For months, prior to this writing, the daily news feeds have been rife with grim updates on the COVID-19 pandemic. Yet it appears that there is a parallel pandemic occurring: that of racial discrimination unleashed because of COVID-19.

Researchers at the Australian National University are inviting people to record their experiences of racism following on from the Australian Human Rights Commission reporting a spike in racial discrimination complaints linked to COVID-19. Lead researcher Dr Michael Platow says that COVID-19 has allowed racism to thrive, that it is enabling a “prejudice pandemic” in that – both in Australia and around the world – it serves as a rationale for racism (Strategic Communications and Public Affairs, 2020). Simultaneously, the death in the United States of several unarmed black men in white police custody has sparked global protests against the treatment of people of colour.

As a mental health professional, you may be asking what these two seemingly unrelated events have to do with each other, or with counselling. You could also be forgiven for asking what – given the global nature of this issue – you can do, and what your responsibility as a counsellor/therapist may be. Our preceding article discussed racism and how it often manifests in covert microaggressions against its targets. In this article we detail some of the mental health professional responses that can address racism, both on personal and societal levels.

No overt racism, but what about implicit bias?

So here you are, most likely an ethical, broadminded counsellor/therapist who abhors intolerance and racial prejudice, and we’ve just said that you can address racism. Perhaps we even intimated that you have some responsibility to do so. What can you do?

Lance Smith, an American Counseling Association member whose research focuses on racial bias within the counselling profession, advises that counsellors should start by looking within. Conceding that most counsellors’ training emphasises diversity, he nevertheless maintains that societal bias can influence counsellors. Each year, this associate professor and school counselling coordinator in the University of Vermont counselling program has his students take the Implicit Association Test on race. He says that most show an automatic bias in favour of white people. That doesn’t mean, he says, that his students – and most counsellors – are racists. Rather, Smith explains it as a phenomenon which sees white dominance being “downloaded into our software without our permission” (Meyers, 2017).

With the Implicit Association Test, Smith is acknowledging that most counsellors do not exhibit overt (sometimes called “old-fashioned”) racism, but the therapeutic relationship is not immune to the subtle microaggressions (click here for discussion on this in our previous article) that are so powerfully able to undermine it.

Monica Williams, a psychologist and associate professor at the University of Ottawa, talks about the experience of race-based trauma (trauma resulting from the cumulative experience of racism, as opposed to experiencing it in a single, discrete event). She notes that many white therapists, never having been subjected to racism, are dismissive of the impact of racism on their minority clients. It is outside their mental framework to think of racism as traumatic. Typically, such therapists subscribe to a “colour-blind” approach as a way of working with clients from different racial, ethnic, or cultural backgrounds. Some social scientists note, however, that a colour-blind ideology is actually a form of racism, as it offers such therapists an excuse to remain ignorant of the customs and cultures of their non-white clients (and fellow human beings!) (William, 2013).

Microaggressions to look out for

So, how might subtle microaggressions insert themselves into a therapy session? Williams offers examples of statements made by actual therapists to African American clients:

“I don’t see you as Black. I just see you as a regular person”. The meta-communication to the client here runs something like, “There is something odd or irregular about you due to you being black. I am making a special effort on your behalf to ignore inconvenient differences”.

“If black people worked harder, they could be successful like other people”. Apart from ignoring institutionalised or systemic racism and other social factors which make it hard for minority groups to be materially successful, statements like this show that the therapist has taken on the stereotype that African Americans are lazy. By extension, the client could understand that she is being regarded as lazy, too.

“Don’t be too sensitive about the racial stuff; I didn’t mean anything bad/offensive.” In this scenario, the therapist has made a racially offensive or insensitive remark. The client courageously – given the power imbalance – speaks up about it. Does he get an apology? Nope. Rather, the therapist advises him to get over his hypersensitivity, because the therapist “meant well” (Williams, 2013).

As counsellors, we make a commitment that our first responsibility is to “do no harm”. But for a vulnerable client, already feeling stigmatised by showing up for therapy, remarks such as the above create distance from the therapist, unwillingness to share sensitive information, and lead to early termination from the treatment. Do we know how much harm such therapist remarks might make?

No, but research by Constantine (2007) has found such microaggressions to be the largest predictor of dissatisfaction with counselling by African American clients; the clients believed that such therapists were incompetent and the therapeutic alliance consequently suffered.

