When the Minnesota Department of Human Services emailed True Thao to tell him he’d been chosen to receive an Outstanding Refugee Award, he first thought it was some kind of a scam.
“I wasn’t sure what to make of it,” Thao admitted with a laugh. “There is so much on the internet these days that’s not true. I actually thought someone was playing a prank on me.”
True didn’t respond for several days, until he heard from Jaime Ballard, one of his colleagues at the University of Minnesota’s Department of Family Social Science immigrant and refugee research team.
“Then I knew it was the truth,” he said. “I finally responded to the email and said, ‘Thank you. And I’m humbled.’”
This kind of response is in keeping with the generally humble approach that Thao has taken for the more than two decades that he has run True Thao Counseling Services, a private practice providing mental health services and other support to members of the Twin Cities refugee community.
Ballard said that she and her colleagues at the university were inspired to nominate Thao for the award because they felt that his efforts to support the mental health of Minnesota refugees deserved recognition. “True is extremely humble and extremely focused on strengthening his community. He’s not in it for himself. He’s in it for the community.”
Thao, who is Hmong, came to the United States as a refugee in 1976 at age 11. Since settling in the Twin Cities in 1995, he’s dedicated himself to providing counseling services to people who’ve come to this country fleeing persecution.
Ballard said that one of Thao’s greatest strengths as a therapist is the way he draws from his personal history to understand and support his clients. “One of his strengths is he understands how your mindset can be impacted by your experience being a refugee,” she said. “That helps him help his clients.”
Inspired by an older brother, Thao earned a master’s degree in social work. When he arrived in the Twin Cities, he worked as the director of a small nonprofit for a couple of years before opening a solo counseling practice. He wanted his practice to take a different approach from what he’d seen in most Western-focused clinics. He wanted to combine his Western training with his cultural values.
“My office is nothing like your traditional private practice,” Thao said. “It is more like a community center.” While the focus is on supporting his clients’ mental health, Thao also centers on supporting them in other areas of their lives. “I do clothing drives. I do advocacy with landlords when my clients say, ‘My house has no heat.’ You can’t do mental health when basic needs aren’t being met.”
Because he takes a non-Western approach to mental health support, Thao explains that his clinic, which is temporarily operating remotely because of COVID-19, doesn’t look like other mental health practices.
“It’s not exactly a beautiful setting. I like to have a lot of food in my waiting room. I like to play videos about farming from the old days. My Karen clients come in and say, ‘That’s what we do at home.’ It helps them feel at home and comfortable. My clinic is very different in that aspect.”
Nikki Farago, Minnesota Department of Human Services assistant commissioner for children and family services, said that her agency selected Thao for the award because of his long history of service to refugee communities in Minnesota and other states where he’s lived.
“For nearly 30 years, True Thao has used his cultural insight and expertise to guide and counsel other mental health practitioners to better support Minnesotans from many different backgrounds, including those who arrived here as refugees,” Farago said. “We recognize Mr. Thao’s contributions in making the field of mental health care more sensitive to the different experiences and perspectives of everyone who calls Minnesota home.”
‘This is not the only option’
While he was trained in a more Western approach to mental health counseling, Thao said he has always made a point in his interactions with clients from non-Western cultures to tailor his treatment approach to their world view. He believes that no single culture knows the best approach to mental health care. An approach that might feel strange or unbelievable in some cultures might actually be healthy and useful in another.
When a client expresses discomfort with the standard “therapist-in-the-chair-patient-on-the-couch” approach to counseling, Thao explained, “I will say, ‘This is not the only option. You are more than welcome to explore your cultural traditions to see what you think works best.’ The truth is, we really don’t know which approach is more likely to work for each individual.”
For some clients, like those from the Hmong tradition or other Southeast Asian cultures, Thao explained that there is a belief in shamanism or messages that are being sent through a person’s body and psyche that could dictate their future actions. Take, for instance, Hmong clients who see panic attacks or anxiety as a sign that they could be being called to become a shaman.
“A few of my clients have seen that as an explanation for their anxious behaviors,” Thao said. He advises them to talk to elders and decide if this is the answer to their problem: “Some don’t come back, and maybe they have become shamans. Others do come back to me and then we move ahead with working to tackle their anxiety.”
Often, Thao said, Southeast Asian refugees consider seeing a mental health professional as part of a larger campaign for wellness: “When they do seek help, many believe that a mental health provider like myself is part of the continuum of treatment, maybe toward the end of the process. First, they seek out herbalists, shamanism, a priest, maybe a medical doctor. The medical doctor might say, ‘Go to True Thao.’ That’s how they end up with me.”
Thao’s client population is not limited to Southeast Asians. He’s worked with people from many refugee communities, including a number of individuals from Africa.
