Why African-Americans are Less Likely to Go to Therapy

People have many different ideas about why we—African-Americans—do not seek therapy. Some believe therapy is only for wealthy white people, while others believe they should not seek help outside of their family. Here are some of what I think are the more prevalent reasons some African-Americans choose not to seek therapy:

“But I don’t have a mental health issue.”

Many people think they must have a mental health issue to go to therapy. While it is true that some people with mental health issues seek therapy, anyone can take advantage of the service. Therapy is a paid service that connects you with a trained professional who can provide you with the support you need to live a healthier and happier life.

When I first met Andre, he was apprehensive about seeking therapy. For many months, he questioned whether or not he should be in therapy. He felt his life was manageable and thought he did not have enough problems to go to therapy. He had a job and people who cared about him. After several discussions about the purpose of therapy and its benefits, Andre accepted his desire for therapy.

Find a Therapist

In a recent session, Andre said the healthiest people he knows are all in therapy. He realizes that therapy can benefit everyone, not just a small segment of the population. Andre further explained that the people he knows who have the most problems are not in therapy. As a therapist, this makes perfect sense to me. Recognizing that your life is not how you want it to be—or that you need additional support—takes courage and self-reflection. This is the thought process of people who have a sense of who they are, but want more from their life and themselves.

“I can talk to my friends and family.”

Why do people sometimes need to go outside of their family, church, or friendship circle to get the help and support they want? Sometimes going outside of that comfortable and familiar circle can propel them to make changes. Many times people do not tell their family or friends everything that is happening in their lives—not to be deceptive, but because they care about what their family and friends will think.

Keisha came to see me because she was thinking about leaving her husband. She recently found out he had an affair. Her family adored her husband, and she was afraid of what they would say. She had not made up her mind about leaving, but she needed someone to talk to—someone who would not immediately tell her whether to leave or stay.

When you are concerned about what another person is thinking and feeling, you cannot focus on yourself and your own needs. In my opinion, that is the benefit of therapy. You can share all of your thoughts and feelings without being concerned about the therapist. You can focus on you, what you need, what you want, and ways to accomplish your goals. Sometimes people are more honest when they go outside their circle of family and friends. As backward as it may sound, it can be easier to  share your feelings, fears, and pleasures with someone who you do not see every day.

Keisha was relieved to talk about her marriage with someone who did not judge her or tell her what to do. This freedom allowed her to be honest with herself and to decide what she believed to be best for her. Ultimately, she decided to stay and work on her marriage. Keisha realized that she needed to come to a decision on her own rather than being told what to do.

Does this mean your family and friends aren’t helpful? Absolutely not. Instead, it means therapy can add to the support they provide by giving you an objective person to help you review your options as you decide what is best for you.

“It’s just another racist system.”

As an African-American, I am aware of persistent racism in our country. This is true on a large scale as well as in our daily interactions. I think we have many reasons to be suspicious of outsiders and to be distrustful of their motivations and actions. The Tuskegee Syphilis Experiment—in which African American men infected with syphilis were not given treatment during a research study even after an effective treatment was identified—is a perfect example of why we are wary of outsiders.

Our schools consistently peg our children as aggressive, out of control, and low-achieving. We have to fight to receive the same services as our white counterparts, whether it’s in our schools, hospitals, or the workplace. Going to therapy poses another opportunity to encounter racism and discrimination if you’re met with an insensitive or ignorant therapist.

When I worked in an agency, I often saw African-Americans who said in the first session, “I’m so relieved that you’re black.” Some said they felt more comfortable with an African-American therapist because they could talk about life and their culture without having to teach or explain the basics. Others did not like the racism they sometimes encountered with white therapists.

For example, Ayanna, an African-American woman in her thirties with two children, had previously met with a white therapist before coming to see me. She was put off when the therapist began asking questions about her educational history. The therapist seemed surprised when Ayanna said she went to college.  Rather than assuming Ayanna had a college degree, the therapist asked her how many years of college she had completed. The therapist then asked if Ayanna’s children had the same father. At that point, Ayanna felt she would not be comfortable with a therapist who seemed to make assumptions about her educational background and family life based on her race.

Ways African-Americans Can Benefit from Therapy

“So why bother?” With all of the struggles and oppression we might face on a daily basis, we need an outlet. We need a comfortable environment where we can talk about the impact oppression has on us and healthy and productive ways to deal with it. Holding in the pain, frustration, anger, and sadness can leave you feeling angry and dissatisfied—not a rewarding way to go through life.

When you find an effective therapist, therapy can be a place to gain support and find more satisfying ways to live life. It might be the only place where you are not required to have all the answers. It is a place where you only have to be concerned about yourself and your needs.

Therapy provides an objective perspective from a trained professional. They can provide feedback based on what they see now, not based on how you used to be. Although our family and friends may love us and provide us with support, they usually cannot be objective like an outsider. A therapist has no ulterior motives; their only motive is to help you make the changes that you want to make in your life.

How Can African-Americans Find a Therapist?

First, figure out what is important to you. Do you care what race your therapist is? What about gender? If you think seeing an African-American therapist is necessary for you to be open and honest, then look for one. If you are not sure, then try a few different therapists and see who you connect with. Do not be afraid to ask for what you want. Remember, this is a service you are paying for, and as a paying customer, you have the right to ask for what you want. From there, the therapist can tell you if they are able to provide that service. If they cannot, ask them to give you referrals until you find what you are looking for.

Before scheduling an initial session, determine the therapist’s fee and make sure you can afford it. Therapy is a useful tool that helps people in times of crisis and fosters growth in times of reflection. However, it is not as useful if you are not committed to it. So make sure that you can afford the therapist you choose. You may have to alter your budget to afford it, but if it obliterates your budget, look for someone with a lower fee.

Finally, do not forget what you already know. You get what you pay for. Do higher prices mean better service? Not necessarily, but a quality and effective therapist will usually charge within the average range for the area.

When you are ready to enhance your life or get help with a current crisis, a therapist might be just the person to call.

Editor’s note: Names and identifying information have been changed.

© Copyright 2008 by Tonya Ladipo, LCSW, therapist in Philadelphia, Pennsylvania. All Rights Reserved. Permission to publish granted to GoodTherapy.org.