Should You Be the Same Race or Gender as Your Therapist?

One of the things that I am most often asked in my phone consultations with folks is about matching between client and therapist along gender or race lines. That is, should you be the same gender or race as your therapist?  As with most answers in psychology...it depends!

Finding the right therapist to work with is no easy feat. First, there is the research. You scour search results of sites like Google or sort through results on directory sites like Psychology Today in order to find a mental health professional in your area (with payment terms that you're comfortable with). You may not even know what you're supposed to be looking for! Should you have someone of your own race or should you not care? Does it matter? What about gender? Then, you make a quick call or schedule your first session and anxiety sets in. Now, you actually have to go.

It takes a lot out of you.

Research exists on the topic of matching between client and therapist along racial and/or gender lines, and the results are mixed.  Based on the research that I've seen, there doesn't seem to be much difference in terms of treatment outcomes as it relates to therapist/client matching. That is, you are likely to gain similar outcomes if you are Black man meeting with a Black male therapist or a While male therapist. Are you surprised? Me too.

Of course, this all starts with the basis that there is no, or very limited, bias on the part of the therapist. The research indicates that therapists of all races, who are comfortable with their own racial identity and competent in working with clients of difference racial groups, are equally efficient. That's particularly good news if you live in an area where you are not able to find a therapist of your own race, if that is your preference.

When it comes to race, it seems that you can be sure a therapist of any race that is competent in working with your racial group can be effective at helping you work through your biggest concerns.

Another idea that I found interesting about the research is that the length of treatment IS affected by therapist, client match. Specifically with regards to race, there is research that indicates that while match doesn't so much matter for White folks, Black folks are more likely to stay in therapy longer when matched with Black therapists.

The research on gender (or sex) matching between therapist and client is also mixed. There is some research that indicates that, similar to race, gender matching makes no significant difference in terms of treatment outcomes. However, there is research that indicates that women tend to stay in treatment longer when matched with women therapists. Inversely, men may be more likely to drop out of therapy, and sooner, when matched with male therapists. Go figure.

It should be noted that all research attempts to explain trends that are able to be generalized about the population at large. Some research does a much better job at this than others.  So take all of this information with a grain of salt.

At the end of the day, what matters most is who are you most comfortable sitting across from. When you're empowered with an answer to that question, you will be much more comfortable and prepared to work through your concerns with a therapist than you can grow to trust and lean on.

Additional suggested reading on the topic: Your Therapist is White. You're not. Is this a problem?

Sources:

Cabral, R. R., Smith, T. B. (2011, October 11). Racial/Ethnic Matching of Clients and Therapists in Mental Health Services: A Meta-Analytic Review of Preferences, Perceptions, and Outcomes. Retrieved April 4, 2017, from http://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1079&context=facpub

Flaherty, J. A., MD, & Adams, S., PhD. (1998, January 01). Therapist-Patient Race and Sex Matching: Predictors of Treatment Duration. Retrieved April 04, 2017, from http://www.psychiatrictimes.com/articles/therapist-patient-race-and-sex-matching-predictors-treatment-duration

Jones, E. E. (1978, January 01). Effects Of Race On Psychotherapy Process And Outcome: An Exploratory Investigation. Retrieved April 04, 2017, from http://insights.ovid.com/psychotherapy-theory-research-practice/psytr/1978/10/000/effects-race-psychotherapy-process-outcome/4/01437416

Sterling, R. C., Gottheil, E., Weinstein, S. P., & Serota, R. (1998, July). Therapist/patient race and sex matching: treatment retention and 9-month follow-up outcome. Retrieved April 04, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/9744135

Jason Silva on Technology, "Origins" and What Makes Us Human

This past week I was fortunate to be able to see TV host and awe-inspiring wanderer Jason Silva sit down for an interview at AOL's Build Series in NYC. In this interview Silva talks about how innovation and technology affects us in modern times. His newest show, "Origins: The Journey of Humankind" explores how innovation and different forms of information technology have affected our development as a species.

What I find most fascinating about this interview is how Silva talks about his new show and how we can use "Origins" to understand and cope with the ongoing innovation of technology and our relationship to it.  As a therapist, I'm not only interested in what happened to us, but also the how behind those histories. That is, I think that how we make meaning of our experiences and the impact on our lives is just as important, if not more important, than the events themselves. Watch a portion of Silva's interview below.

How to Have a Healthy Hookup: 3 Skills You Need

Guest post submitted by Dr. Davila and Ms. Lashman.

Hookups are pretty prevalent these days. Although some research shows they don’t have a negative impact on most people, for some, hookups can be stressful, unsatisfying, or confusing. Are we going to see each other again? What will the person think of me? How do I feel about myself for doing it? Did I get what I wanted out of it? Why do I feel like it was all about the other person? These are just some of the questions we've heard from real girls, and these questions can lead to uncertainty and disappointment.If you’re interested in hooking up, there are three skills you need to use to increase the likelihood that you’ll have the experience you want and that you won’t end up confused and feeling bad.

