A friend of mine posted to Facebook the other day, seeking to see a therapist who was a woman and a person of color, like her. This stirred up the question in my mind: Is that a better outcome for someone?
In thinking about this question, I think the most important guideline here is obvious: It’s all about you. If you are more comfortable seeing someone whose demographics and experience match your own, then that needs to happen (although that can be a challenge). There is little more important to the ability to get real value out of therapy than the strength of the relationship between a patient and their therapist, and if having someone of your race and gender is important to you, than you should certainly do whatever you can to make that happen.
The good news, however, is that research indicates that having a therapist of your race or gender is not a requirement for positive outcomes, as long as you and your therapist are comfortable with any demographic differences.
In 2011, Brigham Young University conducted a meta analysis of studies (thanks to Joe El Caraballo for the catch). The meta analysis found:
- There was a “moderately strong” preference for a therapist whose race/ethnicity matched the patients and a “tendency” for patients to view therapists of their own race/ethnicity more positively than other therapists.
- However – and this is arguably more important – in terms of outcomes, the meta analysis found that there was “almost no benefit” when it comes to matching patients with therapists of the same race/ethnicity.
The analysis went on to note the importance of teaching cultural competency for all therapists, ensuring that they are able to appropriately treat patients from all walks of life. That was a theme in a Guardian article on the subject, which noted the importance of that competency. From the article:
Dior Vargas, a 28-year-old Latina mental health activist, recalls a therapist in college – her second one – who she stopped going to after realizing she was “culturally incompetent”.
“She wasn’t aware of how close-knit Latino families are. That they are a part of my decision-making process. My therapist didn’t understand that, she would say: ‘No, you need to stand up to your mother.’ That felt very disrespectful to me. Maybe sometimes you do, but the way she said it made me very defensive.”
The article also noted the challenges of gender from the perspective of an African-American male client and a white female therapist:
With one white female therapist, he says he felt his gender and race made her treat him like a threat that needed to be controlled. “She shut me down when I expressed anger. The response was you need to stop your anger, as opposed to “let’s work with that and figure out why you are angry,” which would have been a healthier therapeutic response, he says.
I think these two examples really cut to the heart of the issue. A “mirror match” isn’t necessary. Cultural competency and sensitivity is.
On a personal level, that’s been my experience. I’ve seen three therapists in my life who have really, truly made a positive difference, and all three were men. My counselor in college was gay, my first psychologist was a straight white Jewish male (so basically me), and my current psychologist is a straight Venezuelan immigrant. While these were characteristics which I obviously noticed, it’s never something that I felt made an impact in my therapeutic experience. That’s because they all understood my background.
In retrospect, I suppose that the Jewish therapist did understand some things about my upbringing and culture which would have been impossible for another therapist to truly understand, having not lived with it, but I never felt like this was a barrier. When I would explain things to them, they would fold that information into further conversations. They never judged, never questioned and never made me feel like I was wrong for feeling a certain way. While my upbringing wasn’t their experience, they never used their own experiences to color mine in a negative way.
As always, I’d love to hear what you have to say – what has been your experiences in this area? Positive? Negative? Let us know in the comments below!
Mike Schlossberg - Author 