Counseling Hesitancy in the Black Community
February 2026: This personal essay was written in 2022 by Laketra Chick, MSW, Registered Clinical Social Work Intern, to explore the lived experience and history behind counseling hesitancy in the Black community. Drawing on both personal and professional perspective, Laketra names the very real reasons many Black people feel cautious about therapy and what it takes to build trust. The reflections below are for education and validation, and are not a substitute for personalized mental health care or emergency support.
Key takeaways about counseling hesitancy in the Black community
- Mistrust of therapy and healthcare in the Black community is rooted in real historical harms, including the Tuskegee Syphilis Study and other abuses of power.
- Many Black clients worry whether therapists will truly understand their culture, family dynamics, and experiences of racism and microaggressions.
- Faith, ancestral strength, and stereotypes like the “strong Black woman” and “hypermasculine Black man” can make it harder to seek help, even when support is needed.
- BIPOC‑affirming therapy in Florida should be a safe place to be fully yourself, talk about racism, and explore faith, identity, and emotions without judgment.
- Therapists serving Black clients must acknowledge history, honor cultural strengths, and treat clients as experts in their own lives.
BIPOC therapy in Florida can be a very freeing and healing experience for a lot of people. In recent years, especially since the start of the pandemic, mental health has become more of a priority. Now, individuals look for ways to feel happier, less anxious, and navigate life’s challenges. Despite its recent popularity, not everyone is pro therapy. BIPOC therapy can be met with skepticism from a lot of different groups. One of these groups is the Black community. Given the history and present circumstances of the black community, who can blame them? Don’t call it unnecessary paranoia. The reservations come as the result of centuries and generations of unfair treatment and injustices. This post seeks to highlight some of the reasons Black people have been hesitant to engage in therapy.
“Can I trust you?”
One of the most prominent reasons members of the Black diaspora worry about therapy is because of its mistrust. Many American medical professionals and health organizations establish reasons for this. What reason would Black people have not to trust organized systems in this country? History. Experiences. True stories that have been passed down by grandparents. These people saw the days when those put in positions of power to protect people instead used their power to harm them. One widely known instance of this betrayal is the USPHS (the United States Public Health Service) Syphilis Study at Tuskegee, formerly called the Tuskegee Study of Untreated Syphilis in the Negro Male.
In 1932 in the state of Alabama, 600 men were involved in a study where they were told they were being treated for a condition called “bad blood”. This was a phrase commonly used at that time for a host of different diseases and ailments including syphilis (Of the 600 men, 399 of them had syphilis). In addition to treatment, the men, most of whom were sharecroppers, were also promised other perks. Such as:
- rides to and from the treatment center
- food on days of their treatment
- free medical exams
- burial insurance
Sounds like a good deal, right?
The true purpose of the experiment was not to serve low-income individuals by giving them access to free health care. As the name of the study states, researchers were looking to gain knowledge on the progression of syphilis and its effects on the body over time when left untreated. Over the course of the study, doctors “treated” the participants with placebo drugs like aspirin. Other doctors were persuaded not to treat the men at all. Eventually, when penicillin was discovered in 1943 as the cure for syphilis it was still not considered a course of treatment for the participants of the study.
As the experiment went on, men died and became blind as a result of advancing syphilis in their bodies. Furthermore, wives and girlfriends were infected and gave birth to children born with the infection. Researchers and doctors stood by and watched families’ lives be destroyed all while telling the men that they were helping them. This was fairly simple to do because…why wouldn’t they trust their doctors?
So, how did this plot for a cruel, sci-fi horror film end?
A writer with the Associated Press heard of the experiment from a friend and wrote a story about it in 1972. What followed was a full-on investigation into the study. The Assistant Secretary for Health and Scientific Affairs created a panel whose whole purpose was to look into the specifics of how the researchers carried out the experiment. The results from the research protocols that were going to keep the men safe were either ignored or “deeply flawed”. In the simplest terms, the men in the study were not presented with the opportunity to give informed consent.
As was mentioned before, the men just thought they were being given treatment for bad blood. They were never told what the researchers were looking to study or even given the full name of the experiment (the Tuskegee Study of Untreated Syphilis in the Negro Male). Furthermore, the men were never told about the possible consequences of being involved.
