The United States was founded on stolen land and stolen people. The historical and generational trauma and oppression that continues to impact communities of color, and specifically, black communities, has been more than harmful. As a clinician in mental health, it is necessary to understand these systematic and historical barriers that perpetuate racism, oppression, privilege, and white supremacy.
I am a white social worker and therapist practicing in Brooklyn, NY. The vast majority of my clients seeking mental health treatment are Black Americans. What I have seen since the beginning of my practice, and what has become all the more prevalent now, is that white and non-black therapists are not adequately addressing police brutality, systematic racism and oppression, and historical trauma with their clients.
In this last year alone, I have grown dramatically in my understanding of black trauma and the ugly history of the United States. There have been times of discomfort for me, as I’ve had to address my own personal biases that I did not want to admit. But as a white person, the one who has historically caused the harm, it is necessary to be uncomfortable during this time and until justice has prevailed. I cannot call myself a “good therapist,” if even such a thing exists, if I cannot acknowledge and process the deepest barriers and pain my clients face. I have seen too many white therapists moving forward with clients and failing to discuss and hold space for this insurmountable pain. It is time that white therapists practice holistically, and that includes the macro pain that communities of color are burdened with. Here is how I have done this thus far in my practice.
During an intake session, before therapy has begun, explore your client’s cultural identity and the impact of that identity on their daily life and mental health. Don’t simply use empathy in these conversations, but be empathetic. It is this time that you are also able to address your white privilege, and begin the conversation about having therapist-client relationship across cultural identities.
Be educated and do not expect your client to teach you. This is a balance to have. It is impossible for clinicians to know everything about every culture and ethnicity. In terms of working with black identifying clients, it is important that you have a thorough understanding of historical racism and oppression. In this regard, the client will not be further burdened in teaching you, but in processing their own experience.
Validate your client’s pain and acknowledge your privilege so that the therapeutic relationship may truly blossom in its openness and empathy. If you are not the one to address this, it may not come up at all. As therapists, we must not cause harm to clients, and when we neglect to acknowledge and discuss this oppression, we are being complicit. We are allies for our clients and the vulnerable populations we work with. We are fierce advocates. This is not limited to protesting, petitioning for legislation, and changing policy. We are an advocate in the session, as we speak on the racism and bigotry our client has been and continues to be a survivor of.
The NASW Code of Ethics blatantly speaks on the ethical responsibility for social workers to engage in social justice work. The Code of Ethics also states that social workers should engage in providing pro-bono work, and I believe these two elements go hand in hand. A tweet from a black woman, of whom was seeking therapy, detailed her inability to go to therapy in the midst of these protests and high profile cases of black murder. She expressed her pain, and more than than, her pure exhaustion. This woman’s therapist continued to charge the client the no-show fee for not providing 48 hours notice, as well as attempted to convince her to come into therapy that was done in a tone of persuasion and not compassion. This is not social justice work. This is not anti-racist therapy. When we see this long-term crisis continue in the United States, and we know the history and the impact of generational trauma, why do we continue to charge for treatment and are unable to meet clients where they are? The stealing of black lives is a pandemic in itself, and though we advocate for change, white therapists are still falling short in direct practice work. Now what would I have done in this situation I described above? I would have said okay. I would have spoken with genuine empathy and compassion, and informed my client that I am an ally and fighting alongside her. I would have made it known that I am a support, and that it is completely and 100% understandable to not attend the session that day. And then I would be available as a support if she changed her mind. After having that conversation with this client, I would NOT have charged a fee for being traumatized, because that is what is was.
With my clients thus far, I have continued to open the door for conversation, support, and acknowledgement. The last session for the parent support group I facilitate was spent supporting the members, all of whom are black mothers. After the group ended, I sent each person an email confirming my allyship and support, acknowledging my privilege, and expressing my understanding if they could not bring themselves to attend. I described my pain for them, and how I stand with them in this fight for justice. The response I received confirmed the pain my black clients are facing. Some members responded to me stating that that email and outreach brought tears to their eyes, and how comfortable and supported they felt in our relationship. The simple acknowledgement of my privilege and their trauma solidified a trusting and therapeutic alliance.
It is not only during these protests for George Floyd that social workers and therapists operate within anti-racist practice. We do not fight for social justice only when it is trending. When the topic is no longer hot, it is necessary we continue having these conversations with our clients because their blackness does not change. The history of oppression, racism, policy brutality, and murder has not changed. The heavy burden has not changed. Because these things do not change, we cannot stop this work. It is our duty and ethical obligation at all levels of social work, and we fall on our privilege when we neglect to continue anti-racist practice.