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Microaggressions, Stereotypes, and Social Stigmatization in the Lived Experiences of Socially Marginalized Patients/Clients: A Social Justice Perspective

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Book cover Prejudice, Stigma, Privilege, and Oppression

Abstract

Mental health practitioners have an ethical and moral responsibility to practice social justice principles in their work with their socially marginalized patients/clients. Using a social justice lens, this chapter will bring awareness of social injustice in the form of microaggressions, stereotypes, and social stigmatization experienced by socially marginalized patients/clients in interactions with their healthcare practitioners. The lack of practitioner cultural competence is discussed as a possible contributor to the unjust treatment that patients/clients experience. A philosophical and moral framework will be used to problematize the biases of practitioners who enact these behaviors in interactions with their clients. Social justice education will be suggested as a curriculum-based or professional development-based means to expose and modify unjust behaviors and attitudes.

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References

  • Aneshensel, C. S. (2012). Theory-based data analysis for the social sciences. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Bandura, A. (1991). Social cognitive theory of self-regulation. Organizational Behavior and Human Decision Processes, 50(2), 248–287.

    Article  Google Scholar 

  • Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2016). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497553/pdf/12815076.pdf

    Article  Google Scholar 

  • Bisel, R. S., & Adame, E. A. (2017). Post-positivist/functionalist approaches. In C. R. Scott & L. Lewis (Eds.), The international encyclopedia of organizational communication (pp. 1–22). Hoboken, NJ: John Wiley & Sons. https://doi.org/10.1002/9781118955567

    Chapter  Google Scholar 

  • Bjorkman, M., & Malterud, K. (2009). Lesbian women’s experiences with health care: A qualitative study. Scandinavian Journal of Primary Health Care, 27(4), 238–243.

    Article  PubMed  PubMed Central  Google Scholar 

  • Boler, M. (2004). Feeling power: Emotions and education. New York, NY: Routledge.

    Google Scholar 

  • Bowleg, L. (2013). Once you’ve blended the cake, you can’t take the parts back to the main ingredients: Black gay and bisexual men’s descriptions and experiences of intersectionality. Sex Roles, 68(11–12), 754. https://doi.org/10.1007/s11199-012-0152-4

    Article  Google Scholar 

  • Burgess, D. J., Warren, J., Phelan, S., Dovidio, J., & Van Ryn, M. (2010). Stereotype threat and health disparities: What medical educators and future physicians need to know. Journal of General Internal Medicine, 25(2), 169–177.

    Article  PubMed Central  Google Scholar 

  • Byrd, M. Y. (2014). Diversity Issues. Advances in Developing Human Resources 16(4):515–528.

    Google Scholar 

  • Byrd, M. Y. (2016). Selective incivility: A micro aggression targeting racial and ethnic groups in the workplace. In M. F. Karsten (Ed.), Gender, race, and ethnicity in the workplace: Emerging issues and enduring challenges (pp. 123–149). Santa Barbara, CA: Praeger.

    Google Scholar 

  • Byrd, M. Y. (2018a). Re-conceptualizing and re-visioning diversity in the workforce: Toward a social justice paradigm. In M. Y. Byrd & C. L. Scott (Eds.), Diversity in the workforce: Current issues and emerging trends (pp. 334–346). New York, NY: Routledge.

    Chapter  Google Scholar 

  • Byrd, M. Y. (2018b). Does HRD have a moral duty to respond to matters of social injustice? Human Resource Development International, 21(1), 3–11.

    Article  Google Scholar 

  • Byrd, M. Y., & Scott, C. L. (Eds.). (2018). Diversity in the workforce: Current issues and emerging trends (2nd ed.). New York, NY: Routledge.

    Google Scholar 

  • Chavez, C. I., & Weisinger, J. Y. (2008). Beyond diversity training: A social infusion for cultural inclusion. Human Resource Management, 47(2), 331–350.

    Article  Google Scholar 

  • Connor, S. L., & Wilson, R. (2006). It’s important they learn from us for mental health to progress. Journal of Mental Health, 15(4), 461–474.

    Article  Google Scholar 

  • Corrigan, P. W. (2005). On the stigma of mental illness: Practical strategies for research and social change. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Corrigan, P. W., & Watson, A. C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16–20.

    PubMed  PubMed Central  Google Scholar 

  • Corrigan, P. W., Watson, A. C., Byrne, P., & Davis, K. E. (2005). Mental illness stigma: Problem of public health or social justice? Social Work, 50(4), 363–368.

    Article  PubMed  Google Scholar 

  • Craig, S. L., Bejan, R., & Muskat, B. (2013). Making the invisible visible: Are health social workers addressing the social determinants of health? Social Work in Health Care, 52(4), 311–331.

