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Opinion 'Having a therapist who understands your race, sexuality and gender is important'

Niamh Jimenez says there is a lack of diversity in the therapy setting and outlines why that matters.

THE RECENT ANNOUNCEMENT by Minister Joe O’Brien of the National Action Plan for Racism 2023-2027 reflects a growing awareness of the need to respond to important demographic changes within Irish society.

According to the 2016 Census, 15 per cent of the Irish population is made up of ethnic minorities, a figure which has likely soared with the latest, unprecedented rise in immigration.

Along with these demographic changes, Ireland has also seen profound cultural shifts and the growth of an increasingly flexible, liberal understanding of identity. Debates about conformity and resistance are at the forefront, as a society collectively re-evaluates the meaning of race, gender, sex, and sexual orientation.

Diversity in the therapist’s room

Despite these sweeping changes, Irish psychotherapy still echoes the voices and viewpoints of a fairly homogeneous majority. As I have indicated elsewhere, the membership of the Irish Association for Counselling and Psychotherapy (IACP) is, according to one of its recent member surveys, 91 per cent white Irish.


In my view, the fact that the majority of Irish therapists are white, heterosexual, able-bodied and gender-conforming is not the crux of the problem. People cannot be expected to apologise for any aspect of their biology, even if that aspect confers privilege. However, institutions that lack diverse representation have a responsibility to routinely monitor and address any potential for unconscious biases or ill-informed assumptions about minorities.

They also have a responsibility to adapt their theories, methods, and frames of reference to meet the evolving mental health needs of a diverse population.

Rather than remaining insulated from the social, political, and cultural context, we need to remain attuned to the unique challenges and experiences of marginalised communities.

As major social changes take place, many are recognising this need for greater inclusivity and representation both within psychotherapy and throughout our health services. The IACP has recently established an Equality, Diversity, and Inclusion (EDI) Committee, and intermittently advertises continuing professional development (CPD)-type workshops, with a particular emphasis on gender identity and sexuality. At the end of this month, the DCU “Race for Mental Health” event, organised by psychotherapists Ravind Jeawon and Ejiro Ogbevoen, and DCU’s Assistant Professor in Psychotherapy Ray O’Neill, will seek to highlight the need for greater racial and cultural awareness within Irish mental health services.

Moving forward

While there have been positive steps towards greater inclusivity in Irish mental health services, the IACP has yet to follow in the footsteps of its British counterpart, the British Association for Counselling and Psychotherapy (BACP), by requiring formal EDI learning objectives in their core-accredited psychotherapy and counselling programs. This apparent emphasis on diversity training as non-mandatory, supplementary material serves to diminish its overall importance.

It is crucial to understand that a person’s race, sexuality, or gender identity is not an accessory that is added later in life but a core part of a person’s being, which can play a huge role in shaping the unique trajectory of their development.

Ireland is not alone in these oversights. Traditional Western psychotherapy programmes have long taken an approach that prioritises the individual, often side-lining key aspects of identity such as race, gender identity, sexuality, and disability. This approach subtly suggests that the “default” client is someone who conforms to the majority, excluding those whose life experiences and self-definitions fall outside of these narrow confines.

To truly live up to inclusive values, it is important to recognise that this routine omission can leave both minoritised student therapists and clients feeling unseen, unheard, and unsupported.

While efforts are underway to change this on the Irish front, there are also areas of potential improvement which are less discussed. To truly understand the experiences of minorities, for instance, we might expand our focus beyond just the individual and family unit to consider the complex relationships that can exist between marginalised individuals and wider society. This includes everything from schools and universities to workplaces and local communities.

Trauma-informed approach

While no individual should be reduced to their identity characteristics, many minorities share the trauma of being unable to conform to societal norms and physical standards that they cannot biologically satisfy. Some carry the daily burden of hypervisibility and threats to their safety, while others are forced to navigate workplaces and institutions whose policies systematically disregard their unique needs, cultures, and experiences.

For many of us, it is important that our therapists have some knowledge of these experiences, and the socio-political conditions within which they develop, in order to feel safe.

As a black Irish woman, I know first-hand how social exclusion and prejudice can play just as instrumental a role in shaping a person’s sense of self as the absence or disruption of parental love. Yet, therapist training often places a disproportionate emphasis on the individual and their family dynamics, failing to recognise the influence that broader societal forces can have on a minoritised person’s worldview, perceptions, behaviours, and sense of self-worth. Additionally, focusing predominantly on early life trauma and past conflicts neglects the ongoing, pervasive nature of systemic inequality that marginalised individuals can face throughout their lives.

As we strive to achieve institutional change towards greater inclusion and respect for minoritised individuals, it is essential that we engage in good dialogue and actively involve minoritised voices within the reform process.

This means valuing the unique experiences and expertise of all groups and avoiding the dilution of identity and lived experiences in academic jargon and divisive politics. We are more likely to achieve these goals when our collaborative efforts are supported by mutual respect and honesty, as opposed to guilt, fear or saviourism.

It is not enough to profess colour blindness. Within the mental health sector, it’s crucial to acknowledge and address the structural inequalities that impact the mental health of Irish minorities, even if this requires confronting uncomfortable truths. We too often forget that by remaining silent or failing to challenge these inequalities, we become complicit in maintaining them.

Niamh Jimenez is a freelance writer and online journalist covering racial inclusion, mental health science and digital therapeutics. She is also currently undertaking a master’s degree in humanistic and integrative psychotherapy. 

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