A Competence Framework for Embedding Race, Culture & Anti-Discrimination in Practice

A Competence Framework for Embedding Race and Culture 2.0

A practical approach to race and multicultural competence.

Mamood Ahmad is a UKCP Psychotherapist, trainer, author, and founder of “The Antidiscrimination Focus” (TADF) which works with individuals, training providers and institutes who wish to embed anti-oppressive practice into their curriculum and organisation. 

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ABSTRACT: A practical competency framework is presented for race and cultural competence based on evolving (2.0) continuum of competencies needed to support clients with range of racial-cultural group categorisations, including based on phenotype, heritage, ethnic identities. This competency was developed through synthesis of existing multicultural competencies, race (phenotype) based racism experiences, expertise, theories and tried and tested training delivery method over 14 months.

KEY WORDS: race, racism, antidiscrimination, antioppression, competence, multicultural, decolonizing, culture, ethnicity, trauma, racial trauma.

ma@paththerapy.co.uk

For all counsellors, psychotherapists, psychologists, psychiatrists, and mental health practitioners including therapist, trainers, curriculum planners, researchers and supervisors.

Defining Race and culture 2.0

Race and culture 2.0 is an all-inclusive model of practice which considers the psychological impact on clients, as well as their experiences and strengths, in relation to their racial-cultural group assignments and meanings, whether by society, birth, geolocation, or self.

Racial-cultural groupings may exist along intersections of phenotype, heritage, and cultural group(s) such as ethnicity, language, citizenship status, nationality, migration history, homeland, common intergenerational and collective history, ultimate beliefs such as faith, and worldviews. While psychological impact is often in relation to the client’s racial-cultural positionality within a western cultured society (similar/different), it is also inclusive of a multitude of relationships within and between racial-cultural groups, e.g., Black to White, White to White, Catholic to Protestant, South Asian to East Asian, multiracial to Black, Roma to White, etc. Therefore, to be explicit, considering the effects of a White client’s identity within a western or another cultural context is part of this inclusive practice.

Further, the inclusive model of practice allows us to consider the impact on clients, as well as the conflicts, experiences, and strengths of clients belonging to or interacting within embedded cultural group(s) (ECG) within society. Examples include family, profession, LGBTQIA+ community, social groups, faith groups, as well as micro and macro systems such as education, mental health, political systems, and healthcare.

Competency Principles

There are eight guiding principles for working with aspects of race and culture.

Developing an Anti-Discrimination Practice

This competence requires the development of an antidiscrimination action and skills in recognising and improving services, whether within the self as a ‘practice of one’ or an organisation / agency. Broadly, these skills relate to identifying improvements to access, experience, service quality, and outcomes for Majority Diverse clients or for any other disadvantaged groups or individuals.

Embed as Standard Into Practice

Race and culture 2.0 must be seamlessly embedded into the therapist’s approach (not as an add-on), including assessing, conceptualising, and working therapeutically with all clients regardless of their racial-cultural grouping(s). Furthermore, this understanding provides further opportunities for reflexive practice in considering how theories, research, curriculum, and our approaches are influenced by the cultural context(s) within which they have evolved.

Salience of Phenotype (including skin tone)

The clients’ phenotype and its intersection with communication approach such as language, dialect, tone and observable expression must be actively considered. Considerations include the therapist’s own colour such as white, race process, impediments within the relationship, as well as clients experience within the world. Therapists need to mindful of race avoidance such as viewing clients experience solely in relation to clients’ cultural contexts and worldview.

Working on Your Own Racial-Cultural Identity

This competence requires therapists, trainers, supervisors, and researchers to work on their own racial-cultural identity in consideration of the high-level aims outlined above, paying particular attention to the power dynamics in society, the profession, and between themselves and their clients. Further, this allows for the first-hand experience of a racial-cultural development process, which could be relevant to clients.

Affirming Racial-Cultural Groups

The therapist affirms the similar/different racial-cultural group identities of the client. Therapists need to be aware of the magnitude of their responsibility in working with clients of similar/different racial-cultural groups, including those who experience the loss of heritage such as with transracial adoptees. Therapists need to ensure they work in an anti-superiority and anti-assimilative way with clients from similar/different racial-cultural groups in order to preserve and affirm their identified heritage.

