‘Created for people of color. Period.’

Clients seek out therapists of color at Madison's Anesis Therapy for a shared understanding of race and trauma

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Brittney Theus started seeing a therapist when she was 10 years old, three years before her mother, who was bipolar, kicked her out of the house. She continued therapy over the years, but felt uncomfortable addressing the root of some of her pain and trauma.

The reason she held back: Her therapist was white.

“I couldn’t bring up things that were specifically related to race,” says Theus, who’s Black. “These were things that were happening to me that I needed to process but I didn’t talk about them because I didn’t want to make my therapist uncomfortable. And if I did bring them up, it felt like I was putting a burden on our relationship.”

Theus also worried that her issues related to race might be dismissed or downplayed by her white therapist. “I didn’t want to feel like I was seeing something that she thought wasn’t there,” she adds.

When her therapist moved away about six years ago, Theus began looking for a replacement with a specific goal in mind: “I decided to find a Black therapist.”

“I needed to find a therapist who had a first-person understanding of how my struggles are impacted by the color of my skin,” says Theus, a 33-year-old mother of three and certified nursing assistant who is studying to become a registered nurse. “I wanted to find someone who could understand the intersectionality of it — what it meant to deal with and cope with the trauma, while addressing how racial disparities and discrimination added to my experiences.”

After some searching, Theus found Anesis Therapy.

The Madison-based clinic aims to “provide more culturally competent mental health care in Dane County,” says owner and psychotherapist Myra McNair. “I wanted to create a place that was not just a side program for people of color but was created for people of color. Period.

“Historically, psychology is very European-based and very individualistic in how it approaches families,” adds McNair. “But for many communities of color, they don’t think individualistically. So, when someone comes into our rooms, we’re seeing their community with them and within them.

“We’re understanding all of the systems that are involved as well,” she continues. “And, that’s sometimes the reason why people have mental health issues — because there’s systemic racism and historical trauma involved. We understand all of that so people don’t have to come in and explain that to us. We get it and that means we can get to work right away.”

McNair founded the clinic in 2016 and at the time was the lone therapist. It now has a full-time staff of more than 40 that includes marriage and family therapists, social workers, substance abuse recovery coaches and counselors, as well as child and family advocates, in-home mental health program managers and crisis stabilization specialists. Anesis staff includes those who identify as Black, Latino, Asian and other ethnic backgrounds. The clinic offers services in English, Spanish, Albanian and Hmong. Currently, Anesis therapists see more than 1,800 clients — most are people of color, but some are white.

In January, Anesis consolidated two of its smaller offices and moved into a stand-alone building just south of the West Beltline Highway at 815 Forward Drive. Anesis received a $250,000 loan from the city of Madison through its new Commercial Ownership Assistance Program to help with the purchase. The clinic also operates a satellite office on the north side.

As it has grown, the clinic has forged community collaborations, contracting with the Dane County court system and establishing a new partnership with the UW-Madison Department of Psychiatry. Dr. Ryan Herringa serves as director of the UW-Madison Division of Child and Adolescent Psychiatry and specializes in treating youth who have experienced trauma. He says Anesis is an exception in the field.

Providing therapists of color “makes a huge impact in creating a safer and more welcoming space,” says Herringa, who facilitates the collaboration between Anesis and UW-Madison. “It’s not that you couldn’t create that space between a white therapist and a patient of color. But it takes a lot more work and there’s still always going to be that gap.

“As a white guy, I have no idea what it’s like to be discriminated against wherever you go for, probably, all of your life. Or to be worried constantly about being pulled over [by police],” he says. “But the therapists at Anesis know about that and there’s something powerful about that shared experience and knowing someone else has been through that.”

Continuing stigma

While Anesis has grown quickly, there are considerable challenges in providing mental health care to people of color. Historic discrimination leads some Black and brown people to view the healthcare system as a tool of oppression. And there continues to be a stigma that seeing a therapist means someone is weak or mentally defective. According to a study from the Centers for Disease Control, 23 percent of white adults received mental health treatment of some kind in 2019 while less than 14 percent of Black adults sought similar help.

McNair says barriers to people of color seeking therapy have existed for generations. Some people of color believe that “therapy is just for white people” or that “because we’ve been so strong and we’ve gone through so much, that there’s been this untold or unspoken rule that we don’t need therapy,” she says. “And, that’s true, we are strong, but we’re human too, just like everyone else. We do need support and we do need help, just like everyone else.”

Even Theus, who drives from her home in Janesville twice a month for therapy at Anesis, feels the weight of the stigma. “Are people going to see me as an unfit parent because I’m trying to seek help?” she asks, adding that part of the reason she’s in therapy is to continue to work through her childhood trauma. “We’re already criminalized for the color of our skin and that stops us from not only getting ourselves the help we need but also from getting our children the help they need. It stops us from getting our children screened for things like autism and other developmental delays and disorders. This all impacts how we approach our health care and mental health.”

Anesis client Alex Booker says some people of color view therapy as only needed for extreme trauma. “[They] feel that if they weren’t raped or molested or their mom wasn’t killed in front of them then they really don’t need to go to a therapist,” he says.

Cultural differences also play a part. “Doctors’ offices are seen as white spaces,” continues Booker, a 26-year-old Black man who has been going to therapy since he was a child. “When we go there, it’s not connecting, it’s not clicking — it’s just these white people telling you different things to do that don’t really align with how you live.”

