The first time Jacqueline Garcia sought therapy, she was in college. She'd lived in Tijuana until she was 12 years old, and she had struggled with the transition when her family immigrated to the United States.
She signed up for an initial therapy session with a mental health professional but never made a second appointment. She said she didn't feel like her white therapist understood or validated her experiences.
"I felt a little bit disillusioned, but that experience helped me to understand that I needed to find someone I would feel comfortable with," Garcia told The Times in Spanish.
Five years passed before Garcia was ready to search for a therapist again. She wanted to work with a bilingual mental health professional who could understand her childhood and its effects on her young-adult life.
"I could unravel myself really well [with the new therapist]. In that first session, I was comfortable enough to explain my feelings that I had buried inside me for so long," said Garcia, now a Los Angeles-based clinical social worker.
"Having someone who is not culturally competent and/or informed can lead to experiencing microaggressions, feeling misunderstood or even perpetuating oppressive behaviors," said Lydiana Garcia (who's not related to Jacqueline Garcia), a Los Angeles-based psychologist.
A culturally competent mental health professional, by contrast, aims to be sensitive to and understand your cultural background. That includes your values, race and religious or spiritual beliefs.
A therapist with this kind of training allows you to focus on talking about your experiences and how you're feeling without having to explain the nuances of your family dynamic or upbringing.
Here are some tips for Latinos looking for a culturally competent therapist from Lydiana Garcia; Katheryn Perez, a licensed marriage and family therapist in Burbank; and Angelica Tello, assistant professor of counseling at the University of Houston-Clear Lake.
Why it's important
There is often "shame and guilt that might come from wanting to start therapy and your Latino family not supporting that," Perez said.
That shame, she said, comes from an internal barrier of believing mental health services are "solo para los locos" — only for crazy people.
A culturally competent professional, Perez said, would understand why it was so difficult for you to seek help in the first place.
"It really helps build that relationship between the client and the therapist. The client usually feels more comfortable and safe, which helps them with the healing process," she said.
To identify whether a mental health professional will fit your needs, Perez advises that you conduct a short interview. Ask questions such as:
What experience do you have with my specific culture or background?
Do you understand the values and beliefs associated with the Latino family, and what that means?
Have you had clients of different cultural backgrounds?
Have you had a Latino client before?
What is your understanding of how white privilege and oppression affect people of color?
If you feel more comfortable expressing your thoughts and feelings in Spanish, look for a bilingual therapist.
Working with culture in mind
Tello and Lydiana Garcia both said that when clients go to therapy, they may not get the chance to discuss their cultural experiences, the intersections of identities or how systemic marginalization impacts mental health. To Tello, a professor and researcher of mental health, that reflects the mental health field's lingering "white, Western ... and very individualistic" point of view.
"Identifying problems from an individualistic perspective without taking into consideration systems of oppression, effects of colonialism, generational trauma and many [related issues] tends to blame the individual for their current circumstances and at times prescribe treatment that is not made for folks of color," Garcia said.
To be culturally competent, Tello said, is to take the time to get to know the client.
For example, she said, a lot of Latinx clients have a strong spiritual or religious connection, so that's something that can be incorporated into the healing process.
Often, clinicians are quick to identify the mental health issue and solve it without understanding the client's cultural values, she added.
She does a lot of work with first-generation college students, and she said she emphasizes their strengths, such as their ability to navigate unfamiliar social spaces at school or at work.
Tello observed that a lot of people who are first-generation immigrants or the first in their families to go to college "have had these constant messages that we are less than, othered, or something is different about us." Her advice is to "recognize that you have cultural values that others may not have that push you forward in the different areas of your life."
Tello prefers the phrase "culturally affirming" over "culturally competent." "Competent" can imply you've reached a certain level of knowledge and skill, she explained, but a culturally affirming therapist recognizes that there isn't a one-size-fits-all model when it comes to cultural influences. Others prefer "culturally sensitive" or "culturally responsive."
Such therapists consider a wider range of factors — including socioeconomic status, generation or LGBTQ identity — and raise those topics in discussions with their clients.
Mental health directories
Latinx Therapy has a national directory of therapists, 98% of whom are Spanish speakers.
Therapy for Latinx is a Yelp-inspired directory of local Latinx therapists.
Latinx Therapists Action Network is a mental health platform and directory of mental health professionals who serve migrant communities.
National Queer & Trans Therapists of Color Network is a directory of professionals who specialize in serving LGBTQ people of color. The network also provides financial assistance.
Psychology Today has a specific search engine for individuals looking to locate a Latino therapist.
Inclusive Therapists is a directory of therapists who describe themselves as culturally responsive and social justice-oriented.
Not everyone will have the means to shop around for a culturally competent therapist, Perez said, but there are options out there. High schoolers, she said, can reach out to a school counselor or ask a teacher to help identify appropriate mental health assistance. Colleges have mental health centers on campus, and local clinics offer mental health services.
Another option is asking private practice therapists or nonprofit clinics whether they offer therapy sessions priced on a "sliding scale." This means the fee for the service is based on a person's ability to pay. The therapists in the Latinx Therapists Action Network commit to providing mental health services for those in need on a sliding scale for a maximum of 12 sessions. Other directories will allow you to search for therapists who offer sliding-scale rates.
This story originally appeared in Los Angeles Times.