    Article  PubMed  Google Scholar 

  • Dessel, A., Rogge, M. E., & Garlington, S. B. (2006). Using intergroup dialogue to promote social justice and change. Social Work, 51(4), 303–315.

    Article  PubMed  Google Scholar 

  • Dewees, M., & Lax, L. K. (2008). A critical approach to pedagogy in mental health. Social Work in Mental Health, 7(1–3), 82. https://doi.org/10.1080/15332980802072421

    Article  Google Scholar 

  • Dovidio, J. F., Penner, L. A., Albrecht, T. L., Norton, W. E., Gaertner, S. L., & Shelton, J. N. (2008). Disparities and distrust: The implications of psychological processes for understanding racial disparities in health and health care. Social Science & Medicine, 67(3), 478–486.

    Article  Google Scholar 

  • Edwards, P., & Vance, S. (2001). Teaching social justice through legal writing. The Journal of the Legal Writing Institute, 7, 63–86.

    Google Scholar 

  • Feldman, S. (1999). Please don’t call me “dear”: Older women’s narratives of health care. Nursing Inquiry, 6, 269–276. https://doi.org/10.1046/j.1440-1800.1999.00041.x

    Article  PubMed  Google Scholar 

  • FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(1), 19.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ford, L. A., & Yep, G. A. (2003). Working along the margins: Developing community-based strategies for communicating about health with marginalized groups. In T. L. Thompson, A. Dorsey, R. Parrott, & K. Miller (Eds.), Handbook of health communication (pp. 241–261). New York, NY: Routledge.

    Google Scholar 

  • Gaertner, S. L., & Dovidio, J. F. (2005). Understanding and addressing contemporary racism: From aversive racism to the common ingroup identity model. Journal of Social Issues, 61(3), 615–639.

    Article  Google Scholar 

  • Gaston-Johansson, F., Hill-Briggs, F., Oguntomilade, L., Bradley, V., & Mason, P. (2007). Patient perspectives on disparities in healthcare from African-American, Asian, Hispanic, and native American samples including a secondary analysis of the Institute of Medicine focus group data. Journal of Black Nurses Association, 18(2), 43–52.

    Google Scholar 

  • Gilligan, C. (1982). New maps of development: New visions of maturity. The American Journal of Orthopsychiatry, 52(2), 199–212. https://doi.org/10.1111/j.1939-0025.1982.tb02682.x

    Article  PubMed  Google Scholar 

  • Goffman, E. (1963). Stigma. Englewood Cliffs, NJ: Spectrum.

    Google Scholar 

  • Gonzales, L., Davidoff, K. C., Nadal, K. L., & Yanos, P. T. (2015). Micro-aggressions experienced by persons with mental illnesses: An exploratory study. Psychiatric Rehabilitation Journal, 38(3), 234.

    Article  PubMed  Google Scholar 

  • Grady, M., & Edgar, T. (2003). Racial disparities in healthcare: Highlights from focus group findings. In B. D. Smedley, A. Y. Stith, & A. R. Nelson (Eds.), Unequal treatment: Confronting racial and ethnic disparities in healthcare (pp. 392–405). Washington, DC: The National Academies Press.

    Google Scholar 

  • Granger, N. (2012). Micro-aggressions and their effects on the therapeutic process. Society for Humanistic Psychology. Retrieved from: http://www.apadivisions.org/division-32/publications/newsletters/humanistic/2012/10/microaggressions.aspx

  • Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology, 74(6), 1464.

    Article  PubMed  Google Scholar 

  • Hamilton, S., Lewis-Holmes, E., Pinfold, V., Henderson, C., Rose, D., & Thornicroft, G. (2014). Discrimination against people with a mental health diagnosis: Qualitative analysis of reported experiences. Journal of Mental Health, 23(2), 88–93.

    Article  PubMed  Google Scholar 

  • Hanafiah, A., & Van Bortel, T. (2015). A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia. International Journal of Mental Health Systems, 9(1), 10–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hatchett, L., Elster, N., Wasson, K., Anderson, L., & Parsi, K. (2015). Integrating social justice for health professional education: Self-reflection, advocacy, and collaborative learning. Online Journal of Health Ethics, 11(1). https://doi.org/10.18785/ojhe.1101.04

  • Hatzfeld, J. J., Cody-Connor, C., Whitaker, V. B., & Gaston-Johansson, F. (2008). African-American perceptions of health disparities: A qualitative analysis. Journal of National Black Nurses’ Association: JNBNA, 19(1), 34–41.

    PubMed  Google Scholar 

  • Hopkins, P. (2010). Practitioner know thyself! Reflections on the importance of self-work for diversity and social justice practitioners. Tamara: Journal of Critical Organization Inquiry, 8(4), 157–171.

