Decolonizing Traditional Therapy: Nurturing Culturally Inclusive Mental Health Practices

In the pursuit of a more inclusive and equitable world, various fields are undergoing transformations to shed the remnants of colonization. The realm of mental health is no exception. Decolonizing traditional therapy practices involves reevaluating and adapting therapeutic approaches to ensure they resonate with diverse cultures and experiences. In this blog post, we will explore the concept of colonization in the context of mental health, define decolonization, and offer five practical ways to initiate the process of decolonizing therapy practices. This blog will discuss specific ways colonization plays a role in Mental Health and five ways we can decolonize our practices as therapists.

Colonization in the Context of Mental Health

Colonization refers to the historical process by which one group exerts dominance and control over another, often leading to the imposition of its values, norms, and systems onto the colonized group. This process has deeply influenced various aspects of society, including mental health practices. Traditional therapy methods have often been rooted in Western perspectives, inadvertently sidelining indigenous, non-Western, and marginalized voices and worldviews.

Here are some ways colonization has influenced the history of mental health: 

1. Cultural Stigmatization and Pathologization: Colonization often involved the imposition of Western cultural norms and values on marginalized populations. This cultural imposition led to the stigmatization and pathologization of traditional indigenous beliefs, practices, and spiritualities. Indigenous healing practices, which were once seen as holistic and culturally relevant, were often dismissed as superstitious or primitive by colonizers. This contributed to the marginalization and discrimination of indigenous individuals, impacting their mental well-being. 

2. Loss of Traditional Healing Practices: Colonization resulted in the loss or suppression of indigenous healing practices, including those addressing mental health. Indigenous communities had their own ways of understanding and treating mental distress, often rooted in shamanism and spiritual traditions. The suppression of these practices led to a disconnect between indigenous individuals and culturally relevant mental health support, exacerbating mental health challenges. 

3. Trauma and Loss of Autonomy: The forced displacement, dispossession, and violence inflicted on indigenous and colonized communities by colonizers resulted in profound trauma. This trauma, which often went unaddressed or misunderstood, had a significant impact on the mental health of individuals and communities. The loss of autonomy over their lives and lands, as well as the experience of cultural erasure, contributed to feelings of powerlessness and despair. 

4. Introduction of Western Psychiatry: Western psychiatry, with its Eurocentric perspectives, was introduced in colonized regions. This psychiatric framework often failed to understand and address the unique mental health needs of indigenous and colonized populations. It pathologized indigenous cultural practices and labeled resistance to colonization as mental illness, further exacerbating the mistrust of Western mental health systems.

5. Overmedicalization and Institutionalization: In some cases, colonizers resorted to overmedicalization and institutionalization as a means of control. Indigenous individuals who resisted colonization or displayed non-conforming behaviors were often labeled as mentally ill and confined to institutions. This unjust practice further marginalized and disempowered indigenous communities. 

6. Intergenerational Trauma: The trauma experienced during colonization has been passed down through generations, resulting in intergenerational trauma. This trauma manifests as a range of mental health challenges, including depression, anxiety, substance abuse, and suicide, among indigenous and colonized populations. Healing from this trauma often requires culturally sensitive approaches that acknowledge the historical context.

Defining Decolonization in Mental Health 

Decolonizing therapy involves a conscious effort to challenge and dismantle the colonial structures, biases, and power dynamics that have shaped mental health practices. It aims to create a more inclusive and culturally sensitive approach that respects diverse backgrounds and acknowledges the impact of historical trauma and systemic oppression on mental well-being. 

Here are Five Practical Ways to Decolonize Your Therapy Practice:

Cultivate Cultural Humility and Awareness: Make a commitment to understanding your own cultural biases and assumptions. This includes people of color. Myself, as an East Asian Woman have bias and preferences for calm emotional states. When I sat with a client of Italian heritage I found myself pathologizing how animated and expressive she was. Thanks to reflective supervision I was able to acknowledge my own cultural biases here. You can do the same by engaging in regular self-reflection to identify your biases and assumptions. Ask yourself questions like, "How do my own cultural beliefs influence my therapeutic approach?" and "Am I making any assumptions about my clients' cultural backgrounds?" Actively seek to learn about diverse cultural perspectives on well-being by attending workshops, reading literature, and engaging in conversations that expand your awareness of different worldviews. Last but not least, seek consultation and supervision from Clinicians or Consultants who can offer you different perspectives. Don’t have any yet? Join one of my training, workshops, or consultation group.

Center Cultural Diversity in Assessment and Treatment: Offer treatment options that are flexible and adaptable to accommodate the unique cultural needs of each client. This might involve exploring alternative therapeutic modalities or approaches based on the client's cultural preferences. Personally I’m a huge fan of ACT and IFS for this reason. Incorporate culturally sensitive assessment tools that respect and accommodate diverse beliefs, practices, and languages. This can include the Cultural Formation Interview (CFI) or doing a Cultural Genogram. By acknowledging and incorporating cultural contexts, you create a more relevant and empowering therapeutic experience. 

Collaborative Therapy Approaches: Embrace a collaborative therapeutic relationship that respects the expertise and insights of your clients. Recognize that they are the experts on their own lives, and work together to co-create treatment plans that align with their cultural values and aspirations. During sessions, actively involve clients in treatment planning and decision-making. Ask open-ended questions like, "What are your goals for therapy?" and "How do you think we can best achieve those goals while considering your cultural background?" Go further and get curious about how they might define the problem they are experiencing and what reasons they believe are contributing to this problem. This approach empowers clients and acknowledges the significance of their unique cultural identities. 

Make space for Indigenous and Traditional Practices: Recognize the wisdom embedded within indigenous and traditional healing practices. Ask your clients if they have any spiritual or religious beliefs. Get curious about their own cultural ancestry and how healing was addressed. Be sure not to assume that all people of color will want to embrace traditional ways though. I’ve had many clients who are of color that want to move away from this. Where appropriate and with consent, integrate elements of these practices into therapeutic interventions. You can also engage with local healers and elders to gain insights into time-tested methods that can contribute to holistic well-being. 

Continual Learning and Advocacy: Commit to ongoing education and advocacy efforts that challenge the status quo and amplify marginalized voices. Attend conferences, engage in discussions, and collaborate with colleagues to collectively decolonize mental health practices. This includes greater acknowledgment that the DSM is centered on the white male experience and that many therapeutic protocols appropriate ancient traditional healing practices. Advocate for changes and acknowledgment of where our field’s practices come from.

Decolonizing traditional therapy practices is an essential step toward creating a mental health landscape that embraces diversity, equity, and cultural respect. By acknowledging the impacts of colonization, engaging in cultural humility, and actively reshaping therapeutic approaches, we can work together to foster healing spaces that honor all individuals' unique backgrounds and experiences. As we journey towards a more inclusive future, let us be mindful of the transformative potential that decolonized therapy practices hold for the well-being of all. 

How will you commit to decolonizing your practice?