This episode is brought to you by PAR. The Feifer Assessment of Writing examines why students may struggle with writing. The FAW and the FAW screening form are available on PARiConnect- PAR’s online assessment platform. Learn more at parinc.com\faw.
All right, y’all, welcome back. Glad to have you.
I’m also very glad to have Dr. Linda McGhee back to talk with me about Unconscious Bias in Assessment. You might recognize Linda from episode 123 where she talked with us about just general Multicultural Competence in Assessment. If you haven’t listened to that, I would [00:01:00] definitely recommend you go back and check it out. Linda talks during today’s episode about how this current episode is sort of a level 2 paired with level 1 of episode 123. So, if you haven’t checked that out, I would invite you to do so.
So, let me tell you just a little bit about Linda, and then we’ll get right into our discussion.
Linda is an incredibly accomplished woman. She got her doctorate in Clinical Psychology at George Washington University. But before doing that, she got her law degree from George Washington as well, after which she practiced law and served in various administrative roles for a number of years. She did her undergraduate at the University of Michigan. She’s currently on the clinical faculty for the Washington School of Psychiatry.
She is a former Adjunct Professor at George Washington University and the Chicago School of Professional Psychology where she taught [00:02:00] personality assessment. She’s currently a Board Member of the Maryland Psychological Association and served as the Director of the Teaching and Learning Center at the Landon School in Bethesda, Maryland. Before that, she was a psychologist for several years at that school as well.
She specializes in anxiety, depression, and adjustment-related issues. Stressors surrounding academic and high school/college pressures are part of the deal as well. And as far as assessment, she specializes in the assessment of kids and adolescents for learning problems, emotional problems, executive functioning, and ADHD. She also does some advocacy using her law degree to help families navigate the IEP process.
In addition to all these things that I’ve already mentioned, Linda also does a good bit of public speaking and writing on a variety of issues, including all of the above, as well [00:03:00] as diversity assessment and ethical concerns.
As you’ll hear during the conversation, Linda also offers multicultural competence training specifically around culturally competent assessment. And there’ll be links in the show notes if you’re interested in contacting her.
Before we jump to the conversation, I would like to invite any of you advanced practice owners out there to consider joining the Advanced Practice Mastermind group. We’ll be starting on January 7th at 9:00 AM mountain time. We have one spot left. And this is a group for practice owners who are ready to take their practices to the next level and really want the accountability of being in a group of peers who can hold your feet to the fire and help you reach those goals in your practice. You can learn more at thetestingpsychologists.com/advanced.
All right. Let’s jump to my conversation with Dr. Linda McGhee.[00:04:00] Dr. Sharp: Hey, Linda. Welcome back to the podcast.
Dr. McGhee: Thank you, Jeremy. Happy to be here.
Dr. Sharp: I’m happy to have you back. Thank you so much for reaching out and being willing to come back on after our first conversation.
Dr. McGhee: So, after we had our first conversation, and you put this note on the first conversation that we were at the beginning of the George Floyd. The George Floyd murder had taken place. The killing of George Floyd had taken place, and we were in the process of digesting it. And you and I both agreed that it would be a good time for me to come back and talk about some things that came out as a result of that.
Dr. Sharp: Yes, I totally agree. In so many ways, it feels like that was yesterday and a lifetime ago. There’s so much that has happened since [00:05:00] then.
Dr. McGhee: And it definitely seems like 12 years for me. But I’m happy to be back because one of the things that you and I were talking about earlier is that I was very passionate about us as psychologists bringing our whole selves to the practice and challenging ourselves to do better with regard to race.
And the by-product of me calling the arms my peers was me challenging myself to do more, to step out there more. The same thing I’m urging other people to do. To enter into some slight discomfort and to be a positive force for change. I feel like psychologists we’re at the forefront. The whole country is undergoing all of this mental instability. And even as testers, we can do our part because our [00:06:00] decisions impact a whole lot of people.
Dr. Sharp: Oh my gosh. Yeah, they sure do. Well, I have to say too, I’ve been watching you on social media and email and all those things, and it’s been super inspiring to see you really walking the walk. I know that you’ve been doing this work for a long time, but it seems like you’ve stepped it up over the last six months or so and
Dr. McGhee: I have.
Dr. Sharp: you’ve got a lot out there. And it’s just such good content. You’re really doing the work, which is amazing.
Dr. McGhee: I started off in this career already having another career. When I first got into it, people talked to me a lot, Jeremy. You and I have talked about marketing, but I’ve always felt like it’s important to have something. I now feel like I have some things that I want to say that I feel comfortable talking about not just some market myself. I have a harder time separating [00:07:00] myself from the brand.
Dr. Sharp: I would argue, that’s how you know you’re in the right place. It’s like the passion and the business intersect with what people want to hear. And I think all three of those things are happening right now for you, which is really cool to see.
Dr. McGhee: It is. I’m very fortunate.
So when we were talking, one of the things that I wanted to talk to you about is that in addition to the things that you’ve seen, one of the things that I’ve done is, I’ve done a lot of training and reading on trauma, but I’ve also taken a diversity inclusion program at Cornell.
And so the idea for the day sure came out of that, which is to talk about not… we talk about racism, but racism as a byproduct of the building block of it, which is unconscious, which you’re thinking in your unconscious about the personnel it’s across from you. The categorization system that we all use [00:08:00] because it makes our brains work easier, right? Because to categorize things makes our brain work easier. But sometimes we put a bias on people because we’ve been taught and conditioned to think about people in a certain way. And we all have it. So, that’s how we came to this topic today. I want to talk about racism, but I was also wanted to talk about how we get there.
Dr. Sharp: I love that. Yes. So maybe…
Dr. McGhee: Go ahead.
Dr. Sharp: Yeah, I was just going to say maybe if you’re ready to just dive into it, maybe you can do that.