Helping clients with race-related stress

Let’s be clear about how long the tentacles of racism are. They extend beyond problems in people’s social and economic lives, stretching into physical and psychological health issues. Race-related stress, which can build to a level of trauma, can occur even if the minority group member was mistaken that a racist act occurred; it is only necessary for the person to believe that they were a victim of racism for race-related stress to happen.

In addition to the obvious emotional reactions of anger, sadness, anxiety, fear, frustration, depression, isolation, and a sense of helplessness or hopelessness, people may experience paranoia, resentment, self-blame, and self-doubt. They may try to cope maladaptively with avoidance tactics, disengaging, or substance use. Health concerns may range from heart disease, hypertension, muscle tension, and sleep disturbances to digestive imbalances and issues.

Stereotype threat

And here is one that the typical therapist of a minority client may not have thought of: stereotype threat. Those who feel isolated due to experiences of racism may be reluctant to interact with people from other racial or ethnic backgrounds or participate in community activities because of the fear that their actions will confirm existing stereotypes about their self-identified racial group.

Such clients may fear that others will see them not as the individuals they are, but as representatives of their racial or ethnic group. Carrying such a load induces much anxiety, negatively impacts performance in many life domains, and can lead to the Imposter Phenomenon (Brown University Counseling and Psychological Services, 2020).

What is the Imposter Phenomenon?

If a person internalises the negative racial stereotypes about the capabilities of their racial/ethnic group, they may begin to feel like an imposter (as shown by statements such as, “Oh, I probably only got the job because they needed more (fill in the blank with the name of the minority group)”. The effects of Imposter Phenomenon include anxiety, denial of competence, fear, guilt, life dissatisfaction, overachievement (as people march “double-time” trying to be good enough), paranoia, sadness, and shame.

If your client suffers from this, they may refuse to answer questions in any class they are in, fail to put their hand up to try new projects at work, or feel only temporarily satisfied after a successfully completed project, because they refuse to view the success as proof of their capabilities. An unsuccessful project, meanwhile, may result in the person feeling “validated” about their lack of capability (Brown University Counseling and Psychology Services, 2020). Such a person lives in constant fear of the “truth” about their capabilities being “seen” by colleagues, bosses, peers, and partners.

How the counsellor can help with Imposter Phenomenon

First, understand that your awareness of the issue, along with unwillingness to dismiss its hurtful power, will do much to help clients fully let in what they are dealing with. The traditional helping tools of building a strong support network (particularly including members of their cultural group) and leaning into any spiritual holding they may have can be invaluable.

You can encourage such clients to take classes or otherwise study about the historical experiences and contributions of their cultural group. Ultimately, you are likely to be doing a lot of CBT-style re-interpreting and reframing negative situations, as in the following three steps:

  1. Have the client identify negative feelings, which can lead to erroneous negative thoughts
  2. Get the client to do a reality check with you, identifying examples that counter the negative (self-doubting) thoughts and feelings.
  3. Make a more positive re-interpretation

Always, clients need to know that they have been “heard”, and feel that they have been “met”. Racism is real and it hurts.

Get out of the office and into the community

Most counselling programs offer guidelines for multicultural competencies to their trainees, but some observers note that academia’s contribution to stamping out racism is not enough, and counselling practitioners need more than academic standards of cultural competence. Courtland Lee, a past president of the American Counseling Association who has written much about racial and social justice issues, argues that counsellors need to understand the trauma that results from police brutality and living in oppressed neighbourhoods, or what it’s like to live pay cheque to pay cheque.

In short, she says, counsellors need to get out of the office and into the community to talk with people (not just clients) about real-world issues. In addition to direct work with clients, counsellors can help address issues of race and racial tension in some of the following ways:

  • Making themselves available to facilitate dialogue between the community and the local police. Given the miscommunications that have occurred in both the United States and Australia, a training initiative to build not only the cultural competence of police, but also their basic communication and helping skills, would be invaluable. Some observers have commented how secondary victimisation occurs when victims of racist hate crimes (that is, minority group members) encounter law enforcement personnel who purposefully fail to characterise the racist aspect of the crime. At best, victims of such crimes have found legal remedies to be reluctant or unresponsive. At worst, they have rightly perceived law enforcement personnel to be among their most brutal, powerful victimisers (Craig-Henderson & Sloan, 2006).
  • School counsellors and other mental health professionals could sit on the school board to advocate for an anti-racism curriculum in the school.
  • Clinical mental health counsellors and other mental health professionals should sit on state boards on peak bodies to ensure that licensures and certifications include competencies about anti-racism.
  • Counsellors can form support groups of other counsellors and like-minded co-workers who also understand how big – and how undermining of society – the issue of racism is (Meyers, 2017).
  • When out in the community and viewing racially-motivated actions, counsellors can harness the power of the bystander (assuming they can do so without putting themselves at risk), by:
    • Speaking up, calling out racist slurs and actions for what they are, and letting the perpetrator know that it is not acceptable
    • Supporting the victim, standing next to the person being targeted and asking them if they are ok
    • Taking evidence, recording incidents on the phone, taking a picture of the perpetrator, and reporting the abuse to authorities (Australian Government, 2020).

