A couple of weeks ago two articles came out highlighting a study, which found that black and poor people seeking therapy in New York City are much less likely to be called back by therapists. These findings are disheartening and as a psychologist and advocate for black women’s mental health it is something I must address. While I am well aware of the history of racism in the field of psychology, I naively hoped that the mandates for diversity training and modest increase in racial/ethnic diversity among psychologists was doing enough to address ongoing issues of racism and discrimination among therapists. Sadly, it turns out that not nearly enough progress has been made. It is frustrating to know that after someone has the courage to acknowledge their need for therapeutic help and takes the steps to find a therapist, they may have to call a large number therapists to find someone to work with or even return their call.
This is unacceptable. As therapists it is our job to do what we can to enable people get the help that they need. We must do better. I know that private practice can be tough and that there are ebbs and flows in available appointment times, particularly evening and weekend times. However, if you do not have openings in your private practice, you should make an effort to communicate that to potential clients (e.g. a specialized voicemail, note on your website, or calling clients back and informing them directly). How would you feel knowing that your lack of responsiveness might have discouraged someone from getting the help that they need?
The second, more significant issue, highlighted in the study is the discrimination against people who sound black or like they are from a working or lower class. While some of the therapists in the study may explicitly hold prejudicial beliefs. It is likely that many of therapists are unaware of their biases. As psychologists it is essential that we actively look for, and address, our biases. If you notice that you have a negative reaction or feel resistant to returning the call of a potential client who may be an ethnic minority or from a working class, I urge you to take steps to address this. Seek out continuing education courses that will improve your multicultural competence and seek consultation from colleagues regarding these issues.
To Potential Clients
On behalf of therapists, I apologize for our failings, shortcomings, and discrimination. I apologize for times when you called and we did not answer. I apologize for times when you were in therapy and felt dismissed or unheard. If you can, please forgive us for the ways that we have failed you. I know that it takes a lot to acknowledge that therapy would be helpful; to get to a place where you are willing to share your deepest thoughts and feelings with a professional. I applaud those of you have gotten to this place and I am sincerely sorry if your efforts to find a therapist have not been successful because you have not heard back from the people that you sought help from. I hope that you will not give up on therapists and therapy altogether because of negative experiences that you may have had. Below are my recommendations for ways to find therapists who might more responsive to requests.
Finding a therapist
One of the ways that many people look for therapists is directly through their insurance company (this was the strategy used in the aforementioned study). One issue with this approach is that the directories of insurance companies may not be kept up to date so it is possible to see therapists listed who no longer take that insurance or accept new clients. Additionally, the insurance companies’ lists often include very little information about the therapists so it can feel like you are blindly calling people.
I recommend using the search function on www.psychologytoday.com. This website allows you to search therapists by name, specialty, and insurance. Additionally, therapists post their head shots and describe how they approach to therapy, which will help you decide which therapists might be a good fit. Importantly, therapists pay to have their profiles listed on this website, which means that those who are listed may be more likely to have availability for new clients. With that said, it sometimes involves making several calls to find a therapist with availability that matches yours who is also a good fit so I encourage you not to give up.
If you would prefer to do less leg work, another option is to look for an organization or group private practice that has a number of therapists who do therapy. These organizations often take a range of insurance plans and they typically have a central intake system that will help you get connected to a therapist. These organizations can be a good option and help you gain access to a number of clinicians with one call. Also, these organizations typically have websites with pictures and biographies of therapists and listing of their specialties, which can make it easier to choose the therapist you want to work with.
My biggest frustration when I read the articles on therapists discrimination was that people in a profession that is committed to helping those in need would be neglecting and harming potential clients to due racial and class biases. My biggest fear was that these articles and people’s negative experiences related to seeking therapy might discourage those in need from getting help. My hope is that we as therapists will work diligently to address our biases, continuously increase our multicultural competence, and work to make therapy more accessible.