Dr. McGhee: Okay. Our world view impacts our practice. And so, the unconscious bias exists in all humans not just psychologists, and that race is a central part of our functioning in this country. And it requires us to be intentional about addressing [00:09:00] it. It doesn’t go away even if you’re a good person. It requires that you have what I’m now calling intentionality to deal with it. And that our requirements and our profession to be ethically competent requires us to educate ourselves on race and cultural competency.
And so those are sort of like my five guiding principles. And then the last one I’m just tacking on is, but it’s not easy. And I’m acknowledging that. For everybody who’s out there listening, who’s trying, who definitely is uncomfortable with the situation that we find ourselves in as a country and as clinicians and that wants to do better, to break this down a little bit so that it’s easier to understand.
Dr. Sharp: Yeah, I think that’s going to be super helpful. I think a lot of us would obviously agree with [00:10:00] that idea that we have these unconscious biases that come up in our work, but then what happens after that is a little murkier. And so any guidance that you might have will be valuable
Dr. McGhee: So, let’s start with just what it is because we talk about these terms and sometimes we don’t know what they mean.
Dr. Sharp: Sure.
Dr. McGhee: So an unconscious bias which is sometimes called implicit bias is a snap judgment basically. It results from mental shortcuts, pre-existing knowledge. And they make us very efficient in interpreting incoming information, but it happens below our level of consciousness. It’s about what and who we see. And the judgments tell us who is likable, who is safe, who is valuable, who are [00:11:00] right, and who’s competent.
As clinicians, we have this duty to be culturally competent, whatever that means. And the APA, in one of the principles, requires us to respect the rights and dignities of all people. And so we have this sort of a competing notion of we already have these categorizations in our brain, but we have a duty to be culturally competent. And how do you marry those two things?
Dr. Sharp: Right. That’s the challenge.
Dr. McGhee: Yeah. So, let’s start just a little bit with just some basic theories on race. One is that, when you think about race, you think about the individual, you think about their group, and you think about their experiences. [00:12:00] That’s from Sue & Sue’s tripartite model on considerations of race. You think about the individual, you think about their cultural group, and you think about the experiences that they have across cultures.
As humans though, when we are challenged on our unconscious biases, we go through stages. It’s almost like grief. So first we deny that we have biases because we think of ourselves as good people. And then we defend the status quo. When it becomes indefensible, we minimize it. And then we finally come into a sense of acceptance, adaptation, and integration. We accept that we have biases, w`e try to adapt them so that we can meet our ideal of being a [00:13:00] good person, clone more closely, and then we integrate them. All of this takes mental practice, energy, and intentionality.
Those stages came from this theory called Bennett’s Developmental Model. And it has to do with intercultural subjectivity. How do you integrate the idea that your bias is interfering with you clinically? And how do you work yourself through that? It’s interesting.
Dr. Sharp: Absolutely. I would guess that there are a lot of us, this is how it goes according to this model, it’s hard to even acknowledge this is happening in the first place. And it’s easy to get stuck in those first couple of stages.
Dr. McGhee: And it just doesn’t have to do a race or culture or [00:14:00] citizenship status. It has to do with a lot of things. And it has to do with how we’re raised. Like I was raised in a conservative Midwest. And so, in my practice of psychology, there are other areas that I had to deal with because of the way that I was raised in a Pentecostal church around sexuality and all these things. So, we all have things that we work on, but race and culture are unique, particularly for African Americans and some native Americans, it particularly has to do with the history that’s embedded in all of us because of the history of our country.
So how it pertains to what are some examples of unconscious bias is that:
1) I’ll just toss out a few. They’ve done these studies after study and a lot of teachers and professionals that deal with children in school [00:15:00] settings have been known to be less likely to predict successful outcomes for black students. So their expectations are lower going in without anything else.
So think about this. If your child comes into the room and the teacher already has an expectation that they won’t be a high-performer, think about how that impacts the way that they teach you or the way that they assess you.
Another really broader one is similarity bias. We tend to enjoy working with people that are like us, that look like us, that come from our neighborhoods, and also tried and true.
And finally, one of the really general ones is [00:16:00] confirmation bias. So we have a theory in our mind and that forms our hypothesis and they can form my hypothesis around testing. And then we set out to prove that hypothesis, right?
Dr. Sharp: Absolutely. That happens so much. It’s an active fight to not let that happen.
Dr. McGhee: Sometimes you’re writing the report and the data… I spend a lot of time on my data. And it’s on my dining room table now, a home office. And I would have a different result. The data wouldn’t support my hypothesis. It takes me a couple of drafts before I’m like, “McGhee, you’re just wrong.” That is a beautiful hypothesis, erudite, and outstanding in nature, but ultimately incorrect. And so, we have to constantly be checking [00:17:00] ourselves in terms of race and culture on whether or not we’re confirming the bias that we haven’t confronted the underlying bias that we talked about.
Some that are more specific to race are just the idea that people prefer names that are closer to their own names. And in many instances, a lot of Anglo names are very different from a lot of African-American names or names that are from people from other countries. It just feels like that we’re more attracted to names that sound like our names. And that impacts your judgments and all kinds of things. So it’s just very, very interesting.
One of the things, just a quick aside, is that when I’m doing workshops at schools is to ask people to be careful and [00:18:00] make sure you pronounce the child’s name right. Because that’s just a sort of like you’re giving them agency, and you’re giving them personhood by saying and recognizing their name. And you can ask them how to say it, but please work on saying someone’s name right that’s in front of you for testing. It is one of my pet peeves.
Dr. Sharp: Sure, that’s a very simple way though that we might miss out`.
Dr. McGhee: A couple of other things that I have come up with just from my doing this for 12-15 years. One is that, from studies, we give black boys and black girls, we give them what I call adultification bias. Based on their age, they’re presumed to be more adults, less innocent than their white peers.
What happens is that that [00:19:00] sort of works out sometimes to be like less in need of protection, and less in need of nurturing if we’re making them more adult. And so for black girls, that intersects with the girl part of the black girl, and it leaves them particularly uncovered.
