“My whole training I’ve been trained to work with diversity, no-one has taught me how to work with similarity”: Exploring how Black Clinical Psychologists in the UK experience working with racially similar clients

Background: For Black populations, pathways to mental health services are complex, and representation in the clinical psychology profession is low. Numerous initiatives in the UK aim to improve diversity for clinical psychologists and service-users. However, changes in literature seem slow in responding to increasing racial diversity in clinical psychology. For instance, when cultural sensitivity is considered for ethnic minority clients, focus placed on therapist–client differences implicitly assume therapists are from ethnic majority backgrounds. This prevents consideration of therapist–client similarities for ethnic minority practitioners. Aim and Methodology: A critical realist qualitative paradigm was taken using reflexive thematic analysis to explore how Black clinical psychologists in the UK experience working with racially similar clients. Semi-structured interviews were conducted with a purposive sample of 16 Black clinical psychologists. Findings: This study highlights the double-edged nature of racial integration into practice for Black clinical psychologists in same-race therapy. Racial similarity enhanced connection and cultural understanding offering safety to explore other intersectional identities with clients. However, assumptions and judgements needed monitoring as they risked arising from racial overidentification. Furthermore, differing intersectional identities both prevented and led to alternative forms of connection. Similarly, multifaceted factors influenced accessing support about same-race therapy from racially similar or different supervisors. The desire to depart from Eurocentrism both in clinical practice and when Black clients and clinical psychologists help-seek were expressed by participants. Failures, obstacles and the hope of enhancing the integration of race and culture into training and the wider profession were highlighted. Conclusion: Overall Black clinical psychologists find racial similarity in therapy beneficial, but challenges with overidentification and the integration of race into practice must be recognised. Recommendations discuss advancements for culturally sensitive practice and the need to explore similarity and difference when considering diversity to improve psychology services and the profession for all.