Kasamahan
Nonprofit community enriching Filipino/a/x mental healthcare
Mental Health Blog
Frances Mulcahy, LMFT, began joining the Kasamahan Monthly Consultation Group for licensed Filipino/a/x mental health professionals during the second half of this year, and we are grateful that she did! Frances quickly stood out in her responsiveness and thoughtfulness with group themes, and her ability to move naturally between English and Tagalog while speaking on complex mental health topics. Initially, she was invited to explore a possible group entry on how being the bunso may shape the way Filipinas provide therapy, a perspective that contrasts with the more normalized experiences of eldest daughters naturally stepping into careers in healthcare including those shared by previous blog authors, Roanne and Charlene.
In connecting with Frances outside of the group, it became clear that her journey has more fascinating elements to highlight such as being a Filipina American that both immigrated to the U.S. and became a therapist later in life. Her lived experiences brought her to to where she is today, providing a bridge between cultures while also walking with her second generation Filipino American clients as a first generation Filipina American therapist in a parallel process of decolonizing the self.
12 | Empowering Second Generation Filipino/a/x Clients as a First Generation Filipino Therapist
Published December 4, 2025
What would like us to know about your professional mental health background and the therapy you provide?
Frances Paola Mulcahy, MA, LMFT she/her
Licensed Marriage & Family Therapist
San Francisco Bay Area, CA
I'm a Filipina bilingual Licensed Marriage & Family Therapist, and I have the privilege of working with clients all across the Bay Area and California. I received my Master’s in Counseling Psychology from the University of San Francisco and began clinical practice in 2021. My work is deeply rooted in community mental health (CMH) and my foundational experience came from serving survivors of intimate partner violence in a non-profit setting, which remains a cornerstone of my approach today. I transitioned out of my CMH work in October and I’m now in group practice full time.
My specialty is providing trauma-focused care for the Filipino/a/x community, as well as the larger AAPI and BIPOC communities. In my clinical work, I primarily use an integration of Eye Movement Desensitization and Reprocessing (EMDR) and Dialectical Behavioral Therapy (DBT), and I'm also learning to integrate Decolonized and Indigenous Psychology into my practice. It's a joy to work with my clients, many of whom are first and second-generation Filipino/a/x, and I offer therapy in both English and Tagalog.
What would you like to share about your Filipino/a/x background and identity?
My experience as an immigrant is at the very heart of my work. I was born and raised in Manila and moved to the US in my early 30s, joining my parents who had immigrated ahead of me. Like so many of us, mine is a transnational Filipino family—my brother is still in Manila, and our relatives are spread across the Philippines, the US, and other parts of the globe.
This experience, along with being a therapy client myself, deeply informs how I practice. You might think that since I spent most of my life in the Philippines, I’d feel completely secure in my identity. But the truth is, I often navigate the exact same identity issues that many of my second-generation clients face—especially that feeling of not fully belonging, either here in the US or back home.
May you elaborate on the ways your lived experiences growing up through your young adulthood have informed your decision to pursue therapy as your second career?
My path to becoming a therapist is deeply personal. I'm the youngest of two, but with my brother being seven years older, I often felt like an only child. My childhood was frequently lonely, defined by the tension and conflict in my parents' marriage. This environment taught me to be a sharp observer; I became skilled at reading non-verbal cues and naturally slipped into the mediator role. I didn't realize it at the time, but those early experiences were shaping me into the highly-attuned, deeply-feeling, and intuitive person I am today.
I've always been insatiably curious about why people do what they do and this curiosity only grew when I had a short stint as a preschool teacher, wondering how my students would turn out as adults. Thanks to the encouragement of a mentor, I decided to pursue a Master’s in Developmental Psychology program at the University of the Philippines and completed one year before moving to the US. Though my path was interrupted, my interest in psychology never waned; it evolved.
