What Therapists Need to Understand When Working with BIPOC Clients
By Kush Desai
Your client is sitting across from you, explaining why her grandmother’s advice still guides her biggest life decisions. You find yourself giving that familiar, polite blank stare. You might nod along, but your client can tell you don’t really get it.
This disconnect is more than just an awkward moment. It can actually stop the healing process before it starts.
Silence about race might feel like the “safe” or polite choice, but it acts as a massive barrier to the therapeutic alliance. Well, ignoring racial identity creates what I call an “explanation tax.” This happens when your client has to use their own therapeutic energy to educate you about their basic reality instead of focusing on their growth.
To build genuine clinical safety, you have to practice “broaching.” Day-Vines et al. (2007) define this as your intentional, proactive effort to discuss racial and cultural differences. It moves you along a professional continuum from an “Avoidant” style, where you minimize race, to an “Infusing” style where you integrate cultural factors into every part of the process. Once you decide to speak up, you must also change how you view your own expertise.
In this blog, we will explore what it looks like to move from cultural competence to cultural humility, challenge Eurocentric assumptions in your clinical practice, and build a more responsive approach to working with BIPOC clients.
Embracing Cultural Humility
Simply learning a few facts about a culture is never enough. In fact, if you just collect “cultural facts” without changing your internal stance, you risk stereotyping the person in front of you. You have to move from just being “knowledgeable” to being “humble.”
I want you to see the clear difference between these two professional stances:
Cultural Competence → This involves the integration of knowledge and specific standards. It often feels like a checklist or a “mastery” of information that has a defined end point.
Cultural Humility → Based on the work of Tervalon and Murray-Garcia, this is a lifelong commitment to self-evaluation. It is a posture where you admit you don’t have all the answers and work daily to fix power imbalances.
Cultural humility shifts the power dynamic in the room. It positions your client as the ultimate expert of their own lived experience. Plus, it reminds you that you aren’t there to “master” a person; you are there to learn from them. This humble stance is vital when your traditional training clashes with a client’s core cultural values.
De-centering the Eurocentric Lens: The Myth of Universal Boundaries
Traditional Western therapy models are rooted in individualistic assumptions. These assumptions can be harmful when you apply them to BIPOC clients from collectivistic backgrounds.
Take Maria’s story as a concrete example. Maria is a first-generation Mexican-American who sought help for anxiety. Her therapist suggested she set “strict boundaries” and distance herself from her family to manage her stress.
This felt like a direct attack on Maria’s values. In her culture, family obligations are expressions of love and moral responsibility, not “codependency.” The therapist’s suggestion was a Eurocentric projection of health that didn’t fit Maria’s world.
When you project Eurocentric “independence” as the only version of health, you cause a therapeutic rupture. It forces the client to choose between their healing and their community. You have to shift your focus from internal family dynamics to the external pressures that shape your client’s daily reality.
Contextualizing Distress: Racial Trauma and Systemic Stress
Symptoms like anxiety or hypervigilance often make perfect sense when you look at them through the lens of systemic oppression. They aren’t always a sign of individual pathology. Often, they are valid survival responses.
You must consider these external factors that impact BIPOC mental health:
- Racial trauma and the weight of everyday microaggressions.
- Historical medical mistrust caused by long-standing healthcare inequities.
- Systemic barriers like housing insecurity and environmental hazards.
Your diagnosis must “contextualize distress.” Well, if you fail to acknowledge systemic racism, you risk overdiagnosing. For example, research shows African Americans are frequently overdiagnosed with schizophrenia and underdiagnosed with mood disorders due to clinician bias. Failing to see the system risks misidentifying a survival response as a mental disorder. Your growth in these areas is a continuous professional journey.
Growing Your Culturally Responsive Practice
Culturally responsive care is an intentional, consistent decision to celebrate what makes each person unique. It is a philosophy that guides you to fully see and value every part of your client’s background.
I want you to use this “Green Light” checklist to self-assess your progress:
- Proactively ask about cultural identity during your intake process.
- Acknowledge your own personal limitations and biases out loud to your clients.
- Incorporate cultural strengths, like community or spirituality, into the treatment plan.
Moving toward this model isn’t just about ethics. It is about clinical effectiveness. This approach leads to lower dropout rates and much better patient outcomes across diverse populations. I invite you to move from reflection to active professional support.
How We Can Help
Working with BIPOC clients well is a lifelong commitment, not a checklist you complete once. Supervision and consultation offer a dedicated space to examine your biases, process complex cases, and keep growing in your cultural responsiveness. At Firelight Supervision, we support therapists doing exactly this work. Reach out today to learn more about our services and find the right fit for where you are in your practice.
References:
Day-Vines, N. L., Wood, S. M., Grothaus, T., Craigen, L., Holman, A., Dotson-Blake, K., & Douglass, M. J. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process. Journal of Counseling & Development, 85(4), 401–409. https://doi.org/10.1002/j.1556-6678.2007.tb00608.x
Author Bio
Kush Desai is a licensed clinical social worker, approved clinical supervisor, and blogger with Firelight Supervision. Kush supports provisionally licensed and fully licensed clinicians in building clinical confidence and cultural responsiveness, with a particular focus on BIPOC clinicians and those working with diverse, multicultural populations. He specializes in grief and loss, crisis assessment and risk management, integrative behavioral health, serious mental illness, and supervision rooted in cultural humility and anti-oppressive practice. Follow Firelight Supervision on Instagram, Facebook, and LinkedIn.
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