People from Global Majority (GM) backgrounds (including Black, Asian, and other minority ethnic groups) often struggle to seek mental health (MH) support. Existing research focuses on barriers to seeking help, such as stigma and a lack of information. However, even when people from GM backgrounds access therapy, they often have worse results than White British individuals. The relationship between a person and their therapist is an important part of successful therapy. This research explored how people from GM backgrounds experience relationships with therapists, including what helps or hinders them.
Systematic Review: Ten studies were reviewed to understand how participants experienced their relationships with therapists. Participants wanted to feel heard, understood, and safe enough to be themselves. Many initially felt unsafe, and trust had to be built slowly over time. Warmth, empathy, and therapists sharing small personal details helped participants feel more comfortable. Participants found it hard to bring up race or culture, waiting for therapists to start these conversations instead. When discussed, participants mostly felt misunderstood or dismissed, which caused them to end therapy or stop sharing. Participants valued curious, open-minded therapists who openly discussed differences among them (e.g., age, gender, culture) without making assumptions.
Empirical Study: Eight Southeast Asian adults were interviewed about their experiences in therapy. Participants talked about mental health stigma and hiding emotions as common within their communities, which they wanted to break away from. Feeling accepted and not judged was important for developing trust. Therapists who used warmth, humour and a flexible, genuine approach helped participants feel connected, whereas rigid or overly formal styles pushed them away. When misunderstandings happened in therapy, honest communication and therapists taking responsibility helped repair the bond. While cultural curiosity and understanding were valued, some participants prioritised getting quick, practical help with their problems than discussing their background.