    Google Scholar 

  • Ingram, I. L., & Walters, T. S. (2007). A critical reflection model to teach diversity and social justice. Journal of Praxis in Multicultural Education, 2(1), 23–41.

    Article  Google Scholar 

  • Johnson, J. L., Bottorff, J. L., Browne, A. J., Grewal, S., Hilton, B. A., & Clarke, H. (2004). Othering and being othered in the context of health care services. Health Communication, 16(2), 255–271.

    Article  PubMed  Google Scholar 

  • Jones, S. R., & McEwen, M. K. (2000). A conceptual model of multiple dimensions of identity. Journal of College Student Development, 41(4), 405–414.

    Google Scholar 

  • Jost, J., & Kay, A. C. (2010). Social justice: History, theory, and research. In S. T. Fiske, D. Gilbert, & G. Lindzey (Eds.), Handbook of social psychology (Vol. 2, 5th ed., pp. 1122–1165). Hoboken, NJ: Wiley.

    Google Scholar 

  • Kant, I. (1996). Kant: The metaphysics of morals. Cambridge: United Kingdom, Cambridge University Press.

    Google Scholar 

  • Keen, S. (2006). A theory of narrative empathy. Narrative, 14(3), 207–236.

    Article  Google Scholar 

  • Kiselica, M. S. (2004). When duty calls: The implications of social justice work for policy, education, and practice in the mental health professions. The Counseling Psychologist, 32(6), 838–854.

    Article  Google Scholar 

  • Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111–116.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kumagai, A. K., & Lypson, M. (2009). Beyond cultural competence: Critical consciousness, social justice, and multicultural education. Academic Medicine, 84(6), 782–787.

    Article  PubMed  Google Scholar 

  • Lilienfeld, S. O. (2017). Micro-aggressions: Strong claims, inadequate evidence. Perspectives on Psychological Science, 12(1), 138–169.

    Article  PubMed  Google Scholar 

  • Link, B. G., Cullen, F. T., Frank, J., & Wozniak, J. F. (1987). The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92(6), 1461–1500.

    Article  Google Scholar 

  • Lipkin, M., Quill, T. E., & Napodano, R. J. (1984). The medical interview: A core curriculum for residencies in internal medicine. Annals of Internal Medicine, 100(2), 277–284.

    Article  PubMed  Google Scholar 

  • Louchart, S., & Aylett, R. (2004). Narrative theory and emergent interactive narrative. International Journal of Continuing Engineering Education and Life Long Learning, 14(6), 506–518.

    Article  Google Scholar 

  • Malik, K. (1996). The meaning of race: Race, history and culture in western society. New York, NY: Macmillan.

    Book  Google Scholar 

  • Manis, A. A. (2012). A review of the literature on promoting cultural competence and social justice agency among students and counselor trainees: Piecing the evidence together to advance pedagogy and research. Professional Counselor, 2(1), 48–57.

    Article  Google Scholar 

  • Marmot, M., Friel, S., Bell, R., Houweling, T. A. J., & Taylor, S. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Lancet, 372, 1661–1669.

    Article  PubMed  Google Scholar 

  • McLaughlin, A. (2011). Exploring social justice for clinical social work practice. Smith College Studies in Social Work, 81(2–3), 234–251.

    Article  Google Scholar 

  • O’Neill, M. (2015). Applying critical consciousness and evidence-based practice decision-making: A framework for clinical social work practice. Journal of Social Work Education, 51(4), 624–637.

    Article  Google Scholar 

  • Pearson, S. D., & Raeke, L. H. (2000). Patients’ trust in physicians: Many theories, few measures, and little data. Journal of General Internal Medicine, 15(7), 509–513.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pellegrino, E. (1978). Ethics and the moral center of the medical enterprise. Bulletin of the New York Academy of Medicine, 54, 625–640.

    PubMed  PubMed Central  Google Scholar 

  • Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., McCullough, J. R., & Hipolito-Delgado, C. (2015). Multicultural and social justice counseling competencies. Alexandria, VA: AMCD.

    Google Scholar 

  • Rawls, J. (2001). Justice as fairness: A restatement. Cambridge, MA:Harvard University Press.

    Google Scholar 

  • Rhodes, W. C. (1995). Liberatory pedagogy and special education. Journal of Learning Disabilities, 28(8), 458–467.

    Article  PubMed  Google Scholar 

  • Richardson, L. (1990). Narrative and sociology. Journal of Contemporary Ethnography, 19, 116–135.

    Article  Google Scholar 

  • Rogers, A., & Pilgrim, D. (1993). Service users’ views of psychiatric treatments. Sociology of Health & Illness, 15(5), 612–631.

