African Americans Are Socialized Around Race

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So doing psychotherapy with African Americans without talking about race just doesn 't work. But it 's not your fault.
African Americans are socialized around race, race has special meaning, and they expect to talk about race in psychotherapy; that 's simple enough and not an especially revolutionary idea to many. But here 's the rub. Why do most practitioners avoid talking about race despite race 's special meaning to African Americans? How come so many practitioners accept African Americans feeling unsatisfied even if feeling psychotherapy was helpful? Most important for this work, what happens to the therapeutic alliance when you exclude race in psychotherapy systems and clinical sessions?
Why isn 't it your fault? Let 's answer some
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"I rarely initiate discussions about race." "I leave it up to the (African American) client to bring up racial issues." "I feel comfortable talking about racism in society, but I don 't know how the patient will take it." "Racism is a social ill that needs to be corrected; therapy is about personal issues." "What if race isn 't important to the client, I don 't want to offend her."
So both sides vent frustration at poor outcomes; where African American customers and practitioners disagree is their explanations. At bottom, the binding element for African American explanations is skin color is the cause of inferior clinical treatment.29 In contrast, White practitioners don 't offer such a succinct conclusion but deny or fear discussing racial categorization as a cause.
So why isn 't it your fault?
Here 's an answer: psychotherapy systems exclude race.
In effect, while race has special meaning for African Americans, it 's absent in the psychotherapy systems and clinical sessions that typically guide a clinician 's work with African Americans. What a pickle! For all the polemicists out there, in a nutshell, there are competing visions for psychotherapy with African Americans. Neither side is monolithic. On one side, which I 'll call the Universal approach, researchers and scholars hang their hat on the belief that psychotherapy systems are sufficient for treating African Americans because
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