Students perform at Beats Rhymes and Life’s annual summer festival in Arroyo Viejo Park, Oakland. (Photograph by Diane Bezucha, courtesy of Tomás Alvarez) 

Tomás Alvarez thought it would be easy to connect with students when he became a social worker at Berkeley High School in Berkeley, Calif., in 2004. After all, he was a young man of color who had grown up on urban music and culture—much like the adolescent males he would be counseling. He thought that offering them a space to talk about their problems with somebody they didn’t know well would be welcome. He soon discovered otherwise.

“For a lot of communities of color, that idea of therapy is not one that really resonates,” says Alvarez. “It’s a foreign concept.” The cold reception he received from the students might have put off other counselors, but Alvarez was undeterred; he just kept looking for ways to connect. Observing the young men throughout the school day, he soon identified one possibility. “What I noticed was that these same young men that were on the verge of getting kicked out all identified with hip-hop visibly in their dress and their speech,” he says. “At lunchtime, I saw them hanging out with each other, and what were they doing? They were rapping.”

Alvarez thought that if he could incorporate hip-hop culture into his approach to therapy, he could connect. This time, he did. Flash forward 12 years, and today Alvarez is an advocate of hip-hop therapy, an approach to counseling that utilizes hip-hop cultural elements to provide treatment to youth with emotional trauma and other mental health conditions. In 2011, he helped establish Beats Rhymes and Life (BRL), an Oakland-based nonprofit organization serving youth ages 12 to 24; and in 2016, he founded the Hip- Hop Therapy Global Institute, which brings together clinicians, artists, scholars, and foundations to advance the practice of hiphop therapy worldwide. (He is also a SEERS Fellow at the Program on Social Entrepreneurship at Stanford University.) For Alvarez and his contemporaries, hip-hop has proved to be a vital resource for connecting with marginalized youth who might otherwise have difficulties opening up in traditional counseling settings.

The Catalyst for a Larger Mission

Alvarez says his initial work combining hip-hop and counseling became the catalyst for his larger mission after he noticed that students were registering improved attendance and after-school participation. His experience was confirming the findings of a 2001 US Surgeon General’s report detailing the disparities of mental health care and race, which noted that “[c]ulture influences many aspects of mental illness, including how patients from a given culture express and manifest their symptoms … and their willingness to seek treatment.”

“I realized I had something that I couldn’t walk away from,” says Alvarez. “This [approach] could potentially help me and others to engage young men of color—who have been historically disenfranchised from our mental health system—to get the support that they need so that they don’t end up in the juvenile justice system.” Unfortunately, for a lot of young men of color, the first opportunity they have to access mental health care comes after they’re already in the juvenile justice system, Alvarez notes.

BRL’s formal outreach begins with recruitment and screening for entry into services called Therapeutic Activity Groups (TAGs). Once enrolled, youth meet biweekly with clinicians and hip-hop artists at schools or community sites for sessions usually lasting 12 to 18 weeks. Afterward, some young people are referred to a more intensive service that meets at mental health facilities for a period of time ranging from 18 weeks to one year. These services culminate in the production of a group album and a showcase event where enrollees perform their own original songs.

BRL Alumni—Healing Themselves, Healing Others

For a lot of students, BRL is unlike any other type of program they’ve seen. Ben White, for example, says that recreational activities hadn’t reached him, and neither had other programs at his school. He gave BRL a try when he was 17, after seeing a flyer advertising the program.

Now 26, White reflects, “A lot of teenagers go through a very awkward phase, and it’s hard for them to express the emotions that they go through. Myself, I just didn’t know what to do with everything that was going on in my life.” BRL’s counselors helped him to tap into his inner hip-hop lyricist to express his own apprehensions, and helped him to vocalize his thoughts on societal problems. He was also able to use his newfound ease with expression on an album put together by BRL. “Putting those emotions through songs and hip-hop really helped me make sense of my own story,” he explains.

White has since earned a BA degree in child adolescence development, and today he is giving back to the organization that helped him find his footing. He is a BRL clinician who helps facilitate youth groups in San Francisco, teaching the language of hip-hop and offering counseling services. “My biggest hope is that people will start to see the utility of hip-hop therapy, and that it gives opportunities for youth of color to heal themselves to the point that they can help others,” he says.

