Culture / Ethnicity / Race
Grace S. Woodard, B.S.
Doctoral Student
University of Miami
Coral Gables, Florida
Noah S. Triplett, B.S., M.S.
Doctoral Student
University of Washington, Seattle
Seattle, Washington
Jasmine Blanks Jones, Ph.D.
Postdoctoral Fellow
Johns Hopkins University
Baltimore, Maryland
Minu Ranna-Stewart, LICSW
Assistant Director/Clinical Director
Harborview Medical Center, Abuse and Trauma Center
Seattle, Washington
Nathaniel Jungbluth, Ph.D.
Clinical Psychologist
Seattle Children’s Hospital
Seattle, Washington
Shannon Dorsey, Ph.D.
Professor and Associate Chair of Graduate Studies, Psychology
University of Washington, Seattle
Seattle, Washington
Increasing behaviors that demonstrate cultural competence and humility is important, yet there is little literature on how to incorporate anti-racism into mental health treatments. Existing evidence suggests White clinicians are unlikely to discuss race in cross-racial dyads unless patients raise the issue. Clinicians’ avoidance of race may not only damage the therapeutic relationship, but also contribute to Black Americans’ perceptions that therapy is less effective with less racially sensitive counselors. It is important to have validated, theoretically driven measures to evaluate multicultural competency to improve mental health treatment for Black Americans and other people of color. Intentions capture an individuals’ motivation to perform a voluntary behavior. Meta analyses have found that intentions moderately correlate with behavior, which makes intentions one of the most robust predictors of behavior. Using self-report measurements of intentions to predict mental health clinicians’ behavior has empirical support and may be more feasible than objective measurement of behavior. The current study builds and validates a scale measuring clinicians' intentions to ask about race within psychotherapy, which is an important clinician behavior for the quality of mental health care for Black Americans. Participants (N = 119) took part in a state-funded Cognitive Behavioral Therapy (CBT) training initiative for child-focused community mental health clinicians. Participants were given the Intentions to Discuss Race in Psychotherapy Scale (IDRPS), which was developed to capture clinicians’ intentions to discuss race in therapy. The scale was developed following best practices from the Theory of Planned Behavior (Francis et al., 2004). Fifteen items were rated from 1 = Strongly disagree to 7 = Strongly agree. Clinicians were also given the Multicultural Counseling Knowledge and Awareness Scale to assess divergent validity. To establish content validity, we followed the best practice recommendations of Boateng et al. (2018) following a multi-step evaluation process. Adjusted item total correlations were used to reduce items. A two-factor model, based on the Theory of Planned Behavior, demonstrated excellent fit to the data, X2 = 9.74, df= 8, p = .284. The other model fit indices are favorable (RMSEA = .04, p = 0.28, [90% CI 0.00, 0.121]; CFI = 1.00; SRMR = 0.03). A chi squared difference test found the two-factor model is superior to a one-factor model, X2 = 1.22, df = 1, p = .270. The final scale demonstrated excellent internal consistency (Cronbach’s alpha = .84) and discriminative validity with the awareness (r = .275, p < .01) and knowledge (r = .310, p < .001) subscales of the MCKAS. The IDRPS holds promise as a theoretically-driven measurement tool which can be used to evaluate multicultural competency. Future studies should seek to establish predictive validity of the IDRPS by measuring clinician behavior. Lastly, there are practical implications based on the validation of this theory-driven scale, including the ability to evaluate the impact of trainings on clinicians’ intentions to talk about race in psychotherapy with the goal being improved mental health outcomes of Black Americans and other people of color.