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African Americans and multiracial people experience unique mental health needs. From vicarious stress caused by racial trauma to increased burnout from caring for family members because of cultural expectancy, therapists and other mental health providers should be aware of these distinct needs. Below, we learn more about the types of therapy that many Black people benefit from, as well as the barriers preventing them from getting it.
Common Types of Therapy African Americans Need
Whether they actively seek therapy or not, there are many types that African American patients may benefit from depending on their mental health needs. These therapy modalities have consistently underserved the Black population, but that does not mean that their mental health problems cannot be addressed by effective therapy techniques such as those listed below.
Psychotherapy is often referred to as “talk therapy” and is the most common. Many Blacks benefit from talking out their emotions, daily struggles, and negative behaviors with a therapist through weekly or other regularly scheduled therapy sessions that typically last around an hour. Sessions with the right therapist can help address symptoms of depression, anxiety, stress, mood disorders, insomnia, and more. Choosing the right type of therapy is also important, as there are several forms and each has various benefits.
- Cognitive Behavioral Therapy (CBT): CBT is one of the most common types of psychotherapy and can address many behavioral and emotional issues through changing distorted thinking patterns, learning effective coping strategies, and more.
- Dialectical Behavior Therapy (DBT): This therapy is most effective for patients who experience intense emotions and related behavioral issues. It is recommended for those with more severe mental health needs like patients with PTSD, suicidal behavior, and eating disorders.
- Behavioral Therapy: Many Black youths have behavior problems in school for various reasons, but many cite racial bullying as the reason for acting out once they are comfortable speaking with licensed counselors offering effective CBT.
- Emotional Focused Therapy: Emotional support can be vital in treating past trauma and those currently experiencing relationship challenges.
- Eye Movement Desensitization (EMDR): Racial trauma is especially prevalent in Black people and EMDR is one way of helping to reprocess trauma, moving past traumatic experiences and treating PTSD.
- Family Therapy: Many Black people are not accustomed to sharing their personal struggles, even within their own families. Family therapy can help create open communication that improves the relationships between couples as well as parents with their children.
Group Therapy/Support Groups
There are many benefits of group therapy. However, Black people and people self-identifying as Black may benefit from this type of therapy more than most. Many therapists recommend group therapy because it helps participants realize they are not alone in their struggles. You may be able to find a support group specific to your needs, such as experiencing racial trauma, being a caregiver to family members, becoming a new mom, living with a specific mental or physical illness, or going through major life events. While a therapist may refer you to a support group, you may also find one nearby or online through a social media platform, networking channel, or a library calendar of events.
Family therapy is often used as a preventative measure for child maltreatment. According to one study conducted in Sacramento County, California, African American children accounted for only 11% of the population but over 30% of deaths due to child abuse and neglect. However, maltreatment of children is not the only reason for family therapy. It can discover mental health needs within the family unit that can be addressed with individual therapy and other treatment options. There are many reasons why Black families are less likely to participate in this type of therapy compared to those of White people. However, the benefits of it have been well-documented in recent years.
Trauma can come from many sources, including being involved in or witnessing a vehicle accident, losing a loved one, wartime experiences, childhood abuse, and more. However, many Black people experience racial trauma as individual racism, systemic or structural racism, and vicarious or transmitted stressors. Trauma-based therapy that focuses on realizing, recognizing, and responding to the trauma that was experienced so that a patient can live happier and mentally healthier.
Medication Assisted Therapy
According to a 2019 study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), the African American population is extremely susceptible to substance use disorders. Over 5 million Black people have a mental illness and over 2 million have a substance use disorder. Of those, nearly 1 million have both mental health needs and struggle with a substance use disorder. Medication-assisted therapy combines behavioral therapies like those listed above with FDA-approved medications to treat substance use disorders and co-existing mental health needs.
Barriers to Effective Therapy Services for Black Americans
Finding the right therapist is challenging for anyone, but can be especially difficult for Black people. The barriers to proper care listed below are just a few factors that affect the Black population and how mental health treatment looks different compared to that for White people. Let’s take a closer look.
