“Therapy can be restorative, but can also be really harmful”: Therapy experiences of QTBIPOC clients.

Abstract

Research suggests that queer and/or trans Black people, Indigenous people, and other People of Color (QTBIPOC) generally experience higher levels of psychological distress and depression, leading to poorer mental health outcomes (e.g., Lim & Hewitt, 2018; Sutter et al., 2018). However, little is known about the experiences of QTBIPOC individuals in therapy. The purpose of this grounded theory study was to understand the nuanced narratives of QTBIPOC individuals in therapy. Twelve QTBIPOC individuals were interviewed about their experiences in therapy, as well as their suggestions for how therapists can improve mental health treatment. Using minority stress and intersectional theories as frameworks, the following core category was identified: An optimal therapy experience is contingent on the intentional dismantling of systemic oppression in therapy. The six categories that comprise this core category included therapy microskills encourage continued help-seeking despite cultural barriers, proximal stress leads to hesitation in the therapy room, ignorant therapist reactions exemplify distal stress, explicit validation of identity and experiences of oppression strengthens the therapeutic experience, shared identity facilitates the therapeutic bond, and therapy must be decolonized and center nontraditional healing practices. Results of the present study suggest that therapy can be ineffective—or even harmful—for QTBIPOC individuals when systems of oppression are not adequately dismantled in the therapy room. Our findings prompt important directions for practice with QTBIPOC individuals as well as institutional advocacy.

Bridging the multicultural orientation framework with sexual and gender minority psychotherapy: A mixed studies systematic review.

“…Therapists missed important cultural opportunities when they only engaged in superficial conversations about SGM topics, failed to recognize the significance of clients’ romantic partner (e.g., Shelton & Delgado-Romero, 2011), or discounted the impacts of societal discrimination (e.g., Welch et al, 2000). For example, in one included study (Arora et al, 2022, p. 504), a queer black woman noted how her therapist could have better attended to her identities and multiple axes of oppression by, “taking that next step, seeing how [my] identities played a role.”…”

“Me being myself isn’t a barrier”: Identity and praxis of nonbinary psychotherapists.

“…Some participants in the present study reported that they were told not to disclose their nonbinary identity in the therapeutic work. Given the push to discuss power, privilege, oppression, and identities in therapeutic work, particularly when working with marginalized communities (see Arora et al, 2022), training programs that discourage nonbinary identity disclosure are reinforcing the delegitimization of nonbinary identities and perpetuating cissexism. Faculty in training programs and clinical supervisors should be required to participate in regular nonbinary focused trainings to ensure their competence in working with and training nonbinary clinicians.…”

“…Recently, psychotherapeutic research has begun examining the therapy experiences of clients with marginalized identities (e.g., Arora et al, 2022; Morris et al, 2020). However, the experiences of psychotherapists with marginalized identities, particularly nonbinary 1 psychotherapists, have remained relatively unexamined.…”

O potencial da FAP como terapia culturalmente responsiva

“…Essa visão não propõe mudanças estruturais, mas maior atenção para as microhabilidades (microskills) do terapeuta que facilitam o proveito do tratamento pelos clientes (p. ex. Arora et al, 2022;Brown, 2008).…”

“…Exemplos de erros são desacreditar a experiência que o cliente tem da sua identidade e lugar social, ou limitar a oportunidade de ele descrever a sua compreensão do seu contexto (Lee et al, 2022). Desmantelar essas dimensões de opressão envolve as microhabilidades do terapeuta: a validação explícita da identidade e das experiências de opressão e o acolhimento de soluções que vem de fora da cultura do terapeuta (Arora et al, 2022). Quais microhabilidades da FAP podem ser relevantes aqui?…”