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The Elephant Is Not Pink: Talking About White, Black, and Brown to Achieve Excellence in Clinical Practice


Incorporating issues of race and racism can improve clinical engagement and the therapeutic alliance. Assessing, understanding, and responding to experiences related to racial identity and racism related stress can be an important factor in a clinician’s ability to be culturally responsive. A vignette of client treatment presents common dilemmas in clinical treatment. Responses to questions about race from focus groups are presented to frame the experiences of women of color who struggle with poverty and social-emotional issues. A framework of multicultural antiracist practice highlights the skills necessary for clinicians, supervisors, and managers.

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  1. 1.

    “Hazel” is a composite character developed for this vignette based on the clinical and research experiences of the authors.


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Correspondence to Lisa V. Blitz.

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Pender Greene, M., Blitz, L.V. The Elephant Is Not Pink: Talking About White, Black, and Brown to Achieve Excellence in Clinical Practice. Clin Soc Work J 40, 203–212 (2012).

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  • Racism
  • Racism related stress
  • Microaggression
  • Race
  • Therapy
  • Counseling
  • Cultural competency
  • Cultural responsiveness