Oppression is not “culture”: The need to center systemic and structural determinants to address anti-Black racism and racial trauma in psychotherapy.

Abstract

Psychology, and the United States more broadly, finds itself at yet another reckoning point with White supremacy and anti-Black racism. The American Psychological Association has even recently apologized for psychology's role in upholding systemic racism and White supremacy, and articulated expectations for psychology's role in dismantling systemic racism and White supremacy throughout psychology. Yet, the norms of White supremacy pervade our professional and individual consciousness, resulting in our radical movements toward a "culturally responsive psychotherapy" seeking to adapt to, and ultimately becoming quashed by, the very oppressive systems it seeks to upend. In this article, I argue first that to address anti-Black racism and racial trauma in psychotherapy, it is imperative to move beyond notions of "culture" and "identity" to a structural competency model of psychotherapy and psychotherapy training. Structural competency and examples of its integration are briefly discussed. I then offer and expand upon two additional recommendations: That we must learn about and incorporate the incredible work of Black, Indigenous, and people of color scholars who have offered robust guidance in how to engage in healing racial trauma in individual and family psychotherapy; and, that to ethically engage in and develop an antiracist psychotherapy equipped to heal racial trauma, we must individually and collectively engage in our own conscientization and radical racial healing. Throughout, I emphasize the importance of prioritizing the work of scholars of color, whose work I seek here to integrate and build upon, but do so as a low socioeconomic status-origin, White woman with disabilities scholar situated at complex axes of both privilege and oppression. Clinical Impact StatementQuestion: How might we finally move toward an antiracist psychotherapy that is equipped to support the healing of racial trauma? Findings: Multiple resources and concrete guidance are provided for theoretical case conceptualization, psychotherapeutic techniques, and most importantly, engaging in one's own radical racial healing, that can support clinicians' development of an antiracist psychotherapeutic practice. Meaning: To genuinely develop an antiracist psychotherapy and support the healing of racial trauma, we must move beyond misdirected notions of "culture" and "identity" toward a structural competency model; deeply familiarize ourselves with the robust scholarship of Black, Indigenous, and people of color scholars; and engage in our own individual and collective racial healing. Next Steps: Future research and theory should be developed to shift toward structurally informed, antiracist psychotherapeutic training and practice; and, psychotherapeutic training should incorporate conscientization and racial healing as a standard part of our professional preparation.

Essential elements for working with racial trauma: A guide for health service psychologists.

“…However, though psychotherapy can be an effective tool for the facilitation of healing from racial trauma, racism is ultimately a societal-level phenomenon that requires structural-level interventions. Here, we urge the field of psychology to engage in more urgent and sustained antiracist advocacy and for training programs to explicitly incorporate antiracism as a core and essential aspect of psychologist preparation (Wilcox, 2022).…”

Introduction to special section: Addressing racism, anti-blackness, and racial trauma in psychotherapy.

“…Last, Wilcox (2022) provides a poignant critique of existing frameworks to address anti-Black racism and racial trauma in psychotherapy and argues for the adoption of a structural competency model of psychotherapy and psychotherapy training. The author draws upon existing and robust work of BIPOC scholars to highlight how to advance antiracist practices in psychotherapy and psychotherapy training.…”

Grasping at the Root: Transforming Counseling Psychology

“…What we teach and how we teach must radically change. We can no longer tinker around the edges but instead we must re-imagine and redesign our curriculum by centering the new frameworks (c.f., Fish & Syed, 2018; Liu, 2022; Mosley et al, 2020; Singh, 2020; Wilcox, 2022) that help us to reconsider and transform every aspect of our work. We must also dig deep into the work of our counseling psychology colleagues who are radically transforming what is possible.…”