Racial, Ethnic and Cultural Issues
Therapy that is Culturally Competent
THERAPISTS WHO GET IT
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.
ETHNIC IDENTITY ISSUES
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.
RACIAL DISCRIMINATION CAN CAUSE TRAUMA
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.
- Huffington Post. (2016, Aug 27). It’s Called “Battered Race Syndrome.” Or, Something Like That.
- CTV Toronto. (2016, July 10). Trauma of Massive Shootings: How to Look After Your Mental Health During Traumatic Shootings.
- Washington Post. (2016, July 9). How do I teach my son to stay alive?: The collective trauma after violence.
- Huffington Post. (2016, July 8). Watching Videos of Police Brutality Can Traumatize You, Especially If You’re Black.
- Washington Post. (2016, July 7). This is the brain on horror: The incredible calm of Diamond Lavish Reynolds.
- The New York Times. (2015, June 24). Racism’s Psychological Toll
- NPR. (2015, July 2). Coping While Black: A Season Of Traumatic News Takes A Psychological Toll
Read some featured articles from the BWC Clinical Director, Dr. Monnica Williams at Psychology Today:
- How Therapists Drive Away Minority Clients
- Culturally Incompetent Therapy: When Therapists Do Harm
- The Link Between Racism and PTSD
Our therapists have published important research in the areas of ethnic minority mental health.
TRAUMA AND AFRICAN AMERICANS
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.
CULTURE AND PSYCHOPATHOLOGY
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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