By Yara Mekawi, M.A., and Joya Hampton, PhD
Note: This article is featured in our Clinical Science newsletter: Fall 2019
A California-native, Dr. Natalie Watson-Singleton’s journey in academia started at the University of Dallas for her undergraduate degree in psychology, then to the University of Illinois at Urbana-Champaign for her doctorate in clinical-community psychology, and then back south to Atlanta, where she is currently an assistant professor at Spelman College. Dr. Watson-Singleton’s expertise centers on Black women’s mental health, a passion she has been pursuing ever since she learned about and was “hooked” on the concept of intersectionality in college. You can find her work in outlets such as Cultural Diversity and Ethnic Minority Psychology, the Journal of Counseling Psychology, and the Journal of Black Psychology. Right now, she is focused on implementing a study funded by the National Institute on Minority Health and Health Disparities entitled, “Culturally Responsive Stress Reduction: A Mobile Mindfulness Application to Support Health Promotion for African Americans.” When she isn’t busy piloting culturally-responsive mobile health apps for African Americans, mentoring students, or teaching, she enjoys practicing restorative yoga, getting soothing massages, and eating good food with good friends. We are so excited to have had the opportunity to sit down with Dr. Watson-Singleton and talk to her about her research and approach to diversity across scientific, clinical and pedagogical contexts.
1. What is your definition of intersectionality (or diversity)?
Intersectionality recognizes that intersecting identities (e.g., race, gender), along with intersecting forms of oppression (e.g., racism, sexism), contribute to different experiences and health trajectories for individuals. Also, consistent with the initial theorizing of intersectionality by Black feminist theorists, such as the Combahee River Collective, it’s important to me to highlight how intersectionality’s original aim was to examine multiple marginalized identities specifically rather than multiple identities generally. Although this application of intersectionality has been debated, I think it is imperative to focus on multiple marginalized identities because I have seen research employ the “buzzword” of intersectionality while conducting research with the most privileged members of marginalized groups (e.g., white women) when this approach is what Black feminists were trying to problematize and challenge.
2. From your perspective, how is intersectionality (or diversity) relevant to the field of clinical science?
First, clinical science aims to expand scientific knowledge in the field of clinical psychology in order to reduce the pervasive and persistent burden of mental illness. Yet, in our discipline, there is limited scientific knowledge and research on the experiences of marginalized groups who are affected by intersecting “–isms” (e.g., racism, sexism), like African American women, poor women, and sexual minority people of color. Therefore, intersectionality becomes a clarion call to remind us of the gaps and blind spots in our scientific knowledge base; blind spots that can cause us to overlook and to not address the disproportionate rates of mental illness and barriers to treatment for diverse groups. Second, clinical science values delivering empirically-based services, and when this value is combined with intersectionality’s key questions of, “Who is included?” and “Who is not included?”, we are encouraged to examine for whom our services were designed to serve and for whom are services treat best. For example, research indicates that African American women experience more health benefits when they are treated with culturally-tailored interventions. Yet, despite this information, African American women are not routinely offered culturally-responsive behavioral health care. Also, African Americans are less likely to receive evidence-based medication therapy or psychotherapy. Therefore, when the field does not prioritize making treatment decisions or using treatments that are scientifically grounded, underrepresented communities suffer the most. Third, intersectionality provides a useful heuristic for understanding how individuals’ identities and lived experiences are negotiated via direct contact with sociocultural factors, like institutional practices, politics and practices, and societal values. This focus ensures that we, as clinical scientists, encompass multi-level variables within our understanding and treatment of mental health for marginalized populations.
3. From your research, what are some major themes or lessons learned about African American women’s mental health and help-seeking behavior?
#Blackwomenscholarshipmatters - As an African American woman doing research on African American women, I sometimes felt I had to go above and beyond to justify the importance of my work. There have also been times when there seemed to be an implicit devaluing of topics related to women of color, especially if this work was being conducted by women of color. Despite not always feeling welcomed within the academy, whenever I would discuss my research about strength and its impact on African American women’s health, I would watch as my friends’ and family members’ eyes would widen with excitement. They were moved to know that someone cared enough to do research on a topic that was relevant and meaningful to them. These experiences validate and affirm the importance of my work, and they further motivate me to conduct psychological research that reflects the importance of context and culture.