Racial-Cultural humility

Therapist’s need be reflexive in how they view clients from and with similar/different groups and worldviews, ensuring they see the uniqueness of the client rather than relying on external sources of knowledge. Therapists see difference, shared humanity, and uniqueness.

Responsibility for Reaching Clients

While the matter of whether the client will feel you can help them is a complex and multi-factored issue, it is vital that the therapist be open to continuously self-reflect on their ability. Furthermore, they must be critical of the nature of their service to ‘reach’ clients rather than making implicit judgements or stereotypes associated with various racial-cultural groups, such assuming certain racial-cultural groups just do not come to therapy. Ask what improvements are needed in your own practice?

Ongoing Practice

Therapists must obtain supervision from a qualified therapist who has undertaken the decision to follow this or equivalent competence standards, as well as committed themself to an anti-discrimination ethos. Therapists need to continue their development of race and culture while recognising this as a lifelong process. It is particularly important that this development includes experiential activities such as group encounters or gaining lived experience within various racial-cultural groups.

How to Use

This framework may be used as input to reflect on your own competence and plan your training and self-development. It is suitable for training organisations, curriculum designers and CPD organisers in assessing gaps in learning. It is not a substitute for training. In addition, this is not a complete framework for transpersonal, religious, and spirituality competence, but rather a starting point for integrating clients’ worldviews and methods of healing into practice in an affirming anti-discriminatory manner.

Any feedback or requests for change: email: admin@tadf.co.uk (or tadf.co.uk)

Structure

This framework, for convenience, focuses on eight interrelated themes.

  • Professional and ethical framework
  • Relationship development
  • Racial-cultural discrimination
  • Racial-cultural identity development
  • Integrating and adapting therapy
  • Migration and acculturation
  • Anti-discrimination practice
  • Knowledge and self-awareness

Professional & Ethical Framework

1To integrate, assess, and conceptualise race and culture throughout the process and for all clients.  
2To complete continuous training and self-development in race and culture, which includes racial-cultural identity development and experiential learning.   This framework can be used as a reflective guide to plan development.
3Work with racial trauma only if you have worked sufficiently on your own racial-cultural identity, including biases and oppressor/oppressed dynamics.  
4Assess the client’s worldview and racial-cultural context(s), including faith and spirituality, as part of the initial assessment to determine your suitability to work with the client and to minimise the unnecessary chance of early exits.  
5To explore and assess the clients’ beliefs within their cultural context(s) such as stigma towards mental health problems and therapy.  
6To continuously develop cultural empathy, understanding, and humility for similar/different cultures to your own.  
7To affirm people of similar or different cultures to your own.  
8To work in a respectful, empathic, non-judgemental, and accepting manner by working relative to the client’s cultural context(s) while monitoring racial-cultural biases, worldview biases, and morality biases.  
9To work in a respectful, empathic, non-judgemental, and accepting manner by monitoring the possibility of inferiorising, assimilating, or stereotyping the client’s worldview or their racial-cultural group(s).  
10To work with a supervisor who is race, culture, and anti-discrimination aware, such as those who have been through training, engage in own racial-cultural identity development, and experiential practice, as well as shown commitment to further learning.  
11Practitioners are aware of the importance of bringing all of their clinical work to supervision, including how (or whether) they have addressed their clients’ racial-cultural issues, and exploration of the relationship dynamics.  
12To understand why fixed beliefs about race, culture, or how therapy must be practiced could lead to a client’s early exit, poor experience, and poor outcomes.   Examples include disbelief of racial-cultural discrimination contributing to psychological problems, being colour-blind, avoiding or bypassing race discussions in favour of other factors, or sticking to the belief that race and culture must not be broached unless the client raises it.  
13To continuously reflect on how therapeutic theories, modalities, research, interventions, and problem formulation are culturally embedded and, thus, may need to be adapted, not used, or significantly changed for specific clients, including using methods of healing from clients’ own racial-cultural group(s).  

