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[00:00:00] Dr. Sharp: Hey everyone. Welcome back to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m Dr. Jeremy Sharp, your host, a licensed psychologist, group practice owner, and private practice coach.

Today’s episode is a timely and serendipitous one. Dr. Linda McGhee and I recorded this episode, I think within a day or two of George Floyd’s murder, before the video was widely released and before the protests began. So we did not get into that area specifically, but this area of culturally responsive assessment is incredibly important. And like I said, a timely discussion given the events in our country over the last few weeks more acutely and certainly over the last, who knows how many [00:01:00] years, in a broader sense.

Linda and I really cover a lot of ground. And when I say Linda and I, I really mean Linda. She dives into a number of topics in this very nuanced area of assessment. And while we might just scratch the surface in a number of ways, it’s certainly impossible to do just one episode on culturally responsive assessment.

We do get into her experience with culturally responsive assessment and the ways that we can be more aware of how diverse clients present in our office, things we need to be mindful of, and ways that we might approach the assessment differently. I think you’ll get a lot out of this episode. Linda is a fantastic speaker and guest and shares a number of personal experiences that really bring this topic to life.

Let me tell you a [00:02:00] little bit about Linda. She’s a pretty incredible person. She got her Doctorate in Clinical Psychology at George Washington University. However, before she did that, she also got her law degree from George Washington University. She practiced law and served in a variety of administrative roles for a number of years. She is currently an Adjunct Professor at George Washington University and the Chicago School of Professional Psychology. She is a Board Member of the Maryland Psychological Association. She recently served as the Director of the Teaching and Learning Center at the Landon School in Bethesda, Maryland.

Her treatment specialties include anxiety, depression, adjustment disorders, stressors around academics. High school/college pressures are also something that she focuses quite a bit on. And in terms of assessment and testing, she specializes in the assessment of children, adolescents for [00:03:00] learning problems, emotional problems, executive functioning, and ADHD. She uses her background in law to provide educational advocacy for clients and families around IEPs and other educational pieces. She also has a related specialty in consulting with families on school selection, both local and boarding schools around the country.

Linda is also a public speaker. She has written on a variety of topics and is well published. And as you’ll hear during the episode, Linda is really moving in the direction of helping other clinicians become more competent in their skills and specifically with their cultural competence. If you have any desire to increase your skills in that area, I think she is a great person to get in touch with.

All right. Without further ado, here is [00:04:00] my conversation with Dr. Linda McGhee.

Hey everybody. Welcome back to The Testing Psychologist podcast. As you heard in the introduction, I have Dr. Linda McGhee here talking with me here all about culturally responsive assessment, a topic that I think is really important. We’re going to do our best to work through some of this here for you. Before I totally jump in, which is hard because I’m excited about this, let me say, welcome to the podcast, Linda.

Dr. McGhee: Thank you. Happy to be here.

Dr. Sharp: Well, I’m really happy to have you. I was glad that you reached out and it’s been cool even since then. We’ve connected doing the webinar for the Maryland Psychological Association. That went really good.

Dr. McGhee: Where [00:05:00] I chair the education committee. So, it’s been really great. It really gave our members a taste of what it’s like to go back. There are various ways that you can do it. And just from the notes that people have sent me, they found it to be very useful to just start to think through how you want to present yourself as a testing psychologist post. And, I guess, we’re not even post COVID, but at least we’re putting our feet back into the water a little bit.

Dr. Sharp: Yeah, exactly. I feel, with a lot of folks I talk with either coaching or just in the Facebook group, there’s just so much to wade through and it’s unknown. And I feel like so many people just need like, here are your options, you can do this, this or this. Pick one. If you don’t want to do anything, that’s fine too, but here’s what you could do and just lay it out very clearly.

Dr. McGhee: And I think this really people have responses to the options. I know that I did, and we can talk a little bit [00:06:00] more about that, and including some of the things that we’re talking about, which is the cultural and multicultural aspects of assessment, which bought up some alarm bells with me about going back to testing and which way that I would go back to testing. So, I’d be happy to talk about those.

Dr. Sharp: Yeah, I think that’s definitely part of this discussion. In every, well, not everything, most things that I have run into about this whole teletesting or going back in person, there’s always this subtext of, well, who’s that going to marginalize even further? Who has internet access? Who doesn’t? Who’s computer literate? Who’s not? 

Dr. McGhee: Which is at the center of my concerns. I even saw this pre-COVID when I was looking at Q-interactive. I started using Q-interactive. And just the sort of facility that some kids had with technology and others didn’t, everybody doesn’t have an iPad.

[00:07:00] Dr. Sharp: Right.

Dr. McGhee: That’s a presumption that we make. When you use Q-interactive, you presume that the kid is facile and uses that technology easily.

Dr. Sharp: Right. So have you found yourself having to… well, how do you work with that? If you run into kids who are less facile with the iPads, do you address it in the moment? Do you do some training? Do you make notes in the report? What do you do?

Dr. McGhee: Honestly, what I do is I do a significant screening beforehand. I have people fill out questionnaires. I chat with usually moms, not to be sexist, but it’s typically the moms. They’re bringing kids in and I make a decision prior to them getting there. I think that’s a much easier solution that makes them feel more comfortable and confident as to me, as opposed to me trying to train who’s [00:08:00] training into the… I just make a decision. If I think based on what I’ve heard so far that I need to just use the books, then I just use the books.