The historical construct of black boys is that we sort of view them as deficient, and not up to par, sometimes dangerous. And so the same thing holds true for black boys, is black girls are viewed as less innocent than their like-age white peers.
Also their size. They’re thought of to be older if they’re large. [00:20:00] And they’re thought to be more mature. I have a 6’5″ son, and he’s been like that for a while. And I worry about his interactions with the police because he was really young and really large. I feared that he would be thought of as an adult.
So a couple more things are that we do not understand trauma as testers in a way that I think that we should. And I am definitely including myself in this group because we think about conduct and we understand it to be pathological as opposed to symptomatic, which is why I’ve always not loved the ODD conduct disorder diagnosis.
Dr. Sharp: I’m right with you.
Dr. McGhee: Then children of color are often seen as what they do [00:21:00] not what has happened to them. This is a whole definition of trauma that we tend to definitely overlook. And there are some conspirators there that help us along the way. The teacher may not know, or she might not have asked why young men might appear to be angry or silent or just not speaking up.
A lot of times parents hide things. And honestly, they hide things from white people because they don’t trust the information is going to be used in their child’s best interests. And they fear being stigmatized. We’ll talk more about that later.
Another way that has to do with autism that I think unconscious bias comes up and some other diagnosis is the tendency not [00:22:00] to classify behaviors as autism in children of color. And this is as opposed to intellectual disability, which is which people are more likely to get than autism. So for some reason, even though the science is clear the incident rate is the same across races is that we as clinicians are missing that diagnosis with African-American children. They’re being diagnosed later. And so, the outcomes are challenged because of that. And even people, this goes across having resources.
Dr. Sharp: Hmm. Why do you think that is? And not to go down too much of a rabbit hole, but with this autism, in particular, what’s getting missed and kids of color or black kids in particular?
Dr. McGhee: I think the idea of a 4 and [00:23:00] 5-year-old being in class having behaviors that are outside of the norm or viewed as behavioral in children of color. And so they get directed down the route of conduct. You need to make him sit still. Why is he moving like that even though it might be clear that it’s repetitive, right? A clear sign.
Also, I think access to programs because every state has the Child Find, the really early services. And I think if you don’t have access to that, a lot of children on the spectrum are diagnosed that early, and it becomes very, very clear. And so, I think that a lot of people of color miss the opportunity, and then they’re already in school already. So, you’re already a couple of years behind, believe it or not, because your peer, [00:24:00] a child with autism might have been diagnosed at 3 years old and you were diagnosed this 6 years old. What I tell my clients is that we don’t have three years to wait. I think that’s the case.
Dr. Sharp: That’s so true.
Dr. McGhee: The last thing I want to talk about before we talk about addressing it is that these two notions I think that diagnosticians have is that they think that because we’re clinicians, we’re not subject to unconscious bias because we know better. We know about races. We know about race theory. We know about trauma. And so we used to feel like that we’re somehow exempt. And that is not true. Everyone has an unconscious bias. We’re all products of the society, how we grew up. And so, a lot of times when I talk to clinicians, they’re looking at me like, “I already know all of this.” But I’m like, “But you don’t see your own [00:25:00] blind spots. No one does.”
Dr. Sharp: That’s so true. Sure.
Dr. McGhee: And then I get this defensiveness around the test data. Well, the actual test data should be paramount. That’s the fairest system. Let the test data speak. And my thought is, we don’t do that for anyone. We do not. We interpret every child that comes in. And we should be interpreting everyone that should come in. So, my thought is, the test data is the test data. I tell people to report the data, but I tell people to contextualize the data. We do it for everyone. We should do it for everyone. And it should be used per what it is.
Now, me [00:26:00] personally, I have always done in before it these hard words. I’ve done sort of a strength-based approach where I try to like, because testing, whether it’s educational, executive function, or emotional, which are the three branches that I particularly specialized in and specialize in, I get a lot more data from everything other than the test data than I do from the test data, or at least as much.
So let’s think about what we actually mean instead of just spouting off of the intellectual point.
One is, how does the child come into the room? I did hundreds of WIPS and WISC for admissions testing for private schools. And I would see kids that already [00:27:00] had the confidence of the world. And I saw some kids come in with their shoulders slump. This is at 4 years old. This goes to show you how much these things are embedded when the children are little. When they come into the room, do they seem nervous? Are they shy? Do they feel judged? A lot of kids of color are already under the gun. They’re already being scrutinized.
So, you just sitting across from them and just beginning your testing without trying to get behind what’s going on with them is going to yield a result that may or may not encompass their strengths.
How do they act adversity when they start getting things wrong? Do they pull themselves together? Like all of these things, we use to assess, right?
And so, they have nothing to do with whether or not you can pull the right matrix reasoning, multiple-choice, or a pattern. It’s just like, but if you get [00:28:00] number 7 wrong, did you just fall off a cliff and not get any right, or do you like sticking it? Or are you gritty? Even if you getting them wrong, do you hang in there, and then you might get one of the hardest ones right? So then that tells Dr. Sharp a lot. That tells Dr. Sharp that something is in there. He got the hardest one right but he missed 1 through 8. That’s a whole different score than someone who got the same score but just went down to their discontinue point and just discontinued, right?
Dr. Sharp: Yes, absolutely.
Dr. McGhee: My point being is that we don’t just look at test data. We look at the entirety of the child. So why shouldn’t culture, what’s going on in the home, parenting, the whole nine yards come into play? [00:29:00] But again, how does it come into play? And all of these things are not easy at all. I’m fully admitting that.
Dr. Sharp: I appreciate you acknowledging that. Well, there’s a lot to say about that and this whole journey that we go down as clinicians to combat some of these biases, and just acknowledging that it is hard and it is a journey is important.
Dr. McGhee: When I taught kids assessment at George Washington in Chicago school, one of the things that we did was when we dissected the cases, we always talked about, okay, what’s the cultural component? And then it was just such an organic setting to be able to say, “Yes, you considered culture well, but you need to make that diagnosis though because the data supported.” Now we [00:30:00] need to talk about why this person got here, how this person got here, but you call this diagnosis. So I was able to help them to titrate culture in a way that we don’t really have out there in the field. And we don’t have the comfort level to have this conversation, right?
