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A Conversation With Dr. Beverly Greene About Marginalization and Mental Health

I spoke with Dr. Beverly Greene about how marginalization impacts mental health, why it’s important for therapists to understand this, and how clients can identify what they believe about themselves and why.

Dr. Greene, PhD, ABPP, is a Professor of Psychology at St. John’s University and a practicing clinical psychologist in New York City. She is the author of over 100 scholarly publications, twelve of which have received national awards for making significant contributions to psychological literature. Dr. Greene’s work advocates for a greater understanding of the intersections of race, gender, sexual orientation, and social marginalization in psychotherapy.

You advocate for—and practice—a political and social consciousness in therapy. What is lost when a therapist doesn’t consider the impacts of marginalization on a person, or how someone’s cultural framework affects their worldview?

I don’t think you can have a full understanding of who your patient is if you’re looking at them in a decontextualized fashion. People are products of an interaction between themselves and their environment. Just as they have an impact on their environment, the environment has an impact on them. It shapes their behavior, informs what they think and how they see the world.

Social marginalization requires psychological energy. I try to think: “What does this person have to do every day to be sane in the world?” If you think in terms of LGBTQ people having to be secretive about their sexual orientation—what does that do to a person? How can they live if they have to keep a large part of their lives secret, and if they’re taught to regard it as something wrong about them?

When you make an assessment about what people do—or how they make choices about what they do—first you have to ask yourself, “What choices do they have?” They can’t act on choices they don’t have.

When working with anybody, but especially marginalized people, it’s important to figure out: how do they deal with the hand they are dealt and what did that hand look like? How were they dealt that hand?

Yeah, this makes me think of another question I had about how people are often pathologized for their reactions to marginalization. For someone who might not understand how this can show up in therapy, can you explain?

Sure—you can see someone as appropriately hypervigilant or paranoid. For some people, what has traditionally looked like paranoia in racially marginalized group members is an appropriate level of hypervigilance. If you look at ethnoracial minorities, their physical embodiment is apt to elicit a range of reactions from people that they have to be prepared to manage.

You have to be aware of it, so that you know enough to stay away from situations where you may get hurt or face hyper surveillance. If you go into a store and you’re hyper surveilled, it helps to know that that’s going on.

Yeah, it’s self-protection.

Exactly, it’s about being appropriately aware of your environment. If you don’t know anything about what the person’s environment is like, it’s premature to make assumptions about what that means.

I read that you support people—especially people with multiple marginalized identities—in recognizing what they’ve been told about themselves and what they really believe. Could you explain that process? How do you help people parse out deeply ingrained beliefs that don’t really align with themselves?

I think in part, good therapy does that with anybody. We’re not born knowing who we are; we learn those things. It’s important to help people get a sense of: ‘How did you come to believe what you believe? Where did you learn that? What makes it ring true or not? Are the places you learned that reliable? Who are you outside of how somebody else sees you?’

That’s part of therapy, because everybody has internalized something that is based on someone else’s need to see them a certain way. With marginalized groups, you’re talking about social structures that have presented people with denigrating, distorted images of themselves. You have to be judicious about what you believe and where that’s coming from.

Black families have needed to give their children more realistic pictures of who they are; part of their having to manage racism is managing other people’s distortions of them, but they have to learn that those distortions are not who they are.

And in the therapy room, does that look like kind of slowing down and questioning where a belief might come from?

When you discuss with patients how they view themselves and others, you want to ask, ‘Well, where did you learn that? When was the first time you heard that about yourself? Who said that? Did they say it, or was it communicated in some other way? Does that source have an investment in viewing you in a certain way that is connected to how they see themselves? Are they operating out of a negative personal bias?’

When it comes to marginalization, you do a history of that person’s marginalized identity. For instance, what was the earliest memory they have of their racial identification? What was the nature of that situation? Was it something somebody told them or was it embedded in some incident?

Next, it’s when did they understand what that meant? Black children realize they’re Black far earlier than they necessarily understand that in a conceptualized way. That’s just what they are, that’s what the family is, but what does that mean? The meaning is very important to understand—when that occurred and how.

