Understanding subtleties in cultural differences, expectations, and worldviews can be further complicated when differences in language or interactional patterns enter into the therapeutic process as well. Implicit bias is defined as an unconscious and unintentional bias (van Nunspeet et al., 2015). Individuals may not be aware of their implicit biases (Byrne & Tanesini, 2015). These biases are the result of combinations of factors, including an individual’s early experiences and learned cultural biases. In fact, indications of precursors for these biases actually show up quite early in development. Thus, ongoing critical self-reflection that acknowledges the existence of implicit biases within everyone is necessary. Repeated and evolving processes of self-reflection make healthcare professionals’ implicit biases explicit and, therefore, subject to examination and change (Byrne & Tanesini, 2015; Self-reflection and self-critique Self-reflection and self-critique are ongoing, lifelong processes that allow all healthcare professionals to continually refine their understanding of themselves and their actions and reactions within counseling contexts and to continually broaden and deepen their cultural understanding through introspection (Foronda et al., 2016). Through ongoing self-reflection and critique, the healthcare professional develops a better understanding of the dynamics within and outside the healthcare arena and of the ways these dynamics affect the patient’s life, the healthcare professional’s life, and the interactions between healthcare professional and patient. Self-reflection is defined as deliberately paying attention to one’s own thoughts, emotions, decisions, and behaviors. It is important for healthcare professionals to be able to self- reflect in “real time” as they deal with the variety of situations encountered in an ever-changing healthcare environment (Wignall, 2019). Self-critique is the process of critically examining ourselves to continually refine our understanding of ourselves and our actions and reactions and to continually broaden and deepen our cultural understanding through introspection. Self-reflection and self-critique are best incorporated into practice on a reflexive basis. That is, the ongoing process of self-reflection should result in an automatic process of reflection as an integral part of practice. (Foronda et al., 2016). Some techniques and tips for self-reflection and self-critique include: Respectful partnerships Developing respectful partnerships is key to providing healthcare services with cultural humility and, more generally, to developing a relationship within the counseling setting that allows work to begin and to continue in a productive fashion. Respectful partnerships include discussing and addressing difficult topics and issues such as race, socioeconomic class, gender, sexual identity, and disability. These discussions are uncomfortable for many, as they bring up feelings, often passionate, associated with “–isms,” group identification, prejudice, quotas, and affirmative action. Yet these differences between healthcare professional and patient are a presence in the room and, when ignored, have the potential to interfere with an honest and open exchange (Minarik, 2017). Healthcare professionals often attempt to take the emphasis off race, class, gender, and other areas of difference by denying the effect these aspects of diversity have on patients (e.g., “The only race I know is the human race”), or by trying to show that they understand the patient’s experience because they, too, are a member of an oppressed group. For example, an African American patient may not feel that the healthcare professional, as a bisexual Jewish woman, understands subtle racial insults from personal experience. Some healthcare professionals
Fitzgerald & Hurst, 2017). In addition to understanding their own implicit biases, healthcare professionals, especially those from dominant societal groups (e.g., White, heterosexual, male), need to explore their own racial, ethnic, sexual, and class identity. Individuals from dominant cultural paradigms often consider themselves without racial, ethnic, sexual, or class identity as they have privilege; their identities are considered the norm. However, without deep exploration of intersecting aspects of personal diversity, it is difficult to understand oneself and where biases might insert themselves into healthcare professionals’ relationships (Fisher-Borne et al., 2015). Healthcare Consideration : Mental and behavioral health professionals might find it helpful to take an Implicit Association Test. These tests are widely available (see the Resources section) and provide instantaneous feedback for the practitioner that may lead to meaningful reflection and growth. ● Learning journals : Learning journals serve as a place to write and reflect on concepts you have explored and learned. These can come from interactions with patients, including critical incidents which have contributed to your cultural understanding in some way. As you practice, you can reflect on conversations and insights from working with patients. Journaling about your cultural understanding journey can help you identify areas where you’ve grown, and areas where there’s room for progress. ● Use of an observer : This requires consent from the patient and a comfortable, trusting relationship with a colleague, preferably one with a different cultural experience and background than you. Having an observer present when interacting with patients introduces a neutral third party who can provide useful insight into your strengths and areas for opportunities with respect to cultural humility. ● Mindfulness practice : Mindfulness is the act of paying attention to present-moment experience while holding an attitude of acceptance and receptivity. Mindfulness cultivates self-awareness, as well as awareness of and sensitivity to others. This technique allows us to see and experience things “as they are”—that is, without judgments, self-narratives, or mental filters. Practicing mindfulness can help prevent “autopilot” mode, where we go from one task to another with little or no acknowledgement of our attitudes, biases, and assumptions and how they may affect others. Techniques for building mindfulness include meditation, breathing exercises, and yoga. imply that because they personally do not discriminate against oppressed groups, no personal or societal problems exist associated with race, class, LGBTQ status, or disability. This attitude negates the experiences patients may have in the larger society, where they experience various degrees of marginalization based on their intersecting identities (Minarik, 2017). A variety of microaggressions can interfere with establishing a respectful partnership. When counselors are members of the dominant culture, they are not immune to engaging in microaggressions, which are defined as brief, everyday unconscious or conscious exchanges that convey denigrating messages to people because they belong to an oppressed group or groups (Davis et al., 2016; Gottlieb, 2020; Nadal et al., 2014; Sue & Sue , 2021). There are various microaggressions, including microassault, microinsult, and microinvalidation. Microassault A verbal or nonverbal attack intended to hurt another, such as name calling or visually ignoring a person.
Page 271
Book Code: PYFL4024
EliteLearning.com/Psychology
Powered by FlippingBook