Dr. Sharp: That’s the thing, right. I think a lot of us probably know we should be doing better or different, but the comfort to have those conversations is not always present.
Dr. McGhee: And so then we need to talk about sitting in that discomfort because the way that I’ve gotten better about thinking about it, teaching about it, and getting feedback about it is by doing it. And it is not comfortable.
It’s not comfortable necessarily for me to talk about it. So I had to overcome internal thoughts myself too [00:31:00] in order to get out here, as you said earlier, to claim this platform for assessment. It involved its own psychological process. I think most of the people that are so enthusiastically on your site each and every day, which I love, by the way, Jeremy. I don’t have a lot of Facebook time, but yours is a go-to place, but I think most of the people on your site are growth mindset, people. They’re work in progress and they know that they are, right?
Dr. Sharp: I think so.
Dr. McGhee: When I was on your show before, I talked about this book by Dolly Chugh, The Person You Mean To Be where she talks about accepting yourself as goodish as opposed to good because it still gives you a ramp, right?
Dr. Sharp: Yes, I love that.
Dr. McGhee: And so you’re doing the [00:32:00] self-analysis, but then you’re also letting go of being a good person in exchange for a goodish person. And so, when you start to think about it and you accept that you have it, then the idea is like, okay, so what’s next?
Dr. Sharp: Yes. I like that.
So before we move on, I don’t want to forget this. I wanted to ask you, it sounds like a lot of this stuff tails with the stereotype threat kind of stuff that I talked to Josh Aronson about a couple of months ago, I think. How are those related? Are they distinct concepts? Are they the same? Can you talk through that at all?
Dr. McGhee: Yes. An unconscious bias is a categorization system that sometimes results in bias. The stereotype threat is the idea that [00:33:00] I fear so much that I’m going to meet the stereotype that I in effect undermine my own progress, and I almost regress to the stereotype because I fear it so much.
An example of that is what a lot of African-American kids do when they go to college. And I did this myself. I went to the University of Michigan in Ann Arbor. And when I was struggling, I isolated because I didn’t want anyone to know that I was struggling because of the shame of struggling. For other people in other cultures, it’s sorta like, well, I’ll go to office hours. And now that I’ve raised my own child in private schools mostly, and I treat the children that go to private schools, I now know that they’re trained from when they’re kindergarten to go and ask the teacher and to be the first [00:34:00] person in line for office hours.
And I don’t know about you, Jeremy, and I don’t know how things are out there as opposed to the East Coast, but I’ve driven many mornings for my child to get an extra study session. And so all of those things have been ingrained in him as opposed to a kid who doesn’t come up in that setting like myself, who went to public school and even the University of Michigan is a public school, but it’s kind of like pebble beach. It has a public golf course.
It’s not really a public school. Do you know what I mean? It’s an elite public school.
So I stayed in my room. So what happens is that you stay isolated from your teacher because you don’t want them to know. You get help later. You’re already more likely to be struggling financially. You’re more likely than not to feel like you’re not adequately prepared.
And I want to just give a shout out to the Steve Fund, which I work with a lot who are an [00:35:00] organization. I’m one of their mental health experts that works with mental health with kids of color in college. So this is where I’m getting the data from. And they have done all this research and all this compilation of research.
So I’m already always likely to feel all of these things, but I’m more likely to meet the stereotype because the anxiety about this stereotype combined with other sociological factors means that that threat that the student feels, it leaves them more likely to meet the stereotype, but they fear meeting the stereotype.
So, the stereotype threat is more in the eyes of the person who is the subject and the unconscious biases in the minds of everyone about other people. Does that make sense?
Dr. Sharp: Yeah, two sides of the same coin that seems like. And there’s some relationship there. Yeah, certainly.
I [00:36:00] did want to ask you as well, you said, which I think is so important is that a big part of this process is just being willing to sit in the discomfort that comes up. And so I’m curious for you, how do you do that? How do you handle that personally when you’re uncomfortable? How do you work through that, fight through that, persevere when you know it’s important?
Dr. McGhee: Like most nerdy people with three degrees, I try to learn my way out of it sometimes. I’ll try to read more and understand more about it. But ultimately as therapists, we know that you just sometimes have to sit with it and just be uncomfortable. The political and racial situation in this country right now is very uncomfortable for me. It’s uncomfortable for me to talk about. It is [00:37:00] uncomfortable for me to exist in. I am at a sort of a low level of anxiety about it. I worry about my child. And a lot of people, particularly people of color feel like that right now.
Sometimes the discomfort, you just have to sit with it and figure it out. Like Joy DeGruy who wrote Post Traumatic Slave Syndrome, she says that you have to think about using your privileges to make things better. So she is talking about like being in the discomfort, but then also ultimately figuring out how to take this discomfort and do something that’s positive out of it. But as you will know, running from it and denying it doesn’t always work.
So, in terms of [00:38:00] of unconscious bias, you have to learn what they are and that you have them and assess which biases are more likely to impact you. I talk to people about race a lot apart from unconscious bias. And I ask them about how race was talked about in their home. And so they either have this answer, right? The answer is typically like, “We didn’t talk about it.”
Let’s take a quick break to hear from our featured partner.
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All right, let’s get back to the podcast.
So, first, you learn where your unconscious biases are. That you have them and you acknowledge and accept that. And it doesn’t have any reflection on you as a person. And then you assess how it most likely impacts you. And again, we were talking about growing up, how is race discussed in your home? When did you have a concept of yourself as a racial being?
And so interesting. I just went to this training by Dr. Ken Hardy who’s an [00:40:00] expert in this field. And he says that most black children are aware and cognizant of racial themselves as black when they were 2 to 4 years old.
