Engaging in Social Justice Activism in Clinical Science

Jennifer Pearlstein, MA

University of California - Berkeley

Psychology has a longstanding history of human rights violations, including reinforcing and  providing credibility to discrimination against marginalized groups and contributing to social and healthcare inequities (Guthrie, 2004). Many psychological practices have given rise to the very mental health challenges our research and practice tries to address (Roberts et al., 2020). The harms caused to marginalized groups demonstrates an abuse of power and directly opposes the mission of the field. The American Psychology Association’s Ethics Code indicates psychologists “respect and protect civil and human rights” (American Psychological Association, 2017). Embracing each person’s value and worth is at the core to the practice of clinical psychology. Therefore, psychological science and practice is inherently political, and it is essential that we use our power to promote social justice (Buchanan & Wiklund, 2020). But how?

Fortunately, many of the skills we teach from empirically supported therapies can help us fight social injustice effectively. Below, I will draw from strategies from interventions from Dialectical Behavior Therapy (DBT) as an example of how our skillset as psychologists and psychologists-in-training makes us well-positioned to engage in effective social justice activism aligned with individual strengths and values. Although empirically-supported intervention strategies are useful to draw from, it is critical to acknowledge that these empirically supported interventions are often designed from a Eurocentric approach that over-emphasizes individual-level methods (French et al., 2020) and may be mistrusted by marginalized groups (Thompson et al., 2004; Watson et al., 2016).

Radical Acceptance

To speak out and act against social injustice, we need to first acknowledge the presence and longstanding history of social injustice. Rather than ignoring or resisting, we must radically accept the existence of pervasive systemic inequalities, and how our field of psychology has contributed to these injustices. To be clear, radically accepting the existence of systemic inequality is not the same as tolerating that inequality; instead, it means that we are not denying or resisting the existence of social inequality. To this effect, the American Psychiatric Association recently issued an apology to Black, Indigenous, and People of Color (BIPOC) for the psychiatric practices that have contributed to inequity in clinical treatment and limited access to care (American Psychiatric Association, 2021), evidence of the important first step of radical acceptance.

We also need to radically accept that fighting for social justice will be a long fight that is at times unequal and unfair. Accepting the long fight means taking the time and space to replenish, restore, and recharge. We must also radically accept the imbalance in who is impacted by a lack of equity and who has historically been responsible for this fight in order to not burden or over rely on the oppressed to strive for social justice.

Identify strengths and “do what works”

Empirically supported therapies prioritize doing what works, which means not every skill will work for every client. Not every form of activism will work well for every psychologist or trainee, and it is important to assess personal strengths and domains of influence to target activism efforts accordingly.

Activism can take many different forms. Is your strength in organizing or leading meetings or journal clubs? Do you publish papers that could cite more scholars from underrepresented communities? Are you a teacher who could increase representation of BIPOC in your syllabi? Do you excel at social media? Identify the skills and strengths you can rely on across various professional domains to engage in effective activism.

To ensure you are doing what works, follow the lead of others who have already paved a path for effective activism. Listen to responses from diverse perspectives to determine whether your social justice activism efforts are effective. Despite good intentions, activism efforts can miss the mark (i.e. Maurantonio, 2017), highlighting that what works may not always be intuitive.

Elevate and follow the lead of others

Psychologists have been engaged in social justice activism long before the recent events that have motivated greater engagement from psychologists and trainees. For example, Dr. Na'im Akbar published his first critique of the Eurocentric nature of psychology and mental health in the 1970’s and since focused much of his work on the pathologizing of black experiences. Not only can we learn from leaders like Dr. Akbar, but we also need to honor, cite, and elevate them. Marginalized voices, especially Black voices, are often silenced and discounted. If you are non-Black, your goal must not be self-promotion, but instead to elevate Black voices by sharing their work and giving credit. 

Communicate effectively

Identify your goal and audience and cater your message accordingly. If your goal is to inform the public, avoid jargon. Choose outlets you are comfortable using and that effectively delivers your message to the intended audience. Online platforms like Twitter can help reach a wide audience, whereas blog posts like the SSCP Diversity Blog or Psychology Today will likely only reach other psychologists.  For longer-form discussions, you may want to also consider outlets like podcasts. 

Pattern of behavior

Combatting social injustice requires consistent and widespread action. Beyond speaking out, change requires engagement in and promotion of specific actions to fight social injustice (e.g., attend protests, donate to social justice causes, sign petitions, volunteer for anti-racism organizations). Outside of formal activism efforts, there are proximal opportunities to promote social justice in our science and clinical practice, such as diversifying recruitment efforts for trainees, clients, and participants; reducing costs for treatment or fundraising in order to provide reduced cost services; and expanding training in culturally competency and sensitivity. For more ideas, consider reviewing the SSCP diversity-related reflection questions. Again, identify which actions are well aligned with your strengths and values and do what works.

