Ableist Microaggressions, Disability Characteristics, and Nondominant Identities

Melissa D. Deroche, Lee Za Ong, Jennifer M. Cook

Microaggressions are commonplace overt and covert forms of discrimination that convey disparaging messages to individuals who hold marginalized identities, including people with disabilities (PWD). Although PWD are a prevalent nondominant identity group in the United States, little is known about the occurrence of ableist microaggressions in this culturally diverse community, including how ableist microaggressions are experienced based on disability characteristics and other nondominant identities. A sample consisting of 201 PWD completed an electronic survey that examined the occurrence of ableist microaggressions based on visibility of disability, type of disability, and nondominant sociocultural identities. We found that PWD have a moderate level of lifetime occurrences with ableist microaggressions, the visibility of disability impacts the occurrence of ableist microaggressions and the types of ableist microaggressions experienced, and sociocultural identities may predict minimization types of ableist microaggressions.

Keywords: microaggressions, disability, nondominant identities, ableist, visibility

People with disabilities (PWD), similar to other minoritized groups, encounter stereotypes, stigma, prejudice, and discrimination. Stereotypes are generalized beliefs about a group with shared characteristics that can result in prejudice (Sue & Spanierman, 2022). Discrimination occurs when individuals or systems act on prejudices by limiting or restricting access to opportunities, resources, and services (Olkin et al., 2019). Discrimination results in ableism when it is perpetrated against PWD based on their disability status. Microaggressions are one form of discrimination and are defined as intentional or unintentional verbal, non-verbal, and/or environmental slights that convey disparaging messages to individuals based solely on their marginalized group membership status (Sue & Spanierman, 2022).

In recent decades, scholars have examined the occurrence of microaggressions with individuals who hold several different minority group identities and found that microaggressions are present in everyday life for minoritized individuals, negatively impacting their mental health (Capodilupo et al., 2010; Keller & Galgay, 2010; Nadal et al., 2014). Although there are a significant number of studies addressing microaggressions associated with race and ethnicity (Forrest-Bank & Cuellar, 2018; Nadal et al., 2014) and gender and sexual identity (Capodilupo et al., 2010), research regarding microaggressions experienced by PWD is only in its infancy.

In their foundational work, Keller and Galgay (2010) qualitatively explored the existence of microaggressions directed at PWD. Using two focus groups (N = 12) with PWD who had a range of visible and hidden disabilities, they identified eight microaggression domains experienced by PWD: (a) denial of identity, (b) denial of privacy, (c) helplessness, (d) secondary gain, (e) spread effect, (f) patronization, (g) second-class citizen, and (h) desexualization. Their work spurred both qualitative and quantitative studies focused on the ableist microaggression experiences within the general disability community (Kattari, 2020; Lett et al., 2020) and specific disability communities, including people with mental illness (Gonzales et al., 2015), physical disabilities (Conover et al., 2017a), and intellectual disabilities (Eisenman et al., 2020). Also, researchers have examined ableist microaggressions within specific settings such as schools (Dávila, 2015), the workplace (Lee et al., 2019), and higher education (Lett et al., 2020). Collectively, these results supported the initial eight ableist microaggression domains Keller and Galgay identified and expanded how they were understood.

The multidimensionality of disability has led scholars to examine the influence of disability characteristics—including visibility, severity, type, and age of onset of disability—on the occurrence of ableist microaggressions. Visible or apparent disabilities are defined primarily by the use of an adaptive aid or accommodation such as a cane, crutches, service animal, hearing aid, or wheelchair that results in others immediately labeling the person as disabled; whereas people with hidden, invisible, or non-apparent disabilities are likely to pass as nondisabled and must navigate how, when, and to whom to disclose their disability status. Using two different ableist microaggression scales with relatively large samples of PWD, both Conover et al. (2017a) and Kattari (2020) reported that level of visibility of disability impacts the occurrence of ableist microaggressions, with individuals with visible disabilities consistently experiencing more ableist microaggressions than their counterparts. Further examination of these differences resulted in Andreou et al. (2021) reporting that people with visible disabilities encountered more helplessness- and otherization-related ableist microaggressions, while persons with hidden disabilities encountered more minimization-type ableist microaggressions. In contrast, the impact of severity, age of onset, and type of disability on the occurrence of ableist microaggressions have yielded mixed findings, suggesting more research is warranted. For instance, Conover et al. (2017a) found that people with severe and early onset of disability (i.e., 0–40 years) reported greater lifetime experiences of ableist microaggressions, while Andreou et al. (2021) noted no differences based on severity or age of onset. With respect to type of disability, Conover et al. (2017a) reported no differences, while Andreou et al. (2021) found overall differences in the occurrence of ableist microaggressions, as well as type of ableist microaggressions, experienced by people with different types of disabilities.

Although some scholars have considered PWD’s intersecting cultural identities in their research studies, including sexual minorities (e.g., Conover & Israel, 2019; Hunt et al., 2006), gender identities (measured as male and female; Conover et al., 2017a), women with visible and invisible disabilities (Olkin et al., 2019), and racial or ethnic minorities (Conover et al., 2017a; Dávila, 2015), few studies have added to our understanding of ableist microaggressions across intersecting sociocultural identities. For example, Conover and Israel (2019) found that PWD who were also sexual minorities encountered ableist microaggressions in sexual minority communities, while Conover et al. (2017a) discovered that gender (as measured by male and female) and race (as measured by White or Person of Color) did not impact the occurrence of ableist microaggressions; these results contrast Dávila (2015), who found that Latinx PWD encountered microaggressions that aligned with both racial and disability microaggressions.

Although scholars have provided valuable data about ableist microaggressions they have not considered the full range of sociocultural identities PWD hold or the differences in the types of ableist microaggressions (i.e., helplessness, minimization, denial of personhood, and otherization) PWD experience combined with their nondominant sociocultural identities. The purpose of this study was to examine the occurrence and types of ableist microaggressions PWD experience and whether their nondominant sociocultural identities impact their experiences of ableist microaggressions. Our intention was to reveal critical information counselors can use to better serve their clients who have disabilities and experience ableist microaggressions.

Methodology

For this quantitative study, we utilized surveys and online data collection to investigate our three research questions that aligned with the study purpose.

  • Research Question 1: What are the participants’ experiences of ableist microaggressions based on the Ableist Microaggressions Scale (AMS; Conover et al., 2017b) scores and subscale scores?
  • Research Question 2: Do AMS scores and AMS subscales (i.e., Helplessness, Minimization, Denial of Personhood, and Otherization) have a relationship with the type of disability and the visibility of the disability?
  • Research Question 3: Are other nondominant sociocultural identity factors associated with or predictive of AMS scores and AMS subscales?

We anticipated participants would report differences in the occurrence and types of ableist microaggressions they experienced based on visibility of disability and disability type and that having nondominant identities would influence the occurrence of ableist microaggressions. More specifically, we expected people with visible disabilities to report higher occurrences of ableist microaggressions than their counterparts and that disability visibility would influence the type of ableist microaggressions. We anticipated variations based on disability type regarding frequency and type of ableist microaggressions. Finally, we expected PWD nondominant sociocultural identities to be associated with the occurrence of ableist microaggressions.

Procedures
     This study was approved by the first author’s IRB. We recruited participants through targeted disability organizations (e.g., Council of State Administrators of Vocational Rehabilitation, Wisconsin’s Centers for Independent Living, Alabama Department of Rehabilitation Services) and social media platforms, many of which were specifically for PWD (e.g., Blind Pen Pals, VR Professionals, Cerebral Palsy Support, and Spinal Cord Injury Peer Mentor Program Facebook groups). Additionally, we sent email invitations to professional and personal contacts and posted on listservs of various professional organizations that serve PWD. The email invitation and posting included a brief description of the research study; inclusion criteria; an informed consent document; and a URL link to the secure, confidential survey via Qualtrics. To proceed to the study questionnaires, participants had to meet the following criteria: 1) at least 18 years old, 2) have a high school diploma or GED, and 3) have a diagnosed disability. The online survey portal was divided into six parts: informed consent, consent, screening questions, demographics, AMS questions, and two optional open-ended questions regarding their personal microaggression experiences and their interest in participating in future related studies. This study was Section 508 compliant and accessible to participants with disabilities. In total, 254 participants responded to the online survey; 53 participants were excluded because of vastly incomplete or unusable data, resulting in a final sample of 201 participants.

Data Collection
Demographic Questionnaire
     We used a self-report demographic questionnaire to collect information about age, sex, gender identity, sexual orientation, racial/ethnic identity, religion/spiritual identity, education, employment status, and source of income (see Table 1). In light of the diversity within the disability community and to allow for within-group comparisons, we asked for type of disability (i.e., physical, sensory, psychiatric, and neurodevelopmental) and visibility of disability (i.e., visible/apparent, invisible/hidden, or both). Participants reported their highest level of education and their job responsibilities as they apply to their training, education, and skills. Because income level is subjective in terms of individual needs and geographic U.S. region, and PWD often have more than one income source, we asked participants to name their sources of income instead of a dollar amount.