I originally came to the US for a relationship that I soon realized was abusive. My experience with intimate partner violence is what led me to seek help at a domestic violence agency, which is where I first received therapy. Therapy provided me a chance to explore my ambivalence about the relationship and once I decided that I would leave my abusive partner, I was able to receive support in being able to leave the relationship safely. Once I was able to safely exit from it, I transitioned to working with a long-term therapist who helped me understand myself better and recover from that very traumatic experience. Benefitting from therapy for almost a decade is what led me back to my interest in psychology and gave me the courage to pursue my Master’s in Counseling. Had I stayed in the Philippines and pursued being a Developmental Psychologist, I probably would’ve ended up doing research and teaching, but my move to the US and pursuit of Counseling Psychology has allowed me to provide direct clinical care to folks in the community.
Before becoming a therapist, I had a whole other career in tech, non-profit, and corporate settings, exploring roles in DEI, marketing, operations, and people management. I'm proud to be the first in my family to transition to a career in mental health, and it has been so meaningful to see my choice encourage others in my family to consider this path, too.
In your transition to primarly see Filipino clients working through intergenerational trauma, what are some general themes and patterns that you notice in their therapy process with you?
As I've focused more on my work with fellow kababayans, I've seen several powerful themes emerge around identity, belonging, and intergenerational trauma. So often, the work begins with clients wrestling with a core set of fundamental questions. They're asking things like:
"Am I Filipino enough?"
“Why can’t I relax? How can I feel safe?”
"How can I possibly respect my family and set boundaries with them?"
"How do I even begin to encourage my family to explore therapy?"
"What do I do with all this rage I feel? Where did this come from?”
"How do I pursue what I want, not just what my family wants for me?"
As I start to unpack these questions, clients often find they are deeply tied to common cultural themes. We find ourselves exploring the weight of “utang na loob” (the invisible debt of gratitude), the constant tension between “pakikisama” (getting along) and true “kapwa” (fellowship; unity of self and other), debilitating perfectionism, hypervigilance, and the impact of anxiety and caregiver burnout. We also name the very real impact and echoes of colonialism and war on our families and nervous systems.
My clients, more often than not, realize that their struggles are so often rooted in the transmission of unresolved intergenerational trauma. Many of them grew up in authoritarian households—homes where many of their emotional needs were unmet, often because their caregivers were also carrying their own unprocessed trauma. It's that pain, accumulated from layers of environmental and sociopolitical stressors, passed down by caregivers who were carrying that pain themselves.
Although many of your clients are second generation, what are ways you connect or even learn through their experiences as a Filipino therapist who immigrated to the US as an adult?
It’s been really interesting to discover that, even though many of my Filipino clients only partially speak Tagalog, they often seek me out specifically because I'm a native speaker. It creates this flexibility in the therapy room, where we can naturally slip into "Tag-lish" whenever it feels right or relevant.
I initially expected that linguistic fluency (being a native speaker) would be the primary advantage. What surprised me was how often the most significant "Aha!" moments didn't come from translating complicated concepts, but from the sudden, powerful clarity of a single, untranslatable Tagalog word (like tampo or gigil). The true value wasn't just translation, but validation. This showed me that often, the therapeutic goal is not finding an English equivalent, but sitting with the felt sense of that cultural emotion, which is a key part of processing the cultural self.
Having this shared culture creates such a valuable shorthand. A good amount of the time, I might know what they mean when they talk about their mom giving them "a look" (as in “you’re in trouble” kind of a look), or even when they use a phrase like "yung ano ni ano"—if I have enough of their family history, I can often pick up the narrative. I also understand the differential acculturation conflicts inherent in Filipino multigenerational households—tensions between the collectivist values (e.g., utang na loob, hiya) of the 1st generation and potential westernized, individualistic drives of the 2nd and 3rd generations can present as clinical anxiety, chronic guilt, or difficulty establishing healthy boundaries.
Since the training you received and the modalities you mentioned earlier are not specifically tailored to a Filipino cultural experience, what are creative ways informed by your lived experience, that you are supporting your Filipino clients?
I think one way I leverage my Western Psychology training is to provide psychoeducation on trauma and how it affects our nervous system. When they are able to make sense of their experience through the lens of neurobiology, I observe that clients often find it helpful to have more ways to describe their experience, especially when they’ve been told that they’re too sensitive or “OA” (as in over-acting, which is a Filipinism for being dramatic). I use culturally-relevant metaphors when providing psychoeducation to help clients understand their bodily response to distress. For example, I often use the metaphor of being stuck in fifth gear to illustrate being stuck in a hyperarousal state, which often resonates with Filipino clients who have driven a stick shift back home.