Culture matters – like, it really matters. Given my research and clinical interests, I spend a lot of time talking to African Americans about how to create and develop culturally-responsive behavioral health interventions. I truly enjoy this work, and one of the things that has continued to surface is the importance of culture. Culture – the socially shared values, norms and beliefs reflected in our everyday practices, institutions and artifacts – imbue our perceptions, behaviors, and attitudes regarding mental health. For most of the people I talked to, it was important to see their cultural values and practices reflected in behavioral health interventions and provided by people who understood their cultural background. Therefore, for many of the African American clients and research participants I have spoken to, there is a desire to engage in interventions developed “for us by us.” I have learned that if we – clinicians and researchers alike – truly and meaningfully attend to culture in its complexity, we can create interventions that promote comfort, validation, and a sense of belonging among diverse communities, including African American women.
Culture matters, but it’s not the only thing that matters. Because of my research and clinical interests, I not only talk to African Americans about how to develop culturally-responsive behavioral health interventions, but also I provide consultation on how to tailor interventions to meet the needs of diverse groups. One of the challenges of this work has been to emphasize the importance of culture and culturally-relevant factors while also protecting against the tendency to overly rely on cultural stereotypes. Therefore, I am continuing to learn about the importance of helping people to understand the salience of cultural values while also attending to meaningful within group differences.
4. How do you utilize research about African American women in a clinical context, in terms of assessment and case conceptualization?
In my research, I am repeatedly reminded of the clinical relevance and impact of the Strong Black Womanhood Schema – a multidimensional dispositional style that reflects women’s distinct intersectional race-gendered experiences – in African American women’s lives. Many women adhere to this schema’s expectations, like suppressing emotions, taking on multiple roles and responsibilities, forgoing emotional support from others, and prioritizing others’ needs over their own. I am especially attuned to how this unique socialization for African American women gives way to prescribed attributes and behaviors that foster inner strength and self-efficacy as well as may influence emotion regulation difficulties. For example, this schema’s expectation to suppress emotions to avoid appearing ‘weak’ can lead to chronic emotional inhibition, nonacceptance of emotions, and limited emotional awareness. These emotion regulation processes may lead to unhelpful coping strategies and harmful health outcomes in the context of individual stressors, like trauma and gendered race-related discrimination. Therefore, as a multiculturally-oriented clinical scientist, I approach assessment and case conceptualization by attending to prominent, empirically-validated theories of psychopathology (e.g., models of emotional regulation) as well as individual-level (e.g., trauma history) and sociocultural-level factors (e.g., gender socialization) that influence presenting concerns and barriers to effective action.In my research, I am repeatedly reminded of the clinical relevance and impact of the Strong Black Womanhood Schema – a multidimensional dispositional style that reflects women’s distinct intersectional race-gendered experiences – in African American women’s lives. Many women adhere to this schema’s expectations, like suppressing emotions, taking on multiple roles and responsibilities, forgoing emotional support from others, and prioritizing others’ needs over their own. I am especially attuned to how this unique socialization for African American women gives way to prescribed attributes and behaviors that foster inner strength and self-efficacy as well as may influence emotion regulation difficulties. For example, this schema’s expectation to suppress emotions to avoid appearing ‘weak’ can lead to chronic emotional inhibition, nonacceptance of emotions, and limited emotional awareness. These emotion regulation processes may lead to unhelpful coping strategies and harmful health outcomes in the context of individual stressors, like trauma and gendered race-related discrimination. Therefore, as a multiculturally-oriented clinical scientist, I approach assessment and case conceptualization by attending to prominent, empirically-validated theories of psychopathology (e.g., models of emotional regulation) as well as individual-level (e.g., trauma history) and sociocultural-level factors (e.g., gender socialization) that influence presenting concerns and barriers to effective action.
5. What unique barriers or stressors might graduate students of color face in clinical science doctoral programs? What strategies do you think faculty members and administrators can employ reduce these barriers?
