Diversity, Equity, Inclusion (DEI) Column

 back to December newsletter 
by Pooja Gupta, AMFT

Through this past year, Cinema Therapy Club, a CAMFT initiative, provided us with a unique opportunity to sit with the feelings and lived experiences of many different characters as beautifully portrayed in different movies. We screened a movie every month, starting February 2024, and then reflected on and processed our personal responses to the movie after the screening. These screenings allowed us to explore the experiences of the diverse group of people that we all represent, including but not limited to Autism awareness, Addiction recovery, Aging and experience of older persons, and Diverse identities based on Race, Gender, Sexual Orientation and Physical abilities. In spite of the diversity of characters being represented through the movies, the experiences of the characters were unified around love, friendship, adversity, resilience, courage, and survival and invoked a range of emotions inside us, the audience.

Movies are and always have been a powerful medium of storytelling, providing us with an immersive experience of peoples’ lives, emotions, and perspectives. Watching and reflecting on movies as part of the Cinema Therapy Club presented us with a unique chance to parse through the rollercoaster of emotions bubbling up inside us in response to the stories depicted on the screen, which could very possibly be the stories of our patients in the therapy room. Some parts of the stories brought a smile to our faces and others brought tears to our eyes; there were some scenes that led us to covering our eyes in terror and others led us to sit on the edges of our seats with excitement or anxiety. Some of our emotional responses while witnessing the same sequence of events were shared and others were unique to each one of us.

We hope this experience not only allowed participants to reflect on their feelings but also provided an opportunity to examine our hidden or unconscious biases in response to the stories unfolding in front of us. As therapists, we are more familiar than most with the human need to protect ourselves from any pain or anticipated danger. The experience of examining our own response to the diverse group of characters being portrayed in the movies probably allowed us insight into whether we were distancing ourselves from the pain by putting ourselves in a place of privilege and allowing ourselves to believe that somebody else’s pain is uniquely their own and can never be ours. These were moments of introspection that reminded us of all those times in therapy that challenge our empathy, our non-judgmental stance, and our ability to provide a safe space to our patients. These were moments that, hopefully, brought us face-to-face with our blind spots and led to our growth as people and as therapists.

As the year ends, we are so grateful to have had this shared emotional journey with everyone who could join us for the movie screenings this year. We hope to continue this cinematic experience in the coming year, hopefully in greater numbers and with more thought-provoking movies that can help us reflect and grow together.

Pooja Gupta, AMFT

back to November 2024 newsletter 
by Kusum Punjabi, AMFT

Director of DEI Kusum Punjabi shares how different cultures honor the new moon, and how we can help our clients work through the varied emotions they may be experiencing during this time of year

As mental health practitioners in California's diverse therapeutic landscape, we regularly encounter the richness of intersecting cultural narratives. The October new moon of 2024 offers a particularly poignant moment for reflection, as it coincides with Diwali, Día de los Muertos, and Halloween – three distinct cultural traditions that illuminate how the same celestial event can carry profoundly different meanings across communities.

In Hindu traditions, this new moon marks Diwali, the festival of lights. Devotees celebrate Rama's triumphant return from exile, symbolizing the victory of light over darkness, knowledge over ignorance. Homes glow with diyas (clay lamps), and families gather to share sweets, reflecting the sweetness of homecoming and renewal. For our South Asian clients, this period may evoke complex emotions tied to family obligations, cultural identity, and the challenge of maintaining traditions in the South Asian diaspora.

Simultaneously, for our Latine/a/o/x communities, this lunar phase heralds the approach of Día de los Muertos, when the veil between worlds grows thin. Unlike Halloween's spooky undertones, this Mexican tradition views death not as frightening but as a natural continuation of life. Families construct ofrendas (altars) adorned with marigolds, photos, and their departed loved ones' favorite foods. For these clients, this season might surface grief differently – not as something to process alone, but as a communal experience of remembrance and celebration.

Meanwhile, the Western tradition of Halloween transforms this same dark moon into a night of costume and masquerade. What began as the Celtic Samhain, marking summer's end and the harvest season, evolved through Christian influence into All Hallows' Eve. Today's secular celebration invites participants to play with identity itself – a temporary liberation from fixed social roles that might resonate particularly with clients exploring questions of personal authenticity and social presentation.

This convergence of traditions offers a powerful lesson in phenomenology – how our lived experiences shape our perception of reality. The same new moon appears radically different through these cultural lenses: a triumph of light, a bridge between worlds, or a night of transformation. None of these perspectives is more "true" than the others; each represents a valid way of making meaning from the same astronomical event.

