Roadblocks to Decolonizing Clinical Practice

I am often asked “How do we decolonize the field?” Of course there are many answers but one that comes up often for me is that we need to stop the worship of individualism and we need to stop equating individualism with wellness.

Colonizing practices are those that reproduce the existing conditions of oppression by failing to challenge the hegemonic views that marginalize groups of people, perpetuate deficit-based ideologies, and continue to disenfranchise diverse clients and communities.

An often taken for granted, unchecked perspective of clinicians about clients or potential clients is that clients should behave in certain ways that demonstrate they are truly invested in therapy. This is often has an individualistic bias and a “pull yourself up by your own bootstraps” mentality. You hear this particularly with clinicians have those informal conversations with each other about the clients they are seeing. Essentially we have this notion of explicitly and implicitly defining “good” and “bad” clients.

The following roadblocks are in quotes because each of them can and often are important aspects of therapeutic healing, however, in the field they are taken-or-granted components for successful therapy with little consideration for culture or context. These are exclusively individualistic perspectives that are often imposed on our clients by well-meaning therapists. In fact, without our explicit awareness that they are specifically individualistic and capitalistic notions, we also impose these on ourselves as mental health professionals.

“Personal Responsibility”

Many times therapists use this concept with blinders that exclude context, history, and systems of inequality that can limit or impact the ease of movement toward healing for Brown and other racially marginalized populations. If we impose this concept without context it further invalidates the experiences of our people. When we bring this concept of ‘personal responsibility” out in session as “lesson” for our Brown and BIPOC clients, we are most likely imposing a White, Eurocentric, individualistic notion of “responsibility”and have stopped looking for the existing competence and autonomy that the client currently possesses.

“Not ready for change”

Typical help offering behaviors of therapists can be met with a hesitancy from Brown and BIPOC clients to address the issue directly and clients may continue to speak indirectly. When this happens, we should take note not to solely evaluate this behavior from a Western perspective and assume the client is "not ready" for change. Judging indirect communication as unhealthy and avoidant is an error often made when we only know how to look at the world from an individualistic lens. Often it is not the client who is not ready to change, but us who is not ready to change.

“Can’t change others. Let’s focus on you”

This phrase and sentiment is often used to redirect clients when they begin to discuss behaviors of others in their lives that they see as problematic for themselves. However, this perspective is also overtly individualistic and can also be patronizing for a client who is more collectivistic. Sometimes focusing on others' behaviors is just as important if you have a more relational view of the self. Additionally, others' behaviors are crucial to consider when those behaviors are racist, discriminatory, or oppressive toward Brown and BIPOC clients.

“Doing work in therapy”

This is a clearly capitalistic notion that implies we need to put more effort toward our therapy goals or we will remain stuck. This becomes problematic when counseling is only seen as successful if there is this “work”. Sometimes the process requires things to settle. We need to be still and observe. This notion only counts success if there is a product to show for it.

“My” client

This also is a capitalistic notion that connotates ownership. If we use ownership langues it reinforces a hierarchy. Although, this is way of speaking may not directly have a negative impact on clients, it is still a roadblock to decolonizing because it allows us to ride the status quo of an ownership mentally. This is particularly important when we are actively trying to decolonize. We must do all we can in subtle and not subtle ways to remind ourselves that clients do not belong to us, especially Brown and BIPOC clients.

• Dr. Manuel X. Zamarripa, Chicano Psychologist