In this series of blog posts on Spruce customers, we’re highlighting healthcare professionals who focus on serving communities of color. Members in these communities often face multiple barriers to seeking out the help that they need. Research shows that though these folks are more likely to report psychological distress, they are still less likely to seek out treatment than white folks. The factors underlying this issue are undoubtedly complex and may include the stigma associated with mental illness in communities of color, as well as socioeconomic barriers, provider bias, and inequality of care. Because it’s our mission to expand access to healthcare, we’d like to spotlight our customers who are doing the most work to support these communities.
We sat down with Dr. Goode-Cross, founder of East Towson Psychological Services, to learn more about his practice, his treatment philosophy, and how the Black Lives Matter movement has affected his work.
Tell us about your practice.
East Towson Psychological Services was founded to meet the needs of clients of color through individual and couples therapy. Most of our clients are African American, and about 50% identify as somewhere in the queer continuum. That includes being gender-expansive, transgender, non-binary, gay, bi, lesbian, and more. Regardless of the client’s racial or ethnic background, sexuality, or gender identity, our therapists aim to affirm all of someone’s identities and provide support.
Do you have a specific specialty or focus?
These populations have a lot of trauma, just by nature. When you’re living in a world that doesn’t treat you kindly, it can be pretty traumatic. A lot of our clients deal with daily slights, microaggressions, and police or work encounters that make them feel less than affirmed or validated in their identities. A lot of anxiety and depression follows, and so we work with a lot of folks who have trauma and anxiety and depression.
We also do evaluations for people who are interested in gender confirmation surgery. Depending on where you are or what insurer you have, you often need a letter from a psychologist if you want to start hormone therapy or undergo top or bottom surgery, and so we help with this as well.
How did you get into this type of work?
I am a psychologist, but I trained to be a professor. I focused on research and was on the faculty of two institutions before I became a practicing clinician. I went to grad school after seeing a lot that happened within the Black and queer communities. I noticed that interpersonal relationships were affected not only by familial relationships but also by societal norms and rules that were not really affirming. It felt like the best way to interrupt that cycle was through some sort of psychological intervention. I liked research because it added to the literature people could use to make evidence-based interventions. I think that’s a valuable process, but it was a little slow for me. So I ended up becoming a psychologist. I became a training director at a community health agency founded in Baltimore as a gay men’s health clinic, and I loved it. It got me closer to the people I wanted to work with clinically and I loved the work. One thing led to another, and I ended up starting my own private practice and growing it to a group practice.
What challenges did you come across when starting your own private practice?
A lot of them. The first challenge was capital. I found that many of my friends with the same specialty as me had a different experience, because they had more capital on hand. Many came from different types of families or had resources that I didn’t have. I am a first-generation college student. I don’t come from money, so there wasn’t a lot of money at my disposal. Capital was a big part of the challenge to starting my practice.
I also think finding therapists who understand the population we work with and feel the same way about therapy as I do has been a challenge. Most therapists have had a class on multicultural counseling. So most have had enough basic training to not be outwardly hostile to people who are different from them, but that doesn’t mean that they are culturally competent; that just means that they are sufficiently polite. I know this experience very well, not just because I’m Black and gay, but because I did research on the short- and long-term outcomes of discrimination. So I’m really clear about the type of work I think works best, and it has to be relational. We work with people who often have experienced some degree of relational trauma, whether that be with their family of origin, because they’re trans, because people are mean to them, or because they can’t find a job. So it’s really important to me to find therapists who can understand that struggle and who can ride with the relational challenges that come with the population. That has been less easy than I might have hoped.
What fuels you in your work?
Back when I was a researcher, I did a study with 50 Black therapists from across the country. I learned that there is a different passion when you get to work with your community. It requires more from you, but it pulls on you. I still find that to be the case with my own work. There is something about working with someone who looks like you, someone who could be your son, your nephew, your father, your brother, your sister, your relative, or someone you just know. That is beautiful. I enjoy working with folks who identify with the same community as me. I think it makes the community stronger. I also enjoy the supervision aspect. I provide supervision to all the therapists in the practice, and I enjoy helping them grow as therapists, helping them be more open, and helping them do this work more effectively. It feels like it’s part of my calling, so I feel really enriched by that.
How has the Black Lives Matter movement affected your work and your practice?
That is a complicated question. All that has happened in the last seven months has pushed folks to a breaking point, and it has made it very clear that people need more support than they have. The phone has been ringing off the hook, and most of the time we have a wait list.
What I can say from my clinical work is that Black folks have generations of anecdotal evidence saying that Black lives don’t matter. This is not news. If you actually read what the movement says, it’s really about the belief that Black people deserve to exist and live full healthy lives regardless of what their sexuality or gender identity is. Regardless of who they are, they deserve to have a whole humanity. It’s really benign. But that’s what makes others’ reactions to it so harmful. What I’ve seen is that Black folks are hurt that so many people find that statement offensive. Their friends tell them that they don’t understand or they don’t agree. They hear their coworkers or colleagues saying that they don’t understand why this has to be a thing — all lives matter. Black folks have gotten sick of it and need more support. They have grown tired of putting up with maltreatment; they have grown tired of being frightened, and they have grown tired of being abused and having to be silent about it. They are reaching out to clinicians who look like them, who understand them, and who understand their struggle.
What would you want potential new clients to know about you and your practice?
This is a place where you can come, be heard, feel seen, feel understood, and continue in your healing journey. This is a place where all parts of you get to be affirmed. You don’t have to be split, you don’t have to code switch, and you get to be your most authentic self. Our therapists feel passionate about affirming you and all of your identities. This is a place where you can come and not have to hide or play down the parts of you that you feel are undesirable or unwelcome in other spaces. That’s what I want potential clients to know.
How has the pandemic affected your practice?
The pandemic made me rethink what I thought about teletherapy. I used to be a therapy purist, thinking I had to be in the room with the person. But I’m also close to middle age and Black, so if I were to get COVID-19, the outcomes don’t necessarily look great. I have to be really thoughtful about the work I’m willing to do in person. Though telehealth is not exactly the same as meeting in person, it’s pretty close. It’s been a nice push that I wouldn’t have had outside of the pandemic, and I recognize the benefits. I also think clients are enjoying it. It eliminates so many barriers because of commute time or child care. A new mom can nurse her baby and take care of her responsibilities, while still getting the help that she needs.
How has Spruce helped you run your practice?
I’m grateful to Spruce. When I first started looking, it was more expensive than the other options I was considering, but as my practice has grown, it has been quite nice. It’s a good way to talk to other therapists without having to text each other directly. It allows my team to communicate while still having professional boundaries. We can talk about clients without breaching confidentiality and while keeping it secure. I appreciate being able to send my team a message.
The telehealth function has also been nice. Our EHR has a video platform, but it doesn’t work all the time. We do many of our telehealth visits through Spruce, and they have been really nice.
What are your favorite Spruce features?
I like the team messaging and the patient secure messaging feature. Patients don’t have to send us emails and can communicate directly with their therapist from their phone. I also like having the ability to video call my patients as well.
If someone wanted to reach out, how can they best connect with you?
I want people to know that it’s important for them to go where they feel comfortable, particularly when it feels like the world is imploding and on fire. They should find where they feel most authentic, and that may be East Towson or somewhere else, and that’s perfectly fine. Everyone needs to be affirmed, but particularly people of color. They need to find a place with people who will understand them.