Majority of Counselors Lack Training to Treat Racial Trauma, Study Finds

The percentage clients who have experienced racial trauma far exceeds the percentage of counselors who are trained to identify and treat it.

Rebecca Troeger
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Given racism’s ubiquity in the lives of people of color and its harms to their mental health, researchers Carrie Hemmings and Amanda M. Evans investigate counselors’ competency in addressing racial trauma with clients of color. The findings of their exploratory study, published in the January 2018 issue of the Journal of Multicultural Counseling and Development, highlight a troubling gap between the prevalence of race-based trauma as a presenting concern and counselors’ preparedness to offer responsive care to affected clients.

“There is general agreement that experiences of racial and ethnic discrimination result in negative psychological outcomes,” the researchers write, “to improve health outcomes among [individuals of color] IOCs, those who work with minorities, including all health professionals, must address racism.”

Photo Credit: Creative Commons, U.S. Air Force

Hemmings and Evans, from Auburn University, note that the U.S. population is changing. While it is expected that the majority of the population will be people of color by 2044, racism remains deeply entrenched in the U.S. and continues to shape the daily experiences of people of color. The authors cite numerous studies that document the pervasive presence of racism in the lives of people of color. They highlight their findings in the present-day context of racially-driven violence (e.g., police killings of Tamir Rice, Freddie Gray, and numerous others; the Charleston church shooting) and the new forum for racism that the internet has provided.

They also offer an overview of the research on racial discrimination’s many harmful health effects, which include elevated blood pressure, increased psychological distress and diminished mental health, and poor self-esteem. Racism is a social determinant of health that works counter to the goals of health and mental health professionals,” Hemmings and Evans write.

One study examining people of color’s experiences of racism found that 91.4% of participants (n = 260, all individuals of color) had experienced racial discrimination. Although 54% of these respondents felt that this experience “had a significant impact on them,” when the researchers inquired about the help-seeking behaviors participants used to cope with these distressing experiences, they found that less than 10% of participants had sought assistance from a “helping professional.” The researchers hypothesized that individuals of color might be reluctant to reach out to counselors for help because of perceptions that counselors lack awareness of and expertise in working therapeutically with racial issues.

Taking into account the deleterious health effects of racial trauma and its omnipresence in the lives of people of color, as well as researchers’ call for counselors to be equipped to address racism when working with clients of color, Hemmings and Evans set out to investigate practicing counselors’ skills in working with clients’ race-based trauma. Race-based trauma, or racial trauma, is defined as “the emotional, psychological and physical reactions to personal experiences with harassment and discrimination that cause pain.”

To undertake their investigation, the researchers developed and administered a Race-Based Trauma Survey for Counselors to 106 counselor participants. The survey collected information about counselors’ encounters with race-based trauma in counseling, their understanding of the kinds of experiences that contribute to race-based trauma, and their prior training in identifying and treating such trauma. Their sample of counselors was 69.8% White, 15.1% African American, 6.6% biracial, 3.8% Latina/o, 1.9% Asian American, and .9% Pacific Islander. Participants included master’s level mental health and school counselors, doctoral-level clinicians in training, and licensed psychologists.

What the researchers found after analyzing the survey data was striking: although 70.8% of counselors noted having worked with clients who discussed experiences of race-based trauma, only 33% had participated in training to identify racial trauma, and an even smaller percentage – 18.9% of counselors – had received instruction on the treatment of race-based trauma. As the authors note, this finding points to a significant gap between the needs for care and the current realities of practitioner expertise and service delivery.

The researchers explain that the topics of race, racism, and discrimination “are not broached in the counseling relationship because of counselors’ unease; fear of saying the wrong thing and offending the client; lack of specific multicultural training that focuses on race, discrimination, and racism; or lack of understanding of the importance these issues have in the lives of IOCs.”

The study’s limitations include the fact that the survey has not yet been administered and tested with other samples, which undermines its validity, as well as the possibility of bias and social desirability having influenced participants’ self-reported survey responses.

The authors close by writing that counselors must be pro-active in gaining the skills necessary to support clients grappling with race-based trauma, and should push for the field to strengthen its focus in this area. They recognize that counselors are in a bit of a double bind, however, in that training opportunities and models for treating racial trauma are currently few and far between. They hope that their study will help address this gap by stimulating further research that will ultimately result in the development of “racially sensitive and appropriate assessments,” new approaches to care, and increased training opportunities.