I ask them about their first memory of racism. Who did they talk to about it? If anybody, because that tells you whether this was something that could be talked about. When you’re taught not to talk about certain things early on, that doesn’t just go away.

The other questions I ask are: what is the worst situation they’ve encountered as a function of race, and what was the most recent? How did they feel about it? How did they respond? How were they taught to respond? Did the people that taught them to respond do that, or did they do something different?

Often, families tell people, “Do as I say, not as I do.” Well, before kids understand what you say, they’re watching what you do.

Yeah, they’re noticing things early on.

Yeah, and they’re forming their own conclusions—based on the limitations of their cognitive and emotional development—to try to explain what they’re seeing. Especially if they’re not talking to anybody about it.

I think those are important things to do in therapy. One can apply that analogy to any racial group, as well as to sexual minority individuals. When did a person first become aware of what came to be understood as a same sex attraction? What did that mean? How did they feel about it?

It’s really important to explicitly consider the development of identities. And you may find that people don’t believe you about your experiences, so you make a point of developing networks of people who understand, who you can talk to. A therapist should be one of those people.

How (or does?) your work as a therapist inform your teaching?

It has completely informed my teaching. The first ten years of my career, I was working in inpatient child psychology at King’s County hospital, and also for a time for the Board of Ed. In community mental health as well as private practice, I came to understand that practice is like the mash unit and the university is the officer’s club.

Of course I value research—I’m a university professor—but in the therapy room you’re not responding to data points. Even when people belong to the same group, every human being is unique. How that person understands their situation, or assesses the choices they have, may be very different from a person who is a member of the same group who has similar experiences.

Yeah, I appreciated a lot just reading things you’ve said about how being part of a group impacts someone, but that it’s so individual.

Yeah, because that person has a family and a history of individual experiences that shapes their sense of whatever group they’re in. Not all families are alike. What kind of help and support children get as they’re developing and trying to navigate all this is complicated for parents as well. It’s an extra layer of things, on top of all that is involved in being a parent.

I read that you’ve written 11 books and close to 100 publications. Are there any that stick out to you that would be particularly helpful for our blog’s audience? The audience is largely people who are entering addiction or mental recovery. And there might be some people that came to treatment and want to work in the field. Are there any you would recommend?

There’s one, Psychotherapy with African American Women: Innovations in Psychodynamic Perspectives and Practice, that I edited with Leslie Jackson, who is now deceased unfortunately. But I think it may still be the only book organized around Black women who are therapists writing about psychotherapy with Black women. So, I think that is something people may find helpful.

Also, something called A Minion of Women: Family Dynamics, Jewish Identity and Psychotherapy Practice. I asked 25 women who were practicing psychotherapists—and who self-identified as Jewish women—how the dynamics in their family shaped their identity as Jewish women, and how that gets expressed in their practice of psychotherapy.

Is there anything we didn’t talk about that you want to add?

I have a couple projects underway. One is called Threading Needles in the Dark, Wearing Gloves: How Mothers of Black Children Have the Talk, Then Walk the Walk. It’s about developing a deeper understanding of what mothers of Black children carry emotionally, and how that extends well into the adulthood of their children. It’s told through the eyes of women who are raising or raised Black children and what that felt like.

I’ve had a couple groups; one of them we presented to the Ackerman Family Therapy Institute, and it is on YouTube. It’s about how having the talk isn’t a one-time thing; it really encompasses the racial socialization of Black children.

So, it’s all about having a capacity to step outside one’s reality and see that for another person, things may be very different. You might stand in the same place, but how you are treated and what you have to manage may be very different.


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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.


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Mark Gold
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.


Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.


Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.


Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.


In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.


Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”


Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.


McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.


As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.


“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”


McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA


Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.


The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.


Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.


Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.


In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.


Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.


“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.


Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.


Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA


Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.


The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.


With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Corporate and Charitable Leadership

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Personal and Educational Background

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.