Tag Archives: Multiculturalism & Diversity

Multiculturalism & Diversity

Addressing the invisibility of Arab American issues in higher education

By Souzan Naser February 5, 2021

COVID-19 has wreaked havoc in just about everyone’s life, and it is not lost on me that individuals are deeply feeling the cost of this pandemic. Too many people are grieving the loss of loved ones, recovering from their own illnesses, suffering from food and housing insecurity, and coping with depression, anxiety and isolation. As we begin to settle in with a new presidential administration, we can begin to have a glimmer of hope that our country will take a more aggressive approach to managing the spread and treatment of COVID-19.

For me, the impact of the pandemic has been less severe, and I feel especially fortunate. I was reaching the midpoint of my sabbatical when the virus took hold and shelter-in-place orders were issued. Like many of those reading this article, I was scheduled to attend the April 2020 American Counseling Association Conference in San Diego, and I was thrilled to have been given the opportunity to present and facilitate a workshop. My presentation, adapted from my doctoral research, was to examine the paucity of Arab American cultural competency training available for college counseling professionals. I also planned to unpack the contemporary needs of Arab American students, their expectations when meeting with a counselor, and the factors that increase their likelihood of engaging with a mental health provider. I am passionate about this research, especially given the lack of adequate mental health services for Arab American students and how this affects their success.

In this piece, my aim is to amplify the micro-level personal concerns of Arab American students who participated in focus group sessions that I led, those whom I counsel and teach, and those more broadly who live in the Arab American community of Chicagoland (Chicago proper and its adjoining suburbs). I will also provide recommendations, based on feedback from students, so that we can keep pace with the contemporary challenges of this population and confidently assist them when they call on us for support while experiencing psychological distress.

Study background

Since 2015, I have been studying the preparedness of community college counselors to effectively engage with Arab American college students. Pre- and post-tests were used to assess counselors’ levels of cultural competency with Arab students. The post-tests were administered after counselors participated in a 90-minute professional development program called Understanding the Arab American College Student.

My study also included Arab American college students, who through a series of focus group sessions offered a rich critique of how the political landscape shapes their experiences and identities. The information they shared also captured the essence of who they are culturally, socially and religiously, and how they navigate their identities at home and school. They also shared the importance of having mental health practitioners who understand their worldview and can be turned to for support.

Background on Arab Americans

Arab American identities are vast and complex, and the Arab American students with whom counselors interact in their offices are just as diverse as the 22 countries these students emigrated from or have ancestral ties to: Algeria, Bahrain, Comoros Islands, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen. Members of this community have been immigrating to the United States since the late 1800s and have long been a part of the fabric of American society, making significant economic, educational and political contributions. According to the Arab American Institute, which is one of the longest-standing Arab civic engagement organizations in the U.S., it is estimated that nearly 3.7 million Americans trace their roots to an Arab country. Although Arab Americans live in almost every part of the U.S., more than two-thirds of them reside in just 10 states: California, Michigan, New York, Florida, Texas, New Jersey, Illinois, Ohio, Pennsylvania and Virginia.

There are many assumptions about Arab Americans that can interfere with the therapeutic process and alliance. For instance, Arab and Muslim are not synonymous; in fact, over 60% of Arabs residing in the U.S. are Christian, not Muslim. Arab Americans may be first, second or third generation. Some are fluent in Arabic and English, whereas others may speak only one. Another commonly held misconception revolves around the citizenry status of Arabs. Of Arabs in the U.S., 82% are citizens, the majority of whom are native-born.

Misguided beliefs, stereotypes and popular assumptions may lead us to view members of this community as one-dimensional, but in fact, Arab American students are distinct, so each student should be regarded as an individual with unique experiences.

Political stress

Although we lack data on students who have an Arab background because they are expected to identify as white/Caucasian on most college and university admission forms, a few campuses such as the University of Illinois at Chicago have some data illustrating that Arab Americans make up a significant portion of the student body. Additionally, the college for which I work sits in a congressional district that has one of the largest concentrations of Palestinians in the U.S. It is clear that we also enroll a sizable number of other Arab American students. Because Arab American students constitute a significant percentage of the college population — while simultaneously facing targeting and various forms of racial/ethnic exclusion — it is imperative that our field incorporates a mental health framework that honors this population’s sociopolitical experiences and cultural and religious background.

In addition to facing many of the same challenges that college students generally encounter, such as navigating academic stress, negotiating relationships with friends, and deciding on a major, Arab students are subject to an ongoing and unrelentingly hostile political climate. These students, their families and their communities at large are dealing with the impact of anti-Arab and Islamophobic foreign and domestic policies such as the global war on terror, the Muslim travel ban, mass surveillance, and racial profiling programs promoted under the “countering violent extremism” framework. These policies and programs trickle down into Arab Americans’ everyday lives in the form of hate crimes, discrimination and a generalized sense of fear.

All of this can contribute to the development of mental health issues or exacerbate already-existing psychological disorders. Focus group participants shared how repressive policies shaped by the Trump administration (especially the Muslim travel ban executive order) translated into their everyday experiences of feeling anxious, alienated, intimidated and untrusting of institutions that are meant to be supportive. Several students at the time disclosed their feelings of uncertainty with comments such as, “Personally, I was scared during the election and when Trump became president,” “There’s still some fear that I have about what he can and cannot do to us as Arabs or Muslims,” and “The Muslim ban was very traumatizing, not just to me, but to people who could not come back to the States when they left for vacation.”

In failing to understand the political stress our Arab students are enduring, and by neglecting to engage in meaningful and elevated conversations about political issues that concern them, we run the risk of these students prematurely terminating sessions. Students in the focus group spent a considerable amount of time discussing the factors that would discourage them from returning to see a counselor. The following quotes highlight some of the factors mentioned:

  • “It has to be a judgment-free zone, and if it isn’t, then I wouldn’t return to counseling.”
  • “I don’t want to be judged or misunderstood based on what they’re hearing about Arab Americans in the media.”
  • “There has to be a connection. The counselor has to understand me as an Arab American.”

Culturally competent practitioners must be able to monitor their biases and examine how their own racial/ethnic backgrounds may play a role in forging an authentic relationship with Arab American students. One of the biases mental health professionals may hold that could influence their attitudes toward this population is associating all Arabs or all Muslims with a potentiality for criminality or terrorism. These associations are not held exclusively by professionals in our field. Rather, they are common misconceptions that are the product of government discourse, domestic policies and campaigns such as the global war on terror.

In my research, nearly 70% of the counselors surveyed agreed that many people may hold negative attitudes, stereotypes, preconceived notions and biases about Arab Americans. Other biases, steeped in corporate media, include the portrayal of Arab and Muslim women as docile and submissive — victims of a backward culture and religion from which they need to be rescued. A student who participated in the focus group sessions indicated that they “worry about how counselors get their information about us. Are they getting [it] from media outlets, and how does this impact the way counselors work with us?”

Despite our every attempt as professional counselors to be supportive of Arab and Muslim college students, applying a one-size-fits-all approach without critically examining our understanding of how anti-Arab racism and Islamophobia operate may not serve their best interests. While many counselors who are committed to diversity may have backgrounds in some social justice/racial issues, they usually lack training in the area of Arab American exclusion and discrimination.   

Cultural considerations

While social injustice is a factor to consider when working with Arab American students, they, like any other students, also need to sort through a wide range of micro-level challenges. Family issues, intergenerational dissonance, acculturative stress and identity confusion are just a few of the personal stressors that may compromise this population’s emotional well-being.

In Arab society, family is central. Family is the conduit through which cultural continuity is promoted and through which the rich traditions and values of the homeland are invoked. Both the immediate and extended family are heavily involved in the enculturation, upbringing and decision-making processes of the Arab American students you counsel. Counselors may find that even through adulthood, Arab American students will not make decisions in isolation. Rather, the expectation is that they will consult with members of their family before deciding on a course of action. Because they come from a collectivist society, in which the needs and wants of the group supersede those of the individual, these students may hesitate to act if a course of action or decision does not mirror the values of the family, does not benefit the collective or is considered shameful.

Whereas the dominant white middle-class U.S. values emphasize autonomy and freedom to make decisions without having to defer to others, cultural norms in Arab families dictate the opposite. As clinicians, we should consider how the practice of encouraging students to differentiate their individual identity from that of their family is antithetical to most Arab Americans. When our Arab American students are feeling obligated by their family to make a decision that does not necessarily satisfy their own desires, we should explore how we can assist them in negotiating an outcome that meets their need without being seen as a betrayal to their family.

Rather than viewing these distinct cultural forms as dysfunctional or expecting our Arab American students to align with Euro-North American-centric ideals in order to be healthy and feel supported, I propose that we use the inherent strengths of their own heritage, culture and values. By doing so, we are demonstrating an appreciation for their background and worldviews. Focus group participants shared the importance of integrating their cultural heritage when implementing therapeutic techniques. One participant stated, “Non-Arab counselors need a better understanding of who their Arab students are and the mechanisms our parents use to raise us.” Another suggested, “Counselors shouldn’t assume things about us; they should ask us about our values, beliefs and customs.”

Although it cannot be emphasized enough that family represents a core aspect of Arab culture, we also come to learn that honor, respect, morality, hospitality and generosity are other dominant features of this group. When working alongside Arab American students, it is useful to keep these cultural norms in mind so that these students will feel heard, understood and appreciated.

Intergenerational dissonance — another common source of stress for Arab American students — can arise when students are feeling pressured to hold steadfastly onto traditions of cultural heritage or religious values with which they no longer identify. Students shared the stress of negotiating relationships with their parents, and the acculturation differences between them, with these types of responses:

  • “Our parents worry about us becoming ‘Americanized’ and disregarding our traditions and religious practices.”
  • “I think there are a lot of struggles that Arab Americans face, especially if they were born in America but their families were not.”
  • “We feel obligated to do what our families expect of us.”

Students also candidly shared how intergenerational dissonance leads to other points of contention, including students wanting more freedom than the parents are willing to give, and the negotiation of romantic relationships, marriage and career choice.

