Culturally Responsive Psychological Assessment With Racially and Ethnically Diverse Older Adults

Abstract

The older adult population in the United States (U.S.) is becoming more racially and ethnically diverse, whereas most practicing neuropsychologists are white. Psychologists hold social privilege of which they may not be aware and work in health care systems that benefit the racial majority. System-level change is necessary to create a more equitable and accessible health care system for racially and ethnically diverse older adults. It is vital for the field of psychology to understand how oppression, power, and privilege impact the accessibility, reliability, and effectiveness of psychological assessment. The aim of this article is to address how historical medical injustices, poor education quality, barriers to communication, biases, and intersectionality influence psychological evaluations. Via a selective literature review, we illustrate how these issues apply to working with racially and ethnically diverse older adults. We discuss the historical context of the multicultural approach to assessment; system and interpersonal-level manifestations of oppression; and age-cohort-related considerations. A clinical vignette illustrates how oppression, power, and privilege can manifest in the context of an evaluation. We issue a commentary and call to action, charging psychologists to implement individual and system-level change. We provide recommendations for culturally responsive psychological assessments.