[CantExplain]

Are whites overrespresented in therapy, both as practitioners and as patients?

And if so, why?

[feralkittymom]

As practitioners, in the US, yes. It's improving, but it's a topic at most conferences in the field. As clients, I suspect access and cultural factors may make this traditionally true, but something that's also slowly changing.

That sounds unlikely, unless you are talking specifically about the countries represented on PC. In any case, it's impossible to know, and the reasons for any dissimilarity would be different in each country. In Sweden, many refugees who deal with PTSD get CBT, for instance, but the number of immigrants is very small so I doubt whether they represent more than a tiny minority.

Do you have any idea of what the situation is in New Zealand?

[CantExplain]

Originally Posted by Mastodon

That sounds unlikely, unless you are talking specifically about the countries represented on PC. In any case, it's impossible to know, and the reasons for any dissimilarity would be different in each country. In Sweden, many refugees who deal with PTSD get CBT, for instance, but the number of immigrants is very small so I doubt whether they represent more than a tiny minority.

Do you have any idea of what the situation is in New Zealand?

I met one Maori woman at group and one of my Ts was Polynesian. I always thought of her as Samoan, but given that I went to her while I was in Rotorua, Maori seems more likely.

[shezbut]

Those two questions are very difficult for us to answer.

We aren't statisticians ~ which would really be your best bet for finding accurate answers on such a wide variety of factors. I'd assume that studies have been done on Q's like these in the Sociology field.

That's my opinion...

If you are a minority that wants to enter the field is there much resistance? I would think not? I am sure I saw a stat that upper middle class is most likely to go to therapy. I don't know if there is a big percent of Caucasians over others but they hold a bigger percent anyway. I wonder how far off the statistic would really be from the patient breakdown since many therapists get interested through some personal or family experience.

In my field (IT) it is still white male dominated and still a challenging environment for women and >some< minorities. (South East Asians and Asians integrate well.) Women still struggle with promotions and pay equality.

I would think therapist would be a little easier to get along with just by the nature of the profession. Just speculation.


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[CantExplain]

Originally Posted by shezbut

Those two questions are very difficult for us to answer.

We aren't statisticians ~ which would really be your best bet for finding accurate answers on such a wide variety of factors. I'd assume that studies have been done on Q's like these in the Sociology field.

That's my opinion...

I thought anecdote and speculation would be more fun.

Agreed, shezbut - I am in a profession that wants hard data based on randomised samples of huge populations, so I was thinking the same thing.

In my country, skin colour and ethnicity are two variables that are not registered in data bases of any kind. There are strict laws against that and exceptions are rare. I think many other European countries have similar laws. So the only way to find out would be by getting permission to make a survey of practitioners and patients. It wouldn't surprise me if something like that had been done, but I wasn't able to find anything in a quick search just now.

Originally Posted by CantExplain

I think anecdote and speculation would be more fun.

It's a sensitive topic in many countries, and for very good reason.

[eta: by "very good reason" I don't mean that it is a good thing that racial prejudice exists. I mean that people who experience discrimination and the ugliness of white privilege have every reason not to feel amused when the subject is treated as something to tell anecdotes about. It's like sexism - we may think it's dead, but it really isn't, and making fun of the way women are underprivileged just isn't amusing. This is said with the greatest respect to CE, whom I know to be a thoroughly good guy.]

[CantExplain]

Originally Posted by Mastodon

It's a sensitive topic in many countries, and for very good reason.

Are you suggesting we shouldn't talk about it?

I think it is an interesting discussion because therapy is not exactly like other white dominated fields in that I am not sure it is due to discrimination.. Or at least I think ... Having said that... Access to care can be discriminated against... More likely by class though.

Any time I want those hard numbers I can find them. I'm too lazy to look now thus speculation is fine by me.

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[shezbut]

Originally Posted by Mastodon

In my country, skin colour and ethnicity are two variables that are not registered in data bases of any kind. There are strict laws against that and exceptions are rare. I think many other European countries have similar laws. So the only way to find out would be by getting permission to make a survey of practitioners and patients. It wouldn't surprise me if something like that had been done, but I wasn't able to find anything in a quick search just now.

Wow, very interesting.

