A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures.
By Christina Caron | New York Times
July 16, 2021, 12:30 p.m. ET
Several years ago, while Charmain Jackman was going through a rough patch in her marriage, she started looking for a Black, female therapist. At the time, she said, she was desperate to find someone who would understand who she was, as a Black woman.
“I wanted to come in fully as myself and not worry, ‘Is this person going to get it? Am I going to have to explain everything?’” she said.
But even Dr. Jackman, a psychologist from Massachusetts with decades of experience, kept running into roadblocks. Her insurance carrier did not offer demographic data on any of her in-network providers. A search on Psychology Today, one of the most commonly used internet directories of mental health professionals, was returning results that did not include women of color. And, at the time, the website Therapy for Black Girls only had a couple of therapists in her state who took her insurance.
“So,” she said, “I decided I would create the site that I would want to use.”
In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments, but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.
The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.
Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.
“What we’re speaking to with cultural competence is not how much do you know about individual cultures, it is more how do you show up in any space in a way that allows other people to feel welcome, to feel heard and to feel understood,” said Alfiee M. Breland-Noble, a psychologist in Arlington, Va., who has taught cultural competence and multicultural counseling skills to mental health professionals for more than two decades.
Dr. Jackman’s website, InnoPsych, which officially went live in January of last year, has a free, searchable directory of potential therapists. Users can filter providers by several categories, including their state; the type of insurance accepted; and the therapist’s availability, ethnicity and specialty.
The list of therapists — all of whom are people of color — nearly numbers 450, and keeps growing.
“Our goal is to feature 2,021 therapists of color in 2021,” she said.
Other organizations go a step further and help patients set up therapy appointments. The nonprofit Black Men Heal, for example, offers up to eight free online counseling sessions. About 70 percent of clients choose to pay for additional sessions, said the executive director, Tasnim Sulaiman, a psychotherapist in private practice in the Philadelphia area who founded the organization in 2018.
It can be difficult for people of color to locate a therapist with a shared cultural background. According to the Census Bureau, about 18 percent of people in the United States identify as Hispanic and 13 percent as Black, but an American Psychological Association report found that only 5 percent of psychologists are Hispanic and 4 percent are Black — 86 percent are white. A similar disparity exists among the country’s social workers and psychiatrists.
Eric Coly, who formerly worked in finance, founded Ayana Therapy in 2020, about eight years after hitting “rock bottom” while facing anxiety and depression.
Back then, he struggled to find a therapist who could understand the intersection of his different identities as a Black man and an immigrant from Senegal who has lived in different parts of the world.
“This product was almost meant to heal my former self,” he said.
Ayana, which means “mirror” in Bengali, asks users to fill out a questionnaire that is meant to capture “your many nuances,” Mr. Coly said, and then matches you with a culturally competent therapist. The cost of each online session is currently $60.
Providers are vetted through a process that includes two interviews and reference checks.
While Ayana was created for a multitude of races and cultures, as well as those who identify as L.G.B.T.Q., some websites cater to a more niche set of users like LatinxTherapy, Therapy for Black Girls, Therapy for Black Men, the Asian Mental Health Collective and the National Queer and Trans Therapists of Color Network. Melanin and Mental Health features a directory of therapists of color, many of whom are in Houston. The Black Emotional and Mental Health Collective, a wellness nonprofit that trains people to respond to mental health crises, has an online directory with a variety of Black practitioners including therapists, yoga instructors, doulas and mediators.
Employers are also starting to recognize the need for culturally competent providers. The companies Indeed, Thumbtack and Critical Mass, which is part of Omnicom Group, have recently partnered with Therify, which uses artificial intelligence technology to match employees with providers in their state. Half of Therify’s nearly 300 online therapists are people of color and 20 percent specialize in serving clients who identify as L.G.B.T.Q., said the company’s chief executive, James Edward Murray, who interviews each provider.
About four years ago, when Mr. Murray was searching for a therapist to process the trauma of having lost his father at a young age, he had seven consultations with different providers before finally landing on a therapist he felt comfortable with.
“I had countless friends who just gave up, who needed care but didn’t get it because it was so hard to find a good fit,” said Mr. Murray, who founded Therify in November 2020.
While racial matching can be helpful, he added, “the most important thing is someone who leads with empathy and understanding.”
Hurdle, previously known as Henry Health, likewise does not select providers based on the color of their skin. The company is unique in that it not only vets its therapists, it also trains them using a cultural competence curriculum developed by Norma L. Day-Vines, an associate dean in the School of Education at Johns Hopkins University.
“We look for therapists with a foundation in cognitive behavior therapy and trauma-informed care, and layer our technique over those techniques,” said Kevin Dedner, the chief executive of Hurdle. He founded the company in 2018 after struggling with depression for years.
After a client registers for therapy, Hurdle sends them a link to an app, and the company’s customer service team assigns a therapist from a group of providers located in Washington, D.C., Maryland or Virginia. (Hurdle plans to expand into four more states this year.) Many types of commercial insurance are accepted, but if a patient is paying out of pocket, each session costs $99.
Tips on finding a culturally competent therapist
Keep in mind that online therapist directories do not always have the resources to verify licensing or vet the quality of the therapist, so it’s important to do your own due diligence. First, make sure that your therapist is licensed and in good standing with their licensing board. If you were researching a psychologist, for example, you would start by looking them up on the Association of State and Provincial Psychology Boards.
After you’ve located someone promising, ask for a free “get to know you” session where you can interview the therapist about treatments and cultural competence, said Melanie M. Domenech Rodríguez, a professor at Utah State University and an expert in multicultural psychology.
Dr. Rodríguez suggested asking the following questions:
What is your approach to treating my issue?
Do you use an evidence-based treatment? If so, what it is called?
How often do you work with Black, Indigenous and other people of color?
What challenges have you faced in providing services to people of color and how have you addressed them?
When you eventually start seeing someone, the National Alliance on Mental Illness recommends asking yourself the following questions:
Did my provider communicate effectively with me?
Is my provider willing to integrate my beliefs, practices, identity and cultural background into my treatment plan?
Was I treated with respect and dignity?
Do I feel like my provider understands and relates well with me?
If you can answer yes to each of these questions, you’re off to a great start.
“Cultural competence matters,” Dr. Domenech Rodríguez said. “But it is defined by the clients, not the therapists.”
Christina Caron is a reporter for the Well section, covering mental health and the intersection of culture and health care. Previously, she was a parenting reporter, general assignment reporter and copy editor at The Times. @cdcaron