Decolonising Therapy

Decolonising therapy

challenges Eurocentric frameworks, addressing systemic inequalities like racism, sexism, homophobia, and classism. It validates diverse lived experiences and provides culturally sensitive, affirming care.

For communities, this means:

• BIPOC individuals receive care that acknowledges racial trauma.
• LGBTQIA+ people access affirming, bias-free spaces.
• Forced migrants find support for navigating systemic barriers.
• Sex workers are respected, not stigmatised.

By fostering equity and inclusion, decolonising therapy creates healing spaces that empower individuals and strengthen communities. It’s essential for a more just and compassionate society.

Decolonising Psychotherapy: Embracing Collective Healing

Decolonising psychotherapy means moving beyond Eurocentric, individual-focused models to include diverse cultural practices like collective healing. Many BIPOC communities process trauma through shared experiences and mutual support, which resonate deeply with their lived realities.

In responses to tragedies and situations like the Grenfell Tower fire, terrorist attacks or COVID-19, statutory services have highly depended and focused on individual support—but there’s also a need forcollective healing especially when the traumas themselves were collective. Evidence-based approaches, such astrauma-informed group workandcommunity storytelling circles, narrative approaches, recognise individuals as part of a collective, fostering resilience through shared grief and meaning-making.

I'm not saying remove 1:1, I'm saying let's think past 1:1, Eurocentrism and NICE guidelines which do not always serve BIPOC interests.

By integrating these culturally sensitive practices, we can ensure mental health responses honour both individual and communal healing. Isn't it about time to rethink how we approach care in diverse communities?

Saquib Ahmad 16/12/24

#decolonisation #decolonisingtherapy #mentalhealth #fightingfear #queerbipoc #bipoc #therapy #culturallysensitivetherapy

Decolonising Psychotherapy: Honouring Diverse and Consensual Relationships

Therapy often reinforces heteronormative and mononormative ideals, positioning heterosexual, monogamous relationships as the default or superior model. This perspective marginalises individuals in consensual non-monogamous relationships, such as open or polyamorous partnerships, as well as communities like the LGBTQIA+ community and some religous communities.

These biases can pathologise diverse relationship structures, mislabeling them as “trauma responses” and "fear of commitment" or minimising their importance. Decolonising psychotherapy means moving beyond these limiting frameworks to empower individuals through consent, communication, and affirmation.

This isn’t to deny compulsive sexual or romantic acts aimed to seek external validation or even the existence of coercive control, which can sometimes be present in non-monogamous relationships or structures (NB; coercion can also occur in monogamous relationships). However, it is critical to distinguish dynamics like these from healthy and consensual relational choices that reflect personal autonomy and mutual respect.

Consensual relationships—whether monogamous, non-monogamous, or otherwise—are valid expressions of love and connection. Therapists must adopt inclusive, culturally sensitive practices that affirm the diversity of relational choices and ensure every client feels valued and supported.

Wouldn't it make more sense to honour consent and thus consensual open relationships or any other consensual relationship structure rather than cling to coercive monogamy? Or will we let our moral beliefs hold our clients back?

Saquib Ahmad 18/12/24

#decolonisation #decolonisingtherapy #mentalhealth #fightingfear #queer #lgbtqia #monogamy #heteronormativity #openrelationship #polyamory

Decolonising Psychotherapy: Affirming and Supporting Sex Workers

Stigma often leads therapists to view sex work as inherently harmful, framing it as the source of a client’s distress rather than examining the systemic and societal issues at play. Decolonising psychotherapy involves affirming sex workers’ agency and dismantling biases, recognising that their challenges are often rooted in the environments and systems they navigate, not the work itself.

Sex work can indeed be traumatic, but this is often linked to how problematic their clients behave—driven by shame, sexism, homophobia, transphobia, misogyny, or other oppressive attitudes—or due to discrimination from legal and criminal justice systems shaped by systemic versions of the same discriminatory issues. By understanding these broader dynamics, therapists can focus on supporting sex workers in addressing the real sources of their distress.

Decolonised approaches require therapists to educate themselves on the socio-economic contexts of sex work, affirm the validity of consensual choices, and advocate for systemic change in sex work as well as the broader society.

Isn’t it time we move away from seeing sex workers as “broken” and instead recognise that it’s oppressive systems—not their work—that create or exacerbate their struggles? Shouldn’t therapy be a space where sex workers feel respected, validated, and empowered to navigate their realities—and not our prejudices in the room?