Often in immigrant families, the children adopt dominant white middle-class U.S. values at a much faster pace than their parents do. This can cause disharmony and disruption in family functioning. According to psychologist and scholar John Berry, a number of factors, including age at immigration, language fluency and the reason for leaving the home country, determine the ease and comfort with which individuals adjust upon immigrating to the U.S.

During the course of my research and my years spent counseling Arab American students, I have learned that some of these students have assimilated with ease into mainstream U.S. life but have determined that it is equally important to them to maintain the richness and beauty of who they are as Arabs. They view themselves as members of a collectivist people with a strong extended family network, a rich heritage and culture that informs their way of living, and (for some) a religious framework from which they draw strength and guidance. These students have learned how to effectively and strategically weave in and out of the American and Arab in them; they have found a way to manage the conflicts associated with intergenerational dissonance.

Students who are struggling with identity confusion, and pushing back against familial pressures, want to explore the facets of their identity on their own terms. Focus group participants explained the challenges of trying to live “on the hyphen” (as in Arab-American) and navigating the contradictory worlds in which they live:

  • “I feel like Arab students are lost and don’t know how to act. They’re like in between and unsure if they are more Arab or more American.”
  • “Our families struggle with understanding what it’s like for their child to be an Arab living in America. We struggle with being American at school, and we struggle with being Arab at home.”
  • “I live both the Arab and American life, but I feel like non-Arabs see me as the other.”

Arab American students face ongoing angst caused by trying to live out their hyphen, which involves modifying and massaging the parts of their heritage that they want to maintain and embrace and discarding those that are no longer meaningful to them. Negotiating the complexities of their identity is further complicated by living in a hostile political landscape in which they are generally made to feel unwelcome and marginalized.

During the time of my study, Arab American students were in the thick of grappling with the realities of a newly elected president who was targeting members of their community with a travel ban and threats of deportation. Students spent considerable time processing how the election cycle and rhetoric from Donald Trump left them feeling vulnerable and affected their sense of belonging on campus. One student stated that Trump’s jingoistic sentiments during the election period “[bred] all kinds of hostility and hate, not just toward Arabs, but all other minorities, and the results have been disastrous.” According to a 2017 report by the Southern Poverty Law Center, hate crimes against Muslims grew by 67% in 2015, the year that Trump launched his campaign for president.

Arab American students’ sense of security has been punctured by a hostile climate that criminalizes and scrutinizes them. Students are telling us that it is a complicated time to be Arab or Muslim, and they need counseling professionals to have an understanding of how their identities are being shaped by the political landscape. Considering these conditions, how do we establish safety in the therapeutic encounter? How do we affirm these students’ humanity and obviate their concerns?

Counseling considerations

To establish culturally responsive care to Arab American students, we need to consider both the macro-level political stress that is causing these students harm and the micro-level challenges that affect their psychological well-being. As counselors, we have a unique opportunity to strengthen understanding of the contemporary challenges Arab American students face and the therapeutic measures we use to address them.

These students are informing us that they will benefit from counselors who are familiar with family dynamics, intergenerational dissonance and identity confusion. As counselors trained in Euro-North American counseling theory and technique, we need to critically examine the applicability of these models to the Arab American student and modify the strategies we use so that they complement the worldview of this population. If we fail to do so, we may mischaracterize cultural norms, beliefs, values and traditions as oppressive or primitive, which could inadvertently shame the students with whom we are working. We may also construe or unfairly judge these students’ family interactions as unhealthy with blurred boundaries, or consider them enmeshed and fused, interfering with individuation and differentiation of self.

These terms, inherent in Western models of family therapy, are incongruent with the Arab American family system. Applying these concepts may unknowingly leave these students feeling judged, misunderstood or misheard and could lead to premature termination of therapy. Instead, we should consider reframing our understanding of Arab American family dynamics by viewing these interactions as loving, caring and uplifting, and meant to provide unconditional support.

In addition to the factors previously mentioned, students shared other elements that would discourage them from returning to see a counselor:

  • “I had a counselor who would advise me or come up with solutions that were more appropriate for non-Arabs.”
  • “I was given solutions from counselors that do not match what I am looking for or who I am.”

Those who participated in the focus group also explicitly let us know that it is a trying time to be an Arab American student. They are traversing a hostile political climate that is causing them psychological distress. Being well-meaning and using the compassion that called us to this field may not suffice. As counselors, it is our duty to intentionally address any gaps in our knowledge base concerning the roles that culture, racism and oppression play in impeding these students’ abilities to function academically and personally. If we neglect to do so — and if misguided beliefs, popular assumptions or personal biases go unchecked — we may unintentionally revictimize these students. To eliminate the potential for harm, we can monitor our sensitivity to the historical and current oppressions that Arab American students experience. This can be accomplished in part by attending professional development opportunities that increase our understanding of this population’s sociopolitical, cultural and religious needs.

Finally, we can help these students re-create and reimagine the world they live in by acting as agents of change who advocate for and work alongside them to eliminate institutional discrimination. This includes having conversations with administrators to critically examine our campus communities to determine whether we are taking the necessary steps to promote a sense of belonging for this population.

Institutional responsibility includes counting Arab American students on admission forms and monitoring any inequities that could leave these students feeling vulnerable and paralyzed. Our institutions of higher education should also take intentional steps to diversify the recruitment and hiring of faculty and staff to complement the demographics of their respective student body populations. Ultimately, the question that counselors and institutions of higher education should be asking is, “How do we help Arab American students feel safe, understood and integrated?”

 

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Souzan Naser is an associate professor and counselor at Moraine Valley Community College in Palos Hills, Illinois, where she has won awards for her work on increasing diversity on campus. Her doctoral dissertation addressed the paucity of Arab American cultural competency training available for counseling professionals. She was born in Palestine and raised on the southwest side of Chicago, in the heart of one of the largest concentrated Arab American communities in the U.S. Contact her at nasers2@morainevalley.edu.

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Wanted: Bilingual and bicultural counselors

By Lindsey Phillips February 3, 2021

Successful therapeutic relationships are built on trust and understanding, so counselors can ill afford to have words and phrases become “lost in translation.” Cultural competency on the part of counselors is also crucial, especially as clients are becoming more linguistically and culturally diverse.

According to the 2019 American Community Survey conducted by the U.S. Census Bureau, 22% of U.S. households speak a language other than English at home, with 13.5% speaking Spanish. And this number will only increase in the years ahead. The Instituto Cervantes, in its Yearbook of Spanish in the World 2019, estimates that nearly 1 in every 3 Americans will be Hispanic by 2060, making the United States the second-largest Spanish-speaking country in the world after Mexico. The Pew Research Center projects that 19% of Americans will be foreign born by 2050, up from 12% in 2005. It also estimates that 82% of U.S. population growth will come from immigrants and their descendants.

The counseling profession emphasizes cultural competency, but evidence suggests that the mental health field as a whole isn’t keeping up with the rising demand for bilingual and bicultural services. According to survey results released by the American Psychological Association in 2016, approximately 10.8% of U.S. psychologists reported being able to provide services in a language other than English, with only 5.5% able to provide services in Spanish.

This lack of culturally competent services can take a toll on people’s mental health. “When clients can’t find a bilingual counselor, they become more isolated. Often, they don’t talk about their emotional issues because they don’t feel that they can be seen or understood on a linguistic or cultural level,” says Ingrid Ramos, a licensed professional counselor (LPC) and the director of the Bienestar (wellness) and Resilience programs at The Women’s Initiative in Charlottesville, Virginia. “Then, you see a worsening of symptoms.”

To better meet the needs of bilingual and bicultural clients, mental health professionals must become more culturally competent themselves. That goes beyond simply speaking another language or being aware of cultural difference. Clinicians need to be prepared to offer bilingual services and practice cultural humility, which requires better bicultural/bilingual training opportunities and supervision.

Finding the right words

Language is central to counseling because it allows clinicians to build rapport and better understand clients’ life experiences, thoughts and behaviors. But fluency in the client’s native language is often not enough to make a counselor linguistically competent in session. Olga Mejía, an associate professor of counseling at California State University, Fullerton (CSUF), acknowledges that mental health terminology doesn’t always translate. She often tells her counseling students, “There’s Spanish, and then there’s therapeutic Spanish.”

Although Spanish is Mejía’s first language, she admits she felt lost during her first clinical position after completing her doctoral program. Her clients and colleagues alike assumed that she could easily offer mental health sessions in Spanish, but she struggled to translate certain technical terms commonly used in the field such as confidentiality and the cycle of violence.

That’s because the process isn’t as straightforward as translating the words and phrases directly, Mejía explains. A direct translation often doesn’t take into account the cultural context and nuance between languages. Therefore, she advises her counseling students to translate the idea behind the terms rather than searching for the perfect word. For example, even if there isn’t a word-for-word match for boundaries in the client’s language, a counselor can explain that people often set rules or limits in relationships.

According to Ye (Agnes) Luo, an assistant professor of counseling at the University of North Texas, even explaining what a counselor is and how that differs from a psychologist can be challenging because some languages, such as Mandarin, use the same word to describe both professions. And certain countries may not distinguish between these roles the way that the United States does, she adds.

Luo, an American Counseling Association member and LPC in Texas who speaks both Mandarin and English, has learned that she can’t simply ask clients if they understand what counseling is because the client’s understanding of counseling may differ from her own. For example, she has worked with clients from Asian countries who expect counselors to prescribe something to “fix” their presenting issues. These clients viewed her as an authority figure rather than perceiving therapy as a collaborative process, she notes.

Interpreters must also be aware of the nuances involved in the way mental health professionals speak. Ramos advises counselors who use interpreters to discuss the therapeutic process with them before going into session. “Our communication is our tool,” Ramos says. “How we say things, how we ask questions, how we reflect back to the client — that’s the counseling intervention.” Therefore, it is important that interpreters also understand how to communicate in this way when translating for clients, she points out. For example, an interpreter could accidentally misrepresent a counselor’s reflective statement by telling the client, “The counselor is repeating what you just said,” rather than translating the reflective statement.

