Reflective practice and difference: Some thoughts (PART1)

Ethnic/race differences in the capacity to be reflective?

As is now well known, there are number of possible barriers Black and Minority (BME) applicants into clinical psychology training must overcome to get access to our rather selective profession (I have previously written a few thoughts on my experience here and here) so, I was quite intrigued and slightly dispirited to recently find out that such applicants tend to, it has been found by some selectors, be assessed less favourably on their capacity to be reflective. As a result, some courses are providing reflective practice workshops to students from BME backgrounds as part of their efforts to increase access to the profession for these underrepresented groups*.

Are such initiatives to be welcomed? Certainly, their impact in terms of application outcomes remains to be established but some may argue that they may indeed be part of the solution to addressing enduring inequality of access to the profession across various ethnic and racial groups. In all honesty though, I remain perplexed by this finding. I met yesterday with members of the Minorities in Clinical Psychology Training Group and as part of the committee meeting, we discussed this state of affairs. I was not the only one who was conflicted. All of us found the claim rather odd or unexpected. To many, it ran counterintuitively and went against our experience.

This led us to become curious. To attempt to consider some of the reasons which may account for this finding which in essence, is the purpose of this post. Here, I will not specifically consider potential assessment issues such as possible bias, though given the slippery and subjective nature of the concept and possible difficulties in assessing it fairly and reliably, I do believe they may require some attention. Rather, the post here will aim to start a conversation on some of the issues which may impact on minority applicants and particularly those of BME backgrounds as their capacity for reflection is assessed.

The importance of reflective practice

Demonstrating reflective practice is a key skill for most professionals and particularly for those working within ‘helping professions’. Various definitions of reflective practice exist. Most entails an introspective process by which one considers and deconstructs one’s actions critically so as to derive maximum learning from them, acquire new insights and become better aware of areas requiring development. Consequently, being reflective, in theory, involves paying attention to both our professional and personal values and to how they might interact with our clinical practice and inform our feelings, actions and behaviours. Engaging with reflective practice is a professional requirement for clinical psychologists.

It balances and add personal contexts to the scientist-practitioner model which puts emphasis on the generation and integration of scientific knowledge and the development of psychology as a ‘science’ by focusing instead on some of the individual factors and processes that may become engaged within the practice of our profession. Reflective practice aims to promote effective interventions, foster continuous professional development and thus help safeguard the wellbeing of the practioners and the safety of service users. Thus, it is right that mechanisms to assess and encourage the reflexivity and reflection of practioners be put in place.

Differences in self-disclosure

Demonstrating reflectivity necessarily entails being open about one’s experience, feelings and internal processes. When one belongs to a racial minority it is likely that this process of self-disclosure may be influenced by issues of race and by cultural differences. Demonstrating self-reflection in interview settings may be particularly demanding for racial minorities. It may mean being open about contentious or sensitive race or culture related experiences and their associated feelings and behaviours whilst being aware of the need to avoid triggering defensive or other unhelpful responses in those around you. Responses, many would have, no doubt, encountered along their professional journey. A tricky balancing act particularly when one may be faced by an all-white interview panel.

Many of us have to regularly consider, at each stage of the professionalization process, how much of our racial self we can bring into training/work spaces without becoming excluded, labelled, pigeonholed or otherwise problematised. Some of us have even been discouraged from bringing those aspects of our experience and identity at work or perhaps more commonly, advised to place a ‘limit’ onto them . It is quite common to hear BME applicants discuss the space it has been recommended, they should afford such experiences whether by supervisors, tutors and/or peers. Yesterday, I heard examples of such guidelines with peers stating they’d been advised to devote no more than ‘a single line’ or ‘a short paragraph’ to their racialized reflections and issues of race or culture.

Racism and oppression as reflective frameworks

These recommendations, although well intentioned may be quite problematic. They perpetuate the notion that difference, diversity or equality issues are ‘adds on’ which can thus be extracted from clinical activities or indeed from people’s experiences of the world. This view is rather simplistic and its Meta message quite oppressive. Essentially, it, albeit possibly inadvertently,  posits that aspects of our lived experiences as racial minorities may be irrelevant or extraneous to our personal reflections or to our development as psychologists normalising whiteness and, in the process, expecting us to whitewash our experiences, our learning and development needs. It arguably albeit indirectly, requires that BME students uphold the status-quo to be deemed acceptable.  The limits so many expect BME students to place on race related issues, echo a common way many do diversity and equality e.g. by devoting a day or two to issues of difference rather than embedding them within all aspects of what we do.