Dr. Sharp: That’s fair.

Dr. McGhee: I’m not anti-Q-interactive. I just feel like that for some kids it works and for some kids it doesn’t. And even beyond multicultural or kids from different cultures, I think for some kids, generally, it works better than with others. So, I just make a judgment.

Dr. Sharp: Absolutely. I think I was on the podcast with Jordan Wright maybe, it was one of those COVID teletesting podcasts I did. I was talking about how our kids transition to “homeschool.” That’s a loose term in our home, but we set them up with laptops and they didn’t know how to use a laptop. They’ve never used a laptop computer. They’re more [00:09:00] used to a tablet interface. So even something like that, it’s like, you just never know with kids.

Dr. McGhee: And my son who’s a rising senior at the University of Maryland, went to an iPad school. And so he was even used to writing his papers on phones. And I’m like, how the heck are you writing a three-page paper on a telephone, but I will look at his papers and they would be fine. They didn’t look like I would expect an iPhone paper to look, which would be a mess, to be honest with you, but they didn’t look like a mess at all.

Dr. Sharp: That’s impressive. The thought of writing a three-page paper on phone.

Dr. McGhee: He was trained on that though.

Dr. Sharp: Sure.

Dr. McGhee: I’m old enough there. I was a lawyer, so I actually hand-wrote all my briefs, 200-page briefs, if you can believe this and someone typed them in.

Dr. Sharp: I can believe it. I don’t want to believe it, but I can, because I’m old enough to remember those. Yeah.

Dr. McGhee: I [00:10:00] converted to writing them on a computer.

Dr. Sharp: Geez. I hear you. That’s wild. Well, let’s see. Before we get too deep into it, we’re just off to the races, which is great. I’d like to ask, why is this particular area important? Why is it important and why is it important to you?

Dr. McGhee: I think one of the things that I will say is that this is a little bit of a corrective emotional experience in terms of… I was somebody who came up without a lot and I keep those people close to my heart. And also, I’m the typical American. I love the underdog and I really seriously believe in the American dream. I’m a living proof of it. I’m one of 12 kids. I came out of the housing projects and was able to go to college.

And I see the door closing for so many people, even [00:11:00] since I was younger. People say, well, they’re going to college, but I see them shut out of the elite colleges. And the elite college is what catapulted me. I’m just going to be honest about that. Going to the University of Michigan helped me tremendously. To this day, it does. And we just have to be honest with ourselves that, you might be able to get an education, but it’s the quality of the education.

In addition to that, I work in Chevy Chase. So I still see a lot of kids who are minorities and they are still suffering, even though they’re in the upper-middle-class or they are in their lower upper class and their parents can afford tuition, there are still disparities. There are still expectations, stereotypes and biases. So this is a subject that I really work on with my whole heart. I’ve done it in assessment and therapy and it’s now speaking [00:12:00] and writing. We’re working on a book about racial anxieties in school environments. So, it’s near and dear to my heart. And like I said, I’m always in there. I use that legal background. And I’m in there fighting for those kids each and every day.

Dr. Sharp: Well, that seems clear. You’ve done it in so many ways across the course of your life. That was one of the things that I was really drawn to when we started the talk because you’re living this stuff in so many ways, personally, professionally, different professions. So, I hear you.

Dr. McGhee: Thank you. And Law is a good training ground for a psychologist. I’m just going to say that.

Dr. Sharp: My gosh. Now that could be a whole conversation in and of itself, right? That transition, Geez.

Dr. McGhee: Yeah, it’s real Combat Training.

Dr. Sharp: Gosh, that’s unbelievable. I [00:13:00] admire you and what you’ve done.

Dr. McGhee: Thank you.

Dr. Sharp: Yeah. So we’re here. We want to talk about assessment; culturally responsive assessment and what that might look like. I know you’ve done a lot of writing, speaking and educating on this topic and working.

So, I’m trying to think where to where to dive in. Maybe we could just start with a 10,000-foot view and a general discussion of like, in your experience, where are you seeing points within our assessment process that are, I guess, most susceptible to not being culturally responsive or just areas that pop up most commonly and things we’re missing or not doing?

Dr. McGhee: Let me count the ways.

Dr. Sharp: Yeah, sure.

Dr. McGhee: First off is just cultural fears. They are fears that are [00:14:00] grounded in reality. And they come from a couple of different spots. One is that the pain of feeling like your child might be stigmatized. So you have an African-American son and you’re already fighting perceptions about him. And you figure out that he might have ADHD or he has executive dysfunction or whatever, but you’re in this school where your kid is struggling to survive and do you even want to further stigmatize him by getting tested?

So oftentimes, it’s a little bit of a joke because I say, Jeremy, to people like I have half the people that are running toward testing trying to get every accommodation they could get, and then certain cultures are running away from testing and they don’t understand that the other half is like, you know, a lot of private schools that I work with up to a third of the kids for getting accommodations.

And there’s no magic around why some of them perform better is because they [00:15:00] have a time and a half and they get to take their ACT over three days where you only have to take a subject matter a day. So even with extra time, like if you have ADHD and you’re taking all of them on the same day, that’s a complete and total disadvantage because you can’t even focus that long.