Medical interpretation can feel more transactional, but because counseling involves emotional disclosure and vulnerability, it requires a certain tone and set of communication skills, continues Ramos, who serves on the board of Creciendo Juntos, an organization that provides support and resources for Latinx families and Latinx-serving organizations in the city of Charlottesville and Albemarle County. For this reason, the Virginia Department of Behavioral Health and Developmental Services distinguishes between medical and mental health interpreting, she says. For example, the agency underscores the importance of mental health counselors and interpreters meeting before a session, while acknowledging this is not always necessary in medical settings.

Counselors also have to be upfront with clients about their bilingual language proficiency, advises Luo, a counselor at C2 Counseling in Corpus Christi, Texas. When searching for her own personal counselor, she found a clinician who advertised herself as bilingual in Mandarin and English. But in their first session together, the counselor asked Luo if it was OK if she spoke in English, not Mandarin, because she had never used Mandarin in a clinical setting. Luo acquiesced, but it was not the experience she had desired or expected.

Cultural competency and humility

Counselors must consider the client’s country of origin, not just the client’s language. “Language is essential,” notes Mejía, a bilingual and bicultural licensed psychologist. “But [clinicians] have to have the language with the cultural competency or cultural sensitivity, along with the cultural humility.” For example, in Spanish, knowing when and how to use tu and usted (both words for you) changes depending on age, gender, seniority and familiarity. If counselors don’t have the cultural understanding of that distinction, then they could hurt their relationship with the client, and the client will not feel seen or heard, she says. 

As Alaina Hanks, a licensed professional counselor-in-training at the Gerald L. Ignace Indian Health Center in Milwaukee, points out, a lack of cultural competency can also have serious repercussions, including potential misdiagnoses. Some of Hanks’ Native American clients have told her that other mental health professionals previously misdiagnosed them as having schizophrenia or depression with psychotic features because they mentioned seeing spirits or receiving guidance from ancestors during a traditional ceremony. Counselors must listen to the client and learn about their culture to accurately determine what is connected to culture and what is clinically significant, she stresses.

“A huge part of [cultural humility] is understanding the history of where you are and what that means,” says Hanks, an ACA member who helped co-author the article “A collective voice: Indigenous resilience and a call for advocacy,” published on CT Online in February 2020. She advises counselors to start by learning the histories of the places where they live and work because these histories, in combination with current policies, affect clients.

Because Ramos, who is from the Dominican Republic, often works with clients from Mexico and Central America, she brings a sense of cultural humility and curiosity into session with her. Sometimes, her clients assume that she understands everything they say just because she speaks Spanish. She knows not to make that assumption. Instead, she routinely asks, “What does that phrase mean in your country?” If she still doesn’t fully grasp what the client is trying to convey, she will dig deeper and ask what the phrase means in their community or family.

“As a bicultural counselor, it’s important to remember that every culture has its own way of speaking about symptoms, illness and treatment,” Ramos says. To gain a better understanding of the presenting issue, she asks clients how they understand or see the problem and how their culture views their symptoms or behaviors. She also asks how people in their culture typically cope with these symptoms or behaviors.

Because Native American approaches to wellness are often about gaining balance, Hanks, who is Anishinaabeg and enrolled in the White Earth Nation in Minnesota, sometimes incorporates the medicine wheel when working with Native American clients. The medicine wheel is a sacred symbol used by many Indigenous tribes to represent all knowledge of the universe. It consists of a circle, divided by a horizontal and vertical line, with four colors (black, white, yellow and red). Each tribe interprets the medicine wheel differently.

In Hanks’ traditional teachings from her Ojibwe tribe, the medicine wheel operates as a way for Indigenous people to understand the world and their roles within it. “I have used it similar to a wellness wheel in helping clients identify where they need balance in their lives or finding ways to reconnect counseling concepts in a cultural framework,” she says. She also uses it to initiate conversations about grief and the cycles of life.

Although the medicine wheel is widely recognized among Native American populations, its use varies from tribe to tribe, Hanks says. For that reason, she cautions counselors to practice cultural humility and get training before incorporating the medicine wheel in their clinical practice. The same can be said about the use of any intervention that might speak more fully to a client’s culture but with which the counselor is largely unfamiliar.

Mejía urges counselors to be curious and culturally humble to ensure that they don’t fall prey to assumptions or black-and-white thinking about a culture. For example, in working with a teenage Latinx client, counselors shouldn’t automatically assume that the client is going to leave home to attend college. Instead, Mejía advises clinicians to slow down and consider: Why wouldn’t the client go away to college? What cultural factors might encourage the client to choose a college closer to home? What would it be like if the client did attend school away from home?

Striving to cultivate cross-cultural relationships

Ramos often uses narrative therapy to incorporate a client’s culture, family context and worldview — including their sense of spirituality — into treatment. She frequently uses Latinx cultural references, such as dichos y refranes (i.e., Spanish proverbs and sayings), to engage clients and make their culture and stories central to the session. For example, in a group format, Ramos may ask clients to share popular sayings used in their family, community or culture that relate to the dynamic the group is discussing. In the past, clients have mentioned dichos such as “El tiempo lo cura todo” (which is similar to “Time heals all wounds”) and “Dios aprieta, pero no ahorca” (which is similar to “When God shuts a door, he always opens a window”). This technique can help clients reconsider how they view themselves and their personal journeys, Ramos says.

Ramos doesn’t believe that counselors have to be proficient in Spanish to incorporate Spanish sayings into their practice. “The main point is always to use invitational language in the counseling setting to elicit the dichos and reflections from the client as a way to honor the cultural meaning the dichos might have for them,” she explains.

Ramos also focuses on cultivating the relationship from the second the client enters her office. In the United States, people have grown accustomed to filling out forms as soon as they enter a health facility, but that isn’t true for all cultures. Ramos points out that many Latinx cultures value personalism (i.e., person-to-person contact). So, she first gets to know her clients and discusses the forms with them rather than simply handing them the forms without any explanation.

Ramos has noticed that if she clearly explains the intake process to her clients who are immigrants or refugees, they are more willing to engage with the steps needed to get services. On the other hand, if she just hands these clients a form, they may hesitate to answer questions because they don’t fully know or trust her yet. Simply saying, “Welcome to the office. How did you find us?” or “How can we serve you today?” can be a nonthreatening way to start the conversation, Ramos suggests. “It doesn’t have to be a 30-minute intervention. It can be five to 10 minutes of explaining why they are here and what the process is,” she adds. 

Counselors also need to be sensitive to literacy levels. Asking clients to fill out forms may cause anxiety or shame if they don’t know how to read or write in their native language, Ramos points out. Cultivating that relationship for the first 10 minutes before having them fill out forms can help put clients at ease. Ramos then asks clients whether they feel comfortable filling out the forms themselves or might prefer her support in doing that. This is a simple way to dismantle the shame around any literacy issues so that focus can be put on clients’ needs, she explains.

Recognizing the need for bilingual/bicultural training

Given the increased demand for counselors who are bilingual/bicultural, there is a corresponding need for counselor education to include more programs aimed at preparing counselors to be linguistically and culturally competent. Unfortunately, says Mejía, an ACA member whose research focuses on immigration and the training of bilingual/bicultural therapists, there are not many programs like this currently in the United States, and for the ones that do exist, there are no standards for this type of training.

Mejía noticed that many of the bilingual counseling students at CSUF lacked the support they needed during their practicum training. They rarely had bilingual/bicultural supervisors, and they often had to translate documents, forms and counseling terms on their own without any guidance, she recalls. “They’ve been learning all the [counseling] skills in English, and all of a sudden, they are expected to do it in a different language,” which was intimidating and challenging, she says.

In response, Mejía started and serves as the director of the Ánimo Latinx Counseling Emphasis program at CSUF. The program consists of five master’s-level courses focused on helping students become self-aware as bilingual and bicultural counselors, knowledgeable of Latinx cultures and therapeutic Spanish, and familiar with interventions appropriate to Latinx and Spanish-speaking clients. It also teaches counseling students about social justice advocacy for issues relevant to the Latinx community and allows students, depending on their proficiency, to practice speaking Spanish in a clinical setting. 

Ánimo, which loosely translates to encouragement or spirit, is in its third year, and Mejía can already see the positive impact the program is having on the counseling students at CSUF. She frequently gets inquiries from students about the program, which speaks to the need for such training. But behind the program’s success is a harsh reality: It took 10 years of determination and dedication on the part of Mejía and her colleagues to receive the institutional support needed to bring the program to fruition.

Bilingual/bicultural training programs such as Ánimo also allow counseling students to support and learn from each other. The students in the program recently decided that they want to establish an Ánimo student group to build a supportive community for bilingual/bicultural counselors, which Mejía thinks is a wonderful idea.

Challenges faced by bilingual/bicultural counselors

Often, there is a cultural “tax” associated with being a bilingual or bicultural counselor. Mejía started the Ánimo program to help counseling students, but she doesn’t get consistent faculty release time (i.e., reduced teaching responsibilities to work on other projects) to fulfill duties related to the program, including training faculty, promoting the program, interviewing prospective students, attending meetings, and conducting exit interviews with graduating students. In addition, prospective and current students often seek her out — as director of the program — for advising and mentoring. Still, she finds a way to balance it all because as a first-generation college graduate herself, she knows how important these connections are and how valuable the program is to other bilingual/bicultural counselors. 

Sometimes, colleagues and agencies may expect bilingual counselors to take on additional roles — including ones that might be outside their scope of knowledge or training. When Ramos was an in-home counselor, she would support clients by attending school or social services meetings with them. Those agencies didn’t always schedule an interpreter because they assumed she would operate as both the client’s interpreter and therapist. “That put me in a situation where my mind that I wanted to use for the emotional support of this family now had to be used for interpreting,” Ramos recalls. Interpreting itself can be taxing, she adds, so she had to set boundaries and assert that she needed an interpreter in certain situations so that she could successfully perform her true job as a counselor.

