By CarmenLeah Ascencio
This is the second installment in CarmenLeah’s new, monthly column about QTPoC wellness and healing.
We do not all need to go to therapy, but we should all deal with our shit. Our shit keeps us from having healthy relationships, making our dreams happen, treating other people well and forming revolutionary communities. I have shit. I can be a bossy know-it-all in my personal relationships and have struggled to restrain my need to be in charge in professional ones. Doing my inner work has helped me find peace and be a better person to work and love with. So, what’s your shit and would some confidential, one-on-one support help you face and sort through it better? If the answer is yes, here are ten guiding factors that can help QTPOC find the right therapist.
1. Cost. If you don’t have insurance, enough income or are undocumented, look into LGBQT centers, domestic violence agencies, rape crisis centers, and community based health clinics to see if they have free or sliding scale counseling. Many of them do. Also, be honest with yourself. How much could you actually (not preferably) afford to spend per month?
- Be specific about your search. Google something like “woman of color therapist who works with trauma” (or whatever your specifications are).
- See if there is a free therapy referral service you can call, which finds therapists for you based on what you are specifically looking for. Here’s an example service is Massachusetts: http://www.therapymatcher.org/
- Look for a psychologist, a clinical social worker, or a mental health counselor, not a psychiatrist. In general, psychiatrists provide medication, not therapy.
3. Shop around. Meet with 2 to 3 therapists before you decide who to work with. You do not need to work with the first therapist you meet! Therapy is about a relationship; it may take a few tries to find the right match.
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4. Interview the therapist. Your first session is not only about your evaluation, but also about evaluating the therapist. Come prepared with questions that are important to you. These questions could be:
- “What percentage of your clients are people of color and what are their races/ethnicities?” Yes, you can ask this and should ask this of white therapists. (Same goes for any identities that are important to you – i.e. if therapist is cisgender ask about their work with trans* folk).
- “How do you address issues related to societal oppression, like racism and transphobia in therapy?” If the therapist becomes flustered, or tells you that they don’t see color, that’s a clear sign to get out!
- “Why do you do this work? Can you tell me about why you decided to become a therapist?” This can give you a lot of info – especially in making sure you ain’t about to start therapy with a savior “help people” type.
- “What can I expect a session to look like?” Some people want concrete tasks, skills, and structure in therapy. If this sounds like you, make sure the therapist does this. Many do not.
- “Do you specialize in trauma?” (If relevant). If they don’t have specialized training, they could cause more harm than good. Ask them to explain their trauma treatment. If they use exposure therapy, ask them how they prepare you for this. This type of therapy can be harmful when done incorrectly.
5. If you have trauma, the early focus of therapy should be about making sure that you feel safe and have the coping skills to regain stability when you are triggered. If you don’t yet have these skills, there should not be a lot of focus on telling stories about the past. Coping skills are essential to building the safety necessary to explore the impact of harm from the past.
6. You are not a teacher or a friend. You should not have to teach your therapist about race, gender, class, etc. This is something they should know or recognize they don’t know and make effort to learn. If you find yourself continuously spending time in session explaining basic things about your identity that can be learned about in a book, find someone else. Conversely, if the therapist is spending a lot of time telling you about themselves, particularly when it does not further your own insight, this is a sign of poor boundaries. You are there for you, not them. Seek support elsewhere.
7. Trust your gut. If it doesn’t feel right, don’t stay. You don’t need to explain why. Therapy is about YOUR needs, not the therapist’s needs. You also have to be honest with yourself. Is your gut telling you something is off or are you trying to find a reason to avoid therapy? Be truthful. Anything less won’t help you.
8. Be wary of immediate diagnosis. Most mental health treatment in the U.S. is grounded in a Western European medical model. This means that many diagnostic approaches do not take into account environmental causes of stress. This has lead to oppressive and stigmatizing diagnosis for many folks of color. For example, almost all of the Black and Latina commercially sexually exploited girls that I worked with were diagnosed with oppositional defiant disorder or conduct disorder, with no consideration of the fact that they were controlled by a pimp and repeatedly sexually assaulted. Black men are also diagnosed with Schizophrenia at rates four to five time more than other groups. This over diagnosis began during the civil rights era, when rage about injustice was pathologized as an individual illness, rather than the product of a racist society.
If you get a diagnosis on the first session, be wary of the therapist’s approach. Unless it’s very clear, most diagnoses take a few sessions of evaluation and even then, can be questionable.
9. Don’t assume because the therapist is a POC or queer that they have radical politics or that they know about things that might be important to you, like polyamory, sex work or BDSM. I know people who have had bad experiences with both white and POC therapists. Hence point #4. Interview therapists and if necessary, consider expanding your idea of the “perfect therapist” to get your needs met.
10. Do the work. Be clear about what you want to get out of therapy before you go. If you aren’t sure, discuss it with a friend. The therapist isn’t going to perform magic or fix you (also, you are not broken and don’t need to be fixed). The therapist serves as a facilitator of your growth. The more you put in, the more you get out.
These are some basic guidelines. For some folks, finding the right therapist will be hard because you are worried about hurting the therapist’s feelings and have a hard time saying no. I feel you. And, you can either choose to stay in unhelpful therapy because you want to avoid an uncomfortable conversation or you can be uncomfortable for a few minutes and get support that might change your life. You choose.
*Thank you to everyone who contributed to this piece by sharing their stories with me!
CarmenLeah Ascencio a public health social worker, community theatre facilitator, trauma-sensitive yoga instructor, educator and proud Boricua 2nd generation queer femme. She is currently the director of Get Free, a Black Girl Dangerous program, and is the creator of Freedom Labor Love, a consultancy business that helps organizations and schools be trauma informed, emotionally healthy and inspired social change environments. CarmenLeah facilitates BGD Get Free workshops at organizations and schools. To find out about booking CarmenLeah, go here.
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