Anti-racism in speech and language therapy: part 3

This, the third in our series of podcasts looking at anti-racism in speech and language therapy, centres on the Anti-racism survey report Feb 2023 which was researched and written by SLT student and EDI rep at Reading University, Chloe Nkomo.

Chloe talks about the key takeaways from her report.  She is joined by Dorett Davis, one of the founders of the network group 'SLTs of Colour' and RCSLT chair Dr Sean Pert. The group discusses:

• Key findings from the report.
• Lessons learned, but what still needs to happen.
• What can each of us do about it? 
  • How to manage uncomfortable conversations.
  • How to challenge racist behaviour, or practices that disadvantage minoritised groups.
  • Being able to reflect on your own background and how that might marginalise or advantage you.
  • Making a start on this journey.
• RCSLT's role in this

Interviewees:

• Chloe Nkomo, MSci Speech and Language Therapy at University of Reading
• Dorett Davis, Head of CYP Therapies, Lewisham, representing SLTs of Colour
• Dr Sean Pert, Chair of the RCSLT and Senior Clinical Lecturer and Consultant Speech and Language Therapist

Useful links from RCSLT

• Analysing diversity, equity and inclusion in speech and language therapy
  Nkomo, C., Pagnamenta, E., Nair, V., Chadd, K. and the Royal College of Speech and Language Therapists. (2022). Royal College of Speech and Language Therapists. Available online: https://www.rcslt.org/learning/diversity-inclusion-and-anti-racism/ 
  
  
• Anti-racism in AHP Education: Building an Inclusive Environment, Council of Deans of Health, April 2023
  Highlights the issues affecting minority ethnic Allied Health Professions (AHP) students and provides recommendations for how universities can embed the key principles of anti-racism within their processes.
  https://www.councilofdeans.org.uk/2023/04/council-of-deans-of-health-release-new-report-anti-racism-in-ahp-education-building-an-inclusive-environment/ 
  
  
• RCSLT’s anti-racism programme of learning: https://www.rcslt.org/learning/diversity-inclusion-and-anti-racism/programme-of-learning/ 
  
  
• RCSLT list of resources on microaggressions and bullying
  https://www.rcslt.org/wp-content/uploads/2021/02/microaggressions-and-bullying-resources.pdf 
  
  
• RCSLT materials on starting anti-racism conversations in your workplace
  https://www.rcslt.org/learning/diversity-inclusion-and-anti-racism/programme-of-learning/#section-3 
  
  
• Reflecting on positionality using a social identity map
  Jacobson, D., & Mustafa, N. (2019). Social Identity Map: A Reflexivity Tool for Practicing Explicit Positionality in Critical Qualitative Research. Int

Please be aware that the views expressed are those of the guests and not the RCSLT.

Please do take a few moments to respond to our podcast survey: uk.surveymonkey.com/r/LG5HC3R

Transcript

Speaker Key (delete/anonymise if not required): 

HOST:                         JACQUES STRAUSS 

CHLOE:                      [FULL NAME]

DORIT:                        [FULL NAME] 

SEAN:                         SEAN PERT

MUSIC PLAYS: 0:00:00-0:00:06

HOST:                         0:00:06 Welcome to another RCSLT podcast. My name is Jacques Strauss. 

This is the third in our series about racism. In our first podcast, we spoke to SLTs of colour to get their views on and hear more about their experiences of racism within the wider profession. 

In the second episode, we took a closer look at the Royal College of Speech and Language Therapists as an institution, and specifically the report that Kiki Maurey wrote about racism within RCSLT and what needed to change. And now, about a year later, we have convened a panel to revisit the topic. 

Some significant changes have happened in RCSLT since, but we thought this would be a good opportunity to take stock of what has been achieved and what still needs to be done. And in this episode, we’re not only talking about how we can improve the working environment for minoritised clinicians, but also how we improve service delivery and the outcomes for the diverse communities of the UK. 

I started by asking the panel to introduce themselves. 

CHLOE:                      0:01:08 Hi, I’m Chloe [inaudible 0:01:10] and I am a final year SLT student at the University of Reading. 

DORIT:                        0:01:14 Hi, I’m [Dorit 0:01:14] Davis. I’m a speech and language therapist and a member of SLTs of Colour. 

SEAN:                         0:01:19 Hello, my name’s Sean, pronouns are ‘he/him’ and I am Chair of Royal College. 

HOST:                         0:01:25 I wonder if we can start with you, Chloe, you have been involved in writing a report, and I wonder if you could tell us a little more about what that report is and how it came about? 

