“I want a group. I don’t know what it looks like yet, but I want a space where we can begin to talk about our health as individuals and as a community.”
This quiet but powerful declaration by Dr. Chaina Carothers encapsulates the heart of a conversation on Black mental wellness that moved beyond stigma and toward something far more radical: healing in community, learning together, on our own terms.
A licensed clinical social worker and the Director of Equity and Belonging at the University of Washington, Dr. Carothers wears many hats. By day, she works to train child welfare professionals across the state. On Saturdays, she provides direct therapeutic services, supporting clients who are “ready to try something different.” And in every space, she advocates for wellness with both honesty and cultural clarity.
Mental Health is Health
In our conversation, we talked about how mental health is connected to everything. “The research shows that Black people are dying because of poor health outcomes – and mental wellness is part of that story,” Carothers said.
Too often, she explains, our community treats mental wellness as an afterthought. Historical trauma, systemic inequities, and a cultural legacy of “just getting by” can all obscure the signs of stress, anxiety, or depression. Many of us carry burdens so deeply embedded they’ve been normalized.
“We are passing it on. We’re carrying things we were never meant to carry. And sometimes we don’t realize it until we begin to wonder: ‘Why are things still like this?’ That’s when it’s time to reach out. You don’t have to wait until a crisis.”
Finding a Therapist: Start Where You Are
When asked how to even begin the journey toward therapy, Carothers is direct.
“It’s frustrating,” she said. “I’m not going to sugarcoat that. Systems are messy. But the moment you recognize something is wrong and ask a question – that’s a big deal.”
For those seeking help, she recommends starting with someone you trust: a doctor, a professor, a friend who’s been through therapy or even community groups. Online resources like Psychology Today or employee assistance programs (EAPs) can offer entry points. But Carothers cautions that not all therapists are listed online, and many face limitations due to insurance, waitlists, or licensing boundaries.
Insurance, she notes, is often one of the biggest deterrents.
“Some providers don’t take certain types of insurance, or clients get dropped after sudden policy changes,” she said. “And since the pandemic, waitlists have exploded.”
She encourages people to ask about sliding-scale fees or community-based support programs. For example, some organizations in Washington cover up to 10 sessions for Black and Brown clients seeking culturally responsive care.
When It’s Not Working
A central takeaway from the conversation is this: clients have power, even if the system makes them feel otherwise.
“It’s all about you,” she said. “If something doesn’t feel right – say it. If the therapist talks more about themselves than they listen to you – run. If you don’t feel heard or supported, you can leave.”
Carothers recommends giving a therapist one to three sessions. The first visit is often focused on paperwork and assessment. By the second or third session, a client should feel a sense of rapport and trust – or at least the potential for it.
“You’re the expert on your experience,” Carothers said. “The therapist is there to help you sort it out, not define it for you.”
It is entirely reasonable – and even necessary – for clients to assess whether a therapist is the right fit for them. This can include asking questions, interviewing the therapist beforehand, and reviewing their approach to ensure it aligns with the client’s needs and values. Clients also have every right to expect that therapists follow professional and ethical guidelines, such as informed consent, which outlines what to expect from therapy, confidentiality policies, and the client’s rights. Taking these steps isn’t overstepping – it’s part of being an informed and empowered participant in your own care.
“Therapists are held to ethical standards,” Carothers said. “If something crosses the line, it’s OK to report it. This is serious work – lives are at stake.”
The Role of Race, Culture and Lived Experience
The interview took a nuanced dive into what it means to seek therapy as a Black person. Representation matters – but not in a one-size-fits-all way.
“Before I did research, I would’ve said racial identity is important. Now I say it’s extremely important,” she said.
Carothers notes that many Black clients – herself included – seek providers who share cultural knowledge, understand systemic racism, and can hold space for racial and cultural trauma without needing it explained.
It is also important to realize that the Black community is not a monolith. While racial and cultural alignment in therapy is often beneficial, Carothers is transparent about the complexity of this relationship. She shares that having a Black therapist doesn’t always guarantee a good fit. Cultural differences, generational gaps, religious or patriarchal values, and varying views on gender or sexuality can create tensions even within same-race therapeutic relationships.
Sometimes, she shares, non-Black therapists for specific needs, such as medical trauma, can be effective as well. It is nuanced.
Bias, stereotyping, and even inappropriate familiarity – like therapists using slang or personal anecdotes to “connect” – can create discomfort or even harm. In her own dissertation on anti-Black racism in clinical settings, every participant reported some form of racial bias in therapy.
“We need therapists who can listen actively, advocate: she says and emphasizes that being culturally humble is paramount. “If I’m talking about advocating for my child in school, I don’t want to explain why that’s exhausting,” elaborates Dr. Carothers.
It is not your job, as the patient, to endure situations like this. “You can leave,” she firmly states.
Creating What We Need
Near the end of the conversation, Dr. Carothers offers a vision: a low-risk, collaborative community space to learn and talk together about our wellness, outside of the formal structure of therapy.
She’s not alone in this vision. The call for community-based wellness spaces – a modern-day version of what once happened organically in churches, barbershops, or even golf clubs – is thinking outside the box. Her invitation is clear: “If any Black therapists want to come together to form something, so we can be more intentional about supporting our community – let’s do it.”
Final Words: Rewriting the Script
To those hesitant to seek help because “that’s not what we do,” Dr. Carothers offers this: “For over 400 years, people have demanded certain behaviors from Black folks. Those demands may not look the same today, but they’re still here. That weight we carry? We were never meant to carry it alone.”
Healing begins with naming what we carry. Therapy can be part of that journey – not as a final destination, but as one of many tools in our pursuit of wholeness.