Interracial Psychotherapy: A Report of the Treatment of an Inner-City Adolescent

The effectiveness of interracial psychotherapy has been a subject of controversy in the psychiatric and psychoanalytic literature. The primary debate centers around the issue of whether therapists can effectively understand and work with patients of a different race. One position holds that, especially in the case of minority racial groups, matching patients with same-race therapists is essential. For instance, Oberndorf (1954) reasoned that “from a therapeutic standpoint, transference in its positive form is most likely to be easily established and examined (analyzed) between patient and hospital and patient and physician if their psychological biases do not differ too widely” (p. 757). He went on to state that “the integration of the mentally disturbed individual can best be achieved if he is treated by one of those who understand his motivations, rather than by one considered expert in a particular form of mental illness” (p. 758). There is significant support for this position among some investigators surveying the usage of psychotherapy by blacks and other minorities. Olfson and Pincus (1994) studied demographics of psychotherapy usage by analyzing data from 36,000 individuals across the United States, part of the 1987 National Medical Expenditure Survey. They found that only 2.8% of therapies lasting longer than 20 visits involved black patients; a disparity that was not accounted for by income. They felt that low availability of minority therapists explained this finding, although they did not have the data to support this interpretation. Flaskerud (1986) set out to study psychotherapeutic underusage by ethnic and racial minorities in the United States. She expected to find that differences in ethnic or racial patient-therapist matching in four mental health agencies in Southern California would be associated with psychotherapy drop-out rates. In analyzing the data, there proved to be no significant association. She continued to recommend ethnic and racial ma