De-Colonizing Mental Health: Clinician Perspectives on Kniffley Racial Trauma Therapy

Background and Purpose: Black, Indigenous, and people of color (BIPOC) often have high exposure to traumatic stress and race-based trauma, impacting their overall well-being. However, various barriers impede BIPOC accessing, trusting, and utilizing mental health services that could improve well-being. Additionally, clinicians often lack attention to race/culture in treatment, particularly among White clinicians, and often are not trained to address race-based trauma. Exploring the experiences of clinicians trained in Kniffley Racial Trauma Therapy (KRTT), this study aimed to: (1) Understand clinicians’ perceptions of competence with addressing race-based stress; and (2) Explore clinicians’ perceptions of growth, skill development, and translation to practice, given their particular racial identity.

Methods: A purposive sample (i.e., 15 clinicians) trained in KRTT participated in 1-hour long virtual focus groups to discuss their training experience and potential influence on practice. Participants identified as White (60%), Black (26%), Hispanic (7%), and Asian (7%). Also, participants identified as female (86%), male (7%), and non-binary (7%). Focus groups were separated into two groups, by participant race (i.e., BIPOC clinicians and White clinicians), were audio recorded, transcribed verbatim, and analyzed by two research team members using qualitative analytic software.

Findings: Most commonly reported themes were organized into four categories, which are reported below as main findings.

1. Clinical Confidence with Race-Based Stress: BIPOC clinicians described personal knowledge and experiences with race-based trauma, but a lack of knowledge about clinical tools for addressing race-based stress with clients. White clinicians described feeling relatively confident with the theoretical concept of race-based stress, but reported having little confidence in their ability to effectively address race or race-based stress in treatment.
2. Training Impact: Both BIPOC and White clinicians discussed not having clinical tools for addressing race and racial trauma, but described how the training validated the need to be direct with clients about race and also included important content, including a standardized framework, various scales, clinical tools, and information on how macro factors impact the work that they do with BIPOC clients.
3. Post-Training Considerations: Both BIPOC and White clinicians discussed the need for further cultural humility in their practice and BIPOC clinicians described the unique need for self-care as a BIPOC clinician treating BIPOC clients.
4. Suggestions for Training Improvement: Clinicians provided various recommendations for improving the training.

Conclusions and Implications: Findings illuminated the utility of KRTT and the need for further training for White clinicians, as well as self-care support for BIPOC clinicians. Through evaluation of the KRTT training protocol, clinicians identified ways in which the intervention can enhance their work to better meet the needs of BIPOC clients. Given our field’s social justice focus, research is vital in exploring ways to better treat the unique trauma experiences faced by BIPOC, as well as equipping clinicians in meeting the needs of this population.