CHLOE:                      0:01:40 Sure. It came about through the University of Reading Europe scheme, which is an undergraduate research opportunities program, and it gives undergraduate students a wide variety of research opportunities across the university. 

It was a scheme I’d always wanted to take part in, just to develop my own research knowledge and skills. And it just so happened that the year I took part, the Royal College had linked up with Uni of Reading for a project around DEI in SLT, which is a particular interest of mine. 

So, I was tasked with organising and analysing data collected from a survey prior to the Royal College anti-racism workshops in 2021. That survey explored perceptions of anti-racism and issues of DEI in relation to the profession, and it looked into what areas of research should be prioritised for the future also. 

Those survey results were analysed within four themes, so around the workforce, meeting the needs of service user populations, overall clinician confidence, and support for or experiences of underrepresented SLTs and students. 

I also looked at responses between white ethnic group respondents and respondents from minoritised backgrounds. So, really trying to dig into the data, just to see if there were any differences between those groups. 

HOST:                         0:02:59 Brilliant. And so, we come to the main question, which is: what did you find? 

CHLOE:                      0:03:04 Most interestingly, there was a really clear discrepancy between expressed degree of confidence between white ethnic group respondents and those from minoritised backgrounds, so with minoritised clinicians and students overall expressing far less confidence in the level of commitment of organisations to DEI in the workforce, commitment to meeting the needs of service users in conducting assessments for multilingual service users, and also in the level of support for an experience of underrepresented SLTs and students. 

So, a very clear picture of difference there, which I think is really interesting and warrants some further explanation, which I think we’ll dig into a bit later! 

But overall, it was a very mixed picture, so I think there are some very clear areas of further research identified. The top three research priorities were racism and anti-racism in SLT, anti-racism, diversity, and inclusion aspects of training, and cultural awareness or competence of SLT. 

Again, the members that did take part in the survey have clearly identified where they would like the Royal College and academics to direct their future research, which I think will be really helpful. 

HOST:                         0:04:15 If I understand you correctly, one of the key takeaways is minoritised SLTs are going, we think there’s still quite a lot of work to be done, and potentially their white counterparts don’t think there’s as much work to be done. 

CHLOE:                      0:04:28 That’s exactly it. And as well as what work needs to be done it’s also the initial acknowledgement that racism and issues of racism exist in the workplace, in universities at a structural level. So, even that recognition that that is happening on a daily basis. 

HOST:                         0:04:46 Dorit, I wonder if I can turn to you and ask you a couple of questions. Firstly, were you at all surprised by the findings of this report? 

DORIT:                        0:04:56 No, I’m not surprised by the findings of the report. It’s a common theme amongst our followers. We’ve also been involved in some work with undergrad and postgrad students on speech and language therapy courses and that’s very much their experiences. 

HOST:                         0:05:18 We’ve now spoken to you on two separate occasions about this topic. A fair bit has happened in the interim; I think it was about a year ago since we last spoke. I wonder what are your perceptions about what things are like, what has changed, what has not changed? Can you give us a general overview of your thoughts? 

DORIT:                        0:05:37 I think the College has embraced the anti-racist, anti-racism agenda. If you look back what was on the College’s websites and the discussions we were having pre-2020, there was very, very little. Diversity was looking perhaps more at men coming into the profession. There was a lot of emphasis on bilingualism or multilingualism. But the real underlying nutty conversations about race, and being a minority in the profession wasn’t really addressed.

And the College has listened, and we are certainly… I mean, you go onto the College website, there’s lots of resources that’s there. The imagery that we’re seeing now of therapists of different ethnicity; prior to 2020, I think I hardly ever saw a black face or an Asian face in College materials. In fact, that definitely has changed. 

But, of course, the work that the College is doing based on the report that was conducted by Kiki that looked at the way the College Board is constructed and the recommendations, and we are now seeing more therapists from minoritised groups coming forward to be on the Board of Trustees and also in the various committees. There’s still small numbers, but there is definitely a sign of therapists from minoritised groups starting to engage more in the business of College. 

HOST:                         0:07:19 When we recorded the last podcast, Mary Heritage was the outgoing Chair of RCSLT and Sean Pert was the incoming Chair. So, I asked Sean, what was the state of play when he took over? What are his thoughts on what has happened since and what still needs to be done? 