Luo says some of her bicultural counseling students find it difficult to establish boundaries in session. If a counselor feels personally connected to a client because they share a language or similar culture, a danger exists that the counselor could overidentify and self-disclose too much, she cautions.

Isolation can also be an issue for counselors who find themselves in a region or clinical practice in which they are the only ones who are bicultural or bilingual. All counselors can benefit from participating in support groups with other helping professionals, but bilingual/bicultural counselors have unique challenges that may require them to find support groups with clinicians who also share these struggles, Ramos says. For example, a bicultural counselor may have high caseloads of people whose immigration or socioeconomic status affects their ability to access the resources they need, which in turn may affect their well-being.

Of course, it may not be easy to find this support if counselors live in an area without much diversity. Ramos offers the following suggestions for connecting with other bilingual/bicultural professionals:

  • Reach out to agencies within the community that provide mental health services to see if they have bilingual counselors on staff.
  • Find organizations that provide services to immigrants and refugees and that focus on education and advocacy. Although these organizations may not concentrate solely on mental health, they do work to identify the needs and gaps in services for these populations, Ramos says. And counselors could collaborate with these organizations to build a resource network.
  • Check with the counseling or social work departments at local universities and colleges to find alliances of refugees, immigrants or other minority groups.
  • Attend online webinars and trainings, which are more widely available now because of the COVID-19 pandemic. These events will help counselors connect with other bilingual and bicultural providers.

Improving supervision for bilingual/bicultural trainees

One of Mejía’s motivations for starting the Ánimo program was the lack of available supervisors who are culturally and linguistically competent. A supervisor’s lack of cultural competency is a barrier for counselors-in-training, Mejía asserts. Students often tell her they feel unheard or overlooked when their supervisor doesn’t understand an issue they have as a bicultural counselor or as a counselor working with a client from a different culture.

Mejía also gets frustrated when supervisors ask their trainees to translate another colleague’s session or the clinic’s forms or to answer the phones because they are bilingual. Trainees are not compensated for this work, and these tasks don’t count toward their clinical hours, she points out. Mejía often asks supervisors, “Would an English-speaking trainee be required to do this?”

Ramos has noticed that bilingual/bicultural counselors-in-training tend to dismiss their own feelings and challenges when they don’t have a supervisor who is culturally competent. They may think that they are the only ones dealing with an issue and hesitate to bring up their concerns with their supervisor. “Having a supervisor who can relate culturally with the population you are serving can fill the gap needed in support for the counselor,” she says.

As Hanks observes, it can be challenging for supervisors and counseling professionals who have been in the field for a long time to admit that they don’t know something. But taking a reflective and humble approach to supervision helps bicultural counselors to feel seen and heard, she says.

Hanks recalls a positive experience she had with a supervisor who was curious and didn’t make assumptions. While working in a youth shelter, Hanks was approached by a Native American child because she assumed that Hanks, who is also Native American, would better understand her. Hanks’ supervisor didn’t address the situation by telling her to set better boundaries. Instead, the supervisor said, “I noticed this one child is really close to you. Tell me more about it. Tell me what you think is going on. What do you think about it clinically?” Those questions led to a productive conversation about Hanks’ therapeutic relationship with the client.

Luo has always had supervisors who were culturally different from her, and none of them asked about how their cultural difference affected the dynamics of supervision. Luo encourages supervisors to be the ones to initiate these conversations rather than waiting for trainees to bring up the topic. Now as a supervisor herself, Luo makes a point to always address culture with her supervisees. For example, she might say, “As you have probably noticed, we come from different cultural backgrounds. Do you want to talk about how these cultural factors affect our relationship?”

Bridging cultural differences

In Milwaukee, Mark Denning of the Oneida Nation created the program Unity Fire to address challenges related to the COVID-19 pandemic and social justice struggles. The program is open to the public and uses Native American customs to help unite communities during a time when many people feel isolated, unheard and unsafe.

Hanks attended a unity fire held during the protest over the killing of George Floyd and remembers it being heavy with emotion. The firekeepers taught those attending how to offer a prayer into the fire using traditional sacred medicines. “There’s space at these fires for [cross-cultural] connection,” Hanks says. “That’s why they call it the ‘unity fire.’ It’s all about people uniting again.” 

Ramos’ agency — The Women’s Initiative — aims to create community partnerships. Its Bienestar program provides counseling in Spanish to Latinas and connects Latinx children and men with bilingual providers in the community. It also offers workshops and presentations centered on Latinx cultural values and resiliency, mental health issues, and cultural barriers that this population often faces.

Staff members at The Women’s Initiative also offer support groups for immigrant and refugee women. For example, Ramos led a basket weaving group, which for many clients was a way to connect a culturally significant craft with emotionally relevant concepts such as change, disappointment and resilience.

The Women’s Initiative also partnered with the International Rescue Committee and Hyojin Im, an associate professor in the School of Social Work at Virginia Commonwealth University and an expert on mental health services and refugee communities, to host trauma-informed cross-cultural psychoeducation (TICCP) leadership training for immigrant and refugee communities in Charlottesville. The TICCP program offers a series of workshops that teach bilingual leaders in these communities about the mental health impact of refugee and immigrant trauma and cultural adjustments to a new country.

TICCP has been a way to bring immigrant and refugee communities together and to create leaders within those communities from which others can learn about mental health, Ramos notes. These leaders “can help to make referrals and to deal with the stigma around mental health,” she adds.

Ramos loves connecting bilingual/bicultural therapists with immigrant and refugee communities and empowering these communities to be active participants in their own mental health. “Whenever I can bridge that gap [between cultures], I like to do it,” she says, “because I know it means a client or family will receive a better service.”

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Unmasking White supremacy and racism in the counseling profession

By Patricia Arredondo, Michael D’Andrea and Courtland Lee September 10, 2020

Our country has been roiling through two major pandemics. The first, COVID-19, is still relatively new, and with a vaccine, the incidences of this miserable disease should decrease and diminish over time. In contrast, the pandemic of White racism and White supremacy has long been at the heart of the persistent psychological, emotional and behavioral racial tensions and injustices that we face in the United States. The senseless killing of George Floyd and other Black citizens has raised awareness once again of the violence of White racism and police brutality in many sectors of society.

The National Institute of Mental Health recently published a report indicating that between 17 million and 22 million adults in the United States are in need of professional mental health services each year. It was further determined that only 41% of these individuals receive such services. The fact that a majority of adults in need of mental health services do not receive this important care represents an ongoing health care crisis in our country. And, of course, COVID-19 stressors are only compounding mental health distress.

When researchers focused on the racial disparities linked to this pandemic, those from African, Asian, Latinx and Indigenous backgrounds were found to be substantially overrepresented among those adults not receiving or not having access to mental health care. This finding reflects what supporters of the Black Lives Matter movement and many social justice advocates in general are talking about when they point to disparities resulting from systemic racism and White privilege in this country.

Institutional racism in the profession

In 1982, nearly 40 years ago, Derald Wing Sue wrote, “Counseling is the handmaiden of the status quo.” This phrase relates to the ways that many counselor educators, practitioners, supervisors and students are inextricably linked to perpetuating White racism and White supremacy by remaining silent, noncommittal and inactive in the face of so many forms of structural and institutional racism.

Sadly, this situation is still a reality as unintentional and covert forms of racial injustice continue to be manifested in counselor training, research and practice. For example, how prepared are counseling students to work with those who speak English as a second language, those who are recipients under the Deferred Action for Childhood Arrivals program, families in poverty and so forth? When are counselor training programs requiring community service to link to social justice principles and competencies endorsed by the American Counseling Association? How do counselor training programs prepare students to talk about racism with clients? If counselor educators and counseling programs were to take on these three queries, they would find opportunities to unmask racism and decrease their behavior as a “handmaiden of the status quo.”

Professionals and students alike must commit themselves to move toward bold, courageous and morally grounded actions. We must go beyond our favorite mode of operating, which often involves the overuse of intellectual analysis of these social pathologies. As we critically analyze the mental health impacts of these injustices on our clients’ lives, let us be reminded that Martin Luther King Jr. warned us that an overemphasis on such intellectualization without substantial social justice actions too often results in the paralysis of analysis.

Challenging the counseling status quo

In 1992, Michael D’Andrea, one of the co-authors of this article, wrote a column in Counseling Today (then named The Guidepost) titled “The violence of our silence: Some thoughts about racism, counseling and human development.” In that column, he asserted that if they continued to operate as witnesses and bystanders to various forms of institutional, societal and cultural racism, counseling professionals and students would become guilty of being racists themselves through their silent complicity.

Some progress has been made as a result of a minority of counselor educators, practitioners, supervisors and students taking courageous action to boldly and routinely describe the ways that White supremacy and White racism adversely affect the counseling profession and the racially diverse clients we serve. However, it is apparent that much more needs to be done in these areas. Today, there are education and training programs guiding professionals in moving away from bystander behavior and toward action. The #EquityFlattensTheCurve initiative is offering a Bystander Anti-Racism Project.

Identifying areas of urgency in the counseling profession is also part of unmasking racism. Just take note of the contemporary counseling profession. In doing so, you are likely to see the following: counselor educators, graduate students, supervisors in counseling centers, textbook authors, the theories studied, the research methodology applied in studies, CACREP site visitors, and the leadership in ACA, the Association for Counselor Education and Supervision and other professional associations all seeming to have a homogeneous identity.

Little has substantially changed over the past 50 years. A majority of White counseling students continues to be taught by a majority of White professors. Multicultural counseling is still a one-semester course. Theories of counseling, career development and human development are Eurocentric in nature and dated. Furthermore, counseling research has not advanced knowledge about racism, White supremacy and the well-being of people of color. Samples of convenience continue to be normative, with many research participants coming from White, Western European, English-speaking and often Christian backgrounds.