For us as therapists, this cultural confluence reminds us to practice radical openness in our clinical work. When a client mentions "celebrating this weekend," we must resist assuming we know what that means. Their celebration might involve lighting diyas, arranging marigolds, or carving pumpkins – or perhaps something entirely different.

This intersection of traditions also highlights how cultural identity isn't monolithic but fluid and often multiplicative. A client might celebrate Halloween at school, build an ofrenda at their grandmother's house, and join Diwali festivities with friends. Each experience adds depth to their lived experience rather than diminishing other aspects of their identity.

As we move through this season, let us embrace these overlapping narratives as an invitation to deepen our cultural humility. Every client brings their own moon, their own light, their own way of marking time and making meaning. Our role is not to assume but to inquire, not to know but to learn, creating space for all the diverse ways humans understand and experience their world.

back to October 2024 newsletter
by Kusum Punjabi, AMFT

October 10, World Mental Health Day, serves as an important reminder for mental health professionals to reflect on the often unseen aspects of mental health issues. While common conditions like anxiety and depression are well-documented, many hidden places harbor mental health problems, often unnoticed until they escalate. As therapists, recognizing these spaces and adopting proactive approaches to attend to them can be of great consequence.

1. In the Shadows of Social Media

The impact of social media on mental health has become increasingly significant. Research shows that while social media can provide support, it also encourages comparison and feelings of inadequacy (Vogel et al., 2014). Individuals often curate idealized versions of their lives, which can mask underlying struggles. Therapists should encourage clients to examine their social media habits and consider the effects on their self-esteem and well-being.

2. Within High-Pressure Environments

High-pressure environments, whether in workplaces or educational institutions, often contribute to mental health challenges. A study by the American Psychological Association indicates that chronic stress from unrealistic expectations can lead to burnout, anxiety, and depression (APA, 2020). Therapists should remain attuned to signs of distress in clients who feel compelled to keep pushing forward. Regular discussions about work-life balance can help uncover hidden mental health issues before they escalate.

3. In Unspoken Generational Patterns

Many families carry unaddressed traumas that subtly influence mental health across generations. Research in family systems therapy highlights the impact of generational patterns on individual mental health (Bowen, 1978). Therapists can guide clients to explore their family histories and the ways these dynamics affect their current struggles. Addressing these hidden patterns is crucial for breaking cycles of pain that may persist for years.

4. Underneath Cultural Expectations

Cultural norms can significantly inhibit discussions about mental health. Many individuals feel pressured to conform to societal expectations, leading to the suppression of feelings. This is especially true in marginalized communities, where mental health issues are often stigmatized (Kuehner, 2017). Therapists must cultivate cultural competence and create safe spaces for clients to express their struggles. By acknowledging cultural contexts, therapists can help uncover issues that might otherwise remain hidden.

5. Within the Silence of Men’s Mental Health

Men often face societal pressures to adhere to traditional notions of masculinity, which can inhibit open discussions about mental health. Studies indicate that men are less likely to seek help for mental health issues due to stigma (Mahalik et al., 2003). Therapists should advocate for awareness that specifically addresses men’s mental health, fostering environments where men feel safe to express their emotions and seek support.

6. Among Members of the LGBTQIA+ Community

Members of the LGBTQIA+ community may face unique mental health challenges, particularly when questioning their identities. The fear of rejection and discrimination can exacerbate feelings of anxiety and depression (Budge et al., 2013). Therapists should create affirming spaces that encourage exploration and support for individuals navigating their identities, helping them process their experiences in a safe environment.

7. For Persons with Non-Visible Disabilities

Individuals with non-visible disabilities, such as chronic pain or neurodiversity, often face misunderstanding and stigma. This can lead to isolation and untreated mental health issues. Therapists should be vigilant in understanding the diverse experiences of these clients, ensuring their mental health needs are validated and addressed.

Conclusion

On this World Mental Health Day, therapists are invited to delve into these hidden places where mental health issues reside. By recognizing the signs and fostering open conversations, we can bring these problems into the light, helping clients navigate their mental health journeys with support and understanding. Our ultimate goal is to create a culture of openness and awareness, ensuring that mental health issues are acknowledged and addressed, no matter where they hide.