So, parents getting over this stigma is one thing. Money is another. In Washington DC, the average testing needs to be now over $3500 a battery from private practitioners. Very few as, you know, insurance companies will pay for assessments. And the places that do them under insurance have six months or a year waiting lists, like Kennedy Krieger, which is at Johns Hopkins in Baltimore children’s hospital in DC.

There places that do it, but good luck getting it done. And also, during COVID, [00:16:00] the waiting lists are going to get even longer. I don’t know about you, but I’m now looking into the late fall and asking people, honestly, can they wait to 2021, which seems crazy, but this is where we are.

So you have calls, and then you have like the cycle ED element that I kind of touched on which is like, what does it entail? People don’t understand that testing is a big process. I test over three sessions, 2 to 3 hours each session. And I don’t do them three days in a row typically. So we’re talking like weeks and then it takes weeks to do the testing feedback and then the report and just psychoeducation around the process, including the costs.

And then there’s finally a fear around what the results are going to be used for. And there are some historical reasons why that’s the case. I work with some private schools and they’re [00:17:00] trying to get testing and the parents suspect, and there may be some validity to that, that the school isn’t maybe using it to help them, but they might be using it to “counsel them out.” So, there’s just a lack of trust in terms of the parents in the school.

Also, some of the cultural barriers have to do with the testers themselves. The understanding that when a kid comes in, a kid from another culture might be super sensitive to being judged and misunderstood, and so to not just burst into testing immediately. Let the kids settle in. I know a lot of testers and some of them are great.

I trained at GW, and I honestly say it’s one of the best training institutions out there for assessment. So [00:18:00] I was trained well, so were my peers, but it is just an understanding that you might be dealing with a kid who is used to being judged and found wanting. And so, to have some extra sensitivity there that maybe make sure the kid is at ease. Sometimes I’ll just say, we’ll be doing block design. Are you nervous? And the kid will say, “Yes, I am nervous.” And I’m like, okay, let’s put the block design aside for a second and just get to know them a little bit, ask them what they’re interested in.

It is those kinds of things that I don’t know if my colleagues fully understand the full value of. And it’s not like they’re insensitive, but it’s a lack of understanding that that kid is coming in there from a different point than the other non-minority [00:19:00] children.

And when I used to do WIPCs, I used to do WIPCs for admissions. I still do them, but not as much anymore, but I used to do them at Kingsbury which is a school in DC. And they used to provide this admissions testing for all the private schools. And I did hundreds of them while I was training. So that was the best training ground ever, WIPCs and WISC.

I learned at 4 and 5 years old that kids have the confidence or lack thereof. It starts so young. And that was the best training that I have ever taken, bar none, is that with those 4 and 5 -year-olds to see how some of them were coming to the room and they could just rule the world, but some of them came in, shoulders hunched, not feeling confident. And so, that’s the kind of sensitivity that with practitioners, we could [00:20:00] do more of.

And finally, the instruments themselves. Some of the phrases, some of the things that they test, even now, like postage, kids don’t know anything about postage, right? They don’t know anything about vacuum cleaners. There’s a lot that they don’t know about. And seeing themselves, for example, we used to use the… I trained on the TAT- Thematic Apperception Test. Now, I’m doing the Roberts a little bit more because the’re brands of the Roberts that you can get that have Hispanic kids and they have African-American kids and to have a mix.

So just be aware that you might get different results if you just pull out cards that just have white people on them as opposed to mixing it up a little bit. And then honestly, I find some instruments from doing hundreds and hundreds of them, work better than others. [00:21:00]And so, I just substitute in, if I see a kid reacting in a different way, and I’m like, well, I might add in this other tests that might be better if they’re feeling uncomfortable or whatever.

You saw this in the article that I wrote about this. Kids from various ethnicities, if I know that this piece of data is going to be used, it’s going to be particularly important in terms of diagnosis and what the school does, I make sure my corroboration is there. Do you know what I mean?

Dr. Sharp: Of Course.

Dr. McGhee: And so, I don’t base decisions and conclusions on one piece of data. I make sure if it’s a decision point item, that I’m fully cooperative and I’m aware of the norms like non-verbal testing IQs tend to be higher in African-American [00:22:00] kids. And so, sometimes I will use a few more of those just to sort of show the breadth of what the kid can do.

Who is verbally mediated? African-Americans score better on non verbally mediated. Now, I will say this is just a little bit of departure from your question. I do like the WISC-5 because it has more non-verbal measures. So it has three non-indices. And so, I actually think that is a little bit, and in the norm are more non-white children. So those two things combined make the WISC much a fairer instrument for African-American kids and Hispanic kids, in my view.

Dr. Sharp: I see. There’s so much to unpack from all those points that you just went over, but maybe let’s go in reverse order since we’re talking about tests already.[00:23:00] Are there other measures that you have found tend to be more appropriate or culturally sensitive, if that’s the right term?

Dr. McGhee: I’m wanting to just make a comment on two measures that we all use that are like the MACI, the Millon. I feel like the ways that nonwhite kids express themselves may be a little bit, especially when they’re comfortable in the testing environment, they may be pathologized more on those measures because they may be seemingly overdramatic. And so, it’s measuring, it’s pathology and it’s not teasing out like he feels comfortable with me, he’s going to tell me.

