Anti-Oppressive Counseling and Psychotherapy

Action for Personal and Social Change

Jason D. Brown

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9781138087354
• eBook ISBN: 9781351615037
• Topic: Education
• Subtopic: Education Counseling

In Anti-Oppressive Counseling and Psychotherapy, Jason D. Brown examines the impact of structural inequality on mental health and provides a framework for an anti-oppressive practice that recognizes privilege and challenges systemic barriers. Incorporating theory, research, and detailed case studies, readers will learn how to implement intervention techniques that take into consideration the diverse social identities of both therapist and client. The text also teaches students and practicing psychotherapists how to use anti-oppressive practices to effect social change within their communities and society at large.

1
Oppression and Mental Health

This chapter introduces the topic of global inequality and presents some evidence of its existence with social, economic and political examples across Canada and the United States. A colonial analysis of historical relations between original Indigenous peoples and European immigrants to North America explores the beginnings of oppression. The arrival and establishment of settler societies represented the views of white, European, Christian males. This analysis illustrates concepts of diversity, privilege and disadvantage. It is followed by an introduction to psychological studies of stigma, prejudice and micro-aggressions.

Why is social inequality relevant to professional counseling and psychotherapy?

• We live in an unequal society. Each of us is born within a hierarchy. Position in the hierarchy is advantageous to some and disadvantageous to others. Social positions have a substantial lifelong effect on individuals.
• Inequality produces oppression. Problems exist at both the structural level and the personal level as well as in between. Social problems manifest as personal problems (e.g. gender differences in employment position and income). Personal problems manifest as social problems (e.g. employment and income opportunities and outcomes differ by gender).
• Oppression is reflection of a group’s and individual’s status relative to others. It puts one member of a particular group at a distinct advantage over members of another group. Differences exist in power, influence and control. These differences manifest as unequal opportunities and unequal outcomes.
• Forces of oppression are structural (e.g. market, globalization, colonization) and reflected in policies and practices between nations. These forces are national (e.g. government policy, ownership, participation) and reflected in policies and practices within nations. The forces are also local (e.g. location, services, capital) and reflected in policies and practices within communities. These forces are personal (e.g. esteem, agency, identity) and reflected in personal meaning.
• Counseling and psychotherapy focus on individuals. The practices operate from the basis that problems exist or are accessible within the individual. Such problems manifest as imbalances, excesses or deficiencies of known properties of the mind.
• An anti-oppressive (AO) perspective broadens the view of individuals to the forces that exist outside and recognizes the profession and the professional positioned within systems of oppression.
• From an AO perspective, mental health is personally and structurally determined. Personal problems manifest as imbalances, excesses or deficiencies of known aspects of a community or society.
• AO Counseling and Psychotherapy (AOCP) locates a portion of the responsibility on context that can be influenced by a collective. AOCP views interpersonal circumstances and the social context as legitimate targets for change. The professional and client engage in both internal and external change to address the problem.

Chapter Outline

• Inequality
  • Economic
  • Social
  • Political
• Positions Against Social Inequality
• Legacies of the Settler Societies
  • Race and Ethnicity
  • Gender and Sexuality
  • Employment and Ability
  • Age
  • Religion
• Colonialism Today
• Social Privilege
• Oppression
• Stigma and Prejudice
• Micro-Aggressions
• Conclusion
• Web Links
• Key Terms
• Discussion Questions

Inequality

In 2017, Oxfam reported that “8 men owned the same wealth as the poorest half of the world”, and Credit Suisse reported that those in the top 1% of global wealth together owned more than the rest of the globe (Anand & Segal, 2017). Today, the United States holds 33% of global wealth, while Canada holds 3%. There is clear evidence of global economic inequality. The country one is born in and the income distribution of that country are highly predictive (Milanovic, 2015). However, differences within nations are widening to a greater extent than the gaps between nations (Milanovic, 2016).

Within nations, an index known as the Gini coefficient reflects the income distribution. It is one of the most widely used measures of inequality. On this measure, a score of 0 represents maximum equality and 100 represents maximum inequality. In Canada, the Gini coefficient for 2010–2015 (United Nations, 2016) was 33.7 and the US was 41.1 (Bogliacino & Maestri, 2016). According to the World Bank (2015), the nation with the highest Gini, of 176 ranked nations, was South Africa at 63.4 and the nation with the lowest Gini was Ukraine at 25.5. Internationally, Canada ranked 68th and the United States 117th, reflecting a major gap between their least and most wealthy citizens.

The relationship between inequality and social problems is linear and positive, such that the greater the inequality, the greater the indices of violent crime, obesity, mental illness, imprisonment and teen births (Wilkinson & Pickett, 2010). With greater equality, there is a greater sense of cohesion, trust, cooperation and social stress (Wilkinson & Pickett, 2017).

The connections between low population and personal health status are evident in developmental trajectories (Pless, Hodge, & Evans, 2017), as well as within regional and local communities with higher concentrations of risk factors (Fazel, Geddes, & Kushel, 2014). There is ample evidence that policies associated with improved access to education, health care, housing, employment and other services within disadvantaged or underserviced areas and populations have a positive leveling effect (Allen, Balfour, Bell, & Marmot, 2014). In the sections that follow, connections between economic, social and political inequality are described.

