by Isabelle Lanser & Alexandra S. Tanner, University of California, Los Angeles
As the field of psychology and the clinical science community in particular examine the ways our field has historically been complicit in the discrimination and oppression of marginalized groups, it is important to re-examine the structure of our current training programs to identify opportunities for positive change. Decades of research have highlighted the importance of integrating social justice frameworks and sociocultural context into psychology training (e.g., Burnes & Singh, 2010; Seng et al., 2012; Clauss-Ehlers et al., 2019). In this article, we offer recommendations for clinical science programs on how to assess inclusion of social justice and multicultural considerations in existing curriculum, research, and clinical training.
Evaluating clinical science mission statements and topics of faculty/departmental research is an important starting point for this assessment. The clinical science model aims to expand our understanding of the scientific basis for the etiology, maintenance, and treatment of mental illness (PCSAS, 2020). In practice, this aim has led to an increased focus on the biological and psychological correlates of mental disorders, often at the expense of considering relevant historical and contemporary sociopolitical contributors to mental illness, such as racism, systemic oppression, and privilege. This phenomenon is widespread across the field of psychology. For example, a recent analysis of 26,380 articles published in the top-tier journals of cognitive, developmental, and social psychology from the 1970s to 2010s found that only 5% of articles highlighted race (e.g., racial categories, racial identity, racial segregation, racial stereotyping, racial inequality, race-related outcomes; Roberts et al., 2020). Further, an analysis of articles from 2015-2016 published in clinical, cognitive, social, and developmental journals found that 73% of publications neglected to mention the race of participants at all (DeJesus, Callanan, Solis, & Gelman, 2019). As leaders in the study of mental health, clinical science programs have a unique opportunity to assert that social justice and multicultural considerations are foundational to our understanding of mental illness rather than specialized topics of psychology. Thus, we encourage clinical science programs to review their mission statements to examine the language articulating their clinical and research priorities and consider how these statements might reflect larger biases in the field.
In the same vein, regarding course curriculum, we urge programs to evaluate how much time is spent in the classroom discussing social justice considerations versus biological and psychological factors of mental illness. The following questions could be used to guide such an assessment:
- To what extent does your course material emphasize the bio-psycho- factors of mental illness over the social- factors?
- To what extent do students learn how to interpret biological and psychological data within the sociopolitical context in which it was gathered?
When considering curriculum changes or solutions to address these gaps in training, we implore clinical science programs to amplify the work of luminaries in the field of social justice psychological research. In practice, this might look like consulting with schools of social work and public health tied to your institution to collaboratively develop this curriculum or advocating for researchers in these fields to have access to joint appointments within your department.
Ongoing initiatives within the field have aimed to diversify clinical psychology demographics. As the field increases diversity of trainees, it is equally important to assess faculty and supervisor diversity and consider potential impacts on students’ training experiences. Two recent studies conducted by the APA’s Center for Workforce Studies found that in 2016 84% of all active psychologists in the United States were White (Lin, Stamm, & Christidis, 2018) and in 2017-2018 nearly 90% of tenured psychology faculty in the United States were White (APA, 2018). Given the lack of racial and ethnic diversity in the field, we urge programs to consider the following:
- Do the faculty and supervisors within your department come from diverse backgrounds that are representative of the trainees and client populations they support?
- Are the faculty and supervisors adequately prepared to discuss issues of social justice or discrimination with diverse trainees?
Within clinical training, we also encourage programs to consider how their trainees’ identities, sociocultural backgrounds and contemporary experiences intersect with the curriculum. For example,
- Do the training materials and literature provided to students represent a diverse array of therapist-client interactions?
- Do the case examples explore issues of social injustice and considerations for how to discuss and provide support for these experiences?
Honest assessment of the implicit and explicit biases embedded in the existing structure of clinical science training programs is an essential first step toward integrating social justice and multicultural considerations into core training. This integration is necessary to establish truly comprehensive models of mental illness, develop culturally sensitive interventions, and adequately support and prepare trainees from all backgrounds to deliver care to diverse clients.
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References
American Psychological Association (2018). Psychology faculty salaries for the 2017-2018 academic year: Results from the 2017 CUPA-HR survey for four-year colleges and universities. Washington, DC: Author.
Burnes, T. R. & Singh, A. A. (2010). Integrating social justice training into the practicum experience for psychology trainees: Starting earlier. Training and Education in Professional Psychology, 4(3), 153-162. 10.1037/a0019385
Clauss-Ehlers, C. S., Chiriboga, D. A., Hunter, S. J., Roysircar, G., & Tummala-Narra, P. (2019). APA multicultural guidelines executive summary: Ecological approach to context, identity, and intersectionality. American Psychologist, 74(2), 232-244. 10.1037/amp0000382
DeJesus, J. M., Callanan, M. A., Solis, G., & Gelman, S. A. (2019). Generic language in scientific communication. Proceedings of the National Academy of Sciences, 116(37), 18370-18377. 10.1073/pnas.1817706116
Lin, L., Stamm, K., & Christidis, P. (2018). Demographics of the U.S. Psychology Workforce. American Psychological Association, Center for Workforce Studies. Retrieved from https://www.apa.org/workforce/publications/16-demographics/report.pdf
Psychological Clinical Science Accreditation System (2020). Mission & Function. https://www.pcsas.org/about/mission-function/
Roberts, S. O., Bareket-Shavit, C., Dollins, F. A., Goldie, P. D., & Mortenson, E. (2020). Racial inequality psychological research: Trends of the past and recommendations for the future. Perspectives on Psychological Science. 10.1177/1745691620927709.
Seng, J. S., Lopez, W. D., Sperlich, M., Hamama, L., & Reed Meldrum, C. D. (2012). Marginalized identities, discrimination burden, and mental health: Empirical exploration of an interpersonal-level approach to modeling intersectionality. Social Science & Medicine, 75, 2437-2445. 10.1016/j.socscimed.2012.09.023
Disclaimer: The views and opinions expressed in this newsletter are those of the authors alone and do not necessarily reflect the official policy or position of the Psychological Clinical Science Accreditation System (PCSAS).