Highlighting the Harm of Implicit and Explicit Biases: An Ethnopsychopharmacology Study of Black and African Americans of the Diaspora Being Diagnosed
Presented by Rethel E. Gill, PsyD, MSCP
Recorded on Thursday, March 14th, 2024
Access provided upon registration on “My Courses” page
“With Great Power Comes Great Responsibility.” Although this is the Second Rule of Neurotransmission, it also resonates for first year practicum psychology trainees as we were taught that there is power in DSM diagnosis and that those diagnoses could potentially follow a young client “for life.” Professionally and personally, l witnessed how diagnoses like Oppositional Defiance Disorder combined with implicit and explicit biases have become a dangerous mental health cocktail that once labeled as a child, some adults have found it difficult to vocalize their trauma(s) or mood disorders, C-PTSD, and treatment resistant depression. Studies conducted by (Feisthamel & Schwartz, 2009; Schwartz & Feisthamel, 2009) indicated that African Americans have been diagnosed with oppositional defiant disorder (ODD) at disproportionately higher rates than other demographic groups. What are we missing clinically? What harm are we doing with our clinical and prescriptive rights?
This presentation will explore implicit and explicit biases and how aversive racism plays a more covert role that could lead to life-long consequences for our clients when they are either underdiagnosed or over diagnosed or not properly medicated. For example, African Americans are still diagnosed with Schizophrenia at a disproportionately higher rate than non-Hispanic whites (Fadus, et al, 2020). How do we account for this in an age of well-meaning and cultural diversity trained therapists, doctors, and clinicians? We need to explore deeper how aversive racism infuses the structures of egalitarian values of the people who treat patients from “historically marginalized groups” that are the global majority. Although Joel Kovel coined the term aversive racism in 1970, Dovidio and Gaertner (1986, 2000, 2005) have done the most influential and extensive research about it.
“In 2021, 80.6% of the Clinical and counseling psychologist workforce were White, of which 67.7% were women and 32.3% were men.” 8.62% were Black and 5.49% were Asian.” With most of the treating clinicians for the Black/African American community being non-Black-African American, it is imperative to continue to engage in discussions regarding implicit and explicit biases as well as overt and covert and aversive racism.
When attended in full, this program offers 1.0 APA CEs for Psychologists.
“With Great Power Comes Great Responsibility.” Although this is the Second Rule of Neurotransmission, it also resonates for first year practicum psychology trainees as we were taught that there is power in DSM diagnosis and that those diagnoses could potentially follow a young client “for life.” Professionally and personally, l witnessed how diagnoses like Oppositional Defiance Disorder combined with implicit and explicit biases have become a dangerous mental health cocktail that once labeled as a child, some adults have found it difficult to vocalize their trauma(s) or mood disorders, C-PTSD, and treatment resistant depression. Studies conducted by (Feisthamel & Schwartz, 2009; Schwartz & Feisthamel, 2009) indicated that African Americans have been diagnosed with oppositional defiant disorder (ODD) at disproportionately higher rates than other demographic groups. What are we missing clinically? What harm are we doing with our clinical and prescriptive rights?
This presentation will explore implicit and explicit biases and how aversive racism plays a more covert role that could lead to life-long consequences for our clients when they are either underdiagnosed or over diagnosed or not properly medicated. For example, African Americans are still diagnosed with Schizophrenia at a disproportionately higher rate than non-Hispanic whites (Fadus, et al, 2020). How do we account for this in an age of well-meaning and cultural diversity trained therapists, doctors, and clinicians? We need to explore deeper how aversive racism infuses the structures of egalitarian values of the people who treat patients from “historically marginalized groups” that are the global majority. Although Joel Kovel coined the term aversive racism in 1970, Dovidio and Gaertner (1986, 2000, 2005) have done the most influential and extensive research about it.
“In 2021, 80.6% of the Clinical and counseling psychologist workforce were White, of which 67.7% were women and 32.3% were men.” 8.62% were Black and 5.49% were Asian.” With most of the treating clinicians for the Black/African American community being non-Black-African American, it is imperative to continue to engage in discussions regarding implicit and explicit biases as well as overt and covert and aversive racism.
After attending this intermediate-level program, participants will be able to:
- Explore the nuances of having explicit egalitarian beliefs while having implicit biases and stereotypes that contradict their conscious beliefs.
- Strategize methods to interrupt the effects of implicit bias that is rampant in the healthcare system.
- Explore the pathologizing of race and how this phenomenon strengthens the concept of racial and ethnic disparities stem from “innate racial differences” (Amutah, et al., 2021).
This program meets APA’s continuing education STANDARD 1.1: Program content focuses on application of psychological assessment and/or intervention methods that have overall consistent and credible empirical support in the contemporary peer reviewed scientific literature beyond those publications and other types of communications devoted primarily to the promotion of the approach.