The way Booker sees it, a therapist of color is best suited for dealing with trauma, anger, confusion and fear related to the police killings of George Floyd, Breonna Taylor and Tony Robinson, as well as smaller examples of everyday racism.

“There are those big issues, but it’s also things like microaggressions when I was at school or work and I was undermined or being labeled as acting a certain way when I wasn’t — it really helps to talk through those issues,” says Booker, who works as the ​​assistant farm education manager at the Badger Rock Neighborhood Center and owns an agriculture business that supplies products to Black- and brown-owned catering companies.

He also feels more free to discuss problems he has with other people of color when talking to a therapist of color. “When I have an interaction with a Black person that I need to talk about, I can do that and not feel like I’m dogging out Black people.”

Both Booker and Theus are moved to spread the word about how therapy has helped them. “I’ve encouraged a lot of my friends to go to therapy through my social media,” she says. “I explain how it’s helped me grow and heal — I think it helps to show the positive experiences I’ve had.”

Therapist shortage

Cultural stigma around therapy is not the only significant challenge facing Anesis. There’s also a shortage of mental health professionals nationwide, one that is more acute when it comes to therapists of color.

According to estimates from the U.S. Bureau of Labor Statistics and Census Bureau as well as the American Psychiatric Association and the American Psychological Association, the number of psychiatrists, psychologists and therapists of color floats somewhere between 2-8 percent of all mental health professionals. (The range accounts for the large number of different titles, certifications and licensures in the mental health field.)

Groups like the National Association of Black Counselors are trying to increase those numbers, but recruiting people of color to be therapists is an uphill battle.

“To become a therapist, it’s almost as much time as a doctor goes to school,” explains Tamara Ferebee, co-founder of NABC and a therapist. “It’s about six years of training and then you only make about $55,000 a year, if that. So, it’s a challenge because we’re not paid well and it’s a very stressful field. Combine that with a lack of support or mentors to help you and it’s particularly taxing for Black students.”

NABC is working to create a national network of Black-owned and operated mental health clinics that would, among other things, help place students in internships and residencies.

The group also currently assists clients with finding a Black therapist in their area, when possible. “There are more of us working as therapists in urban areas and in the eastern and southeastern parts of the country,” says Ferebee. “But sometimes I do get calls from someone in a more rural area, like on a military base, and I can’t help them — I have to tell them, ‘I’m sorry, there just are not any Black counselors there.’”

Ferebee doesn’t see the shortage situation improving. “I’m concerned it’s going to get worse,” she says. “A number of us are older — 40 years old and above — and as we begin retiring, we aren’t recruiting enough new therapists to replace ourselves.”

McNair says Anesis currently has a waitlist of between eight to 16 weeks.

To help address this shortage, McNair and the UW-Madison Department of Psychiatry are partnering on a new program where students of color who want to work with clients of color can serve a psychiatry residency at Anesis.

“For clients of color to be able to work with a psychiatrist who looks like them is rare,” says Herringa. “There just aren’t enough psychiatrists as it is, and it’s even harder to find psychiatrists who are in a historically marginalized group.”

Working with the courts

The clinic has also forged a partnership with Dane County’s juvenile court system.

When a child is arrested and charged with a crime, a social worker from the court or child protective services can assign an in-home mental health team from Anesis to work with the child’s family. McNair says this team “works in a very preventative way to address what led to the problems so the kid isn’t taken away and put somewhere like Lincoln Hills [youth prison]. We really focus on mending relationships and keeping that family together.”

A psychotherapist is just one member of the team, adds McNair. “There are family advocates who see the families like two or three times a week. And they do things that you don’t usually get with therapy.” For instance, if a young person is trying to get a job or a driver’s license, the family advocate can go into the schools and meet with teachers to help with those needs.

Dane County Circuit Judge Everett Mitchell, who is Black and presides over the juvenile division, says he’s seen many children of color and their families respond well to working with Anesis. “There’s a lot of mistrust in these systems, so the representation of medical providers of color leads to better trust,” he says. “And, you don’t always have this time to try to build that trust, so having that shared social history allows the therapeutic work to begin so that they can work on those deeper issues that have brought the child into court in the first place.”

Mitchell says the need for services like those offered by Anesis will continue to grow. “Anesis has entered into not just the criminal justice system, but they’ve entered into the child welfare system, which is the greatest need for us right now because of the the severity of anxiety and depression and suicidal ideation in our younger population,” he says. “We’re going to need more services like these to make sure young people and families are able to process the complexities of mental health as these problems present themselves in our community and also in schools.”

Making sense of the world

In the couple of years that Booker has been seeing a therapist at Anesis, his view of life has changed drastically. He says that’s mostly because he’s been able to express and process how race affects his life.

“I’ve been able to stop viewing myself through the lens of living in a white world,” he explains. “People are going be racist. That’s just how America is right now, how the world is right now. So what can I do? I can talk about it and work through it and try to make my existence in the world as peaceful as possible.”

Theus says everyone needs a “neutral source to go to to talk about everyday life struggles because life is hard.

“I will always seek therapy as a tool to help me thrive in life,” she says. “We all need a way to process our own personal issues and cope with the world around us.”

For McNair, providing therapy specifically for communities of color in the Madison area has exposed a far greater need that she imagined.

“This was a huge gap that needed to be filled,” she says. “They’re here and we’re here for them.”