All of this leads us to assert that the counseling profession has stagnated. This perpetuation of persistent Eurocentric conformity will soon be irrelevant and contribute to greater inequities in the preparation of counselors and the delivery of mental health care. This professional irrelevance will occur as a result of the unprecedented demographic transformation occurring in our nation. As one example, in 2013, for the first time, the percentage of Latinx high school graduates going on to college was higher than that of any other group, as reported by the Hispanic Research Center, and this representation in colleges continues. How many counselors are aware of this demographic shift?

Moving to action: Applying the MCCs 

In 2003, the ACA Governing Council approved the Multicultural Counseling Competencies (MCC), originally published in 1992 by Derald Wing Sue, Patricia Arredondo (one of the co-authors of this article) and Roderick McDavis. The awareness, knowledge and skills paradigm remains as vital today as it was in 1992 when the MCC were published and in 1964 when the Civil Rights Act was passed. The MCC, the subsequent document on operationalization of the competencies that promotes intersecting identities in sociohistorical contexts (1996), and the Multicultural and Social Justice Counseling Competencies (2015) remain anchors to lean on during these times for needed change, increased awareness, more expansive knowledge and bold actions in the counseling profession. The 1992 competencies addressing racism are cited here for further application.

  • Culturally competent counselors possess knowledge and understand about how oppression, racism, discrimination and stereotyping affect them personally and in their work. This allows them to acknowledge their own racist attitudes, beliefs and feelings. Although this standard applies to all groups, for White counselors it may mean that they understand how they may have directly or indirectly benefited from individual, institutional and cultural racism.
  • Culturally competent counselors are constantly seeking to understand themselves as racial-cultural beings and actively strive to develop a nonracist identity.
  • Culturally competent counselors are knowledgeable of sociopolitical influences that impinge upon the life of racial and ethnic minorities. Immigration issues, poverty, racism, stereotyping and powerlessness all leave major scars that may influence the counseling process.
  • Culturally competent counselors become actively involved with [ethnic/racial] minority individuals outside the counseling setting (via community events, social and political functions, celebrations, friendships, neighborhood groups and so forth) so that their perspective of minorities is more than an academic or helping exercise.
  • Culturally competent counselors strive to eliminate biases, prejudices and discriminatory practices. They should be cognizant of clients’ sociopolitical contexts when conducting evaluations and providing interventions. They also continually attempt to develop greater sensitivity to issues of oppression, sexism and racism especially as they affect their clients’ lives.

Racial reckoning: If not now, when?

The country has entered a period of racial reckoning. New incidents of racism and anti-Black behavior are reported on a daily basis on city streets, on college campuses and in stores. The challenge to not be bystanders persists, and as counselors committed to advancing diversity, equity and inclusion, we must be activists and advocates for social justice. We must rise to the task of unmasking White supremacy and White racism in both our professional training and practice as professional counselors.

We need to ask ourselves, if not now, when will we take these actions? If not us, who will make the changes to have the counseling profession move beyond the “violence of our silence” and the role many educators, supervisors and students play as “handmaidens of the status quo”?

 

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Patricia Arredondo is a past president of the American Counseling Association and the Association for Multicultural Counseling and Development and a founding member of Counselors for Social Justice. She partners with organizations to address diversity, equity and inclusion initiatives through the Arredondo Advisory Group. Contact her at parredondo@arredondoadvisorygroup.com.

Michael D’Andrea is an associate professor at Springfield College in Springfield, Massachusetts. He is one of the founders of Counselors for Social Justice. Contact him at michaeldandrea1@gmail.com.

Courtland Lee is a past president of the American Counseling Association and the Association for Multicultural Counseling and Development. He is a professor in the counselor education program at the Washington, D.C. campus of the Chicago School of Professional Psychology. Contact him at clee@thechicagoschool.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Encountering and addressing racism as a multiracial counselor

By Michelle Fielder and Lisa Compton August 11, 2020

It was a simple question, “How are you doing?” that started us on a path of discovery. I (Lisa) wanted to check in with Michelle, my teaching assistant, after racial tensions consumed the news. George Floyd had just been killed, and the media were focused on his death, the shooting death of Ahmaud Arbery, and the outcry for justice for the African American community.

Michelle was initially numb, unsure of how to articulate the different thoughts and feelings the recent events had triggered for her. I could tell she needed a break from our usual academic work, so I assigned a reflective activity to give her space for introspection.

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The events brought to my (Michelle’s) mind a comment that actor Will Smith had previously made on a late-night television show: “Racism is not getting worse; it’s getting filmed.”

As my ideas began to crystallize, Lisa and I began to share our perspectives on the sobering current events. The result was a rich dialogue between us — raw, authentic and refreshingly open.

What follows is an excerpt from our discussion. We hope that it will stimulate other discussions and encourage counselors to not fear engaging in dialogue about race. We believe that such open communication will help us to better understand one another and the reality of systemic issues, to identify our blind spots and areas for growth, to improve our care for clients and to move our profession forward.

Racism at first glance

Lisa: Michelle, you told me how triggering the recent acts of racism in America and subsequent protests have been for you. Could you share some of your background?

Michelle: I was born to an African American father and a Japanese mother around the civil unrest and well-publicized riots of 1968. The United States was embroiled in an unpopular war in Vietnam, and racial tensions at home were an additional black eye on our status as a world leader. It is sobering to consider that the institutionalized racism which led to the widespread violence and destruction of many cities, including Washington, Chicago and Baltimore, has not been eliminated over my lifetime.

My first understanding of racism occurred when I was in the first grade. My mother would meet me after school each day to walk the mile or so back to our house. One day, a white pickup truck pulled alongside us, and two Caucasian men started yelling racial epithets and throwing beer bottles at us. My mother grabbed me and ran into a nearby park where they could not follow in their vehicle.

My mother reported the incident to the police, but it was not investigated, and the matter was dropped. It was not until several years later that I understood what transpired that day and the reality that the very notion of my existence was abhorrent to someone simply based on how I looked.

The path to becoming a counselor

Lisa: That must have been a terrifying experience for you. What impact did your childhood have on your career path as a professional counselor?

Michelle: I became driven to prove my value and worth to society through academic and athletic achievement. When it came time to apply to college, I wanted to mark the “other” box because, back then, “multiracial” was not an option.

My mother surprisingly challenged my decision: “Michelle, whether you like it or not, the world is going to look at the color of your skin and decide that you’re African American. Why not show them you are also kind, driven, intelligent and talented? It doesn’t have to be either-or.”

My mother’s advice empowered me to look beyond my neighborhood and the typical path of my peers, which was community college or service and retail jobs. I applied to the United States Naval Academy and was accepted into the 10th class that allowed women. As a midshipman, it was not lost on me that there were few black or brown faces, and I was often reminded that there were 20 other applicants for everyone who was accepted, so I had to make my presence count.

I found my follow-on experience in the Marine Corps to be a great example of inclusion, as we all worked together toward a common mission. There were not black, white, brown or yellow Marines — we were all “green.” As an intelligence officer, I became adept at understanding the human nature of our enemies and advising appropriate responses to conflict. This intuitiveness and desire to bring healing to suffering led me straight to my next career as a professional counselor.

Experiencing racism with clients

Lisa: Have you experienced racism in your interactions with clients and, if so, how have you managed it?

Michelle: Depending on how I wear my hair, it has apparently been difficult for others to determine my race. Over my lifetime, I have been mistaken for Filipino, Puerto Rican, Thai/Burmese, South Korean and Samoan.

As a licensed professional counselor, I have had clients decline to meet with me because I was not pale enough for their liking or not dark enough “to understand their experience.” Several clients have made racially disparaging comments about African Americans or Asian groups in my presence because they were unaware of my multiracial background. One Caucasian client made the flip comment, “She [a Hispanic friend] is so stupid. What did she expect dating a Black guy? They’re all dogs and can’t keep a job!”

Those comments were spoken so casually that it is not hard to imagine that worse was being said in other settings. It is a sad reminder that racial prejudice and stereotyping are still at the forefront of some people’s minds. Sad because such views prevent the speaker from seeing the potential good aspects of another race and benefiting from their culture. Sad because such divisiveness prevents unity that could make us stronger as neighbors, co-workers or fellow journeyers on this path through life. My identity is not the “little mongrel” girl who had to hide in a park, nor are those individuals being described the sum of those demeaning or devaluing statements. We can and need to do better.

Early in my career, I had a Caucasian client tell me he hated “Black people.” I was quite surprised, and it must have shown on my face because he immediately added, “But you’re all right. You’re not like the other ones I’ve met.”

As you can imagine, I was angry at his audacity and saddened by his views, but I knew based on where he was in treatment that it was not the time to get into a heated debate about his racial beliefs. However, I realized that his sharing of those ideas with me indicated that he felt safe to do so in my presence and that I had been entrusted with a variable that I had not known about him previously. While I was offended by his remark, I remember thinking, “Stay focused on the client. This is not about me; it’s about the client.”

I am going to be judged, fairly and unfairly, but I choose to live in a manner to be a credit to my race rather than a detractor. I also recognize that every instance of racism is a learning opportunity — for me to better understand how the other person came to their beliefs and for clients to perhaps expand their views to see past a person’s appearance to their character. We are all a product of our genetics, nurturing, environment and experience. A client’s life may have taught them to hate, but if we, as counselors, do not believe in the potential for people to change and grow, we are in the wrong profession.

Racism can come in many forms. It can be overt or covert, generational or situational, and institutional or individual. As counselors, we need to be prepared for however it manifests and to recognize that some people are not even aware of how hurtful their beliefs are until they are uttered out loud and someone checks them on it. When working with clients, I have come to recognize that racism is often based on fear, and the more information the client is willing to learn about the object of their fear, the less impact it has. Working with a client’s racist remarks takes the same unconditional positive regard that you would give any client, and it is an opportunity to model healthy self-concept and emotional regulation.

