Leaning into the uncomfortable feeling to make room for change

By Maddy Coe, Research Assistant in the Surrey Clinical Psychology Team

What’s the problem?

It’s not difficult to see where the idea of the stereotypical ‘white, middle-class female’ psychologist comes from. All you need to do is look at your cohort in an undergraduate psychology lecture theatre to see a fairly homogenous bunch staring back at you. It seems this trend continues on into the pool of qualified clinical psychologists; the most recent insights and analytics data published by the HCPC for July 2023 show 85% of current clinical psychologists on the HCPC register are white. This is markedly higher than the proportion of 77% white registrants within all other registered professions (HCPC, 2023). This is a pretty uncomfortable truth for those of us who fit this stereotype to admit. This discomfort is likely why, more often than not, it gets swept under the carpet with a new topic of conversation or a joke, doomed to become one of those topics that is avoided at all costs.

Although I always strive to advocate for my friends and peers with marginalised identities, I’m not so proud to admit I was also guilty of ‘carpet sweeping’ in the past when put in the hot seat myself. Recently, I was encouraged to lean into this uncomfortable feeling and unpick what those emotions were and where they came from. I was fortunate enough to attend the 2023 Annual BABCP Conference, where I went to a keynote by Professor Margo Ononaiye about ‘Equity, Diversity and Inclusion: Moving from tokenism to meaningful action’. During her talk, Professor Ononaiye spoke about the differences between tokenistic actions and actual meaningful change in relation to creating a diverse and inclusive psychological workforce. This included exploring whether psychologists from racially and ethnically minoritized (REM) backgrounds are being supported within the psychological professions, and whether white psychologists are truly able to offer meaningful supervision and support to those psychologists from REM backgrounds. This talk encouraged me to reflect on my own experiences as a middle-class white female in psychology and how this may differ for those from different backgrounds. This also made me question where my and other people’s tendency to sweep these uncomfortable issues under the carpet might come from. Upon reflection, I realised I had struggled to find the right career path for years and felt really quite lost and isolated because of this. However, during a placement year as an honorary assistant psychologist, I finally felt the ‘click’ of finding the right profession for me and I clung onto this newfound passion like a life raft. During my first experience of the psychological profession however, I quickly learnt about how homogenous the clinical psychology workforce is and, further, that I very much fit the stereotype. I suppose this felt like an uncomfortable truth; by pursuing clinical psychology I would only be adding to the problem. Perhaps the feelings of dissonance this truth causes manifests in the tendency to gloss over the issue or avoid it altogether in an act of self-defence.

So what?

It wasn’t until I listened to Professor Ononaiye’s talk that I realised how privileged I was to have had the opportunities and positive experiences that led me to have this ’click’ in the first place. I realised that the positive experiences which were so pivotal in my psychological career were so inaccessible for many. I was able to take an unpaid role, safe in the knowledge that I could live with my mum for another year (sorry mum), I could drive myself to the required locations in this community-based role, and I didn’t have any dependents relying on me which allowed me to fully embrace each opportunity I was given. Further, upon deciding psychology was the right path for me, my career aspirations felt so attainable because 85% of the people that were modelling the very job I wanted were just like me. Supervisors, trainees, colleagues within MDTs that I worked alongside were white, middle-class individuals; just like me. They were modelling the career I wanted to pursue, whilst supervising and providing me with opportunities that nurtured my aspirations to become a psychologist. I had meaningful support in place from day one, but today I wonder if I were from a REM background, would I have had such positive early experiences and the support that allowed me to see a space for myself within clinical psychology?