Ableist Microaggressions Scale
     The AMS (Conover et al., 2017b) is a 20-item self-report measure of PWD’s lifetime experiences with disability-related microaggressions. The AMS has four subscales: Helplessness, Minimization, Denial of Personhood, and Otherization. Item examples include: “People offer me unsolicited, unwanted, or unneeded help because I have a disability” (Helplessness); “People are unwilling to accept I have a disability because I appear able-bodied” (Minimization); “People don’t see me as a whole person because I have a disability” (Denial of Personhood); and “People suggest that living with a disability would not be a worthwhile existence” (Otherization). Participants were instructed to think only about their personal ableist microaggression experiences when responding to the AMS items.

Responses were rated on a 6-point Likert-type scale, ranging from 1 (never) to 6 (very frequently), and three items included a not applicable response option, as these items may not be relevant for individuals with invisible/hidden disabilities. Possible total scores range from 17 to 120, with higher scores indicating greater levels of lifetime experiences with ableist microaggressions. The overall internal consistency reliability was .92 (Conover et al., 2017a) and .95 (Conover & Israel, 2019), and the internal consistency reliability scores for the AMS subscales were .85 for Helplessness, .65 for Minimization, .90 for Denial of Personhood, and .84 for Otherization (Conover et al., 2017a). Cronbach’s alpha for the AMS in this sample was .90.

Data Analysis
     All statistical analyses were performed using IBM SPSS Statistics Standard V27. To answer Research Question 1, we ran descriptive statistics for all measured variables of AMS scales and subscales (see Table 2). For Research Question 2, we conducted factorial analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) to understand whether the AMS scores and subscale scores differed based on the type of disability and the visibility of the disability as independent factors. To answer Research Question 3, we utilized multiple regression analyses to investigate the predictive variables of participants’ sociocultural identities and AMS scores and subscale scores.

Table 1
Demographic Characteristics of Participants (N = 201)

Variable    n   %
Disability Type a
Physical 100 49.8
Sensory   89 44.3
Psychiatric/Mental   61 30.3
Neurodevelopmental   43 21.4
Disability Type
Physical only   55 26.8
Sensory only   55 26.8
Psychiatric/Mental only   12   5.9
Neurodevelopmental only   11   5.4
Two or more disabilities   68 33.2
Disability Visibility
Visible/apparent   62 30.8
Invisible/hidden   84 41.8
Both visible and invisible   55 27.4
Age
18–29   33 16.4
30–39   44 21.9
40–49   57 28.4
50–59   39 19.4
60–69   20 10.0
70+     8   4.0
Biological Sex
Female 158 78.6
Male   43 21.4
Gender Identity
Woman 150 74.6
Man   43 21.4
Gender queer     5   2.5
Self-identify in another way     3   1.5
Affectual/Sexual Orientation
Heterosexual 155 77.1
Bisexual   20 10.0
Gay     5   2.5
Lesbian     3   1.5
Pansexual     5   2.5
Queer     7   3.5
Self-identify in another way     6   3.0
African American/Black   15   7.5
Asian or Pacific Islander American     5   2.5
Variable    n   %
Euro American/White 153 76.1
Jewish     6   3.0
Latino/a or Hispanic     8   4.0
Native American     1     .5
Middle Eastern     3   1.5
Biracial     2   1.0
Multiracial     2   1.0
Self-identify in another way     6   3.0
Religious/Spiritual Identity
Agnostic   34 16.9
Atheist   20 10.0
Buddhist     2   1.0
Christian: Catholic   32 15.9
Christian: Protestant   72 35.8
Jewish     6   3.0
Muslim     2   1.0
Self-identify in another way   33 16.4
Education
High school diploma/GED   15   7.5
Some college, but no degree   27 13.4
Associate or trade school degree   19   9.5
Bachelor’s degree   44 21.9
Master’s degree   72 35.8
PhD, EdD, JD, MD, etc.   24 11.9
Employment Status
Full time   94 46.8
Part time   30 14.9
Unemployed   34 16.9
Student   22 10.9
Retired   21 10.4
Training/Education/Skills Compared to Job Responsibilities
On par   85 42.3
Exceeding   54 26.9
Lower     4   2.0
Not applicable   58 28.9
Source of Income
Job 120 59.7
SSI   27 13.4
SSDI   37 18.4
Retirement/pension   22 10.9
Unemployment benefits     2   1.0
Other income sources   43 21.4

Note. SSI = Supplemental Security Income; SSDI = Supplemental Security Disability Income.
a Participants had the option to indicate more than one response; therefore, totals are greater than 100%.

Table 2
Descriptive Statistics for AMS Items by Subscale

    M   SD
Total AMS score 61.01 20.60
Overall AMS item   3.05   1.03
Subscale: Helplessness   3.30   1.34
H1. People feel they need to do something to help me because I have a disability.   3.29   1.61
H2. People express admiration for me or describe me as inspirational simply because I live with a disability.   3.65   1.80
H3. People express pity for me because I have a disability.   3.11   1.59
H4. People do not expect me to have a job or volunteer activities because I have a disability.   2.95   1.82
H5. People offer me unsolicited, unwanted, or unneeded help because I have a disability.   3.47   1.76
Subscale: Minimization   3.60   1.56
M6. People are unwilling to accept I have a disability because I appear able-bodied.a   3.63   2.01
M7. People minimize my disability or suggest it could be worse.   3.62   1.81
M8. People act as if accommodations for my disability are unnecessary. a   3.56   1.76
Subscale: Denial of Personhood   3.07   1.47
D9. People don’t see me as a whole person because I have a disability.   3.32   1.66
D10. People act as if I am nothing more than my disability.   2.66   1.52
D11. People speak to me as if I am a child or do not take me seriously because I have a disability.   3.16   1.74
D12. People assume I have low intelligence because I have a disability.   3.08   1.84
D13. Because I have a disability, people attempt to make decisions for me that I can make for myself.   3.11   1.70
Subscale: Otherization   2.63   1.22
O14. People think I should not date or pursue sexual relationships because I have a disability.   2.09   1.54
O15. People indicate they would not date a person with a disability.   2.93   1.73
O16. People suggest that I cannot or should not have children because I have a disability.   2.37   1.60
O17. People stare at me because I have a disability. a   3.18   1.93
O18. Because I have a disability, people seem surprised to see me outside my home.   2.42   1.65
O19. Because I have a disability, people assume I have an extraordinary gift or talent.   2.49   1.72
O20. People suggest that living with a disability would not be a worthwhile existence.   2.91   1.74

Note. AMS = Ableist Microaggressions Scale; H = Helplessness; M = Minimization; D = Denial of Personhood;
O = Otherization; M = Mean; SD = Standard Deviation
a Item includes “not applicable” response option.

 

Results

For Research Question 1, there was substantial variability in participants’ responses to individual AMS items (see Table 2). Participants had an overall total AMS mean score of 61.01 (SD = 20.60). The response mean score was 3.05 (SD = 1.03). The response means for the AMS items ranged from a high value of 3.65 (SD = 1.80) to a low value of 2.09 (SD = 1.54). In the Minimization subscale, the response mean was 3.60 (SD = 1.56) and ranged from a high value of 3.63 (SD = 2.01) for “People are unwilling to accept I have a disability because I appear able-bodied” to a low value of 3.56 (SD = 1.76) for  “People act as if accommodations for my disability are unnecessary.” For the Helplessness subscale, the response mean was 3.30 (SD = 1.34) and ranged from a high value of 3.65 (SD = 1.80) for “People express admiration for me or describe me as inspirational simply because I live with a disability” to a low value of 2.95 (SD = 1.82) for “People do not expect me to have a job or volunteer activities because I have a disability.” In the Denial of Personhood subscale (M = 3.07; SD = 1.47) the responses ranged from M = 3.32 (SD = 1.66) for “People don’t see me as a whole person because I have a disability” to M = 2.66 (SD = 1.52) for “People act as if I am nothing more than my disability.” For Otherization, the response mean was lower than the other subscales (M = 2.63; SD = 1.22) and ranged from a high value of 3.18 (SD = 1.93) for “People stare at me because I have a disability” to a low value of 2.42 (SD = 1.65) for “Because I have a disability, people seem surprised to see me outside my home.”

     For Research Question 2, we conducted a factorial ANOVA to understand the relationship between AMS scores, type of disability, and visibility of disability. Main effect results revealed that ableist microaggression experiences were significantly different for the visibility of disability factor—that is, whether the participant had visible, hidden, or both visible and hidden disabilities, F(2, 189) = 6.12, p = .003, partial ŋ2 = .061; however, ableist microaggression experiences were not significantly different based on disability type, F(4, 189) = 2.26, p = .064, partial ŋ2 = .046. The Scheffe post hoc test revealed visibility categories were significantly different. The invisible/hidden disability group significantly differed in ableist microaggression experiences from the visible/apparent disability group and the visible and hidden group. The invisible/hidden group (M = 2.57, SD = 0.11) scored significantly lower in their AMS compared with the visible/apparent disability group (M = 3.31, SD = 0.14) and visible and hidden disability group (M = 3.41, SD = 0.26). Calculated effect size revealed a small proportion of AMS variance was accounted for by visibility of disability, while interactions between type of disability were not significant, F(5, 189) = 1.69, p = .138, partial ŋ2 = .043.

