MelissaLavallée

Understanding Power Dynamics in Mental Health Care

By Melissa Lavallée MACP, BA-Psyc

Mental Health Educator & Counsellor

Imagine walking into a therapy session. You hope for healing but quickly realize the counselor doesn’t understand your cultural background. They also don’t grasp the real-world struggles you face. Traditional counselling approaches often come from Western perspectives. These techniques don’t always tackle the experiences of marginalized communities. These communities deal with systemic oppression, historical trauma, and complex cultural identities.

Decolonizing counselling isn’t just about adding diverse elements. It’s about challenging and changing practices within mental health care. These practices often perpetuate oppression. Therapists use the Multicultural and Social Justice Counselling Competencies (MSJCC) to create fair, inclusive, and genuinely supportive spaces.

Understanding Power Dynamics in Counselling

Effective counselling recognizes that mental health isn’t just personal—it’s also shaped by external factors like racism, sexism, and colonialism. Many traditional counselling models focus on individual issues without acknowledging these broader influences.

The MSJCC framework encourages counselors to explore power dynamics by:

• Reflecting on Yourself – Being aware of your own privileges and biases.
• Understanding Your Clients – Appreciating the real-life challenges clients face.
• Navigating the Counselling Relationship – Openly addressing power imbalances.
• Taking Action Beyond Therapy – Getting involved in advocacy and community efforts.

Using this approach, counselors can create relationships that empower and uplift clients.

Social Justice Theories to Guide Decolonized Counselling

To effectively practice decolonizing counselling, therapists should explore key social justice theories. Here are four powerful approaches:

1. Relational-Cultural Theory (RCT)
RCT was developed by Jean Baker Miller in 1976. It focuses on the importance of relationships. It emphasizes connection and empathy.

Why it matters:

• Recognizes how systemic oppression leads to psychological distress.
• Highlights the value of community connections for healing.

Practical applications:

• Encouraging mutual support and empowerment.
• Helping clients reconnect with supportive communities.

2. Critical Race Theory (CRT)
CRT, created by Derrick Bell in 1995, explains how racism is deeply embedded in society.

Why it matters:

• Challenges racial biases in mental health systems.
• Validates the experiences of clients of color.

Practical applications:

• Using culturally affirming approaches.
• Openly discussing internalized oppression.
• Advocating for policy changes to fight racism in mental health care.

3. Intersectionality Theory
Kimberlé Crenshaw introduced intersectionality in 1989 to highlight how multiple identities intersect, shaping unique experiences of oppression.

Why it matters:

• Recognizes the complexity of identity and oppression.
• Helps therapists create more personalized approaches.

Practical applications:

• Tailoring therapy to clients’ unique experiences.
• Avoiding one-size-fits-all approaches.

4. Liberation Psychology
Ignacio Martín-Baró developed this approach in 1994, emphasizing collective healing and resistance against oppression.

Why it matters:

• Empowers clients through cultural and ancestral wisdom.
• Sees mental health as both collective and political.

Practical applications:

• Participating in community healing efforts.
• Helping clients resist oppressive narratives.
• Using cultural memories and histories in healing.

Practical Ways to Decolonize Your Counselling Practice

Ready to make changes? Here are practical steps you can take to start decolonizing your therapy practice:

Honor Indigenous Land & Knowledge Recognize and respect the land you’re on, and thoughtfully include Indigenous healing practices.

Community-Based Interventions Get involved with collective healing through community partnerships and grassroots organizations.

Advocate for Policy Change Actively support policies aimed at reducing mental health disparities.

Decenter Western Narratives Integrate healing methods from diverse cultures, including Eastern mindfulness practices and African or Latinx community healing traditions.

Increase Accessibility Provide flexible options like sliding-scale fees, pro bono services, or mobile therapy to remove financial barriers.

Reject Neutrality Acknowledge that therapy is political; speaking out against oppression matters.

Decolonizing counselling is an ongoing journey. Here’s how you can start today:

1. Reflect on Your Own Identity Think about how your background shapes your counselling approach.
2. Keep Learning Read works by BIPOC authors, attend social justice trainings, and stay open to new perspectives.
3. Take Action Advocate for justice, challenge oppressive systems, and amplify marginalized voices.

Healing isn’t just about personal change; it’s about building a fairer world. How are you working to decolonize your counselling practice?