Is Seeing a Therapist Who Lacks Cultural Safety Better Than No Therapy at All?

Julia Childs Heyl is a clinical social worker dedicated to addressing mental health disparities, healing intergenerational trauma, and practicing depth psychotherapy.

Therapy’s significance is increasingly recognized, yet individuals from marginalized communities often face unique challenges when seeking mental health support. Issues like racism, xenophobia, and homophobia can infiltrate therapy sessions, leading to experiences of microaggressions or discrimination rather than the culturally safe environment clients deserve.

Research reveals that 84% of psychologists are White, making it difficult for people of color to find therapists who share their backgrounds and lived experiences. Consequently, some may settle for therapists who do not reflect their identities, risking care that feels culturally unsafe.

Choosing a therapist who lacks cultural safety is not a substitute for having no therapist. This article guides you through options to access affirming and culturally safe mental health care.

Understanding a Non-Culturally Safe Therapist

To begin, it’s essential to clarify what "culturally safe" means. This concept goes beyond simply learning about different social, economic, or racial groups. While cultural knowledge is valuable, it doesn’t guarantee that clients will feel secure and respected during therapy.

Cultural safety involves therapists actively examining and addressing power imbalances within their relationships with clients. This contrasts with "cultural competency," which focuses on acquiring knowledge about other cultures, and "cultural awareness," which takes a step further but still may not fully engage with power dynamics.

For instance, a culturally aware White therapist might study generational trauma in Black communities, attend workshops on racial oppression, and reflect on how their White identity affects their work. While this is an important start, a culturally safe therapist openly discusses the power and privilege inherent in their role, creating space for clients to express how safe they feel.

Addressing differences in identity openly allows clients to explore feelings about being in therapy with someone from a different background. It invites clients to voice their needs for safety and to process any discomfort or challenges that arise.

In contrast, a non-culturally safe therapist avoids these critical conversations, leaving clients without room to unpack their experiences of marginalization within therapy.

Worse still, such therapists may rely on stereotypes, make incorrect assumptions, or respond defensively if clients raise concerns about cultural misunderstandings. They might shy away from discussing race or deny how their own racial identity influences the therapeutic relationship.

Rather than being open, curious, and adaptable, these therapists might rigidly approach cultural learning as a checklist, which can hinder therapeutic progress and even cause additional trauma.

Is It Better to Have No Therapist Than a Culturally Unsafe One?

When healing from trauma or life challenges, it can be tempting to overlook a therapist’s cultural insensitivity. However, therapy with a non-culturally safe provider risks compounding harm rather than alleviating it. Trying to heal in a space where ignorance or bias exists can be exhausting, frustrating, and damaging.

Trust is fundamental in therapy, and it’s often difficult to build or maintain trust with a therapist who disregards cultural safety or fails to repair harm caused by ignorance. Since the therapeutic alliance is key to effective treatment, this poses a significant obstacle.

Therapy requires investment of time, energy, and resources, and clients deserve to receive care that respects and honors their identities. Engaging with a therapist who is dismissive or harmful can lead to increased distress rather than relief.

Therefore, a non-culturally safe therapist is not preferable to having no therapist at all. Nonetheless, this should not discourage you from seeking help. The goal is to find culturally safe care, and there are strategies to achieve this.

Finding a Culturally Safe Therapist

Studies show that BIPOC individuals receiving therapy from BIPOC providers experience lower dropout rates. Yet, culture encompasses more than race, including religion, sexuality, and socioeconomic status. Thus, sharing racial identity alone doesn’t guarantee cultural safety.

To locate a culturally safe therapist, consider using online therapy directories that emphasize diversity and inclusion, such as:

• Inclusive Therapists
• Latinx Therapy
• Therapy for Black Girls
• Therapy for Black Men
• National Queer and Trans Therapists of Color Network
• Asians for Mental Health

After identifying potential therapists based on specialty, fees, and location, arrange a consultation call to evaluate cultural safety.

During this call, inquire about how they manage power dynamics, handle cultural differences, and foster a culturally safe environment. If aspects of your identity—such as religion or sexuality—are important, bring these up to gauge their understanding and openness.

Key Questions to Evaluate Cultural Safety

• What experience do you have working with clients from ________ (specific racial/ethnic groups, immigrant backgrounds, LGBTQIA+, etc.)?
• How do you think your race influences your work with clients from different backgrounds?
• What steps have you taken to deepen your awareness of White privilege and accountability? How do you address this in therapy with clients of color?
• What does providing culturally safe care mean to you?
• How comfortable are you discussing topics like White privilege, racism, discrimination, microaggressions, and systemic oppression?

Observe their responses carefully. Are they open, thoughtful, and warm, or do they seem defensive or unprepared? A therapist truly committed to cultural safety will welcome these conversations.

Finding the right therapist may take time, but don’t settle for someone who dismisses your experiences. It is possible to find culturally safe therapy that supports your healing.

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References:

1. American Psychological Association. Psychology’s Workforce is Becoming More Diverse.
2. Curtis E, Jones R, Tipene-Leach D, et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. International Journal for Equity in Health. 2019;18(1):174. doi:10.1186/s12939-019-1082-3
3. Norcross JC, Lambert MJ. Psychotherapy relationships that work III. Psychotherapy. 2018;55(4):303. doi:10.1037/pst0000193
4. Ibaraki AY, Hall GCN. The components of cultural match in psychotherapy. Journal of Social and Clinical Psychology. 2014;33(10):936-953. doi:10.1521/jscp.2014.33.10.936

By Julia Childs Heyl, MSW
Julia Childs Heyl, MSW, is a clinical social worker and writer focusing on mental health disparities through a critical race theory lens. Clinically, she specializes in treating people of color experiencing anxiety, depression, and trauma using depth therapy and EMDR trauma treatment.

Updated by Hannah Owens, LMSW

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