We utilized a MANOVA to determine the effect of disability types and visibility of disability using four dependent variables that represented the AMS subscales (i.e., Helplessness, Minimization, Denial of Personhood, and Otherization). The Box’s Test was significant (p = .01), indicating that homogeneity of variance was not fulfilled, so we used Pillai’s trace test statistic to interpret the results. The results revealed that visibility of disability, Pillai’s V = .323, F(8, 374) = 8.99, p < .001, ŋ2 = .161, significantly affected the combination of the AMS subscales. The factor interaction indicated no statistical significance, F(20, 756) = .94, p = .535, ŋ2 = .024, nor was there statistical significance for the main effect of types of disability, Pillai’s V = .097, F(16, 756) = 1.17, p = .285, ŋ2 = .024.

The multivariate effect sizes were very small based on univariate ANOVA and Scheffe post hoc tests. ANOVA results indicated that visibility of disability significantly differed for all AMS subscales: Helplessness, F(2, 189) = 17.25, p < .001, ŋ2 = .154; Minimization, F(2, 189) = 16.02, p < .001, ŋ2 = .145; Denial of Personhood, F(2, 189) = 4.74, p = .01, ŋ2 = .048; and Otherization, F(2, 189) = 11.99, p < .001, ŋ2 = .113. Participants with visible disabilities experienced more Helplessness and Otherization microaggression types, while participants with invisible disabilities experienced more Minimization microaggressions. Participants with both visible and invisible disabilities experienced Denial of Personhood microaggressions more frequently. Table 3 presents the adjusted and unadjusted group means for AMS subscales by type of disability and visibility of disability.

Table 3
Adjusted and Unadjusted Means for AMS Subscales by Disability Types and Visibility of Disability

Subscale   Helplessness Minimization Denial of Personhood   Otherization
ADJ

M

UA

M

ADJ

M

UA

M

ADJ

M

UA

M

ADJ

M

UA

M

Disability Types
Physical only 3.09 3.38 3.00 2.80 2.66 2.85 2.45 2.69
Sensory only 3.57 3.64 3.49 3.41 3.48 3.46 2.77 2.82
Psychiatric/Mental only 2.17 2.17 4.47 4.47 2.25 2.25 1.76 1.76
Neurodevelopment only 2.95 2.25 3.70 3.73 3.05 2.11 2.77 1.88
2 or more disabilities 3.41 3.31 3.85 4.23 3.21 3.23 2.75 2.69
Visibility
Visible/apparent 4.02 4.07 2.56 2.51 3.29 3.30 3.15 3.19
Invisible/hidden 2.41 2.51 4.17 4.30 2.40 2.51 1.95 2.01
Both visible and invisible 3.54 3.63 3.59 3.76 3.64 3.65 3.01 2.93

Note. AMS = Ableist Microaggressions Scale; ADJ = Adjusted Mean; UA = Unadjusted Mean.

 

For Research Question 3, predictors were transformed and collapsed into dummy variables so they were useful for data analysis. Standard multiple regressions were conducted to determine the accuracy of the sociocultural identities (i.e., age, sex, gender identity, sexual orientation, racial/ethnic identity, religion/spiritual identity, education, and employment status) to predict AMS scores. Regression results indicated that the overall model does not significantly predict AMS scores, R2 = .052, R2adj = .019, F(14, 186) = .73, p = .74. Although the results did not predict AMS scores overall, they significantly predicted Minimization scores, R2 = .157, R2adj = .093, F(14, 186) = 2.47, p = .003. This model accounts for 9% of variance in the Minimization score. We found that race/ethnicity (β = −.51, p = .04), education level (β = −.69, p = .03), and employment status (β = 1.18, p = .03) significantly predicted AMS Minimization scores.

Discussion

Our findings both support and extend our understanding of the occurrence of ableist microaggressions and the types experienced by PWD who have different disability characteristics and who have a range of sociocultural identities. Participants in our study reported, on average, higher lifetime occurrences of ableist microaggressions (M = 3.05) than what Conover et al. (2017a) found (M = 1.70). These differences may be due, in part, to an increased recognition and awareness of ableist microaggressions. The high average scores reported in each subscale are consistent with the Helplessness, Minimization, Denial of Personhood, and Otherization scores reported by other researchers (Gonzales et al., 2015; Keller & Galgay, 2010; Olkin et al., 2019).

In our study, visibility of disability differentially impacted the overall occurrence and types of ableist microaggressions PWD experienced. Like in previous studies (Andreou et al., 2021; Conover et al., 2017a; Kattari, 2020), participants in our study with visible disabilities reported higher occurrences of ableist microaggressions than people with hidden disabilities or those with both visible and hidden disabilities, and they reported more Helplessness and Otherization types of microaggressions. It is plausible that people with visible disabilities experience Helplessness and Otherization ableist microaggressions more frequently because of the dominant culture’s perception that disability is catastrophic and results in functional limitations beyond their disability, presuming that PWD need unsolicited help from able-bodied individuals and that PWD are burdensome (Keller & Galgay, 2010; Olkin et al., 2019). Like Andreou et al. (2021) found, participants with hidden disabilities indicated fewer overall ableist microaggression experiences, but they reported higher Minimization microaggressions than their counterparts. Because people with hidden disabilities generally do not fit the stereotypical representation of a person with a disability, they may pass as nondisabled and must prove their disability status. This is consistent with findings that individuals living with concealable chronic and mental illnesses encounter experiences in which the existence or severity of their symptoms are denied by others (Gonzales et al., 2015; Olkin et al., 2019). Unique to our study is the result that participants who identified as having both visible and hidden disabilities experienced more Denial of Personhood microaggressions, indicating PWD being reduced to their disability status (Conover et al., 2017a) and/or PWD’s other sociocultural identities being ignored or denied (Keller & Galgay, 2010).

PWD with different types of disabilities did not differ in the overall occurrence of and types of ableist microaggressions they experienced. Partly, our results concur with Conover et al. (2017a), who noted no differences in the occurrence of ableist microaggressions among people with different types of physical disabilities. In contrast, Andreou et al. (2021) reported that people with medical conditions/chronic illnesses indicated fewer ableist microaggressions than their counterparts and that disability type was related to Helplessness, Minimization, and Otherization. The variability across these studies may be due to real differences or the ways in which scholars classified disability types.

The sociocultural identities we examined did not predict the lifetime experiences of ableist microaggressions, aligning with prior researchers’ results (Conover et al., 2017a). However, unique to our study is that we found that race/ethnicity, education level, and employment status are predictive of Minimization ableist microaggressions for people of color (POC), those with graduate degrees, and PWD who are employed full time. We proffer these results may be understood from the standpoint that microaggressions toward PWD are pervasive and may intersect with other nondominant identities (Sue & Spanierman, 2022). It is not surprising that participants with nondominant racial identities had higher Minimization scores given that POC frequently report being dismissed and ignored within U.S. culture (Nadal et al., 2014); based on our study results, this holds true for POC with disabilities. Additionally, because society typically views people with graduate degrees and those who work full time as more capable, PWD who fit these categories may be more likely to experience microaggressions that minimize the existence or severity of their disabilities because they are perceived as more capable based on education and employment.

Implications

Given the ubiquitous nature of ableist microaggressions experienced in the disability community, it is vital for counselors to recognize, acknowledge, validate, and be culturally aware of and sensitive to the presence of microaggressions in the lives of PWD, and in turn, consider that socioemotional problems may be a product of microaggressions rather than attributes related to their disability (Chapin et al., 2018; Sue & Spanierman, 2022). However, counselors must understand that PWD may not use the terms microaggressions, ableist, or ableism explicitly, so they need to listen and attend to client stories that communicate such experiences and determine whether or not these experiences are part of their symptomology. Grounded in the AMS domains evident in the study results, we proffer that clients may share stories that communicate instances in which PWD experience:

  • Helplessness: PWD are given unsolicited assistance, restricted in performing daily activities, denied their independence, or not directly communicated with by others.
  • Minimization: PWD are required to continuously prove, substantiate, or explain the existence of their disability.
  • Denial of Personhood: PWD must endure others’ singular focus on their disability or disregard of their additional sociocultural identities.
  • Otherization: PWD experience others denying, questioning, or expressing irritation regarding accommodation requests or must deal with people assuming that impairment
    in one area results in impairment in other areas.

Failure to appropriately attend to these inequities experienced by PWD or to engage in cultural humility can lead to early termination, impede the working alliance, and/or result in additional psychological harm (Sue & Spanierman, 2022).

Because counselors are products of their environments, they are at risk of developing unconscious biases toward PWD with visible and hidden disabilities, and left unchecked, they can unintentionally communicate these biases within the counseling process. Biased beliefs can unwittingly drive actions that can damage the counseling relationship and result in microaggressions, including seemingly well-intended, innocuous actions like holding a door (i.e., Helplessness) or unilaterally determining a treatment plan without client input (i.e., Otherization). Such actions can usurp the autonomy of clients with disabilities and result in denying clients their basic ethical rights. Additionally, counselors may inadvertently overlook disability identity when they do not include ability/disability status or questions about disability or chronic illness as part of their intake and assessment procedures (i.e., Denial of Personhood; Cook et al., 2020). Without this knowledge, they may mistakenly minimize a client’s hidden, undisclosed disability because they were unaware of it (i.e., Minimization), yet our results support that this may occur with apparent/disclosed disabilities, too. Consequently, we recommend counselors provide intake questions that give clients the opportunity to identify their disabilities, to include additional self-determined relevant information about their disability, and to express how they would like the counselor to refer to their disability. Furthermore, counselors must follow up about intake form information during the clinical interview (Cook et al., 2020).