SEAN:                         0:07:37 I think all I’m doing, really, is carrying on that drive, that enthusiasm, to engender change. It’s very easy to have the optics right; I think a lot of companies, if you look at advertisements, if you look at the way that companies have… which companies always do, don’t they, they protect themselves by looking the part. And that’s very important – people need that representation, so they can see themselves in those roles, in those positions. 

But I think it’s a bit of a double whammy, really, when it comes to diversity in professional organisations, because there’s this cyclical negativity that happens, and I think this has a lot to do with not only racism but social class and intersectionality, which is experienced by a lot of our members. Thinking that you have to have a grand career plan to be part of our governance features, and you don’t. And we’ve had some really brilliant members of our nominations committee and the process of appointing committee members and board members, and having people with disabilities, as well as maybe different sexualities and genders and different racial groups. 

And people are not as simple as being one identity – that intersectionality is really, really key. And it’s key to understanding our service users and our colleagues as well, because we’re all more complicated and interesting than one aspect of our identity. But these are core aspects of our identity. 

So, Mary really set the wheels in motion and I think it’s up to us on the board to really keep leading on that. I think now, if you look at the composition of the board, it’s a good start, but it is just that start of cultural change. People default to what they know and this is a new way of thinking and it does require us to constantly challenge assumptions about who should be on committees, who should be on our governance structures, in order to be representative of our wider community. 

I’m very aware that, as a cis white man, I have some diversity, but I can never completely understand the life experience of people with different protected characteristics than I do. And having people on committees and boards allows us to access those perspectives. And that we know from research, both in corporate situations and in health situations makes us better at what we do. Having that diversity of thought allows us to see how society is changing and progressing. So, I think it’s absolutely core to what we do. 

CHLOE:                      0:10:28 We need to think about who is on our board, who we’re seeing in front of us. I think we also need to think about why that’s so important, why that questioning needs to be central to what we do. Having a more diverse board is so important in terms of representation for myself as a student of colour being able to see people in those positions of power. That’s what we’re talking about – power structures. It’s really important for me in terms of my career progression or my career goals. 

HOST:                         0:10:57 Where do we think we are in terms of the profession? 

CHLOE:                      0:11:00 Sure. So, I think from a university perspective, and from a training perspective, I think we still have a long way to go. A lot of, if not all, of our training and evidence base comes from a very Eurocentric perspective and standpoint. I see higher education institutions as almost churning out the same SLT. If we look at our majority group within the profession – white, middle-class female – if we’re continuously churning out those type of SLTs or those standards, then not only are we excluding certain groups from joining the profession or fully integrating into the profession, but we’re also not meeting the needs of service users who also don’t fit into that dominant group. 

So, for me, I think there’s a long way to go in terms of really interrogating our profession, the history of the profession, where we’re getting our research from, where our norms are coming from, where our standards are coming from. And until we do that, and integrate it into curriculum and into training, I think it’s going to be very difficult to make that shift, really, that needs to influence our practice, ultimately. 

HOST:                         0:12:13 Are you saying this is similar to the problem that they found, for example, when they were doing clinical trials, they were often just using men and not including woman in clinical trials, and that skewed those results very considerably in all sorts of fields. Are we saying there’s a similar thing to address within SLT about the research that we’ve done and the practices and therapies that are being used?

CHLOE:                      0:12:37 Yeah, absolutely. I think that’s a really good example, as well. A lot of us are aware of the difference or the discrepancy in terms of diagnosis with autism, for example, between men and women, or boys and girls. And that’s because much of the research is based on the male presentation. So, I think using that as an example is a really good way to think about within SLT, and really think about when we say the standard of English is X, Y, Z, who is setting that standard? Where has that standard come from? And who are we excluding when we set that standard? 

So, there’s a lot of work in terms of decolonisation. And that’s a big, scary, confusing word, I think, if you’ve not heard it before, and if you’re new to these kinds of conversations! But really, it’s about looking at the past, looking at history, and thinking about the influence of colonialism as a historical period in what we do today, because it’s still very much alive in our practice. It’s not an intentionally colonial practice that we’re all taking part in – none of us want that – but we have to acknowledge that much of our practice and our learning and our training is influenced by white supremacist colonial ideologies. 

HOST:                         0:14:00 Dorit, I’d be very keen to know your thoughts on this. 

DORIT:                        0:14:02 I trained a long time ago. These discussions were just not there. Even though in my mind I was I was aware of it, I don’t think the profession was certainly ready for those conversations. And there were one or two people, I’m not going to deny, but I don’t think it was in a place. I think it had started to recognise around bilingualism and the South Asian communities, but that was about as far as it was prepared to go. And I think it’s really exciting that this generation that are being trained and the Black and Asian and other ethnic minority therapists on courses are now becoming much more vocal. 