But when he asked as groups of white people, adults, a lot of them were not aware of themselves as white people, not aware of racial difference because wear themselves as white. And so there are adults. So they could sort of show you how race is sort of metabolized in this country. But his theory is that you go from race socialization, how we’re socialized on race and that leads eventually to race trauma.
But going back to the central point, so you assess what biases impact you. How did you talk about race? Were you comfortable talking about race? Was your mother or father or somebody who was staunchly [00:41:00] you treat people this way, you don’t treat people this way, good or bad, but how you’re used to dealing with it, and then you kind of figure out how it impacts your work.
Your reticence to bring something up may be a part of your conditioning system growing up. But it may not necessarily help you when a parent is clearly worried about stigma, but you won’t talk about it. This is one of the I’ll give peel back the curtains a little bit about when black people come into my office, they tell me, I want to own this. This is why I’m paying you X thousand dollars for this testing. I want to own this so I can look at it and decide whether they give it to the school, which is [00:42:00] not an approach that white parents often take. They are protective of data in different ways, but not like I don’t want the system to know anything because I am so mistrustful of a system.
And so if you as a clinician can not talk about that, then how are you best serving your client? So, you need to figure out how these biases and how you grew up, and how you’re conditioned to speak, how to talk about that in a way that best serves your clients. So like, we were joking earlier about people. I used to work at a school and other people would always come and tell me, I don’t think I’m serving the black kids. And I’m like, okay, so let’s work on it, but then you have to actually do the work.
And that again, I want to emphasize that this is not easy work. It involves a lot of nuances and subtleties [00:43:00] that are not all that obvious and that you have to get supervision training. Just in a side, you have to read. You might have to consult. And so you have to work on it. And that’s not easy to do because you have to make it a priority as we’re all living our 24/7 lives to take the time to learn. But as I have been saying, this period for me has been a real learning curve and a speaking curve because I have the ability to sit and actually pay attention to a CEU.
Dr. Sharp: Sure.
Dr. McGhee: The commute is now taken up with things that I actually want to be doing.
Dr. Sharp: That’s great. I always think it’s interesting that people, you know, we have this model where we are totally [00:44:00] okay setting aside 3 or 4 days in a row to go to a conference like APA or something like that. But it seems much harder somehow to set aside even an hour a week to do this continual learning and really keep on top of these issues as they arise. For me, that’s a much better model than doing a conference once a year for 36 hours.
Dr. McGhee: Right. So all the studies on unconscious bias show that just going to a training in and of itself doesn’t do much. You have to do plus. Unconscious bias training plus thinking, getting more training, getting more supervision. A lot of times it means spending time with the other and humanizing the other. So, we have to fight willful [00:45:00] blindness because this is a decision, right?
Because we as psychologists know better. You have to humanize the other. And that means you’re around them. And that too is a conscious decision. You avoid this thought of like, I just have good intention. So because my intentions are good, I can stop the inquiry there, right?
Even there are things that we’ve been conditioned as a society in how to treat ethnic minorities that prevent people from humanized others, right?
We have this savior complex that we’re going to go in and we’re going to save them. We type cares people. This is another word of saying we stereotype people. I’m talking a little bit more about that in a minute about testing. We’re overly [00:46:00] sympathetic, or we feel like that tolerance is enough.
Remember when tolerance was the catchphrase and now no one says tolerance anymore because to tolerate somebody is just not a high standard.
So, we talked a little bit about how psychologists feel like they’re sometimes impervious to unconscious bias. Another thing that I see as a major pitfall is that we don’t recognize that microaggressions can be out of our awareness also. These are like the day-to-day things that happen that are injurious to people typically who are oppressed. And they too can be very subtle to the person saying them, but it can be very dangerous.
I’m [00:47:00] going to give you an example. I get this a lot. People come to tell me about other psychologists. So, it was an African-American kid in my office. I said that I took Chinese and she acted so surprised. Or I said that I was number one in my class and she acted like that was so unusual and made several comments about it.
And so, that microaggression is reflecting the unconscious bias that African-American children can’t be academic thought leaders. And we’re not even aware of it.
The other one is, where are you from? That’s been made into memes and all kinds of things, right?
Dr. Sharp: Oh my Gosh, yes.
Dr. McGhee: But it persists, Jeremy. These are things that they’re not just examples. I hear them all the [00:48:00] time.
Dr. Sharp: I’m sorry to interrupt, but this is important. The where are you from question, I’m sure there are some people out there who are like, what is the big deal with that? Why is that a thing? Can you talk a little bit about why that’s a thing?
Dr. McGhee: Well, it’s another ring, right? It depends on how you ask the question, right?
Dr. Sharp: Sure.
Dr. McGhee: First of all, I try to give people to have things in writing because sometimes if you have a good background, good referral question from good referral sources already giving you a lot of information, then you don’t necessarily have to have that conversation. But if you’re going to ask the parent, if you’re going to ask the kid or the adult, you can say, not as a leadoff, this should come into a whole series of questions about a person’s background. Or I understand your [00:49:00] parents are from Bangladesh, how did you come? Did you come to this country as a child?
Where are you from has become a little bit of a cliche. Now in and of itself, that one I have some sympathy for you as opposed to mispronouncing someone’s name because you think it’s straightforward, where are you from? But it implies that you’re not from here. I’m sure you’ve seen the satire videos where the person says I’m from Sacramento because they’re actually literally from Sacramento. 2 or 3 generations might be from Ghana, but they’re from Sacramento. That’s just one that came to my head when I was preparing for this.
The last thing I want to talk about that’s kind of a pitfall and it’s [00:50:00] really hard for us to think about is this idea that even when we study culture, it’s a push/ pull, right? Because we get these courses and training on this culture acts like this, this culture acts like that, and they may be giving you some data as good, but sometimes it risks perpetuating stereotypes, right?
