Barriers and Facilitators BIPOC Clients Encounter in Receiving Mental Health Services

Black, Indigenous, and people of color (BIPOC) have historically had lower return rates for psychotherapy and a higher likelihood to discontinue therapy as compared to non-Hispanic White clients. Given that premature discontinuation of psychotherapy treatment has been linked with lower rates of mental health symptom improvement, understanding factors that contribute to BIPOC client continuation and discontinuation of psychotherapy services can help mental health care clinicians improve therapy continuation rates for BIPOC clients. Existing literature has remained unclear, and results are conflicting in identifying factors that contribute to BIPOC clients continuing therapy and factors that contributed to discontinuing therapy. Much of the existing literature has focused on clinician perspectives of factors contributing to BIPOC client continuation and discontinuation, and with wide variety among BIPOC client samples, understanding broader consensus was difficult. Therefore, it was important to understand diverse BIPOC client perspectives on factors that contributed to BIPOC client continuation and discontinuation of therapy services in the U.S. The purpose of this study was to understand, from BIPOC client experiences and perspectives, what factors contribute to continuation and discontinuation of BIPOC therapy services. Participants included 25 BIPOC-identifying individuals with current and/or previous therapy experience. Using a qualitative constructivist grounded theory methodology, participants were asked their perspectives on factors that contributed to continuation and/or discontinuation of therapy services in their experience. Results for continuation factors and discontinuation factors largely mirrored one another. Based on participant perspectives, factors such as quality of services, clinician skills, clinician integration of culture, client-clinician matching, and external factors played a role in some form in both the continuation and discontinuation of BIPOC client therapy services. Findings provide implications for clinical utilization and future research considerations to increase the continuation of therapy services for BIPOC clients, with hopes of improving the quality of mental health care services for BIPOC individuals in the U.S.