Saquib Ahmad 20/12/24

#decolonisation #decolonisingtherapy #mentalhealth #fightingfear #sexwork #sexworkiswork #stopstigmaagainstsexwork

Decolonising Psychotherapy: Forced Migrants Deserve Better

Assuming that forced migrants are now safe in the West is a harmful myth. While it may be relatively safer than the conditions they fled, forced migrants continue to face significant threats. Racism, xenophobia, and anti-migrant sentiments are pervasive, as highlighted by the racist and Islamophobic riots across the UK in the summer of 2024, culminating in the tragic arson attack on a hotel housing migrants. These acts are not isolated incidents but part of a wider systemic issue of racism, Islamophobia, and the war on migration in the UK—and the West more broadly.

For queer forced migrants, these challenges are compounded by homophobia and transphobia, present both within migrant communities and the wider public. In many cases, they are forced to navigate layers of discrimination and violence, including within housing centres shared with queerphobic individuals. Their reality involves a constant balancing act of managing systemic barriers, personal safety, and emotional exhaustion.

Decolonising psychotherapy means addressing these realities head-on by adapting therapy models, policies, and procedures to meet the unique needs of forced migrants, including queer forced migrants. This includes:

• Flexible Engagement: Recognising the unpredictability of their lives, allowing leniency for missed appointments, lateness, or cancellations without penalisation.
• Trauma-Informed Care: Acknowledging the intersection of systemic oppression, ongoing threats, and displacement trauma. For example, narrative therapy can help forced migrants reclaim their stories of resilience.
• Specific Support for Queer Forced Migrants: Creating safe and affirming spaces that address the dual challenges of migration and LGBTQIA+ identity, such as group therapy tailored to their experiences of isolation and discrimination.
• Adaptable Interventions: Avoiding rigid tools like diaries or logs that are impractical in settings with limited privacy or resources. Alternatives like brief-session therapies or EMDR can be more effective.
• Policy Revisions: Overhauling strict rules that set these communities up to fail, focusing instead on accessibility, compassion, and understanding.

Decolonising psychotherapy isn’t just about individual care—it’s about accepting and validating experiences, not checking for "thinking errors." Their pathology isn’t caused by them but by the systems they exist in. It is also about challenging the systemic issues that forced migrants face and mitigating them wherever possible, ensuring mental health services adapt to their realities. Let’s create therapeutic spaces that validate their struggles, empower their resilience, and genuinely support their healing.

Saquib Ahmad 08/01/25

#decolonisation #decolonisingtherapy #mentalhealth #fightingfear #forcedmigrants #refugees #asylumseekers #queerforcedmigrants #queermigrants

Decolonising Psychotherapy: Addressing Anti-Blackness in Mental Health

Black clients often face systemic bias in mental health services, from misdiagnoses to harmful stereotypes. Decolonising psychotherapy means recognising these biases, validating lived experiences of racism, and providing culturally responsive care.  

Systemic Bias in Mental Health  

• Misdiagnoses: Black individuals are disproportionately diagnosed with schizophrenia compared to mood disorders, even when presenting with similar symptoms to white patients. This may stem from implicit bias, where clinicians misinterpret expressions of anger or distrust (often a reasonable response to systemic racism) as psychotic symptoms. Research has shown significant disparities in these diagnoses, highlighting the impact of bias.  
• The "angry Black woman" trope leads to Black women's pain being dismissed, resulting in inadequate treatment for conditions like depression and anxiety. The "aggressive Black man" stereotype contributes to over-policing, harsher sentencing, and even fatal encounters with law enforcement. These stereotypes have roots in the history of slavery and were used to justify oppression.  
• Conflicts within Black families (e.g., between siblings or cousins) are often dismissed as “fighting” or antisocial behaviour, rather than recognised as signs of abusive dynamics, which perpetuates harm and misses opportunities for intervention. For example, a child acting out due to witnessing domestic violence might be labelled as having a behavioural problem instead of receiving trauma-informed care. This may occur due to cultural misunderstandings of family dynamics or a lack of understanding about the unique stressors Black families face leading to a contextless diagnosis that only serves to punish black people

Understanding Historical and Systemic Contexts  

An understanding of Black communities’ lived experiences in the US, UK, and other Western countries is essential for effective mental health care. The experiences of the Windrush generation in the UK, as well as other waves of migration due to war, persecution, or socioeconomic challenges, highlight how systemic racism and xenophobia have shaped Black communities’ realities.  

Black immigrants often faced hostility, as evidenced by historical race riots, daily racism, and systemic barriers to employment and housing. The demonisation of immigration by mainstream media has fuelled prejudice, leaving Black communities feeling alienated and unsafe and more race riots across the UK. Redlining, which systematically denied Black families access to home ownership, concentrated poverty and limited opportunities, impacting mental health across generations. The school-to-prison pipeline further compounds these issues for Black youth.  