And, as ineffective a strategy such fragmentation is in terms of  increasing inclusion and equality, it may be equally unhelpful for racial minorities to use it to demonstrate their capacity to reflect, to learn from experience and to grow as professionals. This is because arbitrarily limiting the use of someone’s key analytic framework may not only impede spontaneous and authentic self-disclosures and the sharing of important learning which may have been acquired personally and professionally, it may also suck the life or dynamism out of their presentation and/or out of any interactions with them. It may create a relational obstacle or reduce their genuine engagement in discussions. Race, inequality and oppression may bear important influences on how many individuals from ethnic minorities understand their clinical work/experiences and how they make sense of their personal or professional values. And, those lenses have much to contribute to the profession.

Reflective practice and culture competency

One undesirable consequences of our focus on reflective practice may be the further individualisation of clinical psychology. Reflective practice, it has been argued, invites us to focus on our processes as individuals rather than as social agents located within broader socio-political and cultural contexts. Shouldn’t part of the assessment of reflective practice entail considering whether those entering the profession may be able to recognise and challenge oppression and subjugation in both its subtle and more obvious manifestations? It would seem that, given the psychological consequences of oppression and the current inequalities in the system within which we operate, to be of critical importance that those recruited into the profession, be able to reflect on their privileges and disadvantage, their personal contributions and/or gains to systems of oppression and devaluation and be committed to working towards social justice.

Perhaps, the focus on reflective practice as a global competency may perpetuate the invisibility of the political nature of our personal processes and erase specific axes of oppression and domination, their intersection and impact on us as psychologists of colour. Leaving unacknowledged the fact that one might demonstrate competency in reflective practice but struggle to manage social and cultural differences, or to critically examine the hemogeny and normativity of white Eurocentric (but also cis-hetero-able-bodied-middleclass-Christian) assumptions and values, the violence they may exert of racial minorities (and other oppressed groups) and the privileges and opportunities they might create for others. Explicitly assessing for these specific dimensions of reflection may well yield different findings in terms possible race differences in reflective practice. It may also in doing so, highlight important strengths in racialized (or other minoritised) applicants that current selection frameworks may unintentionally mask. Strengths which may lie at the core of our profession’s capacity to offer more culturally competent and socially grounded interventions.

* These workshops are offered to those who access the London BME mentoring schemes coordinated by the London Diversity Working Group and currently led by UCL.

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  1. Why are BME communities problematised in clinical training? Why the supplementary wokshops? Speaking as a qualified UKCP registered psychotherapist submerged in the sea of self reflective practice from my formal MSc training ending 15 years ago and my ongoing development since then I wonder how many contorted shapes BME and other ‘othered’ communities have to reposition themselves into to progress in training institutions. I feel we are constantly playing ‘Twister’ just to try and fit in and this is psychologically and physically exhausting. We are forced like our clients to leave our lived experiences outside the room to make our trainers, colleagues and examiners happy and defensive free while at the same time we are encouraged to bring ourselves into the room holistically and be self reflective. How can we leave the disapproved of parts of our lived experiences outside the room and come into the room at the same time. Only aspects of us are allowed to be know before those tutors and trainers in their inability to be self reflective about their hegemonic privileged positions exclude what they don’t want to acknowledge or address. These tutors are the ones needing extra self reflective training so they can begin to acknowledge the interrelatedness of social structures like racialisation and psychological processes and distress. No wonder BME clients/patients do not generally benefit from mainstream talking therapies. The master’s tools cannot break down the master’s house. If my reality and others like me makes you defensive well that’s not MY problem, it’s yours and you need to be self reflective enough to acknowledge and start to address your need to develop and quit criticising and judging people who look like me.

    1. Thank you Olukemi for your comment. I think you’ve articulated the paradoxes and some of the issues better than I could have, thank you. I am glad to see other Black practitioners have survived their training and have not ‘sold out’. I look forward to more insight from you. Guilaine.

  2. After reading your article and those on a similar theme, plus my own training/supervision/CPD experiences coupled with feedback from members of BME communities who have been similarly distressed, I am left wondering if there is space to discuss with other interested clinical professionals both trainees and qualified, a response to what is effectively institutional oppressive practices within many training organisations.
    When BME communities are vastly over represented in police sectioning, diagnosis of bipolar disorder and schizophrenia, are over prescribed neuroleptic ‘medication’ and don’t generally get referred to talking therapies, and when they do, they are met by the defensiveness you mention above, can we as clinical practitioners afford to stay silent. As Audre Lorde said, ‘our silence will not protect us’. If interested a reply to my email address would be welcomed.

    1. Hi Olukemi, thanks for your invitation. I do think it is a great idea, potentially. I wonder wether it might be worth liaising with existing groups or collectives such as the BAATN who are already engaged in making BME voices in clinical training heard. I sit on the Division of Clinical Psychology Inclusion, Equality and Diversity Strategy working group and some of these issues are being addressed and recognised in clinical psychology too (well at least in some corners) but change is painfully slow. I’d be open to hear what you have in mind so may drop you a line, perhaps I could contribute, capacity is an issue still at present but I will aim to email you.

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