“I’ve had the honor of working with Somali clients,” Thao said. Western-style therapy is mostly unknown in Somali culture, he explained, so he approaches mental health treatment in a way that his clients are more comfortable with. “If they say they want to see their imam as part of their treatment, I’ll say, ‘Go see your imam.’ I am open to working with my clients as they explore all the options that best suit their culture.”
While the chosen approach to therapy differs among his refugee clients, Thao said that most struggle with similar mental health concerns.
“The three primary issues I see my adult clients for are depression, anxiety and trauma,” he said. “In our treatment, we talk about reactions to life events. We talk about what happens in the brain. We help them to feel like they are not going crazy, that actually these responses mean their body is working really well. I explain that their mental health issues are a normal reaction to their life experiences.”
Catherine Solheim, professor and director of graduate studies at the University of Minnesota’s Department of Family Social Science and one of the people who nominated Thao for the award, said that she’s always been impressed with his holistic approach to mental health.
“Our vision of working with refugee families is to see them holistically in all the parts of their lives and True is really a leader in this. We learn a lot from him in that when he sees families he sees not just the trauma or the psychological issues that they are wrestling with but he also sees the real-life day-to-day struggles that they’re facing and how those things impact their emotional and psychological well-being.”
Thao, Solehim added, brings his own life experience to bear in his work, and that approach has helped many of his clients build happy and successful lives in their adopted country.
“True sees the families in his practice in their whole,” she said. “As someone who was a refugee himself many years ago and who is now very successful, he has a unique viewpoint that his clients truly appreciate.”
Thao said that his childhood was good background for a career in mental health.
“Growing up as a refugee kid among adults who at first struggled to speak English, you are often asked to help interpret for parents and other relatives,” he said. “Because of that, you naturally lean toward the helper, bridge roles.”
His family’s first home in the United States was in Providence, Rhode Island. They lived there for several years before relocating to the Wisconsin cities of Appleton, Milwaukee and Whitefish Bay. In 1995, Thao and his parents moved to the Twin Cities.
“In the Hmong culture, the parents live with the baby son,” he explained. “So when Mom and Dad say, ‘I think we are going to go to Minnesota and spend time with the other children,’ we just left.”
During college Thao got a full-time job as a bilingual mental health worker at program for Southeast Asian refugees.
“The focus was Cambodian, Laotian, Vietnamese, Hmong,” he said. “In that capacity I encountered a lot of mental health issues where clients had the symptoms but did not have the background to understand what was really happening. That triggered me to pursue a degree in social work with a focus on mental health. I wanted to be able to help people understand how they could be helped through counseling.”
Thao is all too aware that therapists of color are still rare in Minnesota: “There have been a number of studies that showed that the number of mental health professionals that are refugees, immigrants or people of color is very small,” he said.
People unfamiliar with mental health care see great benefit from working with professionals who have similar life experiences and ethnicities to them, Solheim said. That’s one part of what makes Thao so impactful to his clients.
“I really wish we had many more therapists like True, therapists that come out of the community and understand their unique issues.”
Thao agrees with this assessment. He’d like to see more mental health professionals that came from immigrant and refugee communities.
“Refugees understand that you don’t need to pathologize refugees,” he said. “We’ve lived through similar experiences and because of that we understand that refugees are going through a lot of transformation in a short period of time. Our personal experience helps make us that more impactful in our interactions with our clients.”
COVID-19 has forced Thao to make significant changes to his practice. Like most mental providers in the state, he moved all therapy sessions to telemedicine after the statewide shutdown this spring. That move meant that he lost many of his clients, who were older and have limited access to or comfort with technology.
In June, he made the tough decision to close his office.
“We were paying the rent but not going in,” Thao said. “I’ve had this office since 1997. I am going through my own grief and loss.” He plans to reopen his in-person practice after the pandemic dies down: “I will have to have a clinic again. It is just a matter of time.”
In the meantime, True Thao Counseling services has become a community partner agency with St. Paul Public Schools. He offers remote mental health counseling to children from refugee families.
“I would say probably about 75 percent of my work now is with St. Paul Public Schools,” he said, adding that he’s still seeing some adult patients from his original practice, and he’s working to help shift his older clients online.
And he’s making plans for a brighter future. Solheim recalled a recent conversation she had with Thao about a new practice model he’s developing.
“True doesn’t settle for things,” Solheim said. “He’s always looking for new ways to reach families. The other day, he said, ‘I’ve been thinking about how it could help to make the mind-body connection through yoga. What if I opened a one-stop shop?’” Thao, Solheim explained, is now working to expand this idea, building a wellness center where clients could get financial education, community support, movement, mindfulness and therapy all in one place: “He’s always thinking ahead and thinking about new things that could help the community.”