Visions Journal

Reimagining recovery with cultural responsiveness

Aisha Afzal

Reprinted from the The Ongoing Journey of Recovery: Recovery across the lifespan issue of Visions Journal, 2025, 20 (3), pp. 10-12

Imagine a space where you're expected to pour out your deepest struggles, but the lens used to make sense of your pain is distorted. For many racialized folks, this is what recovery in the current mental health care system can feel like: designed without our lived realities in mind. One example: some folks don't frame their experiences using terms like anxiety or depression, but as a disruption in balance, a spiritual test or a weight carried for generations. Unfortunately, they can go unheard.

I’ve sat on both sides of the therapy room—first as a client, then as a clinician—and I've felt the disconnect. Too often, recovery is framed as a solo journey. But unwellness doesn't happen in isolation. It’s shaped by systems, histories and the realities we move through every day. Therapy often draws from a Eurocentric lens. This lens misses the way people across cultures actually experience distress and recovery.

Cultural responsiveness isn't something to check off a list. It's a practice. The goal isn't to have a perfect understanding of every cultural nuance, but to develop a practice that's flexible. This approach takes humility, curiosity and a willingness to unlearn what we think we know about healing. We have to:

• stay open

• make space for new ways of understanding

• recognize that we'll always be learning

Revisiting the clinician role

Therapists are not blank slates. We bring our own worldviews, training and assumptions into the room. Western therapy tends to centre individualism, emphasizing personal agency and self-actualization. But for folks from collectivist cultures, well-being is deeply intertwined with family, community and shared responsibility. The idea of putting yourself first can feel unnatural, or even selfish.

We need to let go of the assumption that Western mental health and recovery models fit everyone. There is no one-size-fits-all approach. To practise cultural responsiveness, we need to reflect on how our positions and perspectives shape how we interpret clients' experiences.

We can start by making changes to how we work towards recovery. Below, I explore a few changes.

Listen: Meeting people where they are means listening to how they make sense of their own struggles. If we require clients to shrink their pain into predefined boxes, we risk missing the full picture. Therapy should never make clients translate their experiences into terms that aren’t a fit. It should be a space where their own language and truth are enough.

Resist labels: Beyond that, the very lens clinicians use to diagnose fails to capture the impact of systemic oppression. What gets labelled maladaptive coping might be survival. What’s seen as avoidance may be necessary withdrawal from spaces that have historically caused harm. Without an understanding of intergenerational trauma and racism, the labels we use in recovery risk making pain a disease instead of making space for its context.

Research backs this up. A metaanalysis of 78 studies found that culturally adapted therapy is nearly twice as effective as standard therapy for racialized communities.¹ Beyond making therapy feel more inclusive, it's about making it work.

Consult: For culturally responsive recovery, clinicians should make use of consultation. Consultation involves seeking guidance and feedback from experienced peers to improve care. This lets therapists regularly explore cultural context, systemic oppression and alternative healing frameworks.

Accept: Clinicians working for recovery in all their patients should also accept that healing might look different depending on someone’s community, faith or family dynamics. That includes creating space for collective ways of coping, for storytelling and for spirituality.

Work towards systemic change: Even the most well-intentioned clinician will struggle to provide culturally responsive care if they work in a system that doesn’t prioritize it. A diverse team is simply performative if those perspectives don’t influence the way services are delivered. This isn’t about representation; it's about divesting power.

Who decides what "best practices" look like? Mental health care is so deeply connected to larger systems that shape access, outcomes and the definitions of mental illness and wellness. Often, folks seeking support are not only navigating personal struggles, but the weight of structural inequity and racism. Yet, mainstream approaches reduce distress to individual problems, ignoring the conditions that create unwellness. This replicates the very harm mental health care seeks to heal.

Rethink suicide prevention: By the time many racialized people reach a crisis point, it goes beyond individual despair—it's harm upon harm. It's the end point of systemic neglect, racism and the barriers that have failed them. Suicidal feelings are often a response to oppression, intergenerational trauma and unaddressed pain. The mental health system often steps in at the peak of crisis but does little to address the conditions that pushed people there in the first place.

Standard suicide prevention models rely heavily on involuntary hospitalization, despite little evidence that forced care prevents suicide. For racialized folks, these responses can be deeply retraumatizing, leading to coercive treatment and heightened surveillance.

Teams need to move beyond checklists and standardized safety plans. We need to centre trust and relationship-building. We need to build holistic, affirming plans that draw on cultural strengths, faith and communal care.

Encourage pod mapping: This concept was coined by disability activist Mia Mingus.² In pod mapping, folks identify small groups of people (pods) who can provide immediate practical or emotional support. Support may include integrating spiritual practices for those who find these are important. Pod mapping may also involve trusted community members or elders in ways that align with the client's values. The goal is to prevent immediate crises, but also to foster long-term sustainability and recovery.

Culturally responsive care recognizes people in recovery as the experts of their own lives—not passive recipients of therapy or care, but active participants in their healing. Even when they're in crisis, even when they're suicidal and even when the system fails to imagine alternatives.