In light of the results from the panel’s investigation, the experiment was put to an end in October of 1972, some 40 years after it began. By that time, men had died from syphilis and associated complications, and wives and children had been infected. In March of the following year, the Department of Health and Human Services called for the United States Public Health Service to treat survivors of the experiment. Survivors were also awarded money through a class action settlement and given an apology from President Bill Clinton in May of 1997.
This is not a fictional story about a group of people in a faraway land thousands of years ago.
This is a horrifying story of people not so different from you or me, that could have been our parents or grandparents or great grandparents. If you look hard enough, you can still find traces of the Tuskegee experiment. The last participant died in 2004. The last widow receiving benefits died in 2009. Children of the participants are still receiving medical benefits even today. If something this heinous could happen in the country where you live, to people who look like you, what would keep you from thinking a similar deception couldn’t happen again?
Unfortunately, this has developed widespread fear and applies to many in the health or medical field
Granted, therapists and counselors do not usually attend medical school, but they are also considered to be health care professionals. They are responsible for providing intervention and treatment for the health and well-being of the mind. They must also seek to build rapport and trust with individuals of this community. Acknowledging the hesitancy for receiving treatment and the history that plays into this is just one step in building this rapport.
“Do you understand me?”
If mistrust of the healthcare system is not a factor, the next barrier that may hinder the Black community’s willingness to attend therapy is the lack of culturally sensitive clinicians. And we aren’t talking about a therapist just saying they are culturally competent, we mean continually learning and acknowledging that they will never be culturally competent because cultural sensitivity is about continually learning and being open to learning. Every client brings their unique experiences, history, and beliefs even when from the same culture.
We must remember the client is the expert
Yes, therapists are the experts when it comes to the client’s diagnosis and treatment modalities, but the client is the expert in their life. It is the partnership of these two individuals that helps lead to success for the client. However, there are certain characteristics of this community (like the generational trauma of the Transatlantic slave trade and its present-day implications) that can make for a learning curve for clinicians not fluent or familiar with this culture. A clinician not understanding the hardships, victories, language, family dynamics, etc of the Black community can be discouraging for a person already having to deal with not being understood in different environments like work or school.
BIPOC therapy in Florida should be a safe place.
A place where Black people can go to speak with a non-judgmental, knowledgeable professional about the weight placed on their shoulders, unrealistic expectations, and whatever else life has thrown at them. It is likely that the individual is already code-switching in various environments or presenting themselves in a way that makes them seem more palatable to society, even if it’s at the expense of feeling uncomfortable. It is their hope that during sessions they can be supported, seen, valued, and heard by their therapist. As with any other demographic, it is important for clinician to tailor their approach to that of the culture of their client.
Black people attending therapy want to be able to discuss experiencing racism and microaggressions without being encouraged to think maybe the other people involved in the incidents “didn’t mean it that way” or acted “on accident” in situations that are clearly racially motivated. A microaggression is still a microaggression even if the person involved didn’t realize what they were doing or saying was a microaggression. A therapist doesn’t need to have been raised in Black culture to serve Black people. However, building trust and rapport with a Black client will come easier if the therapist has at least taken the time to listen and understand what it means to be Black in America. Black clients want to be able to speak openly in session without also having to overly educate their therapists on the basics of Black culture and the Black experience in America.
“Is this a Black thing?”
Black people are not a monolith. There is a wide range of likes, hobbies, and interests that exist within the community. There are, however, some things that are more widely agreed upon in the culture than others. Therapy is slow to become one of those things. There are various reasons why therapy has not been viewed as “a Black thing” in the past. First, the amount of Caucasian Americans who attend therapy is more than any other racial group. This can give off the idea that therapy is something for white individuals. Rather than for anyone who agrees to it.
Secondly, religion, specifically Christianity, has played a major role in the Black community. It is what was relied on by Black ancestors to endure 400 plus years of enslavement. God and Jesus, the prominent figures of Christianity, are known to have a host of different abilities. One of which is the ability to heal physical and mental diseases. As a result, a lot of members of the Black and Christian community will rely on God as the only healer of the mind and heart. Popular song lyrics like, “…long as I got King Jesus…don’t need nobody else” echo the sentiment that nothing outside of God is necessary to heal or help with life’s struggles.