References:

• American Psychological Association. (2020). Stress in America: A national mental health crisis.
• Bowen, M. (1978). Family Therapy in Clinical Practice. 
• Budge, S. L., Adelson, J. L., & Howard, K. A. (2013). Anxiety and depression in transgender individuals: The roles of social support and social identity. Journal of Consulting and Clinical Psychology, 81(3), 545.
• UK Government Disability Unit. (2020, December 17). Living with non-visible disabilities.
• Kuehner C. Why is depression more common among women than among men? Lancet Psychiatry. 2017 Feb;4(2):146-158. doi: 10.1016/S2215-0366(16)30263-2. Epub 2016 Nov 15. PMID: 27856392.
• Mahalik, J. R., Burns, S. M., & Syzdek, M. (2007). Masculinity and perceived normative health behaviors as predictors of men's health behaviors. Social Science & Medicine, 64(11), 2201-2209.
• Vogel, D. L., Rose, J. P., Roberts, L. R., & Eckles, K. (2014). Social comparison, social media, and self-esteem. Psychology of Popular Media Culture, 3(4), 206–222.

back to September 2024 newsletter  
by Kusum Punjabi, AMFT

In honor of Hispanic Heritage Month, SCV-CAMFT Director of DEI Kusum Punjabi provides suggestions for ways clinicians can provide culturally sensitive support to Hispanic clients

Creating a therapeutic approach that is culturally sensitive and tailored to Hispanic clients involves understanding and integrating the unique cultural, familial, and societal factors that influence your client’s mental health. This approach recognizes the rich diversity within Hispanic communities - including Mexican, Puerto Rican, Cuban, and other Hispanic heritages - and seeks to honor and incorporate cultural values and traditions into the therapeutic process.

Understanding Cultural Context

Hispanic cultures often emphasize close family ties, respect for traditions, and a strong sense of community. For instance, the concept of "familismo," which prioritizes family needs over individual desires, is central to many Hispanic families. Recognizing this can help therapists understand how family dynamics influence a client’s mental health and therapy process (Zayas et al., 2011).

For example, a Mexican client may view family support as crucial to their well-being. Acknowledging and integrating family members into therapy sessions, when appropriate, can help address family-related stressors and strengthen the therapeutic alliance. This approach respects the client's values and leverages their support system to facilitate healing.

Addressing Acculturation Stress

Acculturation—the process of adapting to a new culture while maintaining one’s ethnic identity—can create significant stress. This might manifest as anxiety, depression, or identity confusion. A culturally sensitive therapist recognizes these challenges and provides support tailored to the client’s acculturation experience. For instance, a Cuban-American client struggling with the tension between traditional values and modern societal pressures might benefit from exploring these conflicts within therapy. Understanding how acculturation impacts mental health can allow therapists to offer more relevant interventions and support (Torres & Voell, 2013).

Navigating Cultural Stigma

Cultural stigma around mental health can be a significant barrier to seeking help. Many Hispanic clients might experience mental health issues as a source of shame or weakness due to cultural attitudes. Creating a non-judgmental and validating environment is crucial for overcoming this stigma. Therapists can help clients feel understood and supported by openly discussing cultural attitudes towards mental health and addressing any fears or concerns related to seeking therapy (Gonzalez et al., 2010).

For example, a Puerto Rican client who feels reluctant to discuss their mental health due to cultural stigma might benefit from a therapist who acknowledges these concerns and provides reassurance that seeking help is a strength, not a weakness.

Incorporating Cultural Practices and Traditions

Integrating cultural practices and traditions into therapy can enhance the therapeutic experience. Therapists might incorporate traditional rituals, celebrate cultural milestones, or use culturally relevant metaphors and stories. Dr. Pilar Hernandez, a psychologist specializing in Hispanic mental health, often uses cultural rituals to help clients feel more connected to their heritage while addressing their mental health needs (Hernandez, 2018).

For instance, including a discussion about cultural holidays or family traditions in therapy sessions can help clients feel seen and understood. Celebrating events like Día de los Muertos can provide opportunities to discuss grief, loss, and family connections in a culturally meaningful way.

Conclusion

A culturally sensitive therapeutic approach for Hispanic clients involves understanding and respecting their cultural values, addressing acculturation stress, overcoming cultural stigma, and incorporating cultural practices into therapy. By embracing these elements, therapists can create a supportive and effective therapeutic environment that honors clients' identities and enhances their mental health journey.

back to September 2024 newsletter  

References

National Alliance on Mental Illness (NAMI). (2020). Mental Health Disparities: Hispanic Americans. Retrieved from NAMI

Torres, L. R., & Voell, C. (2013). Acculturation and mental health among Hispanic immigrants. Journal of Clinical Psychology, 69(5), 513-524.

