The Cost of Healing in Silence
Navigating Racial Trauma and the Call for Culturally Responsive Care
1. Edition March 2026
224 Pages, Softcover
Wiley & Sons Ltd
An up-to-date and expert discussion of how to create a more culturally responsive mental health care system
In The Cost of Healing in Silence: Navigating Racial Trauma and the Call for Culturally Responsive Care, veteran psychotherapist and trauma specialist Ashley McGirt-Adair delivers an effective roadmap for culturally responsive mental health care that acknowledges, understands, and begins to heal the ways racial bias and stereotypes infiltrate counseling. Blending contemporary research, practical tools, and searing personal stories, McGirt-Adair offers both a personal narrative and a comprehensive guide to more equitable mental health care.
The Cost of Healing in Silence offers techniques for culturally responsive care that demonstrates how mental health care can be improved by offering therapy that is reflective of and sensitive to a range of identities. McGirt-Adair helps readers uncover the impacts of racial trauma and navigate the scars it leaves behind, offering culturally attuned techniques for healing and restoration that honor identity and community.
You'll also find:
* Actionable guidance for recognizing and addressing racial bias in therapeutic settings
* Inspiring amplifications of marginalized voices, including those whose pain has often been overlooked and dismissed
* Strategies for improving access to Black therapists and implementing changes that prioritize cultural responsive care
Perfect for people of color who have faced discrimination, bias, or unequal treatment in healthcare settings and are seeking guidance on how to heal from these experiences, The Cost of Healing in Silence is also a must-read for healthcare professionals, educators and allies committed to transforming healthcare into a more equitable system.
Opening Note: A Message to the Reader xiii
Chapter 1 Spanish Harlem 1
Chapter 2 Liquor Stores on Every Corner 21
Chapter 3 Cracks in the Foundation 41
Chapter 4 The Price of Silence: A Grandmother's Final Struggle 69
Chapter 5 Safe Enough to Speak: Stories Held Gently--Janelle's Story 91
Chapter 6 The Weight of Racial Trauma 101
Chapter 7 In the Absence of Reflection 111
Chapter 8 Misnamed Shadows: When the Blues Turn Silent 137
Chapter 9 A System Not Built for Us 155
Chapter 10 The Power of Being Responsive 167
Chapter 11 Tending to the Wound 175
Resources and Next Steps 183
Acknowledgments 187
About the Author 189
Index 191
"In The Cost of Healing in Silence, Ashley McGirt-Adair delivers a courageous and transformative call to break cycles of pain and isolation. With truth, tenderness, and conviction, she shows that our healing, both individual and collective, begins when we dare to speak, to feel, and to reclaim our wholeness."
--Uché Blackstock, MD, Founder and CEO, Advancing Health Equity; New York Times best-selling author of Legacy: A Black Physician Reckons with Racism in Medicine
"The Cost of Healing in Silence is a powerful guide for anyone navigating racial trauma or working to build systems worthy of our communities. Drawing from deep clinical expertise and lived truth, Ashley McGirt-Adair offers a rare blend of wisdom, vulnerability, and practical tools that make this book as healing as it is essential."
--Marcus Harrison Green, journalist and author of Readying to Rise
"Ashley McGirt-Adair offers a powerful and much-needed contribution to our understanding of racial trauma. As a leading expert in this work, she brings clarity to the historical and generational battles our community faces, blending scholarship and lived experience in a way psychology has often missed. Her storytelling is rich and deeply human, giving readers both language and healing. This is a timeless work that will empower generations."
--Dr. Patrice N. Douglas, Licensed Psychologist and LMFT; Founder and CEO of The Weight Room
"In this powerful and deeply necessary book, Ashley McGirt-Adair writes with the clarity of a scholar, the heart of a healer, and the courage of someone willing to speak the truths most would rather bury or simply erase. She reminds us that healing is not just about survival. It is about joy, belonging, and reclaiming our right to feel. The Cost of Healing in Silence is both testimony and scholarship; a gift to those who live with the daily realities of weathering and to anyone committed to building systems where Black wellness is possible."
--Arline T. Geronimus, ScD, author of Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society