Bringing It in the Room: Addressing the Impact of Racism on the Therapeutic Alliance

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It is well documented that people of color face disparities in access to and quality of healthcare. There are inequities in healthcare outcomes as well. The biases of healthcare providers are one of the many factors that contribute to healthcare incongruence. Often overlooked, race impacts therapeutic relationships and highlights ingrained patterns of binary thinking, thereby creating hierarchies. Some physicians experience anxiety regarding addressing racism, leading to avoidance of its existence and effects on the physician–patient alliance. Others address the dynamics by bringing the patient’s family experiences and lived experience “in the room.” By following the “emotional red thread,” we can bring clarity to the issue of making racism a neutral topic of conversation in treatment. As it has so often in the past, racism should not and cannot be ignored.