Centering and decentering client disclosures: A qualitative study of therapists' responses to clients' experiences of discrimination.

Clients who are societally marginalized because of their identities may seek support from therapists to process experiences of discrimination and oppression. Therapist navigation of these cultural conversations is a crucial skill. However, there is limited research examining how therapists immediately respond to clients when they disclose experiences of discrimination. In this study, 66 participants watched two brief videos of fictitious clients disclosing experiences of covert and overt discrimination. Participants watched one of two video vignettes, with one focusing on a White lesbian woman client and another focusing on a Black woman client. After watching each video, participants were asked to respond to clients as if they were the clients' therapist. We used reflexive thematic analysis to code participant responses, which spanned three themes: (a) invalidation and decentering of client's emotions, appraisals, and experiences; (b) incongruence and avoidance of client's language around identities; and (c) empathic attunement and centering of client emotions, appraisals, and experiences. While some participant responses were interpreted as emotionally aligning with the client, other participant responses were coded as minimizing or questioning client experiences of discrimination or using language incongruent with how the client self-identified. We discuss implications for research, training, and practice in navigating conversations about discrimination with psychotherapy clients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).