A close friend of mine from a REM background had a considerably different experience during that same year; he experienced racial abuse from his colleagues whilst working as a support worker during his placement year. This crucial first experience of clinical work almost deterred him from pursuing the psychological profession altogether. Fortunately, as we continued our studies together, he secured his first Assistant Psychologist post in a role that had supervision tailored for BAME candidates. This meant he was provided with a role-model and effective supervision that led him to not only apply for doctoral training but secure an interview on his first ever round of applications. A small snapshot into the importance of stepping away from tokenistic acts of ‘diversifying’, and instead carving out systems that inspire early career psychologists from diverse backgrounds, whilst ensuring they have the correct support throughout every step of their journeys.

Now what?

I’m acutely aware of my position as an aspiring psychologist who is yet to secure a place on training – I know there is so much that I don’t know yet. But I hope that this blog post may remind those in more senior and influential roles about the trickle-down effects of their actions. They say the higher you climb up the tree, the further you are from the ground… so here’s a message from the ground, if you will. I have seen first-hand how powerful these diversity and inclusion initiatives can be in levelling the playing field. Initiatives like the Diversity and Inclusion 2018-2022 Strategic Framework (HEE & NHS, 2018) offer a way up the career ladder to those who become unfairly stuck on the steps below due to their backgrounds, identities, and entrenched systemic inequalities. The need for these initiatives is evident; recent findings show there is a lack of diversity in leadership roles within the NHS, and further, that applicants from BAME backgrounds are less likely to receive an offer than their white counterparts for doctoral training in the UK (Muthy, 2022). Increasing representation is not just a box that needs to be ticked, it is being the change you want to see. With a more diverse workforce, there come more role models for the aspiring and early career psychologists of various backgrounds. With these role models comes supervision that is supportive, protective, and inspiring for those who find their passion in the psychological professions.

As for my next steps? I plan to channel another quote that inspired me during the 2023 Annual BABCP Conference, “Think globally, act locally” (Judy Hutchings, OBE). Professor Ononaiye spoke about the importance of educating ourselves and becoming allies to move towards a more diverse and inclusive profession. I will continue to access the resources available on the PPN website to educate myself and become an ally who advocates for those from REM backgrounds. The PPN Equality, Diversity, Inclusion Resource Bank developed by Professor Ononaiye and Tessa Thomas can be accessed here for anyone who wishes to join me. There is so much I don’t know, but I’m taking steps to learn more and be led by the people that need my allyship. I will also try to start these uncomfortable conversations and encourage fellow ‘carpet sweepers’ to lean into the uncomfortable feeling, with the aim of creating space for progression. Hopefully, then, those that aspire to be part of the profession can fulfil that aspiration with support and allyship from those who are more privileged.

Acknowledgements

I’d like to extend a warm thank you to my supervisor, Dr Neha Cattra, for creating a space for open conversations, and for encouraging me to actively engage with the topic. I’d also like to thank my manager, Dr Lucy Hale, for allowing me the opportunity to attend the conference to begin with! 

References

Equality, Diversity and Inclusion. (2023). Psychological Professions Network. https://ppn.nhs.uk/resources/equality-diversity-and-inclusion

HCPC. (2023, July 4). Diversity data: practitioner psychologists – July 2023. Health and Care Professions Council. https://www.hcpc-uk.org/resources/data/2023/diversity-data-practitioner-psychologists-2023/

HEE & NHS. (2018, June). Diversity and Inclusion Our Strategic Framework 2018-2022. Health Education England. https://www.hee.nhs.uk/sites/default/files/documents/Diversity%20and%20Inclusion%20-%20Our%20Strategic%20Framework.pdf

Hutchings, J. (2023, July 12). Working with parents to prevent and/or reduce violence against children. BABCP 51st Annual Conference, United Kingdom of Great Britain and Northern Ireland.

Muthy, Z. (2022). Does your ethnicity matter when selecting future Clinical Psychologists?: an experimental study [Doctoral Thesis]. Royal Holloway, University of London.

Ononaiye, M. (2023, July 12). Equity, Diversity and Inclusion: Moving from tokenism to meaningful action. BABCP 51st Annual Conference, United Kingdom of Great Britain and Northern Ireland.