Barrier 1) As an African American woman doing research on African American women, I often felt like I had to go above and beyond to justify and/or explain the importance of my work. Growing up I witnessed how my mother, grandmother, and aunts displayed a quiet strength as they cared for others. They persevered in the midst of hardships, forever “keeping it together” for the sake of family and work life. Experientially, I knew that African American women were utilizing life management strategies that were a response to marginalization and that were negatively impacting their health. Yet, I was not satisfied with what the (lack of) research had to say about this phenomenon. When I decided to study this phenomenon, I received support from some. Also, I regularly received questions like, “Is this phenomenon generalizable to all women?” “What are the implications of solely focusing on African Americans/African American women?” These kinds of questions about my research made it difficult to disentangle which questions/concerns were indicative of the desire to enhance my research’s scientific merit versus indicative of an implicit devaluing of topics related to communities of color. Meaning, when students conduct research with European American samples do they routinely receive similar questions about the (lack of) generalizability of their findings? Therefore, I think some graduate students of color may feel that the kinds of questions they’re interested in are devalued and discouraged.
Barrier 3) In my experiences, academia has been designed to highlight all the ways we are not enough – the ways we have not published enough, the ways we have not written enough, the ways we have not done enough service nor secured enough grants, etc. This is difficult for anyone, and I think this is especially challenging for graduate students of color who may already feel as if they do not belong or as if they are navigating a space not designed with them in mind.
6. You graduated from a combined clinical and community program. How did your community psychology education influence how you think about clinical research and practice?
I received invaluable training in my clinical/community program, and it has shaped my clinical research and practice in a number of ways. Because of this training, I am committed to adequately attending to the effects of institutional and social inequities that enable and/or perpetuate marginalization, and in turn, shape the health trajectories of marginalized group members. Therefore, my clinical understanding of any presenting problem, whether as a clinician or researcher, takes into account systems of equality and inequality. Relatedly, although my research agenda considers the necessity of access to and availability of culturally-responsive behavioral health interventions for diverse groups, I understand the inherent limitations of treating behavioral health concerns at the individual level. Therefore, I am an advocate for social justice initiatives that aim to create policies and institutional practices geared towards enhancing the lives of diverse communities.
Note. This article will be featured in our Clinical Science newsletter: Fall 2020.
“Rona”, as I colloquially call the virus when in conversation with friends and loved ones, has caused a complete upheaval of my life professionally and practically. In this column, I will discuss some of the implications from COVID-19 as a graduate student of color and personally. I will then provide some recommendations for students and for faculty members on how best to support their students from marginalized populations, including a positive initiative I have seen take place within my own organization.
COVID-19: The Good, the Bad, and the Semi-Ugly
Before all of the associated changes from COVID-19, I can admit that I was trying to accomplish too much this semester and was risking burning out. There is literature to suggest that ethnic minority students in graduate programs face stressors including racial discrimination, racial prejudice, feelings of isolation, and different cultural expectations that negatively impact their academic experience (Dyrbye et al., 2007). As a result, ethnic minority students had higher rates of burnout and depressive symptoms, and a reduced quality of life. Not only was I on a trajectory towards burnout by virtue of being one of the few minorities in my program, I was also actively (unintentionally) pushing myself to that point.
COVID-19 slowed me down dramatically. Professionally, almost all of my obligations were abruptly put on hold. I ended up cancelling my Spring Break plans and entered into immediate self-isolation. However, I did not realize how much I had been pushing myself until about a week into my Spring Break (my University extended Spring Break an extra week) when I realized I had barely opened my laptop and was checking my email at the rate of once every few days (I typically check my email multiple times in one day). I felt free, but I also felt an inkling of guilt at not being productive. To compound these feelings, New Jersey quickly emerged as the second epicenter of COVID-19 in the U.S. While I am currently living in Alabama for school, I am from New Jersey and many of my family members still live there. My parents and my grandmother are all either older or have some health complications that would make them vulnerable to the virus. My mother is also a certified nurse midwife, making her an essential worker. On top of my guilt at being unproductive, I was developing growing anxiety for my family. I made the decision not to fly home in early March for fear that I might catch something on the plane and give it to my parents (imagine the irony). It was a hard notion to contend with for many of the early weeks of the pandemic.
