As a therapists and change agents we get to work with clients daily and witness their stories and transformations. We are equipped to address hard issues, be it depression, addiction, or even trauma with our clients and witness the hard steps taken towards change. However discussion about issues that impede a person's wholeness and sense of well being are not always about presenting conditions found in the DSM-V. It is equally as important to discuss issues of identity and the reality that our society and the populations we serve still experience disparity in issues related to race, class, gender, power and privilege. Even still, these conversations. Trust me..I understand! Below are some considerations I have found useful when starting these conversation in therapy. I would love to hear your thoughts and related experiences. Please share your comments.
8 suggestions for therapists on how to openly discuss race, power, privilege and social class issues in therapy:
1. Be open minded and curious. Ditch preconceived ideas and beliefs about a person’s race, culture and ethnicity. Make no assumptions about a person’s experience based on their identity.
2. Consider how racial/ethnic differences between client and therapist might affect the therapy. Discuss openly about race differences (between therapist and client) at the start of treatment. This invites dialogue and communicates an openness, making it clear that the therapist is available for these conversations.
3. Don’t be discouraged if the client is not interested in discussing these issues right away, if even at all. The impact of making the discussion available is significant in building rapport, demonstrating willingness and establishing trust.
4. Acknowledge that power, privilege and racism may affect interactions between you and your client. You both may have feelings that get stirred based on your individual experiences. Be aware that conversations about race, power and privilege can be difficult. Particularly when the therapist is a member of the group benefiting from power discrepancies.
5. Don’t be surprised by resistance or strong feelings from your client (or you as the therapist). These are delicate and sometimes painful subjects to broach. However in doing so, as mental health professionals, this demonstrates vulnerability and a willingness towards learning; as we are all (hopefully) striving for multicultural humility in our work and interactions.
6. If you are wondering whether the discussion is necessary or appropriate; err on the side of Yes! Be willing to take risks with your clients.
7. Therapists should be self-aware enough to examine any personal reactions or barriers to having such discussions. Seek supervision often around these issues and approach any personal feelings with curiosity.
8. Be aware that historically, psychotherapy has been a service accessible to mostly those of privileged backgrounds. Although this is changing, many cultures do not view psychotherapy as a viable option. Whether this has to do with limited resources or cultural considerations, therapists should be able to have those discussions with clients.