Diversity - Guidance for Contextualising Clinical Psychology Teaching to account for Anti-Racism

It is important to acknowledge how difference is understood and experienced across the different aspects of psychology, specialisms, research and testing and outcome materials. The first step in doing so is to recognise issues of difference – or as is often the case, the lack thereof. This includes thinking about the benefits and strengths these differences bring. To consider this, you could include the following:

• Which communities are more served by the given services and why that might be the case?

• Who is excluded and who is regularly centred in the given context?

• Who are the most and/or disproportionately affected by a given experience or represented in a given service/research?

• How are research methods and content influenced by this, i.e., qualitative research mostly through white, western lens, “norms” used in quantitative research are not applicable to other communities, racial bias and discrimination of authors/clinicians influencing interpretation. 

• Recognition and discussion of over-presentation and under-representation of communities in given context, i.e., people from racialised backgrounds are over-represented in psychosis and forensic services, but less likely to be offered primary care services or to be seen in eating disorders service.   

The faces and founders of psychology are overwhelmingly that of white men. One’s social identity, positioning and power influences the perception of others. For psychology this results in an almost homogenous group defining what is routinely considered normative psychological experience, thinking, behaviour and therapy.  It is not possible for any author or clinician to achieve true objectivity because perceptions, biases and positioning form the lens from which the world is viewed. It is therefore essential to apply an additional critical lens to all theory, assessment and therapy. The following is worth considering:

• What are the social identities and intersections of the authors/clinicians?

• What were the values and beliefs held by the authors/clinicians?

• What are the likely biases and blind spot these authors/clinicians might have?

• How might this be of disadvantage to certain groups of people and where do we see this manifest today?

• What was the political context during the times this author/clinician was developing this work?

• What communities does this author/clinician centre/focus on?

Theories and models are often centred on European and American, white, western ideologies and experiences, thus psychology has long been considered for white people, by white people (White 1979). To consider this, your teaching content could explore the following:

• Who are these ideas/theories/approaches based on or developed for and who are excluded from them or who do they not apply to?

• Who do they benefit and who do they disadvantage, i.e., who is required to mould themselves to the apparent “norms” of experiences and behaviour?

• Is this idea/theory/model sensitive to different needs or adaptable to different communities?

• Who is likely to be considered “mentally ill/abnormal/non-compliant/not psychologically minded” for presenting differently?

• What was the political context during which these ideas/theories/models were developed?

• Is there a link between the development of said idea/theory and oppression?

• What led to the development or was the function of these ideas/theories/approaches, i.e., much of the early work on intellect was a directly linked to the justification of racial segregation in schools.

Racial trauma (unlike other traumas) often perceived as an internal process and viewed as an inability to cope or manage emotions (suggesting that people are paranoid or sensitive) rather than acknowledging the impact of external factors that perpetuate racism i.e., systems and institutions. Racism, directly or indirectly, macro or micro has a significant impact of physical, psychological, and emotional wellbeing. To consider this, the following could be included:

• Routine consideration of racism and discrimination as traumatic experiences within a person’s context, including the explicit assessment and exploration of a person’s experience of being racialized and reflection on the potential for intergenerational trauma at a biological, psychological and social level

• Acknowledgement that while racism and discrimination can directly influence wellbeing, this also happens indirectly through experiences of othering, isolation, identity problems etc

• To consider these experiences in formulations, in fact, racism should be considered as predisposing and preparing factors (Beck, 2019)

• Recognition that as health professionals and systems we are part of, we are likely to perpetuate these experiences

• Explore how racism and discrimination is experienced by clients in different/specific services, i.e., racialised people more likely to be detained and less likely to be offered talking therapies or how in physical health settings they are less likely to be offered pain medication and more likely to die in childbirth etc.

The term “ethnic minority” is widely and regularly used to describe “non-white, non-western” communities.  This is problematic as the implication is therefore that all people from racialised background can be summed up in one smaller, inferior and “other” group. This is replicated in psychology, where European/Western (and white) ideologies are synonymous with “normal”. This is also perpetuated in research whereby European/Western psychology content is regarded as superior (more sophisticated and scientific etc). This doesn’t only reinforce biases within psychology, but also fails to make good use of the ideas, theories and models developed by the vastly diverse communities that are part of the global majority. To account for this, you can consider the following:

• Are all the resources and papers you are sharing developed and/or written by only European and American authors/clinicians? If so, how does this effect the lens from which the teaching is being delivered?

• Are we critically evaluating the resources we include in the context of difference and biases?

• How do you decide the quality and usefulness of resources?

• How can you actively seek and include resources from the global majority? Or ideas from Indigenous Psychologies, Liberation Psychology, African Psychology, Faith-based Therapies etc.

• What are the merits of including resources developed and/or written by the global majority within the given context?