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What is culturally competent therapy? Here's why that matters now more than ever

Mental health care is for everyone and it's important to find the right provider.
A study from the American Psychological Association found that in 2015, the psychology workforce was 86% white, 5% Asian, 5% Hispanic, 4% Black and 1% were multiracial or from other racial/ethnic groups.
A study from the American Psychological Association found that in 2015, the psychology workforce was 86% white, 5% Asian, 5% Hispanic, 4% Black and 1% were multiracial or from other racial/ethnic groups.Kiki Ljung / For TODAY
/ Source: TODAY

During Asian Pacific American Heritage Month, TODAY is sharing the community’s history, pain, joy and what’s next for the AAPI movement. We will be publishing personal essays, stories, videos and specials throughout the entire month of May.

The day of the Atlanta shootings, I was shaken.

Like just about everyone, my own mental health during the pandemic had suffered before the March 16 attacks at three different spas. Despite usually identifying as mixed race, the Japanese part of me was stunned by the shootings that left eight people dead, six of whom were Asian women.

As a journalist who reads and writes about horrific atrocities all the time, the past decade of news coverage has been a little traumatizing. As the pandemic wore on, I found it harder and harder to get out of bed and go to work — after all, what awaited me was a shift full of more coronavirus coverage, protests against police violence or perhaps another attack on an Asian elder.

The shootings in Atlanta proved to be the last straw for me. I had to get help and talk things out with someone.

In one of the Asian American Facebook groups I’m in, a fellow member suggested finding a therapist who is “culturally competent.” Though the phrase was new to me at the time, the thought behind it immediately clicked. I thought back to well-meaning therapists who I always felt like didn’t understand me fully — who couldn’t understand certain parts of what I was talking about without a lot of explaining, which always took a while and some of those precious, expensive minutes.

I found a new therapist, who is also multiracial, on a recommendation in that group and never looked back.

May is Asian American Pacific Islander Month but it’s also Mental Health Awareness Month. If you feel like you might want to try therapy, now is a great time.

The challenge and importance of finding culturally competent care

Jenny Wang, an Asian American psychologist who also runs the popular Instagram account @asiansformentalhealth, told TODAY that in college she had realized the mental health field was mostly white.

“Why is it that we are not seeing more people of color to work with these communities?” she recalled asking during her graduate training. “There was always this question of like, culture, identity, racial identity (that) was almost like an afterthought. It was something that we were taught that we should value, but we were never actually taught how to go about that.”

She added that now, as an Asian American in the mental health field, she finds that many other members of her community have events and traumas left unprocessed.

“You know, so much of Asian American experience is, ‘Let's not talk about it,” she said. “It was ‘Let’s not talk about the pain, let's not talk about the struggle.’ And so we largely have experiences that are unprocessed, are not within kind of our conscious awareness.”

“A lot of times it is allowing that person to, in a sense, make sense of their experience through even the act of verbalizing and naming … being Asian while also being American, it can — at times — feel as though identity is fractured into parts,” she explained.

Growing up, Harry Dixon was no stranger to those kinds of conflicting ideologies. Now a San Diego-based licensed professional clinical counselor who identifies as gay and multiracial, he told TODAY that growing up in a “very traditional Korean household” had been difficult for his mental health.

“My parents weren’t accepting or tolerant of mental health viewpoints,” he said. In college, he began going to therapy but still never felt fully understood by his straight, white and Christian therapist.

At the time, he had been working towards becoming a physician but he changed course towards what he sees as his life calling.

“I was like, ‘I still want to help people, but I don't want to be, I don't want to be a doctor… I don't want to just pop in for 15 minutes…. I actually wanted to sit down and actually get to know their stories,'” he explained. “I don't want another gay Asian person to feel like they're alone with their mental health struggles with their sexuality questioning and have to really struggle with another therapist who is well meaning, but there's definitely some blocks and so I wanted to be able to be that person that I had a really hard time finding — and I still have a hard time finding a therapist that's like me.”

It’s an issue Melody Li, a therapist in Austin, Texas, was acutely aware of as well.

Li told TODAY that she recognized her field is “predominantly white and quite hetero-centric,” so she started building a community in Austin for queer therapists of color.

As more people heard about their group, she started, which is a directory of therapists with all kinds of backgrounds and identities.

“The goal really is to make it simpler and safer for people with marginalized identities to find a therapist that gets them,” she explained. “(Clients) had a really hard time finding a therapist that is social justice oriented (and) culturally responsive, and I'm like, ‘It shouldn't be that hard.’”

Wang, who also helps maintain a free Asian therapist directory within the Asian Mental Health Collective, says she has seen a large uptick of people seeking therapy during the pandemic.

“A lot of questions have been surfacing about racial or ethnic identity,” she summarized. “I think a lot of people are wondering, like, ‘What does it mean to be Asian American? I'm not even really sure.’ Some people will say, ‘I spent a lot of my life thinking that I wanted to be white, right, and now I realized maybe I don't want to do that but what does that actually mean going forward?’”

Wang is referring to what’s known in therapy-speak as “trauma reaction.” When people immigrated to the United States and experienced racism — specifically, in this case, many Asians, though other minorities have experienced similar instances — the idea was to try to assimilate to fit in and avoid further attacks. The idea of Asian Americans as the “model minority” somewhat stems from that, Wang added, though younger members of the diaspora seem to be shifting away from that mentality.

“I think that there is certainly a movement towards how do we move away from the model minority mentality? How do we move away from perhaps the trauma reactions of racism and move towards a place where we actually feel like we're able to speak up and do it safely?” she said. “I think a lot of the earlier immigrant generations lacked the language, they lacked the knowledge and also they lacked the legal protections in terms of being able to speak out and not have very severe consequences."

“And so I think this millennial generation and beyond, they're realizing that we can't hide under the shadow of the model minority, or invisibility," she said.

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