Children with special needs and physical disabilities are consistently at an increased risk of victimization (Malecki et al., 2020). Adults who are members of a minority group suffer from higher rates of bullying (Lewis et al., 2011). Some minority workers have been shown to endure a bullying rate that is two to three times higher than that of their nonminority coworkers (Lewis et al., 2011). Namie, Christensen, and Phillips (2014) found that Hispanic Americans, African Americans, and Asian Americans all experienced higher rates of workplace bullying, both witnessing and targeting, than White Americans and that their individual group rates were each higher than the national average. In the workplace, as in school settings, differences of any type increase a person’s risk of being bullied or experiencing other forms of victimization. For decades, “social psychologists have repeatedly demonstrated that individuals who do not belong to the group are devalued” and that they are more likely to be used as scapegoats in the workplace (Zapf & Einarsen, 2011, p. 188). Being a victim of bullying and other oppression results in a much greater likelihood of depression and posttraumatic stress disorder (PTSD) in adolescents (Kosciw et al., 2020; Schuster & Bogart, 2013). Adult victims of workplace bullying, or community oppression, will show signs of stress and trauma (Hogh et al., 2011). The inability to concentrate, insomnia, mood swings, anxiety, depression, and physical symptoms eventually cause impairment at school and work, resulting in increased rates of absenteeism or presenteeism (being present at work but unable to function optimally; Einarsen et al., 2011; Lutgen-Sandvik & Arsht, 2014). As such, the context of a client’s diversity elements may have a direct effect on the client’s reasons for presenting to counseling in the first place. Intersectionality is a concept that is used to describe how these various dimensions come together to privilege or oppress individuals and groups of individuals. Race, ethnicity, and immigration The U.S. is a nation of immigrants. The racial, ethnic, and immigrant diversity within American society is often cited as one of its greatest strengths. However, it has also been a challenge for the U.S. and for Americans in terms of fully accepting and embracing the broad array of immigrant groups that have become American. Historically, every new immigrant group has experienced various degrees of prejudicial and discriminatory treatment and exclusion from mainstream society. However, the experience of many European (e.g., Irish, Italian, German) immigrants was one of initial discrimination followed by swift acculturation and assimilation, likely aided by their physical appearance and language being similar to those of earlier settlers. Asian and Latina/o immigrants have experienced prejudicial treatment, possibly because of readily identifiable physical and language differences. Historical evidence of mistreatment is well documented, with perhaps one of the most egregious examples being the internment of Japanese Americans during World War II (Nagata et al., 2015). Although Americans often think of the journey of voluntary immigration of the many ethnic groups that come to America to build a “better” life, the legacy of the forced immigration of African American slaves is often overlooked. African Americans endured 250 years of enslavement followed by 60 years of “separate but equal” status as well as continuing racist practices in education, housing, health, and the criminal justice system. The systemic and continuous oppression of African Americans is a direct legacy of this forced immigration and has resulted in
Intersectionality is defined as “multiple, intersecting identities and ascribed social positions (e.g., race, gender, sexual identity, class) along with associated power dynamics, as people are at the same time members of many different social groups and have unique experiences with privilege and disadvantage because of those intersections” (Rosenthal, 2016, p. 475). Each individual has a multitude of diverse identities; some are visible and some are not readily identifiable. Each of the identities intersects with the other identities. The multiple intersections can serve to provide for further oppression and marginalization or further power and privilege, and/ or they could mitigate one another, providing some facets of privilege and others of oppression. For example, an African American college professor who is a heterosexual woman with a doctoral degree is often oppressed and marginalized because of her race and gender; however, as a highly educated academic who is not gay, she experiences power and privilege, particularly in the academic classroom setting as the course professor. Another example is a female student who has experienced poverty on and off throughout her life cycle and identifies as biracial and gay; she may experience multiple identities that compound her oppression and marginalization (i.e., female, poor, gay, biracial). The concept of intersectionality provides a useful framework for healthcare professionals, as it helps them to understand the complexity of patients’ diverse identities. Further, it provides a structure for understanding the multitude of factors that may cause a patient to be oppressed and/or privileged within the context of American society. In this same manner, it is important to recognize that culture is best described as fluid and subjective, as will be discussed in greater detail with respect to providing patient care with cultural humility. enduring educational, health, and wealth disparities (Bunch, 2016). “New” immigrants from Afghanistan, Haiti, and other war- torn or environmentally impacted countries are experiencing prejudicial treatment in society and healthcare today. The economic and social burden of caring for these immigrants, in addition to the typical flow of immigrant populations, has aroused discriminatory attitudes in society and even in healthcare professionals that may already be stressed by COVID patient care. Mental and behavioral healthcare professionals’ understanding of the differential treatment of current and past immigrant groups based upon ethnic, racial, religious, and linguistic background is paramount to understanding their patients. The way in which individuals and groups are treated on a sociopolitical (macro) level, group (mezzo) level and on a daily individual interactional (micro) level necessarily affects their views and understanding of the world in which they live. From a person-in-environment perspective, individuals act upon the environment, and the environment acts upon and reacts to the individual. Thus, while individuals help shape the environment around them, the environment also shapes the individual (Hutchison, 2021). A demographic breakdown of the diversity in the U.S. is provided in Tables 1 and 2. This breakdown may help healthcare professionals better conceptualize the potential diversity of experiences among their patients.
Book Code: SWUS1525
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