Relationship Development

1Ability to actively broach, assess, and explore racial-cultural aspects of clients’ experiences, intersecting discrimination, cultural contexts, and personal worldview with respect, curiosity, humility, and acceptance.  
2Knowledge and awareness of types of language, including verbal and non-verbal, which could cause difficulties in the relationship.  
3Ability to understand with immediacy the potential power dynamics of race, culture, and other intersections within the relationship, including when you hold a similar racial-cultural identity.  
4Ability to understand, empathise, accept, and work with clients’ emotional reactions towards experiences of racial trauma and racial-cultural otherness, including when directed towards the therapist.  
5Monitor any biases, assumptions, stereotypes, and generalisations you make about a client’s race and culture, such as based on their phenotype, communication style, lived cultural experience, nationality, and worldview.  
6Recognise your own worldviews and cultural contexts and, in doing so, do not inadvertently impose or assimilate the client’s cultural group, individual values, or valuing systems into your own.  
7Work actively to empathically understand the client’s cultural group context(s) and remain non-judgemental, respectful, and empathic, regardless of your own worldview and cultural context(s).  
8Monitor self-in-collusion with the client’s generalisations and stereotypes about racial-cultural group identities, even if it is part of the client’s own racial-cultural group(s).  
9Recognise whether you minimise, disbelieve, or pathologize clients’ experiences of racial-cultural othering and discrimination.  
10Ability to ascertain and use correct racial and cultural labels based on individual self-identification, including their name.  
11Ability to use self-disclosure and questions appropriately to develop the relationship and deeper understanding of a client’s context.   For example, disclosing your own racial-cultural identity and background.  
12Ability to use a language interpreter (including sign language).  
13Ability to describe to your clients why you believe you can work with race, culture, and an anti-oppressive ethos including elements of training, experience, self-development, and advocacy.  

Racial-Cultural Discrimination

1Ability to broach and have respectful, assured dialogue about race, racism, cultural racism, systemic discrimination, internalised discrimination, and intersectional forms of discrimination.  
2Ability to recognise and work with racial-cultural trauma, intergenerational trauma, racial discrimination, and racial-cultural othering, including systemic forms of intersecting discrimination.  
3Ability to receive and work with strong embodied emotions.   For example, because of racial wounds, cultural loss and grief, and internalised racial-cultural affects such as guilt and shame.  
4Ability to work with internalised racism and internalised forms of racial-cultural and intersectional oppression.  
5To consider both inter and intra forms of racial-cultural discrimination.   For example, those within and between PoGM Cultural groups, White other, and mixed-race groups.  
6Work with respect, empathy, humility, and acceptance when clients challenge you about your ability, knowledge, sensitivity, and language in working with race and culture.  
7Ability to work with clients who hold racist beliefs or use othering racial-cultural language (subject to own limits worked through with a qualified supervisor).    

Racial-Cultural Identity

1Ability to broach and explore experiences in relation to aspects of race, culture, and intersecting identities (such as gender, sexuality, sexuality, disability, neurodiversity, and socio-economic status).  
2Ability to use racial-cultural identity, acculturation, and cultural identity frameworks as a tool to compare self and client’s racial identity development, as well as conceptualise the client’s adaptation and acculturation difficulties.  
3Ability to recognise racial-cultural identity as a potential source of strength as well as psychological concern.  
4To hold your own racial identity development – and thus attitudes, beliefs, and process – as being separate to that of the client.  
5Ability to help clients develop their racial-cultural identity narratives.   For example, exploring childhood and current experiences, use of genograms to explore intergenerational trauma patterns, and acculturation conflicts.  
6Ability to work with challenges of migration and citizenship, including providing signposting to services that can help support basic human needs and adopting an interdisciplinary approach to recovery and support.  
7Ability to help clients incorporate ultimate beliefs, such as religion and spirituality, into therapeutic practice and recognising them as part of a client’s worldview.  
8Allow autonomy for the client in describing their racial-cultural attitudes, beliefs and ways they wish to racially-culturally self-identify.  

Integrating and Adapting Therapy

1Work with cultural humility to assess, conceptualise, and co-create plans and interventions with the client while recognising the limitations of generalised knowledge being “applied” to clients because of their actual or assumed cultural groups and cultural context(s).  
2To take a recovery-based approach that fully incorporates the religious and spiritual needs of the client.  
3To actively seek and, where appropriate, use resources aligned to individuals’ values and beliefs as a supplement to therapy.   Examples include community groups and healing methods.  
4Ability to adapt the therapeutic approach, assessment, conceptualisation, responses, meanings, and interventions based on the client’s worldview, cultural group(s), and cultural context(s).  
5To recognise and assess the client’s worldview and work with them to conceptualise the interventions in harmony with it.   For example, faith and spirituality.  
6Recognise and adapt therapy based on the understanding that theory, modality, problems, and the therapeutic construct could in part be culture bound.   Examples include healthy attachment, time formality, child development and meaning of problems and symptoms.

