Psychotherapy Bulletin

Psychotherapy Bulletin

Social Justice, Advocacy, and Early Career Practice

Clinical Impact Statement: This article highlights the importance of early career professionals’ involvement in advocacy and social justice movements. Further, the incorporation of advocacy counseling in psychotherapy can also help clients feel empowered when social and institutional barriers are impacting their lives. Recommendations for incorporating advocacy curriculum in graduate psychology training programs are provided.

Colin Kaepernick kneeling for Black Lives Matter. Protests at Standing Rock. Fighting against the elimination of Deferred Action for Childhood Arrivals (DACA). #MeToo. Social justice movements are abundantly present in our current political/cultural climate. Where is psychology’s role in these movements? What are our personal roles, as early career practitioners? How do we help those we serve as they struggle with uncertainty and feelings of helplessness? How do we maintain self-care while harboring those same concerns?

Psychology and the American Psychological Association (APA) was slow to embrace social justice (see Leong, Pickren, & Vasquez, 2017, for historical review). However, through acknowledgement of the importance of advocating for clients—often from oppressed, marginalized, and vulnerable populations—the presence of advocacy and social justice efforts in psychology have grown and widely expanded. From institutional policy changes to local policy to the United States Supreme Court amicus curiae briefs, psychologists and other mental health professionals have played important roles in instrumental social changes.

Advocacy and Social Justice as an Ethical Obligation?

As an early career psychologist, I have asked myself: Ethically, do professionals in the field have an obligation to involve themselves in such advocacy and social justice efforts? As always, we consult with the APA’s Ethical Principles of Psychologists and Code of Conduct (Code of Ethics; 2017) to provide guidance. Although Section 3 (Human Relations) of the enumerated Code describes avoiding discrimination and harm to the public, there are no explicit ethical guidelines addressing psychologists engaging in advocacy and social justice work. Thus, examining how advocacy fits into the General Principles of the Code of Conduct may provide clarity. For instance, Principle A: Beneficience and Nonmaleficence reads,

In their professional actions, psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons, and the welfare of animal subjects of research … Because psychologists’ scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence.

Safeguarding the welfare and rights of the clients we serve is fundamental. Essentially, psychologists should not cause harm to others; in some cases, this may require them to advocate for the well-being and rights of individuals. For example, solitary confinement for adults and juveniles is a burning issue in corrections currently. Despite the wealth of knowledge throughout the last decade describing the harm caused by those in solitary confinement (e.g., Kaba et al., 2014; Metzner & Fellner, 2010; Whitley & Rozel, 2016), paired with the push for trauma-informed care and treatment, segregation and isolation continue to be common practices. Fortunately, mental health providers have been in the forefront of shifting policies surrounding isolation, as psychological research has been used to support policy change.

Principle B: Fidelity and Responsibility suggests adherents to the Code of Ethics should be “aware of their professional and scientific responsibilities to society and to the specific communities in which they work.” Clients often discuss psychosocial difficulties they’re facing—economic burdens, employment struggles, and neighborhood struggles. Those who provide mental and behavioral health care to a community develop a sense of the pulse of that community via their clients. In addition, watching the local news or reading your local paper (or social media) helps identify community social problems. In our roles as advocates, we should feel empowered to address these problems as related to our areas of competency. Writing an Op-Ed or Letter to the Editor about critical topics is one way to insert psychological and scientific knowledge into the public sphere. For example, after a viral video reached the Internet depicting problematic cheerleading practices, colleague Dr. Brian Gearity (Clinical Assistant Professor at the University of Denver’s sports coaching program) discussed coaching certification and proper sports coaching with local news station (Bolton, 2017; watch the video here). This is an excellent example of using acquired knowledge from our field and advocating for others and better practices.

The most fitting Principle related to advocacy and social justice is Principle D: Justice, which challenges us to “recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists.” What does this mean for an early career clinician? Simply, psychologists should advocate for equality for their clients. In working with vulnerable populations, clients often do not have the privilege and platform mental health practitioners have in their roles. Therefore, it is an underlying mission for providers to help promote those populations to advocate for themselves, while advocating for them as professionals. We can begin to incorporate these values as part of our own professional development during training and continuing into our early career practices.

