Evidence-Based Treatments for Racial Stress and Trauma: A Therapist Tool Kit

"Evidence-Based Treatments for Racial Stress and Trauma: A Therapist Tool Kit," by Marie Chesaniuk, PhD

According to Williams and colleagues (2022), 30% of People of Color (POC) may suffer from some degree of racial trauma. In this journal club, I provide a therapist took kit for evidence-based treatments and practices for racial stress and trauma, all of which were developed by POC. Here is a mini one stop shop for a vocabulary bank for essential terms related to this topic, assessment tools, and two levels of treatment options for clinicians.

30% of People of Color (POC) may suffer from some degree of racial trauma.

While this is not an exhaustive review of the racial stress and trauma literature, I put together a shortlist of evidence-based practices based on two literature reviews that each offered a treatment protocol based on available evidence (i.e., Williams et al., 2022; and Metzger et al., 2022.) I pulled together some essential background information, assessment recommendations, and two levels of evidence based practices (EBPs) therapists can incorporate into their practices to address racial stress and trauma.

What is essential background knowledge for implementing EBPs for racial stress and trauma?

This includes some basic vocabulary for discussing racial stress and trauma, statistics, and a brief orientation to resilience – or strengths-based – conceptualizations of coping and treatment.

What do you need to assess when addressing racial stress and trauma?

Williams and colleagues (2022) recommend several self-report measures of racial and ethnic stress and trauma to assess symptoms and severity. Additionally, the Cultural Formulation Interview, which is unique in a few ways. First, as an interview, it facilitates an exchange between the clinician and client and also uses the client’s narrative history of illness and social context. It also has an informant version to incorporate others in the client’s life. The main topic of the interview is cultural impact (according to the client and/or informant) on problems, coping, and help seeking. And finally, Williams and colleagues (2022) recommend a standard trauma history for a comprehensive trauma approach.

Evidence Based Practices for Racial Stress and Trauma

Evidence based practices to address racial stress and trauma are therapeutic strategies and skills that can be incorporated into a larger ongoing treatment. For example, if a racially stressful event occurs during an ongoing ACT for depression treatment, you could apply mindfulness and defusion techniques and tap into values that affirm client identity. These treatment skills and strategies have been shown to alleviate racial stress and can also be integrated into a larger ongoing intervention. Other therapeutic strategies and skills for addressing racial stress and trauma include psychoeducation on racism and colorism and how it impacts mental health, self-compassion, and accessing external social supports. See Williams and colleagues (2022) for full review of supported techniques.

Evidence Based Treatment Protocols for Racial Stress and Trauma

In this journal club, we reviewed Williams and colleagues (2022) Healing Racial Trauma Protocol and Metzger and colleagues’ (2022) Racial Socialization Integration in Trauma Focused-CBT via PRACTICE Stages. Both approaches are steeped in well-established cognitive behavioral approaches to trauma treatment, like Cognitive Processing Therapy and Prolonged Exposure. They differ in focus on primarily adults (Williams) versus adolescents (Metzger), but both offer ways to move through a full treatment of racial stress or trauma as the main presenting problem. See the toolkit or each publication for the full protocol.

Further Reading and Resources

I provided links to further reading related to this topic as well as to Dr. Monnica Williams’ personal webpage where she compiles information about ongoing research on this topic, books she has written, and links to many of the assessment measures referenced here so you can find them and use them in your own practice. I also linked to Dr. Isha Metzger’s personal webpage, which has unique resources for allyship, youth, and her Black and EMPOWERED Podcast. And finally, I linked to a review of anti-racist therapist training programs so therapists can learn more about how to spot effective trainings on this topic. Creating affirming and effective therapy practices is part of our lifelong learning.