Here, in the US, giving our "race" is voluntary. But, we are asked by different types of companies all of the time. Some are just doing phone interviews, for whatever they happen to be researching. Others are prospective employers; there are others...but I can't recall them right now.

Originally Posted by CantExplain

Are you suggesting we shouldn't talk about it?

Please see my addition to the post you replied to.

IN my part of the world there are indigenous therapists. They usually see indigenous clients. We need more of them.

[someone321]

I agree with Mastodon that in Europe it's not common to ask for skin color or ethnicity - I've lived in few European countries and I have never been asked in any kind of survey... In addition, here where I live, there are not many immigrants and it is true that there are much more white Ts and clients but it's not due to discrimination...

[sweepy62]

Interesting, I am in the usa, I used to live in nyc, where its a big melting pot, now I am elsewhere still in the states, but here the majority is caucasion, come to think about it, the mental health community where I attend all the therapist and pdocs and gp are caucasion, but the clients vary as far as different nationalities, I hope that helps.

[HazelGirl]

I would guess in the USA, it reflects the fact that more white people attend college. So more white people get jobs that require higher education, such as therapists or doctors.

[winter4me]

This is an issue in the US, and there is a recognized need for professionals in all fields to better reflect the diversity of our population. Some college programs make an effort to find diversity, some do not. I think the issue is related in some part, still, to racism, and in some part to cultural differences in how mental health problems are viewed and handled. One problem, and I know I had a lot to learn when I worked in diverse settings, is the lack of knowledge we white Americans have re: other cultures. This was brought home to me when I worked in a women's prison, and a Hispanic woman came to see me often with c/o abdominal distress. I was unable to find a physical cause (other than the stress of incarceration/change in diet) until I responded to her cell one day, and a cellmate explained to me that the woman's son had gone into the army and she did not know where he was---Once I was able to get that information for her, and she had contact with her son, the GI distress resolved. She did not share her distress with me because she did not feel it was appropriate to do so... And, when I worked at a prep school, a fellow-nurse predicted that I would see some of the Korean students around the holidays as they were not going home but that, culturally, it was not acceptable to express homesickness ---sure enough---
I know that cultural norms change over time and in light of the place we are in; but I am sure some of my behaviors/expressions would be misunderstood in another culture. Being the 'dominant' group usually means, also, being less knowledgeable about minorities; they need to understand the majority to get ahead, we do not have that pressure...

Originally Posted by winter4me

This is an issue in the US, and there is a recognized need for professionals in all fields to better reflect the diversity of our population. Some college programs make an effort to find diversity, some do not. I think the issue is related in some part, still, to racism, and in some part to cultural differences in how mental health problems are viewed and handled. One problem, and I know I had a lot to learn when I worked in diverse settings, is the lack of knowledge we white Americans have re: other cultures. This was brought home to me when I worked in a women's prison, and a Hispanic woman came to see me often with c/o abdominal distress. I was unable to find a physical cause (other than the stress of incarceration/change in diet) until I responded to her cell one day, and a cellmate explained to me that the woman's son had gone into the army and she did not know where he was---Once I was able to get that information for her, and she had contact with her son, the GI distress resolved. She did not share her distress with me because she did not feel it was appropriate to do so... And, when I worked at a prep school, a fellow-nurse predicted that I would see some of the Korean students around the holidays as they were not going home but that, culturally, it was not acceptable to express homesickness ---sure enough---
I know that cultural norms change over time and in light of the place we are in; but I am sure some of my behaviors/expressions would be misunderstood in another culture. Being the 'dominant' group usually means, also, being less knowledgeable about minorities; they need to understand the majority to get ahead, we do not have that pressure...

How much of the resistance was due to your race vs the profession? I am not saying there should not be more minorities and your school point makes sense. I'm asking because I believe therapy is not accepted everywhere. How big is the therapy industry in Korea and Mexico vs US? I also have a hard time thinking the industry would shut out minorities as other professions due. I think it is an important distinction.

I heard a funny story recently where therapists (psychologists?) wanted to help people in Eastern Africa and they were eventually asked to leave. Why? Because their treatment of depression involved being around other people and being outside. They couldn't understand why it would be helpful to sit in a room with a stranger and talk about all the problems in your life.

