Diversity Training through Literature: The Fishbowl Grand Rounds

1. Diversity Training through Literature: The Fishbowl Grand Rounds Innovative and Engaging Ways to Learn about Groups of People Jessica Henderson Daniel, PhD, ABPP Boston Children’s Hospital 2014

2. Location • Department of Psychiatry • Multi-disciplinary Training Site: Psychology. Psychiatry and Social Work (Interns, Fellows and Residents) • Staff—Early Career to senior Staff

3. Interns in Program-Phases • Little knowledge about persons who would be seen as diverse—in terms of race and ethnicity • Taught to acknowledge that they are different—patient and provider—and move on • Invite the patient to feel free to initiate discussions about differences

4. Brief Review of Context • Since the 1980’s—a re-segregation in the US in terns of housing and education • Elementary school • High School Years—segregated tables in the cafeteria • College-Relationships that ignore differences

5. Instruction and Training • Lectures • Review of Literature • Documentaries—Viewed and Discussed • Experiential Exercises • Anonymous Questions

6. Novels for Education and Training • Ideal—a multi-racial/ethnic group of clinicians discuss a novel by and about persons of color with the author • Journey—Achieving the ideal

7. Training in the 21st Century • Strategic Planning • Who—Begin with the current staff • What and How—Begin with books that include racial issues but also present psycho-social issues that do not require an explicit discussion about race

8. Initial Fishbowl GRs • Six staff members would discuss a novel in front of an audience • Other staff and trainees would listen to their discussion • After the discussion—audience would join the Fishbowl participants by sharing their comments and questions

9. Participants • Two from each of the three disciplines • Male and female • Mid-career and senior staff

10. The Experience • No one declined the invitation to participate • Excellence attendance • Attendees had read the book • Individual Presentations( 4-5 minutes) • Participation in the Q and A was good • Delayed start—a panelist was 10 minutes late—no one left the room • Minimal discussion about race

12. 2004—The Fall of Rome Issues: • Racial Isolation—adult and adolescent • Crossing SES lines in a boarding school • Loss • Depression • Anger management • Stereotype threat • Microaggressions • Inter-racial relationships—adolescent and adult

14. 2005—The Emperor of Ocean Park  Issues: • Middle class Black family –stresses • Deal making and consequences                                • Relationships that cut across SES and racial lines

16. 2006-Caramelo  Issues: • Mexican American family • The joys and stresses of returning to the family in Mexico                                • Acculturation

18. 2007---72 Hour Hold 2008—72 Hour hold (with invited presenters)  Issues: • Generational issues—alcoholism  • Mental illness of daughter  • The strong Black woman who cares for all—employees, male friend and his son and her daughter • The stress of seeking care and the potential awkwardness of being the only Black person in a group  • The revolving door of mental health care  •  Mothers serving as their own case coordinators • The reality of living with your daughter who has a chronic serious mental illness 

20. 2009—Namesake   Issues: • Understanding the arranged marriage  • Immigration to the US  • Raising first generation children—different developmental stages   • Marital tensions  • Belonging to an ethnic community—the advantages and disadvantages • History of India

22. 2010—The Brief Wondrous Life of Oscar Wao Issues: • The history of the Dominican Republic • The relationship between the history and immigration to the US  • DR communities in the US  • The DR history’s impact on family and marital relationships  • DR and the Haitian presence in the DR

24. 2011-Brother, I’m Dying   Issues: • The history of Haiti—political and economic                                • The earthquake in Haiti    • Immigration process for Haitians-children separated from parents  • Immigration—placement in detention centers   • Lack of access to medical care  and legal assistance In detention centers   • Development of children –separated and re-united  

26. 2012-Blanche Cleans Up by Barbara Neely    Issues: • The world from a maid’s viewpoint   • Raising children in an under-resourced urban environment  • Sexual orientation—voiced and unvoiced  • The ties between the poor and the wealthy, the Black and the White • Deal-making across racial and SES lines      • Community elders and their roles

28. 2013-A Free Life by Ha Jin  Issues: • Different perspectives of Chinese (discussion led by a Taiwanese and a person from Hong Kong) • Separation of parents and children—the how and why     • Re-unification of the family •  Dreams deferred or destroyed as a consequence of the immigration process

29. Engagement Matters • Introduction to literature across cultural groups • Increase receptivity to different voices within groups • Learning can be stimulating as well as a pleasure

30. Recommendations • Phase 1 • Begin with Ted-Tube—The Danger of a Single Story—engaging talk by the brilliant Nigerian writer Chamamanda Adichie • Selection of Faculty—Senior and junior • Preparation –To integrate science and practice (Including TF reports including Immigration, Zero Tolerance, etc) • Selection of Book—Medium length—preference on kindle

31. Recommendations • Phase II • Clinicians who are members of the group in the book • Historical Info • Current ties to the country • Listen for differences among the presenters—age of immigration, SES, mobility since immigration, current contact with their respective racial-ethnic group.

32. Recommendations • Phase III—Invite the authors • Author only—Reading and then Q and A • Author present and then interviewed by faculty • Author present and then joined in discussion with several training faculty member

33. Let the Reading Begin • Grand Rounds • Clinical Seminars (Internship and Post-Doctoral Programs) • Graduate Programs • Reading groups for psychologists