Addressing Role Complexities for the Multiculturally Competent Psychologist: A Brief Report Michelle Melton, Psy.D.

Transcription

1 1 Addressing Role Complexities for the Multiculturally Competent Psychologist: A Brief Report Michelle Melton, Psy.D. There exists an urgent need to directly address the structural factors that diminish the psychological health and well-being of millions of people (Psychologists for Social Responsibility, 2011). As mental health services have become more accessible to diverse peoples and communities, psychologists role in addressing the influences of social, political, historical, and economic contexts on individuals' behavior has also increased in complexity. Psychologists are called to promote societal understanding, affirmation, and appreciation of multiculturalism against the damaging effects of individual, institutional, and societal racism, prejudice, and all forms of oppression based on stereotyping and discrimination. This call to action directs psychologists, implicitly and explicitly, to become involved in public policy to inform social practices. Competencies for psychologists also reflect involvement in prosocial change, particularly the multicultural competencies. Multicultural competencies, hold psychologists to a high standard as we are charged to ally with, advocate for, and, at times, become activists in using psychological science to improve the condition of individuals, organizations, and society. For some in this profession, being called to integrate into the sociopolitical arena is a just and noble cause supported by the ethos of profession. But for others, it may seem beyond the scope of professional training and purpose. What, then, influences psychologists readiness or hesitancy to be leaders in prosocial change? This author hypothesizes that balancing the aspiration of scientific objectivity and the lived experience of our realities contributes to the complexities inherent in this question (and its answer). For example, psychologists have the knowledge, skills, and expertise to understand all aspects of the human experience from the functions of the brain to the actions of nations, from child development to care for the aged (APA, 2015). However, professional expertise does not remove psychologists from the influence of the passions, wounds, status, or privileges of personal identities. In short, psychologists are not the uninvolved observers, whose personal biases, a priori commitments, emotional involvement, etc. are absent in professional functioning. Therefore, the juxtaposition of the professional and the personal calls for a unique and ethical blending. The question then becomes, how might one be an ally, advocate, and/or activist within a profession that values unbiased, sound scientific data to address specific social problems and improve human welfare? The following is a brief report summarizing how advocacy is a foundational and functional competency for practitioners of psychology. It is hoped that the reader will have a more robust understanding of advocacy as well continue to take professional responsibility in demonstrating psychology s place and value within our communities and the world. Should this call to action be made? APA s Guidelines on Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists (2002) indicate the multiculturally competent psychologist provide leadership as agents of prosocial change, advocacy, and social justice. This guideline is also consistent with APA s 2009 vision statement that indicates that those in the field of psychology can serve as advocates, leaders, and champions for psychological

2 2 knowledge and practice informing policymakers and the public to improve public policy and daily living promoting psychological knowledge and methods to facilitate the resolution of personal, societal and global challenges in diverse, multicultural and international contexts; and the application of psychology to promote human rights, health, well-being and dignity (Farberman, 2009, para. 12). Although focus on psychologists being involved in social arenas has become more explicit, psychology s influence in social contexts is not new. Psychological science has long been involved in effecting the conditions of people. For example, G. Stanley Hall, the first president of the American Psychological Association, justified the withholding of civil rights from African Americans because their sexual impulses arrested their development from adolescence throughout life (Stanley, 1905). Another example of psychology s influence on the conditions of communities is the expert testimony of Drs. Clark and Clark in several school desegregation cases, including Brown vs. Board of Education. Drs. Clark and Clark s testimony was based on their research on the effects of segregation on identity development in school-aged children. These two examples, though polar in their impact, exemplify the power of applying psychological science within the sociopolitical arena. Overall, psychology has a place, and adds a unique value, in addressing the effect that structurally oppressive and marginalizing social policies and practices have on the health and well-being of people. Psychologists can approach carrying out social responsibilities in two ways: using zir work as a means for bringing about prosocial change, and/or moving the discipline as a whole toward an integration of activism with scholarship (Lewis, Ratts, Paladino, & Toporek, 2011). The question is no longer if psychology should be explicitly involved, but how can one be an ethical, multiculturally competent psychologist without considering allyship, advocacy, and activism? Defining the Terms It is important to define and understand these roles ally, advocate, and activist to be better able to move effectively in them. Ally refers to a person, group, or nation that is associated with another or others for some common cause or purpose ( Ally, n.d.). Allyship can take many forms. It can be a middle-aged White man wearing a Black Lives Matter shirt while kneeling during the national anthem being played at a middle school basketball game. Or, a Hispanic, documented, woman and psychology practicum student developing and facilitating a group for undocumented Mexican women to address the effects of Arizona s anti-illegal immigration act. Both serve as examples of allyship. Compared to allyship, the role of activist may conjure thoughts and images of chaos and lawlessness. The definition of activist, however, is more unbiased than popular association. An activist is a person who campaigns to bring about political or social change ( Activist, n.d.). Activism ranges from individuals to organizations, from local to international. Activities for campaigning span from organizing and participating in protests to displaying symbols of the campaign itself. For example, individuals who have rallied for pro-life, wore a safety pin on the lapel of a jacket, displayed a MADD sticker, voted in a state or national election, marched for science, signed a petition for stricter gun laws, or argued for stricter sentencing for drug related charges, have been in the role of activist. For psychologists, with an ethical principle to improve the conditions of individuals, communities, and organizations, activism may range from serving on workgroups investigating healthcare disparities to being a member of an organization that

