essay

Title: Group therapy: in the final part of our series on prejudice, Stephanie Northen looks at how people's attitudes and behaviour can be challenged

Author(s): Stephanie Northen

Source: Nursing Standard. 24.13 (Dec. 2, 2009): p22.

Document Type: Article

Copyright : COPYRIGHT 2009 Royal College of Nursing Publishing Company (RCN)

http://www.nursing-standard.co.uk/

Full Text: 

SUMMARY

The role of education and training to overcome bias is the subject for the final part in the series on identifying and dealing with prejudice,

Attitudes * Diversity * Education * e-learning * Equality * Feedback * Interactive process * Outcomes * Prejudice * Training

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A teacher had been trying to get her class of eight year olds to understand the concept of racism. She thought they were failing to internalise the concept. She said: 'They are doing what white people do. When white people discuss racism, what they are experiencing is shared ignorance.'

The next day the teacher divided the children into two groups on the basis of eye colour. She told the blue-eyed children they were superior and gave them a pseudo-scientific reason for this.

The brown-eyed children were made to wear a ribbon round their necks, were not allowed to use the blue-eyed pupils' water fountain and were criticised and disparaged.

The blue-eyed children quickly became arrogant, bossy and nasty, while their brown-eyed classmates became nervous and subservient. The grades of the blue-eyed improved, while the grades of the brown-eyed got worse.

The teacher then reversed the situation. The brown-eyed children were superior, but, significantly, while they developed some of the nastiness of the blue-eyed pupils, it was far less intense. Their knowledge of what oppression feels like modified their behaviour.

This now famous experiment was carried out in Iowa in 1968 by Jane Elliott, an elementary school teacher. It is an early example of an exercise designed to overcome prejudice and it has always been controversial. Ms Elliott, who eventually left teaching for a successful career as a diversity trainer, has been accused of humiliating children and waging a psychological war.

Jay McGovern, one of the 450 pupils 'trained' by Ms Elliott between 1968 and 1984, says she was an outstanding teacher, but criticises her for putting people down and ridiculing them. Others, however, thank her for making them think about prejudice.

Some of Ms Elliott's techniques influenced race relations training in the 1970s. This was not constructive, says Carol Baxter, head of equality and diversity at NHS Employers. 'We used to put people on a guilt trip. It was very frightening for white people. There are other ways of teaching equality and diversity.'

Self-reflection

John Twitchin, director of London-based Diversity Works, a UK consultancy that has worked with more than 25 NHS organisations, agrees. He says: 'We ran race awareness courses, but they were simply not effective because they upset people instead of encouraging self-reflection.'

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Is there a more humane and effective way to teach people about prejudice? Certainly a full frontal assault along the lines of 'you are prejudiced and you must not be' does not work, says Dominic Abrams, professor of social psychology at the University of Kent. Instead, many psychologists support the idea that contact between groups reduces prejudice.

Ideally, they argue, people are brought together in a supportive environment where they have equal status and some common goals. But these situations can be hard to manufacture. It is easier to organise 'extended contact' where just one person forms a friendship with someone, against their usual prejudiced instincts.

Gradually, levels of prejudice reduce as people learn to see those they are biased against in a different light, and that message spreads within the individual's group.

A different technique is being researched at the University of Kent. It asks a person to imagine that they are with someone they are prejudiced against. 'We imagine that if we are spending time with this person then they would like us, and if they like us then we should like them, and if we like them then we will probably like their group,' says Professor Abrams.

Such contact groups, real or imaginary, would not be viable within the NHS, says Mr Twitchin. 'Academics might be able to do this with nice, pliable students, but it would be naive to try to extrapolate that to the real lift, of actual organisations. While the staff come from a wonderful rich variety of cultural backgrounds, they do not see attitudes as relevant to their professional role.'

Attitudes are also not a priority for Professor Baxter, who says: 'We have shifted from beating people about the head for their attitudes to saying "I don't care about your attitude. I only care about your behaviour".'

Certainly the equality and diversity dimension of the NHS Knowledge and Skills Framework starts with behaviour. Level one, the statutory, minimum, requires merely that staff act in ways that support equality and value diversity. But staff may not know how to do that, or fail to realise that they are acting inappropriately. Does their training help?

Udy Archibong, head of diversity and inclusion at the University of Bradford school of health studies, has reservations. She worries particularly about e-learning packages. First, there is no practical follow-up to help people apply what they have learnt. She argues: 'The danger is that some people who have been through this kind of training automatically feel that they have got all it takes to be nice.'

Basic approach

Mr Twitchin is also critical of NHS diversity and equality training. 'Diversity training has come to mean little more than a person, using bullet points and PowerPoint, telling staff whether or not they are complying with the law.'

So what can the NHS do to tackle prejudice effectively? Mr Twitchin has found the best approach is an indirect one. He asks nurses if they are keen to find out how they can achieve better outcomes with new skills. Then he gives them practical tips on how they should engage with people from different backgrounds.

'When they try different ways of behaving they get new kinds of feedback from the patient,' he says. 'Then it becomes an interactive process.' Changing their practice has encouraged them to reflect on the attitudes that underlay their previous practice.

Such practical tools, he says, will help start to dismantle 'the inherited culture and procedural framework' that give rise to discrimination NS

In this series

* What prejudice is November--11

* How to analyse your prejudices--November 18

* Dealing with prejudice--November 25

* Overcoming prejudice--December 2

Stephanie Northen is a freelance journalist

Northen, Stephanie

Source Citation   (MLA 7th Edition)

Northen, Stephanie. "Group therapy: in the final part of our series on prejudice, Stephanie Northen looks at how people's attitudes and behaviour can be challenged." Nursing Standard 24.13 (2009): 22+. Academic OneFile. Web. 31 Mar. 2014.

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