by Alexandra Pajak, LCSW
Within the last several years, there have been numerous studies linking racist acts, both violent and nonviolent, to symptoms of trauma in people of color (POC). I believe it is important for social workers to be aware of the ways in which people of color experience racism, the ways in which our own personal biases can affect the therapeutic process, and how these relate to the NASW Code of Ethics.
People who experience racial trauma can develop the same post-traumatic symptoms as physical trauma and sexual assault survivors. Symptoms can include anxiety, depression, hypervigilance, somatization, and rumination. Social workers can provide support to clients by validating their emotional reactions and identifying racial trauma as what it is—trauma. For this reason, research indicates that applying treatment approaches for PTSD also works for survivors of racial trauma (Polanco-Roman, Danies, & Anglin, 2016; Robert, Gillman, Breslau, & Breslau, 2018).
Racial trauma can take the form of violence committed against POC. However, more subtle and covert forms of racism can also lead to a trauma response. These covert forms of racism can include institutionalized racism, conflict with teachers while growing up, unnecessary placement in special education, and disparities in access to healthcare and housing. Microaggressions are another form of subtle racism. Microaggressions include racist jokes, inappropriate comments, and prejudice (Polanco-Roman, Danies, & Anglin, 2018; Malone & Malone, 2015; Jerniga & Daniel, 2011).
When Caucasian clinicians accept that people of color experience discrimination in ways white Americans do not, we improve our cultural competence. This is a change from the outlook of “I’m colorblind” and “I don’t see color,” which research indicates is neither helpful nor realistic. Instead, social workers can ask clients about their history of racial trauma, validate the experiences for what they are (trauma), address self-blame, and incorporate these disclosures into culturally competent treatment plans (Burkard & Knox, 2004; Sue, 2013; Plaut, Thomas, Hurd, & Romano, 2018).
In addition to accepting and learning about racism as experienced by POC, social workers must be mindful of our own prejudices and emotional reactions when working with racial minority clients, as uncomfortable as this process may be (Reynolds, 2017). We all have implicit bias, which refers to the unconscious preferences and judgments we make about people based on race and gender. Among clinicians, implicit bias can negatively affect communication and decision-making with clients (Gonzalez, Deno, Kintzer, Marantz, Lypson, & McKee, 2018). Guidance from supervisors can help us effectively work through these implicit biases (Pieterse, 2018). Harvard University’s Project Implicit provides another useful approach to addressing our implicit biases. Project Implicit is an online test to assess unconscious biases the user may have (https://implicit.harvard.edu/implicit/).
Education on the unique experiences of people of color and self-awareness of our own implicit biases are also crucial to ensure we best follow the NASW Code of Ethics (2018). The NASW Code of Ethics, Ethical Standard 1.05, Sections (a), (b), and (c), Cultural Awareness and Social Diversity, requires social workers (a) “understand culture and its function in human behavior and society,” (b) “have a knowledge base of their clients’ culture and be able to demonstrate competence in the provision of services that are sensitive to clients’ culture and to differences among people and cultural groups,” and (c) “obtain education about and seek to understand the nature of social diversity and oppression with respect to race.”
As social workers in an increasingly diverse society, learning from and about others’ experiences is crucial in our care for clients and adherence to our field’s ethical standards. Addressing racial trauma directly with clients, validating the trauma response, and continual self-reflection on our own biases best serves our clients and our profession as a whole.
Burkard, A. W., & Knox, S. (2004). Effect of therapist color-blindness on empathy and attributions in cross-cultural counseling. Journal of Counseling Psychology, 51(4). DOI: 10.1037/0022-0184.108.40.2067.
Gonzalez, C. M., Deno, M. L., Kintzer, E., Marantz, P. R., Lypson, M. L., & McKee, M. D. (2018). Patient perspectives on racial and ethnic implicit bias in clinical encounters: Implications for curriculum development. Patient Education and Counseling, 101(9), 1669-1675. Retrieved from https://doi.org/10.1016/j.pec.2018.05.016
Jerniga, M. M., & Daniel, J. H. (2011). Racial trauma in the lives of black children and adolescents: Challenges and clinical implications. Journal of Child & Adolescent Trauma, 4(2), 123-141. doi.org/10.1080/19361521.2011.574678
Malone, M., & Malone, H. (2015). Housing segregation and the prison industrial complex: Looking at the roots of today’s school-to-prison pipeline. In L. Dowdell Drakeford (Ed.), The Race Controversy in American Education, (Vol. 1, pp. 149-168). Santa Barbara, CA: Praeger.
National Association of Social Workers. (2018). Code of ethics. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Pieterse, A. L. (2018). Attending to racial trauma in clinical supervision: Enhancing client and supervisee outcomes. The Clinical Supervisor, 37(1), 204-220. doi.org/10.1080/07325223.2018.1443304
Plaut, V. C., Thomas, K. M., Hurd, K., & Romano, C. A. (2018). Do color blindness and multiculturalism remedy or foster discrimination and racism? Current Directions in Psychological Science. Retrived from https://doi.org/10.1177/0963721418766068
Polanco-Roman, L., Danies, A., & Anglin, D. M. (2016). Racial discrimination as race-based trauma, coping straetgies, and dissociative symptoms among emerging adults. Psychological Trauma, 8(5), 609-17. doi: 10.1037/tra0000125
Reynolds, J. E. (2017). Addressing racial trauma in therapy with ethnic-minority clients. Eds: Lebow, J., Chambers, A., & Breulin, D. C. Encyclopedia of Couple and Family Therapy. doi.org/10.1007/978-3-319-15877-8_931-1
Robert, A. L., Gillman, S. E., Breslau, J., & Breslau, N. (2018). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine 41(1), 71-83.
Sue, D. W. (2013). Race talk: The psychology of racial dialogues. American Psychologist, 68(8), 663-672. Retrieved from http://dx.doi.org/10.1037/a0033681
Alexandra Pajak, LCSW, earned degrees from Agnes Scott College, Georgia Tech, and The University of Georgia. She has more than 10 years’ experience in the correctional mental health field.