Multicultural supervision requires a unique skill set, and there are important factors that supervisors and training sites should take into consideration when working with trainees of color. Many trainees of color in mental health fields find themselves being the only one that looks like them in primarily white spaces.
In reading these four suggested points, I hope that existing supervisors, early career therapists, and trainees who wish to one day supervise will take note. The face of our field is forever changing, and it is time that we consider factors that can promote the success and well-being of all future clinicians.
1. Create a Culture of Equity and Inclusion
Clinicians of color increasingly report on social media, and in university cohorts, their experiences of microaggressions, often from supervisors. Microaggressions, also known as “death by a thousand cuts,” intended and unintended, all cut the same, and they leave trainees feeling separated from and less than their peers.
Apart from microaggressions, we all carry some unconscious bias in some way, shape, or form. However, it takes an extraordinary person to acknowledge it and correct it, especially when confronted with it. Instead, supervisors may respond to this critique with denial and defensiveness. Training sites would benefit from having procedures and training for their supervisors concerning cultural competence, unconscious bias, and diversity issues in the workplace.
When I had the opportunity to give a presentation on a topic related to psychological assessment, I prepared a talk called “Testing and Assessment with Persons and Communities of Color.” Only three of us attended, myself and two other psychology interns. No supervisors, postdocs, or directors attended, as they had done in the past with other presenters. Not attending this talk was a missed opportunity, as I talked about microaggressions, stereotypes, and bias. Perhaps roundtable talks on diversity and meeting trainees’ needs could be a start.
While many large training sites may have diversity and inclusion policies and a designated diversity officer in place, smaller training sites and private practices often do not. Not having such policies in place fails to provide an inclusive internship program and can create a culture of high turnover and low productivity.
2. Abuse of Power is Emotionally Painful
I know of trainees who have gone home in tears because their supervisors treated them like they were less-than. For some, this happens throughout their training.
I ask that supervisors remember that they, too, were once trainees needing guidance. Trainees are here to learn from supervisors, to look up to them, and to get to where the supervisors are. Trainees do not pose a threat, and it hurts when supervisors take them for granted or treat them harshly.
The supervisor-supervisee relationship can be an extremely delicate dynamic when white supervisors in particular are paired with trainees of different racial or ethnic backgrounds. Harsh and abusive treatment can be perceived by the trainee as threatening, riddled with microaggressions, and harmful. Supervisors can support trainees of color by taking care not to speak harshly, by being more constructive with their criticism, and by perhaps providing more microaffirmations as an alternative.
Training sites could also benefit from facilitating Training the Trainer sessions. It may be helpful to bring in a third-party professional to help facilitate these training sessions. It may also be beneficial to have these training sessions be a safe space for supervisors to express their needs and concerns. Supervisors’ projections onto supervisees may stem from their own emotional pain and burnout. Employee Assistance Programs (EAPs) may effectively serve the supervisees and the supervisors who may need this service as well.
3. Retaliation for Grievances has Consequences on Both Sides
Every training site should have a grievance process noted in their trainee handbook. Despite this, some training sites inadvertently create a culture where students do not feel they can safely bring a grievance against a supervisor without consequences.
While most trainees make attempts to resolve issues directly with supervisors, there are circumstances where resolution is not possible. Particularly if a trainee reports an experience of discrimination, they may have to contend with retaliation.
Retaliation occurs when an employee is dismissed after they have reported discrimination, according to the U.S. Equal Employment Opportunity Commission (EEOC). Some sites may refer to their trainees as “employees” of the site, or hold them to the same standards and expectations as their regular employees. As a result, trainees may be protected under the Americans with Disabilities Act, and may be entitled to the same rights as defined by the EEOC.
Retaliation is illegal, and the consequences for training sites could range from monetary fines from $50,000, based on the size of the practice, to sanctions by the relevant professional licensing board.
The threat of losing a training position as a result of speaking up for oneself can create fear and stress for trainees. If a trainee is dismissed, they experience a loss of trust in clinical supervisors. With the loss of a training position, there may also be a potential loss of clinical hours and financial hardship as a result, especially if the position was paid. The trainee’s mental health may suffer.
Dismissed trainees also run the risk of being blacklisted and having a hard time finding other training opportunities. This causes even more stress, and it can create delays in completing their graduate programs.
Retaliation also has negative consequences for a training site. The action sends a negative message to its remaining trainees, often creating a chilling environment. It may also make the training site less attractive to future students.
4. Have Compassion For Trainees
Financial empathy, and remembering your own personal struggles of being a trainee, can help you to understand and identify with your trainees. Trainees are paid little to nothing, and this comes with its own challenges and stressors that can potentially undermine a trainee’s work-life balance. These challenges can lead to significant burnout and can affect performance.
In particular, students of color tend to be more disadvantaged in the financial arena than most other students. The Journal of Diversity in Higher Education published a study by Gasman, Hirschfeld, and Vultaggio (2008) that focused on experiences of African American graduate students. They found that financial issues were not only a major concern for this population, but also a factor in program completion, and a predictor of personal and academic stress. Some trainees have likened internship and postgraduate placements to a form of modern-day indentured labor because of the poor compensation.
Some of us are single parents to multiple children. Some move across the country with their families without a second source of income.
Supervisors may not know everything that is going on in a trainee’s life, but, supervisors can support their trainees respectfully in a number of ways. For instance, I interviewed with a training site recently, and one of the first questions the site director asked was, “What are you doing for self-care?” The question stumped me, as I had never been asked this question by any interviewer before. Supervisors can show concern about their trainees’ well-being by simply asking and creating opportunities for self-care to prevent burnout.
Another way that supervisors can support their trainees is to advocate for them if they can. If supervisors are not a part of the decision-making process for stipends, then perhaps finding out who is, and making a case for their trainees to be appropriately compensated, is a good start.
Simon Sinek’s book Leaders Eat Last comes to mind. Sinek writes that “we should all be the leaders we wish we had.” Advocating for your trainees and supporting their ability to live above minimum wage is an excellent way to support your trainees.
Creating a culture of diversity and inclusion, fostering emotionally safe environments, avoiding retaliation, and having compassion for trainees will go a long way toward showing trainees of color that they, and their work, matter.