Migration and Acculturation

1Ability to discover and explore various aspects of a client’s racial-cultural context(s) such as cultural group, migration experiences, level of acculturation, familial roles, cultural norms, and beliefs.  
2Ability to assess and conceptualise the client’s level of acculturation, identity, and adaptation challenges within and between social and cultural groups.  
3Ability to formulate how a client’s cultural context(s) such as societal culture, citizenship, migration experiences, family, community, or work relate to that client’s problem.  
4Ability to reflect on how cultural context(s) enculture and influence the client’s worldview.  
5Develop and apply knowledge of theory and lived experiences of migration, citizenship, acculturation, and adaptation challenges.  
6Ability to work with and incorporate a client’s faith, spiritual beliefs, and secular and non-beliefs into the process.  
7Ability to recognise and potentially broach the impact of discrimination because of a client’s cultural identity, ultimate beliefs, and migration and citizenship status.  
8Ability to explain to clients the impacts of migration and acculturation events on mental health.  

Anti-Discrimination Practice

1Recognise why an antidiscrimination stance is needed for fair practice.  
2Understand current equality legislation, such as the Equality Act 2010 and its limitations to fair practice.  
3Ability to use anti-discrimination practice (ADP) skills to recognise factors within self and practice which could create barriers in access, experience, and outcome for Majority Diverse and contextually marginalised clients.  
4Develop relational social allyship skills which can be used to support clients and/or for people in your world.  
5Ability to analyse disproportionality within practice and how that gap may be alleviated, such as through direct or indirect contact with outreach projects.  
6Have an awareness of potential empowerment action(s) which the client or therapist may take based on their client’s experiences of suffering and injustice.     This does not mean “actioning” that awareness unless client-driven.  
7Recognise the need for a holistic and multi-factored approach to equality, diversity, and inclusion which incorporates understanding of power dynamics.  
8Awareness of how power within the self can be used adaptively to remediate ecological issues within systems, including self-in-practice.  
9Continuously understand and recognise potential for self-in-practice to create negative experiences for clients.   Examples include, the application of incongruent universal skills, lack of racial-cultural self-development, or blind spots which lead to internalised critical reactions towards the client.  
10Ability to consider self-care and support interventions for clients based on overt, aversive, or marginalised racial-cultural experiences.  
11Develop resources or directories of organisations that can offer signposting, support, and advocacy for the client’s needs. Examples include support their intersecting racial-cultural group, status, and problem.  

Knowledge & Self-Awareness

1Be aware of in-world events which may be impacting clients due to their racial-cultural identity.  
2Use self-care, therapy, supervision, and peer support groups to support your practice.   For example, to self-manage strong self-emotions and to reflect on racial-cultural biases and your relationship with clients.  
3Understand different formulations of racism, such as social, cultural, accumulative, systemic, structural, and internalised.  
4Continually understand the context of racial-cultural discrimination for specific racial-cultural groups, including mixed race, White other, GRT, migrants, faiths, and diverse cultural groups.  
5Recognise and explore boundaries, reactions, and ways of working with clients who hold racist beliefs and/or who use racialised racial-cultural language.  
6To work on your own racial-cultural and intersecting identity, including positionality, racial-cultural experiences, and racial, historical, and intergenerational trauma.  
7Knowledge of western cultural context(s) and its impact on self and all racial-cultural groups.  
8Understand current and evolving forms of racial-cultural discrimination and social justice issues.   Examples include anti-Blackness, modern-day slavery, GRT cultural loss, anti-Semitism, and Islamophobia.  
9Gain a working understanding of your own and clients’ racial-cultural groups’ histories, cultural contexts, and social challenges while not making assumptions around clients’ unique experiences.  
10Continually develop an understanding of a range of specific racial-cultural lived experiences based on specific racial-cultural groups.   For example, Nigerian, South Asian, Muslim, Jewish, GRT, Kurdish, Ukrainian.  
11Understand the impact of racial and intersecting forms of discrimination on mental health and to be able to explain these to clients.  
12Continuously understand how race and culture operates in the world.   For example, historical understanding of racism, embedded in language, comparative treatment of groups, and its relationship with power dynamics.  