PWD with multiple intersecting nondominant sociocultural identities experience the inherent complexities associated with possessing overt cultural identities (e.g., POC) and concealed cultural identities (e.g., sexual/affectual orientation). It is essential for counselors to explore clients’ identities that are most important to them (i.e., identity salience; Hunt et al., 2006) and their experiences of privilege and marginalization. Accordingly, counselors must work to understand the privileged and marginalized statuses related to all of their identities and specifically related to ability/disability in order to broach effectively. To do so, counselors must examine their attitudes, beliefs, and assumptions about PWD to combat unconscious biases that could influence their behavior or interpretations in the counseling relationship (Chapin et al., 2018). To do so, Deroche et al. (2020) recommended reading autobiographies or blogs written by PWD (e.g., Heumann & Joiner, 2021), listening to or watching Ted Talks given by PWD (e.g., Young, 2014), following or joining social media pages specific to disability or PWD, and/or reading scholarly literature centered on the lives of PWD. Additionally, we recommend counselors engage in culturally responsive care, including use of disability-inclusive language (Kattari, 2020); discuss specific accessibility and accommodation needs (Chapin et al., 2018); assess office accessibility; and create disability-friendly policies (Chapin et al., 2018; Olkin et al., 2019).

Counselor educators and supervisors are responsible for preparing students and supervisees to work with PWD. Consequently, professional counselors need more than one day slated for disability topics in their multicultural counseling course. Most importantly, professional counselors need to know that PWD have historically been and are continually on the frontlines advocating for their civil rights and promoting social justice and equality. Although it is likely impossible for most programs to add another course to their curriculum, it is reasonable and doable to integrate disability into established courses as they have for other cultural topics and for supervisors to make intentional efforts to address ability/disability within clinical supervision. Strategies include creating case studies that portray PWD or disability identity (see Smart, 2012 for examples); developing activities, assignments, or projects that require counselor trainees to explore negative attitudinal barriers and social inequities experienced by PWD (Deroche et al., 2020); discussing how disability impacts family roles, responsibilities, and dynamics; using cultural broaching in the classroom and in supervision (Day-Vines et al., 2021); and designing program policies and materials that reduce attitudinal and access-related barriers for students and supervisees with disabilities.

Limitations and Future Research

The study results must be understood in the context of its limitations. Self-selection bias may have influenced who decided to participate in the study. Although we included a definition and examples of ableist microaggressions in our informed consent document, PWD who were more familiar with or had an interest in this topic may have chosen to participate compared to PWD who were less familiar or knowledgeable about ableist microaggressions. Our use of the AMS (Conover et al., 2017b) introduces limitations associated with its psychometric properties, as no normative data is available. Additionally, the AMS purports to measure the lifetime occurrence of ableist microaggressions, requiring participants to retrospectively report information from years prior; retrospective recall of ableist microaggressions may result in inaccurate data (Kattari, 2019). Although there is benefit to understanding the long-term effects of ableist microaggressions, we suggest that researchers pursue longitudinal studies rather than utilizing a one-time measure that relies on participants’ recollections.

Although our sample included people with a range of disability types and visibility of disability, the majority identified as White, heterosexual women who are employed and who had some level of higher education experience. The racial (Goyat et al., 2016), educational (Paul et al., 2021), and employment (U.S. Bureau of Labor Statistics, 2023) inequities reported in the disability community are not representative of our sample. We suggest that future studies intentionally sample individuals who are more representative of the disability community. Finally, counseling researchers must continue to investigate how ableist microaggressions manifest in the counseling relationship, best practices for helping clients heal from microaggressive experiences, and appropriate supervision and educational interventions to prepare counselors and counselors-in-training to work with PWD who have experienced ableist microaggressions.

Conclusion

The results of our study add to the paucity of research specific to ableist microaggressions, particularly with respect to visibility of disability and other nondominant sociocultural identities of PWD. Like other studies, we found high average scores in all domains, and that visibility of disability resulted in higher AMS scores and impacted the type of ableist microaggressions experienced. Although the sociocultural identities we examined did not predict the lifetime experiences of ableist microaggressions, we found race/ethnicity, education level, and employment status are predictive of Minimization ableist microaggressions for POC, those with graduate degrees, and PWD who are employed full time. We offered that all counseling professionals—counselors, counselors-in-training, counselor educators, and supervisors—must attend to disability microaggressions regularly within their professional roles and specifically, we urged researchers to increase their attention to ableist microaggression research. Together, we can reduce ableist microaggressions and eventually increase access for PWD within professional counseling.

 

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

 

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Melissa D. Deroche, PhD, NCC, ACS, LPC-S, is an assistant professor at Tarleton State University. Lee Za Ong, PhD, LPC, CRC, is an assistant professor at Marquette University. Jennifer M. Cook, PhD, NCC, ACS, LPC, is an associate professor at the University of Texas at San Antonio. Correspondence may be addressed to Melissa D. Deroche, Tarleton State University, Department of Counseling, 10850 Texan Rider Dr., Ft. Worth, TX 76036, mderoche@tarleton.edu.

A Phenomenological Exploration of Counselors-in-Training’s Experiences of Microaggressions from Clients

Corrine R. Sackett, Heather L. Mack, Jyotsana Sharma, Ryan M. Cook, Jardin Dogan-Dixon

Microaggressions can and do occur in the counseling process, yet there is a dearth of literature about how counselors-in-training (CITs) experience this phenomenon from clients or how they may respond to clients who perpetuate microaggressions against them in a therapeutic setting. Therefore, in this constructivist phenomenological study, we explored CITs’ experiences of microaggressions from clients in the counseling process. Two interviews with six participants of various marginalized identities revealed the following themes: (a) internal reactions, (b) attempts to contextualize, (c) prevalence of microaggressions, (d) navigating microaggressions, and (e) seeking support. Findings and implications for CITs and counselor educators and supervisors are discussed.

Keywords: microaggressions, constructivist phenomenology, counseling process, counselors-in-training, counselor educators

Microaggressions have been defined as intentional or unintentional ongoing verbal or nonverbal offensives experienced by individuals of a marginalized group (Ratts et al., 2016) and as “subtle and stunning” daily racial offenses that impact the health and well-being of individuals (Pierce, 1970). Counselors and counselors-in-training (CITs) of marginalized identities are often uncertain of whether or how to respond to microaggressions in counseling sessions while keeping the counseling relationship intact (Branco & Bayne, 2020). As such, counseling researchers have the opportunity and responsibility to explore the experiences of counselors or CITs who are the target of microaggressions from clients. Scholarship around this topic can help the counseling profession, and counselor education specifically, in developing competencies to help guide CITs and counselors in these situations.

Given the reality that there are clients from privileged groups receiving counseling from CITs from marginalized groups (Haskins et al., 2015; Ratts et al., 2016) and that the counseling process is an intersection of cultural identities between the client and CIT (Ratts et al., 2016), there is potential for microaggressions to occur in this relationship. Various studies have explored microaggressions within the counseling setting as experienced by clients who identify as racial/ethnic minorities (Constantine, 2007; Crawford, 2011; Morton, 2011; Owen et al., 2011, 2014); however, much less is known about counselors’ and CITs’ experiences with clients who may perpetuate microaggressions against them (Branco & Bayne, 2020). Given the dearth of literature focusing on how CITs can and do handle microaggressions from clients, we aimed to help fill this gap in the literature by exploring CITs’ experiences of microaggressions from clients.

In the 1970s, Harvard-trained Black psychiatrist Chester M. Pierce coined the term “microaggression” to describe the insults that he witnessed Black Americans encounter daily (Pierce, 1970). His work has been seminal in laying a foundation for understanding the damage that negative interracial interactions have on Black Americans’ health. Decades later, Sue and colleagues (2007) continued Pierce’s research on microaggressions and expanded its definition to include experiences of cultural bias, prejudice, and power imbalance. Literature about microaggressions in the counseling profession highlights the negative impact of counselors being the offender, or the person who perpetuates microaggressions, toward a racially/ethnically marginalized client in session (Constantine, 2007; Owen et al., 2011).

Although racial microaggressions toward racially/ethnically marginalized people have been studied extensively, microaggressions can also target gender, sexual orientation, ability status, class, religion, and other visible and invisible identities (Chan et al., 2018). The consequences of microaggressions on the counselor–client relationship have been studied in the context of gender (Owen et al., 2010) and sexual orientation (Shelton & Delgado-Romero, 2013). As such, there is a need for more research to explore microaggressions as a phenomenon that affects various identities. When individuals identify with multiple salient identities, they are more likely to experience privilege and oppression. For instance, a person can experience White privilege while simultaneously experiencing marginalization from identifying as queer—this person can belong to both oppressive and oppressed groups. Because one identity can be stigmatized while another is privileged, there is complexity in understanding one’s whole identity rather than only its parts. The Multicultural and Social Justice Counseling Competencies (MSJCC) include a quadrant to represent a privileged client and a marginalized counselor (Ratts et al., 2016) that can be used to conceptualize the dynamic of microaggressions experienced by counselors from clients. It is possible, of course, for counselors and clients to identify with being in more than one quadrant simultaneously as members of both privileged and marginalized groups. Further, the intersectionality of race, gender, sexual orientation, and other identities may increase the frequency and impact of microaggressions (Williams et al., 2021). Microaggressions toward intersecting marginalized identities compound their harmful impact (Nadal et al., 2015).