Perhaps even though the numbers are small, there are far more than when I trained. I think there was one other person on the course with me; we were a very small group. So, I think it’s really good to see, and to see that some universities are responding by looking at the content of what they’re training the therapists and the perspective of being much more critical – asking: where is this knowledge coming from? Things that we’re told a facts, let’s critically analyse. Whose fact is it? And is there another way that we can actually approach this? Classic child rearing and storytelling. In some cultures, there’s a real rich oral approach to storytelling, yet are we recognising that when we are actively pushing books. 

Books certainly have their value, but it’s about working with families to say, what do you do? And that’s just as valid. It’s okay to be passing down your stories in this way, as well as having books rather than people feeling, well, clearly, the way my grandmother told me stories is not something for me to do with my child, it has to be books. 

And so, I think the students coming out will pose a real challenge to their practice educators, and it is something about their ability to feel safe to challenge because they will be bringing the new to… Well, I would say, in reality, I think the practitioners in the field, there is interest and people are making some changes, but it’s still very, very, very small numbers, so it is going to be how do we upskill people who’ve been qualified for quite a while or before this movement, and people to understand the significance of the changes that we are looking for, and how that impacts on outcomes. 

There’s been a lot of focus, obviously, on the experiences as a minoritised clinician in a predominantly white space, but it’s also how we move to look at we need to get the best outcomes for our clients. Minoritised people can be anywhere in the country where they may well be less than 1% of the local population and it’s how we help people to understand what does that actually mean. 

CHLOE:                      0:17:17 Yeah, just to come in on some of Dorit’s comments around the student experience and how to challenge things on placement, at university, etc. I think there are two parts to that. So, from a student perspective, it can sometimes feel like quite a challenging conversation or situation to have. As a student, there’s a power dynamic there on placement or at university where you’re the student, you’re the learner, and you might have a practice educator who’s incredibly experienced. So already, that power dynamic is quite unsettling and can make challenging conversations even more challenging. 

So, I think being able to acknowledge that as a student and being confident in yourself and in your knowledge that you do have, but also being comfortable with the fact that you don’t know everything, but if you ever feel uncomfortable, it’s okay to challenge it. And actually, the response from those around you, so in education, out on placement, etc., that hopefully should be a supportive one. If it’s not, then there are places you can go for support. 

For example, the Royal College. So, you can call the Royal College, or use online resources if you’re ever unsure or if you’re unhappy with the way something has been responded to. But also using sources at the university, so academic tutors, clinical tutors, your peers, as well. So, if you’re uncomfortable with something, sometimes just having that conversation with a peer and getting another viewpoint on it can be really helpful, and also help just get it out of your head so you’re not festering with it. 

But also, there’s another side to it. From a clinician perspective, or from an educator perspective, I think it’s really important that those people are acknowledging that power dynamic and that power structure and what power they are holding in these situations, and how that situation might be for a student. So, perhaps creating safe spaces or opportunities for students to feel they can share those opinions, either within a student body or a student staff perspective can be really useful, just to break down those barriers in terms of power structures. 

HOST:                         0:19:23 What Dorit and Chloe said is really important for us to think about. On the one hand, there is the experience of minoritised clinicians within the NHS and other settings. But then there was also the important question of the service one is able to deliver to a diverse community. 

So, I asked Sean as a lecturer if he had thoughts about the training of SLTs. 

SEAN:                         0:19:41 I certainly do, having been one of the few clinicians working in bilingualism for the last quarter of a century! I published assessments alongside my colleague, Dr Carol Stow, based on normative data from local communities who speak languages other than English and using that knowledge to empower therapists to see that culturally appropriate, linguistically appropriate, adapted assessments and therapy packages are crucial if we’re to provide an equitable service. 

If you look at, for example, assessment, some assessments have been ‘updated’, in inverted commas, with, as I say, optical things like some people of colour in. But it goes deeper than that. Do communities recognise the activities, the people, the objects in those assessments? Working in Greater Manchester with lots of Pakistani heritage families, even if they spoke just English, the way that children eat, they wouldn’t use cutlery, for example, so using those in comprehension assessments would immediately culturally disadvantage them. I think people, they don’t really think this through. 

