Cultural ruptures: Addressing microaggressions in group therapy.

Abstract

Objective: Because therapy groups represent social microcosms, social dynamics from outside of the group play out in the context of the group, including those related to power, privilege, and oppression, like microaggressions. Left unaddressed, microaggressions have negative impacts on the health and well-being of the targets, perpetuate systemic inequity, and present a particularly destructive form in rupture to the group. The objective of this practice review is to help prepare group therapists to address the cultural ruptures known as microaggressions. Method: We first briefly review the literature on microaggressions, including those that occur in individual and group psychotherapy, to highlight the importance of addressing microaggressions when they occur. Next, we review the literature related to multicultural competence, multicultural orientation, difficult dialogues, and bystander intervention to suggest practice recommendations for addressing microaggressions in group therapy at the therapist and group levels. We also present a case example to illustrate these recommendations in practice. Results: Our practice recommendations highlight actionable ways for group therapists to proactively prepare to address microaggressions both before and outside of the group and in the here-and-now. Conclusions: Microaggressions are likely to occur in the social microcosm of the group and addressing microaggressions in groups is essential. Group leaders can proactively prepare themselves and the group to address microaggressions as they occur to minimize harm to the targets and the group-as-a-whole. Highlights and Implications• Microaggressions, or subtle discriminatory slights that perpetuate inequality, are likely to emerge in the context of the social microcosm of group therapy, as they have been found to in individual therapy.• At the group level, the group can also set norms that encourage and support difficult cultural dialogues, develop a group MCO (i.e., their cultural humility, and willingness and comfort in addressing cultural issues, like those presented by microaggressions), develop capacities for bystander intervention, and create corrective emotional experiences in response to cultural ruptures.• Additional empirical research is needed on microaggressions in group therapy, as well as the preparation of the therapist and group to successfully negotiate these cultural ruptures as they occur.

Ruptures and repairs in group psychotherapy: Introduction to the special issue.

“…The articles are useful to group therapists who are working with clients in group treatment. The clinical examples provided by Miles et al (2021) and Garceau et al (2021) demonstrate the different ways that leaders can engage group members and address ruptures in the group. They provide guidance to group therapists as we enter into this challenging and meaningful work.…”

“…In this special issue, Miles et al (2021) present a practice review that delves into identifying microaggressions in group therapy and a model for addressing ruptures caused by microaggressions. The authors highlight the importance of addressing microaggressions when they occur in group psychotherapy, and they describe group leader factors that influence the process of repair that include multicultural competence, multicultural orientation, and comfort with difficult dialogues.…”

“…In addition to empathy, some leaders have more experience leading groups and are less anxious about failing or making a mistake when they observe a rupture. Some leaders have more experience with diversity, lived with marginalized identities, or have more experience addressing microaggressions (Miles et al, 2021).…”

“…Group Dynamics: Theory, Research, and Practice This special issue of rupture and repair in Group Dynamics: Theory, Research, and Practice begins where the special edition of the International Journal of Group Psychotherapy left off. It focuses on empirical research, including a metaanalysis of the alliance-outcome association in group treatment (Alldredge et al, 2021), studies on the measurement of ruptures and repairs in group therapy (Garceau et al, 2021;Gullo et al, 2021;Svien et al, 2021), an investigation of the effectiveness of rupture repair group supervision (Urmanche et al, 2021), and a practice review of the impact of microaggressions, a specific type of rupture in group therapy (Miles et al, 2021).…”

Examining between-group and within-group cultural concealment in group therapy.

“…Despite these advancements, there is a paucity of research examining clients’ cultural concealment in a group therapy context. This is surprising, given the vast literature on multicultural group counseling (Bemak & Chung, 2004; Burnes & Ross, 2010; Chen et al, 2008; Eason, 2009; Merta, 1995) and the acknowledgment that cultural dynamics directly impact processes and outcomes of group-based interventions (Chen et al, 2008; Kivlighan & Chapman, 2018; Miles et al, 2021). Similar to an individual therapy context, group therapy members’ cultural concealment may be driven by client factors and group factors.…”