The Covid-19 pandemic isn’t stopping Psychology Assistant Professor Veronica Johnson, Ph.D., from diving into important research. Instead, the American Psychological Association just named her a Psychology Summer Institute (PSI) Fellow in the Minority Fellowship Program (MFP), and she’s embarking on a pretty timely study. “My research really centers on making sure that we have equity in mental health service delivery,” says Johnson. Trained as a counseling psychologist, Johnson noticed in her own practice that primarily Black women were seeking her out for therapy. “They’d say things to me like, ‘I’ve been waiting for two years to get treatment.’ When I’d ask them why it took them so long to get treatment, they’d tell me that they were waiting for a Black female therapist to have an opening in their caseload,” says Johnson. The women were symptomatic and experiencing intense anxiety and depression, but they were delaying their treatment until they found a Black, female therapist that would see them.
“We’re trying to meet a need where people of color are waiting to be treated by their peers of color, but there just aren’t many of them. Over 90 percent of the psychology workforce is white.” —Veronica Johnson
“My upcoming research comes from the notion that I want to make sure that as we’re recruiting and training a more diverse field of psychologists, we also make sure that white therapists feel safer and more informed to treat minority clients,” Johnson explains. “We’re trying to meet a need where people of color are waiting to be treated by their peers of color, but there just aren’t many of them. Over 90 percent of the psychology workforce is white. So, we need to make sure that the white clinicians are getting good training when it comes to working with minority clients. It also means that we have to make sure that we’re getting those minority patients in the door, reducing the gap in mental health service delivery specifically for clients of color.”
Experiencing Heightened Stress
People in marginalized identity groups—be it people of color, sexual minorities, trans identified individuals, or individuals living with a disability—have to deal with the everyday stressors that everyone deals with, but they have an added layer of stress, such as facing discrimination, that others don’t experience. Meaning that, “minority populations actually do need mental health support and treatment far beyond others, but get it less than half the time,” says Johnson. For the Black community, Johnson feels that we’re in a critical time to find effective ways to encourage mental health treatment. The Covid-19 pandemic has disproportionately impacted the Black community, and Black folks are directly affected by the current racial climate, which only highlights a long history of systemic racism that they’ve been navigating. “We understand why there’s a stigma about mental health treatment for Black people. Black people are over diagnosed with things like schizophrenia and other psychotic disorders. We understand why Black people are hesitant to engage in psychotherapy with white clinicians and non-Black clinicians, because they feel like those clinicians won’t understand what they’re experiencing. Black clients really struggle with this notion that they have to ‘teach’ their therapist about their experience of being Black in America. But they’re already in a vulnerable position, and have maybe suffered some trauma. Then they go into this therapy space, and they have to do a bit more work,” says Johnson. However, when we look at the outcomes of Black clients working with white therapists, they’re similar to when a Black client is working with a Black therapist. “The problem is that Black clients simply don’t want to initially engage with white therapists. We have to get the Black clients in the room, and on the other side, white clinicians have to be appropriately prepared to deal with the types of situations Black people are facing in our country,” says Johnson. “When the Black client talks about their experience, they need to get validation and understanding instead of being pathologized.”
Mastering the Methodology
Oftentimes in multicultural psychology, there isn’t as much of an experimental element within the research design. Instead there’s normally a deep dive into people’s experiences, because no one would want to expose someone to discrimination. “But in this particular project, what I’m doing is examining the different outcomes between people who get a culturally competent therapist versus a therapist who just believes that ‘everybody’s everybody’ or ‘we’re all just humans,’” says Johnson. “I’m testing whether the culturally competent therapist has the ability to really engage the client of color versus a therapist who sort of states that they ‘don’t see any differences because we’re all just human beings.’ Are they able to engage a client of color—specifically a Black client—in therapy?” Some of the preliminary data already suggests that the culturally competent therapist—who focuses on both similarities and also differences, and allows for a conversation about differences to happen—is ultimately more successful in both engaging and retaining clients of color.
“It’s actually quite a powerful feeling for a person of color when someone outside of their own racial group says, ‘I see you.’” —Veronica Johnson
Opening Minds and Doors
One of the goals of Johnson’s work is to create more situations where Black clients can see a Black therapist, if that’s their strong preference, but also to make sure that a Black client who cannot find a Black therapist doesn’t go without services. “We know that going without services exacerbates mental health symptoms,” says Johnson. That’s why she’s focusing on therapists who are authentically culturally competent—therapists who have done the work in order to understand their own biases and assumptions about people of color, and recognize the longstanding systems of oppression that people of color face day in and day out. “If the therapist has done the work, the client won’t encounter the need to ‘teach the therapist.’ The therapist can be in the room with the client—even with a privileged racial group status—and validate the concerns the client is talking about. It’s actually quite a powerful feeling for a person of color when someone outside of their own racial group says, ‘I see you. I’m validating what you’re saying. I’ve never experienced this, but I can validate fully and authentically that you’ve gone through these things.’ It’s certainly powerful when that comes to the Black client from the Black therapist, but it’s also powerful when it comes from a white therapist to a Black client.”
Looking at the Larger Context
After learning about her research, many of Johnson’s John Jay colleagues have been encouraging and recognize the need for her work. “In the Psychology department there are social psychologists, forensic psychologists, counseling psychologists—we all come from these very different domains of psychology,” says Johnson. “When I’ve spoken to them about my research, they all really recognize the need to increase equity and mental health service delivery. They recognize the ways in which poverty, depression, and anxiety lead to problematic behaviors, opening the door to things like earlier involvement in the criminal justice system.” Johnson believes that the research could extend to other areas, even within our educational system. “If we take a step outside of the psychotherapy context, we could look at relationships like an advisor and an advisee. Specifically, a student of color being more comfortable with a white academic advisor.” Johnson theorizes that there might be something done in the initial phases of getting to know a student that would allow him or her to feel more comfortable expressing if they encountered racism or discrimination. “The student comes to their advisor as a safe place to talk things through and find support. I think that a tremendous sort of intervention can happen at the beginning of the relationship to help positively shape how the relationship moves forward.”
In light of the current events impacting the Black community, Johnson is focusing her research specifically on Black clients, but she believes the study’s results could inform interactions across different races. “The goal of this research is to span across different racial groups. We understand why there are significant gaps between white Americans and Black Americans. We understand this from a historical perspective. But we also want to understand the nuances between a Black client working with a Latinx therapist. We don’t really understand what it means for a Latinx client to seek out therapy from a white or Black therapist. Because Latinx people are also severely underrepresented in the psychology workforce, that exploration needs to be done too,” says Johnson.
Ultimately, Johnson wants people from marginalized communities to see that the depression, anxiety, and trauma that they’re suffering from is not of their own making or because of their own mental failing. “It’s a response to the oppressive society that we live in. As mental health professionals we can treat them and get people to a higher level of functioning, but we can’t cure a racist society.”