It says he’s going to assess this honestly, but if it’s pulling in a little bit of development, like [00:24:00] 13 and 14 year olds might express themselves a little bit more dramatically, and that might be the same across cultures, but it’s also pulling in the way that various cultures express themselves, and that may lead to more pathology.

And the way that our DSM is set up, it is designed to measure conduct and it is designed and measures oppositionality, but it’s not very good at trauma. And a lot of that oppositionality and conduct is because the kids are traumatized. And that’s not measured very well across the instrument. The propensity for African-American and Latino children to be victims or have trauma perpetrated on them or experience trauma or higher. And [00:25:00] a lot of that has to do with economics and the historical context by which African-Americans and Latinos exist in this country. But I find that they’re not good triggers of trauma. I’m like, yeah, he looks ADHD, but there’s trauma here.

Dr. Sharp: Yeah, that’s such a good point.

Dr. McGhee: Of course, he can’t pay attention. One quick thing I want to say is that I worked at this charter school. So I came through GW and I worked at this charter school that was so bad. It was raided by the police and shut down.

Dr. Sharp: That’s bad.

Dr. McGhee: And what I realized three days into counseling in there is that, number one, school is number 77 on their list because a lot of the kids had so many things going on. I’m going to give you an example of this.

[00:26:00] I used to take snacks with my kids to therapy. I had a little boy, so I would just pack up his Cheese Nips and his apple juice and apples and things, and then I would put in bags. And I would take them to my kids in treatment. So I was sending it across from my kid and he says to me, I said to him, “Why don’t you eat your snack?” And he said, “Well, I’m saving it for my sister’s dinner.” And then it hit me where I was, what I was dealing with.

Dr. Sharp: This kid has bigger things on his mind.

Dr. McGhee: He’s worried about feeding his sister. I’m trying to have a chat with him about his schoolwork and all these other things.

So it’s in that context that these kids are coming to our offices and we’re just opening up our books and start testing [00:27:00] and he might trigger the hyperactive-impulsive, oppositional rubrics, but he really needs therapy because he’s traumatized. And I’m not averse against always not giving him the diagnosis, but a lot of people trick ADHD that don’t primarily have a biological attention deficit or executive functioning deficit. Does that make sense to you?

Dr. Sharp: Oh gosh, absolutely. Yeah. I think that’s one of the greatest challenges for us maybe as a field or a discipline is just generally separating trauma from any number of other things. And then you throw on this layer of the cultural components.

Dr. McGhee: We’re learning too. Because historically speaking again, up until a few years ago, depression [00:28:00] was the number one diagnosed disorder. And I think all of us are good at treating depression because it’s easier than anxiety, number one, and much easier to treat, and it’s much was much more a part of our training- treating depression.

So then anxiety became the number one diagnosis. And then I think all of us are learning about how to treat anxiety. So then with the advent of these ACEs studies about adverse childhood experiences, where now every doctor asks you, do you have anxiety? Do you have depression? What I always joke about is like, yeah, but what are you doing about it? They just answer it, right?

Dr. Sharp: Yeah, right.

Dr. McGhee: You should accompany that with a referral because a lot of people just ask, but now we all understand what its like for a kid who might have 3 or 4 [00:29:00] ACEs coming into your office. And this is regardless of race, but it’s particularly acute in certain communities. But if you know that the mother was hooked on prescription medication and actually is on probation, might’ve served a couple of months in jail where the kid was separated from her, that makes a big difference in a way that I think we would see them than if you didn’t know that information.

So one of the things that I say when I write is that I have the people fill out a form, but I spent a lot of time than my business people tell me is advisable with the people on the phone myself, no one does it for me, just listening to whoever calls in and requests the testing. [00:30:00] I ask a few questions, but I take notes even whether they come to me or not. But if they come to me, I have those notes because they may not always come out on the form.

Another thing that is particularly acute in African-American communities is that people might not be diagnosed. I write about this a lot. You ask them their history, anybody been diagnosed with ADHD, learning disorder, or mental illness and they’re going to check no because no one was diagnosed.

No one was diagnosed in their family because there was no means by which they would be diagnosed. There was no access to mental health care. It was just like, your kid was lazy or whatever. But if you ask them, is anybody in your family have problems in school? Did anybody have any kind of adjustment-related difficulties? [00:31:00] And then they will tell you that, oh yeah, I have this cousin… I hear this a lot and it’s funny, but not really… I have this cousin that’s like rain man, or one of my brothers had to do 9th grade three times or I have this uncle that stayed in his room for 2 or 3 years. And so you have to be a little bit more of a detective as opposed to just filling out that form where they may check No and you just assume that they came from a fairly well-adjusted background.

Dr. Sharp: Right. That’s such a good point. It reminds me, Donna Henderson was talking about this in a way with girls and autism, how it’s a self-perpetuating [00:32:00] cycle where girls aren’t diagnosed, so they’re not included in the research. So then they don’t have that in their family history. And when you look for it, it’s just like this ball that rolls downhill. And it sounds like there are some parallels here where….

Dr. McGhee: Same with ADHD. Martha Dinkler writes a lot about it also as an addition to Donna, who’s done some good work with autism. I’ve been recently working with Marilyn Monteiro moderating some of her panels. And the way that she does it her interviewing, I have learned a lot from her and hope to continue to do so and apply because I was instinctively applying some other things that she had done in my own work with the executive dysfunction and anxiety.