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[gayleggg]

I worked in a mental health office and we had two African Americans as counselors(one man and one women). We had many African American clients. I have also seen an African American counselor myself and my psychiatrist was Indian(I saw her for 7 or 8 years before I moved). I like to think that it is pretty open for any nationality who wants to practice in the mental health field. I'm causian and have found good counseling does not depend on race.

[Favorite Jeans]

It's a really good question. As people have pointed out, there are many answers here. I think it's important to think about "barriers" to becoming a therapist and to accessing therapy in very broad terms. For example, it would be unusual in most places for a counselling or clinical psychology program to overtly state that members of certain ethnic groups were discourged from applying. However, the cost of tuition, the language of instruction, the ethnic makeup of the faculty, the location of the school and which thinkers and philosophies are included in the curriculum will all have a huge impact on how accessible or attractive the specific program and often the entire discipline will be to various groups of potential applicants. The same barriers will apply to clients and potential clients.

I was briefly in therapy in my second language (which I speak quite fluently) with a T who knew little about my ethnic/cultural background (and wasn't so interested) and was ever so slightly homophobic. It was okay enough but I never fully opened up to her and while I trusted her with my meds (she was a pdoc who was great with meds!), I didn't really ever want to talk about my feelings. It was a time in my life when I desperately needed therapy and could not have afforded to pay out of pocket and pdocs are fully covered by the public plan. It was definitely better than nothing, but also nothing like the really good therapy I've since had.

I offer this little anecdote because it helped me--overall a quite privileged person--understand a bit about barriers. It is harder to open up in a language other than your first language. It is hard to open up if you think that your T regards your ethnic group, your sexuality or some other component of your identity as inferior or somehow inherently pathological. And it can be a self-perpetuating problem because the less diverse the group of trainees in counselling/psychotherapy programs, the less enlightened all T's will be about issues of diversity and the less likely clients from diverse groups will be to seek out therapy.

[PeeJay]

Culture and economic class certainly play a role in all fields.

Given that there are several minority fellowship programs hosted by the major therapist-member organizations, I would imagine that they are trying to diversify the field.

I go to a clinic that has about 20 therapists. All but two are white. The other two speak spanish.

So if you were a black person and wanted to speak to a black therapist, you could not go to my clinic.

As far as whether that is a problem, that is in the eye of the beholder. I wouldn't blame anyone for wanting to talk to a therapist who grew up in the same culture or community.

[winter4me]

Originally Posted by Michanne

How much of the resistance was due to your race vs the profession? I am not saying there should not be more minorities and your school point makes sense. I'm asking because I believe therapy is not accepted everywhere. How big is the therapy industry in Korea and Mexico vs US? I also have a hard time thinking the industry would shut out minorities as other professions due. I think it is an important distinction.

I heard a funny story recently where therapists (psychologists?) wanted to help people in Eastern Africa and they were eventually asked to leave. Why? Because their treatment of depression involved being around other people and being outside. They couldn't understand why it would be helpful to sit in a room with a stranger and talk about all the problems in your life.

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I think this is what I was saying; there are still issues around racism in the US, but also, other cultures often have different ways of dealing with mental health issues, and may not consider what essentially white western men believe is useful, and they are right since all treatment (medical and otherwise) does need to take into consideration, and respect the beliefs of those being treated. The issues are sometimes different also (for example, I wouldn't know the reasons, suicidal thoughts/acts/completions are much higher in older white males than in, say, females; but rare in the African American community where other problems are more common. Schizophrenia seems to run pretty consistently worldwide but the treatment differs. (think how we have moved through and away from the Victorian sight of, say Freud...)---It is an ever-changing field, like most professions. And we all bring something different to the table; there is no one size fits all.

[Faking sane]

I think it's largely a product of religion. Many Christian sects believe that mental disease is caused by spiritual deficit.

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[winter4me]

There is a great book that addresses this ethical, and practical issue from a medical perspective called The Spirit Catches You And You Fall Down: A Hmong Child, Her American Doctors, and The Collision of Two Cultures by Anne Fadiman
Basically, everyone is trying to do what they believe is Best but...