Oppression on an individual level in the form of microaggressions, regardless of whether they are intentional or unintentional, can have a devastating impact on individuals’ physical and mental health (Pierce, 1970; Ratts et al., 2016). Depression, anxiety, and post-traumatic stress have been reported by researchers as being associated with microaggressions (Williams et al., 2021). Thus, it is feasible that CITs would experience these same mental and physical reactions to microaggressions within the counseling relationship (Branco & Bayne, 2020), which in turn seems likely to influence their work with current and future clients.

Purpose of the Study
     Branco and Bayne (2020) asserted that counselor educators are called to provide training for counselors from marginalized identities to work with clients from privileged identities, and the counselor education field is lacking in this area. Because the cultural experiences and backgrounds of clients and counselors impact the counseling relationship (Constantine, 2007; Crawford, 2011; Morton, 2011; Owen et al., 2011, 2014), counseling process, treatment selection, and outcomes, it is critical that counseling researchers expand inquiry in this area (Hays, 2020). Specifically, counseling researchers need to inquire more about counselors’ experiences with social injustice and how those affect the counseling process. As established, the MSJCC framework allows for counselors and clients from many intersecting privileged and marginalized identities (Ratts et al., 2016). Although previous studies have focused exclusively on racial microaggressions from clients, Branco and Bayne (2020) called for a broader examination to include counselors or CITs who identify with a marginalized status outside of race and ethnicity. As such, the purpose of the current study was to explore CITs’ experiences of microaggressions from clients, regardless of the one or more marginalized identities they carried, through van Manen’s (2016) constructivist hermeneutic phenomenological approach. This is a reflective process focused on the lived experiences of participants. By specifically focusing on CITs’ experiences of microaggressions from clients, we gain insight into how to better provide supervision and training in this area. Thus, the research question that guided this investigation was: “What are CITs’ experiences of microaggressions from clients in the counseling process?”

Method

Research Design Overview
     We chose van Manen’s (2016) constructivist hermeneutic phenomenological approach for this inquiry of CITs’ experiences of microaggressions from clients, as it aims to increase thoughtfulness, grasp essential meaning, and come into closer contact with the world while providing thought-provoking data that are ideal for clinical practice (Sackett & Cook, 2021). van Manen described hermeneutic phenomenological research as choosing a phenomenon of serious interest, investigating the lived experience of the phenomenon, reflecting on its essential themes, describing the phenomenon through writing and rewriting, remaining in pedagogical relationship, and balancing the parts of the whole of the research.

Researcher Reflexivity
     Following van Manen’s (2016) advisement that researchers be aware of and transparent about their own experience of the phenomenon under investigation and the influence of their own values, beliefs, and experiences, we describe our positionality here for transparency. At the time of the study, authors Corrine R. Sackett, Jyotsana Sharma, and Ryan M. Cook were faculty members in counselor education programs at research universities—Sackett was an associate professor and Sharma and Cook were assistant professors. Heather L. Mack and Jardin Dogan-Dixon were graduates of a CACREP-accredited program specializing in clinical mental health counseling; Mack was practicing in agency and private practice settings and Dogan-Dixon was a correctional psychologist. Sackett, Mack, Sharma, and Dogan-Dixon identify as heterosexual and cisgender women, and Cook as a heterosexual and cisgender man. Sackett, Mack, and Cook identify as White, Sharma identifies as Asian Indian and international, and Dogan-Dixon identifies as Black and from a Christian background.

Sackett was drawn to this line of inquiry after a supervision session in which a supervisee disclosed a microaggression from a client related to gender. The supervisee’s site supervisor (a male counselor) was in the session as a co-counselor. Following the session, the CIT and site supervisor processed the event. Although the site supervisor was supportive, he advised the CIT not to address the microaggression with the client because it was not related to the client’s counseling goals. The CIT described feeling dismissed by her site supervisor’s response. She also described uncertainty in how to continue a meaningful counseling relationship with the client afterward without addressing the microaggression. This experience led Sackett to seek guidance from the literature on CITs’ or counselors’ handling of microaggressions from clients, but she found limited scholarly resources. Sackett was influenced by this experience in her conceptualization of the current study, and in analyzing and writing the findings. Further, while recognizing her privileged identities, Sackett has experienced gender microaggressions that have impacted her and the way she views this topic area. Mack, while also recognizing her privileged identities, has experienced gender microaggressions from clients and a site supervisor. Sharma identifies as an international scholar of Asian Indian descent. As an international woman of color, Sharma has experienced many microaggressions since moving to the United States. She has experienced microaggressions from clients, colleagues, and supervisors. Cook has wondered how supportive or unintentionally unsupportive he has been as a supervisor and faculty member with CITs’ experiences of microaggressions. Dogan-Dixon has experienced gendered racial microaggressions from clients, peers, and supervisors in various counseling settings across her training. She initially struggled to address microaggressions in the moment because of potential rejection and backlash; with practice, however, she has learned to address microaggressions in multiple ways, including caring confrontation. She now educates others on how to navigate microaggressions in personal and professional settings. In harnessing the interpretive nature of van Manen’s (2016) approach, instead of bracketing these biases, we embraced them as part of the process (Prosek & Gibson, 2021).

Participants
     Participants included six CITs from CACREP-accredited counselor education programs in the United States. Sampling was purposive for the phenomenon under investigation (Prosek & Gibson, 2021), and all participants met the eligibility criteria of being enrolled in a CACREP-accredited master’s program with a specialty in clinical mental health or school counseling, being enrolled in or completed practicum or internship in their program, and having lived experience of microaggressions from clients in the counseling process. Constructivist qualitative studies tend to have smaller sample sizes that allow for more depth of understanding and intriguing findings (Boddy, 2016). Though we recruited from across the United States, our resulting sample consisted of participants from the Southern region of counselor education programs. Participant ages ranged from 26–30 years. Self-named gender identity included one female, two cisgender female, two cisgender male, and one participant who did not specify gender. Self-named sexual orientation included one straight, one lesbian, two bisexual, and two who did not specify. Participants self-identified their racial/ethnic identities as Hispanic (one), Hispanic/Latina (one), Black/Afro Latino (one), Caucasian (one), and White (two). Those who answered the question of other relevant identities named student or partnership status. Participants were entered into a drawing for one of three $15 Starbucks gift cards after completion of the second interview as a token of appreciation for their time.

Participant Recruitment
     Sackett obtained human subjects research approval from her university of employment’s IRB. Sackett then recruited participants by sending two rounds of emails explaining the purpose of the study to contacts from 387 CACREP-accredited master’s programs in the United States with specialty areas in clinical mental health and school counseling. The email requested the faculty member send the recruitment email with the purpose of the study and a note about what participation entailed to their master’s students who were currently enrolled in, or had completed, practicum or internship in their program. Inclusion criteria included the experience of a microaggression from a client, regardless of marginalized identity(ies) of the CIT. The email asked CITs to contact Sackett if interested in participation. When participants contacted Sackett, she completed the informed consent process and referred them to Mack to schedule the first interview. Ten individuals contacted Sackett with interest in participating in the study. However, four of the initial 10 individuals reported not having experiences of microaggressions to share after hearing the definition of a microaggression from Mack (see Data Collection below).

Data Collection
     Mack conducted two interviews over Zoom with each participant. Two interviews per participant allowed for sustained engagement with the phenomenon, and interviews were spaced from 1 to 3 weeks apart per participant to allow time for reflection between the interviews. This resulted in 12 interviews. Each participant answered demographic questions during the first interview that requested gender, age, race/ethnicity, any other relevant identities, and pseudonym. To begin each interview, Mack broached her identities with participants (Day-Vines et al., 2007) and verbally gave participants a definition of microaggressions as intentional or unintentional ongoing verbal or nonverbal offensives experienced by individuals of a marginalized group (Ratts et al., 2016). Interview questions were centered on CITs’ experiences of microaggressions from clients, in line with van Manen’s (2016) recommendation that the interview be strongly oriented to the phenomenon. Interview questions were developed by Sackett, Mack, and Sharma and were informed by extant literature of counselors’ experiences of microaggressions from clients (e.g., Branco & Bayne, 2020), multicultural counseling competencies (e.g., Ratts et al., 2016), and CITs’ prioritization of information for supervision (e.g., Cook & Welfare, 2018), coupled with the authors’ respective expertise and perspectives. Researchers used the same interview protocol for both interviews, which can be found in the Appendix. While being mindful of the differences between counseling and interviewing (Sackett & Lawson, 2016), Mack utilized counseling skills to facilitate discussion and to communicate empathy (Kleist, 2017). Interviews ranged in length from 24 to 62 minutes (M = 46.1; SD = 11.82), except for Lila’s second interview of only approximately 5 minutes, as she indicated she had nothing to add from the previous interview. Interviews were audio-recorded and later transcribed by a graduate assistant.