3 3 advance[s] peace and social justice through the ethical use of psychological knowledge, research, and practice ( Our Mission, para. 1, n.d.). Unlike allyship and activism, advocacy may be a more professionally sanctioned role for psychologists. There are several general definitions of advocate that are fitting. For example, anyone who argues the case of another; one who speaks in support of something; or, a person who supports others to make their voices heard, or ideally for them to speak up for themselves ( Advocate, n.d.). APA s perspective seems to build upon these general definitions, highlighting that advocacy is guided by the philosophy that public policy should be based on available scientific knowledge, and that psychological research can contribute to the formulation of sound public policy to address specific social problems and improve human welfare ( Guide to Advocacy, n.d., para. 1). Psychologists who serve on state-wide work groups to develop rules for judges to follow when approving DV offender treatment programs are a direct example of advocacy guided by scientific knowledge to inform public policy. The definitions presented provide general guidelines for the lived experience of each role. However, with such a broad scope to draw from, incorporating and balancing the roles with the other professional functions of a psychologist calls for more deliberate and practical considerations. Practically Speaking To best address the role complexities of being an ally, advocate, activist, and psychologist, the following 4 steps are suggested. Step 1: Doctor, know thyself! Central to becoming effective in advocacy, allyship, and activism is awareness of one s self as a cultural being. More specifically, recognizing that, as cultural beings, psychologists may hold attitudes and beliefs that can detrimentally influence perceptions of and interactions with individuals who are ethnically and racially different from themselves (APA, 2003). Consequently, awareness of one s explicit and implicit biases shapes the (1) recognition of the importance of multicultural sensitivity/responsiveness, knowledge, and understanding about ethnically and racially different individuals; (2) employment of constructs of multiculturalism and diversity in psychological education; (3) recognition of the importance of conducting culture centered and ethical psychological research among persons from ethnic, linguistic, and racial minority backgrounds; (4) application of culturally appropriate skills in clinical and other applied psychological practices; and, (5) the encouragement of the use of organizational change processes to support culturally informed organizational (policy) development and practices (APA, 2003). It is recommended, therefore, that psychologists create a plan for regular self-reflection using practices that lead to the understanding of the effects of the diverse cultural influences on their own beliefs, thinking, behavior, and worldview (Hayes, 2016). Further, because of the way privilege and oppression can separate people, psychologists may need to put in extra effort into finding and learning knowledge to understand the experience of social injustice(s) to serve effectively in the roles of ally, advocate, and activist. Hayes s (2016) ADDRESSING model is an effective tool to assist psychologists in developing awareness of attitudes and biases. The ADDRESSING model (Age, Developmental and acquired Disabilities, Religion, Ethnicity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, and Gender) helps one become aware of the cultural