So I trust trained dynamically and it was sort of like, you look at the culture, but you treat the person in front of you. That was ingrained in me time and time again. You’ve got to treat the person in front of you. So the person in the stereotype might like this, this and this, but you might have me in front of you who grew up in Southern Indiana, who knows a lot about country music, who is interested in English period movies. [00:51:00] And so you treat me like I am in front of you telling you these things without surprise, right?
So the problem that I had with a lot of cultural courses on multicultural competence is that sometimes they may perpetuate the stereotype. I don’t like it when they say, well, Asian-American or African-Americans may not come back. They may have actually had the statistic that African-Americans may not show up for the third appointment. But when that’s the only thing that’s in your head, it’s sort of fights that idea of fighting unconscious bias. Do you get what I mean?
Dr. Sharp: Yes, well, the only thing I can come up with is like, it is hard to fight through that. Like it just reemphasizes that we have to continually be aware of this kind of thing. But I’m [00:52:00] curious if that’s what you’re getting at or if there’s more to add to that.
Dr. McGhee: So, it is sort of like the course in isolation doesn’t always give you data. It gives you data about the culture, but it doesn’t always integrate the study of cultures with the integration of the individual. Does that make sense now?
Dr. Sharp: Yeah, absolutely. When we get into that, I know this just keeps coming up, it’s this idea that we really have to be present and be conscious when we’re working with folks. It seems like that should be a no-brainer, but like you said, these unconscious biases are always running around.
Dr. McGhee: And we’re [00:53:00] uncomfortable around issues of race. When I was doing this training recently, which is why I think this actually works really well is when you have an outside person come in and help. I said to the people in this practice that I’ve taken through four segments of training is that the black people on your staff are not okay right now. And I went through what they’re going through. The practice owner came to me and she’s like, no one has ever said anything like that just straight up in my face to let her know that we are not okay right now.
And so when you’re talking to your psych associate, she’s expected to show up at work and do all the things. And she’s doing it, but she’s not okay. That’s information as helpful [00:54:00] for you to know. It’s also helpful for you to know that, you know, like I’ve just treated a kid who is a Mexican-American and he’s been taunted at school online. So it’s useful for you to be able to say, how are things going? This has been really interesting few months in America. Just sure it opens this conversation.
And then he pours out with the fact that he’s being taunted and called racial slurs at his school. I’ve heard from Jewish kids, the same thing. Vandalism at their synagogue. These things would be helpful for us to know in terms of what we conclude about a child in the assessment. That’s a part of us leading up to the assessment, which is what I guess now we should talk about it a little bit. It’s like, how do you [00:55:00] bring a multiple cultural family into assessment. How do you perform the assessment? How do you make the interpretation?
And so, I sent and I’ll do it again this time, the article that I wrote about Multiculturalism in Assessment, and a lot of this is in there, but a lot of this is stuff I’ve learned recently. Make sure the process is explained. You do this with everyone, but just make sure a lot of times, especially outside assessments are not well understood. Even the IEP processes for those of you who are testing in schools are not well understood. Make sure you talk about consent in the language of the other person, both the English language that the person understands, but if it’s English is their second language to make sure that the explanation is clear, right?
You want to also [00:56:00] make sure the referral question is clear. Why are you here? Do you understand why you’re here? I ask the kid that all the time, do you understand why you’re here? Again, this is the fine line. It’s like you don’t want to act like the person lacks knowledge, you might make them be sensitive. I always ask, do you understand? Before I pull out my bell curve, I ask, “Did you want to see a bell curve?” And they were like, “Yes, please.” Because no one has ever actually explained it to them, which is also a little bit alarming that they’ve been tested before and no one has actually explained to them how our test center around 100 and what this means, right?
So I explain all of that to the parents. [00:57:00] I try to get a good family history. And I have it on my SimplePractice’s form, but I’m aware of other cultures and social economics groups may have not been diagnosed. And even a lot of white groups, if you have people in your family, they may not have been diagnosed. So you want to dig deeper. Does anybody else have issues with focus in your family? Oh yeah, my dad does. Oh yeah. And they’ll say no. And then I’ll say anybody have any problems with school? And they’ll say, oh, uncle Jimmy did 9th grade three times. But nothing would have been diagnosed.
So then you want to be sure that you need testing to answer the referral question. Because a lot of times I get people, I try to… one of my, Jeremy, for lack of a [00:58:00] better word, superpowers is triage, okay?
Dr. Sharp: Yeah, that’s great.
Dr. McGhee: Okay. So a) That might need testing, but it doesn’t need testing now. If you have several thousand dollars, we need a therapist first. Because I help people triage resources where the need is and the money because we’re not cheap, Jeremy.
Dr. Sharp: This is true.
Dr. McGhee: I have a detailed conversation about who owns the testing before the testing starts.
Dr. Shap: That’s interesting.
Dr. McGhee: That comes up in a lot of situations because I’ve tested on behalf of schools, I’ve tested in public school, I’ve tested in charter schools, I’ve tested for Chi Chi private schools. And the question is who owns the testing? One private school that I tested for, [00:59:00] they used the testing in a way that was sometimes not positive. And so me as the clinician, I had to decide what to tell the people because if they’re using the testing as a means regularly to counsel people out of the school, what is your ethical obligation?
Dr. Sharp: That’s important for people to know that.
Dr. McGhee: So they’re paying for the testing, but they’re using it to make decisions. And the parents don’t have very little rights to control the testing. I mean, even those conversations are not comfortable at all. You know they’re paying the fee, so they’ll get a copy of the report. They’ll use the data to make recommendations to you about your future. And they may or may not be consistent with my recommendations. Point [01:00:00] blank. And that’s a hard conversation if the school is paying your fee.
Dr. Sharp: Yes.
Dr. McGhee: So you have to parse all of this stuff out, but a lot of times it comes out with regard to culture because of the economics of it.
I refer out if language is the issue. My Evansville, Indiana French does not get me to the point where I can test in French, so I don’t do it. But a lot of people use the English version and they make disclosures. But if that language is really not good or the English language capabilities are not good enough where I feel like they can take the vocab test and I’m going to get a real reading of G from the WISC, then I refer out. You’re nodding Jeremy, and they can see you, but this doesn’t always happen.[01:01:00] Dr. Sharp: It’s true. Yeah.