So, take the client I mentioned previously who stated that he hated Black people. For this interview, I will call him “John.” When John made that statement, I did not react to his remarks, but I was able to work with him later in therapy surrounding some of his distorted schemas when he was ready. The following are some practical suggestions for working with clients who show signs of racism:

1) It’s not about you. (Do not personalize clients’ racist remarks).

Me: “It sounds like there are anger and pain behind that statement. Tell me about the Black people you’ve previously met.”

John: “Well, they make me sick. They’re lazy. They lie around doing drugs and collecting a welfare check while I bust my butt working all the time.”

2) Gently challenge any overgeneralizations.

Me: “Who are ‘they’? Are you talking about specific people you know?”

John: “No, you know what I mean. Just Black people.”

Me: “I know some Black people, but they don’t do drugs and they have jobs.”

John: “I know they’re not all like that. Like I said, you’re all right because I know you work for a living.”

Me: “So you don’t hate all Black people, just the Black people who are uneducated or unemployed?”

John: “Yeah, I guess.”

3) Help clients clarify their feelings.

Me: “Some might take your response as jealousy rather than hatred. You work hard, but they get by without working. Would you consider jealousy to be a better word?”

John: “No! I’m not jealous of those Black people. Shoot, I’m way better than them. I’m financially secure with a good job and a house. There’s nothing to be jealous of.”

Me: “You do work hard and have a lot going for you. So, why are you comparing yourself to them?”

John: “I’m not! They’re a drain on society. They could be doing as well as I am if they would just apply themselves.”

Me: “So, help me understand. If there is no comparison in your eyes, why do you even care?”

John: “Because my taxpayer dollars are going to finance their lifestyle.”

Me: “Actually, your and my tax dollars are going to finance a lot of things, like the military, Social Security and the national debt. Do you hate them too?”

John: “No, that’s just stupid. Of course I don’t hate the military. They’re necessary for our nation’s defense. It’s just our precious resources should only be used on important things that benefit all of society.”

Me: “If hate is too strong, or not the right word, what is a better way to describe how you feel?”

John: “I guess you could say I’m frustrated.”

4) Help clients clarify their beliefs.

Me: “OK, you are frustrated with some uneducated or unemployed Black people.”

John: “Yeah, because they’re on welfare.”

Me: “I also know a lot of people on welfare — White, Black, Hispanic, etc. Are you frustrated with them as well?”

John [staring at me]: “I know what you’re doing. No, I’m not frustrated with all of them. You are just twisting things around.”

5) Follow up with psychoeducation.

Me: “I’m just trying to understand what you believe and why you believe it. Words matter, and I hope you can see there is a big difference between ‘I hate Black people’ and ‘I’m frustrated with what I believe is the misuse of taxpayer money.’

Some people are where they are due to a lack of nurturing, growing up in an unsafe environment or even traumatic experiences. But when you are hindered by those things, which are outside of your control, and the color of your skin habitually prevents others from seeing you as a person or recognizing your worth, it is hard to have hope of living any other way.

We all have biases — because of our genetics, nurturing, environment and experiences — that can incite our emotions and distort our thinking. Racism occurs when we start believing those distortions about an entire group of people without considering individual differences. It may be easy to blame an entire group of people in a situation, but it is much more helpful to honestly examine why we feel the way we do and, when in our power, to do something about it.

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Having an open conversation about race with a client is possible, but counselors must consider the client’s readiness and make sure the discussion is integral to the context of the client’s presenting issue. The counseling office is not a bully pulpit, nor is it a place for counselors to get their own emotional needs met. However, when a client is ready and open to discuss the subject, counselors should be ready to “go there” while maintaining empathy and without allowing countertransference to interfere with their effectiveness.

Experiencing racism within the profession

Lisa: Thank you for sharing your experiences and such practical suggestions for working with clients. I think we are often caught off guard by comments made during sessions, and it is very helpful to think ahead of time about what to do in those situations. In addition to interactions with clients, have you experienced racism within our professional field?

Michelle: Sure. I once had a colleague tell me that she was no longer going to take Medicaid clients because they were “all Black, unemployed and unmarried with a gang of kids.” Another colleague commented that the Black clients brought their kids in for testing for attention-deficit/hyperactivity disorder “just so they can get a check.” These were seasoned professionals who had been seeing clients for many years.

Lisa: How disappointing to hear such comments from your peers. As a Caucasian, I have noticed that many of my White colleagues feel content in knowing that they do not personally hold prejudiced feelings against others. However, I realize that a lack of personal hate does not do enough to confront systemic racism. What can we do as a profession to make progress and move forward in this area?

Michelle: The first thing is to stop apologizing. I cannot speak for all people of color, but we are not looking for apologies. Now, let me caveat that: I always advise my clients to “own what’s yours.” If you personally contributed in any way to the oppression of a person of color, then apologize to that person. Otherwise, a blanket apology often indicates that someone does not understand the nature of institutional racism.

Secondly, ask, listen, learn and act. We will never solve the problem if we do not understand the nature of the problem. Ask people of color about their experiences. You may be surprised how many instances of racism — such as inappropriate comments or jokes in the workplace — individuals have had to push aside or ignore. Question formal processes at work that have been in place for a long time because “that’s the way we’ve always done things” attitudes can indicate tacit approval of an oppressive infrastructure (e.g., not taking Medicaid clients because it does not pay as well as commercial insurance).

Listen to the conversations being held when people of color are not in the room. They may be an indication of an undercurrent of racism (e.g., gossip or complaining regarding people of color) that needs to be exposed.

Learn by reading books, listening to podcasts or subscribing to YouTube channels by people of color.

Act by speaking up when you hear racist comments or when you see acts of discrimination. Be willing to get involved with faith organizations, social justice movements and causes of people of color (e.g., speaking at a city council meeting about trauma-informed care for African American neighborhoods or joining a peaceful march). Lastly, help affect the future of the counseling profession. Become a supervisor and share the wisdom you learn about institutional racism and the need to work with people of color to fix the system.

Thirdly, for supervisors, it is important to recognize that our supervisees are coming from different backgrounds and are at different levels of multicultural competence. I hold an initial interview with my supervisees to get a sense of their goals, strengths and weaknesses. Included in this interview is a question about their ethnicity, nurturing, environment and experience as it pertains to working with race and other marginalized groups. The answer is usually, “I had a multicultural awareness class as part of my master’s degree.” I take that to mean that they do not know what they do not know, so the onus is then on the supervisor to prepare counselors-in-training in this area of competency.

I take a developmental approach with supervision and challenge supervisees to take multicultural considerations into account as they approach each client and their diagnosis. Our discussions also include case studies tailored to increase their ability to recognize their own biases and blind spots.

These past weeks, with all of the media coverage of the racial unrest, have offered a rich environment for my supervisees to learn about institutional racism and to ask questions about social justice for their clients. It is not just a multicultural issue but also an ethical one. So, I try to ensure that my supervisees are not only comfortable working with people of diverse backgrounds but also willing to admit their own areas of cultural ignorance and work toward increasing their knowledge.

Connecting multicultural competency and trauma-informed care

Lisa: Is there any other area where we can look for change?

Michelle: All professional counseling organizations have submitted statements of support to the current nonviolent protests and offered ways to help support the victims of racial trauma. This is a great start to addressing the issue. However, if we want to make a difference, we need to reevaluate the profession’s approach to multicultural and trauma-informed education because they go hand in hand.

Most counseling programs have one mandatory multicultural class and may offer some trauma electives. However, multicultural competency should be infused throughout the program, and trauma-informed care should be a required part of every curriculum. Recognizing that the design of the master’s programs is toward clinical competency as determined by face-to-face hours, how well do practicum and internships expose and evaluate multicultural and trauma care competencies? Your new book, Preparing for Trauma Work in Clinical Mental Health, addresses concepts such as historical trauma, disenfranchised grief, advocacy and ethnic identity strength and would really fill this curriculum void.

For provisional and licensed counselors, in the same way that ethics continuing education is required every year, multicultural and trauma refresher training should be required on an annual basis to ensure that counselors are maintaining the best practices. To obtain licensure, counselors should demonstrate competency in working with diverse clients and various trauma backgrounds. In addition, all professional counselors should take an active role in advocacy work on behalf of their clients and in their communities.

Just as the color of my skin is going to be subconsciously noted by the people I meet, similar experiences are happening to our clients of color, most of whom have lived with some form of oppression during their lifetime. Counselors need to be prepared to approach multicultural considerations in trauma-informed care to understand how to appropriately establish strong therapeutic alliances with clients and enhance safety and stabilization. This is a herald’s call for counselors to change the way we approach the effects of institutionalized racism if we truly want to be agents of change.

 

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Michelle Fielder is a licensed professional counselor and approved clinical supervisor in private practice. She is also a doctoral candidate in the counselor education and supervision program at Regent University. Contact her at michfi3@mail.regent.edu.

Lisa Compton is a certified trauma treatment specialist and full-time faculty at Regent University. Contact her at lisacom@regent.edu.

 

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Black mental health matters

By Lindsey Phillips July 27, 2020

Racial violence and discrimination are woven into the fabric of the United States. The way policies and laws are implemented. The weaponization of Whiteness and privilege. Disparities in education and health care. The horrible and senseless killings of Black people throughout our nation’s history and into the present day.

How do daily acts of racial violence, injustice and discrimination affect the mental health of Black Americans? What is it like to work and live beside people who don’t value you as a human being? What is it like to live in a country where your rights are frequently threatened?

Dominique Hammonds, an assistant professor and testing coordinator in the Department of Human Development and Psychological Counseling at Appalachian State University, provides a quick glimpse into the complexities of being a Black woman and counselor in a racist society. Hammonds, wearing a shirt that read “Black and Educated,” was shopping in Walmart recently when a White woman passed by her and casually said, “You’re disgusting.” In that moment, Hammonds felt powerless. She feared the consequences of saying or doing anything in response.

Hammonds left the store and shortly thereafter went into a counseling session where her client recounted feeling powerless, angry and upset because of injustices they were experiencing in their life. Hammonds had to compartmentalize her own feelings of powerlessness to help the client.

