Antiracism in clinical practice

The word ‘racism’ brings up a lot of emotions, such as shame, guilt, and anxiety. As a clinician, it is important to respect diversity, to acknowledge that racism is happening, and to ensure that it does not interfere with our behavior in making treatment decisions.

Dr. Kamal explains that ‘racism’ is not a value that you hold, instead, it should be about the impact of a behavior. A dialectic aspect of racism is that a good person can be seen as racist if they said and behaved in invalidating ways, even if they did not want to cause any harm.

According to Platt (2017), there are three types of therapist responses. Anti-therapeutic responses include the clinician’s defensive reaction and the tendency to seek reassurance. Fo example, when a white co-leader was given a feedback that they interjected a color person too frequently, the white co-leader may react defensively and over-explain that they did not mean to be racist. Another type of therapist response is a non-therapeutic response, which is showing passive interactions due to the lack of knowledge. The therapist may not be aware that what they said or did was racist, and it was suggested that white people tend to have a lot of anxiety in “not knowing” about their racist behavior which interferes with treatment. Lastly, a therapeutic response is the ideal response that can bring out a positive therapeutic effect. This is when the therapist accurately and specifically identifies a racist behavior presented in the sessions and directly consider the harm it has caused, who has been harmed, and the necessary skills to tolerate the distress that the harm has caused. It is crucial to extend the DBT skills to target racism in individual and group sessions.

As a therapist, it is important to support diverse groups of patients by carefully considering how a response to racism could influence the therapist-patient relationship and the impression the therapist gives to the patient. When responding to microaggressions, a therapist should express feelings and validate how racism makes the clients feel. Depending on the situation, it may be necessary to pretend that you don’t understand or use humor (Nadal, 2014).

Take responsibility fo your actions.

Consider the impact of the problem behaviors.

State what skills could be used to avoid the problem behavior.