Therapy’s Essential, But Is It Helping Us?

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Therapy’s Essential, But Is It Helping Us? The Black Gen Z Mental Health Check-In.

Black Gen Z is the most therapy-literate generation the United States has seen. They share appointment updates on TikTok, reference trauma responses in casual conversations and seek healing out loud in ways that once seemed taboo.

But if we ask them if therapy is actually helping them, then the answers get more complicated.

Despite being more open to therapy than previous generations, many young Black people are walking away from sessions feeling unheard, over-pathologized, or emotionally dismissed. For them, therapy is that much-needed space for them to finally be heard and understood.  

The therapist is in, but not always accessible

Licensed therapist Vernique Esther said the biggest barrier for Black Gen Z is not stigma, but access.

“Gen Z is likely the first generation to see therapy as normal and beneficial,” Esther said. “But access and finding the right match are still real challenges. The cost of therapy when paying out of pocket can be unmanageable, especially in our current economy.”

Esther, like many independent clinicians, has opted out of insurance panels because reimbursement is inconsistent or delayed. For Gen Z clients who turn to lower-cost platforms like BetterHelp, the quality of care can vary.

Joy Pate, a therapist and somatic practitioner, said that cost is not the only hurdle. She notes that clients can feel misunderstood when therapists are more focused on being solution-oriented than allowing proper space for their emotions to be heard and understood. 

“Emotional shutdowns can happen when clients feel their experiences are being dismissed or invalidated, or when therapists do too much too soon, such as exploring trauma without providing the tools for clients to regulate their emotions,” Pate said.

Therapy that hears and misses

For some Gen Z clients, therapy began with hope. One anonymous medical student said she entered therapy after a traumatic experience involving medical neglect. Her parents had to intervene, and therapy was offered as part of a hospital settlement.

“I fell head over heels in love with my therapist,” she said. “She took her time to listen. It felt like a space to rant, to just speak freely.”

But even in a good experience, she described the challenge of being vulnerable while managing how she was perceived.

“You’re trying to say something but not say too much, so it doesn’t imply something else,” she said. “The tricky thing about therapy is that what you say matters, but everything you don’t say also matters.”

Another anonymous client said she left therapy feeling judged and emotionally disconnected.

“I just wanted to rant. But in the middle of it, my therapist would cut in and say something. Her facial expressions made me feel like I was being judged, and that broke the flow,” she said.

She described experiencing four different therapists before walking away altogether.

“One even breached confidentiality by telling my parents something I said without warning me first,” she said. “That was it for me.”

Representation, relevance and repair

James Harris, the lead therapist at the Healing Club and the founder of Men to Heal, explained why clients may feel emotionally misunderstood or shut down during therapy. 

“If a client does not fully understand the purpose or goals of therapy, they may feel lost or disengaged. If they don’t connect with the therapist or have rapport is a big reason as well, especially if we are talking Gen Z. Overall, the most common is probably due to a disconnect from the session as a defense mechanism. This is new to them, so to not shut down may feel safer.” Harris said. 

Harris also said that historically, Black clients have been misdiagnosed or overdiagnosed because their emotions are interpreted through a biased lens. “Black men have been misdiagnosed and overdiagnosed with schizophrenia, bipolar, and antisocial personality disorders, as their emotions are read as psychotic. Black teenagers are more likely than their white peers to show signs of bulimia, but get diagnosed significantly less, even if they have identical symptoms. Black mothers are at a greater risk for postpartum depression, but are less likely to receive treatment,” he said.

He emphasized that therapists must pay attention not just to how they diagnose, but to the atmosphere they create and the cultural sensitivity they bring to the space. From intake forms to lighting, even the smallest cues can signal to clients whether they are truly welcome.

“Each individual has their own lived experience and relates to culture in a unique way,” Harris said. 

Pate shares that view “As a culturally-sensitive practitioner, I’m mindful of the importance of being curious about how their culture and identity informs their experience instead of making assumptions that because we share parts of our identity/culture, our experience is the same,” she said.

Esther agrees, adding that she brings her full self into the room to avoid creating a clinical distance as she believes that therapy should not feel sterile.

“Therapists are not blank slates as we’re taught in school,” she said. “Clients choose me because my expertise is evident, but I’m also honest about my experiences, so they know they can overcome hardships and still thrive. Plus, as a millennial, I’m old enough to be their friend or big cousin, which helps create a connection.”

A path forward

Despite mixed experiences, the desire for healing remains strong. Both anonymous clients said they would try therapy again if they could find someone they trust.

“I want to get better for my future, for my children,” one of them said. “I want to look back and be proud that I healed.”

Therapists say the field must meet this generation where they are. That includes more affordable options, stronger cultural training and systems that don’t punish Black clinicians for working outside the traditional mold.

Pate believes the match between client and therapist is just as crucial as access.

“Therapy is most effective when clients are properly matched with the right therapist,” she said. “Whether that comes by way of a matching program or consultation process, there should be an emphasis on finding a therapist whose style and training align with what you need.”

She also sees promise in community-centered models.

“Group therapy can be effective across generations, especially in the Black community, as it encourages us to lean on each other as we navigate the challenges that come with the Black experience,” Pate said.

According to the National Institutes of Health, Black youth are more likely to turn to family members over professionals for mental health support. Despite this, a 2022 report from Melanin Muse found that Black Gen Z and millennials are actively pushing back against stigma and making mental health care a priority.

For these generations, therapy is not a trend. It is a necessity. And the question is not whether they are willing to try. It is whether the system is willing to meet them with care that truly sees them. 

Healing for Gen Z will take more than awareness campaigns and the utilization of digital platforms. It will take better laws, more trained Black therapists and mental health care that values their stories as much as their symptoms. 

Therapy may be trending, but surface-level gestures aren’t enough. Until care fully meets the needs of those trying hardest to believe in it, healing for Black Gen Z might stay slightly out of reach.