4 4 influences that shape identity. Using this model may also bring forward awareness of the intersectionality of identity. For example, a psychologist may hold status and privilege associated with their age, socioeconomic status, and racial identity, as well as hold minority status identities in their gender, national origin, and sexual orientation. Intersectionality, then, adds complexity to the roles of allyship, advocate, and activist. Acknowledging this complexity may not provide answers about how to serve in these roles; rather, it may allow for better integration of personal and professional identities and roles. Step 2: Choose a Plan and Act. Integrating roles of ally, advocate, and activist with a professional role and functioning need not detract from one another. Having a plan assists in navigating the integration. A plan can involve change interventions and empowerment strategies (Lewis, Arnold, House & Toporek, 2002). The focus of these interventions and strategies can be individual clients, communities, organizations and systems, the public domain, and/or sociopolitical arenas. The following are suggested steps to develop a plan of action: 1. Identify barriers to the well-being of individuals and vulnerable groups 2. Identify appropriate interventions and strategies 3. Identify supports and potential allies and barriers 4. Implement plan 5. Assess impact and/or effectiveness of implementation The following are examples of interventions and strategies that can be incorporated into a plan of action (American Counseling Asscoiation, 2003; European Federation of Psychologists Associations, 2015): Train students and clients in self-advocacy skills Recognize the signs indicating that an individual s behaviors and concerns reflect responses to systemic or internalized oppression Help clients and students gain access to needed resources Alert community or school groups with common concerns related to the issue Develop alliances with groups working for change Identify the strengths and resources that the group members bring to the process of systemic change Provide and interpret data to show the urgency for change In collaboration with other stakeholders, develop a vision to guide change Analyze the sources of political power and social influence within the system Develop a plan for dealing with probable responses to change Recognize and deal with resistance Prepare written and multi-media materials that provide clear explanations of the role of specific environmental factors in human development Communicate information in ways that are ethical and appropriate for the target population Disseminate information through a variety of media Identify and collaborate with other professionals who are involved in disseminating public information Assess the influence of public information efforts undertaken Distinguish those problems that can best be resolved through social/political action

5 5 Identify the appropriate mechanisms and avenues for addressing these problems with allies, prepare convincing data and rationales for change with allies, lobby legislators and other policy makers Maintain open dialogue with communities and clients to ensure that the social/political advocacy is consistent with the initial goals Educate psychologists about the structural factors that diminish the psychological health and well-being of people, their possible implication in psychological principle fulfilments, violations, and their professional responsibilities Call to action national and local psychology organizations and associations to make public stand against violation of human rights, intervene with scientific knowledge, and alleviate consequences Collect and publish evidence and information on effects of policies and practices that oppress and marginalize Issue recommendations and guidelines for preventing oppressive practices at an institutional or societal level with due attention for potential groups of victims (such as children, patients, etc.) and perpetrators Step 3: Accountability. Psychologist take professional and personal responsibility for the challenges that diminish the psychological health and well-being within our communities and nation. Instead of separating the profession from structural problems that influence psychologists personal lives, recognize one s participation in a system of access for some and exclusion for others. In doing so, psychologists also take responsibility for being a part of ending unjust policies and practices, and creating communities of psychological health, diversity, and inclusion. Consequently, it is recommended that psychologists form partnerships with colleagues to hold accountable peers, communities, and institutions in areas where prosocial change, advocacy, and social justice are needed. For example, psychologists can start or join consultation groups or organizations to share their plans and activities, and receive feedback and support as needed. Step 4: Self-care. Allyship, advocacy, and activism can be burdensome. Couple these roles with a profession whose members are at increased risk for overlooking or ignoring their own emotional needs and reactions (Barnette, Baker, Elman, Schoener, 2007), there is an even higher potential for distress and impairment that will render services ineffective, and at worst unethical. Therefore, self-care is imperative. Psychologist are urged to incorporate mindfulness-based positive principles and practices into the work (Wise, Hersh, Gibson, 2012), as well as develop a Competency Wellness Action Plan (CWAP) (Melton, 2017). Mindfulness-Based positive principles and practices draw primarily from mindfulnessbased stress reduction, acceptance and commitment therapy, and the positive psychology movement, but is a practice that is intentionally and explicitly non-clinical (Wise, Hersh, Gibson, 2012). Through mindful awareness, psychologists can increase comfort with difficult emotions in roles as professionals, allies, advocates, and activists. Mindfulness-based practices may serve to simultaneously enhance self-compassion, compassion for loved ones and the clients, communities, organizations served, and decrease ruminative tendencies about difficult situations/circumstances and one s personal limitations.