 

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Hemmings, C., & Evans, A. M. (2018). Identifying and Treating Race‐Based Trauma in Counseling. Journal of Multicultural Counseling and Development46(1), 20-39. (Link)

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21 COMMENTS

    • Sorry, but whatever prejudice (and prejudice is not the same as racism, the proposed dominance of one race over another) is directed toward white people by people of color pales in comparison (sorry, bad pun there!) to what darker skinned people have to put up from their Caucasian counterparts in the USA. The fact that you refer to “leftists” as a group and talk about anyone who disagrees with “them” suggests some prejudice on your part, as you are grouping “leftists” together and assuming that you understand “them” and know how “they” act and believe that “they” are all the same. I do get what you are talking about – there are some subgroups on the left who are highly authoritarian and who are intolerant of disagreement. But this is clearly just as true for some subgroups on the right, who often target gay people, minorities, women, and anyone who doesn’t share their worldview.

      Personally, I see the left/right conservative/liberal spectrum as a distraction pushed on us by those REALLY in power, so that we’ll fight with each other instead of joining forces with each other and demanding a more equitable sharing of the fruits of our incredibly productive society with the people who work so hard to keep it productive. But that’s just my opinion. You’re entitled to yours, but not to your own set of facts.

      • “Personally, I see the left/right conservative/liberal spectrum as a distraction pushed on us by those REALLY in power, so that we’ll fight with each other instead of joining forces with each other and demanding a more equitable sharing of the fruits of our incredibly productive society with the people who work so hard to keep it productive.” I agree.

      • Nice politically correct virtue signaling there, Steve. If white America is so hostile toward and prejudiced against “darker skinned people,” then why do such people immigrate to the United States in such large numbers every year? Moreover, why do such people even want to come to the United States in the first place? Black African and Caribbean immigrants to the United States (unlike African American descendants of slaves) have, on average, higher levels of education, wealth, and wellbeing than whites born in the United States. The same is true for other non-white ethnicities in the United States (South Asians, Southeast Asians, Southwest Asians, East Asians, Cubans etc.).

        • That is a foolish analogy. Obviously, people come here because of a) economics, and b) relative freedom from oppression in their own country. Obviously. Do you really think it’s rational to assume that because the USA appears a better option than their home country, the USA has no problems with racism? Do you really believe there are only two options, that the USA is perfect and wonderful (except for those awful liberals and dark people, of course) or that the USA is horrible and that everyone needs to escape it?

          Every country has its strengths and weaknesses. I’m happy to be an American and I believe the American Constitution and other elements of our political system (especially the court system) are admirable and worthy of emulation. At the same time, I’m realistic – no country is perfect, and it should be clear to anyone who isn’t closing their eyes that this country was partly built on slave labor, and that the consequences of slavery and the subjugation of the native population still affect us all today. To believe otherwise is simply closing one’s eyes. It’s not “politically correct” – it’s factually observable, both in statistics and in millions of anecdotes that anyone who is actually interested in the truth can easily obtain.

          It’s easy to use confirmation bias to support your belief system. It’s a lot harder to look at actual data. The truth is almost always very gray. It is uncomfortable to love this country and still believe it can be improved.

          • Nice straw man argumentation there, Steve. A) I never stated or even implied that the United States is a “perfect” nation with no racism. B) I never denied the history of racism in the United States.

            My position is that, although racist views do exist within the white American population as they exist within every human population, they are not (as leftists claim) embedded in the institutions of American society, and they are not representative of the general views of white Americans. Are there Richard Spencer types within the white American population who hold white supremacist views? Absolutely, but there are also Louis Farrakhan types within the black American population who espouse black supremacist views. The point is that such people constitute a fringe minority and that white Americans in contemporary America are overwhelmingly not hostile toward others on the basis of ethnicity or race.

            How is it a “foolish analogy?” If “people of color” (a racist term used by leftists to divide people) were being systematically oppressed by white America, they wouldn’t be coming here. Period. They also wouldn’t, on average, be doing better than white Americans economically and educationally. During the 1930s, were Jews generally trying to enter or leave Nazi Germany? Likewise, are Saudis who embrace Christianity or atheism generally trying to stay in or leave Saudi Arabia?

