The Vital Role of Therapy in the Black Community

African American and multiracial populations experience unique mental health needs. From interpersonal stress caused by racial trauma to increased burnout in caring for family members due to cultural expectations, therapists and other mental health providers must be aware of these distinct needs. Below, we learn more about the types of therapy that many black people are accessing, as well as the barriers that prevent them from receiving it.

Common types of therapy needed by African Americans

Whether they actively seek therapy or not, there are many types that African American patients can benefit from depending on their mental health needs. These forms of therapy do not consistently serve the black population, but that does not mean that their mental health issues cannot be addressed with effective therapy methods such as those listed below.


Psychotherapy is often called “talk therapy” and is the most common. Many Black people benefit from talking with a therapist about their emotions, daily struggles, and negative behaviors through weekly or other regularly scheduled therapy sessions that usually last about 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 different benefits.

  • Cognitive Behavioral Therapy (CBT)CBT is one of the most common types of psychotherapy and can address many behavioral and emotional problems by 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 associated behavioral problems. It is recommended for those with more severe mental health needs, such as patients with PTSD, suicidal behavior and eating disorders.
  • Behavioral therapyMany black youth have behavior problems at school for a variety of reasons, but many cite racial bullying as a reason to show up when they feel comfortable speaking with licensed counselors who offer effective CBT.
  • Emotionally focused therapyEmotional support can be vital for those dealing with past trauma and those currently experiencing relationship difficulties.
  • Eye Movement Desensitization (EMDR)Racial trauma is particularly common among black people, and EMDR is one way to process trauma, move past traumatic experiences, and treat PTSD.
  • Family therapyMany black people are not used to sharing their personal struggles, even within their own families. Family therapy can help create open communication that improves relationships between couples as well as parents and children.

Group Therapy/Support Groups

The benefits of group therapy are many. However, black people and people who self-identify as black may benefit more from this type of therapy than most. Many therapists recommend group therapy because it helps participants understand that they are not alone in their struggles. You may find a support group specific to your needs, such as experiencing racial trauma, being a family caregiver, becoming a new mother, living with a specific mental or physical illness, or going through a major life event. While a therapist can refer you to a support group, you can find one nearby or online through a social media platform, networking channel, or library events calendar.

Family therapy

Family therapy is often used as a preventative measure for child maltreatment. According to one study in Sacramento County, California, African-American children made up only 11% of the population, but more than 30% of child abuse and neglect deaths. However, child abuse is not the only reason for family therapy. It can identify mental health needs within the family unit that can be addressed through individual therapy and other treatment options. There are many reasons why black families are less likely to participate in this type of therapy than white families. However, its benefits have been well documented in recent years.

Trauma-focused therapy

Trauma can come from many sources, including being involved in or witnessing a traffic accident, losing a loved one, war 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-focused therapy that focuses on awareness, recognition and response to the trauma experienced so that the patient can live a happier and more mentally healthy life.

Adjunctive drug therapy

According to a 2019 study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), the African American population is highly susceptible to substance use disorders. More than 5 million black people suffer from mental illness and more than 2 million from substance use disorders. Of those, nearly 1 million have both mental health needs and struggle with a substance use disorder. Medication-assisted therapy combines behavioral therapies, such as those listed above, with FDA-approved medications to treat co-existing substance use disorders and mental health needs.

Barriers to Effective Therapy Services for Black Americans

Sad, depressed and black man with anxiety in college, stress and headache from education on university degrees.  Depressed, frustrated and a student with mental health problems is crying on campus.

Finding the right therapist is hard for everyone, but it’s especially hard for black people. The barriers to proper care listed below are just a few of the factors that affect the black population and how mental health treatment differs compared to whites. Let’s take a closer look.

Domestic responsibility

Regardless of ethnicity, many women become caregivers to family members at a young age, becoming adults quite early. This “coming of age” affects black adults more than most, and especially women. According to the American Psychological Association, this process leads to burnout and stress. Black women are particularly prone to carry the burden of their families without external emotional support and personal experiences of negative race relations, adding an internal responsibility to help those around them deal with racial trauma.

Mental health stigma

Unfortunately, mental health stigma is particularly prevalent 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 believe that mental illness is a sign of weakness. These beliefs create a powerful barrier to seeking help for these conditions, the first step of which is often therapy. One reason for this barrier may be the sense of shame in the black population that surrounds 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.

Socio-economic status

Today, a black person has a slightly higher average income than just ten years ago, but it is still not enough compared to whites and the general population. Economic growth has not supported the black population as much as other races. More black adults reported poor access to health care due to location and transportation availability, access to health insurance coverage, educational attainment, community resource opportunities, and median household income. Black youth with mental health needs are particularly vulnerable based on socioeconomic status compared to other ethnic groups.

Navigating the healthcare system

The health care system in the United States is becoming more complex and health literacy is lagging behind. The vast majority of those trying to find coverage or a provider report difficulty. Black populations are disproportionately affected by lack of community resources in low-income neighborhoods, low educational attainment among Black youth, and more. Having health insurance coverage doesn’t always mean one will find a provider, as it can be difficult to find one that accepts the right coverage and accepts new patients. This process is tedious even for those who understand it.

Systemic and structural racism

Racism in our political and economic systems affects the black population from the financial assistance they receive to the insurance coverage they are eligible for. These forms of racism exist at a structural level and can only be changed by political and economic reform.

Because systemic and structural racism exists, many black people fear discrimination in the health care system. With mental health stigma, encouraging those with mental health needs to seek the emotional support they need has been difficult in the past. However, as this racism is addressed and slowly changes the landscape of our health care system, more black adults are receiving appropriate care.

Being uncomfortable with the subject

Many black patients are reluctant to bring up the topic of racism with their therapist, but will talk about it if the therapist brings it up first. This can be an uncomfortable topic to talk about, but it is an important one to discuss with patients of color. Most therapists aren’t sure how to bring it up or what to discuss. However, it is also important to reiterate that conversations with the therapist are confidential so that any patient feels comfortable 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 has been proven that regardless of ethnicity, most people prefer to see a provider who looks like them. It makes sense that talking to and opening up to someone 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 be reflected in the current number of practicing providers.

Less culturally competent providers

Even providers who are not Black can become culturally competent by learning more about their patients and their ethnic backgrounds. Many people of color report different symptoms of the same mental illness. For example, depression in African Americans often manifests itself in physical pain, while whites may not. Providers who make an effort to understand these medical differences and 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

Regardless of why you’re looking for one, finding a therapist and seeing them regularly shouldn’t be a challenge for anyone, regardless of race. However, the number of black people affected by health disparities is staggering, and we must do more to address this issue. One of them is raising awareness of the problem. Black Health Matters is helping to do just that this Mental Health Awareness Month by sharing our unique needs and struggles, the stories of African Americans doing more in our communities, and helpful mental health resources.

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