Social Justice and Race in the United States: Key Issues and Challenges for Couple and Family Therapy

Caste and Black intergenerational racial trauma in the United States of America

The United States (U.S.) racial caste system and White dominance began in slavery, culminating in Black intergenerational racial trauma. Until recently, Black intergenerational racial trauma largely was ignored by family scholars and therapists. Given that Black intergenerational racial trauma is inseparable from racial caste in the United States, it should be regarded as a wider, systemic problem, requiring intervention at the micro (e.g., family) and macro (e.g., society) levels. The U.S. dominant White society's investment in conserving racial caste furthers the ideological (e.g., political) and sentimental (e.g., democratic ideals) nullification of Black intergenerational racial trauma. Therefore, Black intergenerational racial trauma is often disenfranchised and can hamper Black people's experience of racial trauma as a collective. As passive bystanders, family scholars and therapists are co-conspirators in the long, enduring suffering of Black people. As advocates, family scholars and therapists are called upon to name the racial hierarchy in the United States as a caste system and to advance Black humanization. Specifically, Wilkerson's (Caste: The origins of our discontents. Random House, 2020) notion of the U.S. racial hierarchy as a functioning caste system frames the discussion of Black intergenerational racial trauma and includes the following topics: Black racial trauma, disenfranchised Black intergenerational racial trauma, collective Black intergenerational racial trauma, Black intergenerational racial trauma and the U.S. academy (traditionally White institutions of higher learning), history and its impact on Black intergenerational racial trauma, the Black body and racial trauma, intersectionality and the U.S. caste system, and collective hope and resilience.

Some subtleties of whiteness in the workplace: Steps for shifting the paradigm

This paper asserts that whiteness is a major ideological framework that is subtlety interwoven into our institutional structures and is a major organizing principle in the workplace. Efforts to increase racial equity, inclusion, and belongingness within the workplace and throughout society at large are ineffectual and virtually impossible without addressing the deleterious effects of whiteness. Addressing these pervasive subtleties in the workplace requires more than changing the complexion of an organization; instead, it also involves devoting ample attention to promoting widespread cultural change by being intentional about dismantling whiteness. An illustrative list of four preliminary steps for shifting the racial paradigm by attending to the ideology of whiteness in the workplace is provided.

Culturally humble and anti-racist couple and family interventions for African Americans

Anti-Black racism including structural racism and racism-related disparities have come to the foreground in recent years with the increasingly frequent and brutal police killings of innocent African Americans, the disproportionate impacts of the pandemic on the Black community, and the effectiveness of the Black Lives Matter movement. There have been calls to action to ensure cultural effectiveness of couples and family therapy for African Americans. As one response to these calls, this article provides recommendations for culturally humble and anti-racist couple and family interventions. These best practices focus on the necessity of embracing a systemic stance and a strengths-based culturally responsive lens when assessing and intervening with African American couples and families. They focus on the need for therapists to be intentional about and consistent in engaging in self-exploration and taking the necessary steps to be not just competent but also capable. The final set of best practices detailed relate to assessing and intervening using a strengths-based approach in a culturally responsive, anti-racist, and socially attuned fashion. The article concludes with recommendations for couple/family therapists to develop a critical consciousness, engage in anti-racist practices, and address oppression while advancing healing and liberation, all of which are essential to ensuring the resilience and well-being of African American couples and families.

