On Enhancing Competent Work with African American Clients: Challenging Persistent Racial Disparity Trends by Examining the Role of the Working Alliance

Abstract - Trends of racial disparities continue to persist across a variety of rehabilitation domains (e.g., acceptance rates, types of services offered, rehabilitation outcomes). African Americans consistently have poorer rehabilitation outcomes when compared to their White counterparts. Scholars have identified issues of racial bias in clinical judgment within cross-racial client-counselor relationships as a likely central factor contributing to this trend. The strength of the working alliance between counselor and client has been shown to be predictive of positive client outcomes. Factors within the helping relationship, such as color-blind attitudes and racial microaggressions, which have been shown to erode the alliance with African American clients, are discussed, as well as the use of broaching strategies to directly address the issue of race with clients as a means of strengthening the working alliance.Keywords: African Americans, racial disparities, working alliance, racial bias, cross-racial counseling relationshipsAs the field of rehabilitation continues to progress into the 21st century, concerns over racial equity, both in service provision and in outcomes, continue to make client racial group disparities a germane topic in the larger discussion on outcome equity for individuals who seek services. Disparities along racial lines are still identifiable within rehabilitation outcome data, revealing that people who are members of racial/ethnic minority groups continue to achieve differential outcomes when compared to thenWhite counterparts (Capella, 2002; LeBlanc & Smart, 2007; Moore et al., 2009; Olney & Kennedy, 2002). Rehabilitation professionals, being members of a larger American society where racial inequities persist, have been socialized into societal patterns of culturally-biased norms, attitudes, values, and beliefs concerning race; it cannot be surprising that society's patterns of inequity are mirrored in the professional work counselors engage in with consumers (LeBlanc, Wilson, & Juchau, 2008; Sue, 2004). The impact of such racial stratification has real implications for the lived experiences of members of racial and ethnic minority groups who have disabilities.Researchers have identified four groups of variables believed to contribute to the issue of racial disparities within rehabilitation service systems: (a) client characteristics, (b) counselor characteristics, (c) characteristics of service provision, and (d) macroeconomic indicators (Bellini, 2003; Matrone & Leahy, 2005). Of note, counselor race and consumer race continue to show some level of relationship to consumer outcomes (Alston, Gayles, Rucker, & Hobson, 2007; Bellini, 2003; Cumming-McCann & Accordino, 2005; Martin, 2010; Matrone & Leahy, 2005; Rosenthal, 2004; Rosenthal, Wong, Blalock, & Delambo, 2004; Whitfield, Venable, & Broussard, 2010). The interaction between counselor and consumer and the influence of race may be responsible for some of the variance seen in the analyses of outcome data for racial groups (Whitfield et al., 2010). Due to the predominance within the rehabilitation counseling field of service providers who are White (LeBlanc et al., 2008), efforts to address the role of race in the relationship that is built between counselor and consumer are appropriate and important. As the field of rehabilitation seeks to bridge the outcome gap that exists for diverse consumers, consideration of the working alliance, described succinctly as the degree to which both counselor and client are engaged in collaborative work, offers rehabilitation professionals an opportunity to examine the ways they can improve outcomes for diverse consumers by focusing on the consumer-counselor relationship (Baldwin, Wampold, & Imel, 2007).The purpose of this article is to assist readers in understanding how issues interconnected with race can impact the development of the working relationship between counselor and client/consumer. …