Black History Month: Why Therapy Must Be Political for POC Clients
Black History Month started over a hundred years ago in the US, as a way to bring Black voices and stories to discussions of history, and it is now celebrated in the UK too. As we celebrate it another year, it's essential to reflect on the origins of therapy and how its roots are intertwined with broader societal dynamics—both of inclusion and exclusion. This provides an important context for understanding how mental health care continues to evolve, especially in addressing the needs of marginalised communities today.
the impact of racism on mental health support for poc clients
Racism has long impacted the level of support offered to people of color (POC) seeking mental health care. For many Black clients, therapy often feels (or is) less accessible, and when support is offered, it’s more likely to be in the form of medication or coercive interventions rather than talking therapies. The deep-rooted nature of racism in the mental health system also means that intersectionality is often overlooked, leaving certain groups invisible in mainstream mental health discussions. Much of the research and literature on Black mental health has focused primarily on African-Caribbean men, leaving gaps in understanding the unique challenges other Black clients face, such as Black women.
Psychotherapy and psychiatry were developed in 19th-century Europe and America, reflecting the values of the time, including the racist ideologies embedded in these societies. Early psychotherapy was mostly reserved for wealthy, middle-class men, and its theories, rooted in Eurocentric worldviews, continued to shape the mental health system in ways that excluded, marginalised or disempowered minoritised groups.
As a result, many Black clients struggle to find therapy that resonates with their experiences, especially when working with therapists from ‘majority culture’. Studies show that Black clients are more likely to drop out of treatment sooner than white clients and are more frequently given more severe diagnostic labels. They are also disproportionately offered medication over therapy. These disparities can be linked to the institutional racism embedded in mental health services, where a Western idea of what constitutes ‘normal’ or ‘abnormal’ behaviour often leads to misdiagnosis or the over-medicalisation of people of colour. This contributes to the over-representation of people of colour in mental health services, with many being medically institutionalised or hospitalised unnecessarily.
The lack of attention to culture and intersectionality in therapy has made it difficult for many Black clients to feel seen or understood. Mainstream therapy models, built on Western industrial values, often fail to address the specific needs of clients who don’t belong to the ‘majority’ culture, leaving many without the support they truly need.
why therapy must be political
In many Western therapeutic traditions, the focus on individual experience tends to depoliticise the therapy process, often ignoring the significant impact of structural inequalities on minoritised clients. Feminist perspectives remind us that the ‘personal is political’, urging therapists to recognise how clients’ personal experiences are deeply rooted in societal issues.
When therapists separate politics from personal experiences, they risk minimising or pathologising the lived realities of marginalised clients. Merely providing core therapeutic conditions to POC clients does not address the everyday challenges they face, especially in the context of ongoing systemic oppression.
This depoliticised approach can lead to harmful outcomes, such as viewing mental health issues as solely internal problems, neglecting the external factors that contribute to distress. For example, offering a few CBT sessions via the NHS or antidepressants is insufficient for someone dealing with the compounded trauma of racial violence and oppression. By framing mental illness as a personal flaw, we distract from the need to address the sources of societal violence and inequality, which can further entrench the status quo.
As a therapist, I believe it is vital to bring politics into the therapeutic space. I strive to be aware of my own privilege and biases, acknowledging how they might influence the therapeutic relationship. I actively work to recognise and discuss issues of race, gender, and other identities, understanding that neutrality can perpetuate harm. I aim to create a space where clients can explore their experiences of oppression while receiving unconditional positive regard.
Therapy should not simply aim to reduce stress; it should also validate the struggles clients face as responses to an oppressive world. I recognise that barriers to accessing therapy—such as financial issues or lack of childcare—are real challenges that need addressing. By being conscious of these inequalities, I strive to create a more inclusive therapeutic environment for all clients, working against the systemic forces that contribute to their distress.
Conclusion
As we honor Black History Month, it’s important to acknowledge the ongoing influence of systemic racism within mental health care. Therapy cannot remain neutral when the lives and experiences of Black clients are deeply shaped by societal and structural inequalities. To truly support clients, therapy must be political—it must address the intersections of race, culture, and oppression that impact mental health. By recognising these realities, we can create a more inclusive and effective therapeutic practice that supports healing and empowerment.
If you’d like to explore issues related to racism or systemic oppression in a supportive space, please don’t hesitate to reach out. Together, we can work in a way that honors your unique experiences, challenges the systems that affect you, and creates a space where you feel safe, seen, and supported.
Help and Resources
Black Minds Matter - free, one to one, culturally appropriate talking therapy for Black people in the UK.
BAATN - provide therapeutic support to people who identify as Black, African, Asian and Caribbean.
References:
Ahsan, S. I’m a psychologist – and I believe we’ve been told devastating lies about mental health. https://www.theguardian.com/commentisfree/2022/sep/06/psychologist-devastating-lies-mental-health-problems-politics.
Baik, Sun W. Therapists owe marginalised clients more than empathy. https://www.asparagusmagazine.com/articles/therapists-owe-solidarity-to-marginalized-clients-who-face-racism-oppression-and-violence.
Chantler, K (2005). From disconnection to connection: ‘Race’, gender and the politics of therapy. British Journal of Guidance and Counselling 33 (2).
d’Ardenne, P. and Methani, A. (1989), Transcultural counselling in action. Sage Publications: London.
Fernando, S. (2017). Institutional Racism in Psychiatry and Clinical Psychology: Race Matters in Mental Health. Palgrave MacMillan: London.
Lago, C. and Thompson, J. (1996). Race, Culture and Counselling. Open University Press: London.
McLeod, J. (2019). An introduction to counselling and psychotherapy: theory, research and practice. Open University Press: London.