Moreover, my larger struggle was in challenging the rhetoric of the “Strong Black Woman”. The Strong Black Woman race-gender schema holds that Black women must be strong, self-reliant, resistant to negative mental health outcomes regardless of the circumstance, and willing to take care of others even at her own personal expense (Abrams, Maxwell, Pope, & Belgrave, 2014; Black & Peacock, 2010; Nelson, Cardermil, & Adeoye, 2016; Watson & Hunter, 2015). For the Strong Black Woman, breaks are not even thought of. This is a not a role I actively sought, but it is absolutely one that I have fallen into. For this reason, after my second week of doing nothing, the feelings of peace quickly shifted to blame, guilt, and some self-chiding. The grace that I had given myself during the weeks prior had dissolved into negative self-talk suggesting that I should be doing more and that my productivity should have doubled (or even tripled) with the increased time at home. I was unduly hard on myself. I had to have some candid conversations with loved ones, engage in journaling, and find others who seemed to understand my struggle (see the citation for the New York Times piece: “Stop Trying To Be Productive”) in order to let myself off the hook and find a happy medium between self-care and productivity during COVID-19.
I am not at all an expert on the marginalized student experience during COVID, but I want to share a couple of things that I have found helpful personally that could help you if you are a student from a marginalized population, or if you are seeking to help your students from marginalized populations.
Recommendations for Students from Marginalized Populations During This Time
Limitations of My Experience
While I acknowledge that COVID-19 has presented additional hurdles for all graduate students regardless of race, ethnicity, or cultural background, I would be remiss if I did not highlight a special group that could be disproportionately disadvantaged at this time: students of Asian descent and/or international students from Asian countries. There is a portion of the rhetoric surrounding COVID-19 that is placing blame on Asian countries for the creation and spread of COVID-19. Some of the implications from this have been hate crimes and mistreatment of selected groups of people/students. I cannot fathom what students of Asian descent/from Asian countries might be going through at the moment, and I will not try to speculate about or dictate their narratives for them.
Abrams, J. A., Maxwell, M., Pope, M., & Belgrave, F. Z. (2014). Carrying the world with the grace of a lady and the grit of a warrior: Deepening our understanding of the “strong black woman” schema. Psychology of Women Quarterly, 38, 503–518.
Black, A. R., & Peacock, N. (2011). Pleasing the masses: Messages for daily life management in African American women’s popular media sources. American Journal of Public Health, 101, 144–150.
Dyrbye, L. N., Thomas, M. R., Eacker, A., Harper, W., Massie, F. S., Power, D. V.,…Shanafelt, T. D. (2007). Race, ethnicity, and medical student well-being in the United States. Archives of Internal Medicine, 167, 2103-2109.
Lorenz, T. (2020). Stop trying to be productive. Retrieved from https://www.nytimes.com/2020/04/01/style/productivity-coronavirus.html
Nelson, T., Cardermil, E. V., & Adeoye, C. T. (2016). Black women’s perceptions of the “Strong Black Woman” role. Psychology of Women Quarterly, 40, 551–563.
Watson, N. N., & Hunter, C. D. (2015). Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking. Cultural Diversity and Ethnic Minority Psychology, 21, 604–612.
Thomas Ollendick, Ph.D.
Distinguished Professor in Clinical Psychology
Director of the Child Study Center
Virginia Polytechnic Institute and State University
Thomas H. Ollendick, Ph.D., is University Distinguished Professor in Clinical Psychology and Director of the Child Study Cent- er at Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. He is the author or co-author of 350+ research publications, 100+ book chapters, and 38 books. His recent books include the Oxford Handbook of Clinical Child and Adolescent Psychology, Innovations in CBT Treatment for Childhood Anxiety, OCD, and PTSD (Cambridge), and Emotion Regulation and Psychopathology in Children and Adolescents (Oxford).