I think as well, things like research and therapy, all intervention starts usually in universities with a research idea. And I’ve been a consultant on the [inaudible 0:21:16] research randomised control trial at Newcastle University with Professor Cristina McKean. And we were really keen to include case studies of a new intervention for language in languages other than English, because this is just never done. Most research say our criteria are no problems with IQ, no problems with hearing, and no bilingual children. So, by definition, we are creating this monolithic monoculture template as a correct way of understanding speaking and being. And people are… they need permission to say, well, [inaudible 0:21:56] adapt and assessment and do a mean length of utterance that’s probably far more insightful and informative than just verbally translating something. The way languages encode things is completely different in other languages. 

I was talking to a group of therapists about things like prepositions, they don’t exist in some languages. Determiners don’t exist in some languages! It just goes on and on! English is a very strange morphologically poor language. There are no gender agreements, that’s highly unusual in language. So, there’s both very sound linguistic and cultural things that are in the way of providing this equitable service. 

And we’ve had clinical guidelines for a long time and, yet, this is still experienced by our service users that they’re not being given double the amount of time to work alongside professional interpreters and so forth. And this is institutionalised racism, because we are disadvantaging services users because they need these additional reasonable adjustments in order to have the same quality outcomes as monolingual, white English speakers. 

I think this is music to my ears, and the more people that hear that message, the better, really! 

CHLOE:                      0:23:10 We are a critical profession. We are constantly critically appraising evidence. And the one thing we don’t look at critically is our history and our origins, and where our research and where our understanding of quote unquote ‘normal’ comes from. So, that’s one thing that we just need to critically interrogate in order to open up our understanding of what needs to change, for me. 

Are our practices currently leading to overrepresentation of current groups? I would absolutely argue, yes, if we’re working from a position of white middle-class norms; anyone who doesn’t fit into that group or those groups is immediately going to be seen as othered, as less than, as not performing, not meeting expectations. And we’re putting those people in multiple groups. Sean mentioned intersectionality earlier and it’s incredibly complex. But we’re immediately othering those people and labelling them as whatever they’re being labelled as. And that is inevitably going to influence their later outcomes, their perception, their self-perception, their academic performance, their social relationships. So, the impact we have and the power we have as a profession is huge. 

HOST:                         0:24:26 This is very important, because we’re say it’s about equity of outcomes for users. It’s about the service that we’re able to offer and so forth. What do we think the reception of this type of stuff will be for existing speech and language therapists who may have been in practice for 10, 15, 20 years? And do you have thoughts on how we reach out? Because it’s a big ask, and it’s a big change. 

SEAN:                         0:24:54 I have experience of this because people often ask me this kind of stuff about the clinical guidelines around bilingualism. And although it’s important to acknowledge that not all bilingual people are people of colour, there’s a big intersection there. 

Our guidelines say really helpful things, like you must have double the amount of time. But that’s a cost to the service and therapists need to challenge when they’re not provided with that, because, as I say, it can lead to institutionalised racism where the people involved aren’t actively against these things, but they’re not being implemented, so the persistence outcome is to act against people in our communities who are the most vulnerable.

I think the role of RCSLT is really to say these guidelines are really important. It’s interesting that HCPC are strengthening their standards of proficiency in September to really highlight how important and central these things are. And I think it’s about, when we’re in a situation post-pandemic where there are huge waiting lists, therapists feel under tremendous pressure to see as many service users as possible, to be as effective and efficient as possible. And this leads to short-termism. 

If you meet a family who don’t speak English and you work with a professional interpreter, and you culturally adapt, you bother to ask people, how do you eat at home, how do you live at home, what’s your religion like, what impact does that have on your child’s understanding of the world, so that we can have really culturally sensitive and, therefore, accurate assessment, then you set up a really great relationship with that family. They’re likely to keep attending, so a lot of people say things like, families from a certain community don’t engage; why would you engage in a service that doesn’t meet your needs or that discriminates against you or makes your life difficult? So, there’s a lot talked about hard to reach families – there’s no such thing, it’s services that don’t meet the needs of families. And I think as well, it’s about saying, we have both a moral, ethical and professional responsibility to really challenge when we’re told we can’t deliver such services because what’s the point of waiting in some case years for a service if it’s then no use to you. 

So, I do think that RCSLT, we will support members around that. But I think it’s important. Some of my students were surprised when they went on placement and said, shouldn’t we have an interpreter for this lady who’s had a stroke, and then, magically, an interpreter suddenly appears! 