Counselors play an important role in helping Black Americans cope with and heal from racial stress and trauma, but they can do more. Namely, they can also take steps toward changing an unjust and racist system that powerfully and negatively affects the mental health of Black Americans.

A distrust of mental health

Research indicates that Black Americans are 20% more likely to report serious psychological distress than are White Americans, yet they are less likely to use mental health services.

Loni Crumb and Janeé Avent Harris, who are both assistant professors of counselor education at East Carolina University (ECU), examined, along with two of their colleagues, the negative perceptions of mental illness and treatment among Black Americans. They found that stigma, a lack of trust in mental health care and a mislabeling of Black people’s presenting concerns make this group more apprehensive to seek counseling. Financial constraints and a lack of access to culturally responsive mental health care are additional barriers, explains Crumb, a research and innovation associate with the Rural Education Institute in the College of Education at ECU. (See their article “African Americans’ perceptions of mental illness and preferences for treatment” in the Journal of Counselor Practice for a more detailed discussion of their findings.)

This distrust is not unfounded. Black Americans have been misdiagnosed and overdiagnosed with schizophrenia for decades, for example. (For more, read “The historical roots of racial disparities in the mental health system” by Tahmi Perzichilli at CT Online.)

Angie D. Cartwright, an associate professor of counseling at the University of North Texas (UNT), stresses the importance of looking at how and why the mistrust of mental health began in the Black community. “Institutional and systemic racism is the foundation of a lot of our medical treatments, including mental health counseling,” Cartwright says. “And, historically, when [Black people] invite others into [their] homes and communities, then problems happen.”

Sitting with discomfort

Counselors, not clients, should be the first to broach issues of racism. This isn’t necessarily easy or comfortable.

Counselors often conflate comfort and safety, but they are two different things, insists Cartwright, a licensed professional counselor and licensed sex offender treatment provider who is the clinical director and owner of North Texas Counseling and Wellness.

As she explains, being comfortable enough to broach the topic does not mean the topic itself will be comfortable. “It’s not comfortable to say, ‘I was discriminated against,’ ‘I had a gun pulled on me’ or ‘I was fired because my boss is racist,’” she continues. “There are some conversations we will always feel some discomfort talking about. And that’s OK.” But clients should feel safe enough to share their experiences — ones that will often be uncomfortable for counselors to hear, she adds.

“You have to get comfortable with being uncomfortable,” says Hammonds, a licensed clinical mental health counselor (LCMHC) in North Carolina. “Part of the [counseling] skill set is learning how to have these discussions in a way that feels comfortable.” For example, can counselors say the word Black, acknowledge their own ethnic identities or discuss racism knowledgeably? If not, then clients know they won’t be able to go beyond a surface-level discussion with them, Hammonds explains.

What counselors say doesn’t even have to be overly complicated, notes Hammonds, an American Counseling Association member. They can simply say, “I just want to check in. There’s a lot going on around us right now. What’s that been like for you?” or “I’m curious how you as a Black American might be affected by racial violence and oppression.”

Being open and brave about this topic will likely result in some missteps. That’s part of the process, says Hammonds, who encourages counselors to use those mistakes as opportunities to learn.

One misstep may be getting defensive when clients express anger, distrust or sadness about their experiences. “If you find yourself getting defensive — trying to explain away the client’s experiences or identifying with client experiences and feeling like you have to apologize … on behalf of the system — don’t,” Hammonds says. “All you’re doing [in getting defensive] is communicating to the client that you’re still not comfortable and haven’t done your own personal work around this.” And apologizing just puts clients in a position where they feel obligated to say, “Oh, it’s OK,” she adds.

Instead, she advises counselors to reflect on their own internal experience and to tune in to what might be prompting that response. Perhaps it’s a case of the counselor wanting to protect their own ego, or maybe they are masking their own discomfort or lack of knowledge. If counselors find themselves becoming defensive in session, they can tell the client, “I feel like I’m reacting to something right now, and I recognize that I need to do some self-reflection. But I don’t want to heap that on you.” But do this briefly, Hammonds says, or else the session becomes about the counselor rather than the client.

Building trust and rapport also becomes critical to creating a sense of safety for these clients. Too often, counselors jump to diagnosis and treatment because the mental health system encourages them to have a solid plan and work toward a goal fairly early in treatment, Hammonds points out. She encourages counselors to slow down and first invest time in establishing good relationships with their Black clients.

Context matters

As Avent Harris, an ACA member, points out, counselors won’t be aware of needing to broach the topic of racism unless they understand its historical and political context. Put simply, they have to know what to look for and ask about.

“You don’t learn this context or gain this cultural awareness by just reading the DSM [Diagnostic and Statistical Manual of Mental Disorders],” says Avent Harris, who specializes in multicultural considerations in counselor education and the role of spirituality in Black mental health help-seeking behaviors. She advises counselors to move beyond reading only counseling texts to explore the works of Black scholars, theologians and authors.

Counselors may also need to adjust a technique or approach to better fit with their clients’ experiences. For example, the thought of going for a run in the evening sounds straightforward, but for many Black people, and Black men in particular, it can evoke a sense of fear. They question whether they will be safe or if their choice to run could cost them their life.

If a client brings this fear up in session, it could be dangerous for the counselor to use a thought-stopping technique, with the aim of interrupting, removing and replacing the client’s “problematic thoughts,” Hammonds explains. Suggesting that the client simply stop thinking that running could harm them ignores their experiences and the existence of the racism embedded in society, she says.

Instead, Hammonds, president-elect of the North Carolina Counseling Association, says the counselor should consider the context around the client’s fear of running alone at night. Where does that fear come from? How does society contribute to or perpetuate this client’s fear and anxiety?

“Those are the types of discussions that we need to be making space for,” she says.

Self-awareness and honesty about biases

Hammonds stresses the importance of counselors reflecting — honestly — on their own experiences and biases. As she points out, counselors often like to think, “I took this multicultural course, or I’ve worked with clients from diverse backgrounds, so I’m doing OK.” But it may not mean that at all, she emphasizes.

This self-awareness starts with counselor training. Working with diverse clients is the best way to learn to appreciate differences and to examine one’s own biases and beliefs, says Crumb, an LCMHC in North Carolina.

This diversity should also extend to counselors’ consultation groups. Avent Harris, an LCMHC associate in North Carolina, looks for colleagues who will provide honest feedback and challenge her own thoughts and beliefs. She says that if she has an uncomfortable moment in session, these colleagues would ask, “So, what made you uncomfortable in that moment? What questions do you need to ask yourself to reflect on that moment?” They wouldn’t just echo her thoughts or tell her “not to worry about it,” Avent Harris says.

Hammonds recommends that counselors continue to record and watch themselves in session just as they did during graduate school and supervision. “There’s so much value in replaying your words and listening from that outsider’s perspective,” she says. The process affords counselors a chance to (re)consider their words, think about the purpose of their statements or actions, and evaluate whether they really listened to and heard their clients.

Counselors should also get their own counselor. “Some of this stuff is deep-rooted. It takes time to dig up those roots, to understand them, to untangle them and to repot them,” Cartwright says.

She jokes that her mother always told her, “Never trust a beautician with bad hair.” This same principle applies to counselors, she says. They have to make sure they take care of their own mental health before working with clients on their well-being. “And clients will be able to tell if you … have done your work,” she adds.

Cartwright, the project director for UNT Classic (a program that addresses disparities in mental health services for Black and Hispanic populations in the Dallas-Fort Worth metro areas) and UNT ICBH Project (a program that supports graduate students during clinical training), suggests that her colleagues, especially those who hold identities associated with privilege, work with a counselor who identifies with a marginalized group or with intersections with which the privileged colleague struggles.

They should also intentionally put themselves in a position in which they are the minority, continues Cartwright, a member of the ACA Advocacy Task Force and president of the International Association of Addictions and Offender Counselors, a division of ACA. For example, she suggests that White counselors attend a Black church one Sunday. “If you are uncomfortable for that short time that you’re there, imagine what your Black clients feel like on a daily basis when they are constantly in spaces dominated by White people,” she observes.   

Finding voice and value

Black clients report to counseling with the same common presenting concerns that other clients have. But in addition, Hammonds says, they often seek counseling because of issues of “voice and value.” They have experiences that either minimize their voice or communicate — overtly or covertly — that their ideas, opinions and problems don’t matter or don’t matter as much as those of others, she explains. Feeling undervalued, dismissed and unheard can lead to anxiety, depression and other mental health issues, she adds.

Cartwright specializes in underserved populations in counseling and counselor education, mentorship in counselor education, and offender and addictions counseling issues. She once worked with a client who was experiencing racism and discrimination at her job. The former client was the only Black woman on a large corporate team, and she noticed that meeting times would suddenly change without anyone alerting her. She also got the sense that her co-workers were talking about her behind her back. At first, she internalized this discrimination and started thinking that she must be bad at her job. She felt like an impostor.

But after another colleague confirmed the woman’s suspicions of racial discrimination, the former client filed a lawsuit and won. The win came at a cost, however. She learned that co-workers had purposely changed meeting times without letting her know. Other colleagues whom she had thought were well-intentioned had made racist and hurtful remarks about her that were uncovered during the lawsuit and investigation.

As a result, the client began to question her judgment and worth. Cartwright helped the client learn to feel valued and trust herself again. They worked on challenging the client’s thoughts that she wasn’t good enough. For instance, they used self-affirming techniques such as daily affirmations and “I” statements that allowed the client to identify and acknowledge her strength and resilience.

Even if counselors can’t relate to being discriminated against at work, they probably can identify with feeling like their voice hasn’t been heard, Hammonds says. With that perspective, counselors can take intentional steps to empower these clients in session.

For example, Black clients often feel like they can’t or shouldn’t tell counselors if they didn’t like the way the counselor phrased something or if a moment in session made them uncomfortable, Hammonds notes. But they should be made to feel comfortable voicing those thoughts, she continues, and it’s up to counselors to create a space that invites that feedback.