Dr. McGhee: Also what has come up recently is the electronics. Some kids may or may not be exposed to electronics. So if you’re testing on an iPad, I really feel that you should have a conversation about whether that kid is blowing an iPad. A lot of kids are, but a lot of kids aren’t. You want to select an interpreter. If you’re using an interpreter for some particular reason that you haven’t referred, you want to make sure they don’t have a dual relationship with the client. They’re not their sister because that will color the data.
Doing testing online has come up a lot in terms of cultural sensitivity. I’ve mentioned to you before that I wasn’t sold on the idea. So the testing that I am doing, I am doing [01:02:00] in-person because I am concerned about… and I’m making no judgment, so no angry emails to Jeremy. Okay, y’all? I’m making no judgments. This is a personal decision. I’m concerned about people saying they’re testing people in their homes. I’m concerned about the cultural differences. I’m concerned that a lot of the methods haven’t been tested on groups that are maybe of different ethnic origins. So I’m testing in person. But that’s also a consideration is to think through the cultural considerations before you test someone that’s from a different culture.
And finally, just like how you collect your data from the part before you do the testing, is that consider culture. So for example, you might have a highly intelligent kid who uses slang or English might be their second [01:03:00] language. Jeremy, you and I may not know what the heck they’re talking about, but that could be highly intelligent people. So be aware of the fact that we make judges about people because they may use non-standard English and not go behind that wall and see.
Again, talking to the family about stigma. And this is a very hard conversation, I think cross, culturally to have. And it’s one where I think sometimes can have that conversation easier. But you have to get comfortable with it because you have to say, you fear stigma. So where is the cost-benefit of diagnosing your child with a learning disorder now when they’re 6 years old and remedy in it as opposed to like this stigma issue?
I understand. But I always tell [01:04:00] them, there are reasons why black people are afraid of the educational system in this country. So I sympathize with them, but I push them toward treatment because these issues when you catch them at 6 years are different than when you catch them at 17 years.
And unfortunately, I get a lot of older children from ethnic groups. They’re past 15 years. And that just pains me to no end, because they’re out of runway. It’s harder to deal with those issues. And I think about how much pain that causes the child, that they’ve known that there’s an issue, that they have ADHD the whole time, and the fear of stigma prevents them from being diagnosed. So that’s one that I feel strongly that all clinicians to be able to talk about and figure out how to talk about it.
And finally, just one last thing is, people [01:05:00] from different cultures might express emotions differently. They may be more emotional in sessions. And that doesn’t necessarily mean that they got emotional regulation problems or that is pathologized. It’s just that certain cultures may express emotion more and certain cultures may express emotions less. We should consider culture when we’re making judgments about it. And it’s not always the clinical judgment. It’s just that the person could be… you know what I’m saying? Does that resonate?
Dr. Sharp: Yes, it really does. I’m just thinking about that. That one, in particular, is resonating for me. So just to pause on that and know that a lot of diagnoses that we make are sort of contingent on emotional regulation and how it’s expressed, right? [01:06:00] So, yeah, I’m just pausing. This all makes so much sense.
Dr. McGhee: And again, this is from 15 years of me thinking about this. This is about consultation because this is the time when Jeremy says, I had this case and he was kind of […] and then I realized it might’ve been defensive, but I want to see if I’m categorizing, let me tell you some facts. And then I say, well, okay, so it seems like that this might be feeding into this and this might actually be a cover for his anxiety. So you do want to talk about it in the emotional section.
Or it just could be like, this is how he talks about his voice in a conversation. So don’t overemphasize that in the report. I’m not suggesting you never mentioned it. You could say in the behavior observations seemed to be happiest when he was talking about this or [01:07:00] show more emotion, but it shouldn’t necessarily rise to the level of pathology. So does that make it a little bit easier to categorize it in your mind?
Again, all of these things that we’re talking about, Jeremy, in this session as opposed to the last session, this is multiculturalism advanced as opposed to want or won. But going back to some basics, in the testing environment, I like to take my time generally. You can probably tell by listening to me that I’m a thoughtful person in terms of testing. I like to get to know the person. I like to see if they’re stressed at the beginning and see if I can ask assuage that a little bit before we get started, because I want good data.
You want to think about your outline data. Don’t [01:08:00] overrank outline data. Either find some collaboration for it or talk about it, but don’t… I strongly see sometimes like there’s one dangling piece of information that the person puts their entire clinical judgment on. And I think that that’s done sometimes with the cultural groups more.
Dr. Sharp: Do you have examples of that? Anything that you can think of?
Dr. McGhee: I feel a lot with behaviors, more so than anything else. It’s just like if the person is talking a lot in class or talking over the teacher and that’s when one data point that seems to come out in the terms of a conduct disorder, or in terms of like, you know, it’s just not even appropriately [01:09:00] developmentally considered in terms of culture sometimes because your average middle school boy doesn’t have googobs of self regulation.
And so when you think about it with culture, sometimes I’ve seen it explained as developmental with some kids. And sometimes I see it explained as a conduct disorder or oppositionality, that’s more appropriate because I really see conduct disorders as oppositionality as opposed to developmental.
And again, these are subtleties. The point of what I’m trying to say is that if you’ve gone through and you have support for the oppositionality based on more than one data point, right? One teacher on a Connor’s called them ODD, but the other teacher, the parents and the tutor didn’t. [01:10:00] Then think about that point of data and think about, you know, what I didn’t mention before is, you also have to watch your reporters. Just see if they’re overly positive, overly negative. And sometimes the test doesn’t catch them. The negativity is supposed to be built in, but sometimes the test doesn’t catch them.