So, we know from research that even students who might think they don’t have a lot of power, just by asking questions and saying, is this best practice, how do we do this; opening those conversations might be enough, in some cases it won’t be, but it’s about then maybe having a confidential discussion with a clinical advisor to really say this is not working, so that we can then look at how to spread best practice. 

It’s incredibly challenging for all services involved, and I don’t want anyone to feel bad about maybe not meeting everything now. As long as you’re engaging in that service improvement and developing towards a better service. I think it’s about supporting people saying, we’re not going to criticise you for having responded to very, very extreme demand. But that’s no excuse for cutting corners around these really, really important issues because then it becomes cyclical. If we exclude members of certain communities from our services, they then talk to other members of their community and say speech therapy’s no good. And then, if you’re a young person thinking of being a speech therapist, you’re going to be put off joining us. 

So, it really is a huge cultural change for the profession as well. 

DORIT:                        0:28:52 Those are really key points that you’ve raised there, Sean, and I just wanted to add on to that that I think that there’s something for therapists in the field who are practicing, it is that sense of people feeling bad. So, once you start to talk about race and racism, people can’t separate the concept from the person. [Inaudible 0:29:15], I’m not a bad person? Well, I’m not suggesting you’re a bad person. And I think it is about people, when they’re asking these questions and feeling comfortable asking the questions to our clients, and knowing why you’re asking the questions as well, and doing something. 

Because I do think there’s a lot of good work that is going out – I want to reiterate that. But there’s also where people are going through the motions and not quite understanding that the ‘so what’ about what they’re doing, and people have to feel comfortable with having these conversations and the response that you get may not make you feel comfortable, but to use it as a learning point, and to go and do some of the research themselves that they need to understand. 

And I also wanted to share, I was driving into work and there was something on the radio, in fact, I think they were reviewing the Ockenden Report about lack of minority women’s experiences of maternity services. And there was a client who was saying that we’re described as hard to reach, but I would say we are easy to ignore. And I think that that really stuck with me, that it’s very easy to ignore because we’ve got long waiting lists. It may cost services to pay to have interpreters and to have reports and papers translated that it just becomes something that’s just a little bit too much for organisations to do. 

CHLOE:                      0:30:56 Before I say what I’m about to say, I just want to preface it by saying that this is not a personal individual judgement or attack what I’m about to say, but there’s a really important notion we haven’t yet brought up, and that’s the notional concept of white privilege. And if we return to the findings of the report, so that discrepancy in terms of perception, acknowledgement, etc., of racism and issues of DEI, that discrepancy we can link, I think, back to notions of white privilege. 

                                    So, to be able to recognise that, by simply being white, you have the luxury of not having to think about systemic and individual difficulties that minoritised service users, clinicians, students, endure on a daily basis. 

                                    If we start there, that’s a really important thing that I think needs to be addressed and opened up before we go onto these much deeper and more explorative pieces of work. But just being able to reflect personally on your own position within our profession and how your positionality – and by ‘positionality’, I mean the factors that make up your social identity – but how your positionality influences your perceptions of racism. So, when these conversations come up, and they are difficult conversations, but they’re not ones that minoritised clinicians or students have the luxury of ignoring. But when these conversations do come up, how do you react? Are you dismissive? Are you defensive? Are you upset? Do you feel attacked? And why is that? Because the person talking to you, I can almost guarantee they’re not attacking you personally. 

                                    So, I think being able to – and this is a very uncomfortable process – but be able to interrogate yourself and how you’re reacting to these conversations and these DEI initiatives is a really important step to be able to move forward. 

HOST:                         0:33:03 So, I think the question of white privilege is an interesting one. We can all agree with the concept that’s being described – white people are not disadvantaged by their characteristics. But I do think it’s worth considering whether the term ‘white privilege’ is helpful. In my experience, there’s a lot of pushback, understandably. A person may say, I grew up poor, or working class, or in a single parent family; I had no privileges. And the result is that we sometimes end up talking past each other. 

SEAN:                         0:33:38 Everybody thinks their life is the baseline! Everybody does! That’s part of being a human being. Everyone must think like I do. And that’s part of the cultural conditioning that everybody has from their particular. You have a particular viewpoint because you’re part of a particular social or ethic or whatever group, and it’s important to recognise that. 

                                    Similar things, policing of language and so forth, happens for class. A lot of students are surprised I have a Northern accent and I teach them phonetics. And I’m like, well, you’re going to encounter people who speak like me on placements and that’s just the way it is. 

                                    So, I think it’s about recognising the world is a big, big place with lots of different ways of living, and that’s what culture means. 