Hidden struggles

A May 31 article in the Washington Post reporting on protests in the wake of the killing of George Floyd described a less visible impact of racial violence: “the private weariness and anguish felt by many [B]lack people in the country.” In other words, many Black people are exhausted.

Emotional exhaustion is another reason that Black individuals often seek counseling, Hammonds says. Besides being fatigued from the discrimination and injustices that they experience daily, they often find it necessary to code-switch — changing the way they talk and express themselves when they are outside of their homes and Black communities.

To help explain this concept, Hammonds uses the analogy of counseling professionals switching their “hats” or roles. They may go from teaching to supervision to having a counseling session with a client and back to teaching again, all in the same day, which can be taxing.

“Switching roles, having to constantly pause and reconsider how much you can share and what is your role in this new context, and always being aware of what you can and can’t say and what you can and can’t do is exhausting,” Hammonds says. “And that’s an emotional labor that many White Americans aren’t required to do.”

Black women often face an extra burden. As Avent Harris explains, “Black women are expected both inside and outside their community to not be vulnerable, to not share emotions and to carry the weight of everything on their shoulders.”

This unrealistic expectation can take a toll on mental health. In fact, many of Cartwright’s clients struggle with the “Black superwoman syndrome” — the myth that Black women are impermeable. They feel pressure to do it all and to do it well. Although this isn’t really a syndrome, it does help explain the chronic stress these women endure while trying to juggle multiple roles and keep up with the daily demands placed on them by family, work and community.

Cartwright’s clients often discuss feeling misunderstood at work and how co-workers minimize their experiences. Cartwright normalizes these experiences for her clients, but she also expresses how sad it is that this is their “normal.”

The trauma of racial violence

Instances of brutality and violence against Black people are not new, and neither are the racial disparities that regularly confront them. The main difference today is the ability to easily document such instances, says Hammonds, whose research interests include technology in counseling, multicultural counseling and community determinants of mental health. Almost everyone today has a smartphone in their pockets, and more people are using them to record acts of race-based violence and to demand justice and accountability.

These videos also continually expose others to these traumatic and heinous acts. This can be particularly traumatizing for Black people, who often internalize the traumas they witness because they know it could have easily happened to them, Hammonds says.

The disparaging comments on social media can also be traumatizing and triggering for Black Americans, Crumb adds. For instance, they may read a racist comment made by a supervisor or colleague. Then they have to return to work and sit beside that person, knowing how that person really feels about them.

“And so often, [Black people] are expected to move through the world, to hear all this, to see all this, and have no emotional reaction or response,” Avent Harris says. Counselors can help change this by validating clients’ emotional reactions to racial violence and discriminatory remarks, she adds. This involves letting them know that it’s OK to feel disappointed, sad, angry, scared, anxious or whatever else they are feeling.

The trauma of being exposed to racial violence and remarks also has a collective effect. “Collective trauma is exposure to stressful events that threatened a sense of safety on a group level,” Hammonds explains.

On a recent episode of The Thoughtful Counselor podcast, Hammonds described how repeated exposure to racial violence and discrimination operates like a wound that won’t heal: “That spot’s been nicked so many times. We can go about the process of healing, but before you know it, there is another nick. Then you’re walking around doing your best to cope, shielding that spot, anticipating situations that might nick you again. … You are always on edge. You’re withdrawing. Your trust is slow to build in other people and situations. You feel angry and sad. And you start to think, ‘Is there something wrong with me? Why can’t I get out of this cycle?’”

This collective trauma correlates with symptoms of depression and posttraumatic stress disorder such as avoidance, reexperiencing, numbing and hyperarousal, she adds.

If a community experiences stress together, then counseling approaches that draw on the power of relationships are helpful, Hammonds says. These approaches include relational therapies, psychodrama, drama therapies, creative approaches and group therapy.

Hammonds often incorporates music into her sessions with clients. She describes music as being akin to a picture book because it connects people to a certain memory, place, emotion or experience in their life.

When clients can’t easily describe their thoughts, feelings or perceptions in their own words, she asks them to think of a song that best captures their emotions or that represents what they see around them. She then pulls up the song and plays it in session, asking the client, “What is powerful about this song? How do the lyrics or beat affect you?”

Impacts on Black children

In the summer of 2016, Philando Castile was fatally shot in his car by a Minnesota police officer during a traffic stop. Castile wasn’t alone. His girlfriend, Diamond Reynolds, and her 4-year-old daughter witnessed the entire incident.

After the shooting, Reynolds, who was now in handcuffs, was understandably distraught and emotional. Her daughter tried to comfort her, exclaiming, “Mom, please stop saying cusses and screaming ’cause I don’t want you to get shooted.” A few minutes later, the girl said, “I wish this town was safer. … I don’t want it to be like this anymore.”

The girl’s words illustrate how racism and racial violence affect children even at a young age. “Black youth are just as affected as their Black parents are by systemic racism and injustices,” says Crumb, an ACA member whose research interests include rural and school-based mental health services. Black children are affected directly and indirectly. They witness racial violence and discrimination themselves, and they hear adults talking about it at the kitchen table. “Then, they assume these thoughts, these fears … [and] this distrust,” Crumb adds.

Again, counselors should take the initiative to broach the topic of racism with these youth. Crumbs calls it “taking the temperature of the room” because counselors can check in to see how children are doing. For example, a counselor could say, “This has been a tough summer with COVID-19 and a lot of people getting harmed and dying. How are you feeling?”

Then counselors should let the children guide the conversations, Crumb says. Some may verbalize their feelings. Others may use play or draw a picture to express their emotions.

Crumb points out that school settings are often the only access that some Black communities have to counselors. But because of mistrust and fear, they may not view counselors and schools as “safe spaces.” Crumb advises counselors to be mindful of current and historical racial inequities within school systems and to alter their approaches accordingly in attempting to connect with these children.

Younger children may not have the vocabulary to easily communicate their feelings. They often “speak” through play and toys. So, Cartwright recommends that counselors keep an assortment of toys, dolls and activities that will allow children to communicate in the way in which they feel most comfortable. If they want to use a brown doll, counselors should make sure it is available to them, she adds.

But as Reynold’s 4-year-old daughter demonstrated, some Black children possess an early awareness of racism and a vocabulary to discuss it. They often have little choice. Black children will be exposed to inequities earlier than their White peers because of their parents’ lived experiences and the conversations they overhear, Avent Harris explains.

Crumb encourages counselors, especially school-based counselors, to be courageous in advocating for Black youth. Black youth are often overlooked academically and are disproportionately suspended, she says. Counselors can be vocal in questioning why that is the reality. Likewise, if diagnoses of attention deficit/hyperactivity disorder and conduct disorders are disproportionate toward one ethnicity, counselors can ask questions and press for answers.

More than that, counselors can do something about such disparities. For example, they can lead professional development trainings for teachers, Crumb says.

Partnering with the Black community

Black people may rely on informal networks of support such as family, friends and their church communities when it comes to issues having to do with their mental health, Crumb says. She add that counselors should encourage clients to continue using these supportive networks because it is imperative that they have trusted individuals to whom they can turn to discuss their experiences of race-based trauma.

Counselors should also reach out and form relationships with stakeholders in Black communities. Crumb and Avent Harris recommend partnering with community organizers, historically Black Greek-letter organizations, those involved with the juvenile justice system, law enforcement personnel and faith leaders.

Faith leaders are often both spiritual and political leaders in the Black community, Avent Harris says, so collaboration with them is crucial. “A lot of times, how [Black Americans] conceptualize events, crises, pain and suffering is coming from [their] spiritual beliefs systems,” she adds.

In an article written for CT Online after the 2015 church shooting in Charleston, South Carolina, that took the lives of nine Black people, Avent Harris suggested that counselors could meet with Black pastors and offer to speak in their Sunday morning services, co-sponsor a mental health day or provide referral resources.

Counselors should also think of these partnerships as a preventive measure. Counselors need to be invested and involved with Black communities before crises happen, Avent Harris stresses. She challenges her colleagues to name five contacts they have a working relationship with in the Black community and could reach out to immediately. If they can’t name five, she says, then they have some work to do.

Less talk, more action

The words diversity and inclusion have steadily gained prominence in the counseling profession, but Avent Harris believes this has allowed counselors to largely become complacent and not move past thinking of “change” as simply including and hiring diverse individuals.

“It’s not just diversity and inclusion. It’s how we’re doing equity work, how we are doing anti-racism work,” she emphasizes. “What are our actions behind the words that we say? And do our actions align with what we say and who we say we are as a profession?”

Avent Harris, like many other Black people, is exhausted from having the same conversation over and over again about what the Black experience is like. “It’s time to move beyond that talk and really implement action,” she says.

Taking action doesn’t mean that all counselors have to hit the streets and protest, but they can commit to influencing the spaces they are in, Crumb says. Maybe that’s writing an article. Maybe that’s offering a training. Maybe it’s working to inform policy. Maybe it involves working toward making positive change in their communities or within themselves.

Cartwright also suggests one small step counselors could take that would have a huge impact: making their services more accessible to communities of color by offering one pro bono slot a week or having a sliding scale.

Although 2020 hasn’t been the year we wanted, it may be the one we need. Every day, we hear the global rallying cry, “Black Lives Matter.” Behind that cry are Black people who are suffering and dying because of systemic racism. We hear the refrain: Trayvon Martin, Tamir Rice, Eric Garner, Philando Castile, Charleena Lyles, Atatiana Jefferson, Breonna Taylor, Ahmaud Arbery, George Floyd, Tony McDade, Rayshard Brooks, and countless others who have died.

These are the tragic killings that make the news. But how many others die daily without drawing widespread attention? How many more face daily injustices or discrimination?

Yes, their lives matter. And their mental health does too.

 

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On June 22, the ACA Governing Council issued a statement on anti-racism. As this article was being written, ACA leadership was listening to a cross section of members and volunteers to develop an action plan that would give life to the statement. For more, see tinyurl.com/ACAAntiRacism.

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.