The Broaching Attitudes and Behavior Survey (BABS): An Exploratory Assessment of Its Dimensionality

Broaching body size and sizeism: Input from specialized clinicians

Broaching issues of identity and power with clients in the context of their mental health care is affirmed as an effective multicultural and social justice counseling skill by a growing evidence base. Considerations for broaching body size, including size difference and sizeism, with clients has not yet been studied, thus clinicians lack guidelines for facilitating these conversations. In this consensual qualitative research study, we present themes involved in broaching body topics based on our interviews with nine clinicians specialized in treating clients with eating disorders and body-related counseling concerns. Themes addressed counselor development, conceptualization of broaching, clinical-decision-making, practice, and impact of broaching body topics in session. Clinicians identified professional and personal developments they pursued and would advocate for training future clinicians to better serve clients. Descriptions of unique and shared aspects of broaching clients' intersectionality and body-size specifically depict avenues for tailoring broaching conversations. Specific examples of effective and ineffective broaching conversations, including language used and psychoeducational components, provide recommendations for practice and connect to observed impacts on the client, counselor, and counseling process.

The development of the Broaching Assessment Scale: A client-rated measure of therapists' broaching behaviour in clinical counselling

Objective: Addressing ethnic-cultural topics during the process of psychotherapy, i.e. broaching, is considered highly important for ethnic minority clients who consult mental health care services. Surprisingly little is known, however, about clients' perception of a therapist's broaching qualities, and how clients' mental construction of broaching translates into behavioural broaching acts a therapist may display.

Method: Based on previous work and nine in-depth interviews with ethnic minority clients, a client-rated measure of therapists' broaching behaviour was developed and psychometrically evaluated in two samples. Sample 1 (N = 252 UK ethnic minority clients) was used to empirically delineate the factor structure of an initial item set. Participants were then resolicited to complete a revised item pool.

Results: The empirical structure resulted in a final 25-item broaching instrument with five subscales probing into therapists' broaching behaviour. This Broaching Assessment Scale (BrAS) was validated in Sample 2 (N = 239 US ethnic minority clients). Strict measurement invariance of the factor structure was observed across the two samples and distinctive correlational patterns with therapeutic process measures were found.

Conclusion: The BrAS provides new insights on how sensitivity to ethnic-cultural topics can be targeted along its concrete features, and is a promising tool for conceptualizing culturally sensitive mental healthcare assessment.

Broaching partially-shared identities: Critically interrogating power and intragroup dynamics in counseling practice with trans people of Color

Background: Much of the literature on transgender and nonbinary (TGNB) experiences in counseling focuses on White experiences with few recommendations for trans people of Color (TPOC). Research suggests mental health care providers lack intersectional sensitivity with TPOC, lack knowledge of TGNB issues and engage in microaggressive behaviors, notably with Queer-identified clinicians. Aim: To explore issues of power and privilege in the counseling relationship with Queer-identified clinicians and apply the multidimensional model of broaching behavior with TGNB clients of Color. Method: A critical review of conceptual and empirical literature focusing on the interaction and impact of client and clinician race, gender, and sexual/affectional identities in the counseling relationship is presented. Informed by the authors' counseling experiences and respective positionalities as a Black Queer ciswoman and a White Queer transman, the multidimensional model of broaching behavior is applied to a composite case vignette. Results: The model provides a practical tool to facilitate critical conversations of power, privilege and identity in the counseling relationship. Conclusion: With a dearth of scholarship addressing the role of cisgender or White privilege in the counseling relationship, this article outlines strategies to broach issues partially-shared identities with TGNB clients of Color. Recommendations for culturally informed counseling practice, supervision and research are also provided.