Moving from Cultural Competence to Antiracism

We’ve all heard about cultural competence in clinical practice. And while it’s important, it’s also not enough.

So today, Thema Bryant-Davis, PhD will get into some first steps in becoming an antiracist practitioner.

Click here for full transcript

Dr. Bryant-Davis: So, it’s important to know that white therapists can be anti-racist therapists. What I mean by that, as opposed to just cultural competence – cultural competence is often about like, “Have you learned some information about different communities, do you have some sense of your own identity?” But to have an anti-racist stance is more active, it is more intentional, and some directories or mental health networks have started educating communities of color to tell them that it’s a small percentage of psychologists and mental health professionals that are ethnic minority. So as they’re looking for therapists – and you can even have an ethnic minority therapist who does not have that consciousness around being actively anti-racist – so, what these networks are recommending to people when they call to look for a therapist is to ask them, “What are your thoughts about the impact of racism on mental health? What are your thoughts about the impact of white supremacy on mental health?” as a taste test. If the answer is, “I believe people are people,” well then there you have your answer that this is not someone who is going to be able to acknowledge and engage with you because they’re not even willing to acknowledge that it exists and that it has an impact. It’s important to be able to communicate awareness and compassion that these events are happening, and that oppression is a reality now. That historical piece is helpful to know and it is very important to be able to not go into victim-blaming. So when we go in to try to defend and explain people who have said or done harmful things, then it lets the client know, “This is someone who is not really safe for me, they’re not really for me,” and it what it requires from us – and when I say “from us” I mean whenever you’re a part of the majority group – is to release my defensiveness because our usual tendency is to connect with the person we see as a reflection of ourselves. Because if the mom did something bad, then maybe that means I do something bad, so that I need to make it okay. And so, the example that comes to me from my own experience is around working with clients with disabilities as an able-bodied person. I was teaching multicultural psychology, and I had a guest presenter who uses a wheelchair and she was talking about coming across the campus at a place where I used to teach and the invisibility of systematically everyone refusing to look at her. As she came across the campus, no one would look at her. So in my “able-bodiedness”, what my instant defensive instinct, which I didn’t speak on but what came to my mind, was I know what that is because I have done it, in terms of trying not to stare looking away, without ever taking into consideration what would it feel like if everyone does that, if everyone is averting their gaze? Again, that difference between intention and impact – even if you did not intend to be rude or mean, that it is an erasure, and so to be able to sit with that. What I would say for white clinicians, when an ethnic minority client is describing an experience, your instinct may be to try to figure out how they could be interpreting it incorrectly because we want to believe that things are fair and right. Maybe I would do that or maybe my cousin would do that, and we’re not bad people, but instead to really sit with, “What is it this person is saying and what might it be like to have that experience?” and then to respond with that support. I want to say, actually, that that can be very therapeutic and healing in a way that hits on another level than them hearing it from me. What I mean by that is when I’ve had rape survivors who were raped by a man had a male therapist tell them how wrong that was of what happened to them, it registers in another way because this person in some ways they identify with that group. So instead of feeling powerless, like, “Oh I won’t be able to help my ethnic minority clients,” instead, with humility because people have talked about now not just cultural competence but cultural humility which is, “I don’t know everything,” and a continuous learning and an openness and a recognition. So, with humility and compassion, this could really be a therapeutic moment, it could really be healing.

What are your biggest takeaways from what you just heard? Please let us know by leaving a comment below.

If you found this helpful, here are a few more resources you might be interested in:

Working with the Trauma of Racism

When Staying Neutral Isn’t the Best Approach

The Same Pandemic, Vastly Different Experiences

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192 Comments

Nancy Ferguson, Marriage/Family Therapy, Chapel Hill, NC, USA says

This is important information to share with therapists because we are often of another group than our clients–age, sex, ethnicity, race, etc. The client needs to feel and know that we are able to enter into their world as they share their trauma with us as therapists. It takes courage and humility for both the client and therapist to work successfully together for an effective patient outcome.

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Lori Sangha, Counseling, CA says

I so appreciated this information and especially hearing again about the key differences between “cultural competency” and “anti-racism/oppression”….more active and compassionate orientation…
As a woman from a visible minority I am also privileged in many ways …..how clients from my own culture (ethnicity perhaps is more accurate) view me, how I “sit with them” and how I acknowledge and accept this dynamic, has always been of great curiosity to me.

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Courtney Lee, Social Work, Seattle, WA, USA says

I really like the way the Dr. Bryant-Davis explains the way white practitioners can be harmful, but also healing. I also love the question she encourages clients to ask potential therapists, they need to be able to answer that! Absolutely. I also appreciate how Pat Ogden reminds the white therapist that if the client’s goal is not to talk about social justice, then we drop it because it’s about the client’s goals, not ours.

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Tamarah F., Student, CA says

Thank you for this constructive reminder how, in all facets of life, those of us with certain privileges (always and, more acutely, at different moments) can work to better support those who are systemically marginalized feel validated and supported and not dismissed – particularly in the most vulnerable of relationships. Committing to being anti-racist is an always active awareness and approach that begins with accepting that racism IS systemic; listening and taking in the individual’s experience, and; requires affirmation – not downplaying or dismissing that person’s experience – even if the intention is to comfort them. Feeling a need to say “I’m not racist” (even with the best of intentions and even silently to oneself) makes it about the self and not the person in front of us. It reroutes the conversation away from them with a defensive non sequitur.
Thank you again.