The Soul of Therapy: The Therapist’s Use of Self in the Therapeutic Relationship

This paper is based on the premises that the conscious, active and purposeful use of self by the therapist in the therapeutic process is an essential aptitude in establishing an effective therapeutic relationship, and that this therapeutically purposeful use of self can and should be incorporated in the training of all therapists in a explicitly systematic manner. The paper will attempt to identify the contributions of the “what and how” the use of self by therapists contributes to the therapeutic process. First of all, therapists’ use of self is meant to be viewed as a Common Factor as defined by Sprenkle, Davis & Lebow (2009), which is a perspective about the effectiveness of therapy that “asserts that the qualities and capabilities of the person offering the treatment are more important than the treatment itself” (p. 4). Secondly, the use of self by therapists emphasizes developing the skill set of the therapist in the conscious, active and purposeful use of self as is in the moment of the therapeutic engagement with clients, and does so without denying the importance of therapists working to resolve personal issues of theirs that may interfere with the therapist's professional effectiveness. Therapists’ use of self gives particular emphasis to the purposeful use of self as is in therapy’s relationship, assessment and interventions whatever the therapy model (Aponte & Kissil, 2016). Thirdly, the use of self represents an aptitude that can be developed and refined through well elaborated structures for schooling therapists in the therapeutic use of all they bring of their personal selves to the therapy relationship including through the use of their human vulnerabilities as they exist at the moment of empathic engagement with clients.

"Always Thinking About Safety": African American Lesbian Mothers' Perceptions of Risk and Well-being

Although there is a growing body of knowledge focusing on lesbian families and their parenting experiences, African American lesbian mothers are often underrepresented in research. This qualitative exploratory study aims to understand the constructions and perspectives of African American lesbian mothers, from an urban East Coast area, on risk and well-being. Fifteen in-depth semi-structured interviews were conducted and analyzed at the end of 2016, coinciding with the presidential election yielding main themes that were significant for the participants pertaining to the mothers' experiences and construction of the challenges and risks to well-being. Main themes first focused on discrimination and insensitivity in everyday spaces; then moved into the effects of political climate on perceived safety and security, conditions and unintended consequences of the coming out process; and ended with strategies for reducing risk. Adoption of an intersectional framework to discuss our findings allowed us to explore the ways in which multiple identities engage to shape experiences and constructions of risk and well-being among African American lesbian parents. The results suggest the importance of context (e.g., political, historical, gender-related, racial) when working with LGBTQ+ families of color.

Reflections on our efforts to help mental health agencies become more "culturally competent"

This paper reflects on our decades-long cultural training experiences, offering details on training efforts we made and considers in hindsight interventions we wish we had been able to implement. The paper describes what we think could be necessary for organizational training/consultation to facilitate the transformation of organizations in the direction of social justice and the delivery of efficient and effective services to a community. We reflect on organizational training to promote cultural competence and social justice. We encourage readers to take the broadest possible perspective on the larger systems issues that tend to undermine such efforts, so they can better achieve their goals for organizational change.

Distributive Justice in Family Relations

The aim of this paper is to highlight the important contribution of the lens of distributive justice to an understanding of family relations. Existent justice research in the family tends to focus on specific family relations: spouses, parents and young children, elderly parents and adult children, with most research addressing the division of labor between spouses. We seek to go beyond the specific family relations in order to highlight justice-related themes that are common across family relations. We elaborate upon three claims. First, we show that while the ideal of equality underpins justice in contemporary Western societies, actual distribution practices across family relations are characterized by persistent inequality. Second, although the gap between the ideal of equality and unequal distribution practices may create a sense of injustice among family members, we show why this is not necessarily the case. Third, we elaborate upon the positive and negative consequences that result from feelings of justice or injustice across family relations. We conclude by discussing the interweaving of love and justice in the family.

Microlevel Advocacy: A Common Process in Couple and Family Therapy

Advocacy is an essential element to mental health practitioners' professional identity. Some scholars contend that many couple and family therapists lack the skill set needed to effectively advocate. However, these researchers often discuss advocacy solely on the macrolevel, which makes advocacy appear unidimensional and may feel out of reach for many practitioners. In this article, we argue that advocacy is not unidimensional, but consists of two levels: macro- and microlevel advocacy. Microlevel advocacy is client-centered and is effectively performed by couple and family therapists on a regular basis. By broadening the definition of advocacy to include the microlevel, we argue that advocacy is a common process of couple and family therapy that cuts across therapy models and is interwoven into the very being of a couple and family therapist. We present in this article a comprehensive case vignette to illustrate how microlevel advocacy may be performed by CFTs. Clinical and training implications are offered to help clinicians begin to bridge the gap between micro- and macrolevel advocacies.

