Grounding and Advancing the Canon of Culturally Congruent Care: Black Women's Reimagining of Mental Health Care and Implications for Social Work Theory and Practice

Background and Purpose: Black women face distinct mental health risks due to the cumulative effects of systemic oppression, including racism, sexism, and misogynoir. Theoretical frameworks such as collective trauma, racism-related stress, Intersectionality, and Black Feminist Thought provide critical insight into how these converging forces uniquely shape Black women’s psychological experiences. Despite elevated risk, Black women encounter persistent structural barriers to care and, when they do access services, are often met with models that fail to reflect their cultural values, lived experiences, and social realities. While professional organizations like the NASW and APA emphasize culturally congruent care (CCC), critical perspectives, including Radical Healing and Black Psychology, argue that a deeper reimagining of current mental health paradigms is necessary to truly meet the needs of Black communities. The purpose of this study is to explore how self-identified Black women define and characterize CCC, and to examine how these definitions both align with and diverge from established theoretical frameworks and traditional approaches to mental health care.

Methods: This study leveraged a qualitative study design with a contextualist/critical realist epistemology, using data gathered during in-depth focus group interviews. A sample of adult participants who self-identified as Black women (N = 22) were recruited through purposive, convenience, and snowball sampling. Data analysis followed Braun and Clarke’s six-phase reflexive approach to thematic analysis, which emphasizes identifying, analyzing, and interpreting patterns of meaning within qualitative data.

Results: Final analysis revealed thirteen themes that highlight the ways Black women in this study define and characterize CCC. These include: 1) Communal; 2) Encourages Self-Definition; 3) Fosters Self-Knowledge; 4) Centers Joy, Laughter, and Play; 5) Facilitates Knowledge and Resource Exchange; 6) Affirms and Promotes the Visibility of Black Women; 7) Demands Collective Responsibility; 8) Addresses Black Women’s Unique Needs, Lived Experiences, and Stressors; 9) Low-Barrier, Equitable, and Secure; 10) Prioritizes Authenticity, Empathy, and Accountability, 11) Fosters Diversity; 12) Action-Oriented; and 13) Provides a Respite.

Conclusions and Implications: This dissertation contributes to social work scholarship by grounding and advancing existing theoretical frameworks through the lived experiences of Black women. Participants’ definitions of CCC provide empirical support for models such as Radical Healing, Black Psychology, Intersectionality, and Black Feminist Thought, affirming the centrality of joy, collective care, intergenerational knowledge exchange, and resistance to systemic oppression. At the same time, their conceptualizations challenge dominant mental health paradigms by emphasizing care that is communal, low-barrier, action-oriented, and contextually responsive. Black women reject approaches rooted in passivity, emotional suppression, or clinical detachment, instead calling for care models that honor authenticity, flexibility, and the sociopolitical roots of distress. This study urges the field of social work to reimagine CCC through the lens of Black women’s cultural expertise, ancestral healing traditions, and lived experiences. By doing so, it invites a reorientation of mental health care toward models that are truly aligned with Black women’s cultural realities, care needs, and visions for healing.