And so, it’s really clarifying to me that someone’s developed these interviewing [00:33:00] methods, but you’re right. A lot of things are overlooked, especially when you’re switching it from girls to boys for a minute, because in the African-American community, the boys are the ones who are not diagnosed or misdiagnosed the most, where you might see someone not asking for help in the corner, not talking to the teacher or not wanting to talk to the teacher. And then the teacher was like, well, I’m not going to talk to them because they don’t want to talk to me, but they might be depressed and they might be anxious. And that behavior is often characterized as problematic behaviourally, as opposed to this boy is anxious.

And not only from the educational perspective, it’s also educating clinicians and parents around these issues because we [00:34:00] all are born. We all have biases. As clinicians, we know this, but we still fight against it and refuse to acknowledge it. As some of the literate people say, we want to go colorblind, which is a denial in effect for racial differences, and we don’t want to train ourselves. Everybody has biases. I have them. We all have this system of internal care classifications that we do. And just the admission of it and making yourself aware of it and accepting it for clinicians is a huge thing. But it also makes you a better clinician, because at least you can figure out ways to ask the questions.

[00:35:00] Sometimes, Jeremy, this stuff is sensitive and people don’t feel comfortable, but that might be the time you consult with another clinician that is comfortable. If you call me, I would be willing to help you. How do I ask about this? Well, why do you want to know that? And let’s talk about ways that you can have that conversation. There’s help out there, but I feel like we’re mirroring our clients in terms of culture sometimes. We don’t want to step into the breach or fear of saying or doing the wrong thing or that somebody might say that you have racial problems, but if you don’t though, it’s a denial.

So, I firmly urge people and I try to speak the way I’m speaking right now, which is in a compassionate, empathetic way to people. And I’m also a problem solver. So, those two things combined, it’s like, [00:36:00] if there’s an issue and you come to me, I don’t care if I’m off the clock, I’m going to respond to that call because I feel like if a clinician reaches out to me, then they really are concerned and they want to do better.

So I’m always urging people, if you don’t know, find a clinician who does. And now that you and other people are online, there are resources out there. I have a sensitive question, could you DM me about… I mean, on your Facebook page, people are more than happy to help.

Dr. Sharp: Yeah, that’s one of the benefits of a forum like that, I think. I do want to highlight that. You hit the nail on the head with the idea that a lot of people, a lot of clinicians are scared to really dive into this. I think there’s some fear thereof being criticized or even [00:37:00] ostracized or any number of responses that can really turn you off.

Dr. McGhee: And we’ll as a society, we’re here anyway. Forget about psychology for me. To use a non political term, we’re a right hot mess right now. So, it just mirrors, but how are we going to understand if we don’t ask?

The other day I was reading something, I think it was in one of your questions, and I was like, “What is that?” I just asked a person. I had no idea what that was. And we’re referring to some kind of drink, alcoholic drink or something, and it was called a snowball or something. I’m like, I don’t know. How would you know if you don’t ask?

And also, just do a lot of listening. A lot of times, you don’t have to provide a solution. A person just wants to really feel like they’re being [00:38:00] heard. And they will only tell you if they’re comfortable with you. And business-wise, I’m just going to say this out too, because we all are in business. The population in this country is going increasingly nonwhite. Okay?

Dr. Sharp: Absolutely.

Dr. McGhee: Many states of the country, it’s already over. Over 50% of 8-year olds now are nonwhite. So in terms of your market, being named as serving different populations, it’s going to be helpful business-wise, if for no other reason.

I’d love to think that we’re all trying to make this country better. We’re all trying to reach for understanding. And I fully support those ins, but economically, it’s going to be a must, especially as we go national. I do think, Jeremy, one day that we will be doing all of [00:39:00] this telehealth.

Dr. Sharp: Yes, you’re not alone.

Dr. McGhee: I absolutely think so. I have some opinions about the current situation, but that might exacerbate some of the things that we’ve been talking about, but I think we’re going to be doing all of these telehealth assessments and therapy across the entire country in the foreseeable future.

I’m very happy that the APA and the governing organizations are taking the opportunity to team together, first of all. And I think that we’re going to end up with national therapy in the very near future, which makes me extremely happy because I’ve been playing it by the book and referring my college kids to other people and no one else is doing that, to be honest with you. But to think about it from the business perspective, it’s just like, you have to be able to serve [00:40:00] populations of people that you are not necessarily 100% comfortable with, right?

Dr. Sharp: Yeah. That leads me to ask about and talk about how to do that. And that’s such a big topic, but just taking that leap, like you said, to start to recognize maybe biases that we may have and actually start to work on it. I think that’s the tough part.

Dr. McGhee: I think that you can start by acknowledging that it exists, and being aware of what’s going on around you because sometimes when I talk to people and I’ll say, like this morning I said something to someone about the shootings that have been going on by the police and these killings by the police. They were like, oh, oh, and I’m thinking like, “Wow. I just feel like their spheres are really narrow. Like if you didn’t know about that and you wouldn’t know that maybe I would have some feelings about [00:41:00] that, that’s one issue.

So it’s like taking off the willful blindness binders and actually paying attention to what’s going on around you, educating yourself about bias because a lot of people don’t feel like that’s a real issue- that bias is a real issue. Doing some readings. As clinicians, consulting, training, but consulting. I really do feel that consulting has two impacts. One is you get a direct answer to your question, but two, it gives you exposure.

