Implicit Bias and Mental Health Professionals:

This book is about how Implicit Bias impacts therapists and others in their professional work. You will read about what is Implicit Bias, how it is formed, how it can compromise our professional work and the work of other professionals, and what we can do to mitigate these issues. Authors C. Curtis Holmes, Ph.D. and Courtney Lamb, LMSW share ideas and techniques that can make a big difference in how professionals handle these complicated issues while working with child abuse issues… The book is first aimed at helping mental health professionals (MHPs), with certain high probability issues about Implicit Bias, who decide to include the treatment of mental health disorders in children. Many other professional disciplines will come into play as well, and they can also benefit from many of these insights. How can this be the case? … Systems designed to intervene with child maltreatment are complicated and often difficult to manage. Yet, mental health professionals seeing child clients need to learn about these intervention systems and where these systems fit into a clinical practice. For example, the Federal Child Abuse Prevention and Treatment Act (CAPTA) includes that all 50 states have laws requiring mental health professionals (and numerous others) to report suspicions of child maltreatment to their state’s child protective service agencies. In Georgia, this agency is referred to as the Division of Family and Children Services, or “DFCS”. The branch of DFCS which investigates reports of child maltreatment is Child Protective Services, or “CPS”. However, other branches of DFCS may also become involved with intervention about child maltreatment, such as the branch referred to as “Foster Care”. Therefore, a child’s therapist will need to learn all about their local system of child welfare/social services, and possibly learn how to work collaboratively with numerous case managers. However, there are numerous other systems at play with child maltreatment cases besides the child welfare system, including law enforcement, prosecutors, and judges… There are big differences between being effective as a prosecutor of child abuse cases vs. being effective as a prosecutor of drug offenses, or traffic violations, or property crimes, etc. Many District Attorney offices end up with child abuse prosecutors specializing in their field with additional training and further legal research. It is likewise important that judges become familiar with the laws frequently pertaining to child abuse cases in their court rooms, and how Implicit Bias can unconsciously impact legal decisions about judicial decisions… Other professionals who might become involved in child abuse cases include health professionals such as pediatricians, OB/GYN doctors, and SANE nurses (Sexual Assault Nurse Examiners). Does a child therapist need to learn more about this field? Indeed, they do! … Another system of people who may be involved in child abuse cases include a Court Appointed Special Advocate (CASA), or a Guardian Ad Litem (GAL). These people represent either volunteer or professional legal advocates for the child in court… School personnel can also be a very valuable source of information since the child is in school almost as much as he/she is at home. Often the school counselor or the school social worker can be of great help. Some systems even provide the child’s therapist to come to the school to see them there in which less time is lost that would otherwise occur when a child is let out of school to travel to a therapist’s office and later back to school… There is also a need to have the involvement in child abuse claims of a professionally trained Forensic Interviewer. This is a person trained in how to ask children questions in the most beneficial and least leading manner possible to obtain the child’s best description of their experiences that led to an investigation of child maltreatment (or perhaps as a witness to another reported crime). Forensic Interviewers need specialized training and ongoing peer review to hone their skills and stay up to date on the best methods to use. In Georgia, free training is offered in a program called “Child First Georgia”. Child First, and some other national Forensic Interview models, represent well-accepted national models and fit what are considered “best practices” … Victim Advocates are also invaluable to manage the needs of the family in the stressful circumstances they find themselves confronting regarding allegations of child abuse... All, of these different types of professionals, and occasionally some others, become important for a mental health professional treating children to come to understand as well as the systems within which they all operate… However, the current best model of systems to address child abuse cases to date are the ever-evolving Child Advocacy Centers (CACs). A CAC typically offers a child-friendly location, Forensic Interviews, (sometimes) SANE exams, (sometimes) Victim Advocates for the family, case tracking, (sometimes) mental health services to child victims, coordination of investigations, and coordination of other services… This book will explain all about these systems in a manner that is useful to not only mental health professionals of children, but also helpful to staff at CACs, and helpful to other professionals participating in Multidisciplinary Team (MDT) activities related to child maltreatment cases… All persons have at least some Implicit Biases. These biases can spring forth from our own experiences growing up, or from our general culture, or from the peer groups we associate with, or even from our own families. Even the lack of any experience with a cultural/ethnic group can result in Implicit Bias about a member of that group. It is virtually impossible to avoid all possible Implicit Biases, but we need to become more aware of them and seek to mitigate them to the best of our abilities. Is there any data suggesting that Implicit Biases are already affecting mental health professionals, CAC staff, and MDT members? Unfortunately, the answers are Yes, Yes and Yes! So, our work is cut out for us to do all we can about these issues.