Cultivating the Therapeutic Alliance in a Telemental Health Setting

Telemental health services have broadened during the last decade (Choi et al. 2019; Pierce et al. 2020). More recently, Severe Acute Respiratory Syndrome Coronavirus 2019 (COVID-19) restrictions have led to an escalation in clinical services through telemental health settings. The purpose of this phenomenological study was to consider perspectives of Marriage and Family Therapists (MFT)s who are working in telemental health settings prior to and/or as a result of COVID-19 restrictions and consider the role that telemental health has in building therapeutic connections with clients. Researchers presented an online survey that explored participants’ perceptions of providing telemental health. Participants included 23 MFTs who were currently licensed or working under an MFT supervisor. Data analysis uncovered the following thematic responses: (a) doing telemental health is similar, but different, than in-person therapy, (b) adapting to telemental health is worthwhile, and (c) validating clients’ voices and experiences is fundamental to building an alliance in telemental health therapy. Findings supported the importance of further training in telemental health, specifically related to cultural humility and alliance building within telemental health settings.

The Experiences of Couple/Marriage and Family Therapists of color: A Survey Analysis

The family therapy literature documenting the experiences of couple/marriage and family therapists (C/MFTs) of color as a group is limited. The purpose of this study was to assess the status of C/MFTs of color in their clinical training programs, clinical work, and related areas of professional challenges and opportunities. Participants (N = 113) completed a one-time, anonymous electronic survey on SurveyMonkey consisting of demographic questions, closed- and open-ended questions about their experiences. Key findings are reported related to C/MFTs of color experiences in training programs, areas of professional need, and working with racial and/or ethnic minority clients. These findings shed light on how social justice principles and practices upheld in our field are experienced from the emic perspectives of C/MFTs of color. These voices help to broaden our understanding of how we might move forward in advocating for and advancing a more culturally responsive agenda within our profession.

Black Lives Matter: We are in the Same Storm but we are not in the Same Boat

Black Lives Matter is a clarion call for racial equality and racial justice. With the arrival of Africans as slaves in 1619, a racial hierarchy was formed in the United States. However, slavery is commonly dismissed as that less than noble aspect of the United States' history without really confronting the legacies of racial inequality and racial injustice left in its wake. White supremacy, based on the myths of white superiority and Black inferiority, have obscured racial inequality and racial injustice, resulting in blaming the victims. Using Black Lives Matter as a platform, we focus on some key considerations for theory, research, education, training, and practice in clinical, community, and larger systems contexts. Broadly, we focus on Black Lives Matter, literally; Black dehumanization; historical oppression; healing; and implications for the field of family therapy. More specifically, we draw attention to health disparities, mass incarceration and aggressive policing, intergenerational racial trauma, restorative justice, and antiracist work.

COVID-19 Interconnectedness: Health Inequity, the Climate Crisis, and Collective Trauma

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.

African American Couples in the 21st Century: Using Integrative Systemic Therapy (IST) to Translate Science into Practice

The complexity of the African American community in the United States continues to evolve. The growing number of professional African Americans who grew up in the postcivil rights era combined with the persistent reminders of inequity paints a complex backdrop for understanding African American relationships. The majority of our knowledge about African American couples disproportionately comes from nonclinical social science fields such as sociology and demography. Unfortunately, the scholarly literature on how to work with African American couples is relatively scant. This paper seeks to add to this limited literature by providing clinicians and scholars with a proposed set of issues to consider when conceptualizing and treating African American couples. In particular, the complexity and nuance needed to work with African American couples are best done by using an integrative model. Thus, this paper will discuss how the Integrative Systemic Therapy (IST) model is particularly well suited for working with African American couples. This paper will summarize the science on African American marriages with a focus on salient factors such as gender, SES, and trust, which will then be translated into clinical practice by utilizing a case example. The case example will be of a middle-class couple in order to delineate the challenges and the growing heterogeneity of African Americans. The article will conclude with a commentary on the evolving heterogeneity of African Americans, which sheds light on how an integrative perspective is important for disentangling and embracing the growing complexity of African American couples.