I grew up in Southern Indiana. The county was 2% white. I’m used to traveling and cultures. I was a banking attorney and I traveled all over the country where there were no ethnic minorities. So a lot of y’all are practicing in those same kinds of places. And so, you would not have access to people from other cultures except for the one time they show up in your office. [00:42:00] So exposure to people like myself helps because you get to know somebody like that. It’s not a concept. It’s the mom of your kid’s friends. Being in a relationship with ethnic minorities, I feel like is essential.

So the consultation plays a dual role. And finding a good consultant, I openly understand and sympathize that it is not so easy. But being open to learning, not feeling like you have to be defensive if something happens. I feel like sometimes people feel like they have to defend it and explain it away. And I see that a lot. It’s like, well, what did the other person do to deserve that? And it’s like, just listening. If a person is [00:43:00] expressing themselves about how they feel about certain things and you don’t have to defend it. It’s not you personally doing it, but it’s a part of a system that people just need to be aware of.

And I know that a lot of those answers are not necessarily going to be satisfying to many other people that hear it, but it’s a process. It’s just like when you have any other thing in your life that you are mentally struggling with, it’s a process and you go two steps, walk forward and a half a step back.

Some of my parents’ attitudes about certain groups of people and certain sexualities, I had to go through a process trying to unlearn those things. And then the same thing with race, it’s just you have to acknowledge that you may not have been brought up by the most progressive people. I’m acknowledging that my parents necessarily weren’t in many areas. [00:44:00] But realizing that is a process. I just feel like it’s very difficult to do it in isolation.

Dr. Sharp: Yeah. You brought up the consultation piece a lot, which makes sense to me. Just for folks who might want concrete ideas on how to do that, how would you suggest that folks reach out or find individuals to consult with because that in itself is overwhelming?

Dr. McGhee: Right. On a local level, go to your association meetings. Don’t just take the CEUs in diversity just to take the CEUs in diversity. I’m being honest with you. I’ve done that just to get to CEU, but lately what I’ve been trying to do is trying to find something that I don’t know, and I haven’t been exposed to. [00:45:00] And that’s what I urge you all to do is go to those CEUs with an open mind and an open heart, and try to learn something. Talk to the people presenting. Get in a relationship with people that are trying to think more broadly about certain things.

If there are local clinicians that you are met and you’ve met at luncheons or whatever, I was telling you before, I’m starting a national consultation group surrounding testing. So, I’ll talk about how to get in contact with me later. But one of the things that I want to do and leave behind is a better place in assessment. That is so near and dear to my heart that I want to leave it a better place than the way I left it.

And my time in this area is growing short, as I told you before because I’m doing more speaking and writing. So I won’t be doing more test reports, but hopefully, in this area of consultation and doing [00:46:00] CEUs on culturally aware assessment, I can do my bit to make it better, but it’s on the clinician to reach out. And it’s better to do this proactively. That’s my thought.

Dr. Sharp: Do you have thoughts on the APA divisions that might relate to all of this? 

Dr. McGhee:  Yes, some of them are actually doing good work and I consult with some of their papers when I’m doing my own papers.Why are you laughing at some of them, Jeremy?

Dr. Sharp: It was more of the actually, yeah, that’s all we’re actually doing.

Dr. McGhee: They are doing some good work and I use some of their research in terms of my own papers and my own speeches. I actually urge people to look at those. And now, they’ve gotten out there really [00:47:00] aggressively in terms of racing COVID. So, that’s another area that I really urge the listeners to look into because they’ve done a fabulous job. So, there are things that they do that are useful. I particularly like the research.

APA is a big monster. It’s hard to figure out what your niche is, but lately, when I see the news clips that they send on some of the things that they’re doing with African-American youth and Hispanic youth and Native American youth, I read those things because I actually think that there’s such a dearth of research in those areas. The doctors that are working with them are doing some amazing things in that regard.Unfortunately, this year the convention is going to be, I guess, on Zoom, but [00:48:00] I think is a fabulous resource. It’s just hard to navigate. Do you find that, Jeremy, sometimes?

Dr. Sharp: Absolutely. It can be overwhelming. The conference is overwhelming. It’s hard to really find your place, I think, and hard to identify even an individual to reach out to if you wanted to do that. It’s really tough because the folks who are more prominent and visible or publicly reachable are in positions that take a lot of time and don’t necessarily have the ability to do consultation. 

Dr. McGhee: Yes. And it’s even hard to get them. When I find myself sitting next to them, I’m like […] because I’m just curious to know and I laugh because it’s like if you had me as a captive.

Dr. Sharp: Totally. Yeah, that’s right. Now, have you found any, you mentioned reading, so, I’m curious about any literature that you found, any books [00:49:00] that might point us in the right direction at least to start or check out.

Dr. McGhee: Yeah. When you do this, I’m going to get the correct titles, but How To Be An Antiracist is a good book. White Fragility is a good book. We’re on, in popping in this area, Jeremy, right now. It’s a lot. And so, what I will do after this is I will send you a book list and you can publicize it because there’s a lot of things going on out there. But I will say this, you just have to get started. Sometimes I tell people to listen to their kids because their kids will tell them, dad, you shouldn’t refer to this group of people as this, or you shouldn’t have said that. And dad, the preferred term is gay. So they will actually jack you up quicker than anybody right now.