                                    I agree that the word ‘privilege’ can be triggering for some people, because they might say… myself, I was from a working-class family, we weren’t well off, we didn’t have books in the home, it was very difficult. And it’s really important, because I might say, well, I’ve suffered homophobia during my career. None of that is relevant because people can’t see that, unless I choose to out myself. 

                                    Having white privilege doesn’t mean that you haven’t had challenges in your life, and it doesn’t mean that you are immune to discrimination for other aspects of your identity. But I know, having lived and worked with people of colour and from different backgrounds, that when I’m living my life I don’t suffer microaggressions simply from that initial contact to the colour of my skin or the way I’m dressed, and those kind of things. 

                                    And I think it’s important to know… we’ve used the term ‘cultural competence’. In the checklist that we developed for Royal College [Sinitta 0:35:34] and I, we chose cultural inquisitiveness. Because I’ve worked with lots of different families from different communities and religious and cultural backgrounds; I don’t think I’ll ever be competent in anyone’s culture – including other white people, I hasten to add. I think the way that we do things and think is quite different. But I’m inquisitive, or as my students say, nosy, in a professional way because I really want to find out about how do you live your life, how’s that for you? 

                                    I think it’s about us being… I’ve spent a career, and I’m really grateful for that, being challenged about the way I think, which means that I’m really comfortable with it. and I think it’s a bit like anything – we have to practice being uncomfortable, we have to practice not reacting, we have to actively listen. We’re supposed to be good as professionals at actively listening and not reacting. It’s a human natural response to say, that’s not me, how dare you! We need to hold the lid on that and listen, and carefully listen. 

                                    And I think the final point I’ll say is there’s been a lot in the press and the media about the anniversary of the inquiry of Stephen Lawrence, and we’ve learned all the lessons from that; these weren’t implemented in policing. It’s not enough just to identify these things. We have to say, why isn’t it enough to know that these things happen? It’s not enough because it’s about our everyday behaviour. It’s about every action we take as professionals. 

It comes back to, we have to do a lot of hard work, and that’s why I think the reports and the guidelines and so forth, they can be there… many, many times we can keep revisiting these things. It’s a bit like understanding unconscious bias. Great. You understand that you have these biases. What are you going to do about it? 

CHLOE:                      0:37:30 It is triggering, this term ‘white privilege’. It’s incredibly triggering. But it’s also incredibly real. It exists. We are all adults and we should be able to have this conversation. Minoritised SLTs and students don’t have the luxury of being able to ignore this conversation. So, I don’t see why anyone else should have that luxury! I don’t think that’s fair. I don’t think that’s equitable at all for anyone. 

And I think, just going back to what I was saying earlier, we need to look at why we’re reacting in that way, if we’re reacting in that way. Yes, it’s uncomfortable, and yes, that might be your initial knee-jerk reaction, but we all have the skills, hopefully, and the emotional regulation skills to be able to bring that down and then approach the conversation from a different perspective. 

For me, and I don’t know if this is going to come across a bit hard line, I don’t think it’s acceptable to shy away from terms like white privilege just because they cause a reaction. 

DORIT:                        0:38:38 I agree with what Chloe is saying. It was perhaps never labelled as boldly as it is now. I want to reflect from the perspective of imagining that departments, private practices across the country grappling with this EDI work and what are we going to do, and from the perspective of potentially being the only minoritised therapist in that team, in that practice, and how you manage those conversations. Because if there’s a white person you are feeling uncomfortable, how do you think it feels as the only black therapist who is either being looked upon to share my life’s experiences and not only would necessarily they may be things you experience in the course of your work, but you may be [inaudible 0:39:36] things that just happen in your day-to-day life. Because, let’s face it, racism isn’t just a speech and language therapy issue, it’s a societal issue. 

Even little things, well, they’re quite big things. Things that happen in the world and you… George Floyd, okay, we were all in lockdown in our little Teams screens. But how many people [inaudible 0:40:00] happened. When we had the World Cup and it was the penalties, and once I saw those black footballers missing [inaudible 0:40:09]. This is not going to be good! And then coming in to work… and I’m fortunate, I’m in a team with many diverse therapists so we could say, yeah, we knew the backlash that was going to come, we knew that, but white colleagues not really understanding that. 

And it’s when things happen in the world that you come in to work and your white colleagues pretend that it hasn’t happened. It took George Floyd’s killing. But we’ve had… we’ve got Stephen Lawrence. There were lots of other black people and Asian people who’ve been killed at the hands of either the police or racist people. But yet, these conversations, they’re not talked about at work. They’d rather talk about anything else other than this. 