The main idea here is that, in terms of the “racial pandemic” we spoke of earlier, counsellors have a role to play in getting out of the office and into the community to fight the forces of intolerance which drive frustrated, despairing clients to our rooms.

Counselling after the hate crime

A majority of victims of hate crimes cope well with little or no assistance, but some may require more help. In cases where you receive into your rooms someone who has been the victim of an overt, racially-motivated hate crime, there are four principles proposed by the United Nations Office for Drug Control and Crime Prevention (1999) to guide your work.

  1. Counselling should be focused only on the criminal incident and the consequences of that incident. The post-victimisation counselling should be “trauma-specific”, which requires victims to be assessed for development of PTSD and anxiety. Doing this helps ensure that the victim confronts the crisis reaction, thereby beginning the path to full recovery.
  2. The counsellor must assume the role of a “silent” partner in order to ensure the victim’s independence. For example, if a client decides to re-locate their housing, the counsellor can provide guidance and support, but should not expect to be involved in locating the home or doing the client’s packing. Recovery for the victim will be faster if they perceive that they are in control of their life and able to execute desired changes.
  3. Counsellors can help victims to find meaning in their experience by encouraging them to consider spiritual, legal, and philosophical forms of expression. These will help clients to overcome the sense of nihilism common after criminal victimisation; effective coping often involves the search for meaning.
  4. Counsellors need to recognise their victimised clients’ needs to alter existing routines or to create new ones. As a matter of safety at least, daily routines may need to be dramatically altered. Hopefully, the counsellor can nonjudgmentally support the decisions made, but if the choices are consistently maladaptive, the counsellor may need to refer the client to further support resources in the community.

These principles can be embodied in the psychoeducation, review of legal implications and options, establishment of support networks, and revisitation of the hate crime that will also need to happen at some stage in the counselling process (Craig-Henderson & Sloan, 2006).

Summary

Sadly, despite decades of racism being fought on multiple fronts in many countries of the world, it is still with us, either in the form of overt racism, such as racially-motivated hate crimes, or in the insidious form of microaggressions perpetrated – often unconsciously – by many highly moral people who consciously loathe the idea of racial intolerance. We have suggested that counsellors can have a significant role in helping reduce its powerful negative impacts, both in direct work with affected minority group members and in their community work. Specifically, we noted that counsellors should start by looking within and introspecting to discover any unconscious bias which may “leak” into sessions and jeopardise the therapeutic relationship. As counsellors, we need to help clients understand and overcome the negative impacts of race-based stress found in stereotype threat and Imposter Phenomenon. Importantly, we are urged to get out of our therapy rooms and into the community; we noted numerous roles counsellors can play in this regard. If working with a victim of a racial hate crime, we have advocated that the four principles of the U.N. Office for Drug Control and Crime Prevention be followed in order to most greatly assist the client.

We end with the sober reminder that many, if not most, counsellors go into the helping business because they want to play a role in maximising human potential. To not act against racism when we see it happening is to sacrifice a massive opportunity for that maximising.

References

  • Australian Government. (2020). Racism is not acceptable. Australian Government. Retrieved on 8 July, 2020, from: Website.
  • Brown University Counselling and Psychological Services. (2020). Coping with race-related stress. Brown University. Retrieved on 9 July, 2020, from: Website.
  • Constantine, M.G. (2007). Racial Microaggressions Against African American Clients in Cross-Racial Counseling Relationships. Journal of Counseling Psychology, 54(1), 1-16.
  • Craig-Henderson, K., & Sloan, L. (2006). After the hate: Helping psychologists help victims of racist hate crime. Clinical Psychology Science and Practice, May, 2006, 481-490.
  • Meyers, L. Facing the realities of racism. Counseling Today. Retrieved on 9 July, 2020, from: Website.
  • Strategic communications and Public Affairs. (2020). Australian National University. Retrieved on 8 July, 2020, from: Website.
  • United Nations Office for Drug and Crime Prevention (1999). Handbook on justice for victims. New York: United Nations Office on Drugs and Crime.