Black children are often taught to navigate societal discrimination, including police harassment and disproportionate stop-and-search practices. These systemic challenges, coupled with negative or tokenised media portrayals of Blackness, have long-term impacts on mental health and deepen mistrust of mental health services. The legacy of slavery and ongoing systemic racism creates historical trauma, manifesting as anxiety, depression, PTSD, and substance misuse. This trauma is intergenerational, impacting the mental well-being of entire families and communities.  

Addressing Mistrust  

Therapists must acknowledge that mistrust may be ongoing. Therapeutic raptures, no matter how small, must be addressed carefully. Your fragility is less important than the client’s need for safety. Rebuilding and preserving trust requires constant effort and care.  If we see mistrust as yet another symptom of their "schizophrenia" or other another mental illnesses, we overlook the crucial context in which a Black person would naturally be mistrustful of mental health services, therapy, and clinicians, especially if they are white in the West.  

Decolonising Practices  

• Trauma-Informed Care: Recognise the systemic impact of racism, migration trauma, and historical trauma.
• Cultural Competence: Understand migration patterns, systemic barriers, racial trauma, and the specific cultural nuances of the Black community. This involves challenging personal biases and adapting therapeutic approaches. A lack of cultural competency can lead to misdiagnosis, ineffective treatment, and further mistrust.  
• Challenging Stereotypes: Dismantle tropes like the “angry Black woman” or “aggressive Black man.”  
• Recognising Safeguarding Issues: Address conflicts within Black families with sensitivity, recognising them as potential abusive dynamics.  
• Flexible Therapy Delivery: Offer online, early morning, evening, or shorter sessions, including from cars or community locations, accommodating the realities of Black clients’ lives.  
• Advocates in Therapy: Allow trusted third parties to support clients during sessions to help rebuild trust and mitigate systemic failures.  
• Addressing mistrust: Mistrust is not a symptom but a context of lived experience to address and navigate with understanding and humility.

A Call to Action  

Decolonising psychotherapy is about creating safe, equitable spaces that respect identities and validate struggles. By addressing systemic racism and adapting practices, mental health services can become a tool for empowerment rather than exclusion. We must advocate for more diverse representation in the mental health workforce, support organisations providing services to Black communities, demand culturally competent training for therapists, and challenge racist policies and practices. Let’s make therapy inclusive and transformative.

Saquib Ahmad and edited by Rachael Moore 05/02/25 

For more information about Rachael click here. 

#decolonisation #decolonisingtherapy #mentalhealth #fightingfear #antiblackness #blm #blacklivesmatter #blackcommunities #blackafricancommunities #blackcaribbeancommunities #blackpeopleintherapy #BIPOC

Decolonising Psychotherapy: Rethinking Addiction

The dominant treatment protocols for addiction are steeped in a punitive, pathologising model—one that sees the individual as the problem, the behaviour as the illness, and abstinence as the only cure. It is a framework that aligns disturbingly well with the global “war on drugs”—a war waged not on substances, but on people, disproportionately those who are poor, racialised, and already marginalised.

We are told that addiction is a personal failing. That the addict must hit rock bottom. That they must be “ready” for treatment. That they must “stay clean.” But what does any of this mean when addiction is not a moral flaw, but an adaptation to distress? What if the issue is not the addict, but the environment in which the addiction emerges?

Addiction as Punishment, Not Understanding

Many addiction treatment models still revolve around the idea that the individual must simply resist temptation—that if they cared enough, they would stop. That if they loved their family, if they respected themselves, if they wanted to live a better life—they would just say no. This is the same moral logic that underpins incarceration, criminalisation, and societal rejection. The same logic that fuels shame-based “tough love” interventions, often endorsed by loved ones and professionals alike.

But we must ask: what are we asking people to say no to? Is it really the substance or behaviour itself—or are we asking them to stop engaging with the only thing that has offered them consistency, comfort, and copingin a life marked by pain, alienation, and trauma?

From the Rat in a Cage to Rat Park: The Power of Context

Much of our understanding of addiction stems from outdated and overly simplistic experiments. In the early 20th century, researchers placed rats in isolated cages with two options: plain water or water laced with heroin or cocaine. Time and again, the rats chose the drugged water until they overdosed and died.

This became “proof” that drugs are inherently addictive.

But in the 1970s, psychologist Bruce Alexander conducted a now-famous counter-experiment known as Rat Park. Here, rats lived in spacious cages with colourful balls, running wheels, food, nesting material, and—crucially—other rats. They were still given access to the drug-laced water. But in this enriched environment, they rarely touched it, and none consumed it compulsively.

