Therapists Are Less Willing To Use Relatively Effective Tough Love Cognitive Behavioral Therapy Techniques On Blacks Than On Whites
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Earlier: Did Obama Undergo Cognitive Behavioral Therapy?

Various lines of evidence suggest that America has been enduring worsening mental/emotional health during the Great Awokening, especially among the types of people who are supposed to be helped by Wokeness (women, blacks, LGBTs, nonbinary black women, etc.)

Why? Jean Twenge argues with much evidence that the emergence of smartphones and social media was bad for the feminine psyche. But there could be other factors specifically related to the ideology of the Great Awokening that helps explain the unhappiness explosion among the Woke.

For example, one reason appears to be that Cognitive Behavioral Therapy, which appears to have the best track record of effectiveness among talk therapies, is falling out of fashion for use with Patients of Wokeness.

From PsyPost (which publishes academic press releases):

Therapists find it less appropriate to use cognitive change strategies when treating Black vs White patients

by Patricia Y. Sanchez June 15, 2022

New research published in Cognitive Behaviour Therapy found that therapists find it less appropriate to use cognitive change therapeutic techniques with Black patients compared to White patients.

Cognitive behavioral therapy (CBT) is a well-established treatment for depression and works by helping patients identify and adjust maladaptive thought and behavior patterns. Therapists help patients to do this using cognitive methods to bring about cognitive change to then decrease symptoms of depression.

My layman’s impression is that Cognitive Behavioral Therapy works sort of like this:

Patient: “Whenever I think about how my life was ruined by my mother / ex-boyfriend / boss / the White Male Patriarchy / FDR’s redlining / hair-touching, etc., I get so depressed.”

Therapist: “So don’t think about that so much. Here are some techniques for you to try that many have found helpful in overcoming depression by getting out of self-undermining thought spirals like yours.”

In essence, CBT is skeptical and/or apathetic about what patients say is Their Truth about Their Lived Experience. Its attitude toward patients’ asserted recollections tends to be, “Swell, but let’s move on.”

But we’ve been trained to Believe Women, especially intersectional Black Women, about their Lived Experience. So therapists are pressured by our culture to validate the self-destructive recollections of blacks—Why, yes, you should be depressed about Emmett Till—and thus not be as quick to use the arsenal of CBT techniques to help blacks as to help whites.

Study authors Iony D. Ezawa and Daniel R. Strunk looked at existing data on CBT treatment of depression and found that therapists utilized cognitive methods less extensively when they worked with Black patients compared to when they worked with White patients. Why this difference is observed is not clear.

“Some psychologists have suggested that culturally competent therapists working with minority patients would be well-advised to avoid questioning the validity of patients’ thoughts and beliefs, and instead validate their patients’ self-reported experiences,” explained the researchers. “Were therapists using other techniques, such as validation (i.e. affirming patients’ experiences are understandable and make sense), in place of cognitive methods? Or perhaps, were there some clinical characteristics other than race that might account for these differences? Furthermore, might these differences be related to therapists’ own racial attitudes?”

They sought to answer these questions by conducting an experiment to examine therapists’ judgments of the appropriateness of different clinical CBT strategies (e.g., cognitive change and emotional validation) to treat depression in either White or Black patients. The researchers recruited 218 American and Canadian therapists to complete the study (most of whom were White: 84.4%).

Each participant was presented with four clinical case vignettes which contained information about the depressed patient’s background, their presenting problem, and an image of the patient. Therapists either received all Black patients or all White patients (manipulated by the image of the patient).

Participants also answered a series of questions measuring their judgment of the appropriateness of several clinical strategies with each patient. They also completed measures of racial attitudes toward Black people and social desirability (i.e., the tendency to respond in a way that is socially desirable rather than truthful).

Results show that, in general, therapists thought cognitive change strategies were more therapeutic for White patients and indicated they’d spend more time working on cognitive change strategies with White patients than Black patients. On the other hand, therapists thought validation techniques were more therapeutic for Black patients than White patients.

Overall, validation strategies were rated as more important than cognitive change strategies for Black patients, but these strategies were rated equally important for White patients. Racial attitudes were related to these judgments in that more positive racial attitudes were associated with judging both cognitive change and validation strategies as therapeutic.

“These findings support our hypothesis that therapists tend to regard validation strategies as more appropriate to use than cognitive change strategies when treating Black patients. We suspect that therapists were inclined to think that using cognitive change strategies would risk suggesting that the therapist does not believe or fully appreciate the patients’ experience.”

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