Acknowledge and accept personal bias and mistakes

Becoming self-aware of personal biases and noticing when mistakes are made requires mindfulness and emotion regulation. Mindfulness can improve self-awareness and a nonjudgmental stance, which can facilitate constructive conversations when mistakes are made. Use effective emotion regulation skills to reduce defensiveness and increase humility. If a client or research assistant informs you that they were offended by something you said, you may react with feelings of anger or defensiveness. Your emotional impulse may be to argue, “but I did not intend to offend!” Effective emotion regulation may involve acting opposite to this impulse to instead approach with a genuine curiosity to understand what was offensive and to apologize and repair the damage done.

Use relational and objectivity effectiveness for accountability

When calling out others or responding to being called out, remember to maintain compassion, be gentle, demonstrate interest, and validate – both with others and with ourselves. When we are called-out, we sometimes react defensively. This is particularly true for those with privilege who are unaccustomed to having our behavior challenged. When called-out, pause. Reflect on your behavior and listen to the people you have upset. Apologize and develop an action plan to do better in the future.

Academics and clinicians are busy, and while we often have great intentions, sometimes we lose track of the hours in the day. How will you increase the likelihood of achieving your goals? To set intentions, consider making SMART goals that are Specific, Measurable, Achievable, Realistic, and Timely.  Are you spearheading diversity and inclusion initiatives at your institution? Altering your recruitment methods to improve representativeness? Planning to read two papers on diversity science by diverse scholars each week? After identifying specific goals, how do you intend to hold yourself accountable? Partner with others; you can join committees to increase diversity, equity, and inclusion, and there are additional opportunities through professional organizations like Society for the Science of Clinical Psychology (SSCP) Diversity Committee.

Engaging in social justice activism as a clinical psychologist or trainee is aligned with the ethical principles guiding clinical psychological science and practice. Relying on the empirically-supported strategies we use in therapy, we can engage in social justice activism that is rewarding, effective, and aligned with the mission of our field.  

References

American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. American Psychologist, 57(12), 1–20. https://doi.org/10.1037/0003-066X.57.12.1060

APA’s Apology to Black, Indigenous and People of Color for Its Support of Structural Racism in Psychiatry. (2021). American Psychiatric Association.

Buchanan, N. T., & Wiklund, L. O. (2020). Why Clinical Science Must Change or Die: Integrating Intersectionality and Social Justice. Women and Therapy, 43(3–4), 309–329. https://doi.org/10.1080/02703149.2020.1729470

French, B. H., Lewis, J. A., Mosley, D. V., Adames, H. Y., Chavez-Dueñas, N. Y., Chen, G. A., & Neville, H. A. (2020). Toward a Psychological Framework of Radical Healing in Communities of Color. Counseling Psychologist, 48(1), 14–46. https://doi.org/10.1177/0011000019843506

Guthrie, R. V. (2004). Even the Rat was White: A Historical View of Psychology (2nd ed.). Pearson/Allyn and Bacon.

Maurantonio, N. (2017). “Reason to Hope?”: The White Savior Myth and Progress in “Post-Racial” America. Journalism and Mass Communication Quarterly, 94(4), 1130–1145. https://doi.org/10.1177/1077699017691248

Roberts, S. O., Bareket-Shavit, C., Dollins, F. A., Goldie, P. D., & Mortenson, E. (2020). Racial Inequality in Psychological Research: Trends of the Past and Recommendations for the Future. Perspectives in Psychological Science ​. https://doi.org/10.1017/CBO9781107415324.004

Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ Perceptions of Psychotherapy and Psychotherapists. Professional Psychology: Research and Practice, 35(1), 19–26. https://doi.org/10.1037/0735-7028.35.1.19

Watson, N. N., Black, A. R., & Hunter, C. D. (2016). African American Women’s Perceptions of Mindfulness Meditation Training and Gendered Race-Related Stress. Mindfulness, 7(5), 1034–1043. https://doi.org/10.1007/s12671-016-0539-3

About the Author

Jennifer Pearlstein, MA, is a sixth-year doctoral candidate in the Clinical Science area at the University of California, Berkeley mentored by Dr. Sheri Johnson. Prior to graduate school, Jen completed her undergraduate studies at Truman State University and coordinated research on interventions for pediatric bipolar disorder at Stanford University. Jen conducts research on emotions, cognitive control, stress, and psychopathology. Jen’s work aims to (a) understand the cognitive, affective, and biological effects of stress in relation to psychopathology; (b) apply basic stress science to improve treatment, and (c) investigate the effects of identity-related stress on mental health. Jen’s research has been supported by the National Science Foundation and the National Institute of Mental Health. Next year, Jen will complete her clinical internship at the University of Washington - Psychiatry.