prepared to talk about their race, even when it’s challenging. Your clients’ well-being is worth the effort.