In this edited volume, three leading experts in race, mental health, and contextual behavior science address the urgent problem of racial inequities and biases, whichoften prevent people of color from seeking mental health services--leading to poor outcomes if and when they do receive treatment. This critical and timely guide provides clinicians and educators with evidence-based recommendations for addressing inequities at multiple levels, as well as best practices for compassionately and effectively helping clients across a range of cultural groups and settings.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Challenging students to think critically about the complex web of social forces that leads to health disparities in the United States. The health care system in the United States has been called the best in the world. Yet wide disparities persist between social groups, and many Americans suffer from poorer health than people in other developed countries. In this revised edition of Health Disparities in the United States, Donald A. Barr provides extensive new data about the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term. This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"—from opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients. As both a physician and a sociologist, Barr is uniquely positioned to offer rigorous medical explanations alongside sociological analysis. An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.

Eliminating Race-Based Mental Health Disparities offers concrete guidelines and evidence-based best practices for addressing racial inequities and biases in clinical care. Perhaps there is no subject more challenging than the intricacies of race and racism in American culture. More and more, it has become clear that simply teaching facts about cultural differences between racial and ethnic groups is not adequate to achieve cultural competence in clinical care. One must also consider less “visible” constructs—including implicit bias, stereotypes, white privilege, intersectionality, and microaggressions—as potent drivers of behaviors and attitudes. In this edited volume, three leading experts in race, mental health, and contextual behavior science explore the urgent problem of racial inequities and biases, which often prevent people of color from seeking mental health services—leading to poor outcomes if and when they do receive treatment. In this much-needed resource, you’ll find evidence-based recommendations for addressing problems at multiple levels, and best practices for compassionately and effectively helping clients across a range of cultural groups and settings. As more and more people gain access to services that have historically been unavailable to them, guidelines for cultural competence in clinical care are needed. Eliminating Race-Based Mental Health Disparities offers a comprehensive road map to help you address racial health disparities and improve treatment outcomes in your practice.

Cowritten with the founders of functional analytic psychotherapy, Functional Analytic Psychotherapy Made Simple offers a practical, behavioral treatment approach focused on client interpersonal relationships and the therapeutic relationship. Functional analytic psychotherapy (FAP) is a research-based treatment for mental health disorders and has been shown to enhance the quality of interpersonal relationships. If you’re a therapist, how you relate to your clients can have a profound impact on treatment outcomes. This book integrates the latest research on the importance of the therapist-client relationship with the new science of social connection into a user-friendly, flexible clinical framework. In this book, you’ll find an introduction to the conceptual foundations and clinical practice of FAP, with an emphasis on practical clinical scenarios and personal reflection. You’ll learn the theoretical basis of FAP in contextual behavioral science and how to apply functional analysis—the core assessment method of behavior therapy—to the therapeutic relationship. You’ll learn to understand the therapeutic relationship and social connection in terms of the Awareness, Courage, and Love model. You’ll also learn how to balance authenticity and compassion with strategy and case conceptualization to make your therapeutic relationships more compassionate, flexible, and effective. And finally, you’ll discover how to apply principles to effectively cope with challenging moments in the therapeutic relationships—such as how to address ineffective behavior happening in the therapy interaction from the first moment of therapy, what to do when therapy does not seem to be progressing, and how to end therapy well. No matter your treatment background, this book will provide invaluable strategies for adopting functional analytic psychotherapy in your practice, enhancing relationships with your clients, and improving overall treatment outcomes.

Microaggressions have been identified as a common and troubling cause of low retention and poor psychotherapy outcomes for people of color. All therapists want and intend to be helpful to their clients, but many unknowingly committing microaggressions due to unconscious biases and misconceptions about people from ethnic and racial minority groups. Managing Microaggressions is intended for mental health clinicians who want to be more effective in their use of evidence-based practices with people of color. Many well-intentioned clinicians lack the necessary skills and knowledge to effectively engage those who are ethnoracially different. This book discusses the theoretical basis of the problem (microaggressions), the cognitive-behavioral mechanisms by which the problem is maintained, and how to remedy the problem using CBT principles, with a focus on the role of the therapist. Not only will readers learn how to avoid offending or harming their clients, they will also be better equipped to help clients navigate microaggressions they encounter in their daily lives. Managing Microaggressions will endow clinicians with a clear understanding of these behaviors and the errors that underpin them, leading to more successful therapy.

Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.