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Olia, Marriage/Family Therapy, FL, USA says

Great clip. Being vulnerable and work through issues takes courage and humility…and readiness for the challenge…

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Mike A, Another Field, Los Alamos, NM, USA says

Oh my gosh, thank you!

I am not a practitioner, but I am actively involved in anti-racism, and one thing that has been different for the past couple of years is that for the first time in my 50 years of life, I am not having the experience of being constantly gas-lighted by all, or almost all, non-brown-skinned people around race issues.

I have also been leading a men’s group, where we are listening to bell hooks on audible and discussing feminism in light of our beliefs, experiences, and values, and trying to figure out how to grow, as men away from blindly accepting the misogyny that is ubiquitous in society.

One result is that on a closed forum for sober people (I’m sober 25 years) the discussion of sexual predators in ‘support groups’ came up.

I noticed that one woman, a survivor, was fearlessly making a case, which was being minimized, dismissed, and/or gas-lighted by others.

I posted a (rather long comment) about how society is absolutely fine with sexual assault against women and children, which I backed up with evidence. I pointed out how those societal issues would obviously be introduced into our support system, and that if we claim to be there to help people who need to get sober, we need to be on the lookout for and be ready to address predation, including when it isn’t illegal, but simply immoral.

I then went on to say that I certainly wouldn’t end up agreeing with every single thing the woman might say, but that for purposes of this thread, I have her back, that her comments have consistently hit the nail on the head and that people should stop arguing and start listening.

She sent me a message thanking me and letting me know that my comment made her cry. It is powerful to find an ally who is part of the opressing group.

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Javier, Counseling, AT says

I read a good deal of posts that are interesting
here. You spend a whole lot of time writing, Thanks for sharing!

Best regards,
Abildgaard Schneider

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Linsday Purcell, Occupational Therapy, Brooklyn Park, MN, USA says

I appreciate this video so much. We watched this as part of a class in my Master’s OT program at St. Kates in St. Paul, MN. In general I have taken in some education about anti-racism, but not from a practitioner perspective as much. I understand how the overall health-care system takes part in systemic racism and I hope to not contribute to that in anyway when I am in practice. I really like the idea of validating a patient’s experiences of not being heard, or dismissed due to prejudice. We know this happens much more to ethnic minorities and I think it’s important to take a step back and ask about a person’s previous experiences with health care workers, ask how they understand their condition/illness/disability, etc. and what they know about themselves and what works for them. This is good practice for all patient interaction, but especially as part of the way to practicing cultural humility to me.
Thank you for this talk.

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Pineiro-Hall, Counseling, USA says

Good measure of awareness when looking for a therapist as well as a great interview question!!! “What are your thoughts about the impact on racism/white supremacy on mental health?”

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Christine Clock, Another Field, Spokane, WA, USA says

Such great examples that Dr. Bryant-Davis used! Being able to link how someone feels in other situations to how someone might feel that has experiences racism was very helpful. The healing that can happen when we receive affirmation from the offending party, even If we were not the perpetrator, but just have a similarity to the perpetrating party, was also encouraging to hear. Thank you for this video, I found it to be inspiring and enlightening.

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Rebecca Denby, Psychotherapy, CA says

Thank you for this video, Dr. Bryant-Davis. I liked the example you provided regarding intention vs impact and why it is impact that matters. Also, I had not yet heard the term cultural humility and I appreciate the opportunity to learn it.

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Amelia Caudle, Social Work, Winston-Salem, NC, USA says

Thank you — very good things to be aware of and I am so glad we are having these conversations.

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Donna Clark, Counseling, Coatesville, PA, USA says

That was validating!

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Johanne Goncalves, Counseling, AU says

A recent conversation with two colleagues at work raised the issue that a white person cannot truly understand what it feels like to have the subjective experience of racism. I have attended Cultural Competence training and information sessions and I cannot remember being asked the question “what would it feel like to have the experience of being racially vilified?” I continue to feel disappointed when people keep making the statement “All Lives Matter”, in response to the “Black Lives Matter” campaign. Of course all lives matter, however, this campaign is about anti-racism.

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Catherine Gonick, Another Field, NY, USA says

So how does one look at a person in a wheelchair? I know averting eyes is harmful, but what is in between that and staring as a walking person passes a person in a wheelchair?

I liked the example at the end, comparing the effectiveness of a male therapist affirming to a woman the wrongness of rape to that of a white therapist affirming the wrongness of racism to a black patient. Citizen to citizen, the white person would be told that antiracist talk is not enough; you need do something.

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- Tamarah F., Student, CA says
  
  In response to your question: Perhaps in the same way we’d look at someone with mobility similar to ours. We’d catch their eye as we pass each other. Maybe a small but warm smile. Something that says: “Hi. I see you.” Maybe take note if other’s are noticing (vs staring). It’s the same with people who are houseless. Just quick eye contact. See. Each other. It reminds us both of how connected we actually are.
  
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