So sometimes with teachers, I either find that they’re flatline. They rate nothing as high or they rate a lot of things as high. And you need to compare that to other teachers, the parents, and other data points. A lot of times when I used to do younger kids, I talked to the teachers. I used to do classroom observation. And I used to get a lot of good information, not just about the kid, about the classroom, the [01:11:00] classroom management, and how the person felt about the kid picked up on the fact that they had made a lot of judgements or had just basically given up.
In this book that I had just read by Daryl Fujii on neuropsychological testing, he talks about choosing tests that have been validated in the native language and culture. A lot of people use Google scholar to look up the testing history if the person is from another country. Their English is fine, but they want to consider whether the test had been normed in their culture.
So, when you’re thinking about the post-test environment when you’re giving out feedback, with families that are really concerned [01:12:00] and in their fear stigmas dissection, I personally start off with my bottom line. Sometimes the bottom line is there are issues that have to be addressed. But the bottom line is that there’s nothing in here that is going to severely impact your child’s trajectory if you address these issues because they’re so anxious and upset. And that’s just, again, something that I have experienced is that they’re so hyped up and they come into the session and they start crying before I’ve even started. That’s how much stress is attached to their child being judged in this system that we’re dealing with, in this American system.
I’ll also try to speak to some strengths because a lot of times a child may not be that great in school. There may be a great artist. And I’ve had a lot of kids in my practice both on the treatment side and the therapy side who are now photographers, artists, musicians, [01:13:00] dancers, and that is what keeps them whole. Emotionally is their strength to get through the fact that there are BC students. But they have strengths. So I also like to talk about their strengths including their family strengths because a lot of times they have cohesive family units that are very invested in their success.
I also like to think about the awareness and utility of some of the recommendations. This is one of my favorite areas. I think that’s one of the areas that as a profession, I’ve read hundreds of testing reports, maybe thousands, and the recommendations are generally that weaker sections of the reports. And a couple of them [01:14:00] stand out. One is repeating the grade.
Dr. Sharp: Oh, gosh.
Dr. McGhee: You’re saying, “Oh gosh,” but it still appears in a lot of people’s reports. So, unless you’re doing something different in that year, consider not putting that in your reports.
Also key differences in school systems. We all presume sometimes that the people are in good school systems. And then you make a recommendation where there are no services. So, consider where your kid is. I’m in DC where I worked at a charter school that was raided and closed by the police. And I interned and still, we’re friends.
So I’ve been in the exact opposite ends of the educational spectrum in the [01:15:00] United States. And so there was a vast difference between those two places. And I think that we don’t consider that enough in our reports.
So finally, Jeremy, I want to kind of sum up and have some parting advice and then talk a little bit about what I’m doing is that we need to look at racial trauma, and we need to understand it developmentally, generationally, and historically. Understand that the things that we talked about here, understanding culture is nuanced. It’s not easy. And it takes a lot of experience to get to where you want to go. We want to see the individual but have some knowledge about their cultural backgrounds.
Progress is made outside of the comfort zone. And you [01:16:00] have got to put yourself out there to learn. Don’t fear, making a mistake or saying it wrong. Let those things keep you from speaking and acting on behalf of the best interests of the child. Work on skills. Like when I was trying to get of lead better at testing, I worked on every re every kid. I try to learn a new skill. I try to learn a new instrument. Just work on it a little bit at a time.
I want to just leave the people this advice. Learn to do good, seek justice, correct oppression. And that is from the book of Isaiah in the Bible.
Finally, what I’m doing is I started this multicultural assessment group on Facebook and we are trying to disseminate information that will help people to do more culturally competent assessments. We are having a [01:17:00] conference. Our first conference will be this spring, but you’ll be hearing more from us. And actually I was inspired to do this by Jeremy and some other people.
I’m also doing training on race with private practices. And then in 2021, I think I’m going to start offering them online just to individuals that want to attend. But I’m also going to be doing individual consultations with practices who want to do better in terms of multiculturalism, generally, either on the therapy side or the assessment side.
And finally, I’m going to continue my work in assessment by trying to develop more writings on this subject and in workbooks and some things that I’m going to come out within 2021.
Dr. Sharp: I love it. We’re ending with a bang here. I feel like the last five minutes is just a call to action in so many ways.
So I will list all those things [01:18:00] in the show notes, obviously. Just judging from the response to our first episode, I’m guessing people are pretty interested in this content, and I know that you got a big response when you open that multicultural assessment group on Facebook.
Dr. McGhee: So, I just want to give a quick shout out to Nisha Drummond and Selena Hurd who started the group with me. They’re amazing young psychologists. And so I am just looking forward to big things coming up with them.
Dr. Sharp: That’s so cool. We’ll have all those links so people can find you and find the group and any of these other resources that you’ve mentioned. I really can’t say enough. Thanks, Linda for coming on again for a round two and sort of taking this to the next level with this discussion.
I hope it’s not our last and I really wish you well in all these adventures that you’re going on.
Dr. McGhee: Thank you, Jeremy.
Dr. Sharp: All right, y’all, thank you so much for [01:19:00] tuning into this episode. I hope that you enjoyed this next-level conversation with Dr. Linda McGhee, all about unconscious bias.
Like I mentioned in the show notes and in the episode, I think this is a great pairing with the episode on stereotype threat with Dr. Josh Aronson from a couple of months ago, that’ll be linked in the show notes as well, along with any of the resources that Linda mentioned.
Like I mentioned at the beginning, if you’re an advanced practice owner who would like the accountability of a group and the comradery of peers who are largely in the same place to take your practice to the next level, I would love for you to consider the Advanced Practice Mastermind group. We will be starting on January 7th, which is a Thursday. And it’s a cohort model that will run for 10 meetings over the course of about five months.
So if you have had some goals for your practice but [01:20:00] haven’t quite been able to bring them to fruition, or if you’re feeling isolated, or if you just want some support as you grow your practice, this could be the right group for you. So, I invite you to check out the details at thetestingpsychologist.com/advanced and you can sign up there for a pre-group call with me to see if it’s a good fit.
Okay, y’all, have a great Thanksgiving and take care. We’ll talk to you next week.
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