He is the past editor of the Journal of Clinical Child and Adolescent Psychology and Behavior Therapy, as well as founding and current Co-Editor of Clinical Child and Family Psychology Review. He is Past-President of the Association for the Advancement of Behavior Therapy (1995), the Society of Clinical Psychology (1999), the Society of Clinical Child and Adolescent Psychology (2007), and the Society for the Science of Clinical Psychology (2010). The recipient of several NIMH grant awards, his clinical and research interests range from the study of diverse forms of child psychopathology to the assessment, treatment, and prevention of these child disorders from a social learning/social cognitive theory perspective. He has served as the mentor and dissertation advisor for 44 doctoral students – all since joining Virginia Tech in 1980.
Dr. Ollendick received an Honorary Doctorate from Stockholm University in 2011 and holds Honorary Adjunct Professor Positons at Roehampton University in London, Griffith University in Brisbane, Australia, and Sydney Institute of Technology in Sydney, Australia. He was awarded the Distinguished Research Contributions to the Field of Clinical Child Psychology in 2007 (APA), the Career/Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies in 2013, the Lifetime Achievement Award for Scientific Contributions from the Society of Clinical Psychology (APA) in 2017, the Aaron T. Beck Lifetime Career Award from the Academy of Cognitive Therapy (2019), and, most recent- ly, the Lifetime Achievement Award from the Spanish Society for Child and Adolescent Clinical Psychology (2019).
Tommy Ho-Yee Ng, M.Phil.
Tommy Ho-Yee Ng, M.Phil. is a sixth year Ph.D. student in Clinical Psychology with a Specialization in Neuroscience at Temple University under the supervision of Dr. Lauren Alloy. Tommy earned a B.A. in Psychology from the University of California, Berkeley and a M.Phil. in Psychiatry from the University of Hong Kong (HKU). He is completing his clinical internship at NewYork-Presbyterian Hospital / Weill Cornell Medicine.
Tommy’s research is committed to improving our understanding of bipolar disorder and unipolar depression. His work is funded by grants from the American Psychological Foundation, the Council of Graduate Departments of Psychology, the American Psychological Association of Graduate Students, the National Institute of Mental Health, and the Sir Edward Youde Memorial Fund. Tommy is the recipient of a number of awards, such as the Early Graduate Student Researcher Award from the American Psychological Association, the President’s Award from the Society Research in Psychopathology, and the Outstanding Student Researcher Award from SSCP.
1. What are your research interests? Bipolar disorder and unipolar depression are two of the most debilitating conditions in the world, according to the World Health Organization. Many patients do not respond to conventional treatments and remain symptomatic after years of treatment. Despite the great public health significance, major unanswered questions exist regarding their underlying mechanisms. Yet, understanding their pathophysiology is crucial for translating foundational knowledge to theoretically coherent interventions designed to prevent or treat these impairing conditions. My area of research is exciting to me because of its potential to lead to targeted prevention and treatment programs for those with or at risk for mood disorders and relieve their burden.
2. Why is this area of research exciting to you? Bipolar disorder and unipolar depression are two of the most debilitating conditions in the world, according to the World Health Organization. Many patients do not respond to conventional treatments and remain symptomatic after years of treatment. Despite the great public health significance, major unanswered questions exist regarding their underlying mechanisms. Yet, understanding their pathophysiology is crucial for translating foundational knowledge to theoretically coherent interventions designed to prevent or treat these impairing conditions. My area of research is exciting to me because of its potential to lead to targeted prevention and treatment programs for those with or at risk for mood disorders and relieve their burden.
3. Who are/have been your mentor(s) or scientific influences? I am fortunate to have received mentorship from a group of inspiring scientists who also happen to be incredible human beings. This includes Dr. Sheri Johnson who helped me to discover my love of research; Dr. Ka Fai Chung who provided me with the freedom and encouragement to rigorously pursue important research questions; Dr. David Smith who has been extraordinarily generous with his time and instrumental in my learning of neuroimaging methods; and Dr. Lauren Alloy who has been unbelievably supportive and deeply invested in my growth in every way.
4. What advice would you give to other students pursuing their graduate degree? Do what you genuinely want to do, not what you think you should do. One of the most wonderful things about our profession is its wide range of career options. Find out what career path is the most suited and exciting to you as quickly as possible during graduate school and plan your time accordingly