Hip-Hop Wellness

Raphael Travis, an associate professor at the Texas State University School of Social Work, says that one of the reasons hiphop resonates with the youth it aspires to reach is that at its core, its values are about individual and community empowerment. “On a personal scale, there’s an individual essence of identity,” he says, “but there’s this community side that’s always been there, as far as having a critical eye of being aware of what’s going on around you.”

Hip-hop culture was born in New York City in the early 1970s. As the city experienced rapid economic decline and increased violence, South Bronx youth turned in numbers to deejaying, breakdancing, rapping, and creating graffiti art as a way to avoid criminal temptations within their neighborhoods. Hip-hop therapy can similarly come in various forms, though counselors tend to emphasize the rapping element of the culture in particular because of its storytelling nature. Some instructors, for example, conduct “freestyle” rap sessions, long considered the calling card of a highly skilled rapper, to help students convey their feelings. (Freestyling involves the ability to improvise complex rhymes with other participants in sessions called “cyphers.”)

As Ian Levy, a school counselor at New Visions Charter High School in the Bronx, explains, “As men of color, there’s especially a stigma of, ‘I can’t talk about my feelings; I can’t appear weak or vulnerable because if I do, then I’m not going to be successful in the world in which I am living in,’” he says. “If I first met you, and I didn’t know you, I wouldn’t start exploring my feelings with you. But if I was in a cypher, and I spit a verse about an experience that I had that was traumatic, you would be like, ‘That’s dope’ [i.e., ‘That’s great’], and it would be a completely different type of interaction, because there’s a level of cultural credibility within the cypher that substitutes itself for any kind of awkwardness one might have to opening up and being vulnerable.”

Taking a different approach, William Clay, a counselor at Charles Carroll Middle School in New Carrollton, Md., likes to make use of hip-hop videos in sessions with students, in concert with dissecting lyrical content. The song “Runaway Love,” and its video by the artist Ludacris, which deals with sexual abuse, provides one example.

Clay explains how he used three different scenarios of abuse in the video to connect with a female student who herself was a victim. “They had the police come to the school, and they couldn’t get her to talk,” says Clay. “They called me down to the principal’s office, and I told her, ‘I want you to watch this video, and I’ll be back in 10 minutes.’ She [had] watched the video twice by the time I came back to the office. My script was already written in my book, and my first question was, ‘Which one of those girls in the video do you relate to?’ And she told me it was the first girl, Lisa, and from there she opened up.”

Expanding the Practice

Alvarez made the difficult decision to step down from his role as CEO of BRL in late 2015 after helping the organization launch its first headquarters in Oakland. “It was hard to respond to the growing need from outside of the organization and also run the organization,” he says. He launched the Hip- Hop Therapy Global Institute the following month with the intent to meet that need.

“With Beats Rhymes and Life, every year we had a waitlist of kids to get into our programs,” says Alvarez. “The demand always exceeded our ability to meet it, and that’s the case for others who are doing work in hip-hop therapy. An objective of the institute will be to foster and galvanize this ecosystem.”

As practitioners work to make hip-hop a more widely used instrument for therapy, they’re realizing that to succeed, they need to help the mental health community shed any negative assumptions it may hold about hiphop culture. “Education bureaucracies tend to be a little bit more progressive, and so do public health bureaucracies,” explains Alvarez, “but mental health is very conservative.”

Hip-hop therapy’s strongest advocates also recognize the need to develop rigorous ethical standards for the practice, as well as the need to conduct more research to add to the academic literature on the effects of using hip-hop in the counseling process.

Alvarez is optimistic that hip-hop therapy can be not only a reactive method for addressing youth trauma, but also an active one for promoting healthy youth. “The beauty of hip-hop therapy is that it [can] be offered downstream … as a form of treatment [and also] upstream as an early-intervention and mental health promotion tool.”

He is equally enthusiastic that hip-hop therapy is helping youth of color accept and even seek out mental health assistance. “I believe that hip-hop therapy has eradicated the stigma of therapy for youth of color,” he says. “There is no shame in going to hip-hop therapy.” As he notes, “Where else are you going to have a teenager wearing a [BRL] shirt that clearly confirms they are receiving mental health services?”

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