Another example of tailoring my approach to Filipino clients is providing self-affirmations in Tagalog. I remember one particular session where a client asked me to specifically provide Tagalog affirmations and we explored how it might cultivate a felt sense of empowerment. This client, who had been struggling with powerlessness, was so deeply moved upon reciting the affirmations below in Tagalog:
Mahalaga ako at may halaga ang aking presensya.
(I am important and my presence matters.)
Tinatanggap ko ang aking sarili nang buo at walang pag-aalinlangan.
(I fully accept myself without hesitation.)
Kaya kong harapin ang kahit anong hamon.
(I can face any challenge.)
It was an eye-opening and moving experience for both my client and I, as it was my first time expressing Tagalog affirmations out loud. It has been a practice for me since then.
Are there western clinical interventions that you learned from your training that may be helpful for Filipino clients and therapists to learn about?
When clients come to me, they're often looking for support in two main areas: needing more coping skills in their toolbox or seeking deeper trauma resolution.
For that in-the-moment, "I need help now" support, I find DBT to be incredibly useful. And for processing the deeper trauma, many clients have experienced profound relief from EMDR.
My training as a domestic violence counselor means I'm also equipped to explore relationship dynamics and issues of power and control. (I've found that using culturally-appropriate adaptations of the power & control wheel can be so illuminating for clients.) This, of course, flows right into attachment-based work, which is essential for exploring our attachment styles and working towards more secure ways of relating—especially that crucial concept of repairing through conflict. I also find somatic interventions and parts work are invaluable for helping clients navigate their internal worlds and heal their attachment system.
Ultimately, my approach is highly relational and being able to speak Tagalog helps establish therapeutic alliance and rapport. I'm always aiming to provide corrective experiences right there in our therapeutic relationship. This means constantly tracking for that tendency to “fawn” and giving clients opportunities to make choices and use their voice with me. That, right there, is what I find builds a stronger, more authentic relationship and leads to those positive, lasting outcomes.
To learn more, here are some resources I find helpful:
Brown Skin, White Minds: Filipino -/ American Postcolonial Psychology
Filipino American Psychology: A Handbook of Theory, Research, and Clinical Practice
Coming Full Circle: The Process of Decolonization Among Post-1965 Filipino Americans
EMDR Therapy and AAPI Populations
Power & Control Wheel in Tagalog
How to Successfully Navigate Cultural Challenges with Filipino Clients
What are you hoping for in continuing to work with therapy clients as you transition into full-time private practice?
Looking ahead, my real hope is to continue growing in my personal identity and decolonial work. My journey in understanding myself and our Filipino community is constantly evolving. I recently went home to the Philippines and experienced a guided tour of Intramuros, which reminded me of the enduring trauma of colonization on our people and what it took to gain independence. Paired with the genuine hospitality and kapwa spirit of the Filipinos I met, it was a powerful experience of reconnection that often moved me to tears. This particular visit also brought into sharp focus the contemporary struggles against destructive forces, both natural and man-made, like corruption. One of the highlights of my trip was meeting cultural critic Katrina Stuart Santiago, whose work inspired me to delve into books by Filipino authors exploring both Indigenous and mainstream culture. These moments weren't just about learning facts; they were profound reminders that for our community, this re-engagement with our narrative is a vital form of cultural affirmation and healing—a way to reclaim our story and find belonging in the narrative.
My ultimate goal is to provide truly culturally-responsive care for our Filipino/a/x clients, and I'm on a journey to learn how to meaningfully integrate my training in Western modalities right alongside Sikolohiyang Pilipino. I know this is a lifelong commitment, and that’s exactly why I’m so grateful to be with the larger Kasamahan community.
Is there anything else that you would like to share?
As the psychologist E.J.R. David reminds us, "Our strength is in our kapwa - our shared identity, our shared humanity."
That's the spirit I want to bring to this work, and I'm so grateful to be on this journey with all of you.
To connect with Frances, you may reach out through www.francesmulcahytherapy.com
If you are are also a Filipino/a/x therapist, you may find her at a future Kasamahan Consultation Group meeting.