Advocacy in Psychotherapy

How does advocacy fit into psychotherapy? Are your clients discussing the events outlined above? How are they coping with the present uncertainty regarding those social issues?

Advocacy counseling has a long history in field of psychology and psychotherapy (see Kiselica & Robinson, 2001, for a review). Advocacy counseling, or social justice interventions, involves “helping clients challenge institutional and social barriers that impede academic, career, or personal-social development” (Lee, 1998). Becoming involved in an advocacy organization may help clients feel more in control in situations affecting themselves, their families, and communities. In psychotherapy, advocacy counseling can be used to increase a client’s sense of personal power.

Discussing self-advocacy skills and providing a space to discuss important social issues in treatment can empower clients to become advocates for themselves and their communities.

For example, Savage, Harley, and Nowak (2005) discuss employing social empowerment strategies in counseling with gay and lesbian clients as a means of self-advocacy. These strategies help clients to develop a positive identity while becoming empowered enough to advocate for themselves and their communities and simultaneously pushing against systems of discrimination and marginalization. Their model serves as an effective approach for assisting clients in becoming their own social justice advocates and getting involved in creating change.

Systems-Level Change

Social justice movements need psychology, and especially the engagement of those early in their careers. Mallinckrodt, Miles, and Levy (2014) note that social justice advocates rely on social psychology literature about perception, prejudice, and attitude changes, as well as the negative consequences of oppression, such as chronic stress. Systems advocacy involves the therapist assuming roles to facilitate systematic change. Many early career professionals are or will soon become involved in administrative and leadership roles; in these roles, we can leverage our awareness and enthusiasm to influence our organizations and to facilitate change.

Regarding psychology’s involvement in social justice, Vasquez (2012) noted, “One of our tasks is to determine what our psychological theories, scientific research, and clinical experience have to say about the grand challenges that profoundly affect our daily lives, our society, and our world.” (p. 342). One identified barrier to engaging in advocacy efforts identified by psychologists was a lack of awareness of public policy issues and perceived lack of enough knowledge to discuss such issues competently (Heinowitz et al., 2012). However, as a field we can translate our knowledge, expertise, and research into policy change. For instance, research regarding families and same-sex couples, along with several APA Council resolutions, greatly impacted the United States Supreme Court’s decision for Obergefell vs. Hodges (2015), which found the Defense of Marriage Act (DOMA; 1996) unconstitutional under the Fifth Amendment. What is your niche? Think of ways you can use your knowledge, skills, and expertise to influence policy.

Future Directions

APA Benchmarks include advocacy as a competency for clinical training in the practice of psychology. The Benchmarks defines advocacy as “actions targeting the impact of social, political, economic or cultural factors to promote change at the individual (client), institutional, and/or systems level” (American Psychological Association, 2011). Despite being identified as a benchmark for clinical training (American Psychological Association, 2011), advocacy in psychology is not universally taught or discussed in graduate programs in psychology. According to a 2005 survey conducted by the National Council of Schools and Programs of Professional Psychology (NCSPP), 62% of faculty and student respondents reported advocacy training was not offered (Lating, Barnett, & Horowitz, 2009).

In order to develop and fill a pipeline of professionals involved in advocacy, public policy, and social justice efforts, graduate training programs must expose students to these arenas. For example, within the Graduate School of Professional Psychology at the University of Denver, a course entitled Psychology, Public Policy, and Advocacy is offered to graduate students across graduate psychology programs. The course introduces students to political advocacy, as well as connects students with current and former legislators, nonprofit agencies, and grassroots organizations to examine how psychology trainees and mental health practitioners can impact various systems. Recently, students also attended Colorado Mental Health Hill Day, which connected them with mental health advocacy groups and legislatures from across the state. In order to properly prepare students for this important area of the workforce, it is essential they have exposure to advocacy in their training.

As a mental health practitioner, are you aware of current legislation impacting your practice? Your institution or employer? Professional advocacy is “a synthesis of both public policy and social justice advocacy” (Heinowitz et al., 2012). Heinowitz and colleagues (2012) note, “Professional advocacy in the field of professional psychology demands that clinicians advocate not only for fair access to appropriate services but also for the important legislative changes necessary to enhance the quality of life of patients and at-risk populations” (p. 373).