And so you listen to your kids. When they tell [00:50:00] you, No, it’s probably you should think about how you can challenge yourselves. Sometimes I hear myself say something and I’m like, that wasn’t the fairest way I could have characterized that or the most compassionate way that I could have characterized that. And just to be aware of it.

But like I said, the consultation, the training, being open to your kids, being with certain kids and trying to understand other cultures, because I feel like that that is the way is that the kids think differently about race than we do. They don’t grow up within the historical context that we grew up in. And unfortunately, we’re having some setbacks, but they view things differently. And if we could just take things through their lens [00:51:00] and be in community because I think when you have friends or your kids have friends or in certain groups, it makes you look at them a whole different way.

When that cubicle person, that person next to you in the next office is in a group and you can talk to them about events in the news, I just think that that it helps, but it’s hard because still live in a pretty segregated society. Very few of us live in integrated neighborhoods. I bought in this particular neighborhood because it was integrated. But we still live in segregated neighborhoods, so it’s very difficult to be in contact because we’re siloed.

Dr. Sharp: Absolutely. And you were talking before we started to record about how there just aren’t that many African-American or minority [00:52:00] neuropsychologists or assessment psychologists. And so, even thinking about it from that side, how do we…

Dr. McGhee: When I had my 4 year old tested when he went to private school, I had this woman who now sits on the Maryland Psychological Board with me, Dr. Isabelle Blackwood-Ellis, assess him. And between us and another 2 people, we do a lot of the assessments. And I put Northwest in IOWA, Montgomery County towards DC area. And one of the things that I was saying to you earlier is that I particularly like executive dysfunction and emotional issues, and I do high stakes accommodations like LSAT, MCAT, that kind of really tricky accommodation work and SAT and ACT appeals which brings them in my legal background.

[00:53:00] They’re not that many of us that do a good job of that. And that goes race wide, but particularly in the African-American community, that’s a subspecialty of a subspecialty of a sub-specialty. So one of the things that I’ve made my peace with now is doing a consultation and training around testing so that I feel like that I’m helping the next generation, because when I go to meetings, I see older people. I see people past 45 or 50. And I’m like, well, who’s going to be the people that come after us. And are they going to be trained in the way that we were trained?

And so, it’s incumbent upon all of us to do that because we don’t want to leave it. We don’t want to be so good that people can’t find us and follow in our footsteps. We want to leave the profession with people that are trained, knowledgeable and can [00:54:00] pick up the torch. So that’s one of my aims now is to go from report writing to more of a consultative role. I’ll still take some cases that have to do with parents who can’t agree on schools and testing around that, obviously divorcing parents who can’t agree on school and some of the most difficult like MCAT or LSAT type things, but I will now be training practices who want to introduce testing, training in areas where you don’t have to necessarily be a Ph.D. or a PsyD in order to get in. And doing some cohorts where I do a supervision cohort. I take 6 or 7 people and take them through a year of instruments. So, that’s my plan for the future. We’ll see how that works out.

Dr. Sharp: I love that. [00:55:00] Just before I forget to ask, if people are interested in that, I would guess people will be interested in that, how do they find you and express that interest?

Dr. McGhee: My practice website is drmcgheeandassociates.com And my speaker website is https://www.lindamcghee.com/. And either one of those you can get through me. I’m on Facebook at Linda McGhee, Good mental health with this name on my mentor radio show. And I’m also on Instagram and Twitter. So you can find me. I’m also on LinkedIn. So under Linda McGhee.

Dr. Sharp: Yes, and I’ll link to all those in the show notes so that people can find you easily. That’s such a needed resource, I think that I would imagine you’ll have people lining up for that kind of experience. 

Dr. McGhee: Hopefully. […] [00:56:00] significant interest.

Dr. Sharp: Good. The theme or the thread that runs throughout our conversation, I think even going back to the beginning is trust, right? Diverse clients need to be able to trust the clinician that they might seek out or trust the system that this process is going to work for them. And then, on the flip side, finding someone you can consult with who you trust. And I think you’ve gone a long way toward building that trust even just on the podcast. Like you’re clearly a compassionate kind, straightforward, individual who is willing to provide support for other clinicians.

Dr. McGhee: It’s the trust and the compassion, as you just said, and the realization that various clientele are going to come to you with a whole bunch of historical context. And that’s what I do my most speaking on now and what I’m hopefully taking the [00:57:00] COVID period to write this book on. They’re going to come to you with what I’m calling seven anxieties. So, I’m detailing situations in schools, because most of us do like school-related testing, that bring up racial anxieties. Just for example, a placement into a higher level versus a lower level versus a higher-level math class. And discipline.

All of these things bring up the whole entire racial context of life in the United States for African-Americans. So when you have a parent in front of you that’s acting in a way you’re like, why are they acting defensively? And why are they… The understanding that they come from the historical context of how they got to your office. Even successful ones have had to battle some things that you may not have even thought of.

And so just the realization that they [00:58:00] come to you differently. So if you meet them there, that’s three-quarters of the battle. And not in a condescending way, but just in a real, what I call inquisitive. You’re exploring with them. So, you’re asking them, how did he come to be like that? What happened? You’re doing it in a compassionate way. And you might even ask, do you think race was involved in that decision, but it just flats out. If it’s going on in your head and you’re censoring yourself about what the ask the client, that in and of itself is an exploration, right?

