Racial, Ethnic and Cultural Issues

Therapy that is Culturally Competent


Be Well Kentucky is dedicated to providing culturally-competent services. A key facet of our work with clients is to fully understand the cultural, social, and spiritual issues that shape the whole person. Prior to working with any cultural group, the therapists should possess a basic level of cultural knowledge and sensitivity, through formal education or prior meaningful experiences with members of the client’s cultural group. Cultural understanding is essential to prevent misattribution of symptoms to stereotypes about the client’s race or culture. We also understand that in many communities, mental health care is stigmatized, thus clients may have mixed feelings about even meeting with a therapist.


An individual’s ethnic identity can vary, from not identifying with any particular ethnic group, to identifying heavily with one particular group. Ethnic identity development typically begins in adolescence and becomes fully developed in young adulthood. In ethnic minorities, a strong positive ethnic identity helps to protect against anxiety and depression. In these groups, ethnic identity is shaped by what is called racial socialization. This is what parents do to help prepare their children for the realities of life as a minority in a society that tends to normalize Whiteness. When children do not grow up hearing enough positive things about their ethnic group, they internalize the pervasive negative stereotypes about minorities, resulting in confusion, low-self esteem, and sometimes even self-hate. Culturally-sensitive therapy with an understanding clinician can help to resolve these feeling and improve well-being.


Experiences of racism and discrimination can lead to stress, anxiety, traumatization, and depression. Even low-levels of discrimination experienced on a regular basis can result in psychological unwellness. Several scientific studies have established a link between racism and negative mental health outcomes, including depression, disordered eating, substance use, and overall psychological distress. Many mental health professionals are not aware of the effects of racism on psychopathology because of a societal tendency to deny or rationalize the presence of racism. This can cause minorities who seek help to feel misunderstood by their therapists.

Racism-related traumatic experiences can range from frequent ambiguous microaggressions to blatant hate crimes and physical assault. Racial microaggressions are subtle, yet pervasive acts of racial discrimination perpetuated against stigmatized minorities. These may be brief remarks, vague insults, or even non-verbal exchanges. When experiencing microaggressions, the person on the receiving end may lose vital mental energy attempting to pinpoint the intention of one who commits the microaggression. The more severe race-based stressors, such as physical assault, may be life-threatening, directly causing posttraumatic stress disorder (PTSD). Chronic fear of everyday racial stressors may induce constant vigilance or paranoia, which over time may result in PTSD-like symptoms, or even contribute to PTSD when a more stressful event occurs.

Anyone suffering as a result of such experiences can contact us to schedule an in-person evaluation or phone consultation for treatment. We also do psychological evaluations to assess the impact of the effects of racism in the workplace.


Read some featured articles from the BWC Clinical Director, Dr. Monnica Williams at Psychology Today:


Our therapists have published important research in the areas of ethnic minority mental health.


Williams, M. T., Malcoun, E., Sawyer, B., Davis, D. M., Bahojb-Nouri, L. V., & Bruce, S. L. (2014). Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans. Journal of Behavioral Sciences — Special Issue: PTSD and Treatment Considerations, 4(2), 102-124. doi:10.3390/bs4020102.

Williams, M., Jayawickreme, N., Sposato, R., & Foa, E. B. (2012). Race-Specific Associations Between Trauma Cognitions and Symptoms of Alcohol Dependence in Individuals with Comorbid PTSD and Alcohol Dependence. Addictive Behaviors, 37, 47-52. doi: 10.1016/j.addbeh.2011.08.008

Sawyer, B., DeLapp, R. C. T., & Williams, M. T. (2016). Community violence exposure, racial discrimination, and barriers to treatment: Implications for African American males in counseling. In W. Ross (Ed.), The African American Male Series: Counseling African American Males: Effective Therapeutic Interventions and Approaches. Charlotte, NC: Information Age Publishing.

Sawyer, B., Williams, M.T., DeLapp, R. C. T., & Davis, D. M. (2016). The prevalence, symptomology, and treatment of PTSD in African American children and adolescents. In A. Breland-Noble, C. S. Al-Mateen, & N. N. Singh (Eds.), Handbook of Mental Health in African American Youth. Springer.

Malcoun, E., Williams, M. T., & Bahojb-Nouri, L. V. (2015). Assessment of posttraumatic stress disorder with African Americans, Chapter 11. In L. T. Benuto & B. D. Leany (Eds.), Guide to Psychological Assessment with African Americans (pp. 163-182). New York, NY: Springer. ISBN: 978-1-4939-1003-8. doi: 10.1007/978-1-4939-1004-5_11.

Williams, M., Cahill, S., & Foa, E. (2010). Psychotherapy for posttraumatic stress disorder. In D. Stein, E. Hollander, & B. Rothbaum (Eds.), Textbook of Anxiety Disorders, Second Edition (pp. 603-626). Washington, DC: American Psychiatric Publishing. ISBN-10: 1585622540.

Williams, M. T., & Leins, C. (2016). Race-Based Trauma: The Challenge and Promise of MDMA-Assisted Psychotherapy. Multidisciplinary Association for Psychedelic Studies (MAPS) Bulletin, 26(1), 32-37.


Sawyer, B., Williams, M. T., Chasson, G., Davis, D., & Chapman, L. K. (2015). The impact of childhood family functioning on anxious, depressive, and obsessive-compulsive symptoms in adulthood among African Americans. Journal of Obsessive-Compulsive & Related Disorders, 4, 8-13. doi: 10.1016/j.jocrd.2014.10.004

Chapman, L. K., DeLapp, R., & Williams, M. T. (2014). Impact of Race, Ethnicity, and Culture on the Expression and Assessment of Psychopathology. In D. C. Beidel & B. C. Frueh (Ed.), Adult Psychopathology and Diagnosis, 7e. John Wiley & Sons, Inc.

Chapman, L. K., DeLapp, R.C.T., & Williams, M. T. (2013). Cognitive-Behavioral Treatment of Social Anxiety among Ethnic Minority Patients, Part 1: Understanding Differences, Directions in Psychiatry, 33(3), 151-162.

Williams, M. T., Chapman, L. K., Wong, J., & Turkheimer, E. (2012). The Role of Ethnic Identity in Symptoms of Anxiety and Depression in African Americans. Psychiatry Research, 199, 31-36. doi: 10.1016/j.psychres.2012.03.049

Williams, M. T., Domanico, J., Marques, L., Leblanc, N., & Turkheimer, E. (2012). Barriers to Treatment of African Americans with Obsessive-Compulsive Disorder. Journal of Anxiety Disorders, 26(4), 555-563. doi: 10.1016/j.janxdis.2012.02.009

Mendoza, D.B., Williams, M. T., Chapman, L. K., & Powers, M. (2012). Minority Inclusion in Randomized Controlled Trials of Panic Disorder. Journal of Anxiety Disorders, 26(5), 574-582. doi: 10.1016/j.janxdis.2012.02.011

Wetterneck, C., Little, T., Rinehart, K., Cervantes, M. E., Hyde, E., & Williams, M. T. (2012). Latinos with Obsessive-Compulsive Disorder: Mental Healthcare Utilization and Inclusion in Clinical Trials. Journal of Obsessive-Compulsive & Related Disorders, 1(2), 85-97. doi: 10.1016/j.jocrd.2011.12.001

Williams, M. T., Abramowitz, J. S., & Olatunji, B. O. (2012). The Relationship between Contamination Cognitions, Anxiety, and Disgust in Two Ethnic Groups. Journal of Behavior Therapy and Experimental Psychiatry, 43, 632-637. doi: 10.1016/j.jbtep.2011.09.003

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