In order to properly advocate for our clients, other members of our communities, and ourselves, we must remain up-to-date with current state and federal legislation. Providing legislative testimony, writing letters to your state representatives, and building coalitions are all great ways to become involved. Many state, provincial, and territorial psychological associations (SPTAs) have divisions or leaders dedicated to local public policy issues related to the field, and can provide direction on how to approach certain legislation as a collective unit. In sum, get involved!

Conclusion

Psychology has a longstanding history in advocacy and social justice movements. Although mental health practitioners may not be directly involved in advocacy efforts in their day-to-day work, perhaps they should—including at the client-level. The power of the field is greater than its individual parts: As students, clinicians, educators, researchers, administrators—and, yes, as early career professionals—each of us can be agents of influential social change.

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Cite This Article

Alexander, A. (2017). Social justice, advocacy, and early career practice. Psychotherapy Bulletin, 52(4).

References

American Psychological Association (2011). Revised Competency Benchmarks for Professional Psychology. Retrieved from: http://www.apa.org/ed/graduate/competency.aspx

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/

Bolton, A. (2017, August 25). DU sport coach educator question how high school coaches are trained. 9News. Retrieved from: http://www.9news.com/news/education/local-sports-psychologist-questions-how-high-school-coaches-are-trained/467470096

Defense of Marriage Act (DOMA), 1 U.S.C. § 7 and 28 U.S.C.  § 1738(c) (1996).

Heinowitz, A. E., Brown, K. R., Langsam, L. C., Arcidiacono, S. J., Baker, P. L., Badaan, N. H., Zlatkin, N. I., & Cash, R. E. (2012). Identifying perceived personal barriers to public policy advocacy within psychology. Professional Psychology: Research and Practice, 43(4), 372-378.

Kaba, F., Lewis, A., Glowa-Kollisch, S., Hadler, J., Lee, D., Alper, H.,…Venters, H. (2014). Solitary confinement and risk of self-harm among jail inmates. American Journal of Public Health, 104(3), 442-447.

Kiselica, M. S., & Robinson, M. (2001). Bringing advocacy counseling to life: The history, issues, and human dramas of social justice work in counseling. Journal of Counseling & Development, 79, 387-397.

Lating, J. M., Barnett, J. E., & Horowitz, M. (2009). Increasing advocacy awareness within professional psychology training programs: The 2005 National Council of Schools and Programs of Professional Psychology self-study. Training and Education in Professional Psychology, 3(2), 106-110. doi: 10.1037/a0013662

Lee, C. C. (1998). Counselors as agents for social change. In C. C. Lee & G. R. Walz (Eds.), Social action: A mandate for counselors (pp. 3-16). Alexandria, VA: American Counseling Association.

Leong, F. T. L., Pickren, W. E., & Vasquez, M. J. T. (2017). APA efforts in promoting human rights and social justice. American Psychologist, 72(8), 788-790. doi: 10.1037/amp0000220

Mallinckrodt, B., Miles, J. R., & Levy, J. J. (2014). The scientist-practitioner-advocate model: Addressing contemporary training needs for social justice advocacy. Training and Education in Professional Psychology, 8(4), 303-311. doi: 10.1037/tep0000045

Metzner, J. L., & Fellner, J. (2010). Solitary confinement and mental illness in U.S. prisons: A challenge for medical ethics. Journal of the American Academy of Psychiatry and the Law, 38(1), 104-108.

Obergefell vs. Hodges, 135 S.Ct. 2584 (2015).

Savage, T. A., Harley, D. A., & Nowak, T. M. (2005). Applying social empowerment strategies as tools for self-advocacy in counseling and lesbian and gay male clients. Journal of Counseling & Development, 83, 131-137.

Vasquez, M. J. T. (2012). Psychology and social justice: Why we do what we do. American Psychologist, 67, 337-346.

Whitley, K., & Rozel, J. S. (2016). Mental health care of detained youth and solitary confinement and restraint within juvenile detention facilities. Child and Adolescent Psychiatric Clinics of North America, 25(1), 71-80.

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