Analysis
     We used NVivo Version 12 (QSR, 2018) software to manage the data. Operating from van Manen’s (2016) approach, we were concerned with capturing the essential meaning of the phenomenon, which involved seeing the essential meaning of each participant’s experience, reaching a reflective determination, and explaining the experience. In this process, we gave order to the research and writing by considering the phenomenon in themes. Along with van Manen’s hermeneutic phenomenological approach, we employed the First and Second Cycle coding process described by Miles et al. (2020). After listening to all participant interviews, Sackett reviewed the 12 interview transcripts while utilizing a line-by-line approach to coding (van Manen, 2016). She applied in vivo codes in her first review and then went back through the data to apply a combination of descriptive codes, process codes, emotion codes, and value codes in the First Cycle coding (Miles et al., 2020). This allowed for a way to summarize segments of data. Next, Sackett applied Second Cycle coding, or pattern coding, to group the initial codes into themes. van Manen described this theme development as giving shape to the shapeless in the data.

We followed van Manen’s (2016) recommendation that for deeper understanding, a peer may read a draft of the description of the phenomenon and share their insights of whether the description resonates with their own experience of the participants’ descriptions. As such, Mack, who had conducted the interviews, and Sharma, who listened to the recordings of the interviews, read the steps of First and Second Cycle coding Sackett employed and shared their insights of how the description of the findings reflected their experience of the participants’ accounts. Through this iterative process, we were able to examine, reinterpret, and reformulate themes while keeping in mind van Manen’s guiding question for this process of whether the phenomenon would still be the same if we were to change or delete any theme. We followed van Manen’s advisement to be mindful to capture individual experiential differences in our data analysis and writing process of the phenomenon. In this study, that meant considering the unique identities of each participant, including intersecting identities and how those may impact their experience of microaggressions from clients. We chose to structure our writing of the phenomenon thematically, one of van Manen’s suggestions for organizing the portrayal of the data. There is some overlap in the nuances of the meanings of the themes, as describing a phenomenon is bound to have a somewhat forced quality.

Methodological Integrity
     As suggested by van Manen (2016), the researchers engaged with each other throughout the entire process of data collection and analysis in a collaborative way that led to deeper understanding of the phenomenon. This process strengthened our engagement with the phenomenon and transcended the limits of having a sole researcher. In doing this, we had regular phone calls, video meetings, and emails throughout the study. Sackett kept a reflective journal while listening to the interviews and conducting analysis. Further, we kept a log of each step in the process, including interview data, codes, and theme development, to show the culmination of our interpretation of the findings. Finally, we conducted two member checks through email with each participant. Member checks allowed participants to reflect on the transcripts of the interviews for further insight and to review the themes and allow for feedback on if it was an accurate description of what the experience is like (van Manen, 2016). Therefore, we conducted member checks after interviews were transcribed and after theme development. In the second member check, we invited participants into dialogue around whether the themes reflected their experience of the phenomenon.

Findings

Five themes emerged from our exploration of CITs’ experiences of microaggressions from clients in the counseling process: (a) internal reactions, (b) attempts to contextualize, (c) prevalence of microaggressions, (d) navigating microaggressions, and (e) seeking support. The first theme, internal reactions, had three subthemes: caught off guard, discomfort, and imposter phenomenon. The fourth theme, navigating microaggressions, had five subthemes: fear of responding genuinely, letting it go, attempting to redirect, directly responding, and avoiding. The final theme, seeking support, had three subthemes: site, university, and family and peers. Pseudonyms chosen by the participants are used throughout the Findings section to maintain participants’ confidentiality.

Internal Reactions
     The first theme, internal reactions, embodies what was happening internally with CITs as they experienced microaggressions in the counseling process. This theme includes subthemes centered around being caught off guard, feeling discomfort, and experiencing imposter phenomenon.

Caught Off Guard
     The first subtheme of internal reactions CITs experienced, caught off guard, describes the initial reaction from the microaggression and not being sure how to react outwardly. David cautiously described his reaction to a parent in a school counseling setting as “mostly just confusion and not really being sure how to respond in that particular situation to what the parent had said.” Wesley, on the other hand, also in a school counseling setting, carefully described trying to manage being caught off guard with how he responded nonverbally in the moment:

I put on my poker face. Nonverbally, eyes kind of narrow, brows furrow. . . . [if] they catch me off guard, like one eyebrow goes up. But because . . . of the mask [from the pandemic], they can’t really read my facial expression, they can only see my eyes.

Discomfort
     CITs also conveyed feeling discomfort in their internal reactions to microaggressions, including anxiety, fear, hurt, sadness, and anger. Lila solemnly described her surprise and discomfort with a client making assumptions of her based on ethnicity as “not ashamed, but saddened that she made that difference between us. I didn’t think she would have done that.”

Imposter Phenomenon
     The third subtheme that resonated with CITs’ experiences in terms of internal reactions was imposter phenomenon. CITs often felt microaggressions from clients made them question their competency and even confirmed doubts they already had in the counselor role, as David thoughtfully articulated:

I think this goes back a little bit to the imposter syndrome that a lot of interns feel, and that I know that I’ve certainly felt. It’s like someone seeing me for who I am and confirming all the different feelings that I have about myself. About maybe not being fully capable in the role yet. . . . very much like, “oh you’re seeing me for who I am” and feeling . . . “I agree with you. You’re seeing how I see myself in some situations.”

Attempts to Contextualize
     The next theme, attempts to contextualize, captures CITs’ tendency and desire to try to make sense of the client microaggression and to understand where the client was coming from and why they may have felt that way or may have said those things. For instance, Lila rationalized—while not excusing the microaggression from her client—“I guess the moment when she said that she was ill, and she was going through a lot of issues. So, I kind of understand her, but I don’t think there was a need of saying stuff like that.” Riley came from the perspective that it is part of a counselor’s role to seek to understand the microaggression:

I see where individuals come from and . . . my job will be to understand the perspective of the other individual . . . and show that type of unconditional positive regard and that unconditional empathy toward them. And kind of look at things from their view. I try not to take things . . . too hard. Because it was just the way they were raised.

Prevalence of Microaggressions
     The next theme encompasses CITs’ perspectives that microaggressions are part of their lives and ongoing experiences, and in some cases they described feeling a bit numb or resigned to microaggressions. Riley said that she “didn’t feel anything. I was just like, ‘here this guy goes again.’ I wasn’t frustrated because I didn’t feel my face getting hot. . . . Typically when I get frustrated, my ears start to burn.”

Wesley underscored the prevalence of these experiences in his world, too: “At this point, nothing really surprises me. Maybe it’s me putting on a pair of rose-colored glasses and just using the glass to filter through whatever microaggressions come at me at this point.” He expressed feeling like he had experienced enough microaggressions to “kind of become numb to it. . . . it happens, and you don’t even pay it any mind, especially living in the South.”

Navigating Microaggressions
     The next theme speaks to how CITs navigated, or thought about navigating, the microaggressions with clients. These responses ranged broadly from fear of responding genuinely to letting it go, attempting to redirect, directly responding, or avoiding.

Fear of Responding Genuinely
     The first subtheme captures the participants’ fear of responding genuinely to clients, even when in some cases they would have liked to. Some of this fear centered on participants’ awareness that they may be playing into stereotypes held by clients if they were to respond genuinely, as Riley richly articulated:

That really bothers me . . . I tend to find myself taking a moment to myself, and I’ll be like, “okay, you’re good” . . . “that’s okay. It’s just one thing that one person told you and maybe they were having a bad day.” So, I try to be as understanding as I can.

Riley expressed that society and the media often portray Latina women as “feisty” or “spicy,” and that she does not want to “give [someone] that satisfaction” of confirming the stereotype: “I’m not like that, you know? I’m not spicy. I’m not a food.”

Other CITs described fear of the vulnerability involved with responding genuinely to a client’s microaggression. For example, Blake explained her genuine response and surrounding fear:

And I did disclose to the client that I’m bisexual. I said, “Oh I’m, I’m bi.” But I had that like, even knowing that the client was part of LGBTQ community, I had that question of like, “Why is the client asking? Is this appropriate? What should I say? What do I do?”

Letting It Go
     CITs described often letting microaggressions go for the sake of the client, the counseling, and the counseling relationship. Connecting back to the theme of attempting to contextualize the microaggression, Riley felt it was her responsibility to let it go, “because they’re [microaggressions] from clients, I understand the role as . . . as a student counselor, that I have to kind of push it aside, and bracket those feelings.” Wesley was earnest in his feeling that microaggressions from students’ parents should not get in the way of his work as a school CIT:

Yeah it’s going to take the focus off of the kid. And it’s going to make things awkward. So I’m all for teaching people, but there’s a . . . moment in time when it’s appropriate. And at this point . . . I’m just trying to get through what we’re doing so we can move on to the next parent. No . . . hard feelings, I’m not upset. I’m a little disappointed, but I’m not livid . . . let’s just move on.