Our ancestors have a strong impact on our values
The black community has the idea of being as strong as their ancestors. It is no secret that ancestors of the Black diaspora endured inhumane conditions and treatment for hundreds of years. This happened while working, caring for families, and contributing their talents and abilities to the world. As a result, there is pressure and expectations to handle hard parts of life. Especially, like the ancestors who didn’t have access to medical or mental health services. “They got through it, and so can you!” This way of thinking can be harmful. While it is meant to encourage the person and instill a sense of pride in being a descendent of such a resilient people, it also does not instruct the person to take advantage of the resources not available to the ancestors.
Stereotypes perpetuate the idea that black people can’t show weakness
The “hypermasculine Black man” and the “strong Black woman” perpetuate stereotypes. This idea is that Black people can’t show weakness. These images don’t normalize the reality that, like everyone else, Black people experience a full range of emotions. The “strong Black woman” is also the woman feeling overwhelm with raising children and caring for aging parents. The “hypermasculine black man” is also the man coming from an environment where men were discouraged from expressing fear. Both would benefit from BIPOC therapy in Florida. Emotions are a “Black thing”.Anyone can use online therapy in Florida. The Black community has had to navigate through soul-crushing situations which have created barriers to treatment. It is the hope that this culture and other people groups will feel more comfortable in therapy.
Common questions about BIPOC therapy in Florida
What is BIPOC‑affirming therapy? It’s therapy that actually sees you, your history, your culture, the weight of racism and generational trauma, without asking you to explain or justify any of it. A BIPOC‑affirming therapist works to validate what you’ve lived through, not minimize it or explain it away.
Why might Black people feel hesitant about going to therapy? Honestly? Because the hesitancy makes complete sense. Between the historical betrayals like Tuskegee, the current realities of racism in healthcare, and a culture that has long said “be strong” or “take it to God,” walking into a therapist’s office takes real courage. Add in the exhaustion of having to educate yet another provider, and it’s no wonder people pause.
Can my faith and culture be part of therapy? Absolutely. Your faith isn’t something to leave at the door. For many Black clients it’s a source of deep strength, and a good therapist will honor that. The goal isn’t to replace what sustains you. It’s to add to it.
Do I need a Black therapist for therapy to help? Not necessarily, but who you sit across from matters. What matters most is finding someone who genuinely believes your experiences, doesn’t need you to prove that racism is real, and keeps learning.
What can I talk about in BIPOC‑focused therapy? Anything and everything. The anxiety that won’t quit. The job that’s draining you. The family expectations you carry. The microaggression from Tuesday that’s still sitting in your chest. The pressure to always be the strong one. All of it belongs in the room.
Begin Supportive BIPOC Therapy in Florida Today
If you are part of the Black or broader BIPOC community and feel both hesitant and hopeful about therapy, you deserve support that honors your story and your culture. At True You Always, we aspire to offer a safe, non‑judgmental space where you can breathe, be your authentic self, and move at your own pace. Learn more about our BIPOC therapy services. If you would like support from our skilled online therapists, we would be honored to walk alongside you.
To begin BIPOC‑affirming therapy in Florida:
- Contact True You Always.
- Meet with one of our online therapists.
- Start taking steps toward a more supported and meaningful life.
Other Services Offered at True You Always Counseling
Here at True You Always, we offer many services with a wide range of therapists, with the goal of providing a safe and accepting space for you to be your true self. In addition to BIPOC‑focused therapy, you may also be interested in trauma and PTSD treatment, anxiety and stress counseling, LGBTQIA+‑affirming therapy, or therapy for disordered eating and body image. All of these services are available via online therapy in Florida, so you can get support from the comfort of your own space.
To explore our full range of offerings, you can visit our services overview.
We also know therapy is not the path everyone chooses, which is why we offer online life coaching available nationwide. If you’re looking to develop authenticity or grow more self‑love, you can connect with our online life coach to focus on healing, growth, and living more in line with who you really are.
Please know that all providers are affirming therapists and/or life coaches. True You Always therapists do not engage in any conversion therapy and believe the use of such therapy is unethical. We fully support all of our LGBTQIA+ clients in an affirming and safe manner.
References:
https://www.cdc.gov/tuskegee/timeline.htm