Zayas, L. H., Suarez, M., & Torres, L. (2011). Familismo and its effects on mental health among Hispanic individuals. Social Work, 56(4), 356-365.

Gonzalez, H. M., Tarraf, W., Whitfield, K. E., & Casado, B. L. (2010). The epidemiology of major depression and ethnicity in the United States. Hispanic Journal of Behavioral Sciences, 32(1), 17-43.

Hernandez, P. (2018). Culturally relevant interventions in Hispanic mental health. Journal of Hispanic Psychology, 24(2), 45-59.

back to August 2024 newsletter 
by Kusum Punjabi, AMFT

August 9th, the International Day of the World’s Indigenous Peoples, reminds us to honor the diverse cultures, traditions, and contributions of indigenous communities worldwide. With around 476 million Indigenous Peoples across 90 countries, it's crucial to be mindful of their varied cultural backgrounds and the historical challenges Indigenous Peoples have faced and continue to face.

In working with Indigenous clients, you’re encouraged to embrace practices that integrate their cultural heritage and unique experiences. Here are some practical interventions to consider:

Cultural Competence and Awareness:

• Cultural Training: Take part in cultural competence training specific to the Indigenous groups you work with. This might involve learning about traditional values, social norms, and historical contexts.
• Consultation with Cultural Experts: Collaborate with Indigenous cultural consultants or community leaders to gain a deeper understanding of specific cultural practices and beliefs.

Incorporate Traditional Practices:

• Traditional Healing Integration: If your client is open to it, work with Indigenous healers or shamans to integrate traditional healing practices, such as sweat lodges or herbal remedies, into your therapeutic process.
• Ceremonial Practices: Include meaningful rituals, like storytelling or cultural ceremonies, that resonate with the client’s beliefs to provide comfort and healing.

Create a Safe and Respectful Space:

• Cultural Symbols and Artifacts: Decorate your therapy space with culturally relevant symbols or artifacts that reflect Indigenous traditions and help clients feel at ease.
• Affirmation of Identity: Use affirming language and acknowledge the client’s cultural identity and experiences, showing respect and validation for their background.

Address Historical Trauma:

• Trauma-Informed Care: Apply trauma-informed approaches that recognize the impact of historical and ongoing trauma. Techniques such as narrative therapy can help clients articulate their experiences and process trauma in a supportive setting.
• Community Healing Circles: Facilitate or refer clients to community healing circles where they can share their experiences and receive collective support from their peers.

Empower Indigenous Voices:

• Client-Led Goals: Let clients set their own therapeutic goals and steer the direction of therapy based on their cultural values and personal experiences.
• Strength-Based Approaches: Focus on the strengths and resilience inherent in Indigenous cultures, encouraging clients to draw on these resources during their healing journey.

By incorporating these interventions, you can offer a more culturally sensitive and supportive therapeutic experience, fostering healing and empowerment within a framework that respects their unique heritage and enriches the therapy journey.

back to August 2024 newsletter 

back to July 2024 newsletter
by Kusum Punjabi, AMFT

National Disability Independence Day, celebrated annually on July 26th, marks the anniversary of the Americans with Disabilities Act (ADA) signed into law in 1990. This legislation ensures the rights of individuals with disabilities and also promotes accessibility, equality, and inclusion.

For therapists, this is a reminder of the importance of ensuring accessibility and inclusion in mental health care, so that individuals with disabilities can seek therapy without barriers. Therapists are invited to reflect on their practices, advocate for continued progress, and support clients in achieving their fullest potential.

1. Accessibility: Does your office have ramps, elevators, and accessible restrooms to provide physical accessibility to individuals with mobility impairments?

2. Communication Tools: Can you provide alternative communication methods such as sign language interpreters and speech-to-text services?

3. Training: Do you engage in ongoing training on disability awareness and inclusive practices to better understand the needs of clients with disabilities?

4. Materials and Resources: Do you offer therapy materials in various formats (e.g., large print, Braille, audio)?

5. Inclusive Policies: Do your practice policies explicitly support inclusivity and non-discrimination?

6. Client Feedback: Do you seek feedback from clients with disabilities to understand their needs and improve your services?