So, it is how we bring the world into work and have some of those conversations and recognitions of the impact for staff who are going through these. And so when teams start to have these conversations, it’s a sense of will people be believed when you give an example, when you talk about going into particular shops and the way that you are treated, or the fact that, compared to you, Jacques, I may have to think about where in the world I go on holiday, or even in this country, or even where I buy a house. Things like that that people would say, I don’t really get it, because that’s because of their privilege, the fact that they are white, there’s lots of things they never have to think about because it’s just par for the course for them. 

CHLOE:                      0:41:42 Yeah, I just wanted to add, thinking about the individual responsibility within that, because there’s almost that organisation level and even higher. But at an individual level… I’ve spoken already about this idea of positionality, and I think I’ve got a link to a really good article, which hopefully we can include in the show notes. But being able to reflect on the factors that make up your social identity, and like Sean said earlier, that not just marginalise you but also privilege you is such an important tool for the individual clinician or student. It can influence your everyday practice, but also research, etc. 

                                    But being able to say… for myself as an example, I’m a woman, that marginalises me, but it also advantages me within speech and language therapy because of the perceptions of women in therapy, etc. I’m from multiple ethnic backgrounds, which marginalises me in terms of the colour of my skin and the perceptions that others will have of me. But I’m also more advantaged than darker skinned women, for example. 

                                    So, being able to reflect on those really complex multi-faceted aspects of your identity is so crucial, and I think could make such an important change in the way that we think about what we do instead of just doing it without thinking. 

SEAN:                         I think, firstly, can I say it’s great to have… as Chloe said, we’ve got young people who understand this from lived experience, and it’s really important to listen to those stories, and it’s really important to listen to the fact that we can use this for powerful change, and that’s great. 

                                    On the same theme, though, we can’t ask those people to do all the work, and as Dorit has talked about, it’s painful to talk about a lot of those experiences. So, it’s not about us constantly focusing on what’s gone wrong. We’re good as a profession at making things work, at developing things; let’s put those skills to use. 

                                    I think from Royal College’s point of view, we have this woven into our five-year strategic plan, which sounds very corporate, doesn’t it? But what that means is, we intend to see that as a central part of RCSLT work. So, we have a whole raft of documentation, systems, processes, which hopefully now are removing those barriers that could have made RCSLT institutionally racist in the fact that we’re putting up barriers that we’re not aware of from a particular perspective of privilege. So, all these things are important to put into action, as we’ve said.

I think now we have people who are minoritised on the board and on other committees, it’s about us continuing to have conversations with people. If you’re a student, if you’re a therapist listening to this podcast, it doesn’t have to be about race, it can be, as we say, intersectional. Have you considered being part of one of the governance structures? Because we offer training, we offer support. We can now offer things like buddying of people who have had experiences of being a minoritised person on these structures. 

It feels like a much more comfortable place as a profession. But as I say, we need… the reason I’m doing this podcast, not just because Chloe and Dorit [inaudible 0:45:17], which they are, of course. But I’m just very aware that I have the privilege of being Chair. And by constantly talking about this, by highlighting this, I hope that more people pay attention. So, it’s fine to have privilege if you use it to effect change; that’s what privilege is for, and for sharing that privilege and power with others to effect change. I hope that’s what RCSLT are doing. If we’re not in an area that you’re concerned about, get involved. I think Chloe’s a great role model, actually doing something to highlight those issues. It’s really an amazing piece of work. 

We are listening and engaging, and I hope that comes across, and if it doesn’t let us know and we’ll do our best to make sure that we can correct that. Because we’re really passionate about this, and I hope that comes across. 

HOST:                         0:46:12 A very big thank you to Dorit, Sean, and Chloe for their time today. Now, we need to do more to support and celebrate members of colour through all of our work, including the RCSLT Awards. The awards are an opportunity to celebrate the individuals and teams who have supported and championed speech and language therapy and made a difference to people’s lives. 

There are two sets of awards to enter – Honours, which recognise leaders at all levels within and outside the profession who have made outstanding contributions for the benefit of service users and the profession itself, and the Giving Voice Awards, which celebrate the impactful activities and achievements of those who have contributed to improving the lives of people with communication and/or swallowing needs. If you know an individual or a team who deserves some recognition, please do enter them. Applications close 12 June and details can be found in the show notes. 

Until next time, keep well. 

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