Attempting to Redirect
     Some CITs chose to navigate the microaggression by redirecting it back to the client or to another topic without directly addressing the microaggression. For instance, Riley spoke to her efforts to connect these incidents back to clients indirectly: “Even if it’s something said toward us, we try to find a window . . . or different backdoor type of thing to redirect whatever they are saying back to them.”

Directly Responding
     There were times in the CITs’ experiences of microaggressions in counseling where there was a direct response, either by themselves, a part of the client system, or their site supervisors. CITs seemed to view these instances as reparative in the rift the microaggression created in the therapeutic relationship. For example, Wesley fondly recalled a time when a student apologized for his parent’s microaggression after the fact:

They felt that I was uncomfortable, and they felt the need to try and repair it by apologizing for their parents. So it was very validating to me as a person. And to me as a Black person, because the kid realize what their parents had [done] was out of pocket . . . I’m assuming the kid didn’t want our relationship to suffer. . . . So we talked about it. “Look it’s cool it happened, you and I are still good,” and we moved on.

In a different vein, Blake said that responding directly to a youth client questioning her sexual identity in a public area of the practice helped build trust with the client:

[If] I had hesitated, or if I had said, “oh, no, like I’m not like [that],” I think you know, I think people are perceptive and I think that would have damaged [the relationship]. Even if I’m not sure that the disclosure was an additive piece to the relationship, I think that not being forthcoming would have detracted from anything in that moment.

Avoiding
     Finally, within the theme of navigating clients’ microaggressions, participants reported engaging in avoidance afterward in response. This avoidance included instances when the CIT dreaded contact with the client (or the client system) and limited contact when possible. Avoidance also showed up on behalf of the client by discontinuing work with the CIT in individual or group settings. M relayed that her site found a way to separate her and the client who microaggressed against her: “They even said . . . ‘We’re going to not put her in groups with you . . . it’s just not safe for either of you guys.’” Wesley, a school counseling CIT, somberly described parents trying to avoid him after microaggressing against him: “I’ve had a few [parents] request a different . . . counselor when they come in, because they may feel like they soured their relationship with me already. These are the parents . . . who have noticed that they . . . micro-assaulted me.”

Seeking Support
     The final theme, seeking support, captures participants’ experiences (or lack thereof) of seeking and finding support from their sites, university supervisors and faculty, and family and peers.

Site
     CITs often found support at their sites after experiencing microaggressions from clients. This was frequently seemingly because of physical proximity. Often CITs’ site supervisors or other counselors at the site may have witnessed the microaggression or CITs were able to debrief with someone nearby after it happened. David indicated having a quick but meaningful moment of support with his site supervisor before moving on to their next meeting. He recalled that “after the meeting my supervisor and I just kind of like gave each other a look like, ‘ooh that was kind of a strange meeting.’” M was able to debrief with her site supervisor regularly following repeated microaggressions from her client and found her guidance helpful and supportive, especially in the realm of not taking things personally. M said her supervisor encouraged her to “process it on my own, to make sure that it’s not affecting me . . . to where I can’t even use my counseling skills. Like she didn’t want me to go home at night thinking that a patient hates me.”

University
     For the most part, CITs described either not taking these instances of microaggressions to university supervisors or faculty or facing unsupportive responses when they did. Blake relayed feeling shut down by a faculty member’s humor in a class discussion when she brought up how she handled a microaggression with self-disclosure:

Yeah it was a moment of . . . playful questioning of like, “Oh, that’s the decision you made?” That kind of has that implication that maybe it wasn’t the best decision without having more context, right? And I know . . . that [humor is] kind of his approach. But it was a moment, where I was . . . like, “well I don’t really feel like going further with this.”

In some cases, CITs did find helpful and supportive responses from their faculty. Riley described her professor normalizing her experience and giving her what she found to be helpful advice:

[He] told me, “Sometimes we get things like that,” and that’s when he gave me that advice of trying to redirect the question or redirect it back to the client, versus falling into the trap. Well, he called it a trap. Into that little trap they could be setting for us.

Many participants described feeling as though the microaggression was handled by themselves, at their sites, or through processing with family; thus, they felt no need to bring it up in university supervision.

Family and Peers
     CITs frequently described seeking out their families, friends, and peers for support after experiencing a microaggression from a client. Lila processed her experience with her husband, who gave her advice to have more boundaries with her client and “to keep it more professional. . . . I would sometimes disclose about my personal life because she would ask. So I just stopped disclosing.” Riley expressed feeling the need to vent to friends about her experience, “like ‘What the hell was this lady thinking like telling me that?’ . . . just letting it out.”

Wesley sought support from his mother and grandmother in processing microaggressions perpetuated by students’ parents in his school counseling role. He relayed their supportive response:

It was more of a, “These things can happen, you handle it appropriately.” . . . they have had experiences with microaggressions themselves. [They] may not have known what to call them but have experienced it. And pretty much just applauded me for staying neutral, not punishing the kid for what their parents said, and not completely blasting the parent in the meeting because . . . of a joke they let out.

Discussion

In the current study, we explored six CITs’ experiences of microaggressions perpetuated by their clients in counseling settings. The findings from this study provide insight into how novice counselors experience microaggressions from their clients and choose to handle it. We hope these findings enrich the understanding of client-based microaggressions and offer important implications for CITs, counselor educators, and supervisors.

The first theme, internal reactions, reflected the ways in which participants internally processed the microaggression from their client, which is consistent with prior literature of counselors of color’s experiences with microaggressions from clients (Branco & Bayne, 2020). Interestingly, the CITs in the current study described being caught off guard—feeling confused and uncertain with how to respond—while the more seasoned counselors of color in Branco and Bayne’s (2020) study described buffering and bracing for the microaggression, as if they were prepared for it. Counselors in Branco and Bayne’s study (2020) described their readiness for microaggressions from clients was informed by their prior and extensive personal and professional experiences. Although the CITs may have experienced microaggressions in their personal lives and were used to them, as evidenced by the theme of prevalence of microaggressions, their being caught off guard may be attributable to their lack of counseling experience, and more specifically, having never experienced microaggressions from clients and having not yet learned how to navigate this issue.

The CITs further described how microaggressions from clients caused feelings of hurt, fear, anger, sadness (subtheme of discomfort), and experiences of imposter phenomenon. CITs commonly experience confusion, doubt, and worry about their own professional competencies and preparedness as counselors—sometimes internalizing issues in counseling as their own failures (Loganbill et al., 1982; McNeil & Stoltenberg, 2016). Ultimately, CITs in this study also tried to understand the microaggression from their clients’ perspectives. CITs seemed to understand that people inherit their biases from their families and ancestors and reinforce them through microaggressions, oftentimes unintentionally (Williams et al., 2021). Counselors of color in Branco and Bayne’s (2020) study expressed that they tried to make sense of the microaggression as well, and considered their clients’ worldview, racial identity development, and experiences as they evaluated how they would handle the microaggression. The degree to which CITs can consider the clients’ worldview and cultural identity development may depend on their level of professional development (McNeil & Stoltenberg, 2016) and their own identity development (Day-Vines et al., 2007; Jones et al., 2019).

The CITs in the current study described microaggressions as an ongoing part of their lives, as captured in the theme of prevalence of microaggressions. Microaggressions have been referred to as everyday racism, as they are routine and chronic for individuals of racially and ethnically marginalized populations (Williams et al., 2021). This finding is consistent with prior literature of racial microaggressions (Branco & Bayne, 2020; Haskins et al., 2015, Pierce, 1970). Our findings also extend the knowledge base about microaggressions from clients, as microaggressions can target not only race and ethnicity, but also gender, sexual orientation, age, socioeconomic class, and religion. This finding is not unexpected; as informed by the MSJCC (Ratts et al., 2016), counselors and clients possess multiple identities, both privileged and marginalized, and visible and invisible.

The CITs in this study employed a variety of strategies in navigating microaggressions from their clients. Many CITs felt discomfort in the moment, but they were fearful of responding with their genuine reactions for various reasons. Some CITs tried to redirect the microaggressive client by concentrating on the client’s presenting issue or by taking the focus of the conversation elsewhere. Some CITs directly addressed perpetrators’ microaggressions and expressed that this action helped the relationship, while others decided to forgo addressing the microaggressions altogether. In some situations, clients and CITs attempted to avoid each other following the microaggressive incident. These varying responses are not unlike those found in prior research (Branco & Bayne, 2020). A unique contribution to this study is that our participants even experienced microaggressions from clients’ parents, reflecting a larger system that may foster and perpetuate biased opinions and perspectives toward individuals with marginalized identities. When counseling children, parents play an important role in the counseling relationship, despite not being the identified client (Sackett & Cook, 2021).

