Advancing the Canon of Culturally Congruent Care: Black Women’s Perspectives on Mental Health, Healing, and Cultural Attunement

Background and Purpose: Black women encounter unique mental health challenges stemming from the combined impacts of multiple forms of systemic oppression (e.g., misogynoir). Theoretical concepts like Intersectionality offer valuable perspectives on how these converging elements simultaneously impact the mental health and emotional well-being of Black women. Further, this framework emphasizes the need for mental health approaches that thoughtfully consider how these social and structural contexts uniquely affect Black women's mental well-being. Despite their elevated risk, Black women face significant structural obstacles to accessing care. When they do seek services, they frequently encounter models that do not reflect their cultural values, lived experiences, and social contexts. The field of mental health has introduced various approaches to standardize and culturally adapt treatment across diverse populations, such as evidence-based practices (EBPs) and culturally congruent care (CCC). However, critical frameworks like Black Psychology and Radical Healing highlight that their shared reliance on Western, Eurocentric epistemologies continues to limit the effectiveness of these approaches in addressing the intersectional realities and nuanced mental health needs of Black women. If EBPs and CCC are limited in addressing the unique psychological risks, mental health needs, and lived experiences of Black women, what approaches could be adopted to create mental health strategies that are specifically attuned to their cultural needs? Perspectives in Black feminist Thought urges scholars to center Black women's voices directly for these answers. This study aims to explore how self-identified Black women define and characterize CCC. Additionally, it seeks to examine the similarities and differences between their definitions and established conceptual, clinical, and mental health models.

Methods: This research employed a qualitative study design grounded in a contextualist/critical realist perspective, drawing on information collected through in-depth focus group interviews. The researchers recruited a sample of adult Black women (N = 22) through purposive, convenience, and snowball sampling. Data analysis adhered to Braun and Clarke's six-phase reflexive approach to thematic analysis, which focuses on recognizing, analyzing, and interpreting meaningful patterns within qualitative data.

Results: The final analysis identified four themes that illustrate how Black women in this study define and describe CCC. These themes include: 1) Establishing Low-Barrier and Equitable Care, 2) Constructing Secure, Restorative, and Culturally Responsive Care, 3) Centering Authentic and Accountable Relationships, and 4) Delivering Action-Oriented Care Responsive to Lived Experience.

Conclusions and Implications: Black women's conceptualization of CCC not only challenges but also expands traditional approaches to mental health care. Their definitions contest prevailing mental health approaches by highlighting care that is communal, low-barrier, action-oriented, and contextually responsive. Black women dismiss approaches that emphasize passivity, emotional repression, or clinical detachment, advocating instead for care models that value authenticity, adaptability, and the sociopolitical factors contributing to distress. This study calls on scholars and clinicians to reimagine present approaches to CCC through the insights of Black women. By doing so, this research informs necessary shifts in mental health care towards models of care that genuinely reflect and respond to the mental health needs, cultural realities, and lived experiences of Black women.