7. Empathy and Respect: Do you approach each client with empathy and respect? Some disabilities are not visible, and their absence mustn’t be assumed.

back to June 2024 newsletter

back to June 2024 newsletter
By Liliana Ramos, LMFT, President

Juneteenth is celebrated annually on June 19^th. It marks the emancipation of the last enslaved African Americans in the United States. On June 19, 1865, Union General Gordon Granger announced freedom in Galveston, Texas. This is significant because Texas was the furthest West slave state in the United States. Today, this day symbolizes the end of slavery and the ongoing struggle for civil rights. It honors African American culture, history, heritage, achievements, and resilience. It also emphasizes the significance of freedom, equality, and justice for all. 

Juneteenth was recognized as a federal holiday on June 19, 2021, which became a pivotal day in American history. Since then, Juneteenth has gained broader recognition and importance. It serves as a reminder of the resilience and contributions of African Americans and the ongoing struggle for freedom and justice. By celebrating Juneteenth, Americans honor the legacy of those who fought for freedom and continue to promote awareness and understanding of the enduring impact of slavery and systemic racism.     

Celebrating Juneteenth encourages reflection on past injustices and promotes ongoing efforts towards a more inclusive society with racial equality and justice. It symbolizes resilience and hope while reminding us that we still struggle with systemic racism and inequality. On this day, let us celebrate the contributions of African Americans to our country and remind ourselves to work together towards racial equality, justice, and inclusivity.

In the spirit of inclusivity, a quiz on Black pioneers in psychology created by Kusum Punjabi with contributions from Erika Jenkins with contributions from Kusum Punjabi is in this newsletter for your pleasure.

back to June 2024 newsletter
By Kusum Punjabi, AMFT, Director of DEI

Many individuals from the LGBTQIA+ community know the silence of hiding their true identities, fearing non-acceptance from society and loved ones. This fear can lead to profound trauma, with threats of excommunication, withdrawal of support, and physical harm looming. 

Historically, the behavioral health field has contributed to these traumas. Homosexuality and diverse gender expressions were once deemed moral failings or mental disorders, subjected to punitive measures and conversion therapies. These harmful practices have left deep psychological scars, fostering environments of fear and shame. 

However, the narrative is shifting. Modern understanding recognizes the capacity for diverse sexual and intimate expressions, acknowledging that many traits defy strict gender norms. This broader perspective opens new ways for therapists to support their clients. 

Therapists play a crucial role in helping LGBTQIA+ clients heal from the trauma of secrecy and fear. The therapeutic environment must be a sanctuary where clients feel safe to express their identities without fear of judgment. Establishing this safe space begins with therapists demonstrating unconditional positive regard, empathy, and a deep understanding of the unique challenges faced by LGBTQIA+ individuals. An honest exploration of the therapist's own non-normative sexual and gender preferences can also be beneficial. 

To repair the ruptures caused by past traumas, therapists can acknowledge and validate clients' experiences, helping them navigate the complexities of their identities and supporting them in building resilience. Therapy should address internalized negative beliefs from societal and familial rejection, fostering a positive self-concept. 

Beyond individual therapy, therapists can advocate for systemic change by promoting inclusivity within their practices and communities. This involves educating others about the historical and ongoing challenges faced by LGBTQIA+ individuals and supporting policies that protect and affirm LGBTQIA+ rights. 

Ultimately, LGBTQIA+ clients seek therapy environments where they can be authentically themselves. It is the therapist’s role to ensure their practice is a haven of safety, understanding, and respect, where clients can heal and thrive.

back to May newsletter
By Kusum Punjabi, LMFT, Director of DEI

The racial identifier ‘Asian’ huddles under one umbrella individuals from more than thirty different nations and ethnic groups. Each of these groups has its own customs, languages and cuisines that are distinct from one another.

Being Taiwanese or Pakistani or Bhutanese is a distinct way of being. This way of being is preserved in America within families, and in homes.

Most Asians consider their connection to their ancestral roots a source of pride and belonging, identifying more by ethnicity rather than by race.

In America, members of Asian communities often occupy dual identities- the acculturated ‘American’ one and the one from their culture of origin.

How children are parented within Asian families is often stereotyped in America. Customs such as close parental involvement or children’s obligation to parents is misunderstood when seen through a Eurocentric cultural lens.

Studies have shown that children brought up in homes where their values are in alignment with the values of their parents turn out fine.

It’s when one generation holds onto the traditional way, and the newer one feels pressured to assimilate, that problems begin to arise.

The river of assimilation runs powerfully and cannot be stopped. And yet this is an opportunity for therapists to support their clients of Asian origin by leaning in to understand the role that family plays in their lives, and by critically examining Eurocentric psychologies and frames, before applying them to these families.