Dr. Sharp: That’s so true. So I want to ask you, I’m just speaking for myself and I would guess maybe others are in a similar situation, we live in a very [00:59:00] white area, very, very white. And even Denver, our nearest children’s hospital, the psychologists and neuropsychologists are primarily white. For those of us in communities like that who would like to maybe try to work on building some of that trust and being able to serve some of these communities, are there ways that we might like copy on our website or outreach we could do? You see where I’m thinking. Ways to just…

Dr. McGhee: This is hard and it involves work. I’m not even going to lie to you.

Dr. Sharp: I didn’t think you would. I appreciate it.

Dr. McGhee: There are always ways because you know what, I’ve been all over this country. I’ve been in Denver. I’ve been in places where I have not seen black people in 10, 11, 12 days. I’ve been to Wyoming, Montana, [01:00:00] you name it. But there are some black people in there, some Latino people. The relationship that you establish with school counsellors, you could tell them that you’re interested in this, that you want to help. You might decide you’re going to…

I have a friend of mine who just decided to help kids college counsel. She takes two kids and she’s taking four kids successfully through college processes and she volunteers to take other kids. When she takes them, she asked me to refer and I refer from my practice to her. So there are always people out there that you can ask at the school, the school counselor, at local community groups, groups that you might be in, even national groups.

If we find ourselves in person again, one day, you can ask. I’m involved in this project, a group called the Steve Fund and the [01:01:00] Steve Fund helps support African-Americans in mental health in college because of the access and the stigmas and all the things that, that is a real issue. And that’s the number one or the really top reasons why kids don’t succeed in college is that they isolate until this too bad.

Another thing that I’m involved in, I’m just plugging all my people now, is The SonRise Project where we provide support to parents across the country who are dealing with African-American kids who are struggling. And we do call.

So there are ways that you can get involved and I will give them all to you, but local is where I feel like people have the most impact. If there is a school counsel that you know, and you want to take one free testing case a week, talk to the person who runs the IEP plans. Tell them because she’s going to get many people referred to [01:02:00] her that can’t afford testing. And the school won’t do it because they may be getting Bs but they have ADHD and everyone knows it. But the school may not test them. Volunteer to do testing or go in with a group of you all and rotate where you take in six cases a year and it rotates among you.

There are just always ways. And you can support mental health and even not support assessment because these are just crucial. There are schools that don’t have counselors. You can go in and volunteer a couple of hours a week. It doesn’t even have to be for mental health therapy. It can be in their reading program, which is what I used to do. I used to volunteer in the reading programs and you get to know the kids a lot. So there’s just ways.

I just encourage you, [01:03:00] if that’s in your heart, don’t let another year go by before you make a commitment. And at the point in time that we are in this country, we need people from all races to step up. This is an American problem. This is not an African-American problem, a Latino problem or a native American problem. This is an American problem that we have kids who don’t have certain things like therapy and assessments, and we have kids that have complete access to it. If I can use this call as a call to arms, so be it. I’m great with that.

Dr. Sharp: I’m right with you. I think that’s probably a good note to end on, a strong call to action for those of us who, like you said, have it in our hearts to do something different and pay attention to these dynamics. I like that.

Well, I really can’t say enough thanks for [01:04:00] coming on and talking through this and letting me ask some dumb questions and just stumble through it and then continue to learn.

Dr. McGhee: I appreciate you having me.

Dr. Sharp: Of course. All right, Linda, take care.

All right, everyone. Thank you so much for tuning in to this episode with Dr. Linda McGhee. I can say that the resource list for this episode will be extensive. Linda has been working hard to put together a variety of resources that will help you both in culturally responsive assessment, and in general anti-racism work that you may want to do, which both are incredibly important.

Like I said at the beginning, this is a timely episode, but also not the only episode around these topics and ideas that you can expect. A few months ago, I made a commitment to myself [01:05:00] to integrate more culturally responsive information into the podcasts. And I’ve been working on that in terms of procuring guests and restructuring the podcast a little bit to make sure to have some of that info.

So, this just happens to be a coincidence that Linda’s the first guest and we recorded and released here right around the time that we are currently in. So, I hope you will stay tuned and look for more of this information in the future with the podcast. That’s incredibly important.

Otherwise, I think that’s it. I hope everybody’s hanging in there. My gosh, this has been a hell of a spring and summer now. I know some of us are returning back to in-person testing. A lot of us are not, but there’s a great discussion going on in The [01:06:00] Testing Psychologist Community on Facebook. If you’re not a member yet, you can certainly request a membership.

And the last favor that I might ask is that you rate, and if you’re feeling generous, review the podcast, whenever you listen to podcasts. The more people that rate the podcast, hopefully, rate it well. If you’re tempted to leave anything less than a 5-star review, please reach out to me and let me know what you’d like to see improve. I’m certainly open to that feedback. But please rate/review the podcast and that will help spread the word. It will help increase exposure and allow more people to access this information, which I hope is helpful.

All right. Thanks to all of you who’ve been listening over the last few weeks, months, years. The audience continues to grow and that’s pretty amazing. Looking forward to upcoming episodes. So everyone, hang in there, take care, and we’ll [01:07:00] talk to you next time.

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