Economic

The Vertical Mosaic (Porter, 1965) was coined to reflect the prominent layers of social arrangement. While the book was written 50 years ago, the concept remains and is the subject of discussion and debate. Recently (Porter, 2015), scholars have written about the vertical mosaic in relation to gender and race inequality, citizenship and social justice as well as social class and power. To illustrate, poverty lines in Canada and the United States reflect significant differences between individuals and families along the continuum from least to most wealth.

Low Income Cut Offs (LICO) in Canada are relative measures of poverty that identify the threshold at which families are spending more than 20% of their income than the average on food, clothing and shelter. They are calculated by number of people in a family and by community size. According to the LICO measure, there are several demographic groups that are overrepresented and therefore at risk for poverty (Canada, 2010; Tweddle, Battle, & Torjman, 2015):

1. Children
   • • 9.1% nationally
   • • 23.4% of lone parent
   • • 39.3% in recent immigrant families
2. Women
   • • 9.9% nationally
   • • 29% of all unattached
   • • earn 71.4% of what full-time men earn on average
3. Unattached adults
   • • 58.1% of 18–24 years
   • • 31.6% of 45–54 years
   • • 39.3% of 55–64 years
4. Indigenous peoples
   • • 42.8% of all unattached
   • • 25% of adults in urban families
   • • 27.5% under 15 with family
   • • 63% for 16–24 years
5. People with disabilities
   • • lower average income, $28,503 vs. $37,309 (national average)
   • • 43.9% 15–64 NOT in labor force vs. 19.8% (national average)
6. Recent immigrants
   • • 32.6% of families
   • • 58.3% of unattached
   • • 54.7% of refugees

The US poverty line is based on pre-tax income and proportion spent on cost of a minimum diet, adjusted annually for inflation and reported based on family size, composition and age. The US (Department of Health and Human Services, 2015) poverty rate is quite restrictive but still includes 14.5% (45.3 million people).

• The child poverty rate was 19.9%: for African-American children 36.9%, Hispanic 30.4% and white children 10.7%.
• Nearly half of all female-headed lone-parent families (45.8%) lived in poverty.
• Working age individuals with and without disabilities had discrepant poverty rates of 28.4% vs. 12.4%.
• Women were 35% more likely to live in poverty than men.
• 19% of immigrants vs. 13.5% non-immigrants live in poverty.
• Among 18–44-year-olds, 15.3% of males and 21.1% of females live in poverty, with rates increasing among those who identify as gay or lesbian, at 20.5% and 22.7%, higher for individuals who identify as bisexual, at 25.9 and 29.4%, compared to 20.1% and 21.5% for those who do not identify as a member of the LGBTQ2+ community.
• About 40% of homeless youth identify as LGBTQ2+ (Macartney, Bishaw, & Fontenot, 2013).
• In the UK, poverty rates for Muslims are 50%, relative to those who are Jewish (13%), Sikh (27%), Hindu (22%), Anglican (14%) or Catholic (19%), with 18% as the national average (Heath & Li, 2015).

Social

Social indices of inequality are reflected in victimization statistics. In Canada (Statistics Canada, 2017), hate crimes occurred most frequently based on race or ethnicity targeting—in order of occurrence: Black, East Asian and South Asian individuals. Religion was the second most frequent target of hate crimes, with individuals who were Jewish or Muslim most frequently the targets. Sexual orientation was the third most frequent target of hate crime. In the United States, hate crimes reported to police, in order of frequency (Federal Bureau of Investigations, 2016), occurred on the basis of race/ethnicity, religion, sexual orientation, gender identity and, finally, disability.

In another illustration of social inequality, approximately 70% of incidents of abuse of woman go unreported, and of those that are, one-third are sexual assaults and beatings. Women with disabilities in Canada are 1.4× more likely than women without a disability to experience abuse. In 2013 (US), the rate of serious violent victimization for persons with disabilities (14 per 1,000) was more than three times higher than the age-adjusted rate for persons without disabilities (4 per 1,000).

Political

Political indices of inequality are reflected in voting behavior and representation of elected officials. In the United States, voting rates vary by ethnicity. In the last presidential election (2016), 65.3% of eligible white voters voted, 59.6% of Black voters and 47.6% of Hispanic voters (US Census, 2017). Canada is closer to the goal of building a diverse parliament that represents its population. A cabinet ratio of 48.3% women, 16.1% visible minorities and 6.5% Indigenous comes close to matching a Canadian population that was 50.9% women, 22.3% visible minorities and 4.9% Indigenous (Wherry, 2015).

Positions Against Social Inequality

An argument upon which this text is based is that unequal opportunities and outcomes diminish population and personal mental health. This c...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• Contents
• List of Tables
• Preface
• Introduction: Arguments in Support of an Anti-Oppressive Perspective in Counseling and Psychotherapy
• 1 Oppression and Mental Health
• 2 Psychologies of Liberation
• 3 Anti-Oppressive Practice
• 4 Common Factors
• 5 Social Determinants
• 6 Assessment for Personal Change
• 7 Intervention for Personal Change
• 8 Bridging Personal and Community Change
• 9 Assessment for Community Change
• 10 Intervention for Community Change
• Index