Thursday, April 22, 2021

‘Cultural Humility’ Key to Healing Racial Trauma, Psychiatrist Says

The widespread publicization of violent police encounters with Black people combined with the disproportionate burden of COVID-19 deaths on the Black community is “fuel for psychological trauma,” wrote psychiatrist Gowri Aragam, M.D., of Massachusetts General Hospital and Harvard Medical School and colleagues in an article published Wednesday in JAMA Psychiatry.

What can clinicians do to help people experiencing ethno-racial trauma—the individual and/or collective psychological distress and fear arising from experiencing or witnessing discrimination, threats of harm, violence, and intimidation directed at ethno-racial minority groups?

“Addressing this issue requires a systematic approach that involves recognizing and treating symptoms of racialized trauma while eliminating barriers to care at the clinician, organizational, and system levels,” Aragam and colleagues wrote.

As a starting point, the authors recommend that clinicians take steps to optimize their interactions with patients with values, backgrounds, and experiences different from their own. “The hallmark features of adopting a culturally humble lens (for example, critical self-reflection, openness, nonjudgment, and curiosity) have shown benefits in treatment, such as strengthening the therapeutic alliance and improving outcomes,” they wrote.

Such “cultural humility provides a framework for researchers and clinicians to (1) facilitate dialogue about the impact of race and racism on a person’s mental health; (2) examine their own biases, assumptions, and role in perpetuating racist behaviors and narratives; and (3) develop comprehensive case conceptualizations and needs assessments that more accurately reflect individual experiences and acknowledge the diversity within a community.”

Historically, there have been barriers to engaging in the practice of cultural humility, including “inadequate organizational support and training, avoidance of conversations about race and racism, and clinicians’ difficulty in identifying personal bias and racism (or refusal to do so).” They noted there are several coaching and assessment tools available to help clinicians overcome these barriers, including the 5Rs of Cultural Humility coaching tool and the University of Connecticut Racial/Ethnic Stress & Trauma Scale (UnRESTS).

“The Black community faces an acute and potentially long-lasting mental health crisis that necessitates a critical upscaling of mental health interventions. Further, the national reckoning on institutionalized racism sheds new light on long-standing disparities and the need to integrate cultural humility in direct interactions between patients and clinicians and in the development of health care innovations,” Aragam and colleagues concluded. “Adopting a culturally humble approach offers a potential path to reform, a key to healing racial trauma and advancing health equity.”

For related information, see the Psychiatric News article “Seeing the Chauvin Trial Through the Eyes of Another.”

(Image: iStock/SDI Productions)

Members Invited to Apply for New Presidential Task Force on Social Determinants of MH

APA members are invited to apply for appointment to the new Task Force on the Social Determinants of Mental Health, which reflects the theme of incoming APA President Vivian Pender, M.D. There will also be eight work groups that will address major issues related to social determinants of mental health. The appointments begin on May 3 and end at the close of the 2022 Annual Meeting. Those interested should submit a CV, brief summary of expertise, and specific area of interest to by April 26.


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