The difference? Connection. Safety. Autonomy. Choice. Belonging.

In essence, addiction was not about the substance—it was about the cage.

What If We Treated the Cage Instead of the Rat?

If addiction is a relational and environmental issue, why is so much of our treatment model built around removal and control?

We tell people:
“You must be clean before you can access therapy.”
“Go to NA first—then we’ll treat your depression.”
“You can’t live here if you’re still using.”

We ask them to separate their distress, as if their panic attacks, their childhood trauma, their grief, their homelessness or marginalisation can be surgically removed from the behaviour we call addiction. This is not trauma-informed care. This is disintegration.

Decolonising treatment for addiction means recognising that substance use is often a symptom, not the root cause. That co-occurring conditions must be treated together, not in isolation. That healing happens not through punishment, but through compassion, consistency, and relationship.

Addiction and the Search for Relationship

It may sound strange, but addiction can offer a kind of unconditional relationship—a consistent presence in the midst of abandonment, rejection, and unpredictability.

Loved ones may plead: “If you really cared, you’d stop.” But in doing so, they may inadvertently make their love conditional—dependent on the person’s ability to abstain. The addiction, meanwhile, asks nothing. It is always there. It doesn’t shame. It doesn’t threaten to leave.

Is it any wonder, then, that someone in deep distress might choose the relationship that doesn’t demand their performance or healing to stay?

“Clean” is Not a Measure of Worth

Even our language around addiction is laced with judgement. We refer to people as “clean” or “dirty.” We tell them they must be “stable” to access support—as if their distress disqualifies them from care, rather than signalling their urgent need for it.

Decolonising addiction treatment means dismantling these narratives of purity and punishment. It means asking better questions—not “Why can’t you stop?” but “What are you trying to survive?” Not “When will you be ready?” but “How can I meet you where you are?”

Towards a Relationship-Centred Model

What if, instead of focusing solely on the removal of the addiction, we supported people in building better relationships—with themselves, with others, and with their own emotions and needs?

A decolonised approach to addiction asks:

• How are your relationships—with people, with your work, with your passions, with your pain?

• What would it look like to feel held, understood, and seen in those spaces?

• Can we rebuild trust in your relationship to your own distress, so it no longer has to be numbed or avoided?

This is not a model of abstinence or indulgence—it is a model of relational healing. Because let's be clear, the addiction is a trauma response, but the trauma stems from their attachments. 

Addiction Without Moral Panic

Addiction is not limited to narcotics. It can take the form of alcohol, nicotine, gambling, pornography, shopping, even social media or work. And for each of these, there are also people who engage without developing addiction.

What separates those who develop compulsive relationships from those who don’t is not willpower—it is often context. Many who are not addicted enjoy the protective buffer of supportive relationships, internal safety, or structural privilege.

Addiction is not about the object. It is about the function the object serves—the role it plays in helping someone survive what feels unmanageable.

What Decolonising Addiction Care Looks Like

A decolonised approach to addiction treatment might look like:

• Integrated care, where substance use is explored alongside trauma, depression, or anxiety—not after.

• Language reform, moving away from terms like “clean” and “addict,” and towards “person who uses,” or “person experiencing addiction.”

• Relationship repair, prioritising trust-building with professionals, peers, and loved ones.

• Contextual care, acknowledging structural violence, racism, poverty, homophobia, or isolation as relevant to addiction.

• Harm reduction, offering realistic and compassionate steps that meet people where they are, not where we wish they were.

• Cultural humility, especially when working with communities of colour, queer communities, or people with complex migration journeys, for whom addiction may be deeply entangled with identity, belonging, and survival.

Decolonising treatment for addiction means letting go of the fantasy that abstinence alone heals. It means resisting the systems that punish pain and instead investing in systems that understand it.

Because people don’t heal by being told they’re broken.
They heal by being understood, trusted, and met in relationship.

Let’s move from pathology to compassion. From punishment to partnership.
From isolation to connection.

Let’s stop trying to fix the addict—and start healing the conditionsin which addiction thrives.

Saquib Ahmad 20/04/25

#Decolonisingpsychotherapy #Decolonisingaddiction #AddictionRecovery #TraumaInformedCare #HarmReduction #MentalHealthMatters #EndStigma #CompassionateCare #RelationalHealing #CulturalHumility #InclusiveTherapy #AddictionSupport #QueerMentalHealth #BIPOCHealing #HealingNotPunishment #RethinkAddiction #PsychotherapyReimagined #StructuralViolence #CommunityCare #RecoveryIsNotLinear #TherapyForAll