Identifying and Remediating Personal Prejudice: What Does the Evidence Say?

Abstract

In behavioral health settings, prejudice is a serious problem with significant implications for service delivery. Despite genuine efforts to help, clinicians behave in prejudiced ways toward clients and patients, often leading to problems in treatment or to the abandonment of treatment altogether. In this chapter, we outline the history of prejudice research, discuss definitions of prejudice, and review the empirical research on prejudice reduction interventions. We then critique prejudice reduction research from the perspective that collective action may more effectively produce social change. Finally, we return to the necessity of prejudice reduction in behavioral health care, offering practical suggestions from the literature and from our own experience as clinicians, researchers, and educators. Keywords Prejudice · Bias · Behavioral health · Prejudice reduction · Collective action Susan, a 61-year-old white clinical psychologist in private practice, agreed to an initial consult with Elías, a 24-year-old light-skinned Dominican American man who has been struggling with insomnia. Susan specializes in sleep disorders, and typically uses a cognitive-behavioral approach that has been very effective for many of her patients. On the day of the appointment, Susan noticed Elías's eyes darting to the framed paintings and certificates in her office. When asked if he was comfortable, Elías assured Susan that he was. Elías answered all of Susan's questions quickly and directly, and he listened closely as Susan described the treatment approach. Finally, at the end of the hour, Susan asked Elías about the fee. Would he be able to afford the $250 per session Susan normally charges, or would he need a sliding scale? To Susan's surprise, Elías looked her in the eye and said, "That's racist." Susan was taken aback, and stumbled over her reply. "I-I'm sorry, I didn't mean to-" Elías then drew out his checkbook and said, "I'm assuming I pay you for this one?" He quickly wrote a check and handed it to Susan, who was blushing with embarrassment. As Elías got up