Positive Ethics for Mental Health Professionals. Sharon K. Anderson

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and avoid harm to our clients.

      We are not suggesting feeling guilty or ashamed of being a White person or having other points of privilege (Spanierman et al., 2009). Rather, we are encouraging you to be aware and to develop understanding about racism and other isms, the cycles of socialization and systems of oppression, and cultural humility . Cultural humility is an attitude and a “way of being” with diverse clients that values the presence and importance of cultural factors (Owen et al., 2011, p. 274) and works toward genuine respect and understanding persons as cultural beings. We might suggest that cultural humility also includes being aware of our privilege and acting to dismantle the systems of oppression in which we have been participating.

      Discrimination and Oppression

      Discrimination refers to behaviors that usually stem from prejudiced feelings or thoughts and “which denies individuals or groups of people equality of treatment” (Blumenfeld & Raymond, 2000, p. 22). In our opening story, two women of color were both targets of discrimination (not being acknowledged or seen—treated as if they were invisible and denied service) while the White person just behind them was acknowledged and treated respectfully.

      The following example is something that happened in Sharon’s family some years ago when her children were young and interacted with neighborhood families. The experience addresses another type of privilege and discrimination:

      Bobby (9 years old at the time) said to me (Sharon), “Mom, when we (he and his sister Taya, 8 years old at the time) go over to the neighbor’s house to see if Kenny can play, Gene always says, ‘Bobby’s at the door.’ He doesn’t say anything about Taya.” I asked Bobby why he thought Gene didn’t mention Taya when he announced who was at the door. He said he thought it was that Gene didn’t like Taya. I responded, “That might be true. It might also be that he doesn’t see Taya as ‘counting’ or deserving notice.” The assumption might be that Taya is “invisible” to Gene because of her gender. Whether or not that is Gene’s intent, the covert message to Taya may be, “Bobby, you’re visible and important to recognize (male privilege) and Taya, you’re female; therefore, invisible and don’t count.”

      When we become aware of our own points of privilege, we may be able more fully to really hear, empathize with, and respect some of our clients’ experiences of discrimination and oppression and thereby acknowledge, rather than discount, their experience (Furman, 2005; Sue et al., 2019; Tuason, 2005).

      Journal Entry: Don’t Judge a Book by Its Cover

      Think of a time when you or a person close to you was ignored, devalued, or prejudged because of age, gender, disability, beliefs (spiritual or political), language or speech, or choice of partner (same gender, skin color difference, another issue of difference). Who was doing the ignoring, devaluing, prejudging? How did it feel? What were the resulting behaviors?

      Social Justice

      The moral and ethical obligations we have to treat individual people (clients, co-workers, employees, friends, etc.) fairly become more evident with awareness. McIntosh (1990) states it this way: “Describing privilege makes one newly accountable. As we in women’s studies work to reveal male privilege and ask men to give up some of their power, so one who writes about having white privilege must ask, ‘Having described it, what will I do to lessen or end it?’” (p. 31).

      Social justice counseling/therapy is an active philosophy and approach aimed at producing conditions that allow for equal access and opportunity; reducing or eliminating disparities in education, health care, employment, and other areas that lower the quality of life for affected populations; encouraging mental health professionals to consider micro, meso, and macro levels in the assessment, diagnosis, and treatment of clients and client systems. (p. 488)

      Hailes et al. (2020) use three domains of justice (interactional, distributive, and procedural) to offer guidelines under each of the domains for us to consider as ways to implement social justice work. The guidelines under interactional justice translate into (a) understanding the relational power dynamics, (b) mitigating those power dynamics, and (c) using approaches that focus on client empowerment and strengths. Power dynamics are inherent in the therapist/client relationship and are complicated by the “intersection of multiple co-occurring identities” that present different amounts of privilege (Hailes et al., p. 3). As psychotherapists we need to be aware of how our identities and interactions within the relationship might reconstruct past experiences of oppression and injustice that our clients from marginalized populations have experienced from others in roles of power and representing institutional power. Among the actions we can take are to (a) elevate collaboration and co-create with clients the goals for therapy, (b) be open to direct communication about perceived assumptions and biases we hold, and (c) draw upon strengths-based approaches which empower clients to “develop their self-advocacy skills, strategies, and resources to be agents of change in their own lives” (p. 4).

      Distributive justice focuses on fairness and provision for all, in particular those who have traditionally not received provisions. The specific guidelines include (a) using our energy and resources to serve the main concerns of communities who are marginalized and (b) using our efforts and time to focus on preventive work. Actionable steps could include offering services on a sliding scale, taking on consultant roles in the community for little to no fee, prioritizing preventive or pre-emptive care to lessen the mental health problems of oppressed groups, and advocacy work to change mental health policies for the better of marginalized populations.

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