Skill 1: Insight

This is about knowing what you want, and it’s the first thing you need to do in order to have a healthy hookup. Ask yourself these questions: What do I want sexually? What am I willing to do and not do? What are my limits? And know the answers so that when the time comes you will be prepared and you can communicate effectively about what you want and don’t want. For example, if having an orgasm is important to you and you can only reach it during oral sex, then be prepared to let your partner know. If you don’t like it rough and that’s a limit, then be ready to stop when things go past your comfort zone.It’s also important to have insight about what you’re looking to get out of a hookup. What are your motives and goals? Is it just about the sex? Are you fine with it being just a one-time thing? Are you actually hoping it will turn into a relationship? You need to know because your expectations and hopes can determine how you’ll react to whatever happens – we talk more about this when we get to the third skill, emotion regulation, later in this article. You also need to know to be able to figure out whether you and the other person are looking for the same thing. If you’re not, then you might end up not feeling so great. One key to a healthy hookup is when both people are on the same page, which leads to the next skill.

Skill 2: Mutuality

A healthy hookup is about it being good for both people. Not just you. Not just the other person. Both of you.Often people go into a hookup with the goal of getting sexual pleasure for themselves. Makes sense. So they judge the success of the hookup by whether it was pleasurable for them. But there are two people involved who both want sexual pleasure, and they both deserve to get it. If you’re in it just for your own pleasure and you’re not interested in really pleasing your partner, then stay home with your porn and/or your vibrator and enjoy yourself.On the flip side of that are people who judge the success of a hookup solely by whether they pleased their partner and they completely disregard their own pleasure. This is just as bad as focusing only on yourself. If you’re only focused on giving the other person what they want it may be an indicator that you’re afraid of being yourself, you’re afraid of what the other person might think of you, you’re trying to get the other person to like you – or, most likely, all of the above. If you see yourself in this scenario, then you need to shift your focus from trying to be what the other person wants (or what you think they want) – a situation that leads to people-pleasing – to being yourself and seeing if they like what you have to offer. And in a healthy hookup, part of that is communicating your needs and seeing if the other person is willing to meet them. If not, this is not the hookup for you. Bottom line, a healthy hookup is one where both people get their needs met and both people actually care about meeting the other’s needs.

Skill 3: Emotion Regulation

This skill is about keeping your emotions in check. Post-hookup, you may start to feel those warm twinges of love and images of a beautiful life together. You may start to get anxious about whether you’ll get another text or call. You may get sad or angry if that text or call doesn’t come. You may get excited when it comes late one Saturday night, suggesting a spontaneous rendezvous. All of these feelings can happen.But remember, there’s a reason it’s called a hookup – it’s not a relationship. And it was not intended to be from the beginning. The best thing you can do for yourself is to go into a hookup assuming that’s exactly what it will be. A fun (hopefully!) encounter between two consenting individuals that is not meant to happen again or to turn into anything else. Then, when it doesn’t, you won’t have to be sad, angry or disappointed. You can view the experience fondly, rather than yearning for more. You can remind your developing feelings of love that they are better placed elsewhere, when the right relationship person comes along. And you won’t have to be anxiously checking your phone for a text. Should that text come, you can decide whether you want to pursue it, rather than feeling dependent upon it for a sense of self-worth. And, should your hookup start to turn into a relationship, then you can be pleasantly surprised and see where it goes.For those of you who are on the receiving end of someone wanting a hookup to go further than you want it to go, you need to keep your anxiety or annoyance about this in check also. Be clear and direct with the person about where you are and what they can expect, both up front and afterwards. And be kind in all of your communications. You had sex with this person. You just shared nakedness, bodily fluids, and perhaps lots of other things. It’s an intimate exchange no matter how you look at it. And the people involved deserve to be respected. Don’t let your fears or frustration get in the way of treating a person with respect.If you use these skills to approach and deal with hookups it’s more likely to be a rewarding experience for both people, and that’s what a healthy hookup is about. 

Dr. Davila and Ms. Lashman are the authors of The Thinking Girl's Guide to the Right Guy: How Knowing Yourself Can Help You Navigate Dating, Hookups, and Love.Joanne Davila, PhD, is Professor of Psychology at Stony Brook University, a clinical psychologist in private practice, and an internationally known expert on young women's romantic relationships. She lives in Stony Brook, New York, with her partner. Kaycee Lashman is an organizational change specialist who focuses on relationship dynamics within companies. Married with two children, she lives in Vancouver, Canada.

Connect with the authors at skillsforhealthyrelationships.com, and through their column for Psychology Today.

