Working with race and difference in cross-racial therapy dyads: an exploratory study of psychodynamic psychotherapists

Changing US population demographics and the rise in racial minorities serves as a mandate for innovation within traditional Western forms of psychotherapy. The need for culturally competent clinical practice that addresses issues of race in treatment is paramount. The following study explored white psychodynamic psychotherapists’ experiences of working with race and difference in cross-racial therapy dyads. Eight licensed clinical psychologists who identified as white, psychodynamically-oriented, and had worked with at least one African-American client in the past five years were interviewed about their experiences working cross-racially. Four research questions were addressed: 1) How do white therapists come to understand and think about race in treatment? 2) How do they use race in client conceptualization? 3) How do they address the topic of race and difference when working cross-racially? 4) How do they work with race and difference in the therapy process? A qualitative study design was used and data were analyzed via grounded theory methodology to reveal major themes. Themes identified included: the limitations of race-related trainings; the importance of early experiences, self-exploration, and interactions with people of color to understanding race; the anxiety, shame, and humility of cross-racial work; the significance of race to client conceptualization; the importance of discussing race in deepening the work; the impact of power and privilege on therapy process; the difficulty of working with racialized defenses; and the ability of white therapists to evolve over time. Additional themes included organizational barriers to cross-racial work, and psychodynamic therapy as a treatment for all. The findings of this study suggest important implications for practitioners, organizations, and the field including: the need for more advanced trainings on racial competence and race in treatment; the need for white therapists to examine their own racism and be aware of dynamics of power and privilege in the therapy; the importance of examining systems-level barriers to racial competence; and the continued incorporation of racial and multicultural principles into traditional psychodynamic theory, research, and practice.Psy.D.Includes bibliographical referencesby Bonnie Gordi