Regardless of ethnic background, many women become caregivers for family members at a young age, becoming adults entirely too soon. This “adultification” affects Black adults more than most, and women especially. According to the American Psychological Association, this process results in burnout and stress. Black women are especially prone to carrying the burdens of their family unit without external emotional support and to the personal experiences of negative race relations, adding to the internalized responsibility of trying to help others around them cope with racial trauma.
Mental Health Stigma
Unfortunately, mental health stigma is particularly pervasive in the United States, affecting those of any racial identity. However, the National Alliance on Mental Health reports that more than half of African Americans feel that mental illness is a sign of weakness. These beliefs create a powerful barrier to seeking help for these conditions, the first step for which is often therapy. One reason for this barrier may be a sense of shame within the Black population surrounding mental health. Only by breaking down this stigma for those of any racial identity can we begin to help African Americans seek the therapy they need as well.
A Black person today has an average income slightly higher than just ten years ago, but it is still not enough compared to White people and the general population. Economic growth has not supported the Black population like it has other races. More Black adults reported poor access to healthcare because of location and transportation availability, access to health insurance coverage, educational attainment, community resource opportunities, and average household income. Black youth with mental health needs are especially vulnerable based on socioeconomic status compared to other ethnic groups.
Navigating the Healthcare System
The healthcare system in the United States is becoming more complex and health literacy is falling behind. The vast majority of those attempting to find coverage or a provider report difficulties. The Black population is disproportionately affected because of a lack of community resources in lower-income neighborhoods, lower rates of educational attainment among Black youth, and more. Health insurance coverage does not always mean that a person will find a provider, as it’s challenging to find one that accepts the right coverage and is accepting new patients. This process is tedious, even for those who understand it.
Systemic and Structural Racism
Racism within our political and economic systems affect the Black population from the financial aid they receive to insurance coverage they are eligible for. These forms of racism exist on a structural level and are changing only with political and economic reform.
Because systemic and structural racism exists, many Black people fear discrimination within the healthcare system. Coupled with mental health stigma, encouraging those with mental health needs to seek the emotional support they need has proven difficult in the past. However, as this racism is being addressed and slowly changing the landscape of our healthcare system, more Black adults are receiving appropriate care.
Being Uncomfortable With the Topic
Many Black patients are not comfortable bringing up the topic of racism with their therapist, but will speak about it if a therapist brings it up first. This can be an uncomfortable topic to broach, but it is important to discuss with patients of color. Most therapists aren’t sure how to bring it up or what they might discuss. However, it’s also important to reiterate that conversations with a therapist are confidential so any patient feels comfortable opening up about their experiences.
Lack of African American Therapists
While approximately 17% of African Americans struggle with their mental health, only 4% of therapists are Black. It’s proven that, regardless of ethnic group, most people prefer seeing a provider that is like them. It makes sense that speaking with and opening up to a person who looks like us gives us a sense of comfort that we have common interests or major life experiences. More is being done to recruit and retain Black therapists, but it will take time for this to reflect on the current number of practicing providers.
Fewer Culturally Competent Providers’
Even providers who aren’t Black can become culturally competent by learning more about their patients and their ethnic background. Many people of color report different symptoms for the same mental illness. For example, depression often presents with physical aches and pains in African Americans, whereas White people may not experience this. Providers who make the effort to understand these medical differences and the African American culture will help create an open dialogue with their patients of color that can be mutually beneficial.
Black People and Therapy: Overcoming Challenges for Better Mental Health
No matter the reason you are seeking one, finding and seeing a therapist regularly shouldn’t be a challenge for anyone, regardless of race. However, the number of Black people affected by healthcare disparities is astonishing and we should do more to address this problem. One such to do this is to raise awareness of the problem. Black Health Matters is helping to do just that this Mental Health Awareness Month by sharing more about our unique needs and struggles, stories of African Americans doing more in our communities, and helpful mental health resources.