6 6 Additionally, developing a CWAP centers on engaging in and maintaining positive career sustaining behaviors such as balancing personal and professional demands and activities, taking regular breaks from work, getting adequate rest and exercise, having a balanced and healthy diet, and attending to emotional, physical, relationship, and spiritual needs outside of professional functioning (Barnette, Baker, Elman, Schoener, 2007). Psychologists are encouraged to identify behaviors and activities that prevent burn out. This requires deliberate self-monitoring and assessment. Useful self-assessment tools can be found in the public domain. Routinely completing such assessments may help catch earlier warning signs of burnout including increased feelings of frustration, impatience, or anger toward clients/organization, increased boredom or lack of focus, decreased motivation, and decreased fulfillment and enjoyment from one s work. Additionally, it is also recommended that psychologists develop a corrective action plan before they are in distress or are visibly impaired. A corrective plan can include peer support and supervision groups, personal psychotherapy, individual supervision, professional associations, and colleague assistance programs all may help psychologists with self-care efforts and, if needed, may effectively respond to signs of developing impairment. Conclusion Psychology has a social responsibility to use scientific and professional knowledge to improve the condition of individuals, organizations, and society, respect and protect civil and human rights, and help the public in developing informed judgments and choices concerning human behavior (APA, 2010). The ethos of the field also implies that psychologists have a responsibility to change the nature of the profession itself, moving individual psychologists and the discipline as a whole toward a fusion of activism with scholarship (Lewis, Ratts, Paladino, & Toporek, 2011, p. 6). Consequently, ethical and competent functioning in the role of ally, activist, and advocate is part of the professional responsibility and identity. Furthermore, this responsibility calls for awareness of one s cultural identity and biases, articulation of action, creating a plan for accountability, as well as developing a plan to protect against professional burn out and impairment. The intent in describing the inherent complexities between the profession and the social responsibility was not to teach but rather to encourage engagement in open, honest exploratory dialogue that leads to new awareness, knowledge, and skills to strengthen psychology s leadership in advocating for psychological health and well-being for all people.

7 7 References Activist. (n.d.). Retrieved from Advocate. (n.d.). Retrieved from Agency Healthcare Research and Quality (AHRQ). (2012). National health disparities report. Retrieved from Ally (n.d.). Retrieved from American Counseling Association (2003). Advocacy Competencies. Retrieved from American Psychological Association. (n.d.). Guide to Advocacy and Outreach. Retrieved from American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58(5), American Psychological Association. (2006). Report of the Task Force on the Implementation of the Multicultural Guidelines. Washington, DC: Author. American Psychological Association. (2010). Ethical Principles of Psychologists and Code of Conduct 2010 Amendments. Retrieved from American Psychological Association. (2015). About Us. Retrieved from Barnette, J.E., Baker, E.K., Elman, N.S., & Schoener, G.R. (2007). In pursuit of wellness: The self-care imperative. Professional Psychology: Research and Practice, 38(6), DOI: / European Federation of Psychologists Associations, Taskforce Human Rights. (2015). Psychology Matters in Human Rights - Human Rights Matter in Psychology: EFPA Policy and Action in the Area of Human Rights and Psychology. Retrieved from Fabert, R.K. (2009). A stronger vision for APA. Monitor, 40(4). Retrieved from Hall, G. S. (1905). The Negro in Africa and America. Pedagogical Seminary 12.3, p Hayes, P. (2016). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (3 rd ed.). Washington, DC: American Psychological Association. Lewis, J, A., Arnold, M, S,, House, R,, & Toporek, R. L. (2002). ACA Advocacy Competencies. Retrieved June 1, 2017 Lewis, J.A., Ratts, M.J., Paladino, D.A., & Toporek, R.L. (2011). Social justice counseling and advocacy: Developing new leadership roles and competencies. Journal for Social Action in Counseling and Psychology, 3(1), 5-16.

8 8 Melton, M.L. (2014, April 18). Self-care as an ethical standard. Presented to the Carl T. Hayden VA Psychology Postdoctoral Fellowship. Phoenix, AZ. Our Mission. (n.d.) Psychologists for Social Responsibility. Retrieved from Toporek, R. L., Lewis, J. & Crethar, H. C. (2009). Promoting systemic change through the Advocacy Competencies. Special Section on ACA Advocacy Competencies. Journal of Counseling and Development, 87,