This program meets APA’s continuing education GOAL 3: Program will allow psychologists to maintain, develop, and increase competencies in order to improve services to the public and enhance contributions to the profession.
Rethel E. Gill, PsyD, MSCP, Gill Psychological Services
Rethel E. Gill, PsyD, MSCP is a forensic and clinical psychologist who recently completed her masters in Clinical Psychopharmacology. She has worked with clients for almost 20 years with the last 15 years having an emphasis on parolees and probationers who have been charged and/or convicted of sex offenses. Her training in community mental health settings afforded her an incredible experience as she worked with people battling depression, anxiety, PTSD, and trauma. She received an undergraduate degree in Performance Studies from Northwestern University in Evanston, Illinois and studied Italian Renaissance Theater in Blue Lake, California to help her to balance the psychological side of herself. She also has practiced Yoga since she was 7 years old and often shares that as a somatic intervention with some of her clients. She is currently studying for her Psychopharmacology Examination for Psychologist (PEP) and plans to sit for the exam Summer 2024.
Amutah, C., Greenidge, K., Mante, A., Munyikwa, M., Surya, S. L., Higginbotham, E., Jones, D. S., Lavizzo-Mourey, R., Roberts, D., Tsai, J., & Aysola, J. (2021). Misrepresenting Race – The Role of Medical Schools in Propagating Physician Bias. The New England journal of medicine, 384(9), 872–878. https://doi.org/10.1056/NEJMms2025768
Blumenthal, D., & James, C. V. (2022). A Data Infrastructure for Clinical Trial Diversity. The New England journal of medicine, 386(25), 2355–2356. https://doi.org/10.1056/NEJMp2201433
Brett, A. S., & Goodman, C. W. (2021). First Impressions – Should We Include Race or Ethnicity at the Beginning of Clinical Case Presentations?. The New England journal of medicine, 385(27), 2497–2499. https://doi.org/10.1056/NEJMp2112312
Chen, C. L., Gold, G. J., Cannesson, M., & Lucero, J. M. (2021). Calling Out Aversive Racism in Academic Medicine. The New England journal of medicine, 385(27), 2499–2501. https://doi.org/10.1056/NEJMp2112913
Fadus, M. C., Ginsburg, K. R., Sobowale, K., Halliday-Boykins, C. A., Bryant, B. E., Gray, K. M., & Squeglia, L. M. (2020). Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 44(1), 95–102. https://doi.org/10.1007/s40596-019-01127-6
Freire, Paulo, 1921-1997. (2000). Pedagogy of the oppressed. New York: Continuum Galea S. (2022). Moving Beyond the Social Determinants of Health. International journal of health services : planning, administration, evaluation, 52(4), 423–427. https://doi.org/10.1177/00207314221119425
Gopal, D. P., Chetty, U., O’Donnell, P., Gajria, C., & Blackadder-Weinstein, J. (2021). Implicit bias in healthcare: clinical practice, research and decision making. Future healthcare journal, 8(1), 40–48. https://doi.org/10.7861/fhj.2020-0233
Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015). Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. American journal of public health, 105(12), e60–e76. https://doi.org/10.2105/AJPH.2015.302903
Hucko, L., Al-Khersan, H., Lopez Dominguez, J., Cavuoto, K. M., Scott, N. L., Williams, B. K., Jr, Fountain, T., & Sridhar, J. (2022). Racial and Ethnic Diversity of U.S. Residency Programs, 2011-2019. The New England journal of medicine, 386(22), 2152–2153. https://doi.org/10.1056/NEJMc2200107
Sabin J. A. (2022). Tackling Implicit Bias in Health Care. The New England journal of medicine, 387(2), 105–107. https://doi.org/10.1056/NEJMp2201180
Sabol, T. J., Kessler, C. L., Rogers, L. O., Petitclerc, A., Silver, J., Briggs-Gowan, M., & Wakschlag, L. S. (2022). A window into racial and socioeconomic status disparities in preschool disciplinary action using developmental methodology. Annals of the New York Academy of Sciences, 1508(1), 123–136. https://doi.org/10.1111/nyas.14687
Target Audience: Psychologists and Psychology Students.
Psychologists. This program, when attended in its entirety, is available for 1.0 continuing education credits. The Chicago School of Professional Psychology is committed to accessibility and non-discrimination in its continuing education activities. The Chicago School of Professional Psychology is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods.
Non Psychologists. Most licensing boards accept Continuing Education Credits sponsored by the American Psychological Association but non-psychologists are recommended to consult with their specific state-licensing board to ensure that APA-sponsored CE is acceptable.
*Participants must attend 100% of the program in order to obtain a Certificate of Attendance.
If participants have special needs, we will attempt to accommodate them. Please address questions, concerns and any complaints to [email protected]. There is no commercial support for this program nor are there any relationships between the CE Sponsor, presenting organization, presenter, program content, research, grants, or other funding that could reasonably be construed as conflicts of interest.