Counseling Minority Groups in a Time of Racial Unrest

Interest in the Black Lives Matter movement increased significantly with the recent incidents involving police use of force on civilians. The movement gained support as many universities in the United States worked to provide open discourse in an effort to shift focus on the citizens’ growing concerns. In times of social and racial unrest, counselors are critical to helping communities address and process fear.

To learn more, check out the infographic below designed by Bradley University on behalf of the online Master of Arts in Counseling program.

The Roots of Race-based Trauma and Stress

Discrimination is defined as “an attitude characterized by prejudicial, negative or unjust treatment of, attitude toward or judgment of people based on nationality, race, age or gender.” Discrimination has been associated with negative psychological consequences on affected individuals. Even perceived discrimination has been known to cause chronic health disparities related to stress among ethnic minorities. Due to chronic stress, diabetes and hypertension have afflicted Latin Americans, Native Hawaiians and African-Americans.

Research studies released in 2008 and in 2011 showed that perceived discrimination is a proven factor in a number of unhealthy behaviors including alcohol use, cigarette smoking, improper nutrition and substance use. It is also a key factor in individuals’ refusal or reluctance to seek medical treatment.

The symptoms of trauma and stress related to race are similar to those associated with post-traumatic stress disorder (PTSD). These symptoms include depression, anger and vigilance, loss of appetite, apathy, intrusion, avoidance and emotional numbing. Racism-based stress is defined as race-related interactions between groups or individuals and the environment that come as a result of race-based prejudice. These interactions are believed to place a heavy burden on the resources — both collective and individual — of affected people. These interactions even can threaten a person’s well-being.

How Racism is Experienced

Life Events
Short or infrequent life events could have both short- and long-term effects on an individual’s well-being.

Chronic Contextual Stress
Exposure to sociopolitical and institutional inequalities could place minorities at a disadvantage.

Vicarious Life Experiences
Racism, or the perception of it, could be experienced by people vicariously, such as when they hear about racially motivated attacks, particularly if focused on an individual from the same background. Racism also can be experienced through other people’s experiences indirectly and may cause negative emotional responses.

Trans-generational Transmission
The historical context of an individual’s racial group clarifies the dynamics of the current incidents of stress related to racism.

Daily Micro-aggressions Related to Racism
Members of minority groups may be exposed to frequent subtle comments that may debilitate as time passes, hence aggravating their stress.

Collective Experiences
Groups are influenced by political, social and cultural expressions related to racism.

Poverty, Sexuality and Disability
Race-based stress and related conditions often are exacerbated by a person’s status, particularly if he or she is poor, disabled or a member of the LGBTQ (lesbian, gay, bisexual, transgender or queer) community. According to a 2015 study released by the U.S. Census Bureau, 21.4 percent of Hispanics and 24.1 percent of blacks lived in poverty. Conversely, 61.4 percent of the total population consists of Caucasian, and around 41.2 percent of people are considered poor.

Disability also is shown to be a factor that is reflected by race. The Centers for Disease Control and Prevention (CDC) data shows that non-Hispanic black adults and Hispanic adults reported disability more frequently than Caucasian adults. For example, 29 percent of non-Hispanic black adults and 25.0 percent of Hispanic adults are disabled compared to 20.6 percent of Caucasian adults.

By 2014, hate crime targeting the LGBTQ minority group increased in the U.S., now surpassing hate crimes targeting Jews. Of these incidents, the most likely targets of prejudice- and racism-related homicides tended to be black transgender women, followed by black gay men and Caucasian gay men, and Latino transgender women. The most common type of homicide is shooting, followed by stabbing and beating.

Acculturation Stress
Acculturation stress is the psychological impact resulting from adapting to a new (and usually different) culture. A 2009 study showed that anxiety disorders and substance dependence among minority ethnic groups had a strong correlation to acculturation stress. Children and adolescent immigrants also experience acculturation stress, leading to an increase in the incidence of depression-like symptoms. Immigrant women in their early adulthood are also more likely to experience depressive symptoms compared to native-born women in their early adulthood.

Other Factors Causing Race-based Stress
Some studies suggest that historically, African-American women have accumulated life experiences in racial inequality, along with medical underservice, as well as political, economic and social exclusion. These inequalities cause diminished access to useful resources and increase the women’s vulnerability to premature illness and psychological stress. The early onset of disease incidence among African-American females may be explained by the Strong Black Woman/Superwoman concept, also known as the Sojourner syndrome and the Superwoman Schema or SWS concepts. These concepts are to cope with the chronic stress and demands of day-to-day responsibilities and multiple caregiving roles.

A 2013 report published by the Economic Policy Institute states that Caucasians are more likely to be employed than Native Americans. Asian Americans also suffer from stigma related to mental health. Asian-American parents view depression as a threat to their child’s future, leading to poor prospects in marriage and lower chances of success. Traditionally, Asians value education and children who do well in school are considered products of good parenting. Better educational achievement also is believed to bring a brighter future.

What the Numbers Show about Mental and Behavioral Health Among Minorities

Drug use, substance dependence and binge alcohol use range from 4.1 percent to 14.5 percent among Asian Americans aged 12 and above, while the rate among Pacific Islanders and Native Hawaiians is at 6.7 to 15.6 percent. The suicide rate among Asian American women over age 65 is also the highest in the U.S.

Among Alaska Natives and Native Americans, the rate of alcohol use was 21.9 percent versus the national average, which was 22.8 percent in 2014. The rate involving death induced by drugs was also highest among Native Americans in 2010. In 2014, nearly 15 percent of Alaska Natives and Native Americans aged 12 and above used illegal drugs. Mental illness among this group is also at 21.2 percent.

In the same year, over 16 percent of African-American adults had mental illness, and about 17 percent of the 12 to 20 age group used alcohol. Illegal drug use among individuals aged 12 and above was at 10.2 percent. About 9.1 percent of African-Americans suffer from PTSD.

In 2014, 8.9 percent of Hispanics used illegal drugs, while binge alcohol usage in these individuals aged 12 to 17 was at 24.7 percent — an increase of nearly 1 percent from the previous year. About 3.5 percent of Latinos and Hispanic adults also suffered from serious mental issues, while 15.6 percent aged 18 and above reported suffering from mental illness in the previous year.

How to Help

There is no formal recognition of racial trauma in the Diagnostic and Statistical Manual. Members of minority groups who seek counseling due to racial trauma often face the challenge of working with clinicians who do not have the education or skills to help their patients deal with the issues. Of the clinicians who work in mental health, only 10 percent were non-Caucasian. These factors often discourage some patients, prompting them to stop therapy.

To improve the situation, some believe that researchers from ethnic minority groups should lead racial trauma research. Counselors also should understand how to integrate family/community cultural values into the patient’s treatment process and discuss how ethnicity or race affects a person’s life experiences. Counselors also should undergo training to improve multicultural competency.

What the Future Holds

Different factors that lead to racial trauma could further push apart minority groups in the U.S. A counselor who is trained in understanding what causes racial-based trauma will be responsible in providing treatment that is not only effective but also culturally sensitive. Already, the Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards emphasize competencies on diversity and culture for professional counselors. In the 2014 American Counseling Association Ethics Code, multicultural competence and advocacy also are emphasized to provide better assistance to minorities.

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