Honoring the Impact of Racial Trauma and Marginalization Stress in Trauma-Informed Ethical Decision Making

Abstract

Black and Brown people continue to experience high rates of violence and micro/macro aggressions, which leads to marginalization stress (Cokely et al., 2013; Moody et al., 2022). Experiences of discrimination have been linked to serious psychological distress, such as post-traumatic stress disorder and alcohol use (Britt-Spells et al., 2018). At the same time, many individuals living in the United States believe that we are living in a “post-racial society” with the election of the first Black president for two terms (Love & Tosolt, Race Gender Class J 17:19–37, 2010). However, society continues to perpetuate racial trauma against Black, indigenous, people of color (BIPOC) subgroups that continue to be marginalized. The authors of this chapter provide concrete steps to guide ethical considerations to support hel** professionals to honor the experience of BIPOC communities. This consists of integrating: a) the use of trauma-informed principles in addressing the impact of micro/macro aggressions and hate violence towards different minority groups within the United States, b) how the American Counseling Association ([ACA]; 2014) Code of Ethics and the Counselors’ for Social Justice ([CSJ]; 2016) Code of Ethics can be utilized to support minoritized groups in theUnited States. Implications for other hel** professionals are also discussed.

Appendix

Case Scenario II (for Reader’s Practice)

Sofia is a 19-year-old Colombian student who came to the United States with her parents to further her education. She is enrolled in an ESL (English as a second language) program to pursue an Occupational Therapy degree. Sofia often considers herself a social outcast but has made efforts to make friends since moving to the United States. She is extremely interested in working with people to overcome limitations caused by injury, disability, or illness. She maintains good grades in her program and engages in volunteer work.

When Sofia began the internship, her social life changed. She was constantly criticized for her accent. In addition to experiencing discrimination due to her lack of English proficiency, she was also impacted by the semantic and cultural noise or the constant internal translation that takes place when she needs to communicate in English, which also caused her physical exhaustion. Translating in her head impacted her ability to respond and undermined her self-confidence and the confidence others had in her ability to converse. As a result, Sofia felt isolated from other student interns and supervisors. She felt she had neither friends nor support, which led to passive suicidal ideation. In class one day, Sofia began crying and expressing a desire to “no longer exist.” The college professor referred Sofia to one of the counselors from university services, who had an open-door policy on Fridays.

Sofia met with a University counselor intern several times over the next few weeks. While they were able to reduce her passive suicidal ideation, the counseling staff (should this be “wrongly” or “falsely”) suspected that Sofia had a severe mental health condition that required the intervention of a psychiatrist and medication. The University counseling staff reported they were ill-equipped to help a student in Sofia’s “condition.” Sofia denied the presence of severe mental health issues and pleaded with the counseling staff not to report such erroneous findings. Sofia agreed that she was experiencing a mental health breakdown, but not in the way the staff described it.

Sophia was hesitant to speak to a psychiatrist for several reasons. She feared the impact this could have on her internship and degree program and the view of her and her family and thought seeing a psychiatrist would make her seem weak. Because mental illness was taboo in her home country, Sofia was also concerned that she would shame her family. Sofia and her parents worried about the potential professional and social consequences their family would face if anyone in their community found out she had been recommended for treatment. The most difficult for Sofia was still the language barrier, as she did not feel she could fully express herself to any of the counselors because of the discrimination she experienced at her internship site, and none of the counseling staff spoke Portuguese.

The University counseling staff checked in with Sofia once a week, but she was still reluctant to speak with them. She began to shut down and withdraw at her site in her classes. Several students mentioned that they felt unsafe around Sofia. However, the faculty chair agreed to allow Sofia to remain in the program because she had not failed any courses, nor had she threatened to harm anyone.

Sample Reflection Questions

• When the counseling staff recommended psychiatric interventions, was this a culturally relevant response?

• Do you think Sofia was traumatized by her experience? If yes, how will the TIP (trauma-informed principle) support reduce the psychological and emotional distress Sofia experienced?

• Please refer to the ACA (American Counseling Association) or CSJ (Counselors for Social Justice) codes of ethics to determine if there is an ethical dilemma here. What other hel** professional codes of ethics are relevant to address this issue?