    Article  Google Scholar 

  • Rosenberg, R. A. (2013). The human magnet syndrome: Why we love people who hurt us. Eau Claire, WI: PESI Publishing & Media.

    Google Scholar 

  • Ross, P. T., Lypson, M. L., & Kumagai, A. K. (2012). Using illness narratives to explore African American perspectives of racial discrimination in health care. Journal of Black Studies, 43(5), 520–544.

    Article  Google Scholar 

  • Rousseve, R. J. (1969). Counselor, know thyself!: In quest of a viable model of the human condition as a prerequisite for professional effectiveness. The Personnel and Guidance Journal, 47, 628–633. https://doi.org/10.1002/j.2164-4918.1969.tb02965.x

    Article  Google Scholar 

  • Rudman, L. A., Greenwald, A. G., Mellott, D. S., & Schwartz, J. L. (1999). Measuring the automatic components of prejudice: Flexibility and generality of the Implicit Association Test. Social Cognition, 17(4), 437–465.

    Article  Google Scholar 

  • SAMSHA. (2016). Improving cultural competence. HHS publication no. (SMA) 16-4932. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. Rockville, MD: Department of Health and Human Services. Retrieved from: https://store.samhsa.gov/shin/content//SMA16-4932/SMA16-4932.pdf

    Google Scholar 

  • Scheyett, A., & Kim, M. (2004). Can we talk? Using facilitated dialogue to positively change student attitudes towards persons with mental illness. Journal of Teaching in Social Work, 24(1–2), 39–54.

    Article  Google Scholar 

  • Schieff, T., & Rieth, K. (2012). Projects in medical education: Social justice in medicine a rationale for an elective program as part of the medical education curriculum at John A. Burns School of Medicine. Hawai’i Journal of Medicine & Public Health, 71(4 Suppl 1), 64.

    Google Scholar 

  • Sheared, V. (1996). Giving voice in an adult education context. College of Education Review (San Francisco State University), 8, 97–103.

    Google Scholar 

  • Shor, R., & Sykes, I. J. (2002). Introducing structured dialogue with people with mental illness into the training of social work students. Psychiatric Rehabilitation Journal, 26(1), 63–69.

    Article  PubMed  Google Scholar 

  • Snyder, M. (1981). On the self-perpetuating nature of social stereotypes. In D. L. Hamilton (Ed.), Cognitive processes in stereotyping and intergroup behavior (pp. 183–212). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Solorzano, D. G., & Yosso, T. J. (2002). Critical race methodology: Counter-storytelling as an analytical framework for education research. Qualitative Inquiry, 8(1), 23–44.

    Article  Google Scholar 

  • Steele, C. M., & Aronson, J. (1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69(5), 797–811.

    Article  PubMed  Google Scholar 

  • Stevens, P. E. (1993). Marginalized women’s access to health care: A feminist narrative analysis. Advances in Nursing Science, 16(2), 39–56.

    Article  PubMed  Google Scholar 

  • Stuber, J., Meyer, I., & Link, B. (2008). Stigma, prejudice, discrimination and health. Social Science & Medicine (1982), 67(3), 351–357. https://doi.org/10.1016/j.socscimed.2008.03.023

    Article  Google Scholar 

  • Stull, L. G., McGrew, J. H., Salyers, M. P., & Ashburn-Nardo, L. (2013). Implicit and explicit stigma of mental illness: Attitudes in an evidence-based practice. The Journal of Nervous and Mental Disease, 201(12), 1072–1079.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sue, D. W. (2010). Micro-aggressions in everyday life: Race, gender, and sexual orientation. Hoboken, NJ: John Wiley & Sons.

    Google Scholar 

  • Swenson, C. R. (1998). Clinical social work’s contribution to a social justice perspective. Social Work, 43(6), 527–537.

    Article  Google Scholar 

  • Walls, M. L., Gonzalez, J., Gladney, T., & Onello, E. (2015). Unconscious biases: Racial micro-aggressions in American Indian health care. The Journal of the American Board of Family Medicine, 28(2), 231–239.

    Article  PubMed  Google Scholar 

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Correspondence to Marilyn Y. Byrd PhD .

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Byrd, M.Y., Austin, J.T. (2020). Microaggressions, Stereotypes, and Social Stigmatization in the Lived Experiences of Socially Marginalized Patients/Clients: A Social Justice Perspective. In: Benuto, L., Duckworth, M., Masuda, A., O'Donohue, W. (eds) Prejudice, Stigma, Privilege, and Oppression. Springer, Cham. https://doi.org/10.1007/978-3-030-35517-3_12

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