            I also noticed your nasty insinuation that I am a racist who regards “dark people” as “awful.” What is your evidence to back that up? Regarding leftists, I do view them as insufferably self-righteous, hypocritical, and dishonest. In that regard, I plead guilty as charged.

          • Nonsense. If you lived in a very oppressive society, the USA would feel like a breath of fresh air, even if you had to put up with some crap due to your race. Also, if you were starving, it would be worth whatever you needed to suffer in order to find a place where you could earn money and live a decent life.

            I your last sentence, you admit you are a bigot. You also clearly imply that darker skinned people are “racist” toward white people when saying that “liberals” are the same. It doesn’t take fantastic hearing for that dog whistle to come in loud and clear.

            As for systemic racism, you will have to educate yourself on that point. I will assure you that there is hard data that black people and Native Americans are treated differently by our police, our court systems, and our child welfare systems. This is not to say that ALL or even MOST police are racists (remember, grey areas, grey areas). It simply means that black people and native people are treated differently ON THE AVERAGE than white people. It is factual and supportable if you actually believe in data. I question whether you do or not, but I am guessing you don’t really want to think about this area, you just want to attack anyone who disagrees with you as “insufferably self-righteous and dishonest,” because it’s easier to generalize about people than it is to acknowledge that people are complex and that good and evil can exist in the same person and that people can behave in what they believe to be a fair and equitable way while actually being quite unfair and biased. No, that’s too complex to allow for dogma. So I won’t bother talking further with you about this topic. Anyone who is actually in touch with the data knows which of us is talking through his hat.

  1. psychology is just as adept at creating victims and labeling people as psychiatry. their talk isn’t cheap and it is often dangerous, both to individuals and society as a whole.

    people need people, not “professionals.” as much as id like to believe that “special training” will make a difference, I can’t. Obfuscation, mystification, jargon and lies are the core of psychology.

    • As long as the psychologists continue to use the DSM diagnoses, nothing they say or do will be scientifically valid or helpful, I agree.

      “Majority of counselors lack training to treat” any kind of “trauma,” especially child abuse. Today, “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).”

      Contrary to the delusions of all of today’s DSM deluded “mental health professionals,” psychiatric drugs do not “cure” symptoms or concerns of the crimes of child abuse or racism or any other kind of injustice.

  2. Let’s start over like this never happened and no one even responded to the first post.

    Yeah I Survived is on the right track. “Race based trauma” is the equivalent of yet another “mental disorder,” functioning to institutionalize racist oppression as the norm and stigmatize one’s reaction to it, and to adjust the “traumatized” person’s experience so they can better fit into the racist system and its lifestyles.

    Black people don’t need therapy, they need liberation. Anything less is a used Band-Aid.

          • You present no evidence that this is true. Since the USA was to a very significant extent founded on the institution of slavery (and this is factual, not deniable) and the institutions of Jim Crow and the KKK and many others continued well into the 1960s and institutional bias against black people existed (and still does) in voting rights and loans and housing (remember redlining?) and many other areas, I’d say the burden is on YOU to prove that somehow this has all magically disappeared. As I said, there is plenty of hard data supporting my viewpoint, and Uprising has been kind enough to provide a couple of links, and telling stories and using ad hominem attacks against me does nothing to address this data or the obvious and undeniable history of institutional racial bias which has been a major thread in this country’s identity since before it was a country.

            Explaining away facts doesn’t make them untrue.

    • I agree 100%. Therapy to adjust to oppression is totally out of order. Not to say that support can’t be helpful, just like supporting someone abused as a child can be helpful. But it’s not a “mental disorder” to get angry or upset or anxious when you’re kicked around by people who are more powerful than you are. It’s a normal reaction.

  3. To weight in just quickly on this, for sure racism is traumatizing and the lack of awareness and skills by counsellors is a problem, nor is it one that i think will go away. What is likewise important, Oldhead is absolutely right, you need to get rid of racism, and that as distinct from counselling should be the top priority. To act otherwise is to individualize what is systemic.