(PS13-B45) Prevalence and Navigation of Discrimination and Microaggression Experiences in Psychotherapy and Supervision Processes Among Therapists in Training

Background: The mental healthcare field is committed to increasing diversity within its training programs. Some studies have found that therapist trainees, especially those of marginalized backgrounds, have experienced discrimination and microaggressions from their clients and supervisors (Constantine & Sue, 2007; Peng et al, 2020; Bautista-Biddle et al., 2021). This study aims to quantitatively explore the prevalence and navigation of discrimination and microaggression experiences in both psychotherapy and supervision processes among therapists in training who have seen at least one client.
 

Method: This study adopted an online survey design. Participants were recruited from organizational list servs and by contacting directors of clinical and counseling psychology training programs. A total of N = 85 trainees provided usable data in the survey to date: 13% male, 81% female, 6% non-binary; 58% White, 11% Asian, 5% Black, 8% Hispanic, 3% Middle Eastern, 15% Multiracial; 19% master’s, 81% doctorate program. In addition to descriptive results, discrimination and microaggression events were examined inferentially across sociodemographic and training characteristics, as well as in relation to perceptions of self-efficacy.
 

Results: Therapist trainees experienced more discrimination and microaggression events from their clients than supervisors. More than 2 out of 5 trainees (41%) endorsed that they have been asked personal questions about their identity by their clients at least once a month; approximately 1 out of 4 trainees (25%) felt that their clients treated them with less respect at least once a month. About 1 out of 5 trainees (22%) felt that their supervisor treated them with less respect and asked personal questions about their identity at least once a month. In addition, more than 1 out of 10 trainees (10%) experienced all forms of microaggression from clients and supervisors at least once a month. Trainees who have worked with 61 to 70 clients and who have 300 to 400 direct client contact hours endorsed the highest levels of discrimination and microaggression from clients. Trainees who identified as Muslim were significantly more likely to experience microaggressions from their supervisors compared to trainees of other religious backgrounds. Trainees who identified their sexual orientation as “other” endorsed significantly higher levels of discrimination and microaggression from clients and supervisors compared to other sexual orientation identity groups. Trainees’ discrimination and microaggression experiences in psychotherapy and supervision processes were not associated with their perception of self-efficacy as a therapist. When navigating discrimination, many trainees frequently chose to identify key issues in deciding how to respond to discrimination (44%), practice self-care (49%), and talk to a supervisor (34%). Most trainees find reflecting on key issues (41%) and talking to their supervisor to be very helpful (30%).
 

Conclusion: These results highlight the growing need to help trainees navigate professional settings and to help mentors, supervisors, and program administrators provide adequate support to their trainees.