Glossary of Key Terms

Order presented based on continuity of understanding.

Culture. A process of valuing, believing, normalising, othering, and applying of principles, rules, behaviours, and activities.

Western culture. Western culture, sometimes equated with Western civilization, Western lifestyle or European civilization, is a term used very broadly to refer to a heritage of social norms, ethical values, traditional customs, belief systems, political systems, and specific artifacts and technologies that have some origin or association with Europe (Source: Sciencedaily).

Cultural Group. A group of people or society at large (such as western culture, ethnoreligious culture, national culture) which hold a shared but changeable culture.

Embedded Cultural Group (ECG). A cultural group that is embedded within a larger cultural group.

Geolocation. The known geographical origin of a person’s ancestry.


Heritage.
An individual’s known geolocated origin story together with implications for racial-cultural inheritance.

Phenotype. The set of observable characteristics of an individual resulting from the interaction of its genotype with the environment.

Racial Group. A person whose phenotype and/or other observable traits, such as language, could rightly or wrongly be identified as belonging to a particular cultural group and/or descended from a particular heritage or geolocation. Importantly, racial group assignment can lead to socially and institutionally assigned hierarchical categorisation of value, threat and importance based on shared cultural knowledge. Note: Racial Group may also be used in an arbitrary and overlapping way with other definitions such as ethnicity, or nationality.

Worldview. An individual who, through enculturation and experience, holds a personal culture.

Cultural Context. An individual’s dynamic context as they inhabit, interact and move between cultural groups and ECGs.

Racial-cultural group. Any group of people who self-identify along along intersections of phenotype, heritage, and cultural group(s) such as ethnicity, language, citizenship status, nationality, migration history, homeland, intergenerational and collective history, ultimate beliefs such as faith, and personal and group worldviews.

Ethnicity. A specific instance of a racial-cultural group with a set of originating shared values, beliefs, and rituals.

People of the Global Majority (PGM/PoGM). Such as people of African, African-Caribbean, South Asian, East Asian, Middle Eastern, and Latin descent.

Positionality (APA definition). Positionality is one’s own position or place in relation to race, ethnicity, and other statuses. Positionality is not only one’s identities but also relates to the intersection of one’s personal identities and statuses with the systems of privilege and oppression that shape our psychological experiences, relationships, and access to resources.

Micro system. Systems which relate to the individuals’ immediate surroundings. Such as family, school, workplace, friendship group.

Macro system. Systems which govern society such as government, legal and education systems.

GRT. Gypsy, Roma and Traveller ethnicities.

Enculturation. The process by which individuals learn and adopt the ways and manners within their cultural context(s).

Acculturation. The psychological and cultural change based on an individual’s cultural context(s). Often used in relation to the larger cultural group.

Majority Diverse. Clients with or more protected characteristics as well as those with socio-economic disadvantage.

Transracial adoptee. Someone who is of one race or ethnic group with adoptive parents of another race.

References

The competence was synthesised from delivery of training, existing best practice guides, and multicultural competences, including:

[ A ] Crawford, M. J., Thana, L., Farquharson, L., Palmer, L., Hancock, E., Bassett, P., … & Parry, G. D. (2016). Patient experience of negative effects of psychological treatment: results of a national survey. The British Journal of Psychiatry, 208(3), 260-265.

[ B ] Mercer, L., Evans, L. J., Turton, R. & Beck, A. (2018). Psychological therapy in secondary mental health care: Access and outcomes by ethnic group. Journal of Racial and Ethnic Health Disparities, 1-8.

[ C ] Beck, A. (2019) Improving Access to Psychological Therapies (IAPT) BLACK, ASIAN AND MINORITY ETHNIC SERVICE USER POSITIVE PRACTICE GUIDE

[ D ] Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural competencies/standards: A call to the profession. Journal of Counseling and Development, 70(4), 477–486.

Citation:

The Anti-Discrimination Focus, Counselling, and Psychotherapy, tadf.co.uk/race-competence.

The Anti-Discrimination Focus

01344-723151

Admin@tadf.co.uk

Website: tadf.co.uk

Learning portal: learn.tadf.uk

#TADF is an organisational member of NCPS (formerly NCS)

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