Symposia
Dissemination & Implementation Science
Noah S. Triplett, M.S.
University of Washington, Seattle
Seattle, Washington
Jasmine Blanks Jones, Ph.D.
Postdoctoral Fellow
Johns Hopkins University
Baltimore, Maryland
Minu Ranna-Stewart, LICSW
Director, Student Support Services
Puget Sound ESD
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
Evidence suggests White clinicians, who comprise most of the mental health workforce, are unlikely to discuss race in cross-racial dyads unless Clients of Color raise the issue. Clinicians’ avoidance of race may not only damage the therapeutic relationship but also contribute to disparities in service and clinical outcomes. The present study qualitatively assessed barriers and facilitators to discussing racism among community mental health clinicians. Community mental health clinicians and supervisors (n =119) responded to an online survey. Respondents were largely White (73.9%), female (77.4%), and held master’s degrees (85.6%). The survey asked respondents to describe instances in which they “felt confident talking about race” and “chose not to discuss race” with their Clients of Color. Responses were coded and analyzed in Dedoose following thematic coding (Miles & Huberman, 1994). Coding was led by an advanced graduate student with support from two undergraduate research assistants. Several barriers and facilitators emerged across responses. Discussions were facilitated by clinician comfort (i.e., have confidence and good rapport), clinician-perceived relevance to treatment (i.e., race and racism was determined to be relevant to the presenting problem), timing (i.e., having conversations earlier in treatment was easier), and clinician relatability (i.e., the extent to which clinicians could relate to clients’ experiences because of their own identities). Client openness or initiation also facilitated conversations. Discussions were impeded by clinician discomfort (i.e., lacking knowledge, clinician anxiety, or uncertainty about how to begin conversations), clinician-perceived irrelevance to treatment (i.e., race and racism was not determined to be relevant to the presenting problem), timing (i.e., concerns that rapport was not strong enough to have conversations early in treatment or that it was too late to bring up race and racism if not discussed earlier in treatment), and clinician concerns about harming clients (i.e., inadvertently harming clients by discussing race and racism). Findings highlight considerations for equipping clinicians with confidence and skills to sensitively discuss race and racism with clients. Ensuring clinicians can support clients in coping with experiences of racism and discrimination, a necessary compliment to evidence-based care, is an important step toward improving quality of care for Clients of Color.