App Spotlight: Simple Habit

As a therapist I know all too well that most of us need a bit more tender loving care in our day-to-day lives. It's not easy to find time to practice self-care when you're bombarded with daily worries connecting to performing well at work and at home. That's not to mention maintaining your relationships.  Ironically, all these stressors can negatively impact our health too. That is why it's so important that we consistently give ourselves time to restore and recharge.

The aptly named app Simple Habit seeks to help people do just that, create a new daily habit of restoration and rejuvenation.  Mindfulness strategies are very popular these days both in and out of therapy sessions.

Mindfulness as both a philosophy and practical strategy can help us better cope with the world around us and be more present. Research suggests that mindfulness based cognitive strategies can even help combat anxiety and depression. Simple Habit offers both a free version of the app and a premium version. Both versions give users access to guided meditations and mindfulness exercises. With over 200,000 users around the world, there's evidence that many people need a service like this.

On a smartphone, Simple Habit becomes a digital mindful lifeline where you can practice mindful breathing or meditation while on a walk or on your daily commute (just don't do it while you're the one driving). There's a library full of meditations and exercises led by coaches, therapists and yogis to help you achieve daily inner balance.

If greater inner peace is something that you're looking for, Simple Habit could certainly be worth trying. I tried it myself and found it to be relaxing and a great adjunct to my established daily mindfulness practices. For beginners, it represents a welcoming introduction into the world of mindfulness and meditation. Simple Habit is available in the Apple Store and Google Play.

Breaking the Code of Silence: Black Americans and Mental Health

Because of stigma, lack of access and several other factors, only one quarter of Black Americans seek mental health care. Understanding these reasons is the first step toward making a change.

Cost and Availability

People living in rural areas or underserved neighborhoods have difficulty seeking adequate providers close to them. Furthermore, accessing care can be expensive because of the price of services and travel costs. Many Black Americans lack access to quality providers due to ever-increasing costs, even with insurance coverage. According to the American Psychological Association, African Americans are more likely to use emergency medical services than their white counterparts, likely due to being underinsured.

Crippling Stigma

Given the history of African Americans in the United States in regards to slavery, collective cultural resiliency is particularly strong and in some ways a great disadvantage when it comes to accessing mental health services.Additionally, some African Americans have a hard time discussing mental health issues because their emotional conditions are often seen as “white issues.” There is still much cultural stigma around any acknowledgement of emotional conditions that are seen as a sign of weakness.

The Impact of the Tuskegee Experiment

Racism is still prevalent, making many people of color afraid of accepting mental health assistance. Experiences such as the Tuskegee Experiment mark an important cultural collective trauma that persists in African American consciousness today.

In 1932, researchers at the Tuskegee Institute — in collaboration with the Public Health Service —  began a study known as the “Tuskegee Study of Untreated Syphilis in the Negro Male.” This study included 399 men who were diagnosed with syphilis and 201 men in the control group.At the time, even more African Americans lacked adequate health care. White researchers and local doctors promised the men clinic visits, treatment, and medication to manage and ultimately cure their conditions. What participants did not realize was the facilitators lied to them.The men were studied longer than they expected and many died as a result. Researchers intentionally didn’t treat them with penicillin, which emerged in 1945 as a cure for syphilis. It wasn’t until the 1960s, when black researchers began to work at the Tuskegee Institute, that the illusion of treatment crumbled and the story of maltreatment hit the Associated Press. Social worker and epidemiologist, Peter Buxton – also known as Peter Buxtun — has been credited as the whistleblower who broke the story to the press.

Alternative Sources of Support

Due to historical atrocities like slavery and the Tuskegee experiment, Black Americans have a history of accessing local spiritual and religious communities for much-needed emotional and mental support. Churches and religious fellowship have been at the heart of Black survival in the United States. Religious organizations served as organizing centers during the Civil Rights movement of the 1960s and many Black Americans continue to utilize pastoral services as a means for not only spiritual enlightenment but also for everyday guidance.

Lack of Competent Providers

Trust is critical to developing a relationship with a therapist with whom you will ultimately discuss all your hopes and fears. Many Black Americans have interacted with mental health providers and medical personnel that lack a nuanced understanding of issues faced by communities of color. This creates an environment of distrust.Fortunately, now more than ever, graduate schools and therapist training programs are helping therapists in-training gain more experience in treating diverse populations. These programs are also helping therapists uncover their hidden biases and prejudices about Black Americans and other marginalized groups. Providers are now a lot more equipped in addressing the needs of communities of color.Black Americans can be assured that therapists of all ethnicities and backgrounds are dedicating themselves to develop a deeper understanding of the needs and barriers that Black Americans face when engaging in therapy. If you are having a tough time and want support, don’t suffer in silence.If you are in NY/NYC and interested in services with me, please visit Viva to submit an inquiry.

This post was originally published at the Talkspace blog.