The final theme, seeking support, reflected the participants’ willingness and desire to seek support for their experiences of microaggression and from whom the support was sought. CITs must decide whether to disclose an issue experienced in counseling, including microaggressions (Branco & Bayne, 2020), and with whom they trust to share this information (Cook & Welfare, 2018; Cook et al., 2019). Some counselors in Branco and Bayne’s (2020) study spoke of seeking support (i.e., coworker, friend), while others did not and chose to process the event independently. The response of the CITs in our study was also somewhat mixed in this regard, as some CITs sought guidance from professionals at their site or, less often, from university faculty or supervisors, while others sought support from individuals in their personal lives. Given that our participants were trainees, it is not unexpected that they would seek guidance from someone more experienced, like a supervisor (McNeil & Stoltenberg, 2016), though interestingly many CITs did not choose to bring these situations to a university supervisor or faculty member. Further, the participants’ satisfaction with the support that they received, especially from their university, varied greatly. Although some participants felt validated, others felt unsupported. It remains to be seen how the response of the supervisors might inform participants’ actions in the future, although Cook et al. (2019) found that CITs who disclosed a salient concern to their supervisors and felt unsupported may be less willing or unwilling to bring up similar issues in the future with the same supervisor.

The finding that CITs in this study were discussing the microaggressions with family and peers must be carefully considered, even though this finding is not entirely unexpected. Ladany et al. (1996) found that CITs commonly discussed issues withheld from their supervisors with peers and friends, although these people were most often also in the mental health field. Further, studies have found that counselors with marginalized identities value the support of others with shared identities (Branco & Bayne, 2020; Haskins et al., 2015). However, like other scholars (Ladany et al., 1996), we wonder how a CIT’s professional development or client’s care might be impacted by heeding the advice of or seeking support from someone who does not possess the necessary training or is bound to the same ethical and professional mandates as a clinical supervisor or infield peer.

Limitations
     There are limitations to this study that are important to note. Although researchers recruited participants from CACREP-accredited programs from across the United States, the resulting sample consisted of only those from the Southern region. CITs’ experiences with microaggressions in this region may be different from those in other parts of the country. Next, we did not explicitly ask about participants’ targeted identities; this information was inferred from participants’ experiences. Although a plethora of existing research focuses on racial microaggressions, we acknowledge that our participants also spoke about other marginalized identities that were salient to them. Additionally, although our sample size was congruent with the constructivist philosophical stance and scope of the study (Boddy, 2016), the sample was relatively small. Counselor educators should consider the transferability to CITs with marginalized identities working with clients of privileged identities. Finally, given van Manen’s (2016) recommendation for an interpretive conversation with participants around the identified themes, scheduling a verbal conversation with each participant for the second member check may have allowed for more input from participants on the findings.

Implications for CITs, Counselor Educators, and Supervisors
     Readers will need to determine, along with the researchers’ description, the naturalistic generalizability of these study findings to their contexts (Hays & McKibben, 2021). However, the findings from this study offer several notable implications for CITs. As with the participants in this study, CITs experiencing uncertainty with how to respond to microaggressions from clients should be expected, given that microaggressions can be difficult to identify and rectify because of their nebulous nature (Williams et al., 2021) and given the lack of training CITs receive on how to navigate these complex issues (Haskins et al., 2015). Further, learning how to best attend to cultural issues in the counseling relationship is a learned skill (Ratts et al., 2016) that is gained through curiosity, intentional learning, lived experience, and continued professional development (McNeil & Stoltenberg, 2016). As evidenced by findings from this study, as well as other studies (e.g., Branco & Bayne, 2020), counselors choose to respond to microaggressions from their clients in a multitude of ways, including offering no response at all. How best to respond to microaggressions is ultimately the choice of the CITs themselves, including the degree to which they discuss their experience and with whom. For example, CITs must consider their position of power in the counselor role, the impact of any decision on the counseling relationship, the intentionality of clients’ microaggressions, and their own emotional well-being
(Pierce, 1970). Given the complexity of this decision, there may be some useful strategies to help inform CITs’ decisions in how to best respond (Hernández et al., 2010; Nadal, 2011).

CITs may find it helpful to broach cultural identities with their clients at the beginning of their working relationship (Day-Vines et al., 2007). By inviting and normalizing conversations of cultural differences, it may make it easier for both parties to openly discuss microaggressions when they occur. CITs may also find it helpful to model humility in the counseling relationship by correcting their own assumptions about clients (Marbley, 2004). Broaching is a skill and a form of immediacy, or processing the here and now of the counseling relationship, which has been found meaningful in the counseling relationship and the counseling process to clients (Sackett & Lawson, 2016; Sackett et al., 2012) and CITs (Sackett et al., 2012). We believe CITs can harness the skill of immediacy (i.e., broaching) to address microaggressions with clients when they occur in counseling. But first, they need to be taught skills to disarm and dismantle microaggressions to reduce the harm and distress they may cause (Sue et al., 2019). Although the onus is not on CITs who experience microaggressions to always address them in the moment, developing a clinical skillset to educate clients on how to recognize their biases, challenge erroneous beliefs that undergird microaggressions, and develop empathy with those they have harmed is important to mitigating the risk of burnout among CITs with marginalized identities (Williams, 2020).

The findings from this study also offer important implications for counselor educators and supervisors. Fickling et al. (2019) contended that the MSJCC framework (Ratts et al., 2016) should be explicitly integrated into clinical supervision. These findings might also provide a rationale for counselor educators to consider how to infuse the MSJCC framework into their classrooms to better prepare students for microaggressions from clients. Specifically, counselor educators and supervisors can examine with CITs how a counselor holding a marginalized identity can engage with a client holding a privileged identity in a counseling relationship, including discussing or role-playing various scenarios and ways to manage microaggressions from clients (Branco & Bayne, 2020). Encouraging counselor self-care strategies (Sue et al., 2019) in processing these scenarios is critical.

Haskins and colleagues (2015) found that counselor educators acknowledged their curriculum was tailored for White students to work with White clients, even if unintentionally. Counselor education program faculty may apply critical race theory tenets to their curriculum to challenge the dominant White discourse in counselor education, as advised by Haskins and Singh (2015). Our findings highlight the value of training related to CITs’ other marginalized identities as well (e.g., gender, sexual orientation, religion, first language) when working with clients of various privileged and/or visible identities, a need identified by Branco and Bayne (2020). The absence of education on navigating microaggressions may lay the foundation for marginalized students to feel as though their experiences are misunderstood or unwelcomed by faculty or supervisors. The current study provides counselor educators and supervisors with information from CITs on how they experience the counseling process when the dynamics of clients with privileged identities and counselors with marginalized identities are present and political (Ratts et al., 2016). Our study findings fill a gap in the literature of the experiences of CITs who encounter clients who offend and perpetuate microaggressions against them while in session.

Because CITs and supervisees control what they share in supervision, fostering an environment that promotes supervisee disclosure is critical (Cook & Welfare, 2018). Studies of intentional nondisclosure (i.e., supervisees’ purposeful withholding of salient information in supervision; Cook & Welfare, 2018; Ladany et al., 1996) found that supervisors can best mitigate supervisees withholding information by attending to the supervisory relationship and demonstrating cultural humility (Cook & Welfare, 2018; Cook et al., 2020). When a CIT voices concerns related to their identities (i.e., a microaggression), counselor educators and supervisors have an opportunity to support such disclosure in a way that validates the CIT’s experience and encourages future disclosures (Cook et al., 2019). Jones et al. (2019) provided situational examples and related response prompts to guide counselor educators and supervisors on ways to broach cultural differences with their supervisees at the beginning of the supervisory relationship and appropriately attend to cultural issues throughout the relationship. Further, as multicultural competence is positively correlated to a stronger supervisory relationship from the supervisees’ perspective (Fickling et al., 2019), supervisors who work to incorporate the MSJCC framework into their supervision will benefit in their supervisory relationships, hopefully leading to increased disclosure of experienced microaggressions, and provision of appropriate support in navigating the CIT–client relationship.

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

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Appendix
Interview Protocol

Tell me about your experience(s) where a client said something that felt like a microaggression toward you.

  • What feelings came to you when you experienced the microaggression from your client?
  • What thoughts came to you?
  • How did you respond (verbally and/or nonverbally)?
  • How did the client respond to your response?
  • What occurred then?
  • How do you feel this impacted your relationship with the client?

Did you process this experience with anyone? With whom did you share about this experience (peers, supervisors, faculty, friends, family, etc.)?

If you processed this with your supervisor(s), was this a doctoral student supervisor, faculty supervisor, or site supervisor?

  • How did your supervisor(s) respond?
  • How did your supervisor(s) encourage you to respond?
  • How did you feel about that response from your supervisor(s)?
  • How did you proceed after the feedback from your supervisor(s)?

If any further action was taken with your client following supervision:

  • How did your client respond?
  • How do you feel about how it went?
  • How do you feel this impacted your relationship with the client?

Did you seek [additional] supervision following [remedial] interactions you may have had with your client?

  • From whom?
  • What was the feedback from your supervisor(s)?

How do you feel this entire experience impacted your relationship with your supervisor(s)?

Any other experiences?

Corrine R. Sackett, PhD, LMFT, is an associate professor at Clemson University. Heather L. Mack, LPC, works for The Well Center in South Carolina. Jyotsana Sharma, PhD, ACS, LCMHC(NH), is an assistant professor at Oklahoma State University. Ryan M. Cook, PhD, LPC, ACS, is an associate professor at the University of Alabama. Jardin Dogan-Dixon, PhD, is a Correctional Psychologist for the Federal Bureau of Prisons. Correspondence may be addressed to Corrine R. Sackett, 225 S. Pleasantburg Dr., Suite D-1, Greenville, SC 29607, csacket@clemson.edu.